A news article in The Salt Lake Tribune states that suicide has reached a 50-year peak. It has become so prevalent that there has been a reduction in the average life expectancy of Americans. Why is this happening?

The Art-Science Museum in Singapore conveys how art and science not only are related, but actually converge to be one. I find that concept true and useful as I think about suicide.

Last month, Utah Opera produced Charles Gounod’sRoméo et Juliette,” a retelling of Shakespeare’s masterpiece. During the opera, the duke tries to legislate peace. To both families, he says, “You whose hatred, fertile in pretexts, maintains discord and fear in the city, take … the solemn oath of obedience to the laws of your prince and of heaven!” (Lay down your weapons.)

Romeo reacts mournfully, “Distraught with grief! … decree which disarms us too late,” while Capulet grimly asserts, “Peace? No! no! no! no! no, never!”

Capulet’s tribal stubbornness lays the groundwork for suicide. Why do Romeo and Juliet kill themselves? Tribune writer Sean Means questioned whether teens should be watching “Romeo and Juliet.” Will it inspire them toward suicidal thinking or behavior? On Oct. 11, Tribune writer Erin Alberty reported an upsurge in suicidal thinking among teens to 1 in 4. She reported speculation that social media may be the cause, although, correctly, she went on to state that it is more complicated than that. In fact, it is a lot more complicated.

The reasons any one person may die by suicide are many and varied. The operatic “Roméo et Juliette” illuminates six common reasons.

1. The pain of existence. Juliet refers to the pain of living with the tribal wrath of her family. “Hatred is the cradle of the fatal love!” A common theme in suicide: Just make the pain stop!

2. Belief in a glorious afterlife. Romeo and Juliet, being deeply religious, are absolutely convinced that what comes after will definitely be better than life now. This same belief appears to motivate many teens who are members of The Church of Jesus Christ of Latter-day Saints, who share a rock-solid belief in a glorious afterlife.

3. Loneliness. Romeo and Juliet are prepared to deal with the hatred of the world, “Let us flee to the ends of the earth! Come! Let us be happy!” But, “If I may not be his, let the grave be my wedding-bed!” For some, loneliness is as painful as terminal cancer.

4. Accident. Friar Laurence had planned a stratagem where the lovers would look as if they died, but actually he and Romeo would save Juliet. Something goes awry. He fails to make contact with Romeo, the consequence of which is two dead people. Real suicide is often like that. It can start as a gesture of something else, and then it goes in a wrong direction or too far — with fatal results.

5. Impulsivity. Romeo visits Juliet in the tomb. One quick look, one quick kiss, and boom! From out of nowhere, he produces poison and swallows it. So many times, this is the way real suicide happens. No months of careful planning. In fact, life can be going pretty well, but then something happens, and boom! An impulse combined with lethal means, and an irreversible fatal result.

6. Ignorance of consequences. In the opera, Juliet wakes up when Romeo is still alive after taking poison. Seeing her, he is deliriously happy, telling her of “the intoxicating light of love and of heaven” that he is bringing to her, of “God’s mercy and goodness” as if nothing has happened until (essentially), “Oh yeah, I forgot. I took poison and I’m dying.” As unlikely as it sounds, this is probably quite common among young people who act suicidally, without truly being aware of what the consequences are going to be.

There is far more to the study of suicide than I am offering here, but it is still stunning to me how much light one timeless work of art can shine on a complex subject! Thank you, Shakespeare, Gounod and Utah Opera!

Michael A. Kalm

Michael A. Kalm, M.D., is in the private practice of psychiatry in Utah and also public affairs representative of the Utah Psychiatric Association.