Accidental Death Among The Mentally Ill And The Tragic Case Of Elisa Lam

When I look back at my journals from around the time I was diagnosed as bipolar, it’s hard to tell whether I was being real or putting on an act. A therapist suggested many years later that I was being “histrionic” — a word that indicates a pathology while also suggesting the symptoms are performative. This is exactly how it felt at the time.

Even at my worst, I worried I was being melodramatic. It’s terrifying to doubt the legitimacy of a suicidal ideation when you’re in the grips of it — it can feel like you’re daring yourself to make it real.

I’m reminded of this when I think about the case of Elisa Lam, the 21-year-old Canadian college student whose body was found rotting in a water supply tank of the Cecil Hotel in Los Angeles in February 2013. The cheap hotel had a macabre history of strange deaths and suicides, and had housed at least two known serial killers. This, coupled with slow-motion video footage of Lam in an elevator taken shortly before her disappearance, prompted wild speculation among Internet conspiracy theorists.

The fact that no one knew what brought Elisa Lam to a seedy hotel on the fringes of L.A.’s Skid Row — and that officials and the media stayed mostly silent on the case during the investigation — only seemed to fuel the Internet’s imagination. Online at message forums like Reddit and The Ghost Diaries, commenters speculated that Elisa was on drugs. Some suspected she’d intentionally taken her life. Others insisted her death was a murder — and that the eerie video footage shows Elisa being chased by her murderer standing just outside the shot. Theories persisted even after experts determined Elisa’s body language in the video suggests she wasn’t afraid, but excited, playful, and flirtatious.

To this day, conspiracy theorists are bent on solving the “unsolved mystery” of Elisa, even though the case is closed. On June 21, 2013, medical examiners determined Elisa Lam’s death was accidental, and listed bipolar as a contributing factor.

In the end, what happened to Elisa was not paranormal, but common. And it was something that all too easily could’ve happened to me.

***

Depression is not romantic, though it is often romanticized — sometimes even by the depressed. On her blog, Elisa quoted Virginia Woolf, who wrote of the disparity between thought and action, a soul active in broad daylight but also contemplative and dark as night. In another post, she commented on how life can feel like a long succession of days and nights that are neither good nor bad, but fine. She wrote of dropping classes and losing time, her fear of failing out of school, how much she hated her legs, and how she considered herself lazy and in need of more time at the gym.

“It is a weariness that keeps me at a standstill,” she wrote in one post. “I spent about two days in bed hating myself,” she shared in another. “Why don’t I simply do the things that I know will make me feel better? It isn’t rocket science. It isn’t that difficult. Get out of bed. Eat. See people. Talk to people. Exercise. Write. Read.”

Elisa wrote of blackness, bleakness. And then, sometimes, of relief. “Last week was absolute insanity,” she revealed. “There will never be another like that. Last Sunday night and this Sunday night were polar opposite.” And, “I feel so lucky that I met such a wonderful, awesome guy. He makes what pain and anger I felt meaningless. He understands my humour and has such beautiful intelligent eyes. What broken heart? Why would I ever think of killing myself?”

No mention again of this man. No mention before of wanting to die.

Conspiracy theorists wonder if Elisa ever really existed, but having read these words and experienced depression myself, I have no doubt she did. I know the darkness she expressed; the kind that makes women board planes alone for secret destinations and reasons unknown.

By age 24, the blackness creeping into my life felt more real than reality. Before this, I was your typical Midwest transplant living in New York City, gainfully employed and in grad school, pursuing an MFA in writing. I can’t explain what happened except to say that my attitude soured. I grew cynical of my outwardly normal life. Without much explanation, I left my boyfriend of eight years, quit my job, and started hanging out in Starbucks, where I wrote gibberish in journals and cried. Sometimes, my unorthodox lifestyle felt writerly. More often, I was aware that something was wrong. My behavior grew increasingly erratic. Some days, I was filled with restless energy, and would launch myself into ambitious projects I never finished. I sent long, overly personal emails to my professors — or to strangers, including writers I had never met. I was lonely. I began meeting men in Washington Square Park. It became a game to see how fast I could get a man to come home and have sex with me. This led to meeting strangers online for “casual encounters,” which ultimately led to my selling sex.

As a sex-positive feminist, critical of our sex-negative culture, I had trouble recognizing my sexual conduct was a cause for alarm. Looking back, I see how desperate I was to escape my depression. When I wasn’t acting out, like Elisa, all I’d want to do was sleep. I had trouble forcing myself to do simple things: go to class, make my bed, brush my teeth.

In my case, I wasn’t actually bipolar — nor was I suffering from Borderline Personality Disorder, as the therapist who called me histrionic had suggested, and which, experts say, is diagnosed disproportionately in young women who have been the victims of sexual violence. Instead, I had complex post traumatic stress disorder and psychosis stemming from childhood trauma. C-PTSD was a much more useful (and way less stigmatizing) diagnosis I had to discover on my own.

Until I did, I suffered. I drank alcoholically. I acted out sexually.

I took incredible risks.

***

It’s ironic that the Internet casts Elisa Lam as a lurid celebrity, considering how ubiquitous mental illness is among young people. Certainly, spinning her story as supernatural doesn’t help lesson the challenges people face in getting help. Though significant, young people who suffer from mental illness, especially women, can feel their very real struggles dismissed as cliché. Students of color and those from poor or working-class backgrounds face particular barriers to accessing help. Then there’s the challenge of landing on a diagnosis and receiving adequate treatment.

A recent study of college students who accessed primary care services in university clinics found that nearly a quarter were depressed, noting that many students experience their first psychiatric episode sometime during those first four years in college.

College students who are living away from their families for the first time, and confronted with mounting academic and social pressure, may find themselves unable to cope. For some, there’s the added financial pressure of supporting themselves and paying for school. Drug and alcohol abuse can trigger or worsen symptoms. Feelings of inadequacy, isolation, homesickness, and heartbreak overwhelm.

These and other factors play a role in this harrowing fact: People with mental illness are up to six times more likely to die in an accident than the general population. Young patients, especially, are at a high risk of premature death. One study found that of 723 patients ages 14–30, 49 had died within 20 years, a substantial portion due to non-suicide, unnatural causes. Accidental deaths include falls, transportation accidents, self injury, and accidental poisoning, including unintended overdose.

For people with bipolar, the risk of suicide and accidental death is high. One study followed 216 patients for around four years following their first-time hospitalization, and found that over half had expressed suicidal thoughts or actions. Of the cohort, 39 attempted suicide. In 20 cases, a life-threatening accident occurred.

That Elisa Lam was the victim of an accident is not unlikely, particularly if she was in the midst of a psychotic break, which is characterized by a loss of reasoning, and is commonly triggered by bipolar mania. Psychosis would explain Elisa’s strange behavior in the elevator. Certainly, mental illness offers a better explanation for what happened than “ghosts.”

Two weeks after her disappearance, poor water pressure helped authorities to discover Elisa’s body. Her toxicology report found no drugs or alcohol in her system, only water in her lungs. It is unlikely she was murdered; she was alive when she hit the pool. Instead, she climbed up to the roof herself, scaled the cistern, and pitched herself into the water, where she drowned.

Her death was an accident the way an accident could’ve happened when I rode my bike haphazardly through traffic. The way some swallow handfuls of pills. We leave it to fate. She was playing Hide and Seek, I imagine, with the darkness, when she jumped into that square of black.

And then the blackness became her.

***

It’s hard to say how I got better. At the advice of a therapist, I started seeing a psychiatrist, who prescribed a cocktail of prescriptions. Wellbutrin treated the depression, while Abilify stopped me from seeing black jagged shapes in the corners of my eyes and Bad Forces I feared were out to harm me. Seroquel made me feel like an elephant shot by a tranquilizer dart; it made me gain weight, so I stopped taking it. Lamotrigine balanced my moods and Lunesta helped me sleep. I took whatever they’d give me, hoping for relief, and I’m lucky they never prescribed me anything “good” — as in, addictive — because around six months later, when I got sober and started recovery, I discontinued everything all at once against my doctor’s advice.

When I went off my meds, I was lucky to experience no negative reaction, as it appears Elisa might have. Elisa’s autopsy report revealed she was on lamotrigine (Lamictal), quetiapine (Seroquel), and bupropion (Wellbutrin), as well as 225 mg of venlafaxine (Effexor), which is the maximum dose allowed per day. These strong medications indicate she was severely depressed. According to the report, she had discontinued certain medications in the days leading up to her death, which may have been a contributing factor.

When I write about my own experiences with psychosis, I feel like I’m writing about another person. These days, I don’t relate at all to the black. I live the kind of normal, happy life the old me would have found detestable. Normalcy, though often difficult and uncomfortable, is nothing like the tediousness of depression. Similarly, normal pleasure is different than mere relief.

This realization came to me around three years ago, the first time I travelled to L.A. Driving along the coast of Malibu, I was struck by the simple pleasure of being present and enjoying a sunset in the company of a good friend.

No longer depressed, I’ve experienced so much that I couldn’t when I was sick. I don’t take for granted that I’m lucky to be alive.

***

Lead image: flickr/simpleinsomnia

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