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1st Scientific Analysis of Suicide Notes Lends Insights into the Heartbreaking Act
A team of researchers analyzed 1,280 suicide notes written between 2000 and 2009 to seek a new prevention strategy.
For decades, the mortality rate across the US was in decline. That’s why the results of a 2015 report were so shocking. For the first time in generations, middle-aged white people saw their death rate increase. Husband and wife economists Anne Case and Angus Deaton discovered this disturbing trend, which began back in 1999. The researchers labeled these “deaths of despair,” resulting from suicide, drug or alcohol abuse.
Approximately 40,000 people take their own lives each year in the US. A new book tries to isolate the origins of the uptick, currently at a 30-year high, and what can be done. The upward trend was found in all age groups, absent the elderly. Now a new book is lending greater insights into this most personal of tragic acts. It’s entitled Explaining Suicide: Patterns, Motivations and What Notes Reveal. The authors say this is the first sweeping, analytical attempt to understand the motivations behind the act, across different age groups.
A multidisciplinary team of academics was involved in this study. They were psychology professor Cheryl Meyer at Wright State University, psychologist Taronish Irani at SUNY-Buffalo State, historian Katherine Hermes at Central Connecticut University, and the late Betty Yung, who was an associate professor of psychology at Wright State University. They wanted to obtain a holistic view using psychology, history, and the social sciences to tackle suicide.
To conduct the study, which would form the basis of the book, researchers examined suicide datasets extensively, including from places as far away as Europe and Oceania. They also collected 1,280 suicide notes from coroner’s offices across Southwestern Ohio, written between 2000 and 2009. These weren’t all notes in the literal sense. Many were pictures of notes written on mirrors, towels, coffee filters, and more. One man even spray painted his note on the floor of his barn.
Last words such as these are only found in 14% of cases. The authors began to notice differences between note leavers and non-leavers in their research, as well as people who attempt suicide and those who complete the act. They believe these findings could help develop better suicide prevention strategies.
20 US veterans commit suicide each day, according to a 2016 Veteran’s Affairs (VA) report. Getty Images.
The academics also evaluated motivating factors, and to what extent each is capable of pushing a person toward suicide. These included: mental illness, substance abuse, interpersonal violence, physical pain, grief, and feelings of failure. They also explored what factors may help protect one against suicide, and make them more resilient. Meyer said after reading all the notes and examining the data, she knew they had a book on their hands.
Many notes were addressed to one person. Others were to no one in particular. There was even someone who addressed the note to their dog. Meyer said it’s hard to understand why some people leave a note and others don’t. According to their research, it all comes down to what motivated the suicide.
There is a faction of note leavers who lash out at the person or group who controlled, manipulated, neglected, or abused them. But most absolve loved ones of any guilt. 70% were motivated to escape overbearing pain, be it physical or psychological. Nowadays, being a white male is the single biggest risk factor. Why is that? According to Case and Deaton, drastic changes in the labor market is the most significant factor. Meyer claims another driver.
“Hegemonic masculinity,” or a perception that heightened masculinity must be portrayed at all times, a goal that no male can live up to. Sooner or later everyone needs to be vulnerable and let their emotions out. This inability to fit into such a rigid framework causes psychological pain in the form of guilt, shame, disgust, and self-hatred. This builds to the point where the person can no longer take it.
Another 23% of note writers ended it all due to unrequited love or love lost. 22% said they themselves created the problem which led to their decision. This includes the loss of a job, a breakup or divorce, legal troubles, arrest or an impending jail sentence, a looming financial problem, or a devastating medical diagnosis. Meyer says there’s a correlation between legal troubles and taking one’s own life. "There is a really strong tie between things like DUIs and killing yourself," she said.
Suicides off of the George Washington Bridge in NYC doubled in 2015, with one occurring every 3.5 days. Getty Images.
The vast majority of notes absolved love ones, saying nothing could have been done to prevent the act. Most people who commit suicide find their own pain too overwhelming to bear. About a third of the notes mention religion, faith, or God. More women left notes than men. And oddly enough, more of the notes were written on the first of the month than any other day.
It’s unfortunate that many people have been touched by suicide in one way or another, yet most are resistant to talking about it. The authors hope the book will help those who are wrestling with it, or who have been hurt by someone who committed it, to speak out, and seek help. So what can we do to help lower instances of suicide? Meyer suggests limiting access to guns, dangerous pharmaceuticals, and other common means.
She also thinks everyone should take a course, much like how we go through “driver’s ed.” to acquire a driver’s license. Every student would be taught to recognize the warning signs and know how to get the person the help they need. Adults in higher or continuing education or the elderly in senior centers could also be offered such a course.
The biggest preventative aspect according to Meyer, rather than sense of resiliency, is acquiring more social connections and developing one’s own sense of purpose. Those who feel isolated or adrift are more likely to consider suicide. "Part of it is the responsibility of the individual, but part of it is our responsibility of keeping that person connected," she said. We usually perceive the warning signs, but don't feel it's right to interfere.
"In the coroners’ reports that we viewed, many people had called for welfare checks on their loved ones. They knew or feared that the person had harmed or killed himself or herself. If the impulse to intervene had occurred at an earlier point, the suicide might have been interrupted and averted. We must learn to trust our guts and to get past our own fears when someone is in trouble and in need of help."
Meyer and colleagues also propose a national prevention plan, to foster a sense of community and social support. Here, counselors should push for healthy lifestyle changes and the application of each person’s precious gifts in a particular direction.
If you feel suicidal, or are concerned for a friend, don't wait: talk to someone, or learn about suicide prevention here. To know more about the connection between depression and suicide, click here:
Join The Daily Show comedian Jordan Klepper and elite improviser Bob Kulhan live at 1 pm ET on Tuesday, July 14!
The team caught a glimpse of a process that takes 18,000,000,000,000,000,000,000 years.
- In Italy, a team of scientists is using a highly sophisticated detector to hunt for dark matter.
- The team observed an ultra-rare particle interaction that reveals the half-life of a xenon-124 atom to be 18 sextillion years.
- The half-life of a process is how long it takes for half of the radioactive nuclei present in a sample to decay.
Gender and sexual minority populations are experiencing rising anxiety and depression rates during the pandemic.
- Anxiety and depression rates are spiking in the LGBTQ+ community, and especially in individuals who hadn't struggled with those issues in the past.
- Overall, depression increased by an average PHQ-9 score of 1.21 and anxiety increased by an average GAD-7 score of 3.11.
- The researchers recommended that health care providers check in with LGBTQ+ patients about stress and screen for mood and anxiety disorders—even among those with no prior history of anxiety or depression.
Study findings<p>For the study, <a href="https://link.springer.com/article/10.1007/s11606-020-05970-4" target="_blank">published in the Journal of General Internal Medicine</a><em>, </em>Flentje and her team evaluated survey responses from nearly 2,300 individuals who identified as being in the lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community. Most of the participants were white, while nearly 19 percent identified as a racial or ethnic minority. Multiple genders were represented with cisgender women (27.2 percent) and men (24.6 percent) making up a majority of the participants. Sixty-three percent had been assigned female at birth. For the most part, participants identified their sexual orientations as queer (40.3 percent), gay (36.5 percent), and bisexual (30.3 percent).</p><p>The JGIM study participants were recruited from the 18,000-participant <a href="https://pridestudy.org/" target="_blank">PRIDE Study</a> (Population Research in Identity and Disparities for Equality), which is the first large-scale, long-term national study focusing on American adults who identify as LGBTQ+. It conducts annual questionnaires to understand factors related to health and disease in this population. </p><p>Participants filled out an annual questionnaire (starting in June 2019) and a COVID-19 impact survey this past spring. Flentje noted that on an individual level, some people may not have experienced a big change in anxiety or depression levels, but for others there was. Overall, depression increased by a <a href="https://patient.info/doctor/patient-health-questionnaire-phq-9" target="_blank">PHQ-9 score</a> of 1.21, putting it at 8.31 on average. Anxiety went up by a <a href="https://www.mdcalc.com/gad-7-general-anxiety-disorder-7" target="_blank">GAD-7</a> score of 3.11 to an average of 8.89. Interestingly, the average PHQ-9 scores for those who screened positive for depression at the first 2019 survey decreased by 1.08. Those who screened negative for depression saw their PHQ-9 scores increase by 2.17 on average. As for anxiety, researchers detected no GAD-7 change among the study participants who screened positive for anxiety in the first survey, but did see an overall increase of 3.93 among those who had initially been evaluated as negative for the disorder. </p>
Risks among gender and sexual minorities<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="fc3fd1ae68b77bbbf58a6995638d6d65"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/EnUqDjCqg0A?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>The LGBTQ+ community is a vulnerable population to mental health concerns because of their fear of stigmatization and previous discriminatory experiences.</p> <p>Previous research by the Human Rights Campaign has found "that LGBTQ Americans are more likely than the <a href="https://medicalxpress.com/tags/general+population/" target="_blank">general population</a> to live in poverty and lack access to adequate medical care, paid <a href="https://medicalxpress.com/tags/medical+leave/" target="_blank">medical leave</a>, and basic necessities during the pandemic," said researcher Tari Hanneman, director of the health and aging program at the campaign.</p> <p>"Therefore, it is not surprising to see this increase in anxiety and depression among this population," Hanneman said in the release. "This study highlights the need for <a href="https://medicalxpress.com/tags/health+care+professionals/" target="_blank">health care professionals</a> to support, affirm and provide <a href="https://medicalxpress.com/tags/critical+care/" target="_blank">critical care</a> for the LGBTQ community to manage and maintain their mental health, as well as their physical health, during this pandemic."</p>
What should health care providers do?<p>The authors of the study recommend that health care providers check in with LGBTQ+ patients about stress and screen for mood and anxiety disorders in members of that community—even among those with no prior history of anxiety or depression.</p><p>As cases of COVID-19 continue to mount, the sustained social distancing, potential isolation, economic precariousness, and personal illness, grief, and loss are bound to have increased and varied impacts on mental health. Effective treatments may include individual therapy and medications as well as more large-scale coronavirus support programs like peer-led groups and mindfulness practices. </p><p>"It will be important to find out what happens over time and to identify who is most at risk, so we can be sure to roll out public health interventions to support the mental health of our communities in the best and most effective ways," said Flentje.</p>
What we know about black holes is both fascinating and scary.
- When it comes to black holes, science simultaneously knows so much and so little, which is why they are so fascinating. Focusing on what we do know, this group of astronomers, educators, and physicists share some of the most incredible facts about the powerful and mysterious objects.
- A black hole is so massive that light (and anything else it swallows) can't escape, says Bill Nye. You can't see a black hole, theoretical physicists Michio Kaku and Christophe Galfard explain, because it is too dark. What you can see, however, is the distortion of light around it caused by its extreme gravity.
- Explaining one unsettling concept from astrophysics called spaghettification, astronomer Michelle Thaller says that "If you got close to a black hole there would be tides over your body that small that would rip you apart into basically a strand of spaghetti that would fall down the black hole."