Suicide in apparently well-functioning young men

In Norway, there is still scant scientific evidence of effective prevention strategies, and suicide rates among young men remain high. 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.

Researchers at the Norwegian Institute of Public Health interviewed close relatives and friends of ten young men who, in spite of accomplishments and successes, had unexpectedly 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.

No signs of mental illness

"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," says researcher Mette Lyberg Rasmussen, the first author of the recently published study.

Vulnerable to rejection and failure

"The study's main findings uncover a particular vulnerability to feeling rejected and to not having succeeded in achieving their goals," explains 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," says Rasmussen.

Unique data

The study is based on a unique qualitative data set, consisting of 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 analysed 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.