Paul J. Schwartz
West Chester, OH (Fall 2017)
|Shortly after Chris Cornell’s death, a rare Black Hole Sun grazes Seattle as it begins its spiritual journey across the USA|
In May 2017, Seattle-inspired grunge rock superstar Chris Cornell tragically and seemingly unexpectedly hanged himself after a concert performance in Detroit. Cornell had been the front man for the internationally acclaimed bands Soundgarden, Temple of the Dog, and Audioslave. He achieved multi-platinum success, composing fifteen albums for his bands and as a solo artist, and was widely regarded as having one of the best rock voices of this generation. His song “Black Hole Sun” won a Grammy Award for Best Hard Rock Performance in 1995 and he was nominated many times for other Grammy and Golden Globe Awards. The rock and roll world grieves the loss of this legendary vocalist, lyricist, songwriter, and guitarist.
Cornell had openly struggled with bouts of depression, and his lyrics suggest a particular sensitivity to the vicissitudes of depressed and suicidal states. Most accounts from his family, peers, and friends suggested that his depression had improved in the months leading up to his death, although some suggest he may have had insomnia and slight agitation. While his suicide remains a terrible and disturbing mystery, perhaps Cornell has revealed a hypothesis about suicide in his words and music.
Cornell’s May suicide is a reminder that this is the month of peak suicide risk in the northern hemisphere. This spring peak in suicides has been replicated in many studies in both the northern (May) and southern (November) hemispheres.1, 2 The primary cause of this notorious spring peak in suicides remains unknown, but cannot easily be explained by cultural or social factors.1 There is also evidence that the amplitude of this spring peak in suicides is zero near the equator (i.e. there is no seasonal variation in the constant monthly baseline risk of suicide) and the risk steadily increases with latitude.2, 3 The cause of this latitudinal gradient in suicide risk also remains unknown. In both northern and southern hemispheres, the number of global Internet searches for “depression” exhibits similar seasonal peaks and latitudinal gradients that consistently precede the spring suicide risk peak by several months.4 There are seasonal rhythms in the expression of certain genes in the human cerebral cortex,5 raising the possibility of a seasonally-vulnerable, neurobiologic substrate driving this seasonality of suicide risk. Seasonal and latitudinal gradients regarding suicide risk are also correlated with similar gradients in photoperiod duration (day length) that are due to the earth’s axial tilt and its revolution around the sun. Such seasonal and latitudinal changes in photoperiod could contribute to the gradients in suicide risk.
But if the winter solstice (darkness) attracts depression and the summer solstice (brightness) attracts mania,6-8 what is happening to mood in May to render certain vulnerable individuals suicidal? Could the transition from winter to spring result in the emergence of mixed depressive states and account for the spring peak in suicide risk? Mixed depressive states are well known to be associated with a greatly increased suicide risk.1 Cornell’s May suicide is a reminder of a fundamental axiom of suicidology—that this beautiful and alluring month actually carries the highest risk of suicide.
Cornell may have also illuminated important aspects about mixed depressive states in his lyrics. Cornell’s description of the mixed state could not be more explicit in his not-so-vaguely suicidal song “Follow My Way” from his album with the undisguised and undoubtedly mixed title “Euphoria Mourning:”9
Little one don’t be a fool,
I’m a wreck when I look mighty.
In Euphoria I’m bruised,
In confusion next I’m lightning.
Euphoria and electric energy are mixed with painful depressive vulnerability and cognitive compromise. Similarly, in his deceptively romantic and soulful song “Say Hello 2 Heaven,” Cornell10 wrote:
Please, mother of mercy
take me from this place
and the long winded curses
I keep in my head
Words never listen
And teachers, oh, they never learn
But I’m warm from the candle
Though I feel too cold to burn
Agony and suicidal yearning accompanies the burning-warm vs. icy-cold tension of the mixed depressive state. This tension of the mixed depressive state was immortalized in the extreme in Cornell’s Grammy award-winning song, “Black Hole Sun:”11
Hang my head, drown my fear
Till you all just disappear
Black hole sun
Won’t you come
And wash away the rain
Black hole sun
Won’t you come
Won’t you come
These lyrics suggest simultaneous wishes to be relieved from unbearable despair by deliverance to both eternal salvation (sun) as well as to eternal destruction (black hole) by way of Cornell’s condensed and projected image of the Black Hole Sun. These verses are a reminder of a second fundamental axiom of suicidology—that the mixed depressive state is associated with a greatly elevated risk for suicide.1
In his wistful song “Seasons,” Cornell12 describes the feeling of being left helplessly behind and forsaken by the inexorable passage of seasons while hope and exuberance are held hostage by the dark despair that characterizes the mixed depressive state:
Now I want to fly above the storm
But you can’t grow feathers in the rain
And the naked floor is cold as hell
The naked floor reminds me
Oh the naked floor reminds me
That I’m lost behind
Words I’ll never find
And I’m left behind
As seasons roll on by
This is a reminder of a third fundamental axiom of suicidology: the risk of suicide paradoxically increases during the process of recovering from depression, whether due to antidepressant treatment or to the natural course of the illness. This risk becomes particularly increased when mood ominously changes from depressed to mixed.1 While most people prone to depression will feel better around May with the advent of spring,13 there will still be a predictable subset of individuals who become derailed by the changing seasons, develop mixed depressive states, and become fatally suicidal.
Cornell’s poetry, therefore, has left us with this important and memorable hypothesis: suicide risk is greatest when winter turns to spring and there emerges a deadly coincidence of a mixed depressive state and a May photoperiod; i.e., suicide risk is greatest when a Black Hole Sun occurs in May. Cornell’s sensitive and poetic hypothesis provides a parsimonious and compelling explanation for the well-replicated yet quite mysterious and notorious epidemiological finding of a spring peak in suicides. Whether this hypothesis about suicide, inspired by Cornell’s own songs, had anything to do with his own torment and suicide will remain unknown.
- Goodwin F, Jamison K. Manic depressive illness. Oxford University Press, New York, Oxford, 1990, pp 227-44.
- Woo JM, Okusaga O, Postolache, TT. Seasonality of suicidal behavior. Int J Environ Res Pub Health, 2012; 9, 531-47.
- Davis G, Lowell, W. Evidence that latitude is directly related to variation in suicide rates. Can J Psychiatry, 2002; 47, 572-74.
- Yang AC, Huang NE, Peng CK, Tsai SJ. Do seasons have an influence on the incidence of depression? The use of an Internet search engine query as a proxy of human affect. PLoS One. 2010; 5:e13728.
- Lim AS, Klein HU, Yu L, et al. Diurnal and seasonal molecular rhythms in human neocortex and their relation to Alzheimer’s disease. Nature Comm 2017; 8,14931.
- Wehr TA. Seasonal affective disorders: a historical overview, in: Seasonal affective disorders and phototherapy. Rosenthal NE, Blehar MC eds., Guilford Press, 1989, pp 11-32.
- Medici CR, Vestergaard CH, Hadzi-Pavlovic D, Munk-Jørgensen P, Parker G. Seasonal variations in hospital admissions for mania: Examining for associations with weather variables over time. J Affect Dis, 2016; 205, 81-86.
- Rosenthal NE, Sack DA, Gillin JC, et al. Seasonal affective disorder and phototherapy. A description of the syndrome and preliminary findings with light treatment. Arch Gen Psychiatry, 1984; 41, 72-80.
- Cornell C. (1999). Follow My Way. Album: Euphoria Mourning.
- Cornell C. (1991). Say Hello 2 Heaven. Album: Temple of the Dog. Band: Temple of the Dog.
- Cornell C. (1992a). Black Hole Sun. Album: Superunknown. Band: Soundgarden.
- Cornell C. (1992b). Seasons. Album: Singles.
- Schwartz PJ, Brown C, Wehr TA, Rosenthal NE. Winter-seasonal affective disorder: a follow up study of the first 59 patients of the NIMH seasonal studies program. Am J Psychiatry, 1995; 153, 1023-36.
PAUL J. SCHWARTZ, MD, completed his undergraduate training in biomedical engineering at Duke University, his medical school at the University of Cincinnati, his psychiatric residency at Yale University, and his psychobiology research fellowship at the National Institute of Mental Health. Dr. Schwartz has published 40 scientific articles on the seasonal chronobiology of mood disorders. He is currently in private practice in West Chester, OH, and is a 5th year candidate at the Cincinnati Psychoanalytic Institute.