The issues surrounding suicide that we’re not talking about

In this emotive op-ed, Dr Bob Murray explains the real why(s) of the suicide epidemic.

I have personally known several people who have “suicided” successfully – only two were close to me, and that is remarkable considering that I have lived a lot of years. Several others, including my mother, were saved because I or someone else got to them before it was too late. One who succeeded was, at the time, a colleague and my best friend, and that was painful.

Suicide is becoming an epidemic throughout the developed world. In many US states, suicide is the number one killer of middle-aged white males and it is even affecting the very young – eight- to 10-year-olds are taking their lives in alarming numbers.

A research paper in the Journal of the American Medical Association documented the alarming increase in suicide rates among 15- to 24-year-olds, particularly in the US, and especially in the last four years. An article by the American Foundation for Suicide Prevention said that medical students’ suicide rate was three times that of other students (other studies show that the overall student suicide rate is increasing alarmingly).

Recent research has shown that this perfectionism is a prime cause of suicide. Lawyers, who are generally perfectionistic, are also increasingly – because of client demands, competition and the changing nature of legal practice – put in a position where their perfectionistic traits are being magnified. This may account for the high rate of suicide attempts by members of that profession.

Middle-aged and middle-class and working-class white men in the US are killing themselves in increasing numbers – some of this is hidden because coroners and others put many, if not most, of the deaths down to “overdose”. Sometimes it’s a close call – one grain of fentanyl gives you a high, two grains can kill you. Suicide in older adults is also a huge and growing problem.

The epidemic among the young and others is spreading rapidly to other parts of the world. Earlier studies showed that suicide rates in Asia were the world’s highest.

How have we come to this? As a psychologist and a scientist, I spend a lot of time considering the reasons why this is happening. Principally, of course, it’s because of the way we live – the disconnect between our work, family, relationships etc. – and what we (Alicia and I) call our “design specs”. These latter are our neurogenetic and other biological design features that enabled us to survive as hunter-gatherers. When the stress of exceeding our design specs becomes overwhelming, we may break – like a tree in a hurricane or even a steel girder.

But there’s a lot of confusion and misleading information out there about suicide. It is oversimplified and the circumstances surrounding the tragedy (things pertaining to the person who has taken their life) are confused with causes. A person may have lost their job and committed suicide, but this does not mean that the person committed suicide because they lost their job.

I think that there are several aspects to suicide which are not given the airing they deserve. These include (but, as they say in the small print, are not limited to):

There are simply too many humans

When I was a psychology student, we used to do an experiment with rats (which are extraordinarily intelligent). We would start with an enclosure with a certain number of the rodents in it – about the ideal number for a community of that species. We then progressively added more rats until the overcrowding became stressful for the animals.

Beyond a certain density, a number of behavioral changes happened. The rats (normally quite friendly creatures) became increasingly aggressive, they isolated themselves (like us, they’re normally social), they refrained from sex and many of them died. Their deaths were not classed as suicide because they were unintentional, but on examination it was clear that their biological systems had just stopped working, their cells ceased dividing normally – mass apoptosis (cell death). I believe our overpopulated society is so stressful that for many suicide – intentional or not – is the only way out. I’m not the only one who has come to this conclusion. Several recent studies have said the same thing calling it “suicide by overpopulation”.

There is a genetic base to suicidality

Scientists are not sure of exactly which genes are involved; for a long time (comparatively), it was thought to be the serotonin transporter genes. More recent research published late last year in Molecular Psychiatry has confirmed the genetic link to the problem of suicide and shown that a number of disparate genes are involved.

Suicide is increasing because of the growing level of stress that we all live under and the way our society is constructed

For example, several studies published this year showed that increasing inequality is closely linked to suicide. Personal or familial economic stress can trigger a suicidal reaction in those that have the particular genetic configuration mentioned above.

Social isolation is a prime cause of suicide and that is increasing throughout the technologically developed world

Indeed, technology is increasingly stripping us of meaningful human contact at work, in the family and in society generally. This is affecting millennials most severely – those who have come to rely on technology the most. Indeed, according to a report from the Stanford Center on Poverty and Inequality, millennials are the “canary in the mine”, showing what will progressively happen to future generations if current trends continue.

Depression may not be a cause of suicide

Increasingly, I and other researchers are beginning to realise that depression and suicide are quite different ailments. They share similarities in that they are both largely genetically based. But depressed people are not necessarily more prone to suicide than others – though people can have both disorders. I also believe that ideating (planning) suicide (which is common in major depressive disorder [MDD]) is not the same as actually attempting it.

I believe that a suicide attempt is more like some forms of panic disorder (PD) – it comes on suddenly and often without immediate warning. Just as with some PDs, actuating suicide may be largely the result of a genetically induced problem with the circulation of glutamate in the central nervous system system – in other words, a blood sugar problem like hypoglycemia. A suicidal attempt can be triggered, like PD or MDD episodes by external events – loneliness, inequality, job loss or insecurity etc. – but these are not the ultimate cause.

It’s only when we take into account these underlying causes of suicide that we can make real progress in ridding ourselves of it.

This post originally appeared on Dr Bob Murray’s blog.