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Suicide Attempters’ Long-Term Survival (hsph.harvard.edu)
145 points by EndXA on July 28, 2019 | hide | past | favorite | 207 comments



PSA: Most suicides occur while the person is alone. Company can be a strong deterrent to attempting suicide.

Thanks in part to an incurable medical condition, I'm sometimes suddenly suicidal and basically deranged. At such times, my adult sons don't leave me alone.

They mostly try to avoid discussing it with me. They don't try to make me feel better or act like unpaid therapists because it not only doesn't work, it's actively counterproductive.

Their policy is to take care of me physically (food, drink, warmth), keep me company and "do not engage Teh Crazeh."

In other words, trying to argue with me at such times about how irrational I am amounts to adding fuel to the fire. It just makes me more upset.

I've lived with this a long time, so I'm often able to just tell them "I'm not right and can't be trusted to be alone right now."

As my health improves, such incidents have become fewer, farther between and shorter in duration. It happened a lot while homeless. It's been much less common since getting back into housing.


Having fought depressions myself, I recognize the pattern of "depressives talking bullshit".

In depressive episodes your mind believes strongly in how hopeless your situation is. When people challenge that conviction, you'll only come up with more reasons, no matter how hare-brained or even psychotic at times. It's just the way it works...


Parent did not mention the word depression, so I do not want to comment on their story, but I want to comment that major depression does have well documented symptoms of transient mental state where delusions and hallucinations feeds into depression. If I remember right from Robert Sapolsky, the mind is creating a plausible explanation for its current state, which is a thing the mind actually does for everyone, but with major depression it becomes quite extreme. It is not something a person can "snapp out" of or be talked into to see things rational. Robert Sapolsky see depression as mostly a biological condition with biological causes, and a common quote from his is that we don't tell people with diabetes to just get over it and start producing insulin.


Well, if she is supervised for a few days in order to avoid suicide, and tries to convince everybody how bad her situation is, "depression" of one form or another is a pretty good bet. I don't think there even is an alternative explanation for recurring episodes like that.


> Most suicides occur while the person is alone. Company can be a strong deterrent to attempting suicide.

This is a lot more complicated than you're making it out.

plenty of people kill themselves in front of their family. Others kill themselves when their family are in the home. Others kill themselves in public. Others kill themselves in hospital wards when they're on 15 minute observations. These are not a tiny fraction of the total number of people who kill themselves.

EDIT: I'm glad you've found something that works _for you_, but it's really important to recognise that your experience is not usual, and that many people would find it invalidating.

EDIT: Page 33. https://documents.manchester.ac.uk/display.aspx?DocID=38469

> Living alone -- Women: 45% Men 50%

This shows that living alone is a risk factor, but it also shows that most people who die by suicide do not live alone.

Page 55 suggests that it's external support that helps, not support by the family:

> 149. In 834 (43%) the patient lived alone. They were less likely to receive additional social support from outside the home (e.g. from a relative, friend or neighbour) as part of their care plan compared to those who did not live alone (138, 44% excluding unknowns vs. 270, 71%


I'm glad you've found something that works _for you_, but it's really important to recognise that your experience is not usual, and that many people would find it invalidating.

My experience is a statistical outlier best case scenario. That's exactly the point of sharing it.

It took years for my sons to develop the details of this approach. Our lives got vastly better when they stopped replying to $crazything with attempted rebuttal and began replying with "Are you hungry? Thirsty? Warm enough?"

> Living alone -- Women: 45% Men 50%

This shows that living alone is a risk factor, but it also shows that most people who die by suicide do not live alone.

That is not directly salient to my point that the act of suicide tends to occur while physically alone, which is certainly not an assertion that it's 100% of the time.

I'm well aware that family can be part of the problem. Family was absolutely part of the problem when I attempted suicide at age 17.

It's generally not constructive to assume the worst about total strangers on the internet and lecture them as if they must be abusive people if they have a relative who is prone to suicidal ideation. In fact, that approach tends to make problems worse.

Abusive situations don't necessarily start with any intent to abuse. They can occur because someone either feels responsible or actually is legally responsible and doesn't have adequate knowledge or tools for coping effectively.

Desperate attempts to control another person in order to avoid X outcome easily turn abusive. "The road to hell is paved with good intentions."

Sometimes simply knowing that it's possible to get through it in a humane and constructive fashion is sufficient to allow more rational impulses to rule the day. Giving in to a sense of desperation or hopelessness is typically not a good thing when facing serious problems.


There is value in moving away from those statistics and looking at the other part of DoorenMichele’s story, which to me feels like one of compassion.

Having people around you who can support you while maintaining their own boundaries, without getting themselves involved or colluding with that state of mind you’re in, can be really powerful. It means you’re still being treated like a human being who has needs beyond what they are panicking about in the moment.

Anecdotally, I’ve been through far too many of those kinds of breakdown to count and I was grateful when the friend I was with (who understood the underlying causes) asked if I needed a hug, or said “I love you,” and basically didn’t react to whatever I’d started crying about. I could be another statistical outlier in that sense but there was always a better alternative than engaging the conversation, and making it more real. You can probably guess that was family related.


> can be really powerful.

It can also be invalidating and harmful. I've met far more people for whom it's harmful than I have who were helped by it.

It's also causing harm to those other people: a relative who attempts suicide will increase your own risk of suicide.

I've spoken to a lot of people who had a relative who died by suicide. Many of them had carer roles for their loved ones. Every single one of them who had this carer role spoke about the huge amount of guilt they now feel, and about their own significant increase in risk of death by suicide.


You are correct, if you really want to do it then you are always going to do it. If you just want to do it a lot, sometimes a little company helps! It can't hurt to try, at worst you'll only live a little longer.


That's definitely not what I'm saying.

Some people don't have a strong intention to die but use a method with high lethality and do die.

> It can't hurt to try, at worst you'll only live a little longer.

Some people have abusive families that increase risk.


> Some people don't have a strong intention to die but use a method with high lethality and do die.

I don't understand what you're saying here. Are you implying a significant enough fraction of people that it bears discussing tries to commit suicide but doesn't really want to die? And even if this is the case, how is that relevant to what we were discussing?

> Some people have abusive families that increase risk.

I never said it had to be family did I? And even if this is true, why does the fact that this is true for some people mean that the average person should not try it at all?

Edit: Not even the original comment was saying it had to be family. They were talking about having company. I don't understand why you are suddenly making this about one specific set of people.


> Are you implying a significant enough fraction of people that it bears discussing tries to commit suicide but doesn't really want to die

Yes. This is why some countries use "accidental death with undetermined intent" as part of their definition of suicide.

Some people self harm frequently and severely. When we talk to them we find out that they do not want to die; that they fear death. But their self harm is so severe and extensive that they are at risk of death. For example, we see people trying to engage with mental health services, trying to get treatment for their self harm, but continuing to self harm and then accidentally dying by overdose.

> I don't understand why you are suddenly making this about one specific set of people.

Suicide kills significant numbers of people. It's important that advice is evidence based. "Have company" is not evidence based. When we give incorrect advice it increases risk; people die.


It's important that advice is evidence based. "Have company" is not evidence based. When we give incorrect advice it increases risk; people die.

A former homemaker telling her story on a discussion forum does not carry the same weight of authority as, say, the CDC in the US putting out official guidelines on how to deal with a suicidal person.

I'm not the only person who has found it helpful to deal with my own suicidal tendencies by seeking a "babysitter" in my social circle. President Lincoln was prone to being suicidal. It was his policy to never carry a pocket knife and to have friends keep him company when his dark moods struck.

I know there are other things I've read pertinent that support the idea that this is an effective approach for some people. I can't currently recall more and I'm in the midst of moving right this minute, plus you have an extremely long history of attacking me personally, wildly misinterpreting my remarks, etc.

I do my level best to view that pattern as due to you being British and me American -- "two nations separated by a common language" -- but the pattern is so consistent that it's quite difficult for me to keep doing that. I cannot recall a single instance where your interaction with me did not feel like a personal attack.

Taking it down from actively and openly ugly and hostile to politely shooting me down doesn't read on my end like you've had a change of heart and are trying to build bridges. It reads on my end like you've just gotten better at politely following the rules while pursuing a personal campaign to go after me for some reason.

If your actual concern is that you believe me to be giving advice in some authoritative fashion that suggests "this is the one and only proper answer" -- which I generally do my best to not do -- there are many ways to address that concern that don't come across like you don't want me speaking on this subject at all.

I will keep your stated concern in mind and perhaps not intro my remarks with PSA in the future. However, that wasn't used to suggest "this is authoritative advice on the topic." It was used to suggest "This is not a suicidal person crying on your shoulder. It is intended to be a constructive and thought-provoking addition to the conversation." because it's really common for people to engage with my remarks as if I'm looking for sympathy or advice or otherwise make it about me rather than about the topic at hand.

I'm well aware that I can opt to not tell my story, but other people here are usually not told they should never ever say anything about themselves if they don't want intrusive attention of that sort. There seems to be a gendered component to the pattern where simply knowing I'm a woman inspires a lot of people to want to make a personal connection with me, regardless of what I say, rather than engage with my point.

I've been here a decade. I've put in considerable effort to figure out how to better engage here to reduce the worst of the drama, but the reality is that I can't control nor even anticipate every single reaction of the five million people a month that visit this site and it's a moving target. If I solve for x, five minutes later I will be dealing with some new iteration of the problem.


Really glad to hear that your sons are there for you. Even gladder to hear that such incidents are fewer and farther between! I can only imagine how much harder it must've been without housing.


> incurable medical condition

which is ? seriously wondering


Great summary of the suicide literature. This is why it's okay to restrain suicidal people against their will - it's temporary madness most of the time

If your happy but very drunk friend wanted to tapdance on the edge of a tall building, would you restrain them if necessary? Or if someone high on shrooms was trying to drink bleach?

A suicidal mind is often one caught in the temporary throes of delusion and irrationality, even if it comes from internal wiring going haywire instead of external substances.

Preventing someone from killing themselves is in their best interest most of the time for that reason. Suicidal impulses are most often fleeting relative to normal lifespan.


It would be interesting to talk to these people and ask if it was the suicide attempt itself that made them not attempt again. If you prevent the attempt will it have the same effect?


I know people who have said the primary reason they don't attempt suicide again is not that they feel life is improving or worth living, but because each attempt further reduced their QoL and they're terrified of what another unsuccessful attempt might yield.


I attempted suicide at age 17. I have been hospitalized twice on a suicide watch.

For me, yes, the failed attempt has served as a deterrent. Due to various intractable issues, my life has sucked for a long time. Adding more scars, more people thinking I'm merely crazy and more medical bills won't in any way enhance my life.

I don't want to survive another failed attempt and I'm usually in no position to make sure I succeed.

So, for me, yes, it's been a factor.

/Anecdata


Speaking for myself, virtually all self administered methods used can be quite painful with an uncertain outcome, due to imperfect information. As I started going through an attempt, as the pain increased, I backed off and realized I had no idea what I was doing and needed to stop. I suppose people that attempt suicide don't see another way of solving whatever they perceive to be the doomsday singularity in their life.


I think it probably depends on whether they tried because they lost all their coping mechanisms or because they were angry. I'm one of the former and I don't think I'd ever attempt it again but it seems people who attempt as an act of rage are more likely to repeat.

I'm not confident that stopping someone would have the same effect as them living through it.


In my opinion the misconception is that suicidal ideation means no will for self-preservation. On the opposite, the urge to think, speak and act on suicidal ideation is at odds with various other emotions and instincts.

One way of threading this needle is to perform attempts which are obviously going to fail, maybe eben intentionally so.

It may take any kind of attempt, be it intentionally or accidentally unsuccessful to lead to treatment or at least the acknowledgement of all parties involved that the problem is actually bigger than a bout of self-pity or lack of character.


I remember working through rounds of depression and constantly confused and doubting my interpretation of .... anything / everything.

It was hard to understand the differences I perception when depressed and not.

One day a doctor almost as an aside said "When you are depressed, you don't see the world the way it is, but you also can't comprehend that entirely or maybe at all."

I finally understood why it was just so different on either end of the depression and non depression world and also how far "off" my ability to understand certain things were.


What is the difference? I mean, the world is the world and the things that happen don’t change just because one sees them in a different way.

Put another way, even if I wasn’t depressed, I’d still be single, diabetic and have a ton of debt. What about that would change?


Optimism for one thing. Non-depressive people usually think their problems are conquerable and they can find some enjoyment here and there.

For another, the perception/prediction of effort is very much different. In a depressive episode patients will estimate all tasks as fundamentally harder, leading to huge problems in motivation and making decisions. It's quite analogous to how increased gravity on another planet would affect your movements and decisions about your movements.

When the capacity for enjoyment or positive emotions is reduced, you won't be seeking enjoyment as much. Which is a vicious cycle, of course.

So yes, depressive symptoms are a big hindrance, even if you have other big problems, none of which I would want to diminish.


My therapist also tries to explain the difference between a “depressing” thought and a “depressive” thought. The first is just sad: “my ex started dating my roommate and that makes me feel uncomfortable”. The latter snowballs into morbid or hyperbolic predictions of the future: “now I’m going to be ostracized from my social group because they won’t want me making things weird. I also work with him and my professional life is going to fall apart. Ill have no safe space and I’m going to crack & burn all bridges i have here. I’m going to need to restart my life somewhere across the country”


Another comparison would be those trait controllers they had in Westworld. The writers/engineers could move sliders on a flexible sheet for different character traits.

In depressive episodes the sliders for "optimism", "motivation", "thrill seeking", "social behavior" would be significantly lower than they are normally.

But the idea that those traits are not constant goes much against our cultural programming, I think.


The language around this is messy because not all depressive symptoms are shared, but I would say it's in how you view it.

In your example, being single and having a lot of debt can change over time. But if you were in the throes of a depressive episode, then you might believe absolutely that neither of them can ever change because they haven't changed yet/they'll take so long/it's impossible for you to expend the effort needed to change them/[...].

The facts are the same, but the conclusions you draw are different.


some people still see these problems are not damaging enough to be sad

- failing love relationship can also be pain, some love the peace of being single

- diabetic may be managed (maybe your case is harder though, I cannot assume it's easy)

- some can find support to fill debt and like to rise above it as a challenge

Much in life is interpretation, and accepting damaging emotions as truer than neutral or positive is not my favorite choice.

Best wishes


1) your ability to cope with it would change

2) your ability to seek help to cope with it would chang

3) your perception of time is often different during an acute suicidal episode - time stretches out which makes this particular moment feel all-encompassing.


The alternative is that you can _only_ appreciate the true state of the world when you are depressed, and everybody else just walks around in a little stupor thinking somehow they and their world matters, when we are all the effect of a run-away accidental chemical experiment.

Or may not, I don't know, but I would be weary about assertions about depression from a person who isn't, even if that person is a doctor.


It is certainly easy to go down that rabbit hole and get all myopic when you're depressed and belive that the only thing you can see is "true". I don't blame anyone for it as it is hard not to, but it's still a problem.

While it is different to compare while depressed, I don't think it is hard to understand that other people who have similar problems / life situations are doing fine... and maybe they know something / do things differently.

That alone doesn't fix anything, but it is a place from where you can evaluate and understand that the world, possibilities, etc, while depressed, shrinks to some extent.


> This is why it's okay to restrain suicidal people against their will

Well, it isn't.


If you believe that, then you should also be willing to exempt anyone who has given notice in advance (let say 2 weeks).

If you are not, then please don't go and lord your believes about peoples lives over them.


i agree to a large degree, though even 1/10 is an appalling rate of suicide vs the general population of 1/5000~


Risk prediction is really tricky. We think the best predictor of risk is a previous suicide attempt, or a previous self harm attempt.

About half of people who die by suicide have a history of self harm, and in the year after attending A&E for self harm people are at 30* to 50* the risk of dying by suicide.

We need the short term intervention to save life, and we need an intense package of community support for the next few months addressing the full range of bio-psycho-social needs of the patient.

We're not getting this right in the UK at the moment. I can't speak about the US.


Would you mind defining self harm? Is it auto-mutilation strictly, or does something like smoking/drinking/other_drugs also count?


For self harm here the definition comes from NICE guidance.

https://www.nice.org.uk/guidance/qs34

> The term self‑harm is used in this quality standard to refer to any act of self‑poisoning or self‑injury carried out by a person, irrespective of their motivation. This commonly involves self‑poisoning with medication or self‑injury by cutting. Self‑harm is not used to refer to harm arising from overeating, body piercing, body tattooing, excessive consumption of alcohol or recreational drugs, starvation arising from anorexia nervosa or accidental harm to oneself.

This definition excludes drug use, but that would be covered elsewhere. For example, the front page of NCISH (National Confidential Inquiry into Suicide and Self Harm, previously NCIS and Homicide by MH patients) has this (under "improving safety in mental health services"): https://sites.manchester.ac.uk/ncish/

> Reducing alcohol and drug misuse

> We recommend there are drug and alcohol services available that work closely with mental health services for patients with mental illness and alcohol and drug misuse.

> Our evidence

> Only a minority of patients who died by suicide between 2006 and 2016 were in contact with specialist substance misuse services, despite alcohol and drug misuse being a common antecedent of patient suicide in all UK countries. In England, there was a 25% fall in rates of suicide by patients in those NHS Trusts which had put in place a policy on the management of patients with co-morbid alcohol and drug misuse. Guidance


It looks to me like you are comparing a lifetime figure against a yearly figure.

Suicide figures are usually given on an annual basis, but we often mistake the figures for lifetime risk, and we are then surprised with how common suicide is within our own experience/extended acquantancy.


thats true, but my statement remains correct regardless.

correct me if i fudge my math. 1- 1/5000 =.9998. .9998^72 = .985702, thus <1.5% chance of suicide over a life time.

.1 is still appallingly high vs .015 (and I think 1/5000 is actually a generous estimate, rates are age adjusted so its hard to apples to apples, but according to wikipedia its 13.42 / 100k - much less than 1/5k).


From the numbers it could very well be that a lot of the ones who die in a subsequent attempt could be bipolar or have some other serious comorbidity in addition to "just" major depression.

There are multiple conditions which can lead to depressive symptoms and suicidal tendencies. Some are more malign than others, which is a strange thing to say about conditions that make you want to kill yourself. But basically, suicidality in bipolar patients can only be significantly reduced by exactly one specific medication.


Are you referring to Lithium or just saying they need one more medication, on average, to get them out of their very deep hole?


They get out of their deep hole very much on their own, usually within weeks or months. But that's actually the problem in bipolar disorder. They can go from total depression to a much more energetic state in days or a few weeks, such that suicidal ideation and feeling like shit can overlap with high motivational energy. And that's the most dangerous time for suicidal tendencies. In a very deep depressive episodes, suicide is just too much effort.

And yes, I was referring to Lithium as the only medication which significantly reduces the incidence of suicide attempts in bipolar patients. But that effect is only visible long-term.


You made quite the leap of logic there.

The article is about people whose suicide attempts failed, and ended up with them alive in hospital. Of these people, only about 10% will successfully suicide later.

There is no connection between these incidents and your justification for restraining suicidal people against their will. I am certain that there is evidence to support your claim, but this is not it.


I see your point, but I also don't see much of a leap.

If 90% who survived suicide did not attempt suicide again it sort of does suggest that had more people survived their suicide impulses they would also be one-timers. Sadly, sometimes one impulse is the last.

I read about bridge jumpers who survived (I think it was the Golden Gate Bridge, FWIW) and most said the instant they left the bridge they had a rush of clarity and profoundly regretted what they had just done.

Haunts me still to think about the ones that didn't survive but likely had that same moment of horror.


>If 90% who survived suicide did not attempt suicide again it sort of does suggest that had more people survived their suicide impulses they would also be one-timers.

It might also suggest that those who survived a suicide attempt used half-hearted measures because it was an impulsive act, while at least some (though we'll likely never know that actual proportion) of those who did not survive their attempt went to greater lengths to ensure their death because their act was more premeditated and planned out than impulsive.

What about the other 10%? Was there a second impulse, then a third one? Sad as it may be to contemplate, not all suicide is a spur-of-the-moment thing, some people will go to great lengths to get their affairs in order and ensure their own death.


I think the point is that they have to execute to get the release from the insanity.

Pulling people back from the brink might stop them trying this time, but perhaps it’s that moment of clarity after all the noise and chaos inside their head has finally been resolved by making a decision and following through, that leads them to recognise the more sensible decisions they should have taken.


You really don't need "supportive evidence" to stop someone from hurting himself using whatever power you have. You just need to be a human being with a functioning heart.


A human being with a real "functioning heart" would not stop somebody from trying to kill themselves.


These kinds of results also point to how much of an impact guns have on suicide rates.

Guns make it a lot easier to attempt suicide and achieve it. In the US, guns are often more readily available than medical treatment. If you have a gun laying around, and you have a short bout of suicidal ideation, that can be an unfortunate combination.

On top of that, people believe it will be less painful than other methods, increasing the appeal.

Virtually any other method of suicide takes more effort and time. The more time an attempt takes, the less probable the patients are to go through with it, and the more likely the attempt is discovered in time.


Methods seem to vary a lot by country, and some of the highest-rate countries don't primarily use guns, so I'm not sure other methods can be easily dismissed as less dangerous. For example, Belgium's overall suicide rate is higher than the USA's, and the most popular method there is hanging (a majority of male suicides, and a plurality of female suicides) [1]. Of course I can't say that the rate wouldn't be even higher if Belgium had more guns, but it manages a quite high rate without them.

[1] https://jech.bmj.com/content/62/6/545


It's misleading at best to reduce differences between countries to one thing, like gun ownership. Nobody said this was the only factor affecting suicide rates. The article you cite provides virtually no information on how the availability of guns, especially because guns are generally much less available in Europe than in the US. Still, about 30% of suicides in Switzerland are committed with guns.

Virtually every country has its own culture around guns and around suicide. Very obviously in the case of Japan with high suicide rates and even ritualistic ways of suicide. Therefore it is impossible to isolate the effect of gun ownership just by looking at different countries.

And "not being the primary way of suicide" is a really weak argument against tightening gun controls to save people's lives. Even if it is "just" 10% in Europe, 30% in Switzerland and about 50% in the US. Those lives are very much worth saving, and at least in Europe, it's already the norm to take away guns from people who have these problems.

Gun advocates often cite Switzerland as a country with very responsible gun owners. Still, if you compare the rates of gun suicides, accidents and murder to their smaller population, it's still quite shocking. But those stories rarely make news abroad.


You were talking about "impact guns have on suicide rates".

People are using method that they think is most successful, and if they own gun, it's very probable that they will use it.

>And "not being the primary way of suicide" is a really weak argument against tightening gun controls to save people's lives. Even if it is "just" 10% in Europe, 30% in Switzerland and about 50% in the US. Those lives are very much worth saving, and at least in Europe, it's already the norm to take away guns from people who have these problems.

This is a weak argument, because it implies that by taking guns, people won't commit suicide, when they may just do it by any other method.

Which the high rates of suicide in several other countries with way less gun ownership than in US point to.

By the way, using emotionally charged statements like "those lives are very much worth saving" when your interlocutor did not suggest anything otherwise is at the very least unpleasant discussion style.


>This is a weak argument, because it implies that by taking guns, people won't commit suicide, when they may just do it by any other method.

That argument is correct; a major suicide prevention measure is taking away methods. When countries switched from coal gas to natural gas, suicide rate went down for this reason.

Suicide is largely a in-the-moment decision and guns make it very easy to act on it.

>Which the high rates of suicide in several other countries with way less gun ownership than in US point to.

I don't think that's true, they may just have a different culture that leads to more suicide. Gun ownership isn't the only difference between the USA and other countries.


People are quite particular about their methods of suicide.

They usually don't want to have any pain, but prefer to die instantly. No method checks as many of these boxes as using a gun.

I got the previous argument as saying exactly that the main method of suicide in Europe is hanging, and not shooting, and therefor taking guns away from most people who don't have a positive need to be armed or with doubts about their reliability wouldn't affect suicides in a significant manner. Otherwise citing that article makes no sense to me, since it actually points to guns being a major factor.

It's impossible to infer the effect of gun ownership on suicide rates by looking at countries. Too many confounding factors, too little number of countries. Same goes for states in the US.

Suicide is a very culturally shaped topic, and on top of that it is affected by the health system, economy and various other factors.


> because it implies that by taking guns, people won't commit suicide, when they may just do it by any other method.

We know that method substitution does happen, but people would be using a less lethal method instead of a very lethal method so that alone will save lives. Also, not everyone will use a different method. We don't really know what the rates are for people switching methods.

Reducing access to means and methods is about the most important short term suicide prevention measure we can take, alongside all the other stuff we need to help people avoid falling into suicidal thinking.


>Gun advocates often cite Switzerland as a country with very responsible gun owners. Still, if you compare the rates of gun suicides, accidents and murder to their smaller population, it's still quite shocking.

Switzerland’s murder rate is among the very lowest in Europe. Only Austria and several of the tinier countries even come close.

https://en.wikipedia.org/wiki/List_of_countries_by_intention...


Thanks to mandatory military service almost every household in Switzerland has a gun.


I wouldn't attribute it to mandatory military service, but rather to the attitude of soldiers/reservists keeping an issued gun at home, with all the benefits and disadvantages.

Which also isn't the norm in most countries with mandatory military service.

Unfortunately, those guns are indeed regularly used in suicides and murders, often in a spur of a moment decision.


How do they define a death by suicide in Belgium? Is that comparable to how they define it in the US?


One confounding factor would be the "Suicide by Cop" thing.


I'd be interested to read any research on how drugs impact suicide rates (particularly if it prevents people who would have otherwise committed suicide). As easy it is to get guns, I think drugs actually a bit easier to obtain despite being the thing that's illegal (due to gun purchase wait period).


> how drugs impact suicide rates

Define drugs. Does it include alcohol? Does the (slow) deterioration of alcohol abuse count? If not, does the one from methamphetamine count?

Mind you, you wrote impact. Impact can be positive as well. Does medicine like SSRIs count?


Yes, any drug that can be considered a coping mechanism against suicide.


This is a good question for several reasons.

We know that alcohol and drug misuse is a risk factor for death by suicide, and that providing drug and alcohol services is a useful suicide prevention measure. See page 17 of this UK document: https://documents.manchester.ac.uk/display.aspx?DocID=40697 (which also links to their evidence)

We know restricting access to means and methods is an important suicide prevention measure. We know this from some natural experiments. When the UK moved from coal gas to natural gas in the home one very common method was removed and we saw a reduction in suicide rates. We again saw a reduction when we introduced catalytic convertors in cars.

https://www.youtube.com/watch?v=iWPEVhrWZS0&t=415s

It touches on how we define a death by suicide? What is counted? What is not counted?

In the US a death by suicide should be defined as: (page 21) https://www.cdc.gov/violenceprevention/pdf/self-directed-vio...

> Suicide -- Death caused by self-directed injurious behavior with any intent to die as a result of the behavior.

The US data is complex and confusing because: (page 12) https://www.cdc.gov/violenceprevention/pdf/self-directed-vio...

> Despite the large volume of data on certain types of SDV, the utility and reproducibility of the resulting information is sometimes questionable. Mortality data are problematic for several reasons: geographical differences in the definition of suicide and how equivocal cases are classified; jurisdictional differences in the requirements for the office of coroner or medical examiner affecting the standard of proof required to classify a death as a suicide; and differences in terms of the extent to which potential suicides are investigated to accurately determine cause of death.18 The quality of the data on nonfatal suicidal behavior is even more problematic than that of suicides. The concerns about discrepancies in nomenclature19-23 and accurate reporting11,24 apply here even more than with suicides. Also, except for rare exceptions there is neither systematic nor mandatory reporting of nonfatal suicidal behavior in the United States at the state or local level, nor is there routine systematic collection of non-suicidal intentional self harm data.

So it's really hard to compare one state with another state.


I was thinking more about the fact that in many households, a gun is laying around. You only need to buy it once, then it can stay, even loaded, in a cupboard or something for years and years. It's a normal not very special thing which at any time can be transformed into a suicide tool.


Suicide by car accident seem close in both effort and time, but maybe the reason we don't hear about it is that determining suicide in those cases is quite hard.


There are multiple reasons why that isn't so much a thing. And it really doesn't seem to be very "popular".

For example it's less effective. A lot of things have to go right, and the consequences of failure are severe, on all levels. Also there is a good chance of surviving in a very painful state.

And on top of that it can be extended suicide, meaning you'll harm or kill other people. Some want that. Most absolutely don't.


I saw a fascinating interview with Kevin Hines, a guy who attempted suicide by jumping off the Golden Gate Bridge, and lived. He said he immediately regretted it after he jumped.

It seems like there is something about there being no turning back that totally transforms one's perspective. Why, after weeks, months, or years of planning suicide, are peoples' perspectives able to totally flip in an instant, precisely when it's too late?


In my circle of friends, there was a similar tragic case: Someone suicidal took deadly poison with delayed effect (5-10min), immediately regretted it and called one of my friends for help. (Sadly, the ambulance couldn't save him.)

The very pessimistic philosopher Emil Cioran (author of e.g. De l'inconvénient d'être né, "The Trouble With Being Born") who beside his suicidal thoughts died at age 84 once said in an interview, that suicidal thoughts are paradoxically the reason, why he stayed alive: The knowledge of the choice to end existence if the suffering is too much makes it possible to endure its insufferableness.

Maybe it is this choice, to live or not, that makes a lot things bearable? And it's much harder if this choice is gone for whatever reason, in one direction or another?


(my conjecture) It’s human nature: your animalian instinct to avoid death takes over once you’re actually facing it


yeah curiosity pushes us to do foolish things, here it's just a morbid context


I wouldn't say that curiosity is a common driver for suicide attempts, or did I misread what you're saying?


I was just trying to find a common, non sad, basis for doing things that will backfire.


Here are some more interviews with people who survived suicide.

https://www.kent.gov.uk/social-care-and-health/health/releas...

In England suicide prevention is a Public Health duty, and public health is normally located within local authorities (a form of local government). So there are a variety of suicide prevention approaches across the country, but they should all be informed by the national suicide prevention strategy.

Kent and Medway felt one problem was with "male help seeking behaviour". They did a lot of work to understand what this actually means, then they released material that appealed to men. They avoid use of mental health language (eg, "depressed"), and they use the words that men use themselves "knackered", "stressed", "regret" etc.) https://www.kent.gov.uk/__data/assets/image/0005/95009/relea...


is this a literal example of survivorship bias?


Any traumatic experience will have an effect. Why is that at all strange?

Have you ever wanted to ask a girl out for weeks, months or years, only to realize you are completely incompatible once you get her? Life is like that, especially when you're younger :)


Maybe this is one problem that VR can solve. Virtually simulated suicides? Virtually simulated anything. You don't have to die or hurt yourself, try X in a safe simulation first to see if you really want to go through with it.


The virtual piece of it would ruin the last second regret. The regret comes from the realization that you've crossed through a door with no return.

Can't ever get that in VR unless somehow the subject does not realize it's fake.


Would it be ethical to subject someone to a virtual suicide they thought was real...in order to convince them to not attempt in the future? The technology seems to be getting to a place we could create such an experience, terrifying though it may be.


VR seems unnecessary. Just have a gun around with blank rounds.


At the range of direct contact to the head, the explosive force of a powder load is deadly whether or not there's a bullet along for the ride.


Good point. How about weakened blanks?


You'd think that once VR got to such an advanced state, we'd have already long before synthesized effective medications / electrical-magnetic therapies (e.g. shock therapy or TMS) to effectively treat depression enough that the VR suicide simulation would be pointless.

OTOH, the most effective treatments we have for depression are almost a century old, have tons of awful side effects, and were discovered by accident (i.e. MAOIs and electroconvulsive therapy), so I'm not too optimistic in the pharmaceutical and psychiatric industries.


Suicidality does not imply depression: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5116433/


Total Recall / P.K. Dick "We Can Remember It for You Wholesale".


That's like learning how to trade using paper money. It removes any threat of consequences and is ultimately not a very useful approximation of reality.


I see where you're coming from, and I think there's an interesting question here -- is the immediate regret a conscious, rational determination? Or is it a primal self-preservation instinct?

While video games and paper money can remove threat of consequences, VR is still extremely good at triggering ancient, subconscious brain pathways e.g. fear of heights. If regret from suicide is similar to fearing heights, then perhaps it would actually be useful?


No, this will increase death by suicide. We know that reading about suicide or watching fictional depictions increases risk.


VR marriage apps with faceapp induced aging.


Placebo pills?


I'd rather say that the urge to kill yourself is fundamentally irrational. Yes, there are relatively "rational" suicides, but these are very rare.

But it may take going to the edge to realize that you want to live and want to die at the same time. An irrational suicidal urge does not remove your survival instinct or will to live, it can only hide it, at best.

I believe that this conflict is at the center of many "strange" or counter intuitive behaviors around suicide.


>I'd rather say that the urge to kill yourself is fundamentally irrational.

How so? If there is little to no expected pleasure and considerable expected pain in the foreseeable future, why is it fundamentally more rational to wait it out or "fight" instead of giving up? Both seem rational choices to me even if I'd choose the former.


For one thing the basis of that decision is a warped perception, if not outright psychotic.

For another, a rational death wish can't really be reversed, especially not within minutes or hours, as seems to be the norm rather than the exception.

We tend to rationalize irrational drives or motivations. But that doesn't make them rational. Depressives can and will try to prove to others why they have to die. But the basis seems to be more a neurobiologic function than an objective evaluation of facts.


What percentage of those with chronic suicidal ideation attempt suicide?


Could VR suicide dissuade people from attempting suicide?


As someone who chronically ideates about suicide (but has never attempted), things like VR rock climbing and (real life) bungee jumping have just made me scared of jumping. But it doesn't make me not want to die, it just makes me want to do it a better way that's less scary


I wish you the best. I don't believe there is any psychological condition worse than wanting to die. Even excruciating physical pain at worst can drive you to that point.

I hope you can learn from these experiences, that your will to live or at least your survival instinct has not gone away, even during such episodes, but was merely drowned out by an irrational mechanism.


No. People committing suicide aren't doing it because they're curious about the sensation of it (which VR wouldn't be able to replicate anyway).


I agree, except perhaps for self-harming behavior in borderline personality disorder. Those contain an aspect of seeking self-experience.

But it get's very complicated to distinguish self-harm and suicidal attempts.

I'd also admit that some patients need to come to the edge to see that they also don't want to die, maybe as much as they want to.


Doubtful. If anything I could see it making people more comfortable with it. Could trigger a copy-cat-like effect where people already fantasizing about it could see getting through the VR experience as a "success" they are ready to emulate.


What the hell would you do in VR suicide? Be present during your own wake? Experience being buried alive?


Probably parent means something like creating a much more realistic and believable experience of imminent demise, like jumping off a tall building. The idea being if you can make enough of the brain believe it is about to die it might trigger whatever it is that changes its opinion on whether or not it should commit suicide.


The feeling is a lot more "I'm glad I didn't die." I doubt it could be replicated in VR.


So do I. I was just clarifying what I believed the original comments intention to be.


Maybe a slight chance of cathartic fake realization. By enacting what they want to do in VR they'd be able to slightly live through their own emotions, express and realize some things and change their mind a bit.


This is far more likely to normalise suicide and to increase rates.


This is actually an interesting question, and people are being entirely too dismissive in down-voting you. Everything from "assisted experiences" in VR to Neuralink could offer really interesting options for those going through something so terrible.


Why should it? AIUI, suicidal people actually want their suffering to end. Going through a VR suicide is totally useless to achieve their actual goal. I think you mistake the motivation. Most people dont kill themselves because they are thrill-seekers. The suicide is a means to and end, literally.


I don't believe VR could ever reproduce what you feel during an actual suicide, so no


The other day a lady jumped off the bridge in a suicide attempt. A passing tourist dived in and rescued her from the river below, someone else went out on a paddle-board to rescue the pair of them and the air ambulance arrived shortly thereafter to take her to the hospital.

The river is tidal and not always that deep. Luckily she didn't jump at low tide when she could have broken her legs or ended up crippled for life. As it happened she ended up in the mental health ward. I imagine they will put her on drugs such as lithium and she will lose her mind. Or they might find they have no reason to keep her in and she might discharge herself to try again.

However, if she had crippled herself then she would not be able to attempt the same thing - jumping off the bridge. But her body would be a living reminder constantly with her of a failed suicide attempt. There would be some impostor syndrome going on with that, people going the extra mile for her due to her being disabled, not through birth or accident but through a failed suicide attempt.

Due to the nuances of a suicide attempt I am not sure that the statistics in this article have much real meaning. Also, what comprises an attempt? A walk into the woods where no rope gets hung from any branch is still an aborted attempt if the intention on the first step was hanging. But actually jumping off the bridge is past that point of no return. There is grey area in this, the teenager taking too many pills can be put down as a 'cry for help' even if there is a point of no return being crossed.

Survival is also a grey area, not just in terms of physical quality of life but mental. The mental health wards of a hospital will put people on pills that take out the high and low notes of someone's mind, turning them into a functional zombie. Survival needs to be qualified as not needing the harsh medication that goes with being processed by the authorities.


I had this weird and strong question the other day: how come evolution didn't manage to wipe out suicidal gestures. Why don't we just fall into a partial coma when our mind is overwhelmed by events. It's a bit odd.. alas evolution is no silver bullet (sic):


The susceptibility for depressive episodes (and suicidal tendencies) is probably the result of other more beneficial "features" rather than evolutional neglect.

For example when you have a serious infection, especially with fever, the immune systems triggers quite a few mental symptoms similar to depression, in an attempt to conserve energy, lessen the impact of the infection and maybe even limit your ability to infect others.


I don't know what partial comma is.

But depression exists for evolutionary reason to conserve energy when we are sick, to limit the risky behaviours like movements (jumping from rock to rock, running after a wild buffalo) etc...

But the problem is that the mechanism which can set us into depression can be tricked by our perception of the reality.

What your eyes see and what you sense does not only depend on your eyes or your senses but also on how your brain interprets those.

If your brain interprets a perfectly sunny day as warning for really long winter, your system can be tricked into sending yourself into depressive state.

Now this can happen for variety of reasons like family problems, where you see your mom and dad hating each other while you were still developing at age 5, your brain development is affected and you sense more danger and pessimism than what a normal person would sense.


It isn't necessarily crazy to want your suffering to end and to believe death is the only solution. This is why we have the right to die movement.


I meant at the biological/neurological level, not social/moral.


The right to die movement is generally about people with terrible medical conditions for which we have no cure.

So I don't see the distinction you are trying to make.


My original question was unrelated to that issue also.


The same reason we have babies born that get cancer. Why do babies get cancer? How come evolution didn't wipe out cancerous gestures in babies?


ask complex as cancer can be, it doesn't cross the whole system's layers


We do have mechanisms that deter us from committing suicide like fear and pain.

The good thing about fear and pain is that they are universally useful, e.g. both when we are on the verge of being reckless and suicidal.


There are other levels of emotional pain where you may harm yourself without any fear at all (no external setup required, road, cliff or else). Your mind will still generate aggressive thoughts aimed at yourself, to the point of suicide. This brain aspect seems very .. hard to understand.


I assume that suicide was a lot harder in the ancestral environment. Also, there was almost no way to get any information about it.


I am 45 and am 99% sure I won't make it to 46. This isn't some unexplained "out of nowhere" ideation. It's a consequence of being beat down and taken from over and over, then having to make due with less and less, rinse, repeat. There is a breaking point. In my experience most suicidal people I come across are so because of the same chronic loss and suffering. Pills and therapy and hotlines don't help. They are plasters ignoring root causes. Root causes take time and money and that's too much to ask.

I posted over a year ago in a desperate attempt to find a job that I could do despite all my issues. I'd been fighting for that for years. Because there is no social system where I am, not one that helps people. Culture here is about bootstraps and anyone who doesn't pull them or have them is a mooch loser who "deserves" what they get. I couldn't get myself anywhere better because of my issues. So I had to try and make due in the same grind but with far less ability and energy. One kind soul, the only one in all this time, offered such a job and I tried to get there, things got worse for me from a few sides and I slid back and couldn't go. I am still TRYING and hoping, but hope isn't enough. You have to be able to act, and the ground has to stay under you and not collapse.

We all know how difficult work and earning can be even when we are young and healthy and love what we do, imagine doing it when in constant pain, with no family who loves you, with no access to high quality medical care. Imagine seeing everyone around you grind and be exhausted and not having the opportunity and endurance they do. Not being able to go home and enjoy something after work because it takes all your mettle just to survive a day.

I have taken to using HN to vent my feelings on this topic when it comes up, and probably sound like a one trick pony. I am not even sure I care anymore. I used to worry what impression I would leave. That I might upset someone or ruin an ally with my depressive state. It all seems like it is irrelevant now as I won't make it anyway. Years ago when I still had some shreds of bootstraps I couldn't get any help from people or systems. I am incredibly resentful because I believe I could have built something then to get through this life and do some good. Now I feel most of the time like I won't make it regardless. I feel only social support/financial security/medical access would even possibly give me a chance..and society and family have decided I am not "worth" that. My value has been recorded and notated. You cannot really beat a system like that. Once you lose you means to grind and become a drain on profits you become a thing to be disposed of rather than a person. Nobody WANTS to be in these shoes. Nobody CHOOSES it.

Until next time...or not...


Same situation here, a bit earlier (36) but same path. You have all my support.

One thing that feels well-spent time for me is, fighting for men’s rights. Can only be done by suicidal people, because people will smash you for opposing feminism. But men need guys who can do it, so I do it, and I lose friend after friend, family, workplaces, NGOs (I used to help refugees) (well, I’ve done the whole charity experience, been everywhere, I’ve always donated a lot) and I’m kicked from social network after social network. Male feminists would dream of seeing me die in a mass grave, anonymously like a USSR political opponent. And that’s exactly how it will end up.

But it is really hard to take myself from the bootstraps and write another blog article, film another video or explain another thing about it. On the positive side, thousands of men have stunning words when they discover my work, like « I was sure, thanks for gathering the statistics » or « I’ve been looking for a channel like yours, who understands men, for 2 years » or « I’ve been watching your videos straight on for the last 72 hours ».

It’s cheerful, but what I wanted was, a (sane) wife, probably a sane world who cares as much for men as for women, a bit of love, and building something. And being millionaire doesn’t change anything to that. Suicide by defending men’s rights against the lies that feminists say.


Do you ever get jealous reading about those medieval monks who would just live in a monastery and read, meditate/pray and copy-down books all day?

I do. When I'm acknowledging my worst depressive tendencies, I feel so much resentment for the way we're told that living revolves around constant productivity and being valuable to others. I think when I want an "out", I really just want to be out of that.

I've had these feelings my whole life though. When I was 14, I was 100% sure I would never make it to 18. I ended up getting hospitalized and changing schools midway through highschool. The therapy and drugs didn't really help the root cause, but the experience made me feel like I had permission to fail in a way. I felt I then knew what it was like to be completely useless and written off by everyone as without value, but it was sort of empowering in a weird way. I felt like I was in the bonus-round of a video game. Not chasing death but not really afraid of it either. Later on, I realized I was less angry with the world when I just accepted myself as a hopeless outlier with no intention of properly assimilating and that people's expectations of me were going to end up aligning accordingly anyhow.

But I think some people need ways to "drop-out", at least for a period. Back in the past, I think monasteries let people with that need escape. I don't know how we're expected to do it today. I wish I did.


Not exactly the same as you, I think the monastery life sounds pretty miserable, but I think the underlying sentiment is for sure there. I never had feelings like this until doctors ruined my health, costing me everything else. I liked my career for the most part and was fortunate in that. I had a decent personal life and enjoyed my time and hobbies and chosen relationships. It was losing my quality of life and being abandoned once that made me non-productive that killed me. Being expected to do more with less when even people in a normal situation have struggles.

I have a clear before/after mindset due to my circumstances. I have great empathy for people who have felt this way their entire life and known nothing else. I don't know if that's easier or harder overall but its equally as miserable in the present moment. As long as our right to live, get healthcare, basic human things, is tied entirely to our ability to earn within a system that is dependent on competing with others and continually "winning", lots of people are going to get left behind. And for many that's fine and those people "deserve" it.


> As long as our right to live is tied entirely to our ability to earn within a system that is dependent on competing with others and continually "winning" lost of people are going to get left behind. And for many that's fine and those people "deserve" it.

People who truly believe that what you describe is "ok" are far more broken than you and I will ever be. They may not know it or see the consequences, but that doesn't change the basic reality of the situation.

When you live within a system that does this to people, what options do we have? We can try to skate by and learn to be thankful for the scraps thrown our way, we can withdraw altogether, or we can try to change things, knowing that change can only be attempted at great personal cost and risk. For me, after I had accepted that I could withdraw at any time, the risks that come from attempting to bring about change are less scary.

I don't know which path you are on in world, but I wish you luck all the same and just wanted to let you know you're not wrong. The world is a messed up place. Selfishly, I'd like to have you around - even if it's only to point out the truth of it on HN as you've been doing. The truth is always valuable and every once in a while, something will resonant with someone in some way, and that means something. Your comment certainly resonated with me.


That's kind of you, and I wish you the same luck and peace.


You can join a church.


I didn't downvote you, but that's not a solution. I am not religious and not interested in that culture. It's a very middle American idea that church replaces family and social support and its some haven to reach out to...it doesn't really work like that except in the brochure.


They realize that everything is futile, including the act of suicide itself


A multiple-suicide-attempt survivor I met once remarked that she felt a mixture of rage and despair at "not even being able to die right". As much as people like to believe that people don't really want to die, sometimes they really do.


It's also an interesting argument for stricter gun control - guns make it incredibly easy for suicidal people to follow through on that impulse. The amount of suicide deaths by gun in America is a testament to this.


Why should those of us who are non-suicidal have to give up our ability to defend ourselves because some suicidal people are gonna shoot themselves?

(I don't own any guns but this screams nanny state to me)


A person and their family are 3x more likely to be shot if they have a gun in their house, so "defence" isn't a great reason to have a gun.


That doesn't follow. I'm probably much more likely to be electrocuted because my house has electricity, but that doesn't mean electricity doesn't serve its purpose.


I'm not sure I'd get electricity installed in my house to help prevent electrocution.


I'm not sure this analogy really works. Electricity kills as a side-effect of its intended use. If gun ownership makes it more like that you will get shot, it has failed at its intended use (self-defence).


There isn't an electrocution epidemic


Nor is there one surrounding gun crime, but news is scary no?


I think "gun deaths at their highest rate in 40 years" qualifies

https://www.weforum.org/agenda/2019/01/chart-of-the-day-us-g...


On the other hand, nobody argues electricity is an essential human right because you need it to fight electrocution.

Guns might serve some purposes in some situations. It's just an incredibly lousy tool for "defending ourselves", with negative utility on average.


“With negative utility on average” - perhaps, but not based on anything stated here.

If you have a source, it would help.


“Living in a house with a gun increases your odds of death“ https://www.vox.com/2015/10/1/18000520/gun-risk-death

Gun ownership has benefits, but safety is not one of them.

Much like how most home robberies take place in the day, the perception of safety from gun ownership is at odds with reality. Hell, you are 25% more likely to be robbed in Alaska than New York State.


I think you're confusing safety with self-defense. The argument isn't that guns make you safer, it's that they give you the ability to defend yourself if you are already in an unsafe situation. On average, most people will never be in a situation where they need to defend themselves, thus getting a gun will increase their risk of a self-inflicted wound. Accidents of all kind (not just guns) are much more frequent than violent altercations. But the crux of the matter is not that, the question that needs answering is "If you are already in a situation where your life is at risk from another human being, does having a gun make it better or worse?" We don't actually know the answer to that question, since statistics on defensive usage of guns are pretty bad.

Another point to make is that there's an undercurrent of personal responsibility. The danger presented by having a gun in your home is something that can be managed if you are a responsible gun owner, but the risk of violence against your self is not something you can easily control. This is the important part, owning a gun for self defense is not about making you safer, it's about transferring the risk from something you have no control over to something you have some measure of control over.

Thus, arguing that owning guns increase your risk of dying from a self-inflicted gunshot wounds holds no weight with people who want to own guns, since it's a fundamental misunderstanding of why one would want to own a gun for self defense.


Looking only at a subset of situations is why people play the lottery and generally make sub optimal choices. It’s easy to ignore the odds and support any argument, but it’s a bad habit to get into.

That said, feeling more secure is by far the most likely situation. While it’s far safer to leave your house in the event of a home invasion than to confront the robbers. Feeling like you can defend yourself is empowering.


Correlation is not causation, that entire article is based on a common fallacy. To name a few counterexamples: 1) Switzerland. Gun ownership is similar to the US but there’s way less crime. 2) Kennesaw, Georgia. Gun ownership is mandatory for every home and crime rates are far lower than in the surrounding counties.


That does not mean it’s safer to have a gun in the home in Switzerland or not. Clearly gun ownership is only one factor at the country level, but we are comparing gun ownership not countries. Gun accidents kill people, where guns extremely rarely save lives.


Even if having a gun in your home in Switzerland raised your chances of gun related death, that still doesn’t mean it’s caused by having a gun. Again, correlation is not causation.

Also, you cannot really measure how often a gun saves a life. On the other hand, you can measure the number of gun accidents and according to Wikipedia they’re less than 1% of gun related deaths which puts them at about 130 per year. IIRC staircases kill about 350 people per year (US numbers).

I would advocate some kind of mandatory safety training for gun owners, but it’s really not the big point here. Measures like banning guns altogehter, I think, miss the point as well. Some places seem to do well with high gun ownership rates, so there must be something else at play that causes the US’s high rates of gun violence. More effort should be put into examining and fixing that in place of steamroller tactics and fearmongering like in that Vox article.


We don’t know how often Guns save lives.

It’s false to say it’s extremely rare.

Partly this is because there is little reporting and data collection that can capture situations where a gun is presented but not fired, but also because of the deterrent effect.


Nobody argues owning a gun is an essential human right. They argue it's a constitutional right.


To the contrary, the constitution doesn't grant rights. It protects essential human rights. There's a reason arms are right up there with free speech and privacy.


> Nobody argues owning a gun is an essential human right.

I do — it's a constitutional right because it is a fundamental ('essential') human right. A free citizen (i.e., not a child or prisoner) has a right to wield violence in defense of himself, others and property; to restrict that right (as opposed to restricting unjust exercises of violence) is IMHO fundamentally unjust.


Yeah but you can’t use a gun to fry an egg


Well Ted Cruz says in Texas it's used for cooking bacon.

https://www.npr.org/sections/itsallpolitics/2015/08/03/42901...

And here you have a more Soviet styled recipe for eggs:

https://www.youtube.com/watch?v=ojg_def2mzM


This doesn’t tell us anything about whether having a gun or not is a good idea for self defense.

Someone with a >3x greater than average likelyhood of getting shot might bring it down to 3x by having a gun themselves.


I think you make a great point, but why stop at guns? Each thing should have a list of pro's and con's made for it, and if the con's outweigh the pro's (on average) then we can just make that thing illegal.

Probably we should start with television. Sure, people get some enjoyment from owning a TV, but think of how much they aren't exercising. Surely owning a TV dramatically increases the probability you are going to be obese and eventually develop heart disease. You are way more likely to watch a TV if you have a TV in your own house.


Very interesting! I get your point, making buying things illegal on the basis of the average of their pros and cons is a slippery slope.

We should probably allow people to buy and sell whatever they want. Who cares if hitmen murder people, the people demand more hitmen!!! Hitmen can kill people that want to kill me, which makes me feel safe!!! Who cares if my judgement is extremely arbitrary and the hitmen are 3x more likely to shoot me than the people I want killed. Awesome. You've really opened my eyes here.

For all the other laws we can evaluate them based uhhhh, not on their pros and cons.


> You've really opened my eyes here.

Once upon a time, there was a wise Zen master. People traveled from far away to seek his help. In return, he would teach them and show them the way to enlightenment. On this particular day, a scholar came to visit the master for advice. “I have come to ask you to teach me about Zen,” the scholar said. Soon, it became obvious that the scholar was full of his own opinions and knowledge. He interrupted the master repeatedly with his own stories and failed to listen to what the master had to say. The master calmly suggested that they should have tea. So the master poured his guest a cup. The cup was filled, yet he kept pouring until the cup overflowed onto the table, onto the floor, and finally onto the scholar’s robes. The scholar cried “Stop! The cup is full already. Can’t you see?” “Exactly,” the Zen master replied with a smile. “You are like this cup — so full of ideas that nothing more will fit in. Come back to me with an empty cup.”

https://medium.com/the-mission/empty-your-cup-a-zen-proverb-...


That's a classic "correlation doesn't imply causation" situation. Those owning guns may have guns exactly because they have a high chance of getting shot, and owning a gun actually lowers the chance. Not saying that this is the case or not, but your statement is misleading.


People who are likely to be shot obtain guns to defend themselves. Who would have thought?


Similarly, why should people who wish to rationally commit suicide have their free will violated because other people are irrational? Shouldn't we respect those who are rational by not infringing on their freedom?


Agreed. Why is it anyone’s business other than the individual if they wish to live or die? My existence is MY existence. If I can’t have that piece of self-determination everything else is hollow.


I agree in principal, but as a society we've probably invested a lot in that individual over the years for healthcare, schooling, etc. Their friends and family have likely made financial and emotional investments in them too. There is a lot of room to at least have some checks on place before you're allowed to exercise that right.


> as a society we've probably invested a lot in that individual over the years for healthcare

In the USA? Good one! Hahahaha!


So the rights of society trumps my own ability to self-determination? If society can dictate that, then there is no basis for any sort of personal freedom.


Yes, absolute personal freedom does not exist in anything we'd call a society. Some just grant more/different freedoms than others.


I think it's a decent argument that gun owners should be allowed to kill themselves. I think it's more difficult to argue that gun owners should be allowed to kill a family member, which is a much increased risk, or that gun owners should be allowed to let their kids kill themselves (the teenage children in a house with guns are far more likely to kill themselves than their friends with no guns in the house).


> Why should those of us who are non-suicidal have to give up our ability to defend ourselves because some suicidal people are gonna shoot themselves?

You can't know if you're not suicidal. That's the whole concept of most suicides being impulsive acts.

E.g. there have been plenty of people who have bought a pack of cigarettes and then killed themselves 5 minutes later without even opening it. Any of us could be five minutes away from killing ourselves and not have even the slightest idea.


There is a scale for depression and suicidal ideation that is highly predictive of future suicide.


We give up a lot for a safer society. Its a trade we make all the time. Should we be allowed to own grenades, machine guns, high explosives and tanks?

You could say that's not necessary for defense but plenty find themselves defended well enough without any arms at all.


> Why should those of us who are non-suicidal have to give up our ability to defend ourselves

That's a rather hyperbolic statement. You are literally saying a gun is the only way you can defend yourself.


Because empathy?


For the same reason that people should be required to get vaccinations. An individual incurs a small risk (complications due to vaccine) to provide the community a larger benefit as a whole (herd immunity).

The presence of a gun in a home make it several times more likely that a resident of that home is killed by gun violence. The presence of a gun in a community at all increases the likelihood of gun violence.


Oh boy! Wait till you read about the statistics on car accidents and injuries being much more likely for those that own a car...


It's about as interesting as reducing the speed limit in regards to cars. Sure, we keep killing innocent people, but we have places to be and stuff.

America was founded on genocide and cultured Europeans thought it was a good idea to kill entire populations who weren't Übermensch less than 100 years ago.

Remember who you're living among :)


Yeah, but that seems like it is one of many, many reasons for more reasonable gun control, yet the US does nothing. If a school full of slaughtered 1st graders or a parking lot full of murdered country music fans hasn't prompted us to do anything, I don't think arguing about people killed by their own hand will change anything, sadly.


I'm not against gun control--I think there are a number of really "low hanging fruit"-type adjustments that could be made in regulation--but I feel that the amount of political energy liberals put toward it is low priority and loses us a lot of other battles.

It's low-priority because guns are much scarier on the news than their actual death counts warrant. More people die in car accidents every year than have died in the entire history of the United States in mass shootings--yet mass shootings are disproportionately used as a talking point. Yearly motor deaths are an order of magnitude more frequent than gun deaths, and that's if you count the more than half of gun deaths which are suicides--if you want to protect yourself from guns, simply not owning a gun is an effective measure. If liberals took proportional action with regard to harm on car safety to how we act on gun safety, we'd be pushing for frequent re-testing for licenses, lower speed limits, easier loss-of-licenses for repeat bad drivers, stricter drunk driving laws, etc. But that's not what's happening.

It loses us a lot of battles, because it alienates a lot of potential allies. True libertarians, for example, tend to be fairly pro-choice, but don't feel strongly about it, but very pro-gun, and feel very strongly about it. We'd have them on our side in votes relevant to abortion a lot more often if we didn't alienate them with regards to gun rights.


Everyone knows someone who was killed in a car accident, and many of us know someone who died of an opioid overdose, but do you know anyone who died of a gunshot? It feels like we do because of the way the news sensationalizes it. Imagine if the news did little vignettes about every person killed in a car accident the same way they do for mass shootings? I think the news "stands up" to the gun lobby not because they are strong but because they are weak. Standing up to the auto industry or big pharma might actually face serious pushback, possibly even from another branch of their own corporate structure.


Or even from their own lifestyle. Standing up against guns is easy because almost nobody needs to own a gun, and none of them work in the media.


People only need to own cars because our development was done carelessly. It could have been and can be done differently.


I think in the US, yes, a similar number of people will know someone who has died of a gunshot, whether from suicide, homicide, or accidental death. When you reflect on it, you probably did know someone who was killed by a spouse or child, or who took their own life with a gun. In fact, it's so commonplace that, like with car deaths, you only hear about it when it is a particularly sensational story. A big difference is people are conditioned to think "gun deaths" means a criminal activity they or their neighbors don't partake in (until a suicide or an intra-family murder occurs).


A quick review of the wikipedia pages puts those two figures in the mid 30,000s per year. Perhaps the methodology is off but it doesn't seem like the gun figure could be off by an order of magnitude or more.

https://en.wikipedia.org/wiki/Gun_violence_in_the_United_Sta... https://en.wikipedia.org/wiki/Motor_vehicle_fatality_rate_in...


> A quick review of the wikipedia pages puts those two figures in the mid 30,000s per year.

Mass shooting != gun violence. Roughly the same order of magnitude of people die from motor vehicles & firearms in the U.S., but very few people die from mass shootings.


I was replying to the part about annual car deaths exceeding cumulative gun deaths. The parent comment has since been edited. It now says (inaccurately) that motor deaths are an order of magnitude more common, which is untrue in the US. Perhaps in the whole world, because gun deaths are relatively infrequent outside the US, Latin America, and war zones.


It's interesting to me that you bring up abortion, since to me, as an outsider (I'm not from the US), the mainstream US debates about abortion and about guns have a lot of parallels. The "against" side tends to paint their proposals as "reasonable, common-sense regulations" but their more extreme arguments tend to be full of misinformation, misunderstandings and emotional pleas to the sanctity of life. On the other hand, the "pro" side either believes that all those "reasonable regulations" are just a transparent attempt by the other side to get their foot in the door, to move the overton window a little bit, so they can enact harsher regulations later, or that those regulations are not reasonable at all and will never be implement correctly.

For example, whenever the pro-choice side hears someone from the other side propose regulations about requiring permits for clinics that perform abortions (something that in principle they might agree to), they fear that the person proposing the regulations isn't really pro-choice but only says that because outright banning abortion would not be politically feasible, thus they fear (rightfully so, since it has happened) those regulations will be so onerous or badly implemented that it will result in a de-facto ban on abortion, maybe those permits will be very hard to get or maybe the organization handing them out will be understaffed and underfunded (or both). Similarly, whenever someone who is pro-guns hears someone talking about mental health checks before owning guns (also something they might agree with in principle), for example, what they fear is that this system will be abused to deprive as many individuals as possible of their rights without due process.

Thus, in this situation, neither debate will move forward because pro side does not believe that the anti side is proposing any legislation in good faith, and the reason they believe so is that in many cases that has blatantly been the case, leading to farther spreading of the divide.

Additionally, as you say, someone might be both pro-choice and pro-guns but the political situation is such that they have to choose one or the other, and thus they choose the one they hold dearer to them, usually one that affects them more personally. Unfortunately for the pro-choice crowd, gun control laws seem to personally affect more people in the US than abortion laws.


> For example, whenever the pro-choice side hears someone from the other side propose regulations about requiring permits for clinics that perform abortions (something that in principle they might agree to), they fear that the person proposing the regulations isn't really pro-choice but only says that because outright banning abortion would not be politically feasible

To be fair, when speaking freely, the pro-life side admits that this is their goal. That is, most pro-life advocates proudly admit that outlawing abortion is their goal. The pro-choice side is so wary of these additional regulations because (as they are currently proposed) (a) their only possible outcome is to close lots of clinics, and (b) the argument that these regulations improve patient care is laughable.

Contrast that with the gun-control debate, where the mainstream gun-control "side" is not advocating for a ban of all guns. Yes, they are in favor of banning some forms of guns (i.e. guns which were banned in the late 90s in the US) and things like mental health and better background checks, but a complete banning of guns is not something that they are arguing for.


A big difference is that there are numerous gun owners who believe in the right of self defense, hunting, and bearing arms generally, who support control in an incremental fashion and do not support confiscation. These people are being honest when they say their ultimate goal is healthy regulation of guns.

In the abortion debate, the "reasonable regulations" are always proposed by abolitionists. The goal is never to make abortion safe and available, it's always to make it burdensome and difficult for both the provider and the patient. Newly empowered by the Trump administration and the sense that they have a new supreme court that will agree with them, they're dropping this tactic and have resumed pushing for abolition.


The United State has average traffic deaths compared to other countries but much higher number of firearm-related deaths than comparable countries. Something is out of wack in the US so it makes sense to put political energy into it.

I think I would agree liberals may overly focus on mass shootings because handguns are killing most of the people but gun violence is a real problem.


Compared to other countries in the region US gun violence doesn't seem much higher. Gun violence is high in Mexico, Honduras, El Salvador, Jamaica, etc. I'm not sure it's fair to compare the United States to some nordic country on another continent rather than its own neighbors.


Our rate is 10x higher than Canada though.


Only counting the mass shootings does not sound like a good argument to me.


In time, I will be that 1 of 10.


Hello! Do you need someone to talk to? I’m not qualified or anything though, just your average software engineer. Ping me.


Nice gesture but you don’t have contact details to ping in your profile


Oops. Updated. Thanks!


In darker moments I always think that eventually, this is an inevitable outcome for someone like me. But as somebody who's also experienced help that worked, even if for only a time, I wish that you (we) can hold on to some hope and trudge on. Maybe life will surprise us and we'll go at it till the end. Good luck.


If you ever need someone to talk to, the national suicide hotline is 800-273-8255. It’s free and open 24x7.

As someone who struggle(s|d) with ideation, I realized that I too was on that path. If I kept idealizing suicide then I’d eventually succumb. Some recommendations:

1. Find a therapist with whom you can build a relationship.

2. Be open to medication. Even if side effects can hurt your quality of life, you’re clearly already suffering from QoL problems.

3. Keep an emotional journal. In it, also track common culprits like sleep, food, alcohol, etc. this can help you identify and avoid triggers.

4. Strongly consider active exercises to change your outlook. Force yourself to have a social life and hobbies. Cognitive behavioral therapy also has a number of (sometimes touchy-feels, yet effective) exercises. You can learn more from the book “Feeling Good”


One can still hope.


This could be an argument against assisted suicide, which probably has a higher completion rate than unassisted suicide. If people want to kill themselves, let them do so themselves. There's a good chance they won't actually follow through.


That's a horrible mentality. Assisted suicide is only for people who are suffering from continuous pain with no chance at recovery.

You would put them through yet more pain just to see if they were really suffering enough?


A big part of assisted suicide is that you have to make it through counseling first and can only do it if you can rationally convince the doctor that you have no better option.

You'll never get it if your reasoning is "my life sucks and nobody likes me".


It's not socially acceptable, perhaps, but most people already have access to plenty of ways to kill themselves if they really wanted to.

Anyone with a car has a number of possibilities, one being carbon monoxide poisoning which we understand to be pretty peaceful.


That's the thing - suicide attempts aren't rational because they grab whatever's at hand and pick a really painful way to do it (paracetamol overdose is one of the worst ways to go - you get to die of liver failure over the next week, when you're probably thinking maybe you don't want to but by then there's literally nothing medicine can do for you).


Some, probably most suicides are quite spontaneous, but many are thought out over a long period. People grab what's at hand because it's the best method they know of. Suicide options are a frustratingly hard topic to google, you get a lot of hotlines but useful information is hard to find.


Generally the issue only comes up for the terminally ill in the first place. They don't exactly have the option of deciding to live.

Quite a few patients refuse to continue treatment at some point, which has effectively the same result. They could back out of that at any time.




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