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The Suicide Epidemic
June 3, 2013 7:59 AM   Subscribe

Self-harm now takes more lives than war, murder, and natural disasters combined. Why are we killing ourselves, and how can we stop it?
Over the last five decades, millions of lives have been remade for the better. Yet within this brighter tomorrow, we suffer unprecedented despair. In a time defined by ever more social progress and astounding innovations, we have never been more burdened by sadness or more consumed by self-harm. And this may be only the beginning. If Joiner and others are right—and a landmark collection of studies suggests they are—we’ve reached the end of one order of human history and are at the beginning of a new order entirely, one beset by a whole lot of self-inflicted bloodshed, and a whole lot more to come.
posted by the man of twists and turns (129 comments total) 56 users marked this as a favorite

 
I just read this today. "Rash of Ky. lawyer suicides concerns colleagues"
posted by JohnR at 8:08 AM on June 3, 2013 [1 favorite]


Is this a problem primarily in Market Economies/1st world? (I don't mean "a first world problem" though, I guess literally I would). Or is it a global thing. If it's the first world, then, I think perhaps one way to resolve this might be to take a close look at what the difference is between the two social organizations and why that might be the case. Perhaps it's due to the theory of Social Alienation as espoused by Marx? Only adapted for the networked age? Perhaps it's due to the struggle for more dignity all the while being told that we have to work harder, not less, and that we have to compete for scarcer jobs? Perhaps consumerism isn't the answer to all our problems.
posted by symbioid at 8:12 AM on June 3, 2013 [4 favorites]


The coordinating center for the GBD, the Institute for Health Metrics and Evaluation, provided Newsweek with custom data that bears this out in dramatic fashion. At first glance, the numbers seem to be uniformly good news. The suicide rate—the number of people per 100,000 who killed themselves each year—dropped in developed countries between 1990 to 2010 and grew only slightly overall. But these age-adjusted good tidings mask considerable trauma in the population at large. Throughout the developed world, for example, self-harm is now the leading cause of death for people 15 to 49, surpassing all cancers and heart disease. That’s a dizzying change, a milestone that shows just how effective we are at fighting disease, and just how haunted we remain at the same time. Around the world, in 2010 self-harm took more lives than war, murder, and natural disasters combined, stealing more than 36 million years of healthy life across all ages. In more advanced countries, only three diseases on the planet do more harm.

So.. suicide is down, but we've gotten better at preventing cancer, heart disease, war and murder even faster than we have at preventing suicide?
posted by escabeche at 8:20 AM on June 3, 2013 [41 favorites]


I thought everybody was only killing themselves to live. Maybe it was just the purple fringe (and lack of mustache where you expect to always see a mustache) talking.
posted by item at 8:21 AM on June 3, 2013


Thanks for posting this. Working in a helping profession, and also living in a place with a very high suicide/self-harm rate, I found the Ven diagram (alone/burden/not afraid to die) really interesting. In my corner of the world the question is how much SH is the result of a society emerging from a collective trauma. But it's hard for people to square that in other places which don't seem to want for anything. Is it to do with the rise in media reporting traumatic events? Are we constantly being fed violent imagery in a way that somehow leads to a kind of global hopelessness?

Another issue may be that the idea that suicide equals Hell has gone away for the most part. I know when I was growing up, people who died by suicide weren't buried in consecrated ground. That isn't the case now, and with secularism rising perhaps there is a deterrent that doesn't exist any more? (Note I am not saying we should bring that back.) Is the idea of suicide less frightening to people who may have felt they were alone and/or a burden, but who wouldn't have been able to go through with the final act?

How can we stop it - I guess if we had to take out one of the Ven circles, letting people know they are not alone and that there is help out there is the most important first step, especially for young people.
posted by billiebee at 8:22 AM on June 3, 2013 [1 favorite]


Is this a problem primarily in Market Economies/1st world?

That is addressed briefly in the article.
posted by Greg Nog at 8:22 AM on June 3, 2013 [3 favorites]


symbioid, nope. The example that came to mind were the Foxconn suicides. That wasn't an epidemic by any means, but significant enough to warrant an investigative report.

Looking at the Wikipedia list of countries by suicide rate, it is an issue worldwide. You can find more information on the suicide rates in certain countries from that list.
posted by filthy light thief at 8:24 AM on June 3, 2013 [1 favorite]


BC Medical Journal: The silent epidemic of male suicide
Men have a shockingly high rate of death by suicide compared with wo­men. Across all countries reporting these data (except China and India) males show a suicide rate that is 3.0 to 7.5 times that of women.[10] In Canada, the male suicide rate is about three times that of women.[11] Figure 1 charts the age- and gender-specific incidence of suicide in Canada, based on data from 2001 to 2005. Two patterns are worth noting:

• The male suicide rate increases fairly steadily with age, peaking in the late 40s, then falling significantly and rising again in the 80s.
• Male rates are greater than female rates at all ages and substantially greater across most of the lifespan.
Aboriginal suicide epidemic in spotlight
In Utah, Trying to Stop a Suicide Epidemic—While Loosening Gun Laws

All the Lonely People [WARNING; NYT OPED: DOUTHAT]
This trend is striking without necessarily being surprising. As the University of Virginia sociologist Brad Wilcox pointed out recently, there’s a strong link between suicide and weakened social ties: people — and especially men — become more likely to kill themselves “when they get disconnected from society’s core institutions (e.g., marriage, religion) or when their economic prospects take a dive (e.g., unemployment).” That’s exactly what we’ve seen happen lately among the middle-aged male population, whose suicide rates have climbed the fastest: a retreat from family obligations, from civic and religious participation, and from full-time paying work.
The Surge in Suicides Has Nothing to Do With Marriage or Religion - "The data doesn't support Ross Douthat's argument"
It's the Economy, Stupid. And Guns, Too. Toward an understanding of the rise of suicides in America
God, Guns And Suicide
What about religiosity? As it turns out, once you control for gun ownership, religiosity does have a statistically significant relationship with suicide ...
In other words, in a hypothetical state with no guns and no religion, we’d expect a suicide rate of 17 (per 100,000), give or take a few points. In a state where everyone had guns, and no one practiced religion, we’d expect a suicide rate of 39. If everyone were religious, but no guns: 11. Everyone religious, everyone owns a gun: 21. From a political perspective, there’s really something for both the left and right to like here.
posted by the man of twists and turns at 8:27 AM on June 3, 2013 [11 favorites]


It’s not a secondary concern, a sideline that will solve itself with new jobs, less access to guns, or a more tolerant society, although all would be welcome.
Actually it seems quite likely that, if there's been a recent (post-2008) uptick in suicides it's almost certainly related to the global financial crisis. Especially in places like Greece, which have seen huge spikes in suicide rates.
posted by delmoi at 8:27 AM on June 3, 2013 [2 favorites]


Yeah, this writer is working really hard to imply that suicide is a growing problem when the data don't seem to show that. Of course it's still a huge social problem (really a cluster of problems i would think) but all the more reason not to distort the narrative.
posted by pete_22 at 8:29 AM on June 3, 2013 [2 favorites]


"...the science world, a place where evolution is still just a theory."

Facepalm. Interesting and important subject for an article, though.
posted by kengraham at 8:36 AM on June 3, 2013 [1 favorite]


Coping with war and natural disaster serves to distract us from the obvious: that our individual lives are empty and meaningless and that aspiring to some state of happiness and contentment is futile.
posted by Flashman at 8:39 AM on June 3, 2013 [11 favorites]


The article seems to say that the really big spike in suicide rate is only observed among people born 1945–1970. And since this is happening all around the world, that's a red flag for environmental issues rather than social trends in any one particular country.

We already know that this is the cohort most affected by environmental lead exposure, and that that was the leading cause of the increase in crime from the '70s to the '90s. So is it possible that lowered inhibitions due to lead exposure are paying dividends again, giving depressed Baby Boomers that final push into suicidality?
posted by aw_yiss at 8:45 AM on June 3, 2013 [12 favorites]


Also, Google searches for Obama + Depression shows mostly these* from today:
Obama: Bring mental illness 'out of the shadows'
Obama: Destigmatize mental health issues
President Obama Enlists Hollywood for Mental Health Awareness Campaign
America has to tackle its suicide problem


*Of course, they also show a number of nutjob tea party right wing websites that want to blame someone that is not a member of Congress over the state of interstate commerce, but that's for a different post.

I'm just glad that 1) this is something that's finally getting the national attention and 2) people are actually realizing that this is the appropriate response to the gun-control issue.
posted by Blue_Villain at 8:46 AM on June 3, 2013 [2 favorites]


" letting people know they are not alone and that there is help"

Actually it might be the opposite, letting people know they are not alone and they are needed. See how many suffering people there are who need each other? If you're sad and lonely and feel useless, consider how many people might need you right now.

People want to serve. They don't want to be charity cases.

A lot of charity/mental health help results in people absorbing resources with no opportunity to give back, with no opportunity to show how much they care about human beings or how willing they are to be there for others.

Sometimes, the helpers might be stealing all of those perks without realizing it. The helpers get the title of professional, they get job status and praise for good deeds and wonderful endeavors. These things FEEL GOOD.

When we lose our jobs or become unemployed are we nothing but a burden? According to a lot of American values... yes. Which is strange because somehow many of the same people feel that dogs have value even though they can't contribute (much) on the financial job market. Yet we can't make a space for humans with limited -or simply not desirable on the job market- abilities to be valued and to give back in the ways they are able?

Giving everyone jobs is a choice that we have to make and with increasing technical ability and mass production we're going to have to make a choice about whether human beings are innately worthy of being given an opportunity to contribute within their ability. Yes it means challenging a purely capatilistic and profit driven view of the work place to make it exist to serve humans rather than to serve money (going into the hands of the few).
posted by xarnop at 8:48 AM on June 3, 2013 [80 favorites]


My mother killed herself last fall, and I'm still trying to figure out what the hell happened. I mean, in her particular case, it was kind of the culmination of a long-term project - she'd been mentally unwell for decades, and had a lot of family things and substance abuse issues going on. But I also always get the feeling that she was caught up in a general case of rural poverty and extreme aversion to getting any kind of help. I don't know. It's nasty, nasty shit.
posted by COBRA! at 8:50 AM on June 3, 2013


I know in the US there are a lot of people out there living paycheck to paycheck without much social support. If anything goes wrong -- health issue, car breaks down, laid off, etc., it can be disastrous. For me personally, I don't have anyone to lean on and there aren't many shelters/support/resources for down-and-out single white males (boohoo, right?). For the most part, I feel no sense of community where I live. I drive around Chicago and see all the homeless folks, the drug addicted, the mentally ill, and I get the distinct sense that society doesn't give a fuck about those people, and I know I'm one misstep away from their situation. Suicide seems like an attractive option at times.
posted by averageamateur at 8:53 AM on June 3, 2013 [14 favorites]


If you're sad and lonely and feel useless
...you might not feel strong enough, or have enough inner resources, to help others. Not at the beginning anyway.

However I take your point about people needing a purpose. Not necessarily a 'job' though.
posted by billiebee at 8:55 AM on June 3, 2013 [5 favorites]


Is it really a rash of suicides, or has the statistical variation stayed the same, adjusting for increasing population? That is, are we seeing say the same percentage of suicides overall?
posted by Old'n'Busted at 8:55 AM on June 3, 2013


But earlier this month, Phillips presented the results of a second paper, an attempt to settle the question of whether the boomers were especially suicidal. She sifted through eight decades of U.S. suicide data, wrenching it to separate the influence of absolute age, peer effects, and the events of the moment, and she found something shocking: the boomers have the highest suicide rate right now, but everyone born after 1945 shows a higher suicide risk than expected—and everyone is on pace for a higher rate than the boomers.
posted by Golden Eternity at 8:58 AM on June 3, 2013 [2 favorites]


First off, COBRA!, so very very sorry for your loss. At times we all try to figure things out like a puzzle, and quite often this is just not how life/the world works. If there's anything I can do to help out just memail me.
Actually it might be the opposite
Queue the indirect reference to the NA/AA sponsor system, which IMHO works so well because It's someone who isn't doing this as a part of their 9-5. You don't have to be paid to help. And often, it's the people who aren't looking to be paid that help out in ways that they will never understand.

But it's also possible that bringing attention to this sort of thing will increase the funding for these types of organizations. Because while money doesn't buy you happiness, it does pay for the rent on the building that may one day host free counselling sessions.
posted by Blue_Villain at 9:01 AM on June 3, 2013 [4 favorites]


Men have a shockingly high rate of death by suicide compared with wo­men.

I think men tend to resort to violence as a solution to a problem more often than women.
posted by Decani at 9:04 AM on June 3, 2013


I was really confused about what "on pace" meant, so I found a link to the damn paper.
posted by aw_yiss at 9:04 AM on June 3, 2013


I know in the US there are a lot of people out there living paycheck to paycheck without much social support. If anything goes wrong -- health issue, car breaks down, laid off, etc., it can be disastrous. For me personally, I don't have anyone to lean on and there aren't many shelters/support/resources for down-and-out single white males (boohoo, right?). For the most part, I feel no sense of community where I live. I drive around Chicago and see all the homeless folks, the drug addicted, the mentally ill, and I get the distinct sense that society doesn't give a fuck about those people, and I know I'm one misstep away from their situation. Suicide seems like an attractive option at times.

See, this is the thing - what am I going to do when I get old? My partner's health isn't that great, we will never have a lot of money, in theory I will get a pension but I'm sure someone will manage to screw us out of that some time in the next thirty years, I expect that social security will be in ruins by then, health care costs a million dollars...Seriously, what the hell do they expect you to do when you're seventy and crippled and broke?

When I worry about cancer or other serious diseases, my main calming method right now is to remind myself that I will be lucky to die young of something fairly coherent - sure, it would be sad to peg out now, I'd hate that, but I should probably aim to die while I still have insurance. My partner would be better off, for one thing. It really depresses me to think that if I do get a serious illness in the next twenty or thirty years, I ought to pray to die of it because at least that's an easy way out.
posted by Frowner at 9:05 AM on June 3, 2013 [20 favorites]


I wonder how much of this is the result of some of the destigmatization of suicide. In fact, one thing I think is kind of problematic is when you have these teens who kill themselves over bullying or whatever, and they end up getting their names all over the media, and in some cases postmortem criminal charges against their bullies.

It sends the message that suicide may actually be an effective way to get back at your tormenters. You'll die, but people will say nice things about you and you'll also ruin the lives of the people who you hate the most.

But that said, baby boomers seem like they'd be at the greatest risk for economic suicide. Think about it: They've been told all their lives they need to save for retirement, yet most have hardly any savings at all. And it's very, very difficult for older people who are laid off after years at one place to find a new job. They may also have health issues, and be years from Medicare. If they don't have kids the future must look pretty damn bleak.

So, for older people lower middle class and below, the depression economy has been a fucking catastrophe.
So.. suicide is down, but we've gotten better at preventing cancer, heart disease, war and murder even faster than we have at preventing suicide?
Pretty clear the article is not saying that.
Yeah, this writer is working really hard to imply that suicide is a growing problem when the data don't seem to show that. Of course it's still a huge social problem (really a cluster of problems i would think) but all the more reason not to distort the narrative.
Um, what?
From 1999 to 2010, the suicide rate among Americans ages 35 to 64 rose by nearly 30 percent, to 17.6 deaths per 100,000 people, up from 13.7. Although suicide rates are growing among both middle-aged men and women, far more men take their own lives. The suicide rate for middle-aged men was 27.3 deaths per 100,000, while for women it was 8.1 deaths per 100,000.
That seems like an increasing rate to me, although I wonder how much of that was post-2008.
posted by delmoi at 9:05 AM on June 3, 2013 [1 favorite]


billiebee, I agree, some people can't work. Sometimes I think we forget that one gift we can give to "needy" people in our families and inner circle is the gift of letting them do things for us that fit their abilities. My great grandma loved doing the laundry. It was ridiculous, it took her an hour to fold the laundry but it didn't hurt anything and it DID save my aunt (her caregiver) the trouble so was genuinely appreciated.

I think sometimes when we think about giving to others, we forget that allowing them to give within their constraints, and appreciating their gifts, can be a very meaningful gift. Telling someone all your problems and letting them comfort you, isn't always just selfish on your part! You might make someones day by giving them a purpose in listening to you.

And for those of us who are differently abled (or disabled whatever term you like) like myself- think how many people you give jobs to who might not be employable otherwise? Their social worker/therapy job was the ticket out of food service and other difficult low paying jobs. They get to sit and listen to your problems, or physically care for you, and have a meaningful and important purpose! They get paid way more money than you do and the social praise for being gainfully employed! You are serving others even when you receive. You might be giving them a bigger gift than they give to you.

(Oh yeah, Blue villian-- money helps!!! I'm not at all suggesting that we not help those with financial need with financial support or other services!)

I wasn't thinking of "jobs" as being purely marketable capitalistic endeavors, but that there are different ways of contributing, including things like being reliably kind and emotionally available, or cooking dinners, or listening and caring. These are skills that a strengths based therapist might help a client identify and use in themselves but it also takes people around them being willing and interested in seeing those gifts as meaningful-- because being recognized for our gifts is such a treasure and it doesn't mean anything if people around REALLY DO see you as only a burden. We want to really be able to give to others in ways others actually appreciate not to pretend to ourselves our gifts are meaningful because our therapist says they are.
posted by xarnop at 9:14 AM on June 3, 2013 [8 favorites]


Seriously, what the hell do they expect you to do when you're seventy and crippled and broke?

For many in my city, the answer is sit in a wheelchair on the sidewalk, pile yourself with blankets, and hope that someone has the kindness to occasionally attend to your basic needs. When animals get sick and old, they go off somewhere to die alone. If you're a sick and old human in a major American city, your fate may be the same.
posted by averageamateur at 9:14 AM on June 3, 2013 [1 favorite]


Actually it might be the opposite, letting people know they are not alone....The helpers get the title of professional, they get job status and praise for good deeds and wonderful endeavors. These things FEEL GOOD.

I think, in a way, being a "professional helper" subverts the help provided. It's not much consolation to answer the question "are you alone?" with "paid professionals are available to do their jobs." The hierarchy of "helpers" probably goes something like: friends/family > nonprofessional helpers who are personally interested > professionals.
posted by cosmic.osmo at 9:16 AM on June 3, 2013 [3 favorites]


I understand the impulse of suicidal thoughts, the wishing for sweet release, feeling burdensome, useless, hopeless. I have been a shivering denizen of this despairing place.

I have been affected by suicide by the death of someone very close to me, and that of a daughter of a dear friend.

I also know that suicidal thoughts are a self imposed pain, sometimes resulting in being ended by self, in the most selfish of manners: suicide. The delusional thoughts that I am doing my family a "favor" stem from a heartless, self-centered fear and self-pity.

I stopped being suicidal by thinking about others, how I could benefit them, regardless of how far down the scale I had gone, by obtaining release from fear and hopelessness by finding something greater than myself.

If anything, in my opinion, suicide is on the rise, because people are more and more concerned with themselves, and less in their communities, families, and peers. A world where one strives to "be the best they can" for their own well-being and supposed happiness, is a world where suicide becomes more prevalent.

But, that's just my .02.
posted by Debaser626 at 9:17 AM on June 3, 2013 [3 favorites]


I don't know why people would think there are only one or two, or even a handful of contributing factors.

Social:
Unemployment, alienation, increased unfocused time, social and religious norms in increased flux, continuous media/news/entertainment cycle, traditional methods (for good and ill) being overrun and discarded, normalization and wide-spread distribution of guns. large parts of the population entering older age with a culture that places optimal value on youth.

Diet:
large amounts of sugar and fat, decreasing intakes of vegetable. It is a weird world where both hunger and obesity are serious problems. Increased use and reliance on pharmaceuticals

Environmental:
Increasing 24 hour cycle with larger numbers of people operating with little relation to diurnal cycles, decreased exposure to sunlight/increased exposure to artificial light, sleep disruptions. Less interaction with the "natural" world, global environment changing,

Philosophical:
More breadth and less depth of knowledge, "everyone is an expert therefore no one is an expert" or devaluing someones expertise because you are able to come up with a hand full of talking points via the internet. Homogenization of popular culture with the simultaneous balkinization of political ideologies,

.
.
.

All, or none of these may platy into it, but I do firmly believe that if there is a global epidemic of suicide it is 9ncreadibly complex.
posted by edgeways at 9:18 AM on June 3, 2013 [7 favorites]


Today I learned that Kurt Vonnegut did not invent the Suicide Booth. But the "free meal in the adjoining Howard Johnson's diner" was a nice touch!
posted by cleroy at 9:24 AM on June 3, 2013 [1 favorite]


And for those of us who are differently abled (or disabled whatever term you like) like myself- think how many people you give jobs to who might not be employable otherwise? Their social worker/therapy job was the ticket out of food service and other difficult low paying jobs. They get to sit and listen to your problems, or physically care for you, and have a meaningful and important purpose! They get paid way more money than you do and the social praise for being gainfully employed! You are serving others even when you receive. You might be giving them a bigger gift than they give to you.

I both agree and disagree with this, particularly when it applies to the perceptual traps that suicidal thinking can create. Where the belief in being a burden intersects with a hopelessness that blots out the possibility of ever feeling relief, it's all too easy to fall into dangerous thinking patterns. Such as the trap of believing that by accepting help, you* are stealing from all those "other" people who also need help and who aren't getting it because you* are using up all the help, leading to the inevitable conclusion that the best way to help those "other" people is to suicide, thereby freeing up said help for "other" people who deserve it more and who have a chance to be able to benefit from it. Once stuck in that spiral, it's nigh on impossible to get out of it.

* the generic 'you' getting caught in the cognitive trap
posted by talitha_kumi at 9:26 AM on June 3, 2013


"He points to that heightened suicide risk shared by athletes, doctors, prostitutes, and bulimics, among others—anybody with a history of tamping down the body’s instinct to scream, which goes a long way to unlocking the riddle of military suicides."

This was most interesting to me. Other than athletes (probably?) all of these groups have a very high prevalence of having experienced or experiencing ongoing emotional trauma in addition to needing to tamp down the instinct to stop what they are doing to continue their behavior/job. As a recovering bulimic, an abuse survivor, and as someone who has considered suicide in the past as a very real recourse, my personal experience is that the ongoing tolerance to the pain/sight of blood/experience of trauma is a real risk factor.
posted by Sophie1 at 9:27 AM on June 3, 2013 [6 favorites]


If someone's life is a constant struggle due to external forces- poverty, strife, raising a family on not enough money, etc., it's easier for a depressed person to convince themselves their misery is caused by those forces. As people get into middle age, a lot of those external forces ease up, and they start to realize that their pain might be coming from inside them. With nothing else to blame, the gaping maw of emptiness gets unbearable. This paradigm shift, I think, can be very unsettling for people. The ones who were already on edge probably get pushed into suicidality.

And there is also the "I'm sick of it" feeling. As people get older, they tend to be less willing to engage in yet another struggle against the darkness. A lot of that is the disease talking, of course, but also the effects of aging. The bloodflow to the impulse control centers of the brain is reduced and, like grandpa talking too loudly in a restaurant, they just care less about not doing what they want.
posted by gjc at 9:28 AM on June 3, 2013 [2 favorites]


The ones who were already on edge probably get pushed into suicidality.

The most profoundly disturbing thing I have read in a long while, I think. At least to me, as someone young who is on the edge.
posted by trogdole at 9:33 AM on June 3, 2013 [2 favorites]


I think that the rise in suicides in those born between 1945 and 1970 may correspond to the disappearance of any safety net for these people. People born in 1970 are 43 now, perhaps feeling the effects of a job market that does not look favorably upon the middle-aged unemployed, and their parents are starting to die in larger numbers so they have no one to turn to. At the other extreme, the people born in 1945 are 68, have lived fairly privileged lives, and yet they are facing the reality of having no retirement fund, possibly with a pittance available to them through Social Security.

I really do think that the rise in suicide must be due to economic crisis for these people. The United States is a nation that, systematically and as a matter of public policy, has very little problem with people being left on the street to beg, scavenge, and die.
posted by Unified Theory at 9:39 AM on June 3, 2013 [6 favorites]


This is a sincere question--it's something that's confused me a long time, and maybe the MeFi community can shed some light on it for me.

Why is suicide such a big deal? Why do we care so much if a grown adult chooses to kill themselves? I mean, we're sad for ourselves when someone dies, but outside of that, I don't really understand the knee-jerk aversion to it. I would argue that for many people, suicide is a pretty rational act, especially in countries with little or no safety net. Killing yourself might mean a better life for your children, or might spare your partner the crippling debt of your medical care. It might spare you the indignity of losing your belongings and being forced into homelessness. For the chronically depressed, it spares them potentially decades of unhappiness. Those all seem like fairly reasonable things to me.

It would be fantastic if there were social services and money enough that parents would always have enough to take care of their children, that loss of a job wouldn't necessarily mean loss of home and stability and etc, that health care and mental health drugs were at a point where mental illness could be reliably, affordably, effectively, and consistently treated, but...we're not at that place. In the meantime, why the harsh DON'T EVEN THINK ABOUT IT for people who feel that suicide is the best of a collection of crappy options?

Calling suicide selfish seems so wrong to me--especially when used as a technique to try to prevent suicide. I would argue that it's selfish to insist that people continue to live, even when they're miserable--what could be more selfish than demanding that someone else should endure unhappiness on your behalf?
posted by MeghanC at 9:41 AM on June 3, 2013 [33 favorites]


Why is suicide such a big deal?

Because it's one of the most horrific things you can do to another person? When I was 9, I walked in on my sister committing suicide. My childhood effectively ended that day and it was years before I could even acknowledge that it had happened, let alone address the issues it had caused. So yes, I consider suicide a selfish act. She took her pain and gave it to me.
posted by averageamateur at 9:49 AM on June 3, 2013 [25 favorites]


I wonder how much of this is the result of some of the destigmatization of suicide. In fact, one thing I think is kind of problematic is when you have these teens who kill themselves over bullying or whatever, and they end up getting their names all over the media, and in some cases postmortem criminal charges against their bullies.

It sends the message that suicide may actually be an effective way to get back at your tormenters. You'll die, but people will say nice things about you and you'll also ruin the lives of the people who you hate the most.


I don't know about getting back at your tormentors, but this earlier post links lack of religiosity and suicide rate, which may be a way to reword destigmatization. Personally, I think of suicide in a different light as a pretty non religious person these days than as a practicing Catholic. Of course, lack of religion probably also correlates with a lack of social connectedness, which is possibly another contributing factor.
posted by 2N2222 at 9:51 AM on June 3, 2013


The Netherlands has a much more accepting pragmatic approach to suicide I believe. Particularly when one is already sick.

I think that whats missing from the discussion is that for some people suicide is a completely rational option. In some cases there really is little point to contined existence.
posted by mary8nne at 9:52 AM on June 3, 2013 [5 favorites]


Calling suicide selfish seems so wrong to me--especially when used as a technique to try to prevent suicide. I would argue that it's selfish to insist that people continue to live, even when they're miserable--what could be more selfish than demanding that someone else should endure unhappiness on your behalf?

I think calling suicide "selfish" is usually not meant literally -- it's a rhetorical attempt to discourage people from emulating it, kind of like calling terrorists "cowards." (Though of course I'm not comparing suicide to terrorism.)

Anyway, you can't look at suicide monolithically. When it's a result of societal failures to help, we are probably displacing our collective guilt onto the person. Which isn't fair, but it seems better to have some negative reaction than to just passively accept it. There's something pretty creepy about that end of the spectrum too.
posted by pete_22 at 9:58 AM on June 3, 2013 [2 favorites]


I only live because dying is extremely painful. There's really no point in living and most of life is suffering anyway so I really don't know why people are so against suicide either. Nonexistence versus a life of suffering is more than a fair trade.
posted by ishrinkmajeans at 10:01 AM on June 3, 2013 [1 favorite]


Delmoi: That seems like an increasing rate to me, although I wonder how much of that was post-2008.

Yeah but look at escabeche's quote:

The suicide rate—the number of people per 100,000 who killed themselves each year—dropped in developed countries between 1990 to 2010 and grew only slightly overall.

The overall trend is flat. Of course in such a large data set you can cherry-pick demographic and time period subsets where it's up or down, and make up compelling narratives about what's causing that, but they're not overly likely to be true.
posted by pete_22 at 10:02 AM on June 3, 2013 [1 favorite]


Calling suicide selfish is not rhetorical psychology. In many (if not most) cases, it is genuinely an incredibly selfish act. Committing suicide, one is only thinking inside one's own experience and while I might think everyone would be "better off without me", most of the time you could not accurately correlate that with facts.
posted by Sophie1 at 10:04 AM on June 3, 2013 [1 favorite]


The pictures in that article were excellent. I'm not at all against suicide but it seems like it is almost always the wrong people who are doing it.
posted by bukvich at 10:06 AM on June 3, 2013 [3 favorites]


Calling suicide selfish is not rhetorical psychology. In many (if not most) cases, it is genuinely an incredibly selfish act.

If suicide is chosen due to mental illness or acute emotional distress, the person was not competent and it's nonsensical to label that "selfish". If it was a rational act, the person was obviously in a lot of pain and/or fear, and felt that was best for them. It might be "self-interested", but I think selfish might apply more to those who think someone who can't stand living anymore needs to suffer for them.

Either way, people who kill themselves are in exceptionally difficult circumstances when doing it, and calling them "selfish" is an immature response. To people who might be considering it, "selfish" is just telling them they are already bad for thinking about it.
posted by spaltavian at 10:09 AM on June 3, 2013 [38 favorites]


But... isn't preventing someone from dying an even more selfish act? For the suicide all of life is pain and anguish and you want to force them to continue to feel that pain so you won't have to go through their separation with life. But for someone who is happy in life the death of their friend won't be as painful as the suicides daily existence. They'll be sad for a little while and then be happy again. A suicide that continues to live is tormented continuously for years.
posted by ishrinkmajeans at 10:11 AM on June 3, 2013 [6 favorites]


The importance of this inquiry is not just with regard to suicide prevention, but also to treating other pyschological conditions that originate from the same conditions. For example, social alienation contributes not just to suicide, but to all kinds of conditions like depression.
posted by No Robots at 10:13 AM on June 3, 2013


More on using "selfishness" as a descriptor:

Depression is a total fucking liar. A depressed brain will believe things and take action (or not take action) based on lies and misrepresentations.

The fact is, there is help for most people. We don't say "Ah, that person has cancer, perhaps it is best if she just let cancer take its course." We get medications and try to make that person better. Perhaps the first course of chemo doesn't work. We don't say, "Well, that person is stubborn and really wants to die of cancer." We try another course of chemo and radiation and try to get that person into remission.

Our understanding of mental health and its correlation to physical health (after all, our brain is part of our body) is pathetic.
posted by Sophie1 at 10:15 AM on June 3, 2013 [27 favorites]


why is suicide such a big deal

Because it scares people. It shakes the foundation that they have of life bring essentially meaningful or worthwhile and a lot of people desperately need that foundation. When one person commits suicide, others often start to examine life more closely and might be more able to come to the conclusion that their own life isn't especially that significant. Because life wants to persist, most humans instinctively try to avoid those lines of thought. Because If suicide was socially acceptable, a hell of a lot more people would do it, and it would seriously fuck up society. Because people are selfish. Everyone's selfsh, it's not a bad thing, but it means that if you matter to them they want to keep you around. Plus, people tend to take it personally, feel guilty or ashamed or whatnot. And it can traumatize the living.
posted by windykites at 10:17 AM on June 3, 2013 [4 favorites]


MeghanC- Death itself, personally, is not a big deal. The process that leads to that death however makes all the difference. I would be so lucky if years from now I can look back and say, "I've led a great life and done good things. It is now time to rest."

People who are driven to that choice out of desperation however? They go through immense amount of pain day in and day out in order to reach that decision. It is the pain that my fellow human beings have to go through that I find so distasteful.

An analogy that I can think of is prostitution. Sex can be and is a beautiful thing. If you enter the field willingly, more power to you. But those who are desperate and forced to this life because it's "the best of a collection of crappy options"? No...I do not find it acceptable at all.
posted by 7life at 10:18 AM on June 3, 2013 [8 favorites]


Spaltavian - I completely agree with you - that calling it selfish is immature and probably not the slightest bit helpful in actual practice with someone who is actively suicidal.
posted by Sophie1 at 10:18 AM on June 3, 2013 [4 favorites]


ishrinkmajeans - as someone who all to often ends up that same headspace, it's not that simple. Losing someone to suicide is not just a "sad for a little while and then be happy again." It's bereavement and then worse still, because there's also all the complications and what-ifs and self-questioning and guilt for not having prevented it. It's a ghastly, horrible thing for anyone to have to go through.

I can't speak for anyone else, but in my own ongoing fight with this question, the danger point is when the emotional pain of being depressed and suicidal becomes stronger than the guilt of being its cause. The point when I start trying to weigh up the balance of the pain inflicted against a lifetime of one-more-day, is the point I need help.
posted by talitha_kumi at 10:20 AM on June 3, 2013


Because it's one of the most horrific things you can do to another person? When I was 9, I walked in on my sister committing suicide.

It affects people very differently, really. I was a few years older than that when my father killed himself and while the actual experience of finding him was fucking traumatic, my experiences watching my mother, my grandfather, and my grandmother die very slowly and in enormous pain were far worse. Had my father not killed himself, it would have been 4 for 4 in Horrible Prolonged Suffering Deaths for my immediate family, and I'm glad he was able to escape that.
posted by elizardbits at 10:22 AM on June 3, 2013 [14 favorites]


This graphic ("Suicide Deaths per Hundred Thousand") on Wikipedia is very illuminating. It is derived from this OECD report, and specifically from this Excel spreadsheet. It gives data on suicide rates for 36 countries since 1960, and it shows that in fact the recent uptick in suicide rates is from relatively low levels (looks like the minimum for the US since 1960 was at 10.8 per 100,000 in the year 2000).

So it seems to me that the recent increase in suicide rates has not made the situation worse than it has been historically; we're still a long way from 1977's peak of 14.3 per 100,000, for example. But it does look like the trend has followed economic cycles pretty closely. It felt like the article was kind of dancing around that fact.

Knowing the historic trends doesn't, of course, lessen the feeling of hopelessness when society seems to not value us.

My gut prognostication is that society is moving toward a situation where we're expected to consume and produce as much as cheaply possible, as long as cheaply possible, until the point when we've outlived our usefulness and are then allowed to wither. And we're kept desperate all the while, allowing the rich to manipulate us and skim off as much as possible.
posted by jiawen at 10:23 AM on June 3, 2013 [2 favorites]


I want to go back to the "make people feel useful" idea. It doesn't make sense to me at all. Say there's someone who's out of work and feels like a burden, so I let him help me with some small task, or I even confide in him about my personal problems. Okay, so why didn't I seek his help before? Probably because he's not that useful to me; I'm really doing this mostly to help him.

But my friend wasn't born yesterday, after all. He sees through my ruse almost immediately, and in consequence he feels much worse than before. Now he knows he's so much of a burden that his friend is making up ways for him to help, so that he doesn't feel so much like a burden! Like a child who wants to "help" make dinner, but actually just makes a mess.

So it seems like personal worth, unlike material things, is completely impossible to give to someone else, by its very nature.

Oh, and if you were happily "helping" someone before, but having read this, realized I'm right: you're welcome!

God damn everything.
posted by officer_fred at 10:26 AM on June 3, 2013 [3 favorites]


The fact is, there is help for most people. We don't say "Ah, that person has cancer, perhaps it is best if she just let cancer take its course." We get medications and try to make that person better. Perhaps the first course of chemo doesn't work. We don't say, "Well, that person is stubborn and really wants to die of cancer." We try another course of chemo and radiation and try to get that person into remission.

That's not what we do. That's what the person with cancer chooses to do. They are also allowed to choose not to treat their cancer, or to try alternative treatments, or to say fuck you do their doctors and then go home. They're allowed the choice of treating something or not, even if the "or not" results in their death. "We" might encourage them to do one thing or another, but they're usually allowed to make their own decision and follow through with as much dignity as they can muster. Not treating cancer is an uncommon decision--not unlike suicide is an uncommon decision--and the outcomes are, I would imagine, often pretty much the same. But it's still a choice that we allow people, or, at least, that we allow people as long as they're physically, not mentally, ill.
posted by MeghanC at 10:30 AM on June 3, 2013 [4 favorites]


Yeah. Not allowing someone to kill themselves is pretty much just removing their agency.
posted by ishrinkmajeans at 10:37 AM on June 3, 2013 [1 favorite]


In a world where a depressed/suicidal person could make informed decisions, we would certainly allow them to make the decision to commit suicide. I am not against suicide in all cases. I genuinely believe that in some cases, which I will not outline here, suicide can be a "best option".

That being said, I wish people with depression or another mental illness were not able to make that decision in a vacuum.
posted by Sophie1 at 10:37 AM on June 3, 2013 [3 favorites]


But... isn't preventing someone from dying an even more selfish act? For the suicide all of life is pain and anguish and you want to force them to continue to feel that pain so you won't have to go through their separation with life.

There are three main scenarios where suicide occurs, in my view:

(1) I think most people who commit suicide do so in response to a problem that is temporary and fixable but they don't realize it because of their depression. Their action is one of desperation, done in the fog of mental illness and despair, and therefore they are not thinking clearly. We do not -- we should not -- let people make life-ending decisions, even the decision to end their OWN life, when they are in the grips of fear caused by an ultimately fixable problem.

In a sense, stopping someone from committing suicide is exactly the same as trying to save someone who is suffering from a heart attack. Both of these people are suffering from trauma/disease and it's fundamental to civilized society that they be saved to the extent possible.

What you are talking about -- the conviction that all life is pain, and therefore it makes sense to just kill yourself -- is depression speaking, which is a fixable condition (or perhaps you are trolling). So it falls under this first example.

But also falling under this category of "fixable" causes of suicide is economic crisis, and to me this cause of suicide seems almost worse than depression not associated with economic crisis because the latter seems more fixable to me. What's horrible about life in the U.S. is that life is very, very good if you're reasonably lucky. But if you're unlucky it is very, very, very, very bad. And I think the unavoidability of invidious comparisons between yourself when you are unlucky, and your peers, makes it far more unendurable to be homeless in the U.S. than it might be in another country where poverty is more universal and prosperity is not so (seemingly) universal. (What I mean is that any given newly-homeless person may be the ONLY homeless person he or she knows, and his or her friends may be relatively privileged people, making the homelessness sting that much more.) Suicides for people in a state of newfound economic privation are particularly troubling because there's not necessarily a "fix" for this through counseling and medication.

(2) A much rarer condition in which suicide occurs, I think, is when someone suffers from terminal illness and commits suicide to avoid a painful, lingering, undignified death. And for that, assisted suicide laws make sense.

(3) Some suicides make sense, I think, when a person has committed a heinous crime and doesn't want to face the shame and ordeal of prosecution and punishment.
posted by Unified Theory at 10:39 AM on June 3, 2013 [1 favorite]


I just want to clarify that my comment was referring to why i think society percieves suicide in general to be apalling or unforgivable. As someone who has been suicidal, I am immensely grateful that there are resources in place to help suicidal people survive- and I think addressing the causes and caring for people and preventing suicide is super important- bor not because I think suicidal people are "bad" or especially selfish. And of course, in the instance of a specific suicide, the reasons that the affected might be upset are much broader than those I outlined.
posted by windykites at 10:47 AM on June 3, 2013




For the suicide all of life is pain and anguish and you want to force them to continue to feel that pain so you won't have to go through their separation with life.

That is something that the suicidal person thinks is true. For some percentage of suicidal people, it is true, but given what depression does to fuck with your perception of the world, I'd be shocked if it's true for most people who commit suicide.

For a large portion of people who try to/commit suicide, that life of pain and anguish can be made better by treating their mental illness; I'd rather have people get that treatment than kill themselves, and having a strong societal prohibition against suicide is a good way to achieve that.

People who are terminally ill are entirely different issue, for me, and I think it's worth treating them separately.
posted by Bulgaroktonos at 10:50 AM on June 3, 2013 [5 favorites]


The delusional thoughts that I am doing my family a "favor" stem from a heartless, self-centered fear and self-pity.

I'm glad that this works for you. But another interpretation that doesn't impugn the thinker is that they're symptoms of a mental illness. You know, as you said, delusions.
posted by liketitanic at 10:50 AM on June 3, 2013 [2 favorites]


Unified Theory: "depression speaking, which is a fixable condition"

In theory, it's a fixable condition. I can tell you from twenty-plus years of relatively dreadful personal experience, which includes a crapload of therapy, medication, and unwanted side effects from said medication, that it is not always a fixable condition.

I'd also like to know how you're defining "fixable". Poverty is arguably "fixable". Chronic illness is, if not fixable, often controllable. Mental illness is sometimes controllable. That said, I'd argue that most people who find themselves seriously contemplating suicide as a release from these things don't actually have the means to fix their problem--which, from experience, only makes things worse. Like, your life could be so much better if only you could get the 10k to pay off this debt, or the healthcare to fix X and Y, or whatever. But those things are out of reach for many people, so their issues remain unfixed and, for them, unfixable.
posted by MeghanC at 10:50 AM on June 3, 2013 [18 favorites]


You guys did read the article, right? Right?
posted by Wemmick at 10:53 AM on June 3, 2013 [2 favorites]


Well, this is interesting timing since I was all suicidal and such on Saturday and spent the day trying to find a painless and 100% successful way to off myself. I did find a couple of methods, but they seemed like a lot of work and I'm kinda lazy. But what really put me off it was reading up on suicide attempts. It seems like a lot of people who seriously attempt it survive had second thoughts between the attempt and the rescue/survival. It would suck if you set up a helium thing and realized nope, I want to live, but couldn't get the bag off.
posted by nooneyouknow at 10:56 AM on June 3, 2013


A SIMPLE WAY TO REDUCE SUICIDES

Yeah...Let's not, y'know, try to help them in their depression/desperation. Let's just make it harder to get enough pills out of the packages. If that isn't an oblivious, all-American solution, I don't know what is.
posted by Thorzdad at 11:03 AM on June 3, 2013 [18 favorites]


nooneyouknow - I can't quite determine if you are serious or not. If you are not, this is no place for jokes. We have had MeFites commit suicide (as you probably well know) and I don't know of anyone who wished they couldn't have done something to help. If you actually do need help, please feel free to memail me.
posted by Sophie1 at 11:05 AM on June 3, 2013


Queue the indirect reference to the NA/AA sponsor system, which IMHO works so well because It's someone who isn't doing this as a part of their 9-5.

For my Dad, AA has been great. He's honestly a lot happier with himself, and he's been more open about what he's gone through. He's tried a few therapists, but he's dedicated to AA. He goes a couple times a week. I'm not sure what lead (or drove) him there in the first place, but I am happy for his sake that it did. I don't think suicide has ever been an option in his mind, but I don't know.

Being able to casually talk to people who are going through the same exact shit (or in some cases, much worse shit) than you is different than professional support. Especially in a culture of "pull yourself up by your own bootstraps," paying to talk to a "shrink" can be seen as personal failure. Heck, going to AA can be seen that way, too, but it's free to check out.
posted by filthy light thief at 11:07 AM on June 3, 2013 [1 favorite]


For anybody interested, I'd recommend checking out http://russelljohn.net/journal/2008/03/a-collection-of-suicide-notes/, which is a collection of suicide notes.

It seems to me that there are probably a lot of different mindsets involved in committing suicide; I'm not sure that looking at suicides as a monolith is going to be useful. There are definitely some selfish suicide notes, and some selfless notes-- I think the former give some evidence to people that want to describe suicide as a selfless act, evidence that they then use against all suicides (inappropriately, in my opinion).

Anyhow, I think a lot of people want to figure out some kind of big fix, when maybe all that's available are small fixes. From the article:

“I’m walking to the bridge,” begins a Golden Gate Bridge suicide note he cites. “If one person smiles at me on the way, I will not jump.”

Not going to work for every suicide, but for the others:

:)
posted by nathan v at 11:11 AM on June 3, 2013 [1 favorite]


Coping with war and natural disaster serves to distract us from the obvious: that our individual lives are empty and meaningless and that aspiring to some state of happiness and contentment is futile.
posted by Flashman at 11:39 AM on June 3 [5 favorites +]


So our individual lives are meaningless, but favorites are still worth giving?

As usual, humanity, you confuse me.
posted by benito.strauss at 11:18 AM on June 3, 2013 [4 favorites]


why is suicide such a big deal
This is a good question... but from a societal standpoint it's not really possible to formulate an answer that's equally as good. Here's the best explanations I can come up with as to why there seems to be a consensus on "suicide is bad, mmm-kay".

1) Every scenario is different. As mentioned previously there are valid reasons why someone of sound mind and body should be able to control how they leave this world. But as with any trip it should be planned. If your family member said they were planning on taking a trip next week/month/year, you'd have time to discuss/plan/prevent/come to terms with this. If you showed up at home and that person had already left it's a completely different story. I'd imagine it would be the same with suicide.

2) We don't have a valid frame of reference to compare something like depression to. Cancer is a disease of the body, but depression is of the mind. Making a decision like this requires a lot of decision making based on predictions and presumptions. (i.e. doctors predict that people will not recover) Depression is something that affects decision making, and since there is no quantitative value to "depression" we don't necessarily know whether individual persons are able to make those decisions without the negative influence of depression.

3) Due to the lack of information and lack of anything to validly compare it to we don't factually know if every instance of depression is "fixable". We have meds to "treat" depression, and some people may appear to grow out of it, but all of our medical information with regards to behavioral health is still in the realm of "well, this appeared to work for some other people, so we're going to hope it works for this person". Which of course subjects patients to innumerable side effects, some of which can be truly awful, under the guise of (4) below, which we don't really understand completely.

4) Humankind has some sort of weird built in self defense mechanism. Evolutionary-wise, this makes sense. Because of that humans are genetically predisposed to (through the thousands of years of humans that do NOT prescribe to this mentality dying out sooner than those who do, and possibly not procreating prior to their passing) valuing life. Unfortunately the best I can do to describe this is by parroting the nonsensical expression "Life is precious".
posted by Blue_Villain at 11:38 AM on June 3, 2013 [2 favorites]


"Why is suicide such a big deal? Why do we care so much if a grown adult chooses to kill themselves?"

Crisis counseling teaches that most suicides are born out of ambivalence, not conviction. There's also the mental health aspect; if one is not a rational actor, acting with correct information (the depressed brain is a liar), then the act of suicide can be a tragedy on a much deeper level. There's also what the broader trend of suicides can indicate on a societal level; an individual suicide may not mean much, and I think people are certainly within their rights to self-terminate, but if it becomes a trend or an epidemic, then the society may want to reevaluate the factors behind it (then again, it may not).

There are a number of ways of looking at suicide(s) that don't involve judgement/criticism of the person committing suicide.
posted by Eideteker at 11:45 AM on June 3, 2013 [5 favorites]


His girlfriend fretted about his tainted DNA.

This terrifies me, too. On my mother's side there's only one person in the two generations above me who hasn't made an attempt on their own life.

There’s an old joke in the black community, a nod to the curious powers of poverty and oppression to keep suicide rates low. It’s simple, really: you can’t die by jumping from a basement window.

My mom's family always told this joke about Puerto Ricans (before you get horrified, they are Puerto Rican), but I guess it's pretty plug-and-play ethnicity-wise.

posted by invitapriore at 11:48 AM on June 3, 2013


Yeah...Let's not, y'know, try to help them in their depression/desperation. Let's just make it harder to get enough pills out of the packages. If that isn't an oblivious, all-American solution, I don't know what is.

That's not the worst part. The part that really sucks my soul out my nose is that messing with the packaging actually works. If some stupid professor proposed that idea, but it turned out that people who wanted to commit suicide are actually pretty determined and it had no effect, that would be one thing. But it DOES prevent suicide! My God, my God.
posted by officer_fred at 11:50 AM on June 3, 2013 [2 favorites]


Fuck I don't know what it is, and I think idly postulating what the external triggers might be is not getting at it right.

I have a deeply ingrained belief that I have the right to take my own life at the time I choose, for whatever fucking reason I want, it's my life, not yours, right?

Seriously, I don't understand what is wrong with killing myself, but maybe then again I'm broken in the head and can't understand it.
posted by Annika Cicada at 11:52 AM on June 3, 2013 [1 favorite]


But it DOES prevent suicide! My God, my God.

Living: not as terrible as blister packs.
posted by the man of twists and turns at 11:55 AM on June 3, 2013 [18 favorites]


it's my life, not yours, right?
Tell that to your friends and family members. They're the ones who will suffer.
posted by Blue_Villain at 11:55 AM on June 3, 2013 [1 favorite]


I view suicide like the death penalty (and war). I don't align with the view that all life is precious without conditions. In the case of the death penalty, some people are just horrible animals and need to be put down. However, deciding who is the animal and who is not is fraught with issues of prejudice and misinformation, therefore I oppose the death penalty and war in practice most of the time -- even though if one could be 100% certain in all cases, I would support it.

Same with suicide. If we knew that people would always make the 100% rational decision about it, we could be more accepting. But people have mental illnesses, they have lapses in judgement (which could be considered temporary mental illness), and they can be coerced or abused. For this reason, I'm comfortable labeling suicide a "selfish" act as a preventative barrier which makes the exceptions (e.g. easing end of life for fatal diseases) more clear cut.
posted by smidgen at 11:57 AM on June 3, 2013 [3 favorites]


Blue_Villain: Tell that to your friends and family members. They're the ones who will suffer.

Other than being empty rhetoric, it kind of misses the point that a lot of suicidal people don't have very many connections. "Friends and family" being trotted out as the reason not to kill yourself backfires spectacularly with isolated and lonely people.

Attempts to guilt suicidal people are not helpful.
posted by spaltavian at 12:00 PM on June 3, 2013 [17 favorites]


For anyone reading this thread that's suffering, There is Help is a page collecting resources for people around the world in all kinds of different situations. Sometimes, talking to someone really does help.
posted by stoneweaver at 12:01 PM on June 3, 2013 [5 favorites]


I'd wager that the suffering of friends and family members after the suicide of a loved one is less than the suffering that drove the victim to take his or her life. The "suicide is selfish" narrative is absolutely victim shaming and harmful. If you read the article (you guys did read the article, yes?) Joiner argues that perceived burdensomeness is a risk factor for suicide. In other words, one of the risk factors for suicide is feeling like you're making the lives of others worse. The reasoning may be erroneous, but it is absolutely not selfish.

From the article:
“We need to get it in our heads that suicide is not easy, painless, cowardly, selfish, vengeful, self-masterful, or rash,” he says. “And once we get all that in our heads at last, we need to let it lead our hearts.”
posted by Wemmick at 12:09 PM on June 3, 2013 [19 favorites]


I've lost two friends to suicide in the last 10 years. I've also had two severely depressed family members die due to what I would consider a semi-suicidal passivity in the face of treatable diseases.

I have one friend that we all watch anxiously, because he has so many mental health and life problems that it's a kind of miracle he hasn't killed himself.

And I can understand all of them. Despite all our shiny toys here in the first world, our lives are still so precarious. Bad luck or illness could put most people on the street in a matter of months. Being so mentally ill you can't work also makes it nearly impossible to get help for your mental illness. Even those who are making money and relatively healthy are haunted by what could happen, or by what is happening to their friends or family. Injustice and environmental loss appear unstoppable. It's hard to believe in a happy future.

Maybe it's surprising the rate isn't higher.
posted by emjaybee at 12:13 PM on June 3, 2013 [5 favorites]


Where I work it seems to be a grim contest between young teens and military personnel. And it took this job for me to realize just how common suicide is. The youngest, a few weeks ago, was a middle school student.


I can't and won't judge people's pain. A decade ago I went through a depression so deep....let's just say since then I know I never will kill myself because I didn't do it then. But after that one episode-mind you, in the past, I had dealt with depression and its permutations and combinations for years-but after that one episode I could say I could really understand why someone would consider suicide.

That having been said, with many happy years since then, even through some really rough stuff in my personal life here and there, I am glad I stayed on this side of things. Suicide is permanent, and so much of what makes a person suicidal is temporary, or could be temporary.

If I could help just one suicidal person hold on just long enough to get past that particular abyss, all that pain was worth it.
posted by St. Alia of the Bunnies at 12:36 PM on June 3, 2013 [3 favorites]


Yeah...Let's not, y'know, try to help them in their depression/desperation. Let's just make it harder to get enough pills out of the packages. If that isn't an oblivious, all-American solution, I don't know what is.
That's not the worst part....messing with the packaging actually works....it DOES prevent suicide!


If package design changes are an answer that "works," then I think the wrong question is being asked. The right question is "why?" not "how" nor "how many?"

Despite all our shiny toys here in the first world, our lives are still so precarious. Bad luck or illness could put most people on the street in a matter of months....you can't work...impossible to get help....Even those who are making money and relatively healthy....Injustice and environmental loss appear unstoppable.

Then what about this?

The life-saving power of belonging may help explain why, in America, blacks and Hispanics have long had much lower suicide rates than white people. They are more likely to be lashed together by poverty, and more enduringly tied by the bonds of faith and family.
posted by cosmic.osmo at 12:38 PM on June 3, 2013 [1 favorite]


OK Wemmick. Thank you for pointing me to the last sentence of the article which BTW, I RTFA previously, but apparently didn't properly digest the last sentence.

I have, until now, thought about suicide as selfish in an academic context, but never as something that the suicidal were actually thinking. I knew it was delusion but I realize that just calling suicidality selfish, academically or not, was erroneous in the first place.

Thanks for the correction. Seriously. I learned something new today.
posted by Sophie1 at 12:49 PM on June 3, 2013 [6 favorites]


A SIMPLE WAY TO REDUCE SUICIDES

Eat the depressed?
posted by grog at 1:06 PM on June 3, 2013 [1 favorite]



When some sort of mental illness is involved I think it can be pretty tricky. I had an experience two years ago which gave me insight into just what happens when a persons brain gets out of whack. For many years I would go through bouts of 'winter blues'. It always happened in the winter. I struggled but got through it. That winter it just went really bad. Before I realized what had happened I was really, really down. Tired all the time and to the point where even taking a shower took a mountain of effort. Classic symptom of depression.

The worst though was the thoughts. I constantly thought about death and how easy it would be to just disappear all the time. Just lying on the couch and thinking. Going out a dealing with people, something I never had problems with before became incredibly hard. I go into a mild panic just trying to make it through buying groceries. It was all dark, dark, dark and no matter what I did I couldn't shake the thoughts. It was like my rational mind had been taken over by something uncontrollable. No matter what I did I couldn't think myself out of it. It was like a war was going on inside my head.

Although I didn't get to the point of actually considering doing anything to myself, one day what was still left of what I'd call my rational brain blazed in and I came to the realization that this wasn't right. I did have some reasons environmentally to be sad and down but nothing bad enough to actually die. What scared me most was that I could see and feel how easy it would be to go that route if my brain went down more. If that bit of the rational disappeared... I could easily see losing myself and finding a way to just leave existing at all. For me it wasn't just to escape any sort of specific pain. It was more like the mere thought of existing was just too much to deal with or not even that necessary.

I managed to drag my ass to my doctor who took my explanation super seriously. In my case, though most like influenced by outside factors the main problem was biological. I took a pill and within three weeks the 'dark' was gone. The difference was striking and to this day I find unsettling if I think about it too much. That so much of what I consider 'me' is based on my brain chemistry is sobering. Now I can't even make myself think in the ways that I was. My thoughts won't even go there for more then a few seconds. I was like a different person.

I have a whole lot more understanding of what it's like to be in that situation. At the time no amount what people would consider rational talking help would have helped. You have a family that loves and supports you. You have a lot to live for. Life isn't that bad because of x,y,z. All true. It didn't matter. My brain was just not capable of processing it in any meaningful way. I totally get it when people talk about killing themselves because it would be better for others in their lives and consider it a selfless act. Even a good act. At the time my head was in that space and that sort of thinking was rational. Now it seems foreign. I don't think that way at all but I remember quite vividly when I did.

I think that trying to understand more about how both environmental stressors as well as biological issues effect brain chemistry and 'thoughts' is important to understanding a dealing with some sorts of suicides. The brain is tricky. Since then not a whole lot has changed in my environmental situation. I live in the same set of conditions and will for some time. Yet I'm able to deal with emotionally and mentally just fine and feel happy and content most of the time. Who knows where I would be right now if I hadn't gotten the biological help that it seems I needed.

As I said before it's sobering for me to think about.
posted by Jalliah at 1:14 PM on June 3, 2013 [20 favorites]


So.. suicide is down, but we've gotten better at preventing cancer, heart disease, war and murder even faster than we have at preventing suicide?

Is that it then? You'd think that the people who are studying this would have taken that into account, before coming up with narratives explaining how changes in society or the economy must be making people miserable.

From this article though, it's not clear that they did.
posted by PJMcPrettypants at 1:39 PM on June 3, 2013 [1 favorite]


Suicide is an overriding of the instinct to survive with the desire to not suffer. This is one of the "gifts" of higher thinking, where choosing to not suffer can trump choosing to continue to exist.

That said, with the exception of assisted suicides in cases of terminal or catastrophically debilitating illnesses, suicide is a delusional, selfish act. It is selfish because of its immediate finality, thereby denying any chance of redemption, forgiveness, or a chance to apologize. Suicides borne of self-pity and/or anger are the proverbial middle finger at everyone who cares about you. If you have no one who cares about you, that loves you, and it is only you in this world, then it is what it is. You honestly weren't really participating in life anyway. But for those thousands who leave behind despairing, damaged and self-blaming families? I will not empathize with you.

You will never hear anyone arguing in the favor of substance abuse with the rationale that we should empathize with the person because being chemically altered is the favorable alternative to a life filled with emptiness, pain and suffering. Loved ones do not write them off, they do what they can to get them well. I drank for years to escape the loneliness, heartache and misery that was my life long before I took the first drink. It was the only solution I had found to my manner of thinking of this world and its people. I caused much pain to my family, whether or not I was in their vicinity. But I had the continuing opportunity to change, which I did after a bit over a decade.

And to my dear friend who killed herself three years ago:

I love you, but what you did was very wrong. Your daughter blames herself. To a certain degree I blame myself. Your grandchild misses you and your selfish decision has tainted us all. You and I, we were in the same boat, but there is always another way; I found mine. I understand the thoughts behind what you did, but I will never agree with your decision. I will never forget you.
posted by Debaser626 at 1:47 PM on June 3, 2013 [1 favorite]


Sarah Perry has written some thought-provoking material regarding the question of whether or not suicide is "selfish." While I don't agree with all of what she writes, I appreciate her empathetic perspective and would like to see the questions she raises more effectively addressed in our cultural narrative about suicide.

She has a book coming out soon called Every Cradle is a Grave: Rethinking the Ethics of Birth and Suicide. I look forward to reading it.

From the blog post I linked above:
"Those who characterize suicide as "selfish" tend to focus...on its effect on those left behind, rather than on the pain of the suicide, and whether it is fair to expect her to continue living so that her friends will not be deprived of her company. (Note that it is also common for them to characterize the suicide in demeaning ways, such as "dumb," "stupid," or "cowardly.") [...]

"...this is the essential disagreement as to the selfishness of suicide: whether it is reasonable to expect someone to continue to live a miserable life for the sake of the feelings of his friends and family. I suspect that most people...cannot imagine that life could be so bad that one's suffering could outweigh that of one's friends left behind. [...]

"Some people who feel that their lives are not worth living, and who would very much like to die, nonetheless continue living for the sake of saving their friends and family the sorrow that their suicide would entail. Is this merely what is expected of them? Or might we characterize their action in continuing to stay alive as particularly selfless?"
The discussion in the comments on that post is fascinating, too. For example:
"For those people who say suicide is selfish because other people's feelings may get hurt: How much money do you think these other people would pay to prevent the suicide? How much money would you pay to prevent a stranger's suicide? You know, you can usually increase a person's quality of life by giving them money, so that they can buy better experiences, or just stop working.

"It's funny how the anti-suicide league labels suicide as selfish, but is not ready to pay a free income to people who might otherwise be suicidal. Give me a thousand bucks each month for free, and thoughts of suicide will be gone for me for the next four decades or so. Life is hard work. If you're not ready to do that work for the lives of other people, you're not entitled to call them selfish if they refuse to do it either."
posted by velvet winter at 1:51 PM on June 3, 2013 [10 favorites]


If you have no one who cares about you, that loves you, and it is only you in this world, then it is what it is. You honestly weren't really participating in life anyway.

It's probably not the best idea to essentially call people worthless in a thread about suicide, no matter how much contempt you have for them. And it seems like people who have nobody that loves them deserve a lot more sympathy than scorn, regardless of context.
posted by parallellines at 2:16 PM on June 3, 2013 [17 favorites]


You honestly weren't really participating in life anyway.

Claiming to be the arbiter of who is an who isn't "participating in life" (whatever that even means) is fairly hypocritical when juxtaposed with accusations that others are delusional.
posted by kengraham at 2:17 PM on June 3, 2013 [7 favorites]


Suicide is an overriding of the instinct to survive with the desire to not suffer.

I remember reading an alternate hypothesis for depression caused suicides. I think it was brought up here on the blue.

The hypothesis is that depression is a way for the body and subconscious to force the mind into a crisis mode where it radically rethinks it's priorities in life. So if you're of a certain age and have yet to achieve certain benchmarks your body/subconscious essentially says "You have no idea why we're alive, let me make you miserable until you get your priorities more in line with mine".

I have no idea if this is backed up by research, but it jives with some of what I've seen and experienced.
posted by tychotesla at 2:28 PM on June 3, 2013 [2 favorites]


"You will never hear anyone arguing in the favor of substance abuse with the rationale that we should empathize with the person because being chemically altered is the favorable alternative to a life filled with emptiness, pain and suffering."

As someone who has worked with homeless using harm reduction services I saw that argument plenty. If we had free safe housing, occupational therapy and work rehabilitation (including modified jobs to meet disability needs)- living wages, and a society that worked to understand and emotionally supported the socially isolated and emotionally needy- I could see recommending people who are suffering to give these supports a chance before making a break for it or using painkillers (legal or illegal).

But since that is not in place I don't give a shit if the homeless and the unloved want to drown in heroin or booze or crack. If you're on the street and your life sucks, pot is way better at relieving stress for a lot of people than anti-psychotics which is why these drugs aren't as popular. They make people feel EVEN MORE LIKE SHIT. No thanks.

Anyone who doesn't like it should participate in more meaningful solutions than currently exist and yes that does involve money for research based solutions and human services- in addition to communities making social and interpersonal interaction more possible for the differently abled and socially isolated people.

Each person is unique and you don't know what it's like in anyone else's head or how hard they may have fought, be fighting, their external or inner demons. That you overcame yours doesn't prove how hard or not hard others fought against theirs even if they lost. I'm not saying I know either, some may not have fought at all, how would I know? It's not my place to know. Just to remember the strength of character I have seen among the suffering masses and that their journey's have mattered- to me... and that I believe with all my heart many of the most judged and hated people have tried more passionately than many could ever dream to love and be loved and be a good person to the best of their understanding. It's just the surviving horrible agony can sometimes detract from how well a person can bring those urges into fruition. And function... much at all.
posted by xarnop at 2:33 PM on June 3, 2013 [15 favorites]


The hypothesis is that depression is a way for the body and subconscious to force the mind into a crisis mode where it radically rethinks it's priorities in life. So if you're of a certain age and have yet to achieve certain benchmarks your body/subconscious essentially says "You have no idea why we're alive, let me make you miserable until you get your priorities more in line with mine".


This sounds evo-psych-y to me, and not very convincing. I mean, first of all, all kinds of people commit suicide -- not just ones who haven't achieved "certain benchmarks." Teenagers commit suicide. Rich people with important jobs commit suicide. People with loving families commit suicide. People with everything to live for commit suicide.

Obviously no single explanation fits all causes of suicide, but the depression-as-evolutionary-strategy theories seem as likely to me as a cancer-as-evolutionary-strategy theory.
posted by pocketfullofrye at 2:43 PM on June 3, 2013 [4 favorites]


I've said for a long time that probably the only reason I haven't tried to commit suicide is that I'm totally squeamish/wimpy about pain. And then I saw that Venn diagram, and I cried. I could feel the pain that I was suffering, not all that long ago, when my life looked great from the outside, but I felt like a horrible worthless friendless person, and all I wanted was to stop being. But I couldn't quite bring myself to buy a gun/jump off a bridge.

I changed medications, went back to therapy, and started getting more exercise. I'm feeling a lot better than I was six months ago. I'm so grateful that I haven't developed the capability for suicide.

(nathan v - thank you for the :) - sometimes when times are bad, little things like that really do help.)
posted by epersonae at 3:14 PM on June 3, 2013 [3 favorites]


Attempts to guilt suicidal people are not helpful.

i'd agree that's the wrong way to deal with a suicidal person at a crisis point, but you're glossing over something very important - suicide is often an act that has more than one victim

the survivors can carry the grief and guilt and confusion with them for the rest of their lives - i know from personal experience - my first girlfriend's suicide changed my life by triggering a depression that caused me to drop out of college and do all sorts of crazy things before i found myself on a much less predictable path then that of a national merit finalist who was going to be some kind of professional

last year i actually wrote an album about the whole experience dealing with her death - 36 years later - it seemed to have helped a lot, i'm more at peace with it now

i never blamed her - she was mentally ill and watching her fall apart was a horrifying experience for me - god only knows what it was for her

there are others - i just found out this year that a guy i hung out with in college had killed himself in 1985 - which is something that i don't understand - i would say that anyone who knew us in the mid 70s would have said i was a lot more likely to go that route than he was - he was together, hip, confident, artistic and had savoir faire - i was a self-medicated mess

what happened to him? - why didn't it happen to me? - how well did i really know him anyway?

suicide has consequences beyond one person's death - and it's not a guilt trip for those of us who express what we feel about those we loved who have killed themselves - we still have to deal with it, we still have to talk about it, and we still have to raise questions and consider the inadequate answers we come up with

we have a stake in this, too, and attempts to shame us by saying our words are "not helpful" aren't right - especially seeing as for many of us, we end up considering the act of suicide ourselves

and how can anyone truly say our stories of grief and confusion aren't helpful? - if one person reading what the survivors feel and think changes their mind about what they're thinking about doing, isn't that helpful? - and i have the feeling there are many people alive who've stepped back partially because they listened to stories like this
posted by pyramid termite at 3:53 PM on June 3, 2013 [6 favorites]


and how can anyone truly say our stories of grief and confusion aren't helpful? - if one person reading what the survivors feel and think changes their mind about what they're thinking about doing, isn't that helpful? - and i have the feeling there are many people alive who've stepped back partially because they listened to stories like this

I can't speak for anyone else. For me they're not helpful because in addition to the pains of depression and hopelessness, it increases the burden by adding the pain of guilt. It makes you feel worse, because in addition to feeling suicidal, you feel guilty and worthless and evil for hurting other people. Because knowing that doesn't stop you feeling suicidal - it just makes you feel even shittier.

I need to stop reading this thread.
posted by talitha_kumi at 4:14 PM on June 3, 2013 [10 favorites]


It does sound quite evo-psych, just-so story-esque. But, that just says it smells overly convenient, not that it's unsound. Here's a Scientific American article with relevant links. The academic criticism I've seen so far seems to be focused on the implication that depression shouldn't be thought of as a serious illness, rather than on whether the core idea is valid. And again: interesting hypothesis, not to be accepted as fact.
posted by tychotesla at 4:22 PM on June 3, 2013 [1 favorite]


there was a philsopher - perhaps Schepenhour? - who argues that in a meaningless world the only question is why NOT kill yourself?

i find answers to that daily, but they're provisional
posted by Charlemagne In Sweatpants at 4:23 PM on June 3, 2013 [1 favorite]


That's the first (and only) philosophical question of Camus, CiS. If you were trying to google, the name you wanted was Schopenhauer.

Why do we care so much if a grown adult chooses to kill themselves? [...] I would argue that for many people, suicide is a pretty rational act, especially in countries with little or no safety net.

A state where dying due to lack of access to a safety net is a rational choice is a sign of warped priorities.

You honestly weren't really participating in life anyway.


No man is an island,
Entire of itself,
Every man is a piece of the continent,
A part of the main.
If a clod be washed away by the sea,
Europe is the less.
As well as if a promontory were.
As well as if a manor of thy friend's
Or of thine own were:
Any man's death diminishes me,
Because I am involved in mankind,
And therefore never send to know for whom the bell tolls;
It tolls for thee.
posted by ersatz at 4:47 PM on June 3, 2013 [3 favorites]


Asking why it's a big deal if grown people commit suicide is like asking why it's a big deal if people die of kidney failure. I mean they're grown adults, and if they just want to die of kidney failure why shouldn't we let them?

Depression is an illness and one of the most common ways this illness kills you is suicide. I agree there might be environmental, sociological, and genetic causes for the changes in brain chemicals that lead to suicidal behavior but it's sad that people are still seeing this as a philosophical issue instead of a medical one.

Suicide is a public health crisis.
posted by sweetkid at 5:28 PM on June 3, 2013 [1 favorite]


Asking why it's a big deal if grown people commit suicide is like asking why it's a big deal if people die of kidney failure. I mean they're grown adults, and if they just want to die of kidney failure why shouldn't we let them?

No, that's a pretty terrible analogy. Whereas suicide can be borne out of mental illness or rational choice, kidney failure is only brought about by illness.
posted by spaltavian at 6:06 PM on June 3, 2013


I don't believe it's brought on by rational choice, at least not to the degree some people in the thread want to believe (euthanasia aside)

I agree my analogy is flawed but suicide caused by depression is caused by chemical problems in the brain. As far as I know, we haven't correctly been able to link exactly how environmental or societal causes may create these problems. So a choice that seems rational may not be.
posted by sweetkid at 6:13 PM on June 3, 2013


In past decades, many people stayed in bad marriages "for the kids", but I think most people now agree that the poisonous atmosphere of a bad marriage is worse than a divorce. Suicide is like a divorce from everyone. Sure it hurts them, but is it worse than forcing them to live with your depression indefinitely?
If mental illness deserves the same respect as physical illness, and if we feel that a person with a terminal physical illness should be allowed to end his life, then we should not stop someone with the terminal illness of depression from ending his life either.
That's why I support education about the relative merits of different suicide methods. For example, I've heard that although a Tylenol overdose is pretty reliable, it's slow and unpleasant, killing your liver but giving you plenty of time to suffer.
posted by Tool of the Conspiracy at 6:18 PM on June 3, 2013 [2 favorites]


By the way, do you know that when you google suicide, it gives you a hotline number above the results?
posted by Tool of the Conspiracy at 6:23 PM on June 3, 2013 [2 favorites]


Debaser626, it is noble of you to vow never to forget your friend.

Infinitely more difficult is finding some way to forgive her.
posted by MoTLD at 6:34 PM on June 3, 2013


sweetkid: "Asking why it's a big deal if grown people commit suicide is like asking why it's a big deal if people die of kidney failure. I mean they're grown adults, and if they just want to die of kidney failure why shouldn't we let them?"

We do, if they don't want to be treated for it. We don't force medical treatments on people in most circumstances. If someone is actively contemplating suicide they may be placed under involuntary psychiatric hold for a period of time. However, if someone is simply depressed there is no legal mechanism to force them into treatment. It's similar to substance abuse. A person may be destroying their life by drinking, but that is ultimately a choice each person makes to drink or to be sober. The agency we recognize in people, the right to make choices about our own health, is itself an important component to healing.
posted by krinklyfig at 6:45 PM on June 3, 2013 [1 favorite]


South Korea has the highest suicide rate in the OECD. The suicide rate here has doubled in the past decade and increased five-fold since 1989.
posted by stavrosthewonderchicken at 7:38 PM on June 3, 2013


Any personal thoughts on why that might be, stavros?
posted by MoTLD at 7:41 PM on June 3, 2013


I could write a book. ;-)
posted by stavrosthewonderchicken at 7:42 PM on June 3, 2013 [1 favorite]


Give us the first chapter. ;)
posted by MoTLD at 7:46 PM on June 3, 2013


The hypothesis is that depression is a way for the body and subconscious to force the mind into a crisis mode where it radically rethinks it's priorities in life. So if you're of a certain age and have yet to achieve certain benchmarks your body/subconscious essentially says "You have no idea why we're alive, let me make you miserable until you get your priorities more in line with mine".

In my reading this tends to show up more with lower levels of depression, when people are proposing it as an evolutionary model. The sort of thing that everyone experiences from time to time, but not so much as major depressive disorder. That obviously doesn't appear to have as much adaptive value. Similarly, minor levels of anxiety might lead you to pay attention to important environmental cues, but disorder-level anxiety would get in the way of that.

posted by bizzyb at 7:56 PM on June 3, 2013


For people who seem not to have read the article:

This guy has a novel and newish conception of suicide, three overlapping circles. If you are in only two of the circles, well, things suck. But if all three apply to you, then things look like suicide.

In no real order, those circles are:
  1. Feeling disconnected from other people (like you don't belong)
  2. Feeling like you are a burden on other people (needing help)
  3. Not being afraid to die.
So often people begin an attempt and don't follow through because they're afraid of the pain, or hell, or some other aspect of death(1). Are contemplating an attempt but then get called upon to help with a task and realize they contribute something to the world(2). Or begin an attempt with the idea that if "one person smiles" they won't do it(3).

When people choose suicide, it's not always based on rational examinations of facts. Feeling like you are a burden can happen to anyone. Feeling disconnected from others is a really common problem. Being unafraid of dying, well, we're training a huge cohort of young people to be willing to "make the ultimate sacrifice."

So ya. It's a public health problem. And we should care. Especially because "not being afraid to die" doesn't have to last for weeks and weeks to lead to suicide. In fact, it can just be minutes. So working hard to address ALL THREE circles is important.

Also, Some people do find themselves with kidney failure as a result of "conscious choices," after years of being told for years to exercise more, reduce blood pressure, stop drinking so much, eat less salt. That doesn't make it any less awful when they die for lack of an organ transplant.
posted by bilabial at 8:01 PM on June 3, 2013 [6 favorites]


Thank you, bilabial, for that slap in the face. ;)

I confess I hadn't read it, it's a long article. That's why I hadn't commented more substantially. But your assertion that this represents "a novel and newish conception of suicide" and your summary got me over my inertia and I'm reading it right now.
posted by MoTLD at 8:18 PM on June 3, 2013


I just realized Wemmick had also tried, but apparently it wasn't quite a hard enough kick in the shin for me. ;)
posted by MoTLD at 8:21 PM on June 3, 2013


When people choose suicide, it's not always based on rational examinations of facts. Feeling like you are a burden can happen to anyone. Feeling disconnected from others is a really common problem. Being unafraid of dying, well, we're training a huge cohort of young people to be willing to "make the ultimate sacrifice."

So ya. It's a public health problem. And we should care. Especially because "not being afraid to die" doesn't have to last for weeks and weeks to lead to suicide. In fact, it can just be minutes. So working hard to address ALL THREE circles is important.

Also, Some people do find themselves with kidney failure as a result of "conscious choices," after years of being told for years to exercise more, reduce blood pressure, stop drinking so much, eat less salt. That doesn't make it any less awful when they die for lack of an organ transplant.


Yes, all of this.
posted by sweetkid at 8:26 PM on June 3, 2013


Give us the first chapter.

I thank you for the request, but today's not a day I'm going to be able to do justice to it -- it's a Big Question that isn't all that conducive to summarizing, I don't think, or at least my take on it isn't. I'll keep it in mind as a longform piece for my recently-launched Korea-focussed blog thing, though.
posted by stavrosthewonderchicken at 8:50 PM on June 3, 2013 [2 favorites]


If you have no one who cares about you, that loves you, and it is only you in this world, then it is what it is. You honestly weren't really participating in life anyway. But for those thousands who leave behind despairing, damaged and self-blaming families? I will not empathize with you.

No. No no no. Depression isn't about objective reality. It is not that there is Literally no one who cares about you, that loves you. In fact, it is that the brain has convinced a person that no one cares. The brain says sneakily, believably, that the depressed person doesn't even deserve to be cared about. That the people left behind are burdened by the existence of the suicidal person and will be better off after the suicide.

And here's an interesting thing. People who have a strong sense of connection to other people...believe they deserve it. People who don't have these connections tend have lots and lots of shame that keeps them from feeling deserving of connection, belonging, affection. That shame? It doesn't just magically spring up from nowhere. Not everybody's shame comes from the same place, but our society is pretty shame based these days. Body shaming, success/failure shaming, political shaming, sex shaming. Making things on what people are instead of their actions. (calling people who make terrible choices "monsters," calling women "sluts" if they have sex we don't approve of, telling people "you should be ashamed of yourself" when they don't treat us the way we expect. We learned this stuff somewhere, so unlearning it is going to be hard. But if we don't unlearn it, we are going to become more and more disconnected.

Connection isn't the only portion of this equation. But it is something we can all work on.
posted by bilabial at 9:24 PM on June 3, 2013 [13 favorites]


"The hypothesis is that depression is a way for the body and subconscious to force the mind into a crisis mode where it radically rethinks it's priorities in life..."

This hypothesis actually resonates with me with regards to lesser forms of depression, but I couldn't say it applies to the type of depression that leads to suicide. When I was in my late 20s, I suffered a 6-month long depression that for me was serious in that I never had experienced anything as unexplainably deadening as this. I had a great-paying job, lived in a great place and had a wide social circle yet I was miserable, sleepless and emotionally flat. I ultimately sought professional help, through which I soon came to realize that everything in my life was to meet others' expectations--that I didn't enjoy what I did for a living, wasn't the go-getter type that I pretended I to be as and therefore didn't relate to anyone in the social circle I was in; and found the big city to be too overwhelming for me. So I changed everything, moved across country, became an artist (which I had always wanted to be but would have never dared express when I was younger) and began doing legal secretary work to pay the bills. Since then, I've never suffered another depression. So yes, in my case, the depression was like being called off the field to rethink my priorities and strategies. And, in fact, I always look back at that depression as a godsend. That being so, I've known others whose depression isn't so linked to oppressed desires or false sense of self but are rather more biological in nature or due to dire circumstances and to them I feel it is rather dismissive to say 'hey look at it this way, your depression, it's just a wakeup call.'
posted by SA456 at 10:08 PM on June 3, 2013 [3 favorites]


How does someone distinguish when someone is suicidal or if they have a death wish?

I notice that in the list of countries by suicide rates that countries with higher unrest, conflict, crime, or disaster seem to be lower on the list. Now, maybe numbers in those countries are harder to get accurate stats for, I recognize that. But, perhaps some of the people who end up being killed in violent conflict or crime were suicidal too, it just gets classified differently because they were killed by someone or something else. I guess this is kind of like "suicide by cop" writ large? That could possibly account for the difference.
posted by FJT at 11:45 PM on June 3, 2013 [3 favorites]


I'm not sure if this has been mentioned or not, but people who are depressed generally don't commit suicide at the bottom of the depression (generally you don't have the energy to plan any act), but as the depression lifts (energy comes back, but thoughts remain.)

Also, a major problem of mental illness (depression, bipolar, schizophrenia, etc.) is that it inherently isolates people and makes them feel like a burden (suicidal desire), even when the symptoms are in remission (apparently there is increased risk when someone with schizophrenia starts their meds, as they become aware of their situation. http://www.schizophrenia.com/suicide.html)

It's hard to maintain a job and a loving relationship with a mental illness. It's virtually impossible to acquire either with a mental illness. At least there are ADA rules about disabilities that mitigate the job side; good luck having understanding family, friends, and especially a SO. Perhaps an acknowledgement that even the ill have a sexuality would help here. "You are loved" by family and friends isn't going to resolve this issue.

I guess my point is for people who suffer from a mental illness, lowering the suicide rate requires a real, sincere attempt to give them some sense of belonging or worth. Simply trying to keep them from having the ability to die is equivalent to trying to plug a leaky dam with a finger; better to drain the reservoir first, even if that's the harder problem at first.
posted by tservo at 3:06 AM on June 4, 2013 [7 favorites]


I've tried not to overwhelm the internets with excess research based stuff, but from a biological immune and allergic reactions can cause inflammation in the brain- which interestingly MAKES PEOPLE FEEL MORE SOCIALLY DISCONNECTED.

When connected to this hypothises- it ads to how important it is for us to understand the human immune system and to address bacterial and fungal/yeast imbalances that we currently tend to overlook as unumportant and aren't very good at successfully treating. Candida, athlete's foot,helicobacter-- there are tons of medicine resistant chronic infections people tend to live with and not know about that can be causing all kinds of minor physical discomforts in the body that people then want to treat with alcohol or drugs- or just feel emotionally out of wack and unloved for "no reason".

Also the relationship between inflammation and loneliness GOES BOTH WAYS- loneliness increases inflammatory responses-- leading to a cycle that could have been caused by either biological or social facters. Inflammatory cytokines don't tell us exactly what the body is responding to- just that it's responding to/working on something. There is likely much more to the story but so far we've got some leads on the relationship between emotions and physical responses inthe body and the ways these interact in feedback loops.

The exciting thing about this is that we can study more closely what social factors tend to cause negative or positive physical responses in different types of people and use that to create better emotional and social supports for people that seem to match physical health needs. I.e. creating evidence based systems of social support and healthy human environments instead of just totally guessing.
posted by xarnop at 4:19 AM on June 4, 2013 [1 favorite]


This was a fascinating article, especially for the Venn diagram of what drives suicide.

Those who are feeling depressed or otherwise in crisis may find this list of resources helpful: http://mssv.net/wiki/index.php/ThereIsHelp
posted by Brandon Blatcher at 5:16 AM on June 4, 2013 [1 favorite]


I guess this is kind of like "suicide by cop" writ large? That could possibly account for the difference.

One of the things that bubbles up from the recess of my memory is a study that tracked suicide rates with single-vehicle car accidents. Intent can be almost impossible to discern.

I wonder how many "industrial accidents" were actually suicides? The long-term drop in heavy industry, construction, or manufacturing jobs reduces opportunities for "accidents" and drives people to seek more deliberate, obvious methods - methods that show up in studies.

I've tried not to overwhelm the internets with excess research based stuff

I love links! Links to research are great! More please!
posted by the man of twists and turns at 5:30 AM on June 4, 2013 [3 favorites]


I'm late to the party, but I work for a crisis hotline service. Suicide prevention is not all of what we do, but it is a part we pay a lot of attention to. I've had occasion over my time here to speak to the survivors of suicide (both those who have attempted and been rescued, and the families of those who've completed suicide). I would say my experience with the attempters vary - some of them have been very glad to have received intervention and are moving forward in very positive ways; others are still grappling with their ambivalence and issues. The families, however, are always struggling and looking to us to provide some information and understanding about what happened and what lead to this moment. Which presents it's own ethical problems around disclosure (confidentiality still applies, even when the person is deceased) but at the same time we are working with a family/person in crisis over the loss.

In terms of the ethics of suicide and suicide prevention, I've been finding this article(abstract only, sorry) interesting:
Although the basis for the moral acceptability of suicide has varied throughout history, two diametrically opposing moral positions, and an intermediate relativist position, can be characterized...

(moralist position) One the one hand, there are those who believe suicide is essentially wrong. Plato held that suicide is an immoral act because it is fundamentally irresponsible in that it permanently destroys a person's relationship with society...In Christian philosophy...suicide is considered intrinsically wrong because it goes against the Sixth Commandment...Other arguments, which date back to Aristotle, contend that suicide harms other people and the society in which one lives...These obligations to society are reflected in the more elevated contemporary argument that taking ones life has disastrous effects on the person's family and friends.

(relativist positions)...the acceptability of suicide and obligations to intervene vary, either according to the situation or context, or the anticipated consequences of action or inaction. Contextualists believe that in some situations, for example when a person has a terminal illness, is very old, or has experienced a humiliating defeat, suicides may be morally acceptable...Consequentialists assess the moral acceptability of suicide and the obligation to intervene in terms of beliefs about the effects of the suicide on the individual, other people, or society. Saying that someone is "better of dead" is a consequentalist argument, as is the justification of suicide prevention against the will of an attempter by the contention that most people when saved are happy to be alive...

(libertarian postions) Arguments that suicide is morally acceptable are usually based on the concept of free will to choose the manner and timing of one's death and people's "rational" abilities to weigh the evidence and choose to end their own lives...In contrast, those who argue against the acceptability of suicide may use...the more popular current contentions that persons who commit suicide prima facie suffer from psychiatric disorders and are thus unable to make a rational choice...the psychiatrist Thomas Szasz contends that the concept of mental illness has replaced the concept of sin in explaining why a person commits suicide...He contends that in a free society one must be free to choose the option of committing suicide...

...the possibility that some suicides may be rational can be debated...The philosopher Jacques Charon connected rational suicide to the following criteria: 1) there is no psychiatric disorder, 2) there is no impairment in reasoning, 3) the person's motives appear to be justifiable or at least understandable by the majority of contemporaries in the same culture or social group. Choron's first requirement...eliminates the majority of suicides since most person who die by suicide suffer from a mental disorder...Given these data, are we justified in asserting that rational suicide, if it exists, is a phenomenon which can only characterize a small minority of suicides?...Even when the person who commits suicide does not suffer from a serious mental disorder, their suicide may still be irrational by any standard; for example when a person is in a temporary state of extreme agitation or depression or his views of reality are grossly distorted by drugs or alcohol

...the psychiatrist Roland Maris has argued that suicide derives from one's inability or refusal to accept the terms of the human condition, that suicide may be seen as effectively solving the problems at hand and non-suicidal alternatives may not do so. In his view, although no suicide is ever the best alternative to our common human condition, for some individuals, suicide reveals and individual's logical response to an existential human condition.
I saw some gender differences stuff being explored earlier in the thread as well - this article is interesting on that front.
posted by never used baby shoes at 10:06 AM on June 7, 2013 [4 favorites]


Qaujivallianiq Inuusirijauvalauqtunik - Learning from lives that have been lived. A McGill follow-back study on suicides in Nunavut.
posted by nubs at 10:57 AM on June 8, 2013


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