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Suicide is not about Despair Part I: Pandemic Follies

Suicide is not about Despair Part I: Pandemic Follies

I have never had any social media for an appreciable time. I deleted my facebook less than a year after creating it (as an adolescent). I've never had an Instagram, etc. In particular, I haven't found myself interacting with others long-term across a social media platform when I do not interact with them on a more personal level. I've never 'followed' a celebrity or social media personality in any meaningful way—all of my celebrity crushes happened to be on dead people, Carl Jung, Goethe, Vergil, and I felt free to leave the persons whom I followed for YouTube content whenever they got annoying (as they all do eventually). I just assumed, then, that I was missing context when pre-pandemic news articles blamed the surge in poor mental health among Millenials/Gen-Z/whomever on social media use and even more broadly on device usage.

There were companies that tried to capitalize on this. I was advertised gizmos that reduce blue light and was told to spend more time with friends in person. Even texting individuals or groups wasn't good enough and was squints training the dopamine centers of my brain like a lottery machine. The research–and the media–were clear. Go outside, do something else, be more healthy.

1 Tractatus Logico-Philosophicus

Complete this syllogism:

  1. If a population spends a large amount of time on a device, even if they are mimicking in-person interactions as a text conversation mimics an in-person conversation, their mental health suffers.
  2. Post March 2020, huge segments of the American population have been spending more time than ever on their devices, in simulacra of activities deemed unsafe in their original forms.

Apparently, the conclusion of this in the "age of COVID" is to use more mental health apps.

We've stopped talking about social media use (or even device use in general) as the precipitant of "anxiety and depression."1 In fact, when I use devices without ad-block, I am now advertised wellness apps. I can exercise in-home with some sort of HUD-style mirror--\(0\%\) financing!–to provide a trainer for me. (The stationary bicycle or home gym equipment is optional.) I can meditate with apps to stay 'grounded' and 'mindful.' (Isn't the point of mindfulness to be connected with what is going on around you?) Michael Phelps says therapy saved his life! And I, too, can do therapy completely online with Talkspace, which company had a very large IPO in January. In fact, the number of wellness apps has "exploded." No worries, though---The LA Times will help me pick one. A lot of people wanted to downgrade to flip phones or "dumb phones" so that they didn't have to deal with the constant barrage of 'content,' ubiquitous with smartphones. Hold your horses! Discover says, "But smartphones come with useful tools, experts say, and don’t necessarily have to make us miserable."

And it is deathly important that I take care of my mental health. After all, this is the worst mental health the country has seen! The alumni magazine of my esteemed alma mater has a plan for our mental health post-COVID. "Mental health is now more important than ever," we keep hearing. COVID-19 has sent people into a state of depression and panic over the pandemic itself, over loved ones affected by it, over travel restrictions and mask mandates and the decreased connectedness we all feel. We've got to pay attention and recover the right way so that we don't end up even more screwed up than before! Right after the pandemic restrictions began, one study reported a 3-fold increase in depressive symptoms among the populations it surveyed. And every time depression is mentioned, suicide lurks in the background.

Suicide is the point I want to dwell on. Our media consider it to be the ultimate declaration of despair. It is the terminal of untreated and advanced depression. People do not kill themselves because they are anxious or without purpose. They kill themselves because they are sad about those things. Suicide prevention dwells on finding therapy for those at risk–after sociological concerns like poverty are addressed (to the extent they may be). Even in the latter case, one is often referred to (useless, without health insurance) therapy to treat their sadness over having lost family members, a job, a house, a life, etc. All therapy can only ever affect the thought, and modalities like CBT and DBT even only claim to train the thought patterns. Of these risk factors, the only thing they even purport to treat is "suicidal ideation."

More substantial evidence, though, simply does not support the belief that we are in the midst of a national mental health crisis much less one of grave importance. The CDC numbers, though not final, so far show that suicides decreased in 2020–by \(>5.6\%\). Let's do some back-of-the-envelope math here. In 2019, \(4.8\%\) of US Adults seriously thought about suicide at some point in the year and about \(.0139\%\) successfully committed suicide (ref). We'll make a simplifying assumption that everybody who committed suicide had suicidal ideation beforehand (though this is not true) and say that suicidal ideation has about a \(0.2896\%\) risk of suicide. A study the CDC published in June, 2020, said that in the prior 30 days to the collection of data, suicidal ideation had been around \(11\%\) for adults. Since the number for the year must be strictly higher, we will take this as a conservative estimate for the year. Hence, in 2020, the risk of suicide from suicidal ideation decreased to less than \(0.0994\%\). By Number Needed to Treat, for every \(1/(0.002896-0.000994) \approx 1100\) or so people with suicidal ideation, the pandemic and responses thereto saved a life–which becomes more significant when you consider that only one in about \(1/0.002896 \approx 345\) people with suicidal ideation commit suicide in the first place. Thus, if you believe that suicidal ideation and suicide are inexorably linked, as we are taught, the pandemic saved \(47500 * (11/4.8 - 0.944) \approx 64,014\) people from despairing to the point that they took their life, even though it made people despair more, in general.

Obviously, there are hundreds of convoluting factors here, but this all points to the sheer absurdity of identifying suicidal ideation as the primary driver of suicide. And fingering other sociological concerns like homelessness, social isolation, etc., makes even less sense as joblessness plunged millions into poverty and homelessness; the social nets, such as they were, were thrown into turmoil (How to run a homeless shelter with a mask mandate? Hint: The lines got longer, and it was even less possible to both fix your life and have a bed in a shelter at night.); and mask mandates, travel restrictions, crowd control, and visa issues kept family and friends apart from each other for months. The only things worth doing in the greater Boston area–going to the MFA and sailing–were both impossible unless you were wealthy enough to own your own yacht. Children wore masks on playgrounds (or didn't go at all). Despair, yes. But why fewer suicides?

First lesson: This codification of the despair of people into the standard language of mental health was a construction, one intended to serve a purpose. Someone needs the American people to be going through a mental health crisis. Probably, the same people who will sell them 'retail therapy,' new phone apps, and 'lifestyles' focused around the improvement of mental health. Probably, the same people who desperately need the American to commute again, to suffer the tiny despairs of living in big cities and breathing unconscionable amounts of nitric oxide. The same people who will adapt to the suburbanite who will continute to work from home regardless by forcing and Indian or Indonesian to commute into work in an even worse environment for less money so they can sell the suburbanite tech support, 2-day shipping, and 8-12 more hours of news a day, in addition to their 24-hour program.

Before the industrial revolution, "work from home," was simply known as labor. Few people–and fewer journalists–care to say something simply because it is true. When I hear something, I don't think is this true? I think why are they telling me this? The answers aren't as related as you might think.

But the above lesson, which is completely obvious to anyone who has ever even heard of Slavoj Žižek and completely unbelievable to everyone else, is a distraction from the main point here: Suicide is not about despair. And it is much less about 'suicidal ideation.'

(to be continued)

Footnotes:

1

These are always and inexorably connected in modern parlance. I don't know of anybody who has "depression" simply put.