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Is the Pandemic Sparking Suicide? Is the Pandemic Sparking Suicide?
(3 days later)
The mental health toll of the coronavirus pandemic is only beginning to show itself, and it is too early to predict the scale of the impact.The mental health toll of the coronavirus pandemic is only beginning to show itself, and it is too early to predict the scale of the impact.
The coronavirus pandemic is an altogether different kind of cataclysm — an ongoing, wavelike, poorly understood threat that seems to be both everywhere and nowhere, a contagion nearly as psychological as it is physical. Death feels closer, even well away from the front lines of emergency rooms, and social isolation — which in pre-Covid times was often a sign of a mind turning in on itself — is the new normal for tens of millions of people around the world.The coronavirus pandemic is an altogether different kind of cataclysm — an ongoing, wavelike, poorly understood threat that seems to be both everywhere and nowhere, a contagion nearly as psychological as it is physical. Death feels closer, even well away from the front lines of emergency rooms, and social isolation — which in pre-Covid times was often a sign of a mind turning in on itself — is the new normal for tens of millions of people around the world.
The ultimate marker of the virus’s mental toll, some experts say, will show up in the nation’s suicide rate, in this and coming years. The immediate effect is not at all clear, despite President Trump’s recent claim that lockdown conditions were causing deaths. “Just look at what’s happening with drug addiction, look at what’s happening with suicides,” he said in a press briefing in the White House Rose Garden on Monday.The ultimate marker of the virus’s mental toll, some experts say, will show up in the nation’s suicide rate, in this and coming years. The immediate effect is not at all clear, despite President Trump’s recent claim that lockdown conditions were causing deaths. “Just look at what’s happening with drug addiction, look at what’s happening with suicides,” he said in a press briefing in the White House Rose Garden on Monday.
In fact, doctors won’t know for many months if suicide is spiking in 2020; each death must be carefully investigated to determine its cause. The rolling impact of Covid-19 on these rates give scientists a sense of how extended uncertainty and repeating undercurrents of anxiety affect people’s will to live.In fact, doctors won’t know for many months if suicide is spiking in 2020; each death must be carefully investigated to determine its cause. The rolling impact of Covid-19 on these rates give scientists a sense of how extended uncertainty and repeating undercurrents of anxiety affect people’s will to live.
“It’s a natural experiment, in a way,” said Matthew Nock, a psychology professor at Harvard. “There’s not only an increase in anxiety, but the more important piece is social isolation.” He added, “We’ve never had anything like this — and we know social isolation is related to suicide.”“It’s a natural experiment, in a way,” said Matthew Nock, a psychology professor at Harvard. “There’s not only an increase in anxiety, but the more important piece is social isolation.” He added, “We’ve never had anything like this — and we know social isolation is related to suicide.”
The earliest signs of whether the pandemic is driving up suicides will likely emerge among those who have had a history of managing persistent waves of self-destructive distress. Many of these people, who number in the millions worldwide, go through each day compulsively tuned to the world’s casual cruelties — its suspicious glances and rude remarks — and are prone to isolate themselves, at times contemplating a final exit plan.The earliest signs of whether the pandemic is driving up suicides will likely emerge among those who have had a history of managing persistent waves of self-destructive distress. Many of these people, who number in the millions worldwide, go through each day compulsively tuned to the world’s casual cruelties — its suspicious glances and rude remarks — and are prone to isolate themselves, at times contemplating a final exit plan.
“That’s how I am,” said Josh, 35, a college instructor in North Carolina who has been consumed in the past with thoughts of suicide. “I see all the bad, the suffering, and I have a tendency to crawl into a hole. Now, with this Covid threat, we’re being told to isolate and stay away from others. It’s like, ‘Oh, I was right all along, and the world was crazy.’”“That’s how I am,” said Josh, 35, a college instructor in North Carolina who has been consumed in the past with thoughts of suicide. “I see all the bad, the suffering, and I have a tendency to crawl into a hole. Now, with this Covid threat, we’re being told to isolate and stay away from others. It’s like, ‘Oh, I was right all along, and the world was crazy.’”
He added, “I haven’t backslid, I haven’t moved. But longer term — I don’t know.” He asked that his last name be omitted for privacy.He added, “I haven’t backslid, I haven’t moved. But longer term — I don’t know.” He asked that his last name be omitted for privacy.
Research done in the wake of natural disasters offers little guidance as to how this group will respond. In a widely cited 1999 paper in The New England Journal of Medicine, researchers from the Centers for Disease Control and Prevention reported that, in communities hit by an earthquake, flood or hurricane, rates of suicide spiked in the years after. But the study authors later retracted that finding, after discovering an error that, when corrected, revealed “no significant increase in suicide rates after natural disasters, either for all types of disasters combined or for individual types of disasters.” Other studies have found increases, or decreases, depending on the group and disaster studied.Research done in the wake of natural disasters offers little guidance as to how this group will respond. In a widely cited 1999 paper in The New England Journal of Medicine, researchers from the Centers for Disease Control and Prevention reported that, in communities hit by an earthquake, flood or hurricane, rates of suicide spiked in the years after. But the study authors later retracted that finding, after discovering an error that, when corrected, revealed “no significant increase in suicide rates after natural disasters, either for all types of disasters combined or for individual types of disasters.” Other studies have found increases, or decreases, depending on the group and disaster studied.
The evidence is stronger when it comes to the impact of economic hardship. Suicide rates in the United States have been rising steadily since 2000 — by 35 percent overall, across most age groups — but the rate of increase roughly doubled in the wake of the 2008 downturn. Historically, the job losses, evictions and displacements caused by recessions tend to lead to an increased numbers of suicides.The evidence is stronger when it comes to the impact of economic hardship. Suicide rates in the United States have been rising steadily since 2000 — by 35 percent overall, across most age groups — but the rate of increase roughly doubled in the wake of the 2008 downturn. Historically, the job losses, evictions and displacements caused by recessions tend to lead to an increased numbers of suicides.
“I think during the actual crisis, suicide will be lower,” said Dr. Marianne Goodman, a psychiatrist at the Department of Veterans Affairs, in the Bronx. “And once the longer-term economic impact is felt, I suspect, suicide will be rising again.”“I think during the actual crisis, suicide will be lower,” said Dr. Marianne Goodman, a psychiatrist at the Department of Veterans Affairs, in the Bronx. “And once the longer-term economic impact is felt, I suspect, suicide will be rising again.”
But the imminent threat of a potentially deadly virus is very different, psychologically, from the exhausting anxiety of facing a future with few job prospects. The descent of a pandemic alters the thinking and behavior of distressed people in ways that are simply not well understood.But the imminent threat of a potentially deadly virus is very different, psychologically, from the exhausting anxiety of facing a future with few job prospects. The descent of a pandemic alters the thinking and behavior of distressed people in ways that are simply not well understood.
For now, many people who have had to manage self-destructive thoughts have found that their inner dialogue has shifted since the pandemic descended.For now, many people who have had to manage self-destructive thoughts have found that their inner dialogue has shifted since the pandemic descended.
“I was in a relatively good place when this started, and I think one of the reasons I’ve stayed that way is that, having had all this experience with depression and anxiety, you learn a lot of skills that are applicable in this pandemic,” said Michelle, 37, a New York teacher with a history of chronic suicidal tendencies, including two attempts.“I was in a relatively good place when this started, and I think one of the reasons I’ve stayed that way is that, having had all this experience with depression and anxiety, you learn a lot of skills that are applicable in this pandemic,” said Michelle, 37, a New York teacher with a history of chronic suicidal tendencies, including two attempts.
“It’s interesting, I’m having conversations where everyone is feeling anxious about the same thing,” she said. “It’s been awhile — since grad school, I think — that I have been a part of conversations like that, and it’s strangely nice.”“It’s interesting, I’m having conversations where everyone is feeling anxious about the same thing,” she said. “It’s been awhile — since grad school, I think — that I have been a part of conversations like that, and it’s strangely nice.”
Dr. Owen Muir, a co-founder of Brooklyn Minds, a program that treats many highly suicidal individuals, said his own clients appear to be doing well so far, despite or perhaps partly because of Covid-related adjustments.Dr. Owen Muir, a co-founder of Brooklyn Minds, a program that treats many highly suicidal individuals, said his own clients appear to be doing well so far, despite or perhaps partly because of Covid-related adjustments.
“The fact you could die any minute, that is very different situation from previously, where you thought, ‘The only way I’m going to die is if I kill myself,’” Dr. Muir said. “That theoretical struggle is very real now, in peoples’ minds, and what I’m seeing in many of our patients is that they make sense of it by wanting to help — like, now is the time to stay healthy and cope with this, for everyone’s sake.”“The fact you could die any minute, that is very different situation from previously, where you thought, ‘The only way I’m going to die is if I kill myself,’” Dr. Muir said. “That theoretical struggle is very real now, in peoples’ minds, and what I’m seeing in many of our patients is that they make sense of it by wanting to help — like, now is the time to stay healthy and cope with this, for everyone’s sake.”
Updated June 2, 2020 Updated June 5, 2020
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
This is not to say that self-destructive urges are somehow fading, only that they now compete with adaptations to a broader, outside threat, therapists and researchers say. In many high-risk people, suicidal thoughts are now more frequent than before, new research suggests.This is not to say that self-destructive urges are somehow fading, only that they now compete with adaptations to a broader, outside threat, therapists and researchers say. In many high-risk people, suicidal thoughts are now more frequent than before, new research suggests.
In a continuing study, a research team led by Dr. Nock is monitoring smartphone data of highly suicidal people for six months after they present in a hospital at risk of suicide. The team has gathered thousands of surveys from people 12 years and older. “From before to after Covid-19, we’re seeing increases in suicidal thinking, among adults, that are predicted by increases in feeling isolated,” Dr. Nock said. But preliminary results suggest that such thoughts are not more frequent among the high-risk adolescent, for reasons the team is trying to work out.In a continuing study, a research team led by Dr. Nock is monitoring smartphone data of highly suicidal people for six months after they present in a hospital at risk of suicide. The team has gathered thousands of surveys from people 12 years and older. “From before to after Covid-19, we’re seeing increases in suicidal thinking, among adults, that are predicted by increases in feeling isolated,” Dr. Nock said. But preliminary results suggest that such thoughts are not more frequent among the high-risk adolescent, for reasons the team is trying to work out.
The relationship between suicidal thoughts, which are fairly common in people with mental health diagnoses, and completed acts, which are comparatively rare, remains a subject of intense study. A fear of infection may push over the edge some people who would otherwise manage.The relationship between suicidal thoughts, which are fairly common in people with mental health diagnoses, and completed acts, which are comparatively rare, remains a subject of intense study. A fear of infection may push over the edge some people who would otherwise manage.
Dr. Makeda Jones, a New York psychiatrist, said that a colleague recently called because her teenage daughter tried to hang herself. “For some people who have not learned the skills to cope, this pandemic makes them feel more vulnerable and out of control,” Dr. Jones said. “And those two things will make some want to seize back control and say, ‘I don’t want to die of this disease, I can do it on my own terms.’”Dr. Makeda Jones, a New York psychiatrist, said that a colleague recently called because her teenage daughter tried to hang herself. “For some people who have not learned the skills to cope, this pandemic makes them feel more vulnerable and out of control,” Dr. Jones said. “And those two things will make some want to seize back control and say, ‘I don’t want to die of this disease, I can do it on my own terms.’”
Only careful study — the first pass, in this morbid, real-time experiment — will determine whether the acute fear of infection outweighs the effects of longer-term economic anxiety. For now, many people who have had to live with a nihilistic inner darkness see everyone in the world outside as suddenly having to do the same — a new experience indeed.Only careful study — the first pass, in this morbid, real-time experiment — will determine whether the acute fear of infection outweighs the effects of longer-term economic anxiety. For now, many people who have had to live with a nihilistic inner darkness see everyone in the world outside as suddenly having to do the same — a new experience indeed.
“It’s almost like you’re in the eye of the hurricane, that’s the way it feels,” said Josh, the college instructor in North Carolina. “I have been sitting with therapists all my life, telling them that the world is on fire, does anything I do matter? Now the world really is on fire, sort of, and I’m trying to teach myself to see both the good and the bad, and to see how I can actually be of help.”“It’s almost like you’re in the eye of the hurricane, that’s the way it feels,” said Josh, the college instructor in North Carolina. “I have been sitting with therapists all my life, telling them that the world is on fire, does anything I do matter? Now the world really is on fire, sort of, and I’m trying to teach myself to see both the good and the bad, and to see how I can actually be of help.”
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