Suicide Antidepressants 01/10/2007 Canada Prominent CEO Kills Self on 2 Antidepressants & Other Psychiatric Meds Summary:

Paragraphs 55 through 57 read:  "Discharge notes from the hospital relating to the March suicide attempt show that Peter was taking six separate medicines simultaneously -- anti-psychotics, muscle relaxants, sleeping tablets and two types of anti-depressants. It's impossible to draw definitive conclusions about what was intended by the mix -- assuming the drugs were prescribed by the same doctor. 'It appears to me that there were too many medications involved,' concluded Dr. Perez, making it clear he was not commenting on Liebel's drug regime but on the general case."

"The Civic's day program physician evidently drew a similar conclusion. He told Peter the switch could take place the following week."

"'They decided the medication approach they had taken was completely wrong,' says Herczeg. 'It was going to take a month to drain the old stuff out of his system and get the new drugs working.'"


http://www.canada.com/ottawacitizen/news/story.html?id=b8245f2f-61d8-4521-ae80-b29a8b626b41



Peter Liebel left home with a lethal cocktail of drugs. The investment banker had tried to kill himself four times in less than six months. So when police showed up to notify his family, they were both dreading and expecting news of his death

James Bagnall, The Ottawa Citizen

Published: Sunday, September 30, 2007

The top ranks of finance and investment banking are filled with super-achievers who value long hours and a mastery of detail. There is no room for weakness, no honour in frailty.

For decades in this competitive climate, Peter Liebel climbed to the highest levels, all the while battling depression.

The investment banker served on the boards of Ottawa-based companies and entertained generously from corporate hospitality suites. He owned comfortable homes in Ottawa and Mont Tremblant, and seemed confident and quick to laugh. Only occasionally did his demeanour hint at insecurity View Larger Image     View Larger Image



In 2000, Peter Liebel, then a senior executive with CIBC World Markets, was selected by the Citizen as one of the most 235 influential people in Ottawa's burgeoning high-tech industry.



Brigitte Bouvier, The Ottawa Citizen
None of his colleagues knew of his torment or how hard he worked to avoid the stigma of mental illness. He clung to normalcy. Even when ill, he completed complex transactions on behalf of Dundee Securities, in part by hiding behind his BlackBerry and other electronic gadgets that allowed him to avoid face-to-face meetings when necessary. In the end, though, it is this determination to hide his depression that may have pushed him over the edge.

When Liebel slipped into the driver's seat of his 2003 Acura SUV at about 1:30 p.m. on Saturday, April 28, he'd already tried to kill himself four times in less than six months. Just two weeks earlier, he'd been released from the psychiatric ward of the Ottawa Hospital -- no longer considered a danger to himself, doctors said. Yet when he left home that late-April day, he was carrying a lethal cocktail of drugs. When he planned to kill himself is not certain. Hours earlier, he'd purchased Senators tickets so he could take his daughter, Sarah, to a playoff game that Monday night. And as he pulled out of his driveway into the cold spring drizzle, he passed festive Sens banners hanging from telephone poles. But his mood was a mirror for the bleakness of the day.

- I thought I knew Peter Liebel. Over the years we'd had dozens of conversations about travel, business, sports and, occasionally, about life. I'd seen him at his best -- when his warmth and curiosity dominated his darker side. Except for his final year, this was most of the time. But Liebel could be mean, too, when his competitive instincts took over or when alcohol coloured his judgment.

In the days after April 28, I began to wonder how I -- and nearly everyone -- had missed signs of his illness. Neighbours, school friends, business colleagues who spent hours with him in pressure-filled situations, and journalists, perhaps especially journalists -- he did not trust any of us with his secret. That burden was for his inner circle, a tight group of relatives who now seem almost relieved to talk about Liebel's last months.

At the centre of the circle were his parents, remarkable individuals who arrived in Canada in extraordinary circumstances. Greta, a native of Aachen, Germany, lost nearly all her family in the Holocaust. Austrian-born George was detained as an enemy alien in England and shipped in 1940 to Quebec's Eastern Townships where he was interned as a prisoner of war.

Later, he was among 1,000 internees who stayed in Canada. He earned a chemistry degree, eventually becoming a senior executive of Felton International, a Montreal firm that produced flavours and fragrances used in bubble gum and incense.

When Peter Liebel was rising in the public service during the late 1970s, he phoned his father every day at 5 p.m. They talked about economics, world affairs and the inner workings of the Trudeau administration. "Dad was absolutely fascinated," says Susan, Peter's younger sister, a grade school teacher in Toronto. In July 1981, George Liebel died of a heart attack at the age of 64. Peter, who had just turned 30, was devastated. He continued to call home daily and he and his mother would talk at length about stocks and the business of government.

The Liebels raised an ambitious son. Peter was student council president at Montreal West High and a top debater. At McGill, he won the Commonwealth scholarship to study at the London School of Economics. "Peter was always an achiever," says Susan, "I don't remember him being any other way." He set out for LSE in 1972, convinced he could do anything. But it was in London that he was first betrayed by his mind.

"Peter would continually ask himself what he was doing in London, what he should be doing with his life," recalls Martin Heppner, a high-school friend also at LSE. "He spent whole days in bed." Liebel couldn't concentrate or analyse things. Nearly as disturbing to him was his indecision. The symptoms would return again and again during his life. At LSE, the funk lasted a few weeks and prompted a visit from Greta. Later, Heppner sent Peter home where he spent the summer with his parents. Liebel returned to LSE in September and eventually earned his master's degree in politics.

"Peter's symptoms seemed to appear most strongly whenever he was confronting a significant change," recalls Heppner, Liebel's best friend until the late 1990s when the pair had a falling out. Once Liebel settled on a path, he was OK. In 1974, Peter landed a job in Ottawa as an analyst at Treasury Board, the federal department responsible for managing the government's financial accounts.

He didn't know it at the time, but his experience was not uncommon. People who suffer major depression tend to exhibit their first symptoms in their early 20s, although years can pass before a recurrence. Liebel never discussed his breakdown with Heppner, or with Susan. Indeed, it's unlikely he even considered it an episode of depression or a warning of something more profound. Whatever it was, he'd recovered, and done so without drugs.

- His depression re-emerged a couple of decades later with a force that took everyone by surprise -- even Margot Montgomery, the very smart librarian who'd caught his eye on the courts at the Rideau Tennis Club during the early 1980s. Margot liked Peter's intelligence, energy and mischievous sense of humour. "We were in love, but I had just finished a rather unsuccessful marriage," she says. "I wasn't sure I wanted to do it again." Peter was persistent. He won her over and organized everything -- the wedding at city hall, honeymoon at Mont Tremblant and their new home near Island Park Drive.

The first years were good, though not without minor irritations. Peter was a nighthawk and didn't mind a messy house while Margot woke up early and valued neatness. After Sarah was born in 1984, Peter was on the road a lot, in Asia and Europe, with the departments of Communications and Industry. He was already a workaholic, though knew enough to take breaks. During the late 1980s, Peter, Sarah and Margot -- by this time working for the Library of Parliament -- took long vacations in Greece, Britain and California.

But in 1988, Peter's workload escalated after he was promoted to assistant deputy minister of Finance. Things were fine for a year or two, but then he started to talk incessantly -- almost obsessively -- about problems at work. Margot tried to help him sort it through. "I didn't understand that I wasn't helping him," she says now.

A difficult stretch began in 1993 when Paul Martin became finance minister. Martin was a bruising debater. He'd offer suggestions, expecting ADMs to have facts at their fingertips and to tell him when his ideas were wrong or unworkable. Some mandarins learned to ignore Martin's short-tempered insults. Liebel, though, took Martin's criticisms personally and would complain bitterly to friends. "Finance was soul-destroying for Peter," said Margot.

Early in 1994, Liebel seized the opportunity to serve as executive director of the Information Highway Advisory Council -- an agency that would advise the government on how to make the Internet available to Canadians. The council submitted its report in the fall of 1995. The period between the launch of the council and its final report would prove nearly catastrophic.

Relations between Margot and Peter were deteriorating, though neither thought to blame the depression. Peter had started to take tranquillizers to settle his thoughts. "He was trying to get himself together through a self-healing process," Margot says. "He went jogging for at least an hour every day." Eventually, Margot consulted a psychologist about her own feelings of helplessness. "I think Margot shielded us from a lot in those years," said Susan. When Margot insisted the couple see a marriage therapist, the counsellor told her, "I can't treat Peter until he gets professional help." The need for outside intervention announced itself more urgently in 1994 or 1995 -- Margot cannot recall precisely. She was driving the family home after a weekend at Tremblant. Sarah, then about 10, and a friend were in the back seat while Peter dozed in the front, numbed by tranquillizers. This was the usual arrangement. Halfway home, Margot noticed her husband was quieter than usual. They had argued earlier, but she hadn't thought anything of it. But now he seemed unresponsive. She sped up the car, dropped off Sarah's friend and arranged to leave her daughter with a relative. Minutes later, Margot pulled up to the emergency entrance of the Royal Ottawa mental health unit. There she learned that her husband had overdosed on pills.

- Investment banking seemed an odd profession for someone who suffered bouts of insecurity. In fact, Liebel's move was preceded by months of indecision. After completing his work on the Information Highway, he took a buyout package. "He didn't know what he would do," said Margot. Peter stayed at his mother's house in Toronto, commuting back and forth to Ottawa as he consulted head hunters.

He discussed his options during endless calls to his brother-in-law Gabor Herczeg and to high-school friend Martin Heppner. Although at the time Herczeg was a consultant with Arthur Andersen, a global accounting operation, and Heppner is a partner with a Toronto-based investment bank, it seems unlikely they influenced Liebel's decision. "He had made his mind up already," says Herczeg.

The outplacement executive connected Liebel with Toronto-based First Marathon Securities, which he joined late in 1996. Liebel had regained his self-confidence, thanks to regular visits to a psychiatrist and a new regimen of anti-depression medicines.

The combination of therapy and drugs seemed to work during the next decade. Not only did his symptoms nearly vanish, but he was able to work at a very high level. This is the way treatment of depression is meant to work. The Centre for Addiction and Mental Health in Toronto estimates more than 80 per cent of people with major depression can recover. Still, it's difficult for doctors to arrive quickly at the precise mix of drugs, dosages and lifestyle changes that offer long-term relief of symptoms.

"Peter was always looking for that magic bullet," says Herczeg, "something that would work right away." But, around 1997, Liebel's drugs were working. As long as they did, he saw no need to adjust his egregious workload.

Late in 1999, Liebel joined CIBC World Markets, one of the country's largest investment banks. He was to open an office in Ottawa and market CIBC World Markets' services to the city's burgeoning high-tech community. He could finally stop commuting to Toronto.

"Peter worked all hours," recalls Susan Croft, his gentle and efficient administrative assistant from 2000 to late 2006. "In the evening, there were conference calls with different companies. He often worked until after 11 p.m." At times Liebel stuffed two or three briefcases with market analyses, securities filings and stock reports. (After his death, his sister found seven briefcases in his home.) He met clients and prospects over breakfast or dinner. He entertained them at his Tremblant chalet or in a corporate box at Scotiabank Place.

Liebel's clients thought him a bit nervous, but he squeezed a lot of infectious energy into his muscular, five-foot-seven frame. Many commented on his drinking in social settings. On some nights, Liebel would slur and walk with an uncertain gait. Colleagues recall that Liebel was particularly difficult at a Boys & Girls Club event a couple of summers ago. Such behaviour may have been the result of mixing alcohol and anti-depression medicine. It also seems a significant clue something was wrong.

Liebel wasn't a good typist, so Croft worked long hours co-ordinating his e-mails. In fact, she'd become a central figure in a highly fluid network that connected Liebel with dozens of CIBC analysts and specialists across the continent. Among her many duties, she'd arrange to have detailed presentations by CIBC World Markets on the desk of potential clients the morning after Liebel made his pitches.

Liebel could be suffocating. He hovered as she worked. When organizing social events, he stepped it up a notch. During the summer of 2000, for instance, he invited several hundred high-tech entrepreneurs, managers and media on a chartered cruise of the Ottawa River. Every 30 minutes, he'd wander to Croft's desk for an update on the party list.

And yet Liebel's tenacity paid off. "He built the Ottawa office from scratch," says Croft, "and he was doing millions of dollars worth of business." Croft understood that Liebel's most annoying office habits were not intentional. When she implored him to give her space, he seemed shocked. Flowers would appear the following morning. Yet he was determined to succeed, so he ended up repeating the behaviour.

"Peter really was a kind person," says Herczeg, "but the other side of his personality was that he was very aggressive." Few in his world found his hours or style of work unusual. "Hardly any of us pay enough attention to family and a normal social life," said one chief financial executive who dealt regularly with Liebel. Margot and Peter separated in 2004. By that time, Sarah had left to study at McGill. Though Peter kept in touch with both Margot and Sarah, his home life was empty. Unfortunately, the departure of his wife and daughter coincided with CIBC's decision to re-assess the need for a World Markets office in Ottawa.

Initially, the closure didn't seem to hurt Liebel. The change was not at his initiative, so he hadn't had time to dwell. Plus he'd received another severance package. "I'd never seen him so relaxed," said Susan. The family, including Sarah and her first cousins, took a Mediterranean cruise to celebrate Greta's 80th birthday.

But Peter's competitive streak returned and he talked with associates about returning to banking. When his family suggested he try something else -- teaching, for instance -- Liebel dismissed it out of hand. In 2005, he landed a job with Dundee Securities, a Toronto-based securities firm that had been thinking about opening an operation in Ottawa.

By 2006, Liebel had a new office in Kanata down the hall from LaBarge Weinstein, a prominent business law firm. Liebel visited frequently during the day to chat and compare notes about the recovering tech sector. He had coaxed Sue Croft out of retirement to serve as his private secretary, albeit on contract. Liebel was free to cultivate his extensive contacts and make Dundee a financier for a new generation of Ottawa tech startups.

And then his anti-depression drugs stopped working.

- The signs were clear to Croft early in the summer of 2006. Liebel wasn't following up with customers. He didn't return phone calls. Decisions were delayed. Liebel confided in Croft about his depression but implored her to keep his secret.

The deception was not easy to carry off. Dundee's Kanata office was small. Liebel and Croft developed a subterfuge. When Liebel appeared to be staring blankly into his desk or computer screen, Croft would enter his office and close the door. There the two would sit quietly, pretending to work. One day Liebel was in particular difficulty. "I can't stand this pain," he uttered quietly.

Later that fall, Herczeg witnessed a more dramatic display. Liebel was confiding his distress when his cellphone rang. Without thinking, he answered and transformed instantly into a professional banker. After snapping his cellphone shut, he went quiet. "It was as though he diverted all his energy into sounding normal," says Herczeg. "The effort exhausted him." It was enough to fool Liebel's clients. During the last half of 2006, Liebel played a central role in at least two deals won by Dundee. His employer raised $18 million in August on behalf of Plasco Energy Group, a private firm that specializes in technology for transforming waste into energy. "I had absolutely no idea Peter was suffering," says Plasco CEO Rod Bryden, who spent hours with Liebel during negotiations over financing.

It was a similar story at Wi-Lan, a patent-licensing firm that sold 6.7 million shares in the fall to Dundee and other banks for $30 million. If anyone could pierce Liebel's shell, it was Steve Bower, Wi-Lan's chief financial officer. Bower and Liebel had attended Montreal West High School. At one point when Bower noticed Liebel was looking gaunt, he asked if he was ill -- cancer, perhaps? "It's kind of like cancer," Liebel replied. Bower didn't press.

Perhaps Liebel was hinting at his depression. Or maybe he was making a cryptic reference to a recent prostate cancer test. Liebel had learned that his blood contained abnormally high levels of prostate specific antigen, or PSA, which suggested cancer. He was consulting urologists at the time of the conversation. Liebel would later discover it was a false alarm. "Of course, Peter being Peter, he began consulting books on prostate surgery and obsessing over what might be happening to him," said Herczeg.

One evening in November, Margot got a call from her ex-husband. Peter told her matter-of-factly he'd taken too many pills. Then he went back to bed. Margot got him to the emergency ward at the Ottawa General campus. His family decided to seek outside help.

- On an unseasonably warm, foggy day in late November 2006, Herczeg and Greta escorted Peter into the Homewood Health Centre in Guelph. Peter had not gone willingly, in part because he was concerned others might learn of his depression. But if help was available, it was here.

The eight-week session takes place in a dorm-like setting and covers all aspects of depression -- physical health, medicines and lifestyle.

"The program is for those who may have been treated in an acute care hospital but aren't getting better," says Homewood CEO Dr. Edgardo Perez, who ran the psychiatric unit of the Ottawa Civic Hospital in the early 1990s. "The main thing with guys is that we don't like to talk about depression and then we get worse and come in late for treatment." Liebel was initially uncomfortable with group therapy. But once he figured out its aim was not to talk about feelings but rather to teach new ways of thinking, he seemed OK.

His doctors at Homewood eventually changed his main anti-depression medicine, which helped. "We were convinced he really was on the road to good health when he left Homewood," said Susan. "He was full of good humour, attentive and very aware of the fact he needed balance in his life -- physical exercise, family life and a spiritual dimension." Liebel returned to work in Ottawa in February. Colleagues were told he'd dealt with an illness and was ready once more to market Dundee. It's easy in hindsight to see that his recovery was tentative. Plus he was returning to a city where he was mostly on his own. His immediate family was now concentrated in Toronto, his daughter was planning to travel to South Korea and his best friend, Martin Heppner, was estranged. He and Margot had separated years earlier. And while she kept in close touch, she had her own life. Even Croft, Liebel's longtime assistant, had retired for good. They all visited frequently and talked Liebel through increasingly dire episodes. It's difficult to see how the family could have done more during the final weeks.

Herzceg, a tall, easy-going native of Budapest, runs a one-person technology and management consulting company from Toronto. Because he is self-employed, Herczeg was able to adjust his work schedule to suit Liebel. Herczeg also knew many of his brother-in-law's clients. The two men had much in common and spoke frequently.

As Liebel's depression deepened, the phone calls -- hourly during the worst of times -- dominated his day. Herczeg expended enormous energy trying to keep his brother-in-law up. When Liebel's moods deteriorated, Herczeg packed his bags and headed to Ottawa for weeks at a time. His relief was huge when Liebel emerged from Homewood in January a seemingly healthy man. Yet in February, Liebel confided to his sister that he was slipping. The mental fog had returned. Twice in March, Peter attempted suicide. The latest anti-depression meds weren't working.

Although we can't know the horror of his mind, it may be exemplified by another CEO who planned suicide but did not follow through. Philip Burguieres, head of a U.S. investment management company, recently told The Times of London about the onset of his own depression. "I was a person who never failed," he said, "It was the greatest Catch-22. I couldn't function and on the other hand, I couldn't let go. I couldn't think of a way out. So I started thinking illogical things like, 'If I wasn't here any more.'"

For Herczeg, these words offered a flash of recognition. "Those are exactly the kinds of thoughts Peter expressed," he said.

(Fully recovered, Burguieres is now an informal confessor to what he says is a secret network of depressed CEOs too afraid of the stigma to come forward. He estimates one in four CEOs experiences the symptoms at least once in their lives.)

On Friday, April 13, Herczeg called 911. Another overdose. When the medics arrived, they checked cupboards, drawers and other crannies. "There were bottles of pills everywhere," said Herczeg, "He'd been hiding them." It's possible Liebel had not been taking the anti-depressant drugs -- perhaps concerned about side-effects or impatient at how long it was taking for them to kick in. Perhaps he'd stockpiled pills with suicide in mind. After Liebel's journey to the Ottawa Hospital's Civic campus emergency entrance, he was admitted to the psychiatric wing.

When Susan and her husband visited Peter on April 16, they "didn't know whether to laugh or cry." The ward held nearly 50 patients, many wandering in a catatonic state. Several were screaming. In the kitchen area, they were greeted by a patient with his rear end exposed. Peter seemed somewhat bemused. Although he was suffering from serious depression, it seemed minor by comparison.

During his final year, Liebel encountered many roadblocks. He had been trying to change his psychiatrist of 10 years only to encounter a six-month waiting list. When his family first checked him into Homewood, he waited only several weeks. But when he contacted Homewood to re-enrol, the wait list was four months long.

"Homewood provides discharge plans for every patient," said Dr. Perez. "These plans include recommendations for followup in the patient's home community with a health-care professional. However, we recognize there is a need for specialized after-care services which are comprehensive and similar to the clinical approaches used at (Homewood). This is often an issue."

Peter's mother, Greta, enquired about a program at Toronto's Centre for Addiction and Mental Health, but the waiting times were lengthy. And so Peter spent April 17 -- his 56th birthday -- in the Civic campus's psychiatric ward.

Told that Peter would spend another week on the ward, his sister and brother-in-law returned to Toronto. But the next day, Greta called with stunning news: Peter was to be released that day -- he was no longer thought a threat to himself. He was instructed to enroll in the Civic's day program. Greta says the physician suggested Peter could fend for himself and told her to return to Toronto. Instead, Greta, who was furious with the advice, moved into her son's house.

On April 23, Peter started the day program that included group therapy. One group member later told Susan that Peter often read his BlackBerry or sent messages during sessions. Peter did not meet with a psychiatrist under the day program until April 27 -- the day before he disappeared. The psychiatrist learned that Peter was anxious to change his anti-depression medicine.

Discharge notes from the hospital relating to the March suicide attempt show that Peter was taking six separate medicines simultaneously -- anti-psychotics, muscle relaxants, sleeping tablets and two types of anti-depressants. It's impossible to draw definitive conclusions about what was intended by the mix -- assuming the drugs were prescribed by the same doctor. "It appears to me that there were too many medications involved," concluded Dr. Perez, making it clear he was not commenting on Liebel's drug regime but on the general case.

The Civic's day program physician evidently drew a similar conclusion. He told Peter the switch could take place the following week.

"They decided the medication approach they had taken was completely wrong," says Herczeg. "It was going to take a month to drain the old stuff out of his system and get the new drugs working."

On April 28, Peter had a down morning, though it's not clear why. Often there is no direct trigger. Peter's family had convinced him his health was more important than work. He had submitted his resignation and was negotiating the details. Dundee declined to comment on this point, other than to confirm Peter was still an employee at the end of April. According to Susan, Peter was concerned he'd lose access to Dundee's hospitality suite, which is why he purchased a pair of Senators tickets online to take Sarah to the April 30 playoff game.

On April 28, Greta was busy making lunch for her son when she noticed the silence. Fearing the worst, she called Margot. Her former daughter-in-law arrived about 20 minutes later and the women called the police. Throughout the weekend, the police hunted -- every hour adding to the worry. Although Peter had tried to kill himself previously, he'd never before disappeared in his car.

The Ottawa Police Service issued a bulletin at midnight April 28, seeking the public's help. They would only say Liebel's well-being was at issue.

Throughout the weekend, Susan called frequently from Toronto, anxious for news. When she finally booked her flight to Ottawa, she selected an arrival time that would coincide with the discovery of Peter's SUV.

The time stamp on Peter's parking arcade ticket revealed less than an hour passed from the time he left home until he pulled into an airport parking slot.

Susan arrived in Ottawa at 10:15 a.m. on the Monday. "When I landed, I was thinking 'Did they check the airport?'" she recalls. "They must have been doing it when I was there."

Three hours later, two constables -- "right out of Law and Order" -- arrived at Peter's house with news the family had been both dreading and half-expecting.

Five days after Peter went missing, several hundred well wishers gathered in the chapel of Hulse, Playfair & McGarry's downtown funeral home. The crowd contained pockets from Finance, the Privy Council Office, the Bank of Canada, Ottawa high tech and Toronto's Bay Street. "Peter would have been surprised by how many showed up," said Susan.

Old friends paid their respects, including Martin Heppner, his estranged chum from Montreal West High. Early this year, Heppner had sent Peter a letter suggesting they forget old issues and get together. The letter was found, opened, on Peter's desk.

On Friday and Saturday, the Liebels and Herczegs welcomed visitors to Peter's house. The place was neat as a pin. Family members conducted conversations on automatic pilot, the grief just under the surface. In the case of Greta, who had now lost a son along with a husband, the injustice seemed truly disproportionate. The quiet chatter in the house touched often on people's surprise at Peter's depression -- and on the eloquence of his sister's eulogy.

"People need to be able to talk about mental illness openly without fear of shame and rejection," Susan had said at the funeral. "We as a family provided him with so much support and encouragement. Sadly, it was not enough."