Most studies of suicide are based on clinical populations, and the detection and treatment of mental disorder is the main focus in suicide prevention strategies in many countries.
However in Norway, several apparently well-functioning young men unexpectedly took their own lives, without any prior sign of a mental disorder. This contradicts previous research which suggests that depression or other mental illness is an important risk factor in suicide.
In the study, researchers at the Norwegian Institute of Public Health interviewed relatives and friends of 10 young men who, in spite of accomplishments and successes, had taken their own lives in young adulthood, about how they knew the deceased and understood the suicide.
The main finding suggests that developmentally, these young men appeared to have compensated for their lack of self-worth by exaggerating the importance of success, thus developing a fragile, achievement-based self-esteem in adulthood which left them vulnerable in the face of rejection and perception of failure.
“Contrary to previous research suggesting that mental illness — in particular, depression — in the period prior to death is an important risk factor for suicide, few of the informants in our study mentioned depression or other mental illnesses in their narratives,” said researcher Mette Lyberg Rasmussen, the first author of the study.
“The study’s main findings uncover a particular vulnerability to feeling rejected and to not having succeeded in achieving their goals,” said Rasmussen.
“In these situations there is a strong sense of shame and of being trapped in anger. This develops into unbearable thoughts that the vulnerable person cannot regulate or manage, and leads to a feeling of a life not worth living.
“The former strategy, which involved compensation with continual increased efforts, does not work anymore, and suicide becomes a way out of a situation of unbearable psychological pain,” said Rasmussen.
Although the study is small, researchers used a unique qualitative methodology including 61 in-depth interviews and 6 suicide notes related to 10 suicides among young men (18 and 30 years) with no prior psychiatric treatment and no previous suicide attempts.
For every suicide, Rasmussen and her co-authors analyzed in-depth interviews with mothers, fathers/father figures, male friends, siblings, and (ex-)-girlfriends about how each one of them experienced the deceased and his suicide in all its complexity.