We don’t know if suicide rates in the U.S. have gone up since Covid-19 first spread around the country, but it’s not hard to find reports of people whose suicides seem indelibly linked to the pandemic.
There’s Dr. Lorna Breen, the ER physician in New York City who worked 18-hour days in the height of the pandemic’s first wave last spring, and then contracted the virus herself.
There’s Christian Robbins, a 16-year-old who killed himself a month into the pandemic in Washington, D.C. His father agonizes about the what-if’s: What if they hadn’t cancelled their family vacation? What if schools hadn’t closed? What if the pandemic had never happened?
And there’s Spencer Smith, a high school sophomore in Maine who died in early December. He left a note for his parents saying he felt stuck at home and disconnected from his friends.
Suicide doesn’t have a single cause. There’s usually a confluence of reasons, which can include mental illness, substance addiction, stressful life circumstances, biology, exposure to suicide, and numerous others. So, it would be simplistic to blame suicides on the pandemic alone. But the pandemic certainly isn’t helping.
Are Suicide Rates Increasing during the Pandemic?
Official statistics about suicide in the U.S. won’t come out for a while. Right now, on the cusp of 2021, statistics for 2019 were released only a week ago. (There was good news, too: The suicide rate dropped by 2.1%, the first decrease in 15 years. However, good news is relative. More than 47,000 people died by suicide in 2019.)
Early research findings about suicide during the pandemic are mixed. Some areas, such as New Mexico, found no increase in the pandemic’s first 6-7 months. However, a study in Maryland found that the suicide rate almost doubled for Black people in the first few months of the pandemic, relative to the same time period during the prior three years. Paradoxically, the same study found that suicide rates dropped by nearly 50% for white people early in the pandemic.
Whether the pandemic is leading to more suicides or not, it’s creating conditions that increase suicide risk. At least 10 million Americans still have lost their jobs. This has left many millions of people without enough food, resulting in hours-long waits at food banks. Poverty has increased. An “eviction tsunami” is predicted once a national moratorium on evictions ends. It’s worth noting that poverty and unemployment are significant risk factors for suicide, as is homelessness.
The Perils of Social Isolation
Perhaps the most dangerous side effect of the pandemic, besides the virus itself, is social isolation. Humans are social animals. We need conversation, touch, laughter, camaraderie. Zoom and phone calls are better than no connection at all, but they can’t nourish us in the same way as a face to face conversation, a hug, a literal pat on the back, a kiss, sex.
Staying at home and physically isolating from others has meant the obliteration of normal daily life. For many people, the new normal means not working at the office or going to school among their peers. If you’re taking care to protect yourself or others, the new normal has meant not going out to restaurants or the gym, not going home for the holidays, not seeing your friends in person.
To me, a United Nations photo captures, no doubt unintentionally, just how deadening isolation can be. A pill bottle encloses a solitary chair. The pill bottle is shut, devoid of fresh air.
The image reminds me of Sylvia Plath’s infamous bell jar of depression. In her autobiographical novel, she compared her feelings of inner deadness to “sitting under the same glass bell jar, stewing in my own sour air.” (Sylvia Plath killed herself one month after The Bell Jar was published.)
The effects of isolation are so grave that experts worry it’s killing older adults, especially those in nursing homes who can’t receive visitors unless a wall and window separate them. Some nursing homes are taking creative measures to let human contact continue, like the one in Texas using “hugging booths” created by Boy Scouts.
Do You Feel Suicidal During the Pandemic?
Even with the devastating effects of the pandemic, it’s important not to convey that suicide is the solution. It’s not. If you’re feeling despair or thinking of suicide, please call the National Suicide Prevention Lifeline at 988 or 800-273-8255 (TALK) or use other free resources listed here.
And please, remember that things are constantly changing. The new vaccines will, as far as we know, get the pandemic under control.
Remember the UN picture I mentioned of the empty chair inside a pill bottle? There are a couple others, too, and they’re more uplifting. Though they’re not explicitly suicide prevention ads, they certainly could be.
“BETTER DAYS ARE COMING,” one states, again and again.
“This isn’t forever. It’s just right now,” another states.
Often, it can sound like a superficial, trite reassurance to say your situation is temporary, when it might be anything but. But at the moment, as far as we know, the pandemic actually is temporary. The end of the pandemic is beginning, now that effective vaccines against Covid are being distributed.
It’s true: This isn’t forever. It’s just right now.
Who’s to Blame for Isolation in the Pandemic?
As long as I’m bemoaning the toxic effects of isolation, I want to make something clear: This article is a lamentation, not a diatribe.
Many people look to others to blame for the isolation and other hardships wrought by the pandemic. I understand the desire to blame someone, anyone, who can be held accountable more than an invisible pathogen can.
Some people blame policymakers. One mother in Illinois is suing the governor and local school district for this very reason. She states her son Trevor Till killed himself in October because shutting down schools and extracurricular activities deprived him of the connections he needed to stay alive.
“He thrived on being busy… These kids NEED THEIR ACTIVITIES! IT IS WHAT HIGH SCHOOL IS ALL ABOUT….” she wrote in a Facebook post.
Trevor’s death, and others’ like his, are tragedies. At the same time, as harmful as isolation can be, I don’t see a way around it in a deadly pandemic of a novel virus. Even with widespread stay-at-home orders and restrictions on businesses worldwide, 1.8 million people had died of Covid by December 30, 2020. In the U.S., almost 348,000 people died of Covid in 10 months, compared to 328,000 deaths from flu or pneumonia in the previous 6 years.
Imagine how much longer the list of Covid casualties would be if fewer people had stayed home, if schools and businesses had remained open without restrictions, if travel had continued unabated. Millions of people would have died in the early months of the pandemic alone. Such an enormous number of deaths would have created even more grief, isolation, and disruption to the economy than those caused by the preventive shutdowns.
Knowing that it’s necessary to hunker down doesn’t make it any easier. It will still be many months before society fully reopens. This makes it all the more important that you connect with others and manage your stress if you’re waiting until it’s safe to resume your old ways of living.
Surviving Social Isolation
Though targeted toward older adults, the journal article “Loneliness and Social Isolation during the Covid-19 Pandemic” contains a list of useful suggestions for people of all ages on how to cope with isolation during the pandemic.
- Use technology to stay connected. No doubt you’ve been doing this for months already. My mother, sisters, and our families have talked via Zoom every Saturday since March. We come from three different time zones; one sister’s in California, I’m in Colorado, and my mother and another sister are in Texas. Our kids (my mom’s grandkids) often join us. Before the pandemic, the last time we were all together was at my father’s funeral, in 2015.
- Structure every single day. Structure and routine can help fend off chaos, even if your routines all occur at home. It might not lessen your isolation, but it could help you to feel less anxiety.
- Keep up physical and mental activities. Remember, exercise doesn’t just help your body. It also improves mood and cognition.
- Get outdoors. After a few months of staying at home, I discovered my vitamin D levels were precariously low. The doctor prescribed pills with 50,000 units of vitamin D. Now, I take 2,000 units a day and make sure I take regular walks during peak periods of sunlight. (Fortunately, I live in Denver, an exceptionally sunny city.)
- Take care of your emotional health. Get therapy, if needed. (If you can’t afford it, check out this article.) Try out anxiety management tools like meditation and deep breathing. Ask friends and family for help if you need it.
- Reach out to older adults you know, and their caregivers. For that matter, also reach out to people you know who are parents of young children, health care providers, other essential workers, and anyone else who seems especially vulnerable to the stresses of the pandemic.
Questions for You about the Pandemic and Social Isolation
What have you done to cope with isolation and other stresses of the pandemic over the last year or so?
What has helped you to stay connected to others?
Please let us know your thoughts in the comments.
Copyright 2022 by Stacey Freedenthal, PhD, LCSW. Written for SpeakingOfSuicide.. All Rights Reserved.
I don’t know if I’m alone in this but as someone who was depressed going in, the social isolation aspect hasn’t touched me at all. I was a recluse before COVID and never required much if any interaction with other people even when I was doing better earlier in life. Today when I do go out, wearing a mask actually helps my social anxiety a little. I worry about money, but in other respects l feel I am doing better under these circumstances, not worse.
I wonder if the stats would show that people who were already withdrawn had no incident spike at all during this time, and that the people who are having problems are the outgoing, extroverted types who are usually very well adjusted?
Paul,
That’s an intriguing question. It makes sense that the effects of social isolation might be more dramatic for people for whom it represents the greatest contrast. I expect researchers will explore these possibilities in the years to come.
Thanks for sharing here!
That one UN poster says “This is not forever, it’s just right now!” That sounds like complete and utter b.s. considering that we are Day 520 into “15 days to slow the spread” and many, many weeks into “4 to 6 weeks to flatten the curve”! I hate to break it to the UN and the CDC that a year and a half with NO END IN SIGHT is FOREVER!
I just read today that they’re likely going to require 6 month booster shots because the vaccines don’t last as long as expected, which of course means this state of affairs is likely to likely last another 6 months to a year. It’s ridiculous. It’s completely bonkers that medical professionals expect a society to live like this indefinitely, and I can’t imagine all the harm that has been done. Not just to the elderly but to children too.
My son is on the spectrum, and had just spent 3 years in early intervention to get him on the normal development curve and fit in somewhat with normal life. He gets out of that and into school (where he’s just another student) and the first thing they do is shut school down for 18 months. Sure, we try our best but where does that leave him? I am convinced there are a lot of kids who haven’t done any significant work academically since March 2020, and this will leave a permanent mark on the personalities of all the young kids who have lived through it.
I have a really hard time believing that the effects of the disease would have been worse than the effects of the lockdown unless COVID is like the Black Death and I have not seen any evidence that it is.
didnt know where else to put it but dont know if you know NBC news used this iste as a resource https://www.nbcnews.com/news/us-news/if-you-or-someone-you-know-crisis-these-resources-can-n1267774
Lee, that’s very nice of you to let me know. Thank you!
I have just come home from attending an “honor walk” where dozens of us lined the halls from the ICU to the OR as our colleague’s 17-year-old son was rolled past on his way to become an organ donor. His parents found him several days ago, almost-but-not-quite completely dead. His father – our colleague – is an ER physician and worked on him until the ambulance brought him to our emergency department, where the young man’s father has worked since before he was born. Everyone on duty that day either knew the young man or knew of him from his father, who is a warm, thoughtful and caring human being. We are all devastated.
I am also an emergency medicine provider, and a nearly 60-year-old member of the LGBTQ community also bullied and beaten down since earliest childhood for incredibly obvious gender non-conformity then later sexuality – and I am and have been chronically suicidal since age 12 if not earlier. By chronically suicidal I mean that suicide is my constant security blanket, my exit strategy. I am never, ever without a plan and a means (perhaps counter-intuitively, I think that is how I have survived for so long, just knowing that I can check out when I have finally, absolutely had enough). I cannot recall the last time the option hasn’t crossed my mind at least several times a day, although I believe there have probably been weeks or months with only occasional and fleeting thoughts.
And I have been acutely suicidal multiple times; planning, rehearsing and so forth. So I believe I can relate to the sentiments of many of the folks who posted here earlier. I personally *have* been helped by both medication and therapy, but clearly not “cured.” I was lucky enough to have a truly remarkable therapist for something close to 25 years and we had the discussion many times about the futility of reminding me that “this too shall pass.” She meant the acute pain, the almost unbearable exacerbation of the chronic underlying misery that I’d otherwise learned to live with. I am proof that “it” does pass – that most excruciating phase – at least it does for most people. I am also proof that it can return, sometimes again and again, for those of us especially cursed. My argument to her in the last many years of our association was that whether or not “this” particular episode would pass was irrelevant, as I had no reason to believe it would not return again. Why would I want to keep going through that, or why should I not at least have the option to decide whether I wanted to bear it all again? One can recover from all kinds of injury and torture – physically – but if it then happens again, and you heal, and then suffer again, and keep repeating the cycle, is it so wrong to simply not want to or be able to bear the agony yet again?
In my profession, I have to intervene with patients in crisis. While early in my career this was a greater ethical concern for me (I’d gone through more than one suicidal crisis before entering this field) I have come to find that many people are, in fact, glad that they were prevented from killing themselves, that their crisis did pass and they found life worth living again. Even before tonight I have worked with survivors of those who were not “saved” and I can tell you that human wails of grief are like a knife to the souls of all within earshot.
Yet as I watched that boy roll pass me tonight, this child I met only once when he was a toddler but whose growing-up I’ve heard about from Dad all these years, with many of my colleagues crying and my heart breaking for his family – I could not help thinking on a parallel track, if you will, that I am in the midst of possibly the worst crisis of my life and I am by no means committed to living indefinitely. Virtually everything in my life has fallen apart in the last 3-4 years and I am not through the worst of it yet. I have my plan and I check on my means at least weekly. I don’t for a minute believe that I would leave nearly so many broken hearts behind, but there are those few who care, and suicide has ripples that carry a long way. I know this, and I simultaneously know that I am capable of putting all of that aside – selfishly, one might fairly say – if I feel I need to. And no, I am *not* saying people who contemplate or complete suicide are selfish – only talking about myself and my ability to be aware of yet in the end not care if I hurt others to end my own pain.
What is my point? Maybe several: not all therapists are bad, not every suicidal person is chronically depressed (or even depressed at all, believe it or not). Some people *are* helped by hotlines and medications and yes, even affirming posters or slogans (in addition to other modalities). These things have not worked for many of the folks who have posted here and clearly they have not worked for me, but I am still in favor of doing every thing we can because some of it will be helpful to someone.
For those of you who may be interested, there are some interesting medical options coming around for treatment-resistant depression and acute suicidality, such as ketamine therapy. Other than the nasal spray isomer version, I don’t believe there is FDA approval yet and I am not aware of any broad agreement in the psychiatric community on how to use it (form of administration, dosing, frequency, with or without concomitant talk therapy, etc.) and so probably not covered by insurance – even if one happens to have insurance. Lots of clinics ready to take your money though, so if you look into it be sure to do your research first. Personally I don’t have the financial resources at this time, especially as I am not sure which way is the “best,” but if those two factors change, I will look into it – if I’m still around.
As I write on every condolence card, I wish (all of) you peace and healing – whatever form that may take for you.
Shaun,
How sad about your colleague’s son, and about your own recurring pain. Thanks for sharing your own experience. I think it’s extremely valuable for others to read, because you describe very realistically (and painfully) the ongoing, fluid nature of chronic suicidality, with its long cycle of ups and downs. But you also testify to (some) others’ survival and gratitude for it, and you allow for hope, at least for others if not also for yourself. Your message is important for others to see.
One of the things (for there are many) that most resonates with me about your comment is this: “…not all therapists are bad, not every suicidal person is chronically depressed (or even depressed at all, believe it or not). Some people *are* helped by hotlines and medications and yes, even affirming posters or slogans (in addition to other modalities). These things have not worked for many of the folks who have posted here and clearly they have not worked for me, but I am still in favor of doing every thing we can because some of it will be helpful to someone.”
That’s my belief, too. I hear from some people via this website or email who seem to operate under the assumption that if therapy, hotlines, affirmations, etc. don’t help them, then they don’t help anybody. It’s a very dichotomous, all-or-nothing way of thinking. I know that not everybody can be helped, but that doesn’t mean we should give up on everybody.
I’m sorry about all the pain you experience. I’m sorry about all the pain so many, if not all of us, experience. Life is very hard, even cruel, at times, and I wonder if we go about the business of it all wrong. Perhaps the pursuit of happiness sets us up for disappointment, and we need to make a different kind of relationship with the pain and anxiety of living, which afflicts some of us more than others. Of course, finding any semblance of peace of mind amid the internal and external stresses of life is easier said than done, especially when so many bad events and unbearable living situations happen to so many people.
It doesn’t seem counterintuitive at all, at least not to me, that suicide is your “constant security blanket,” and that knowing that you can check out when you’ve had enough has helped you to survive. It reminds me of an article that refers to “suicide fantasy as life-sustaining recourse.” Also it brings to mind Nietzsche’s quote that suicide is a great consolation, for it gets many people through a difficult night. I talk about the comforting aspects of suicidal thoughts in my article When Suicidal Thoughts Do Not Go Away. The article might be of interest to you if you haven’t seen it already.
Anyway, thanks again for sharing your experiences here. As you do for others, I wish for you peace and healing.
Stacey, I’ve read your accounts elsewhere of your own experiences with emotional pain and, like just about everyone else here, I’m sure, I’m very glad you are doing much better today. I’m also happy to know that Shaun and you and others who care are in the … caring professions. So please don’t take my comment as any kind of antagonism.
You wrote to Shaun above, “I hear from so many people via this website or email who aren’t helped. Some seem to operate under the assumption that if therapy, hotlines, affirmations, etc. don’t help them, then they don’t help anybody. It’s a very dichotomous, all-or-nothing way of thinking.” You offered this as justification for “not giving up on everybody.”
Stacey, in my long career working with medical communities and legal communities and publishing about end of life decision-making, I have never heard anyone make a serious argument that others should be given up on. I have never heard any argument to the effect that mental health doesn’t “help anybody.” The arguments I hear–the ones that are winning in more and more legislations around the world (most recently Spain and in the recent expanse of its present end of life decision-making laws, Canada)–virtually ALL have to do with personal choice. And this is prevalent here in this article’s comment section, too.
Most commenters recount their own pain and the failure of various systems to offer what the commenters themselves would find helpful. I’m confident that the great majority of commenters here and elsewhere where such comments aren’t immediately censored would agree that therapy helps some people. The very fact that these individuals come here to share their stories supports this. There’s healing, however temporary, in merely sharing in a supportive environment.
So, with sincere respect, I disagree with your assertion that “It’s a very dichotomous, all-or-nothing way of thinking.” While some people may think that way, I believe empiricism would show this is a great minority representation. And where such a perspective exists, I think it’s largely a reaction to people feeling invalidated and dismissed when they share with the professional community that interventions are not succeeding. While people will obviously disagree with me, I am encouraged that more and more legislations around the world are agreeing that it is the individual living her/his life, not the rest of us living outside that life–regardless of our own experiences with pain and resiliency–who should be the ultimate arbiter of her/his own life’s value.
Most people do not believe therapy helps no one. Most people do not subscribe to “dichotomous, all or nothing” thinking regarding mental health. Rather, most people want the power to decide whether interventions (pharmaceutical, behavioral…) are working, whether they’re working well enough, and when/if the pain is persistent enough and bad enough not to be FORCED to keep enduring it.
Thanks for allowing the comment and peace to everyone.
Tom,
Thank you for sharing your thoughts. It gives me the opportunity to clarify. When I said I hear from “so many people,” I didn’t mean to imply that most people think so dichotomously about suicide prevention. I really ought to change my phrase from “so many” to “some” (and will do so shortly) to avoid any impression that I believe people with these viewpoints represent the majority. With that said, I don’t publish comments here that are factually inaccurate, that actively encourage suicide for others, or that personally attack individuals who try to help suicidal people to recover, so the reader comments that you and I see are different.
I appreciate that you acknowledge dichotomous thinking does occur, though you “believe empiricism would show this is a great minority representation.” It may well be a great minority representation — indeed, it must be, or we wouldn’t have the policies and funding supporting suicide prevention that we do have. I agree with you that a unilateral stance against suicide prevention often reflects exasperation and rage about a system that is failing to help the commenter. I just wish that people wouldn’t portray their own negative experiences as universal inevitabilities, because this can do harm to others. (I often see the same dynamic with psychiatric medications, by the way. Though the minority, some people state things to the effect of “meds hurt me so nobody should take them.” This ignores the complex reality that some people have been helped by meds, some hurt by them, and some helped by some meds and hurt by others.)
Thanks for your kind words about my doing better today than in the past, and peace to you, too.
Thanks for clarifying, Stacey. Please allow me to go on record regarding one critical matter. While I believe that the great majority of people advocate many different kinds of therapy (religious, philosophical, self-help/popular, nutrition, exercise, CBT…) and so do not support the conclusion that therapy-in-general is universally ineffective, a valid and persistent question is what, precisely, does it mean for an intervention to “work”? There’s a body of international publications pointing out problems with the definitions and assumptions inherent in the dominant clinical models of mental health and with diagnostic reliability. These are among the chief reasons others, including other clinicians, researchers, and the lay, question the dominant hypotheses of cause/effect and intervention efficacy (what “works”) in mental health.
I respect the feeling that others’ perception that something doesn’t work (like inoculation against a virus) could negatively skew the public’s decision-making, but I give people far more credit to be able to research the evidence in support of different interventions. Surely if an intervention is successful, the population prevalence of the condition it’s designed to treat should significantly abate. And over time, the evidence of amelioration becomes so overwhelming that those who doubt the intervention’s efficacy find it challenging to substantiate their views. If, on the other hand, the condition it’s assumed an intervention is effective against persists, I think skepticism and challenge are both healthy and critical.
I support people’s freedom to decide for themselves what, if anything, lessens their pain. I also strongly oppose coerced interventions, especially for legal adults who can coherently articulate their own life evaluations. Thanks for the opportunity to exchange comments, Stacey.
(cant tell if this response will go towards the post to which i am responding. )re sucicidal thoughts as a security cushion
Until I read all medical journal and other articles I was not aware of how high the rate of failure is and the high chance of damage. It is a sobering concern.
No, we shouldn’t give up. We should grant the right for sane individuals to end their suffering peacefully.
There should always be a means.