I.
Here is a terrible article from the New York Post: Sorry, Liberals, Scandinavian Countries Aren’t Utopias.
Its thesis is interesting and worth exploring, but instead of a principled investigation, the article just publishes a bunch of cherry-picked smears about Scandinavia. Did you know that 5% of Danes have had sex with animals?
(What percent of people in other countries have had sex with animals? I don’t know. More important, I see no sign that the New York Post knows either.)
But the part that really caught my eye was statements like these:
Why does no one seem particularly interested in visiting Denmark? Visitors say Danes are joyless to be around. Denmark suffers from high rates of alcoholism. In its use of antidepressants it ranks fourth in the world. (Its fellow Nordics the Icelanders are in front by a wide margin) … Finland, which tops the charts in many surveys, is also a leader in categories like alcoholism, murder, suicide and antidepressant usage.
The Post is not the only paper to make this argument. The Guardian (“The Grim Truth Behind The Scandinavian Miracle”) has said much the same thing:
Take the Danes, for instance. True, they claim to be the happiest people in the world, but why no mention of the fact they are second only to Iceland when it comes to consuming anti-depressants?…Finland has by far the highest suicide rate in the Nordic countries.
I’ve heard this same argument applied to other issues; for example, in his debate with Noah Smith, Michael Anissimov argues against the supposed success of modern liberal society by pointing out rising rates of depression and suicide.
It’s really tempting to equate depression with misery and misery with social dysfunction. Danes and Finns have high levels of depression, therefore their lives must be unusually miserable, therefore Denmark and Finland are poorly-organized societies.
But first of all, it’s not clear that Scandinavian countries really have very high depression and suicide rates. There are a lot of collections of statistics, and many of them show Scandinavia around the middle. Going by “antidepressant prescriptions” is a terrible way to do things, because it mixes amount of depression with resources devoted to treating depression – if the Scandinavian health systems are as good as everyone says, maybe they just treat a greater percent of their depressives than everywhere else.
But more important, even if Scandinavia does have very high rates of depression, that doesn’t tell us much about whether they’re happy or not. Depression is not the same thing as being sad. Sadness is a risk factor for depression – although even there I suspect that it’s very specific kinds of sadness that we haven’t yet teased out from the general construct – but it is not the condition itself. The condition itself is a complicated mess of neurotransmitters, cytokines, hormones, changes in brain structure, and goodness only knows what else.
Off the top of my head, here are six plausible reasons why Scandinavia could have higher rates of depression than the United States, even if it is a utopian society of perfect happiness.
1. Light. Scandinavia is far north [citation needed] which puts its citizens at very high risk for seasonal affective disorder, which can present as depression.
2. The midnight sun. Scandinavia’s weird day-night cycle could easily disrupt people’s circadian rhythms. Studies find that “increasing evidence points to a role of the biological clock in the development of depression…it seems likely the circadian system plays a vital role in the genesis of the disorder. This is why some European countries use melatonergic substances as antidepressants.
3. Parasite load. It’s positively correlated with temperature, which means Scandinavia probably has some of the lowest parasite load in the world. But low parasite load causes the immune system to get antsy and start attacking random stuff, leading to increase risk of autoimmune disease. If there’s an immunological component to depression – and right now lots of people think there is – then that’s another risk factor right there.
4. Diet. The Scandinavian diet has unusually little fresh food, because the area is a frozen wasteland and most things have to be imported from elsewhere. They’re big on frozen stuff, processed stuff, and canned stuff. I am neither an expert in Scandinavian cuisine nor in nutrition, but if depression is linked to diet and imbalance in the gut microbiome, which there’s some evidence it is, then diet is heavily implicated and the Scandinavians are in a good position to get hit extra hard.
5. Genetics. The New York Post article mentions that Scandinavians have an unusual variant of the MAO-A enzyme (I told you it was a weird hit piece. Scandinavia is too liberal, therefore they have bad genes?). MAO-A is also known as “the thing that processes serotonin” and “the thing that MAO inhibitors, some of the most powerful known antidepressants, inhibit”. I’m not saying this gene in particular is responsible for Scandinavian depression, I’m saying that the article itself is admitting that Scandinavia contains some genetically distinct populations and for all we know this could be involved.
6. Culture. Maybe the biggest factor in the level of depression and suicide in a culture is whether it is culturally acceptable to be depressed and commit suicide. Some of the lowest suicide rates are found in heavily religious cultures and communities who believe suicide is a mortal sin. On the other hand, one of the most suicidal countries in the world is Japan, with its heavily-mythologized history of heroic samurai taking “the honorable way out” when they had brought shame upon themselves. Well, Scandinavia is one of the least religious regions in the world. And all I know about their culture is that they produce about 100% of good death metal, and their native mythology ends with the world being plunged into eternal winter and the gods being eaten by wolves.
II.
But all this is just speculation. Let me give a concrete example of a case where social dysfunction doesn’t track depression and suicidality in a predictable way.
What about white versus black Americans? To some degree these two groups live in separate “societies”. Most people would consider the white society better off in most ways – higher income, better health, more family stability, less involvement with the criminal justice system. If White America and Black America were countries, White America would get all of the accolades currently given to the Scandinavians.
But American whites have higher rates of depression than blacks. There are the usual contradictory studies and arguments about how to adjust for which confounder, but I’m pretty sure this is something like a consensus position right now. More solidly, white Americans have much higher suicide rates than black Americans.
(although I feel bad mentioning this, because the stereotype that blacks never commit suicide is wrong and sometimes prevents black people from getting the help they need.)
We can go a few centuries back and get even more surprising results. Although it’s difficult to get data from the era, analyses of suicide rate among African-American slaves in the antebellum South describe it as “surprisingly low”. I can’t find any hard evidence proving Kurt Vonnegut’s contention that “the suicide rate per capita among slave owners was much higher than the suicide rate among slaves”, but it seems to have been commonly believed. Kneeland writes:
“[These low suicide rates are] consistent with suicide rates for Africa and for people of African descent living in other areas of the world, and further supports the theory that a low suicide rate is an element of African culture.”
If you’re going to say that Scandinavia’s higher depression and suicide rates mean Scandinavia has it worse off than America, you also need to theorize that white people have it worse off than black people, including black slaves. Why don’t you go post something to that effect on Tumblr and see what they have to say? I’ll wait.
III.
Or maybe we’re barking up entirely the wrong tree. What if it’s not even that happy, well-functioning societies can sometimes still end up with high suicide rates? What if people become suicidally depressed precisely because they live in happy, well-functioning societies?
This is the fascinating hypothesis of Daly, Oswald, and Wu (2011), who after crunching the numbers find pretty convincingly that “suicide rates tend to be highest in happy places”:
A little-noted puzzle is that many of [the happiest] places have unusually high rates of suicide. While this fact has been remarked on occasionally for individual nations, especially for the case of Denmark, it has usually been attributed in an anecdotal way to idiosyncratic features of the location in question (eg the dark winters in Scandinavia), definitional variations in the measurement of well-being and suicide, and differences in culture and social attitudes regarding happiness and taking one’s life. Most scholars have not thought of the anecdotal observation as a systematic relationship that might be robust to replication or investigation…this paper attempts to document the existence of a happiness-suicide paradox: happier areas have a higher percentage of suicides.
They then go on to show a strong positive relationship between average self-reported happiness and suicidality across Western nations – Greece is both the least happy country and the one with the lowest suicide rate – and US states, where confirmed hellholes New York and New Jersey are at or near the bottom. The relationship holds whether you adjust for confounders (including income!) or not.
I expected this to be a straightforward effect of modernization/industrialization/liberalism, as per Michael Anissimov’s hypothesis. The country-level data maybe sort of vaguely supports that trend – Greece and Portugal are our token incompletely-modernized countries and have very low suicide rates, Scandinavia is high, and everywhere else is sort of a toss-up. But US states really really don’t support that hypothesis – New York and Jersey both seem high on the modernization/industrialization/liberalism axis, and they’re right in the bottom left corner of the study’s graphs along with Greece and Portugal. Meanwhile, tropical paradise Hawai’i is suicidal as heck, even though it doesn’t seem espcially modern/industrial/liberalized. The US state data also torpedo – albeit less conclusively – an attempt to make the whole issue one of latitude.
One caveat I do have about the US data is that several of the happiest and most suicidal states – at least on the unadjusted plot – are also high-altitude. Utah, Wyoming, Colorado, Montana, Idaho are all up there at the top left side of the graph. But we already know there’s a strong positive relationship between altitude and suicide in 2584 US counties, probably because the brain’s emotional regulation system doesn’t work well in low-oxygen environments. If we assume people living in beautiful open forested mountain areas are especially happy, that takes away a big chunk of the graph right there. But it leaves other chunks untouched, and I don’t think it’s going to be that simple.
The authors’ preferred explanation is that suicide is an effect of relative rather than absolute misery. If you’re depressed and everybody around you is very happy, that makes things worse than if you’re depressed and everyone around you is also pretty miserable. Thus suicide is more common in happier societies.
I really don’t like this theory. Although everyone else should be happier in these societies, the person in question who might or might not commit suicide should also be, on average, happier. There’s no reason to think that the average hedonic distance between potential suicides and their neighbors is higher in these areas. Indeed, given that Scandinavia – and many of the other happy societies – are also some of the most equal societies, I would expect an unusually low hedonic distance between people. And in fact, I notice that suicide rates by country are negatively correlated with inequality – that is, the more unequal the country, the lower the suicide rate (wow, I definitely don’t remember seeing that one in The Spirit Level
On the other hand, I can’t for the life of me think of a better theory, so whatever.
Other things that increase suicide rates, by the way, include springtime, nice weather, high levels of education, and very occasionally antidepressants. My father, a very hard-headed internist, makes fun of me for doing psychiatry because “the whole field is just common sense”, but sometimes it really isn’t.
So you should probably think very carefully before using a difference in depression or suicide rates to support your pet theory about which societies work better than others.
You mainly compare yourself to your peers. In a feudal society it is a bunch of people in a very similar position, so you are Ok. In a very equal society everyone else is a peer, so even in Scandinavia many have it much worse than most peers. But even in Scandinavia the Great Depression of the 1990s made suicides less frequent.
Anothet theory says that when you have to work to make your living, you don’t have time to think and get depressed.
Afros: is it the genes? Are there adoption studies of afros into white familied vs. whites into afro families?
When you live in a country where there are enough *reasons* that you may die or become an invalid or be sacked and burden your family, …, you tend to spend some time thinking of ways to not let it come to pass. Which, I guess, is a useful habit to have, if you don’t want to end your life.
Regarding the last point, Scott makes a giant leap from self reported happiness to material inequality. More unequal societies have lkower suicide rates, so what? Daly, Oswald, and Wu (2011) are talking about happiness.
Just to speculate, if I’m depressed in a place where everybody is happy then i) my feelings of unhappiness contrast with the happiness around me, it becomes easier to see my problem as unsolvable (regardless of my equal material circumstances) and ii) I migth get a lot less understanding, empathy and compassion from the basically happy people all around me.
Suicide correlates with depression, the mind’s resistance to interacting with the world. It also correlates with education, something that could plant seeds of fatalism.
Also, and possibly more important, the average person has a different view of their potential future at different levels of income inequality. With high income inequality, more rich can see many avenues of failure and thus strive to prevent it, and more poor can see many avenues of advancement and thus strive to achieve it. If there’s a large middle class, there will be a greater percentage of people who see a tangled web of paths up and down. They’ll see no great path in any particular direction. They’ll see the future as about the same as the past and will feel powerless, hopeless, or bored.
Suicide may be more common with people who feel they have less control over their own happiness. Maybe happiness is the wrong word.
Suicide may be more common with people who don’t expect the future to be fun, to be novel and challenging, to not be boring.
You’ve noticed you’re confused. Maybe one of your assumptions is wrong. Why do you think people commit suicide?
Pingback: Lightning Round – 2015/01/21 | Free Northerner
You may have learned in Social Psychology that depression is just another word for sadness. That is not strictly true. There are many other factors that come into play here and isolation of depression & suicide as the only two factors to measure is a mistake. Best to recognize that a general sense of life satisfaction (good work/play/sleep) leads to happiness, and the lack thereof leads to depression, which may or may not lead to suicide. If I try & get 260 downloads of an app I make, you’re impressed & that’s satisfying. If suicide is considered culturally acceptable, there are more suicides in that particular state/country.
My wild-ass guess is that maybe more developed countries have higher levels of social isolation, because there are more resources for people to live independent lives, and because there are more resources to exclude or segregate people who are in various ways deficient.
“Meanwhile, tropical paradise Hawai’i is suicidal as heck, even though it doesn’t seem especially modern/industrial/liberalized.”
Hawaii also has a large percentage of active or retired military personnel. As a layman, my understanding is that soldiers are at higher risk of depression or suicide. Have the studies controlled for this?
Does anyone think that the impact of black swan individuals could have an impact on society eitherways? (eg. Maybe country A is just happy coz their president was Groucho Marx)
I always wondered why the conclusion from all these studies about how great Scandinavian countries are isn’t that we should have an aristocracy and a Lutheran state church.
Unfortunately, I haven’t read all of Kurt Vonnegut’s works, so perhaps he did contend that slaves had a lower per capita suicide rate than slave-owners. However, in the interest of correctness, I must point out that the post you link to has Albert Murray making that claim, not Vonnegut.
Successful suicides tend to happen during mixed states – beyond a certain threshold of depression, most are too exhausted and unmotivated to off themselves. This might help explain why ‘happier’ places have more suicide: their people don’t get depressed enough to inhibit successful suicide attempts.
Could it be that, in populations with high suicide rates, all the depressed people have killed themselves already and are no longer bringing down the happiness average?
Woman look for good genes and ability to provide in males. When providing is no longer challenge high genetic load males kill themselves.
I recommend you read the book The Selfish Gene by Richard Dawkins.
What makes you say that?
Thats not how it works.
It’s a pretty common concern among very wealthy people that their heirs could grow up psychologically warped from the lack of challenge in their life. (No citations, sorry. I know about this anecdotally from conversations with wealth adviser types. But maybe you could call it Foxcatcher syndrome?)
And that seems like an intuitively reasonable fear when you’re talking about extreme wealth. But perhaps the concept could be extended.
I rather like the idea that some countries may have become so good at meeting their citizens’ needs that even ordinary people might be vulnerable to Rich People Problems.
The “hedonic distance” hypothesis at least resonates with me. Being around happy people while depressed makes me that much more depressed. It’s way easier to cope when I’m not also being reminded that I’m failing to find the happiness everyone else seems to be splashing around in.
“the brain’s emotional regulation system doesn’t work well in low-oxygen environments.”
As someone who has had
a) not well-controlled asthma,
b) depression,
and c) emotional disregulation
… I’m shocked that not one of the doctors/therapists I’ve been seeing has mentioned this. I’ve been working on all three anyway, because it does seem like common sense that anxiety and asthma attacks would contribute to each other. But still.
“Other things that increase suicide rates, by the way, include”
…and church attendance.
I think the salient bits here are that:
1) suicide rates are not much different in Scandinavia than other oecd countries.
2) the articles does not examine depression rates, but antidepressant consumption where being medicated is accepted enough that Norway re-elected a prime minister while he was on antidepressants.
(which is pretty damn accepting tbh, especially since he was christian-conservative, imagine Bush trying that trick.)
Scott,
Excellent assessment of the article.
Now, that said (and I mean this with all well intention) you should probably leave the HBD stuff to me (or HBD Chick, Staffan, Cochran & Harpending, etc…)
There is a simple way to break all of this down – good old reductionism.
Well, it should be standard for the course by now, but as the aforementioned HBD Chick would ask, where does culture come from?
You only skirted with it, but the explanation for these patterns is obvious: genetics. Here’s a secret: all human populations are genetically distinct. The corollary of this is that genes are involved in the differences between all human groups.
This is should be most obvious when looking at broad racial differences, but it works equally well for differences between ethnic groups within a race. Looking for “external” reasons (e.g., poverty) (reasons which are themselves heritable) as the primary explanation is the Standard Social Science Model (fallacy):
http://twitter.com/JayMan471/status/519163247367577600
You correctly point out that Scandinavian countries do not have the highest suicide rates, either globally or in Europe. That honor belongs to Northeastern Europe – The East Slavic and Baltic states. Oddly enough, central continental Europe also has a high rate, particularly France, as you see mapped here.
http://twitter.com/JayMan471/status/556183876553703424
By the way, in my post More Maps of the American Nations, I broke down the White suicide rate (both firearm-related and non-firearm) in the U.S. Firearm deaths peak across Greater Appalachia and the Far West. Non-firearm suicides are highest in the Old North (Yankeedom and the Midlands).
Historic data would be useful here, but the general trope of various social conditions being responsible for suicides, particularly, global variation in such, is bogus. Global geography reveals a distinct latitudinal pattern (indeed, in both hemispheres, if you look closely); suicide is an issue mostly among cold-weather dwellers, and it appears to be most acute among the people from the coldest climates (indeed, it’s a serious problem for at least some Arctic peoples, particularly the Inuit).
This fits with one other fact: Neanderthal admixture. All non-Africans carry Neanderthal admixture. More poignantly, it appears genes that are involved in depression have been picked up from Neanderthals and have underwent positive selection. See Greg Cochran on it (Adaptive Neanderthal admixture | West Hunter). Major depression, unlike other mental disorders, may be a side-effect of adaptation for dealing with cold, dark winters. This is may be additionally buttressed by the fact that, unlike other mental disorders (like ADHD, schizophrenia, autism, etc), depression doesn’t seem to show a paternal age effect.
This also fits in with the matter of “negative self-evaluation,” a personality trait that is somewhat orphaned in the HEXACO system, but may show affinities to extraversion-introversion, since that seems to show a latitudinal pattern. See:
Predictions on the Worldwide Distribution of Personality | JayMan’s Blog
This explains why the northern Slavic countries have high rates of suicide while the Mediterraneans don’t. The latter faced a different set of selective pressures thanks to the climate, and are less likely to become depressive in response to adversity.
I don’t like your patronizing tone so I’m going to be harsher than usual.
Your reduction to genetics and culture is silly. Is parasite load genetics or culture? It’s one of the top determinants of a whole host of factors including many autoimmune diseases, so you can’t just sweep it under the rug. Is climate genetics or culture? And I don’t mean “climate of evolutionary adaptedness as represented in genes”, I mean actual climate – the kind where a black person in Sweden suffers a colder climate than a white person in the Sahara. To reduce everything to “culture” or “genetics” takes those out of the picture entirely – which is crazy considering the demonstrated link between climate and a lot of psychiatric illnesses.(possible misunderstanding? See below)Second, you’re conflating depression with suicide even though they’re very different things. Contra your claims, depression is not most common in Northern Europe. It’s very difficult to say exactly where it is most common – this list suggests South Asia, this list suggests France + Brazil + USA, this list suggests North Africa, no list suggests Northern Europe. So your “Northern European genes cause depression” hypothesis doesn’t even pass the basic test of matching the data.
High suicide rates also don’t obviously cluster in Northern Europe – Guyana, Kazakhstan, Sri Lanka, Uruguay, South Korea, Japan, and Bhutan all have higher rates than any Scandinavian, Western European, or Central European country (a few Soviet bloc countries are up there, though). I’ll give you South Korea and Japan – you forget to mention that East Asians have higher percent Neanderthal admixture than Europeans – but the rest are anomalous. Sweden, Germany, Norway, Denmark, UK, Germany, Netherlands, Iceland, Belgium, and every other country in North/Central Europe (except Finland) are all around the middle of the suicide rankings. At a glance, I’d say the best predictor is East Asian or Soviet bloc – and I predict that we would see eg higher rates in East Germany than West Germany to demonstrate a clear Soviet cultural footprint. You can find similar results for all sorts of interesting measures like social trust. Communism really sucked.
Equally important to all of this, depression and suicide rates have been rising for – well, as long as we’ve been taking data, but probably a century. This is clearly not a result of genetics. So even if some countries/groups are genetically predisposed to suicide – which the data show little evidence of – this is going to interact with the secular trend – ie which countries have been exposed to whatever factors are increasing the rate most strongly. A good analogy here is obesity – there are known genetic risk factors for obesity, but the secular rise in obesity is caused by something else, probably changing diet plus toxin burden. In the countries that have been exposed to the diet+toxin burden, the people with the genetic risk factors are the ones who become most obese, but in countries that don’t get exposed you can have whatever genes you want and be at low risk of obesity. That’s why for example even though Polynesians have terrible metabolism genes and get fat as soon as Western culture is imported to their islands, over most of recent history the number one factor determining obesity across countries is not genetics but how westernized the country happens to be – even the Polynesians will be svelte before their islands get Westernized. You rule out diet by default, but I continue to think it’s responsible for a big part of the secular trend and therefore may be to blame for some of this affluence/depression connection. Just eyeballing it there seems to be a pretty impressive correlation between cancer rates and depression in various countries and my guess is it’s because of the same biological/dietary/immunological factors.
You may be confusing depression and suicide with bipolar disorder. There’s a reasonable body of research linking bipolar disorder to Neanderthal genes and cold-adaptedness. I don’t see many people other than Cochran bringing up depression in this context, and him only as a random aside. But bipolar disorder, although it causes depression, is a totally different disease with different epidemiology, treatment, genetic loading, et cetera.
TL;DR: You have an excellent hammer and I enjoy seeing your many contributions to hammerology on your blog, but this problem doesn’t show signs of being 100% nail.
It is silly, but while I can’t speak for JayMan, I’m >95% sure you misread him, and that his point was that separating out culture and genetics doesn’t make sense, because most of what look like ‘cultural’ differences (“The Indians save more than the Africans!”) turn out to be genetic differences (“The Indians have more ‘save money’ genotypes than the Africans, and this shows up in the phenotypes!”), because people with spendthrift genes and frugal upbringings are typically spendthrift instead of frugal.
Even if he means that, I disagree with him. Culture is a combination of genetics, history (Middle Eastern culture is heavily shaped by India, as are countries like Indonesia which are culturally unrelated to the countries that invented Islam but got invaded/converted by them), environment (Eskimo culture is pretty much whatever helps you survive in the Arctic, even though they haven’t been around long enough to evolve into it very well), gene-culture coevolution the opposite of Jayman’s expected direction (some theory that Jews entered clerical occupations because Jewish religion strongly promotes literacy, and then Jews adapted to these adaptations) and random drift/chaotic adaptation to small initial random differences.
Scott, I think you’re misreading Jayman, or maybe I am, but I read his blog and many others that he comments on. I don’t think he’s being patronizing.
Otherwise, I’d like to mention that I’m one of your new readers who found you through alt-right/HBD blogs. Like Jayman and yourself, I lean pretty hard to the left yet entertain ideas that are anathema to many liberals. Your blog is refreshing and occasionally makes me feel much more optimistic than I normally do, and I’d like to say thanks.
@Scott Alexander:
Sorry if I seem to come off rude (not the intention), but you have to understand, I deal with nonsense literally on a daily basis:
http://twitter.com/JayMan471/status/556106820050505728
Gene-culture co-evolution. I suppose this is the extension of HBD Chick’s question: where do genes come from? Climate, pathogen loads, etc. These things shape the selective pressures that direct the course of evolution, and hence, the genes we all have.
In any case, as for pathogens, I’ve written a little on that:
Greg Cochran’s “Gay Germ” Hypothesis – An Exercise in the Power of Germs | JayMan’s Blog
Can we agree going forward that correlational links aren’t evidence of causation? For one, there’s no evidence that climate has any effect on mental illness, beyond the fact that certain peoples live in certain climates. Greg Cochran and Paul Ewald have speculated that endemic pathogens may also play a role in such.
Forgive me here, but I must say I think you misunderstand what I mean by that (I certainly wouldn’t say genes AND culture). My point was that genetic differences are involved in:
Differences between individuals within a group
Differences between different groups
Differences between the same group at different times (only over sufficiently long time periods, however – centuries )
So whenever you compare individuals or groups, you need to take genetic factors into account. Indeed, it’s probably where you should start.
I saw that. The key problem is as you describe: it’s hard to get a good idea of mental illness prevalence across the world because of a lack of consistency in diagnosis. So it’s hard to say. I agree, using suicide rates isn’t exactly a valid proxy for depression per se (but it is a good proxy for “suicidiality”.)
But that’s not what I said. Suicide rates are elevated across northern Eurasia vs. the rest of the world. I avoided saying “depression” precisely for the reason that it’s hard to gauge depression rates across the world, as per above.
See above on correlation and causation. Again, as HBD chick would ask, where did communism come from?
(As for the social trust bit, HBD Chick, Staffan, , and I have talked about that).
Have they been rising? I’d love to see historic data from across the world.
But trust me, I know all about secular trends, except what causes them (no one does). I do know whatever causes them, the constrains what these possibly are are tight. Since environmental differences between individuals at the same time cause, at most 25-30% of the variance between individuals (and likely a whole lot less than that thanks to developmental noise), it’s not likely to be anything that varies between people today – which rules out a lot.
No, I didn’t say that. If that’s what you get, I guess I’m not communicating myself properly here. But that’s possible, sure.
Is that age-adjusted? But the other possibility are pathogens.
For the record, most cancers have low heritability and are uncorrelated with IQ. That rules out lifestyle factors as being involved in most.
No, I mean depression. Bipolar disorder does exhibit a paternal age effect, and is likely caused by genetic load. As far as I know, they haven’t linked genes involved in bipolar disorder to those from Neanderthals.
There is of course nothing saying the same genes cause depression in different populations (although they might).
Commenter “Anonymous” below has got the right idea.
I agree you have to deal with a lot of nonsense from stupid people and I respect you a lot for putting up with it. I am asking for recognition as not the sort of stupid person who is saying stuff because they don’t understand genetics exists. I’ve read Cochran, I intermittently read you and HBD Chick and Human Varieties, I’m aware genes exist, but environment sometimes matters too – not in the sense of “tell children to be nice in school and they will” but in the sense of parasites, diet, lead and other toxins, etc. Sometimes it matters through evolutionary adaptation, but other times it matters directly.
I am saying that climate and evolutionary-response-to-climate are two totally different things, and you seem to be assuming that climate can be safely reduced to evolutionary-response-to-climate. Just to give an example, I have a friend who has seasonal affective disorder every year in her (high-latitude) home. So she goes t o the Southern Hemisphere each winter and does fine. Clearly it is the actual effect of climate causing her depression rather than her evolutionary-adaptedness-to-climate.
The same is true of pathogen load. Yes, lots of stuff is probably caused by evolutionary-adaptation to pathogen load, but a lot is probably caused by the load itself. For example, a whole of it important indicators changed in the Southern United States when they eliminated hookworm, suggesting that the worms (and not adaptation to the worms) was the issue. In fact, the strong pathogen-load related correlations in the United States (where people haven’t had enough time to adapt to their environment) show the same thing.
You are making the technically correct point that sometimes environmental factors exert an influence via genes, but I am trying to make the point that sometimes they exert a direct influence too. Are you able to grant that? If so, I’m not sure what we are disagreeing on here.
Um, there’s reams of evidence showing the existence of seasonal affective disorder, correlating light levels with depression, showing different levels of suicide depending on the weather, et cetera. There are even many studies showing that sun-imitating lamps that alter perceived “climate” are a very effective depression treatment. In contrast, your genetic-climate-adaptation hypothesis at this point is completely speculative.
No, you said that “major depression, unlike other mental disorders, may be a side-effect of adaptation for dealing with cold, dark winters.” It’s hard for me to see how you can posit that theory without claiming that depression is more common in northern climes or areas with higher levels of Neanderthal admixture.
Take away the depression component, and you have to claim that suicidality independent of depression is an adaptation to dark winters, which seems less a priori plausible. And I still wish to point out that Northern Europe isn’t an especially suicidal region of the world so we’re trying to explain data that doesn’t exist.
No, sorry, I’m not going to let you get away with saying Communism is genetic. The main way people do all these comparisons is by comparing East Germany to West Germany and finding big differences. Some of the better ones find differences right on the borderline, or counting Allied-occupied parts of Berlin as West. I checked the map of suicide rates and there’s a clear East vs. West German distinction. This is a good control group as the difference is clearly related to the contingent historical factor of whether US/UK vs. Soviet armies conquered an area first in WWII.
You’re ignoring that intercultural variation can be much bigger than intracultural variation. The classic example is the stereotypes of short Japanese people common in WWII. Japanese people started eating a more Westernized diet and now they’re much taller. I’m not sure what the environmental component of height within the US was at the time, but I bet it would have underpredicted the environmental component of US-Japanese differences
…lung cancer is minimally heritable and not correlated with IQ, but we know that it’s very heavily influenced by smoking. I don’t think your methodology here works.
Can we agree going forward that correlational links aren’t evidence of causation?
P is evidence for Q iff P raises the probability of Q, which is true iff P is more probable given Q than given ~Q. Causation entails correlation, hence correlation is more probable given causation than given ~causation.
You can argue that correlation is not strong evidence of causation. But this is a different claim.
Thanks — I was not being terribly precise. Here is a more precise formulation of the claim that causation entails correlation: if A invariably causes B relative to background conditions C, then A will be correlated with B relative to background conditions C. In the example at hand, if we held outside temperature constant and varied the amount of oil burned, the inside temperature would correspondingly vary. I can’t see any counterexamples to this claim (but am welcome to correction if there are some).
On the other hand, if we vary the background conditions, then our correlation might vanish (or reverse), as in the original thermostat example.
That said, the cases which led JayMan to claim that causation is not evidence of correlation do not seem to me to be like that example. For instance, I can’t see what the mechanism would be by which Communism causes higher suicide but does not correlate with higher suicide. (The processes or persons responsible for bringing about Communism are presumably not aiming at a constant suicide rate in their population, as a homeowner aims at a constant temperature.) Perhaps this reflects lack of imagination on my part. I’m content to retreat to the claim that in most cases of interest, subject of course to background knowledge, the probability of correlation given causation is very high, and so in most such cases the correlation of A and B is evidence that A causes B (and evidence that B causes A). This is, of course, compatible with it being weak evidence.
Does anybody know whether suicide rates among intraverts and extraverts are different?
Your elevation hypothesis fails when tested across countries in the Americas: based on tables here: http://www.paho.org/hq/index.php?option=com_docman&task=doc_view&Itemid=270&gid=27710&lang=en (which I found after the link in the Daly, Oswald, and Wu paper failed), the American countries with the highest elevations also have some of the lowest suicide rates. Bolivia and Peru, and Haiti, are the only countries with less than 1 per 100,000; most of the population of Bolivia and Peru live at pretty high altitudes. Colombia’s suicide rate is pretty low, and a big chunk of the population lives above 2500m. On the other hand, the Bahamas and Grenada aren’t known for their lofty heights, and also have very low suicide rates. (And Brazil’s rate is slightly lower than that of Colombia, even though most of the population in Brazil is pretty close to sea level.) I don’t have decent elevation/population distribution data, so I can’t run a correlation between altitude and suicide, but I’d guess it’s in the range of -0.2 to 0.0.
Possible confounder: What if those countries have a higher population of natives who are adapted to high altitudes (a la Tibetans)? Perhaps it’s just white people who kill themselves because the air is thin.
Well, that certainly can’t be ruled out for Bolivia, but both Peru and Colombia have pretty mixed populations, with lots of white and mostly-white people; at least in Bogotá, many of the Indians and mestizos there are originally from lower elevations which would be a further confound.
Something to look into – why is the rate in the British Virgin Islands so much lower than in the U.S. Virgin Islands? Is it the Danish history of the USVI?
Trying to get a one-sentence explanation for a complex phenomenon by glancing over some statistics is a long shot anyway. (It’s often worth a try though.)
By the way, what was the last time you read an news article (especially online) which was interesting and correct? I don’t remember any particular instance from the last few years. Another reminder that I should really change my reading habits.
There is a Darwinian explanation for the positive correlation between general happiness and the suicide rate. No need to spell it out to this group, OC. 😉
That’s what I was going to propose. I was surprised not to see the idea mentioned in the first few comments.
I need it spelled out for me, sorry.
The sad people will die.
The problem with that explanation is that suicide rates aren’t that high.
1. That doesn’t explain why higher happiness correlates with suicide.
2. That makes no evolutionary sense.
It’s a joke.
If everybody in one country who was not happy committed suicide, then everybody who was left would be happy. But if nobody in another country who was not happy committed suicide, then not everybody who was left would be happy. (OC, happiness does not work that way. It’s a joke.)
It’s a Darwinian explanation because suicide is a form of natural selection.
While I did not know the exact percentage of Danish zoophiles, I did know about Danish attitudes (or the stereotype of them) thanks to this webcomic, “Scandinavia and the World”:
I highly recommend this book for insight into the connection between depression and social connections. Lots of good studies, stats, and neuroscience to explain what’s really going on and why depression exists in “happy places”.
http://www.barnesandnoble.com/w/loneliness-john-t-cacioppo/1100291273?ean=9780393335286
As far as the accusation against Scandinavia. I spent 6 years working with danes and spent several months in their country during those 6 years. I can say from my experience that they are indeed happier than the americans I worked with. One of the danes I worked with commented on this happiness rating and said it was because danes are so pessimistic that when the year actually happened they were all pleasantly surprised.
From The Restaurant at the End of the Universe, by Douglas Adams
We should be able to check for 1-5 by looking at historical data, assuming we have that. Those factors should have been fairly constant. If anything, global warming should be improving them.
#6, on the other hand, is pretty much what the original article is claiming.
I’m confused, how does Global Warming change 1,2 and 4, which seems like something involving the sun, instead of the atmosphere?
I suppose 4 also involves the temperature, but I doubt the time and temperature scale on which AGW works on is enough for either agriculture to change or for agriculture to move enough north that the food is noticeably fresher.
I suppose you could have meant “they should remain constant, but some factors should increase due to global warming”, although 4 seems like as if it should change drastically from historical levels, owing to better logistics due to technology and varying amounts of trade due to political/economical factors.
Let’s talk not only about Scandinavia. I think that latitudes, climate, genetics and other things you have mentioned are more or less constant in any country. Then why does suicide rate ever change? And why sometimes it changes so drastically, like, for example, in Greenland?
http://www.slate.com/articles/news_and_politics/dispatches/2009/10/the_suicide_capital_of_the_world.single.html#pagebreak_anchor_2
In 2011 Greendland’s suicide rate was 83 suicides per 100,000 people per year, by far the highest in the world.
If this is because of 6.Culture, then why did the culture change? Was their culture simply doing random walk and then accidentally got into a positive feedback loop?
Were the reasons related to alcohol consumption? By the way, is there a correlation between country’s alcohol consumption and suicide rates? The two Wikipedia lists are not identical, but they seem to be pretty similar. If two countries which are otherwise similar have different alcohol consumption rate, they seem to have different suicide rates as well. Of course, there might be some kind of hidden variable.
Is alcoholism rate a sign for social dysfunction?
I admit that “random walk, positive feedback loop” is a pretty awful theory with which to make predictions, but there is some evidence that it’s possible; “copycat suicides” are a real thing at least on a small scale, and it’s hard to come up with a model for them that doesn’t also predict “when connections between potentially-suicidal people hit a critical density, the number of actually-suicidal people will abruptly jump to a higher equilibrium”.
Alcoholism appears to correlate with at least an order of magnitude increase in suicide rates, possibly two or three. But it’s hard to tell whether the mechanism is “potentially-suicidal people turn to alcohol”, “drunk potentially-suicidal people are less inhibited from attempting it”, “alcohol does enough damage to make some people suicidal”, something else, or some combination of factors. “Let’s randomly select half of an enormous study group, then make them start drinking excessively to see whether more of them kill themselves” is the sort of thing that IRBs frown on.
If two countries which are otherwise similar have different alcohol consumption rate, they seem to have different suicide rates as well. Of course, there might be some kind of hidden variable.
Age of population. More young people=more suicide and more binge drinking.
Nope, proportion of young people actually does a worse job at predicting suicide. And not just because of the developed / undeveloped country axis.
This is interesting.
Approximately 90% of Greenlanders are Inuit, and suicide rate has also been rising in other Inuit populations.
/So, it turns out that Inuits, not Europeans, are the polar opposite of Africans in this respect./
Wikipedia says that they used to have a tradition of pragmatic suicide by the elderly (the living conditions in Greenland were so harsh that the earliest Norse settlers died out; the Inuits survived). Although this new trend consists mostly of young people, they also tend to use very effective methods – hanging and guns. Hunting rifles are common household objects.
The culture has probably changed quite a lot, since Denmark converted Greenland to a more modern economic lifestyle. Previously, Greenlanders could support themselves independently, and wouldn’t care much if Denmark ceased to exist. Now, they live in a remote, economically weak part of Denmark.
http://mipi.nanoq.gl/~/media/2c79218a8db44635b61978c03685691c.ashx
It’s more common among students, the unemployed and unskilled workers, and very uncommon in high-skilled white-collar jobs. Troubled relationships, stressful life events, mental health issues and substance abuse have been identified as contributing factors.
So, I’d say that Inuit suicide, unlike Scandinavian antidepressant use, does seem related to social dysfunction.
I’ve always found (rationalizations of) the “SSRIs can cause suicide” effect to have a lot of predictive power.
For example, what if depressed people would commit suicide but are too unmotivated to do so—and giving them an SSRI boosts motivation (dopaminergic side effect at one week) before any actual anti-depressant effects kick in (usually 3–6 weeks), such that they become very motivated to do something about their life… while still in a depressed state of mind?
If that is the mechanism, I would predict that societies with causal factors for both depression and mania would have the highest suicide rates.
This is a great place to mention the Viking Birthday Dirge:
> Other things that increase suicide rates, by the way, include springtime, nice weather
I remember I’ve read somewhere that patients in the hospitals tend to die early in the morning (as opposed to the middle of the night) because that’s when they lose hope.
Another thought: what if predisposition to depression is not a result of, but an adaptation to living in the far north, like a kind of hibernation instinct? If it’s a given that it will be super cold and dark for a good part of the year, then maybe it’s adaptive to become low-energy and unmotivated in reaction to cold and darkness?
Related anecdata: I grew up in a sunny part of the southern US, but my ancestors are from Ireland and other cold dark places, a fact which is reflected in my skin tone, which seems obviously adapted to absorb maximum UV radiation for vitamin D when sun is available, but which is not well suited to my sunny place of birth. I am probably mildly bipolar, which might also be an adaptation to stark seasonal differences, and a need to be really high energy sometimes and really low energy at other times.
So, not sure whether bipolar, as well as unipolar depression is more common near the… poles, but if so, it might be that having ancestors who lived near the poles is more important than actually living there.
I have also read of the opposite problem: Ethiopian immigrants in Detroit apparently suffer unusually high levels of SAD. One guesses that there is not enough sun there to provide the amount of UV light they are evolutionarily adapted to deal with and expect.
Also, in fairness to the original article, some people are fucking weird about Scandinavia. For liberals, there’s a constant flood of articles saying “Scandinavia does X, Scandinavia is awesome, therefore we should do X”. For conservatives, there’s a bunch of talk about how they’re low on diversity and thus have a more functional society.
Though maybe I’m just overexposed to this attitude, having lived in an area with a lot of immigrants. But I find it pretty annoying, either way. The semi-worshipful view of these countries creeps me out. Undertones of nationalism and societal engineering from the liberal side, undertones of racism from the conservative side, tribalism for both, yuck.
If you are arguing with the sort of conservatives who think anyone who disagrees with their brand lf conservatism most be a Stalinits, then Scandinavian is a useful shorthand for what you actually think. That isn’t Scandinavia worship, though.
Usually, any mention of Scandinavia is not actually about Scandinavia, it’s about a local American issue on which Scandinavia can serve as a remote and non-factcheckable source of rhetorical ammunition.
—Bjørn Staerk
+1
Someone has to suggest it: could higher IQ be a cause of higher suicide rates (or contribute to/be related to a cause, such as greater introspectiveness)?
Good point. Greater introspection, greater exposure to idea-sets that promote Schopenhauerian ennui, and also perhaps a correlation with greater overall nerdiness/dearth of social skills that leads to loneliness and isolation. Between genetics (about which I’ll leave it to others to have opinions) and the Flynn effect presumably being more powerful in societies with universal quality education, higher IQ seems reasonable.
American data would seem to falsify the IQ hypothesis. Check out pages 49 and 50 of http://www.paho.org/hq/index.php?option=com_docman&task=doc_view&Itemid=270&gid=27710&lang=en
Cuba, Surinam, and Guyana probably aren’t the countries with the highest IQs, and I doubt that Peru and Bolivia have overall lower IQs than most of the rest of the Americas.
I would think it has more to do with struggle, purpose, and meaning than with anything else. In a society where all your needs are taken care of, where you have no real meaningful struggles, you have less to live for. Call it the psychological equivalent of Newton’s third law of motion. Plus you are surrounded by a culture that’s necessarily more stoic and has lower expectations all around, so little things like romantic rejection or a dead end job don’t seem like real problems – either to you or to anyone you talk to.
It’s a cognitive bias, the same that that causes the parents who get hit the hardest by the disutility that having a child causes, are those who find the most “meaning” in it.
Unpacked : humans sometimes experience disutility without compensation. Their brain then invents a fuzzy feeling of “meaning” to delude them into resignation to the disutility, regardless of whether they could stop it from happening to them.
It seems really weird to call this a “cognitive bias” rather than “minds working exactly like they’re supposed to.” People find things which are difficult and costly to be meaningful, and the fact that they feel this way is a “bias” because… why, exactly?
Because the illusory meaning prevents them from solving the problem which is the thing causing them disutility in the first place.
Of course, if they prefer the illusory meaning to the absence of disutility, then it would arguably be better to leave them deluded, but I see that as equivalent to treating an bacterial infection that causes self-flagellation with heroin instead of antibiotics.
Why wouldn’t feelings of meaningfulness be part of utility?
They are, but in the same sense as heroin is positive utility to the flagellant : it helps cope with the disutility, but it really doesn’t solve the problem, the source of the disutility. It rearranges the preference order in a way that may not align with the preferences hidden under the comfort of the delusion: “there is meaning in this disutility I experience”, “it is good that i feel the pain because then i get sweet, sweet opiates”.
tl;dr : it is a bias because it works against having a good decision theory.
Meaning is “illusory” in precisely the same way that sadness is illusory: it exists in the mind of the person experiencing it. So if the subjective experience of meaning allows someone to survive the subjective experience of depression, well, I’m gonna call that a win.
Your concern seems to be that meaning removes the motivation for people to escape from their circumstances. In cases where escape from circumstances is unlikely or impossible, then this feeling of meaning seems to be a really good palliative to have. And in cases where escape is possible, I don’t see that “meaning” is actually preventing many people from taking action. On the contrary, you often hear people say that they gain meeting specifically from the work required to get out of a terrible situation.
I didn’t mean illusory in that sense, i mean in the sense that it does not reflect truth. Sadness because of Things That Happened is supposed to help reinforce aversion to things that make feel sad, while depression is supposed to be more typically caused by things outside of the depressive’s control. Moreover, I’m not sure that feeling of meaning doesn’t reinforce depression more than it helps… The meaning I found in my depression was more helping to sustain it, but I know that’s me and I know that I have no idea whether that’s typical.
In cases where escape is unlikely or impossible, those are cases where it would be better to have a palliative, I totally agree with that point.
But in cases where escape is possible, I know that there are people who are actively hindered by that feeling from getting out of the situation (I was* one, and I’m certainly not the only one ever); but of course, it’s a very good strategy to find even an illusory meaning, even if only for motivational purposes, in working as required to get out of the situation.
* possibly still am… probably.
Incidentally, this could be a good argument against MRA claims that claim that higher rates of male suicide show we are in a gynocentric society or whatever.
(I get the sense that you wish so many of your blog posts weren’t regarded as a go-to resource for MRAs. I’m not sure whether it would be better or worse if some of your posts were selectively misinterpreted in service of MRA arguments, and some of them were selectively misinterpreted in service of feminist arguments.)
IIRC, women have higher suicide *attempt* rates; men succeed more often because they use more violent methods. So you could spin it the other way just as easily, if not easier.
Now there would be a gutsy argument for MRAs: “Women are trying to kill themselves more! This shows how good they have it in comparison to men!”
Or we could come up with a different explanation by showing how many of these happy, first world countries also happen to have a high amount of feminism (however you want to measure that). Therefor, feminism causes suicide 😛
tl/dr: Depression might be a response to lack of relatively weaker in-group members.
I think the the equality/inequality explanation is worth another look.
The rank theory of depression makes good points about the adaptive value of depressive symptoms. When the subject is in a situation of low social rank, typical depressed symptoms like greatly reduced ambition and aggression, loss of energy, sheer unpleasantness (which reduces voluntary interactions) etc. make a lot of sense. They make the individual accept a subordinate role. Since this has obvious survival value, it should be selected for in any social species that has a dominance hierarchy and non-ritualised in-group fights.
But how could this adaptation detect low status? It can’t require reflective thinking, because depressed dogs exist. My suspicion (not from rank theory) is this: What triggers the depression response is a lack of obviously relatively weaker (dependent or safe to bully) group members. My suspect is some dumb “do I know anyone I’ve dominated recently” pattern detector, maybe located near the superior temporal and lingual gyri.
This not only fits the data regarding correlations with societal inequality. It also explains how pets help, why the retreat it triggers actually makes it worse and why depression worsens sleep (low-ranking members of a cohabiting group need to be more alert at night because they sleep on the edges). It also fits really really well with a lot of depressed patients’ stories, who often report disappearance of a significant comparatively weaker in-group member shortly before symptoms begin. And it explains bullying (and why it tends to be inflicted by bullied people) as a way to keep the depression response at bay.
But in order to be adaptive, this depression response has to be at least interruptable, if not reversible. (When the saber-tooth tiger is around, the lack of energy etc. must be temporarily suspended.) So its physiological correlate has to be some sort of self-reinforcing circle of hormonal, neurological, behavioral etc. signals that can be disrupted. That disruption is what electroconvulsive therapy, antidepressants, other psychoactives and sleep deprivation do. It isn’t about specific levels of BDNF, serotonin etc. (these couldn’t be corrected in an instant when spotting the tiger) but only about changing the weights between them so the self-reinforcing depression signal loop falls out of sync. But once the disruption is over, unless the perceived position in the dominance hierarchy has changed in the meantime, the depression response kicks in again, by right of its adaptiveness.
This suggests a possible intervention I haven’t read anywhere: teaching. Being a teacher for a bunch of pupils creates a temporary but sharp status divide between the teacher and pupils. So if you think this hypothesis has merit, consider suggesting to depressed friends (or patients) that they teach something, any skill of theirs, to a group of people. Or lead an improvised choir, or direct a bunch of submissive helpers cooking a complicated meal, or something with similar status properties. Of course depressed people will abhor this kind of task, but maybe you can convince them to try it for just a single hour. I bet that one hour would already have a noticable effect that you could build on.
I like your theory, but I have a quibble.
Wouldn’t a truly adaptive strategy involve being pleasant and ingratiating yourself with higher-status group members, rather than pushing them away with your surly attitude?
See also: Uncle Tom syndrome, Stockholm syndrome
Hmm, I would actually expect the opposite to be true. Or something like the opposite, rather. I don’t think it’s the increased equality of modern society that causes depression, but the increased inequality. It’s not that we don’t get to dominate anyone; it’s that we’re constantly surrounded by people who are more powerful than us. If you work for a large corporation, there may be more status levels between you and the CEO than could even exist in a small tribal society.
Though anyway, I’m not sure how much I believe my own theory here. Neither of our explanations seem to allow for naturally submissive people who enjoy being dominated (although presumably it’s more nuanced than this, and some types of being dominated are enjoyable, while others suck).
You might be interested in this section of the OP:
Yes, this explanation is not post hoc enough 😛
A quick search for “depression rate teachers” leads to a bunch of articles about how high that rate is. Other top-ten-depression-rate occupations apparently include nursing-home workers, child-care workers, social workers, and health-care workers (including doctors, not just nurses), each of which sounds to me like a career that would have no shortage of opportunities for interaction with lower-status people. Even if lower-status kids don’t count (maybe your hindbrain can’t rule out the possibility of them ending up as higher-status when they’re your age?) that still leaves nurses (who interact with lots of low-status people), doctors (who do the same and are high-status themselves), and social workers (whose clientele are specifically selected for low status).
I’m not sure whether these jobs are evidence for or against the “people in more egalitarian countries are more depressed because they can’t even see any rational explanation for their depression” theory. If you job is trying to help physically, psychologically, and/or economically damaged people, and you’re feeling depressed, do your thoughts turn to “it makes sense to be depressed considering how much suffering I have to witness” or to “it makes no sense to be depressed when I have things so much better than these people”? It seems like you could tell a just-so story either way, then tell a second just-so story about whether “rational” or “irrational” depression is likely to become worse, and by the time you’re done you’re just overfitting, not really theorizing.
Excellent points, thank you for your help. I hope I’m not overfitting when I repeat the relevant status differential has to be within the depressed individual’s in-group. So donating to starving kids in Africa shouldn’t significantly impact depression, unless one deeply feels them to be part of one’s in-group.
I failed to mention I was thinking about teaching a circle of interested friends or at least a group of fellow patients, in an informal skillsharing kind of setup.
In the case of teaching a circle of interested friends, I guess I agree that it would likely have helped, but that no longer seems to be about a status differential. To me the most useful aspects would be that (a) I’m interacting with friends, hopefully on a more than superficial level, and (b) I can feel I’m accomplishing something useful in teaching them. As the teacher for a summer course I feel a lot more replaceable compared to, say, helping a friend figure out SQL, not because the skills are different but because the relationship is.
But…not to be overly critical, but “hang out with friends” seems like the sort of advice I’d have come up with anyway.
This is obviously anecdotal, and I’m sure there were a number of reasons for it including the medication I was taking at the time, but this didn’t work for me. Last summer I taught a college class, and was arguably the most depressed I’ve been in my life.
Also, I’m pretty sure I’d rather have friends around than subordinates, though maybe you’re arguing that it’s a lot easier to acquire the latter?
This is just excellent. It predicts my experience well.
Your theory matches nicely why research into fixing male depression with teststerone shots seems to be workable. When you lose a dominance contest, your T drops about 10-20%, when you win one it may increase as much as 1000%. Not winning any may cause an extra drop.
If T is the barometer of the success of dominance contests (meaning it does not play a lot of role in causing success, but its level is a clear signal of how much success you have), then you may as well simulate that success with a T shot.
The guardian guy seems to think that the highish Finnish
homicide rate is related to the gun ownership rate, which isnt exactly an antiliberal point,
Is there any correlation between suicide and whether people have children?
ITT: “sure, sure, depression isn’t a measure of sadness … but hey, what if people in Scandinavian countries are actually really sad because they have no challenge in their lives?”
>Culture. Maybe the biggest factor in the level of depression and suicide in a culture is whether it is culturally acceptable to be depressed and commit suicide. Some of the lowest suicide rates are found in heavily religious cultures and communities who believe suicide is a mortal sin. On the other hand, one of the most suicidal countries in the world is Japan, with its heavily-mythologized history of heroic samurai taking “the honorable way out” when they had brought shame upon themselves. Well, Scandinavia is one of the least religious regions in the world. And all I know about their culture is that they produce about 100% of good death metal, and their native mythology ends with the world being plunged into eternal winter and the gods being eaten by wolves.
Thaaat … seems kind of like what the neoReactionaries were saying? That modern culture is too emotionally permissive, or whatever?
Anyway, if true, it seems like a solid point against modern/progressive society. It may not outweigh the benefits, even so, but still.
>The authors’ preferred explanation is that suicide is an effect of relative rather than absolute misery. If you’re depressed and everybody around you is very happy, that makes things worse than if you’re depressed and everyone around you is also pretty miserable. Thus suicide is more common in happier societies.
>I really don’t like this theory. Although everyone else should be happier in these societies, the person in question who might or might not commit suicide should also be, on average, happier.
… unless depression is “a complicated mess of neurotransmitters, cytokines, hormones, changes in brain structure, and goodness only knows what else“, so people are just as depressed regardless of how happy they “should” be if they weren’t depressed?
The Christian pastor Michael Pearl recommends beating (oh, sorry – “spanking”) your children with a plastic tube if they appear angry, sad or insufficiently enthusiastic to obey your orders. He claims that this method results in children who laugh a lot.
Same idea, different scale?
I think that may be different. I know the guy and his ideas are creepy as fuck, yet, if we look at it from the princple of maximum charity we can say that perhaps it helps from breaking free from the ego. In the sense that having to endure pain you hate enduring and really really don’t want it makes you okay with things you really don’t want. This, perhaps leads to seeing what you want and not want as something less important, and more focus on how things objectively are.
Yet, even in the best case it is like taking ideas for farming from the Bible. The basic principles may work, but we can use way more modern ways to put them into practice.
Maybe the biggest factor in the level of depression and suicide in a culture is whether it is culturally acceptable to be depressed and commit suicide.
I’m not sure that should always be considered a single unit. What if the more suicides the fewer long-term depressives? Even where suicide is also unacceptable, still the person will not be around to be embarrassed, so that may not be much of a deterrent.
If it’s true – and I’m not sure it is, since suicide is famously underreported in some cultures because it’s, well, socially unacceptable – then I’d imagine it’s a question of identifying as “depressed”, and suicide being a readily-available option. If your culture views suicide as something cowards do, and you don’t identify as a coward, that’s very different from it being something “normal people” do.
We know suicide rates (and totally-not-suicide vehicle crashes, depressingly) increase noticeably when there’s a high-profile news story about someone committing suicide, and IIRC it’s pretty clear that switching away from gas ovens decreased suicide rates (because they were just such a temptingly obvious way out, back in the day); so the sheer availability of an option is important. So … it would be pretty surprising if this had no effect.
Still, if social acceptability of suicide is the single most important factor in suicide rates, that’s a lot stronger and more worrying than I would have anticipated.
IIRC it’s pretty clear that switching away from gas ovens decreased suicide rates (because they were just such a temptingly obvious way out, back in the day); so the sheer availability of an option is important.
Another comment mentioned availability of guns in Finland. For statistics crunching, such figures are probably available and relatively unambiguous.
We know suicide rates (and totally-not-suicide vehicle crashes, depressingly) increase noticeably when there’s a high-profile news story about someone committing suicide
I expect my sarcasm threshold is set too high.
Relatively few suicides in Finland are by gun – about a fifth of the total. Gun ownership is about as common as in Sweden or Norway, but Finland has consistently higher suicide rates.
Wild and implausible theory: everyone is born with a determined amount of potential happiness. In a happy country, you use it up quicker, and so more people reach a point where they are like, “meh, guess I’m done now.”
You can tell I’m not a psychiatrist or a neurologist, right?
For the record, I don’t know many Scandinavians, but I’ve liked all the ones I’ve met. Pretty sure that joyless is a very inapt way to describe my interactions with the Vikings so far.
I think you’re a lot more likely to encounter the more outgoing, adventurous Scandinavians abroad. The grim pietists of my home region don’t make much of themselves outside the country’s borders.
Alternate theory: each society has a certain happiness threshold, below which they will kill themselves. Happiness is randomly distributed. For the sake of example, I’ll just use a 0-10 scale for happiness.
Greek people have a strong suicide taboo, and will only kill themselves at or below 1 happiness – thus, living Greeks are in the 2-10 range, averaging to 6.
Danish people have almost no suicide taboo, and will kill themselves at or below 5 happiness – thus, living Danes are in the 6-10 range, averaging to 8.
Of course, I wouldn’t actually expect happiness to be evenly distributed. But, for example, a bell curve will just make the effect more extreme – if the only people who commit suicide are at rock bottom, very few will die. If anyone who is just having a really bad year kills themselves, you’re going to have a problem.
So, erm, TL;DR: The effect could be going the other way?
It is hard for me to imagine not having much of a suicide taboo (I am Hungarian, we have brutal suicide stats, still).
I mean specifically the part that people who have parents who love them killing themselves. How can a society not see this as something causing horrible pain to people you owe a lot of gratitude to? It’s the most ungrateful thing ever. It is the only thing worse than refusing to give grandkids to your parents. (Child-free people will probably hate me for this, but I think this is part of the implied social contract between parent and child. Parents don’t spend 18 years of time and money on kids just because they are cute, they expect something back. Which is: to pass on the genes. If somehow doctors told me I can have kids but by kids will be sterile, I would not want to have kids. Their temporary cuteness does not worth the investment. Making the dynasty go on as long as possible worths it.)
Sure, I understand if orphans etc. or people with shitty parents have little suicide taboo.
But for people whose parents are okay, it is a terrible breach of contract IMHO.
Although here in Hungary suicide rates are high, I don’t know of anyone who did it, probably it is not young and middle aged middle class people with functional families. I think it is the old, homeless, alcholic people who have no families. Or some other kinds of poor “outcasts”. But not the well to do people with okay parents, of that I am sure.
This is interesting, because it implies that people with shitty parents can recover from the abuse and have a happy life where they’re free to choose whether to have children or not, whereas people with decent parents have major life decisions dictated for them. Would a loving parent abuse their child, in order to allow them to break the contract without guilt?
This suggests freedom to choose is crucial to well-being. I am highly suspicious of it, I think it is mostly a post-Enlightenment Western cultural myth… a meaningful life does not necessitate choosing the meaning, the goal, it is perfectly possible to be given a fixed social role and goal at birth and be happy at pursuing it.
Basically I am not a big believe in freedom. It may be socially useful, like, more economic output or preventing murderous tyrants to take power, but I am not convinced more free people are necessarily happier.
I think the modern Western myth of freedom is largely based on vanity and proide: we dislike limitation and fixed roles because it offends our pride, we don’t feel “special” enough.
But it is easy to see how a humble man who does not feel special would easily accept and be happy in a prescribed role.
Personally, I yearn for just that, I yearn to be reborn into a culture where they tell me what to live for. Freedom is hard for me to deal with, everything looks an unimportant hobby.
When you don’t have freedom, others can impose their view of the good upon you, or disregard what’s good for you altogether. Different people have different lifestyles that would make them happy, and to push some into doing what others think is good would make them less happy. That’s why there’s an inherent connection between happiness and freedom to choose.
For example, suppose that you’re gay and want to engage in a same-sex relationship, but the general moral view in society is that homosexuality is immoral and should be discouraged, and thus you are pushed away from it (maybe even by force). It’s easy to see why this would make you less happy.
[warning: dear reader, if you are depressed right now, maybe go practice some self-compassion instead of reading this]
OK, here’s what a depressed person, from their own point of view, can give their parents:
[note: depressed perspective starts here]
1. Disappointment. Lots and lots of disappointment. More and more of it, for the rest of their life.
2. Negative money. Depression can make you unproductive, but you still need to eat. You need shelter. You need clothes. Who’s going to pay for all that? That’s right. Your dear, loving family.
3. Shame. Remember that disappointment? Now think how your parents will feel while trying to hide it from others in social conversation, struggling to defend you while facing their own dose of bitter disappointment from themselves, extended family and the rest of society. They must have failed as parents to have brought up such a useless child, right? True or not, that’s what people might think.
4. Misery. Sadness. Pain. Hopelessness. Anger. Have you ever been close to a depressed person for a prolonged period of time? Tried cheering them up? Grown frustrated when nothing seemed to work? Like a drowning person, they’ll drag you down with them.
So, if the depressed person stays alive, the negative effects on their parents accumulate every day, until the parents’ goodwill, or their money, or their emotional strength, or their life runs out.
But if the depressed person commits suicide, the parents will experience a period of acute grief (“your child died so young? how tragic!”), but then, hopefully, will be able to move on with their lives. As a bonus, they might even dream of all the good things their child could have done, and remember them fondly, blissfully unaware of how utterly useless and broken the child was.
[note: depressed perspective ends here]
1) I don’t understand your point of view. As long as my child isn’t directly harming other people and I can afford the financial and time costs of supporting them why would I be disappointed? Very few people think their own lives are not worth living. Your child’s life probably has worth to them. Why would I be disappointed my child is living a life worth living? I understand people have their limits. But normal depression seems like something most families could deal with if they had a better attitude.
2) Money flows from parent to child in almost all families. Presumably if the child is depressed (or has some other illness) then more money will flow. If the parents lack money I could see the problem. But I live in the USA. Most couples could easily afford to support their child or sibling. And this is without any real hardships. I have a twin sister. If anything happened to her I would be glad to financially support her. I feel like “oh no my income took a 20-30% hit” is barely a concern. Why would I even care?
3) The shame thing is people being silly. With some notable exceptions (adolescent anorexia for example) trying to change other people is rather unlikely to work. Besides I don’t understand what is shameful about being depressed. I could understand being ashamed of a child who hurt other people seriously. For example being ashamed of a child who committed violent crime. But being depressed seems to be morally neutral.
4) “Have you ever been close to a depressed person for a prolonged period of time? Tried to cheer them up?”
Yes one of my GFs was depressed for about 2 years while we were dating. I did lots of nice things for her like buy her flowers and cook for her! But Idk if I ever tried to cheer her up. Its not my place to decide how other people should feel. If I gave her flowers I wanted her to know I loved her and was thinking of her. The goal of other nice things might be to solve practical issues (I was a better cook and people like to eat). But I loved her as she was. Its not my job to try and change her.
You sound like a very kind and generous person, Anonymous. Your friends and family are lucky to have you in their lives.
However, here are some popular parental concerns:
http://i.imgur.com/3aFIVdr.png
How are the parents supposed to move on with their lives? This is a very unreal perspective for me. For the parents, children ARE their lives, often they have nothing else in their lives.
Take my mother. She is 60, retired, lost my dad, has no friends because childhood friends you run out of until 60 and it is hard to make new ones after college, if it was not for me and my wife and kid, she would have NOTHING, absolutely nothing to live for, just going through the mechanics of living like brushing teeth and occasionally eating something.
It is brutally hard to fill out life with meaningful stuff to do and the very reason people choose to have kids is that.
Basically kids are a purpose, a goal, and they keep the nihil, the ennui at bay.
So no, I don’t believe parents can move on. They lost their whole reason to live.
That was a very moving comment, thank you.
[end of sincere part]
Well, by your own logic, she should have had more kids — surely 10 or 12 would be sufficient to cover both suicide and other unfortunate outcomes.
“Child-free people will probably hate me for this, but I think this is part of the implied social contract between parent and child.”
If there isn’t free acceptance of the terms, it’s not a “contract”. Don’t use words for things they don’t mean. And different people have different reasons for having kids.
“Parents don’t spend 18 years of time and money on kids just because they are cute, they expect something back. Which is: to pass on the genes.”
Most people aren’t motivated by genes.
“If somehow doctors told me I can have kids but by kids will be sterile, I would not want to have kids.”
That’s rather disturbing.
Social contracts aren’t freely consented to by every individual: that is why they are social. Like, taxes.
If not genes, then the family name and the inheritence. But the issue is, we spend a life building and earning things we won’t spend to zero until death. We want to pass them on.
If they’re not freely consented to, in what sense are they contracts? A contract binds me because I agreed to it – otherwise, how is it different from some other external imposition?
Interesting stuff, as usual. I was a bit surprised that you didn’t explicity connect this to your post on “chronic psychitis”.
What follows is pure speculation: I’d like to know if there’s a correlation between prevalence of depression, and allergies. A couple of months ago, I saw a talk by an allergology researcher, and he said it was a real mystery, and a total disgrace to science, that allergies have increased explosively, especially in rich societies, and no one can point to the mechanism WHY. Allergies are auto-immunological inflammatory processes gone awry. Following the hypothesis in “chronic psychitis”, depressions may be an auto-immunological inflammatory process. Stuff like a negative correlation with “parasite load” has been mentioned in both contexts. Could there be a common causal factor?
Warning : wild speculation – I Am No Authority
1. Immune systems have always been locked in arms races with pathogens. Every immune system is quite likely to kill a random pathogen, but some pathogens do end up killing the host.
2. Hygiene and modern healthcare, afforded by technology and money, reduce the exposure to pathogens.
3. Immune systems are calibrated to defend against the most dangerous things first, and if there are no really dangerous enough things in their environment, they train to defend against anything that makes them react even a little. Dust, acari, milk, gluten, their own hair…
As for the link with depression… I don’t know. Depression seems to be caused by a variety of things, some physiological, some environmental cues, most likely a heap of various factors interacting chaotically in an entangled mess of redundantly entwined feedback loops.
> What if people become suicidally depressed precisely because they live in happy, well-functioning societies?
Makes perfect sense. Excitement and challenge are often necessary for your life to not be boring and be meaningful, but often people are too lazy to pursue them for their own sakes. A more challengig environment, that forces this on people, can be better.
This is known as “upper middle class kid blues”. Lacking the fantastic toys and adventures of the really rich, but also not really having any challenge the poor have, and, unlike the poor, are not forced to extensive social interaction, they tend to end up isolated, lonely, depressed.
This is an U-shaped curve. The poor get excitement out of the shit they have to deal with, the rich just wave a platinum credit card and people sell them excitement in heaps, the middle, upper-middle can easily get stuck in a boring life where nothing happens.
And yeah, Scandinavia is very good at making everybody middle class, thus, stuck at the bottom of the U shaped excitement curve.
I live in Austria which is very similar. A few years ago the chancellor said something along the lines “Yeah I am boring, but isn’t that a national trait? I don’t think the government should provide excitement to people, they should seek it out themselves. If we are boring we do our jobs well.” Well, yeah, but it suggests maybe they are doing a too good job of shielding people from hardship.
It is easy to dismiss this all as luxury problems. But luxury problems are REAL problems. Having it too good is a REAL problem if you don’t have the motivation, the willpower to purposefully make your life harder / more exciting. It can mean absolutely real depression and ennui.
Shenpen’s guess strikes me as the most spot-on of the thread.
Challenges motivate, and challenges overcome make people proud and happy. The tougher the challenge, the more powerful the reward. But most people avoid challenges, because challenges look a lot like work. Disadvantaged folks don’t have the resources to lie back and avoid challenges; they have to face them, or perish. Well-advantaged folks can lie back (whether that be on mom’s couch, dad’s trust fund, or the taxpayer’s dole) and avoid life’s harder challenges, thus remaining demotivated, unhappy, and anhedonic . . . that is, depressed.
Thanks, but my point is also includes, that beyond a certain well-advantaged level (super-rich) it gets better again, because buying fantastic adventure becomes possible and easy. If I wanted to do something in the jungles of the Amazon it would require careful preparation to keep it affordable. It would require a long trip with multiple connecting flights on the economy class taking off at 02:00 and figuring out which grocery-store foods won’t give me the runs and so on. But if a chaffeur just takes you to an airport where the jungle guide is already waiting for you in the private airplane, it would be fairly easy to get into these adventures.
So it is not simply a relative correlation with wealth, but an U-curve, a valley between two kinds of highs.
Agreed that Shenpen’s comment is excellent. And the U-shaped curve idea is a significant improvement over the “people long for the excitement of the ‘Walking Dead'” comment I left upthread.
From the article:
>He climbed stairs to his office every day
Exercise is bad, right, and heart disease is a status symbol.
>well into his 90s
…
On food: I did a project in Aalborg. Every day the company got delivered a big box of lunch which consisted of fresh lettuce and other salad, smoked fish, wholmeal bread and yes a bunch of process liver pate type of stuff. Overally it healthier than the average British or German meal, although clearly not as salad-crazy as the French. Danes seem to be really into bread, although the better, wholemeal-rye sorts.
Anecdata in support of the sunlight and springtime depression links:
The Ferrett found his springtime depression cured when his doctor prescribed him a massive dose of Vitamin D after a heart attack.
People with an external struggle or living in adverse conditions probably don’t feel like burdens or feel that they have nothing to do. A subsistence farmer would know that every day is a struggle against starvation, but in that struggle they are vitally important, both for their own survival and the survival of their family and community.
Pingback: Depression as a false negative | Aceso Under Glass
How about success in certain areas of social organisation push other psychic needs/issues into sharper relief? Suicide rates notoriously fall during wars, but that does not suggest that peace is dysfunctional.
I don’t believe there’s an interdiction in place, but just to be sure – are you OK with us sharing this on social media?
I have a significant number of friends with a direct interest in mental illness and while most of this is probably only of peripheral relevance to them, I rather appreciate being able to present info regarding the field without it being directly about their problems, if that makes sense?
Here’s another theory that I do not personally endorse: Depressive Realism.
1. There is a theory that people with depression are more realistic than people without it. They see the world in an unbiased light, and are depressed because they cannot form positive delusions.
2. Leftism is correct, so unbiased and realistic people vote for it 🙂
3. Therefore, the countries with the highest depression and suicide rates will naturally be leftist 🙂
That was the Leftist Troll version of the theory that I don’t endorse. Now here is a much tamer version that I actually think might have something going for it:
1. People with depression often feel like they have no control over their life. Whether they are correct or not is up for debate.
2. Leftism promises a strong welfare system that will take care of you if your life gets screwed up by circumstances beyond your control.
3. Therefore, people with depression are more likely to choose Leftism, since they assign a greater probability to their life getting screwed up by circumstances beyond their control. Countries with high rates of depression will be more leftist.
I personally think the evidence indicates that Depressive Realism is not a very good theory. But I do think the idea that depressive pessimism might contribute to leftist ideology might be worth investigating. Are there any studies that correlate depression with political ideology?
Hmm. That’s really interesting. Ridiculously speculative, also not endorsed theory: It might correlate with fatalism more generally: the northern European groups that tend to be more depressive also tended to be more likely to adopt Calvinism or pietist Lutheranism back in the day. And then you add in Weber’s (very imperfect, but good enough for suggestive brainstorming) Protestant capitalism thesis, and you think, hmm: not only may being depressive have dragged northern Europe from capitalism to social democracy, it may have dragged them from feudalism to Weberian capitalism in the first place, via dour Protestantism. (My own mental example here isn’t the Scandinavians, but the Scots: famously “dour,” so maybe depressive, once very Calvinist and capitalist, now quite socialist relative to the rest of Britain.)
Is it appropriate to include Finland among Scandinavian countries? If I understand correctly, Finland is pretty different from Norse countries in terms of language and culture.
Let’s try a *depressing* hypothesis: your brain is tuned to solve difficult problems where you have high personal stakes. Any time you succeed at that, you get a rush of dopamine/serotonin/oxytocin/whateverin which keep you happy and well regulated.
But if your life is too easy, for instance because you live in a nanny state which takes care of you cradle to grave and places a welfare safety net to catch you any time you may fall, then you rarely get to experience high personal stakes and high rewards for success. Therefore you become bored, you start to think “my life is meaningless” and you become depressed.
Obviously there is going to be some personal variation in that, but you see the point.
^
Yeah, but they were under Sweden for a long time. The cultural influence has been strong, and it’s not even just one way – there are really old Finnish minorities in Norway and Sweden too, not to mention their hunter-gatherer cousins the Sami.
Well, I don’t know about you, but I don’t get suicidal when I’m bored. I get suicidal when I experience the combination of high personal stakes and zero hope.
I have argued that it is a disconnect between expectations (internal and external) and actual possibilities that drives people to despair. Well off people may commit suicide more often than the poor, but if you look at relatively poor groups with high suicide rates, such as native Americans or Indian farmers, this seems to be a pattern.
The spike in suicide rate with Indian farmers comes, I believe, from microcredit. They feel pressured to use this new opportunity, but if they fail, they can easily be saddled with a strong social and economic obligation do things that just aren’t possible.
Whereas when native Americans have so much higher suicide rate than the (also historically oppressed, also poor) Black Americans, I think it has to do with how the native has historically been romanticised as a noble creature of indomitable spirit (even as they were slaughtered – that part of US history I have trouble wrapping my head around). The dissonance between that romantic ideal and the social misery of reservation life must be pretty bad, even if it’s just there in the back of your mind.
If you have zero hope about something, then you have a very low subjective uncertainty about the outcome. So how could the stakes be high?
That’s an interesting question. My best guess is that I simultaneously believe that I must do X, and that I won’t.
Finland is a bit poorer and more conservative than Sweden, but culturally very similar. My personal stereotype is that we are even more quiet and demand even more personal space than the Swedes, but otherwise are pretty much the same. It’s correct that the languages are completely different, though.
Finland is not a Scandinavian country. Scandinavia consists of Sweden, Norway, and Denmark. If you want to include Finland, you might use the word Fennoscandia, though the Nordic countries (or the neologism Norden), which also includes Iceland, is usually preferred. See for example http://www.nnn.se/intro/norden.htm or http://www.norden.org/en/fakta-om-norden-1/history-of-the-nordic-region/the-nordic-region-2013-part-of-europe-since-the-viking-era/
I was a bit surprised this had not yet been pointed out 🙂
Most people outside of Norden don’t seem to know about Norden 🙂
Norden is also simply the German word for North.
what do you think of Alain de Botton’s “status anxiety”? to vastly oversimplify, he posits that the meritocratic mindset contributes to depression/suicide because you have no one to blame but yourself if you haven’t achieved your goals (wealth, happiness, mate, etc). in other societies, you can scapegoat God or fate or the bourgeoisie or whatever for the things lacking in your life. that may be more comforting and lead to less depression/suicide.
if you are depressed and your life really sucks but you had no control over the outcome, why commit suicide? you aren’t to blame and thus feel no shame. if you are depressed and you think you have caused your own depression, and you think you have the agency to end it if only you would do [insert positive action here], suicide may be a more honorable option than continuing to live in shame (a la samurai).
There’s a Chestertonian argument to be made about status anxiety: in societies where you were legally stuck being a peasant, it wasn’t your fault you were a peasant, and it wasn’t that bad. Now, if you live in the projects or can’t find a job, you are constantly bombarded with cues that it’s your fault. Thus, in order to make the poor less miserable, we should bring back castes or something. (Not endorsing argument.)
Tocqueville gets credit for that one:
There is a much more apropos quote, but I can’t seem to find it at the moment. It discussed how, when men rise based on merit, they had nobody to blame but themselves and their own clear inferiority if they failed. If their positions were set at birth, on the other hand, they could simply blame fate.
Great Tocqueville quote. I think maybe Burke made a similar argument somewhere, too?
What if Depression is like Torsion Dystonia, but for white people instead of Ashkenazim? Covaries with IQ, so you get these countries full of smart nordic-descended people who are also more likely to be depressed. The problem isn’t necessarily soluble on a social level because it’s a genetic predisposition to certain kinds of neurochemistry. If you want to get even more ambitious with this hypothesis, something similar would help explain the common stereotypes that creative geniuses tend to be mentally troubled.
*people talking about lack of “purpose” in post-scarcity societies leading to depression and suicide*
Me: “computer games to the rescue!”
In all seriousness, assuming that is the case, that is somewhat disconcerting considering the inevitable obsolescence of humanity, and simulated challenges seem to be the way to counter this. Hyper-immersive virtual reality MMOs as the ultimate suicide prevention tool?
(These kind of challenges are superior to giving people real challenges because a) the consequences of failing are not horrible and b) they are voluntary)
By “real”, I should have said “challenges with serious consequences for failure to complete”
But if you want to simulate a challenge, staring at a box and pushing buttons will not suffice. People hitting each other in the face with boxing gloves, or climbing tall stuff that would be extremely dangerous if not for the safety ropes, are more of a simulated challenge. In other words: sports. And this is precisely why sports were invented! Sports were literally invented to simulate war and other dangerous stuff, it is not a new idea, it is a 19th century one (revived from the antique ages).
We need to push people so that basically everybody should compete in some sports, and for most people actually martial arts would have the most benefits. Enough about the bullshit of “exercise” i.e. something bland and repetive. Sports simulate precisely those things our species evolved for.
Well, I was talking about “hyper-immersive virtual reality” for a reason. And was thinking more about the future than the present.
I actually think current games/sports- electronic or otherwise- don’t offer enough to most people to accomplish this anyways. The kind of thing that immediately comes to my mind is something like an RPG world type simulation.
I don’t actually have anything against physical sports- I even play one. Granted, It’s Humans vs Zombies which is the nerdiest physical sport ever, but it still involves running around (while shooting people with nerf guns).
Edit: on second thought, various currently possible games and sports might be enough to help a significant amount of people avoid depression. But full VR (as in the “you have cybernetic implants in your brain’s sensory inputs and it feels completely real when you plug in” kind, not the currently existing Oculus Rift type stuff) would still be better at this clearly.
I once read about “suicide as escape from the self”, a model of a person’s progression towards suicide. I didn’t read the original publication as it was very long and I don’t have any background in psychiatry, but I found a summary reducing it to several stages.
The first stage is for the person to perceive themselves as having not lived up to some standard or expectation. Because the person believes the standard to be realistic, the higher it is the worse they feel for not meeting it. The distance between them and the expectation is great. So if everyone around you has an amazing perfect life, something seemingly innocuous like getting poor grades in school can be devastating.
Another factor might be the classification of things as suicide. In a utopia, each person is carefully accounted for and most causes of mortality are predictable. In a hellhole, there are many plausible reasons a person might suddenly be found dead, and one might not classify an alcohol-drenched body lying in the gutters as suicide.
Suppose Ruritanian psychiatrists continue to prescribe antidepressants to episodic depressive patients for years and years but Atlantidan psychiatrists prefer to prescribe antidepressants sparingly and intermittently in response to acute depressive episodes. Then Atlantis would appear to have lower rates of depression than Ruritania even if actual rates were identical.
Broken links.
(I’m just trying to be helpful. Delete this comment whenever you want.)
Native Swede chiming in here (bias disclosed)
I’m not sure what statistics (or urban legends) the original article is relaying upon, but here’s what wikipedia has to say, and it fairly well reflects other statistics I was looking at as well.
Suicide: http://en.m.wikipedia.org/wiki/List_of_countries_by_suicide_rate
Depression: http://en.wikipedia.org/wiki/Epidemiology_of_depression
Scandinavian countries are scattered in different places throughout the lists in most lists. And Finland and murder? Really??
http://en.wikipedia.org/wiki/List_of_countries_by_intentional_homicide_rate
So first of all the statistics isnt even accurate. Secondly, high use of anti-depressants, couldn’t that simply mean a) high efforts to battle depression and b) anti-depressants as preferred method of doing so, in some combination or other?
As for Scott’s reasons,
nr. 1 absolutely, it’s a big issue here, although I’ve heard somewhere it doesnt correlate very well with clinical depression. More like a thing everyone feels for some part of the dark year
nr. 2 Midnight sun is an issue only very far north in the countries, but sure, days in summer are very long and people tend to sleep less then.
nr. 3 May be correct, sounds reasonable, but of course the statistics wasnt accurate, so one would have to look for low parasite count in lots of countries then..
nr. 4: bit of a LOL on this one. Not that it may not hold though for some Norwegian food (I’m a Swede, so I’m supposed to be suspicious to anything from Norway).
However, some of the richest, most health aware countries in the world arent gonna skimp on eating well, and urban areas in Stockholm has the same craze for ecological, organic, local produce, exotic imported fresh fruit and vegetables, etc, as anywhere in California. We want our super fruits!!!
nr 5 & 6 might well be true, its kind of hard o tell.
But again, statistics weren’t even accurate to begin with, so deeper research is needed to undersand the issue. I’ll throw my card out there and say that I think social isolation plays a big role, and it has been linked to higher inflammatory states as well
But if the whole point of the original article was to get Scandinavians to come down from their high horses a bit, and not be so smug about their own countries then I’m sure it would be useful for some.
Fellow Scandinavian chiming in here, a Norwegian with dysthymia (so even more biased, or maybe it’s relevant experience).
I agree with you on light. On food, it’s true. Maybe it’s better in Sweden, but traditional Norwegian cuisine is bland as hell. I worked in a hospital kitchen for a while, and we generally made the kind of food old people like. I also have older parents than most people of my generation, so I ate a lot more blood pudding and browned servelat (that is, pig brain bologna) than what was common (or rather, I was served more of it. I was a pretty picky eater, do you blame me?).
There’s very little doubt in my mind that Polish, German and British traditional foods are slightly healthier, and that say French, Italian or Spanish traditional foods are much healthier. The only thing Norwegian traditional food has going for it is lots of fish, but I suspect cod liver dumplings have other ways of making you feel down. While you’re right that we eat more modern now Rasmus, there are a lot of people who eat surprisingly traditional (not least the elderly).
About cultural factors: of course, culture itself is a product of many things, so it’s hard to say if this is a symptom or a part of the problem. But traditionally, low-church Norwegian Christianity (pietism) is intensely bleak. Gambling, drinking and dancing are banned not just out of a legalistic notion of sin, but also the deep conviction that these are pointless, hollow joys that will only bring you more grief down the road.
Here’s an example of a very popular hymn in Norway. It’s quite progressive for the pietist era (written by a Danish priest close to the royal family, high church by these standards), but it gives an idea of the kind of things people thought of at the height of pietism.
Let’s see: hopes dying, the sun of happiness going down, panic attacks (the word for fear in verse two is literally “angst”), sleepless nights of being sick to death of all your own thinking? Sounds like depression to me.
The form clearing strikes again. That was me.
Wow. That’s some hymn. No wonder Scandinavia went massively secular as soon as it became socially thinkable. Yikes.
My recollection of Danish food:
They eat the most pork (source) and the most organic produce (source) per capita of any nation.
They used to eat a lot of fish, but according to my host father it’s now expensive enough that they don’t eat much anymore. But that could have just been him; at least in America herring and mackerel are still pretty cheap.
The vegetables he served were all cooked to death, but he was an old guy who grew up on a farm, and I would expect the same of a 60-year-old reared in Minnesota.
There is an old saying that describes various aspects of Scandinavians with enough truthiness to make us chuckle:
Swedes live to eat
Norwegians eat to live
Danes eat to drink
Rampant speculation.
In poverty, oppression, or other dysfunctional patterns, there’s an obvious cause of misery. If somebody forecloses on you, there’s a person (or entity) that seems to be directly causing that misery. Even if you are just sort of ambiently sad, then you’re still likely to frame the sadness as ‘because I am poor’ or ‘because society keeps making me use the crappy bathrooms’.
But if there’s no obvious reason for you to be sad, but chaotic brain chemistry fluctuations make you sad anyway (or you unknowingly have a bad diet or lack exercise, or otherwise have sadness caused by non-obvious and capricious factors), then there’s no personal narrative that can coalesce around some external source of misery. Without an external source, the misery get blamed on one’s self, or at least on ‘the universe’ in a more ineffable way. For these people, there is no possibility of a political revolution or financial windfall that could make them happy.
Slapping an overly simplistic model on things: let’s say that humans are motivated exclusively by the goal of making the hurting stop, and are a member of exactly one society. Each society causes its humans to experience a certain amount of hurting, normally distributed within each society, and human brains make themselves hurt, normally distributed independently of their society. Humans may only take three actions- protest, watch television, or commit suicide. Humans will always protest, if their h(society) is above a certain value. If their h(brain) is above a certain value, they will commit suicide, but only if they are not already protesting. If humans neither protest nor commit suicide, they watch television.
It seems pretty clear that, in this model, a society where h(society)>>h(brain) will experience very low suicide rates. If humans were ‘rational’ in this model, they would all commit suicide (because hurting goes to zero), but if they are constrained to protest social hurts before solving brain hurts through suicide, then high levels of the former insulates them from the latter.
Returning to the real world, it does seem plausible that survival imperatives slant us towards considering external sources of misery.
Here is my best guess, which some of the above commenters have come close to, as to why “happier” (sub)cultures might have higher depression and suicide rates. In an oppressed subculture or a society in which the people face greater obstacles or a more oppressive environment, individuals are more likely to grow up with a stoic, “life is about pain and struggle” attitude. In general, at a fairly early age they may develop better skills for coping with setbacks. However, someone growing up in an atmosphere of high expectations for success may be relatively lacking in these coping skills.
I mean, this is pure unfounded speculation, but I sometimes think about the situation with the formidable job market currently faced by the young adults who grew up in middle-class America, where it was expected that one would get a college education and relatively easily be able to secure a nice job. I expect that this is currently a major source of depression among members of my generation. But I wonder how differently one might cope with a similar job situation in a less developed country, or in America a century ago, with much less guarantee of a decent education and where it was probably sort of expected that the vast majority of people would live out their lives with relatively unpleasant, low-paying jobs.
I like, but I think oppressed is the wrong word here, it certainly applies to the bit about black vs white suicide rates, but I think a better phrase would be “environmentally stressed”, because presumably this is also true of people for whom the whole oppression paradigm doesn’t really apply. Rather than a function of just culture, it’s a function of culture and/or any other stressor or challenge in the environment.
Anecdote. I tend towards the depressive myself and when I hit the lowest point the way I pull myself back out is giving myself any sort of challenge to overcome, even an artificial sort of stress (cold showers, etc.) seems to help. Anecdote over, continue wild speculation.
I’m also not entirely convinced of the whole stoic “life is about pain and struggle” is quite right either. I think it might have deeper roots than just attitude, more of a species-wide predisposition for struggle.
Also wouldn’t you expect coping skills to occur in high expectation environments as long as you don’t actually meet expectations relatively often?
I agree with you, and think this is an important distinction from the above comments about needing to feel a sense of purpose/have someone to blame. I think there’s something to that argument as well–it’s helpful to be able to construct a mental model that gives some purpose to what you’re going through–but I think it’s only part of the story.
Expectations play a huge role in happiness. I’ve read an article affirming this general idea, and offering a definition of happiness as the difference between expectations and reality (with the complication that we also feel happy by anticipating good things, so we can’t game the system by expecting to be totally miserable). It’s one thing to have the rather crappy life that you expected to have, and a totally different one to have the same rather crappy life when you expected everything to be rainbows and unicorns with an angelic host serenading you for all major life accomplishments.
*Warning: Massively Speculative*
The first thought that comes to my head when I hear that suicide rates are much higher in happier countries, is that in some sense depression can be a function of lack of purpose, rather than vice versa. Or at least that having a strong sense of purpose may allow temporary relief from depressive symptoms. So for example if you live in a small agrarian village where you can’t expect that your family will be taken care of if you die, that is a hell of a reason to live so to speak. But as societies get more and more industrialized and personal responsibility and by extension personal sense of purpose gets more diffuse and difficult to maintain you see a concomitant spike in suicide rates because people who would have forced themselves to survive for the sake of others simply no longer feel compelled to.
Edit: I’m assuming that happiness and industrialization are have a strong relationship, which I might need to be corrected on. Although I suspect that areas that report high happiness but aren’t industrialized may also be resource rich environments, in which case my point still stands to some extent
I wonder if a subsistence lifestyle leaves less opportunity for the kind of introspection that makes the symptoms of depression worse.
That seems like it might be right, but I can’t think of a good way to test it.
Unless IQ correlates well with introspectiveness, in which case it would probably show a relationship because poorer and more miserable countries probably show lower IQ thanks to higher parasite load, and a variety of other factors (i.e. increased heavy metal exposure)
Edit: No not that kind of metal
Self reported data makes me itch. I don’t even trust my own self-assessments, so I’m certainly not inclined to trust the average person’s.
How do you plan to assess depression rates without self-report?
If I had someone holding a gun to my head asking about this issue, I’d use self-reports to analyze depression in Scandinavia. But since I’m not in such a situation, I can pick and choose which problems I want to investigate. And I want to stay away from problems that force me to rely on weak forms of evidence.
This was 27chaos, by the way.
“Off the top of my head, here are six plausible reasons why Scandinavia could have higher rates of depression than the United States, even if it is a utopian society of perfect happiness.
1. Light. Scandinavia is far north [citation needed] which puts its citizens at very high risk for seasonal affective disorder, which can present as depression.”
I would think that SAD would be rather unpleasant. How is this a possibility for how Scandinavia has higher depression but isn’t unhappy? This applies to the rest of your list as well: you just come up with a bunch of reasons why Scandinavians would be depressed, but don’t explain how those factors wouldn’t also make people less happy.
Presumably the debate went like this:
“Liberals”: Our country should be liberal social-democratic, like Scandinavia!
New York Post / Kyle Smith: No, then we’ll get depression and suicide.
Scott: Here are some plausible causes for Scandinavian depression and suicide that are unrelated to being liberal and social-democratic.
Perhaps Scott’s idea of “utopian society of perfect happiness” is formed on the basis of social organization alone — after all, that’s what the disagreement is about. No one’s saying that we should copy the amount of daylight from Scandinavia.
It’s rather sloppy to present a rebuttal of an argument without clearly articulating what argument it purports to rebut. And Scott mentions several things, such as diet and culture, that are under the control of humans.
“suicide rates tend to be highest in happy places”
In addition to all the things that you mentioned, I wonder if relative happiness isn’t more important than absolute happiness.
If I’m miserable, but everyone around me seems miserable too, I might just take misery as a fact of life and be stoic about it.
But if I’m miserable, and everyone around me seems really happy, I might wonder what’s wrong with me.
Anybody know if there’s a study out there that plots suicidality against Facebook penetration?
Not suicidality, but sadness: http://www.slate.com/articles/double_x/doublex/2011/01/the_antisocial_network.html
I hypothesize that the biggest factor is that the human psyche evolved to succeed under conditions of hardship. On the one hand, we naturally seek to alleviate our hardship.. because this is the only way to survive. We seek food and shelter and warmth because those who didn’t died. So survival ensured a desire to alleviate hardship. But since for most of the history of humanity hardship could not be eradicated and had to be endured, the psyche evolved to function well under conditions of hardship. The result is that if we get what we desire — no hardship — our psyches can’t properly function under those conditions.
This has long been my suspicion too, though there are some potential counterpoints to the idea.
Often, it seems to be the case that overwhelming personal hardship can trigger depression among people living in first world countries… for example, a study here finds that having to care for a physically/mentally ill relative (which probably counts as a significant hardship) results in “extraordinary” rates of depression.
Article here:
http://www.smh.com.au/news/national/high-rates-of-depression-in-carers/2007/10/14/1192300600633.html•National
Study here (paywalled though):
http://dro.deakin.edu.au/view/DU:30010534
And, children who have been abused/neglected are at higher risks of depression:
http://www.webmd.com/depression/features/depression-often-starts-in-childhood
If we’re postulating that the mind is primed to deal with hardship (and the lack of this hardship is what triggers depression), then childhood neglect/abuse would presumably be the kind of thing that would send the message “yep, lots of hardship in this world… better start dealing with it” to the developing brain. Which is not what the evidence suggests.
Maybe the mind isn’t primed to deal with “hardship” per se, but with subsistence-level living. Thus, peasants and slaves might have lower suicide rates while the wealthy sit around having ennui and despair: if the Buddha had been a peasant instead of a prince, he presumably would’ve taken the Four Sights for granted rather than having an existential crisis about them.
Lots of anarcho-primitivist types like to point to the popularity of “Walking Dead”-type entertainments to show that at least some modernity-coddled humans long for the meaning and efficacy attached to surviving by the skin of the teeth. The popularity of entertainments centered not just on adventures, but on the camaraderie of groups who survive adventures together (e.g., “Star Trek”) is probably related.
Here’s the thing, though: if that’s right, then taking care of an ailing relative or being abused as a child aren’t hardships in the relevant-sense. In that case, we’re not optimized for caring for the beneficiaries of modern medicine, or for being abused. Instead, in that case we’re optimized for subsistence living and tribal conflict.
Since I like not living in a brutal Hobbesian hellscape, I’d be pretty interested in how to replicate the psychological goods of subsistence and tribal conflict without actually lowering material living standards or making the world more violent. Outdoor hobbies? Sports? First-person shooters? Dunno.
I just checked the Wikipedia page on suicide rates. And with the caveat that this kind of statistics is really difficult to compare properly, Sweden, Norway, Denmark and Iceland are ranked 35, 37, 41 and 42 – lower than the USA at 30.
I noticed that too. I think the article switches between talking about depression in Denmark and suicide in Finland without really drawing a clear distinction, and I follow them in this. Maybe I shouldn’t.
Scandinavia may have historically had a low parasite load in the “malarial Africa” sense, but some have argued that relatively high historical rates of leprosy there are a causal factor for the cliche of Scandinavians being unusually attractive. See here: http://www.gnxp.com/new/2006/10/22/leprosy-and-scandinavian-babes/
What a silly just-so story. In the evolutionary sense, leprosy lasted a blip longer in Scandinavia than elsewhere. But I’m supposed to believe that in this short time period, Scandinavian men who didn’t care about appearance were so likely to accidentally marry a leper and get infected that it was a strong selective pressure?
You really seem to like this “blip” thing, thinking that it didn’t last long enough is a knock down argument against any given evolutionary change having happened. Agnostic noted that this period, where leprosy was common in Norden but very rare outside it lasted 500 years. I think 20 or 25 generations is in fact a reasonable estimation of how many generations that is, don’t you?
A one generation event is quite enough to have a substantial impact on their descendant’s evolution. This is almost what the idea of punctuated equilibrium as popularised by Stephen J. Gould means. Most of evolutionary time is a slow grinding out of small, small gains in evolutionary fitness that follows short periods of massive gains after a new ecological niche is discovered. Twenty five generations is a looooong time.
Agnostics mechanism for the selection that lead to Scandinavians being anomalously good looking for their latitude may be wrong but you’ve given no reason to think it’s stupid.
He knows population genetics and proves it by using it in the linked post. Do you have any expertise in evolution, biology or genetics?
Since this is still annoying me; leprosy is a progressive disease. One does not go instantly from looking fine to resembling a pretty fresh zombie, it takes years. Leprosy having the same effect on preference for good looks as parasite load is completely plausible. If you want to argue that parasite load has no effect on mate preference or on the good looks of different ethnic groups you can definitely get a publication in Nature or Science if you can back it up.
On the idea of evolution being capable of proceeding quickly please reflect on the fact that modern breeds of cattle, horses, cats and dogs are all less than three hundred years old. All that magnificent variety is very, very new on an evolutionary scale. Different landraces like terrier, mastiff or hound have a long history but Chihuahas, Great Danes, German Shepherds etc. are all very new.
I’m guessing suicide has less to do with relative happiness and more to do with the needs on the top of the maslow pyramid not being satisfied . Genes play a role too, I imagine. There is so little we know about suicide. If we knew more, perhaps more could be done to prevent it .
I also think this is a good hypothesis. When you’re already near the top of the pyramid but unable to achieve “self-actualization,” there is no straightforward, one-size-fits-all solution which will result in having your needs being met. You can struggle for years with the feeling that something is missing and end up getting nowhere.
On the other hand, if you’re on the bottom of the pyramid because you’re starving, it’s very clear what you need to do: find food, by any means necessary. You keep at this until you either accomplish it or starve to death. You have a clear, straightforward goal, and perhaps that is enough to keep you going.
I want to be very clear that I am by no means implying that being at the top of Maslow’s pyramid is in any way worse than being at the bottom. That is quite obviously absurd. I am merely hypothesizing that the inability to form clear, actionable goals which will lead to self-improvement may be a reason for some people to commit suicide.
What about the fact that you only have time for existential angst when you are relatively well off?
I tend to think of suicide being related to shame rather than sadness. And if there is one thing I’ve generalised to all Scandinavians after reading Knausgaard…
Someone’s got to namedrop Durkheim, and here is as good a place as any.
(Really, all these armchair speculations and no outside references? Y’all need to step up your game.)
On a related note, the Swiss stock market fell 13% today on currency problems, along with the currency falling some 20 or so %. These Nordic countries could be in for a world of hurt soon because of runaway private debt combined with sluggish growth. A lot of citizens are over-leveraging to pay for homes and healthcare, but the small economies, unlike the USA, can not sustain it. Like Greece, Spain, Portugal, and Italy of 2011, the next wave of European crisis could be in Nordic countries . http://www.interest.co.nz/sites/default/files/embedded_images/image/HouseholdDebt.jpg
The problem is the universal healthcare isn’t so great either. Citizens will almost always finance private care if they can afford it
The swiss currency didn’t fall, it rose. That’s why the stocks fell.
I’m more confused by when Switzerland became a Nordic country.
Thank you.
The SNB decoupled the franc from the Euro. They realized that pegging the franc to the Euro (joining the Eurozone by proxy) was finally (and always) too much of a risk and cut their losses.
The financial media is describing his event in a negative light (I wonder why…), but being the first country to get out of a sinking monetary vessel has some obvious advantages.
And being any country to get out of a sinking monetary vessel is still a good idea.
Its true that people often prefer private healthcare when they can get it, but that isn’t an argument against having a public healthcare system, for much the same reason that a preference for private transport, amongst these who can afford it, isn’t an argument against having a public transport system. The attempted argument plays on two different notions of “good”.
I don’t understand why people compare the NHS to the nicest possible private experience – it should be compared to the experience of having no (or crap) health insurance and no (or little) money.
Obviously private health care facilities catering to rich people are *nicer*, they have *more money* to spend on niceness. The point of universal health care is not generally niceness, it’s being accessible to everyone.
The why is that they are repeating what they have heard.
US levels of debate about public healthcare are Emersonian …the terrible logic of “buses are bad limousines” is in par with invented facts about death panels,
The issue is that in some countries, e.g. Canada, “universal health care” means that private purchase of health care is restricted in various ways, meaning that in many cases you can’t access care immediately even if you can afford it. This is most American’s understanding of the concept.
So rich people shouldn’t (and generally don’t) complain about the existence of the bus even if they don’t ride it, but if you try to force them to ride the bus when they can easily afford a limousine, they are going to be justifiably annoyed.
The analogy to public transit may be more apt than you suspect; outside of New York, poor people are overrepresented among transit riders, which means that when someone wants to block off a lane for dedicated bus service, the opposite is strong enough to make ridiculous ideas like this look palatable.
I’ve noticed that Usians sperm to regard “you can’t get private healthcare” is a central or typical feature of public healthcare, although, globally, it isn’t. That is just another way the debate is being based on nonfacts.
Usualy comment get reported for being unkind.
I reported this one for being unnecessary and untrue. I think it’s the first time I’ve done that.
To be fair, I’d say it is only unnecessary by virtue of being untrue. And misinfo is more common than disinfo.
One theory that seems to fit all this data: if a person is feeling depressed, their natural instinct is to find something about their environment and decide that’s what is causing their depression. Societies with low happiness tend to have lots of things to be depressed about, and many members of highly unequal societies can point to being at the bottom of the social hierarchy as the cause for their depression. This helps them hang on until their depressive episode ends. But if everything is going great in your life, and you’re *still* depressed, that becomes pretty depressing in itself. In fact, it might produce a feeling of hopelessness, because there’s nothing you think you can ever do to improve your depression. (And I remember reading that hopelessness is strongly predictive of suicide.)
Edit: looks as though others have already proposed my theory. Anyway, if the theory is true, that suggests that framing depression as a disease and telling people how long it typically takes to get better on its own could be valuable.
Another question: has there been any research on the efficacy of changing one’s context for depression? For example, traveling to a new city/country, getting a new job, moving to a new home, etc.
This Hyperbole and a Half comic describes the feeling of being more depressed because everything seems to be going well in life. Apparently many psychologists consider the comic a highly accurate portrayal of depression. This blog post further describes the problem of people who are “depressed about being depressed”.
No, that doesn’t fit all of the data.
confirmed hellholes New York and New Jersey
Come on. 😐
Gallup seems to tell us that New York and New Jersey are, as of 2014, 28th and 24th on measures of well-being. Now, these people you cite get their data from something called the “Behavioral Risk Factor Surveillance System (survey years between 2005-2008)”; is that a better measure? Or a worse one? Who knows? In any case, “hellhole” is clearly a nonsensical description.
New York and New Jersey, in warmer weather, provide a cavalcade of every-shifting icky smells, which sounds a little hellish to me.
This is not the case in my experience. (In New York City, there’s the occasional icky smell in some places, which is true of any city — and NYC much less so than others I could name, SF being one. If we broaden our view to include the whole state, well, then this is just plain false for most of NYS.)
(as for NJ, who knows. They have nice highways, though.)
Are suicide rates correlated with depression? You jump quite abruptly from depression to suicide, but the suicide rates in Scandinavia aren’t that high compared to the rest of Europe. Even Finland is approx. on the same level as France.
The first section didn’t surprise me but the second section, particularly this bit:
That was straight out of the journal of Whatnowbitch?
Of course the response would probably be something like “But that’s only because [assert ad hoc reason why white Americans might commit suicide more]”. Which isn’t much of a counterargument, but arguments of this form are very common.
Unrelated but the most bizarre example of this type of rebuttal that I have seen is here. The argument is that men are only stronger than women on average because they have more muscle mass on average, therefore it is a myth that men are stronger than women.
Re: muscle in men and women
Uh…I feel like I was hit with a shovel and don’t quite understand what I jsut read. To clarify: The author changed the definition of “strength” from “capacity to exert force in certain lifts” to “capacity to exert force per muscle volume”? And also that it is incorrect to say men are stronger (which most people use first def. but author uses second def.??) because that’s not true, men just have characteristics that….make them stronger (first def)?
Neat, I accidentally clarified the ol’ motte-and-bailey. Am I one of the cool kids now?
In other news, women might be as strong or stronger than men, but ants are stronger than women.
Funny, I had no trouble with the article.
It’s spends a lot of time addressing the problem of conflating “mean of A > mean of B” with “All A > all B”. Quite frankly, the vast majority of humans have trouble with this, so addressing it in particular seems worthwhile.
It points out measures of strength besides with net power, but doesn’t pretend net means nothing. It just doesn’t exclude all other information.
Hypothesis: the key difference is purpose. People who feel that there is something they have to do or that there are others who need them will be less likely to commit suicide, even if they are simultaneously less happy than someone who is sort of adrift.
This would explain why richer countries and communities in which the question of basic survival has essentially been solved and they feel they can contribute little might have higher suicide rates while subsistence farmers have lower. It would explain why unemployment tends to lead to higher suicide rates (as we have seen, the simple fact of unemployment being miserable isn’t necessarily good enough).
It would predict that those who have a clear purpose – for example, mothers of young or disabled children – would be less likely to commit suicide. The retired and elderly would be more likely. I have no idea if this is in fact the case.
I was going to say something similar. I wonder how much lack of stimulation (i.e. lack of boredom) correlates with suicide and/or depression. Has anyone ever studied that? That might also help explain why areas with low sunlight are more prone to depression.
This has also piqued my curiosity on some other metrics like risk taking/aversion or agency. It would be really difficult to measure either of those but I’m curious if anyone has ever tried….
Along a similar vein:
When everything is taken care of, we have time to think. We have the luxury to do with our time whatever we please. I suspect that in the history of human evolution, there hasn’t been much of a reason for said evolution to polish the resulting mode of thinking.
So the more our societies progress, the more time our brains spend in a mode that they’re not optimised for. I can see how that might cause issues.
‘We want to have a purpose’ could be a symptom of that – or vice versa.
While I’m not sure of it, I suspect that most ancestral humans were actually much less busy, with more time to think. Hunting and fishing both involve a lot of sitting and waiting.
Even after agriculture, how busy were shepherds tending their flocks? Sure, you have the occasional hungry lion or host of singing angels, but most of the time you’re probably just watching grass grow and then watching sheep cut it down again, which is why David was able to learn the harp and write all those psalms.
I’m sure somebody who grew up on a farm will correct me about the latter, though.
Good observations! I think you’re right.
This farm girl agrees with you, at least about the past.
I grew up on a farm with tractors and plows and medicine to give the cows and wells and fences to troubleshoot, and tax paperwork, and that was before computers, which require even more attention. But we still had hours driving the tractor, which I for one used as solitary thinking-time. A generation or two ago, there was more, when hoeing and planting and such were done by hand. Way back to gathering took some high intelligence (“Which mushroom?”) but there were a lot of routine tasks, pounding the hides or shelling the acorns. And a lot of walking to get anywhere, and fetching water and wood — all plenty of relaxed-thinking while muscle-working time.
What is probably new, is sedentary time with shallow frantic button-pushing — thus constant attention required for quick mental reaction to artificial complicated gadgets or to squiggles on a screen or for manipulating quill on parchment.
@Neike
(Leaving this here because I think you’re more likely to see it)
In another post you mentioned that you are against xenophobia but are also against demonization of milder forms of xenophobia, and would prefer to have a dialogue rather than shun anyone who endorses xenophobia. Is that correct?
If so, as I am someone who is sympathetic to weaker versions of xenophobia, would you be interested in a having a discussion over this issue (particularly with regards to Europe)? As you said, holding such beliefs publicly is social and political suicide, so if you can convince me not to I will happily oblige. And for what it’s worth I’m not white, and I didn’t grow up in a developed country, my thoughts on the matter were developed entirely within the last two years.
We could discuss it on Ozy’s blog since that topic is banned here.
“Is that correct?”
Yes; though I have to admit I’m not sure I’d be a good partner in discussion, since I seem to mostly have two modes of discussion, which are ‘smile and nod while I soak up the arguments for later mulling on’ or ‘agree with everything because it’s an echochamber of what I would have said’. I am notoriously uncomfortable trying to convince anyone of my positions.
I’ll linger on Ozy’s blog and be on the lookout for your thread, though. 🙂 I’d definitely be interested in hearing your thoughts.
Okay I have a short comment up.
One societal factor may be acceptance of suicide and depression. That is, where suicide is heavily stigmatized, even illegal, many cases of suicide may become reported as an accident or unknown cause in order to protect the victims reputation, shield the family from scandal and avoid non-suicide insurance clauses.
More accepting societies — especially largely non-religious ones like Scandinavia or Japan — may simply report a truer rate than other places. How many single-car accidents where the driver “lost control for unknown reasons” and slammed into a concrete pillar, or “accidentally” shot themselves while cleaning their gun are really suicides, for instance?
Indeed. Plus in such suicide hating societies wouldn’t people take more care to make their suicide look more like an accident?
“Parasite load. It’s inversely correlated with temperature, which means Scandinavia probably has some of the lowest parasite load in the world.”
Do you mean positively correlated? If they were inversely correlated, we wouldn’t expect the same region to have both low parasites and low temperature, right?
Thanks, fixed.
(my brain might naturally think of temperature as “coldness”. Not sure why)
Inverse Temperature is more natural for lots of questions in thermodynamics. The concept of ‘coldness’ never bothered me anyway (once I’d learned thermodynamics). </reference fail>
Was going to post basically the same thing. Air conditioners especially I always found easier to think of as moving cold instead of heat.
This where just picking a damn single metric to measure society might just work.
For example, life expectancy or QALY or DALY.
Let’s say we have two societies: crappy one where people live till 40 and good one where people live till 80. Where is the highest suicide rate? I bet in the “80 one” because suicide goes up with age. I wonder how much of the suicide increase historically is due to people just living longer. It’s a bit of a depressing thought for the life-extension movement.
Now that said, all things being equal(sunlight, height), suicide, especially in same age groups is strong evidence that something is malfunctioning. Of course it can get over-shadowed by other problems, such as number of people killed by governments.
Still, all of this comes back to the fundamental problem: it’s hard to measure societies and the moment you have more than 1 metric, you are not VonNeumann rational.
So, let’s just pick life expectancy (or more importantly life expectancy increase) as a good way to both track progress and compare societies to each other. Suicide increases or car accidents or police brutality with all other things being equal will decrease total life expectancy, so they are already accounted for as part of “bad society”.
CONTENT WARNING: TALKS ABOUT SUICIDE IN A VAGUELY POSITIVE LIGHT. ESSENTIALLY EVERYONE WHO ATTEMPTS SUICIDE AND SURVIVES REGRETS IT. IF YOU WISH TO COMMIT SUICIDE, AND YOU ARE NOT VERY OLD AND/OR SUFFERING FROM A HORRIBLE DEGENERATIVE DISEASE, DO NOT COMMIT SUICIDE. IF YOU ARE, MOVE SOMEWHERE WHERE TRAINED PROFESSIONALS ARE ALLOWED TO DO USE EUTHANASIA AND CONSULT A TRAINED PROFESSIONAL.
>It’s a depressing thought for the life-extension movement
Not necessarily. Dying of old age sucks horrifyingly; see, Scott’s post on this very subject. Suicide, on the other hand, can be quick and occur at a time of your choosing. A world with a 100% suicide rate, but similar lifespan, would be unquestionably better than ours.
Also, life-extension also involves (in theory) extending one’s healthspan, which I suspect will decrease the suicide rate with age.
OTOH, since life extension has entirely rested so far on improved sanitation, antibiotics and decreased infant mortality, and the rest on keeping you alive in increasingly unfun ways, and nothing looks likely to change that anytime soon, this may be entirely moot.
Major kudos for your warning.
>>It’s a depressing thought for the life-extension movement
>Not necessarily. Dying of old age sucks horrifyingly
How does arguing that there exists something even worse than X make X less depressing? Part of the reason the increased suicide rates are depressing is because they are a reflection of how crappy old age is.
Attaching this in the shadow of Eldritch’s warning.
I haven’t seen anyone mention the idea that some of the causation may be running the other way. As unhappy people remove themselves from the group, the percentage of unhappy people will decrease, so the statistics will show a higher percentage of people happy, thus moving the country higher up in the rank of happy countries.
A professor I had in Denmark joked about exactly this. “We have high happiness and high suicide because all the unhappy people kill themselves.”
Seriously, though, the number of people lost to suicide is so small it can’t explain much of anything.
That sounds like Stalin’s recipe for happiness: kill all unhappy people.
> “essentially everyone who attempts suicide and survives regrets it”
I find this sentence to be particularly poorly phrased…
Having a cynical moment: it’s also not clear that this is actually an argument for not attempting suicide, rather than for [attempting suicide and failing].
well, those who don’t try, don’t fail. The best method for not failing is not trying, at a 100% non-failure rate.
> The best method for not failing is not trying
Yeah, this actually explains so much of my life. 🙁
>> “essentially everyone who attempts suicide and survives regrets it”
> I find this sentence to be particularly poorly phrased…
Actually, I strongly suspect the sentence to be factually incorrect. Does the OP has a cite for this claim.
A little googling indicates here indicates that 7-13% of people who try and fail will eventually succeed. I’d expect it to be much, much higher if nearly 100% still wanted to commit suicide.
I think the claim was that they regret the suicide attempt, not that they regret surviving. So I’m with those who think the original was poorly phrased.
Maybe depressed people in happier places are more likely to wind up in the particular region of depression where they are suicidal but aren’t too demotivated to commit suicide, the same way that it sometimes happens when people first start using antidepressants?
Industrialized nations have higher suicide rates than non as well. Akin to the black/white point made by Scott, we can ask if we’d rather live in Namibia.
I wonder if the change in lifestyle from jobs where people were engaged in manual labour all day to the more sedentary lifestyle is what makes the difference. Many people in industrialised nations get no exercise at all, and we have strong evidence of the psychological benefits of even an hour of moderate exercise, how much more do you get from doing it all day?
A good movie to illustrate the gulf between blacks and whites re: suicide is The Sunset Limited:
http://www.hbo.com/movies/sunset-limited#/
The hedonic distance thing is an interesting way to put it – but here’s another theory. It’s not whether you’re unhappy, it’s whether you know you have a reason to be unhappy, that depression might be self-reinforcing in some way.
“I’m really unhappy but that’s because I’m a medieval peasant”
vs.
“I’m totally unhappy at life, but looks at how awesome everything is living in a modern industrialized society! Well, if everything is this awesome and I’m still miserable…”
(caveat: no psychological training whatsoever and this is almost certainly wrong)
That was pretty close to my thought. I was thinking in terms of hope. If I’m depressed and a peasant, then I can hope for a revolution. If I’m depressed and life is great, I’m not sure what I have to hope for.
Perhaps this also helps explain why religious people tend to be less suicidal. (They also tend to be happier, which seems to confound Scott’s data otherwise.) That is, religious people, even if they are depressed now, tend to feel like they have something beyond themselves to live for/hope for the future.
I’m pretty sure you have it backwards. The peasant isn’t depressed because he doesn’t expect a better life. The modern man is depressed because everyone tells him he can be anything but he ends up working a crappy office job.
Also no psychological training but I do have loads of experience being depressed. That makes sense.
Having something to work for/struggle against seems to inoculate against depression. I think it’s to do with directing anger and energy outwards against your obstacles instead of inward, at yourself. Plus struggle creates a sense of meaning, or at least a way to avoid a sense of meaninglessness. Like how people in Britain were apparently all very happy during World War II.
Also, when you can’t blame an unjust society or The Man for fucking up your life, you have to blame yourself. Which feels bad.
I’ve heard this described as the “nothing left to blame” theory of suicide.
In my experience, it was a major factor, I think.
I wouldn’t know how far to generalise, though.
This is about how I usually imagine it. I interpret the hedonic distance as less between you and those around you and more between how you feel and how you think you ought to feel given how your life is. “I feel miserable, but I bet I would be happy if I could solve problems X, Y, and Z” vs “I feel miserable even though everything in my life is fine”.
Alternatively, Scott’s statement that “the person in question who might or might not commit suicide should also be, on average, happier” could just be wrong. It could be that some people are going to be depressed and equally, utterly miserable regardless of what their actual life is like, and in societies where most of the people around them are happy this stands out more and makes them more suicidal.
My thoughts exactly.
IIRC, happiness is one of the most consistently heritable traits in twin studies (as high as .8), and remarkably robust to extreme events like winning the lottery or losing a limb.
I had a similar idea when reading this post:
Having an external force to blame your misery on is associated with major psychological benefits. It leads to reduced depression and suicide rate.
The social justice movement can be partly understood in this context. You have a group of people clinging to a victim ideology that reduces their probability of integration and success, simply for the very real psychological benefit of having a plausible bogeyman.
I can’t find it at the moment, but I remember reading a study a few years back that said that people who accept responsibility for their problems are happier than people who blame them on others (if I recall I think it said that people who blamed their problems on abstractions like “society” were slightly less happy and people who blamed their problems on specific people they knew were really unhappy).
From least to most depressing:
1. Accepting responsibility for your problems and believing you can solve them.
2. Blaming abstract factors.
3. Blaming other people (presumably people you can’t get away from).
4. Accepting responsibility for your problems and believing you can’t solve them.
Alternate hypothesis:
if you spend all your time bearing grudges against people, they won’t like you very much.
I’m thinking something in this general direction. The way my brain phrased it was: okay, you and most of the locals have reached the top of the hierarchy of needs, it’s time for some self-actualization…only, oops, without an immediate, near-mode struggle presenting itself, you don’t actually have much of a self to actualize. Cue existential horror.
No psych training, no idea if I’m talking out my ass here, etc. But it seems plausible to me that, without suffering to provide direction, a non-trivial number of people will fill the hole themselves.
Call it the Agent Smith hypothesis.
I don’t think that many depressed people have gotten to the top, no. Modern industrialized society only provides the first two levels — and they don’t tend to have much of the third.
“Love” and “esteem” seem like matters that are in oversupply.
((That said, Maslow’s hierarchy is pretty much psuedoscience, ,so I’d caution against using it in a predictive sense to start with))
This was also what I was thinking. If you’re depressed but your life objectively sucks, you can blame your low moods and other symptoms on the suckiness of your life. It doesn’t cure the depression, and the cause is probably not your circumstances in the first place, but this illusion gives you hope. Hope that if whatever is going horribly wrong gets fixed, you’ll feel better, and that can be enough for some to keep going.
When there’s nothing obvious to blame, that hope isn’t there to provide a small buffer and help you fight the depression enough to live.
Attaching this to a long string of comments more or less agreeing. This is what a wise Monk from India said; external problems give you hope that if you solve them, you will be happy. When you’re in a perfect situation and still not happy, there’s nothing to hope for.
Agreed.
Suicide=unhapiness + lack of adversity
People kill themselves over little things more often than incomprehensibly awful ones. Losing your job or losing a competition, being publicly humiliated versus being on the brink of starvation every day.
The former leads to suicide precisely because it’s easier to cope with thus internalization of the problem and feeling that suicide provides a valid alternative “I’m going to feel bad regardless but killing myself will at least make me look better” a struggle between the self in the moment and self in memory(story or social self) with the former giving up.
People survive at least partly out of spite.
As a crude approximation, I’m pretty sure suicide = loneliness works better.
You have put in words the hypothesis I was missing from the article. I was wording it more like: is there hope I can change anything for the better? And the more things are ok, the harder it is… It’s hard being at the cutting edge.
Wouldn’t the relative suicide thing be related to the happiness of the people you actually know and interact with regularly? And isn’t there a lot of stratification in social environments in unequal countries?
If it’s just some rich assholes who live on the other side of town that you never see that are happy, but all the people you interact with are also unhappy and struggling, then eh, you’re not alone, you’re not worse off than the people around you.
But if it’s all your neighbours and friends and family and coworkers and classmates that seem successful and happy, then you are alone and… blah blah blah depressive thoughts.
I don’t know. This is speculation. But it’s never been Bill Gates and Elon Musk that I compare myself to when I’m depressed, it’s the people I know.
I’m still not sure why people would be more likely to stratify into groups happier than they are in high-happiness countries.
Perhaps happiness is more correlated with income in lower-income countries, and people tend to income segregate.
Well, suicidal people overwhelmingly tend to be depressed, and depression, as you pointed out yourself, is not the same as “sadness.”
You can be suicidally depressed when you have lots of reasons to feel happy and fulfilled (take Robin Williams for a convenient high profile example.) These various reasons to be happy may not be a very effective protective factor. If depressed people compare their perceived happiness level to those of their peers, then the contrast might be larger in high-happiness communities, because the happiness of depressed people poorly tracks their life situations.
This is more or less what I was trying to say.
What Desertopa says here:
can explain why high-happiness countries have more suicides.
On a related note, I wonder if a “sense of agency” might promote suicide, and also be correlated with happy or rich countries. If you have the idea that each person is supposed to control their own life, maybe it becomes more thinkable to end one’s own. This hypothesis is designed for slaves vs slave-owners, but also might apply to people just starting to take antidepressants.
Except people who watch lots of TV may compare themselves with celebrities even if they don’t know them in meatspace.
This is similar to the line of thought I had while reading this. Say that unequal countries stratify into classes based on wealth, and lack of wealth is correlated with other, non-depression forms of sadness. Now say that internal/biological factors are a larger contributor to depression than external factors are (I’m not sure how true this is, but it’s the impression I’ve got from the little I’ve read on the subject).
This would result in an even distribution of depressed people between classes. However, the people in the lower classes would be surrounded by other unhappy people, so it would be harder to recognize their depression, and if suicide is based on happiness relative to peers then they would be less suicidal. Depressed people in the upper classes would clearly stand out relative to their happier peers, and would also be more suicidal as a result.
This could result in unequal societies having fewer people whose depression stands out than in societies which are more homogeneous. It would also suggest that homogeneous societies with lower quality of life would have lower suicide rates than those with higher quality of life; I don’t know whether or not this is the case.
I’m not particularly confident in any of the assumptions this uses so correct them if you know otherwise, this just seemed to me like an explanation that was at least plausible.
100% of good death metal, you say? And how are you aware of this, Scott? (Also, allowances for hyperbole aside, that’s a bit unfair to the Americans and Brits.)
Mostly from friends. My metal tastes don’t run towards the death side of the spectrum, but I still think Scandinavian groups are some of the best – particularly Nightwish, Sonata Arctica, and Turisas.
Scandinavia is strongly associated with melodic death metal which is less, uh, morbid. The US gave us brutal death, on the other hand (and invented the genre as a whole..)
Of course us Brits pioneered grindcore and melodeath, in the case of Carcass with the same band! From which we can conclude Liverpool is a desolate wasteland of urban decay but can’t resist a catchy tune.
“From which we can conclude Liverpool is a desolate wasteland of urban decay but can’t resist a catchy tune.”
I can confirm that this is entirely correct.
I loves me some Nightwish, but cannot state strongly enough that while it may be operatic and/or melodic, it most definitely is *not* Death Metal.
Neither is Sonata Arctica for that matter. Scott seems to be confusing symphonic/power and death.
That’s what I said – although I admit it was confusingly worded. My friends who like death metal tell me Scandinavia is good – I prefer other kinds of metal and like [the bands I named]
Maybe you mean black metal? You could make a more credible case for a hyperbolic 100% coming just from Norway, even, if you claimed to be a purist.
Plus then you get church burnings and murder as a bonus.
Nightwish is real legit. I used to be super into them back in the day. Might I recommend Rhapsody of Fire? Extremely excellent symphonic metal.
Feeding my reputation for contrarianism, I’m sure, but I don’t know of any interesting Scandinavian metal bands besides Burzum, Dissection, Drottnar, and a few out of Finland.
Then again, I don’t like death metal or Nightwish-style pop metal, so.
Them’s fightin’ words, Cookie Monster!
Dammit, Scott, now I’m going to have to listen to Showtime, Storytime AGAIN. You’re not helping my Floor Jansen addiction.
You listen to Nightwish? I expected better tastes. It’s all fake fantasy role playing, vampire bullshit with very shallow references to magick and suchlike.
Here is an excellent parody of the whole “dark”, “gothic”, “grufti” genre: https://www.youtube.com/watch?v=_hkNXPZ0EVk
http://www.moron.nl/lyrics/spray/i-am-gothic-lyrics.html
I thought you are into bands who keep it real, who wear street clothes and sing about real life and are non-prententious… I am a bit disappointed now.
I hope you’re either joking or 13.
My music is better than your music because musicians dress in the way that my friend and acquaintances say is the right way to dress.
Do you listen to your music, or do you watch it?
In the interest of steelmanning this, what he is probably trying to say is that the type of musical performance associated with Nightwish incorporate many fantastical elements without a deeper meaning. He suggest that music which connects more directly to the listener’s life experience is more artistic – an argument made by the literary realists in the 19th century.
That said, he does sound like a whiny 13 year old.
In fairness, Nightwish can get silly as hell with that sort of thing. This is the band that wrote a song based on the Dragonlance books.
I like Nightwish well enough; I really liked them in college, before they kicked out Tarja and her awesome vocal range and before my musical tastes drifted. But the over-the-top fantasticism can be a little jarring sometimes, and so can the occasional overuse of synth effects (e.g. on “Sleeping Sun”, which is otherwise the best song on my edition of Oceanborn).
(Also, werewolves, not vampires.)
In fairness, Nightwish can get silly as hell with that sort of thing. This is the band that wrote a song based on the Dragonlance books.
Hey, so did Blind Guardian and they are the greatest Power Metal band in the world.
Fantasy role playing vampire bullshit is awesome. If you don’t appreciate it, that’s your loss.
If it’s good enough to win Eurovision in 2006, don’t knock it! 🙂
The ‘gay vampire ghost opera dubstep’ (as I saw it tagged while liveblogging Eurovision on Tumblr in 2013) came from Romania, as befits a vampire (my favourite of the competition that year, but not the winner).
I’ll accept “vampire”, “ghost”, and “opera”, but are we just slapping the “dubstep” label on anything we don’t like now?
What?? It is very good that musicians try to create interesting fantastic worlds and not just merely sing about what they see outside their window. That makes the world a more interesting place.
If you just go for “real life” you miss out on so much great stuff, though. Realism may have its place, but so do fantasy and abstract emotion.
Lots of confusion here. Scott, none of those bands are death metal.
There are two main variants of death metal in Scandinavia: Gothenburg (At The Gates, In Flames, etc.. – the original melodic death metal (also the reason why metalcore exists), not Carcass, who only turned melodic much later) and Stockholm (Entombed, Dismember, Grave – more melodic than US death metal, but less so than Gothenburg). Other bands don’t really have unique sounds or basically take on more American sounds. Norway is known for its black metal scene (the so called second wave), but lots of other good black metal bands started out at the same time throughout Europe.
Finally, the biggest exponents of death metal are 100% American. Bands like Death, Morbid Angel, Obituary, Deicide, Malevolent Creation (Florida) and Immolation, Suffocation, Cannibal Corpse (NY/Buffalo) or Nile (more recently) are much more representative of the genre than their Scandinavian counterparts.
Higher rates of antidepressants could just mean that people with depression get treated more often. It’s certainly not all of the effect, and it doesn’t explain suicide rates, but it could be something.
Yes, I agree.
High reported happiness combined with high rate of antidepressant use can also be explained by “the medication works as intended.”
I like your explanation better. But I’m still a bit taken aback by the newspapers seeing a contradiction in the first place.
Pingback: Depression Is Not A Proxy For Social Dysfunction | Neoreactive