Suicide Prevention

[Michael McMahon]

"But a healthy dose of social pressure, judgment, and yes, honest vocal expressions of genuine moral disgust and anger at those who actually commit suicide, is also necessary. Without it, we send a clear signal, no matter how well meant: “It’s OK. In the end, we’ll understand. Maybe we will even think you were more complex than the rest of us.” "

- Boris Zelkin

What exactly do you mean by contagion? It's important not to let any concept get hijacked by those intent on stigmatising suicide like the one above. 

[iNow]

17 minutes ago, Michael McMahon said:

What exactly do you mean by contagion? 

Seriously?

[Michael McMahon]

Well how does one person dying by suicide encourage others to do the same? What's the mechanism? Everyone knows what suicide is, so why would not reporting it result in less suicides? As I've said before suicide must be very painful so only those with severe pain would attempt it.

[iNow]

10 minutes ago, Michael McMahon said:

Well how does one person dying by suicide encourage others to do the same?

Are you familiar with social learning theory, or even the copycat effect?

[Phi for All]

2 hours ago, Michael McMahon said:

Well how does one person dying by suicide encourage others to do the same? What's the mechanism?

This is pretty basic stuff. Substitute almost anything, good or bad, for "dying by suicide" in your above question, and I think you'll have your answer. 

How does one person blowing up a building encourage others to do the same?

How does one person eating an ice cream cone encourage others to do the same?

Emulating observed behavior is one of the foundations of how we learn, from a very young age. It's a spectrum ranging from avoidance to admiration to hero worship, and it's very powerful.

Also, I'm not sure I agree that sending a message that suicide is NOT OK is necessarily stigmatizing it. You can decry an action without implying anything about the person performing it. I want to be able to say suicide is a horrible thing, without implying a person is horrible for contemplating it. Does that make sense?

[Michael McMahon]

But there's a lot we don't understand about the mind. We can't control a lot of our subconscious such as the sensation of colour. Similarly we're not in complete control of our emotions. Mental illness seems to be deceptive. Depression, for instance, may delude the person into thinking everything is meaningless. They can't remember being happy. I think it's important not to be harsh when their beliefs, memory and thoughts might be impaired.

[StringJunky]

9 minutes ago, Michael McMahon said:

But there's a lot we don't understand about the mind. We can't control a lot of our subconscious such as the sensation of colour. Similarly we're not in complete control of our emotions. Mental illness seems to be deceptive. Depression, for instance, may delude the person into thinking everything is meaningless. They can't remember being happy. I think it's important not to be harsh when their beliefs, memory and thoughts might be impaired.

Whether a depression is meaningful or meaningless depends whether the cause is endogenous (neurologica)l or reactive due to some personal adverse event or injury. The former could be classesd as meaningless because its cause is due to some unknown neurochemical events that is essentially spontaneous. If a person has a painful/debilitating, progressive, terminal condition. I wouldn''t call them deluded for being depressed and wanting to end their life.

[iNow]

1 hour ago, Michael McMahon said:

But there's a lot we don't understand about the mind. We can't control a lot of our subconscious such as the sensation of colour. Similarly we're not in complete control of our emotions. Mental illness seems to be deceptive. Depression, for instance, may delude the person into thinking everything is meaningless. They can't remember being happy. I think it's important not to be harsh when their beliefs, memory and thoughts might be impaired.

All of these things are true. They remain true even while acknowledging the validity of Phi’s point 

58 minutes ago, StringJunky said:

Whether a depression is meaningful or meaningless depends whether the cause is endogenous (neurologica)l or reactive due to some personal adverse event or injury

I’d be cautious referring to any of them as meaningless. While the causes potentially differ, the impact on one’s life can be extremely meaningful regardless of cause. 

It's not the depression that’s meaningless, but meaningless is often how the depressed person views existence itself. 

Edited June 6, 2019 by iNow

[Michael McMahon]

Even if there are copycat suicides, they'd be in a small minority compared to those who die of mental illness. It does not justify ostracising victims. 

[iNow]

1 hour ago, Michael McMahon said:

Even if there are copycat suicides, they'd be in a small minority compared to those who die of mental illness. It does not justify ostracising victims. 

Nobody is advocating ostracizing victims. Quite the opposite. They need love and kindness. Who are you responding to?

[Michael McMahon]

If one accidentally falls off a ladder, they're not guilty of negligence and endangerment because they are the only victim. So it makes no sense to imply that suicide victims committed anything.

[dimreepr]

12 hours ago, Michael McMahon said:

If one accidentally falls off a ladder, they're not guilty of negligence and endangerment because they are the only victim. So it makes no sense to imply that suicide victims committed anything.

It's not very often that they're the only victim ("no man is an island"), and you're the only one assuming 'committed' has negative implications. 

In fact you seem to on a crusade to defend these unfortunate people, when no-one is attacking them; what's your agenda?

[SerengetiLion]

On 5/22/2019 at 11:06 AM, seriously disabled said:

Everyone should have the right to die by suicide if their lives become very miserable and they are really not happy with everything.  

I hate how society thinks it has the right to decide for a person that he should continue living a miserable life rather than choosing to die.

My life is my life. It's nobody business but my own. Therefore I am the exclusive owner of my life and I have the exclusive right to decide what to do with it.

And if I am not happy and living a miserable life then I should have the right to end my life if I choose so.

 

 

I so agree with you because nobody knows our undesirable thoughts that consume some to the breaking point.

[Michael McMahon]

“FAITH, hope and love: these are the cardinal human virtues. They also define a now deeply unfashionable concept: manliness. And since we can, quite rightly, no longer use the crude force of a pagan taboo as a control over people's lives, then we must extol the positive, especially the moral concept that is the most noble of them all. Not for me, or you, or us, but for others; the concept that conveys faith, hope and love, which together go by that very simple and very male word, "duty".”

- Kevin Myers

https://www.google.ie/amp/s/amp.independent.ie/opinion/columnists/kevin-myers/kevin-myers-suicide-is-self-murder-and-must-remain-taboo-26798158.html

 

“Suicide spreads when people feel authorised to opt for it, and when they have lost the will to remain alive. The second part is less important than the first part. Most people wish they were dead at some time or other in their lives. It is the culture of authorisation that translates a possibly temporary indifference to life into a decisive and final action which can be a key factor in the spread of suicide. The more people hear of suicides, the more suicides will follow. And the emotive, non-judgmental, godless culture that has emerged in recent years rules out the use of taboo as a social influence on society generally. If anything, nowadays, a suicide will receive a larger funeral than a cancer victim. So what impact does the sight of a huge funeral have on a depressed person who feels that life is not worth living, and they are a burden to others? Will their own death not merely end all their misery? And their funeral will then serve as a paradoxical affirmation of how important they really were: yes, well, the point is that suicide is not a rational choice.”

- Kevin Myers

https://www.google.ie/amp/s/amp.independent.ie/opinion/columnists/kevin-myers/kevin-myers-as-a-society-we-seem-paralysed-by-suicide-26810287.html

 

Stoicism: “the endurance of pain or hardship without the display of feelings and without complaint.”

Machismo: “strong or aggressive masculine pride.”

 

Whether one cries and wails or is instead equanimous, the mere experience of pain itself in both instances is a sign of humility and the recognition that you’re not omnipotent. It’s easy to seem calm and relaxed when your not currently in any pain or living an idle rich lifestyle! If you’re able to withstand pain with steely perseverance; then that’s obviously great for you. But it’s still perfectly acceptable when someone needs to be more expressive about the pain they’re in order to get help. 
 

If stoicism is to be seen as a sign of humility and helpfulness, then it would be contradictory to be patronisingly proud of it. Suicide should be discouraged primarily because it’s extremely sad that the victim would miss out on the rest of their life. I understand arguments about the grief of relatives and parental suicide which, while clearly important, is nonetheless secondary to the wellbeing of the individual themselves. At the end of the day, people don’t exist in life to appease others no matter how much they like each other.
 

Historical cases of sacrificing one’s life and martyrdom are brave precisely because they freely choose to do so and it wasn’t actually owed to anyone. Dying of terminal illness is very brave because of how much more aware they are of their mortality and impending death. But obviously everyone will eventually die and no one is immortal. Suicide doesn’t conflict with stoicism per se as it’s conceivable to kill oneself without displaying any emotion. Opting to have an anaesthetic during heart surgery shouldn’t be seen as taking the easy way out.

https://www.totalhealth.co.uk/blog/can-you-have-surgery-without-anaesthetic

[Michael McMahon]

I don’t think openly allowing suicide would increase the current suicide rate. It would just have a palliative affect on those who have unfortunately lost hope and have decided that they can’t live any longer.
 

Heavily relying on involuntary admissions could deter other people from trying to get help in case they too become confined to the hospital. The detainment can be well-intentioned, particularly when a patient might have low self-awareness. But we must be mindful not to excessively depend on it as the loss of freedom may adversely affect self-stigmatisation among patients. 
 

The toleration of suicide may counter-intuitively reduce the materialising of that event. This is because we often procrastinate. This is bad when it comes to homework. But in the context of suicidal ideation it would obviously be very good. It might give the patient peace of mind that they can end their life if the pain exceeds the threshold that they can tolerate. This may possibly prevent them from getting overwhelmed to the point that they actually try to die. So it could paradoxically give the patient more time and energy to battle their mental illness.

[Michael McMahon]

Some criticism of suicide is generalised. It includes other confusing issues that aren't directly relevant towards voluntary self-initiated suicide itself. Therefore we've to disentangle each topic. Firstly there's the allegation that vulnerable people could be pressured by ill-intentioned people into suicide. The trouble I have with this argument is that mental health services extend beyond those with severe mental illnesses. Therefore any disabled or elderly person that was hypothetically being bullied into suicide would be equally entitled to attend counselling services. Psychologists can obviously work with mental health difficulties arising in both able-bodied and disabled people. Secondly assisted-suicide and euthanasia are separate to the debate on suicide itself. What I will say is that assisted suicide actually reminds me of self-defence policy more than euthanasia. For example, knives and guns are banned in hospitals for security reasons rather than solely suicide prevention. Therefore providing someone with a weapon for suicide which is legal to own at home isn't the same as euthanasia. After all the person is always free not to use the weapon on themselves. Therefore the difference between assisted suicide and self-suicide appears to be just the availability of lethal instruments. One might argue that taking lethal medication is quicker and less intimidating than other forms of suicide. Although all death is equally painful and really the different methods of suicide are just variations on the spectrum of pain intensity and duration. I can only guess that a quick death will be momentarily excruciating while a slow death is less severe but more prolonged. The only possible risk I can think of with assisted suicide is one of tone where a person wasn't sufficiently encouraged to live. However this is subjective and dependent on the patient's specific personal situation and of those around them. I don't see a slippery slope with assisted suicide because the patient is free not to use the weapon as I've said previously. I'm not necessarily advocating assisted suicide and my initial post was about suicide prevention. Perhaps a caveat I might have with euthanasia is that the mind and subconscious might have ways to slowly adapt to extreme physical impairment. So in my opinion a baby born with severe disability or a non-verbal patient can't really automatically be said to be in unbearable pain. Besides that point I'm a bit unsure at the moment and am neither advocating euthanasia nor particularly opposed to voluntary forms of euthanasia.

https://www.government.nl/topics/euthanasia/euthanasia-and-newborn-infants

Just to mention that the assisted suicide debate might be germane to patients who are fully decided on suicide while euthanasia is often discussed in the context of paralysis where the person has physical difficulty with the action of suicide. 

[Michael McMahon]

On 5/21/2019 at 10:38 PM, Phi for All said:

And I'm not advocating it for everyone, but I do think some people want to be told their thoughts of suicide are silly and transitory. So I'm loathe to remove that tool from a professional's bag.

https://www.google.ie/amp/s/ancailinrua.com/2014/01/03/donal-walsh-and-suicide-whats-missing-from-the-debate-and-where-do-we-go-from-here/amp/

 

Maybe if you’ve a personal relationship with the patient where you know the advice will be well-received then it might not be a bad attitude. Expressing a cheerfully optimistic and mischievously stoic sentiment to overcome your difficulties could help if it was in a very friendly context. But in my opinion the risk is that it depends on the tone of the statement. It might be misunderstood in a busy environment with innumerable interactions between staff and patients. Remember there are countless psychiatric hospitals and patients in any country. Adopting this confident mindset as official policy could create an unnecessarily tense or awkward atmosphere in certain situations.

[dimreepr]

1 hour ago, Michael McMahon said:

Maybe if you’ve a personal relationship with the patient where you know the advice will be well-received then it might not be a bad attitude.

Maybe the word 'patient' is the bias, that leads to a bad attitude. 

[Michael McMahon]

On 6/6/2019 at 11:45 PM, StringJunky said:

If a person has a painful/debilitating, progressive, terminal condition. I wouldn''t call them deluded for being depressed and wanting to end their life.

I agree that a person who has a terminal condition isn't delusional if they're suicidal. But I'm not sure in such circumstances should we label their specific suicidal ideation as depression seeing as the primary source of their pain is physical deterioration. Or else should we use the term depression to simply describe all people's suicidal ideation irrespective of other unique factors? For example its possible for someone with a debilitating condition to be suicidal out of extreme body aches rather than finding their life meaningless. That is to say if their physical condition improved they'd no longer be suicidal in this hypothetical example. Maybe it's most accurate to say that such a person's suicidal ideation arises from a combination of different reasons. Perhaps the confusion is that despair (such as a poor prognosis of a progressive disease) and depression (as in finding your existential purpose absurd) are closely related but non-identical adjectives that frequently co-occur in certain patients.

 

On 6/7/2019 at 12:38 AM, iNow said:

It's not the depression that’s meaningless, but meaningless is often how the depressed person views existence itself.

I'd concur with that assessment. I think depression doesn't have to be related to a person's particular faith or the strength of their belief in God. Nor does depression have to be related to atheism or other metaphysical issues. Maybe sometimes it is and other times not. It might occur solely out of the unpredictability of our emotions as caused by the reasons mentioned:

On 6/6/2019 at 11:45 PM, StringJunky said:

endogenous (neurologica)l or reactive due to some personal adverse event

It may even be caused by relationship or work issues rather than spiritual concerns:

https://edition.cnn.com/travel/article/france-chef-michelin-withdrawal-scli-intl/index.html

Just like paranoia it might be possible to think that God is against you in terms of the problem of evil and the theodicy of victimisation or else that the impersonal universe is uncaring and unhelpful towards you:

"Dystheists may themselves be theists or atheists, and in the case of either, concerning the nature of the Abrahamic God, will assert that God is not good, and is possibly, although not necessarily, malevolent." (Wiki)

 

[Michael McMahon]

https://www.youtube.com/watch?v=be7MVQ0uaWs

Father Ted - Shaft - Radiohead

 

Atheists might try to counteract death anxiety by always engaging in mindfulness so as to concentrate on the present moment and not long-term death. Atheists aren't depressed in the way that they're able to view death as a meaningful incentive to live their life to the fullest. Some theists believe in heaven while others believe in reincarnation or else a combination of both heaven and reincarnation. Others adopt a myriad of tactics such as surrounding yourself with friends, fulfilling life ambitions or material pursuits in order to concentrate fully on them and distract their attention away from worrying about death. Yet another method is to decide to think about death only when your death is imminent where you'll be at your most attentive stage. One more approach is to passively accept whatever happens in a wait-and-see manner which might be used by agnostics. But if you spent too long contemplating eternal oblivion without having any personal strategy to overcome it then that might also lead to fear or depression. What happens after death is beyond our control and we're powerless to to stop or alter the outcome. Therefore spiralling death anxiety that gets worse and worse could ironically lead suicidal ideation if you approach death pessimistically. If you view death as meaningless then unfortunately it might lead you to think that life is meaningless. Although there are lots of other unrelated sources of depression.

 

[iNow]

It's strange to me that you keep trying to force an atheist / theist dichotomy into the subject of suicide prevention. Unless you have data suggesting that belief / disbelief in deities is relevant here, then you really should consider stopping. 

[swansont]

!

Moderator Note

I will make iNow's suggestion official. Leave the theist/atheist approach out of this discussion of suicide prevention. If you wish to discuss this in religious terms, open a thread in religion, and post credible evidence to back any claims.

 

[John Cuthber]

On 6/6/2019 at 11:45 PM, StringJunky said:

Whether a depression is meaningful or meaningless depends whether the cause is endogenous (neurologica)l or reactive due to some personal adverse event or injury.

I realise it's a year or so late but...
That distinction is almost certainly meaningless.

There isn't some magical cause and effect relation between an adverse event and depression.
Some people become depressed after, for example, losing their job.

But many don't.

 

On the other hand, no matter what the chemistry in your brain might be doing, you will experience negative events in your life.
So, if you are predisposed to depression, there will always be an event which might (on its own , or in combination with others) be the "causative event.".

 

I think the reality is that the actual cause will be a combination of those two.
But I have to say that it's only my opinion because I don't think it would be possible to find out.

What test or experiment would you use to distinguish?
 

How could you ensure that the chemical / neurological effect was there but no external cause ?

How would you ensure that the external cause was there but without any chemical imbalance?

17 hours ago, Michael McMahon said:

Atheists aren't depressed in the way that they're able to view death as a meaningful incentive to live their life to the fullest. 

At the risk of incurring Swansont's wrath by prolonging the  inclusion of theism/atheism, that statement is factually incorrect.

 

There are "plenty of" depressed atheists. (Obviously,  there are far too many, but there are "plenty" to prove that Michael does not know what he is talking about)

Sorry;  I didn't think it should be allowed to stand uncorrected.

[Michael McMahon]

2 hours ago, swansont said:

!

Moderator Note

I will make iNow's suggestion official. Leave the theist/atheist approach out of this discussion of suicide prevention. If you wish to discuss this in religious terms, open a thread in religion, and post credible evidence to back any claims.

 

Yes that's fine and I won't post about it again. (Just to backtrack a little I didn't mean atheism or theism were sources of depression as both groups are perfectly happy; merely that being confused might add to someone's uncertainty.)

27 minutes ago, John Cuthber said:

At the risk of incurring Swansont's wrath by prolonging the  inclusion of theism/atheism, that statement is factually incorrect.

 

There are "plenty of" depressed atheists. (Obviously,  there are far too many, but there are "plenty" to prove that Michael does not know what he is talking about)

Sorry;  I didn't think it should be allowed to stand uncorrected.

Yes I wasn't trying to imply there weren't depressed atheists; just that there are also many happy atheists.

(I'm not extending the debate on theism/atheism and am only clarifying a misunderstanding in a previous post. I didn't add any new information.)

 

 

[StringJunky]

On 9/10/2021 at 1:38 PM, John Cuthber said:

I realise it's a year or so late but...
That distinction is almost certainly meaningless.

There isn't some magical cause and effect relation between an adverse event and depression.
Some people become depressed after, for example, losing their job.

But many don't.

 

On the other hand, no matter what the chemistry in your brain might be doing, you will experience negative events in your life.
So, if you are predisposed to depression, there will always be an event which might (on its own , or in combination with others) be the "causative event.".

 

I think the reality is that the actual cause will be a combination of those two.
But I have to say that it's only my opinion because I don't think it would be possible to find out.

What test or experiment would you use to distinguish?
 

If one becomes  inexplicably depressed , with no known current cognitive/emotional issues, either internal or external, that, would imo, probably point to a persistent endogenous or organic cause. I'm a 40 year+ on/off chronic depressive, and can experience it spontaneously, even when my life seems to be going well and basically happy in myself.  Being acutely depressed over one-off life issues, such as job loss and bereavement are responses to known events... and natural. The ability to distinguish between endogenous and reactive states is likely down to assessing behaviour patterns and life events timeline. There is everything in between, of course.

Edited September 12, 2021 by StringJunky