The death of famed chef Anthony Bourdain, who apparently killed himself in a hotel room in France, caps a week of unnerving news about suicide.
Rates are climbing across the United States, the Centers for Disease Control and Prevention reported on Thursday — in some states, by as much as 30 percent since 1999.
Prevention remains an elusive goal. Just days earlier, Americans were stunned to learn the designer Kate Spade had hanged herself in her New York apartment.
The interior drama that turns self-destruction into an idea, then an attractive choice, and finally a necessary solution is rarely evident to survivors. We do not know what mix of impulses drove the designer and the chef to suicide.
Notes left behind, when they exist, can provide clues. Researchers have found few patterns in those missives, however, and little to predict behavior.
Yet scientists do know that contagion can be a factor, from previous research into so-called suicide clusters, especially in young people.
There is no formal definition of a cluster, but research by Dr. Madelyn Gould, a psychiatric epidemiologist at Columbia University, has shown that multiple suicides can occur close together, both in time and in place.
It happens on average in at least five communities a year in this country, studies suggest. Up to 5 percent of suicides among adolescents occur close to others, a higher rate than found in adults.
These suicide flurries can emerge as grim, incomprehensible fads. Over several months in 2007 and 2008, three high school students in the close-knit community of Nantucket, Mass., killed themselves. They were thought to be acquainted
The year before, 17 young people are thought to have killed themselves in Bridgend, a county borough of 130,000 in Wales.
Some clusters may just be coincidence, and investigators have looked in vain for similarities or shared reasons. But one common thread is media coverage.
Researchers have found that highly publicized suicides can precede others, often by similar means, in the months that follow — in people already thinking about killing themselves.
The likelihood of this contagion appears to depend on the prominence of the coverage. In recent days, certainly, Ms. Spade’s death has been widely reported.
While contagion is not a factor in most suicides, Dr. Gould has written, the elevation of relative risk “given exposure to the suicide of one or more other persons may be quite great.”
She added: “Although the number of suicides that occur in clusters may be relatively small, they represent a class of suicides that may be particularly preventable.”
Two issues cloud prediction and prevention efforts. One is that about 80 percent of people who make an attempt never tell anyone in advance.
The other is that the act is often impulsive, and can be impulsively interrupted. As the G.K. Chesterton poem “A Ballade of Suicide” has it:
But just as all the neighbors — on the wall —
Are drawing a long breath to shout “Hurray!”
The strangest whim has seized me … After all
I think I will not hang myself today.
Conversely, once the notion to commit suicide takes hold, it may just as suddenly create an inevitability of its own.
In his landmark book, “The Savage God,” the English poet and critic A. Alvarez, who attempted suicide himself, wrote that suicide is “a closed world with its own irresistible logic.” He continued, “Once a man decides to take his own life he enters a shut-off, impregnable but wholly convincing world where every detail fits and each incidence reinforces his decision.”