Marilyn Monroe, Ernest Hemingway, George Sanders, and Virginia Woolf- what do all these people have in common? Death by suicide. Hard as it may be to swallow, the fact remains that these very famous people who were viewed as successful and had the world at their feet, took their own lives in a fit of depression, anger, melancholia and out of sheer hopelessness. But this phenomenon is not exclusive to celebrities, people from all walks of life continue to succumb to pressures of life and commit suicide. Tens of thousands of people die in this manner every year in the United States alone, not to mention the thousands who die in other parts of the world. The National Institute of Mental Health (2004) reported that in 2000 around 29,350 people committed suicide in the United States and it was ranked the 11th leading cause of death.
Suicide is probably as old a phenomenon as death itself. Ancient Roman history reveals that suicide was common but it was considered a serious issue only when a military personnel was involved (Ferracuti 1957). According to research conducted by Silving (1957), suicide had a different position in ancient Catholic history. Catholic Church saw it as a form of self-sacrifice, however Saint Augustine denounced the practice calling it a blatant violation of the divine commandment "Thou Shalt not Kill" (Ferracuti, 1957)
However serious studies about suicide, its causes and impact were undertaken after 1800s when suicide notes were published and victims could now be seen as human beings in caught in desperate and unfortunate circumstances. Etkind (1997) observes that "the notes showed them [suicide victims] to be human, suffering from such common problems as poverty, infidelity, and plain bad luck" (p. 2).
Edwin Shneidman is one name that repeatedly appears in suicide research. His essays, articles and books on the subject, often co-written with colleagues, have explored the issue in detail revealing that the entire episode of suicide can be divided into three phases. The first key component is "inimicality." According to Shneidman (1980) "inimicality" is an "unsettled life pattern in which one acts against one's own best interests, reduces one's prospects for happiness, provokes reactions against one's self and, in general, ruins one's own life and career" (p. 11). In this situation or state of mind, the individual becomes his own "worst enemy" thus working against his own interests. The second element is that of "Perturbation" in which person undergoes severely negative psychological condition where he sees everything in a dark light and there appears to simply no exit. The third key component is "Constricted thinking." This is the stage when the person seems to exist in a "tunnel vision" that is characterized by "a narrowing of the range of perceptions, of opinions and of options that occur to the mind" (p. 12). Shneidman asserts that while having these three conditions might not lead to suicide in all cases but such feelings are often accompanied by development of suicidal behavior. Such a person is trapped by "the idea of cessation" of life that might ultimately result in actual suicide.
Shneidman and colleagues (1965) indicated the presence of clues and signs that a person is on the verge of committing suicide. They also suggested situations that give rise to "suicide crisis" claiming that there are often four possible reasons why a person decides to end his life. These do not apply to every single case of suicide but are found to be prevalent in majority of cases. The person under suicide crises might not always take his own life but there is a grave possibility of that happening especially when support is missing. These four situations are: a) Moments of extreme anger, disappointment and general hopelessness with life. Such moments give rise to suicidal behavior in an impulsive individual. B) Clinical depression that makes life appear not worth living. C) Serious chronic illness d) When others' behavior is seen as the main problem.
Shneidman and colleagues maintain that suicidal people are likely to give clues of their intentions with statements like:
My family would be better off without me."
I'm going to end it all; I can't stand this any more." won't be around much longer for you to put up with me." don't want to be a burden."
This is the last straw; this is all I needed." can't stand it any longer: I want to die." (Shneidman, Farberow, and Leonard, 1965, p. 9)
These statements are worth paying attention to as they often foreshadow death by suicide. Suicidal patients do not develop the suicidal streak randomly but are suffering from it for some time before they actually take their life. For this reasons, it is believed that there are always signs that a person may be in grave danger of committing suicide. An important clue is when a person gives away things that were once very dear to him. If a person starts giving away things or working on his/her insurance policies etc., then people around them must see it as a sign of some form of emotional or psychological disturbance that can prove fatal.
There is never one single cause of suicide that could be found in all reported cases. In each case, the cause of death differs usually falling in the broad categories of social, psychological and environmental etc. Psychological or physical causes of death include clinical depression that is probably the single most common factor found in suicide cases. People with chronic or clinical depression lose interest in everything they once enjoyed and give up on life. They suffer from an overwhelming sense of hopelessness believing that nothing will improve and thus death is the only refuge for them. However the causes of depression itself may be biological or environmental. Some people are pre-disposed to depression because of a medical history of depression in the family while others may develop it due to extreme circumstances. Dr. Howard Sudak, a professor of medicine at the Case-Western Reserve University School of Medicine and chief of psychiatry at the Cleveland Veterans Administration Hospital states: "Depression, often the root of self-destruction, can be either biologically or environmentally caused. Someone can have no biological predisposition to profound depression but still become depressed and hopeless enough to commit suicide. Conversely, someone can have a reasonably happy development in favorable circumstances and be genetically so predisposed that he or she gets profoundly depressed." 7
Clinical depression is a big killer since in 15% of cases end in suicide. Depression is different from general lows that every person experiences in his or her life. We cannot expect to be in a state of high all the time and there are days when everything appears to go the wrong way. However on these days, no matter how down we feel, something inside us encourages us to go on because we have hope that tomorrow will be better. On the other hand, clinical depression is the state of mind in which a person loses hope completely and this absence of hope is the most important predictor of the individual's future behavior.
Social conditions also play an important rule in increasing suicide rate. These factors include everything from broken homes to deteriorating personal relationships to joblessness. People suffering from money problems are as likely to commit suicide as someone suffering from abuse relationships. Thus social conditions have a great bearing on a person's chances of committing suicide.
Emile Durkheim (1858-1917) was a French philosopher who devoted his life to the study of social conditions and their impact on a person's health and welfare. Durkheim believed that social conditions could drive a man to suicide and it is wrong to assume that a normal sane person would never commit suicide and that suicide is exclusive to mentally disturbed people. In his celebrated work Le Suicide, Durkheim wrote:
the suicides of the insane differ from others as illusion and hallucinations differ from normal perceptions and automatic impulses from deliberate acts. It is true that there is a gradual shading from the former to the latter; but if that sufficed to identify them, one would also, generally speaking, have to confuse health with sickness, since the latter is but a variety of the former. Even if it were proved that the average man never kills himself, and that only those do so who show certain anomalies, this would still not justify considering insanity a necessary condition of suicide; for an insane person is not simply a man who thinks or acts somewhat differently from the average. Thus, suicide has been so closely associated with insanity only by arbitrarily restricting the meaning of the words. (p. 66)
Insanity is only an ambiguous term for psychosis or abnormal behavior. What Durkheim meant to say was that abnormal behavior is not a good predictor of suicidal tendencies and he was right since it is only when abnormality in behavior crosses a certain line that it is seen as a problem. In other words not all kinds…