This is the second part in a series about mental health. The first part can be found here. 

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Any comprehensive approach to mental health must acknowledge how devastating guns are to our wellbeing.

A gun is by far the most reliable means to kill oneself. Eighty-five percent of gun-aided suicide attempts are successful, according to the Harvard Injury Control Research Center. In contrast, only two percent of pill-aided suicide attempts succeed. In 2014, 60 percent of gun-related deaths in the United States were suicides, according to the Centers for Disease Control and Prevention.

Stronger laws aimed at keeping firearms from people who are suffering from depression and other mental illnesses would save thousands of lives. But if the deaths of twenty-six schoolchildren and teachers at Sandy Hook Elementary School on December 14, 2012, did not lead to any meaningful gun-control legislation, the self-murders of the desperate and depressed will likely inspire similar apathy.

By failing to restrict access to firearms, we aid and abet suicide.

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We must consider our addiction to war a component of our mental healthcare crisis.

In 2012, as NPR reported, the number of suicide deaths in the U.S. military were a record 349—more than the 295 Americans who died fighting in Afghanistan during the same time. In 2013, according to U.S. News, someone in the U.S. military committed suicide every 18 hours.

The suicide rate among U.S. troops deployed to Iraq between 2004 and 2007, a period of intensified fighting, jumped from 13.5 to 24.8 per 100,000, according to a report issued in 2009 by the Army surgeon general. Some 8,000 veterans are thought to die by suicide each year, a toll of about 22 per day, according to a 2012 U.S. Department of Veterans Affairs study.

Members of the U.S. military are trained to kill and have weapons to do so. It is painfully easy to see how they could use their talents and access to weapons on themselves.

For some soldiers, there is a greater danger to their lives than war. It is themselves, in war’s wake.

 

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A CDC study covering the years 1928 to 2007 shows a striking correlation between joblessness and suicide. So it’s no surprise that between 1999 and 2010, a decade when the dot-com bubble burst and the financial system nosedived, the suicide rate soared. While one might assume men, who are stereotypically perceived as providers and are therefore susceptible to feelings of failure when they cannot support their families, would be more vulnerable to suicide during tough economic times, women showed a greater increase in suicide rates over the first decade of the twenty-first century, 31.5 percent to 27.3 percent. Women likely now feel as much pressure as men to be providers—and feel an equivalent hopelessness when they cannot find work.

Willy Loman, from the Arthur Miller play Death of a Salesman, is literature’s preeminent example of a hard-working American prodded by economic ills, as well as personal failures, to kill himself. Sadly, variations of his story are replicated every day in real life.

Even the fear of losing one’s job, as I discovered when my short-story collection failed to find a publisher, can be mood-altering.

Sadly, our country seems content to remain a country of haves and have-nots, thereby sustaining a climate of misery. In a 2012 chart compiled by the Central Intelligence Agency, the United States ranked forty-fourth on a list of countries with the most unequal distribution of income. The fine company we were keeping? Cameroon, the Philippines, and Bulgaria. We were so far from equitable distributors of wealth such as Sweden, Denmark, and Norway that we might as well be in a different solar system. It is perhaps no coincidence that the U.S. ranks higher in suicides per capita than every Scandinavian country.

Daniel Kahneman, a Nobel Prize-winning economist, famously said in a TED talk that Americans earning less than $60,000 per year “are unhappy, and they get progressively unhappier the poorer they get.” In 2015, the U.S. Census Bureau estimated per capita income at $28,930.

Therefore, the average American is unhappy.

 

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Our suicide epidemic might be seen as ironic because there are more methods than ever to treat depression, the most significant risk factor in suicide. From antidepressants to ECT, transcranial direct current stimulation (tDCS), transcranial magnetic stimulation (TMS), and deep brain stimulation (DBS), patients have myriad (although never guaranteed) options to ease their anguish. Even Tylenol, as revealed recently by researchers at the University of British Columbia, can soften our existential unease.

But none of these treatments, however potent, can fix what may be underlying our depression: loneliness, alienation, and anxiety about what is becoming of our world.

In theory, we are more interconnected than ever. Facebook. MySpace. Instagram. LinkedIn. Twitter. Choose your platform…or your poison. A virtual community is, alas, no more than what its name states: close to being something without being it. Words, smiley-face emoticons, and even video lack the warmth of a handshake, a real smile, or an embrace.

In a 2010 survey by the AARP, one in three adults over the age of 45 reported feeling chronically lonely. In an AARP survey ten years earlier, only one in five adults answered the same way. John Cacioppo, a Chicago psychologist who has studied loneliness for two decades, estimates that 20 percent of Americans—or 60 million people—suffer from chronic loneliness and are unhappy as a result. Loneliness, it seems, is expanding even as we have more means to reach each other.  

Loneliness and the state of being alone are, of course, different. Being alone doesn’t have to be lonely. In fact, for a number of us—writers, for example—it’s essential to the work we do. Even so, as a society we are becoming more isolated in the literal sense. In 1950, according to The Atlantic, less than 10 percent of American households contained only one person. By 2010, the number was 27 percent.

Persistent loneliness can lead to depression, which can lead to worse.

 

Mark Brazaitis is the author of seven books, including The Incurables: Stories, winner of the 2012 Richard Sullivan Prize and the 2013 Devil’s Kitchen Reading Award in Prose. His book was featured on the Diane Rehm Show, where he discussed his experiences with depression and mental-health treatment.