Last week, Tim Brennan authored an engaging article expressing his anguish at an all-too-frequent occurrence: suicide. He focused mostly on the prevalence of this in the musician culture, and like many of us, he struggles to make sense of it. Why people commit suicide and what factors appear protective against it are complicated, but I’d like to offer my thoughts on the subject.
For me, the easiest suicide to understand is when it can be traced to severe mental illness. (I emphasize “severe” mental illness because I believe we all qualify, in some fashion, for a mild case of the crazies….) In a nutshell, severe mental illness interferes with our ability to think logically. Therefore, reason isn’t available as a safety net or counter measure; also, these people are often prone to swings of extreme emotion, but ill-equipped to bring those big swings back into balance. There are other factors, of course, but generally, those with severe mental illness have little or no effective deterrent against suicide. (What’s interesting is that we’re often hard-pressed to put friends or acquaintances who take their own lives into this category. And yet, according to the American Foundation of Suicide Prevention, 90 percent of suicides occur because of mental illness. What are we missing?)
Another somewhat understandable reason for suicide is drugs and/or alcohol. The statistics vary, but more suicide attempts (successful or not) occur while people have mind-altering substances in their blood.
To answer Tim’s question, highly creative artists seem to have a predilection for abuse of drugs and alcohol and mental illness. That’s a double whammy. In 1992, psychiatrist Dr. Arnold M. Ludwig conducted a study at the University of Kentucky Medical Center. He published an extensive biographical survey of 1,005 famous 20th-century artists and writers. He compared their mental health with individuals in more conventional professions, and found that artists and writers experienced two to three times the rate of psychosis, suicide attempts, mood disorders, and substance abuse than did successful people in business, science and public life. Wow. The sole, somewhat comforting reality, however, is that in my experience, artists themselves seem aware of this connection, and when I personally treat them, I promise them we will work together to ensure we don’t snuff out their creative spark.
So that’s some unfortunate insight into the artist connection.
Here’s another group worthy of discussion: college students. A percentage of my patients are students—some come seeking assistance in coping with and understanding the death of friends by suicide; others have attempted suicide, survived, and come to me for treatment. Why college? Well, it generally goes hand in hand with a decrease in supervision and structure—for many, that’s prime time for testing your own limits, which brings us back to that excessive drinking/ experimentation with drugs factor. Most anyone who’s been to college can attest that this behavioral response is common, but make no mistake: it’s a flirting dance with death. These things impair judgment, lead to risky behavior, and poor impulse control. Death may be entirely accidental, but folks… dead is dead.
Those sub-groups aside, there’s the life experiences angle. Suicide.org has a list of these that may precipitate depression or suicide.
The death of a loved one.
A divorce, separation, or breakup of a relationship.
Losing custody of children, or feeling that a child custody decision is not fair.
A serious loss, such as a loss of a job, house, or money.
A serious illness.
A terminal illness.
A serious accident.
Chronic physical pain.
Intense emotional pain.
Loss of hope.
Being victimized (domestic violence, rape, assault, etc).
A loved one being victimized (child murder, child molestation, kidnapping, murder, rape, assault, etc.).
Unresolved abuse (of any kind) from the past.
Feeling "trapped" in a situation perceived as negative.
Feeling that things will never "get better."
Serious legal problems, such as criminal prosecution or incarceration.
Feeling "taken advantage of."
Inability to deal with a perceived "humiliating" situation.
Inability to deal with a perceived "failure."
A feeling of not being accepted by family, friends, or society.
A horrible disappointment.
Feeling like one has not lived up to his or her high expectations or those of another.
Bullying. (Adults, as well as children, can be bullied.)
Surely we’ve all faced one or more of these things at some point. Why then have we survived while others have not? Well, there again arises the possibility of mental illness gone undetected, untreated. But how we cope with stress is a big-time factor, influenced both by genetics and life experience. We know the genetics are a roll of the dice, and well, our life experiences are only within our control to an extent. But these experiences do include what we’ve managed to learn from parents (and others) about how to deal with stress. They also include our spiritual/moral beliefs. Many seriously depressed patients with fervent Christian faith have said to me, “I could never commit suicide because of my faith.” In each such occurrence, I give thanks to God for the individual’s faith. It means I can sleep better at night. These are circumstances of how faith influences a decision pertaining to suicide, in a protective way.
On the flip side, remember “Harikiri?” Seppuku (a form of Japanese ritual suicide) was first attributed to the Samurai class of warriors. However, in World War II, many soldiers and civilians chose this method of suicide rather than to be disgraced by surrendering. That’s right—die painfully rather than lose. Additionally, as Japan began to lose the war, Kamikazi pilots would kill themselves in an attempt to utilize their aircraft as explosive missiles. The tradition of suicide as an alternative to defeat, capture, and shame was deeply entrenched in Japanese culture. This represents circumstances where culture and societal expectations influences the decision to end one’s life.
Bottom line? Each of us has an investment in our culture. The choices we make for ourselves influence others. The vision of what type society we wish to live in can be achieved or lost by what we do or fail to do. Also, there is something deeply sad in every suicide. It reverberates questions about the value of human life, about what went wrong in that individual, and about why nobody was present to understand or help. Disturbing questions, indeed, but worthy of answers.
If you think someone is suicidal, do not leave him or her alone. Try to get the person to seek immediate help from his or her doctor or the nearest hospital emergency room, or call 911. Eliminate access to firearms or other potential tools for suicide, including unsupervised access to medications.
Photo Credit: Psych Central