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How is suicide different in Japan? - nest0r - 2010-03-12

This was originally something I found via some research spurred by posts in the 'Some guy on Kotaku rants about Japan... ' thread, I reposted it in the 'Down and out... ' thread but thought it was interesting enough and contemporary enough that it deserved its own post. I especially found the bits about 'traditional views' on perception of suicide, mental health, and the unemployment rate interesting, and its conclusions about angles to address in reducing the suicide rate:

How is Suicide Different in Japan? [PDF]

Abstract:

In this study, we analyze suicide rates among OECD countries, with particular effort made to gain insight into how suicide in Japan is different from suicides in other OECD countries. Several findings emerged from fixed-effect panel regressions with country-specific time-trends. First, the impacts of socioeconomic variables vary across different gender-age groups. Second, in general, better economic conditions such as high levels of income and higher economic growth were found to reduce the suicide rate, while income inequality increases the suicide rate. Third, the suicide rate is more sensitive to economic factors captured by real GDP per capita, growth rate of real GDP per capita, and the Gini index than to social factors represented by divorce rate, birth rate, female labor participation rate, and alcohol consumption. Fourth, female and elderly suicides are more difficult to be accounted for. Finally, in accordance with general beliefs, Japan's suicide problem is very different from those of other OECD countries. The impact of the socioeconomic variables on suicide is greater in Japan than in other OECD countries; moreover, the empirical result of a significant Gini index in Japan is consistent with individuals' aversion to inequality and relative deprivation, as discussed in the recent literature.

Edit: There are many interesting articles in English and Japanese here: http://www.e.u-tokyo.ac.jp/cirje/research/03research02dp.html - I only found one in both English/Japanese, another paper by the same authors on suicide and family members, in the 2008 section I believe.


How is suicide different in Japan? - gyuujuice - 2010-03-12

I always found suicide to be weak. Just my view of it.


How is suicide different in Japan? - ruiner - 2010-03-12

@IceCream - I don't think it's quite the same as saying there's a prevailing view that being anxious/depressed/etc. is just a superficial weakness that doesn't require pills. But I'm going to try and avoid touching this one, I just wanted to coldly post a link, with the sensitivities and emotions a given that is shoved aside in favour of discussing stereotypes about Japan. ;p

@牛 - It's more complicated than that, but I understand the feeling. Humans are complex, fragile creatures. However, there's tough love, and there's callousness. One is somewhat self-sacrificing, the other self-serving.


How is suicide different in Japan? - TheVinster - 2010-03-12

Just talking or reading about suicide makes me a bit sad. Even though I'm having a tough time now (no job at the moment, can't go to school until mid-May, wasted 2 years after high school) I would never think of suicide as a way out, I guess is how I could put it. Man, just looking at those statistics where a bunch of teenagers have committed suicide is crazy. At the risk of sounding cheesy... so many people who never had a chance to be loved.

Edit: Also, I realize my circumstances of having a "tough time" are not nearly as bad as many other people have it.


How is suicide different in Japan? - ruiner - 2010-03-12

TheVinster Wrote:Just talking or reading about suicide makes me a bit sad. Even though I'm having a tough time now (no job at the moment, can't go to school until mid-May, wasted 2 years after high school) I would never think of suicide as a way out, I guess is how I could put it. Man, just looking at those statistics where a bunch of teenagers have committed suicide is crazy. At the risk of sounding cheesy... so many people who never had a chance to be loved.

Edit: Also, I realize my circumstances of having a "tough time" are not nearly as bad as many other people have it.
Statistically speaking, I do think the majority of those who have killed themselves probably could've ended up leading enjoyable lives, with relatively minor (compared to suicide) changes, or even the simple passage of time. Suicide is kind of final, though--it's total permadeath, dude.

I do like that the article, while somewhat cold in its analyses, is tied into programs like Lifelink (which performs family-level surveys to get a fuller depiction of the realities) and suggests empirically-based comprehensive programs with regards to suicide in Japan.


How is suicide different in Japan? - bodhisamaya - 2010-03-12

It is interesting that there has been a steady decline in female suicides since 1959 according to the graphs.

Suicide is the ultimate expression of selfishness. It almost always leaves the lives of the survivors in shambles. If it were final with consciousness ending at death, as most of those who succeed hope it is (as opposed to those who try to kill themselves with butter knives to draw attention), it might be a plausible way out of suffering. I think that though the body is left behind, the mental state continues.

I had a girlfriend ten years ago who attempted to kill herself. She left a suicide note reassuring everyone that Jesus would be waiting for her after she passed over. She took two bottles of sleeping pills and walked out into the woods. She was discovered though and spent a week in the hospital unconscious. In that time she had a near-death experience of going to Hell. I was there when she woke and she was in a complete state of terror.

A good friend of mine in high school took his hunting rifle and blew his brains all over his bedroom wall. His mother went insane, his sister became a drug addict and his father went into financial ruin. They were a normal middle class family until that event.

Many people have come to me over the years asking for advice while threatening to kill themselves if circumstances didn't change. I always tell them the same thing, "If there is nothing in your own life to live for, devote the rest of it to easing the suffering of others by what ever means you have". It is always useless advise because when a person reaches that extreme of self-absorption, nothing that contradicts their own views of being persecuted will be heard.


How is suicide different in Japan? - ta12121 - 2010-03-12

@bodhisamaya
That's bad news. Scary actually. Unno why, but there always going to be people who consider suicide as a way out.
For me personally I would never consider suicide as a way out. Even if life is hard at times, and I've been through tough times in my life.


How is suicide different in Japan? - bodhisamaya - 2010-03-12

Depression has a cause: Focusing on one's own pain.
It has a cure: Focusing on helping others out of their painful situations.

It really is that cut and dry. Making the transition from the habit of self-concern can be a difficult one though.


How is suicide different in Japan? - ruiner - 2010-03-12

IceCream - Almost apologized, but I'm still not wrong hehe, I think Bodhi's view is fairly rare. I don't agree with it, but it's one of those blandly accurate metaphysical statements that's best left to motivational posters or something.

Also, some of the most depressed people are the least selfish.


How is suicide different in Japan? - kazelee - 2010-03-12

Sick. Just sick.


How is suicide different in Japan? - ruiner - 2010-03-12

IceCream Wrote:sorry... the "very" in "very self absorbed and selfish" was meant to be "very often". and, it is the way a large number of depressed people come across, no matter how unselfish their motives may be overall.

The problem is, Bodhisamaya's view is only one that type... and, at least on the surface appears to be true. But another large problem is the number of people who think "i would never contemplate suicide as a way out" thereby implying that those who do are somehow weaker than they are; instead of that their mental state must be somehow qualitatively significantly different.
Yeah, those forms of callousness/platitudes are often the 'observer' perspective toward others' problems when those problems are coded as affective. Between that and kids popping pills and adults discussing their latest therapy sessions, with pseudo-mystical treatments and cultish anti-psychiatry fighting the psychopriests, megacorporations, and doctors with prescriptive kickbacks and free samples of the latest side-effect laden, fraudulently marketed drugs... Humanity is screwed. ;p

Here's what I wrote to 牛 earlier... I thought it was really obvious, and thus some would find the article I posted a solid addendum to explore, so I deleted, but I suppose it's worth posting again before I quit this thread...

"But there are many times when they don't, or don't feel they have a choice, and don't have the same opportunities to get the space to build their strength and look for other routes. (I don't think simple judgments on 'weak' or 'strong' are interesting or useful at all in life, personally. Too much based on a kind of 'competition' model.) And sometimes they do build their own personal strength, and to them perhaps suicide is more akin to logical next steps (perhaps those other routes aren't worth maintaining) or forms of self-sacrifice. Perhaps in those circumstances, they might even view the living as weak (or cruel for wanting to force them to stick around). ;p"


How is suicide different in Japan? - SimHuman - 2010-03-12

My aunt committed suicide after a decade of struggling with schizophrenia (delusions, hearing voices, loss of reality), periodic institutionalization, and resulting depression, before there were reliable treatments available. Her father also suffered from schizophrenia. Virtually all mental health professionals now believe there is a substantial genetic component to schizophrenia, as is evidenced by twin studies. Schizophrenia is an organic sickness of the brain and no amount of being "strong" or "snapping out of it" could've helped her or my grandfather.

More modern evidence indicates that there are genetic components to major depression as well, much of it also from twin studies. (Twins raised separately are compared as adults. This is one of the most useful ways to study whether a psychological condition has a genetic component.) Not all suicides are by people suffering from an organic brain disorder like a brain-chemistry-induced depression, but many are, and again, trying to "be stronger" can't help such people. Outside intervention is necessary.

If you don't believe that chemical imbalance can be the cause of a mood disorder like depression, I recommend reading about post-partum depression and post-partum psychosis. The radical hormonal changes of pregnancy can cause some women with no history of mental illness to suffer major depression or psychosis.

(Of course, there's also "depression" in the sense of depressed mood and, yes, self-absorption that does go away with behavioral changes and a fresh perspective. The point of my post is that lumping together "woe is me" depression and "my brain can't experience pleasure" depression is wrong.)


How is suicide different in Japan? - ruiner - 2010-03-12

Yes, although I think it's relatively rare that there's a substantial physical basis for depression, vs. something more common and ephemeral. But that's the problem, even though we might have a tendency to assume others are part of the latter, or the depressed/etc. might feel (with the help of someone with a prescription pad) they must be one of the rarer few, we can't really be sure either way--even with twin studies that suggest genetic correlation as a component of depression, it's not so easy to diagnose the problem in individuals as such, or to determine the extent that other factors in their life play a part. Thus it's best to take that more flexible, comprehensive approach. </platitude>


How is suicide different in Japan? - SimHuman - 2010-03-12

Any standard program of treatment for depression that includes medication, whether or not there's a genetic component, will also include behavioral treatment including direct counseling, support groups, recommendations for stress relief classes and dietary modification, etc. I assume that's what you include in a flexible, comprehensive approach. Medication is often part of the first line of therapy because it's easier to get the patient to comply with the large lifestyle modifications needed to alleviate moderate depression if they can, metaphorically, see through the cloud of depression to the possibility of feeling normal again.

Severe depression can also be a result of non-genetic insults to the brain's integrity such as past drug use, legal or not, PTSD, and, as mentioned, pregnancy. The chemical, rather than emotional, nature of the depression is similar and likewise cannot be controlled by psychological therapy alone.

Incidentally, the only serious depression I've suffered was a result of direct tampering with my brain chemistry. I used the standard medication for a rare stomach disorder. As it happens, the drug crosses the blood-brain barrier, causing severe depression in almost half of users, and gives a good 10% hallucinations! I spent the two weeks I used it sleeping 14 hours a day and either crying or numbly wishing myself dead the other 10. Nothing, anywhere, that I tried in that time made me feel an ounce better. I recovered from the depression within a week of discontinuing the medication. It was a fascinating experience in hindsight.


How is suicide different in Japan? - ruiner - 2010-03-12

@Sim: I can't really disagree with any of this, I almost want to check to see if you're one of my aliases! ;p Nonetheless, my constant naggings stem from my impression (and I'm confident it's accurate ;p) that medication as a 'first line' is commonly the default band-aid--with periodic dosage/Brand changes, and that's it, with actual behavioural modifications and the like a kind of 'last one chosen as your teammate'. I think the standard is more to say that it's the standard than to actually practice it, both from a doctor and patient perspective.

@IceCream - My impression is that you need to do some research on the negative side of prescription drugs. I agree with you in general and think that over time it will and should be kept at and improved, but I think you seriously underestimate the deleterious effects.

Edit: Here's a good 'primer' of sorts, an article that enumerates points (places for you to branch off into tangents, should you accept this mission ;p) after extrapolating from a survey: http://www.psychologytoday.com/blog/side-effects/200905/overprescribing-antidepressants (comments are interesting too... and tangents/facts I think are viable but of course take overall point with a grain of salt, as the author also wrote a book on 'shyness'/anxiety that skewers the psychopharmacological industry)

Bonus fun piece about what Mind Hacks labels the 'recent sh*tstorm' about the new DSM: http://www.mindhacks.com/blog/2009/12/publication_of_new_d.html (See links within links for interesting topics such as financial conflicts of interest, not to mention the whole issue of 'scientific perspectivism').


How is suicide different in Japan? - theBryan - 2010-03-13

From my experience and the experiences of people I know I've come to the belief that depression and ultimately suicide are a very personal and subjective disorder and so its very difficult to give adequate advice to someone no matter how well intended. I actually tend to agree with bhodi that focusing on your on problem will generate depressive states and that one treatment certainly is to act more selflessly but this is only true for mild depression.
There are kinds of depression that are seriously like being locked in a box, even though you could be in paradise you wouldn't know it because it is dark all around you and the floor is cold unkind metal. There's probably even a hand to the door to this box but it is so dark you can't see it and all you do is sit in a corner and hope to make it go away one way or the other. You can't see your family and friend and the wonderful world just feet away from you outside and you can't hear their pleading because you're locked in a box of depression. Now whether "the box" is a psychological one or one built by a chemical imbalance depends on the person.

Also a side note, there was an article in Newsweek the other week about how there's mounting evidence that many anti-depressants owe any effectiveness they do have to the placebo effect.

http://www.newsweek.com/id/232781


How is suicide different in Japan? - bodhisamaya - 2010-03-13

ruiner Wrote:Also, some of the most depressed people are the least selfish.
This does often seem to be the case as we all know someone who is always giving and just gets taken advantage of. Motivation must be examined.
I should have gone further into what being selfless means. True selflessness is to give with the expectation and the desire that nothing will ever be given back. No praise, no love, no reward or recognition whatsoever except the motivation to prevent pain in others. I don't know how to explain this further without bringing religion into the discussion so I will leave it at that.
I do not give that advise to the truly mentally ill. I am talking about those with all the reasoning faculties that define us as human. Personal responsibility has to be taken all other cases. There are a million causes for being depressed, including hormonal. They all can be overcome, in my view, with true selfless motivation.


How is suicide different in Japan? - ruiner - 2010-03-13

bodhisamaya Wrote:
ruiner Wrote:Also, some of the most depressed people are the least selfish.
This does often seem to be the case as we all know someone who is always giving and just gets taken advantage of. Motivation must be examined.
I should have gone further into what being selfless means. True selflessness is to give with the expectation and the desire that nothing will ever be given back. No praise, no love, no reward or recognition whatsoever except the motivation to prevent pain in others. I don't know how to explain this further without bringing religion into the discussion so I will leave it at that.
I do not give that advise to the truly mentally ill. I am talking about those with all the reasoning faculties that define us as human. Personal responsibility has to be taken all other cases. There are a million causes for being depressed, including hormonal. They all can be overcome, in my view, with true selfless motivation.
I honestly don't think our views are all that different--with the exception that I take a zero-spirituality approach...

There are many paths to Enlightenment, even if they are actually one path, and some can't be entered in this life without finely attuned guidance to teach one how to fish or blossoming serendipity, with some science mixed in. </zen>

Personally, I was born without serotonin and a pipe through my brain, but I became a breatharian, for going on 500 years now. I will tell you how, after I publish my book on one of those self-publishing sites.

Now for something we can all make fun of:


Here's the real Bodhisamaya:



How is suicide different in Japan? - ruiner - 2010-03-13

I don't know, between blogs like Mind Hacks: http://www.mindhacks.com/blog/2010/01/the_rise_and_fall_of.html (Edit: I'm including Norwegian Shooter's comments as well, keep in mind... for sites like this usually I include the comments as recommended when recommending an entry) and the Controversy section of Wikipedia: http://en.wikipedia.org/wiki/Antidepressant#Controversy - I think they have it covered.

I wrote more but meh, I've lost interest.


How is suicide different in Japan? - ruiner - 2010-03-13

Those sorts of differences are what I wanted to originally branch off into, hehe, re: the OP, but now I'm spent.

By the way, I do think quite a few young people especially have not received potentially very helpful treatments or at least things to give them breathing room, re: depression and drugs, because their parents or whomever were the type to say 'no no you don't need antidepressants, it's just a phase... ' - But my focus was on overall trends, so it perhaps came off that I was dismissing them, which I'm not.

Get folks to the doctor, sure--though not as a knee-jerk response to every case of 'the blues', but make sure the doctor is not financially or even 'memetically' inclined to look first to drugs and free samples like 'Halloween candy', and likewise that the person is encouraged to do something counter to their nature, which is to do the hard work of using these tools as bootstrapping mechanisms with the aim of examining how to wean themselves off, or at least try to...

I'm tempted to repeat our conversation on the nature of consciousness, because I think explaining to people the kinds of 'preconscious' (edit: and 'nonconscious', depending on the [cognitive, not psychological] terms/model) warpings and influences on thoughts in the healthiest, most average of contexts for an individual, and the needs in externally and internally adjusting them, might be helpful in explaining why it's not so easy to present one worldview/altered state of perception as a viable solution to a depressed individual. Although you'll remember I professed a strong belief in all but the most extreme cases, that long-term external reinforcement w/ drugs (or structured religion ;p) is unnecessary, vs. the power of one to shape their own thoughts once they have their foot in the door, so to speak.

Then again, with everything unrelated to Japanese I've ever said on the forum, it's possible I have a completely opposite view! ^_^


How is suicide different in Japan? - Surreal - 2010-03-13

Best I found with a little bit of searching for everyone who come in here and would like some tips on helping a suicidal person:

http://www.ehow.com/how_5835155_suicidal-student-before-it_s-late.html

What is written in that guide can be seen in many highly reliable sources (I chose that article because it's so straight-to-the-point and practical). It's worth a read if you haven't seen it before. It's directed at helping students, but it really is very general. It's to be taken seriously, as I suppose most would know because there's almost always someone in your life who ended up committing suicide.

Suicide, like so many human acts, can't be inherently judged; what's more interesting is the context in which it occurs and the motives the killer/victim has. If I were to recommend a book for understanding suicide, supposing the person I was talking to isn't bored by long books, I would tell them to read Infinite Jest by David Foster Wallace. This is because it's a damn good book and it gives the most 'inside' feel of severe depression and circumstances leading to suicide I've found.

Also, it's been said before but I'll say it again; much as we'd like it to be otherwise, this is reality. If you happen to have a all-the-way messed up childhood, a genetic disease or a brain tumor at the wrong spot, being told you should use your 'willpower' isn't gonna help at all. Brain structures that are wired 'wrong' because they've tried to adapt to an extremely hostile environment won't just miraculously zig-zag around until your whole personality and sense of being has changed because you 'want to'. Keeping a false sense of reality to comfort yourself is fine with me. But you'd better be ready to let it go and get working with what you and whoever you are trying to help actually have, mentally and physically, when you're gonna get out there.

Even in cases of a "normal" person (oh look we can 'relate' to them how nice they're kinda human), turning them into scapegoats isn't very fruitful. It's blatantly obvious that the environment plays an important role, which means that in a general sense it is more useful to be hating on the people responsible for these factors.

On a personal level, you're effectively saying that suicide is a total no-no and not even worth talking about which I, while I have no solid evidence or even correlations here, believe is a big part of why Japan has so many problems to begin with. It seems pretty logical, really; keeping an open dialogue about suicide and other death/life-issues is important for helping suicidal persons, at least in industrialized countries. This has been proven.A country where talking about religion and life/death-issues in general is consided impolite in a time marked by social desolation for many is in the high-risk zone for suicidal rates I'd say.

And if I was about to commit suicide and everyone's talking about how it's bad to die instead of really showing me how it's, for ME, from MY point of view, good to live I'd be like meh.


How is suicide different in Japan? - nest0r - 2010-03-13

死生観, that's a cool term.


How is suicide different in Japan? - Dankoochoo - 2010-03-14

This comes from a country that once had Samurai commit Seppuku because they did not want to be in a dishonurable situation. (In fact, the Seppuku itself was considered a very honourable act!) This ended up following through the modern day.

Even so, I have my reasons why suicide is not the way, yet you might call me culturally intolerant.


How is suicide different in Japan? - ruiner - 2010-03-14

Dankoochoo Wrote:This comes from a country that once had Samurai commit Seppuku because they did not want to be in a dishonurable situation. (In fact, the Seppuku itself was considered a very honourable act!) This ended up following through the modern day.

Even so, I have my reasons why suicide is not the way, yet you might call me culturally intolerant.
It's this type of thinking about Japan + samurai/kamikaze/etc. that inspired me to post the article in question. ;p


How is suicide different in Japan? - bodhisamaya - 2010-03-14

ruiner Wrote:Here's the real Bodhisamaya:
Ah, that was a very profound teaching!
Prisoners put in solitary confinement for years go insane, whereas as a monk achieves enlightenment alone in his mountain cave. Each will hallucinate their internal demons but the monk has been prepared to face them. The young disciple was frightened off by the guru's simple "***** Off!!!" and so spared inevitable insanity.