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New article about suicide

 
 
Aedes
 
Reply Sun 6 Jul, 2008 02:56 pm
From today's NY Times magazine, very worthy of discussion here!

[INDENT] July 6, 2008
The Urge to End It All

By SCOTT ANDERSON
"There is but one truly serious philosophical problem," Albert Camus wrote, "and that is suicide." How to explain why, among the only species capable of pondering its own demise, whose desperate attempts to forestall mortality have spawned both armies and branches of medicine in a perpetual search for the Fountain of Youth, there are those who, by their own hand, would choose death over life? Our contradictory reactions to the act speak to the conflicted hold it has on our imaginations: revulsion mixed with fascination, scorn leavened with pity. It is a cardinal sin - but change the packaging a little, and suicide assumes the guise of heroism or high passion, the stuff of literature and art.

Beyond the philosophical paradox are the bewilderingly complex dynamics of the act itself. While a universal phenomenon, the incidence of suicide varies so immensely across different population groups - among nations and cultures, ages and gender, race and religion - that any overarching theory about its root cause is rendered useless. Even identifying those subgroups that are particularly suicide-prone is of very limited help in addressing the issue. In the United States, for example, both elderly men living in Western states and white male adolescents from divorced families are at elevated risk, but since the overwhelming majority in both these groups never attempt suicide, how can we identify the truly at risk among them?

Then there is the most disheartening aspect of the riddle. The National Institute of Mental Health says that 90 percent of all suicide "completers" display some form of diagnosable mental disorder. But if so, why have advances in the treatment of mental illness had so little effect? In the past 40 years, whole new generations of antidepressant drugs have been developed; crisis hotline centers have been established in most every American city; and yet today the nation's suicide rate (11 victims per 100,000 inhabitants) is almost precisely what it was in 1965.

Little wonder, then, that most of us have come to regard suicide with an element of resignation, even as a particularly brutal form of social Darwinism: perhaps through luck or medication or family intervention some suicidal individuals can be identified and saved, but in the larger scheme of things, there will always be those driven to take their own lives, and there's really not much that we can do about it. The sheer numbers would seem to support this idea: in 2005, approximately 32,000 Americans committed suicide, or nearly twice the number of those killed by homicide.

But part of this sense of futility may stem from a peculiar element of myopia in the way we as a society have traditionally viewed and attempted to combat suicide. Just as with homicide, researchers have long recognized a premeditation-versus-passion dichotomy in suicide. There are those who display the classic symptoms of so-called suicidal behavior, who build up to their act over time or who choose methods that require careful planning. And then there are those whose act appears born of an immediate crisis, with little or no forethought involved. Just as with homicide, those in the "passion" category of suicide are much more likely to turn to whatever means are immediately available, those that are easy and quick.

Yet even mental-health experts have tended to regard these very different types of suicide in much the same way. I was struck by this upon meeting with two doctors who are among the most often-cited experts on suicide - and specifically on suicide by jumping. Both readily acknowledged the high degree of impulsivity associated with that method, but also considered that impulsivity as simply another symptom of mental illness. "Of all the hundreds of jumping suicides I've looked at," one told me, "I've yet to come across a case where a mentally healthy person was walking across a bridge one day and just went over the side. It just doesn't happen. There's almost always the presence of mental illness somewhere." It seemed to me there was an element of circular logic here: that the act proved the intent that proved the illness.

The bigger problem with this mental-illness rubric is that it puts emphasis on the less-knowable aspect of the act, the psychological "why," and tends to obscure any examination of the more pedestrian "how," the basic mechanics involved. But if we want to unravel posthumously the thought processes of the lost with an eye to saving lives in the future, the "how" may be the best place to look.

To turn the equation around: if the impulsive suicide attempter tends to reach for whatever means are easy or quick, is it possible that the availability of means can actually spur the act? In looking at suicide's close cousin, murder, the answer seems obvious. If a man shoots his wife amid a heated argument, we recognize the crucial role played by the gun's availability. We don't automatically think, Well, if the gun hadn't been there, he surely would have strangled her. When it comes to suicide, however, most of us make no such allowance. The very fact that someone kills himself we regard as proof of intent - and of mental illness; the actual method used, we assume, is of minor importance.
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Didymos Thomas
 
  1  
Reply Sun 6 Jul, 2008 05:32 pm
@Aedes,
Great article. Thanks, Aedes.

In the third paragraph we find this:
Quote:
The National Institute of Mental Health says that 90 percent of all suicide "completers" display some form of diagnosable mental disorder.


And I'm glad we have someone in the medical profession to help with this - how many people display some form of diagnosable mental disorder?

I look around and see some degree of mental illness is just about everyone I meet - and in myself as well. Not that I look around and see a world of schizophrenics or anything, and this isn't entirely pessimistic, but I see a great deal of mental unwellness, if that makes any sense.
de Silentio
 
  1  
Reply Sun 6 Jul, 2008 07:02 pm
@Didymos Thomas,
Didymos Thomas wrote:
Great article. Thanks, Aedes.

In the third paragraph we find this:
The National Institute of Mental Health says that 90 percent of all suicide "completers" display some form of diagnosable mental disorder.


What qualifies as a diagnosable mental disorder? Do depression and anxiety? Or is that term reserved for mental problems like schizophrenia?

I ask, because it seems that if they qualify depression as a mental disorder (especially "temporary depression") I see there figure of 90 percent as being a little skewed.

(sorry Didymos, you said almost the same thing. I guess I should have read your whole post before responding. Statistics just push the wrong buttons with me!)
Aedes
 
  1  
Reply Sun 6 Jul, 2008 09:48 pm
@de Silentio,
de Silentio wrote:
What qualifies as a diagnosable mental disorder? Do depression and anxiety?
Yes. Well, major depressive disorder, hypothymia, etc -- there are multiple different disorders that fall under the categories of depression and anxiety.

Quote:
I ask, because it seems that if they qualify depression as a mental disorder (especially "temporary depression") I see there figure of 90 percent as being a little skewed.
Pick up a copy of the DSM-IV -- there are strict criteria as to what constitutes a psychiatric diagnosis.

As to the prevalence of mental illness in the general population, I don't know a figure off the top of my head, but it's very very high. I'd guess 30%-40% or so have a psychiatric disorder (which basically means that the symptoms interfere with their normal life activities).
0 Replies
 
diamantis
 
  1  
Reply Mon 7 Jul, 2008 06:15 am
@Aedes,
To my opinion what the prospect suicidals should have in mind is that they should not do to their shelves what they do not want to do to the others.
Didymos Thomas
 
  1  
Reply Mon 7 Jul, 2008 01:48 pm
@diamantis,
Quote:
To my opinion what the prospect suicidals should have in mind is that they should not do to their shelves what they do not want to do to the others.


Maybe, but the conditions under which people tend to commit suicide don't seem to allow for that much reflection.

I guess I always understood that some suicides were impulsive, but I had no idea just how impulsive. The British coal-gas example really hit me, and the bridge examples were compelling as well.

I have a question to pose - How far do we go in preventing suicide? England phasing out coal-gas seems an easy decision to make. Suicide barriers on bridges, or even just higher railings, seems easy enough as well. What about a ban on handguns, though?
GoshisDead
 
  1  
Reply Mon 7 Jul, 2008 03:54 pm
@Didymos Thomas,
Maybe we should build a Nerf World, Abuse the Material Rights of the masses to save the few.

Suicide became an issue with humanity as soon as humanity understood its own mortality in an abstracted manner. Once people understood that there was a possible choice to be made someone probably made it. I think the issue here is not about preventing suicide per se, but in diagnosing mental illness, and what rights do the mentally ill have in regards to their own choices.
Didymos Thomas
 
  1  
Reply Mon 7 Jul, 2008 06:31 pm
@GoshisDead,
Quote:
I think the issue here is not about preventing suicide per se, but in diagnosing mental illness, and what rights do the mentally ill have in regards to their own choices.
But mental illness does not necessarily mean more likely to commit suicide. How many mentally ill people do not commit, or even attempt, suicide?

I think you're right; we have to try as best we can to diagnose and treat mental illness. But given the impulsive nature of so many suicides, addressing mental illness seems only a portion of the pie. Guns account for a large number of successful suicides in the US, many of which seem to be impulsive - take away the guns and, if the article is accurate, we should see a sharp decline in successful suicides in the US.

Quote:
what rights do the mentally ill have in regards to their own choices.


Do sane people have the right to take their own lives? Do the mentally ill have the right to take their own lives?
GoshisDead
 
  1  
Reply Mon 7 Jul, 2008 07:24 pm
@Didymos Thomas,
Indeed to abstract it further from suicide, do we have the right to try and prevent someone's suicide? Who has the right to make a choice at all. I chose to talk about the mentally Ill and suicide #1 as the article states suicide is a good indicator of a person having been mentally ill, and #2 we are more likely as a society to restrict the choices of the mentally ill because we assume that they are not capable of many "rational' choices.
0 Replies
 
Aedes
 
  1  
Reply Mon 7 Jul, 2008 08:25 pm
@Didymos Thomas,
Didymos Thomas wrote:
But mental illness does not necessarily mean more likely to commit suicide.
Yes it does. Statistically mental illness is the strongest predictor of a suicide attempt. Compared with the general population people with mental illness are FAR more likely to attempt suicide.

Quote:
How many mentally ill people do not commit, or even attempt, suicide?
Many. But that misses the point. Risk is a statistical statement applied to a population. It doesn't predict the behavior of a given individual in the population.

Quote:
Guns account for a large number of successful suicides in the US, many of which seem to be impulsive - take away the guns and, if the article is accurate, we should see a sharp decline in successful suicides in the US.
Guns are the primary reason why males are far more successful at suicide attempts than females. Females are more likely to attempt a drug overdose, which often is unsuccessful.

[/quote]Do sane people have the right to take their own lives? Do the mentally ill have the right to take their own lives?[/quote]The right under what body of judgement? Committing suicide is not illegal. Attempting it is. But I think most of us agree that irrespective of the crime, it's in the best interest of the criminal and of society for people with mental illness to get effective diagnosis and treatment.
ThoughtAsStupid
 
  1  
Reply Thu 10 Jul, 2008 07:17 pm
@Aedes,
OntheWindowStand
 
  1  
Reply Thu 17 Jul, 2008 05:40 pm
@ThoughtAsStupid,
When I was a child one my friends committed suicide purposefully he was 6 without a mental illness.
This topic just reminded me of it.
0 Replies
 
rado
 
  1  
Reply Fri 18 Jul, 2008 05:21 pm
@Aedes,
Aedes wrote:
Yes it does. Statistically mental illness is the strongest predictor of a suicide attempt. Compared with the general population people with mental illness are FAR more likely to attempt suicide.


If you think about it, it's obvious. Our psychological well being is alfa and omega in life. Other things being equal, if you feel good psychologically, all is well, if you feel bad, all is hell. The reason for our psychological condition doesn't really matter, in any case, it's how we feel that matters.

Rado
0 Replies
 
rado
 
  1  
Reply Fri 18 Jul, 2008 05:36 pm
@diamantis,
diamantis wrote:
To my opinion what the prospect suicidals should have in mind is that they should not do to their shelves what they do not want to do to the others.


Well would you want others to keep themselves alive, even though they may be suffering so much that life has become meaningless to them, and there is no way to make things better?

Rado
0 Replies
 
astrotheological
 
  1  
Reply Sat 6 Sep, 2008 12:49 pm
@Aedes,
Just wondering but how would you define someone as mentally ill because I've got AvPD and I still can think for myself. I'm just am afraid of being around other people.
wallacemonette
 
  1  
Reply Sat 6 Dec, 2008 03:56 pm
@astrotheological,
I believe I am a sane person. I am a college student at a state university, I get good grades, I can keep a job, I have good friends. So I find it strange that 90% are considered to have a mental disorder. I have thought about suicide a lot and it seems strange that most consider it a problem. It seems to me the conclusion that suicide is appropriate can be come to from a logical perspective. If I think of the meaning of my life on a scale of how small its importance would be to the universe and then for sure infinitely so if other dimensions are considered then it seems there is some rationality to getting it over with, moving on. I'm going to die, why not sooner than later? When has a person lived enough? Babies die, kids die. I'm 21 and in comparison to other lives, I've already accomplished enough.
Rose phil
 
  1  
Reply Mon 8 Dec, 2008 10:04 pm
@Aedes,
I read an article awhile back that claimed that most suicides were accidents. I thought it might be true because I had an understanding about how some people, perhaps young people, can become very angry with someone or very hurt by someone and make a suicide attempt 'just to show them'. And these angry and hurting attempts often go wrong and do result in suicide. Your thoughts on this please.
0 Replies
 
sarek
 
  1  
Reply Tue 9 Dec, 2008 03:16 pm
@wallacemonette,
wallacemonette wrote:
If I think of the meaning of my life on a scale of how small its importance would be to the universe and then for sure infinitely so if other dimensions are considered then it seems there is some rationality to getting it over with, moving on. I'm going to die, why not sooner than later? When has a person lived enough? Babies die, kids die. I'm 21 and in comparison to other lives, I've already accomplished enough.


The universe is a little too big for me to comprehend. How about being important to even just one single other person? Is that not enough reason?
ItMustBeKate
 
  1  
Reply Tue 30 Dec, 2008 06:41 am
@sarek,
sarek wrote:
The universe is a little too big for me to comprehend. How about being important to even just one single other person? Is that not enough reason?


To be honest, that is not enough reason for me. That seems like a nice little statement - if you help one person, you can cause a lot of good things, or words to that effect - but essentially there are 6 point something billion of us on Earth. My ability to affect one other flawed being, or even a few hundred in my life, does not justify my existence.

The only thing preventing my suicidal thoughts is the fact that I haven't done anything yet in my life. Haven't accomplished anything or left anything of note, really. So I'm holding on.
xris
 
  1  
Reply Tue 30 Dec, 2008 07:30 am
@ItMustBeKate,
I have always thought those who contemplate suicide as very self centred and have little thought for those they leave...am i being harsh? I had friend whose son killed himself, it destroyed him and his wife..Its never those who kill themselves that suffer..If they think they are suffering could they contemplate who they leave?My sympathy lies with those whose lives are destroyed by these acts..
 

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