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In the past, drug abuse deaths were more common in middle-aged blacks than in middle-aged whites. Now they are more common in whites. The same pattern holds for deaths from alcoholic cirrhosis of the liver. The suicide rate for whites was four times that of blacks.

Could people be taking drugs and killing themselves as a response to the economic slowdown? Maybe. But, if so, Dr. Deaton and Dr. Case said, then why aren’t people in other countries responding the same way?

Recent reports of illness and disability might provide some clues. More middle-aged whites report that their general health is not good; and, more report chronic pain

older people are actually doing better — less addiction, disability rates falling.

how much of what they are seeing might be attributed to the explosive increase in prescription narcotics.

the people who report pain in middle age are the people who report difficulty in socializing, shopping, sitting for three hours, walking for two blocks.

Dr. Deaton envisions poorly educated middle-aged white Americans who feel socially isolated are out of work, suffering from chronic pain and turning to narcotics or alcohol for relief, or taking their own lives. Starting in the 1990s, he said, there was a huge emphasis on controlling pain, with pain charts going up in every doctor’s office and a concomitant increase in prescription narcotics.

Dr. Deaton noted that blacks and Hispanics may have been protected to an extent. Some pharmacies in neighborhoods where blacks and Hispanics live do not even stock those drugs, and doctors have been less likely to prescribe them for these groups.

So we're all the same after all.Under the right conditions - no control over your life, low pay, no job, little in the way of job prospects, no healthcare, little education, families break down when the man can't be the breadwinner, and then along comes poor health, substance abuse, depression, despair - all those ills that were blamed on black people's supposed lack of morals.Now that white kids are dying of heroin we need to change the laws, end the war on drugs, legalize pot, and change how we talk about what were formerly known as 'junkies'.White men are in despair as a result of economic problems, white kids are doing hard drugs in numbers that everyone's starting to notice, and AIDS is plaguing white communities, and now we need to care. So we're all human?

Because white people are depressed over their diminution in society by the policies of the Federal Government, the education system, racial animosity and biased media outlets that are rampant through the society. These doctors are clueless liberals that will try to find any reason to blame, other than the truth. It's not the drugs, it's what is causing them to want the drugs. White males have been denigrated for the past 50 years. The effects have to be building up and weighing on them.

John is a trusted commenter Boston 6 hours ago No, their diminution in society came from globalized capitalism. A lot of these working class white people were Reagan voters. I'm the same age as them, I saw it happen. They thought they were getting "Morning in America" but instead they got morning for Walmart and sunset for the working class. That's enough to make anybody turn to pills and booze.

DougH Lithonia, GA 7 hours ago To some extent, it's of their own making. High school educated whites tend to vote Republican. Over the last 30 years, Republicans have sold them a bill of goods. They abandoned unions, opposed increases in the minimum wage, and opposed regulation, including safety, wage fairness, etc.So now they are paid less. They have no way of changing that (short of high education) and the big beneficiaries of lower taxes have been the businesses and owners that for which they work. Did those owners bless the workers with the fruits of their benefits? Of course not. They kept the reduced expenses as profit, increased CEO wages, and kept cutting benefits before finally shipping their jobs overseas.Perhaps, if they stopped voting against their own interests, they would fair better.

dw659 Chicago 8 hours ago Why? Simple. Because to males, a 'loss of control' is an unacceptable change. 200 years of being 'in control' just because you are born white and male is ending. Many men can't face a world where they are of 'lower status' than women, blacks, Hispanics, Asians, etc. They don't want to live in that world.....

dale south africa 5 hours ago Its true ! I am a conservative man and i live i johannesburg. I cant imagine what it must be like respecting all things under the suns . From females, gays blacks etc Children of slaves dictating societies . oprah picking presidents. the bully is not allowed to be at his natural best and strongest with this new liberal socialist agenda , everyone equal attitude. im not white but if I was who would want that

Linda is a trusted commenter Oklahoma 54 minutes ago I know so many white men in this small town I live in who never had anything to do with their children. They didn't care about anybody through their productive years and now they're surprised that nobody cares about them.

AC USA 5 hours ago Could it be because these guys have no close family ties? They are the ages that their parents are probably in nursing homes or already passed away. These blue collar, high school educated guys fathered unwanted children with women to whom they may or may hot have been married and divorced. But now at middle age comes time for them to feel wanted and valued by their progeny (dad, dispense some life wisdom to us, help us with college, getting married, a down payment on a house, take your grand-kids fishing, etc.), but they dumped their kids by not wanting to pay child support, or having a bad attitude and not helping their kids at all past age 18. So they kids moved on without dad's love and "support" (monetary or emotionally). The "all for myself mentality" they have espoused has finally come home to roost. There is no going back in time, they are all alone, have no purpose as jobs are hard to come by at that age - even more-so blue collar ones - so they drink/take pills to dull the pain, then overdo it.

suzinne bronx 5 hours ago Think white families more often DO NOT stick together. At middle age and white, have ZERO contact with any family members. By the time I was 16 most had died, moved away or become estranged. Know this amps up my chances for suicide, and that's probably going to pan out too. Flag

Paul '52 is a trusted commenter NYC 2 hours ago The is the first cohort to experience the phenomenon that if you do the same job as your parents you won't do as well or better. These are the auto workers, the airport baggage handlers, the truck drivers. They are, in fact, more productive than their fathers, but they're not paid as well and they don't have pensions. And the disappointment is taking its toll.

“We can’t make any bold statements until we have more national data,” said Arielle Sheftall, a principal investigator at the Center for Suicide Prevention and Research at Nationwide Children’s Hospital in Columbus, Ohio.

Suicides are comparatively rare events, and it is hard to know how to interpret changes in small numbers and whether they represent statistical hiccups or broad trends. Rates usually fall off during times of war or natural disasters, when people feel drawn together to fight for survival against a common enemy.

In the early days of the pandemic, families posted colorful drawings of rainbows in their windows and children stuck their heads out each day at 7 p.m. to ring bells and cheer for health care workers.

The initial sense of crisis and purpose may have been a source of strength for people around the world. A new study of suicide trends among residents of 10 countries and 11 states or regions with higher incomes found that the number remained largely unchanged or had even declined during the early months of the pandemic, though there were increases in suicide later in the year in some areas.

People of color have also been pummeled financially, particularly low-wage earners who have lost their jobs and had few resources on which to fall back. Many who remain employed hold jobs that put them at risk of contracting the virus on a daily basis.

Anxiety and depression have risen across the board, and many Americans are consumed with worry about their health and that of their families. A recent study found that one in 12 adults has had thoughts of suicide; Hispanic Americans in particular said they were depressed and stressed about keeping a roof over their heads and having enough food to eat.

“It’s one stressor on top of another stressor on top of another stressor,” Dr. Sheftall said. “You’ve lost your job. You’ve lost people in your family. Then there’s George Floyd. At one point, I had to shut the TV off.”

Researchers who study the racial trends said increases in suicide among people of color were consistent across the cities and regions that they examined — and all the more striking because suicide rates among Black and Hispanic Americans had always been comparatively low, about one-third the rate among white Americans.

Noting that other countries had taken steps to restrict access to the site, the lawmakers also asked about removing it from search results in the United States.

Members of the site are anonymous, but The Times identified 45 people who had spent time on the site and then killed themselves in the United States, the United Kingdom, Italy, Canada and Australia. Most of them were under 30, including several teenagers. The Times also found that more than 500 members of the site wrote so-called goodbye threads announcing how and when they planned to end their lives, and then never posted again.

And the new administrator made the site private, meaning that the content — including discussions about suicide methods, messages of support and thumbs-up emojis to those sharing plans to take their lives, and even real-time posts written by members narrating their attempts — is now visible only to members and not the public.

The site draws six million page views a month, and nearly half of all traffic is driven by online searches, according to data from Similarweb, a web analytics company.

Citing The Times’s reporting, Mr. Blumenthal wrote in his letter, addressed to Google’s chief executive, Sundar Pichai, that the content on the suicide site “makes the world a dark place for too many,” and that Google had the ability and legal authority to steer “people who are struggling away from this dangerous website.”

Google’s hands are not tied, and it has a responsibility to act,

The operators of the suicide site have long used Cloudflare, an American firm that provides cyberprotections, to obscure the names of its web host, making it difficult or impossible to know what company is providing those services.

After the article was published, on Dec. 9, Marquis announced on the site that he was resigning as an administrator, permanently deleting his account and turning over operation of the site to someone using the online name RainAndSadness.

In Uruguay, where assisting suicide is a crime, the Montevideo police have begun an inquiry in collaboration with a local prosecutor’s office in response to The Times’s investigation, said Javier Benech, a communications director for the office.

In the United States, while many states have laws against assisting suicide, they are often vague, do not explicitly address online activity and are rarely enforced.

Members of the suicide site who post instructions on how to die by suicide, or encouragement to follow through with it, could be vulnerable to criminal charges depending on the jurisdiction. But so far, no American law enforcement officials have pursued such cases in connection with the website. Federal law typically protects website operators from liability for users’ posts.

The report seeks to quantify one of the most chilling elements of Boko Haram, an Islamist extremist group that has assaulted the Lake Chad region of Africa for years with thievery, beheadings, kidnappings and the torching of entire villages.

According to Unicef, the overall number of suicide bombings increased from 32 in 2014 to 151 last year. In 2015, 89 attacks were carried out in Nigeria, 39 in Cameroon, 16 in Chad and seven in Niger.

Cameroon has had the highest number of attacks involving children, Unicef said.

In its report, Unicef said it needed $97 million to provide vaccinations, schooling, drinking water, mental health aid and other assistance to families affected by Boko Haram

It said that between 2009 and 2015, attacks by the group destroyed more than 910 schools and forced at least 1,500 more to close.

She told the BBC's Newsday programme that she had been scared to carry out the attack, but that her brother had promised only her targets would die

"I said: 'No, I will kill myself rather than go with you'," she said.

'If you don't do it this time, we will make you do it again

"I won't go back there. God didn't make me to become a suicide bomber. I ask the president to put me in a good place."

Falmata was forced to make a choice - marry a fighter, or go on a “mission”.

Life in the camp was incredibly monotonous. Wake up, pray, eat, clean, pray, eat, and clean - all day long. There were daily religious lessons, long hours reciting verses from the Koran.

almata was approached by armed men and instructed to prepare herself for something important. Her feet were to be decorated with henna. Her hair was to be straightened. Was she being prepared for her wedding, she wondered. Was she going to be married off to a fighter after all? “My friend Hauwa had agreed to get married as a way of trying to stay alive,” Falmata says. “She wanted to find a way to escape.

Two days later, she was approached by fighters. A bomb was forced around her waist.

Falmata was told that if she killed non-believers, she would go straight to paradise.

In their hands were small, homemade detonators. On the way, the three of them discussed whether to carry out the “mission” or abandon it. Should they just do as they were ordered, or try to make their escape? They decided not to carry out the attack.

“A lot of the people we meet who have been in these camps haven’t had much education before, neither Western nor Islamic,” says Akilu.

Sanaa Mehaydali is thought to have been the first female suicide bomber in modern history. The 16-year-old killed herself and two Israeli soldiers in a suicide attack in southern Lebanon in 1985.

s that hundreds of young girls have been forced to carry out attacks in the past three years, in Nigeria, Cameroon, Chad and Niger.

d of 2017, 454 women and girls had been deployed or arrested in 232 incidents, Pearson says. The attacks killed 1,225 people. Pearson is the author of a study about Boko Haram’s use of female suicide bombers.

The first time a girl was forced by the group to carry out an attack was June 2014. The bombing of a military barracks took place shortly after the notorious kidnapping of 276 schoolgirls, who became known as the Chibok girls.

She says at first it was mainly young men who carried out suicide attacks - ones who were inspired by Boko Haram’s ideology and rhetoric.

n] military offensive got more intense, the pool of young men volunteering dropped significantly, so Boko Haram started kidnapping and coercing young girls for suicide missions.

It was the same daily cycle - eat, clean, pray, recite Islamic verses for hours, sleep.

She had not gone far before she met two men on the side of the road. What she didn't know was that they, too, belonged to Boko Haram - but a different unit. Falmata was kidnapped for a second time.

ny actually learn about the Koran for the first time w

. They find that religion is a coping strategy.”

A belt of explosives was attached to her stomach. But this time she ran into the forest as soon as the fighters left her.

On the way she joined a group of hunters who allowed her to travel with them across the woods.

Fatima Akilu has met a number of youngsters like Falmata. She says that when they return, they need time to re-establish family bonds. “She’s been away from her family for too long and she might have changed during this time. But her family may also have changed and have traumas of their own.”

She had tasted freedom, but this would turn out to be short-lived. So why didn’t she detonate her suicide belt and end it all? “I wanted to live,” she says. “Killing is not good. It’s what my family taught me and what I believe in too.”

their explanation begins by dismantling several others.

Was the source of the problem America’s all-too-ready supply of prescription opioids?

About a million Americans now use heroin daily or near-daily. Many others use illicitly obtained synthetic opioids like fentanyl.

As Case and Deaton note, most people who abuse or become addicted to opioids continue to lead functional lives and many eventually escape their dependence

The oversupply of opioids did not create the conditions for despair. Instead, it appears, the oversupply fed upon a white working class already adrift.

although opioid deaths plateaued, at least temporarily, in 2018, suicides and alcohol-related deaths continue upward.

Could deaths of despair be related to the rising incidence of obesity?

Case and Deaton report that we’re seeing the same troubling health trends “among the underweight, normal weight, overweight, and obese.”

Is the problem poverty?

Overdose deaths are most common in high-poverty Appalachia and along the low-poverty Eastern Seaboard, in places such as Massachusetts, New Hampshire, Delaware, and Connecticut. Meanwhile, some high-poverty states, such as Arkansas and Mississippi, have been less affected. Black and Hispanic populations are poorer but less affected, too.

How about income inequality? Case and Deaton have found that patterns of inequality, like patterns of poverty, simply don’t match the patterns of mortality by race or region.

A consistently strong economic correlate, by contrast, is the percentage of a local population that is employed

In the late nineteen-sixties, Case and Deaton note, all but five per cent of men of prime working age, from twenty-five to fifty-four, had jobs; by 2010, twenty per cent did not.

What Case and Deaton have found is that the places with a smaller fraction of the working-age population in jobs are places with higher rates of deaths of despair—and that this holds true even when you look at rates of suicide, drug overdoses, and alcohol-related liver disease separately. They all go up where joblessness does.

Conservatives tend to offer cultural explanations

People are taking the lazy way out of responsibilities, the argument goes, and so they choose alcohol, drugs, and welfare and disability checks over a commitment to hard work, family, and community. And now they are paying the price for their hedonism and decadence—with addiction, emptiness, and suicide.

Yet, if the main problem were that a large group of people were withdrawing from the workforce by choice, wages should have risen in parallel.

Case and Deaton argue that the problem arises from the cumulative effect of a long economic stagnation and the way we as a nation have dealt with it

For the first few decades after the Second World War, per-capita U.S. economic growth averaged between two and three per cent a year. In the nineties, however, it dipped below two per cent. In the early two-thousands, it was less than one per cent. This past decade, it remained below 1.5 per cent.

Different populations have experienced this slowdown very differently

Anti-discrimination measures improved earnings and job prospects for black and Hispanic Americans. Though their earnings still lag behind those of the white working class, life for this generation of people of color is better than it was for the last.

Not so for whites without a college education. Among the men, median wages have not only flattened; they have declined since 1979. The work that the less educated can find isn’t as stable: hours are more uncertain, and job duration is shorter

Among advanced economies, this deterioration in pay and job stability is unique to the United States.

In the past four decades, Americans without bachelor’s degrees—the majority of the working-age population—have seen themselves become ever less valued in our economy. Their effort and experience provide smaller rewards than before, and they encounter longer periods between employment.

The problem isn’t that people are not the way they used to be. It’s that the economy and the structure of work are not the way they used to be

Today, about seventy-five per cent of college graduates are married by age forty-five, but only sixty per cent of non-college graduates are

Nonmarital childbearing has reached forty per cent among less educated white women.

Religious institutions previously played a vital role in connecting people to a community. But the number of Americans who attend religious services has declined markedly over the past half century, falling to just one-third of the general population today.

Case and Deaton see a picture of steady economic and social breakdown, amid over-all prosperity.

climate—the amount of social and economic instability not only in your life but also in your family and community—matters, too. Émile Durkheim pointed out more than a century ago that despair and then suicide result when people’s material and social circumstances fall below their expectations.

why has the steep rise in deaths of despair been so uniquely American

The United States has provided unusually casual access to means of death.

The availability of opioids has indeed played a role, and the same goes for firearms

The U.S. has also embraced automation and globalization with greater alacrity and fewer restrictions than other countries have. Displaced workers here get relatively little in the way of protection and support.

And we’ve enabled capital to take a larger share of the economic gains. “Economists long thought that the ratio of wages to profits was an immutable constant, about two to one,” Case and Deaton point out. But since 1970, they find, it has declined significantly.

A more unexpected culprit identified by Case and Deaton is our complicated and costly health-care system.

The focus of Case and Deaton’s indictment is on the fact that America’s health-care system is peculiarly reliant on employer-provided insurance.

As they show, the premiums that employers pay amount to a perverse tax on hiring lower-skilled workers.

According to the Kaiser Family Foundation, in 2019 the average family policy cost twenty-one thousand dollars, of which employers typically paid seventy per cent.

“For a well-paid employee earning a salary of $150,000, the average family policy adds less than 10 percent to the cost of employing the worker,” Case and Deaton write. “For a low-wage worker on half the median wage, it is 60 percent.”

between 1970 and 2016, the earnings that laborers received fell twenty-one per cent. But their total compensation, taken to include the cost of their benefits (in particular, health care), rose sixty-eight per cent. Increases in health-care costs have devoured take-home pay for those below the median income.

this makes American health care itself a prime cause of our rising death rates.

we must change the way we pay for health care. Instead of preserving a system that discourages employers from hiring, retaining, and developing workers without bachelor’s degrees, we need to make health-care payments proportional to wages—as with tax-based systems like Medicare.

So far, the American approach to the rise in white working-class mortality has been to pour resources into addiction-treatment centers and suicide-prevention programs. Yet the rates of suicide and addiction remain sky-high. It’s as if we’re using pressure dressings on a bullet wound to the chest instead of getting at the source of the bleeding.

Case and Deaton want us to recognize that the more widespread response is a sense of hopelessness and helplessness. And here culture does play a role.

When it comes to people whose lives aren’t going well, American culture is a harsh judge: if you can’t find enough work, if your wages are too low, if you can’t be counted on to support a family, if you don’t have a promising future, then there must be something wrong with you

We Americans are reluctant to acknowledge that our economy serves the educated classes and penalizes the rest. But that’s exactly the situation, and “Deaths of Despair” shows how the immiseration of the less educated has resulted in the loss of hundreds of thousands of lives, even as the economy has thrived and the stock market has soared.

capitalism, having failed America’s less educated workers for decades, must change, as it has in the past. “There have been previous periods when capitalism failed most people, as the Industrial Revolution got under way at the beginning of the nineteenth century, and again after the Great Depression,” they write. “But the beast was tamed, not slain.”

Today, the battles are over an employer-based system for financing health care, corporate governance that puts shareholders’ interests ahead of workers’, tax plans that benefit capital holders over wage earners.

We are better at addressing fast-moving crises than slow-building ones. It wouldn’t be surprising, then, if we simply absorbed current conditions as the new normal.

He argues that the tools of social media are just too sharp for young minds. On digital platforms teens parade themselves, often to an audience of strangers, and this is leading to addiction, paranoia and despair

For girls, the effect is especially acute. ‘What we’re seeing is a very sharp, sudden change in girls’ mental health all around the Anglosphere and the Nordic countries,’ he says. A big change was evident from 2013, when physical friendship groups started to be supplanted by smartphones and online chat. ‘But you cannot grow up in networks. You have to grow up in communities.’

The first is that they are fragile and can be harmed by speech and words.

But if you’re a secular liberal girl, you’re probably more than twice as likely to have a mental health problem.’

a University of Michigan survey into ‘self-derogation’ – i.e., how likely teenagers are to say they are ‘no good’ or ‘can’t do anything right’. Figures had been stable for years but started rising sharply ten years ago – except for among boys who identified as conservative and said that religion was important to them.

irls simply use social media more. But Professor Haidt also thinks they are more likely to buy into what he calls the ‘three great untruths’ of social media

boys who have religion in their lives seem to be less susceptible. ‘If you’re a kid who’s a religious conservative, on average, your mental health is not really much worse than it was ten years ago

Next, that their emotions, and especially their anxieties, are reliable guides to reality.

And finally, that society is one big battle between victims and oppressors. All this, he says, is the subtext to social media discourse.

‘It’s what I’ve been calling the phone-based child,’

So we had playdates in childhood, up until around 2010.’ In Britain, he says, the number of children who went on real-life playdates then fell sharply.

Social media is a bit of a misnomer, he says. It’s no longer about connecting people, but ‘performing on a platform’. Perhaps this is fine for grown-ups, but not for children, ‘where they can say things in public, including to strangers, and then be publicly shamed by potentially millions of people

Children should not be on social networks. They should be playing in person. Social media platforms should never be accessed by children until they’re 18. It’s just insane that we let kids do these things.’

I ask if he thinks all platforms are equally dangerous

if you get your news from social media (which many people do – in the UK, Instagram has overtaken all newspapers as a news source), this can change your view of the world, especially as the algorithms tend to promote the most provocative views.

‘TikTok is probably the worst for their intellectual development. I think it literally reduces their ability to focus on anything while stuffing them with little bits of stuff that was selected by an algorithm for emotional arousal. Not for truth.’

If asked to choose whether they side more with Israel or Hamas, ‘the great majority of Americans side with Israel, except for Gen Z, which is split 50-50’,

‘There was a Twitter thread recently showing how if you look at what people are saying on TikTok, you can understand why

TikTok and Twitter are incredibly dangerous for our democracy. I’d say they’re incompatible with the kind of liberal democracy that we’ve developed over the last few hundred years.’

Might it just be the case, I ask, that there’s less of a stigma around mental health now, so teenagers are far more likely to admit that they have problems?

why is it, then, that right around 2013 all these girls suddenly start checking into psychiatric inpatient units? Or suicide – they’re making many more suicide attempts. The level of self-harm goes up by 200 or 300 per cent, especially for the younger girls aged ten to 14

we see very much the same curves, at the same time, for behaviour. Suicide, certainly, is not a self-report variable. This is real. This is the biggest mental health crisis in all of known history for kids.’

he increased number of suicides since 2010 is so large that I suspect this is among the largest public health threats to children since the major diseases were wiped out

His third rule: no phones in schools.

What should parents do? They know that if they try to remove their teenager’s smartphone, their child will accuse them of destroying his or her social life. ‘That’s a perfect statement of what we call a collective action problem,’

‘Any one person doing the right thing is in big trouble. But why do we ever let our kids on social media? It’s only down to the dynamic you just said.’ New norms are needed, he says. And his book will suggest four.

Rule one, he says: no smartphones before the age of 14.

‘Give them a flip phone. Millennials had flip phones. They texted each other

Rule two: no social media before 16

In Britain, suicide rates started rising in 2014, up about 20 per cent for boys (to 420 a year) and 60 per cent for girls (to 160 a year).

finally: more unsupervised play. ‘Both of our countries freaked out in the 1990s, locked up our kids because we lost trust in each other. We thought everyone was a child molester or a rapist.’ Children and teens could do with six or seven hours each day out of contact with their parents, he argues. Keeping them inside risks more harm than the outside world would pose.

militant group and other Sunni militants frequently use car bombs and suicide attacks to target public areas and government buildings

39 civilians, while the rest were members of the security forces

He added that up to 65 other people were wounded and nearly 50 cars were damaged. Hillah is located about 60 miles south of Baghdad.

Iraq has seen a spike in violence in the past month with suicide attacks in and outside Baghdad, all claimed by the ISIS, killing more than 170 people

ISIS controls large swaths of Iraq and neighboring Syria and has declared an Islamic “caliphate” on the territory it holds.

at least 670 Iraqis were killed last month due to ongoing violence,

One of the two major causes of distress, Luthar found, was the “pressure to excel at multiple academic and extracurricular pursuits.”

From their answers, Luthar constructed a profile of elite American adolescents whose self-worth is tied to their achievements and who see themselves as catastrophically flawed if they don’t meet the highest standards of success.

Middle-class kids, she told me, generally do not live with the expectation that they should go to Stanford or earn $200,000 a year. “If I’ve never been to the moon,” she said of middle-class families, “why would I expect my kids to go there?” The yardstick for the children of the meritocratic elite is different, and it can intimidate as much as it can empower.

The second major cause of distress that Luthar identified was perhaps more surprising: Affluent kids felt remarkably isolated from their parents.

The kids in the affluent communities she studied felt their parents to be no more available to them, either emotionally or physically, than the kids in severe poverty did.

Some of the measures Luthar used were objective: Did the family eat dinner together, or hang out in the evenings? Here, she discovered that some busy parents would leave adolescents alone in the afternoon and evening and often weren’t home at all during those hours

Children had the sense that their parents monitored their activities and cared deeply about how they were spending their time, but that didn’t translate into feeling close. Many children felt they were being prodded toward very specific goals and behaviors by parental cues, some subtle, some less so.

a feeling of closeness to parents was inversely linked to household income, meaning that the most-affluent kids felt the most alienated.

The New York Times columnist Frank Bruni’s Where You Go Is Not Who You’ll Be: An Antidote to the College Admissions Mania warns of the dangers of insisting that admission to an elite college is necessary for a successful life.

But it turns out that this combination can be just as hard on a child’s well-being.

Since Levine wrote The Price of Privilege, she’s watched the stress in the Bay Area and in affluent communities all over the country become more pervasive and more acute.

Now, she reports, the teenagers have no sense of agency. They still complain bitterly about all the same things, but they feel they have no choice.

Many have also fallen prey to what Levine calls a “mass delusion” that there is but one path to a successful life, and that it is very narrow

Adolescents no longer typically identify parents or peers as the greatest source of their stress, Levine says. They point to school. But that itself may suggest a submission of sorts—the unquestioned adoption of parental norms.

In March, after spending two days among Palo Alto’s parents and civic leaders, Luthar came to see the community, still in shock over the suicides, as hovering somewhere between fear and denial.

The meeting she attended with select parents, scholars, mental-health professionals, and community leaders was academically rigorous and yielded many important insights. But it was “eerie” in its almost complete lack of feeling

“There are a lot of very hard truths that are just not being spoken.”

Gunn is more than 40 percent Asian, and some non-Asian parents, particularly ones who’d grown up in town when the Asian population was smaller, felt the shift was poisoning the culture of the entire school.

Her first semester, Chiu got an F on a geometry test, which “totally traumatized me.” Her relationship with her parents started to fray, “because it just took too much energy to speak in a polite tone of voice.” She began to dread swim practice and even Girl Scouts and band, “but I didn’t want to be a quitter.” She remembers wishing that someone had broken up with her, or that she was anorexic, or that she had some reason to explain to her parents why she felt so sad. “I also felt like I was already saying that I was too stressed, and nobody—neither my parents nor my teachers—seemed to care or take me seriously.

well-educated parents are quick to distance themselves from the Tiger Mom. We might admire her children’s accomplishments, but we tend to believe these can be coaxed out of a child through applause, not scolding. In fact, this particular combination of lavish praise and insistence on achievement defines our era of protective, meritocratic parenting

Starting in seventh grade, the rich cohort includes just as many kids who display troubling levels of delinquency as the poor cohort, although the rule-breaking takes different forms. The poor kids, for example, fight and carry weapons more frequently, which Luthar explains as possibly self-protective. The rich kids, meanwhile, report higher levels of lying, cheating, and theft.

Providing praise and love when a child performs especially well can look like healthy parenting, he says, because the parents are giving the child more of a good thing. But if praise comes only when a child succeeds, the child is likely to develop a sense that his or her parents’ affection depends upon good grades, or touchdowns, or mastery of a religious text, or whatever the parents’ priorities might be.

The aim of healthy parenting, Assor says, should not be to shower children only with praise and trophies, or to encourage self-esteem based on no real achievements. It should be to disentangle love from the project of parental or pedagogical guidance

Giving specific, positive feedback about something a child has tried hard at, or critical yet constructive feedback when a child fails, is perfectly appropriate. “But being warm and nice is a different matter,” he says. “We want to be nice and warm also when our kids do not achieve and when they do not try hard to achieve.”

The hope is that, secure in love, a child can experiment more freely and begin to find his or her own voice.

With the help of therapists and time, Chiu could better explain what she had experienced—depression, the dangers of not sleeping enough. She learned that her idea that she could escape by manufacturing a mental-health crisis was itself a sign of a mental-health crisis.

Not atypically for people who come to consider suicide, she’d lost her ability to think clearly or solve problems, and ended up trapped in a tunnel ruminating about escape, until self-destruction became the only light she could see.

Almost by definition, suicide points to underlying psychological vulnerability. The thinking behind it is often obsessive and then impulsive; a kid can be ruminating about the train for a long time and then one night something ordinary—a botched quiz, a breakup—leads him or her to the tracks.

the closer I got to the heart of this story, the less I felt I understood that link. Some details neatly fit the narrative that academic pressure has caused lethal amounts of stress in Palo Alto—Taylor Chiu’s experience, for example. Will Dickens, who died in 2009, had a learning disability, and his mother, Janet Dixon-Dickens, told me he never forgot it at Gunn. Cameron Lee, on the other hand, wasn’t obviously oppressed by schoolwork, and neither was J.P. Blanchard, or Sonya Raymakers, a girl who died in June 2009, soon after being accepted into her dream program at New York University.

In these days of assumed meritocracy, where children can be turned into anything, we admire them as displays of remarkable engineering, to be tweaked and fine-tuned into bilingual perfection. What we’ve lost, perhaps, is a sense that there may be things about them we can’t know or understand, and that that mysterious quality, separate from us, is what we should marvel at.

Admitting we don’t entirely know why teenagers kill themselves isn’t an invitation to do nothing to prevent it from happening. It’s just a call for humility, a short pause to acknowledge that a sense of absolute certainty about what children should do or be or how they should operate is part of what landed us here.

Aid in dying remains hotly debated in several countries and has been at the heart of several major court cases. Earlier this year, a German court overturned a ban on assisted suicide. In Portugal, lawmakers took a first step in February toward allowing euthanasia, but the legislative change could still be vetoed by the country’s president.

Spain is a traditionally Catholic country and the Church has strongly opposed the idea of decriminalizing euthanasia or assisted suicide.

Mr. Sánchez was voted into office in January at the helm of Spain’s first coalition government, and the euthanasia law was the first one presented by his left-wing administration as part of its bid to promote a more liberal agenda. Under a previous Socialist government, Spain also became in 2005 one of the first countries to legalize same-sex marriage.

Among the estimated 47 dead were 39 civilians, while the rest were members of the security forces. The attacker struck shortly after noon local time when the checkpoint was crowded with dozens of cars, a police officer said. He added that up to 65 people were wounded.

Such attacks “force the government and the militias to look back and reallocate resources and reassess”, said Bill Roggio, a senior fellow at the Foundation for Defense of Democracies, referring to the mainly Shia militias fighting alongside government forces.

Last January, a suicide bomber, a Russian citizen with possible ties to the Islamic State, blew herself up at a police station in the Sultanahmet area, killing an officer.

Many analysts have attributed those attacks to the Islamic State, saying the terrorist network was trying to touch off a civil war in Turkey.

We know that social position affects both when you die and how sick you get: The higher your social position, the healthier you are. It turns out that your sense of relative social rank — where you draw a line on an abstract ladder to show where you are with respect to others — predicts many health outcomes, including depression, sometimes even more powerfully than your objective socioeconomic status.

cities also break traditions and fracture families, and they breed psychiatric illness. In a city you are more likely to be depressed, to fall ill with schizophrenia, and to use alcohol and drugs. Poverty and rapid urbanization sharpen these effects.

What has exploded in India over the past few decades, but also everywhere else in the world, is information about other people. As we watch television, surf the Internet and follow events around the world, we become intimately aware of other ways of living and of others who are richer and more powerful. We place ourselves in a vast social order in which most of us are ants. It may truly be a depressing reflection.

Some of these figures might simply reflect more willingness to label an experience as a symptom. For example, until recently, most Japanese understood intense fatigue as sacrifice for one’s work and suicide as an act of reasoned will. In her book “Depression in Japan,” the anthropologist Junko Kitanaka writes that partly as a result of aggressive pharmaceutical marketing, many Japanese began to think of their fatigue and suicidal thoughts as symptoms created by a disease. The number of diagnoses of depression in that country more than doubled between 1999 and 2008.

IS still controls large swaths of Iraq and neighboring Syria and has declared an Islamic "caliphate" on the territory it holds. The extremist group controls Iraq's second largest city, Mosul, as well as the city of Fallujah, 40 miles west of Baghdad.