Podcast on Male Suicide
Dr. Eric Caine is chair of the Department of Psychiatry at the University of Rochester Medical Center in New York. An expert consultant to the President’s New Freedom Commission on Mental Health, Caine is one of the nation’s foremost researchers in the field of suicide prevention and an expert on mental illness and suicide among the elderly. He talks with us today about male suicide, the use of antidepressants and suicide, and suicide prevention.
Dr. Caine noted that many suicide victims--especially older men--have seen their physicians within a few weeks of killing themselves. But he says that most general practioners don't ask the right questions: it's not enough to ask how someone feels, because often the most depressed guy will usually say "fine." They need to ask more pointed questions like "are you enjoying life as much as you used to? and "are you having fun?" The bottom line is, more education is needed about males and suicide in our culture as it is claiming the lives of around 24,000 men a year in the US out of 30,000 total suicides. What can be done about it? Listen to the podcast and find out.
You can visit the Suicide Prevention Action Network at www.spanusa.org for more information on suicide or take a look at Night Falls Fast: Understanding Suicide.
You can listen to the show directly -- no downloading needed -- by going here and clicking on the gray Flash player. You can download the file by clicking right here, and you can subscribe via iTunes by clicking here. A lo-fi version suitable for dialup, cellphones, etc. is available by going here and selecting the lo-fi version.
This podcast is brought to you by Volvo at www.volvocars.us.
posted by Helen at 8:49 AM
46 Comments:
Those pictures of you give me a reason to live, DrHelen. More, please.
Male suicide, hah?
Been there, done that, failed.
Lucky for you, huh!
Do you have any sisters....in Southern California?
bugs,
On the contrary, I am glad you're here. I enjoy reading your comments.
Jon,
I looked at the case you were talking about and it is indeed upsetting to see that a doctor would break such a privilege. I agree that laws should not allow for this type of disclosure--especially given that the man was drinking beer at home and not at work. If a person sees a psychologist, there is doctor/patient confidentiality except in the case of a suicidal or homicidal threat and depending on the state, there may be other circumstances where confidentiality may be broken--child abuse or elder abuse (which I find sort of odd).
Anyway, your point is well taken. Perhaps men are afraid they will lose their jobs or livelihood if found to have certain mental problems. However, this is unlikely and I might add, it is more important to have peace of mind than it is to live with depression by not getting any help, just based on the minute chance confidentiality would be broken. Perhaps clergy would be good for men, someone that they trust more. Also, for a depressed man, it helps to ask friends or someone you trust to recommend a good professional, someone that works well with men and understands some of the stressors etc. they have. There are many good professionals out there who can help with depression and get a person back on track. As far as being afraid one will be hospitalized against their will, that is virtually impossible. I cannot even get those in who want to go to the hospital. It just doesn't happen much anymore.
Listening to your podcast....interesting stuff. When I was younger (20's) and lived in Chicago,I always took the subway or EL train. Even tho I wasnt a bit suicidal, I had fleating fears that I would, on impulse, jump in front of the train....so I always stood as far back from the edge of the track as I could. I confessed this to my roommate and she admitted she had the same fears, tho she as well had no intent to suicide. So I began to ask others if they ever had the brief fear that impulse would take over and they would jump in front of a train and almost everyone said yes.
So here is my question Helen. Have you ever heard of this? Do you think some suicides are unplanned but rather an act of impulsivity?
Debbie
We live in a police state that considers men second class citizens. Especially divorced men. Anything thing that you say can and will be used against you. in the last 15 years a multitude of laws have been written that make it a crime to do or say or do many things. Our government now has the ability to track all we say and do. New laws force mental health practitioners to inform authorities on any thing that we say or do that they think may be harmful to the state ( kind of like Nazi Germany when everyone was afraid of their neighbors. You better look out for your self or just commit suicide. Call the authorities and they will come out and commit suicide for you. I am form Central Florida and believe me they will shoot first and ask questions later. I have never see such a hostile place.
Hi Debbie,
Believe it or not, suicidal thinking is common; in a study done by the Centers for Disease Control and Prevention, it was found that one in ten college students seriously considered suicide duing the year, many had gone as far as drawing up a plan. One in five high school students feels the same way. The line between suicidal thought and action are not clear. I think many of us as human beings have had some thoughts such as what you described. The difference is generally psychopathology that is left untreated in an individual.
Driving a man to suicide is as bad a crime as outright murder. Maybe it is worse because the man you drive to suicide sufferes longer. Many men are drivin to suicide by irrational destruction of their famiies by feminist "family" courts that routinely seperate men from their children. It is worse than mass murder, killing thousands of good men every year.
Bob
Catch more of bob see bobstruth.blogspot.com
The show got me to thinking of all the suicides I've been exposed to in my 49 years. I've never known anyone who has been murdered, but can quickly think of seven people I have known personally who have committed suicide. Your guest was right. It is a big problem when you actually think about it.
Perhaps men are afraid they will lose their jobs or livelihood if found to have certain mental problems. However, this is unlikely
How is it unlikely??!
Very interesting show. My father, age 78, seems to be going through some of the things discussed; upset about diminished physical capacity, says he is ready to just give up and die, etc.
I had kind of dismissed them because for example, instead of now shooting a round of golf in the high 60's low 70's, he hardly ever breaks 85. That is his idea of diminished physical capacity. But to him it is very real and he is probably depressed. I'm going to try to do something about it.
Debbie: When I was younger I had an airplane and flew all over the place. My suicidal impulse was to load up with enough fuel to fly 4 or five hours out over the Pacific Ocean, well past the point where I would have enough range left to return to land. I always wondered what kind of thoughts would be going through my head in the time interval between passing the point of no return and actually running out of fuel. Obviously I never did it, and those types of "suicidal urges" don't seem to pop into my head anymore.
Helen: I am normally very good at imitating people's accents; but for the life of me I can't imitate that Tennessee lilt of yours.
Dr. Helen wrote: "The difference is generally psychopathology that is left untreated in an individual."
So, basically Dr.H. you are saying that suicide is a non-adaptive response to the individual's failure to take advantage of the voodoo psychology scam that you represent?
Luv your sexy photos!
You're a Freudian at heart, right?
I work for a defense contractor and have a fairly high level security clearance (higher than Sandy Bergler's, in fact). One of the questions we get asked during the vetting process, a process that needs to be renewed periodically, is have we sought mental health counseling? Just being asked that question is intimidating, and the clear implication is that in seking such help, one risks losing one's clearance and of course, one's job. For a man, this is just about the worst thing that can happen. For most men, their ability to provide for their family is roughly the equivalent of a mother's ability to nurse her infant.
I had occasion to actually ask one the security people at work about the implications of seeking such help, and the news I got provided some relief, but still, I'm skeptical, and it'd have to really be crazy to seek such help. Then of course, I'd have Cpl Rosarion's Catch 22 (spelling?), and in realizing I'm crazy, then I'm really not crazy...
Rusty
Tomcal,
My voice is a bit odd--I was born in Berkeley, moved to Tennessee at three and my father had a Bronx accent so I picked up a rather weird voice. Not sure what to do about it other than accept it for what it is.
Anonymous 4:28:
No, suicide is a non-adaptive response which is fatal--someone taking their own life is depressed--and responding in a non-adaptive way. I do not think my "voodoo psychology" is always the answer, it may be a friend, clergy or someone who can help but a professional who understands the cognitive mindset of suicide can be an asset to a suicidal person. I have seen psychotherapy help many people to become less depressed, if you want to call that voodoo, be my guest.
Helen:
You have a great voice, I never said it was odd, just that your accent was hard to imitate, and now I understand why!
TC
Jake:
I started counting up suicides too. The last one was a waiter at the restaurant where I eat almost every night when I am at my home in Nicaragua; that was - 2 weeks ago tonight (.38 cal pistol). About 10 years ago my banker decided to off himself in his living room for his family to come home and see (shotgun); and right after I graduated from high school one of the most stable guys (at least we thought) took a hike and did himself in for some reason (shotgun). While I was in college, my parents' next door neighbor's son, a guy about my age, did the shotgun thing in his bedroom over spring break. I also talked a guy I know out of suicide (would have been a pistol) about 15 years ago, or at least kept him talking until the professionals arrived to take over for me. Of those five, all were male. To date, I have not heard of a single suicide by a female I have met, and I am 48.
Oh, I just remembered another, a kid, about 21, who was a great help to me in a village in Nagaragua where I was drilling water wells about 6 months ago. Also male. He left a note - couldn't come to grips with the fact that he was gay.
And for the record I have never known a murder victim.
And another I just remembered. A neighbor up the street jumped off of a freeway overpass into oncoming traffic on the 101 freeway about 10 years ago, also male.
Of all of the above 7 (so Jake and I have the same number if I include my friend's failed attempt) only 1 had the courtesy to go out into the woods and do it in private, in fact he was just a missing person for quite a while; at least I admire him for that.
All of the others did it in ways that that made a quite a display, 5 to their families and 1 to some innocent driver on the freeway, leaving deep emotional scars on the survivors. I consider that to be very selfish and impolite.
tomcal,
Suicide can be an aggressive act--especially when done in a way that will leave the most pain. In fact, the song Jeremy, written by Pearl Jam is about a teen who killed himself in front of his classmates in high school. Now that anger turned inward is often turned outward which is why you see situations where men kill others first in a mass shooting and then kill themselves. "Why suffer alone, when you can make others know how you feel," is how some men feel these days. Society doesn't deal with this kind of pain and as our expert on sucide said in the podcast, many of these men are not sympathetic characters and don't want to work with them and the men themselves do not seek help, perhaps for good reason. I thought that was the reason that mental health professionals existed, to help the people who really needed help, but perhaps I am naive.
Of course I am not a professional, but from my perspective you are right. Only 2 of the above 7, the banker and the gay kid, seemed to me to be be genuinely nice guys; but then both of those did it in ways that were extremely painful for their families - shotgun and hanging, both in the living room.
Regarding these people being hard to work with: As I was trying to keep my friend from pulling the trigger, he had his family in there with him, and was threatening to take them out too, under the theory that they could not survive economically without him. I was really thinking much more about them than him. In fact I specifically remember thinking "why doesn't he just go off and do it by himself, so I don't have to deal with this? He's kind of an a-hole anyway".
Thankfully a crises management team, plus all sorts of other family members and friends of his arrived and took me off the hook, he ended up getting help, and the story had a happy ending; but he is still an a-hole.
Oh, I just remembered another. A friend's grandson, straight A student, age 17, captain of the football team, about 3 months ago. Shotgun in his bedroom.
Now I guess I am tied with Jake. We both know 7 actuals, but I am 1 year younger that Jake.
tomcal
I don't want to turn this into an inventory of suicides, but I would like to mention one of them... a fellow I will call Mr. A.
I grew up in a small island village off the coast of Maine. Mr. A ran the town dock and was the janitor in the village grammar school. He was a lovely man, always cheery and bright. He taught me to sail as a boy and I spent hours at his boat yard, mesmerized by his sea stories.
Eventually, I grew up and went away to the mainland for school and adulthood. While deployed with the Marines on Okinawa, Japan I got a letter from my mom telling me that Mr. A had died... that in fact he had driven his car into his barn and left the engine running. As it was just several months after his wife had died, the word around town was that he had died of a "broken heart".
After listening to Glenn and Helen's show, I am convinced that it was more than that - more likely depression from being old, alone and sad that his lovely wife was gone forever. But it goes to show that not all suicides are "aggressive" acts or calls for public attention. Sometimes, as with Mr. A, suicide is simply an act brought on by personal and private despair. In any case, I was desperately saddened by his passing and have always hoped that he didn't suffer too much in his last days.
That should excite the feminists knowing that 75% of all suicdes are men committing the act!!!!
Though I didn't know her personally, my wife had a friend, an elderly woman, who committed suicide within weeks after her husband's death from cancer. Basically your story with the sexes reversed. Its very sad because she left children, grandchildren, and great-grandchildren whom she no doubt could have benefited greatly had she lived.
Your story gives me even more incentive to try to help my dad (to get him some help) through what I am now almost almost sure is an episode of pretty severe depression.
But my own feelings are interestingly callous in this respect. I feel that my dad and I are at peace with each other, so with respect to me, if he wants to die and feels that his time is up, why shouldn't he?, and get started with his life in the hereafter.
But when I think about my kids and their cousins, I realize that he has so much more to offer them that it would be a tragedy if he dies now. So like I said, tomorrow I am going to embark on a mission to try to get him some treatment, even though it won't be easy.
My last post above should have been addressed to Jake.
anonymous 12:53:
Sadly, I wonder about that myself sometimes, is suicide in the US unimportant because men mainly the ones who kill themselves? I don't know the answer to that but I wonder what would happen if one wanted to get a grant to help reduce male suicide? Would it even be possible?
Tomcal,
Try to help your father if you can, living with depression, no matter what one's age is no way to live.
Helen:
Of course you know I diasgree with most of what you say. (In particular, your seeming lack of even-handedness when it comes to politics.)
As for your suggestion that men are marginalized in our society, I don't say it's not there. I just don't see it as much. (Perhaps I would see it more if I watched television.) Also, my sense is that women are still marginalized in more pervasive, institutional and harmful ways.
However, I did see something last night that I thought would certainly be ammo for you. I was shopping for Christmas cards at Target and there were probably at least 4-5 cards for sale that were meant to appeal to the type of woman who likes to ridicule men. The most ridiculous one portrayed the three wise men making comments such as "Women really are smarter than men" and "We should just thank god women put up with us", etc.
Obviously, they wouldn't sell cards that said such things about women. Women aren't marginalized in THAT way, at least.
Andrea
Andrea,
I am not looking for ammo, just equality and justice.
"As for your suggestion that men are marginalized in our society, I don't say it's not there. I just don't see it as much. (Perhaps I would see it more if I watched television.) Also, my sense is that women are still marginalized in more pervasive, institutional and harmful ways."
Andrea, when you state it that way, there's no problem - one type of marginalization feeds the other, in a cycle. So you attack women's marginalization, and it will help with men's marginalization.
What is happening is a renegotiation of the division of labor between the sexes, and it has ben uneven. In the past the division was basically women got the responsibility and authority at hoem (children) and men had the corresonding role outside the home (work, some religions, since God was out there). Even as recently as a century ago most men and women simply could not get by on their own. Now they can. Women don't want the economic dependence of having to rely on a man's income, so they demand and get access to jobs that used ot be off limits. Men no longer need women to make thier clothes or make their food. All that can be bought outside the home now.
The big snag has to do with children. Women have pretty broad access to jobs in society, and generally the only areas where they are underrepresented are areas where they are not very eager to enter - combat and other dangewrous and dirty work - you don't hear women clamoring to get into the crab fishing fleet, for instance. Men do not have the same access or control over homelife.
There is the general perception that children belong to women. This colors the debate on abortion for instance, since preproductive issues get snaffled up in bodily integrity issues. We as men are told "too bad; that's just biology - you can't have a law to fix every quirk of nature." but funny thing; we have laws to fix all kinds of natural inequalities -for instance male adultery can never be as serious as female adultery, since a man can never pass off some other woman's child on an unsuspecting wife and compel her to put 18 years of her life into raising it; at worst ehr sense of security is shaken, and maybe her vanity - but nevermind, the law and the culture regard both types of adultery as equal. (And I agree.) So we are not doomed to live with the inequalities nature imposes, unless we are men, it seems.
I think a lot of this is temporary. It is what in the Army is called "the pain of transition" It is the price of building a better world. And it is tempeorary - men are getting fed up and will end it eventually, but not as fast as the women who love them - women are usually much louder about the way their men are mishandled then the men are themselves. Helen is one of these women.
If you're feeling oppressed, a stretch in your local psych ward can be illuminating. Nothing like busting out a.m.a at three in the morning to restore that manly sense of your own potency...
i too have contemplated suicide, and i still have a tendecy to wish i had a button that would end my life fast, and painless. like the suicide booths in futurama.
i read once, suicide attempt is generally a cry for help at least on the female side, but men are so good at planning that the majority of men succeed. its not so much as a cry for help as a true self destruction.
Or it may simply be that men don't do cry-for-help suicides any more than we do any other cry-for-help behavior, or even ask-for-directions behavior.
Case in Point......Male, middleaged, married, children.........wife leaves him, claims abuse, children removed from the male parent, child support and alimony deducted from pay automatically, male loses house, male loses children, male faces bankruptcy, male fights wife in court forchildren, judge decidedes "in the besat interest of the children" father is now a weekend visitor, mother speaks lowly of father to children, children hate father, father now in bankruptcy, father thrown in prison for not providing support payments he cannot afford, FATHER COMMITS SUICIDE....bad daddy
I might suggest that male suicides tend not to be "cries for help" but rather attempts to exert control. In typical male fashion, we experience our intractable pain as a problem that must be solved. Not to solve it is a failure, a sign of our own impotence in our own lives. Suicide is our way of both escaping the pain, solving the problem, and avoiding the failure - once and for all.
Cry for help suicide attempts are also an attempt at control, an manipulative, sleazy little trick -not at all the same thing as when some one commits suicide in an attempt to get control of his own situation. Not at all.
i know one person who killed himself, i used to work with his girlfriend, she and her kid found him in their flat.. because he couldnt find a job.. and presumably couldnt see a future.
jim - I think it depends on how you define "cry for help." If a person consciously does it to get attention, to make everyone stop what they're doing and "rescue" the person from whatever problems they're facing (or not facing), then I'd agree - highly manipulative.
There are also people - I guess they're called borderline personalities - who do the same thing, but more or less unconsciously. They manipulate others with emotional displays, but they really *believe* what they're doing is honest. (Doc, correct me if the nomenclature is wrong.)
In other cases, the suicide drama is not played out for the benefit of others. It's often narcissistic in nature, done to reinforce ones own special status as especially sensitive, troubled, helpless, etc. This isn't superficial - it goes to the center of ones ego, the idea that the thing that you are, good or bad, somehow can't survive because it doesn't fit in the real world, or vice versa.
And in another sense, "real" suicides are "cries for help" since the person has basically run out of alternatives (in their own mind) and really does need help. But they can't or won't consciously ask for help because of the desire for control or because they believe no one will actually help them.
That's my half-assed theory, anyway...
Sounds good to me - not so half-assed. There is a real difference.
jim - sounds like you have some personal experience. Hope I'm wrong.
No, thank God! But I pay attention to other people's troubles, and in another life part of my job was worrying about troops' morale and such. we had both the grandstanding suicide threats and the real thing. Guess which were the hardest on all of us.
I expect it was the guys who threatened rather than those who actually did it. Dead guys, I guess it's all over but the paperwork and informing the family. Drama queens just keep on giving...
There was a guy in Basic at Ft. Knox who climbed up a water tower and threatened to jump off. He just wanted out - homesick and stressed. Since he hadn't been in very long, they obliged him with a ticket back to El Salvador or wherever he was from. I wondered at the time what a guy like that would have done if given access to an M-16. I kind of think now that he would have...climbed up a water tower and threatened to jump off. But what do I know?
Hi Mrs. Smith,
Yes, I totally agree that the disclosure by physicians about suicidal ideation is a gray one - especially among youth. I've heard a great variety of case study anecdotes about how a lot of physicians may be to tempted to overreport in order to guarantee their own legal security.
I'm currently a teenager myself, and being a guy, I certainly understand where you're coming from. The pressures to conform to gender roles, ie. "tough guy", is really a tragedy for the face suicide prevention. Again, I speak from a youth's perspective, saying that perhaps this pressure is even more so rampant among youth who are only forming their identities, and therefore more susceptible to any comments or insults that may attack this.
Not to mention a lot of physicians nowadays are simply AFRAID to ask "The Question". They are only human afterall.
Nice blog, by the way.
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