A Mysterious Change of Mind
Why do people die by suicide?
This column was first published in the October 2018 issue of Scientific American.
Anthony Bourdain (age 61). Kate Spade (55). Robin Williams (63). Aaron Swartz (26). Junior Seau (43). Alexander McQueen (40). Hunter S. Thompson (67). Kurt Cobain (27). Sylvia Plath (30). Ernest Hemingway (61). Alan Turing (41). Virginia Woolf (59). Vincent van Gogh (37). By the time you finish reading this list of notable people who died by suicide, somewhere in the world another person will have done the same, about one every 40 seconds (around 800,000 a year), making suicide the 10th leading cause of death in the U.S. Why?
According to the prominent psychologist Jesse Bering of the University of Otago in New Zealand, in his authoritative book Suicidal: Why We Kill Ourselves (University of Chicago Press, 2018), “The specific issues leading any given person to become suicidal are as different, of course, as their DNA—involving chains of events that one expert calls ‘dizzying in their variety.’” Indeed, my short list above includes people with a diversity of ages, professions, personality and gender. Depression is commonly fingered in many suicide cases, yet most people suffering from depression do not kill themselves (only about 5 percent Bering says), and not all suicide victims were depressed. “Around 43 percent of the variability in suicidal behavior among the general population can be explained by genetics,” Bering reports, “while the remaining 57 percent is attributable to environmental factors.” Having a genetic predisposition for suicidality, coupled with a particular sequence of environmental assaults on one’s will to live, leads some people to try “to make the sh*t stop,” in the words of Winona Ryder’s character in the 1999 film Girl, Interrupted.
In Bering’s case, it first came as a closeted gay teenager “in an intolerant small Midwestern town” and later with unemployment at a status apex in his academic career (success can lead to unreasonably high standards for happiness, later crushed by the vicissitudes of life). Yet most oppressed gays and fallen academics don’t want to kill themselves. “In the vast majority of cases, people kill themselves because of other people,” Bering adduces. “Social problems—especially a hypervigilant concern with what others think or will think of us if only they knew what we perceive to be some unpalatable truth—stoke a deadly fire.”
Like most human behavior, suicide is a multicausal act. Teasing out the strongest predictive variables is difficult, particularly because such internal cognitive states may not be accessible even to the person experiencing them. We cannot perceive the neurochemical workings of our brain, so internal processes are typically attributed to external sources. Even those who experience suicidal ideation may not understand why or even if and when ideation might turn into action. This observation is reinforced by Ralph Lewis, a psychiatrist at the University of Toronto, who works with cancer patients and others facing death, whom I interviewed for my Science Salon podcast about his book Finding Purpose in a Godless World (Prometheus Books, 2018). “A lot of people who are clinically depressed will think that the reason they’re feeling that way is because of an existential crisis about the meaning of life or that it’s because of such and such a relational event that happened,” Lewis says. “But that’s people’s own subjective attribution when in fact they may be depressed for reasons they don’t understand.” In his clinical practice, for example, he notes, “I’ve seen many cases where these existential crises practically evaporated under the influence of an antidepressant.”
This attributional error, Lewis says, is common: “At a basic level, we all misattribute the causes of our mental states, for example, attributing our irritability to something someone said, when in fact it’s because we’re hungry, tired.” In consulting suicide attempt survivors, Lewis remarks, “They say, ‘I don’t know what came over me. I don’t know what I was thinking.’ This is why suicide prevention is so important: because people can be very persuasive in arguing why they believe life—their life—is not worth living. And yet the situation looks radically different months later, sometimes because of an antidepressant, sometimes because of a change in circumstances, sometimes just a mysterious change of mind.”
If you have suicidal thoughts, call the National Suicide Prevention Lifeline at 800-273-8255 or phone a family member or friend. And wait it out, knowing that in time you will most likely experience one of these mysterious changes of mind and once again yearn for life.
October 3rd, 2018 at 7:30 am
While suicide is more often than not a tragedy that affects others as much (or more than) someone who takes his/her life, it’s his/her life.
I have told my wife that if I am ever diagnosed with prostate cancer, I intend to do nothing, other than treat it with massive doses of opioids if there is pain. Some would call this “suicide.” We are all going to die eventually, and I reserve the right to choose the way in which I die — preferably quickly and with dignity, rather than declining into a vegetable state.
October 3rd, 2018 at 7:48 am
Selden….generally speaking, if you are ever diagnosed with prostate cancer….just have it removed. Otherwise you’ll live a life of uncertainity & doubt about your treatment. I had mine removed about 20 years ago when first diagnosed.
October 3rd, 2018 at 9:15 am
This was a very nice column. Thank you, Dr Mike, for writing it. Suicide is a huge problem but we don’t speak of it so it is a hidden huge problem. Thank you for shining a light on it today.
As I have mentioned before, I teach college and consequently I have a lot of contact with people in their late teens and twenties. A lot of them are living in a state of crisis – if they are lucky it’s only a minor crisis. Since my college serves a lot of ‘underrepresented’ students, I see many who face homelessness, unemployment, immigration uncertainty, gang violence, etc.
Some are at the ends of their ropes. They are in despair.
I am not qualified to offer them any help. I am a lowly astrophysicist who sees the human mind as a dark mystery. All I can do is listen to them, care about them and tell them about the resources our school offers.
Now, I’ll (mis)quote your last line about talking to someone and waiting it out, because most likely they will experience a mysterious change in mind and once again yearn for life.
October 3rd, 2018 at 10:00 am
Albert Camus in his essay on “Absurdism” says that suicide is the only important unanswered philosophic question. He says, in essence, that the question is not “why do we commit suicide” but “why do we not”.
October 3rd, 2018 at 11:59 am
I have two sons who died by suicide,and I still wonder why.
October 3rd, 2018 at 3:36 pm
Suicide is something none of us can understand until we have been in (in my mind) the shoes of the person who has psychologically given up and see no other answer than to remove themselves from the equation. The people remaining will never come to grips with the why.
I am a two time cancer survivor. Twelve and a half years ago, I was given six months to live. It never occurred to me to do anything other than to give this life everything I have. I have succeeded and flourished in ways I never thought possible and the people around me have benefited from me being here. Maybe the “why” in me just never occurred.
Selden. Do you research and your homework. Get multiple opinions. Read the studies. Prostate cancer is far from a death sentence.
October 3rd, 2018 at 6:35 pm
On Camus’ “why do we not.” Because humans and other animals’ brains are pre-wired for survival. If not, we would be extinct long ago
Is it true that Apple computer’s logo is inspired by Turing’s cyanide-laced apple?
October 4th, 2018 at 12:53 pm
when I feel suicidal, I feel despair, not depression. It is the “I just can’t go through this same tedious shit again” feeling. my breath just goes and my stomach feels hollow. It is a feeling of dread that life will go on and nothing will change. It definitely is exacerbated when my blood sugar bottoms out.
October 6th, 2018 at 12:07 am
A man rescued from suicide after jumping off a bridge was asked, “Did you regret it?” The reply was, “The second I went over the rail.” He was lucky. He got another chance.
October 7th, 2018 at 4:16 am
vel’s exasperation of despair “I just can’t go through this same tedious shit again” reminded me of something comparatively much more mundane, but perhaps, in a weird way, relevant to the problem of “a feeling of dread that life will go on and nothing will change”.
Not at all to make light of the seriousness of suicide, I recall how I felt liberated when, at the time, my most precious possession went up in fire and smoke! My only car, on which I had to depend for getting to work, burned on the first day of employment on the parking lot of my workplace. I was happy! That car, over the course of many months, had tormented me with a slew of mean mechanical problems, driving safety issues, and mounting repair costs. I did not realize how badly I needed to let go of it. But the fire let me see. I was free and happy.
Suicide — what’s the motivation? What is (believed) to be gained if anything? Once I lose this life, there is no opportunity to acquire another life, unlike another car, used or new. So, it must be that blot — dread of a miasma, that’s out of breath, a lifeless life — that’s got to go!
But then, what do I know?
October 7th, 2018 at 1:26 pm
The August/September 2018 issue of FREE INQUIRY magazine has an article on suicide titled “Humanism and Suicide: A Positive View” by Lowery R. Brown. Check it out!
October 7th, 2018 at 8:10 pm
Suicide isn’t always a bad thing… my mother had cancer three separate times through her life. She didn’t give up, but at the end she died afraid, drugged up, confused and in agony. If she had felt it was socially and morally acceptable to voluntarily commit suicide months earlier, I feel like she would have gladly taken that option and said goodbye to us on her own terms. On the other hand, a good friend of mine nearly committed suicide and I still have lingering fear that he might go through with it some day, and another friend’s father committed suicide, shattering her life for almost a decade. Suicide can be a graceful way out that lets you preserve your dignity and identity, or a horrible mistake that destroys the lives of those who love you most. It all depends on the circumstances.