Male depression and suicide: the facts, the figures and a little bit of hope

by Martin

in Depression in Men

Male depression and suicide: No-one can pinpoint an obvious reason

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.

Does this theory sound plausible? It certainly does to me and would probably account for suicides as diverse as those of Cleopatra, Kurt Cobain and Peter Roebuck.

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.

The numbers

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
1 Lithuania 2009 61.3
2 Russian Federation 2006 53.9
3 Belarus 2007 48.7
4 Sri Lanka 1991 44.6
5 Kazakhstan 2008 43
6 Hungary 2009 40
7 Latvia 2009 40
8 Republic of Korea 2009 39.9
9 Guyana 2006 39
10 Ukraine 2009 37.8
11 Japan 2009 36.2
12 Slovenia 2009 34.6
13 Estonia 2008 30.6
14 Republic of Moldova 2008 30.1
15 Finland 2009 29
16 Croatia 2009 28.9
17 Belgium 2006 28.8
18 Serbia 2009 28.1
19 Poland 2008 26.4
20 Uruguay 2004 26
- - - -
36 New Zealand 2007 18.1
39 United States of America 2007 17.7
41 Canda 2004 17.3
54 Australia 2006 12.8
59 United Kingdom 2009 10.9

 

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.

Need Help?

Australia

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

United Kingdom

The Samaritans:
Telephone helpline: 0845 790 9090
1850 60 90 90 if you are in the Republic of Ireland
Anonymous E-mail: samaritans@anon.twwells.com
For Children and Youth:
Childline: 0800 1111

United States

National 24 Hour Suicide/Crisis Lines:
1-800-SUICIDE (1-800-784-2433)- handles both crisis and suicide calls
1-800-233-HELP (1-800-233-4357)
1-800-273-TALK (1-800-273-8255)
For Youth/Adolescent:1-800-448-4663
Covenant House (Adolescent): 1-800-999-9999

New Zealand

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)

Canada

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.

Other resources

Suicide as Psychache: A Clinical Approach to Self-Destructive Behavior by Edwin Schneidman .

Image

Main image: No-one can pinpoint an obvious reason, acrylic on canvas, 123cm x 102cm by Martin Grover

About the Author

Father, husband, writer and website publisher, discontented in his day-job, he writes here about depression - his own and in general. You can follow Too Depressed on Twitter. Please share the content on this site with all your friends, followers and contacts using the buttons above.

Contact the author

Last revised on December 7, 2012

{ 9 comments… read them below or add one }

Adam Alvarado May 22, 2012 at 11:57 am

Hmm. Just reading this, and seeing the name Cleopatra there made me wonder. It seems, at least from the anecdotes and stories left to us, that suicide was a very different thing thousands of years ago – not quite as taboo or completely outrageous – as some cultures even thought of it as an honorable and just thing, something that actually wasn’t the result of depression like we know it today, but countless reasons that would seem very odd to us because of what modern society has taught us. But today, maybe because of these collegiate studies which treat it simply as a statistical problem rather than a human problem and all the too-positive or misguided self-help and whatnot, instead of focusing on why they feel (essentially) a duty to end their life and the feelings that must fuel that duty, we simply deny they have that right at all, right? We don’t empathize with it and work from there. We deny it’s legitimacy or rightful existence in the realm of possibilities, and so maybe the “help” they get actually only contributes to the helplessness or disconnect the sufferer feels.

Anyway, maybe the evolution of suicide would be a great topic too, cause it seems despite all the studies and whatever other attention given it, people are no closer to figuring out how best to help those who make the ultimate decision. Thanks for the time put into the post! You obviously took great care…
Adam Alvarado recently posted..The Only “1%” in the World We Should Give a Damn AboutMy Profile

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Martin May 22, 2012 at 2:48 pm

Thanks for your input Adam.

I think you make a valid point about the help people get. I think that’s why targeted help (like CALM’s) seems to have some success.

Interesting cultural point too. It’s pretty speculative, but if you look at the list of 100 or so countries featured by the WHO, you can guess that there are some strong cultural factors, like social cohesion, economy, religion etc influencing the prevalence of suicides in the various countries.

Good to get you comments.
Martin recently posted..Male depression and suicide: the facts, the figures and a little bit of hopeMy Profile

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Vinson May 29, 2012 at 3:12 am

Thank you for sharing this very informative data to us, I’m assigned to do an extensive research about suicidal cases worldwide and lucky to found this article. I was shocked seeing that Lithuania has the highest cased of suicide in men.
Vinson recently posted..Most Effective Natural Treatments for DepressionMy Profile

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Martin May 29, 2012 at 9:00 am

Hi Vinson, thanks for your comments.

As I mentioned in my response to Adam, the question of what accounts for the high rates of suicide is one that needs investigating. According to this 2005 research by Lithuanian researchers, there is a pretty strong correlation in Lithuania between unemployment, especially long term unemployment, and depression. They say:

Fifteen years have passed since Lithuania declared independence in 1990. The newly independent country faced many challenges in the transformation of political, social and economic systems. The transition from a planned to a market economy caused an increase in competition, rise of private capital and changes in the labour market that involved growing unemployment. Until the early 1990s, the prevalence of joblessness in Lithuania was very low (about 1% of the working age population). The unemployment rate gradually increased during the 1993–2001 period. In 2001, the unemployment rate reached its highest, ever-reported level of 16.4%. Since 2002, joblessness started to decrease; nevertheless, the unemployment rate was still 8.2% in Lithuania in 2005. In spite of that, there is an inadequate social support system for unemployed persons in Lithuania. Only 16% of registered unemployed persons receive unemployment benefits. More than 28% of these persons are long-term unemployed

The research concludes:

The results indicated that depression is a severe problem in the unemployed population. Depression is more elevated among the long-term unemployed. This leads to arguing for common efforts in providing needed social support and health care to reduce the effects of unemployment on mental health.

Duration of unemployment and depression: a cross-sectional survey in Lithuania, Mindaugas Stankunas, Ramune Kalediene, Skirmante Starkuviene and Violeta Kapustinskiene BMC Public Health 2006, 6:174

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Mike Sperber July 14, 2012 at 4:10 pm

“…odd coincidence (actually I think there is a word for this phenomenon but I can’t recall it at the moment..”

Is the word for which you searched “synchronicity”?
I enjoyed your essay and hope you are feeling better.

Mike

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Martin July 14, 2012 at 4:13 pm

Thanks Mike, that might just be it.

And thanks for your kind words.
Martin recently posted..Male depression and suicide: the facts, the figures and a little bit of hopeMy Profile

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Sam August 14, 2012 at 2:36 am

This is an excellent post. Having attempted suicide in the past and coming close to it many times since, I understand mental illness-related suicide. In these instances I think it is more accurate to say that the victim lost their battle with (depression, schizophrenia, whatever). I like to think that this might help survivors understand that their loved one was not “being selfish” but was very, very sick.

However, I’d always wondered about non-mental illness related suicide, it’s causes, what goes on in the minds of those who die this way, etc. So thank you for a very informative post.

PS: In a recent email from the Black Dog Institute I read that suicide is now the LEADING cause of death for Australian males under the age of 44. Pretty scary stuff.

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Martin August 18, 2012 at 7:56 pm

Hi Sam
Thanks for commenting and complimenting the post. The prevalence of suicide really is scary stuff as you say.
But there are ways that can help and one of those has to be more ‘normalisation’ of mental health issues. I think it would help men in particular if they could seek help for these problems without the sense of shame and failure that seems to accompany them.
It’s a good point you make about suicide not being a selfish act too.
All the best
Martin
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Mike August 12, 2013 at 11:08 am

I’ve been suffering from depression for several years now. Fortunately, I have not reached the point of attempting suicide, but through my recent treatments, it has been determined that I have suicidal ideations. I was shocked to see that 15% who are diagnosed as clinically depressed die by suicide. I would also like to know how many more may have attempted suicide, but were not successful. This illness has really taken over my life, and I am doing everything I can to make sure I’m not one of those 15%. It’s not easy, and I can’t EVER give up.

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