Suicide and Compassion in the West

This image was shamelessly stolen from Canuckistani’s article: http://mondo-canuckistani.blogspot.com/2006/09/suicide.html. I was going to post some comments on her site when I noticed that my response was long enough to be an article all by itself.

The gist of Canuckistani’s post was that we Westerners decry some people’s apparent lack of respect for human life and yet demonstrate a lack of respect ourselves. In particular, the example was suicide bombers, in the case of Islamic fundamentalists, and the callous attitude that many people take towards those that attempt or succeed in suicide.

I agree with Canuckistani’s basic idea – the perception of suicide is that it is a choice or an option – but I think this is a changing perception. In 2002, for example, about 10% of the US population was using Prozac or similar drugs[1] – it's awfully hard to trivialize depression when the use of anti-depressants is so widespread.

That drugs like Prozac have been developed at all indicates that our society takes depression and suicide pretty seriously. The anti-depressants available before Prozac were about as effective, but much harder on the person taking the drug. If we don’t care about suicides and depressed people, why develop drugs whose only real improvement is the reduction of side-effects?

Compare this to the reaction of Egypt over the crash of Egypt Air flight 990: the Egyptian government refused to admit the possibility that one of the pilots could have been committing suicide despite the results of the investigation[2]. It is much harder to make progress against suicide and depression if you refuse to admit that these conditions even exist in your country.

While Western countries may have made progress with regards to how suicide and depression are viewed, there is still a lot of room for improvement. I think the attitude that they are somehow choices is prevalent in the US and elsewhere, as is demonstrated by some of the responses to Canuckistani’s post.

If suicide and depression is relatively inexpensive to treat, why are so many people dying from it? For example: about 3,000 people died in 2001 due to the terrorist attacks of 9/11, but more than 10 times that died in the same year because of suicide[3].

Examining the larger picture, however, I definitely agree with Canuckistani’s idea. I previously posted some articles on how people protest abortion in the US, but don’t seem to care that the United States has one of the highest infant mortality rates in the developed world. If we value life so highly, why don’t we do a better job of taking care of newborns, for crying out loud?

So while I agree with the basic ideas of Canuckistani’s post, I don’t think her particular choice (depression and suicide) are quite as apt. In particular the advances made in the West, and the tendency in Islamic countries to refuse that suicide and depression even exist make that argument a tough sell.

Technorati: Suicide, Depression, West, Prozac, SSRI

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I was originally going to post that I completely agreed with Canuckistani’s take when I did a bit of research into the topic and discovered that the West has actually been making substantial progress towards the treatment of depression and suicide. Here are some of the references that I used in this article:

[1] Estimated US population for 2002 was about 280 million by the US Census Bureau, http://www.census.gov/prod/2002pubs/01statab/pop.pdf. Roughly 33 million prescriptions for Prozac or similar drugs in 2002 according to Milane et. al. Thus more than 10% of the population was using such drugs during 2002.

[2] http://en.wikipedia.org/wiki/EgyptAir_Flight_990. OK, so wikipedia is not exactly an authoritative source, but you can find other links on the net that say essentially the same thing if you look for “Egypt Air 990,” and wikipedia summed it up nicely.

[3] According to the CDC (http://www.cdc.gov/ncipc/factsheets/suifacts.htm), 30,622 people died from suicide in 2001.

[4] The following studies indicate a statically significant link between the rate of SSRI prescriptions and suicide rates, but a causal relationship has not been firmly established. Never the less, it seems reasonable enough to draw that conclusion.

"The relationship between antidepressant medication use and rate of suicide."; Gibbons RD, Hur K, Bhaumik DK, Mann JJ.; Archives of general psychiatry; 2005 February

"Modeling of the temporal patterns of fluoxetine prescriptions and suicide rates in the United States."; Milane MS, Suchard MA, Wong ML, Licinio J.; PLoS medicine, 2006 Jun

"Association between mortality from suicide in England and antidepressant prescribing: an ecological study."; Morgan OW, Griffiths C, Majeed A.; BMC public health [electronic resource]; 2004 Dec