[HN Gopher] The undiscovered country: Can suicide be predicted?
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       The undiscovered country: Can suicide be predicted?
        
       Author : lermontov
       Score  : 47 points
       Date   : 2021-07-20 22:13 UTC (1 days ago)
        
 (HTM) web link (harpers.org)
 (TXT) w3m dump (harpers.org)
        
       | alpaca128 wrote:
       | Well that's an interesting way to fight ad blockers. Hiding the
       | whole content.
        
       | one_off_comment wrote:
       | I feel like the article didn't deliver on its promise. The author
       | never got to try out the device that's supposed to predict
       | suicide. I was most curious about that because I find myself
       | skeptical such a thing could work.
        
         | derbOac wrote:
         | https://psycnet.apa.org./record/2016-54856-001?doi=1
         | 
         | Suicide is notoriously difficult to predict. That meta-analysis
         | is one example; once you account for base rates in realistic
         | scenarios, you can do very little better than chance.
         | 
         | Some of this might have to do with the nature of predictors;
         | maybe with deep learning and real-time data this might improve
         | slightly, but I doubt it somewhat (there are significant
         | ethical issues involved in such data regardless but that's a
         | different issue).
         | 
         | One of the biggest problems in this area is that suicide is
         | such a low base rate phenomenon that it's difficult to predict
         | for that reason alone. Not only that, but many of the
         | predictors are relatively high base rate by comparison, so
         | there's a very very very low signal to noise ratio.
         | Statistically speaking, it's like finding a needle in a
         | needlestack.
         | 
         | I think adding to the complication is that it's not really that
         | you want to know if someone eventually commits suicide, what
         | you want to know is whether they do so within a certain
         | actionable timeframe. That is, for most of the decisions such
         | predictions are being clamored for, it doesn't really help to
         | know that there's a 70% chance that someone will commit suicide
         | eventually; what practitioners really want to know is "what are
         | the odds someone will commit suicide if I make decision X right
         | _now_. " This is a significantly more difficult thing to study.
         | 
         | I personally believe that the approach to suicide in developed
         | countries is horribly misguided and probably unethical, focused
         | too much on the act and not prevention of the state
         | (psychological, sociological, economic) that leads to it. It's
         | unethical to leave someone in such a personal hell that they
         | want to exit it by killing themselves; preventing themselves
         | from doing so, without removing them from that state, only
         | deprives them of a means of relief.
        
       | spywaregorilla wrote:
       | I would tend to assume suicide is fairly predictable with high
       | sensitivity and the data many corporations have from surveillance
       | of customers tbh.
        
         | anonymouse008 wrote:
         | Let's just say I get really concerned about my fairly stable,
         | committed household when I get therapy and dating app ads...
        
           | motohagiography wrote:
           | Given ads are necessarily both targeted and predatory, and a
           | not a few of them are planted as part of sophisticated
           | political campaigns and operations, someone in your house
           | probably just triggered a link on their trapline.
           | 
           | Ads for therapy are to stoke fears of people they may be
           | mentally ill, and ads for dating sites are to make people
           | feel isolated. They're just used as priming for selling you
           | an additional something else to relieve the feelings the
           | primers created.
           | 
           | If I wanted you to look at my ad, I'd present something you
           | would look away from, and have my product ad right there
           | waiting for where you will likely look to. Look at the
           | difference between ads in the margin of pages, vs. those
           | inline to the content.
        
         | mensetmanusman wrote:
         | That's an interesting take, I wonder which company, Google or
         | FB, has better predictors? Surely they have enough data to
         | actually have the best predictors when compared to academics
         | looking at monthly statistics.
        
       | dbtc wrote:
       | If suicide can be predicted then I would why not homicide? And
       | then perhaps all crime.
        
       | pmoriarty wrote:
       | In _" Why do people die by suicide"_, Dr Paul Thomlinson goes
       | over the research on predicting suicide.[1]
       | 
       | First, he talks about a well supported model called Joiner's
       | Model, based on research which shows that people who are most
       | likely to commit suicide have all three of these factors:
       | 
       | - Thwarted belongingness ("I am alone")
       | 
       | - Perceived burdensomeness ("I am a burden")
       | 
       | - Ability to commit suicide ("I am not afraid to die")
       | 
       | Perceived burdensomeness has two components: Liability ("My death
       | is worth more than my life to others") and self-hate ("I hate
       | myself")
       | 
       | Thwarted belongingness also has two components: Loneliness ("I
       | feel disconnected from others") and absence of reciprocal care
       | ("I have no one to turn to and I don't support others")
       | 
       | And finally, capability to commit suicide is predicted by:
       | Lowered fear of death, elevated physical pain tolerance, family
       | history of suicide, clustering/exposure to suicidality, combat
       | exposure, suicide attempts, childhood maltreatment
       | 
       | And another model with the acronym "IS PATH WARM" shows that
       | people who are most likely to commit suicide are likely to have,
       | feel or be:
       | 
       | - I = Ideation
       | 
       | - S = Substance Use
       | 
       | - P = Purposelessness
       | 
       | - A = Anxiety
       | 
       | - T = Trapped
       | 
       | - H = Hopelessness
       | 
       | - W = Withdrawal
       | 
       | - A = Anger
       | 
       | - R = Recklessness
       | 
       | - M = Mood Change
       | 
       | [1] - at about 25 minutes in to
       | https://www.youtube.com/watch?v=Arywx88jMXw
        
         | agumonkey wrote:
         | interesting categorization, very much so, I find there's a
         | duality in the lonely/self-hate group. So many people who feel
         | like that are utterly normal, they just can't connect other
         | realities than their own judgement.
        
         | autoexec wrote:
         | Joiner's Model seems to exclude people who are candidates for
         | assisted suicide. They often don't feel alone, don't feel like
         | a burden, but are terminally ill, in constant pain, feel
         | they've lived long enough, seeing significant mental/physical
         | decline etc. You can shoehorn them into "IS PATH WARM" under
         | hopelessness, trapped, or anger I guess.
        
       | FinanceAnon wrote:
       | It's impossible to measure, but I wonder what % of suicides
       | happens because of the culture that we live in. A lot of times
       | when you read about someone commiting suicide it's blamed on that
       | individual or their mental health - but is that really the root
       | issue? How many of the suicides wouldn't happen if society was
       | set up in a different way?
        
         | yCombLinks wrote:
         | I think the culture is extremely relevant. If you look at this
         | map on the right:
         | https://en.wikipedia.org/wiki/Gender_differences_in_suicide
         | You'll see China is a significant outlier, being the only
         | country with a higher suicide rate for women than men. All of
         | the western nations have rates between 3.5 and 4 as many men
         | commit suicide as women, a shockingly high difference.
        
         | xtracto wrote:
         | I think you are onto something. An example for me would be,
         | someone committing suicide in the USA due to the perception of
         | having to confront some incredible stressful event in the
         | future; whereas the exact same situation in another country
         | (with different culture) would not yield the same weight to
         | that person.
         | 
         | As an example, take Jeffrey Epstein suicide (let's assume thats
         | what happen). He might have sought that exit given his possible
         | future perspectives. Had he been in Mexico (where I live) he
         | may have had a different (more lenient) perspective of his
         | future.
        
           | [deleted]
        
       | leksak wrote:
       | At points in my journey I've thought that the one genuinely good
       | thing that I could maybe end up doing for others is to end my own
       | life so that the way mental health patients are treated receives
       | another impetus for change so that others can get the help I
       | didn't get while desperately reaching for it.
        
       | giantg2 wrote:
       | 'Pote explained that the basic mechanism is comparable to the
       | process "used in lie-detector tests, like you see in the
       | movies."'
       | 
       | And yet polygraphs are known to be unreliable, to the point that
       | they are generally not admissible in court. It would probably be
       | better marketing if they don't imply that their product is
       | comparable to an qn existing tech that is unreliable.
        
         | omniglottal wrote:
         | Better marketting can and probably should include honest
         | implications of a product's limitations.
        
       | neonate wrote:
       | https://archive.is/WyW6u
        
       | hashhar wrote:
       | The lack of empathy in the comments is scary. No wonder the
       | situation is so bad.
       | 
       | Let me present a scenario which might seem more relatable since
       | it seems people understand physical pain but have no "scale" of
       | what mental pain could be like.
       | 
       | You have a chronic pain (maybe one of wrists is broken in a way
       | that there is no solution). No painkillers help. Every doctor you
       | go to doesn't have a quick-fix. People around you keep telling
       | you "you're imagining things", "be spiritual", "it isn't as bad
       | as you think", "it'll go away". Nothing you try seems to help.
       | You wake up every day feeling the pain and it keeps getting worse
       | with no end in sight.
       | 
       | EDIT: Missed one crucial component. The pain is so much that you
       | cannot have normal social interactions because 80% of your energy
       | is spent trying to cover up the pain. You feel exhausted all the
       | time due to this and don't have the energy or the motivation to
       | do anything.
       | 
       | Image living this for even a year (where this is what life looks
       | like for some people for the last 20 years or more) and then tell
       | me you wouldn't say no to "anything to make the pain go away".
        
         | 52-6F-62 wrote:
         | As someone who now does suffer from chronic pain due to
         | abdominal adhesions post-pancreatic trauma and having had
         | issues with depression in the past, I'll take the adhesions.
         | 
         | At least I can take a pill to get some relief on occasion.
         | People understand.
         | 
         | Your description and analogy is dead on.
        
         | Clubber wrote:
         | >"anything to make the pain go away"
         | 
         | Sure, I think our rampant overdose problem and drug and alcohol
         | over-use problem in general is a symptom of this. That's one of
         | the reasons the war on drugs is so insidious, it punishes the
         | people already suffering, which makes them suffer more, forcing
         | a downward spiral that is almost impossible to get out of. All
         | from a perceived moral failing.
         | 
         | The US is pretty cruel to its citizens. It's not overtly, in-
         | your-face cruel like historical regimes, but still cruel, none
         | the less.
        
           | hellbannedguy wrote:
           | I have not done much traveling, but Americans seem to self-
           | medicate more?
        
             | autoexec wrote:
             | Actual medication and healthcare services (especially
             | mental healthcare) are not always affordable or accessible
             | in the US. Recreational drugs are everywhere though, so
             | plenty of people turn to them for whatever degree of relief
             | those drugs can provide.
        
             | handrous wrote:
             | We take _way_ less vacation and have _far_ more financial
             | uncertainty and more bills (more complexity and more to
             | keep track of just to get by), so our background level of
             | stress is probably higher on average than in, say, most
             | Western European states.
             | 
             | There may be other reasons that affect it more, but I'd
             | fully expect that to be enough to result in more self-
             | medication, all else being equal.
        
         | pmoriarty wrote:
         | This reminds me of the case of Dax Cowart[1][2], who as a young
         | man suffered tremendous burns from an accident which he
         | survived but which killed his father who was with him.
         | 
         | He lost his eyes and face, had both of his hands amputated, and
         | was forcibly given agonizing treatments for 14 months.
         | 
         | At his request a documentary video was made about him, which he
         | titled "Please Let Me Die"[3]. It was shown to lawmakers and
         | judges in hopes of allowing him to refuse medical treatment.
         | 
         | He was forced to endure the treatment against his express
         | wishes, survived, and graduated law school to become an
         | advocate of patient's rights. Still, he always maintained that
         | he should have been allowed to end his life.
         | 
         |  _" No human being has the right to force another human being
         | to undergo that kind of pain and to take away that person's
         | right to self-determination."_
         | 
         | [1] - https://en.wikipedia.org/wiki/Dax_Cowart
         | 
         | [2] - https://www.youtube.com/watch?v=WAQHuaua4W0
         | 
         | [3] - https://medhum.med.nyu.edu/view/10105
        
           | hashhar wrote:
           | Thanks for sharing this - I haven't yet looked but the
           | description itself makes me feel bad that we don't let people
           | make decisions for themselves.
           | 
           | I feel the only reason we don't let people chose that path is
           | to make ourselves feel good and feel "guilt-free".
           | 
           | I recently had a situation where someone in my family was
           | diagnosed with a life threatening condition but the dilemma
           | was that if you chose to undergo treatment their life will
           | turn to shit. If you don't then they might suddenly die one
           | day - albeit happy and normal.
           | 
           | I felt a lot of guilt trying to find reasons to convince
           | people why the 2nd option was better. If you think rationally
           | the only reason to pick the 1st option is selfishness. For
           | the person who has undergo the treatment the 2nd option is
           | hands down the better one.
        
             | Lammy wrote:
             | It is illegal to kill oneself because it deprives the state
             | of a taxpayer, and the state will not tolerate theft of its
             | human resources.
        
               | saiya-jin wrote:
               | Its way more primitive than that - christian moral code
               | prohibits suicide as those will end up in hell. Then not-
               | so-small part of population feels entitled to project
               | their own righteous path unto rest of humanity while even
               | feeling great about doing that 'in accordance to god's
               | wishes'. Next thing you know, any abortion is illegal,
               | heck in places like Poland even basic human rights are
               | violated by exactly this kind of self-righteous crowd.
               | 
               | Obviously this is just one of example of one random major
               | religion and tells us mostly about how small many humans
               | are and how it manifests across society. Feel free to
               | apply this to much of evil caused by mankind, basically
               | since we were humans.
               | 
               | Eye opening for me was when I met this fellow Texan guy
               | in Nepal in 2008, great guy otherwise, who was telling me
               | how all those arabs in Iraq and Afghanistan would make
               | great christians. They just need to understand the right
               | choice. He really believed it. If felt so surreal.
               | 
               | Interestingly, place like Switzerland which is highly
               | religious has been for a long time bastion of self-
               | assisted suicide, so that folks come here from all over
               | the world to end their life peacefully. Tells you about
               | how remarkably tolerant society this is (there are tons
               | of other examples I can see every day around me, but
               | that's for another topic).
        
       | Razengan wrote:
       | Just allow people the basic freedom to leave the fuck out of this
       | world if they really want to.
       | 
       | But no, that would mean one less entity to milk for labor and
       | money.
        
         | AnIdiotOnTheNet wrote:
         | Yeah, it's funny how no one gives a flying fuck about your
         | suffering and will actively encourage it for their own benefit
         | right up until you start talking about suicide.
         | 
         | Of course, 90% of the time that's because they see an
         | opportunity to sell you on a new drug, religion, or ideology.
        
           | derbOac wrote:
           | Or protect themselves liability-wise, or from guilt.
        
           | nicoburns wrote:
           | Yeah, this bugs me too. We shouldn't be talking about suicide
           | prevention. We should be talking about preventing suffering.
        
           | kmnc wrote:
           | It often seems weird to me that any time a seemingly happy
           | and successful celebrity commits suicide the underlying
           | reasons and especially the mental state at the time are
           | largely brushed away. Everyone is quick to praise them for
           | their success, and be sympathetic to their "struggles" yet no
           | one is willing to dig deep into anything.
           | 
           | "Successful" people suicides are incredibly interesting
           | because it forces us to ask the question "were they ever
           | happy?" yet it is a question usually ignored in most post
           | suicide bio films that seem to come out immediately after.
           | There is this idea that suicide has to be treated with quiet
           | respect, and whispers at funerals...we keep ignoring the
           | actual issues and brush suicide off as a "mistake in the
           | moment". Bullshit, anyone who commits suicide has been
           | contemplating it most of their lives.
        
       | underseacables wrote:
       | _Robert Lowell once said that if humans had access to a button
       | that would kill us instantly and painlessly, we would all press
       | it sooner or later._
       | 
       | I think this explains suicide better: For most, it's an
       | irrational act done in the spur of the moment.
       | 
       | What I think is more interesting is when suicide is done as a
       | _rational_ act with planning, and consideration for others.
        
         | easterncalculus wrote:
         | I'm not convinced there's anything rational in suicide by
         | definition. Every organ, vessel, and part of your body,
         | especially your brain, is dedicated to keeping you alive for as
         | long as possible. If it makes you feel the need to end your
         | life, by definition it is not working.
         | 
         | A lot of bad things can happen to you in a lifetime, but death
         | is the worst, without a doubt. To feel the need to inflict it
         | upon yourself is therefore not rational at all, even if it is
         | premeditated. What seems like one irrational spur of the moment
         | decision is really one that in most cases had been considered
         | well before. No one ends their own life before thinking about
         | it beforehand.
        
           | TOMDM wrote:
           | An argument from organ function only operates if you believe
           | the process of evolution that created those organs and their
           | "goals" are what defines human meaning.
           | 
           | I personally believe humans derive their own meaning in life.
           | Temporary chemical imbalances and runaway feedback loops of
           | emotional harm can certainly lead to impairment of rational
           | judgement concerning suicide, but that doesn't mean that if
           | you accept the premise that humans derive their own value
           | that there can be rational avenues to suicide.
           | 
           | For situations like accute depression and anxiety (of which
           | I'm intimitely familiar) are situations where I would argue
           | ones judgement is impaired when it comes to suicide, and I
           | don't doubt that said impairment is extrapolable to many
           | other situations.
           | 
           | >A lot of bad things can happen to you in a lifetime, but
           | death is the worst, without a doubt.
           | 
           | I think that comes down to whether you believe that
           | 
           | A) Someone can experience a negative qualia
           | 
           | B) Someone can rationaly predict that said living situation
           | is now a permenant state of affairs with a high enough degree
           | of certainty
           | 
           | C) That death is a negative (negative only insofar as it can
           | effect others) to neutral qualia that is still higher than
           | and therefore preferable to an expected permenant negative
           | qualia.
           | 
           | I'm not of the opinion that this is something that can
           | typically be done independently, as humans are vulnerable to
           | a host of conditions that can impair our ability to make
           | judgement B, and I sure as hell hope that anyone wanting to
           | make that decision trusts the people they ask to help them
           | make it.
           | 
           | The protoypical example people tend to use is alzheimers
           | victims, who are frequently (but not always) permenantly and
           | irrecoverably (for now hopefully) distressed.
        
           | pmoriarty wrote:
           | _" Every organ, vessel, and part of your body, especially
           | your brain, is dedicated to keeping you alive for as long as
           | possible."_
           | 
           | They're not dedicated to keeping people alive. They _may_
           | play a role in keeping some people alive (or not, depending
           | on a lot of factors).
           | 
           | You're imagining purpose for organs and cells which just
           | exist and sometimes function or sometimes don't.
           | 
           | Even if they did have some purpose (which there's no evidence
           | for), does that mean that humans should blindly submit to
           | whatever that purpose is?
           | 
           | Why shouldn't a human be able to make their own decisions
           | instead of giving over decision-making authority to their
           | body?
        
           | dec0dedab0de wrote:
           | _I 'm not convinced there's anything rational in suicide by
           | definition. Every organ, vessel, and part of your body,
           | especially your brain, is dedicated to keeping you alive for
           | as long as possible._
           | 
           | I would say it's dedicated to keeping you alive long enough
           | to raise children and help your children raise children.
           | Which may be the same thing in practice, but more in line
           | with how evolution works.
        
           | Thiez wrote:
           | That's an interesting assumption. So _only_ acts that are in
           | "harmony" with what your body desires are rational, and all
           | other acts are, by your definition, irrational? So when I'm
           | under water, swimming up to the surface, and my body is
           | telling me to take a breath _right now_ , that would be
           | rational? And suppressing the urge until I reach the surface
           | is irrational?
        
         | s1artibartfast wrote:
         | One major challenge is that careful premeditation does not
         | necessarily mean suicide is rational. There is a big crossover
         | between people who consider suicide and people with disorders
         | negatively impacting their cognition and decision making.
        
           | aeturnum wrote:
           | > _people with disorders negatively impacting their cognition
           | and decision making._
           | 
           | I think we should be really careful about how we think & talk
           | about this.
           | 
           | There are a few situations (like psychotic breaks) where
           | people fully believe delusions that, in a short time, they
           | will reject. We can cleanly call those experiences
           | "irrational."
           | 
           | On the other hand, people who experience long term depression
           | literally experience the world differently in a way that we
           | frequently cannot 'correct'[1]. Those people are not
           | irrationally convinced that the world is hard to be in - they
           | have brains for which things feel worse than for neurotypical
           | brains. We can agree on all objectively measurable qualities
           | of the world and their experience of that world will still be
           | subjectively and consistently worse.
           | 
           | The conversations from the right-to-die movement can be
           | useful here, as chronic pain and disease offer a lens through
           | which to understand. We have all experienced physical pain,
           | but we have not all experienced serious depression.
           | 
           | All I mean to say is that in the same way that someone with
           | any chronic illness should have some choice in when and how
           | they die, people who have chronic mental conditions should
           | have the same right. We do not want to make the mistake of
           | thinking that a person in a more complicated situation is
           | compromised in some way - just that their world is more
           | complex and we should take care to attend to the specifics of
           | it.
           | 
           | [1] It's not clear what way of seeing the world is 'right'
           | but I will use correct here even with its implication that
           | neurotypical people live in the real world.
        
             | s1artibartfast wrote:
             | I totally agree that it is a very tricky subject,
             | especially regarding depression. Having some experience
             | with it myself, I would argue that irrational pessimism is
             | a major feature of depression. For example, people cannot
             | accurately asses actions and activities that would in fact
             | make them happier if they were to follow through.
             | 
             | In this way, I think they are clearly distinct from those
             | with terminal illness or chronic pain.
             | 
             | I agree that people should have the right to choose death,
             | independent of the rationality of their decision.
             | Ultimately, people are the owner of their body and steward
             | of their life, even if they are imperfect and irrational
             | ones. Taking autonomy away turns individuals and their body
             | into the property of someone else.
             | 
             | I think there is some room for temporary holds and crisis
             | management, but all such activities should be finite in
             | duration.
        
               | aeturnum wrote:
               | > _I agree that people should have the right to choose
               | death, independent of the rationality of their decision_
               | 
               | I don't think that that there is an ethical imperative to
               | allow people to carry out irrational decisions. I was
               | trying to say that, if someone with depression or another
               | chronic mental illness decides they would rather be dead
               | than alive, then after we determine that decision doesn't
               | come from a passing[1] delusion, then we should give that
               | desire the same weight we give to people with other
               | chronic conditions. We all have the right to choose,
               | after a time, that we do not want to live this way.
               | 
               | I also think that having a global standard for "rational"
               | v.s. "irrational" is difficult enough that I think
               | drawing strong lines tends to do more harm than good. So,
               | in practice, I suppose I support people who
               | "irrationally" wish to end their lives, but only due to
               | the impossibility of determining what 'rational' means
               | for each of our subjective perspectives.
               | 
               | [1] Whatever "passing" means - it is not an easy
               | question.
        
               | s1artibartfast wrote:
               | I think we agree in principle. I think that defining
               | rational vs irrational IS difficult, and therefore choose
               | to draw the line such that it doesn't matter for a
               | persons right to choose.
               | 
               | This addresses the fact that a severely depressed person
               | may not be able to make the same objective assessments of
               | the world that the chronically I'll can.
               | 
               | A severely and chronically depressed person might think
               | "I have no chance at happiness" when in reality, they
               | actually do. If they base their decision on this premise,
               | they would be following faulty logic. My point is that
               | they have a fundamental right to act based on their
               | conclusions, _even if they are wrong_.
        
               | aeturnum wrote:
               | > _My point is that they have a fundamental right to act
               | based on their conclusions, even if they are wrong._
               | 
               | 100% agree!
        
         | MeinBlutIstBlau wrote:
         | Suicide is not irrational in of itself. Facing 25-Life?
         | Perfectly rational. Lost all your money and have no retirement?
         | Still very rational. All you friends left you and you are
         | completely alone to fend for yourself? Still rational.
         | 
         | America needs to get over itself that life needs to be lived
         | until a natural death. Not everybody wants to further deal with
         | the excessive burdens of life. Suicide, when not done in a spur
         | of the moment decision, can be wholly rational. Wanting to live
         | a garbage quality if life because society thinks it's weird to
         | just end it to not suffer is some Catholic guilt being forced
         | on everyone.
        
           | autoexec wrote:
           | For the most part, I agree with you, and people should be
           | free to choose their own death at any time for any reason
           | (rational or otherwise), but "all your friends leaving you"
           | may be something that can be changed. At the very least new
           | friends can almost always be found. It wouldn't seem rational
           | to me at least to end your life over that for most people. I
           | can respect a person's right to make that choice in any
           | situation, but I don't have to agree with it.
        
           | tpush wrote:
           | > All you friends left you and you are completely alone to
           | fend for yourself? Still rational.
           | 
           | I don't think suicide is a rational response to that; I even
           | think it's dangerous to frame it as any kind of 'rational'
           | action to take in such a situation.
        
         | SirFatty wrote:
         | Someone can think about killing themselves for months or years
         | before actually doing it.. are you suggesting that is
         | irrational because there wasn't a plan or consideration of
         | others?
        
           | naturalauction wrote:
           | "All 29 people who survived their suicide attempts off San
           | Francisco's Golden Gate Bridge have said they regretted their
           | decision as soon as they jumped."
           | 
           | https://ennyman.medium.com/a-lesson-from-29-golden-gate-
           | suic...
           | 
           | Sure most suicide attempts aren't done this way but I think
           | statistics like this showcase how many suicides are
           | irrational on some level. If it was rational then you'd think
           | they wouldn't immediately regret it (unless the regret is
           | irrational I guess).
        
             | AnIdiotOnTheNet wrote:
             | Perhaps their regret is a significant contributor to their
             | survival though.
        
               | giantg2 wrote:
               | Or perhaps they are only saying they regret it so they
               | aren't thrown into a mental hospital. I wonder if there
               | was a follow up on longterm survival.
        
               | jsmith45 wrote:
               | Of 515 people prevented by police from jumping off the
               | Golden Gate Bridge between 1937 and 1971, by the end of
               | the 70s only 6% of them had committed suicide by other
               | means.
               | 
               | Source: "Where are they now?" by Richard Seiden
        
               | giantg2 wrote:
               | Interesting, thanks!
        
           | underseacables wrote:
           | The final act itself is either rational, or irrational. I
           | think most people commit suicide as an irrational sudden
           | decision. They may have thought about it, they may have
           | planned about it, but I think there's a clear delineation
           | between someone who says screw it, and kills themselves,
           | versus someone who plans and commits the act with thoughtful
           | deliberation. To make it easier to understand, perhaps you
           | might look at this between a person who sees a train coming
           | and decides in that moment tk step in front of the train, and
           | someone who takes a Final Exit approach at home.
           | 
           | The mystery is what is going through the persons mind at the
           | moment of self execution.
           | 
           | edit: I used the wrong word to describe a final act.
        
             | spywaregorilla wrote:
             | Rationality seems like an irrelevant term here. Desire for
             | suicide is obviously subjective and has no objective
             | answer. I doubt spur of the moment suicides are very
             | common, although the 'an hero' kid and the one that
             | misunderstood their robinhood debt come to mind. Most
             | suicide is going to be premeditated to a large degree. How
             | certain do the specifics need to be for it to be considered
             | rational? I think that's grey. A lot of people point to
             | studies showing people who survive suicide attempts often
             | say it was a mistake, but these strike me as having an
             | enormous survivor bias embedded in them (not on the initial
             | attempt, but on additional more successful attempts
             | subsequently). So long as an act isn't based on strictly
             | false premises or mind altering substances, I'm inclined to
             | say most are "rational" if such a term can be applied.
             | 
             | I've never been suicidal, but I've always felt that strong
             | anti-suicide advocates, while strongly well intentioned,
             | might not be fully reasoning out their belief systems. I
             | think I'd greatly prefer to go out on my own terms in old
             | age, without need for qualifiers like pain or disability.
             | 
             | Recognizing the time for your conclusion is a tropey act
             | for old characters in fiction, and implies deep wisdom. But
             | in real life we assume anyone feeling similar has lost
             | their mind.
        
               | underseacables wrote:
               | Anytime there is talk of suicide in this community I've
               | always remembered heartbreaking final words of Bill
               | Zeller. Didn't know him personally, but I would consider
               | his act a rational one. I do think suicide can be
               | irrational, which comes down to heat of the moment. I've
               | had a few friends commit suicide, and it's a horrible
               | thing to endure, but I understand. A persons choice to in
               | their life should be theirs completely, but I hope it's
               | one that is done with a rational thought out purpose. Not
               | a spur of the moment thing.
               | 
               | https://gizmodo.com/the-agonizing-last-words-of-
               | programmer-b...
        
             | finnh wrote:
             | (sorry to be that guy, just a useful FYI)
             | 
             | I think you may want "ultimate"? penultimate = second-to-
             | last.
        
               | underseacables wrote:
               | Ah! Thank you, you're absolutely correct. I changed it to
               | "final".
        
             | kar5pt wrote:
             | Living can be irrational too. There are plenty of people
             | who are completely miserable with no hope or plan to make
             | anything better, but still choose to live out of pure fear
             | of death.
             | 
             | There's always a conversation over whether suicide is
             | rational, but no one thinks to ask if living is rational.
        
         | tablespoon wrote:
         | >> Robert Lowell once said that if humans had access to a
         | button that would kill us instantly and painlessly, we would
         | all press it sooner or later.
         | 
         | > I think this explains suicide better: For most, it's an
         | irrational act done in the spur of the moment.
         | 
         | Or it's rational, but we have some "irrational" mechanisms to
         | prevent it that are best defeated by an impulsive act [1].
         | 
         | I don't actually believe that, but it's hard to argue against
         | it under certain common sets of assumptions.
         | 
         | [1] e.g. from a rationalist/materialist perspective: suicide is
         | to avoid/escape pain, and it also removes the pain of guilt for
         | doing it and the pain of missing out on all future pleasures,
         | etc. However, evolution has formed us to reproduce, no matter
         | how painful the struggle is and how subjectively irrational it
         | is to endure it.
        
         | pmoriarty wrote:
         | _" Robert Lowell once said that if humans had access to a
         | button that would kill us instantly and painlessly, we would
         | all press it sooner or later."_
         | 
         | They'd push it even sooner if no one they cared about depended
         | on them.
         | 
         | A lot of people stay alive simply out of a sense of
         | responsibility towards others.
        
           | agumonkey wrote:
           | I think the storage space for our notion of 'others' or
           | 'loved ones' is one extremely potent part of our minds. I am
           | who I love somehow, my brain goes against destroying that
           | bond.
        
           | spaetzleesser wrote:
           | "They'd push it even sooner if no one they cared about
           | depended on them. A lot of people stay alive simply out of a
           | sense of responsibility towards others."
           | 
           | That would be me. I don't want to be a burden to people.
        
       | morpheos137 wrote:
       | Barring cases of extreme physical pain or terminal illness or old
       | age I can't understand the point of suicide. You are not around
       | to enjoy the result of your consequent non-existence. Chronic
       | severe mental illness is another possible reason but even for
       | that I believe it can be treated in many cases with
       | unconventional approaches like pschedelics (eg ketamine,
       | exercise, religious experience, etc).
       | 
       | Suffering is a natural part of life not something to be escaped
       | on a whim.
        
         | hashhar wrote:
         | TL; DR -- You have a chronic pain. No painkillers help. Every
         | doctor you go to doesn't have a quick-fix. People around you
         | keep telling you "you're imagining things", "be spiritual", "it
         | isn't as bad as you think", "it'll go away". Nothing you try
         | seems to help. You wake up every day feeling the pain and it
         | keeps getting worse with no end in sight.
         | 
         | Image living this for even a year (where this is what life
         | looks like for some people for the last 20 years or more) and
         | then tell me you wouldn't say no to "anything to make the pain
         | go away".
         | 
         | ---
         | 
         | Hear me out.
         | 
         | Let's say you wake up tomorrow with a bit of a headache. You
         | take an aspirin and go about your day.
         | 
         | You wake up tomorrow but it's still there. You visit a doctor
         | who tells you to "take it easy" and you go about your day
         | again.
         | 
         | You wake up the next day and it's still not better. You
         | begrudgingly get out of bed and go about your day. Someone
         | tells you that you seem a bit irritable today. You then try to
         | be aware of it and end up spending considerable mental energy
         | trying to be "sociable". You get back home a bit exhausted.
         | 
         | You wake up and it's worse. Your brain seems to amplify little
         | things up to 100. You spilled some milk and you think the
         | entire day will be like this. You feel "let's stay in today". A
         | friend comes over, you end up exhausted trying to put on a
         | normal face and overthink about how come it looks so easy for
         | your friend to plan a night out today? They invite you and you
         | accept hoping it might help.
         | 
         | You visit the party and you feel a bit okay while in the
         | moment. You go back home and you feel exhausted and sleep.
         | 
         | the next day is even worse. Your brain tells you why bother
         | getting out of bed - it's not like anything nice is going to
         | happen to you today. you fight it and get out of bed but you
         | can't find your slippers - you feel the day is going to be shit
         | again but you go out anyway.
         | 
         | Repeat previous paragraph x 1 year. Now the next day your brain
         | convinces you there's no point in getting out today. You stay
         | in, skip a few meals and it's night. You put on a movie and you
         | enjoy it. Once it's over the feeling comes back. You get
         | frustrated - you pick out some substances to help you "feel
         | less". Maybe this feels a bit better.
         | 
         | You repeat this for a few months.
         | 
         | You are now so irritable and so envious of others that your
         | personal relations start to suffer and you lash out on others.
         | Slowly your circle shrinks.
         | 
         | Now it's easier to not get out of bed.
         | 
         | By now you've had the same day for the last 5 years and you
         | can't see it getting any better. You go to a therapist. If they
         | are good maybe you both figure out some things together that
         | help you conquer small things - like getting multiple slippers
         | one for each room and your brain no longer needs to panick if
         | it can't find the slipper.
         | 
         | But sadly most of the people aren't so lucky.
         | 
         | You try many medications, substances but nothing seems to last.
         | You want a quick fix but there is none to be found (unlike for
         | physical pain). 10 years have gone by with the same morning
         | every day - each a bit worse than the last. Now you think "This
         | isn't going to improve I think. Nobody has answers. There are
         | no solutions. Nothing seems to help. There is no sunshine.".
         | 
         | Your inner voice tells you about a few other things you haven't
         | tried yet. And that's how we lose you.
         | 
         | So forgive me for saying this but people like you who have no
         | empathy and are so willing to invalidate how many people feel
         | on a daily basis don't deserve to be making decisions for
         | others.
        
         | kenjackson wrote:
         | > You are not around to enjoy the result of your consequent
         | non-existence.
         | 
         | For a lot of people, that isn't the point. They've really lost
         | hope. They think there is no end to the suffering. Many times
         | they've already tried ways to effectively blunt feeling in
         | their life with, at best, limited success. I've heard it said,
         | "what's the point? i can't go through this any longer".
         | 
         | > Suffering is a natural part of life not something to be
         | escaped on a whim.
         | 
         | But if you all feel and foresee is suffering, what is the
         | benefit of living? I'm not advocating suicide at all, but I'm
         | trying point out why it can seem rational.
        
         | sneak wrote:
         | > _Suffering is a natural part of life not something to be
         | escaped on a whim._
         | 
         | All major life choices can be made on a whim, if the chooser so
         | desires it. That's the nice thing about liberty.
        
           | morpheos137 wrote:
           | So it is ok if somebody kills you on a whim?
        
         | colinmhayes wrote:
         | Some people are just generally unhappy. They have been for
         | decades. At that point why would they want to continue? After
         | 30 years of unhappiness one day they'll wake up happy?
        
         | 98Windows wrote:
         | You have been blessed with a happy life then, feel glad you
         | don't understand the appeal of suicide
        
           | morpheos137 wrote:
           | actually I have a pretty bad life right now. I just chose not
           | to feel too bad about it and I know it can and will change.
        
         | MeinBlutIstBlau wrote:
         | The point of suicide is to end suffering, not commit to a happy
         | predictable retirement. If you ever have a moment in your life
         | that causes you to contemplate it, you'll understand.
         | Otherwise, I personally don't believe people like you should be
         | making decisions for those people who do. You have no
         | understanding of what it feels like to consider that as
         | actually being a rational thought.
        
           | morpheos137 wrote:
           | Nothing about life is rational.
           | 
           | I believe I "contemplate" suicide frequently but I have no
           | inclination to do it because what good would it do me?
           | Suicide is self-murder no matter how we sugar coat it. If we
           | reach a point as a society where murdering ones self is
           | condoned why wouldn't that make murder of others less severe?
           | If life is not sacred then it seems to me that murder becomes
           | more like a property crime.
        
         | [deleted]
        
         | [deleted]
        
       | cmehdy wrote:
       | I like the article for the most part. I've noticed many comments
       | here are lacking the empathy that is so fundamentally needed in
       | this world to help those who suffer alleviate the pain, so as a
       | fellow struggling one I figured I could throw my words to the
       | wind.
       | 
       | People more readily mentally visualize somebody without a leg,
       | somebody with open fractures. Not so much for mind stuff, it's
       | not concrete enough to most until it turns physical (i.e. you're
       | a bloodstain on the floor). That's why some comments go along the
       | lines of "I can understand suicide for physical pain but not for
       | mental one". I would suggest that a broken self hurts more than
       | an open fracture, and lacking certain central abilities to
       | stabilize the self leaves you much more legless than if you lost
       | your physical legs.
       | 
       | Other comments point out the endless rational vs irrational
       | discussion. I'd ask them: when you go get a drink at a cafe and
       | you're about to order a cappuccino but you ask for a latte, how
       | do you see the whole process? You've planned something rationally
       | (going to get that cappuccino) and made a seemingly irrational
       | choice at the end (getting the latte). Are you rational or not?
       | 
       | Furthermore, by what lens do you judge when the absence of
       | rational decision is an illness? Typically people will reply
       | either with a utilitarian point of view or a selfish one: either
       | you are being counter-productive to society with your guts and
       | bloods that need to be cleaned and the lack of your presence in
       | the consumerist world, or I take it all backwards and call you
       | ill first because that's what agrees with my worldview ("you're
       | sick, you can't know what's good for you").
       | 
       | What I have done with myself and others is to acknowledge that
       | those bits of perhaps-irrationality are not relevant to helping
       | things, as we all have them in different places as we live and
       | that's okay. It's also important to acknowledge that one can be
       | right to feel like they're backed into a corner when a lot of
       | evidence accrues towards that. BUT, the essential part is to show
       | methodically that (1) there are levers of action that we are
       | steering clear of due to cognitive distortions or lack of
       | awareness, and (2) all suicidal people are fighting to be alive
       | much more than even they might know, as they're still around even
       | when making aimless steps due to the crushing pain. In short, tap
       | into what wants to live to push back against what wants to die,
       | and show that the realm of what is possible to advance is much
       | larger than one might think when in the fog.
       | 
       | ----
       | 
       | With that said, I have my own take on parts of the article
       | itself.
       | 
       | > A reader of a late-nineteenth-century edition of Chambers's
       | Encyclopaedia would find committing suicide described as a
       | "heinous crime," for which the punishments included "an
       | ignominious burial in the highway, with a stake driven through
       | the body." Today the National Institute of Mental Health cautions
       | against saying that a person "committed" suicide at all; better
       | to say that they "completed" it, to avoid the implication of an
       | illicit or criminal act.
       | 
       | As if suicide wasn't still considered a vile and illegal thing.
       | You can share your mental health struggles with a therapist just
       | fine until you're a risk to yourself and they call people to,
       | forcibly if needed, remove you and take you wherever they want.
       | Your rights can be severely limited or removed entirely when a
       | psychiatric emergency is considered - how is that any different
       | from being treated like a criminal? Psychiatric intake can
       | pragmatically be worse than prison intake, from someone who's
       | seen both.
       | 
       | It's not seen as vile by everybody but there are still far too
       | many people who frame the process with words of abandonment, with
       | selfishness, with dismissal of all the inner work of the
       | suffering through the singular use of irrationality as an
       | absolute concept ("you're just irrational"), and so on. You're
       | not considered as an equal to your peers when you're suicidal,
       | and that's not something you get to argue against because that's
       | just part of how you're defined by them. See the following
       | paragraph for something related.
       | 
       | > When patients told Freud that their lives were hopeless or
       | without purpose, he considered this an impressive display of
       | self-awareness. "We can only wonder," he wrote, "why a man must
       | become ill before he can discover truth of this kind."
       | 
       | That's Freud we're talking about so whatever.. but that train of
       | thought still seems to exist quite a bit nowadays. The
       | introspection and the ability to shatter illusions is put in the
       | same box as the delusions that a "sick" person has, leading a lot
       | of people with severe depression and other disorders to associate
       | one with the other since society does it too. "My ability to dig
       | deeper is part of why I am sick" is entirely the wrong message to
       | send to a vulnerable person, and it is just incorrect. For it is
       | not the power to see beyond the surface that is a problem, but
       | the delusions one might hold or acquire about the process. CBT
       | points it out with the terms of cognitive distortions, which is a
       | start. It doesn't necessarily offer a wholly coherent narrative
       | for the emergence of those distortions, nor does it offer a
       | strong logical argument to disprove the utility of those
       | distortions (i.e. somebody in pain could say "so what if I see
       | everything in black and white? this is how I've managed to
       | survive so far, so you better prove to me that what you're
       | offering would help me survive better").
       | 
       | > (about Shneidman) "I am against suicide committed by other
       | people," he wrote, "but I want to reserve that option for
       | myself."
       | 
       | This holds meaning that most healthy people might not realize.
       | People who commit suicide go to the last place where there is a
       | semblance of effective control and ability to choose an option,
       | have some agency, in a world that (objectively sometimes but not
       | most of the time) presents no other option. Healthy people have
       | the comfort of a grip on their existence, or at the very least
       | the comfort of an illusion of a grip on it. Despite having their
       | own beliefs and instabilities, they aren't mandatorily taught CBT
       | and other such similar things - whereas it is expected of the
       | "sick" to do more of the homework. It's like breaking your legs
       | on a hike and then being asked to do leg workouts to keep up,
       | when other people happen to be luckier and go without both things
       | and wouldn't themselves be able to do the workout.
       | 
       | But this is a necessary thing for a person with mental illness to
       | do nonetheless, and I'm not debating that point. What I am trying
       | to point at however is that the world of people who are unaware
       | of such struggles is filled with a violent hypocrisy that
       | contributes to the reasons for very lacking mental health
       | services and very lacking social support from peers, as it drives
       | the ones who suffer away from everybody else. It would do well
       | for any healthy person to acknowledge that they, too, could be
       | cornered into helplessness if their need for control (or the
       | illusion of it) shattered. That brings them closer to the person
       | considered ill, and thus narrows the gap for bridges to be built
       | - showing both kinds of people that there is a passage between
       | the states. That's an application of empathy that would
       | strengthen the vulnerable at no other cost. But the healthy too
       | can have cognitive distortions and might actually fear that it
       | weakens them.
       | 
       | This sort of disconnect between those who study the subject
       | matter and those who experience is it nothing new, so it's funny
       | to see that it surprises people who've worked on the subject for
       | a while (as the article highlights about Brent and Shneidman)
       | 
       | > "One of the problems with suicide," he said after a time, "is
       | that the person who killed themselves takes a lot of the answers
       | with them."
       | 
       | And the people who failed are not being asked much of anything,
       | but instead being told what to do. You'll be diagnosed this,
       | given those meds, told to apply this and that method. Any
       | question about mind and life are only there in order to give you
       | a method, not to understand. Something diametrically opposed to
       | the mind of the suffering in the first place, which seeks
       | understanding of self and answers so much that it spirals and
       | loses track of healthy methods to do so. Funnily enough, I think
       | both sides are going at it kinda wrong, and we can do much better
       | by weaving both approaches together and treading the middle line.
       | Sometimes you need a practical tool, and sometimes you need to
       | understand for the sake of understanding. Be both to yourself, be
       | both to others.
        
         | hashhar wrote:
         | > People more readily mentally visualize somebody without a
         | leg, somebody with open fractures. Not so much for mind stuff,
         | > it's not concrete enough to most until it turns physical
         | (i.e. you're a bloodstain on the floor). That's why > some
         | comments go along the lines of "I can understand suicide for
         | physical pain but not for mental one". I > would suggest that a
         | broken self hurts more than an open fracture, and lacking
         | certain central abilities to > stabilize the self leaves you
         | much more legless than if you lost your physical legs.
         | 
         | 100% agreed. People have felt physical pain of very wide ranges
         | before so they have some "scale" on which they can measure it.
         | e.g. stubbing toe to a fracture to a chronic pain. But people
         | thankfully don't have similar breadth in the level of mental
         | pain they have experienced. So they cannot imagine a "mental
         | pain" ever being equivalent to getting your leg amputated
         | without anesthesia.
         | 
         | I like how Mike Shinoda talks about it - if you woke up with a
         | bad back tomorrow you might take some rest; if it was worse the
         | next day then you take some painkillers and the next day you
         | might visit a doctor. But we don't think similarly for mental
         | health.
         | 
         | If you are not feeling good you may try to go through the day
         | anyway; next day it's worse so you should think "I should take
         | it easy today"; the next day you might visit the doctor.
         | 
         | Another issue which people cannot seem to understand is that
         | someone not taking mental health seriously and saying things
         | like "you are overthinking", "it's not as bad", "knock it off",
         | "you're a downer" etc end up invalidating the other person's
         | existence (since that's what life is like for them at the
         | moment and people are essentially saying your life isn't real),
         | make them feel like a burden, make them feel that the other
         | person's life is worth more than their own, that they aren't
         | useful and that nobody cares if they didn't exist anymore.
         | 
         | Imagine:
         | 
         | Your leg got crushed and I tell you "it's not that bad", "stop
         | being a baby", "get over it", "you are making a big deal out of
         | this". There is no solution for your leg so it hurts the same
         | every day and I keep saying things like that every day. At some
         | point you'll break. Combine the invalidation with the pain you
         | are already feeling and you'll be like "no one understands me",
         | "there's no one to support me", "i'm a burden" etc and maybe
         | one day you'll be gone.
        
       | spaetzleesser wrote:
       | If there was a simple and dignified way to end my life I think I
       | would have done it multiple times already. My whole life so far
       | has been a struggle with feeling that I am not fitting in, with
       | social anxiety, depression and other stuff. There have also been
       | good times but it seems whenever I start to believe that life is
       | good, something happens, and the happiness is taken away. The
       | older I get the more tired I get and I really don't feel anymore
       | like fighting to find a place in life where I feel ok.
       | 
       | What's holding me up mainly is that this would probably freak out
       | family and friends and I don't want to be a burden to them. I
       | also still have the hope that one day things will get better but
       | that hope is diminishing.
       | 
       | I just watched somebody go through a serious cancer treatment and
       | I am 100% sure that I wouldn't have gone through the treatment
       | but would have ended it. I don't want to go through the hell of
       | treatment only to end up back in a life that's not much fun
       | either.
        
       | okareaman wrote:
       | As someone who has struggle with suicidal ideation his entire
       | life, whenever the subject comes up I try to educate people by
       | quoting author David Foster Wallace (who commited suicide) with
       | the best explanation:
       | 
       |  _"The so-called 'psychotically depressed' person who tries to
       | kill herself doesn't do so out of quote 'hopelessness' or any
       | abstract conviction that life's assets and debits do not square.
       | And surely not because death seems suddenly appealing. The person
       | in whom Its invisible agony reaches a certain unendurable level
       | will kill herself the same way a trapped person will eventually
       | jump from the window of a burning high-rise. Make no mistake
       | about people who leap from burning windows. Their terror of
       | falling from a great height is still just as great as it would be
       | for you or me standing speculatively at the same window just
       | checking out the view; i.e. the fear of falling remains a
       | constant. The variable here is the other terror, the fire's
       | flames: when the flames get close enough, falling to death
       | becomes the slightly less terrible of two terrors. It's not
       | desiring the fall; it's terror of the flames. And yet nobody down
       | on the sidewalk, looking up and yelling 'Don't!' and 'Hang on!',
       | can understand the jump. Not really. You'd have to have
       | personally been trapped and felt flames to really understand a
       | terror way beyond falling."_
        
         | jsmith45 wrote:
         | One flaw with the analogy is that a pretty significant portion
         | of suicides (successful or attempts) are impulsive. Many people
         | who attempt it have literally no idea they will when they wake
         | up that morning.
         | 
         | A 2001 University of Houston study of survivors of near lethal
         | attempts showed that 70% of them had only decided to do it an
         | hour or less before the attempt, and 24 percent had only spent
         | 5 minutes before the attempt.
         | 
         | If when attempting it, they discover that their chosen method
         | won't work for some reason, many will just give up on killing
         | themselves rather than looking for an alternative measure.
         | 
         | This has been reliably seen many times. If a change is made
         | such that one suicide method becomes unfeasible, the overall
         | attempt rate drops. If one were committed to offing oneself it
         | is almost impossible to stop them, as there are countless ways
         | to do it. But the statistics are very clear that if some method
         | is removed, alternatives are not always used.
         | 
         | The British had an issue with people killing themselves with
         | oven fumes, back when the ovens used coal gas which created a
         | lot of carbon monoxide, with this accounting for about 50% of
         | suicide deaths. When things were changed to use natural gas
         | where this approach does not work, suicides dropped by 30%.
         | Obviously while that means a portion ending up using some other
         | method, many others simply never killed themselves.
         | 
         | Of 515 people prevented by police from jumping off the Golden
         | Gate Bridge between 1937 and 1971, by the end of the 70s only
         | 6% of them had committed suicide by other means.
         | 
         | Weirdly even some of the non-impulsive cases where people had
         | planned an attempt for days or weeks just give up if their plan
         | is foiled, rather than coming up with some alternative method.
         | 
         | Now obviously not everybody is like this. Some people will
         | continue to try over and over until they succeed. But the
         | numbers suggest that those are very much a minority.
        
           | smolder wrote:
           | These are great points but I don't see them as conflicting
           | with the analogy. The suffering DFW refers to that drives
           | someone to suicide is something felt in the moment. He
           | contrasts the impulsive decision to die with deciding the
           | same based on some balance sheet of suffering.
        
           | autoexec wrote:
           | > Of 515 people prevented by police from jumping off the
           | Golden Gate Bridge between 1937 and 1971, by the end of the
           | 70s only 6% of them had committed suicide by other means.
           | 
           | Perhaps much of that is because they got the help they needed
           | following the incident. It probably also helps that they were
           | a group made up of those who were able to be persuaded by
           | police to not jump in the first place already showing at
           | least some willingness to keep living.
        
           | vmception wrote:
           | You are reducing things to statistics at the detriment to a
           | large number of people.
           | 
           | You are responding to a thread of someone not like what you
           | described, who exists in great numbers as well. The two
           | examples you presented are wildly different: Britain's
           | suicide rate dropped 30% and now they are at square zero
           | again how to prevent all those suicides that keep happening!
           | 
           | The point of even talking about it is to show how useless
           | telling someone "hey just call this phone number, because I
           | care about you, well I don't actually know you but I avoid
           | the topic of suicide" is just as useless as the people on the
           | ground telling someone not to jump from a burning building.
           | 
           | Even if they don't jump (or do call the suicide prevention
           | number), the fire is still there (the underlying problem is
           | unresolved and still not reconcilable)
        
           | Jare wrote:
           | > One flaw with the analogy [...] Many people who attempt it
           | have literally no idea they will when they wake up that
           | morning.
           | 
           | Can you elaborate? That sounds pretty much like the people in
           | the analogy to me. They jump because the alternative they
           | face right now is more terrifying for some reason. It makes
           | sense that not all methods of suicide fulfill that criteria
           | (being less terrifying than the alternative), even if they
           | are all methods to end your life.
        
             | dalmo3 wrote:
             | I reacted the same way when I read that part too, but the
             | rest of the comment illustrates it well with the failed
             | attempts data.
             | 
             | To go back to the analogy, it's as if they try to jump from
             | the window, but there's a safety net that blocks them.
             | They're stuck inside and the fire is mysteriously gone.
        
           | _tulpa wrote:
           | Having been there personally and spent time with others in by
           | same place: it probably can't be anything but "impulsive" for
           | most people. It really is a "hang on til it hurts too much",
           | reasons for/against tend to come and go, and the decision can
           | be made/unmade all the time.
           | 
           | This is human behaviour, and causality is really not as
           | simple as wanking some stats around and making a bunch of
           | super tenuous inference. 'fuck outta here with that
           | reductionist bullshit.
        
           | tialaramex wrote:
           | > The British had an issue with people killing themselves
           | with oven fumes, back when the ovens used coal gas which
           | created a lot of carbon monoxide, with this accounting for
           | about 50% of suicide deaths.
           | 
           | This detail is a little wrong or at least confusing. The coal
           | gas (typically called "Town gas") was about 10-20% carbon
           | monoxide, along with hydrogen, and other flammable gases.
           | When set aflame in a ventilated room, the carbon monoxide
           | burns - like the other gases - producing mostly carbon
           | _dioxide_ which is still slightly poisonous but since we
           | breathe huge amounts of it already it 's not near the top of
           | your list of problems.
           | 
           | In this era British people (maybe 1000 per year or so) commit
           | suicide by turning on the gas supply to an oven but _not_
           | lighting it. The phrase  "stick my head in the oven"
           | signifies suicide for this reason, the implication is not
           | that you would cook your head, but that you would
           | deliberately breathe the poisonous carbon monoxide and die.
        
         | agumonkey wrote:
         | Also some levels of pain completely fuzz the upper layers of
         | the brain in ways that are hard to describe.
        
         | rubyfan wrote:
         | This is an amazing explanation, thank you for sharing this.
        
           | kingsloi wrote:
           | I agree, thank you.
        
         | phkahler wrote:
         | I can agree with DFW on that because it sounds reasonable and
         | consistent with people I've known. The error is in thinking
         | there is a single train of thought leading to the end.
         | "Hopelessness" may not be sufficient, but Demoralization is
         | probably an indicator. I would also posit that excessive or
         | increased rumination (possibly leading to an increased sense of
         | demoralization) is also an indicator. It is apparently also a
         | thing that Borderline patients are at increased risk, though I
         | have no idea what goes through their mind in that moment.
         | 
         | So DFW rejected others ideas on the subject in favor of his own
         | experience? Sounds a little narcissistic doesn't it?
        
       | ppod wrote:
       | >It measured for what Emotra called "electrodermal
       | hyporeactivity" by running a weak current over the skin as the
       | sweat glands open and close. The association with suicide had
       | been advertised by an experimental psychiatrist named Lars-Hakan
       | Thorell, Emotra's founder,
       | 
       | This has regulatory approval in the EU? Why is Harpers even
       | writing about this?
        
       | gmuslera wrote:
       | Wrong science fiction reference, it should be The Minority
       | Report.
       | 
       | Would your prediction cause it? avoid it? It was really about to
       | happen? If you are "testing" it, stopping the people that is
       | about to do it would mess with the test? And not stopping them
       | would count as unintentional murder?
       | 
       | My objections are not about suicides, but about predictions in
       | general and predictions that can affect human lives in
       | particular.
        
       | 3520 wrote:
       | In order to predict suicide you'd need real-time data of wide
       | variety of aspects of a human being (levels of pain,
       | hopelessness, connectedness, capability for suicide, etc) in a
       | way that is impossible to achieve at the moment (insufficient
       | measures and insufficient data gathering techniques).
        
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