Suicide is not a popular topic that most people are anxious to read about. However, it is a serious problem, is commonly associated with depression, and often occurs when depression treatments fail. Since the last two columns dealt with depression and its treatment, this column focuses on this most feared consequence of depression (although often not feared by the person overwhelmed with hopelessness). The atheist Nietzsche, known for his famous quote “God is dead,” wrote that “The thought of suicide is a great consolation: by means of it one gets successfully through many a bad night.” The pain of depression and a meaningless life is sometimes so great that the only hope of ever escaping the horrible feelings lies in the possibility of ending life itself, and for those like Nietzsche, the thought of ceasing to exist is more bearable than continuing on in this emotional state. How is religious involvement related to suicide or feelings about suicide?
Before answering that question, however, I’d like to provide the reader with a little background on suicide. Every year in the United States about 35,000 people die from suicide. This is probably an underestimate since people kill themselves in many ways not reported as suicide, such as car accidents or simply failing to take life-saving medication. Even though underreported, suicide is still the 4th leading cause of death for those aged 18 to 65 in the U.S. The yearly suicide rate in this country is 11 per 100,000, which is the same as it was in 1902 despite the emergence of modern treatments. Each day nearly 2,300 persons attempt suicide and 90 of those individuals are successful. The rate of suicide is highest in adults over age 75, probably due to difficulty coping with the loss of loved ones, health, and independence associated with advancing age.
Depression is the most common cause of suicide, but there are other factors that also play a role: anger, need for control, and impulsiveness; social isolation; alcohol and drug abuse; and certain medications, including antidepressants in adolescents or young adults and narcotic pain killers in middle-aged and older adults. Chronic medical illness increases the risk of suicide, especially in diseases associated with moderate or severe pain, urinary incontinence, seizure disorder, or severe physical disability. Genetic factors may also play a role, as the latest research is beginning to discover.
Cultural risk factors for suicide include the stigma associated with seeking help, barriers to getting adequate mental health care, media exposure to suicide, and believing that suicide over personal problems is acceptable. In Asian families and other groups, factors influencing suicide include attitudes towards a woman’s role in marriage, dominance of extended family systems, and family loyalty overriding individual concerns. Although all major religions condemn suicide for emotional or personal reasons, they are not all equal in this regard. Religions with strong prohibitions against suicide are Islam, Judaism, and Christianity (especially Catholics and conservative Protestants). While the Eastern religions Buddhism, Taoism, Confucianism, and Hinduism generally oppose suicide, they are more accepting of it than Western religions. In Buddhism, for example, while suicide is discouraged for those who are unenlightened, once enlightenment has been achieved, it may be permissible under certain circumstances. Likewise, although Hinduism condemns suicide in general as an escape from life and cause for bad karma, self-willed death may be allowed through fasting in terminal disease or severe disability (called “prayopavesa”).
Religious beliefs and practices may influence suicide risk not only because they forbid it, but also because of their relationship to psychological, social, behavioral, and physical factors that lead to suicide. Since religious involvement is associated with better school performance, greater conscientiousness, improved coping with stressful life events, less depression, faster recovery from depression, and is a source of hope and meaning, it could reduce suicide through these pathways. Furthermore, loneliness and lack of support are strong predictors of suicide particularly among women, and involvement in a faith community may help to increase social support and neutralize social isolation. Likewise, since alcohol and drug abuse are frequently involved in suicide attempts and completed suicide and religious involvement is related to less alcohol and drug use, this is another way that suicide may be prevented. Finally, one of the strongest risk factors for suicide is poor health and physical disability. If religious persons drink less alcohol, use fewer drugs, smoke fewer cigarettes, and engage in healthier behaviors, then physical health may also better and diseases that increase suicide risk fewer. (Go to Page 2)