Suicide : A Very Human Ending

“Suicide,” goes the popular expression, “is a permanent solution to a temporary problem.” The provenance is murky, but the internet attributes the saying to 1980s media personality Phil Donahue. (I was going to write “of all people” but there’s no particular reason that something so profound cannot find its origins in the mouth of a schleppy-yet-endearing daytime talk show host from Ohio.)

In any event, it’s a clever saying, and also one not altogether wrong. I can see why it’s had such viral appeal. Oftentimes a myopic focus on the present, accompanied by a flash flood of negative emotions, gas-pedals that fleeting impulse. Yet if we can survive that terrible moment, we may feel shockingly more composed just a day later.

This tends to be the prevailing narrative around suicide and suicidality—a message cloaked in a constant admonishment to “just reach out for help” if you are feeling this way, and someone will try to see you through to the other side. The problem with this, though, is the obvious reality that some problems really are permanent, thank you very much. We may, with the right therapy or psychopharmacological help, change our perspective of such problems so that they don’t cause us so much ongoing distress. But not all problems fade with time; some actually do get worse. It should not be irrational to acknowledge this existential fact, and yet it remains stubbornly difficult to talk about.

It’s important not to confuse the point I am trying to make with the fact that suicidal people are especially susceptible to poor decision-making. This is because acute suicidality, which involves feeling like one should die now, is a genuine altered state of consciousness. In fact, researchers have identified distinct cognitive biases that attend this mental state, including a distorted, perceptually elongated sense of the passage of time (the clock “slowly drips out,” as one woman who’d attempted suicide put it) and increased egocentric thought (the suicidal person is not being deliberately “selfish” but has impaired perspective-taking abilities, finding it literally difficult to grasp the catastrophic suffering their death may cause others).

However, this does not mean that all suicides are inherently irrational, nor does it mean they are all symptomatic of mental illness. Although it’s true that many of those who die by suicide have underlying conditions, especially mood disorders such as bipolar disorder, the catchall mental illness explanation only takes us so far. The oft-cited “90%” figure—that 90 percent of suicides are attributable to mental illness—is in fact dubious. It’s derived primarily from postmortem analyses (“psychological autopsies”), which are almost certainly subject to hindsight bias. When experts are given edited case histories of people who died by suicide without knowing they’ve taken their own lives, they are far less likely to see a mental illness.

Yet, in the popular discourse, suicide remains inextricably linked with psychological faults, in part because the concept of suicide feels inherently disturbing to people who haven’t experienced it, and in part because adding the language of diagnosis often helps us feel like we’re solving problems. I think the over-reliance on disease models surrounding this topic is a mistake for several reasons. For one thing, the mental illness lexicon is so loaded that everyday people just don’t consider themselves to be part of that medicalized conversation. Depending on your definitions, it may be technically correct to do so, but how many of us with periodic depression or anxiety see ourselves as “mentally ill”?

As a result, many individuals don’t self-identify as suicidal until it’s too late because killing oneself is something that only psychiatrically exotic, disturbed others would do. Those obligatory support lines that the media so liberally shares in the aftermath of a celebrity suicide? “Those are for people with real mental problems,” says the suicidal rationalist. “Me? I’m too sane.” This is about more than just semantics, because many of those at risk are tuning out of a vitally important conversation.

Over the past year or so, while working on a book about suicidality, I’ve received many harrowing emails from people who’ve meticulously laid out for me the “case” for their own suicides. It’s as if they’re saying, “I’ve crunched the numbers, and correct me if I’m wrong, but how is killing myself not an intelligent decision given these variables?” It’s easy in the abstract to say that all suicides should be prevented, and as someone who prides himself on being a sympathetic human being, this is my first instinct as well (my next instinct is to direct them to an appropriate help line). But as a scientist who trades in logical thinking, what often strikes me about these individuals’ descriptions of their lives and why they’re thinking of ending them is that not all of these people are obviously mentally ill. Rather, in a very real sense, the opposite is true—they’re approaching often impossible situations from entirely rational places; indeed, they’d be more delusional not to at least feel suicidal.

Take the case of “Mike,” for example, who reached out to me after reading one of my Scientific American articles on suicide. An articulate 49-year-old handyman, he’d served prison time for an unnamed sex offense and, for the past 13 years, had been living alone in a barn on a remote New England farm, getting room and board in exchange for labor. This lonely arrangement had given Mike, a sensitive outcast, a sense of contained social purpose and had made his debilitating anxiety about facing others at least tolerable. But now the elderly landowner had died and the family was selling off the farm, and Mike was about to be shoved back out into the harsh glare of an unforgiving society.

“I cannot imagine a way to live without the thought of impending doom,” he wrote.

“Sometimes the world can seem like it is filled with enemies,” I wrote back, “but when you lay yourself out there completely, allowing yourself to be honest and vulnerable, you will find people who will surprise you with their kindness and compassion … you can still come out stronger for this, and maybe help others down the road.”

I meant those words, too. Yet, can any of us say with a straight face that Mike’s mortal fears about being ostracized and pilloried as a convicted sex offender in contemporary America aren’t justified? That still doesn’t make suicide a good option, and there are many ways to look at his specific situation, but I would say that his feeling suicidal is certainly understandable, even rational, given the punishing social conditions that he’s facing.

By conceptualizing suicide as an act that only mentally ill people consider, intelligent people—the ones who’ve crunched the numbers and have come out with unfavorable estimates for tolerable living—are left feeling marginalized. One of the most frustrating findings in the field of suicide prevention is a stubborn positive correlation between suicidality and treatment resistance: The more suicidal a person, the more unlikely they are to seek help. In fact, up to 78 percent of those who die by suicide explicitly deny being suicidal in their last verbal communications. That’s revealing of something very, very wrong in the way we’ve been dealing with this grievous problem.

In the book, I tell the devastating tale of Vic McLeod, a brilliant but troubled 17-year-old who jumped to her death from a 10-story building in 2014. It was only much later that her parents found the diary she’d been keeping in the months leading up to her death. Her parents shared it with me. One line—logical libertarianism laid bare—haunts me still: “We are each given a life. We’re supposed to live it. I don’t. It’s as simple as that.” (In fact, it wasn’t as simple as that, as other passages revealed she was deeply ambivalent about her death wish.) “I will be that girl who was sick. Sick in the head,” wrote Vic shortly before she took her own life. “I don’t think I am. I just want to go.”

So, what am I suggesting as an alternative to the overly medicalized suicide discourse, one that continues to posit suicidal feelings as the litmus test for insanity? Perhaps just a realization from those who would weigh in on the subject, including professionals and the public alike, that suicidal thinking is actually more human, and sometimes even more rational, than is being conveyed. Asking someone if they’re experiencing suicidal thoughts is always better than avoiding the subject. It can and often does work as basic intervention. But if the person—rightfully so—fears being seen as mentally ill or, worse yet, is despondent over the prospect of being forcibly hospitalized for a perceived pathology, we’re deluding ourselves in expecting an honest answer. It may be scary as hell for us to hear, but I think saving lives requires a radical shift in the conversation; desperate people need to be free to talk openly about suicide without feeling that the listener is clinically parsing their every word.

Indeed, for so many of us—especially us rationalists—it is this shared appreciation of the fundamental meaninglessness of life, of the funny tangibles of chaos, of being momentarily alive as the fleeting, flawed creatures we are that, ironically, offers us the greatest hope against suicide. What other choice do we have? Sometimes, we have to embrace the absurdity of living to survive our own sanity. One of the cruelest tricks of the suicidal mind is that during those darkest of hours, other people can seem to us one-dimensional and cartoonish, the almost-limitless depths of another consciousness is blighted out by our own nagging, unbearable self-awareness. The truly suicidal person is embraced by a loved one and still feels oceans away. Yet that bubble of egoism can be ruptured in the most unexpected of ways, too.

In my early 20s, I once found myself in the crowded aisle of a grocery store, oblivious to my surroundings, feeling crestfallen, depressed, and well, imminently suicidal over some drama I’ve long since forgotten. While staring at the shelves in a sort of shell-shocked state, a firm but benevolent hand, seemingly out of nowhere, squeezed my forearm. “Step out of yourself for a minute and let me pass,” said a smiling old man leaning over into his cart. It’s a philosophy unto itself; and I still try, sometimes desperately, to live by those words.

Sometimes, You Won’t Feel Better Tomorrow. By Jesse Bering. Slate magazine, February  15, 2019

For much of his thirties, Jesse Bering thought he was probably going to kill himself. He was a successful psychologist and writer, with books to his name and bylines in major magazines. But none of that mattered. The impulse to take his own life remained. At times it felt all but inescapable.

Bering survived. And in addition to relief, the fading of his suicidal thoughts brought curiosity. Where had they come from? Would they return? Is the suicidal impulse found in other animals? Or is our vulnerability to suicide a uniquely human evolutionary development? In Suicidal, Bering answers all these questions and more, taking us through the science and psychology of suicide, revealing its cognitive secrets and the subtle tricks our minds play on us when we’re easy emotional prey. Scientific studies, personal stories, and remarkable cross-species comparisons come together to help readers critically analyze their own doomsday thoughts while gaining broad insight into a problem that, tragically, will most likely touch all of us at some point in our lives. But while the subject is certainly a heavy one, Bering’s touch is light. Having been through this himself, he knows that sometimes the most effective response to our darkest moments is a gentle humor, one that, while not denying the seriousness of suffering, at the same time acknowledges our complicated, flawed, and yet precious existence.

Jesse Bering website

When it comes to suicide, the questions are never easy. What is a suicidal person thinking and feeling? What could we have done to help? Why, in the end, do we kill ourselves? Tuesday, we’re talking about this most human of problems. The writer Jesse Bering is among our guests. He says that if we can tap into suicide’s psychological secrets we stand a better chance of thwarting a tragic act. We’ll also discuss a local effort to address the troubling link between guns and suicide.

Doug Fabrizio talks with Jesse Bering, Morissa Sobelson Henn, Clark Aposhian

Radio West. February 12, 2019. Podcast.

Chapter one of Jesse Bering’s A Very Human Ending: How Suicide Haunts Our Species finds the author in a very dark and, he argues, very human place. The scene is pleasant enough: the woods behind Bering’s former home in upstate New York. He is walking the dogs and considering an oak tree, “built by a century of sun and dampness and frost”. It seems to beckon. “It was the perfect place, I thought, to hang myself.”

Bering is 43, a research psychologist and director of the centre for science communication at the University of Otago. When he took that troubled walk in the woods in his thirties, he’d had a stellar career as an academic in the US and Ireland. He’s also a writer of some style and wit of popular science pieces and books with arresting titles: Why Is the Penis Shaped Like That? and Perv: The Sexual Deviant in All of Us. He has contributed to Scientific American, Playboy, Slate … Playboy? He had a column – Promiscuous Minds – on the magazine’s website.

“I find myself attracted to taboo topics because I think the human response to them is fascinating. I wouldn’t say I like watching people squirm,” he muses a little unconvincingly on the phone from Dunedin. It’s about control, he decides “in terms of being in the position to guide the conversation rather than subjected to it”.

He grew up gay in Ohio, an experience that might make you wish to take some control of the conversation. “I’d had fleeting suicidal feelings since my late- teen years,” he writes. His experience has helped form a singularly non-moralistic attitude to humanity’s infinite, sometimes problematic, variety. “Not only being gay but also just being a very sensitive child and a solitary figure and very analytical in nature,” he says. “That lent itself to social difficulties growing up. A lot of that emotional residue has stuck with me and has influenced the way I see other people and the problems they’re experiencing.”

He is, reviewers point out, unafraid to grasp the nettle. In Perv, Bering writes about a woman who has a relationship with a flag named Libby. He also writes about paedophiles. He’s for a less demonising, more pragmatic and harm-reducing approach to deviancy.

Now, he’s tackling another fraught topic: suicide. He has written about the subject before, in Scientific American. “A very brief piece on the psychology of suicide was the one that generated the most reader responses, from people who could really empathise with the mental states that accompany suicidal feelings that I articulated in that piece.” This time, it’s personal. He has felt “the call to oblivion”, fleetingly, since he was a teenager. “It’s an incredibly intense experience to be suicidal and I felt like I had enough distance from it at that time to be able to put it in perspective.”

Still, it must have been tough. “Hmm. I don’t like the word cathartic but it did have those qualities to it. It was a very challenging book to write emotionally, as you can probably appreciate. But I gravitate to some pretty heavy topics anyway, so it was in my wheelhouse.” His wheelhouse: “Me delving into a really thorny literature and trying to articulate controversial points without having to devote the rest of my professional life to these issues.” He’s glad he’s finished with it.

Including personal experience in a science-y text, however accessible, is an audacious move. He has form when it comes to sharing. “Once you go public with the story of how you masturbated as a teenager to a wax statue of an anatomically correct Neanderthal … there is no going back,” he writes. That startling anecdote first appeared in Perv. “I didn’t want to write a memoir or autobiography about my own suicidality,” he says. “But to write it without inserting myself somehow, and my own experiences, would have felt too clinical or forensic and cold. I just wanted to let the reader know that I was there with them, sort of holding their hand through a complicated conversation.”

The book can be blackly funny. There’s a controversial “pro-choice” Swedish website that lists methods, including an elaborate, excruciating attempt at dismembered-body-as-art. “Suicide will always flop as performance art,” he writes. “The critics will write you off as a desperate bore with no future … Oh, and also, ouch.”

You have to laugh. “Well, the subject matter itself is inherently grim. I didn’t want to write a dark book. I wanted it to explain why suicide, ironic as it sounds, is something that makes us distinctively human.”

What makes us human: the book is as much about that as it is about suicide. He cites the psychological concept called theory of mind, the ability to get into someone else’s. “We are thinking, almost constantly, about what others think,” he writes. “And what we ourselves think. And about what others think we think.” That ability makes us human. As he writes in Scientific American, “It’s a blessing, because it allows us to experience pride, and a curse, because it also engenders what I consider to be the uniquely human, uniquely painful emotion of shame.”

It makes us, says Bering, the “natural psychologists” of the animal kingdom. Animals don’t kill themselves, despite tales – Bering cites a heart-rending few – of animals apparently ending it all out of grief or despair. But surely dogs feel shame, if those online compilations of remorseful canines who’ve eaten the couch are any evidence. “Yeah, who knows, maybe,” he says, laughing. “We co-evolved with dogs so their mannerisms and behavioural traits are a reflection of how we responded to them ancestrally. I think it’s probably anticipation of punishment. I don’t necessarily think it’s worry about us judging them.” It doesn’t mean animals other than humans don’t feel emotion. “It just makes them lucky not to have to undergo the torment of others’ eyes on them, judging them as tormented individuals.”

So, we are “the ape that jumps”. The why of it is complex. Not all suicide, says Bering, is associated with mental illness. “It’s true that the vast majority of people who kill themselves are at least in a fleeting bout of depression. But whether you view that as a mental illness or a psychologically adaptive response to the environment, these are questions that have not been resolved in the field.”

Neuropsychiatrists and suicidologists have isolated a specific type of neuron that could be responsible for suicidal intent. There’s the possibility of evolutionary adaptation. When individuals have low reproductive potential and pose a burden to kin, suicide may make sense. “I think those arguments are something that we have to take seriously, but it’s a fraught problem in the sense that people misunderstand that term ‘adaptation’ to be something that is good for the individual when, in fact, it’s just a mathematical term.”

The book cites some harrowing case studies. There’s the story of 17-year-old New Zealand schoolgirl Victoria McLeod. Living with her loving parents in Singapore, she kept a secret diary. “I think – and I know it sounds melodramatic – that I might not make it this year,” she writes. She was anxious about grades, her prospects in life. She jumps to her death from an apartment building. “I have so many opportunities,” she writes. “If some people were me, they’d be so happy.” The story is tragic, and frustrating. “I know. That did affect me quite deeply. You just want to reach out and grab her.”

Bering looks at the story through the lens of work by provocative US social psychologist Roy Baumeister, “his incisive analysis of what it feels like to want to kill yourself”. Baumeister’s article, Suicide as an Escape from Self, outlines a series of steps or stages of increasingly dangerous suicidality. They include much of what human flesh is heir to: feelings of falling short of expectations, self-loathing and self-blame, high self-awareness …

Reading about these very human responses that can push people to the edge feels oddly therapeutic. “That was part of my intention. My hope was that by helping people understand, intellectually, the problem of suicide, it will give them some distance to the problem and help them to see things a bit more clearly in terms of what’s happening in their own mind. The emotions that go into suicidal thinking are probably quantitatively rather than qualitatively different from the non-suicidal experience. There should be aspects that should be familiar to you even if you’re not actively suicidal.” Not everyone who is suicidal realises that they are. “Had someone asked me at my lowest if I was suicidal, I’d have said not,” Bering writes. “I’m not one of those people, said the pot to the kettle.”

The book feels timely. Suicide has been in the news: celebrity Anthony Bourdain, broadcaster Greg Boyed … “Yeah, a lot of high-profile cases.” How does he rate how the public discussion has been handled? “I don’t have some sort of moralistic view about how it should or shouldn’t be handled, to be honest. I think media have probably done a fair job at handling Kate Spade, Anthony Bourdain, Greg Boyed and these suicides that have cropped up recently. My only worry is more just a logistical one in the sense of [how] these exuberant dedications to them and praise make it seem to certain people, I think, a desirable outcome.”

With suicide, any public discourse is fraught. Did he worry about the effects of a book that unavoidably discusses ways and means? “Yeah, I did, and I’m still not entirely sure how I feel about it, to be honest. I think it’s critical to understand the copycat effect and social contagion when it comes to exposure to the topic of suicide. But just simply trying to elucidate that is part of the problem itself. My argument is that having this sort of meta-awareness of how we are susceptible to contagion effects is important for stopping the contagion. You’ve got to understand the mechanisms to interfere with the process.”

So, silence isn’t really an option. The book addresses the Netflix series 13 Reasons Why, which includes a graphic depiction of the suicide of a teenage girl and its aftermath. In tapes she leaves and flashbacks, Hannah remains a player in her social world after her death. Isn’t that a dangerous fantasy? “Honestly, I didn’t think about the show in those terms. But yeah, simply the idea that somehow you can wreak vengeance on those who have wronged you through suicide is the problem with the story. That is my concern, that you will somehow appreciate the impact of your death on them.”

For Bering, that moment in the forest came about when, burnt out with academia, he chucked in his job to devote himself to writing. His partner was unimpressed. “Juan, the more practical of us, raised his eyebrows early on over such an impulsive and drastic career move,” he writes. Juan was right. Bering found himself, “having turned my back on the academy, fresh out of book ideas, along with a name pretty much synonymous with penises and pervs …”

That period brought a certain celebrity. He went on American talk show Conan to talk about Perv. Bering is easy and entertaining company on the phone and on the page but he lives with debilitating social anxiety. “Writing allows me that sort of social playfulness that is difficult for me in real life,” he says. “I am probably pathologically introverted by nature, but I find myself attracted to topics as a writer that bring attention to me. There’s probably a sick dynamic there at the heart of it,” he muses. Conan must have been terrifying. “It was an experience.” Popstar Kesha went on before him. “She was walking off stage and her bodyguard was there and they thought that I was just some guy who was about to pounce on her or something. Like, immediately before I went to sit in the chair with Conan O’Brien, I was almost thrown off set because they thought I was a stalker.” He can laugh now. At the time he was at a low ebb. “What does a suicidal person look like?” he writes. “Me, in that Conan interview.”

In a way, he wrote the new book for himself. “I was writing it envisioning myself when I was 18 or 19, going through a lot of these issues, and what I wish I had heard at that time. Also, I was writing it for my future self, because I know I will run into these problems again, inevitably.” Why inevitably? “Just because I have these recurrent bouts of depression and anxiety and find myself in this state every once in a while. The best predictor of the future is the past.” It’s a safeguard.

What saved him when the oak tree beckoned was simple: he got the job at the University of Otago. He could stop trying to live off such articles as The Masturbatory Habits of Priests and pick up a regular pay cheque. He’s not complacent. “I therefore whisper this to you as though the cortical gods might conspire against me still: I’m currently ‘happy’ with life.”

He has no illusions about what his book can achieve. “I’m not a suicide-prevention researcher.” His advice tends to the pragmatic: beware of environmental triggers. That can mean getting rid of weapons, even a closet rail. “I think that’s especially true for younger people, who die by suicide oftentimes driven by a flash flood of emotions; these impulsive acts. Simply having a gun at your fingertips is a recipe for disaster.”

Some educational institutions these days build student accommodation without balconies. “Our university has certainly adopted that practice.” When you’re in loco parentis, cut the risks. “Absolutely.”

There is worry about the effect of social media on young people. “You might find fluctuations, but from all available data, cross-culturally and historically, it [the suicide rate] is fairly consistent and it doesn’t seem like recent technological advances have affected that that much.” We haven’t been much good at lowering the rate. “That’s absolutely true.”

Bering offers a less forensic solution. We have evolved as social animals, he writes, “… sometimes our very existence hangs in the balance of what we think others think of us”. It’s what makes us human. It’s what can drive us to despair. So we need acceptance. We need each other. We very possibly need books like A Very Human Ending. “I do think it will help particular people that the message resonates with,” he says. “This sounds corny, but if it saves one life, it was worth it.”

Jesse Bering on why suicide is a distinctly human behaviour. By Diana Wichtel. Noted ,  November 5, 2018

On April 14th, 2014, around four o’clock in the morning, Victoria McLeod, a seventeen-year-old from New Zealand, stood on the roof of a Singapore condominium building, texted a curt farewell to her friends (“Love you all, sorry guys”), and leaped ten floors to her death. Some weeks later, Victoria’s mother spotted a long scuff mark on the building’s façade, which suggested that her daughter had tweaked the trajectory of her fall, insuring that she landed between parked cars on a narrow parcel of tile. “She was so focussed,” Linda McLeod said, “even when she jumped.”

In the months leading up to her death, Victoria (or Vic, as she was called by friends) kept a journal in which she meticulously recorded the torsions of her darkening headspace. Wry and brilliant, Vic proved an astute observer of her peers, as in one passage in which she briskly dissects a paragon of “Mean Girls” popularity: “Walking down Claymore Avenue with $200 Nikes and a cloned training buddy, no doubt to the gym. . . . It’s kind of beyond me how anyone can have their life so sorted.” As her depression deepens, her prose grows more self-aware and more gravely disconsolate. “Today was bad,” she writes. “Sat in the shower. Did the whole crying bit. Sat in bed. Did the whole sad songs and crying bit . . . PLEASE MAKE THIS SAD STOP. FUCKING MAKE IT STOP. God, something out there, please make it stop.”

According to Jesse Bering, a research psychologist at the University of Otago and the author of the new book “Suicidal: Why We Kill Ourselves,” Vic’s journal is an “extraordinary” portrait of cognitive unravelling. While scrutinizing the diary of an adolescent may seem like a dubious scientific enterprise, Bering shows how the evolution of Vic’s dejected bulletins accords with the social psychologist Roy Baumeister’s “Suicide as Escape from Self,” a six-stage theory demonstrating how a person might descend into the pit of self-extinction. What undergirds Bering’s inquiry is the belief that locating the psychological blunders that lead to suicide can help, in time, to curb their prevalence. For Bering, the subject is personal. He writes, “When I get suicidal again—not if, but when—I want to be armed with an up-to-date scientific understanding that allows me to critically analyze my own doomsday thoughts or, at the very least, to be an informed consumer of my own oblivion.”

The timing of Bering’s book is hardly coincidental. Between 2008 and 2016, suicide rates went up in almost every state, and a spate of recent articles have purported to explain why certain demographics—farmers, veterans—have been killing themselves in unprecedented numbers. Bering’s volume thus joins a niche canon of suicide studies—or suicidologies—which, throughout history, has sought to explore the lure of self-destruction. Such volumes include Émile Durkheim’s “Suicide: A Study in Sociology,” Kay Redfield Jamison’s “Night Falls Fast: Understanding Suicide,” and A. Alvarez’s “The Savage God: A Study in Suicide.” Each of these books is a fossil record of its specific historical context. Durkheim’s tome, which was published in 1897, is a glittering testament to the Progressive Era, with its dogged faith in social engineering and its suggestion that suicides can be thwarted via institutional reform. “The Savage God,” meanwhile, was published in 1971, and is haunted by the spectre of Freud and his theory of psychoanalysis.

Somewhat predictably, then, Bering’s book reflects our own cultural fixations. An early chapter, for instance, wonders if suicide should be viewed as an evolutionary adaptation. He summarizes the neuroscientist Denys deCatanzaro, who pioneered the gene-centric view of suicide in the nineteen-eighties, as having said that suicidal thinking is “most common in people facing poor reproductive prospects” and who consume “resources without contributing to their family.” Picture a thirty-year-old burnout who relies on the munificence of a more successful older brother. By committing suicide, this individual might insure his own genetic survival; from a biological standpoint, the older brother’s offspring will have a better chance of thriving if the sponger no longer exists. (As Bering has noted, these “adaptive” decisions aren’t conscious but result, instead, from latent, primordial triggers.) A similar logic underwrites the altruistic suicides that the explorer Knud Rasmussen observed among the Netsilik Inuit community in Canada, where elderly clan members truncated their lives to reduce the caretaking burdens on the next generation.

Bering also examines the role of von Economo neurons (VENs), spindle-shaped cells that contribute to empathy, self-awareness, and other advanced social functions. One study by the neuropsychiatrist Martin Brüne found “significantly greater densities of VENs in the brains of the suicide victims compared to those in the control group.” Another section explores cyberbullying as a possible culprit, although Bering displays the telltale ambivalence of someone who fears being pegged as a Luddite. “The internet is a manifestation of human nature,” he writes, “and because of its unique capacity to bridge formidable social divides, it’s important to emphasize that it summons not only the worst in us, as we’ve seen, but also an astonishing amount of good.” He goes on to extol the ameliorative efforts of companies like Facebook, which use artificial intelligence to detect posts that mention suicide and other idioms of self-harm. Scanter attention gets paid to the numerous studies that show that young people who use social media experience higher rates of depression.

Some readers will be dismayed that Bering seems insensible to larger sociological concerns. While Bering grants that Vic’s depression was possibly made worse by the yardsticks of affluence and achievement, which aggravated her perfectionist streak as she prepared for college, it seems never to occur to him that these apprehensions are outgrowths of larger social systems. Moreover, during a chapter in which Bering explores the recent phenomenon of live-streaming one’s suicide, he doesn’t pause to wonder why Marcus Jannes, a college student who broadcasted his own hanging on a Swedish Web site called Flashback, chose to do so by lassoing computer-network cables around his neck and rigging them up to a doorframe. The symbolism seems wholly lost on him.

“Suicidal” contains no mention of economic inequality or the 2008 recession. For those interested in the nonbiological motivations for suicide, these are strange omissions. After all, to ignore the extent to which depression and suicide are responses to the larger culture is to assume that the deprivations of our moment cannot be amended. For the psychologist Oliver James, the author of “The Selfish Capitalist,” attributing depression and suicide to genetics reveals an unchecked commitment to neoliberalism. “That genes explain our behavior and well-being distracts attention from society as a cause,” he writes. Bering admits that suicide isn’t “inescapably” determined by genes, but he fixates throughout on the pathology of the individual. The critic Mark Fisher, who himself committed suicide, in 2017, rejected this approach in his book “Capitalist Realism”: “The pandemic of mental anguish that afflicts our time cannot be properly understood, or healed, if viewed as a private problem suffered by damaged individuals.”

Strangely, for all his faith in the curative powers of science, Bering defers to the fantasia of dreams for his final recommendation. In the last chapter, he describes a REM vision from his youth in which he enters a palatial theatre and on stage is a mockup of his childhood bedroom. In the corner, the boy version of himself is fast asleep, and, outside a cardboard window, his ghost hovers, Scrooge-like, in anticipation. For Bering, the perspective of this dream—that of a spectator in the audience—proves a useful vantage, too, for the doldrums of waking life. Sitting apart from reality, a person can rest more easily in the belief that nothing actually matters. Because we lack eternal souls, “there’s no afterlife; without an afterlife, there’s only the theater of the now. Suicide? You’ll be dead soon anyway.” It is this “spiritual power” of nihilism that offers Bering a solution.

In “The Myth of Sisyphus,” Albert Camus’s landmark essay, it is precisely this conception of daily life that foments suicidal thinking. “It happens that the stage sets collapse,” he writes. “Rising, streetcar, four hours in the office or the factory, meal, streetcar, four hours of work, meal, sleep, and Monday Tuesday Wednesday Thursday Friday Saturday according to the same rhythm—this path is easily followed most of the time. But one day the ‘why’ arises and everything begins in that weariness tinged with amazement.” The desiccated procedure of modern life soon reveals itself as a proscenium. But, unlike Bering, who finds this a relief, Camus considers it a viable reason to terminate his existence. The rest of his inquiry wonders how we might persist in a world devoid of consequence.

For Camus, there are three options. One, a person could kill himself, yanking the cord on the light show of reality. Two, a person could—like Kierkegaard or Dostoyevsky—commit “philosophical suicide,” embracing an ideological system (Marxism, Christianity) even though Camus believes all such dogmas to be thoroughgoing nonsense. Finally, we might choose Camus’s third option, which is to live an “absurd” life, recognizing the futility of existence but accepting it and somehow finding happiness in the struggle. Like Sisyphus, who’s consigned by the gods to push a boulder up a hill only for it to roll back to the bottom, we must rise and fall each day, knowing the cycle is nothing but a harsh and tedious regimen. (As some critics have argued, Camus failed to see that his submission to absurdism was itself a philosophical suicide.)

Camus was writing almost a century and a half after the Enlightenment, when, as Nietzsche argued, the architecture of religion had been dismantled and citizens of the Western world were left scrounging around for a system of surrogate beliefs. Without the plotline of the Christian gospel, with its messianic view of history, the purpose of life and our place in the world became woefully uncertain. Given Bering’s dogged fatalism—his personal mantra is “nothing matters”—the question of whether people feel this anxiety now strikes him as retrograde and impertinent. This despite evidence that many do, including a recent Op-Ed in the Times, by the behavioral scientist Clay Routledge, which presented new data showing how the surge in suicides could be attributed to a “crisis of meaninglessness.”

Approaching contemporary life-style trends through the lens of philosophical suicide, it becomes clear that, despite whatever lip service we might pay to the diktats of science, a goodly percentage of us still fall on our knees and perform the calisthenics of faith. Whether we bow before the altar of transhumanism, with its robotic promise of eternal life, or congregate in the house of wellness, with its grunting sect of CrossFitters, we are nevertheless embracing an ideology that supplies a certain framework of meaning. Recognizing the spiritual function of these ideologies might help us understand their role in staving off suicide, but Bering fails even to consider them.

For Bering, parsing the etiology of a person’s mental health leaves little room for the musty errand of ideological contemplation. At one point, Bering notes that churchgoers—who place a high premium on communal fallibility—are four times less likely to commit suicide than their secular counterparts. But Bering cannot extract any comfort from this statistic. He admits that he cannot espouse “religion or any other belief system in which human suffering is conceived as meaningful.” Setting aside the question of what sorts of suffering Bering means by this, the point is not that we should all don vestments and recite the catechism. Instead, it’s that the systems we embrace might not be value-neutral, at least insofar as they buttress us against the despair that Camus so painstakingly explored.

The act of suicide necessarily involves the ravages of biology and personal disposition. But it also intersects with the ability of a society—its structures, mandates, and dominant ideologies—to impart and sustain purpose. In December, GQ published a cluster of testimonies about Anthony Bourdain, collected after his suicide, in 2018, which includes a poignant anecdote about his popular “Parts Unknown” episode with Barack Obama. Apparently, during an idle moment while sipping beers in Hanoi, Bourdain leaned over and asked, “We’re both fathers. Can you tell me, is everything going to be O.K.?” The President replied, “Yes, Tony. Everything is going to be O.K.” Bourdain, who on his shows revelled in cosmopolitan curiosity, was appealing to Obama as a fellow-parent, but his query was also, perhaps, that of a writer, one who had grown doubtful of the plotline’s coherence and who wanted our narrator-in-chief to restore the story’s truth and meaning.

“The whole age can be divided into those who write and those who do not write,” Kierkegaard, who himself wrote at length about the scourge of suicide, argued. “Those who write represent despair, and those who read disapprove of it and believe that they have a superior wisdom.” Victoria McLeod was herself a writer and, even at her young age, displayed a gimlet-eyed approach to the world and a winsome narrative persona. In her diary, Vic was at work on a profoundly important story, one that was asking all the right questions. Her struggles across its pages reveal a consciousness that chafed against expectation and social pressures, and that was in desperate search of a more stable narrative. It’s impossible to know, of course, whether a better story would have saved her. The onus falls upon us to examine the ones we’re still telling.

The Two Faces of Suicide. By Barrett Swanson. The New Yorker , January 16, 2019

"I think – and I know it sounds melodramatic – that I might not make it this year,” 17-year-old New Zealand schoolgirl Victoria McLeod wrote in her journal at the start of 2014. “I know when I see those grades bold and black on a piece of paper, I will either jump for joy or jump off the top floor of this condo.”

Her grades came back first class but, on 14 April that year, she still jumped to her death from the 10-storey apartment block. Her devastated parents, Linda and Malcolm, have shared her diary with developmental psychologist and science writer Jesse Bering, in the hope they might help others make sense of the epidemic of apparently talented, healthy and blessed young people, with fulfilling lives beckoning, killing themselves.

Victoria’s is one of a handful of stories Bering examines in depth in this disturbing but compelling book. His remit is broad, not just teenage suicides but across all ages, and he builds towards his conclusions on a solid basis of academic research (mainly others, not his own) that throws up some arresting statistics.

Globally, nearly a million people kill themselves each year (Bering never uses the expression “commit suicide”, a legacy of “judgment-heavy times”, he says, that still carries a troubling note of “legalistic sinfulness”). Of these, as many as 90% have underlying psychiatric conditions, or so some studies have shown (they are hotly contested), especially mood disorders such as depression and bipolar disorder. Another research project suggests around 5% of depressed people will die by suicide, as against half of 1% of the “non-depressed” population.

This isn’t, though, just a mix of statistics, academic arguments and moving case studies, all analysed to identify the series of steps that they have in common and that mark out the path up to death. Bering also writes from the inside as one who, since his teenage years, has, at times, felt what he refers to as the “call to oblivion”.

And so he labours not just to size up what remains an epidemic shrouded in silence and shame, but also to suggest ways forward. A few of these are practical, if politically fraught. The US Centers for Disease Control and Prevention reported in 2014 that there were 10,945 homicides involving guns, and 21,334 suicides by firearm. The case for gun control is as overwhelming as it seems to be unachievable on the other side of the Atlantic.

Ditto regulation of social media. In 1998, in Hong Kong, Jessica Choi Yuk-chun, a young insurance executive, meticulously sealed herself in her bedroom, lit a charcoal grill and killed herself by carbon dioxide poisoning. At the time, the authorities had never come across such a case before but, within a decade, thanks to it being shared on social media, charcoal is now high on the list of chosen “means” for others in similar circumstances.

Controlling access to the means of suicide is important as a deterrent, Bering insists, especially for “impulsive, unplanned suicides…often found among children and adolescents” who, research he quotes shows, sometimes only spend minutes between the decision and the attempt. But he wants to go further, which is where this otherwise admirable book comes up short. Bering chooses to end with an overly simplified appeal to those thinking about suicide for whatever reason. We are, he writes, essentially social animals and “sometimes our very existence hangs in the balance of what we think others think of us”. So, he urges, go and seek out another human being who can acknowledge your suffering.

He backs up this conclusion with the story of a man who jumped off San Francisco’s Golden Gate Bridge. In his suicide note, he had written: “If one person smiles to me on the way [there], I will not jump.” Apparently no one did but while Bering’s “solution” may have saved him, it has nothing to say in the case of the obviously much-loved and now much-mourned Victoria.

A Very Human Ending by Jesse Bering – review. By Peter Stanford. The Guardian , September 2, 2018.