Self-manslaughter.

I was thinking of a family member who had an awful car accident a couple of decades back. Actually it could have been much worse; the car hit a low concrete barrier at speed and flipped. Physically she came through just fine. Mentally she was not well afterward. In fact, she was not at all well beforehand. 

The woman in question had lost her husband of many years, and was driving back home to their empty house after coming up to New York for the funeral. When I found out about this accident -- to a woman with a perfectly clean driving record -- my thought was then as it is now, that her intense grief led to an involuntary suicide attempt. Not self-murder, but self-manslaughter. 

Probably all but the most even keeled or self-possessed of us have had those times when we're so overwhelmed with anger or sorrow or some other form of emotional pain that for a brief period we would blow up the world (or our own world) just to stop the pain. For most it would not bring us to suicide, but it could certainly make us so out of control that we could cause some horrific harm to ourselves by accident. This is very like manslaughter -- there was no intention of killing someone, but a terrifying lapse of control has led to just that -- except the victim is us.  

According to the CDC's provisional data for 2023, heart diseases are still the top cause of death in America, followed by cancer. Accidental deaths are next by a considerable margin, not even a third of heart disease deaths. But they're all awful, because they each took the life of someone who could have lived another day. 

And now I wonder -- how many of them could technically have been caused by self-harm, which is eleventh on the list? I wouldn't be surprised if psychiatrists and statisticians have looked into this, but I doubt there's a way to know. Maybe a population sample that seeks out those who died accidentally to see how many were known to be suffering distress -- but who can say? A lot of men, and women too, try to hide these feelings for a variety of reasons. There's no way to know who was going along, outwardly in control, who suddenly had a moment in which he or she said I can't take one more second of this -- or felt that way without putting it into conscious words -- and made a small mistake with fatal consequences. 

If you're feeling that way as you read this, I ask that you not wait until it escalates but tell someone. The 988 crisis hotline has a good rep. And if you're in a stage of catastrophic distress but don't think it will rise to the level of danger, still try to find a positive way forward. The lady with the car accident I described lived almost four years longer and died of natural causes, but not for one day did she ever move forward out of her grief. She didn't deserve to suffer that way.