Freakonomics Radio - 40. The Suicide Paradox

Episode Date: August 31, 2011

There are more than twice as many suicides as murders in the U.S., but suicide attracts far less scrutiny. Freakonomics Radio digs through the numbers and finds all kinds of surprises.

There won't be a word for college or professor, but I can say, Che aukasai pau aisi chika piga kakakai bai. And that just means my name is Pau Aisi, that's my Piraha name, and I make a lot of marks on paper. Dan Everett is a college professor, a linguist. Off and on for the past 30 years, he's lived with a tribe in the Amazon called the Pidaha. I originally went to the Pidaha as a missionary to translate the Bible into their language. But over the course of many years, they wound up converting me and I became a scientist instead.

And studied their culture and its effects on their language. The Pidaha live in huts, sleep on the ground, hunt with bows and arrows. But what really caught Everett's attention is that they are relentlessly happy, really happy. This happiness and this contentment really had a lot to do with me abandoning my religious goals and my religion altogether, because they seemed to have it a lot more together than most religious people I knew. But this isn't just another story about some faraway tribe that's really happy, even though they don't have all the stuff that we have.

It's a story about something that happened during Everett's early days with the tribe. He and his wife and their three young kids had just finished dinner. Everett gathered about 30 pitahas in his hut to preach to them. I was still a very fervent Christian missionary, and I wanted to tell them how God had changed my life. So I told them a story about my stepmother and how she had committed suicide because she was so depressed and so lost. For the word depressed, I used the word sad. So she was very sad. She was crying.

She felt lost. And she shot herself in the head and she died. And this had a large spiritual impact on me. And I later became a missionary and came to the Pitahah because of all of this experience triggered by her suicide. And I told this story as tenderly as I could and tried to communicate that it had a huge impact on me. And when I was finished, everyone burst out laughing. From WNYC, this is Freakonomics Radio. Today, the suicide paradox. Here's your host, Stephen Dubner.

All right, so Dan Everett was sharing this sad, intimate story about his stepmother's suicide with the Pidaha. When I asked them, you know, why are you laughing, they said, she killed herself. That's really funny to us. We don't kill ourselves. You mean you people, you white people, shoot yourselves in the head? We shoot animals. We kill animals. We don't kill ourselves. They just found it absolutely inexplicable and without precedent in their own experience that someone would kill themselves. In the 30 years that Everett has been studying the Pidaha, there have been zero suicides. Now, it's not that suicide doesn't happen in the Amazon. For other tribes, it's a problem. And as I've told this story, some people have suggested that, well, it's because

they don't have the stresses of modern life. But that's just not true. There's almost 100% endemic malaria among the people. They're sick a lot. Their children die at probably 75%. 75% of the children die before they reach the age of 5 or 6. These are astounding pressures. A group of people that laughs at suicide? It doesn't sound much like the U.S., does it? That suicide is painless. It brings on many changes. Suicide is not a laughing matter here, and it's not so rare either.

Now, compared to the rest of the world, our suicide rate puts us right about in the middle. But here's what's interesting. The U.S. is famous for a relatively high murder rate. It's double, triple, even five times higher than most other developed countries. So if I said to you, what's more common in the U.S., homicide or suicide, what would you say? Listen to Steve Levitt, my Freakonomics friend and co-author and economist at the University of Chicago. He's been studying crime for years. Homicides per 100,000 have fallen from something like 10 to something like 5 over the 15 years

I've been a crime. So essentially, homicide has fallen in half. Wow. So let's say it's roughly five per 100,000 people now. Do you have any idea what the suicide rate is? That's about twice as high. But to surprise you, because it doesn't usually make the newspaper when someone commits suicide, but it always makes the newspaper when someone commits a homicide. But twice as many suicides as homicide. It is surprising, isn't it? The preliminary numbers for 2009, the most recent year for which we have data, show there were roughly 36,500 suicides in the U.S. And roughly 16,500 homicides. That's well over twice as many suicides.

So why don't we hear more about it? Partly because, as Levitt says, most suicides don't make the news, whereas murders do. Breaking news tonight out of Jackson, where police are on the scene of an apparent murder, an apparent double homicide. This latest murder charged with murder, the attempted murder, first degree murder. But also, there are different types of tragedy. Murder represents a fractured promise within our social contract, and it's got an obvious villain. Suicide represents – well, what does it represent? It's hard to say. It carries such a strong taboo that most of us just don't discuss it much.

The result is that there are far more questions about suicide than answers. Like, do we do enough to prevent it? How do you prevent it? And the biggest question of all, why do people commit suicide? Steve Levitt has one more question. I always think to myself, why don't more people commit suicide? If you think about the poorest people in the world surviving on less than a dollar a day, having to walk three miles to get water and carry 70-pound packs of water back just to survive. And those people do everything they can to stay alive.

Whereas I think if I were in that situation, wouldn't I just kill myself? And what does that say to you about human nature, that people in situations way, way, way, way, way, way worse off than you don't kill themselves in large number? My guess is that evolution has built into us an unbelievable desire to stay alive, which looked at from a modern perspective doesn't actually make that much sense. So how should we make sense of suicide? If you personally have been affected by suicide, if you've lost a friend or a family member, it may be hard to even think about making sense of it. But at the risk of shining a light into a darkness that's usually left undisturbed? Let's give it a try.

The first thing we need is a Virgil of some sort to guide us. Someone who's been thinking about suicide and death for a long, long time. I was born in 1942. I lived in London for 22 years of my life. And for the first three years of my life, my mother told me we slept in an air raid shelter every night. David Lester is a professor of psychology at Richard Stockton College of New Jersey, about 20 minutes from Atlantic City.

The classic bomb that came over was called a buzz bomb. As long as it was buzzing, that meant the engine was going. Once it stopped buzzing, it meant it would drop and maybe hit your house. My mother says that even as a toddler, I was very concerned about them. And actually, she said that I would hear them before the air raid warnings went off,

and I would warn everybody, a buzz bomb, and I would rush into the air raid shelter. Ten years ago, I remembered this picture of this little toddler who's very worried about buzz bombs and hiding from them, probably without a mature concept of death, but obviously perhaps laying the seeds of some interest that manifested itself later in life. I've become a thanatologist in general and a suicidologist in particular. Lester is president-elect of the American Association of Suicidology and the eminence

grieves of suicide studies. He's also alarmingly prolific. He's written more than 2,500 papers, notes, and books, about half of which are on suicide. So people expect him to know things that he says are not yet known. First of all, I'm expected to know the answers to questions, such as why people kill themselves. And myself and my friends, we often, when we're relaxing, admit that we really don't have a good idea of why people kill themselves.

So what do we know about suicide? As you drill down into the numbers, one thing that strikes you are the massive disparities, the difference in suicide rates by gender, by race and age, by location, by method, and many other variables. In the U.S., for instance, men are about four times as likely to kill themselves as women. Yes, about three to four, yes. About 56% of men use a gun compared to just 30% of women.

Yes, men tend to use what we would call more active methods. That helps explain the gender gap since suicide by gun is usually successful. The primary method for women is technically called poisoning, usually some kind of overdose. The easy access to medications these days makes medications an important method. For men and women, being unmarried, widowed, or divorced increases the risk. The most typical American suicide is a man 75 or older. But in that age bracket, where a lot of people are dying from a lot of things, suicide isn't even a top 10 cause of death.

For people from ages 25 to 34, suicide is the second leading cause of death. And it's in the top five for all Americans from ages 15 to 54. In terms of timing, suicide peaks on Mondays. There is a Blue Monday effect. But not, as many people suspect, around Christmas and New Year's.

People do not kill themselves more on national holidays. There is a seasonal spike, but it's not in the long, dark days of winter. In fact, suicide rates peak in the spring in most countries. It's as if you expect things are going to be better, and when they turn out not to be better, you're more likely to be depressed in a suicidal way.

David Lester is willing to entertain any theory to examine any pattern. Interestingly, he's found that suicide and homicide are often perfectly out of sync with each other. Homicide spikes not on Mondays, but on the weekends and on national holidays and during the summer and winter. Homicide is also much more common in cities than in rural areas. For suicide, it's the opposite. The American suicide belt's comprised of about 10 western states. It's a sort of wide longitudinal swath running from Idaho and Montana down to Arizona and New Mexico. That's Matt Ray, a sociologist at Temple who studies, well,

here, I want him to say it, not me. To sum up what I do in a word would be to say that I study losers. And I am interested in those who lose out on societal gains and out on opportunities. And it's another way of saying I'm interested in inequalities and stratification. Ray found what he has taken to calling the suicide belt. So, yes, the Intermountain West is a place that is disproportionately populated by middle-aged and aging white men, single, unattached, often unemployed, with access to guns. This may turn out to be a very powerful explanation and explain a lot of the variants that we observe. It's backed up by the fact that the one state that is on par with what we see in the suicide belt is Alaska. All right, so now you can get a picture of the American who's most likely to kill himself, an older white male who owns a gun, probably unmarried, maybe unemployed,

living somewhere out west, probably in a rural area. Now, don't you want to know where aren't people killing themselves? Okay, so I'm standing in front of the Lincoln Memorial. Washington, D.C., our nation's capital. It's got the lowest suicide rate of any American city. Just six per 100,000 people. We sent Vera Lynn Williams there to ask strangers a couple of strange questions. Do you know anyone that committed suicide? Personally, no. No.

Do you know anyone that died of homicide? Yes. Yes, I do. I've got a son that's been murdered. I've got cousins that's been murdered. I've probably been to a hundred wakes in the past year. But I can't tell you one person that I know that's committed suicide. Now, as we told you earlier, there are more than twice as many suicides each year in the U.S. as there are homicides. There are just three places where the homicide rate is higher than the suicide rate.

Louisiana, Maryland, and the District of Columbia. It's not a coincidence that these are also places with large African-American populations. African-Americans are only about half as likely to kill themselves as whites. When it comes to murder, meanwhile, African-Americans are nearly six times more likely than whites to die. In our community, it's different. We have low rates of suicide and high rates of homicide. Why do you think that is? I think a lot of those homicides are probably suicides.

Donna Barnes works at the Suicide Prevention Center at Howard University. It's very easy when you're stressed and you don't want to live anymore to put yourself in harm's way and somebody will take you out. And many times we will externalize our frustration, meaning that we're going to take it out on other people. And then you might have more folks, maybe from the dominant culture, who internalize your frustration and take it out on themselves. We have been socialized to believe that a lot of our disadvantages are based on our surroundings, racism, discrimination, and all of that. So it's really easy for us when we become frustrated and we look at what's going on around us to take it out on the environment and other people rather than ourselves.

I asked David Lester if he had an explanation for the black-white suicide gap. If you're white and in psychological pain, what can you blame it on? It's like other people are doing well. Why aren't you doing well? Other people doing well. Why aren't you doing well? Other people are happy. Why aren't you happy? So maybe that in part accounts for the higher suicide rate in whites as compared to African-Americans is because whites have fewer external causes to blame their misery for. I find this idea fascinating.

As Lester is quick to point out, it is little more than an idea. It's pretty much impossible to prove. The fact is, we usually don't know much about what's going through a person's mind as they consider suicide. But when your life is miserable, when it seems beyond redemption or repair, where do you put the blame? You can blame other people. You can blame yourself. What if you could blame a song? Coming up, places where suicide is epidemic and how it gets that way.

From WNYC, this is Freakonomics Radio. Here's your host, Stephen Dubner. As we said earlier, there are about 36,500 suicides a year in the U.S. That's an average of 100 a day. Now, the vast, vast majority of them you never hear about. They don't make the news. That's not an accident. For decades, sociologists have been studying the media's impact on suicide rates. And some say they've proven that a widely publicized suicide, when described in a certain way, can lead to copycat suicides, a suicide contagion. Here is reporter Sean Cole. All right.

So we're going to have to go all the way back to 1774 when this novel came out. The Sorrows of Young Werther by Johann Wolfgang von Goethe. May 4th. How happy I am that I am gone. My dear friend... For those of you who have never read it, I had never read it, The Sorrows of Young Werther was written mostly as a series of fictional letters by a young dilettante artist named Werther.

He travels to the countryside, falls in love with a girl who's already engaged, despairs, and then borrows two pistols from her fiancé. They are loaded. The clock strikes twelve. I say amen. Charlotte, Charlotte. Farewell, farewell. Sorry to spoil the ending. Now, this book was really popular when it came out. Scholars talk about legions of men in Europe dressing like the character in blue swallowtail coats and canary yellow pants. And while this next part is probably apocryphal, the story goes that many people who read the book killed themselves by the same method. And sometimes they even killed themselves with the book open to the page where he was described as killing himself. David Phillips is a sociology professor at UC San Diego and the father of imitative suicide

research in America. In 1974, exactly 200 years after Verta was published, he released a seminal paper called The Influence of Suggestion on Suicide, Substantive and Theoretical Implications of the Verta Effect. My students and I were the first to provide modern, large-scale evidence that there is, in fact, such a thing as copycat suicide, and we called this, I called it the Virta effect. Now, Virta is a work of fiction, but the Virta effect focuses more on true stories about suicide. The theory goes that whenever the media runs with a big, sensational suicide story, especially if the victim is famous, you can expect a bump in suicide rates.

Phillips and company gathered 20 years of suicide data, 1948 to 1967, from the National Center for Health Statistics. Then they combed through back issues of three major newspapers and honed in on front page suicide reports. The actress Carol Landis, Dan Burroughs, who ran the KKK in New York, one of the most famous stars in Hollywood history. ...is dead at 36. Marilyn Monroe was found dead in bed. Of course, this was back before all the conspiracy theories about how she died. Anyway, in 27 out of 33 cases like this, suicide rates were higher than expected for about two months following the story.

So, for example, Marilyn Monroe died on August 5, 1962. For the rest of that August, U.S. suicide rates were 10% higher than normal. How do we know that there's a 10% increase in August of 62? We're comparing the number of suicides in August of 62 with the number of suicides in August of 1961 and the number of suicides in August of 1961 and the number of suicides in August of 1963. So those other Augusts are the controls. That's right.

In some cases, the bump was a lot smaller. But it's not so much the size, says Phillips, as the consistency. And it wasn't just suicides that went up after these media reports. You also get a spike in single car crashes after suicide stories. And you see that the driver in the single car crash is unusually similar to the person described in the suicide story. So if the person described in the suicide story is unusually young, then the spike in single car crashes just afterwards has drivers who are unusually young, then the spike in single car crashes just afterwards has drivers who are unusually young. So to close that loop, they're not accidents. They're people who are committing

suicide. Right. So all of these things together make it very difficult to think of an alternative explanation. But this is not to say people kill themselves because they read a big splashy suicide story in the paper. It's not really about the causes of suicide. It's about the trigger of suicides. This is Thomas Nieder-Krotendahler, an assistant professor at the Medical University of Vienna in Austria. About 10 years after that original study, the Virta effect hit Vienna in a big way. There was a tremendous increase of subway suicides and suicide attempts on the Viennese subway in the early 1980s. In 1983, there was just one jumper in the Viennese subway, and that person lived. The next year, there were seven suicides by subway in Vienna, and the big Austrian papers

ran graphic stories about them. In 1985, 13 jumpers, 10 deaths, more splashy articles. At the peak, in 1987, there were 11 successful suicide attempts in the Viennese subway and 11 unsuccessful, though granted, three of those were the same guy. Finally, the Austrian Association of Suicide Prevention told the press to tone it down. They issued a whole series of recommendations. Don't include the word suicide in the headline. Don't print pictures of grieving relatives. But you should also mention helplines,

helping opportunities for people in crisis. Amazingly, the Austrian media listened. The stories were less graphic, and they stopped running so many of them. And at the same time, the number of suicides and suicide attempts on the Viennese subway decreased by nearly 80 percent. And, and this is really stunning, the numbers remained relatively low in all the years up until today. Yeah, I thought that was a pretty study. This is David Phillips again. He says he's actually not so comfortable telling the media what to do. He thinks freedom of the press should be inviolate.

But both the World Health Organization and the AP Managing Editors Association asked for his advice. So he basically told them, think of a suicide story as a kind of commercial. If you make the product attractive, people will want it. But if you say… By the way, when a person kills himself, let's say by shooting, he looks terrible afterwards. Or when a person poisons himself, often fouls the bedsheets and things like this. If you talk about the pain and the disfigurement, then I thought that would make it less likely that people would be copying the suicides.

And there may even be a trend growing in the other direction. Thomas Niederkrotenthaler and his team in Austria did their own study, looking at nearly 500 newspaper articles from the first half of 2005. He says not only did they find more evidence for the Werther effect, but they saw suicide rates go down when the media wrote about someone who found an alternative solution to his or her problems. So this may be exactly the opposite side of the same thing. And we called this effect the Papageno effect.

Papageno is another fictional character from Mozart's opera The Magic Flute. Like Werther, he's in suicidal crisis over a girl, his beloved Papagena. But just as he's about to hang himself, three young boys rush the stage and tell him not to do it. They say,

Papageno, use your magic bells and Papageno will come back. And psychologically speaking, we can say, this is what we believe that actually those newspaper or press articles do. They remind people what they can do other than commit suicide. Now, I should say that I'm pretty agnostic about this. This is Matt Ray again, the Temple University sociologist from earlier in the show. My sense is that what this literature misses are all of the times that high-profile suicides occur that don't spark contagion. The one that comes to mind is Kurt Cobain.

Kurt Cobain's body was found inside a garage apartment adjacent to his Seattle home. Dead of an apparently self-inflicted shotgun wound, police say a suicide note was nearby. So everyone was expecting a rash of shotgun-induced, you know, blow-your-head-off suicides in the wake of Cobain's death. They did not materialize. And so the question is, why was it so?

Thomas Nieder-Krotenthaler. There were some specifics about Kurt Cobain's suicide. In particular, Cobain's spouse, Courtney Love. Courtney Love, yeah. Yeah, Courtney Love. She was broadcast in the media immediately after his suicide. I'm really sorry, you guys. I don't know what I could have done.

And she told to the audience, this was really the wrong thing to do. And there is one study actually from the US, which showed that reports that use negative definitions of suicide, so such as suicide is something that is stupid, that you should not do, that those reports are 99% less likely to identify a copycat phenomenon than other reports. So listen, suicide is something that is stupid, that you should not do. After all, I am the media. And this whole show is basically one big suicide article. And as I said to Matt Ray, I've been wondering what type of article it is.

Are you guys trying to figure out how to report on the story without, like, sparking suicides? Well, it is an odd little meta problem, isn't it? I mean I'm doing a story about like whether what I'm doing a story about could possibly cause a suicide contagion. Yes, I'm well acquainted with that dilemma. But what about a song. David Lester, the psychology professor, tells us about the time... In the 1930s, two Hungarians wrote a song called

Gloomy Sunday that was thought to precipitate a wave of suicides across Europe. Freakonomics Radio producer Susie Lechtenberg went to Hungary. Reza Sereza's piano still sits, rather benignly, in the restaurant in Budapest where he used to play his most

famous song. The person in the song is thinking about suicide. He or she wants to be reunited with a lover who's just died. Today, it sounds a bit melodramatic, but as many as 200 people might have killed themselves after listening to this song. Yes, yes, yes, yes, yes, yes. Because they heard the song. Yeah, but it was just the trigger. It was just the trigger, Hungarian psychiatrist Zoltan Riemer says, but it had to be stopped.

The Budapest police enforced a gloomy Sunday ban, and the BBC... The BBC banned that song until 2002. These days, the owner of the restaurant where Ceres used to play still gets requests. He's not afraid to play it, but he feels certain... Absolute. ...that this was a suicidal song. It should come as no surprise then... In 1968, Rezo Ceres. Completed suicide, he was around 70. In 1968, Rezo Seres, Gloomy Sunday's composer,

jumped to his death from the window of his small apartment in Budapest. Unfortunately, this Hungarian suicide story isn't unique to this one man or this one song. Suicide has been epidemic in this country. For most of the last century, Hungary's had the highest suicide rate in the world. Right now, it's more than double the suicide rate in the United States. So what is it about this place? Why are so many people killing themselves here? Oh, my husband.

My husband was very handsome, great-looking, very intelligent. Silvia and Levente Ladomersky met at a concert. He was a neurologist, she worked in finance. He was cool, she says. They fell in love, married, had a daughter. but they didn't have a fairytale ending. Levente's family had a history of mental illness. It was something he was afraid was in his blood. Before we married, we were sitting at the kitchen table,

and he told me that if it ever happens to him that he gets ill and he will need treatment with drugs, then he will refuse the drugs. And if he will never take drugs, he prefers dying because drugs, psychiatric drugs, will change his personality and he wants to remain himself all the time. Levente's mental state deteriorated. He was hospitalized. A few years after, it happened to him exactly what he described. When he had a few moments alone, when doctors and nurses left his room, Levente Ladomirsky hanged himself.

My own suicide, I was able to completely ignore. But my husband is somehow still with us. My own suicide was something I was able to completely ignore. Sylvia tried to kill herself years before she and Levente met, but she says she didn't want to die. It was a cry for help more than anything else. I took a bunch of pills, but made sure that it won't kill me. Everyone in Hungary knows someone like Sylvia, like Levente.

The World Health Organization says in 2008, about 2,400 people committed suicide here. To put that number in context, around the same time in Greece, a country that's roughly the same size, there were 394 suicides. Yes, my name is Zoltan Riemer. I met Dr. Zoltan Riemer in his smoke-filled office in Budapest. He's a professor of psychiatry at Semmelweis University, and he says there are two main reasons the suicide rate is so high. The prevalence of bipolar disorder. We have found the lifetime prevalence of bipolar disorder in Hungary is 5%. The worldwide rate of bipolar disorder is about half that.

The risk of suicide is much higher among patients with bipolar disorder. It can be one factor, but it is just one factor. Alcohol. Alcohol plays a very important role in suicide. And Hungary has the third highest alcohol consumption rate in the world. This country is about the size of Indiana. From the window of a train, the Hungarian Great Plains look like it too. In the southwest, there's a small town called Kishkinhalas. It's a nice little town.

That's psychiatrist Katalin Zanto. So there is a little lace museum there, and there are these women making beautiful laces. On the other hand, if you walk around, then you see drunken people outside the pubs. If you visit the local hospital in the psychiatric ward, there the circumstances were very, very poor. My name is Dr. Ágnes Rácnagy, and I'm the leader of the psychiatric department

of the Kiskunhalas Hospital. Until 2005, Kiskunhalas was the epicenter of suicide in Hungary. Suicide in this town was double the national rate. As one cultural critic put it, living here was like living on psychic death row. I've seen a family, it was a big family, and there were more than 10 suicides in the family. In 2001, Dr. Agnes Ratsnos and a colleague began 100 psychological autopsies, meaning they interviewed families in depth after a loved one had committed suicide.

In 67, there was mood disorder and 60 alcohol. And of course, there were overlaps as well, but this number is huge. This was part of a study that ran for five years in Kiskunhalas. Dr. Katalin Zanto and colleagues trained 28 of the town's 30 general practitioners in suicide prevention. They set up a suicide hotline and made low-cost antidepressants available to residents. Then they compared their results to a neighboring town, a control group. And it worked. Yeah, there were like 34 less suicides during these five years than in the previous five years. Overall, the suicide rate in the region decreased 16 percent. The suicide rate for women

decreased 34 percent. This shouldn't be that surprising. Research by academics in the United States, like Jens Ludwig, has shown that antidepressants do lower the suicide rate. But here's the thing. Even though the suicide prevention program in Kishkunhalas was a success, this model just hasn't caught on anywhere else in Hungary. The country still has one of the highest suicide rates in the world. So, why? Well, we can see a part of the bridge, the Margaret Bridge. Back in Budapest, everywhere you walk, there are musicians playing classical music in the streets. The Margaret Bridge stretches over the Danube, which is the lifeblood of this city. It's stunning, but it's also the place where many Hungarians have jumped to their death.

I met psychiatrist Béla Buda on the banks of the river. I am 73. I was born and lived in Budapest in all my life. He looks exactly how you want someone named Buddha to look. Graying, rotund. I've been told he speaks 17 languages. He says it's just 12. Les sanglots long de violon.

Baudelaire in French. Bless mon coeur. Goethe in German. Der Wunderschöne Monat Mai. Carducci in Italian. Ante porre sempre nella vita. Il essere al parere. Buddha has tried to solve the problem of suicide his entire career. Carducci in Italian. Buda has tried to solve the problem of suicide his entire career.

He started the first suicide hotline in the country. He worked in psychiatric wards when the suicide rate was soaring. But he says this problem is hard to solve, because a lot of people here don't see anything wrong with suicide. The Hungarian general opinion is very favorable towards suicide. If somebody commits suicide, then it is commented as a brave act. Somebody had the courage to end the suffering. For instance, these old men who hang themselves are praised in the community that he was brave enough to free the family from the burden of his existence. Coming up, is it your responsibility to try to stop a stranger

from killing himself? And what do you call someone who considers suicide a rational act? From WNYC, this is Freakonomics Radio. Here's your host, Stephen Dubner. Next year, the Golden Gate Bridge will celebrate its 75th anniversary. You'll hear all kinds of tributes to it, all kinds of facts and figures. One number you probably won't hear, at least in the official proclamations,

is the suicide toll. Since the Golden Gate Bridge opened, more than 1,400 people have killed themselves by jumping off it. There is another place that now attracts more suicides each year, the Aokigahara Forest in Japan. But historically, the Golden Gate is still the world's number one suicide spot. Last year alone, 32 people jumped and died. Now, it should be said that every weekday, about 5,000 people walk across the bridge and don't jump. And 100,000 cars cross it every day. Cars with drivers like, here, I'm going to let him pronounce his name. My name is Pansak Pomaha Supapol.

You see? That's 17 letters all together. He moved here from Thailand in 1968, and he drove a cab in San Francisco for 15 years. One night, I pick up the guy, like, I think, down nearby Tenderloin, and he want to go Golden Gate Bridge. Close to 11 o'clock at like, I think, down nearby Tenderline,

and he want to go Golden Gate Bridge. Close to 11 o'clock at night. I say, okay. So I drove on Franken Street. He say, you want to ask me why I go Golden Gate Bridge at this late? I say, no. I guess if you want to tell me, I guess I will listen to it, right? And he say, I'm going to go and jump off the Golden Gate Bridge.

I said, okay. You're not going to stop me? I said, why should I? So I get out to the Golden Gate Bridge. I think the fare was like $7 or something that time. And he looked at his wallet, he found another $10, right? So he gave it to me another $10. So I turned around and told him, I said, I don't think you need any change. He said, well, I guess you're right, I don't need any change. I said, okay. So I let him off on the side of the bridge. So once he get off, I turn around the cab. I call my dispatcher.

I told him, why don't you call the car patrol over there? And he did. Maybe, I don't know, maybe I was too cool to him. I don't know what happened, did, in fact, jump off the Golden Gate Bridge that night. If he did, he almost certainly died since only 2% of jumpers survive. We also have no idea what was going through his head that night. Did he have a fight with someone? Did he lose his job?

Did he maybe just have one drink too many? Here's David Lester again. I'm expected to know the answers to questions, such as why people kill themselves. If you unpack that why in why people kill themselves, there are all kinds of other things we don't know about suicide either. For instance, the percentage of people who seek help or get help before committing suicide, we don't know. Or even how many people who commit suicide are mentally ill. Lester says there's so much disagreement on this question that estimates range from 5% to 94%.

And then there's the mystery of the suicidal impulse. And I've just found a case, which I'm using in an article I'm writing, where the time between the impulse and the act was something like five seconds. Think about that. Five seconds. The man was walking over a bridge and suddenly the thought came to him. One. You know, he was in some suddenly the thought came to him. One. You know, he was in some, I think, financial distress. Two.

But he hadn't thought about suicide before. Three. But he said, I ought to kill myself. Four. And he immediately jumped off the bridge. Five. And he was saved. And that's the shortest interval I've come across.

One academic study looked at attempted suicides in Houston among 15 to 34-year-olds. It found that in 70 percent of the cases, the time between deciding to commit suicide and taking action was under an hour. Seventy percent of the cases. For about a quarter of the people involved, the time gap was five minutes or less. It's pretty stunning. People are making a permanent decision to end their lives on the spur of the moment. How are you supposed to stop that? Remember this guy? He didn't try to stop his taxi passenger from jumping. You're not going to stop me?

I said, why should I? You know? Why should I? Sounds pretty cold-hearted I? You know? Why should I? Sounds pretty cold-hearted, doesn't it? Or does it? Your life belongs to you. It's a crime to take someone else's life, but not yours, at least not a crime in practice. So should we consider the suicidal impulse a rational choice?

I know what you're thinking. Only an economist would say something like that. An economist like Dan Hammermesh at the University of Texas. He once wrote a paper called An Economic Theory of Suicide. Well, I think there's an epigraph to the paper, which I can't quote exactly. It's by Arthur Schopenhauer. When the value of a man's life is less than... You can read it. I don't have it with me now. Why don't you read it? As soon as the terrors of life reach

the point at which they outweigh the terrors of death, a man will put an end to his life. Exactly. Well, that's just an economic statement. You're weighing the benefits on one side of the equation, the cost of the other. If the costs succeed the benefits, you chop off the investment. Back in the spring of 1972, Dan Hammermesh was hunting around for a research topic. And he thought of a poem he'd read back in high school. The poem is Richard Corey by Edwin Arlington Robinson, written in the last decade of the 19th century. Whenever Richard Corey went downtown, we people on the pavement looked at him. He was a gentleman from soul to

There was something about the poem that nagged him. And he was rich, yes, richer than the king, and admirably schooled in every grace. In fine, we thought that he was everything to make us wish that we were in his place. So on we worked and waited for the light

and went without the meat and cursed the bread. And Richard Corey, one calm summer night, went home and put a bullet in his head. That's it. The last part. It didn't make sense to him. I was always very bothered by the notion that suicide's a problem of rich people.

And that always struck me as an economist as being really stupid, since I believe rich people are generally going to struck me as an economist as being really stupid, since I believe rich people are generally going to be happier, utilities higher, income goes up, you should be less lucky to kill yourself. So that was one of the thoughts running through my mind that spring afternoon in 1972. So Dan Hammermesh did what economists do. He wrote a model to determine the conditions under which suicide might be considered a rational choice.

He came up with three predictions. Suicide, one, rises with age. Two, falls as income increases. And three, falls if your desire to live is high. It's nothing so radical, but at the time, no one had tried anything like this. Then, Hammermesh plugged some suicide data from the World Health Organization into his model. His predictions were right.

He also calculated the opportunity cost of a suicide. A 50-year-old person and a 70-year-old person have different expectations of future happiness, income, and so on. So the price of suicide is higher for the 50-year-old. But whether it makes economic sense for either person to commit suicide depends on what economists call the utility function, how much you value your life. So it all goes back to the Schopenhauer quote at the beginning of Hammermesh's paper. As soon as the terrors of life reach the point at which they outweigh the terrors of death, a man will put an end to his life. Hammermesh may have been the first economist to wrestle with suicide in this way,

but he was hardly the first to intellectualize it. Plato, Aristotle, the Greek and Roman Stoics, the early church fathers, and on up to Durkheim and Freud. Margaret Batten, sometimes called Peggy, is a professor of philosophy at the University of Utah. Plato, she says, argued that suicide was wrong in some cases, not wrong in others. Aristotle thought it was cowardly, an offense to society. Stoics, on the other hand, thought that suicide was the act of the wise man. This is not done in desperation or agitation or depression or any of the things that we ordinarily associate with that term.

But it's the reflective, responsible act of the genuinely wise man. For the Stoics, suicide was a procedure. People who wanted to commit suicide would plead their case before magistrates to get permission. The magistrates kept a supply of hemlock on hand. Whoever no longer wishes to live shall state his reasons to the Senate and after having received permission shall abandon life. If your existence is hateful to you, die. If you are overwhelmed by fate, drink the hemlock. If you are bowed with grief, abandon life.

Let the unhappy man recount his misfortune, let the magistrate supply him with the remedy, and his wretchedness will come to an end. But going forward in history, this was hardly the mainstream view. Christianity held that suicide is a sin. Dante set aside one ring of his inferno for suicides. Fast forward about 700 years, and we're still firm in our moral stance. We can't really consider suicide a rational choice, can we?

We would wake up to the sound of her typing at an astonishing speed on her Smith-Corona typewriter. Margaret Heilbrunn is talking about her mom. Carolyn Heilbrunn was a Virginia Woolf scholar at Columbia. She wrote mystery novels on the side. She was famous for making grand pronouncements, for saying outlandish things. A partner of mine enjoyed drinking

Stolichnaya vodka, so she took to having it on hand, but she insisted on calling it Solzhenitsyn vodka. And she knew it wasn't, but she just, you know, I'll go get the Solzhenitsyn. So it was the same with her once she started saying that she would kill herself when she reached a certain age.

But it was another of those sort of pronouncements. And one thought, oh, well, mommy's prone to pronouncements. And one thought, oh, well, mommy's prone to pronouncements. Carolyn Heilbrunn had decided that by the time she turned 70, she would have accomplished what she could accomplish. She would have had enough of life, and she'd end it. Her family, her husband and her three grown kids, they weren't quite sure what to make of this. It was a relief when her 70th birthday came and went without a suicide. Apparently, she had changed her mind. She even wrote a book called The Last Gift of Time, Life Beyond 60.

Her daughter says she took a lot of pleasure in life, even the small things. She loved gifts, and it was quite easy to please her with a gift. And she'd made some sort of remark about she wanted to start listening to sextets, I think she said. No longer string quartets. No longer string quartets. I want quintets and sextets. And I was at Borders bookstore and found

and cut it up in a sextet by, um, Elgar? And this was on Tuesday, the 7th of October. And I pulled out my cell phone to call her, and her voicemail came on, and I thought, well, I don't really feel like talking to her right now. I was going to call and say, oh, you don't really want Elgar, do you? You really want me to buy you Elgar? And I hung up before she picked up, and I never spoke to her again. Carolyn Heilbrunn waited until she was 77,

and then she did kill herself on October 9, 2003. She wasn't sick, she wasn't depressed, but she did feel she'd come to the end of her writing life. And that was that. She left a note out in the foyer that said, The journey is over. Love to all. Carolyn. Did anyone know that she was planning to kill herself now?

Did your father know, for instance? Oh, no, he didn't know. Your father, he was an economist, yes? Yes. So economists are practiced in the art or science or whatever it is of what's known as rational thinking. Here is the wife of an economist, your mother, who seems to have approached suicide, or at least life and the end of an economist, your mother, who seems to have approached suicide or at least

life and the end of life as a rational decision. Did you see it that way or no? No, I think it's if you're mortally ill and in great pain, I can see seeking to end your life. But no, I think it was unreasonable, irrational of her. But I think she felt it entirely reasoned out and rational. Well, Margaret, I'm sorry for your loss, and again, I very much appreciate your willingness to come speak to us.

Oh, well, thank you. For David Lester, the Dean of Suicide Studies, 40 plus years of research has yielded some answers about the what of suicide, who's most likely to do it and when and how. But the why remains elusive. The people who do it aren't necessarily the ones you might expect. You remember the point Steve Levitt made earlier in the show? How puzzling it is that people whose lives look so hard don't kill themselves in huge numbers? Remember the Pidaha, the Amazonian tribe with their outrageous rates of infant mortality and malaria, but no suicide?

Or African Americans who trail white Americans on just about every meaningful socioeconomic dimension, but commit suicide half as often? Here's what David Lester has been thinking about. Actually, I've done studies on the quality of life in nations and the quality of life in the different states in America. And regions with a higher quality of life have a higher suicide rate. Now, quality of life is more than wealth. The people who try and rate the quality of life use a variety of indices,

health, education, culture, geography, all kinds of things. So they put more into it than just, you know, median family income or individual per capita income. And what I've argued, therefore, is it seems to be an inevitable consequence of improving the quality of life. If your quality of life is poor, I mean, maybe you're unemployed, you're an oppressed minority, whatever it might be.

There's a civil war going on. You know why you're miserable. You know, as the quality of life in a nation gets better and you are still depressed, well, why? Everybody else is enjoying themselves, getting good jobs, getting promotions, you know, buying fancy cars. Why are you still miserable? So there's no external cause to blame your misery upon, which means it's more likely that you see it as some defect or stable trait in yourself and therefore you're going to be depressed and unhappy for the rest of your life. It's so interesting. There are just so many pieces of this puzzle, as you put it,

that are fascinating but confounding. I mean, what you're talking about now, when there's a higher quality of life, suicide tends to rise. Your wife, who's an economist, I wonder if she would consider then calling suicide to some degree a luxury good. Yes. Now, there's an anthropologist in the past, Raoul Narelle, who considered suicide an indication of a sick society. And so in my writings, I've argued it, no, it's an indication

of a healthy society. So it, you know, it is a puzzle. It is a paradox, perhaps we should say. This episode was produced by Susie Lechtenberg and Beret Lamb, with help from Chris Neary, Diana Nguyen, Ellen Horn, and Peter Clowney. Colin Campbell is our executive producer. This episode was mixed by John DeLore. Our thanks to Miriam Donath, Beatrix Clucone in Budapest, and Chrissy Clark in California. If you want more Freakonomics Radio, you can subscribe to our podcast on iTunes or go to Freakonomics.com,

where you'll find lots of radio, a blog, the books, and more.