3- Pridmore & Ahmadi: stress & suicide

Letter to the Editor

Stress may trigger suicidal thinking

Saxby Pridmore1, Jamshid Ahmadi2

1Professor of Psychiatry University of Tasmania, Australia. s.pridmore@utyas.edu.au

2Professor, Substance Abuse Research Centre, Shiraz University of Medical Sciences, Iran. Jamshid_Ahmadi@yahoo.com

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Western medical wisdom holds that all, or almost all, suicide is due to mental disorder. This is supported by retrospective psychological autopsy, a methodology which has been strongly criticised (Hjelmeland, et al, 2012, Shahtahmasebi 2014). World Health Organization (2014) recently described the idea that all those who complete suicide suffer a mental disorder as, ‘a myth’.

The novel has been described as “a mirror journeying down the high road” (Stendhal, 1971, p 365), giving an account of the culture of the time at which it is written.

‘Scarlet and Black’ is a French novel by Stendhal (1971). It was written and published in 1830, and depicts the circumstances of that time.

The protagonist is a tradesman’s son who sets out improve his social status. He experiences many frustrations and humiliations. Stendhal writes:

“Several times the idea of suicide presented itself to him; this image was full of charm; it was like a vision of blissful rest, of ice-cold glass of water offered to the poor wretch who is dying of thirst and heat in the desert” (p 367).

‘Go set a Watchman’ was written by the American, Harper Lee (2015), and offered for publication (but rejected) in 1957. It depicts Alabama at that time. When the protagonist is a pre-teenager, she is kissed on the lips by a teenage male. Ignorant of the facts of reproduction, she believes she is pregnant and is greatly distressed. Lee writes:

“According to her calculations, the baby would come with October, and on the thirtieth day of September she wold kill herself” (p 133).

Careful work from Asia has shown that in that part of the world, suicide may occur in the absence of mental disorder (Phillips, 2010).

The above examples taken from 19th French and 20th Century USA literature, combine with recent Asian finding, to indicate that suicidal thinking in response to stressors (independent of mental disorder) is a world-wide human feature.

References

Hjelmeland, H., Dieserud, G., Dyregrov, K., Knizek, B., Leenaars, A., 2012. Psychological autopsy studies as diagnostic tools: are they methodologically flawed? Death Stud. 36, 605–626.

Shahtahmasebi S (2014). Suicide research: problems with interpreting results. British Journal of Medicine and Medical Research: 5(9), 1147-1157. from http://www.sciencedomain.org/issue.php?iid=716&id=12.

Lee, H., 2015. Go set a watchman. William Heinemann, London.

Stendhal, 1971. Scarlet and Black. (First published in French, 1830; Translated by M Shaw 1953) Penguin Books Ltd., Hammondsworth, England.

Phillips, M., 2010. Rethinking the role of mental illness in suicide. Am. J. Psychiatry 167, 773-781.

World Health Organization, 2014. Preventing suicide: A global imperative. WHO, Geneva.