4 ms·

The increase in suicide rates for both genders (but especially females) are astounding. I really don't believe that any changes in treatment have been so radica

The increase in suicide rates for both genders (but especially females) are astounding. I really don't believe that any changes in treatment have been so radical as to cause this to manifest the way it has.

arp242 4y ago
I don't mean changes in treatment, but rather that some people previously went undiagnosed and "just got over it" on their own. As I said, in my own case treatment didn't help and actually made matters worse as I saw myself more as a victim who "couldn't help myself". n=1 of course. And many people of course do benefit from treatment. As I mentioned: even if this turns out to be factor – and I'm not sure it even is – then I don't think this accounts for 100% of the increase. I don't profess this is the full explanation, merely a possible factor, out of several. I'm also reminded by my uncle, who was born with a serious and debilitating heart condition; he always said that if he had listened to his doctors he'd be a "victim" in a wheelchair inside all day. Of course he did need serious medical attention, including a heart transplant, and he did end up dying from his condition at the age of 51, but overall he led a "good life" and just carried on with things without seeing himself as too much of a victim. It probably would have been a different life if he did. Mental feedback loops can be pretty powerful. It's also worth pointing out the charts look a bit less drastic if you zoom out to the 70s; in fact, suicide for boys especially was a lot higher in the 80s than it is now. The author does address that briefly at the bottom, and provides a link with more detail (which is too much to quote here, but tl;dr is that they believe it's correlated to lead exposure and crime rates – this link also contains the longer timeframe charts).
- xwolfi 4y ago
  Not sure of the value of this tidbit but I heard that in the US, blacks suicided a lot less than whites (quick google seems to say rate of black suicide is a third of white) and it could be because they grow up explaining their issues with external factors, while the whites have no convenient escapes, and even are told they are privileged due to their skin color... so self blame. Really flimsy, I am not an expert but... fits a bit the idea that just looping around yourself self introspecting how much of a failure YOU are might not help.
  - notch898a 4y ago
    I would offer the really flimsy statement most blacks in US are descendants of slaves, who were bred for generations to be optimized for unskilled labor that was given very little mental and health support which meant anyone slightly suicidal just killed themselves off. Slavery is pretty stressful. Society tends to want to ignore the fact the colonists and early Americans literally bred slaves under stressful conditions for centuries and that tends to have ... effects on the genetic pool particularly in remarkably stressful environments where risk factors can cause rapid attrition from reproductive population.
    - shrimp_emoji 4y ago
      I think a more plausible theory is that white people feel more entitlement than black people, not because of some weird genetic memory thing but because they see other white people (or maybe even their parents or great-grandparents) enjoy much higher success than they are. Higher expectations = more pain from shitty circumstances = worse reactions.
      - notinfuriated 4y ago
        This might be true, although I think it depends on the age group of the people committing suicide. I forget where I heard this, but I believe a significant number of people committing suicide have a high correlation with other issues like chronic pain (e.g., https://pubmed.ncbi.nlm.nih.gov/24916035/ https://pubmed.ncbi.nlm.nih.gov/24916035/) or addiction. I'm suspicious that those white people have the kinds of problems you're referring to because I suspect their peers are less likely to be successful or affluent, as people with chronic pain issues probably are more working class, performing physical labor that results in their issues. (Granted, I suppose there is probably a racial element that would account for why, if this is the case, more white people with chronic pain issues kill themselves vs. black people with chronic pain issues.) This is obviously speculation, but so is your comment. I find both to be potentially likely. The scenario you came up with seems more likely for younger people (probably not experiencing chronic pain), and the scenario I came up with is potentially more likely for older people. But we're just spitballing some hypotheses here.
- justsocrateasin 4y ago
  n of 2, this has been my experience as well. I was almost killed in a shooting in 2021, and in 2022 I started seeing a therapist. Going into therapy made me relate to my trauma more, think about my trauma more often, and self identify as a "traumatized individual". I don't think any of that helped. The only thing that really helped was daily meditation/mindfulness, which does the opposite - it teaches you that the thoughts and experiences you have are fleeting and rather than hold on to them you can let them go. That being said, I don't think this is a strong enough phenomenon that it explains the rather large trends upwards in self harm/mental health. I think a good control is the graph that shows Schizophrenia - a 67% uptick shows that the diagnosis rates are probably a lot higher than the early 2000s, since I doubt that schizophrenia is really becoming more common due to social media.
  - beamgirl 4y ago
    Relating this back to social media, I've noticed that at times younger people almost exert a social pressure to link all behavior to anything remotely traumatic. I've had some shitty stuff happen to me, life has had it's rough points, but I've always felt pretty lucky overall. I've noticed in arguments with roommates/friends/etc who are younger by a few years, there is significantly more forgiveness towards anything that can even be tangentially linked to something that can be identified as a trauma. I noticed it because over time it led me to start slowly reframing experiences and actually focusing more on the damage they'd done. And its funny, the most traumatizing experience of my life has probably been the push to open up and focus on my traumas. My mental health has improved a lot since distancing myself from people who are too eager to focus on trauma. I wonder how that plays into the whole social mental health conversation. Like when does starting a conversation and destigmatizing a topic turn into feeding it and enabling it? Not to say by any means mental health was handled well before, but I think we might have made something of a deal with the devil in how we frame mental health on social media.
    - justsocrateasin 4y ago
      I have a lot of thoughts on this as well and I'm not sure. I definitely felt like my mental health got worse when I started therapy, but was it because my mental health was already doing worse? The times in my life when I've been the most anxious or unwell have been when I'm questioning my mental health. And I think that the society we live in does encourage people to open up more. But if you have ADHD / obsessive compulsive tendencies, and your brain works like mine, that opening up can just look like obsessing over why you aren't feeling 100%. Then it's a self fulfilling prophecy.
- brodouevencode 4y ago
  I don't wholly disagree with you, but do think it's probably several things based on things I've seen (my n=1 experience is no more important than yours). I do want to make it clear that there is no good data on this.
willcipriano 4y ago
Tell someone with an issue with their physical condition that it is because of diet and lack of exercise and many would change habits, tell them it's due to a incurable but perhaps treatable cancer and some will chose suicide. Tell kids that they are unhappy due to choices made in day to day life and they might change those choices, tell them it's due to a incurable but maybe treatable issue with their brain and some will chose suicide. The problem may be classifying typical human misery as incurable illness.
- goodpoint 4y ago
  Not at all, it's exactly the opposite. People feel understood and very relieved when they are diagnosed mental illness. Accepting and managing some condition give people hope.
  - willcipriano 4y ago
    To respond I need to separate mental illness into three categories. The first category contains illnesses like schizophrenia, with schizophrenia you can induce symptoms of the illness in healthy people by giving them medicine used to treat parkinsons. We can point to specific structures and chemical reactions in the brain as a cause for the illness, it may not be perfectly understood but we have a good understanding of what is going on. The second contains things like personality disorders. It's not clear these are actually related to physical defects, at least in the same way the first category is. For example people who meet diagnostic criteria for antisocial personality disorder often report no symptoms and are successful in day to day life, some even thrive. Borderline personality types are often distraught over the state of interpersonal reletionships, that is the primary source of their suffering, however they behave in ways that destroy those reletionships. These behaviors aren't accidental, they involve sophisticated thinking, borderlines spin complex webs of lies to justify and hide these behaviors. The third are things that are normal human suffering. Most people feel anxiety for a big date or a job interview. Most people feel sad when they lose a loved one. Negative emotions are a part of life. It's hard to draw a line on what is normal but a nonzero number of people are medicated for having normal human emotions. It may not be helpful for the second and third category to be enabled in the way they have been. For the second group, as the root of their strife is generally interpersonal, and only changing day to day behavior, over a lengthy period of time will have any effect in alevating the true symptoms of the illness. We can pretend the problem "isn't their fault" but essentially all their issues can be tied directly to their own behavior, it may not be their fault but it's certainly their problem. For the third it isn't clear that they need to be treated at all, if you are too sad to go to work because your son died a month ago, nothing is wrong with you. Perhaps people are sad in society in general because the society in general sucks, medicating them in mass lowers the collective motivation to fix the society, what's the end game there?
notch898a 4y ago
It could be that being diagnosed with an illness, even with excellent treatment, symptoms can become a self fulfilling prophecy. If you believe you are at increased risk for suicide, maybe you start thinking more about that and it comes to fruition. Or maybe you take some meds, which make you better 99.9% of the time but that one time your flight is late or whatever and miss the dose and the rebound is twice as bad as never having been on them. Also ultimately suicide by definition is based on most harmful decision of life event rather than what a doctor is probably optimizing for which is best day-to-day ability to function. These are two different optimizations that can be at odds. Almost nobody would choose to feel worse 99.9% of the time to reduce the risk in that 0.1% of the time they're suicidal.
NickM 4y ago
SSRI use has skyrocketed, and multiple meta-analyses have confirmed that they lead to an increase in suicidal thoughts and behavior when used by children and adolescents. I don't necessarily agree with the grandparent poster's point of view, as I do think there are big societal changes leading to decreased mental health that are unrelated to the way we treat mental illness...but I do think the increase in usage of psychiatric drugs is a big problem, and may at least partly explain the increased suicide rates.
- samtho 4y ago
  > SSRI use has skyrocketed, and multiple meta-analyses have confirmed that they lead to an increase in suicidal thoughts and behavior when used by children and adolescents. The prevailing wisdom on this is that many people suffering major depression won’t even have the motivation to go through with suicide. Once the depression has begun to be treated, certain executive functions start to amplify giving sufferers newfound task salience and resolve to go through with it. The problem is that all the symptoms of depression take far longer to subside with consistent SSRI/SNRI usage as prescribed. These drugs take on average 90 days to reach their full effectiveness but not everything happens at once during this adjustment. Along the way, you do reach a strange state of: “well I’m still depressed but I feel empowered to do something about it now.”
  - TchoBeer 4y ago
    I remember this stage when I started taking SSRIs when I was an older teenager. I was warned about it and was seeing a short-term therapist and so I dealt with it well, but there's a short 2-4 weeks where the crushing demotivation that has dominated your life is lifted but you still are stuck in the life-despising thought spirals. I assume that much of this can be mitigated by regular consultation with mental health for the first two month while trying a new medication, but it's possible that isn't true.
P_I_Staker 4y ago
IMO opinion, the patient hostile nature of mental health providers is likely driving some of these suicides, and the industry isn't even trying to detect this (although it would be hard).

arp242 4y ago

I don't mean changes in treatment, but rather that some people previously went undiagnosed and "just got over it" on their own. As I said, in my own case treatment didn't help and actually made matters worse as I saw myself more as a victim who "couldn't help myself". n=1 of course. And many people of course do benefit from treatment. As I mentioned: even if this turns out to be factor – and I'm not sure it even is – then I don't think this accounts for 100% of the increase. I don't profess this is the full explanation, merely a possible factor, out of several. I'm also reminded by my uncle, who was born with a serious and debilitating heart condition; he always said that if he had listened to his doctors he'd be a "victim" in a wheelchair inside all day. Of course he did need serious medical attention, including a heart transplant, and he did end up dying from his condition at the age of 51, but overall he led a "good life" and just carried on with things without seeing himself as too much of a victim. It probably would have been a different life if he did. Mental feedback loops can be pretty powerful. It's also worth pointing out the charts look a bit less drastic if you zoom out to the 70s; in fact, suicide for boys especially was a lot higher in the 80s than it is now. The author does address that briefly at the bottom, and provides a link with more detail (which is too much to quote here, but tl;dr is that they believe it's correlated to lead exposure and crime rates – this link also contains the longer timeframe charts).

xwolfi 4y ago
Not sure of the value of this tidbit but I heard that in the US, blacks suicided a lot less than whites (quick google seems to say rate of black suicide is a third of white) and it could be because they grow up explaining their issues with external factors, while the whites have no convenient escapes, and even are told they are privileged due to their skin color... so self blame. Really flimsy, I am not an expert but... fits a bit the idea that just looping around yourself self introspecting how much of a failure YOU are might not help.
- notch898a 4y ago
  I would offer the really flimsy statement most blacks in US are descendants of slaves, who were bred for generations to be optimized for unskilled labor that was given very little mental and health support which meant anyone slightly suicidal just killed themselves off. Slavery is pretty stressful. Society tends to want to ignore the fact the colonists and early Americans literally bred slaves under stressful conditions for centuries and that tends to have ... effects on the genetic pool particularly in remarkably stressful environments where risk factors can cause rapid attrition from reproductive population.
  - shrimp_emoji 4y ago
    I think a more plausible theory is that white people feel more entitlement than black people, not because of some weird genetic memory thing but because they see other white people (or maybe even their parents or great-grandparents) enjoy much higher success than they are. Higher expectations = more pain from shitty circumstances = worse reactions.
    - notinfuriated 4y ago
      This might be true, although I think it depends on the age group of the people committing suicide. I forget where I heard this, but I believe a significant number of people committing suicide have a high correlation with other issues like chronic pain (e.g., https://pubmed.ncbi.nlm.nih.gov/24916035/ https://pubmed.ncbi.nlm.nih.gov/24916035/) or addiction. I'm suspicious that those white people have the kinds of problems you're referring to because I suspect their peers are less likely to be successful or affluent, as people with chronic pain issues probably are more working class, performing physical labor that results in their issues. (Granted, I suppose there is probably a racial element that would account for why, if this is the case, more white people with chronic pain issues kill themselves vs. black people with chronic pain issues.) This is obviously speculation, but so is your comment. I find both to be potentially likely. The scenario you came up with seems more likely for younger people (probably not experiencing chronic pain), and the scenario I came up with is potentially more likely for older people. But we're just spitballing some hypotheses here.
justsocrateasin 4y ago
n of 2, this has been my experience as well. I was almost killed in a shooting in 2021, and in 2022 I started seeing a therapist. Going into therapy made me relate to my trauma more, think about my trauma more often, and self identify as a "traumatized individual". I don't think any of that helped. The only thing that really helped was daily meditation/mindfulness, which does the opposite - it teaches you that the thoughts and experiences you have are fleeting and rather than hold on to them you can let them go. That being said, I don't think this is a strong enough phenomenon that it explains the rather large trends upwards in self harm/mental health. I think a good control is the graph that shows Schizophrenia - a 67% uptick shows that the diagnosis rates are probably a lot higher than the early 2000s, since I doubt that schizophrenia is really becoming more common due to social media.
- beamgirl 4y ago
  Relating this back to social media, I've noticed that at times younger people almost exert a social pressure to link all behavior to anything remotely traumatic. I've had some shitty stuff happen to me, life has had it's rough points, but I've always felt pretty lucky overall. I've noticed in arguments with roommates/friends/etc who are younger by a few years, there is significantly more forgiveness towards anything that can even be tangentially linked to something that can be identified as a trauma. I noticed it because over time it led me to start slowly reframing experiences and actually focusing more on the damage they'd done. And its funny, the most traumatizing experience of my life has probably been the push to open up and focus on my traumas. My mental health has improved a lot since distancing myself from people who are too eager to focus on trauma. I wonder how that plays into the whole social mental health conversation. Like when does starting a conversation and destigmatizing a topic turn into feeding it and enabling it? Not to say by any means mental health was handled well before, but I think we might have made something of a deal with the devil in how we frame mental health on social media.
  - justsocrateasin 4y ago
    I have a lot of thoughts on this as well and I'm not sure. I definitely felt like my mental health got worse when I started therapy, but was it because my mental health was already doing worse? The times in my life when I've been the most anxious or unwell have been when I'm questioning my mental health. And I think that the society we live in does encourage people to open up more. But if you have ADHD / obsessive compulsive tendencies, and your brain works like mine, that opening up can just look like obsessing over why you aren't feeling 100%. Then it's a self fulfilling prophecy.
brodouevencode 4y ago
I don't wholly disagree with you, but do think it's probably several things based on things I've seen (my n=1 experience is no more important than yours). I do want to make it clear that there is no good data on this.

willcipriano 4y ago

Tell someone with an issue with their physical condition that it is because of diet and lack of exercise and many would change habits, tell them it's due to a incurable but perhaps treatable cancer and some will chose suicide. Tell kids that they are unhappy due to choices made in day to day life and they might change those choices, tell them it's due to a incurable but maybe treatable issue with their brain and some will chose suicide. The problem may be classifying typical human misery as incurable illness.

goodpoint 4y ago
Not at all, it's exactly the opposite. People feel understood and very relieved when they are diagnosed mental illness. Accepting and managing some condition give people hope.
- willcipriano 4y ago
  To respond I need to separate mental illness into three categories. The first category contains illnesses like schizophrenia, with schizophrenia you can induce symptoms of the illness in healthy people by giving them medicine used to treat parkinsons. We can point to specific structures and chemical reactions in the brain as a cause for the illness, it may not be perfectly understood but we have a good understanding of what is going on. The second contains things like personality disorders. It's not clear these are actually related to physical defects, at least in the same way the first category is. For example people who meet diagnostic criteria for antisocial personality disorder often report no symptoms and are successful in day to day life, some even thrive. Borderline personality types are often distraught over the state of interpersonal reletionships, that is the primary source of their suffering, however they behave in ways that destroy those reletionships. These behaviors aren't accidental, they involve sophisticated thinking, borderlines spin complex webs of lies to justify and hide these behaviors. The third are things that are normal human suffering. Most people feel anxiety for a big date or a job interview. Most people feel sad when they lose a loved one. Negative emotions are a part of life. It's hard to draw a line on what is normal but a nonzero number of people are medicated for having normal human emotions. It may not be helpful for the second and third category to be enabled in the way they have been. For the second group, as the root of their strife is generally interpersonal, and only changing day to day behavior, over a lengthy period of time will have any effect in alevating the true symptoms of the illness. We can pretend the problem "isn't their fault" but essentially all their issues can be tied directly to their own behavior, it may not be their fault but it's certainly their problem. For the third it isn't clear that they need to be treated at all, if you are too sad to go to work because your son died a month ago, nothing is wrong with you. Perhaps people are sad in society in general because the society in general sucks, medicating them in mass lowers the collective motivation to fix the society, what's the end game there?

notch898a 4y ago

It could be that being diagnosed with an illness, even with excellent treatment, symptoms can become a self fulfilling prophecy. If you believe you are at increased risk for suicide, maybe you start thinking more about that and it comes to fruition. Or maybe you take some meds, which make you better 99.9% of the time but that one time your flight is late or whatever and miss the dose and the rebound is twice as bad as never having been on them. Also ultimately suicide by definition is based on most harmful decision of life event rather than what a doctor is probably optimizing for which is best day-to-day ability to function. These are two different optimizations that can be at odds. Almost nobody would choose to feel worse 99.9% of the time to reduce the risk in that 0.1% of the time they're suicidal.

NickM 4y ago

SSRI use has skyrocketed, and multiple meta-analyses have confirmed that they lead to an increase in suicidal thoughts and behavior when used by children and adolescents. I don't necessarily agree with the grandparent poster's point of view, as I do think there are big societal changes leading to decreased mental health that are unrelated to the way we treat mental illness...but I do think the increase in usage of psychiatric drugs is a big problem, and may at least partly explain the increased suicide rates.

samtho 4y ago
> SSRI use has skyrocketed, and multiple meta-analyses have confirmed that they lead to an increase in suicidal thoughts and behavior when used by children and adolescents. The prevailing wisdom on this is that many people suffering major depression won’t even have the motivation to go through with suicide. Once the depression has begun to be treated, certain executive functions start to amplify giving sufferers newfound task salience and resolve to go through with it. The problem is that all the symptoms of depression take far longer to subside with consistent SSRI/SNRI usage as prescribed. These drugs take on average 90 days to reach their full effectiveness but not everything happens at once during this adjustment. Along the way, you do reach a strange state of: “well I’m still depressed but I feel empowered to do something about it now.”
- TchoBeer 4y ago
  I remember this stage when I started taking SSRIs when I was an older teenager. I was warned about it and was seeing a short-term therapist and so I dealt with it well, but there's a short 2-4 weeks where the crushing demotivation that has dominated your life is lifted but you still are stuck in the life-despising thought spirals. I assume that much of this can be mitigated by regular consultation with mental health for the first two month while trying a new medication, but it's possible that isn't true.

P_I_Staker 4y ago

IMO opinion, the patient hostile nature of mental health providers is likely driving some of these suicides, and the industry isn't even trying to detect this (although it would be hard).