Suicide is a difficult subject to talk about because of the discomfort and unease it evokes in people. So many negative connotations surround the issue that it has become somewhat of a taboo to discuss it in public. Those that do speak out, often do so too late, after a tragedy has befallen someone they love or were close to. But suicide is a matter of public health and needs to be confronted as such.
A recent report from the CDC (link to the report) states that suicide rates among U.S. adults between the ages of 34 and 64 have increased nearly 30% between 1999 and 2010. This translates into about 38,000 suicide deaths a year, a number that now surpasses the number of people killed in traffic accidents annually. As the report mentions, these numbers are more than likely an underestimate because many suicide deaths are reported as due to some other cause. In addition, these numbers do not take into account the number of suicide attempts that occur each year. By some estimates, for every “successful” suicide there are between 10 and 20 “unsuccessful” attempts, and even this is simply a best guess determination.
There has been relatively more attention payed to suicides in the military, but coverage is still inadequate. In 2012, military suicides outnumbered combat deaths (link to NPR article), and it is estimated that one U.S. veteran kills him or herself every 65 minutes. Undoubtedly, the horrors of combat contribute to these alarming statistics, but most of these deaths occur after the soldiers return from fighting. This seems to indicate that there is inadequate mental health care for the troops, and without proper treatment, post-traumatic stress disorder (PTSD) and other psychological disturbances push some veterans over the edge.
Military suicides are sometimes dismissed as an unfortunate consequence of our prolonged “war on terror,” and as previously stated, there is some validity in this statement. But what then accounts for the surge in the number of suicides among civilians? There has to be some larger societal cause for the increase, but it seems as if very few attempts have been made to identify this cause. In an editorial that followed the CDC’s report, the authors state the following:
Possible contributing factors for the rise in suicide rates among middle-aged adults include the recent economic downturn (historically, suicide rates tend to correlate with business cycles, with higher rates observed during times of economic hardship); a cohort effect, based on evidence that the "baby boomer" generation had unusually high suicide rates during their adolescent years; and a rise in intentional overdoses associated with the increase in availability of prescription opioids. Additional research is needed to understand the cause of the increase in age-adjusted suicide rates and why the extent of the increase varies across racial/ethnic populations.
In essence, they attribute the rise in suicide rates to the poor economy, the indication that “baby boomers” are just more prone to commit suicide, and increased drug use. As to the racial and ethnic variations, suicide rates increased across all groups, but was greatest among Native Americans and Whites (+65.2% and +40.4%, respectively). Irrespective of these variations, the causes listed by the CDC offer an unsatisfactory explanation as to why suicide rates have shot up over the past decade. Yes, the economy has impacted the lives of millions of Americans, and there is a documented, statistical correlation between economic depression and suicide deaths (abstract of journal article, another journal article with a more global perspective). However, the increase began well before the most recent downturn, and rates have continued to go up even as the economy improves. In addition, the U.S. has a higher suicide rate than many European countries that suffered a far greater and more sustained economic downturn. It therefore seems unlikely that economics are the majority factor in suicide deaths. The so called “cohort effect” isn’t really an explanation at all. Stating that “baby-boomers” are more likely to kill themselves because their generation had higher rates of suicide in adolescence is circular reasoning. Finally, while there is definitely greater access to potentially fatal drugs, suicidal individuals generally resort to the most accessible means to end their life. Take away the prescription pills, and they will turn to Tylenol (yes, you can kill yourself with Tylenol, but don't get any ideas), or guns, or whatever. Someone set on killing him or herself will find a way, so again, increased drug usage doesn’t fully explain the uptick.
Of course, the justification that a person uses to take their own life will vary among individuals, and there is almost always an underlying mental disorder that contributes to the sense of terminal hopelessness that precedes suicide. A certain subset of the population may have a psychological predisposition to interpret negative life events as more onerous, but people with such an inclination do not universally commit suicide. From an evolutionary perspective, any genetic factors that contribute to suicidality would tend to be self-limiting, assuming that the person kills him or herself before having children. Even when a suicidal person does have children, there is no guarantee that his or her children will have the same tendency. While there is a correlation between a parent committing suicide and an increased likelihood that their children will also kill themselves (article describing linkage), it is arguable that this risk factor is purely experientially based, i.e. not hereditary.
So we are back to external factors. What has changed in the last decade or so that would lead to increased suicide rates? Perhaps, the more appropriate question is “what hasn’t changed?” I believe that rise in suicide deaths is attributable to societal changes that have negatively impacted the individual’s sense of belonging and overall contentment with life. This is not a novel supposition by any stretch. In 1897, Emile Durkheim used the word “anomie” to describe the breakdown of social norms and the disconnect between personal beliefs and societal expectations and standards. Alienation, either real or perceived, can give rise to helplessness and hopelessness, and lead the abandoned soul down dark roads. Modern society is set up in such a way to simultaneously crush individuality and isolate the individual; it tells a person to conform with the masses and cut the ties to those closest to them. Societal expectations are unachievable in that they literally cannot be achieved; one can never be rich enough, or successful enough, or powerful enough, or own enough stuff. The inevitable failure to attain the absolute in everything leads to a sense of failure and rejection.
Some blame can be placed on mankind’s own creations. Technological advancements have led to incredible societal changes and vice versa. The explosion in cell-phone use, high speed internet access, texting, tweeting, and other social media has giving rise to an always on, hyperconnected world. We can be bludgeoned by information and overwhelmed with news (typically bad) to the point of emotional disturbance. At the same time, people can have a thousand or more “friends,” and at the same time have no one to talk to face to face.
Along those same lines, erosion or personal relationships and group belonging has cast many people into a sea of despair. While I do not lament the general shift away from religion, I must give credit to the more traditional religious institutions’ almost unparalleled ability to provide a sense of belonging and cohesiveness. Modern religion is superficial and self-serving, providing temporary reprieve from the outside world, but not fostering and real personal development. Humanist and other secular groups have had difficulty establishing themselves as credible alternatives. As a result atheists and agnostics may encounter profound isolation even though more people reject religious beliefs everyday.
It seems that a person can be beholden to everyone yet cared for by no one. We are expected to be everywhere at once, to excel at work while cherishing the family, to absorb everything that is thrown at us, to not complain, and to never show any sign of weakness. And so we silently break inside. Some manage to hold the pieces together, but an increasing number of people crumble to the ground. Their broken selves are viewed as worthless in their own eyes, and then what is the point, really? In some terrible sense they are right to think in such a way; there is no clear-cut and easy solution to society’s ills. But to simply give up when one has the ability to at least attempt to transform his or her immediate situation? This is shortsighted and selfish. If a person stops and honestly thinks, they will most often find that they don’t want to kill themselves, but instead only want to end their current life situation. Not finality but change. This is what needs to be promoted: that each person has the ability to alter their own life in some way, no matter how seemingly minuscule, and even if it is simply by reframing their way of thinking. Seeking help is change in itself, and should be lauded not looked down upon. If life seems like a fight, then consider it a challenge where winning takes the form of persevering through each daily struggle; to endure is to succeed. These messages may be lost in the constant noise of our lives, but the more we address the issues that are causing suicide rates to increase the greater chance that they will be heard.
Well done!
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