Asian Journal of Psychiatry 6 (2013) 548–551

Suicidal behaviour in the ancient Greek and Roman world

L. Lykouras a, E. Poulakou-Rebelakou b,*, C. Tsiamis b, D. Ploumpidis c

a 2nd Psychiatric University Department, Attikon Hospital, Athens, Greeceb History of Medicine, Athens University Medical School, Athens, Greecec 1st Psychiatric University Department, Aeginiteion Hospital, Athens, Greece

A R T I C L E I N F O

Article history:

Received 8 April 2013

Accepted 4 August 2013

Keywords:

Ancient Greece

Ancient philosophy

Ancient Rome

Greek tragedies

Suicidal behaviour

A B S T R A C T

Objective: We attempt to present and analyze suicidal behaviour in the ancient Greek and Roman world.

Methods: Drawing information from ancient Greek and Latin sources (History, Philosophy, Medicine,

Literature, Visual Arts) we aim to point out psychological and social aspects of suicidal behaviour in

antiquity.

Results: The shocking exposition of suicides reveals the zeitgeist of each era and illustrates the prevailing

concepts. Social and legal reactions appear ambivalent, as they can oscillate from acceptance and

interpretation of the act to punishment. In the history of these attitudes, we can observe continuities and

breaches, reserving a special place in cases of mental disease. The delayed emergence of a generally

accepted term for the voluntary exit from life (the term suicidium established during the 17th century), is

connected to reactions triggered by the act of suicide than to the frequency and the extent of the

phenomenon.

Conclusions: The social environment of the person, who voluntary ends his life usually dictates the

behaviour and historical evidence confirms the phenomenon.

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1. Introduction

Suicide in antiquity remains a complex issue. Ancient sourcesavoid referring to psychological or social aspects and do notmention the experiences, the mental state, or the way of living ofthe subject. They just mention attitudes and beliefs of that timeand, in most cases, the only known information is the motive thaturges somebody to voluntary self-killing (Van Hooff, 1990). Themain reported reason for suicide is offended honour and shame,that there is an increased individual sensitivity to the expectationsof the society (Dodds, 1950). A person exiled from his homeland asa ‘‘miasma’’, without religious and social identity, he eitherbecomes a suppliant in other altars or commits a suicide (Lester,1997). In antiquity, the suffocating integration in the group and theidentification of each person with the group was the rule anddeviations lead to serious consequences. Despite the lack ofquantitative analyses, researchers (Petropoulos, 2006), estimatethat suicide must have been a common phenomenon. In the Greekand the Roman world, suicide is equally frequent, but the motivesare different and the methods used also differ (Rosen, 1971).

* Corresponding author at: Department of History of Medicine, Medical School,

Athens University, M. Asias 75, Athens 115-27, Greece. Tel.: +30 2107462122.

E-mail address: efpoulrebel@med.uoa.gr (E. Poulakou-Rebelakou).

1876-2018/$ – see front matter � 2013 Elsevier B.V. All rights reserved.

http://dx.doi.org/10.1016/j.ajp.2013.08.001

2. Suicides in Greek antiquity

Mental disease and dishonour or desperate love, constitute themain reasons, which led famous personalities in ancient Greece tosuicide.

The historian Herodotus (Macaulay, 1890) provides a detaileddescription of a suicide: Kleomenes, son of the king of Sparta,suffered the disease of mania and getting a knife, started amputatinghimself. He tore his flesh in strips moving from his thighs, his hips,his loins up to his abdomen before his death.

Neovouli, decided to end her life, because her ex-fiance, thepoet Archilochus, mocked her in his satirical poems (Gerber, 1976).

The death of the famous poet Sappho became a legendary myth:she fell from the top of the high cape Lefkata, in the Sea of LefkasIsland, because of her fiery love for Phaon, who scorned her.Sappho came from an aristocratic family of the Island of Lesbos.She was the leader of an educational artistic school and her closerelation with her female students permitted the legend ofhomosexual tendencies in her environment (Nagy, 1973).

Heroic suicides such as the winner of Salamis, Themistocles(who drank bull’s blood so that he would not fight against hiscountry), the orator Demosthenes’ (who drank poison), and thephilosopher Empedocles’ (who attempted a fatal jump in thevolcano of Aetna), confirm that voluntary death is not always an actof cowardice. They are different from the cases of imposed suicide:Socrates refused to escape, when given the chance, and insisted on

L. Lykouras et al. / Asian Journal of Psychiatry 6 (2013) 548–551 549

drinking hemlock, according to the conviction of the AthenianState. They are not self-sacrifice: the last, rather legendary king ofAthens, Kodros, killed himself in order to save his city. They finallydiffer from facing the certainty of imminent death, as in the case ofLeonidas, at Thermopylae, who knew that there was no salvationfor himself and his Three Hundred soldiers.

3. Philosophical schools and suicide in ancient Greece

Some philosophical schools in Ancient Greece, such as thedevotees of Orpheus and Pythagoras condemned suicide. Accord-ing to their theory, the body is the prison of the soul (gods’ present)and by releasing it from its bond by suicide, man goes against thewill of gods. Plato also condemns suicide: man must not kill himself

before God shapes the conditions for such a need and cites also histeacher Socrates’ saying that men are in some kind of prison and none

should free oneself nor should escape (Jowett, 1999). He revisits thesame subject: one condemns suicide, if not imposed by law, without

the pressure of some painful ordeal and without the burden of an

insufferable shame, with the sole excuse of cowardice and indolence.

Since suicide is disrespectful towards god and a crime against thecity, Plato charges posthumous punishments and suggestsmeasures for the prevention of suicide: the graves of the suicidesshould be at a great distance from others. The suicides should beburied without honours, in desolate and uninhabited areas. Theremust be no epitaph with their name on their tomb (Bury, 1926). Ajust person endures: even if he is poor or sick or in any supposedly bad

state, as finally thinks, they will turn to benefit during his life or when

he is dead (Burnet, 1913).Aristotle openly condemns suicide as an act of cowardice rather

than bravery, saying: as it is lack of energy for someone to avoidhardships, the most foolish of men, unable to cope with difficulties,prefer to commit suicide (Browne, 1853). Aristotle concludes thatsuicide does not destroy himself alone, but also harms hishomeland because he tears its social network apart. Both Platoand Aristotle accept suicide in the case of a painful disease orinsufferable distress caused by shame11. However, most philoso-phers condemn cowardice as a motive for suicide (Vasmatzidis,2008).

Later the cynic philosophers openly recommended thateverybody could decide between two choices: either to acquirewisdom and prudence or to put a bight around his neck (Goodwin,1878). Diogenes Laertius cited love stops by hunger, or else by time. If

these fail, then a bight will do it (Hicks, 1925). The Stoics taught thatanyone could abandon life when it became insufferable (Rist,1969). It seemed appropriate for a stoic philosopher to terminatehis life violently, for dire necessity, tyrannical regime, greathunger, alcoholism, and severe disease. Epictetus summarizesthat: the exit door is always open; the voluntary exit has its time

(Vasmatzidis, 2008). Hegesias, known as ‘‘Peisithanatios’’ (‘‘Deathpersuader’’), taught that death is better than life (Rist, 1969). Aftera great number of suicide acts, considered as dangerous for thesociety, the governor, Ptolemy I Lagos banished him fromAlexandria, whilst banning the propagation of his ideas. Similarphenomena survived to our days and we do witness group suicidesof followers of some philosophical or religious cult (Vasmatzidis,2008).

4. Theories of ancient Greek physicians

Medical science, seeking for better understanding of ennui,depression and pessimism, created the term ‘‘melancholy’’.Meaning the excess of black bile, it also denoted the acceptanceof the theory of the four body humours (blood, phlegm, yellow bile,black bile), which originated from Pythagoras’ teaching but wasexpressed and defined with precision in the Hippocratic Collection.

Hippocrates connected melancholy with the negative perceptionof the world (Jones, 1923). He supported that melancholy maydegenerate into a series of bodily and psychological symptoms:aversion to food, insomnia, nervousness, agitation, gloom, anxiety,moral discouragement, suicidal tendency (Jones, 1931; Potter,1988). Similarly, Galen insists on the psychosomatic nature ofmelancholy assuming that intense thinking and deep sorrow causebody reactions. Therefore, early medicine documented the exactclinical symptoms of depression and identified the extreme casesleading to suicidal behaviour (Edelstein, 1967).

5. Suicide in the Roman era: motives and methods

In ancient Rome the terminology of suicide included the term‘‘voluntary death’’ (voluntaria mors) and ‘‘Roman Death’’, supportsin our days the perception that it was frequent in the Roman world.The fact that historical evidence is limited imposes a carefulexamination of the facts in our disposition about the personalperceptions and experiences of Roman people (Minois, 2003). TheRomans had classified motives for suicide in a diachronically validmanner:

- Fury: this was the category of insane patients.- Advanced age: not always linked to illness and weakness, but

connected with the decision to avoid the hardship of a difficultage (Grise, 1983).

- Physical pain: suicide was the sole salvation (Gourevitch, 1969).- Devotion and faith: common in the army, or in cases of conjugal

loss (after Brutus’s death Porcia swallows live coals).- Shame-dishonours: linked to women’s raping. Lucretia an-

nounced to her relatives that the son of king Tarquinius haddishonoured her and implemented her decision to commitsuicide, gaining general respect (Langlands, 2006).

- Sorrow: connected to the loss of a loved one or psychologicalstress due to a unrequited love.

Each method of suicide (modi moriendi) common in ancientRome maintained a specific symbolism. The way chosen to endone’s life was of great importance and the ultimate goal was thedignity of Death. The most popular methods were

- starvation: which the Greeks called endurance (the Spartanlegislator Lycurgus died thus).

- use of arms: considered as a ‘‘manly affair’’: Nero stabbed his neckwith a dagger saying the famous ‘‘what an artist dies in me!’’(qualis artifex pereo!). Gallantry dictated slitting one’s veins afterbeing defeated in battle.

- poison: often the person in question would simply ask for it fromhis healer, who was familiar with the substances that wouldallow an easy and painless death (Jones, 1978).

- hanging and fall: considered as degrading procedures of voluntarydeath. Tacitus characterizes them ‘‘repulsive end’’ (Kyriazi,2006).

The legislators of Rome paid limited attention to the issue.Anyway, slaves that had attempted suicide automatically had asmaller market value (Garrison, 1883). The Romans supportedsuicide and, therefore, applauded women who did not want to liveafter the death of their husband and those committing suicide afterrape. Lucretius (a suicide himself) cited everyone seeks to escape his

own self, obviously without being able to do so, remaining connected

to himself, against his will and hating him (Minois, 2003).The philosopher Seneca was obliged to commit suicide by

Nero’s command. He had cited I consider someone a coward, if hedies out of fear he might suffer, and, a fool, if he lives to suffer(Burton, 1621). Although Seneca did not reach old age, he had

L. Lykouras et al. / Asian Journal of Psychiatry 6 (2013) 548–551550

prophetically stated if my brain damages and my vital functionsfail, if all I am left with is a soul with no reason, I would pass away,seeing my body being destroyed, ready to fall apart (Reydams-Schils, 2005).

The philosophical trends of the late Roman period dominatedby Neo-platonic ideas, along with pre-Christian cults, mainly thosecoming from the eastern provinces condemn suicide. The mainrepresentatives, Plotinus and Porphyry, stated the first that suicidedisturbed the soul of the dead and the latter (who attemptedsuicide himself) condemned any form of suicide (Kyle, 1998). Atthe crucial point of the dominance of Christianity, the new religionsucceeds a faltering situation and is involved with the issue ofvoluntary martyrdom, hesitating on the attitude it should adopt inthe challenge of the martyrs (Tabor, 1992).

6. Suicides in ancient Greek tragedy

The information gained by modern researchers reflects thenorms through which the ancient world perceived voluntarydeath. There are 1300 cases, mainly from literary sources, that mayillustrate the ancient perception on the issue (Minois, 1995). Thegreat number of swords and knives advocates the theory of amanly exit from life through their use (Van Hooff, 1994). AncientGreek tragedy seems seeking an outlet (‘‘catharsis’’ according toAristotle) from the circle of the perpetually repeated deathcommand (Faber, 1970). The three tragic poets face the suicidaltendency of their heroes differently: the seven extant plays ofAeschylus present no suicides; Sophocles’ seven extant playsdescribe six suicides, while Euripides’ 18 plays four (Garrison,1995).

7. The case of the most famous suicide: Ajax

The resonance of the mythical hero from Salamis, Ajax, impliesthe respect and appraisal of society to suicide for reasons ofhonour. The widespread acceptance of the heroic principle thatdeath is preferable to humiliation transformed the suicide-herointo a symbol, thanks to epic poetry and the tragedy bearing hisname. The most famous play is Sophocles’ Ajax, although his caseinspired more plays (Bushnell, 2005). All myths and traditions,attached to the Sophoclean hero, originate from two lost epics ofthe post-Homeric cycle: the Aethiopis and the Little Illiad (Lesky,1971). However, in all poetic work, whether they are epics, ortragedies, the hero always commits suicide because of the loss ofAchilles’ weapons.

Aristotle classified the play ‘‘Ajax’’ in the genre he calls‘‘Pathetic tragedy’’, i.e. tragedy that contains violent acts (Kassel,1965). Indeed, the hero’s suicide on stage is Sophocles’ dramatur-gic innovation (Sarantoglou, 1984), while Aeschylus in his losttragedy ‘‘Thrissai’’ notifies Ajax’s death by messenger (Mistriotis,1888; Hall, 2010), reinforcing the opinion of a leading classicalscholar that the latter does not include dramatic action (VonWillamowitz-Moellendorf, 1917). Notable psychiatric–psycho-analytic approaches provide a specific reading of the SophocleanAjax (Kouretas, 1951).

The poet describes black blood oozing from Ajax’s wound,possibly to indicate that his mental state was accompanied by anexcessive discharge of black bile, that is, according to Hippocrates,a ‘‘melancholic’’ illness. Detecting the relations between tragedyand medicine, they seem to be communicating vessels and thus theuse of medical knowledge becomes a dramaturgic tool for poets.Psychiatrists support that Ajax’s delirium represents a case ofmelancholy; the accompanying rage, insanity and suicidaldesperation are expected by medical knowledge’’ (Starobinski,1974). Additionally, another opinion says that melancholy, directlyconnected to an excess of black bile, can affect all types of persons

and not only the predisposed melancholic ones (Pigeaud, 1989).Sophocles portrays the hero and masterly recreates the usualsuicidal behaviour, during which we observe the ingeniousconcealment of the already final decision of self-annihilation(Katsouris, 1976). The poet puts in the mouth of the augur Calchasa recommended method of his time: the use of coercion. The augurmade a very precise diagnosis of the emergency of the situationand noted the need for immediate care action, because futurecandidates to suicide often invent come up with different ways toescape the attention of their environment, even of the strictest ofguards and manage to succeed in their goal (Kontopoulou, 1999).

8. Group suicides

Group suicides took place particularly in cases of capture of acity by its conquerors, as an act of group desperation, which afamous sociologist calls ‘‘suicide of the besieged’’ (Durkheim,1897). The greatest number mentioned by historical sourcescorresponds to the 5000 residents of Gamla, who took their ownlives just before the Romans took their city. Information comes alsofrom Art, such as the anonymous Dacians on Trajan’s Column,where officials are delivering poison with a ladle to the citizens.

One epigram mentions that immediately after having read thePlatonic dialogue about the soul (Phaedon) and after a magnificentrhetoric, Cleombrotus of Ambracia jumped in the waters of theStyx, and many of his audience followed him (Burton, 1621).Plutarch mentions the virgins of Miletus, who suffered a ‘‘suicideepidemic’’ and the authorities of the city managed to stop this, onlyafter instituting a command that people, who committed suicidewould have their naked body carried around the agora as a funeral(Burton, 1621).

Decadence of old age has been a frequent motif of suicide,despite the respect for elderly in ancient societies. In ancientGreece, the only exception was the legislation of the island of Kea:This legal for Kea (Keion to nomimon) obliged all citizens to drinkhemlock at the age of 70 (Kramer, 1847; Meineke, 1877). This lawwas gradually abandoned but not earlier than the late Romanperiod (Arnott, 1996; Balme, 2001).

9. Conclusion

Cases of suicide in ancient Greece and Rome, mentioned inhistorical sources and in literal texts, give us an idea on commonviews concerning the voluntary interruption of life. Loss of honourand the unbearable somatic or psychic pain could honourablyjustify a suicide. Philosophical acceptance of suicide flourishedonly through Stoic philosophers. In Rome, there was a consider-able social acceptance in strictly defined circumstances. On thecontrary, divine, philosophical, and legal disapproval of suicide isevidence about its shocking character for ancient societies. Peopleapproved punishments in cases of ‘‘epidemic’’ voluntary deaths.Plato proposed severe posthumous consequences, in accordancewith his philosophical ideas. Punishments focusing on funeralrituals illustrate the social embarrassment in front of an actdenying the ultimate gift of life.

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