A Worldwide Problem

“Suicide is a serious public health problem.”—David Satcher, U.S. surgeon general, in 1999.

THAT statement marked the first time in history that a surgeon general of the United States had made suicide a public issue. More people in that country are now killing themselves than are being killed by others. Little wonder that the U.S. Senate declared suicide prevention to be a national priority.

Yet, the suicide rate in the United States, which was 11.4 per 100,000 in 1997, is below the global rate published by the World Health Organization in 2000—16 per 100,000. The suicide rates worldwide have increased 60 percent in the last 45 years. Now, in a single year, about a million people worldwide take their own lives. That amounts to approximately one death every 40 seconds!

Statistics, however, cannot tell the whole story. In many cases family members deny that a death was a suicide. Moreover, it is estimated that for every completed suicide, between 10 and 25 are attempted. One survey found that 27 percent of high school students in the United States admitted that during the previous year, they had seriously considered suicide; 8 percent of the group surveyed said that they had made suicide attempts. Other studies have found that from 5 to 15 percent of the adult population have had suicidal thoughts at one time or another.

Cultural Differences

The way people view suicide varies greatly. Some view it as a crime, others as a coward’s escape, and still others as an honorable way of apologizing for a blunder. Some even consider it a noble way to further a cause. Why such different viewpoints? Culture plays a major role. In fact, The Harvard Mental Health Letter suggests that culture may even “influence the likelihood of suicide.”

Consider a country in central Europe—Hungary. Dr. Zoltán Rihmer refers to the high suicide rate there as Hungary’s “sad ‘tradition.’” Béla Buda, the director of Hungary’s National Institute for Health, noted that Hungarians commit suicide all too readily, for virtually any reason. “He has cancer—he knows how to end that state” is, according to Buda, a common reaction.

In India there was once a religious custom known as suttee. Although this practice, in which a widow throws herself on the funeral pyre of her husband, has long been prohibited, it still is not quite extinct. When one woman reportedly committed suicide in this way, many of the local people glorified the tragedy. According to India Today, that region of India “has seen nearly 25 women burn themselves on their husbands’ pyres in as many years.”

Remarkably, in Japan suicide claims three times as many lives as do traffic accidents! “Japan’s traditional culture, which has never condemned suicide, is known for a highly ritualized and institutionalized form of self-disembowelment (seppuku or hara-kiri),” says Japan—An Illustrated Encyclopedia.

In his book Bushido—The Soul of Japan, Inazo Nitobe, who later became the under-secretary-general of the League of Nations, explained this cultural fascination with death. He wrote: “An invention of the middle ages, [seppuku] was a process by which warriors could expiate their crimes, apologise for errors, escape from disgrace, redeem their friends, or prove their sincerity.” Although this ritualistic form of suicide is generally a thing of the past, a few still resort to it for the sake of social impact.

In Christendom, on the other hand, suicide was long viewed as a crime. By the sixth and seventh centuries, the Roman Catholic Church excommunicated those who had committed suicide and denied them funeral rites. In some places, religious fervor has bred strange customs regarding suicides—including hanging the dead body and even driving a stake through the heart.

Paradoxically, those who attempted suicide could incur the death penalty. For trying to kill himself by cutting his throat, a 19th-century Englishman was hanged. Thus the authorities accomplished what the man himself had failed to do. Though the punishment for attempted suicide changed over the years, it was not until 1961 that the British Parliament declared that suicide and attempted suicide were no longer crimes. In Ireland it remained a crime until 1993.

Today some authors encourage suicide as an option. A 1991 book about assisted suicide for the terminally ill suggested ways to end one’s life. Later, an increased number of people who were not terminally ill used one of the recommended methods.

Is suicide really the answer to one’s problems? Or are there good reasons to keep living? Before considering these questions, let us first examine what leads to suicide.

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In a single year, about a million people worldwide take their own lives. That amounts to one death almost every 40 seconds!

Why People Give Up on Life

“Each way to suicide is its own: intensely private, unknowable, and terrible.”—Kay Redfield Jamison, psychiatrist.

“IT IS suffering to live.” That is what Ryunosuke Akutagawa, a popular writer in early 20th-century Japan, wrote shortly before committing suicide. However, he prefaced that statement with the words: “Of course, I do not want to die, but . . .”

Like Akutagawa, many of those who take their life do not want to die as much as they want “to end whatever is going on,” stated one psychology professor. The wording so commonly found in suicide notes suggests as much. Such phrases as ‘I could not take it any longer’ or ‘Why go on living?’ show a deep desire to escape life’s harsh realities. But as one expert described it, committing suicide is “like treating a cold with a nuclear bomb.”

Although the reasons why people commit suicide vary, certain events in life commonly trigger suicide.

Triggering Events

It is not uncommon for young ones who give in to despair and commit suicide to do so even over matters that may seem trivial to others. When they feel hurt and cannot do anything about it, youths may view their own death as a means of getting back at those who have hurt them. Hiroshi Inamura, a specialist in handling suicidal people in Japan, wrote: “Through their own death, children cherish an inner urge to punish the person who has tormented them.”

A recent survey in Britain indicated that when children are subjected to severe bullying, they are nearly seven times as likely to attempt suicide. The emotional pain that these children suffer is real. A 13-year-old boy who hanged himself left behind a note naming five people who had tormented him and had even extorted money from him. “Please save other children,” he wrote.

Others may try to take their life when they get into trouble at school or with the law, suffer the end of a romance, get a bad report card, experience stress over exams, or become weighed down by worries about the future. Among high-achieving adolescents who may tend to be perfectionists, a setback or a failure—be it actual or imaginary—may bring on a suicide attempt.

For adults, financial or work-related problems are common triggering events. In Japan after years of economic downturn, suicides recently topped 30,000 a year. According to the Mainichi Daily News, almost three quarters of the middle-aged men who killed themselves did so “because of problems stemming from debts, business failures, poverty and unemployment.” Family problems too may lead to suicide. A Finnish newspaper reported: “Recently divorced middle-aged men” make up one of the high-risk groups. A study in Hungary found that the majority of girls who contemplate suicide were reared in broken homes.

Retirement and physical illness are also major triggering factors, especially among the elderly. Often suicide is chosen as a way out, not necessarily when an illness is terminal, but when the patient views the suffering as intolerable.

However, not everybody reacts to these triggering events by committing suicide. On the contrary, when faced with such stressful situations, the majority do not take their life. Why, then, do some view suicide as the answer, while most do not?

Underlying Factors

“Much of the decision to die is in the construing of events,” says Kay Redfield Jamison, professor of psychiatry at the Johns Hopkins University School of Medicine. She adds: “Most minds, when healthy, do not construe any event as devastating enough to warrant suicide.” Eve K. Mościcki, of the U.S. National Institute of Mental Health, notes that many factors—some of them underlying—work together to lead to suicidal behavior. Such underlying factors include mental and addictive disorders, genetic makeup, and brain chemistry. Let us consider some of them.

Foremost among these factors are mental and addictive disorders, such as depression, bipolar mood disorders, schizophrenia, and alcohol or drug abuse. Research in both Europe and the United States indicates that more than 90 percent of completed suicides are associated with such disorders. In fact, Swedish researchers found that among men who were not diagnosed with any disorders of that kind, the suicide rate was 8.3 per 100,000, but among the depressed it jumped to 650 per 100,000! And experts say that the factors leading to suicide are similar in Eastern lands. Still, even the combination of depression with triggering events does not make suicide inevitable.

Professor Jamison, who once attempted suicide herself, says: “People seem to be able to bear or tolerate depression as long as there is the belief that things will improve.” However, she has found that as the cumulative despair becomes unbearable, the ability of the mental system to restrain suicidal impulses gradually weakens. She likens the situation to the way that the brakes on a car are worn thin by constant stress.

It is vital to recognize such a trend because depression can be treated. Feelings of helplessness can be reversed. When the underlying factors are dealt with, people may react differently to the heartaches and stresses that often trigger suicide.

Some think that one’s genetic makeup may constitute an underlying factor in many suicides. True, genes play a role in determining one’s temperament, and studies reveal that some family lines have more incidents of suicide than others. Yet, “a genetic predisposition to suicide by no means implies that suicide is inevitable,” says Jamison.

Brain chemistry too can be an underlying factor. In the brain billions of neurons communicate electrochemically. At the branched-out ends of the nerve fibers, there are small gaps called synapses across which neurotransmitters carry information chemically. The level of one neurotransmitter, serotonin, may be involved in a person’s biological vulnerability to suicide. The book Inside the Brain explains: “A low serotonin level . . . can dry up the wellsprings of life’s happiness, withering a person’s interest in his existence and increasing the risk of depression and suicide.”

The fact is, however, that nobody is destined to commit suicide. Millions of people cope with heartaches and stresses. It is the way the mind and the heart react to pressures that leads some to kill themselves. Not just the immediate triggering causes but the underlying factors must also be dealt with.

So, then, what can be done to create a more positive outlook that will regenerate a measure of zest for life?

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Gender and Suicide

According to a study in the United States, while women are two to three times more likely to attempt suicide than men, men are four times more likely to succeed. Women are at least twice as likely as men to suffer from depression, which may account for the greater number of suicide attempts. However, their depressive illnesses may be less violent, and thus they may turn to less violent means. Men, on the other hand, may tend to use more aggressive and decisive means to make sure they succeed.

In China, however, more women than men succeed. In fact, a study reveals that some 56 percent of the world’s female suicides occur in China, especially in rural areas. It is said that one of the reasons for impulsive female suicide attempts leading to completed suicides there is the easy access to lethal pesticides.

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Suicide and Loneliness

Loneliness is one of the factors that lead people to depression and suicide. Jouko Lönnqvist, who headed a study of suicides in Finland, said: “For a great number [of those who had committed suicide], everyday life was lonely. They had lots of spare time but few social contacts.” Kenshiro Ohara, a psychiatrist at Hamamatsu University School of Medicine in Japan, commented that “isolation” was behind the recent surge in suicides by middle-aged men in that country.

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For adults, financial or work-related problems are common triggering events