Understanding—and preventing—suicide

The US/UK financial industry has seen eight high-profile suicides in 2014, and it's only March. You can see why Goldman Sachs, Morgan Stanley and nearly two dozen banks and other financial firms have joined the City Mental Health Alliance, a London-based group trying to improve the mental well-being of financial professionals.

Some banks are also reportedly forcing junior employees to take a day off every once in a while, in hopes this may improve their mental health.

There is plenty of reason to praise these efforts, but the fact of the matter is that we have no idea what caused these men to kill themselves.

Sure, the narratives seem simple enough: High-pressure job leads to too much stress leads to. . . well, you know. But the truth of the matter, Sally Satel points out, is that someone in the next office over has the exact same problems and doesn't kill himself.

Satel, a psychiatrist and lecturer at Yale, says that with suicide, there's "a lethal alchemy that takes place." In other words, we're not going to prevent suicide with "small tweaks to a person's schedule."
Nationwide, suicide rates have been trending upward in recent years. According to the Centers for Disease Control, the suicide rate among Americans ages 35 to 64 rose almost 30 percent from 1999 to 2010.

But these things go in cycles, says Jennifer Michael Hecht, the author of "Stay: A History of Suicides and the Philosophy Against It." Suicide rates were actually lower for all age groups in 2002 than in 1970, according to a study in the American Journal of Public Health.

And the "why" is rarely clear. Just as many blame heartless capitalism for the deaths of those bankers, so others assume that the recent spike in military suicides recently is the result of trauma that our soldiers have experienced on the battlefield.

Yet Satel has long suggested that "post-traumatic stress syndrome" is an overused diagnosis. In the suicides of military personnel and veterans, she says, there is often something "more mundane" at work: Problems fitting in with one's family upon returning home is a big issue, as are high rates of unemployment.

As for the rising national rate, Hecht thinks one problem is our modern understanding of depression. Hecht, who has a PhD in the history of science, notes that the idea of depression as a biological problem is a fairly new one — and thus often the one we focus on. But, while she has no doubt that chemical issues in the brain affect people's dispositions, she doesn't want us to overlook a lot of cultural factors.

Not least of which, she says, is the common belief that with enough material goods, we should all be happy. So if you're not living a happy life, you wind up thinking there must be something wrong with you. Says Hecht:
"We are not talking [enough] about how hard life is supposed to be."
In fact, she notes, "There are lots of ways of dealing with extraordinary misery. Staying in bed and weeping is one of them."

And when people talk about suicide as a way to stop "being a burden" on others, Hecht says that they could use a little philosophy: "We're human beings. We are all burdens!"

But what can we do to help?

Thinking too broadly about these issues may blind us to the kind of small-bore treatments that people often need. For instance, many patients who are depressed become overwhelmed as a result of sleep deprivation, Satel reports. She says probably between a third to half of all depression cases can be resolved if sleep problems can be resolved. A recent study at Ryerson University in Toronto found that curing insomnia in depressed people makes it twice as likely that they get past the depression.

Hecht has another thought.

In researching her book, she looked at "suicide clusters," where people in a particular group — like farmers in the 1970s — seemed to be killing themselves at higher rates. On the one hand, it probably had something to do with the economic stresses on farming at the time. On the other, she says, you also had people copying each other. "When people see someone like them respond to a life that is hard and miserable by killing themselves," they'll consider the same "solution." In the wake of Marilyn Monroe's death, there was a significant uptick of women in the same age bracket overdosing on pills.

Hecht believes that simply telling people about these patterns in society may influence their behavior. She asks: "Do you really want to die by [jumping on] a trend?"

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