Thursday, July 26, 2018

The Suicide Epidemic - Get Connected To People!

Christine Rosen
Commentary Magazine 

The recent suicides of fashion entrepreneur Kate Spade and chef-turned-TV-star Anthony Bourdain have sparked a culture-wide discussion, as often happens when a celebrity dies in a horrible fashion. But unlike previous celebrity suicides, the anxieties prompted by these deaths took on a different coloration when it became clear in their wake that their deaths are part of a larger and disturbing public-health crisis we’ve failed to acknowledge. 

According to a recent report from the Centers for Disease Control, suicide is now the 10th leading cause of death in the U.S., killing twice as many people (45,000) as homicide does each year. In more than 25 states across the country, the suicide rate has increased by more than 30 percent since 1999. 

Most of the deaths are people (like Spade and Bourdain) at an age once considered the prime of life, which suggests a kind of epic, deadly new form of the midlife crisis: The largest number of suicides are happening among white men and white women between the ages of 45 and 65 (although rates are rising steadily for nearly all racial and ethnic groups). The news is grimmest for men, who account for three-quarters of all suicides. The CDC’s principal deputy director, Anne Schuchat, told Business Insider that the new data are “disturbing.”

Disturbing and confusing. Suicide has often increased during times of economic hardship; in 1932, during the height of the Great Depression, for example, the rate was 22 deaths per 100,000 people, according to the New York Times. But in the U.S. today, during an economic recovery underway for nearly a decade, the rate is 15.4 per 100,000. And the number of deaths has stubbornly increased despite much better screening and mental-health diagnosis. As the CDC researchers who worked on the recent report noted, “More than half of people who died by suicide did not have a known diagnosed mental health condition at the time of death.” Rather, the researchers listed substance abuse, job loss, relationship problems, and financial woes as some of the many factors potentially implicated in rising suicide rates.

How did suicide, a disease of despair, a last resort, become a solution to the challenges of everyday life for so many people?

The sociologist Émile Durkheim was one of the first people to posit that suicide could be understood culturally and socially, not just as the expression of an individual’s state of mind. His 1897 book, Suicide, noted the myriad and often contradictory ways that cultures had come to understand suicide throughout history (heroic, tragic, noble, a mortal sin), and it identified a typology of suicides. Anomic suicides, he argued, were associated with periods of social and economic upheaval. Altruistic suicides had some connection to commitments to a larger cause (such as soldiers sent on suicide missions during wartime). Fatalist suicide tempted people, such as prisoners, who were left without hope. But it is Durkheim’s egoistic type that has resonance for our current epidemic. Egoistic suicides occur more often in highly individualistic cultures where people feel detached or isolated from society and when social and community ties are weak rather than strong. These are people who no longer feel they belong in society, have few people who can reassure them otherwise, and thus can’t summon a reason to live.

Despite our highly virtually connected society, with its thriving online communities and emphasis on likes and retweets, it’s easy to overlook the widening gulf between the popular images and culture we consume and our private lives, between the images on the screen and the often lonely reality behind closed doors. The New York Times recently reported that in 2005, seven years after pop culture began celebrating the liberated single women in Sex and the City, “single middle-aged women were as much as 2.8 times more likely to kill themselves than married women” (and single men were 3.5 times more likely to commit suicide than married men). Add to that the heavily filtered, seemingly perfect lives posted on Instagram, and the reality of struggling with loneliness or failure, to say nothing of depression, can seem impossible to accept.

This is not a new problem, of course, nor is our eagerness to ignore it. In Philip Slater’s 1970 polemic, The Pursuit of Loneliness, he noted, “The hunger for confrontation and experience draws a lot of attention to social problems, but these are usually dealt with in such a way as to reinforce our avoidance.…The ultimate effect of the media is to reinforce the avoiding response by providing people with an effigy of confrontation.” 

Today, we construct such effigies after every celebrity death, and particularly for suicides. Media coverage provides details of the methods employed and parses the last words and final moments of the dead, even though mental-health experts have long warned that this can contribute to suicidal ideation in vulnerable people and inspire copycat suicides. We encourage greater candor about mental-health issues and have more resources available for those who suffer from challenges. But there is also more widespread information available online about how to commit suicide. And the contagion effect, which has long existed (a spate of suicides in 18th-century Europe was blamed on the publication of Goethe’s novel The Sorrows of Young Werther), is increased by its availability. There was a measurable spike in suicides after Robin Williams took his own life in 2014, for example. Some news outlets reported that Kate Spade had spent hours poring over the details of Williams’s methods before deciding to end her own life in the same way.

At the same time, the taboo against suicide has weakened considerably in recent years. Right-to-die legislation has passed in six states and the District of Columbia. As Rutgers sociologist Julie Phillips told the New York Times, “we are seeing somewhat more tolerant attitudes toward suicide,” especially among the young, who respond in surveys that they believe “we have the right to die under certain circumstances, like incurable disease, bankruptcy, or being tired of living.” Pop culture reflects this in movies and television shows that celebrate the heroism of those who choose to die when their lives appear no longer worth living (Million Dollar Baby); some of these shows, such as Netflix’s 13 Reasons Why, are aimed explicitly at younger viewers. 

Durkheim noted that in highly individualistic cultures, insatiable desires created a great deal of human misery, but that families and communities could serve as reliable curbs on such desires. Likewise, CDC researchers who study suicide mention “connectedness” as one of the major ways to prevent future suicides. But as our virtual communities have expanded, in-person networks (and our interactions with extended families and friends) have eroded. Virtual networks cannot perform the same functions as face-to-face connections. It’s far easier to ignore a Facebook message or an email from a friend than it is to avoid a knock at your front door. And yet in a short span of time, we’ve become habituated to the former kind of “connection” and dismissive of the latter.

Albert Camus began The Myth of Sisyphus with the following observation: “There is but one truly serious philosophical problem, and that is suicide. Judging whether life is or is not worth living amounts to answering the fundamental question of philosophy.” Such deaths were “facts the heart can feel,” Camus noted. Too many Americans are deciding that life is not worth living. The question is whether we will simply accept that this is the inevitable price we pay for a hyper-individualistic, on-demand, atomized, technologically proficient yet disconnected society—or if the horrifying facts about suicide cause us to try to change the way we live now.