Falling Without a Net

Recent data from the Center for Disease Control show an alarming spike in suicides across the United States. We can’t prevent every suicide by rebuilding our social safety net. But the uptick is a collective failure — one that requires political solutions.

Emile Pissarro, L'Île Lacroix, Rouen (The Effect of Fog), 1888. Wikimedia

Yesterday the New York Times published an op-ed about suicide among young people in the United States. As the author writes, citing Center for Disease Control (CDC) data, “After declining for nearly two decades, the suicide rate among Americans aged 10 to 24 jumped 56 percent between 2007 and 2017.” He notes that while suicide remains more common among men, the rate has been increasing quickest among young women, rising 12.7 percent each year as compared with 7.1 percent for young men.

A further look at the CDC data underlines the trend. As Sally C. Curtin and Melonie Heron note in a National Center for Health Statistics brief for the CDC, not only did the suicide rate go from remaining stable among ten- to twenty-four-year-olds between 2000 and 2007 to jumping 56 percent over the following decade, “the pace of increase for suicide was greater from 2013 to 2017 (7 percent annually, on average) than from 2007 to 2013 (3 percent annually).”

In other words, the suicide rate is accelerating — it may well have been even higher in 2018 and 2019.

We tend to think of suicide as the result of individual afflictions, but they’re also social phenomena. These new numbers reminded me of the recent data on young people not having as many children as they’d like to. If  the decision to have or to not have children is a family’s own choice, such choices have social roots, too.

It’s fine not to have kids, of course, but young people reporting doing so because of crushing debt, impossibly expensive childcare, immiserating jobs, or inadequate health care should set off alarm bells. That last one, our crumbling, evil, labyrinthine health care system, is a major part of the story of youth suicide (So is household gun ownership, though the New York Times curiously didn’t mention this.)

In the context of a spike in suicide rates in the UK, the late Mark Fisher once argued — against those who deny suicide’s political causes — that “for many of those suffering from mental illnesses, the capacity to act rationally is impaired, which is one reason that they need to be protected. Without a safety net to catch you, the consequences of falling increase exponentially.

The gutting of welfare programs can’t be mechanically mapped onto every suicide: I’ve known suicides caused by privation, but I’ve also known seemingly blessed inhabitants of charmed lives who killed themselves. When I contemplated suicide, my life had never been better. (I’d have been in the as-yet-unreleased 2019 statistics.)

But socioeconomic conditions are the water in which people swim, and figures like these are ominous warnings about the rising temperature. After all, “deaths of despair” — not just suicide, but overdoses too — are on the rise to such an extent that they’ve caused a decline in US life expectancy.

As for solutions? For starters, a study published this week in the Journal of Epidemiology and Community Health finds that a $1 increase in the minimum wage equates to a 3.4 percent to 5.9 percent decrease in suicide rates for those aged eighteen to sixty-four with a high school education or less, with effects appearing “greatest during periods of high unemployment.” We have to connect suicide rates to a punishing health care system and stagnant wages; improving wages, working conditions, and winning universal health care — including mental health care for all — will go a long way. Fisher closed his column on suicides, five years before he killed himself, with the right idea: “We need to reverse the privatization of stress.”

The same day the New York Times published the op-ed on youth suicide, the news broke that Elizabeth Wurtzel, author of Prozac Nation, had died of cancer at age fifty-two. I learned of her passing while I was on a bus across Brooklyn to a CVS pharmacy, having convinced my psychiatrist to give me a bridge refill of Prozac — twenty days of pills to last me until our next appointment.

Here’s Wurtzel in Prozac Nation:

That’s the thing I want to make clear about depression: It’s got nothing at all to do with life. In the course of life, there is sadness and pain and sorrow, all of which, in their right time and season, are normal—unpleasant, but normal. Depression is in an altogether different zone because it involves a complete absence: absence of affect, absence of feeling, absence of response, absence of interest. The pain you feel in the course of a major clinical depression is an attempt on nature’s part (nature, after all, abhors a vacuum) to fill up the empty space.

Depression is blankness, numbness, lack. It can be starvation, or ache, but mostly it’s just a void. As Andrew Solomon, author of The Noonday Demon: An Atlas of Depression, writes, depression is not the opposite of happiness, but of vitality. It is no furrow or valley but a flat-line — hence William Styron’s complaint about the term, “a noun with a bland tonality and lacking any magisterial presence, used indifferently to describe an economic decline or a rut in the ground, a true wimp of a word for such a major illness.”

For me, depression is selfish, parasitic — the compulsion to spread one’s misery — but it is self-consuming before all else. It is letting my Prozac run out, watching as each day I have fewer pills than the day before, and only contacting the clinic once they run out. It is knowing that I’ve done this before.

As Wurtzel wrote in a 2013 essay reflecting on her life, “this story has the best possible ending, because I am telling it.” I am too, yet there are so many others who can’t.

We can’t rid the world of sadness, much less depression. But that is not the goal. As Corey Robin writes, “the point of socialism is to convert hysterical misery into ordinary unhappiness.” Remove the command to work or starve; take away co-pays and inordinately expensive medication; rebuild collective institutions — trade unions and community, the type of connections precluded by austere neoliberalism.

A spike in suicide rates is a collective failure, and it requires political solutions. It’s up to me to keep up with my appointments and medications. But it will take all of us to make them freely available to everyone, to build a safety net to catch those who fall.