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Lithuania once again takes the dubious honor of being the country with the highest suicide rate in the world, according to figures released this week - and the gap between it and the rest of the world is huge.
The news from the Lithuanian Statistics Department is disheartening. Lithuanians commit suicide more often than anyone else in the world. While last year's numbers have decreased slightly from 2000, they remain an almost two-fold increase compared with 10 years ago.
Lithuania leads the world, with 44 citizens out of every 100,000 taking their own lives. Russia is second with 39. Estonia and Latvia are third and fourth with 38 and 36. The average in the European Union is 20.
Sri Lanka has the highest suicide rate outside Europe, with 31 people out of every 100,000 taking their own lives. Other high rates come from Kazakhstan, Hungary and Belarus.
In 1990 the rate was only 26 per 100,000 people.
The numbers released paint a bleak picture, with most suicides taking place in rural areas where unemployment is high and alcoholism rampant.
According to Onute Davidoniene, director of the State Mental Health Center, pinpointing an exact cause for suicide is impossible. But the clear social and financial problems that exist in Lithuania have had a major effect.
Davidoniene believes that the main reason for the dramatic rise in suicides over the last 10 years has to do with the economic and social transition, which has sharply worsened everyday life for many.
The deep recession resulting from the Russian economic crisis of 1998, which has hit the Lithuanian economy harder than its Baltic and Central European neighbors, is prolonging the phenomenon.
"After independence there was great hope that things would get better, and everybody was waiting for that, but everything is the same and people are without hope," explained Davidoniene.
She especially stressed the problem of suicide in the rural areas and the unambiguous correlation with alcohol.
"Around 80 percent of suicides are alcohol-related, and we see the biggest problems with that in the countryside. In rural areas, everybody drinks."
Nijole Kryzanauskiene, a psychologist from the south-western town of Marijampole, said there was a complex variety of reasons for Lithuania's suicide rate.
Three-quarters of the world's countries and 90 percent of the world's population are living in far poorer conditions than Lithuanians, she argued, so not only social reasons are behind the suicides.
One of them is the Lithuanian mentality, she said - the "stiff upper lip" tradition.
Kryzanauskiene emphasized that Lithuania was the richest republic in the Soviet Union, according to U.S.S.R. statistics - yet even despite that, the suicide rate was higher there than in the rest of the Soviet empire."Lithuanians are emotional and very sensitive people. However, traditions demand that we don't show our emotions in public. Russians can speak about their biggest emotional secrets even to people they have never seen before. Lithuanians are always alone emotionally. Even in the family.
The suicide rate for men is far higher than for women in most countries around the world. In Lithuania, the difference is especially vivid. While 14 women out of every 100,000 take their own lives in Lithuania, so do 74 out of every 100,000 men.
"Men especially hide their emotions," said Kryzanauskiene. "Traditions are very strong among elderly people in the countryside. This is one of the reasons why men, pensioners and farmers dominate the suicide statistics in Lithuania," she said.
Another of the reasons for Lithuania's massive rate of suicide is that little psychological counseling is available, particularly in rural areas. There are telephone helplines people can call to speak with counselors, but Davidoniene believes much more should be done.
"The government has just started a five-to-10 year program, a national strategy for suicide prevention, but it will take some years before the situation really changes."
Alvydas Repecka, a toxicologist with the Baltic-American Clinic in Vilnius, blames alcohol. "The roots of alcoholism are in Lithuania's tragic history. The country lost one-third of its population because of foreign occupations in the 20th century - more than any other. During the Soviet occupation, people had to hide their real thoughts. That was the direct road to alcoholism, a temporary escape route from the stress of reality.
Alcoholism flourishes in the rural areas, where farmers were forced to give up their land and other possessions to the Soviets after World War II. "Now they are forced to adopt free-market rules. But I think the new generation of Lithuanians will be different. They will grow under conditions of freedom, and all these alcohol and suicide problems will be solved," said Repecka.
The media are also to blame, said Kryzanauskiene. "Our newspapers sensationalize about individual suicides. After reading these articles, people can think, 'I'm not alone,' and it will encourage them. I'd prefer that these issues were discussed only by professional psychologists in professional literature," she said.