BY HELEN C. EPSTEIN, Greater Good Magazine

When someone takes his own life, the grief of parents, lovers, children, and friends can be unspeakable. At a memorial for one young suicide I attended a few years ago, the father of the deceased could barely walk to the altar to light a candle. Everyone was crying.

How could this talented, beautiful young person not know she’d be terribly, horribly missed?

Most experts attribute suicide to severe mental illness caused by a brain injury or genetic predisposition, or due to some other, as yet unknown, physical or chemical trigger. Severe depression, bipolar disorder, and schizophrenia are all inordinately common among people who die by suicide.

Severe mental illnesses are no doubt responsible for many, if not most, of the eight hundred thousand or so suicides that occur around the world each year, including, perhaps, that young person’s whose memorial I attended.

My book, Why Live: How Suicide Becomes an Epidemic, isn’t primarily about such cases—or about how to prevent suicide. Such a book would have detailed sections about psychotherapy, restrictions on firearms, safety barriers for bridges, and other measures that really do save lives. Instead, my aim was to explore why some people want to take their own lives in the first place and how that desire might be reduced, in both individuals and communities.

Having spent the past few years reading about suicide, speaking with scores of people who’ve experienced suicidal feelings, and having experienced them myself from time to time, I’ve come to understand that what suicidal people feel is the indifference, not of the universe, but of those closest to them. They sense that their own feelings don’t matter to the people they care most about.

These experiences are backed up by studies showing that the main reason suicidal people want to die is because they think no one cares about them. Some suicides even seem to believe they’re doing everyone a favor by taking their own lives.

Psychologist Thomas Joiner, who’s been studying suicide for thirty years, calls it a force of nature that distorts people’s minds so they become convinced that they are a burden to others and no one wants them around. In study after study, the most common trigger for suicide is a perceived rupture in a close relationship, either with a lover, parent, or other close relative, that seems irreparable to the suicidal person.

Given that suicide seems driven by fraught or broken connections, it’s perhaps not surprising that I also discovered that suicide can spread within social groups like a disease. The suicide rate of particular groups can jump—sometimes increasing three- or four-fold or more—in a short time, meaning it behaves like an epidemic, like malaria during the rainy season or flu in the fall. Suicide epidemics unfold more slowly than these microbial plagues—over years or decades, not weeks or months—but they happen far too quickly to result from genetic changes, and affect far too many people to be explained away as spontaneous cases of biologically caused mental illness or brain injury. The causes therefore must have something to do with the changing social environment in which these people live. Suicide epidemics have occurred on virtually every continent.

  • Between the 1820s and World War I, suicides nearly tripled in Belgium, Italy, and France, and they quadrupled in Austria.
  • In 2014, young veterans of the Iraq and Afghan wars were roughly five times as likely as same-aged civilians to take their own lives.
  • The suicide rate doubled among middle-aged Russians after the collapse of Soviet communism in the early 1990s.
  • It quadrupled in white middle-aged working-class Americans after deindustrialization commenced in the 1970s.
  • Between 1980 and 2003, suicide among Inuit youths in the Canadian Arctic soared from almost zero to a rate 10 times higher than that of the white majority Canadian population.

What’s scary about this is that it means suicide could come for any of us. The very existence of suicide epidemics proves that people with suicidal feelings aren’t a species apart. Anyone can feel suicidal under certain conditions—and the key to stopping suicide epidemics is to change those conditions.

Why suicide spreads

I teach and write about public health and have long been fascinated by epidemics because they always tell a story. In most literary depictions of epidemics, such as Albert Camus’s The Plague or Daniel Defoe’s A Journal of the Plague Year, they seem to strike from nowhere, but this isn’t how epidemics typically behave. Individual cases of disease are hard to predict. Some of us will become ill tomorrow, but there’s no telling who. Even those who take risks may well escape the consequences.

What might cause a suicide epidemic?

First, it’s important to understand what doesn’t. Suicide isn’t more common during wars or where people are poorer or have recently experienced some environmental disaster like a flood, earthquake, or wildfire. Suicide was common among African slaves, especially on the ships en route to America and when they first arrived, but despite segregation, police brutality, mass incarceration, and other outrages, the suicide rate of African Americans has been generally lower than that of U.S. whites since record-keeping began in the 1930s.

What seems to matter is whether people believe someone, somewhere, really cares about and understands them.

The mental pain that drives suicide is really the flip side of love, says Israeli neuroscientist Yoram Yovell. “It probably evolved along with motherhood. . . . Inherent in us are very strong emotional forces that function to keep mothers and babies together. When they get too far from each other, they feel mental pain,” which we experience when we search for love. This is why “so many children’s stories are about a boy looking for his lost mother.”

Evidence supports Yovell’s theory. A 1999 study found that some 78% of high lethality suicide attempters had recently experienced the loss of a close personal relationship, and suicide notes often express love for those left behind. In 2012, Zimri Yaseen and his colleagues reported that suicidal people interviewed in emergency rooms were especially likely to report that in the three preceding days, they’d felt “unusually intense or deep feelings of love,” which they presumably also felt were not reciprocated.

But why would large groups of people—from the islands of Micronesia to the Arctic Circle, from the cities of post-communist Russia to the towns of contemporary America—suddenly begin questioning their most intimate attachments? How does love suddenly disappear—or seem to—from the lives of thousands of people?

In my book, Why Live, I argue that it has to do with how we internalize socioeconomic change.

Fragmenting societies, isolated individuals

The first well-researched suicide epidemic occurred across Western Europe during the 19th century. Intellectuals debated the causes as we debate the vicissitudes of the stock market. Rising suicide rates were attributed to socialism, atmospheric moisture, the vice of masturbation, and the Romantic era inclination to preserve—through death—the passions of youth against the onslaught of Bourgeois boredom brought on by industrialization and urban life.

Doctors even searched, in vain, for a “suicidogenic” organ in the cadavers of people who’d died by suicide. But others blamed society, that collective property of human groups that shapes our thinking and behavior.

As a Jew growing up in France amid increasing anti-Semitism, Émile Durkheim had seen how shared values and beliefs buffered his people against the effects of discrimination and how anti-Semitism tightened bonds among them. He went on to become one of the founders of sociology, which is the study of those bonds: what holds us together, what drives us apart, and what happens as a result.

In his 1897 book, Suicide, Durkheim theorized that suicides increase wherever society is fragmenting and people are growing more detached from one another: where divorce rates are higher, for example, and where Protestants, with their individualistic culture and aloofness from collective ritual, outnumber Catholics. He likened it to entropy—the universal tendency toward chaos and disorder at the atomic level discovered by physicists earlier in the century. Appearing on the eve of humanity’s, as yet, bloodiest century, Durkheim’s book seemed to foreshadow the trouble to come.

What is it about fragmenting societies that causes mental pain?

Durkheim was vague, even a little loopy, when it came to explaining this. At the time, psychologists were just discovering the unconscious, which they explored through studies of hypnosis and hallucinations. Durkheim followed this research closely, and believed that values and meanings flowed through populations like electrical currents, as if societies had what scholars Laurent Mucchielli and Marc Renneville refer to as a “collective soul.” These currents could change people’s behavior through unconscious mechanisms, just as changes in temperature and pressure change the behavior of molecules.

Many late-19th-century scientists believed that our brains generated signals analogous to radio waves. Alexander Graham Bell, Nikola Tesla, and James Clerk Maxwell even wired up helmets and other gizmos to try to measure them. Mark Twain told Harper’s Monthly that thoughts could shoot from brain to brain, without their owners having to open their mouths to communicate. Likewise, Durkheim maintained that whatever suicidal people said about their feelings were just expressions of resolutions planted in their minds by the vibes of a disintegrating society.

The brain-wave theory eventually fell out of fashion. In the 1930s, one of Durkheim’s protégés came closer to explaining the psychological effects of social fragmentation. Maurice Halbwachs taught at the University of Strasbourg from 1919 until his death in a Nazi concentration camp in 1945. His 1930 monograph The Causes of Suicide identified an existential loneliness that, if not entirely new, flourished in the growing towns and cities of 19th-century Europe and the countryside they engulfed.

According to Halbwachs, cities create opportunities for social and economic advancement, but they also create the conditions for exploitative relationships, swindles, romantic betrayals, fragile friendships, broken families, unstable jobs, and many other sources of despair.

As European cities grew, so did a new class of people who were particularly prone to suicide, including abandoned lovers, lonely widowers, workers who’d lost their jobs, nobles shamed by some dishonorable act, gamblers who couldn’t pay their debts, merchants who’d ruined themselves, heirs who’d squandered their fortunes, and others who’d suffered a common bitter fate: sudden exclusion from a cherished social community. As Halwachs writes:

They all see their social level lowered. They are to a certain extent declassed. But what does it mean to be declassed? It is to pass from a group that one knows, that esteems you, to another that ignores you and whose appreciation one has no reason to hold. One then feels a void opening around oneself. Those who once surrounded you, with whom you had so many ideas in common, so many prejudices in common, with whom so many affinities brought you together because you found yourself in them as they found yourself in you, suddenly move away. You disappear from their concerns and their memory. Those among whom you find yourself understand neither your disorientation, nor your nostalgia and your regrets. Detached from the group by a sudden shock, you are incapable, or at least you believe yourself incapable, of ever finding in another any support, nor anything to replace what you have lost.

In the midst of the 19th-century suicide crisis, the very meaning of the word “lonely” changed, from an adjective typically used to describe empty places and people who stood alone before God to one with the emotional and psychological connotations it has for us today. Suicidal despair, Halbwachs wrote, had been rarer in the past because traditional rural life was simpler and more predictable:

We lived on the spot . . . adapted to each other, knowing each other too well to be frequently exposed to the clashes that occur when we move from one place, one situation, one profession, to another. Business carried less risk. Ambitions were less aroused, humiliations rarer. We thought and felt in common. Sorrows and troubles, instead of concentrating within the consciousness of this or that individual, dispersed and died out within the group.

What Halbwachs was describing was the transition from what German sociologist Ferdinand Tönnies called Gemeinschaft, or communities based on trust, mutual respect, and sharing of whatever material goods one had, to Gesellschaft, societies based largely on market transactions and political calculation in which ties of friendship and loyalty are relegated to private family life, and may not even reliably be found there.

As far as I’ve been able to determine, wherever that transition has occurred, a suicide epidemic has followed swiftly behind.

But there is another ingredient, too. As villagers shifted away from subsistence and small-scale farming to wage labor and trade, their intimate relationships became both more fragile and more precious. The extended family, which once formed a social mesh that supported everyone, waned in significance, and walls rose up around increasingly private and nuclearized families, usually dominated by a single, generally male breadwinner, upon whom everyone else in the family depended. If you felt your family didn’t respect and care about you, you were in a new sort of trouble, not just because the community no longer offered you a livelihood, but because your whole identity was at stake.

Love and belonging

Modern capitalist society creates, in all of us, something of the double consciousness described by the great African American sociologist W. E. B. DuBois. When a modern person looks at a stranger, he wonders not only, as his villager ancestors did, “What can I do to help this person? And is he the kind of person who will help me?” but “What does that stranger see when he looks at me? What essence does he detect? A beauty or a beast? A success or a failure? A respectable person or a fool?”

The answer sometimes comes as a disappointment. In traditionally cohesive societies, this mattered less, because a person’s worth was measured by what he did for others, and everyone was capable of contributing something. You might not be the best hunter, fisherman, storyteller, or drummer; you might not be the best grower of breadfruit or builder of igloos; but you still mattered. Only the greedy and selfish were looked down upon and excluded.

In modern societies, generosity still counts, but for far less than it used to. If others find us wanting—because of our looks, talents, graces, bank accounts, intelligence, or for whatever reason—we are alone with it, and must make sense of it, somehow.

For most of us, what makes modern life, with all its loneliness and insecurity, bearable are close relationships with people we count on to see and accept us for who we really are—whatever our flaws. Romantic rejection is exquisitely painful because we feel that that special quality within us, the thing that makes us lovable—and everyone has something—has either been unrecognized or, worse, seen and rejected.

The pain of rejection by a parent or other close relative is even worse because it can make us feel as though no one could ever understand and sympathize with us. After all, they know us best of all.

In the absence of an abstract sense of group belonging, interpersonal love, especially between parents and children and romantic partners, has become the main source of our psychological resilience, our ability to withstand the disappointments encountered in the outside world, just as the mutually reinforcing group gave strength to our ancestors fighting for survival on the plains, tundras, beaches, and forests of the past.

Love is not just a feeling; it’s also a culture, which developed fairly recently, first in Western societies, and then around the world on the heels of capitalism, modernity, and individualism. It’s no coincidence, the social philosopher Erich Fromm pointed out, that as modern ways of life displaced the traditional, cohesive village and clan, love poems, songs, and stories came to occupy the center of Western culture, displacing archaic tales of heroism and godliness.

It’s not that love was absent from the art of the ancient past, but as often as not, it was seen as a cause of calamity and human folly. Think of Helen of Troy, Dido and Aeneas, Adam and Eve. Then, more or less in lockstep with commercial culture and urbanization, love came to be seen as a force superior to the gods or God or honor or historic destiny.

The behavior of parents and spouses changed, too. Until the 1800s, childrearing in England, for example, was seen as an exercise less in nurturing than in training for adulthood. Men who were fed up with their wives could sell them at markets or abandon them and marry someone else without divorcing. Infants who died weren’t even listed in parish registers. Only in the 19th century did heartfelt observations of sons and daughters begin appearing regularly in the diaries of American and English mothers.

Regrowing community

With the growth of markets and formal state institutions, people came to rely less on kinship networks for social welfare and trade and the family gradually shifted from an economic enterprise to a child-centered haven in a heartless world. The 1700s saw the first toy shops, women’s magazines, popular child care manuals, and family portraits. Christian churches, which had previously stressed family discipline and sometimes even the virtues of wife-beating, now promoted ideals of conjugal and parental love.

Today, birthday parties, children’s allowances, and Valentine’s Day cards are symbols we use to assure each other that our most important relationships are real. Meanwhile, parenting manuals, happily-ever-after fairy tales, Hollywood movies, and the novels of Jane Austen, George Eliot, Charles Dickens, Barbara Cartland, Colleen Hoover, and countless others illustrate the enactment of love according to Western norms.

Premodern Europeans, as well as Indigenous groups the world over, didn’t need this culture because in the mutual aid communities of bygone days, you knew who you were and what you needed to do to gain the esteem of others: You had to pitch in for the group. You helped others and they helped you. That was love, and according to accounts of anthropologists, it was everywhere, as ubiquitous as air.

But when these groups modernized, in some cases very rapidly under the forces of capitalism and colonialism, the rules changed. Now it was unclear what the common goals were and what others were looking for in us. If they didn’t like us, there wasn’t a lot we could do about it. If the people we loved—our romantic partners, parents, and children—felt that way, it was intolerably painful because our hearts had nowhere to turn. Every rejection could now elicit devastating feelings of aloneness. “Who am I?” we are left to wonder. “Am I worth anything at all to anyone?”

Signifiers of love—birthday cards and so on—aren’t enough. We need the confidence that our own feelings are understood. Some people, either because of the distortions of mental illness or because they really are lost and alone, simply don’t have it.

But all is not lost. As I argue in Why Live, communities can regrow, just like decimated forests. The best policy I can think of is to strive for greater economic equality, which will naturally reduce insecurity, and, in turn, foster greater spiritual as well as material generosity. We are kinder to one another when we don’t feel threatened. Otherwise, the best advice I can think of is not to make things worse. When positive communities begin to emerge, the trick is not to ruin them. 

Let’s treat communities like ecosystems so that every time a major economic policy shift is proposed—a massive new trade deal or development project—the effects on communities are considered, and the preservation of Gemeinschaft is prioritized. Ideally, studies of this, analogous to the environmental impact studies now required by all World Bank loans to developing countries, would be conducted with the full and meaningful involvement of affected communities.

Some elements of Gemeinschaft survive, even in these harsh times—in well-functioning neighborhoods, in friendship networks, sometimes in the military, and in some schools and workplaces. You know it when you see it; it’s where you feel your dignity is recognized. In defending and building that, we give everyone more reason to live.

Keywords; grief, psychology