Anthony Bourdain and the ‘Silent Epidemic of Male Suicide’ | Hacker News Reader

Anthony Bourdain and the ‘Silent Epidemic of Male Suicide’

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59 pointsuberdru76 comments

Suicide is the 10th leading cause of death in the US and causes more deaths than breast cancer (45K vs 40K) and over 6x deaths from HIV (~7K). 90% of suicides are related to mental illness.

It also takes younger lives than other disease. When combined with deaths due to "poisoning" (generally due to heroin / opioid overdose), suicide + poisoning cause more lost years of life before age 75 than any other major disease reported by the CDC [1]

Imagine how many more people have attempted or considered suicide, and how depressed these people are, and how much lost productivity is and unhappiness is involved in this

Really tragic how little attention is paid to this

[1] https://www.cdc.gov/nchs/data/hus/hus16.pdf

If it makes you feel better, it's only the 10th leading cause of death because we've been extraordinarily successful in combating other illnesses like influenza, gastrointestinal disease, pneumonia, and tuberculosis.

Suicide rates have been going in the other direction in many places. Also masked in the stats is the actual rate. Straight road and car off the edge, overdose and various more lingering causes (substance abuse causing liver failure, heart attack etc). Those aren’t necessarily classified as suicide, but they can sure seem like it to those left.

Actually, suicide was the number 10 cause of death as far back as 1980 and deaths from suicide have increased 64% since then compared to 42% increase in US population. Deaths from pneumonia and influenza have been roughly flat on absolute value basis though decreased in death rate given the increase in population

Source is in a chart in this blog post I wrote, source data from CDC: https://newbio.tech/blog/vc_basics_1.html

>Really tragic how little attention is paid to this

Meh. I’d rather have the silence when the alternate is repeating useless memes at eachother and thinking it’s more productive than the silence.

Suicide is like mass shootings in one way... the media and popular conversation are only equipped to make the problem worse.

Do you think more awareness of and empathy for mental health issues and better resources to support depressed people are pointless? That's presumably what GP meant by "attention".

the media and popular conversation are only equipped to make the problem worse.

I posit that it's possible for this to improve. I further posit that said improvement hinges on allowing for such discussions to occur to begin with so we can work out a path forward to better conversations on such topics.

I agree and disagree. We should devote more total resources to the issue, but maybe not through media? I believe the government has 2 primary responsibilities: applying cost to externalities, and keeping it's constituents healthy. Everything else should be second class. If our (the US) nation's priorities were more than a half-baked set of corporate agendas we might actually have such a government.

It's catch 22. We need people to care about this, but shoving it down our throats on primetime tv isn't a productive way to accomplish this.

I think that more attention in terms of funding and research are helpful, but a better conversation at a societal level could be incredibly valuable. There is so much stigma and shame associated with mental illness and suicide. I know this is said so much it sounds cliche, but it is real and important. So many people could feel better but don't because they are ashamed of others reaction, or because our society's (US but probably others) attitude toward mental illness makes people feel they are bad or broken for experiencing mental illness. A more open discussion and acceptance of mental illness could be incredibly powerful

This is a really difficult and emotional subject that will hit a nerve for a lot of people. I'm a woman and I am quite open about having attempted suicide in my teens and about ongoing struggles with being prone to being suicidal, though I don't really suffer depression. I don't think I'm really the right person to try to lead this discussion about male suicide, at least not today, not now.

But I will ask that people try to say something substantive, per HN guidelines. It's a hard subject that can easily go sideways and frequently does. That doesn't mean it has to.

I don't think it is really helpful to implore people to "get help" while making it clear you don't really want to talk about it in earnest here and now. Having spent a lot of time suicidal, my view is that "Well, yeah, sure. Everyone would like me to get better and most people don't want to deal with it. That feels to me like a very dismissive not my problem, go get your broken self fixed, but don't bother me with it kind of position."

I really rather dislike seeing comments of that sort.

I agree with you. Sincere interest in a persons situation can't be replaced by an anonymous phone call. It is hard though, I think the reflex to "implore people to get help" doesn't come from a place of "not my problem" but rather "I'm not a professional I don't know what you should do, but I suspect here's someone who might."

Like you, I was fairly open, well before and after, about thoughts of and attempts at suicide. I was very fortunate. I had a great network of people in my life who were always there for me in every capacity. But even though they were there for me, they simply couldn't really relate. It wasn't until nearly eight or nine years later that they found themselves similarly ensnared. There was an "Aha" moment where they (unfortunately) connected the dots. I was stuck for as long as I could remember (think elementary school) and just three years free from it I have trouble relating to the feeling anymore.

To anyone out there trying to help somebody: don't be afraid of being unable to understand or relate. If you can, just be there. Trying to relate or caring to be present is 80% of the game. A hotline can't replace that.

Fun story:

The one time I called a hotline, I was in a particularly acute spiral. I don't know know if this was on purpose but the sheer awkwardness of that conversation probably saved my life. Hearing myself try to explain my the situation and it just coming out of my mouth like bad, angsty, incoherent teenage poetry. On the other end of the line was a person who genuinely sounded like they wanted to help but couldn't make sense of why I was so worked up but tried so hard to understand. I think I hung up mumbling "You know what, never mind." and hung up cringing.

I'm aware it typically doesn't come from a place of "not my problem." It usually is well meaning. But it tends to be counterproductive.

My two adult sons live with me. When I'm seriously suicidal in a way that could genuinely lead to my death, they don't leave me alone. We arrange things such that one of them stays with me at all times.

Most suicides happen while alone. Just physically being there serves as a deterrent.

My medical condition is a large factor in my suicidal tendencies. So they do two things for me when I'm suicidal:

1. They take physical care of me.

2. They refuse to engage overly much with the crazy stuff because they know that it is essentially a medical side effect and the cure for that part of it is time and physical care.

And I'm trying to make conversation and generally agree with some of your points. I have no idea how well I'm succeeding. I'm just very tired today.

I agree that "get help" alone can be counterproductive. "I'm not trained in dealing with these sorts of issues, you should get professional help." is better. Better yet (IMO) is my standard reply: "I've been there. I hung myself, and barely survived. The recovery was awful. Don't try, even the most certain methods can fail and lead to enormous suffering. You should try to get professional help, because they're trained at it, but if you ever need to talk feel free to [PM/email/text/call] me. [My phone number/email is...]. {for the phone number people (IRL)} I don't care if it's 3 AM or something, I'll wake up and do whatever I can to help."

I don't want anyone to have to go through what I've been through. For anyone reading this, my email is in my profile. Feel free to contact me if you need to talk, I'll do what I can.

It's a difficult subject. I've lost one close friend to suicide, and one acquaintance; I know a huge swathe of people who've suffered from depression and achieved varying levels of help for it.

From the comments in this thread already I don't think HN is really equipped to handle the conversation. I would say not only that if you're struggling, you should reach out, but that people should "reach in" more and check in on their friends, especially those who seem to be suffering in silence.

I agree. It's ultimately a policy question. Why is funding disproportionate?

I think the "reach in" comment is really important. But I feel like its hard to be aware that this is something people should do, or which friends need attention, or how to broach such a sensitive topic.

I know that FB, apple, google can detect suicidal thoughts with some reasonable level of accuracy and that some of the leaders felt obliged to do something, but not sure what came of it? Seemed like it was mostly for acute situations rather than people at risk who could be helped by a periodic check in. Would be cool if these companies could somehow non invasively encourage ppl close to someone at risk to check on them

Also think that primary care is in a decent position to handle monitoring of potential suicidality, although the PCPs ive talked to are incredibly scared of liability concerns related to this...

"At present, men account for 80 percent of all suicides." Yet, "There’s more funding on research into women’s mental health and the suicidality of women and in young people."

Women attempt suicide more often than men, as far as anyone can tell. https://en.wikipedia.org/wiki/Gender_differences_in_suicide#...

Edit: removed "far more"

Attempting suicide is usually a call for help.

https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...

> Of the attempters, 39.3% (3.5) endorsed the statement that they made a serious attempt, and it was only because of luck that they did not die; while 13.3% (2.1) endorsed the statement that they were serious, but knew the method was not foolproof; and the remaining 47.3% (3.9) endorsed the statement that their attempt was a cry for help, and they did not want to die.

Edit: Ok... I'm just adding some numbers to the parent post because there werent any in the wikipedia link. From the downvotes.. apparently data isn't welcome.

Reported being a very important word here.

is there a way to estimate unreported cases from end result, actual deaths?

Does the risk behavior survey measure anything other than lies from people who can keep their lies internally-consistent for an hour?

(And I do include false negatives in addition to false positives in the liar category.)

National Suicide Prevention Lifeline Call 1-800-273-8255

Putting this here in the event anyone needs it.

You're not alone.

If you don't know what to say, don't ask "What happened?" - that focuses on the problem. Say "Are you OK?" If they trust you, they'll open up.

Suicide is shut down.

Moving country is reboot.

There is a reboot option.

If life doesn't work out elsewhere, I might try to become a monk first, before trying to end my own life. Or taking dangerous occupations, such as war zone journalism. There's nothing else to fear when death is no longer a threat. I haven't yet tried all those alternatives, so I'll do that first before making a permanent decision. I'd still rather commit suicide than be forced to murder someone else though (e.g. military service), so I hope that no government forces weapons into my hands.

This is particularly relevant to Anthony Bourdain's case. If you recall from his earliest shows he was always talking about throwing in the towel and becoming an ex-pat in viet nam or wherever he happened to be.

One thing that struck a nerve with me. If you watch Season 11 of Parts Unknown, you can definitely see a man who is at times struggling with himself and who he is, blatantly, openly so at points.

For all the episodes where he is having a ball, it definitely paints a contrast, and a tragic one at that.

His return to Borneo was rather profound, for me. He seemed to be battling demons, be it substance or other.

I've never seen the show, is there a clip you can point me to? I'm curious how apparent it was.

This is a couple of years old, visiting Borneo for the second time, but I think shows it perfectly, particularly his comments on slaughtering a pig with a spear (with accompanying, though censored, visuals):

https://www.youtube.com/watch?v=1Vum1F3BFkk

I picked up on that too.

Lifeline Australia 13 11 14

Stay strong brothers. You are useful and wanted.

In my opinion it is very disingenuous to talk about suicide and ignore the medications these people were taking.

In many cases the medications have been reported to be correlated with a strong increase of suicidal tendencies when interrupted abruptly or without warning.

This is the case for some prescribed anxiolytics, and also for the drug Bourdain was allegedly taking to combat his tobacco addiction.

Why are 80% of suicides men?

Is this a gender issue?

Is this a gender equality issue?

edit: You've all made my point for me. Comment removed, Kommissar.

According to my quick look at wikipedia, consensus seems to be that men choose more lethal means of suicide than women.

Women tend to choose things like drug overdoses or wrist cutting, while men tend to choose things like hanging or firearms.

Women apparently attempt suicide more.

https://en.wikipedia.org/wiki/Gender_differences_in_suicide#...

I wonder what the numbers would look like if they were instead "number of people who have attempted suicide one or more times" which would seem to be a more meaningful measurement.

If you attempt suicide and succeed you're not going to do it again.

Men are more "successful" at suicide, whereas women tend to "fail" more at suicide.

Interestingly, the suicide attempts are often categorized as a call for help, as specifically stated by the attempters themselves.

https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...

It makes you wonder, why the gender discrepancy? Is this cultural? Social? Are women simply better at asking for help than men? Are men simply more stubborn than women?

It wasn't even 100 years ago that women couldn't even vote, and equal rights for various minority groups took even longer to catch up. I would argue that those groups at that time must have justifiably felt significantly more "disposable", and yet I don't believe they had astronomical suicide rates to match. The same could be said for the entirety of the third world. Your argument doesn't really make sense in that context.

There is a men's mental health epidemic, I'm not trying to diminish that. Where things get tricky is when people lament other groups getting equal representation (politically, culturally, or especially economically) as the reason for it. That is an inherently racist or misogynistic political stance, even when coyly presented devoid of context, because it ultimately must advocate for a return to those inequalities.

It wasn’t even 120 years ago that non-wealthy non-landowners could vote either.

Women’s suffrage was a close flow on from universal suffrage.

It’s historically dishonest to imply that all men had the vote prior to women when that’s not even remotely close to the truth.

Likewise, I’m sure Western/European women felt mighty valuable when generations of me, right up until Vietnam in the 70s when men were still addressing involuntary conscription. Nothing says disposable like being shipped off to war by the boatload.

>You've all made my point for me. Comment removed, Kommissar.

I don't see a point having been made, but I do see a coward unable to abide criticism of their opinions. Whatever those were.

Not sure how else you could reasonably frame the question.

Short answer: we don't know. Slightly longer answer: it also varies a lot between races of men, and between countries, so to unravel this completely you'd probably have to figure out how gender, race, and national culture interact, so don't hold your breath for a definitive answer anytime soon. Probably lots of B.S. answers coming your way soon, though.

I agree. Just interesting that the issue is not proportionally funded. That's perhaps a more interesting question.

I suppose it would be good to know if the ways of preventing and treating those at risk are different depending on gender. If not, why have proportional funding?

You never know till studies get funded.

We do know. We just don't care about distressed men, so we dissemble, rationalize and pass around the FUD.

Men have to prove that they are "valuable" more often than women.

It depends on other factors, and is a generalisation, but i would say that a woman who is a "failure" may not have as gloomy prospects as if he were a man.

How? Women are under represented in the board room and there is a pay gap. We can argue about the causes, but I don’t think you could say that they are getting valued higher than men in the section of life that employment represents.

that's not what the commenter is saying.. they're saying that the pressure on men to demonstrate value is higher than it is on women, which when you look at dating habits between men and women becomes obviously clear.

https://en.wikipedia.org/wiki/Hypergamy

There is a category of women whose life-plan is to go to university, meet a smart boy there, marry, and become a stay-at-home mom.

There isn't really a category of men who go to university to find a spouse and then become a stay-at-home dad.

No judgement on either; but a man who is not successful professionally is generally seen as a deadbeat and has few prospects. A woman has additional options aside from professional success.

So, what your parent is suggesting is that men have fewer options, so the pressure is higher.

There's also a whole discussion that argues men are not attributed any intrinsic value; their value is all rooted in their success, in what they have accomplished. Women on the other hand, the argument goes, are always attributed intrinsic value. Even if they are not famous, or wealthy, or educated, they are still valued. I can't really pose that argument well though, just thought I'd mention it.

As a group, women tend to get a high percentage of their support through personal connections -- family, marriage -- based on a value of "caring" for them. If men don't prove themselves, they are much more likely to be kicked to the curb.

A very high percentage of street people are male. Women who are homeless are much more likely to crash with family or couch surf.

There are complex factors involved in both cases. Male homelessness is also, to some extent, an expression of agency that women often lack and the care that helps put limits on the bottom for women is also a contributing factor to the glass ceiling above.

But it is essentially accurate that the world cares less about men and pressures them to prove themselves or GTFO. (So some GTFO permanently by commiting suicide.)

The statistics present an apparent paradox - women are significantly more likely to attempt suicide, but men are significantly more likely to die by suicide.

Much of the disparity appears to explained by the choice of method; men are much more likely to choose more lethal methods, leading to a greater number of deaths from a smaller number of attempts. Men seem to be more impulsive and progress more quickly from suicidal thoughts to suicidal behaviour.

https://www.ncbi.nlm.nih.gov/pubmed/21529962

Look up sexual dimorphism and start from there.

Tangential...

I'm still not ready to accept incels as people essentially needing assistance, but: https://www.vox.com/2018/6/20/17314846/incel-support-group-t...

I mean, if you react to depression with misogyny and by lashing out at women, I find it hard to pull up compassion for you, but at the same time, is this because our society is failing to treat depression or emotional damage properly ("getting sex for incels," via prostitution or whatever, is a complete non-starter -- the very last thing we need in our society is more impetus on women to just close your eyes and "do it")?

It took the death of someone catering to diversity, women and minorities to even bring this subject into any measure of media spotlight.

When you classify issues into "trendy" and "real", the disproportionate focus distribution between the two reveals a key metric of society.

> focused on catering

I don't think I'd describe a popular food writer as "focused on catering"!

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