2015年经济学人 美国自杀事件 令人发指地无底洞

Suicide in America

An awful hole

Why more Americans are killing¹ themselves

BEING depressed² is like having a terrible headache, says one Atlanta businessman. Except that a few days of rest do not stop the pain: “You're just expected to keep going.” Trying to “man up”, he sought little help for his condition, choosing to hide it instead. “It all gets so debilitating³ that you don't want to go on,” he explains.

He tried to kill himself more than once; fortunately, his attempts came to nothing. But the same cannot be said for a growing share of Americans. The suicide rate has risen from 11 per 100,000 people in 2005 to 13 seven years later. In the time it takes you to read this article, six Americans will try to kill themselves; in another ten minutes one will succeed.

Over 40,000 Americans took their own lives in 2012—more than died in car crashes—says the American Association of Suicidology. Mondays in May see the most incidents. The rates are highest in Wyoming and Montana, perhaps because guns—which are more effective than pills—are so common there (see chart). Nationally, guns are used in half of all successful suicides.

What drives people to self-destruction? Those who suffer from depression are, unsurprisingly, most at risk. The suicide rate also rises when times are hard. During the Depression it jumped to a record 19 per 100,000. It grew after the recent financial crisis too. “Even just uncertainty⁴ over employment” makes people worry a lot, notes Yeats Conwell, a psychiatrist⁵ at the University of Rochester Medical Centre.

The over-75s have historically been most likely to kill themselves, especially if they are lonely or ill. But now it is the aged⁷" target="_blank">middle-aged⁶ who are most at risk. In 2012 the suicide rate for Americans aged 45-54 was 20 per 100,000—the highest rate of any age group. For those aged 55-64 it was 18; for the over-65s it was 15. The middle years can be stressful, because that is when people realise that their youthful ambitions will never be fulfilled.

Women make nearly four times as many suicide attempts as men, but men succeed four times as often. Men favour bloodier⁸ methods: most use a gun, whereas less than a third of women do. Women may be better at asking for help; overall, they are two and a half times more likely than men to take anti-depressants. Whites are nearly three times as likely as African-Americans to kill themselves. Blacks are five times more likely to be murdered with a gun than to kill themselves with one; for whites it is the other way round.

Military veterans are especially prone⁹ to suicide. Data from 48 states suggest that 30 out of 100,000 veterans kill themselves each year—a rate far higher than among civilians¹¹. Many find it hard to overcome the trauma¹² of combat, or to adjust to civilian¹⁰ life. A survey by Iraq and Afghanistan Veterans of America, an advocacy group, found that 31% of veterans had considered taking their own lives. Congress is mulling a bill to overhaul¹³ how the Department of Veterans Affairs handles the problem.

Activists¹⁴ say the government does too little to prevent suicide. Christine Moutier of the American Foundation for Suicide Prevention complains that only $40m of federal funding will go to anti-suicide programmes this year. This does not include the billions the government spends on mental-health problems more broadly.

Some treatments, such as anti-depressants, are often quite effective. More than 20 studies have found that when anti-depressants are more widely available, fewer people end their own lives. For example, between 1991 and 1996 Swedes swallowed 240% more anti-depressants and the suicide rate fell 19%. But it is hard to prove a causal link. And other studies suggest that certain anti-depressants lead young people to think more about suicide.

Making it slightly harder to kill yourself is also surprisingly effective. American pharmacists still sell painkillers¹⁵ loose in pots, enabling people to pour the whole lot down their throats in one movement. This is unwise. After Britain switched to blister¹⁶ packs in 1998, which require you to punch pills out one by one, deaths from overdoses of paracetamol (the active ingredient in Tylenol) dropped 44% in 11 years.

Some who ponder suicide may be dissuaded¹⁷ by counselling. Behavioural therapies, alone or in family settings, allow sufferers to talk through their emotions and actions. A Danish study of 65,000 people who attempted suicide between 1992 and 2010 suggests that providing people with “a safe, confidential¹⁸ place to talk” during up to ten sessions saw repeat attempts and actual suicides drop more than 25%.

Three states have concluded that not all suicides should be prevented. In Oregon, Washington and Vermont “Death with Dignity” laws allow terminally ill, mentally competent residents to ask for prescription¹⁹ drugs to hasten their deaths. Such laws have no discernible effect on unassisted suicide: from 1999 to 2010 suicides among those aged 35-64 increased 49% in Oregon, which has allowed terminally ill patients to end their lives since 1997, compared with a 28% increase nationally.

And what of those left behind? A suicide deeply affects six people close to the deceased, research suggests. Since 1988 some 5m Americans have suffered the loss of a loved one in this way. Christy Simpson, a counsellor in Georgia, knows it can be difficult for families to discuss a loved one's suicide; her mother asked her to tell friends that her sister died in a car accident after she jumped to her death.

Ms Simpson believes that eroding²⁰ the stigma²¹ around suicide would help. “My parents could never talk about [it]. My mother went from perfect health to her grave within seven years,” she says. “The message I got was that what had happened was extremely shameful²² and that we had failed as a family.”

1 killing   

n.巨额利润；突然赚大钱，发大财

参考例句：

• Investors are set to make a killing from the sell-off.投资者准备清仓以便大赚一笔。
• Last week my brother made a killing on Wall Street.上个周我兄弟在华尔街赚了一大笔。

2 depressed   

adj.沮丧的，抑郁的，不景气的，萧条的

参考例句：

• When he was depressed,he felt utterly divorced from reality.他心情沮丧时就感到完全脱离了现实。
• His mother was depressed by the sad news.这个坏消息使他的母亲意志消沉。

3 debilitating   

a.使衰弱的

参考例句：

• The debilitating disease made him too weak to work. 这个令他衰弱的病，使他弱到没有办法工作。
• You may soon leave one debilitating condition or relationship forever. 你即将永远地和这段霉运说拜拜了。

4 uncertainty   

n.易变，靠不住，不确知，不确定的事物

参考例句：

• Her comments will add to the uncertainty of the situation.她的批评将会使局势更加不稳定。
• After six weeks of uncertainty,the strain was beginning to take its toll.6个星期的忐忑不安后，压力开始产生影响了。

5 psychiatrist   

n.精神病专家；精神病医师

参考例句：

• He went to a psychiatrist about his compulsive gambling.他去看精神科医生治疗不能自拔的赌瘾。
• The psychiatrist corrected him gently.精神病医师彬彬有礼地纠正他。

6 middle-aged   

adj.中年的

参考例句：

• I noticed two middle-aged passengers.我注意到两个中年乘客。
• The new skin balm was welcome by middle-aged women.这种新护肤香膏受到了中年妇女的欢迎。

7 aged   

adj.年老的，陈年的

参考例句：

• He had put on weight and aged a little.他胖了，也老点了。
• He is aged,but his memory is still good.他已年老，然而记忆力还好。

8 bloodier   

adj.血污的( bloody的比较级 )；流血的；屠杀的；残忍的

参考例句：

9 prone   

adj.(to)易于…的，很可能…的；俯卧的

参考例句：

• Some people are prone to jump to hasty conclusions.有些人往往作出轻率的结论。
• He is prone to lose his temper when people disagree with him.人家一不同意他的意见,他就发脾气。

10 civilian   

adj.平民的，民用的，民众的

参考例句：

• There is no reliable information about civilian casualties.关于平民的伤亡还没有确凿的信息。
• He resigned his commission to take up a civilian job.他辞去军职而从事平民工作。

11 civilians   

平民，百姓( civilian的名词复数 )； 老百姓

参考例句：

• the bloody massacre of innocent civilians 对无辜平民的血腥屠杀
• At least 300 civilians are unaccounted for after the bombing raids. 遭轰炸袭击之后，至少有300名平民下落不明。

12 trauma   

n.外伤，精神创伤

参考例句：

• Counselling is helping him work through this trauma.心理辅导正帮助他面对痛苦。
• The phobia may have its root in a childhood trauma.恐惧症可能源于童年时期的创伤。

13 overhaul   

v./n.大修，仔细检查

参考例句：

• Master Worker Wang is responsible for the overhaul of this grinder.王师傅主修这台磨床。
• It is generally appreciated that the rail network needs a complete overhaul.众所周知，铁路系统需要大检修。

14 activists   

n.（政治活动的）积极分子，活动家( activist的名词复数 )

参考例句：

• His research work was attacked by animal rights activists . 他的研究受到了动物权益维护者的抨击。
• Party activists with lower middle class pedigrees are numerous. 党的激进分子中有很多出身于中产阶级下层。 来自《简明英汉词典》

15 painkillers   

n.止痛药( painkiller的名词复数 )

参考例句：

• The doctor gave him some painkillers to ease the pain. 医生给了他一些止疼片以减缓疼痛。 来自辞典例句
• The primary painkillers - opiates, like OxyContin - are widely feared, misunderstood and underused. 人们对主要的镇痛药——如鸦片剂奥施康定——存在广泛的恐惧、误解，因此没有充分利用。 来自时文部分

16 blister   

n.水疱；(油漆等的)气泡；v.(使)起泡

参考例句：

• I got a huge blister on my foot and I couldn't run any farther.我脚上长了一个大水泡，没办法继续跑。
• I have a blister on my heel because my shoe is too tight.鞋子太紧了，我脚后跟起了个泡。

17 dissuaded   

劝（某人）勿做某事，劝阻( dissuade的过去式和过去分词 )

参考例句：

• He was easily dissuaded from going. 他很容易就接受劝告不走了。
• Ulysses was not to be dissuaded from his attempt. 尤利西斯想前去解救的决心不为所动。

18 confidential   

adj.秘（机）密的，表示信任的，担任机密工作的

参考例句：

• He refused to allow his secretary to handle confidential letters.他不让秘书处理机密文件。
• We have a confidential exchange of views.我们推心置腹地交换意见。

19 prescription   

n.处方，开药；指示，规定

参考例句：

• The physician made a prescription against sea- sickness for him.医生给他开了个治晕船的药方。
• The drug is available on prescription only.这种药只能凭处方购买。

20 eroding   

侵蚀，腐蚀( erode的现在分词 )； 逐渐毁坏，削弱，损害

参考例句：

• The coast is slowly eroding. 海岸正慢慢地被侵蚀。
• Another new development is eroding the age-old stereotype of the male warrior. 另一个新现象是，久已形成的男人皆武士的形象正逐渐消失。

21 stigma   

n.耻辱，污名；(花的)柱头

参考例句：

• Being an unmarried mother used to carry a social stigma.做未婚母亲在社会上曾是不光彩的事。
• The stigma of losing weighed heavily on the team.失败的耻辱让整个队伍压力沉重。

22 shameful   

adj.可耻的，不道德的

参考例句：

• It is very shameful of him to show off.他向人炫耀自己，真不害臊。
• We must expose this shameful activity to the newspapers.我们一定要向报社揭露这一无耻行径。