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As someone who has struggle with suicidal ideation his entire life, whenever the subject comes up I try to educate people by quoting author David Foster Wallace

As someone who has struggle with suicidal ideation his entire life, whenever the subject comes up I try to educate people by quoting author David Foster Wallace (who commited suicide) with the best explanation: “The so-called ‘psychotically depressed’ person who tries to kill herself doesn’t do so out of quote ‘hopelessness’ or any abstract conviction that life’s assets and debits do not square. And surely not because death seems suddenly appealing. The person in whom Its invisible agony reaches a certain unendurable level will kill herself the same way a trapped person will eventually jump from the window of a burning high-rise. Make no mistake about people who leap from burning windows. Their terror of falling from a great height is still just as great as it would be for you or me standing speculatively at the same window just checking out the view; i.e. the fear of falling remains a constant. The variable here is the other terror, the fire’s flames: when the flames get close enough, falling to death becomes the slightly less terrible of two terrors. It’s not desiring the fall; it’s terror of the flames. And yet nobody down on the sidewalk, looking up and yelling ‘Don’t!’ and ‘Hang on!’, can understand the jump. Not really. You’d have to have personally been trapped and felt flames to really understand a terror way beyond falling.”

rubyfan 5y ago
This is an amazing explanation, thank you for sharing this.
- kingsloi 5y ago
  I agree, thank you.
jsmith45 5y ago
One flaw with the analogy is that a pretty significant portion of suicides (successful or attempts) are impulsive. Many people who attempt it have literally no idea they will when they wake up that morning. A 2001 University of Houston study of survivors of near lethal attempts showed that 70% of them had only decided to do it an hour or less before the attempt, and 24 percent had only spent 5 minutes before the attempt. If when attempting it, they discover that their chosen method won't work for some reason, many will just give up on killing themselves rather than looking for an alternative measure. This has been reliably seen many times. If a change is made such that one suicide method becomes unfeasible, the overall attempt rate drops. If one were committed to offing oneself it is almost impossible to stop them, as there are countless ways to do it. But the statistics are very clear that if some method is removed, alternatives are not always used. The British had an issue with people killing themselves with oven fumes, back when the ovens used coal gas which created a lot of carbon monoxide, with this accounting for about 50% of suicide deaths. When things were changed to use natural gas where this approach does not work, suicides dropped by 30%. Obviously while that means a portion ending up using some other method, many others simply never killed themselves. Of 515 people prevented by police from jumping off the Golden Gate Bridge between 1937 and 1971, by the end of the 70s only 6% of them had committed suicide by other means. Weirdly even some of the non-impulsive cases where people had planned an attempt for days or weeks just give up if their plan is foiled, rather than coming up with some alternative method. Now obviously not everybody is like this. Some people will continue to try over and over until they succeed. But the numbers suggest that those are very much a minority.
- Jare 5y ago
  > One flaw with the analogy [...] Many people who attempt it have literally no idea they will when they wake up that morning. Can you elaborate? That sounds pretty much like the people in the analogy to me. They jump because the alternative they face right now is more terrifying for some reason. It makes sense that not all methods of suicide fulfill that criteria (being less terrifying than the alternative), even if they are all methods to end your life.
  - dalmo3 5y ago
    I reacted the same way when I read that part too, but the rest of the comment illustrates it well with the failed attempts data. To go back to the analogy, it's as if they try to jump from the window, but there's a safety net that blocks them. They're stuck inside and the fire is mysteriously gone.
    - kelnos 5y ago
      I don't think the fire is mysteriously gone in this imagining of the analogy. More like it is still there, but is survivable: still very hot, still very scary, but not clearly moving to inevitably consume you. I think this is just another place where the analogy breaks down. But that's ok, no analogy is perfect, but I think this one does have its uses.
      - quantum_magpie 5y ago
        I still think the original analogy works here - if you make sure that in the moment of panic the windows don't open to prevent voluntary and quick death, the person now has to suffer the agonizing pain of the flames for the rest of their life. It holds even more true if we consider that a large part of suicides are not because someone wants to die - no - it's because someone does not want to live like in present situation anymore. Just like with the fire, the goal is not to die on a sidewalk - it's not dying in the fire. You attempt suicide as last resort - if you die, it's okay, it's final. If you don't, it perhaps changes something for the better.
- 5y ago
agumonkey 5y ago
Also some levels of pain completely fuzz the upper layers of the brain in ways that are hard to describe.
phkahler 5y ago
I can agree with DFW on that because it sounds reasonable and consistent with people I've known. The error is in thinking there is a single train of thought leading to the end. "Hopelessness" may not be sufficient, but Demoralization is probably an indicator. I would also posit that excessive or increased rumination (possibly leading to an increased sense of demoralization) is also an indicator. It is apparently also a thing that Borderline patients are at increased risk, though I have no idea what goes through their mind in that moment. So DFW rejected others ideas on the subject in favor of his own experience? Sounds a little narcissistic doesn't it?
touisteur 5y ago
As usual DFW's writing is striking. I've had very strange experiences when starting antidepressants. For 2 or 3 weeks I'd have sudden urges to 'jump': incoming train at the station, walking over a bridge with fast cars under, walking on the pavements next to fast traffic. I'd see a truck coming and I'd feel such a rush to jump, to end it all. I had never felt so strongly about it, and usually had suicidal ideation at other moments, but never such urgent calls to action. I avoided any triggering situation and started listening to myself a lot more. Apparently it's one of the first weeks' side effects but I wasn't prepared... After 2 weeks it started to fade and the drug started doing its work. But I think it was a huge dopamine rush coming without a counteracting 'I want to live' that was the most revealing about chemical imbalance and how suicide might be sometimes uninterpretable as 'just' psychological.

rubyfan 5y ago

This is an amazing explanation, thank you for sharing this.

kingsloi 5y ago
I agree, thank you.

jsmith45 5y ago

One flaw with the analogy is that a pretty significant portion of suicides (successful or attempts) are impulsive. Many people who attempt it have literally no idea they will when they wake up that morning. A 2001 University of Houston study of survivors of near lethal attempts showed that 70% of them had only decided to do it an hour or less before the attempt, and 24 percent had only spent 5 minutes before the attempt. If when attempting it, they discover that their chosen method won't work for some reason, many will just give up on killing themselves rather than looking for an alternative measure. This has been reliably seen many times. If a change is made such that one suicide method becomes unfeasible, the overall attempt rate drops. If one were committed to offing oneself it is almost impossible to stop them, as there are countless ways to do it. But the statistics are very clear that if some method is removed, alternatives are not always used. The British had an issue with people killing themselves with oven fumes, back when the ovens used coal gas which created a lot of carbon monoxide, with this accounting for about 50% of suicide deaths. When things were changed to use natural gas where this approach does not work, suicides dropped by 30%. Obviously while that means a portion ending up using some other method, many others simply never killed themselves. Of 515 people prevented by police from jumping off the Golden Gate Bridge between 1937 and 1971, by the end of the 70s only 6% of them had committed suicide by other means. Weirdly even some of the non-impulsive cases where people had planned an attempt for days or weeks just give up if their plan is foiled, rather than coming up with some alternative method. Now obviously not everybody is like this. Some people will continue to try over and over until they succeed. But the numbers suggest that those are very much a minority.

Jare 5y ago
> One flaw with the analogy [...] Many people who attempt it have literally no idea they will when they wake up that morning. Can you elaborate? That sounds pretty much like the people in the analogy to me. They jump because the alternative they face right now is more terrifying for some reason. It makes sense that not all methods of suicide fulfill that criteria (being less terrifying than the alternative), even if they are all methods to end your life.
- dalmo3 5y ago
  I reacted the same way when I read that part too, but the rest of the comment illustrates it well with the failed attempts data. To go back to the analogy, it's as if they try to jump from the window, but there's a safety net that blocks them. They're stuck inside and the fire is mysteriously gone.
  - kelnos 5y ago
    I don't think the fire is mysteriously gone in this imagining of the analogy. More like it is still there, but is survivable: still very hot, still very scary, but not clearly moving to inevitably consume you. I think this is just another place where the analogy breaks down. But that's ok, no analogy is perfect, but I think this one does have its uses.
    - quantum_magpie 5y ago
      I still think the original analogy works here - if you make sure that in the moment of panic the windows don't open to prevent voluntary and quick death, the person now has to suffer the agonizing pain of the flames for the rest of their life. It holds even more true if we consider that a large part of suicides are not because someone wants to die - no - it's because someone does not want to live like in present situation anymore. Just like with the fire, the goal is not to die on a sidewalk - it's not dying in the fire. You attempt suicide as last resort - if you die, it's okay, it's final. If you don't, it perhaps changes something for the better.
5y ago

agumonkey 5y ago

Also some levels of pain completely fuzz the upper layers of the brain in ways that are hard to describe.

phkahler 5y ago

I can agree with DFW on that because it sounds reasonable and consistent with people I've known. The error is in thinking there is a single train of thought leading to the end. "Hopelessness" may not be sufficient, but Demoralization is probably an indicator. I would also posit that excessive or increased rumination (possibly leading to an increased sense of demoralization) is also an indicator. It is apparently also a thing that Borderline patients are at increased risk, though I have no idea what goes through their mind in that moment. So DFW rejected others ideas on the subject in favor of his own experience? Sounds a little narcissistic doesn't it?

touisteur 5y ago

As usual DFW's writing is striking. I've had very strange experiences when starting antidepressants. For 2 or 3 weeks I'd have sudden urges to 'jump': incoming train at the station, walking over a bridge with fast cars under, walking on the pavements next to fast traffic. I'd see a truck coming and I'd feel such a rush to jump, to end it all. I had never felt so strongly about it, and usually had suicidal ideation at other moments, but never such urgent calls to action. I avoided any triggering situation and started listening to myself a lot more. Apparently it's one of the first weeks' side effects but I wasn't prepared... After 2 weeks it started to fade and the drug started doing its work. But I think it was a huge dopamine rush coming without a counteracting 'I want to live' that was the most revealing about chemical imbalance and how suicide might be sometimes uninterpretable as 'just' psychological.