The Sisyphus Cycle: How Everyday Stress Leads to Suicide

Sarah Knutson
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By and large, mainstream society agrees that suicide rates are disturbingly high, possibly approaching epidemic proportions. Most people probably also see these issues as part and parcel of “mental illness” and are fairly content to leave the solutions to healthcare industry experts. As the story goes, suicidal people are depressed, depressed people are mentally ill, mental illness is a chemical imbalance or genetic abnormality. Ergo, better drugs or medicine should eventually provide a cure. The experts are working on it. We just need to be patient and let them do their job.

But is this a fatal mistake?

In the first place, there is something of a glitch in the comfortable rhetoric. It doesn’t comport with the actual data.1 According to researchers, a wide variety of cultural, social & economic factors — not just biological or heritable traits — impact suicide rates, e.g.:

  • Disparities in health care, income inequalities, despair, loneliness, lack of belonging2
  • The increased social acceptability of thinking about suicide3
  • Declining socio-economic status
  • Weakened forms of social integration4
  • Relationship problems/loss, life stressors, and recent/impending crises5
  • Increased media screen time for minors6
  • Experiences of trauma, negative interpersonal/ occupational/ academic events, and feeling the burdensome responsibilities of professional life7

The implication is this:

If social factors and garden-variety life stressors like those cited above significantly affect whether or not we off ourselves, then privatized healthcare interventions are — at best — only part of the solution. Pills and other biomedical remedies aren’t designed to remedy broader socio-cultural dynamics — and they don’t claim to. Nor does conventional talk therapy. So confining our approach — and public spending — to the healthcare industry is, ironically, probably deadly. At the very least, it’s not all we can do. Perhaps it’s not even the best thing we can do (see Pridmore & Pridmore, 2016; see Evans, 1994).8

But that begs the question. Because, like, how do we even know where to start with a problem like suicide? It seems so irrational, counter-intuitive, bat ass crazy to most people. What kind of idiot would want to take their own life? 

In a word: What do I do if the problem itself defies logic? If something is totally random, there’s no rational pattern to reason from. That alone makes me vulnerable. Until I know what’s going on, any crackpot can propose a theory.

History is replete with examples:

  • The sun, stars and planets orbit the earth. 
  • The earth is flat, if you walk far enough you’ll just fall off it. 
  • Rabbit feet and knocking on wood bring you luck.
  • Black cats and broken mirrors curse you for days or years. 
  • Normal birth is male, never female or queer, either of which are the mother’s fault.
  • You can determine intelligence and good breeding from the shape or size of someone’s head.
  • Madness is caused by masturbation and wandering wombs.
  • Tooth extraction, organ removal, malaria, insulin shock, lobotomies, electroshock and psychoactive drugs are promising medical interventions.

What’s really true? Who knows? It just goes on like that — for years or millennia until someone actually nails the jello to the wall and proposes some operative principles to make sense of the territory.

Since the jury is still out, the outcomes are dismal, and the mainstream world is still mostly grasping at straws, I figure there’s room to offer my two cents.

Why not? 

After all, I’m a suicide contemplator and attempt survivor. Plus, I’m still alive to look back, reflect, observe some patterns and connect a few of the dots that seem to stretch across the decades of personal struggle. So here goes:

What is it, exactly, that happens for me during those critical periods when ending my life seems like a reasonable — almost necessary — solution?

The Sisyphus Cycle

1. Suicide can be understood as a stress response

You remember Sisyphus, right? The guy who was condemned to push the boulder up the hill, watch it roll back down, and start all over again — for eternity.

The Sisyphus Cycle I’m scared, overwhelmed, alone Defenses amp up Brain shuts down or goes into overdrive I do what I know how to do It doesn’t work Resources diminish Desperation escalates I try to get help It doesn’t work … or feel like me … or fit my lifestyle … or my budget [Graphic: Guy pushing boulder up a hill talking to self, saying “I’m so tired of this...” Retrieved from http://4.bp.blogspot.com/-Yb1qHHYlqYo/T2eYHgywpcI/AAAAAAAAAFk/Ld8ZI6ByPb0/w1200-h630-p-k-no-nu/la+cultura+del+esfuerzo.jpg]

Truth be told, I find that story disturbingly relatable. If you wanted to capture my mindset at the peak of suicidal longings — mountains towering in front of me, huge obstacles weighing me down, crushing odds, repeated failures, futility of existence — that would be it. From there, it’s only a few short steps to exit-oriented “self-help” seeming logical and desirable. So if you asked me, that’s pretty much how I’d explain suicide.

To sum up, you couldn’t write a better recipe for normal stress-response activation:

  1. Everything I’ve tried has failed.
  2. My body is worn out, and wants to quit.
  3. My brain is fried and can’t think of anything better.
  4. No one in my known world is offering meaningful solutions.
  5. Everyone else seems happy with how things are.

After one too many trips around this block, enter suicide:

  • The fail-safe tactic for escaping unbearable pain and suffering (at least in this world).
  • Plus I get to send you a message that I hope you’ll think about after I’m gone.

If you know what to look for, those responses are also indicators that stress is at work here. In the first case, my death is the vehicle for my escape. That’s the classic FLIGHT response. In the second, my death is the weapon. I use the moral capital of my own life to attack a value system and social order that I have judged to be irreparably not okay with me. That’s the classic FIGHT response.

Kind of ironic, huh? Here I am intending to off myself. But when you take a look under the hood, it would be hard to find a more a textbook example of the flight and fight survival strategies in action.

The World My Body Doesn’t Want to Live In

2. For a variety of complex reasons, modern life is more stressful for the human body than one might think at first glance. This keeps me, more or less, in a state of constant alert, which costs energy and wears me down physically and mentally over time.

A lot of people believe that modern progress is taking us in the direction of the best of all possible worlds. We just need to sit tight and wait — it’s only a matter of time before technological advances make utopia possible and we end up with worldwide peace and ease. A hard lesson for me to get in my suicidal journey was that, try as I may, my body refused to believe that. It’s taken considerable experience, reflection and research to give my body some credit. I now believe my body was a lot wiser than I once suspected. I wish I had listened and started taking what my body was trying to tell me seriously a lot sooner. I might have saved myself a lot of pain and self-judgment if I had. In part 2 of this series, I’ll talk about some of the social conditions and physical realities that led me to these conclusions.

The Stress Response and Behavioral Hell

3. As wear and tear increases, ability to manage stress decreases. I begin cycling through a range of seemingly contradictory survival defenses, the “symptoms” of which are indistinguishable from DSM criteria for “serious mental illness.” As a result, I and others increasingly come to believe that I’m crazy and doomed — that my mind and body are untrustworthy, unreliable and irrevocably broken. 

When my life started getting harder than I could comfortably manage, I did what every good citizen is supposed to do. I turned to mental health professionals. When years of talk therapy, exercise, body work, supplements and dietary changes barely made a dent, I finally gave in and consented to pharmaceuticals. Within a few years, my formerly robust body was unrecognizable and irretrievable by me. I was shaking with fear and couldn’t leave my apartment. I had no natural motivation and couldn’t think my way out of a paper bag. For the first time in my life, I was sincerely praying to die.

When I turned to professionals for answers, they basically had none. According to them, I had a “serious mental illness” and this was just how the disease progressed. For a while I believed them and dutifully accepted my fate. But I no longer do.

In part 3 of this series, I’ll share how and why I came to believe differently. I’ll explore the unfortunate, iatrogenic connection (for me) between mainstream treatment and suicide. I’ll share how it turned into behavioral hell instead of behavioral health, even though my providers were good people and none of us wanted my life to turn out this way. I’ll also lay out here why I think that happened — why, for me, “behavioral health” labels and treatment activated suicidal inclinations — and the mediating role that I think the stress response played in that.

Finally, since I’m already in the neighborhood, I’ll broaden the field a bit. I’ll look at why, for me, behavioral health concerns like “mental illness,” addiction and anti-social (inconsiderate, abusive, violent) thoughts and actions — as well as risk for homelessness (becoming “hard to house”) — tended to overlap. Here, again, I’ll be looking at stress/survival responses as a possible common denominator.

Cracking the Code on My Human Condition

4. Understanding the stress response is the key to doing something about it. There are evolutionary alternatives to the stress response, including physical and mental capacities hard-wired into my body. While chronic stress activation may have blocked my awareness, these underlying systems are essential to life, so I wouldn’t be alive if such capacities weren’t functioning and accessible to me on some level.

Just knowing this can open up a world of possibilities. What I am up against is the human condition — not a pathology. If I know what to look for, where and how, I can learn to bypass stress reactivity and generate meaningful, satisfying responses to the challenges life presents.

In this final part of this series, I’ll venture beyond the problem and take a look at solutions. The neat thing about viewing suicide as something that arises from stress and survival needs is that this perspective, in and of itself, can give me ideas and direction for finding a way out. En route to this destination, I’ll recap the essential physiology of the Sisyphus Cycle  and then point out an interesting twist in the stress response that, for me, keeps that cycle endlessly churning. I’ll also explore what I think suicide is trying to tell me — both about myself and the larger world I live in.

Having poured the cement and firmly set the foundation for a broader existential inquiry, I’m going to jump off a cliff and take a huge paradigm leap in search of solutions. I’ll posit how (with a bit of magic mental judo) the exact same physiological mechanisms that leave me wanting to off myself can be harnessed to reverse the stress response. I can learn to work with my body instead of against her, generate energy and hope naturally, and point myself in a direction worth going. I’ll talk about how I practice these principles in real life and how this is helping me to make conscious contact with inborn mental and physical capacities that I didn’t even know I had. I’ll also share how this understanding of myself and life can keep me from getting stuck in old patterns and help me to dust myself off and crawl out of holes when I inevitably do.

All free of charge. No new therapy, coaching, consulting, supplements, body work, or trendy blah-blah modality required. All I have needed for it to work for me are the body, conscience and honest human longings I was born with.

If You Can’t Afford to Sit Around Waiting…

If this stuff speaks to you and you’re in a lot of pain, you don’t need to wait for the rest of this series to come out. There’s a growing community of us who are trying to figure out how to support each other to navigate this territory with dignity, conscience and absolutely no coercion. Even if there aren’t in-person options in your area, there are telephone and online groups that are accessible, literally, from around the world. You can find out more here. I hope you will join us.

Show 8 footnotes

  1. Pridmore, W., & Pridmore, S. (2016). Suicide is not the exclusive domain of medicine. American Journal of Medical Research, 3(1), 174. Retrieved from https://link.galegroup.com/apps/doc/A461608266/HWRC?u=vol_b27&sid=HWRC&xid=6e6d51a6
  2. Hassan, A. (2019, March 7). Deaths From Drugs and Suicide Reach a Record in the U.S. The New York Times. Retrieved from https://www.nytimes.com/2019/03/07/us/deaths-drugs-suicide-record.html
  3. Phillips, J.A. (2019, March 21). The dangerous shifting cultural narratives around suicide. The Washington Post. Retrieved from https://www.washingtonpost.com/outlook/the-dangerous-shifting-cultural-narratives-around-suicide/2019/03/21/7277946e-4bf5-11e9-93d0-64dbcf38ba41_story.html?noredirect=on&utm_term=.602d32b21edb
  4. Phillips, J. A. (2014). A changing epidemiology of suicide? The influence of birth cohorts on suicide rates in the United States. Social Science & Medicine114, 151-160.
  5. Stone, D. M., Simon, T. R., Fowler, K. A., Kegler, S. R., Yuan, K., Holland, K. M., … & Crosby, A. E. (2018). Vital signs: trends in state suicide rates—United States, 1999–2016 and circumstances contributing to suicide—27 states, 2015. Morbidity and Mortality Weekly Report67(22), 617. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5991813/
  6. Twenge, J. M., Joiner, T. E., Rogers, M. L., & Martin, G. N. (2018). Increases in depressive symptoms, suicide-related outcomes, and suicide rates among US adolescents after 2010 and links to increased new media screen time. Clinical Psychological Science6(1), 3-17. Retrieved from https://www.avaate.org/IMG/pdf/suicidio2167702617723376.pdf
  7. Rosiek, A., Rosiek-Kryszewska, A., Leksowski, Ł., & Leksowski, K. (2016). Chronic Stress and Suicidal Thinking Among Medical Students. International journal of environmental research and public health13(2), 212. doi:10.3390/ijerph13020212. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4772232/
  8. Evans, R. G., Barer, M. L., & Marmor, T. R. (Eds.). (1994). Why are some people healthy and others not?: The determinants of the health of populations. Transaction Publishers.

25 COMMENTS

  1. Hi Sarah, haven’t seen you around these parts lately. Good to hear from you but I think you may be making things more complicated than they really are.

    No one in my known world is offering meaningful solutions.

    We live in a toxic profit-oriented socio-political system which has no respect for human needs and human values. Rather than beating around the bushes trying to find new ways of “navigating” a system which is at war with life itself, wouldn’t our energies be better directed into figuring out how to rid ourselves of this heartless, monstrous setup? To me that’s the only “meaningful solution”; we can support one another along the way, but to speak of “support” while ignoring the source of all this hopelessness, pain and frustration is to guarantee that there will be an endless supply of “suicidal” people for psychiatry to exploit. We need to go to the root of the problem, not just hack away at the branches.

    I’ll be paying attention to your writing and will try to offer some randoms insights from time to time. The people I’m working with presently all see the abolition of psychiatry as their main goal, however we support one another in the course of this pursuit, just as ballet dancers might see their main goal as the production but support one another in the process. Support is part of life; it can’t be abstracted or it becomes a commodity.

  2. Thanks Sarah,

    Your Message is always extremely constructive and I’m very interested in your initiatives.

    I was at a late night peer group myself (11PM to 12 AM), when I saw your Article and have been attempting to absorb it since.

    Peer Groups Can Make a Big Difference.

  3. “If this stuff speaks to you and you’re in a lot of pain, you don’t need to wait for the rest of this series to come out”

    If your in a lot of pain my government is going to allow doctors to off you. I’ve not got a lot of confidence in the “legal protections” being offered with regards this Euthanasia Bill, given the failure of authorities to recognise and enforce the ones contained in the Mental Health Act. A little bit of fraud can go a long way, especially in a country that ignores its duties where International Covenants and Conventions go.

    One brief example among many. Did you know that in Australia there is NO avenue for complaints about torture? This despite it being a clause in the Convention. Its got nothing to do with it never happening, its just that complainants are dealt with in other manners (hence the need for a Euthanasia Bill lol). They are giving victims of torture the status of “patient” post hoc and exploiting the loophole in Article 1.1 of the Convention. Not torture if it is subject to lawful sanction, ergo as a patient your human rights are removed and its no longer torture 🙂 How clever. Who said our Politicians werre stupid. Its the public that are idiots allowing them to do this if you ask me.

    Human Rights Commission I hear someone whisper? Try it.

  4. Thanks, Sarah! A few years ago, I was very moved when I first found out about the skyrocketing suicide rate among India farmers because of extreme climate changes. In a way, humanity on Earth is generally speaking suicidal because of the way we have procrastinated too much about the climate catastrophe.

    Please note everyone that I found out about Sarah’s important piece because of the following Facebook group: Unitarian Universalists for Mental Health Justice. If anyone is interested in this open group, you can find it on Facebook at this name: “UU Mental Health Justice.”

    Sarah, your speaking out as a survivor helps get this conversation going, we appreciate that!

    In terms of stressors, it is amazing how negative aspects of the mental health industry match factors that push suicide such as hopelessness, isolation, etc. Survivors speaking out is a potential antidote. I hope others speak out too!

    • Well said David…”In terms of stressors, it is amazing how negative aspects of the mental health industry match factors that push suicide such as hopelessness, isolation, etc.”.

      It boggles the mind how getting “help” from the “mental health” industry is often what pushes people into utter hopelessness.

      • It seems to me that Mental Health Services were designed around the boxes that held Seligmans dogs.

        If one takes a look at the theory he developed around attributions Mental Health Services result in the very attitudes that cause suicide and hopelessness.

        Your illness is “internal”, “uncontrollable” and “global”. These were the factors he identified as resulting in hopelessness. Seemed to me that being spiked and having a knife planted on me for police was “external”, “controllable” and “situational”. The ensuing brutality resulted in what has been labelled “illness”. Clever little trick but also criminal. Not that the law is of any use in my country, perverted beyond recognition.

        Seligman did also help out the ‘interrogators’ at Guantanamo soooo borrow his books, don’t buy them lol

        • Boans I had a look online at Seligman’s theory etc, and I see what you are referring to. Until one gets trapped in the web of psychiatry we are unaware of all the lying, twisting of facts and manipulation that goes on and how psychiatry often uses their power and control to serve their ‘own’ agendas. Yes, it is disgusting and criminal.
          Hmm, “global”, I heard that pathetic excuse too. Unbeknownst to me 4 pysch diagnoses were put on my electronic health records while I was in cancer treatment. Later on I began to be denied health care services because of these labels and requested answers as to what ‘DSM criteria’ I had met for the labels or what I said or did to warrant these labels. They were not able to find out what DSM criteria I had met or any reasoning for the labels so I was told it was “global”.

          • Yes Rosalee it’s certainly worth looking in to if your interested in how these people are subjecting folk to psychological harm and then claiming that it is something “Internal” causing it.
            I have had something of a revelation myself in the past couple of days. You speak about the lying, twisting of facts and manipulation that goes on. In my Book the question is asked on a number of occasions “why do ye conceal truth with falsehood?”And we are told “not to conceal truth with falsehood” which seems fairly obvious but what do we do about those who do this? Of course the answer was there right under my nose lol Why do these people cover the truth with falsehood? Because they HATE THE TRUTH.
            For example in my instance they have concealed the fact that they have kidnapped and tortured a citizen for no other reason basically than they can. Sound bizarre until you examine the truth but …. They had the truth taken to them by me and they do not like it. So what do they do? They conceal the truth with the falsehood that I was a “patient” which is a highly effective form of slander. As most people here who have been slandered with these labels would know. Note, when they speak about the stigma associated with these labels they are admitting that what they are doing is slanderous. If you want to stop the stigma, stop the slander.

            What to do about it? The Book is very clear on these matters.
            Let me repeat that for all.

            THEY HATE THE TRUTH THAT THEY ARE KIDNAPPERS AND TORTURERS SO THEY CONCEAL IT WITH FALSEHOODS.

            If one had the courage to look at what happened to me they would start minus the assumption that I was a “patient”. This reveals the truth. But they do not like this truth and so have committed acts of negligence, fraud and slander to conceal it. And one would be more than surprised by whom has committed these heinous acts.

            Take the truth to them and place it at their feet and do not let them deny it on their day of judgement. Document it and have faith that someday they will be brought to justice. It is a test of THEIR integrity, not yours as to whether they join forces with those who hate the truth. And it will eat away at those who fail like a cancer.

  5. Dear Sarah,
    Thank you for this excellent piece. It is so insightful and powerful I had my spouse read it as well. He said it makes the most sense of anything he has read in terms of why people lose hope and become suicidal. Over the years I had my share of adversities but always found a way to be resilient and hopeful. It was not until after a dreadful encounter with a punitive psychiatrist (for “help” with chemo-induced insomnia) that I sunk into a place of darkness and despair I had never been before. The despair is due solely to the harm of the “iatrogenic connection” to this psychiatrist and her ill-will.

    This piece certainly did speak to me and I look forward to the rest of your series. Thanks again!

  6. I just read a little about Internal Family Systems, and in it, Richard Schwartz, the person behind it, has an interesting point of view, that we are multiple personalities, divided into two types, exiles, and protectors. The exiles bear the burdens, or pains, from life, such as abuse and neglect, and threaten to overwhelm the conscious. The protectors try to keep them at bay. One of the protector class is a suicide part, which is the last ditch effort to keep us from feeling more pain than we could bear, or so the parts think. I also sometimes wonder if most people don’t believe they have worth except from their achievements, so it becomes a life long quest to keep finding any way at all to feel worth. They keep looking and trying things, only to have failure, and face starting over again. I wonder if this compares to your example of pushing the stone up the hill and it rolling down again, as maybe continually trying to work things out in your inner system to find worth that keeps the pain away, only to have it fail again, and have to start the process over.