Reasons for suicide: “I am alone” “I am a burden” “I am not afraid to die”

A long but interesting article on why the rate of suicide is increasing all over the world. My friend who is a psychiatrist called it “well written, with some really good insights”, so I assume that the points made in the article are worth keeping in mind.

Here are some of the more intriguing points:

Throughout the developed world, for example, self-harm is now the leading cause of death for people 15 to 49, surpassing all cancers and heart disease.

and

In 2010 worldwide deaths from suicide outnumbered deaths from war (17,670), natural disasters (196,018), and murder (456,268)

and

And this assumes we can even rely on the official data. Many researchers believe it’s a dramatic undercount, a function of fewer autopsies and more deaths by poison and pills, where intention is hard to detect.

And none of this is easy to explain:

If four out of five suicide attempts are by women, why are four out of five suicides by men? If big cities and beautiful architecture are magnets for suicide, why are natural wonders and public parks as well? Prostitutes, athletes, and bulimics have an above-average risk for suicide, but what else do they have in common? Why are African-American people relatively safe? And twins?

So Thomas Joiner is now trying to come up with a theory of suicide, which attempts to explain why people commit suicide. According to him, people will die by suicide when they have a desire for suicide and the ability to kill themselves. And the desire to die comes from loneliness (“I am alone”) and a perceived burdensomeness (“I am a burden”).

He calls the first “low belonging,” and it’s the most intuitive idea in his formula. Joiner argues that “the desire to die” begins with loneliness, a thwarted need for inclusion and connection. That explains why suicide rates rise by a third on the continuum from married to never been married. It also accords with the fact that divorced people suffer the greatest suicide risk, while twins have reduced risk and mothers of small children have close to the lowest risk. A mother of six has six times the protection of her childless counterpart, according to one study. She may die of work and worry, but not of self-harm.

And if you think that having lots of friends on Facebook helps, think again:

But Facebook doesn’t help. “The greater the proportion of online interactions, the lonelier you are,” John Cacioppo, a professor at the University of Chicago and the world’s foremost expert on loneliness, told Marche. The opposite is also true: more face time, less loneliness.

The other condition for the desire to die is the feeling that you are a burden on your friends/family/others.

This explains why suicides rise with unemployment, and also with the number of days a person has been on bed rest. Just the experience of needing and receiving help from friends—rather than doing for oneself and others—can make a person pine for death. We’re a gregarious species, but also a gallant one, so fond of playing the savior that we’d rather die than switch roles with the saved. In this way suicide isn’t the ultimate act of selfishness or a bid for revenge, two of the more common cultural barbs. It’s closer to mistaken heroism.

The third condition is less intuitive. The “ability to kill yourself” really has to do with the fact that it’s hard to kill yourself. Joiner calls this condition “fearlessness.”

In this way, suicide isn’t about cowardice. It’s not painless or easy, like pulling the fire alarm to get out of math class. It takes “a kind of courage,” says Joiner, “a fearless endurance” that’s not laudable, but certainly not weak or impulsive. On the contrary, he says, suicide takes a slow habituation to pain, a numbness to violence. He points to that heightened suicide risk shared by athletes, doctors, prostitutes, and bulimics, among others—anybody with a history of tamping down the body’s instinct to scream, which goes a long way to unlocking the riddle of military suicides.

For the population at large, it might seem mildly reassuring at first. After all, most of us don’t fall into these categories. But Joiner believes there may be a side door to fearlessness: exposure to violence in media. Remember this debate? Well, it’s basically over. “The strength of the association between media violence and aggressive behavior,” the American Academy of Pediatrics concluded in 2009, “is greater than the association between calcium intake and bone mass, lead ingestion and lower IQ, and condom nonuse and sexually acquired HIV infection, and is nearly as strong as the association between cigarette smoking and lung cancer.”

So, here is my non-expert (possibly flawed(?)) conclusion: what could help with reducing suicidal tendencies and depression? Try to have more friends/family – the kind you meet in person regularly. This will not help when you’re already depressed; so you need to start now. And help other people – the more you help others, the more you’re helping yourself. And try to stay away from violence and pain in media and in real life.

Read the full article. (You can skim over the early parts which are focused on proving that the incidence of suicide is increasing, and go to the more interesting parts later on which give Thomas Joiner’s theory of why people commit suicide.)

Note: In the comments, Sandeep Gautam points out that Joiner’s theory seems to be more targeted towards developed nations, and does not account for the extreme financial hardships in developing countries which can drive people to suicide. He has a bunch of other interesting points to make. Read the full comment below.

And, by the way, if you’re in India and feeling emotionally distressed, or suicidal, and can’t think of anyone to share this with, call the Connecting India helpline at +91 9922001122, or 18002094353 (Toll-free). Or if you know someone else who is in this situation, give them this information. See Connecting India website for more details.