Podcast Summary

Podcast: New Books Network

Host: Dr. Miranda Melcher
Guest: Dr. Helen C. Epstein
Episode: Why Live: An Anatomy of Suicide Epidemics
Date: September 3, 2025

Episode Overview

In this episode, Dr. Miranda Melcher interviews Dr. Helen C. Epstein about her newly published book, Why Live: An Anatomy of Suicide Epidemics. The discussion focuses on understanding the phenomenon of suicide epidemics—sharp, sudden increases in suicide rates within specific populations—and interrogates the social, economic, and cultural conditions that often precipitate these tragic events. Dr. Epstein explores historical case studies, discusses her interdisciplinary research, and engages in a sobering conversation about risk factors, cultural shifts, and the potential for community-based solutions.

Key Discussion Points & Insights

1. Introduction to Suicide Epidemics

[02:19–05:01]

• Dr. Epstein introduces herself as a public health scholar and explains her longstanding interest in epidemics as social phenomena that "always tell a story."
• Her motivation for writing the book was partly personal: a friend’s suicide led her to question whether more was at play than individual psychology and to examine public health perspectives.

  “Epidemics seem to always happen for a reason… I wondered if she was part of yet another suicide epidemic.” — Helen Epstein [03:28]

2. Defining Suicide Epidemics

[05:01–06:50]

• An epidemic is defined simply as a spike in cases among a population over a specific period.
• Suicide epidemics have occurred globally across contexts: among Indigenous groups post-modernization, in Russia after the fall of communism, in the U.S. following deindustrialization, and among Indian farmers tied to economic shifts.

  “What’s scary about that is that really these suicidal feelings could come from any one of us… We’re all vulnerable.” — Helen Epstein [06:26]

3. Research and Methodology

[07:20–08:33]

• Dr. Epstein’s research weaves together anthropology, sociology, economics, and demographics.
• No previous work had synthesized disparate case studies to look for commonalities; her approach aims to extract overarching themes from global suicide epidemics.

  “I just read everything I could about these various affected communities to see if I could find any common themes.” — Helen Epstein [07:48]

4. The Role of Rapid Modernization

[09:12–12:42]

• The key driver of suicide epidemics is rapid modernization, especially abrupt economic reforms.

• These reforms often disrupt communal, subsistence-based societies reliant on mutual support, replacing them with cash economies that emphasize individualism.

• This transition can cause widespread loneliness, identity crises, and a sense of being unneeded—especially as traditional roles are dissolved.

  “An abrupt switch … to societies which are suddenly based on cold, hard cash transactions, where we really live for ourselves alone … creates a kind of feeling of stark loneliness.” — Helen Epstein [10:19]

  • Adolescents and young adults are particularly vulnerable.
  • In pre-modern societies, everyone had a role; modern societies can leave people “needed by no one,” leading to increased suicidality.

5. Case Studies: Russia and Micronesia

[12:58–20:07]

• Russia:

  • Post-communist transition to capitalism led to efficient markets but destroyed social fabric; people lost their sense of belonging.
  • The collapse of shared survival strategies (like blat—exchanges of favors) contributed to heightened feelings of uselessness and despair.

• Micronesia:

  • U.S.-driven modernization replaced communal island life with wage work and nuclear families, disempowering young men.
  • The inability to express emotions in stoic cultures exacerbated the problem; cultural expression of love had not adapted to new circumstances.

  “In societies where that [expressive love] culture hasn’t necessarily developed, … people … may feel very frightened and very lost.” — Helen Epstein [19:23]

6. Cultural Lag and Individual Struggle

[20:25–22:48]

• Dr. Epstein emphasizes that cultural protections against loneliness can lag behind economic change, especially in communities unused to modern standards of emotional support.

  “It’s as though the culture hasn’t caught up with the situation that the modern economy puts these young people into.” — Helen Epstein [21:44]

• Parents may not know how to offer reassurance, contributing to despair among youth.

7. Compound Risk Factors: Trauma and Abuse

[23:24–25:53]

• Suicide risk is highest when trauma is both chronic and compounded across life stages—especially childhood abuse followed by adult trauma (e.g., war).
• Interviews with veterans reveal a consistent pattern: most had suffered abusive childhoods and later endured battlefield trauma.

  “It seems as though repeated trauma … beginning in childhood and then repeating itself in adulthood, seems to be a huge factor in suicide.” — Helen Epstein [23:27]

8. Avenues for Recovery and Hope

[26:10–28:29]

• Recovery among formerly suicidal individuals often rested on:

  • Loving relationships (often with partners)
  • Engaging in artistic pursuits (theater, poetry, memoir)
  • Religious or spiritual engagement (notably Buddhism)
  • In some cases, use of psychedelic drugs under clinical supervision

• Epstein notes that unionization and collective action may rebuild community and protection, particularly among precarious workers.

  “There was something about communicating with an audience, trying to come to grips with their own feelings … and trying to transform it into something that others could grasp … that really seemed to help.” — Helen Epstein [26:44]

9. Looking Forward: Caution and Responsibility

[28:41–29:48]

• While acknowledging the harsh outlook due to economic uncertainty, Dr. Epstein urges vigilance and mutual support within society.

  “We need to really take care of each other as well as ourselves, and find somehow the strength to hold our society together.” — Helen Epstein [29:34]

Notable Quotes & Memorable Moments

• On the meaning of epidemic:

  “Epidemics seem to always happen for a reason.” — Helen Epstein [02:41]

• On the universality of vulnerability:

  “What’s scary about that is that really these suicidal feelings could come from any one of us. … We’re all vulnerable.” — Helen Epstein [06:26]

• On the pain of lost social roles:

  “There are a lot of people who feel needed by no one, as the anthropologist Michelle Parsons puts it. And that’s perhaps the most painful feeling that we can have.” — Helen Epstein [12:11]

• On community after economic change:

  “We are starting to see, I think, this sort of inflationary effects of tariffs and cuts to government spending and the huge numbers of layoffs, for example, and the deportation of undocumented but often necessary workers … and so I worry that we’re in for another rocky economic ride, at least most of us are, who are not tycoons.” — Helen Epstein [29:04]

• On the need for vigilance:

  “We need to really take care of each other as well as ourselves, and find somehow the strength to hold our society together.” — Helen Epstein [29:34]

Timestamps for Important Segments

| Timestamp | Segment | |:-------------:|:---------------------------------------------------------| | 02:19–05:01 | Dr. Epstein’s background and why she wrote the book | | 05:01–06:50 | Defining “epidemic” and global examples of suicide spikes| | 07:20–08:33 | Synthesizing case studies: research method | | 09:12–12:42 | Rapid modernization’s role in suicide epidemics | | 12:58–20:07 | Case studies: Russia and Micronesia | | 20:25–22:48 | Cultural lag and inability to cope with new realities | | 23:24–25:53 | Trauma, abuse, and compounded suicide risk | | 26:10–28:29 | Factors aiding recovery and community prospects | | 28:41–29:48 | Warnings for the future; communal responsibility |

Conclusion

This episode provides a comprehensive and humanistic exploration of suicide epidemics, connecting the dots between abrupt social change, communal breakdown, trauma, and despair. Dr. Epstein’s work underscores the importance not just of mental health interventions but of broader social solidarity in preventing future epidemics: “We all need to be especially vigilant in the near future about that.” [29:44]

For deeper insight, listeners are encouraged to read Why Live: An Anatomy of Suicide Epidemics.