Broken Brains with Bruce Parkman

Understanding the Suicide Crisis with Dr. Helen Epstein

• Bruce Parkman • Season 1 • Episode 72

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In this episode of Broken Brains, Bruce Parkman speaks with public health expert Dr. Helen Epstein about the rising suicide crisis and the complex mental health challenges driving it. They explore the societal factors that normalize suicidal thoughts, the role of long-term counseling, and how community support, art, and expression can promote healing. The conversation dives into the impact of social media, cultural expectations, and family involvement—highlighting the need for open dialogue and collective action to address this growing public health emergency.

 

 

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SPEAKER_03:

Hey folks, welcome to another edition of Broken Brains with Bruce Parkman, sponsored by the Mac Parkman Foundation, where we look at the issue of repetitive brain trauma in the form of repetitive head impacts and how it impacts the kid the brains and mental well-being of athletes and our children, and repetitive blast exposure and how it impacts the brains and mental well-being of our veteran population. And why we bring we talk about this, we bring on authors and doctors and researchers and players and parents, because this issue is not taught in our medical, psychological, nursing uh populations. So it's up to you to be informed, to make those decisions about those that you care and love and those that you know that are suffering right now because they might have been exposed through contact sports and military service. Today, another amazing guest on our show and kind of taking a we're taking a left turn on this one for most of the guests that we've had on this, is Dr. Helen Epstein, is a visiting professor of human rights and global public health at Bard College. She writes frequently for the New York Review of Books and other publications and is the author of three books, including Why Live, How Suicide Becomes an Epidemic. She has also worked as a consultant for UNICEF, the World Bank, the Human Rights Watch, and other international organizations. And if you followed Ms. Epstein, she has been in the thick of some of the most crazy places in this world reporting live. And I am absolutely amazed, and I'm so proud to have her on the show. Ms. Epstein, welcome to the show, ma'am.

SPEAKER_01:

Thank you so much for having me, Ruth.

SPEAKER_03:

It's our pleasure, ma'am. So you know, before we talk about the book, you know, tell us about yourself. And I mean, I've I've seen your report for, you know, all over Africa and and uh all over the world, really. So what drove you into uh this this occupation?

SPEAKER_01:

Um I guess um I don't know. I I uh I used to be a biochemist, actually. And I went uh to Uganda about 30 years ago in East Africa to work um on an early version of an AIDS vaccine. And um uh the results were not promising, but I began to um I got very interested in public health and how to stop the spread of diseases without, you know, sometimes when we all the tools we have is our voices. And um so I ended up spending a lot of time working on that, uh, working on various public health crises in Africa, including HIV AIDS, malaria, Ebola, and so on. And um then in about uh in 2017, a close friend of mine um took her own life, and it really struck me. I knew she was depressed, but I really didn't know uh this wasn't something I expected. And I was very thrown by it. Um and uh we can never, you know, very often um um a psychologist told me that essentially um you know one always looks back and wonders what one might have said, whether something could have made a difference. Um but it is actually very hard to predict who will take um their lives in at any given time. They're out of the thousand, out of a thousand people with severe depression, only one person will um die by suicide in any given year. So it's really hard to know whether we're missing some crucial signal or something until it's too late. And so I began to wonder, because I'm a kind of a public health person, um, I began to um look into the um public health aspects of this and came upon a number of um cases in which the suicide rate of particular populations began to rise very rapidly, sometimes as much as tenfold in just a few years, um, which was um really suggested a social cause. It suggested something in the social environment was causing this. Um it was unlikely to be organic, uh, something like brain injury or mental illness because um because of the speed at which it occurred. And I began to wonder what those conditions were, because what it meant was that um people with suicidal feelings aren't necessarily a species apart that if this could happen in a population, it could really happen to any one of us. We're all uh vulnerable to these feelings. So I wanted to know more about what those feelings were and and um um what are the contextual factors that bring them about. And that was why I uh wrote the book.

SPEAKER_03:

And that's you know, and you start talking about a public health crisis, right? I mean the level of suicidal ideation today is unprecedented. I mean, um, I mean, be besides the issues like we talk about reparative blast exposure, we have a physiological link to mental illness that we'll dive into a little bit easy later, with obvious links to suicidal ideation. Um, you know, we we have a crisis in our younger population and even older populations, really, where suicide has become an acceptable option. And, you know, I remember growing up in the 70s, and we we we had a man, we had a one of our neighbors, you know, hung himself. And the whole population is like, I mean, a whole neighborhood's like, what? I mean, nobody did this back then, right? And and now you don't we don't know of anybody who doesn't know somebody who's taken their life or a family that's been affected by this. So where where do you see this? And I just want to let our audience know we're gonna be talking about uh very, very traumatic issues called suicide, right? So, you know, please take your time with this podcast. If it's gonna be affecting you, you know, you don't have to listen to it. But I want to dive into this because I lost my son. And I have had, you know, I there's been many days I didn't want to think about suicide, but I don't want to be here no more with my boy, without my guy. And so this is our options to dig into this and and let you know, you know, what we're seeing out there. And so back to you, Dr. Epstein. I mean, why is this so why is this considered uh it's like it's almost acceptable to consider this, you know, whether it's you know, people boasting about it, trying to get attention, and then today's, you know, digital social media, hey, you know, they might cry for help. But um, a lot of people are carrying this all the way through.

SPEAKER_01:

I think one thing to bear in mind, I mean, um, you know, my condolences to your to you about your son and to anyone else who's listening who's lost someone close to them. Um, you know, there really ultimately for each suicide, there are no answers. But I think one thing that is common to people experiencing suicidal feelings for whatever reason, whether it's brain injury or um some other reason or mental illness or some other reason, is that there's a feeling, they have no idea how much pain they're going to leave behind. They are in so much pain themselves that they think I know it sounds crazy, and it is crazy, um, that they're doing people a favor. And um, I kind of know this partly because research suggests it. There's a um a very well-known suicide expert psychologist called Thomas Joyner, who's actually studied um thousands of cases, and this is really a kind of common denominator in many of them. And I experienced it myself once. Um, antidepressant pills can help lots and lots of people, and they really help a lot of people, but they can have terrible side effects.

SPEAKER_03:

They have all of them have black box warnings for this stuff. You would give them out like candy, you know, great. Yeah.

SPEAKER_01:

And I I had that side effect. And I I, you know, I've had, you know, bouts of depression in life, as many, many people have, but I did not um, I I suddenly realized, oh, you know, my goodness, all the problems in the world would be saved if I weren't here. And it was uh weird. I knew something was wrong. I knew something this wasn't the way um, this wasn't normal. And I think um, and it was um it was a kind of it's a delusion. And um I don't know. I mean, but the problem is that it's a delusion that is, as you say, increasingly um common and has been since uh really beginning in the 1970s. There's been a five-fold increase in the United States in suicide among um, I guess, working class people, um, people who um um particularly don't have bachelor's degrees and worked um um, you know, work in ordinary jobs, whatever. I mean, as we know, the sort of type of work that people do has changed radically since then. Wages have not risen and so on. And um a lot of um um the Rust Belt, for example, which is a very high suicide area of the United States, has been very severely affected economically, but also emotionally and psychologically. And so that helps, I think, uh I think this is widely recognized by everyone, that this has contributed dramatically to a uh mental health crisis in the country, which at first affected working-age people in their 40s, for example, and 50s. This is where the suicide crisis began, but it's now spreading um into um all groups, including people with BAs, young people particularly, um, and so on. And so it really is becoming, unfortunately, um more and more an American norm, and that's absolutely terrifying.

SPEAKER_03:

It is. And um, you know, the uh it it and despite, you know, we spend billions of dollars on suicide prevention, okay? And I know in the military alone, you know, we're still losing the same amount of veterans that we they, but despite the investment of billions of dollars into, you know, the the military into suicide prevention. Now we also know that we have overlooked repetitive blast exposure and its impact on the brain until just now. And so we we really know, and we do know that that the impact of that and contact sports on brains uh and the damage that results, the mental illness and suicidal ideation are extremely connected as people progress down the spiral. But we have invested billions in addressing this. Why, you know, and of course we've invested billions in other public health crises, you know, Ebola, you know, the the Mika virus, whatever that thing was called, and you know, the whole pandemic COVID thing, okay? Yet they're still around. Okay. So why do you think um we're not doing uh, you know, this despite this crisis, despite you can't deny the data. So why why are we not, you know, what what can we what can we do better?

SPEAKER_01:

Well, I think great question. Um, I mean, I think um one thing is that counseling services, individual counseling services, psychological counseling really can help, but people really need to stick with it. And that tends to be a real problem. Uh, it doesn't work automatically, it doesn't work after one or two sessions. It really is uh a kind of long engagement in a process, and that's very expensive. And even with the billions of dollars that are spent, um, that um the investments need to be even greater and more targeted, I think, particularly uh at that, because it really does save lives. Um, but that's a tough one because particularly veterans, um, a lot of suicide prone societies, um, indigenous groups, for example, uh like the Inuit or Native Americans have very high suicide rate, the Inuit of the Arctic Circle who live up there, yeah. And um they um and also veterans have very high suicides, and um men have higher suicides than women. And I think part of the reason for this is a is a culture of stoicism uh in all of these groups. That's what they one thing that they all share is a tendency not to want to talk about themselves and a real difficulty um in sharing how they feel. And that in a way, um they can't really, you can't really solve this kind of problem alone. You need someone with you. And um so that's what makes counseling services sometimes not work as well as one would like. I think that's one of the reasons. Um it's also that many people are traumatized, uh, as your son was, and trauma, psychological trauma as well as physical trauma, tends to shut down those parts, very parts of the brain, that help you make sense of your emotions, so it can actually um undermine the very mechanisms that you need to try to come to terms with whatever that trauma was. And that can be quite tricky. Um and so uh, you know, there are things, there are things that that uh that help um and help people kind of reach into themselves. One of the things I found from speaking to veterans, um, I spoke to a um a few dozen veterans who very generously shared their experiences with me, and they had um all had suicidal feelings in the past. Some of them had been hospitalized after attempts. And they were um uh what was kind of remarkable to me is that how many of them had engaged to try, I asked them, you know, how what made you feel better? How did you get through this? How did you find some kind of happiness in life or or um a reason for living? And so many of them had uh engaged in artistic projects, poetry, drama, drama in particular, um, and memoir and so on, and music. And I think there's something about bringing it helps art, it helps people bring out of themselves something that's locked inside and even through symbolic means. And uh it did seem to help a lot of them do that. Uh there's very good um um epidemiological evidence also on the effectiveness of um psychedelic drugs, which if used very carefully under medically supervised conditions, do seem to reduce suicidal feelings in people who are struggling with that, in depressed people. Um and they don't know quite how it works. There are many theories, but it does seem to what happens in depression is that you get locked into these spirals where you can't um, these these kind of negative thought patterns where you feel that um every door in your life is shut. And psychedelic drugs seem to untangle whatever those brain networks are that uh lock people into those negative spirals and give them a sense of possibility so that um they can make changes in their lives, which actually improve their lives and then get them out of those spirals. And the um studies of that are pretty powerful, actually, and interesting. And it seems to be almost to work in a similar way that um um that art does, in a sense, that it helps helps people sort of break out of these circ circuits.

SPEAKER_03:

Um to your point on you know the stoicism, you know, the the this whole macho thing in our society has to go away. It's one of the reasons that our kids are playing contact sports, because we think they need to be men, or our you know, our women, you know, uh our female athletes are pushed because you know they're all gonna be in the U.S. soccer team, which only has like, I don't know, 25 players. But we we wear our children's brains out. And I am uh you know, a victim of this. My son wanted to play, you know. I I wanted him to be active, I didn't want him to get hurt, but I had no idea that these back-to-back sports over these years were gonna impact his brain to a point where you know he ran off a hundred foot cliff, and he couldn't tell anybody, and we were best friends. I mean, we sat next to each other during COVID. I practiced my bagpipes, he'd play his game, and we're talking months of knee to knee, and you know, he was my soulmate, and he couldn't tell me. And he couldn't tell his friends, he couldn't tell his coach, he couldn't tell anybody, and this poor boy ate schizophrenia and depression all on his own. And the reason I know so much about this, Helen, is that I've done a lot of spiritual work, I've done a lot of psychedelic work, and I he came to me. And on your point, on these people don't know how much hurt they leave behind. You know, part of it is some of these people take their lives so they don't hurt other people. When they're dealing with schizophrenia, they are dealing, my son dealt with the most horrific thoughts that anybody should have to deal with. And him and we finding that a lot of these football players and baseball players struggling with the same thing, they have an option, whether they could succumb to these voices in their head that you know they get effectively medicated, or like my son with no medication, what do I do? And they decide that their option, their only option, is to leave so that they don't carry out these demonic thoughts or wishes. And I wish like heck I could have known that he was struggling like this because now we know that we have so many options to treat the brain. But and maybe it was my macho part that, you know, being a Green Beret Sard Major, that he felt he couldn't talk to me, he couldn't be weak, or what. I mean, he's only 17, he's still a boy. But you know, that part, you know, it resonates, you know, very well, and I can see where in societies were in that and that's that's uh you know a problem with it. What it whether it's just suicide today or relationships that fathers have with their kids, we've got to get off this macho stuff, man. It's just not the kids need to be kids. And sports we're learning needs to be kid friendly. It doesn't need to hurt. So that's you know something that um we need to, you know, definitely um work on. Um but you know, in in your findings out there about art music and particularly on the psychedelic drugs, um, you know, there's to your point, medically supervised. These are not fun experiences. And I put that out for you know, people think this is all recreational stuff. I've done just about all of them, and none of them are fun. You know, when you got to deal with your trauma, your guilt, your the pain that you've inflicted on others, learn to love yourself, all acceptance. These are all perks to a drug because it does seem to rewire the brain. But, you know, of course they're they're not uh uh available um uh right now. Um do you see a future where psychedelic therapy could be you know applicable to um, you know, uh well let me ask you this question first. I mean, because this is something that every parent asks us is how do I know that my child is struggling, or my partner, or my husband, or wife who played a lot of contact sports? Because again, brain trauma and contact sports are not correlated in this country. So sometimes the effects don't manifest themselves for decades. And so as people become aware, you know, they're aware that you know there might be substance abuse, violence, whatever. But I mean, they're they always ask us, how do I know that, you know, that my my my significant other or somebody that means a lot to me, or somebody I know could be struggling with suicide. Is there an is there an answer to that at all?

SPEAKER_01:

Well, it's you know, um as far as I know, the best thing you can do is is is ask them in a gentle, kind way. I mean, it sounds simple, but it isn't, of course. And it's um uh you know, one of the one of the difficulties is is especially with these suicide prone societies that we talked about before, the macho ones, in particular, is that there just isn't a language for talking about feelings very often. That's almost the definition of a of um these kinds of stoic cultures. You don't talk about that. Um, you know, it was really interesting as I went up to the Arctic Circle and and um hung out with the Inuit people for um a couple of weeks. And um one of the things about about that society is that they very recently were settled, really only in the 1950s and 60s. Before that, they mostly lived on the land in this incredibly difficult circumstances. I mean, the wind can blow a hundred miles anymore. You had to build your house out of snow in a in a raging blizzard. Yeah, exactly. I mean, it was um uh you had to sort of sneak up on a seal to catch it. I mean, it was it was really uh or caribou or whatever. And and so you really don't want drama queens in a situation like that, right? You don't want people. So their whole culture is built around kind of the containment of emotion. But what they have instead is remarkable sense of community. Everybody is immensely sensitive to everyone else's feelings all the time. And they're living in quite close quarters in the winter, they're all in you know inside and or in working in groups, especially. And so um everybody kind of feelings are dispersed. There's the whole group experiences them uh kind of collectively and and works to manage them. Whereas what happens when a group like that is suddenly transitioned into settled life, um, you have to manage your emotions alone, and you're subject to sometimes the insensitive uh treatment of others because um everyone is thinking mostly about his own um emotional and financial and every other type of well-being rather than the group. Um, so you need very different sets of emotional skills to live in a society that um is so-called modern. Um and um, you know, many of us modern people who've been modern for generations still um struggle with that, I think. Struggle a lot. Um brain injuries make it, of course, uh infinitely worse because you're struggling with much deeper problems and even more sensitive than the average person to just the um um um everyday struggles that we all have, I think, and that we all share. And that are much, much tougher than we like to admit sometimes.

SPEAKER_03:

Well, as we look at this digital, this modern world, right? And now we we've got these cell phone thingies, and we got computers, and now we got eyeglasses that can talk to you, and we have AI, you know, and now we've got children that are falling in love with things on AI and and taking their lives. I mean, I just read a horrible story about this wonderful 15 or 17-year-old who fell in love with an AI avatar and took his life. Uh and and so where has the intersection of digitalization and social media and AI, you know, my son was a big gamer. My son was uh a very, very prolific gamer. And he loved it. And I used to love sitting by him and watching the gaming, but after he died, we found out, you know, you know, that he was on Snapchat and all these other things. And while we didn't find for him anything really, you know, he was he just you know, he was struggling with his own mental illness. He really didn't advertise, he wasn't really talking to anybody about it, wasn't looking for ways to kill himself, but he was still all on these social media channels right now. Did your research indicate that, you know, that this is contributing to this rise in suicide and and that, you know, just to, you know, something else for parents to start, you know, worrying about or be on the eye for, or be on the lookout for?

SPEAKER_01:

As far as I understand, the data on gaming in particular, not social media, but gaming does see does um doesn't suggest a connection. Um, that that's um, at least as far as researchers have been able to detect, there doesn't seem to be an issue with gaming. Um, but yes, indeed, um AI is really scary, it's quite new, um, and it does create this illusion of intimacy. Um that is, of course, um false because you're dealing with a mechanical object and not a real human being. And um many people, it does seem have been kind of led into these dark um channels by um into these very dark spaces by um um so by social media, either sort of other people acting from a distance in very insensitive ways, bullying and so on, uh, and also into um uh by by AI increasingly. Um we will have to see where AI goes. It's quite new. But as far as social media goes, um the the data is pretty strong for the United States, I think, the social media, and it's it can be quite dangerous for for kids. But I think it has to do with pre-existing mental struggles, which we also need to worry about, um, and maybe kind of primary, because um um we don't see that correlation in other Western countries where social media has also taken off. So there seems to be something about the interaction, the way we use social media in the United States that is um at the moment special. Um special, yeah. And I think it's it's uh yeah. Um and I think it's something particular with, yeah, as we discussed before, the sort of go-it-alone macho culture, which affects everything, not just our emotional and psychological lives, but the shape of our economy and the um the way we uh treat each other and so on, and the tone of our public discourse and so on, which is so becoming increasingly harsh. It's always been pretty tough, but but boy, lately it's gotten so mean. And I don't think this is going to help.

SPEAKER_03:

No. It's horrible that we can't accept that whatever side of the line you're on, the other half of America is just stupid or whatever. I mean, it's just it's idiocy. And um you know, there's a lot of lack of respect there and a lot of lack of love that really needs to start coming back into our discourse. What do you think what is the yeah, you just brought up a good point? Because we don't uh you don't read about these problems in Japan or Europe, right? And with social media and stuff. Well, what what is I mean, I I find it appalling that I mean, one time I'm not you know making this up, my son, I he was on his iPad, and I clicked on a button that looked weird, and all of a sudden there's two people naked having sex on my son's like nine-year-old iPad. And I'm like, hey boy, where did this come from? And what it was was he was chasing a game around the internet, and these savages had somehow slipped in. You know, he was downloading things trying to get to this game, and he ended up downloading that, you know, horror sexual act. And so, you know, of course, we started locking down stuff, uh, you know. But it seems like, you know, the you can find anything. Any eight-year-old could find anything they want on the internet. And there's no, you know, there's no like there's there's no recourse or or consequences for that. What is the difference when in how Europe treats social media than we do? Is there more consequences for do you do you know what the difference is?

SPEAKER_01:

I don't know. I mean, I know that in um I think in Australia they try they banned it from schools and certain certain things. I don't I'm not aware of legisl yeah, I'm not aware of in the non-anglophone world though, of legislation about that. It's worth looking into, and I have not done so, um, or even debates about it. And I don't know why. I mean, I know I lived in Europe for some years, and I um um I got the sense that there was less I think being young is always in modern times very, very difficult. I don't know if you've remember a famous anthropologist called Margaret Meade. Uh, you heard of her? She was um she was she was very distinguished because she went out to uh the South Pacific in the 1920s, and she studied um a group of people in um uh and she wrote a famous book called Coming of Age of Samoa in Samoa. And there was a big debate at that time because there was a prior to her, there was a psychologist called Stanley Hall who'd written a famous book called Adolescence, which was all about the struggles of young people and the angst and the anguish and this sort of what was called the sturm and drang, the storm and stress of adolescence, the struggle to find one's own identity. And um and she wrote in her book that people in the South Pacific who lived according to these kind of traditional ways and close-knit communities where everyone kind of had a role to play, you caught fish, you did the cooking, you climbed the coconut tree or something like that. Um, they didn't go through that. They're, you know, adolescence for them was, you know, an increasing number of responsibilities, and you got interested in sex and all sorts of things, but didn't uh didn't go through this angst, this anguish. And since then, studies have shown that in, you know, um of of you know, global societies have really shown that that uh adolescent angst and the struggle to to find oneself and the agony of that is really something quite unique to modern to modern societies, that traditional cultures, human societies, um do not have that experience for the most part. I mean, some people struggle, of course, but for the most part, you were judged on how generous you were and how much you pitched in for others and um how much you conform to the norms of the group, of course, which not everybody wants to do all the time. But um but the real the real pain of finding yourself, of constantly having to think, who am I? What where will I end up? What can I do? Who are my friends, who are not my friends? Um, this didn't really arise uh in traditional human societies. But and yet it's it's uh it's probably the hardest thing we ever do as human beings. And and I think that's why youth is such a vulnerable, vulnerable period in uh in our lives for suicide and and for mental illness in general. And um, and of course, social media pretends to help us find answers. It's like this kind of cruel joke. We think um um the computer or the cell phone is finally going to open up this world to us, but in it's a counterfeit world, it's a it's a fake world, and it's useful for some things, um for work, for example, but it's not a substitute for social life and other human beings that love and care about you. And that is the imperative. That is what we really need to find.

SPEAKER_03:

Um, and you might have brought up and I think a good point that you just brought up the difference between us and like I I've got a nephew that's in Germany right now, and they are such a family-centric unit. Like the whole family, multi-generations of family, they hang out together every day, every weekend, they help each other out, they raise each other's kids. I mean, you can't even get neighbors to get along in this country right now, right? And they don't, you know, they don't trust each other. You know, there's not that, you know, I you know, I think being more family-centric and having the family around and together, I think has a lot to do with that because there is, you know, we tend to leave our kids alone, right? We babysit them with TVs and and iPods and iPads, we think that's cool. And hell, you know, sport parents even use sports as babysitter events. Hey, let me just chuck you in a bunch of sports and I'll sit here and read my book or whatever, right? And it's and so I I I think we, you know, the level of involvement that we either expect nowadays as parents, or, you know, schools are now a babysitting service, or I'm just gonna get rid of my kid for the day, right? And not that all parents feel like that, and it's that we're talking, you know, maybe subset, but in the it, but we do know that in America today we're not family-centric. And I think that getting back to that, I even got a daughter right now who's trying to figure out how to get us all in one house. Of course, I got a grandson now, we're gonna get all kinds of interest in that. But it's uh, you know, it's I think that's something to be said there. And uh, you know, and that's uh that's a good point. Like going back to brain injured persons, you made a comment a little bit earlier, like, you know, the if you you with a brain injury, and whether we're not talking just contact sports or being a service, you're talking about car crashes, falls, violent crime, whatever. You've got, you know, you're the odds or the you know, the it seems like you've got besides the struggles, you're saying that um the the you know suicidal ideation is is probably even more problematic for those and those people.

SPEAKER_00:

Um yeah, yeah, yeah.

SPEAKER_01:

I think um Yeah, I I'm not sure how much is is um um I think the struggles with um mental illness, let's say, in general, is particularly depression, particularly the psychotic disorders like bipolar disorder and schizophrenia, are extremely um people with those problems are in major depression and so on, are very, very high risk for suicide. So more than half of all suicides, depending on the country, sometimes up to 90%, are affected by one or other of those conditions. So any brain injury is gonna number one increase just the organic uh likelihood that something like that will happen. The brain doesn't work as well. Um, and it will also increase the kind of self-consciousness, the fears and um that that also exacerbate depression itself. So there's the consciousness of the the injury, and there's the injury itself, and there's the um attitude of others to you when you have such problems, because the world turns away. Uh we turn away from people with those kinds of problems. It's it's uh um it's an active effort to take care of someone who's struggling with mental illness sometimes. And that means those people are increasingly alone. And um when they really most of all need engagement, they need someone to just say, hey, come on, um let's hang out, or something, or let's talk. Uh and so I think um they're all there's an organic mechanism operating there, and there's a psychosocial um aspect to it too, which makes it particularly difficult. And and it gets back to this issue of families, too. I mean, families normally, this is something they could rally round when um American families are under so much stress at the moment. Um with inflation, with everything else. It's um it's very, very um um people are really, really struggling in a way that that Europeans are more cushioned by a kind of welfare state, which not only reduces the economic burden on families, but it also creates this sort of idea that there's some big thing out there taking care of you. And so people are less existentially stressed out all the time. They're less um, you know, worried and kind of panicked about not only am I going to be able to pay the rent tomorrow, but what does it mean that I can't? What does it mean that I'm not adequate to doing this uh on my own? And that's a terrible, terrible feeling. Whereas um, you know, in France or Italy, they might be more likely to be saying saying, I can't pay the rent, it's the government's fault that I can't do that. They're not managing the economy properly. They're not making sure that our wages are adequate and so on.

SPEAKER_02:

Right.

SPEAKER_01:

So um here we blame ourselves. And that just compounds everything. It makes us harder makes it harder to take care of ourselves, makes it harder to take care of each other, too.

SPEAKER_03:

Yeah, and it's it is tough out there right now. I don't think I've ever seen it, you know, this bad with the folks I talk to. And it's um you know, and it's not it's not a political thing, it's just where we're ending up right now with you know our focus on making all the money in the world and not and our lack of focus on each other. And I think that's where, you know, I think um your book goes to the point of that, is that I think by taking care of each other and having that trust and foundation where either we're asking the right questions, because I remember two days before my son left me, I we s we went outside and I'd give him a beer any nowadays. He's getting ready to join the army, you can have a beer, and we sit on a rock wall and we planned out our next trip. We had a father and son trip every year. This one was to Japan. I said, All right. And um, our further our, you know, we we've been to the pyramids, we've been all over this world. And he said, All right, dad, no more two-week trips. Okay, you got to keep it down the one week. You may kind of make me crazy. I'm like, all right, son. And um, I said, All right, well, we're gonna in and out, man. Seven days, mew and me in Japan, you know, you're getting ready to join the army. He goes, All right, dad. And I asked him, is everything all right? He goes, Yeah, dad, everything's fine. And um, because um, you know, I I I used to ask him, you know, not as much as now I, you know, looking back, gosh, the grit, you know, just the the the guilt that you have, you know, the the the the things that woulda, shoulda, coulda, you know, and and uh it eats you alive as the parent of a of a dead child. And um because it's always your fault, you know. Even though, you know, I you know I've resolved everything as much as I can. I was a good dad. I still carry that guilt every day. And uh it'll be with me till the end, until I see him again. That's why I do this thing to kind of make him proud, you know, and and let let them know that I'm doing my best to whatever you know my oversights were or my mistakes, that uh, you know, I'm I am honestly trying to do better and uh make a difference. But uh, you know, as we uh get ready to close out, um if you have any uh last thoughts on this issue, this this terrible, unfortunate reality that faces not only you know me, um, you know, I'm just uh yeah, I'm uh you know, I'm a parent, but there's so many other people that are struggling not only with the possibility of harming themselves, uh, but you got family members that don't know who you know what the what to ask or anything. You know, if you have any advice, um I'd uh you know, last words, I'd uh appreciate your thoughts.

SPEAKER_00:

Yeah.

SPEAKER_01:

Um I I I too felt one of the things I noticed uh in my own um um I mean two two things. One of them is that that I think everyone who loses someone asks themselves the questions that you're asking. And we are all we all make mistakes with each other. I mean, that's the whole thing about human beings that makes us not computers is that we do wonderful, original, amazing things and we screw up and we screw up sometimes.

SPEAKER_03:

I'm definitely not a computer. I could barely turn one on. Yeah.

SPEAKER_01:

But we're not um but we're not um you know, we're not infallible, and it's not about any one thing you might have said or done that triggered this. It's about the world in which um in which you and he grew up and came of age. And that's the point that I'm trying to make in the book is that it's not about what any individual said or did. It's about the structures around us that we can't even see, but that shape our behavior and that shape our thought patterns and our shape our the way we see each ourselves and others. And that's really where I think we need to put the focus rather than um because the uh you know w one will never stop asking questions like the ones you're asking. But uh, you know, um it's really not about you. It's about it's about the the world that we've built and that we've constructed, which is um which is just so tough that some people just can't make it. And um and I think, you know, I and I another thing is that I noticed also with with my friend who took her own life, um, that she fell into this about a year before she died, I guess, she fell into this very dark depression, and I tried to talk to her and she couldn't get the words out. It was this thing of not having a language, I guess. It was sort of the way the Inuit are veterans are. She didn't know how to talk about herself in some way. Um and so um, and I just I didn't know much about suicide then, and so I didn't think much of it. And then um I called her and she sounded so much more cheerful the next morning, and then I saw her again and she was fine, didn't want to talk about it. And I think once people resolve that, you know, that's a time to worry in a weird way, is when people, because people who who are suicidal, sometimes they make this decision, which is that I'm gonna get out of this. And they then it becomes very hard to reach them because they don't show signs of depression. They seem to be brightening up, they seem to be cheered up because they've sort of resolved this. And that's um and that makes it even tougher. And it makes it even more difficult to break through, even more difficult for therapy to work. So this is why we need somehow to work on um if you can't change the entire world and this this the psycho structural structure of the United States, you can at least try to work with the people around you to try to create a kind of kinder micro world where people, where everyone feels they belong. And um that's um um that's that's really through one thing or another. So all power to your daughter in a way. Yeah.

SPEAKER_03:

Well, I mean, it's uh, you know, to your point, when my son's last video, well his only video that he posted just before he took his life, he was happy. He's like, I've been struggling for two years, and he goes, I'm done. And he got happy, he goes, I'm done. And he was that confident and he was stone cold sober that he was going to do the right thing. And I have to honor that. And it wasn't, you know, and and finally, and one of the trips that uh the psychedelic journeys I had, I got right in touch with him, and he let me know that he was scared. Um he was that that that he had hurt us, and um, that we were angry with him for doing what he did. And I'm like, son, we just miss you. I'm not angry with you. You made the decision, and for you it was the right one at that time, and I have to honor that. I just wish you could have talked to me. I wish it I I so wish it was different, but it's not, and I'll never be angry with you, you know. Uh but I I do miss you, and that's that's so I was able to I felt like I was even angels have their doubts, right? And um, I was able to to comfort him on that. But um, Ms. Epstein, I I want to thank you so much. Um, this is uh obviously a tough subject, not only for me, but for a lot of people that listen to this call to even think about, right? Not it's not that you don't even have to be a part of it. That's what's so crazy about this issue of suicide is that you can't fathom it. You know, you can't understand it unless you're either suffering severely or know somebody that's you know contemplating it, but you just cannot fathom why, you know, this this happens so so often. And trying to understand that only helps us become more aware and maybe pushes us to right things. Maybe we can turn down that social media dial and get our kids off this craziness and just go play games and swing from apple trees or whatever it takes, right? But I want to thank you so much uh for your time today and for you know your uh you know, just your your your insight on this issue and um uh and and just want to you know say thank you.

SPEAKER_01:

Well, thank you so much for inviting me and thank you for the work you do, actually, which I think um, you know, it's one of those things that could make a difference in bringing people together to uh talk more openly about this issue and her shared struggle. So thanks a million.

SPEAKER_03:

No, well, thank you. And for anybody that's listening today, if you do know anybody that's struggling, whether it's yourself, somebody you love, or somebody that you know, ask them. Okay, ask them. And you know, the suicide 911 numbers are out there. You can have anybody call us, they call our foundation, we put them in touch with other veterans, whatever we got to do to help. So, I mean, this if this is an issue that touches you, you know, more realistically than others, please reach out. But um, thank you again, Dr. Epstein. Really appreciate you. And everybody, another great episode of Broken Brains. Probably not our happiest one, but you know, again, informative, and that is why I'm here. That's why we are here. Don't forget uh the Army Navy game, December 13th. We're gonna be uh raising money for suicide prevention and mental health illness for our um for our veterans. Uh, download the free book off our website, uh, Youth Contact Sports and Broken Brains, become informed so you can keep going. Um, and like us, subscribe us, push us out there, please. You know, we always can use support out there. We want to thank our sponsor, Blue Fusion, who's helping us with the Army Navy game out there, amazing data and analytics company. And uh I want to thank you all for listening again. And remember, if you have children, they only got one melon. Take care of that then. God bless you all. We'll see you again on Broken Brains. Take care.