This article discusses male depression and suicide.
If you are feeling suicidal, it is vital that you get some immediate support. Please do that now.
Some relevant support services can be found here.
I have had this article in draft for several months, unsure whether I should publish it. In the end I decided I should, as it is intended to promote understanding of the issue of male suicide and to offer some hope and relevant resources.
I’ve been thinking a lot about suicide lately.
Not my own, thankfully, but the frightening prevalence of suicides related to male depression.
This won’t mean much to my American readers, but this train of thought started a few months ago when English born broadcaster and former cricketer, Peter Roebuck, took his life by throwing himself from a South African hotel room window. By all accounts, he leapt to his death minutes after having been confronted by police about an allegation of sexual assault made against him.
I never met Peter Roebuck, nor, in truth, did I especially admire him as a player or broadcaster. I respected his talents but never warmed to him like I had to heart-on-the sleeve cricketers like Nasser Hussain or Mark Butcher.
Nevertheless, this stark act by a clearly troubled man set me thinking – and researching.
Why do people commit suicide?
Suddenly alert to suicide-related material, a day or two after Peter Roebuck’s death I read in the Guardian that scientists have identified a gene variant that is more commonly present in depressed people who had attempted suicide than those who had not.
The research led by Professor J John Mann of the New York State Psychiatric Institute showed that 43% of the depressed patients who had attempted suicide had a particular variant of the RGS2 gene, while less than 20% of them had a “safer” variant of the gene.
Whilst the research is yet to be peer reviewed, it raises the possibility that a test could be developed to ascertain those most at risk of suicide when depressed.
This then may be one genetic explanation for suicide, amongst those suffering from depression at least.
But it is certainly not the whole story. It probably doesn’t explain a death like Peter Roebuck’s, for example.
So what else is involved?
I began drafting this piece as I pondered this question. I left it overnight and then, in another odd coincidence (actually I think there is a word for this phenomenon but I can’t recall it at the moment), the first article in my feed reader when I turned on my i-Pad the following morning was a piece in the Psychiatric Times by Michael Sperber MD, entitled Suicide: Psychache and Alienation. Dr Sperber is a Psychiatric Consultant to the Neuropsychiatry/Behavioral Neurology Service of McLean Hospital in Belmont, Mass.
Dr Sperber draws on the work of suicidologist Edwin Shneidman and philosopher Martin Heidigger to construct an explanation for suicide that sounds both convincing and of general application.
The word Psychache was used by Shneidman to describe “unbearable psychological pain—hurt, anguish, soreness, and aching”. It is this unendurable pain and the desire to bring it to an end, says Shneidman, that is behind the suicide impulse. Although, what actually is unendurable will vary from person to person.
Dr Sperber calls upon Heidigger to explore what might be behind the onset of Psychache.
Heidigger’s theory of ‘being in the world’ posited that that our psychological life involves three elements:
- our intrapsychic or interior life,
- our life of interpersonal relationships, and
- our relationship with the natural world.
Dr Sperber contends that “overwhelming psychache eclipses 1 or more” of these “realms of being”.
Examples of this occurring include extreme betrayal and humiliation, both of which are “mortifying experiences” that “may be ranged on a continuum of shame, with pride and mortification as polar extremes”.
But, concludes Dr Sperber:
“not all persons who have been betrayed or humiliated commit suicide. Suicide occurs when psychache is mortifying and eclipses 1 or more realms of being.”
So, as I understand it, the theory is that suicide may occur when pain and suffering is so intense as to apparently obliterate the foundations that underpin the reasons for a person’s existence.
Of course, you don’t have to be depressed to want to kill yourself. The ‘eclipse’ of the relevant realms of being may well be sudden.
But, clearly, such suffering may occur within a state of depression and, according to Suicide Awareness, Voices of Education (SAVE), depression is indeed the strongest risk factor for suicide.
Depression and Suicide
If we now focus on depression, we can see how easily the typical symptoms of major depressive disorder can give rise to a suicidal tendency.
In a depressive state, in my experience at least:
- our intrapsychic or interior life becomes disrupted significantly as it becomes filled with negative thoughts about ourselves,
- our interpersonal relationships suffer as we withdraw into ourselves, and
- our relationship with the natural world breaks down because we cease to notice much at all about the world around us.
All of this led me to do some further research on the prevalence suicide, which revealed some frightening results.
None of this is new information but it bears repeating here.
I focused first on the US, the UK and Australia.
From the US based SAVE website, I discovered that:
- Over half of all suicides occur in adult men, aged 25-65
- For young people 15-24 years old, suicide is the third leading cause of death
- 15% of those who are clinically depressed die by suicide
- The strongest risk factor for suicide is depression
- An average of one person dies by suicide every 16.2 minutes
- There are four male suicides for every female suicide.
From the US American Foundation for Suicide Prevention, I learned that:
- Nearly 1,000,000 people in the US make a suicide attempt every year
- 90% of people who die by suicide have a diagnosable and treatable psychiatric disorder at the time of their death
- Recent data puts yearly medical costs for suicide at nearly $100,000,000.00 (2005)
- Men are nearly 4 times more likely to die by suicide than women, [yet] women attempt suicide 3 times as often as men
- Suicide rates are highest for people between the ages of 40 and 59.
According to the UK charity the Samaritans:
- One suicide death occurs every 85 minutes in the UK and Ireland
- More than 6,200 pepople died by suicide in the UK and Ireland in 2009
- Suicide is the second biggest killer of young people aged 15 to 24 in the UK (only road accidents kill more young people)
- On 2009 figures, suicide is three times more common amongst men in the UK than women.
Australia’s Black Dog Institute reports that:
- Between 1995-2005, the rate of suicide among males was four times higher than that of females
- The highest suicide rate for males in 2005 was observed in the 30-34 year old age group (27.5 per 100,000)
- Rural areas traditionally record higher suicide rates than urban areas
- Suicide accounts for slightly more than one-quarter of all male deaths in the 20-24 year old age group.
But despite all this, according to the World Health Organisation’s figures for male suicides per 100,000 of population, the US, UK and Australia do not even make it into the top 20 countries.
I’ve taken the WHO figures published at the link above and sorted them to show the 20 countries with the highest suicide rates. The full list in an excel spreadsheet is here.
|Rank||Country||Year||Suicides per 100,000 of population|
|8||Republic of Korea||2009||39.9|
|14||Republic of Moldova||2008||30.1|
|39||United States of America||2007||17.7|
It’s hard to imagine the despair going in places at the top of the list where the male suicide rate is several times that in the major English speaking countries.
Is there any hope?
Thankfully, there is some.
Firstly, there is the prospect held out by research like Professor Mann’s that in the future it might be easier to identify those at risk.
Secondly, there are ways to help us deal with the psychache.
Consider CALM – the Campaign Against Living Miserably – a UK charity set up in response to the high suicide rates in young men and one, judging by its name, that I might have derived some benefit from when I was a young man and the Smiths’ Heaven Knows I’m Miserable Now seemed to be the soundtrack to my life.
In some areas CALM works with local clubs, local communities and with the music and entertainment industries to promote its campaigns to young men. Remarkably, in one area of the UK where CALM has been especially active, young male suicide has decreased by 55% in a ten year period, compared to a national decrease of 20%.
CALM’s success seems to me to indicate that it takes a pretty targeted, specific, credible and intense approach to be able to break down the barriers that men build up and to begin to help them find another way to live.
Men are conditioned to bottle up the feelings that lead us to these states of despair and desperation and men, young men especially, need to hear the right messages in their own language and through media they consider to be their own.
They also need these messages to be replayed over and over to them, so that they become real for them, rather than just part of the endless chatter of the world that they are having trouble living in.
This kind of approach, I suspect, is what is behind CALM’s success.
The challenge for those charged with helping men deal with the pain they face in their life is to communicate in this way more often, more consistently and more effectively and to find the people who can deliver those messages authentically and credibly.
National Suicide Call Back Service – 1300 659 467
“Crisis counselling to people at risk of suicide, carers for someone who is suicidal and those bereaved by suicide, 24 hours per day 7 days a week across Australia”
Other Help Lines
Lifeline (National) – 13 11 14
SANE Australia Helpline (National) – 1800 187 263
Suicide Helpline (VIC) – 1300 651 251
Mensline (National) – 1300 789 978
Kids Helpline (National) – 1800 551 800
Telephone helpline: 0845 790 9090
1850 60 90 90 if you are in the Republic of Ireland
Anonymous E-mail: firstname.lastname@example.org
For Children and Youth:
Childline: 0800 1111
National 24 Hour Suicide/Crisis Lines:
1-800-SUICIDE (1-800-784-2433)- handles both crisis and suicide calls
Covenant House (Adolescent): 1-800-999-9999
Lifeline 24 hour counselling
Lifeline 24/7 Helpline: (09) 5 222 999
Kidsline: 0800 KIDSLINE (0800 543 754)
Chinese Lifeline: 0800 888 880
Suicide Prevention Helpline: 0508 TAUTOKO (0508 828 865)
Go to the Suicide Prevention website and find your local crisis center.
Talk to CALM
The helpline is open 5pm-midnight on Sat, Sun, Mon and Tues, every week of the year.
Call 0808 802 5858 within London – or if you’re outside London call 0800 585858. It’s free, confidential and anonymous.
Text 07537 404717, start your first text ‘CALM1’ (service only available within London, until more funding becomes available).
Thanks to Madam Bipolar for curating much of help information above.
Suicide as Psychache: A Clinical Approach to Self-Destructive Behavior by Edwin Schneidman .
Main image: No-one can pinpoint an obvious reason, acrylic on canvas, 123cm x 102cm by Martin Grover