Why are “deaths of despair” on the rise in the United States, but not elsewhere?

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Researchers conclude that other nations offer more support to their citizens than the United States Geraint Rowland Photography/Getty Images
  • Death rates in the United States have risen, with suicides and alcohol and drug poisonings contributing significantly to the rise, alongside the cardiovascular effects of rising obesity.
  • The causes of despair-related deaths involve factors such as increased isolation and people’s attempts to use substances to satisfy a lack of dopamine in the brain.
  • Some experts suggest the United States should examine how other countries support the human life cycle and adopt these policies to help prevent despair-related deaths.

A recent article in JAMA Psychiatry notes the upward trend in despair-related deaths in the United States. These include deaths by suicide and drug or alcohol poisoning.

This increase is higher than in the control group of 16 other nations. The authors of the article recommend that the United States adopt the practices that these nations use to help their citizens reduce despair-related deaths.

The paper in question examines the National Academy of Science (NAS) report on death rates in the United States. Currently, the United States has higher death rates than 16 other industrialized countries.

Other industrialized countries the researchers used as a control group include Australia, Austria, Belgium, Canada, Denmark, Finland, France, Germany, Italy, Japan, Norway, Portugal, Spain, Sweden, Switzerland and the United Kingdom.

The increase in mortality in the United States is greatest among white adults in low-education, low-income rural areas. In contrast, death rates among black and Hispanic adults have declined.

The increase in mortality is linked to a few different factors, including metabolic and heart disease. These disorders are associated with obesity, which has increased dramatically among all racial and ethnic groups.

However, deaths due to despair contribute significantly to rising death rates in the United States. The authors of the study note that “the main contributors to the increase in mortality are deaths from despair or deaths from suicide and drug poisoning related to addiction to opiates, cocaine, amphetamines, ‘alcohol and tobacco’.

Study authors Peter Sterling, Ph.D., and Michael Platt, Ph.D., both based at the University of Pennsylvania, speculate on the reasons for the increase in despair-related deaths. They note that humans are hardwired to seek out certain things, such as food, comfort, companions, and companionship, and that the brain reinforces these behaviors through the release of dopamine.

They also note how society has moved away from the hunter-gatherer model. These societies had strong bonds of camaraderie, good general health, high levels of cooperation, and plenty of surprises to generate dopamine rushes.

Sterling explained to Medical News Today“The field of anthropology has confirmed the basic picture of life in small-scale societies on all continents. Far from living a ‘wicked, brutal and short’ life [as Thomas Hobbes described life outside society], they tend to be very cooperative and non-hierarchical with low levels of inequality and essentially zero obesity or cardiovascular disease. Many people live to be 70 years old.

The document notes that current life in the United States is highly predictable and people have become more isolated. These factors can cause individuals to seek dopamine surges from other sources, such as drugs and alcohol.

Additionally, humans have long-term needs that must be met throughout the life cycle.

For example, children have emotional and nutritional demands that parents, grandparents, and other caregivers can meet. People also need to learn essential survival skills and have enough time to deal with their emotions.

The authors note that changes in American culture have made living conditions today different from those of our ancestors.

For example, the family structure previously included greater involvement of parents and grandparents. Single-parent families have increased in recent years in the United States. These single-parent families may experience higher levels of poverty, lower levels of prenatal care, and problems with maternity leave. Children from single-parent families may also experience health problems and educational delays.

The authors also draw attention to the rising cost of education, which was not an issue in hunter-gatherer communities. They also argue that today’s typical work situation does not allow for many leisure activities or paid free time.

The article suggests that these issues contribute to the rise in despair-related deaths in the United States based on the needs that humans have throughout their lives.

Many organizations have worked to raise awareness of suicide as a cause of despair-related death. For example, the American Foundation for Suicide Prevention focuses some of its efforts on helping people recognize the warning signs of suicide. The organization used a recent social media post to highlight the following warning signs related to people’s speech, behavior and mood:

  • Speak: For example, talking about being a burden to others, [dying by suicide]feeling unbearable pain, having no reason to live and feeling trapped.
  • Behaviour: Warning signs include increased use of alcohol, drugs or other unhealthy coping mechanisms, withdrawal from activities, isolation from friends and family, giving away valuable possessions, sleeping too little or too much, acting recklessly, visiting or calling people to say goodbye, and aggression.
  • Mood: Possible signs include loss of interest, depression, irritability, anxiety, humiliation, rage and despair.

The study authors note that the NAS recommends the following interventions to help prevent hopelessness-related deaths:

  • increased regulation of prescription drugs
  • increased access to harm reduction products, such as naloxone, and safe injection sites
  • expansion of recovery programs, harm reduction and mental health counseling services
  • promoting resilience in children

However, they believe that this response is insufficient because it does not take into account community support factors. Looking at how other governments and countries support their citizens, they conclude that in many of these countries the number of single parents is much lower than in the United States.

They also note that educational options are more federally managed, college costs are lower, and employers are giving more vacations. They believe that these factors could contribute to the lower rate of despair-related deaths in these countries.

Dr. Sterling has developed for DTM“All of these countries provide cradle-to-grave support to help families through every stage of the life cycle, including prenatal care, maternity leave, preschool and elementary education, post-secondary education, health care and vacations.The United States provides no such assistance, and the National Academy report does not consider them essential to solving our crisis.

The authors further warn that only considering individual factors will lead to a focus on individual solutions. This could lead to attempts to fix the problem through overmedication.

“Each symptom of hopelessness has been defined as a dysregulation disorder in the individual. This incorrectly frames the problem, forcing individuals to struggle on their own by learning resilience, self-help, etc. It also puts the emphasis on pharmacology treatment, providing countless drugs for anxiety, depression, anger, psychosis and obesity, as well as new drugs to treat addictions to old drugs. despair only with pills – on the contrary, pills will only deepen it.

Overall, the prevention of despair-related deaths can be achieved through a combination of interventions. It is important to consider several factors, including how the United States should resolve the issue.

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