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How Many More Suicides Will It Take?

Research shows suicide isn't predictable. Being "perfect" is no protection.

Key points

  • Seemingly sudden suicides have been in the news for years now, and their dramatic stories get our culture's attention.
  • Research shows that science has not found a way to accurately predict suicide. Mental health professionals need to recognize this fact.
  • People often lie in therapy about their level of happiness, while aspects of perfectionism are correlated with suicidal thinking.
Source: Whoislimos/Unsplash

In November of 2022, the highly successful Stephen "tWitch" Boss was interviewed with his wife on "The Jennifer Hudson Show," where they talked of having more children. He added, "I love the little babies."

One month later, tWitch died by suicide, with an alleged note alluding to past struggles.

In March of 2022, Katie Meyer, a star goalie on Stanford's soccer team, was found unresponsive in her dorm room. Her wrecked parents wanted others to know the complication of her story. Her mother stated in an interview: "But we had no red flags...She was excited. She had a lot on her plate. She had a lot going on. But she was, she was happy. She was in great spirits."

In March of 2021, Cheslie Kryst, wrote about her feelings before she'd been crowned Miss USA in 2019: "Why work so hard to capture the dreams I'd been taught by society to want when I continue to find only emptiness?" Yet, as Miss USA, she'd discovered a renewed sense of purpose: "I wasn't searching to collect more awards or recognition."

The pressure seemed to have turned off.

In January of 2022, Ms. Kryst threw herself off a Manhattan high-rise apartment building to her inevitable death. Later, her mother reported that her daughter had attempted suicide in law school. After that, she kept close tabs on her. “We talked about everything,” Ms. Simpkins said. “We talked about her mental state and mental health,” as well as how Ms. Kryst was sleeping and eating. Ms. Kryst also started seeing a counselor. Ms. Simpkins describes Ms. Kryst’s condition as high-functioning depression.

In 2017, after the tragic loss of her ex-husband Rob to suicide, Dr. Jen Ashton, chief health and medical editor and chief medical correspondent for ABC News and Good Morning America, stated in an interview, “Rob had never been diagnosed with depression, never had any of the classic signs of severe depression that we learn about in medical school,” she said. “I blamed myself for not seeing potential signs, even though there were none."

There are many other stories I could tell, of noncelebrities or not-well-known people, whose lives have ended seemingly suddenly. John. Patricia. Jay.

How many more suicides is it going to take?

How many more suicides is it going to take before we as a culture as well as the mental health community wake up to the reality of what's happening?

Suicide potential is being camouflaged; its presence doesn't announce itself. Even loved ones cannot sometimes see. Mental health professionals don't diagnose it as depression, because they're not asking deep-enough questions, relying too heavily on depression inventories, or too rigidly following the Diagnostic and Statistical Manual of Mental Disorders' (DSM's) criteria for classic depression.

Can we not predict suicide? What does the most recent research say?

In an article geared toward mental health clinicians, suicide researcher John Sommers-Flanagan writes, "...the general idea that knowledge of suicide risk, protective factors, and warning signs will equip clinicians to predict individual suicides is an illusion." In a 2017 large-scale meta-analysis covering 50 years of research on risk and protective factors, Joseph Franklin of Vanderbilt University and nine other prominent suicide researchers conducted an exhaustive analysis of 3,428 empirical studies. They found very little support for risk or protective factors as suicide predictors.

In that well-documented article, Franklin writes,

Our analyses showed that science could only predict future suicidal thoughts and behaviors about as well as random guessing. In other words, a suicide expert who conducted an in-depth assessment of risk factors would predict a patient's future suicidal thoughts and behaviors with the same degree of accuracy as someone with no knowledge of the patient who predicted based on a coin flip. This was extremely humbling—after decades of research, science had produced no meaningful advances in suicide prediction.

We know in minorities and in almost every age group, the suicide rate reached its peak in 2018 but is slowly rising again. But we are failing at prediction.

A perfect-seeming life driven by the need to achieve may camouflage suicidal thinking.

The fact that rising levels of perfectionism are significantly correlated with suicidal thinking is another part of the picture. A recent meta-analyses indicated,

...self-generated and socially based pressures to be perfect are part of the premorbid personality of people prone to suicide ideation and attempts. Perfectionistic strivings’ association with suicide ideation also draws into question the notion that such strivings are healthy, adaptive, or advisable.

A study by Barry Farber of Columbia University provides another vital piece of information. Many patients lie in therapy, and what do they tend to lie about? Their actual level of happiness, reporting greater happiness than they feel. And they often don't reveal suicidal thinking.

The perfect-looking life—even being "high-functioning"—can actually be camouflaging unhealed trauma, despair, and loneliness, where the only way out seems to be death.

We've got to wake up. Ask better questions. Don't assume that success protects from suicidal thoughts. Learn from the deaths of Cheslie, tWitch, Katie, and Rob. Remember.

And support one another in healing so that whatever emotional pain exists, it becomes bearable. Not intolerable.

If you'd like to see where you might fit on the spectrum of perfectly hidden depression, click here.

If you or someone you love is contemplating suicide, seek help immediately. For help 24/7, dial 988 for the 988 Suicide & Crisis Lifeline, or reach out to the Crisis Text Line by texting TALK to 741741. To find a therapist near you, visit the Psychology Today Therapy Directory.