August 6th, 2022
The whole essay is a reminder that depression is just a mess.

Over the years, I struggled with what came to be characterized as “major depressive disorder,” and took a cornucopia of medications. Nortriptyline, paroxetine, venlafaxine, buspirone, sertraline, citalopram, pregabalin, mirtazapine. None worked. Optimistically, I tried lurasidone, bupropion, and vilazodone, followed by aripiprazole, amitriptyline, and zaleplon, which also made no difference. Then Restoril, protriptyline, desipramine, escitalopram. Nothing. My psychiatrist began to talk ominously about “treatment-resistant depression.” Nonetheless, I carried on with fluoxetine, temazepam, triazolam, and trazodone.

This piece in the Atlantic is an astringent little take on lethal sadness.

June 21st, 2022
New Wyoming State Anthem: “My Sidearm”
Sing it.

Oh, we ain't got a barrel of money
Maybe we're ragged and funny
But we'll travel along singing a song
Side by side!

We don't know what's coming tomorrow
Maybe it's trouble and sorrow
But we'll travel the road sharing our load
Side by side!

When my deep depression
Makes me wish I were dead
I'll just grab my little buddy
Point you right at my head

When the booze and divorces undo me
When the cold lonely winters cut through me
I'll just go and unlock one of my Glocks:
June 8th, 2022
Now wait. You’re not telling me that the GUN/EXPLODED HEAD equation is …

shifting in Wyoming, are you? A Wyoming senator is

… “surprised” that her office was flooded with calls [after the Uvalde massacre] from constituents expressing a deep desire to do something to stop the spate of mass shootings across the country…

Yeah what a shocker! She certainly assumed they didn’t give a shit.

[Cynthia] Lummis said callers to her office generally have not declared themselves for or against specific policy proposals, but have expressed a “willingness to be open to suggestions.” She also said they may be motivated to act by Wyoming’s high suicide rate.

“The surprise to me has been the number of people that have weighed in, not with particular solutions that they support, but with a willingness to be open to suggestions,” she said. “They’re worried in large about, as I’ve said, the mental health issue, and Wyoming has the highest suicide rate in the nation.”

You could knock her over with a feather. Significant numbers of people in her state are upset about the SCADS of her constituents who use their guns to turn their own heads into tomato soup. How could Senator Loomis ever be expected to anticipate an upset reaction, much less, as Senator, do anything about all the gun suicides? Wyomingites love their guns!!!!! But jeez! Okay! If you insist…

May 4th, 2022
‘[T]he use of guns in political ads is “growing,” and … by 2024 Republicans are going to be blowing stuff up.’

An expert notes the firestorm of Republican ads featuring more and more desperate firearm brandishing.

UD gets this guy’s point that by 2024 guns in ads will be so routine that candidates will be blowing up Planned Parenthood offices to demonstrate their fervency.

But what about after that? What happens when not only guns are a snooze, but bombings elicit a shrug?

UD anticipates that, by 2028 or so, self-immolation will be the only way MAGA fanatics will be able to attract our attention.

May 4th, 2022
A Deluge of Suicides

They’re all over the news, and they’re of two kinds:

  1. The reasonably explicable variety, which features people unable to sustain high levels of isolation and rigor, as in the recent rash of suicides on a navy ship. The numbers got so high that the navy evacuated the ship. These suicides share traits with prisoner suicide.
  2. The more mysterious phenomenon of highly successful people destroying themselves at the height of their power and influence. Here we might think of the 2019 death of Alan Krueger; more recently, several young women athletes, all of whom had just won tournaments and awards, killed themselves. A highly promising young tv star just killed herself. On the verge of her induction into the Country Music Hall of Fame, Naomi Judd killed herself.

The cases of Judd and Krueger seem to involve a kind of existential exhaustion after years-long struggles with clinical depression. The powerful drugs, the endless therapy sessions, the setbacks – everything takes a toll on someone already fatigued and undermined. OTOH, although many young suicides have already exhibited some signs of being troubled, there’s nonetheless an impulsive – almost panicked – feel to some of these deaths. Bizarrely, their fate doesn’t seem gradual, but rather the outcome of a sudden access of horror at the thought of existing for one more second. Their end resembles a psychotic break featuring an insupportable hatred of being.

April 27th, 2022
Lauren Bernett puts one in mind of Katie Meyer…

… both young brilliant athletes – leaders on notable college teams – and both suicides. Meyer died last month, Bernett just the other day. Also last month, a young runner at the University of Wisconsin – Sarah Shulze – killed herself.

Shulze’s parents wrote that her effort to balance “athletics, academics and the demands of every day life … overwhelmed her in a single, desperate moment.” And impulsivity is indeed the mark of most youthful suicides; the same incredible energy that propelled many of these people to academic as well as athletic heights turns against the person herself when she – who knows? – suddenly and catastrophically falls short of her self-demands. Or is it that a hyper-intense life is vulnerable to collapse when for whatever reason the intensity flags, the adrenaline drops?

When I say who knows, I really mean who knows. We can mark these recurrences, common characteristics, etc. But the act itself remains shockingly obscure.

March 31st, 2022
“Oregon Becomes America’s Switzerland”…

… headlines the National Review; and when she read the headline UD thought Hm not bad. Be pretty cool if my little home state, Maryland, were declared America’s Switzerland…

But no. NR is keening over Oregon’s Swissification, cuz it’s now an assisted suicide state for anyone – including out of staters – nearing death and wanting to die. (The Swiss have been fierce defenders of the right to die for almost a century. Hence NR’s nod to the moral and spiritual cesspool which that blighted country has become as a result of this godless policy.)

Chacun à son goût for damn sure, but UD doesn’t mind sharing that she keeps an updated mental tab of convenient lethal locales in case whatever does her in does it slowly and painfully. She’s eager not to beat around that bush, eager not to lie moribund in morphine, or in unmanageable agony, for months on end. For UD, there’s a rather off-putting good-girlism about achieving a perfect attendance record for one’s own disintegration. Better to skip.


Another reason NR should relax about Oregon becoming the suicide capital of America: That distinction has long belonged to Wyoming, where per blown-off capita the numbers are, and always will be, MUCH higher than anything Oregon’s assisted suicide program could reach. A few carefully controlled barbiturates here and there can never hope to compete with twenty loaded Berettas per household.

March 10th, 2022
Wyoming: Keepin’ it Real!

[F]rom 2010 to 2019 gun deaths in [Wyoming] increased by more than 2 1/2 times the national average and gun suicide increased by nearly three times the national average. The rate of gun deaths has increased 54% from 2011 to 2020 in Wyoming, compared to a 33% increase nationwide.

According to the Wyoming Department of Health, suicide rates in Wyoming are consistently higher than U.S. rates. In Wyoming the rate of suicide by gun increased 43% from 2011 to 2020, compared to a 12% increase nationwide.

Nobody blows heads off like the Cowboy State!

March 3rd, 2022
Suicide isn’t spoken until the medical examiner declares it…

… but the death of a very young, championship, Stanford University athlete in her dorm room has everyone thinking it.

Thinking too of how shocking we always find these sorts of deaths – sudden deaths of brilliant, beautiful, vivacious winners seemingly at the top of their form. Soccer team captain, “fiercely competitive,” Katie Meyer was a senior at one of America’s great universities who had taken on a challenging major: International Relations with a minor in history. She could have done pretty much anything.

If it was suicide, and not some unforeseen sudden health crisis (heart failure, for instance), we will probably hear that Meyer in fact suffered from depression; we might hear that her underlying problem escalated as she pondered her imminent transition to post-university life. Or she might have been fragile enough to have been sent reeling by a romantic breakup…

In any case, it’s notoriously true that super-elite athletes may be more prone to depression, for all kinds of reasons.


Update: Self-inflicted.

October 21st, 2021
It’s at the very end of a clause, but at least someone in Wyoming is mentioning it.

[W]hy the push for a special [legislative] session now? Well, for one it makes for good politics. For most Wyoming lawmakers, there are few downsides to a public fight with the federal government, regardless of whether the fight is performative. But that performance isn’t free: Lawmakers will spend taxpayer money gathering in Cheyenne. And they’ll focus on bills that will likely have little impact, all the while avoiding the existing structural issues facing our state.

Because the special session won’t solve the problem of young people fleeing out state for more opportunities elsewhere. It won’t solve the problem of our overreliance on the energy industry to fund services like public schools and health care. It won’t solve the problem of shrinking small towns, an education system that’s not fiscally sustainable or our state’s persistently high suicide rate.

September 22nd, 2021
Research on Suicide in Wyoming: A Gun-Free Zone

UD’s been compiling, during this Suicide Prevention Month, the many forms of writing out of Wyoming about that state’s appalling suicide rate that never mention guns.

Though firearms are the third-most common method for attempting suicide, they are responsible for the largest share of suicide deaths because they are so lethal. Nationally, nearly two-thirds of all deaths by firearm are due to suicide, and Wyoming has had the highest rate of suicide by firearm of any state over the last 15 years. Studies have linked higher rates of gun ownership with increased risk of suicide death, but in Wyoming, which also has one of the highest rates of gun ownership in the country, this is an unpopular topic. As Tom Morton of the Casper Star-Tribune put it in a series of articles about Wyoming’s suicide epidemic, guns and suicide are the “third rail of Wyoming culture.”

So for instance a University of Wyoming news page yesterday touted the work on Wyoming suicides of one of their psychology professors. Let’s take a look.

‘[Carolyn] Pepper’s research team at UW’s Stress and Mood Lab is using nationally collected health data to understand what factors are specific to the Mountain West’s suicide rate. The stoic, individualistic Western mindset is one possible explanation… The Stress and Mood Lab initially studied demographic factors such as age, race, urbanization level and gender. Although all of these were elevated factors in the Mountain West, they did not explain why suicide rates are so high. The research team is now shifting focus to the cultural factors of living in a state with a “pull yourself up by your bootstraps” mentality.’

Hm yes that bootstraps thing… You see it in ‘Deer Hunter’ states like Pennsylvania too, but they have strikingly fewer guns and less suicide than Wyoming…

“I kept thinking someday I should study suicide, but I was sure that someone was already doing this research,” Pepper says. “I waited and waited, but no psychologist was looking at suicide in Wyoming.”’

She was sure cuz… you know… when they’re dropping like flies in your state… when some counties in your state – like Platte – are just stupendously suicidal… you figure the best social scientists around are hard at work on it. But that third rail! Why bother? Just keep ignoring the Uberti in the room and you won’t piss off anyone.


Let’s pile on. When you add to all of this Wyoming’s insanely low covid vaccination rate, with the sort of death rate that goes along with that, you have to conclude that the whole state’s got a death wish.

August 3rd, 2021
If you ever doubted the contagion theory of suicide…

take note of the awful drumbeat coming from the January 6 police.


Police have among the highest suicide rates in the country. They’ve got guns and know how to use them; they witness and take part in traumatizing events all the time; they may medicate stress and despair and anger with alcohol, which may get out of control; and they have a strong “buddy” ethos (this last one goes to the contagion effect).

August 1st, 2021
“[A] severely distressed person with decent upper body strength can clear the chest-high railings with ease.”

After four suicides of young people in a short period of time, it’s an empty Vessel.

Four and no more, at least for the moment; they’ve closed down the shiny new suicide-attractor, the folly that is in fact a folly.

For most people, it’s a fun place to crawl along stairways with a spectacular New York City view; for a few, it’s a beacon of hopelessness. And given the ways of contagion, the site was wired for more and more Werthers.


Now, gazing at its Eschery silence, people think not of the inventive fun, the silly sightseeing, its creator had in mind, but of the absolute opposite of silliness. The Vessel’s manic sprite summons the depressive specter. It is Lear’s Fool, madcap and bitterly melancholy.


Yes, New York City is all ledges to tumble or jump from; no, adding inches to chest-high railings won’t stop suicides (ten years ago, Yale undergraduate Cameron Dabaghi “got a running start and scrambled over a ten-foot-high spiked fence before leaping off” the Empire State Building). But the symbolic power of certain structures (Golden Gate Bridge, NYU’s Bobst Library, Cornell’s bridges, the Vessel) happens, and once it happens it’s all about backtracking, retrofitting, barring, netting, even sometimes closing. Four and done.

July 20th, 2021
Fort Lincoln, the Bronx

Foreign medical residents are killing themselves at an alarming rate at New York’s Lincoln Medical Center, and although only a couple of news outlets have taken note so far, one more death (which would make it four in a short period of time) is probably all it would take for everyone to start sitting up.

This blog has always had lots to say about suicide, a complex and surprisingly common act, and here’s something else to say. When you load people’s lives up with intolerable amounts of shit, some will slog through until it ends, some will find another situation, and some will commit suicide. A doctor comments on conditions at another hospital, Sinai:

I’m a physician. I have a career ahead of me, which I’m too scared to speak out against. I came home again to another suicide. Another doctor dead from Mt. Sinai in NY. I think NY is a horrible place to work. Conditions are deplorable for doctors and you should investigate. Both suicides were horrible — jumped from our high rise. I’m convinced it’s the exhaustion, the demands to perform at 100% 24/7 to meet ridiculous administrative and financial demands.

Add to this the visa hell FMRs endure – their superiors control their visas, and can cancel them if the FMR pisses them off – and you have a serious problem. Plus there’s the particular ethos at Lincoln:

We just had orientation and our program director told us two residents died by suicide. Cold and callous, he told us we’d better reach out if need help. Next day I find out a third resident died. I’m very, very afraid. I’ve sacrificed a lot to come here. I was so excited to be here. Now I’ve never been more depressed in my life. His response to the suicides is chilling. Suicide victims are blamed. He took us into the wellness room and said, ‘Let me be clear we are not here to entertain you; we are here to train you.’ Soldier-like. Very traumatic.


As A. Alvarez writes, suicide is “a terrible but utterly natural reaction to the strained, narrow, unnatural necessities we sometimes create for ourselves.” Or the necessities others create for us. It’s not Lincoln’s fault that covid hit just when these residents arrived; it’s not its fault that the hospital sits in one of the most violent, traumatized communities in the country. But once it grasped these conditions, and once it grasped the particular vulnerabilities of just-arrived residents, Lincoln should have done more to give its new residents a break.

April 25th, 2021
Cuz our Buckaroos are Always Clamorin’ to Off Themselves!

Big Sky Country’s proud of its Number One in America suicide ranking, and no federal gun control is getting in the way of that.

Ain’t got no shrinks out here, either!

Nothing stands in the way of our over-65s who’ve had enough booze and loneliness shooting themselves in the head.


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