Facing the epidemic of suicide

Today there are growing numbers of suicides — especially among military veterans. I just came across a great article from Jennifer Michael Hecht in The American Scholar about suicide. It’s written from a secular, scholarly, but wise perspective. It’s so well-written that I’m doing to quote some sections at length. Here are some excerpts:

Today’s military faces a tremendous crisis. We are losing more soldiers to suicide than to combat. Some of this is attributable to PTSD—posttraumatic stress disorder—but a recent Pentagon study covering the years 2008 through 2011 showed that some 52 percent of those who committed suicide had never been deployed to a combat zone. Last year, military personnel killed themselves at a rate of about one a day. Veterans are killing themselves at a rate of almost one every hour, about 22 a day. Recently the rise in military suicide was so extreme that it made the front page of The New York Times and the cover of Time magazine. The rate is higher this year than it was at this point last year.

The suicide rate is also escalating in the U.S. population at large: 10 years ago it shocked observers by reaching 30,000 a year. Now it is almost 40,000. Around the world and in the United States there are more suicides than murders. For those under 40 years of age, it is one of the top three killers. For older people it is one of the top 10, though their rate of suicide is the highest (other diseases begin to compete for numbers). Women attempt suicide more, but men succeed more often—probably because they have greater access to guns, which is one of the surest methods.

In the civilian population matching the demographics of the military (considering age, sex, and race), between 2002 and 2009 (the latest year for which we have reliable numbers) the suicide rate increased by 15 percent. According to Pentagon numbers, the military suicide rate in the same period increased by 80 percent. Even this disparity may understate the problem, since the Pentagon counts as active duty people who were active for only a few days in a given year, making the rate far lower than it would be if officials counted people who were active for at least six months, for instance.

Why this rash of suicides?

Many soldier suicides come in response to a bad situation: a broken marriage, a financial crisis, legal trouble,  or some other reversal. A recent Pentagon study showed that about half of military suicides had experienced a failed marriage, frequently just months before the victims killed themselves. Another report showed that most suicides occurred in people under the age of 25. Family and friends who have lost someone to suicide often report that the person had legal or financial troubles, or both; that they were struggling with drugs or alcohol; that they came back from the war deeply changed; or that they were frustrated at not being deployed.

By and large, people kill themselves today for the same reasons Ajax (a figure in Greek Mythology that she references earlier in the article) does: because life can be disappointing, unfair, and painful, and we often respond by doing things that make us feel ashamed in the morning. The extent of the misery Ajax experiences is in large part because, as a great hero, he expects so much of himself. These days we expect a lot. We live in a culture that makes us all want to be special, and the math on that will never add up. We all feel terribly let down sometimes.

What to do about this rash of suicide?

If someone is besieged by suicidal thoughts, it is important that he get help from a mental health professional. Talk therapy can work, bringing real insight. Antidepressants can take the edge off the pain as a person figures out her life. But we can also draw on the inner resolve of the individual, and on the history of ideas.

To save our future selves from suicide, we have to do some work now. Boot camp and additional training get a soldier ready for war. In situations where most people would freeze and give up or run away, soldiers are trained to fight the fight and try to get out alive. People do not often speak of it, but the inner life of soldiers and civilians alike can be so brutal that it too requires training in advance of a crisis. We need a boot camp of the heart and of the psyche.

Beyond the moment of crisis, people do not want to die of suicide any more than the person who freezes up in a firefight wants to die in battle—they are both just overwhelmed and undertrained. The German philosopher Ludwig Wittgenstein once wrote that suicide is always a matter of taking oneself by surprise, a rushing of one’s own defenses. Like other defenses, those against suicide can be strengthened. Abundant data show us that the suicidal impulse can be of remarkably short duration. The mood passes. One study followed up on 515 people saved from jumping from the Golden Gate Bridge more than 20 years earlier and found that only between five and seven percent actually went on to end their own lives. Other studies have shown that an overwhelming number of people who have attempted suicide are unambiguously glad they did not die.

An untrained person experiencing profound disappointment or depression may let the part of him that wants to die win the day. Any of us might get to a place where the sliver of ourselves that wants to die is in control for a while. Don’t let it happen. Inculcate into your very being the idea that killing yourself is not an option. This is work everyone should do. Those who have never felt intense inner pain should not scoff at its power. As the 17th-century doctor Robert Burton wrote in The Anatomy of Melancholy: “Hope, ye miserable. Ye happy, take heed.” Everyone suffers; no one escapes. When the bad time comes, it will feel like it is never going to end. But it will. We must think it through now so that the training against suicide kicks in and saves our life and the lives of our fellows.

People considering suicide should keep in mind how it will affect others

As Hecht points out, suicide not only really hurts the people around us by causing them grief and guilt, it also creates a situation where the people we leave behind are much more likely themselves to commit suicide:

The reason I say “the lives of our fellows” is that one of the principal predictors of suicide is knowing someone who has committed suicide. We influence each other to an extraordinary degree. Parents who kill themselves leave behind children who are three times as likely to kill themselves as children who make it to age 18 with living parents. It’s not just parents. According to sociological studies, one suicide in a community very often leads to a rise in suicides by people who knew the deceased, or knew of him, or felt themselves like him in some way, especially with regard to age, sex, and occupation. In my new book, Stay, I compile a large number of studies showing that suicidal contagion is real. It shouldn’t surprise us, because studies have shown that with weight, smoking, recycling, and other choices, people do what they think the people around them are doing. Even with choices as permanent as getting tattoos or having a third child, people follow each other. After one suicide, the suicide rate in a given area increases. It happens at schools; it happens within professions; it happens after a celebrity suicide; and it is happening in the military right now.

Because of this phenomenon, suicide is also homicide—you take somebody with you. When you take your own life, you normalize suicide for people who liked you and who are like you. Once the numbers reach a critical mass, as they have in the military today, it is a massacre. We have to take better care of each other by insisting on sparing ourselves in periods of emotional agony. What I want to tell our soldiers and veterans is this: If you want your buddies to live, you have to find a way to live, too. Living through your misery is a colossal gift to the community. You may now or someday feel as if you are useless, as if the world would be better off without you. But that is wrong. You may have made some mistakes, even some terrible mistakes, but you would do even more damage—immeasurable damage—if you were to kill yourself. It is not an option.

True, someone cannot simply decide not to feel miserable, or just choose not to have suicidal thoughts, but people can choose not to go through with it. Consider, for example, that the powerful cultural taboo against suicide for women with small children corresponds to a low suicide rate for such women. They are no less depressed—50 to 80 percent of women experience some postpartum “blues,” and between 10 and 15 percent suffer from postpartum depression. Nothing suggests that they have fewer suicidal thoughts, but they resist them. If women can do this for their children, then soldiers can do it for their comrades, their families, and their own future selves.

It takes courage to live through feelings of despair

Many great minds in history have spoken of the courage required to stay alive. It may seem like a very different kind of courage than what war requires, but similarities exist. In some cases, courage on the battlefield is observed by many others and can lead to a medal, but even on the battlefield the greatest courage is often witnessed by only a few other people. An act of heroism can nevertheless be deeply satisfying. The courage to live through suicidal feelings and stay alive will not earn a medal, but it will bring the respect of those close to you and may well bring tremendous satisfaction.

And beyond satisfaction, it can bring wisdom. Most people feel at times that they have dug themselves into a hole out of which they cannot climb. No one wants to be humbled in this way, but it is an essential ripening. From military heroes, leaders we admire, and deep thinkers of all kinds, we hear over and over that real knowledge comes from pain. Living through inner pain is how we lose our arrogance, our selfishness, and our ignorance. It is how we acquire gentleness and a sense of responsibility, maturity, and the capacity for leadership.

Our view of suicide is skewed today because of our tendency to expect that life should always be easy and happy

The way we talk about suicide today is off balance. We are so caught up in the language of illness that we end up stigmatizing misery, when in fact misery is a part of everyone’s life. As a nation, we take millions of pills to deal with our sadness, yet we strive to seem fine all the time, such that everyone ends up alone with his or her struggles. We read and write about all sorts of weakness and heartache, but the stories are almost all recovery tales. We are willing to talk about it when it’s over, but while people are at their lowest points they are often isolated by shame about their troubles. We need at least to know that inner pain is common and always has been.

Closing thoughts:

We need to think these issues through and take a stand now so that when we are feeling anguish, we have a commitment to avoid taking our own lives. We need to know that suicide is wrong. We need to read it, and hear it, and speak it, one-on-one and in gatherings.

Ideas are never the whole story: people face biological depression, cataclysmic financial loss, maddening drug addiction, and awful luck in love. To fix the national problem of suicide, among soldiers and civilians, we need better access to mental health care and a better economy. But ideas do matter.

History and philosophy indicate that people can gain strength from knowing of the suffering of heroes, historical and mythical. When we are miserable, it is hard to remember anything positive, so we have to memorize some things before those moments come. Life is meaningful, and it is meaningful for reasons to which we do not always have access, because of our youth or because of our mood. Trust the wisdom of the ages and wait for greater knowledge and better times. Life will raise us up again. Practice having some faith in it.