In this article, it says that Quentin Karmer's doctor had diagnosed him with "mild to moderate" depression. Yet in switching from Serzone to Paxil, he murdered his wife, his 6 year old daughter, 3 year old son and then killed himself.
Depths of Depression
Quentin Kramer's tragic struggle with depression ended in murder and suicide. His mental illness is common, and his friends' and family's -- and society's -- inability to understand it and respond to it are all too common, too.
KAY HARVEY STAFF WRITER
The people closest to Quentin Kramer knew about his depression. But no one -- except possibly his wife, Lisa -- recognized how tormented he truly was.
In a daily journal, Lisa railed at ``the demons who possess Quentin's soul'' and hinted at a growing sense of foreboding.
``I'm not certain of much these days, especially what the next day may bring,'' she wrote. ``I have this terrible feeling that the worst is yet to come.''
Ten days after she wrote those words, a man known for his kindheartedness arose after midnight, shot his wife and the couple's 6-year-old daughter and strangled their 3-year-old son inside their Fergus Falls home. Then, he pointed a shotgun at himself and pulled the trigger.
Quentin Kramer died of major depression. He was 32. He is one of 500 Minnesotans who commit suicide every year. Depression is by far the leading cause of suicide, and suicide is the No. 2 killer of people ages 10 to 34. In his tragic case, the human toll was multiplied by four.
Depression is perhaps the most misunderstood of diseases. It is complicated by a blurring of the lines between normal mood shifts that ``get people down'' and major depression, which involves a chemical imbalance in the brain.
New medications have vastly improved treatment of the disease. But a stigma remains. Some people believe their jobs or images are at stake. As Quentin Kramer's story shows, there may be much more than that to lose.
``When your rotator cuff is out of place, you just go and get it fixed,'' says Carlyle Kramer, the brother who found Quentin's family dead. ``With depression, it can be a whole different story.''
For Quentin's and Lisa's families, the story is one of overwhelming grief, strong Christian faith and unanswered questions:
``Why didn't we see how bad things really were?''
``What more could we have done?''
``Why did we wait too long?''
The answers to those questions can't change the story. But by publicly raising them, they hope to call attention to the potential seriousness of major depression and help cut through the barriers of stigma and shame.
``People are so afraid to talk about this kind of stuff,'' Carlyle Kramer says. ``I didn't want to talk about it. I just wanted it to go away. It didn't go away. It came back in the worst possible way.''
He did everything right
Quentin Kramer was the kind of person who never caused anyone much worry. He was the easiest of their five children to raise, say Roy and Ramona Kramer.
Like his siblings, Quentin grew up in the Shoreview home where his parents still live, four blocks from Island Lake Park, and graduated from King of Kings Elementary School and Concordia Academy.
His brother Garrett recalls his youngest brother as ``a barefoot kid with a fishing pole, running down to Island Lake.''
Quentin's love of the outdoors, lakes and fishing would lure him, after college, to a job with the Minnesota Department of Natural Resources. He received a department commendation last year for his outstanding work as a fisheries specialist. His careful diligence on the job matched his approach to life.
``Quentin always did everything right,'' says Garrett's wife, Denise. ``People sometimes gave him a bad time because he was so good.''
He was known for his calm, gentle demeanor and expertise as a hunter and fisherman. Family members almost never saw him visibly upset. When they did, it was when he observed someone breaking one of the environmental rules he knew so well.
``Even then, he wouldn't blow up,'' says his sister, Gizelle Smothers. ``He would say, `Here's what you're supposed to do.' ''
Quentin met his future wife when the two were sophomores at Concordia Academy. Lisa Wallerstedt was a fun-loving, blue-eyed blonde, and the two quickly became friends. Before enrolling at the academy, Lisa had battled serious depression, say her parents, Don and Jan Wallerstedt. After months of therapy, she was feeling good again. Her parents believe Quentin's friendship and sensitivity helped to pull her through.
Their first real date, as seniors, was to the school's junior-senior prom.
Part of him disappeared
The couple married in 1989 in a church wedding in New Brighton. They moved five years ago to Fergus Falls. Both sang in the choir at Trinity Lutheran Church. Lisa helped with Sunday school and used her artistic talents to direct crafts projects and decorate for Christmas. Quentin served on the board of the church's elementary school, where daughter Corinne was a first-grader.
They liked camping and bicycling, and when Lisa worked evenings for a time at Fleet Farm, Quentin and the children sometimes biked across town to kiss her good night. During practice, when the school band paraded down the street where the family lived, the four of them often ran outside to march along.
As in all families, there were tensions. In the fall of last year, Lisa had a miscarriage resulting from a tubal pregnancy. Quentin agonized over turning down a job promotion that would have required the family to move. And people close to the couple began to notice Quentin's mood had changed.
``Quentin was typically a quiet, laid-back kind of guy,'' says the Rev. David Knuth, the church's associate pastor. ``He didn't share a whole lot. But he had a real dry sense of humor. He could say something funny without cracking a smile. He kind of lost that. That part of him disappeared.''
At Lisa's request, she and her husband met twice with Knuth to discuss Quentin's sadness and anxiety.
``He showed some common symptoms of mild or moderate depression,'' Knuth says. ``He mentioned some things that were happening at work. And Lisa's miscarriage. He felt responsible for that. Some things he talked about I didn't consider to be very significant. But when you're depressed, everything is significant.''
In mid-November, Quentin visited his family doctor, who prescribed Serzone, an anti-depressant. The doctor noted Quentin had experienced ``some thoughts about suicide,'' but had no suicide plan.
Quentin began seeing a psychotherapist, who diagnosed major depression. He later counseled with a second psychologist. Lisa asked for the switch because she didn't think Quentin was getting the care he needed, her mother says.
At Thanksgiving, Lisa and Quentin and their children made the three-hour trip to the Twin Cities to attend family gatherings. Family members noticed Quentin was thinner -- 30 pounds lighter than usual. He seemed more somber and less talkative. When the Kramer family geared up for a traditional game of pinochle, Quentin declined to play. He seemed indecisive, another sign of depression.
``He had a slit in a radial tire,'' his father recalls. ``I offered him use of my car and said I'd fix it. He wasn't sure what he wanted to do.''
Lisa had promised Quentin she wouldn't talk about his depression, her mother says. But as Quentin's moods got darker, Lisa broke that vow. During the Thanksgiving visit, Lisa told Ramona Kramer that Quentin was being treated for depression and wasn't sleeping well.
The word spread through Quentin's family and, after the holiday, set off a round of phone calls, many of them to Quentin. But he wasn't eager to talk about his feelings.
``I was told he was having difficulties,'' says Llewellyn Kramer, who began calling his brother once a week from his home in Green Bay, Wis. ``I didn't get any of that. He tried to sound chipper and said he was doing OK.''
At Christmastime, Quentin and Lisa again visited their families in the Twin Cities. During that visit, people noticed Quentin seldom spoke unless spoken to. His sadness had become more apparent.
``He had a great laugh,'' says his sister, Giselle. ``That's what was missing at Christmas. He couldn't laugh.''
His brothers suggested the men retreat on Christmas afternoon to Garrett's house in Maplewood to play a new computer game. The outing did little to boost Quentin's mood. During a car ride afterward to Lisa's parents' home in New Brighton, Quentin's brother-in-law Jon Smothers asked him what was wrong.
``He wanted to talk, but he couldn't,'' Smothers recalls. ``He said he didn't know what to do.''
The next day at church, Smothers says, he approached Carlyle Kramer and said, ``You talk to Quentin. Do you hear me? There's something wrong here.''
Two years older than Quentin, Carlyle was his brother's childhood playmate and adult fishing partner. Their bond was strong. But Carlyle didn't know how serious Quentin's problems were. The information his family got was sketchy, he says in hindsight, and they may not have known the right questions to ask.
``We didn't know how bad it was because they didn't want to talk about it that much,'' he says.
A total lack of self-confidence
In early January, Lisa wrote in her journal that Quentin couldn't remember happy times. In the shadow of her husband's depression, she struggled to maintain her own sense of mental well-being, a common battle for those who live with someone who is depressed.
On Jan. 11, Lisa called Roy and Ramona Kramer in a panic. She had made an emergency medical appointment for Quentin. On the previous morning, she told the Kramers, she had found him lying on the kitchen floor crying because he couldn't fix the children's breakfast.
``We realized then Quentin needed to see a psychiatrist,'' Ramona Kramer says. ``But the psychiatrist was booked.''
Instead, he saw a psychiatric nurse. Following a doctor-approved list of suggested alternatives, she ordered him to taper off Serzone and begin taking Paxil, another anti-depressant. Switching anti-depressant medications can be a dangerous transition, health professionals say.
During a visit to his family doctor on the previous day, Quentin denied feeling suicidal but ``was somewhat vague in answering,'' the doctor noted. Quentin and Lisa were told that if he felt more depressed or suicidal, he should go to a hospital.
Lisa's call to his parents stepped up Carlyle Kramer's concerns as well. That week, he began calling his brother two or three times each day.
``I realized he wasn't doing well at all,'' Carlyle says. ``It was tough getting him to say anything about what was going on.''
But Carlyle got Quentin to admit he was still in anguish over his decision to turn down the job promotion. He was worried about finances after a string of home and vehicle repairs. And he felt inadequate in his role on a DNR committee that was planning a computer system overhaul.
``That was a big one,'' Carlyle says. ``What I saw was a total lack of self-confidence. He was dwelling on his shortcomings.''
In their numerous conversations with his parents and with Carlyle, they say, Quentin never used the word depression.
Carlyle proposed a plan. The brothers would meet the following Saturday, Jan. 16, in Sauk Center, a halfway point between Fergus Falls and the Twin Cities. Quentin then would ride back with his brother for a weekend visit at Carlyle's home in Roseville.
``He knew the reason was so I could get inside his head,'' Carlyle says. ``He was OK with that. I called back every night that week to set the plan in motion.''
On Wednesday night, Lisa had a long phone conversation with a close friend, Echo Breen, who is a registered nurse. Lisa had no fear for her own safety or the children's, Breen says. But she was desperate to help her husband. Breen suggested admitting Quentin to the hospital psychiatric ward.
``She was scared because she wanted to protect him. She said, `What if everybody finds out? I'd be so embarrassed.' ''
When Quentin Kramer didn't show up Saturday in Sauk Center as planned, his brother Carlyle drove on to Fergus Falls. He parked his car outside his brother's white-frame house and walked inside to find the family dead.
``I went instantly numb,'' he says. ``I looked directly at things that were in that house, yet I didn't see them. I wasn't seeing what I was seeing. It was unreal. Yet I had to report it to police. Because it was real.''
The worst had come.
Families need to be more pro-active
Quentin Kramer hid his depression from a world he feared would judge him. In his workplace, he hid it so well that no one knew.
The health-care system failed to rescue him; his only appointment to see a psychiatrist was set for Feb. 3, three weeks after the family died. Alcohol was not a factor in the murders and suicide.
Could Quentin's family have stopped the train of events had they done more?
They'll never know. Sometimes, nothing can stop a seriously depressed person intent on ending his or her life, experts say. But the Kramers wish they had known then what they know now about the illness called depression.
``People close to a depressed person need to educate themselves,'' Ramona Kramer says. ``And someone needs to fight for their care if they feel it isn't being done exactly right. Families need to be more pro-active. That's where we hesitated.''
In the tragedy's aftermath, the Kramers have learned a lot about depression. They recognize the signs, symptoms and importance of getting the best treatment available. They see the stigma that inhibits people from reaching out. They learned that too often, people don't know what to say to a depressed person.
Family members must find ways to educate themselves about depression, says Mary Kluesner of Minneapolis-based Suicide Awareness/Voices of Education. The mental-health-care system tends to keep loved ones out of the loop because of patient confidentiality laws.
``You break the stigma when you talk about something,'' Kluesner says. ``Just like the stigma that once surrounded alcoholism. Remember? We are talking about the same thing with depression and suicide. But we are just now breaking out.''
Quentin's and Lisa's families are grateful when others who know what they've gone through talk about their own struggles with depression. They know these people understand. Don and Jan Wallerstedt share others' compassion for the man their daughter loved.
``We love Quentin, too,'' Don Wallerstedt says. ``He was a kind, gentle man. We knew it wasn't him that acted in this nature. It was his illness.''
The families have tried to put their gnawing questions aside. They have found some peace through their Christian faith and accepted their horrific loss as out of their control. But the waves of grief continue to flow from what seems such a needless tragedy.
A few days after it happened, Carlyle Kramer's son Conrad, then 3 years old -- the same age as his cousin Shaw -- said to his father: ``Dad, I just wasn't ready for Shaw to die.''
And Carlyle quietly answered, ``I know.''
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