There’s an image that goes through my mind frequently these days. At the end of the fabulous Powell-Pressburger movie, The Red Shoes, despite the suicide of the prima ballerina, the ballet goes on. A dancer carries the ballerina’s red shoes around the stage in her place.
The suicide rate in the U. S. has gone up. The Wall Street Journal attempts to explain the possible causes:
There are at least two possible explanations, Dr. Crosby said. One is the economic downturn: Suicide rates have risen historically during difficult economic times, when job prospects diminish. The CDC tied increases in suicides to foreclosures on homes and evictions several years ago, he said.
Secondly, abuse of prescription painkillers, heroin and other lethal drugs has risen over the past decade and a half, he said. The rate of overdose deaths from opioids, including prescription painkillers and heroin, tripled between 2000 and 2014, according to the CDC. Those deaths include suicides.
Other possible factors: Many people don’t seek or have easy access to mental-health services, including some people who have attempted suicide before, Dr. Caine said. Domestic violence, social dislocation, and chronic medical problems also sometimes play a role, he said.
Some researchers say the vexing rise in suicides among the middle-aged may be the result of a baby-boom generation known for suicides in its youth reacting in a familiar way to new troubles in its older years. “As that population has been aging and become middle-aged, there’s probably a cohort effect,†said Christine Moutier, chief medical officer of the American Foundation for Suicide Prevention, which funds suicide research.
Something else reported: the increase is particularly notable among middle-aged white women. Unless you think that for some reason the explanations proffered fell particularly heavily on middle-aged white women, that sounds inadequate to me.
As with the dancer carrying the red shoes around the stage, there’s something missing.
I don’t know about this specific baby-boomer risk, but it does seem that (a) the religious decline has been accompanied by a reduction in a moral objection to suicide, and (b) there is a radical individualistic view expressed in places like OTB that all men are an island unto themselves and no legitimate objection to suicide can be asserted based upon that individual’s worth to others.
A distant relative killed himself this week, if an in-law of an in-law qualifies as a relation. He was a doctor, about Prince’s age, that killed himself in his office. His obit states how he would like to be remembered, which no father has a right to expect when he’s abandoned a young child. It is a sad and difficult situation, which I would hope to be addressed with sympathy and realism, not flights of fantasy.
That’s something you frequently hear from objectivists. I’ve been arguing against it for decades. I don’t think it’s a view that’s easily held if you know even a little about anthropology or psychology.
However, it’s an idea that’s hard to argue against if human nature is infinitely malleable.
Condolences, PD.
Condolences, PD.
We definitely think differently about the ability of a person to control their own fate. Suicide is a symptom rather than a choice in the same way that alcohol or drugs are attempts to self-medicate. There’s a lack of scepticism, a certainty, that rubs me the wrong way even though I kind of agree that mental illness is a devastating cause.
Pairing up the data with economic data seems really inadequate. Surely the funding for suicide prevention should allow for studying patterns in the individual cases, to find trends? How many were taking SSRIs, how many really were feeling the impact of economic downturn, how many dealing with divorce or other relationship issues, how many diagnosed with mental illness, how many were socially isolated, etc.
It really shouldn’t be that hard or expensive to look at these factors and find trend lines that could point to potential interventions.
From what I know, having access to SSRIs is a lot different from having access to SSRIs and a therapist.
The rise in opiates is also puzzling. It’s presented as if opiates are things that are easy to get addicted to. In a certain sense, they are. But you also have to have a real appetite for that kind of drug. It’s not like cocaine, which most everybody likes if they try it. I had Fentanyl IV’d into me recently, and I couldn’t get it out of my system fast enough.
Cant remember if I said this before, but my partner and I were tasked with redoing our policies on opiate usage in our network. It turns out we have zero addiction specialists in our network, same as our competitor network. Few networks have them. Mental health, especially as it pertains to drugs, is not funded well. Doesn’t pay well either of the most part.
MM- You may not like narcs, but lots of people do. big problem in the trade. I have successfully resuscitated friends and co-workers who OD’s on narcotics, and had an unsuccessful attempt also. We have discussed the narcotic epidemic before. It is the result of bad marketing, outright lies in some cases, bad medicine by the profession, bad culture, the War on Drugs and indifference.
Steve
The various drugs used for mental health are not mind candy even though they are tossed out like they were. These are powerful drugs that alter the brain’s chemistry. For many people with mental illness, the brain’s “juices” do not have the correct chemical make-up, and the pills are used to get it back to normal.
These drugs are like insulin to a diabetic. For the diabetic person, they can be life-saving, but for the non-diabetic person, they can be deadly.
@PD Shaw
I think your wife is in the mental health field, but I get the feeling that a lot of the people do not have a good understanding of what it is like being in the depths of a bad depressive episode. It ain’t like the dog died. It is utter and sheer hell – helpless, hopeless, and total confusion.
In a depressive episode, there is a certain special logic that makes perfect sense to the person. Trying to dissuade the person using everyday logic will only make it worse. I do not know if your relative was chronic or situational, but if it was chronic, this might not have been the first time.
I do not condone killing one’s self, but sometimes, one is already dead inside. What others regard as a living being is really just a hunk of meat with the ability to move on its own, at some point, it will tossed into a hole in the ground to finish rotting.
People have a right to kill themselves under circumstances of intractable pain, or when death is fast-approaching. I find the California death with dignity law a great comfort. I don’t really care what Jehovah’s opinion on it is, if He wanted people to avoid suicide maybe he could have worked a bit harder on creation. Just sayin’.
But that does not mean the person does not have a deep moral obligation to his family. I am not a depressive so I have nothing critical to say of those unfortunates, but I would feel myself to be a failure if I ever abandoned my children, at least until they reach 21. After that, screw ’em, they’re on their own. (Note to self: no suicide for the next five years.)
And can we please not pretend that all drug use is self-medication in reaction to some unpleasantness? It’s just not true. I’ve never been even close to clinical depression and I’ve tried most of the stuff that was around in my youth and did not involve a needle. (I actually did not much enjoy cocaine – it works differently if you’re ADD. For other people it’s a party drug, for me it’s a ‘get to work’ feeling.)
Drugs are fun, or they are relaxing, or on some occasions they are revealing. Sure, in some people it is self-medication. In my case, I smoke pot because I need something to stop my brain and let me sleep at night (I’m a nocturnal person with a 6:30 AM wake-up call) and weed has no calories while whiskey will cost you 70 calories an ounce, which can be better spent on Ben and Jerry’s. Of course some drugs do enslave you or even kill you, but the addiction rates across all major addictive drugs are about the same, ensnaring those with a predisposition but just making the rest of us loopy or silly or tired.
Wonder if the general increase in longevity and better reporting are factors. In the past, a finding of suicide could result in the estate being escheated, burial at the cross roads, (a local graveyard has such a grave), much shame in the community etc. Another factor maybe euthanasia has become acceptable, (a MD I known died the day after he was given a dx of pancreatic ca).
@MM, I would assume that before anybody kills themselves, they would either fail a depression-screening or a drug/alcohol test. I don’t think they are acting in complete control of their mental faculties, which is part of my objection to viewing suicide as a self-actualization. I don’t think a drunk driver who crashes his car is the epitome of free-will, but do recognize the notion that he had moral and legal responsibility nonetheless. People should be encouraged to seek help from self-destruction.
Therapists are probably cheaper than meds. Community mental health centers accept Medicaid, and for those who make too much they’ll work on a sliding-scale / payment plan. The biggest impediment is getting people to go, and if they go, get them not to rely solely on anti-depressants.
” I would assume that before anybody kills themselves, they would either fail a depression-screening or a drug/alcohol test.”
And I would assume that anyone suffering from an incurable disease and in intractable pain would have good reason to be depressed.
You might want to look at this: Kevin Drum: My Right to Die: Assisted Suicide, My Family, and Me
@Tasty, through my wife I probably have a bias that cognitive therapy works and should be encouraged. Medication may be necessary to break the cycle for it to work, however. But I would hate for society to embrace the idea that it is nobody else’s business, or that suicide is inevitable. Culture matters, see Japan.
@sam, I don’t have any problem with assisted suicide laws like California’s. But that law isn’t based on a radical individualistic view, but empowers physicians to decide whether the desire to end life is rational based upon legislative norms.
People should be encouraged to seek help from self-destruction.
Sometimes it’s just not that simple. Receptivity to encouragement has to be present. And, oftentimes it’s not.
Also, there’s an erratic component to suicide, where one minute it seems like the only option, and the next minute the wish to die is completely nullified. I remember a young girl who downed a bunch of pills in a suicide attempt. In trying to reverse the damage done she was crying out how much she wanted to live. Unfortunately, that second request was denied and she died.
I would add alienation and the atomization of society as factors. Many of the traditional social support networks not longer exist or are severely weakened and government sponsored programs have not filled the gap.