Tuesday, December 04, 2007

Depression In America

I received many emails of condolence from readers regarding the suicide of my old friend
. I was surprised by the ubiquity of this tragedy; a number of readers reported they knew three or even more people who had taken their own lives. Here is one longtime correspondent's observations:

"Your column today (12/1/07) was especially poignant. I am deeply sorry for your loss. The emotions you expressed have been experienced by those of us who have also lost friends to suicide. Since 1990, six of our friends -- good friends to professional colleagues -- have committed suicide.

In each case, we wondered if there was more that we could have done. Each time, we pored over the individual's history and talked with family and other friends. All of the people we knew had no financial problems -- some were millionaires. While some were single, others had incredible spouses and outstanding children. All had received medical treatment for depression, ranging from medication to electroshock therapy. This did not prevent multiple suicide attempts by each one. The only thing that became apparent was that the mental pain they experienced daily was over whelming. It is difficult, if not impossible, for those of us who do not suffer from such torment to understand what they experience. "

Another longtime contributor made this observation:

"Very sorry to read about your friend, depression is very hard to handle as I know. I think it's the high standards that we place on ourselves only to fall short in our own eyes. "

This set me wondering if the "pressure to succeed" Western nations have higher suicide rate than other countries. I started with the National Institutes of Health report The Numbers Count: Mental Disorders in America:

Mental Disorders in America

Mental disorders are common in the United States and internationally. An estimated 26.2 percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year. When applied to the 2004 U.S. Census residential population estimate for ages 18 and older, this figure translates to 57.7 million people.

Even though mental disorders are widespread in the population, the main burden of illness is concentrated in a much smaller proportion — about 6 percent, or 1 in 17 — who suffer from a serious mental illness.1 In addition, mental disorders are the leading cause of disability in the U.S. and Canada for ages 15-44. Many people suffer from more than one mental disorder at a given time. Nearly half (45 percent) of those with any mental disorder meet criteria for 2 or more disorders, with severity strongly related to comorbidity.

In 2004, 32,439 (approximately 11 per 100,000) people died by suicide in the U.S. More than 90 percent of people who kill themselves have a diagnosable mental disorder, most commonly a depressive disorder or a substance abuse disorder. The highest suicide rates in the U.S. are found in white men over age 85. Four times as many men as women die by suicide; however, women attempt suicide two to three times as often as men."

I was staggered by the loss of young lives, and by the total number of deaths, which is similar to the total number of people killed each year in traffic accidents in the U.S. (43,000).

Troubled by the high suicide rate among teens, I found this report: Global suicide rates among young people aged 15-19 which revealed that the U.S. is in the middle of global suicide rates for teenagers. This is not comforting, but it does make you wonder about conditions in nations such as Sri Lanka with rates that are much higher than others.

To find out more about adult suicide rates around the world, I went to Nationmaster.com, a treasure trove of statistics, and found these reports:

global suicide rate, females

global suicide rate, males

Clearly, culture and civil strife/stress play huge determining roles in suicide. Why Sweden and the U.S. have similar rates while Portugal's is much lower, I do not know; but we can surely speculate that Sri Lanka's terrible, decades-long civil war must be a factor in that nation's sky-high suicide rate.

By coincidence, frequent contributor azvitt sent in two links on a major report issued by Mental Health America, formerly known as the National Mental Health Association, the country's largest nonprofit mental health advocacy group.

Utah leads the nation in rates of depression
"Utah is the most depressed state in the country, according to a nationwide study released Wednesday. The first-of-its kind examination of the "level" of depression and actual outcomes for those seeking help to treat it, ranks Utah 51st — last in the nation.

Hawaii, Illinois, Maryland and New Jersey are the healthiest states in terms of depression and suicide. Along with Utah, Idaho, Nevada, Wyoming and West Virginia are the least, according to the study.

Other states have a higher suicide rate — Alaska has the highest; Nevada the second — but the four factors combined in the study places Utah last on the list."

Why the sad face, Ohio? Experts detail reasons we're among most depressed

"James Brush, a Monfort Heights psychologist, said Ohio's job losses, coupled with high foreclosure rates, are putting a damper on the state's mood.

"I think it comes down to jobs and financial security for so many people," Brush said.

"In Ohio, if you lose a good-paying job, it's not necessarily true that you're going to find another one. And a lot of people as they get older can't move or don't want to move or won't be considered for jobs that pay as well as the jobs they lost and end up working at much lower pay rates. But their bills don't go down and their mortgages don't go down, and now people that might be in over their heads can't get rid of their houses."

Other studies have shown that people in Ohio and Kentucky don't take very good care of themselves, he pointed out; the states rank high for obesity, as well as heart disease, diabetes and other related diseases.

"When people aren't healthy, they're depressed," Brush said.

The study ranked Utah as the most depressed state, and South Dakota as the least."

Mental health is too complex to be reduced to sound-bites, but access to care was also mentioned as a factor. As our "healthcare"/sick-care system falters/becomes ever less accessible, and as our economy stumbles, I fear for the mental health of our citizenry.

Thank you, readers, for your expressions of sympathy and for sharing your own experiences. They helped me understand how widespread this loss is in our country and indeed, our species.

Thank you, Peter L., ($10), for your kind contribution to this humble site. I am greatly honored by your readership and support. All contributors are listed below in acknowledgement of my gratitude.

To access the archives, please go to www.oftwominds.com/blog.html .

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