3/11/2015

Nothing Changes, Nothing to See Here

Forty-three years ago, in 1972, Democratic Presidential nominee George McGovern selected Thomas Francis Eagleton to be his vice-presidential partner. By August, McGovern had abandoned Eagleton because of his history of depression treatment. Supposedly, a poll found that 77% of prospective Democratic voters said "Eagleton's medical record would not affect their vote." I’d find that hard to believe, but Americans wanted to imagine themselves to be more civilized than they do today. Eagleton returned to the Senate, won two more elections, and retired after a weird blackmailing affair with a niece, a local lawyer, and the Scientology organization. Eagleton was a key player in the Senate's foreign relations, intelligence, defense, education, health care, and environmental legislation. He was an important Clean Air Act and Clean Water Act sponsor. He and Frank Church sponsored the amendment that halted the bombing in Cambodia and effectively ended American involvement in the Vietnam War. Still, to most conservative Americans (the majority of Americans), Eagleton was the “crazy McGovern VP.”

The Greek father of medicine, modern or otherwise, Hippocrates described “melancholia” as a disease with both mental and physical aspects. "fears and despondencies, if they last a long time"1 as the earliest and not yet improved upon description of depression. Freud discovered or pronounced nothing new about depression and not much of value has come about since. So, a couple thousand years of avoidance and denial has led us to where we are today with a minimum of 7% of the US population suffering from a well known, totally misunderstood mental disease that offers largely unsuccessful therapies and the joy of social stigma. The modern approach is to bury the patient in side-effect-laden but ineffective and dangerous drugs (“Why Are More than One in Ten Americans at Risk for Suicide?”). While these drugs are barely or rarely as effective as placebos,  they are a big money-maker for the dope peddlers. In 2013, the dope dealers made $11B on antidepressants alone. No wonder these assholes are spending so much money fighting marijuana legalization. They are just fighting off the competition.

Since 1974 a lot of noise has been made about improvements in mental healthcare but there is no reality behind that noise. The stigma that existed 100 years ago remains, largely, unchanged today. In 2013, 41,149 US citizens committed suicide. Suicide is the 10th leading cause of death for Americans.  And that is with the unmentioned understanding that suicides are dramatically underreported due to . . . yep, the stigma of mental illness. Even the survivors are unable to admit their loved one was ill. As an illustration of that national reality-avoidance, no accurate national suicide attempt statistics are kept. However, in 2013 494,169 people were hospitalized for “self-harm behavior.” There is a sexual component to US suicides, too. Men are 4 times more likely to kill themselves, but women try to kill themselves 3 times as often. You could argue that women are more likely to make a “cry for help,” but you could also argue that men are just more mechanically competent in their attempts. Men are a lot more inclined to use guns for this purpose and firearms account for 51.4% suicide deaths.

The first requirement to fixing a problem is to admit you have a problem. The only admission allowed to mental illness is suicide or at least a fairly serious attempt, which in 1-out-of-12 examples doesn’t do much to fix the problem for the person making that admission. The effectiveness of further attempts is depressingly high. The medical profession ridicules poorly executed attempts as “a cry for help.” If that were true, it’s pretty obvious that crying for help in the direction of American medicine is misguided. You might as well ask a tiger to care for a baby lamb. If US doctors don’t see a dollar sign swirling around your head, they’re not interested.

Outside of the drug profits, all of this self-destruction is socially expensive, too. The estimated US suicide death expense was more than $44 billion in 2010. Even the failures are far from cheap, costing about $2 billion for medical care plus $4.3 billion in lost wages and productivity and other costs. In a so-called capitalist society, you’d think the shear expense of suicide—successful and unsuccessful—would make us do something about all of this self-destruction. Don’t get me wrong. We’re not the worst, most suicidal, country in the world. In fact, we’re #30 behind such wonderful places as Greenland (#1), Lithuania, South Korea, Kazakhstan, Croatia, Russia, Poland, and South Africa. Also, we’re slightly less self-destructive than Japan, Belgium, Finland, Austria, and France. The top ten suicidal countries have some pretty amazing rates of self-destruction from 83/100,000 down to 20/100,000. From there on, though, the next 50 slowly decline in self-annihilation from 20/100,000 to 10/100,000. The USofA is pretty much in the same territory as Bulgaria, Germany, Sweden, Czech Republic, Cuba, Romania, and the UK. Apparently, political and economy systems are disconnected from suicide rates. Neither capitalism, monarchies, fascism, communism, socialism, dictatorships, democracies, anarchy, order, rich, poor, middle class, rural, urban, suburban, and every other description I can use with which to describe a society seems to produce relatively the same rate of self-hate.

Greenland, for some reason, is a standout with 1-in-4 Greenlanders attempting to kill themselves every year and with the world’s highest rate of self-destruction. Greenland’s streets are decorate with signs advertising suicide prevention hot lines, “The call is free. No one is alone. Don't be alone with your dark thoughts. Call." So far, that tactic has been ineffective. People, especially teenagers call the hot line and discover that they are, in fact, alone. We are all alone in ourselves. I suspect that, once they hear the usual perfunctory “we are all in this together” drivel they are even more inspired to put an end to their misery.

In the last couple of decades, I’ve lost three friends to suicide. For a while, back in the 80’s, it seemed like everyone I knew was contemplating—out loud—suicide and taking a shot at it. Supposedly, suicide is “catching” and I’ll admit that knowing people who have checked out for a variety of non-medical motivations makes considering the option a little easier. Malcolm Gladwell calls that a “contagious idea.” That’s possible, but I doubt nearby suicides are the cause of following events.

The fact that the sacrifice needed for any hope of a cure for depression is to suffer the slings and arrows of exposure, stigma, ridicule, followed by even more isolation looks more suspiciously causal to me. Asking for help when the brain doing the asking is the source of the disease is not much different than requiring a cancer victim to administer his own radiation therapy. That is, of course, unacceptable. Because if we admit we need help, we’re weak. If we can’t fix ourselves, all by ourselves, we’re just like that “crazy McGovern VP.” Americans can forgive drunks, drug addicts, cowards, liars, criminals, draft evaders, traitors, National Guard A.O.W.L. rich kids on a bender, complete idiots, greedy bastards, adulterers, and every sort of low life. But our society is incapable of forgiving people for mental illness. In fact, we’re going backwards. The general distain for a “mental illness defense” is evidence that our societal tolerance and compassion for the mentally ill is going backward. Texas and Florida appear to revel in executing the mentally ill and a few other states are showing signs of jealousy.

I don’t think any of this bodes well for any honest attempt at attempting to contain our suicide epidemic. And, if we were capable of honesty, it’s pretty obvious that any physical disease, product, or activity that caused this kind of death, destruction, and expense would be front page news and Fox Views and the other panic generators would be freaking out.

1 Hippocrates, Aphorisms, Section 6.23

2 comments:

  1. Anonymous3/13/2015

    This is classic, "My grandfather committed suicide. It was a complete shock. The family knew he was depressed, but just had no idea that had gotten this bad." If you knew, it was bad. It pisses me off that people expect their depressed relatives and friends to fix themselves. If they had fallen and broken their back, would you say, "Why didn't you get some help for yourself?"

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  2. Anonymous3/18/2015

    Suicide is an world epidemic. It's not just the USofA, but almost every nation has suicide rates that are intolerable.

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