Suicide in the Byzantine Empire (G. Tsoukalas, 2013)

NOTE: The following article is taken from Psychiatriki 2013, 24:55–60

Portrait of Gemistus Pletho, detail of a fresco by acquaintance Benozzo Gozzoli, Palazzo Medici Riccardi, Florence, Italy
Portrait of Gemistus Pletho,

Studying the suicide in the Byzantine Empire is difficult due to the limited number of references to it. Their number is greater in the early years of the Empire, mainly because of the persecution of Christians and gradually decreases. The attitude of the Church also gradually hardens, as well as the law. The law was strictly followed to the West, but as far as the Eastern Empire is concerned there are no references of punishment, confiscation of property or vandalism of dead bodies mentioned. Avoiding public humiliation after a public crime or a military defeat, religious redemption, emotional disturbance and debts, are the main cause of suicide. There are some references of mass suicides, while women suicides are relatively fewer, if the early Christian years are excluded. Suicide is more acceptable to the pagans because of their lifestyle. The therapeutic approach comes mainly through the treatment of depression. Aretaeus and Galen cite some ways to deal with the disturbance in the internal balance of black bile. Their view echoes through the centuries and the subsequent doctors embrace it. At least after the 9th century, more importance is given to the patient’s bliss. Gemistus Pletho tried to revive the Platonic view of suicide shortly before the end of the Empire. The Church forbids Christian burial and troubled soul hovers in an intangible journey.


The references to suicide from the 4th to the 15th century in the Byzantium are extremely limited, which explains the reason why the issue has not been studied extensively.1–2 The attitude of most religions towards the suicide is negative, so the Jewish and Christian religion condemn suicide. These religions, being the antipode of individualism, accept reality as a single entity, focusing on the divine element, around which all the other elements are developed, that is the human and the cosmic, the animate and the inanimate, the rational and the irrational. Life belongs to the divine factor of the reality, which determines the rhythm of beings throughout the whole range of their existence. Each one adapts and submits to the cycle of life and death, determined by the divine element. The human thus is not entitled to disrupt the cycle of life and therefore killing another human being or himself is prohibited and considered as the highest contempt for God who created him.3–6 Suicide has been studied only in the references of removal of own life in the Greek Novel from Antiquity to the Comnenian period.2 According to the Romans, nobles’ suicide shortly before an inevitable death, as in the end of lost a battle or after a disgraceful act, is an acceptable fact,1 although by the 3rd AD century the Roman law punishes suicides strictly.7 Since the 5th century AD the references get fewer and are mainly confined to the hagiographic literature.

The sources mentioning suicides or suicide attempts are primarily religious or secular discourses, in which suicide is generally and often referred as an irreverent act. The Byzantine law punishes self-destruction as well as those who lead others to forced suicide, such as a ruler that leads to suicide a slave who has done some penal offense.1 The therapeutic approach to prevent suicide is found in the treatment of depression and mania and is mainly expressed by Aretaeus and Galen, even if they lived earlier than the creation of the Empire.8

Suicide in the early Christian years of the Empire

St. John Chrysostom praises the Martyr Domina, who drowned her two daughters--Bernike and Prosdoke--and then drowned herself to avoid rape.
St. John Chrysostom praises the Martyr Domina, who drowned her two daughters–Bernike and Prosdoke–and then drowned herself to avoid rape.

Despair is a terrible evil and unhealable passion that erodes the human soul. It destroys everything sound in him, it delivers him to the disaster and pushes him to end his life.9 The despair of the Christian martyrs during the persecutions led some of them to suicide in order to avoid rape or humiliation. John Chrysostom says that the three witnesses Bernike, Prosdoke and Domnine, fell into the river near the city of Hierapolis and drowned to avoid humiliation.10 He even connects their act to a Cristian baptism.1 The tendency of Christians to end their life or cause death because of the pagans, during their persecution, was not considered as suicide in the early years of the Church. It is certain that Christianity invites suicide in a way in which other major religions do not. In the early years of Christianity the faithful Christian can commit suicide if he believes that the time of sin is close, while the suicidal death of a martyr is treated with sympathy by the Church to such an extent that it is not considered as suicide.9

The reason of suicide and the causes that led to self-destruction were often attributed to the forces of evil, and which overcome those with weak faith. There are however quotes like this from the teaching of St. Athanasius, in which the Saint, trying to explain what leads a man to self-destruction, simply says “these are only known by God”.11

Suicide in the Byzantine Empire

During the first centuries of the Byzantine Empire the references to suicide are associated with political upheavals and the change in the fate of the aristocracy members. The defeat in a battle or the guilt for a public crime led militaries or politicians of the Empire to choose suicide over public humiliation. The act is equivalent to common murder and the suicide’s property is confiscated.7 Then the law changed and the property was confiscated only in cases where suicide was committed to avoid the consequences of the law.12

Lausaic History of Palladius

The Church condemns suicide and forbids Christian burial, provided the perpetrators were of a sound state of mind, as in this case the suicide has surrendered his soul to the devil. Those who commit suicide on account of distress, grief or lack of courage have no right to Christian burial.13 The first mention of a suicide burial ban is cited in Lausiac History at about 419, where a priest forbids the burial of two nuns who had committed suicide.14 The suicide’s widow is excluded from bereavement and can get married immediately, while in the case of instigator, the punishment was a 10-year exile.1 Regarding the suicides’ corpses, called “viothanon” or “viothanaton” buried in Kynegion, an area where those executed in Istanbul were buried.15 Relatives should not face penance, except for abstaining from meat, they should attend the Divine Liturgy from the antechamber and finally raise a cross at the point of death of the suicide.2

Over the years the nobles’ or militaries’ suicides continued, with examples the suicides of Maximinianus Augustus, Magnentius, Arbogastes and Gerontios. For Gerontios especially, because of the fact that he was British, it was considered that he perceived “the insane of the barbarian kind” and preferred to be burned alive than surrender.16 To the antipode suicides of the ordinary people were confined among the Christians, due to the reaction of the Church, but were increased among the pagans as they were more vulnerable to violence, or because the act was considered as a form of reaction.1 The philosopher Iamblichus, having been involved in the pagan apposition, was captured by Christians and drank poison to die.1 We have now reached the time when pagans commit suicide to save themselves from Christians. The most prominent cases are those of Maximos of Ephesus, patrician Phocas, Asclepiodotos. Ordinary soldiers are often victims of depression and attempted suicide. In this case, an enquiry is conducted and in case of cowardice follows a disgraceful retirement or death.17–18 Suicides of women were also reduced and limited mainly to emotional reasons, such as loss of a loved one.1 Thus Miroslava, the daughter of the Bulgarian ruler Samuel, threatened to commit suicide if not allowed to marry her lover Ashot. There were also cases of suicides of women who could not stand living anymore with their husbands, whom they abhorred.2,19


There are references of mass suicides like those in the time of Theodosius II, when many were unable to collect the tax required by Attila,20 or when the Phrygian Montanists refused to change their religion coerced by Justinian.1 The exploitation of the poor by the rich or the debt burden often led to suicide. Since the middle Byzantine period and later, suicides are rarely mentioned in relation to the later years of the empire. This means either that there were generalized and thus ceased to be a memorable event, or that they had become more acceptable since the transition of pagans to Christianity. Perhaps suicides simply were not recorded anymore. The few references concern plots and plans of revolution in the army, as in the cases of Agallianos Kontoskelles and Eustathios Argyros.1

Suicide was rarely mentioned in medical books of the time, and according to them the reason was depression, mania or the imbalance of one of the four bodily humors.1,18 In the last centuries of the Empire the references are even more rare and the causes more accidental, such as intolerable life, avoiding execution, demons and passions. Georgios Plethon Gemistos (1360–1452) had a strange vision about suicide, which he recorded in his essay “Book of Laws”. Suicide kills only what is mortal in the immortal soul. The soul is separated from the body and thus all the vicissitudes that can affect its well being, the so-called “eudaemony”.1,21 Plethon proposes in his writings a way of “rational withdrawal”, probably influenced by the course of the Empire, a conscious attempt to escape from the grim realities of the years immediate before the Fall.1

Suicide in literature

Except from the love romances, drama and humorous texts, suicide as a literary motive is encountered in poetry. In humorous poems a crummy husband begs to drink poison in order to avoid his talkative wife.1 The bulk of reports relating to suicide were found in hagiographic literature, which is caused by demonic forces, when the victim is under spell having lost his mind and the control of himself.1 Saint Pachomius says many eremites committed suicide since they did not realize that they had been possessed by unclean.22

The therapeutic approach to suicide


Aretaeus, in his work entitled “On melancholy and On Mania”, correlates mania with crisis of melancholy and projects their periodicity, and the fact that mania frequently affects the youngsters whereas depression the elders.23 He thinks that the cause of the disease is found in the blood and bad humors,23 while especially melancholy implicates the black bile.24 However, he indicates that the main cause of the disease can be found on the nerves. Patients are calm or very serious or unreasonably inert, they get furious, they are smelly, they have agitated sleep, insomnia, irrational fear, they change opinion easily, they are shameless, petty, simplistic, prodigal, exaggerated, they avoid people, they get frightened by dreams, they complain about life, they wish death. Many people’s mental state leads to derangement and stupefaction and the feeling ends up in sorrow and depression, causing resolute anger, sadness and melancholy. Patients are suspected of poisoning and misanthropy, they are considered superstitious, they feel hatred for life and may lead to suicide.23 He is also the first to recognize the impaired function of neurovascular centers in the hypothalamus and the reticular formation,8 indicating that the patients are very slim while eating a lot, their intestines are dry without stools, their skin breaks down, the color is dark green, the pulses are small, inert, inactive, frequent as due to cold, and the urine is sparse, containing acids and bile.23

For its treatment he suggests an etiopathologic approach to the disease. Thus he removes blood from the liver, in which the black bile is produced, while, at the same time, he administers drugs that inhibit its production, such as absinthe juice. Concurrently, he places a suction cup to the head, so that a direct effect on diseased nerves is created. He also suggests a supportive treatment with proper diet, often warm baths, gentle rubbing, swinging and administration of laxatives.8,24 Vomitives are also provided for the elimination of black bile.

Aretaeus also considers that melancholy is the beginning and part of the mania, leading to convulsions and paralysis and in this case hellebore should be administered. In advanced disease asphalt, sulfur and astringent soil that contains aluminum and hydrochloric acid should be used.24 Mania is a chronic confusion of mind and the cause lies in the head and the area of hypochondria. Nocturnal emissions, lust and venereal pleasures are also characteristic symptoms. Eventually, they isolate and lament for their plight, which also can lead to suicide.23

Four Humors Drawing
Four Humors Drawing

Galen generally agrees with Aretaeus that suffering, fear, unwillingness to eat or drink, dark thoughts, are all associated with causes and symptoms of melancholy and self-destruction is a major risk.25 Galen recognised emotional states as factors in disease. Some problems were for Galen purely emotional in origin: one patient worried obsessively that the mythical Atlas would grow tired or sick and drop the sky, crushing the earth. This patient’s anxiety, according to Galen, had developed into melancholia, an overabundance of black bile, which, when accumulated in the brain, caused delirium, aggressive or suicidal behaviour and other psychological problems. Anxiety is, along with anger, the emotion Galen mentions most often as a cause of disease. Both could cause or exacerbate epilepsy; along with diet, temperament, lifestyle and environmental factors could contribute to any number of feverish illnesses; anxiety, in particular, could trigger a sometimes fatal syndrome of insomnia, fever and wasting, or transform into melancholy.26

Although Aretaeus and Galen lived on the early Byzantine Empire, their views on depression and mania survived through the centuries, and marked the therapeutic approach of these diseases.

Due to the fact that love often led to suicide, Ovid gave the remedies for love, or Remedia amoris. Some of them are that the lover should cure the wound of love when it is still fresh and new, without waiting, because being on time is almost a medicine. Moreover a lover should be busy and avoid idleness and excessive sleep. Going to the country could also help, but the lover should know that the recovery process will be very painful, mainly because he needs to forget his beloved and think ill of her, and no pills or witchcraft will alleviate the pain. A lover who wants to recover from the lovesickness should pay attention to his beloved’s faults and show no grief. Most importantly, the lover should not avoid intercourse, because if he remains alone he will become sad. Finally, a certain diet should be followed, where onions should be avoided, he should eat rue because it sharpens the eyesight and drink wine, but only the perfect amount only, otherwise the lover might feel too drowned by alcohol, or the wine might have prepared his heart for love.27

Constantine examines patients' urine
Constantine examines patients’ urine

The next generation of physicians having a great influence on Byzantine thoughts was that of the Arabic physicians. Among them were Rhazes (865–923), Haly Abbas (994) and Avicenna (980–1037), whose thoughts were developed from the Byzantine compilers. Avicenna’s work gained notice to the West by the second quarter of the thirteenth century. The thoughts of these Arabic physicians and philosophers influenced the whole world because they were translated into Latin by Constantinus Africanus (1010–1087) Constantinus recognized the three types of melancholy as indicated by Galen, and added a variety of causes and symptoms related to melancholy. With him, the association of lovesickness, acedia, and mourning with melancholy was introduced. As for the cures for all illnesses associated with melancholy, purgatives and coitus were recommended. It should be noticed that the same cures are recommended for all the illnesses likened to melancholy.28 One observes a circle with the Arabs being affected by the Byzantines and the knowledge returning filtered and refreshed to the West and Byzantium.

The seriously ill sought their healing often in sanctuaries  and if their situation persisted they resorted to sacred grounds of the church, seeking treatment by the patron Saint at the crucial moment.1 The patient’s treatment in hospitals, as for example in the Guesthouse of the Pantocrator in Constantinople, where there was a remote psychiatric ward, can be derived indirectly through the reports of the hospital of the city of Cairo (873 AD). The hospital operated according to Byzantine standards and the mentally ill were treated with extreme caution, always focusing in the bliss of the patient, that is his mental tranquility.29


The references to suicide in the Byzantine empire are numerically much less than expected and their largest number is recorded between 4th and 6th century. In late antiquity, in many cases, such as military defeat or disgrace, suicide was considered an offense consistent with the code of honor, a moral duty. During the early Christian period, suicides proliferate and sometimes are treated with sympathy. Then the attitude of both the church and the legislature hardens. Despite the strict laws though, in Greek literature resources it is not mentioned any case of indignities inflicted upon the suicide’s body or ravages and arbitrary confiscation of his property, in contrast to what happened in the Western Empire.1–2 Perhaps the attitude of the society or the medical influence in favour of the victim, overrode the law. Mental patient or mentally ill, the suicidal always triggered the society, creating feelings of sympathy or repulsion, depending on the reason and time of commitment of the act. Melancholy, mania, depression, emotional frustration, shame, demonic forces, redemption, loss, debts, religion, tortures, such diverse concepts which still all resulted in their zenith in the self-destruction of the mortal body, with the hope of a better trip of the soul in the “afterlife.”


  1. Karpolizos A. Suicide in Byzantium. Ελληνικά 2007, 57:79–104
  2. Karpolizos A. Suicide in Byzantium. Αρχαιολογία και Τέχνες 2006, 99:8–14
  3. Nektarios St. On true and false education. On suicide. Panagopoulos N. Athens, 1989
  4. Boulgarakis H. Suicide and ecclesiastical burial. Armos, Athens, 2000
  5. MacAlister S. Dreams and Suicides. The greek novel from antiquity to the Byzantine Empire. Routlege, London-NewYork, 1966
  6. Begzos M. Suicide and religion. Αρχαιολογία και τέχνες, Athens, 2006, 99:23–29
  7. Corpus luris Civilis, II, Corpus Justinianus, IX,6,5. Krüger P, Hildesheim, 1889: 373
  8. Tsoukalas I. Greek Pediatry from Homer until today. Science Press, Skopelos-Thessaloniki, 2008:399–415
  9. Baruch AB. Suicide and Euthanasia: Historical and Contemporary Themes. Kluwer Academic, Dordrecht, 1989:77–80
  10. De sanctis Bernice et Prosdoce, MPG 50:629–640 (Cod: 5,354: Encom Hagiogr Homilet)
  11. Teaching towards Antioxon. PG 28, 637D–640A
  12. Corpus luris Civilis, I. Digesta, XLVIII,21,3 and 8. Weidman, Berlin, 1888: 870–871
  13. Rhalles-Potles, Matthaios Blastares, ch. 12,1. Περί των βιο-θανών, ήτοι των εαυτοίς αναιρούντων. Petrakakos DA, Die Toten im Recht nach der Lehre und den Normen des orthodoxen morgenlandischen Kirchenrechts und der Gesetzgebung Griechenlands. Leipzig 1905: 52ff
  14. Buttler C. The Lausiac History of Palladius, II. Cambridge, 1904, 97:3–18
  15. Rhalles-Potles. Constantinople in the early eighth century: The Parastaseis Syntomoi Chronikai. Cameron-Herrin, Leiden, 1984:201
  16. Ioannes Antiocheus. FHG IV. Muller, Paris, 1883:610
  17. Basilica, LVII,1,6. Fabrotus, 1647
  18. Corpus luris Civilis. I. Digesta, XLIX. Weidman, Berlin, 1888:16,6
  19. Angold M. Church and Society in Byzantium Under the Comneni,1081–1261. Cambridge University Press, Cambridge, 1995:419
  20. Moschos Ι. Pratum Spirituale. PG b7,3:3048AB. Fronton du Duc, Paris, 1624
  21. Pléthon. Traité des Lois. Alexandre, Paris, 1858: 248–252
  22. Halkin F. Les Corpus Athénien de Saint Pachome. Geneve, 1982:47
  23. Aretaeus of Cappadocia. De causis et signis acutorum morborum. In: Hude K. Aretaeus (ed) Berlin, 1958: Α΄, V & Α΄, V, 4–5. & Α΄, V, 2 & Α΄, V, 3 & Α΄, V, 5 & Α΄,V, 7–8 & Α΄, VΙ
  24. Aretaeus of Cappadocia. On Chronicle Diseases Therapeutics. Kaktos, Athens, 1997:Α΄, V, 1–4, 7–9
  25. De locis affectis libri vi. In: Kühn CG (ed) Claudii Galeni opera omnia. Vol. 8, Leipzig, 1965re
  26. Mattern S. Galen and his patients. The Lancet, 378:478–479
  27. Jacob and Richard Tonson. Ovid. Art of Love 1.123–1.243. London, 1709
  28. Mertz-Weigel D. Figuring melancholy: from Jean De Meun to Moliere, via Montaigne. Descartes, Rotrou and Corneille. Ohio State University, 2005:40
  29. Dols M. Insanity in Byzantine and Islamic medicine. Dumbarton Oaks Papers. JSTOR 1984, 38:135–148

Mount Athos, Homosexuality, Addiction to Heavy Psychotropic Drugs & Suicide (Monk Michael, 2001)

NOTE: The following article, entitled They Take Psychotropic Drugs on Mount Athos, is a Free Press (ΕΛΕΥΘΕΡΟΤΥΠΙΑ) Sunday insert magazine “E” (Έψιλον), Issue 524, 22/4/2001. Peter Papavasiliou interviews Monk Michael Haztiantoniou who lived as a monk in the Sinai desert for 11 years (1988-1998) and Mount Athos for 14 years (1973-1988).

Μιχαήλ, Μοναχός

After 14 years in Simonopetra Monastery, the Athonite monk raised his voice in protest about what is happening in the Athonite state. Today, Monk Michael lives alone in hesychia in the mountains of Corinth, in a cell allocated to him by some pious people. He writes his books from this cell. He has published 12 books so far and many of his accusations can be found recorded in them; he denounces “things and wonders” about the Athonite republic from homosexuality to heavy psychotropic drug addiction!

PP: Do the abbots in the monasteries of Mount Athos display authoritarian behavior?

MM: When they first appeared, these abbots projected themselves as charismatic personalities who had somehow received the mission from God to create a new model of monasticism.1 So, for many people these personalities were expressing hopes and dreams. They endeavoured, they created and built brotherhoods, monasteries, and were very actively involved. However, what all this activity has produced is significant. I can mention a conversation we had with Geronda Paisios on this subject. The basic question that disturbed me was: ‘Why is my generation, on the level of monks, while it presented refinement, culture, and sensitiveness—very positive signs for Geronda Paisios—did not yield spiritual fruitfulness?


PP: Do the abbots use special methods to persuade or to render all the monks conformable?’2

“I think that many Geronta Abbots started out differently and ended up otherwise. It was entirely different when the brotherhood numbered 6 to 7 monks and different when the same Geronda had more monks. In the beginning they organized it patristically and monastically. They had found a tradition on Mount Athos. Later, however, as the brotherhood grew, they started to ‘militarize’ it and treat it like a camp.”3

“Consistency and order had to be kept and a new element appeared which was crucial to the mentality of this organization: the showcase. They were extremely cautious in how they expressed themselves, regardless of how we lived and the things we said amongst ourselves. How will we appear? How will our showcase not be ‘scratched’? How can we ensure that our problems will not be heard about in Thessaloniki?”4

“I was present at the Assembly debate when some Abbot telephoned and said an Iveritis monk (i.e. a monk from Iveron Monastery) was found dead in Thessaloniki. This dead monk was a homosexual and had relations with two Romanians. It didn’t particularly trouble us because such incidents could occur in a large number of monks. But the Abbot whom it offended requested the Holy Community5 publish a paper which would state that this monk had no relationship with the Holy Mountain even though the victim was an Athonite monk for decades.”

“The Holy Community then discussed the matter and said: ‘How would we say this? Anyone would be able to overturn us since he hasn’t been erased from the Monastery…He is a canonical Hagiorite.’ This problem shows that that many Gerondas today have transferred their interest to the showcase.”

Iveron Monastery
Iveron Monastery, Mount Athos

PP: What are the problems behind the showcase? In your books you maintain that a fraction of monks take heavy psychotropic drugs, even by the Abbot’s orders.6

MM: This was also a very great and sad realization for me. It was a painful decision to start disclosing and writing about these things. I did it after 25 years in monasticism though my realizations had occurred many years ago. After publishing certain books that mentioned psychiatric drugs, many monks came forward and assured me that what I write is very mild compared to the realities that are in force on Mount Athos.

PP: You mentioned in one of your books that a pharmacist from Thessaloniki, who was spiritually connected with some monastery on Mount Athos, was put in a difficult position when an Abbot requested boxes of heavy psychotropic drugs from him.7

MM: We say that this monastery is the chief representative of ‘noetic’ prayer (i.e. the continuous repetition of the phrase, ‘Lord Jesus Christ, have mercy on me, a sinner,’ which leads to illumination); meaning it represents whatever is the most spiritual at this time to dispose Orthodoxy towards contemporary issues.

PP: Which monastery are you referring to, Fr. Michael? In what monastery did this incident with the two boxes of psychiatric drugs occur?

MM: The incident concerns Filotheou Monastery and Geronda Ephraim is the abbot who wanted the psychotropic drugs.8

Geronda Ephraim

PP: One can contradict that half of Greece takes psychiatric drugs, anxiolytics, or whatever else.

MM: I do not tolerate this situation. I wish everyone could improve their psychological and spiritual condition with effort and balance their everyday life. But even more, I cannot tolerate this (i.e. taking psychiatric drugs) from the people who came to occupy themselves with a higher way of life, consequently to overcome their human elements and weaknesses and acquire what we call the angelic life.

PP: Namely, the sober, meek and bland lifestyle of many monks on Mount Athos is due to the influence of milligrams of sedatives?


MM: I’ll make a comparison with the Bedouin when I lived in Sinai for 11 years. I was responsible for some hermitages many kilometers away and I watched them basking in the sun with a wonderful smile because they used hashish. They called them ‘sacred plants’ there. They used hashish in their daily lives like tomatoes. They, too, were very meek, mild, smiling and sweet. Consequently, external behaviors and conduct do not suffice for me.9

PP: Let’s return to the Holy Mountain. You’ve written in your books that the abbot, in order to exert psychosomatic control, imposes “reactionary” monks and those who doubt his words every night to take a strong dose of sedative every night. Is this true?

MM: This isn’t a canona that you described, but it does happen. I asked a monk who made a pilgrimage to Sinai, ‘How did you take a psychotropic drug for the first time?’ He answered me, ‘The epitropos (i.e. the epitropos is the abbot’s replacement) put a bottle on the table and told me, ‘You will take one pill in the morning and one in the evening. Geronda sends this and you must drink it …’ As the young monk told me, that night he did ‘obedience’ and drank the medicine. I asked this monk what percentage of the monastery took psychiatric drugs. He replied, ‘A very large percentage of the monks.’

PP: The young monk spoke to you about large percentages of monks taking psychotropic drugs. Was he referring to his monastery or the Athonite monasteries in general?

MM: He spoke to me about his monastery. Of course, I never imagined that psychiatric drugs would find an application in such a large scale. There was a doctor who had continued in Karyes and had taken it upon himself to arrange the pharmacy in a monastery. He had seen the boxes of psychiatric drugs. Later, this doctor decided to become a monk.


PP: Even after seeing the boxes of psychiatric drugs?

MM: Yes indeed. He even became a monk at this monastery where he arranged the pharmacy.

PP: Which monastery?

MM: It is a famous monastery which has over 50 monks in its ranks.”

PP: Can you be more specific?

MM: No, because I think it becomes more personal empathy. Namely, I know these monks. They will say that Michael attacked us personally. I do not want to but if, for some reason, the Community of Mount Athos invites me, then I will speak about the details. I can speak about these things there. I don’t want to become too specific or, perhaps, the time hasn’t come yet … However, the responsibility for these things is transferred to the Abbot and 2-3 persons of his entourage who impose. There is some responsibility and I would even say legal responsibility. One enters a monastery without taking psychotropic drugs and then after 10 or 15 years he starts taking them—and this in a large percentage. Well, then, if our community was healthy, they would not have tolerated this so simply and mildly.

PP: Are there such incidents of people entering Mount Athos healthy and coming out addicted to soothing substances and sedatives?


MM: Yes, this happens quite a lot … (quietly and with a sense of shame). Recently, I spoke with a former Athonite monk who told me: ‘I want to find a channel to speak. They tested 30 psychotropic drugs on me. I lived simply and naturally for 15 years. How did I get on the list to become a guinea pig?’

PP: Did you ever see them moving boxes (i.e. of psychotropics) on Mount Athos during the years you lived there as a monk?

MM: No, I didn’t know about these things. I saw the boxes but didn’t know what they contained exactly.

PP: You thought that they were simple drugs…

MM: Yes. For example, a monk had sent me once to buy medicine when I was out. He had given me a list. At the pharmacy, the pharmacist looked me over well and good.

PP: At the pharmacy in Thessaloniki?

MM: Yes. He asked me, ‘Who do you want these drugs for?’ I told him that I wanted them for a monk. He told me, ‘Father, did you know that these drugs are very heavy and we do not dispense them without a prescription?’ Then I thought they didn’t have the drugs I sought and went to another pharmacy where they told me exactly the same things. When I asked what these drugs were that no one could give me, the pharmacist answered, ‘My Father, I cannot give you these drugs without a prescription and without knowing who they are intended because they are very heavy psychotropics.’ Well, I was very irritated with the monk who sent me.

PP: In other conversations, Fr. Michael, you have revealed to me that many Athonite monks frequently visit a psychiatrist. Is this a fact?

MM: The first is in Thessaloniki. He does therapeutic exercise. He knows the mindset of the monks very well and is very familiar with them. Many monks go to him and they always start talking about the uncreated light (i.e., the indication of the Holy Spirit’s presence that surrounds spiritual monks with brightness) and noetic prayer.”

PP: Does this psychiatrist visit Mount Athos as a family physician?

MM: Yes, he also practises on Mount Athos but the monks visit him in Thessaloniki for more comprehensive treatment. There was an incident where a monk jumped from his balcony and they pulled him out there at a seaside monastery. Fortunately, the monk lived…

PP: As long as the incident is in the past, can we disclose it?

MM: And yet it never became known.


PP: In what monastery did this suicide attempt occur?

MM: Firstly, as the boat goes … However, some specific questions preoccupy me: 1) Why would a monk not be able to leave from a place where he reached a dead end?—because we’re talking about before authoritarianism. 2) If a monk attempted suicide, does the abbot have the right to keep him close by his side? I don’t think so. We know that we all became monks to claim a right, to give rest to our little hearts, to satisfy a spiritual longing, a thirst we have in life. How did these children reach such a tragic point and how did it not become an issue?

PP: Are there many suicide attempts on Mount Athos?10

MM: I know of an incident where a monk had set himself on fire.11

PP: What year was that?

MM: It occurred in 1994 approximately.

PP: Did this happen in a monastery or skete?

MM: In a monastery. Things are much milder in the sketes.”

PP: Who is ultimately responsible for everything that happens in Panagia’s Garden?

MM: Two sides are responsible (i.e. he means the abbots and the monks). However, I think the head is implicated more since he is able to sanitize the emergent. For the emergent comes and is delivered to him with an almost absolute confidence. I would like to see cases of some healthy personalities, open-minded, free, to operate without complex, oppression, etc. We have not seen this yet…

PP: The matter of psychotropic drugs has never been raised to the assembly of the Holy Community?

MM: From what I know, no.”

PP: Only the issue of homosexual relations was raised when and if an outbreak occurred.

Gay monk drawing

MM: Many epidemic cases—indeed, some time ago, an old Athonite monk called me UFO and he expected me to be shrewd. There were cliques in Karyes, or in whatever cell, where we met famous monks and they waited for when I would leave so they could manifest more freely. I treated them all so naturally that I confused them. And so one monk asked me, ‘Well, do you not understand anything about what is happening?’ And he continued in the same tone: ‘Did such and such a monk never suspect you? Let me tell you that there is a cassette which has recorded conversations.’ I answered: ‘But I was friends with him for so many years. When did these things happen?’ And he answered: ‘That is why I call you UFO.’ Yes, homosexual issues have been raised at the Assembly, but I no longer believe in this institution to speak honestly, frankly, at a cost. For many years, decades, I saw that the showcase is their priority and I can also say at some point their economy became their priority. Not an economy in ecclesiastical terms, but rather a ‘practical’ economy, namely, the covering up of everything.

Fr. Michael, do you want to compliment/supplement something?

MM: I would like to emphasize that the children today on Mount Athos (i.e. he means the monks) are very good kids. The love, they look at you with clean eyes. I speak for the majority because there are certainly a very small number of monks who have a pure heart. We said the heads share a large portion of the responsibility…

Elder Joseph synodia


  1. Monk Michael is referring mainly to the disciples of Elder Joseph the Hesychast—Elders Ephraim, Haralambos and Joseph—who took charge of 6 of the 20 main monasteries on Mount Athos in the 60s and 70s.
  2. In the 60s and 70s, many of the Athonite monks had issue with what they viewed as young upstarts (i.e. Elder Joseph the Hesychast’s disciples) starting a new brand of monasticism. Furthermore, many of the Athonite Fathers believed Elder Joseph and his synodia were deluded. Some of the more vocal Athonite opponents of Geronda Ephraim were St. Paisios the Athonite, St. Porphyrios the the Kapsokalyvite, Monk Moses the Athonite, and Archimandrite Vasileiosof Iveron (then Abbot of the Stavronikita).
  3. Some of Geronda Ephraim’s former monastics—both in Greece and North America—have remarked that the structure and atmosphere in the monastery was very oppressive and like a boot camp. Some have expressed that it was like a prison camp without the physical torture but rather with lots of psychological and emotional abuse.
  4. This “showcase” mentality still prevails in Geronda Ephraim’s North American monasteries. One of the main obediences for all his monastics is: “At all costs, do not scandalize the lay people. I do not want to hear complaints from pilgrims. No matter what, always show a good representation of monasticism to the pilgrims.” This is called “front stage” behaviour; i.e. this is the behaviour they want pilgrims to see, however, it does not represent in actuality the truth of what goes on behind closed doors—“backstage behaviour.” When a pilgrim witnesses an action unbecoming of a monastic, or expresses being scandalized due to something a monastic has done or said, then there will be some very serious consequences for that monastic individual. Sometimes this can also include a serious yelling rebuke in front of the scandalized victim to shame and humiliate the monk and appease the pilgrim. No doubt the entire brotherhood/sisterhood will be summoned for a homily where this monastic will be centered out, rebuked and humiliated. This is also done as a warning to the other monastics and to instill fear. Furthermore, the individual monastic will end up in the Lity at the end of the church services confessing their sin and begging every individual leaving for forgiveness.
  5. Athos is governed by the “Holy Community” (Ιερά Κοινότητα – Iera Koinotita) which consists of the representatives of the 20 Holy Monasteries, having as executive committee the four-membered “Holy Administration” (Ιερά Επιστασία – Iera Epistasia), with the Protos (Πρώτος) being its head. Civil authorities are represented by the Civil Governor, appointed by the Greek Ministry of Foreign Affairs, whose main duty is to supervise the function of the institutions and the public order. The current Civil Governor is Aristos Kasmiroglou.
  6. In St. Anthony’s Monastery, one of the monks was on anti-depressants before he entered the monastery and out of economia, Geronda Ephraim allowed him to continue. There have been unsubstantiated rumors of other monastics on psychiatric drugs, too. A monk at St. Nektarios Monastery (NY) entered the monastery taking Ritalin for his ADHD. Geronda Joseph made him stop his prescription immediately and he hasn’t taken any prescriptions for his condition since. There is a blessing for abbots/abbesses, and their second-in-commands to take things like Lorazepam (or other anxiolytics) when they suffer from severe anxiety or panic attacks—something which is frequent in their line of work. As well, on numerous occasions, Fr. Germanos of St. Nektarios Greek Orthodox Monastery in Roscoe, NY, has given homilies about psychiatric and emotional problems being a direct result of a disciple’s disobedience. In these homilies, he has mentioned the fact that many Hagiorites who had been monastics for 15-25 years are suffering from mental illness as a fruit of all the disobediences they had committed. It was unknown if Fr. Germanos was also referring to himself and his own experiences, something the Athonite Fathers do many times when giving cautionary homilies.
  7. Many of Geronda Ephraim’s North American monasteries have a Greek Orthodox doctor, who is also devoted pilgrim. In some cases, a monastery may also have a monastic who is a doctor. In the early days, many of Geronda Ephraim’s monastics did not have any medical insurance. Usually the superior and second-in-command would have private insurance. The monasteries bypassed expensive medical costs by having the loyal and obedient doctor write prescriptions for all their monastics without insurance in the names of those who had insurance. Also, these doctors would also put aside all the free medical samples they received from pharmaceutical companies (if they were medicines the monastics used) and “donate” them to the monasteries. Thus, most monasteries have a large medicine cabinet full of antibiotics, antihistamines, anti-inflammatory drugs, psychotropic drugs (low doses which are said to be useful for pain), muscle relaxants, prescription pain killers, etc.
  8. Interestingly, Geronda Joseph (Ioannis) Voutsas, abbot of St. Nektarios Monastery in Roscoe, NY, is from Thessaloniki. He was also a pharmacist and earned his degree at the University of Thessaloniki.
  9. Though the main emphasis in Geronda Ephraim’s monastery is blind obedience and the Jesus Prayer, external behaviour and conduct also has a very serious importance. Essentially, ‘fake it until you make it.’
  10. Fr. Germanos of St. Nektarios Monastery, Rosoce, NY, has stated in homilies that there is a high suicide rate on Mount Athos. The Gerontikon and Synaxarion are filled with many cautionary tales about monastics who have become deluded or fallen into such despair that they attempted suicide. There are also many cautionary tales about those monastics who succeeded in killing themselves.
  11. To understand the psychology behind why people commit suicide via self-immolation, see:

Eastern Orthodox Saints Who Committed Suicide (Synaxarion & Church Fathers)

In the first few centuries of Orthodox Christianity, the Orthodox Church and the Church Fathers accepted the act of suicide if it was to preserve one’s virginity; i.e. an individual could commit suicide to prevent being raped and it was not considered a mortal sin and one was even eligible to be ranked as a virgin-martyr. Also, some of the martyrs commemorated in the Church were not actually killed by their tormentors but rather they leapt to their own deaths after a period of torture or with the threat of martyrdom. Thus, in the Lives of the Saints of the first few centuries, one can find many saints who committed suicide. After the 4th-5th century, suicide was no longer an acceptable practise to preserve chastity which creates a little confusion. Those before this time period are saints in the ranks of heaven, whereas those who commit suicide after this time period have committed mortal sin and lost their souls.

The majority of the early Church Fathers evidently not only justified but commended suicide in such an extremity. The first Father distinctly to condemn the practice was Augustine (De civ. Dei. I. 22–27). He takes strong ground on the subject, and while admiring the bravery and chastity of the many famous women that had rescued themselves by taking their own lives, he denounces their act as sinful under all circumstances, maintaining that suicide is never anything else than a crime against the law of God. The view of Augustine has very generally prevailed since his time. In the 9th century, St. Theodore of Studite clearly states in his epistle: “It is not permitted in any situation whatsoever for a service or liturgy to be performed for him (namely, the one who commits suicide)” [PG 99, 1477B].

Church Councils Suicide cropped

Interestingly, though homosexual rape and pedophilia were quite predominant in the early days of the Church (both within and without of Christianity), the Fathers seem to only accept women virgin-martyrs. There is no mention of “economia” when it comes to male on male rape. It should be noted that in some medieval non-Christian cultures, a common practise of male victors in a raid or war was to rape (sometimes gang-rape) the male captors to shame and humiliate them. This practise continues today throughout the world both in war and prison systems.

Also, the early Fathers don’t talk much about clergymen hiding behind their rank to sexually abuse others (whether heterosexual, homosexual or pedophilia). This trend which existed in the early Orthodox Church is today quite predominant worldwide. Perhaps this silence is because St. Constantine the Great set the precedent of protecting them when he stated at the First Ecumenical Council: “If I would see with my own eyes a bishop, a priest or a monk in a sinful act, I would cover him with my cloak, so that no one would ever see his sin.”



St. Ambrose of Milan (4th c.): Though St. Ambrose disapproved of suicide in general, he embraced the idea that women who committed suicide to protect their virginity received the martyr’s crown. St. Ambrose ends his ascetical treatise On Virgins by explaining to his sister that suicide is preferable to losing one’s virginity. He tells his sister that she can be confident suicide is permissible when protecting chastity because the Church has examples of martyrs who did that very thing. He then proceeds to tell the story of a teenager named Pelagia who lived in Antioch. She threw herself off a building to avoid lecherous pursuers. St. Ambrose even has her rationalizing her plans in his retelling. Ambrose’s Pelagia says, “God is not offended by the remedy [avoiding rape], and faith mitigates the misdeed [of suicide].” Though still a “misdeed,” St. Ambrose clearly views it as the lesser of two evils when a woman’s virginity is at stake.


Eusebius, Bishop of Caesarea, Church Historian (4th c.): In his Ecclesiastical History, Eusebius writes about the abominable treatment of female Christians formed a feature of the persecutions both of Maximian and Maximin, who were alike monsters of licentiousness. Eusebius wrote about the suicides of St. Domnina and Her Two Daughters and evidently approved of these women’s suicide. [Book VIII, Chapter 12]


St John Chrysostom

St. John Chrysostom (4th-5th c.): St. John Chrysostom’s stance regarding suicide and martyrdom is relatively close to St. Ambrose’s. John condemns suicide, believing it to be against God’s will, and claims that real martyrs do not commit suicide. Even though they do not kill themselves, John believed they must face death willingly. However, like St. Ambrose, Chrysostom accepts suicide for women who are attempting to protect their purity.

St. John Chrysostom, like many of his contemporaries, highly prized virginity, and when he considered the importance of sexual purity, St. John rationalized behaviors that would otherwise be condemnable. Specifically, John advocated suicide for women when necessary to protect their chastity. In his sermon on Julian, suicide is a defeat, though John probably had men in mind while preaching that sermon. In his sermon on the Virgin-Martyr Pelagia, suicide is victory over the enemies of God and over the Devil himself.


St. Jerome (4th-5th c.): The early Church Father St Jerome categorically stated that Christ would not receive the soul of one who commits suicide. [Saint Jerome, Letters 39:3]. However, St Jerome makes an interesting exception to their otherwise absolute and inclusive condemnation: those who commit suicide in order to preserve their chastity.



St. Augustine of Hippo (5th c.): This, then, is our position, and it seems sufficiently lucid.  We maintain that when a woman is violated while her soul admits no consent to the iniquity, but remains inviolably chaste, the sin is not hers, but his who violates her. (Of Lucretia, Who Put an End to Her Life Because of the Outrage Done Her, City of God Chapter 19).



This list is just a brief sample and by no means complete. One can find numerous examples from the first few centuries of the Orthodox Church in the Synaxarion.

St. Agathonike (165 or 251 AD): St. Agathonike did not commit suicide to preserve her virginity, but is in the ranks of “voluntary martyr.” During the reign of Marcus Aurelius, Agathonike became so excited while watching Carpus and Papylus die martyrs’ deaths that she believed she should join them on the pyre. The crowd tried to dissuade her after she announced her intentions, reminding her that her son needed her. She replied that God would take care of him, at which point she disrobed and threw herself on the fire. In the Latin recension of the text, however, Agathonike is arrested with the other two martyrs, which leads Musurillo to suggest, “The Latin redactor was attempting to colour the facts for a later age.” [See: Martyrdom of Carpus, Papylus, and Agothonike 44].

She is celebrated in the Greek Church on October 13th


St. Apollonia (2nd century): St. Apollonia also did not commit suicide to preserve her virginity but did so after being tortured. Dionysius, Bishop of Alexandria (247–265), relates the sufferings of his people in a letter addressed to Fabius, Bishop of Antioch, of which long extracts have been preserved in Eusebius’ Ecclesiastical History: “At that time Apollonia, parthénos presbytis (mostly likely meaning a deaconess) was held in high esteem. These men seized her also and by repeated blows broke all her teeth. They then erected outside the city gates a pile of fagots and threatened to burn her alive if she refused to repeat after them impious words (either a blasphemy against Christ, or an invocation of the heathen gods). Given, at her own request, a little freedom, she sprang quickly into the fire and was burned to death.” [6.41 (PG 20:605–607)]

She is celebrated in the Greek Church on February 9th.

St Apollonia

St. Pelagia of Antioch (late 3rd century): St. Pelagia was a Christian saint, virgin, and martyr who committed suicide during the Diocletian Persecution rather than be forced by Roman soldiers to offer a public sacrifice to the pagan gods. She was 15 years old.

She was home alone during the Diocletian Persecution when Roman soldiers arrived. She came out to meet them and, discovering they intended to compel her to participate in a pagan sacrifice, she received permission to change her clothes. She went to the roof of her house and threw herself into the sea. The patristic sources treat this as a sacred martyrdom rather than an ignoble suicide, usually with reference to the potential that she would have been dishonored by the soldiers.

She is celebrated in the Greek Church on October 8th.

Saint Pelagia of Antioch
Saint Pelagia of Antioch

Saints Domnina, Berenice, and Prosdoce (c. 310)

Saint Domnina and her daughters Berenice (Bernice, Veronica, Verine, Vernike) and Prosdoce are venerated as Christian martyrs by the Roman Catholic and Eastern Orthodox Churches.

Domnina was arrested by soldiers for her adherence to the Christian religion. Fearing that the soldiers would rape her and her daughters, they threw themselves into a river after they asked their guards for a chance to rest for a while or after the soldiers had become drunk with wine. All three women drowned.

The account of St. John Chrysostom tells a slightly different story: according to Chrysostom, Domnina, after jumping into the river, pulled her daughters in with her to prevent them from being raped. Chrysostom praised Domnina for her courage and Domnina’s daughters for their obedience.

She is celebrated in the Greek Church on October 4th.




Saint John Chrysostom delivered the following sermon about St. Pelagia, the Virgin Martyr:

“Even women now poke fun at death and girls mock passing away and quite young, unmarried virgins skip into the very stings of Hades and suffer no ill effects. All of these blessings we experience because of Christ, born of a virgin. For after those blessed contraction pains and utterly awe-inspiring birth the sinews of death were unstrung, the devil’s power was disabled and from then on became contemptible to not just men but also women, and not just women, but also girls….

“It’s for this reason that blessed Pelagia too ran to meet death with such great delight that she didn’t wait for the executioners’ hands nor did she go to court, but escaped their cruelty through the excess of her own enthusiasm. For while she was prepared for tortures and punishments and every kind of penalty, even so she was afraid that she would destroy the crown of her virginity. Indeed, that you might learn that she was afraid of the sexual predation of the unholy men, she got in first and snatched herself away in advance from the shameful violence. None of the [Christian] men ever attempted any such act at all. Instead they all filed into court and displayed their courage there. Yet women, by nature vulnerable to harm, conceived for themselves this manner of death. My point is that, were it possible both to preserve one’s virginity and attain martyrdom’s crown, she wouldn’t have refused to go to court. But since it was utterly inevitable that one of the two would be lost, she thought it a sign of extreme stupidity, when it was possible for her to attain each victory, to depart half crowned. For this reason she wasn’t willing to go to court or to become a spectacle for lecherous eyes, or to give opportunity for predatory eyes to revel in the sight of her own appearance and crudely insult that holy body. Instead she went from her chamber and the women’s quarters to a second chamber – heaven….

“Don’t simply pass over what happened, but consider how it’s likely that she was raised as a gentle girl, knowing nothing beyond her chamber, while soldiers were posted against her en masse, standing in front of the door, summoning her to court, dragging her into the marketplace on weighty sorts of grounds. There was no father inside, no mother present, no nurse, no female attendant, no neighbor, no female friend. Instead, she was left alone in the midst of those executioners. I mean, how isn’t it right that we be astonished and amazed that she had the strength to come out and answer those executioner soldiers, to open her mouth and utter a sound, just to look, stand, and breathe? Those actions weren’t attributable to human nature. For God’s influence introduced the majority. Most assuredly, at the time she didn’t just idly stand around, but displayed all her personal qualities – her enthusiasm, her resolve, her nobility, her willingness, her purpose, her eagerness, her bustling energy. But it was as a result of God’s help and heavenly good goodwill that all these qualities reached maturity….

“In addition to what’s been said, I marvel as well at how the soldiers granted her the favor, how the woman deceived the men, how they didn’t work out the deception. After all, one can’t say that no one effected anything of the sort. For many women, it seems, gave themselves up to a cliff or hurled themselves into the sea or drove a sword through their breast or fastened a noose. That time was full of numerous dramas of that kind. But God blinded the soldier’s hearts so that they wouldn’t openly see the deception. That’s why she flew up out of the middle of their nets….

“Lot’s of people who’ve tumbled from a high roof haven’t suffered any ill effect. Others, in turn, despite suffering permanent disability to some part of their body, have lived for a long time after the fall. But in the case of that blessed virgin God didn’t allow any of these options to happen. Instead, he ordered the body to release the soul immediately and received it on the grounds that it had struggled sufficiently and completed everything. For death wasn’t caused by the nature of the fall, but by God’s command. From that point the body wasn’t lying on a bed, but on the pavement. yet it wasn’t without honor as it lay on the pavement…For this reason, then, that virginal body purer than any gold lay on the pavement, on the street.” [St. John ChrysostomA homily on Pelagia, Virgin and Martyr, translated into English by Wendy Mayer, from the book Let Us Die That We May Live (pp. 148-161)]

Let Us Die

Saint John Chrysostom delivered a sermon about St. Domnina and her two daughters:

In St. John’s sermon probably preached in the 390s in Antioch, the story takes an interesting turn. The women do not just kill themselves; John suggests that the mother actually drowns her daughters. He preaches, “And so, the mother entered in the middle [of the river], restraining her daughters on either side.” Once in the river, John says, “That blessed woman [Domnina] … lowered them down into the waters, and in this way they drowned.” Domnina then drowns herself to claim her martyr’s crown. Astonishingly, in this sermon, the protection of virginity not only justifies self-murder, but also John uses it justify murdering one’s children. He actually esteems Domnina because he claims that drowning her own daughters was an exceedingly painful form of martyrdom. Domnina could have suffered at the court, but then she would not have been able to ensure her daughters’ purity.

She endured far greater tortures in the river [than she would have at court]. My point, as I started saying, is that it was truly far more cruel and painful than to see flesh scourged, to drown her own innards, I mean her daughters, by her own hand, and to see them suffocating, and it required far greater philosophy than to endure tortures for her to have the capacity to restrain her children’s right hands and to drag them along with her into the river’s currents. For it was not the same in terms of pain to see [her daughters] suffering badly at the hands of others and to herself act as death’s servant, to herself promote their end, to herself stand against her daughters in place of an executioner.

John imputes extraordinary suffering to a mother who kills her young daughters, and he not only excuses the killing but also lauds it because she did it to preserve virginity. John commends these martyrs as prime examples for mothers and daughters in his congregation. No doubt, this sermon worried not a few daughters whose reputations were at risk. [see, The Cult of the Saints: St. John Chrysostom, ]

Cult of saints

Saint Ambrose replies to Marcellina, who had asked what should be thought of those who to escape violence killed themselves, by narrating the history of Pelagia, a virgin, with her mother and sister…

  1. As I am drawing near the close of my address, you make a good suggestion, holy sister, that I should touch upon what we ought to think of the merits of those who have cast themselves down from a height, or have drowned themselves in a river, lest they should fall into the hands of persecutors, seeing that holy Scripture forbids a Christian to lay hands on himself. And indeed as regards virgins placed in the necessity of preserving their purity, we have a plain answer, seeing that there exists an instance of martyrdom.
  2. Saint Pelagia lived formerly at Antioch, being about fifteen years old, a sister of virgins, and a virgin herself. She shut herself up at home at the first sound of persecution, seeing herself surrounded by those who would rob her of her faith and purity, in the absence of her mother and sisters, without any defence, but all the more filled with God. What are we to do, unless, says she to herself, you, a captive of virginity, takest thought? I both wish and fear to die, for I meet not death but seek it. Let us die if we are allowed, or if they will not allow it, still let us die. God is not offended by a remedy against evil, and faith permits the act. In truth, if we think of the real meaning of the word, how can what is voluntary be violence? It is rather violence to wish to die and not to be able. And we do not fear any difficulty. For who is there who wishes to die and is not able to do so, when there are so many easy ways to death? For I can now rush upon the sacrilegious altars and overthrow them, and quench with my blood the kindled fires. I am not afraid that my right hand may fail to deliver the blow, or that my breast may shrink from the pain. I shall leave no sin to my flesh. I fear not that a sword will be wanting. I can die by my own weapons, I can die without the help of an executioner, in my mother’s bosom.
  3. She is said to have adorned her head, and to have put on a bridal dress, so that one would say that she was going to a bridegroom, not to death. But when the hateful persecutors saw that they had lost the prey of her chastity, they began to seek her mother and sisters. But they, by a spiritual flight, already held the field of chastity, when, as on the one side, persecutors suddenly threatened them, and on the other, escape was shut off by an impetuous river, they said, what do we fear? See the water, what hinders us from being baptized? And this is the baptism whereby sins are forgiven, and kingdoms are sought. This is a baptism after which no one sins. Let the water receive us, which is wont to regenerate. Let the water receive us, which makes virgins. Let the water receive us, which opens heaven, protects the weak, hides death, makes martyrs. We pray You, God, Creator of all things, let not the water scatter our bodies, deprived of the breath of life; let not death separate our obsequies, whose lives affection has always conjoined; but let our constancy be one, our death one, and our burial also be one.
  4. Having said these words, and having slightly girded up the bosom of their dress, to veil their modesty without impeding their steps, joining hands as though to lead a dance, they went forward to the middle of the river bed, directing their steps to where the stream was more violent, and the depth more abrupt. No one drew back, no one ceased to go on, no one tried where to place her steps, they were anxious only when they felt the ground, grieved when the water was shallow, and glad when it was deep. One could see the pious mother tightening her grasp, rejoicing in her pledges, afraid of a fall lest even the stream should carry off her daughters from her. These victims, O Christ, said she, do I offer as leaders of chastity, guides on my journey, and companions of my sufferings. [On Virgins, Book III, Chapter 7:32-35]

Ambrose virgins.jpg


St. Augustine of Hippo, That Christians Have No Authority for Committing Suicide in Any Circumstances Whatever, City of God Chapter 20.

It is not without significance, that in no passage of the holy canonical books there can be found either divine precept or permission to take away our own life, whether for the sake of entering on the enjoyment of immortality, or of shunning, or ridding ourselves of anything whatever.  Nay, the law, rightly interpreted, even prohibits suicide, where it says, “Thou shalt not kill.”  This is proved especially by the omission of the words “thy neighbor,” which are inserted when false witness is forbidden:  “Thou shalt not bear false witness against thy neighbor.”  Nor yet should any one on this account suppose he has not broken this commandment if he has borne false witness only against himself.  For the love of our neighbor is regulated by the love of ourselves, as it is written, “Thou shalt love thy neighbor as thyself.”  If, then, he who makes false statements about himself is not less guilty of bearing false witness than if he had made them to the injury of his neighbor; although in the commandment prohibiting false witness only his neighbor is mentioned, and persons taking no pains to understand it might suppose that a man was allowed to be a false witness to his own hurt; how much greater reason have we to understand that a man may not kill himself, since in the commandment, “Thou shalt not kill,” there is no limitation added nor any exception made in favor of any one, and least of all in favor of him on whom the command is laid!  And so some attempt to extend this command even to beasts and cattle, as if it forbade us to take life from any creature.  But if so, why not extend it also to the plants, and all that is rooted in and nourished by the earth?  For though this class of creatures have no sensation, yet they also are said to live, and consequently they can die; and therefore, if violence be done them, can be killed.  So, too, the apostle, when speaking of the seeds of such things as these, says, “That which thou sowest is not quickened except it die;” and in the Psalm it is said, “He killed their vines with hail.”  Must we therefore reckon it a breaking of this commandment, “Thou shalt not kill,” to pull a flower?  Are we thus insanely to countenance the foolish error of the Manichæans?  Putting aside, then, these ravings, if, when we say, Thou shalt not kill, we do not understand this of the plants, since they have no sensation, nor of the irrational animals that fly, swim, walk, or creep, since they are dissociated from us by their want of reason, and are therefore by the just appointment of the Creator subjected to us to kill or keep alive for our own uses; if so, then it remains that we understand that commandment simply of man.  The commandment is, “Thou shall not kill man;” therefore neither another nor yourself, for he who kills himself still kills nothing else than man.


St. Augustine of Hippo, Of Suicide Committed Through Fear of Punishment or Dishonor, City of God Chapter, Book I, Chapter 17.

And consequently, even if some of these virgins killed themselves to avoid such disgrace, who that has any human feeling would refuse to forgive them?  And as for those who would not put an end to their lives, lest they might seem to escape the crime of another by a sin of their own, he who lays this to their charge as a great wickedness is himself not guiltless of the fault of folly.  For if it is not lawful to take the law into our own hands, and slay even a guilty person, whose death no public sentence has warranted, then certainly he who kills himself is a homicide, and so much the guiltier of his own death, as he was more innocent of that offence for which he doomed himself to die.  Do we justly execrate the deed of Judas, and does truth itself pronounce that by hanging himself he rather aggravated than expiated the guilt of that most iniquitous betrayal, since, by despairing of God’s mercy in his sorrow that wrought death, he left to himself no place for a healing penitence?  How much more ought he to abstain from laying violent hands on himself who has done nothing worthy of such a punishment!  For Judas, when he killed himself, killed a wicked man; but he passed from this life chargeable not only with the death of Christ, but with his own:  for though he killed himself on account of his crime, his killing himself was another crime.  Why, then, should a man who has done no ill do ill to himself, and by killing himself kill the innocent to escape another’s guilty act, and perpetrate upon himself a sin of his own, that the sin of another may not be perpetrated on him?

The suicide of judas
The Suicide of Judas, ca. 1492. Fresco at Chapel of Notre Dame des Fontaine, France.



The 8 Cases of Suicide in the Bible (Alexander Murray)

NOTE: Although the early Church Fathers allowed the taking of one’s life under certain circumstances, later Church Fathers believed that suicide was not allowed in any circumstance.

St. Clement of Alexandria (3rd century) taught that Christians must not engage in suicide martyrdom because, according to Clement, any man who kills a godly person sins against God, even if that man is himself. Moreover, Christians ought to flee whenever possible because voluntarily presenting themselves for judgment makes them partially guilty of their own deaths. (Stromata, Book 4:4-11)

St. Ambrose of Milan praises St. Pelagia of Antioch for killing herself to preserve her chastity.
St. Ambrose of Milan praises St. Pelagia of Antioch for killing herself to preserve her chastity.

The early Church Father St Jerome categorically stated that Christ would not receive the soul of one who commits suicide. [Saint Jerome, Letters 39:3]. Eusebius, St. John Chrysostom, St. Ambrose and St. Jerome make however an interesting exception to their otherwise absolute and inclusive condemnation: those who commit suicide in order to preserve their chastity.

St. John Chrysostom praises St. Domina for killing her own two daughters, and then herself, in order to preserve their chastity.
St. John Chrysostom praises St. Domina for killing her own two daughters, and then herself, in order to preserve their chastity.

Other Church Fathers believed that suicide was not allowed in any circumstance. St. Augustine of Hippo believed that anyone who took his or her own life was beyond repentance because that person had violated the sixth commandment which clearly states “You shall not murder” (Exodus 20:13). After the 4th century AD, the Church no longer accepted women who committed suicide in order to preserve their chastity into the ranks of Saints. Men and women now had to have patience and endure (with thanksgiving and prayer, no doubt) the rapes and other forms of sexual abuse and humiliation (whether singular or gang rapes) that they endured at the hands of their captors or abusers.

Contrary to earlier Patristic teachings, St. Augustine rejected all forms of suicide, even to preserve one's chastity.
Contrary to earlier Patristic teachings, St. Augustine rejected all forms of suicide, even to preserve one’s chastity.

The Orthodox Church commemorates the Feast Day of saints who committed suicide: Agathonike (October 13), St. Apollonia of Alexandria (February 9), St. Euplus of Catania (August 11), Sts. Domnina, with her two daughters Bernike and Prosdoke (October 4), St. Pelagia of Antioch (June 9), St. Lucretia (November 22), etc.

As well, Church Fathers like St. John Chrysostom and St. Ambrose praise many of these Virgin-Martyr saints for committing suicide—and in the case of St. Domina who threw her two daughters into the river—murder to preserve their chastity.


On Despair and Suicide (Speech of St. Nektarios of Pentapolis)

NOTE: The following article is a pamphlet put together by Archimandrite Parthenios, Abbot of the Holy Monastery Odegetrissa:


On November 20, 1893, St. Nektarios of Pentapolis made a speech in Lamia concerning the serious matter of despair and suicide. Today, because this social problem has alarming dimensions, the enlightened word of the God-bearing Father and contemporary Saint of our Church is very useful and timely.

Despair is a terrible evil and incurable passion that wears the soul of man. It destroys everything healthy in him, delivers him to destruction and pushes him to put an end to his life. The desperate man, though living, is dead because he lost the link with the world and all life’s pleasantries. He thinks that a faster death, rather than a natural one, will remove him from the sorrows and difficulties of life and results in suicide.

The Cause of Suicide

Despair is the cause of suicide and not insanity. Self-murderers are not insane but desperate. The lunatic attempts, even after his rescue, to be killed without premeditating how to die. He never chooses the weapon or means of suicide and is unconsciously driven in its practice because of his insanity.

The suicide of Judas (detail).
The suicide of Judas (detail).

The lunatic is not asking for death, but death is a consequence desperation act. Suicidal men who are saved are healed; they did not attempt another suicide and repented. Therefore, those who are suicidal do not suffer pathologically, but morally. Despair is ethical misconduct. They ignored ethical therapy and when the panic of despair captured them, they committed suicide. Consequently, they are responsible for their actions and have a great unforgivable sin (unless they repent). The medical diagnosis characterizing all those who commit suicide as mentally ill is incorrect.

The Cause of Despair

The causes of despair are many. The main cause is a moral disease of the sufferer. We can divide the morally sick into three categories:

  1. The atheists,
  2. Those weak in faith, and
  3. Those who are overcome by their feelings and faintheartedness.

Execution of Martyrs at Butovo Firing-Range

The Atheists

Those who belong to the first class enjoy their lives as something good, as there are no difficulties. They have a purely materialistic mentality, living without God. Thus, with the first difficulties of life or change of its terms, they are driven to despair and suicide. Of course, this is not a result of insanity. Those who are fully surrendered to the pleasures and goods of this world are also included in the same category. The philosophy of their life resembles that of the Epicureans. But they finally end after a scalable path to suicide, since the constant pleasures of this world bring saturation, saturation brings disgust, disgust brings aversion, aversion brings boredom, boredom brings sadness, sadness brings pain and pain leads to despair, so they put an end to their lives. A group of people in the same category, also occupied by a materialistic mindset, seek to acquire as many goods as possible, considering them as their means of bliss.   They ignored the real and true bliss, God, and worshipping unstable and fluid elements, they failed and were disappointed.

Monastics who leave Geronda Ephraim are compared to Judas who betrayed Christ.

The Weak in Faith

Those people originally living in accordance with divine and human laws, but with the first major difficulties of life, they lose their courage and hope, i.e. God, belong in the second class. Those who lose their courage are deprived of endurance, self-denial and sacrifice on the battlefield—which in this case is nothing more than life itself with its difficulties.

Those who don’t hope in God are insolent, because imprudence is parody of courage. Indeed, it even results in cowardice and pusillanimity. St. Nektarios likens all of them with ripsaspides of warfare and characterizes them as cowards. Namely, suicide is not an act of courage, but cowardice and audacity. It lacks moral courage, since self-murderers do not calculate anything and anyone resulting in their desperate act. Also, this class of suicides do not have the elements of madmen. They are morally sick, who could be treated, if they sought help from God. They are Christians in name, not in essence, since they are ignorant of the grace of Jesus Christ that overshadows all believers, the dispassion and fortitude that should show the Christian about the difficulties of this life. Eventually all who belong to this class, while they start with a superficial faith, they end in infidelity with despair as a consequence.


The Emotionally Ill

Finally, all those who kill themselves frustrated by human love—whether pure (such as juvenile sex) or illegal and despicable—are classified in the third group.

The heartbreak of young people occurs because of grief for the loss of their erotic idol. This brings misery and the inexperience in life matters gives enormous proportions to the fact, which for frustrated youth are considered most evil. But this is a deplorable delusion, ignorance of the future life, lack of religious education and Christian spirit. In this case, those accountable are not the youth but rather their parents, who didn’t take care to bring up their children properly. Indeed, at the critical moment that their children needed care and advice, they showed negligence or urged them into a disastrous relationship.

Archangel Michael Cemetery at St. Nektarios Monastery (NY)
Archangel Michael Cemetery at St. Nektarios Monastery (NY)

The second group in this category (adulterers, etc.) have moral corruption as the cause. They are considered violators of God’s commandments; they destroyed their family and the sanctity of marriage before they were brought to suicide. Those who commit suicide because their pride was insulted and those who were not able to overcome unforeseen difficult or unpleasant moments that occurred in their lives are placed in the same category. The common cause is the lack of Christian education and a Christian lifestyle, resulting in a moral slump, misuse of freedom and foreigner mimicry. If they had a Christian education they would not have committed suicide, but would have repented and corrected their lives.

Cemetery at Holy Protection Monastery (PA)
Cemetery at Holy Protection Monastery (PA)

Treatment of Suicides by the Church

Today the issue of the funeral services for suicides is considered timely, since there are cases where priests refuse to bury them, thus creating tension between relatives of the self-murderer and the Church. Of course, most of the time funeral services for suicides occur according to dispensation. However, which of the two should happen? Following the steadfast tradition of the Church, St. Nektarios prohibits funerals for suicides, highlighting two important arguments. Firstly, the Church has prohibitions on funerals for suicides. Also, there is no special service for suicides. Indeed, in relation to the funeral service, St. Nektarios correctly observes that when the usual service is read for self-murderers, then the Church sins. It sins because it lies towards God, before the people, and indeed inside the holy Church.

Cemetery at St. Anthony's Monastery (AZ)
Cemetery at St. Anthony’s Monastery (AZ)

False, because the service assumes that the dead man was a faithful man and servant of God and that God “called His servant” to the next life. But none of these things are true. He who commits suicide is neither a believer nor a servant of God because the act of suicide proves unbelief and disobedience to God’s will. Also, God did not call the self-murderer, but rather he ended his own life, whose ruler is only God who gave it. The Church has a mandate to bury those falling asleep in the Lord and the funeral service is only for them, which is in accordance with the life and faith of the one buried. Saint Nektarios observes that whoever believe that the Church should not be so harsh and strict towards the living relatives but rather give them consolation and relief by burying self-murderers are ignorant of the serious reasons why the Church refuses—even though the Church always has love and consolation and is grieved about the evil that occurs to one of her children. This evil binds the Church and prevents her from every action.

Funeral at Holy Archangels Monastery (TX)
Funeral at Holy Archangels Monastery (TX)

This attitude of the Church is not vindictive and punitive, but benevolent and healing for the dead and their living relatives. This should explain the Church in its pastoral care for all. The soul of the dead person and of the living relatives are burdened bear via funerals for suicides. This is because the sanctuary of the Church is profaned with the lies told before God (“Blessed are those whose way is blameless, who walk in the way of the Lord,” etc.).

Hieromonk Joseph (SA) performing the funeral service at Holy Archangels Monastery (TX)
Hieromonk Joseph (SA) performing the funeral service at Holy Archangels Monastery (TX)

Conclusions Suicide is a heinous act and it is condemned by the Church and society. It is an act that leads to demoralization and despair and an act of cowardice, selfishness and diseased egotism.


According to the high principles of the Gospel, the Church is not permitted to bury suicides. And his relatives should not seek to make funeral and memorial services with fraud (medical certificate that the self-murderer was insane – psychopath). And of course, doctors should not become accomplices in the fraud.


The Church, with her strict attitude towards suicide—which the relatives of the deceased must understand and accept—stigmatizes the practice and prevents others who probably be pushed into the act like a preventive medicine. But it mainly protects the sanctity of the sacraments and the sacred space of the Temple from the profanation that burdens the soul of the dead and of the living relatives and priests.


The radical therapy of evil will come with Christian education and a spiritual life within the framework of the Gospel’s teaching. Our participation in the sacramental life of the Church and our spiritual struggle is the best treatment of moral corruption and the despair that leads to the horrific act of suicide.

Cemetery at Panagia Vlahernon Monastery (FL)
Cemetery at Panagia Vlahernon Monastery (FL)


  1. Αγίου Νεκταρίου Πενταπόλεως, Περί αληθούς και ψευδούς µορφώσεως, Γραφή περί αυτοκτονίας, Εκδόσεις Ν. Παναγόπουλος, Αθήνα 1989.
  2. Κ. Σταυριανός : «Απόγνωση και Αυτοκτονία» θέσεις και απόψεις του Αγίου Νεκταρίου, Περιοδικό Θεοδροµία, Τεύχος 5, έτος 2000.


 NOTE: In the early Church, the Fathers had conflicting views on suicide. Though the majority of Fathers did not accept any excuse for suicide, some Fathers did accept female suicides if it was to prevent rape.

St. Ambrose of Milan taught that “suicide is preferable to losing one’s virginity.” (De virginibus 7:32).

St. John Chrysostom also accepted suicide for women who were attempting to protect their purity. In his sermon on the Virgin-Martyr Pelagia–who threw herself off a roof–suicide is victory over the enemies of God and the Devil himself. In the case of Sts. Domnina and her two daughters, Bernike and Prosdoke, St. John excuses and lauds St. Domnina for killing her two daughters to preserve their purity. St. Domnina then committed suicide.

For more information on the conflicting views of early Orthodox Patristics on suicide, as well as the contemporary view, see:

SCOBA Pastoral Letter on Suicide (2007)

The following “Pastoral Letter on Suicide” was adopted by the Standing Conference of the Canonical Orthodox Bishops in the Americas (SCOBA) at their May 23, 2007 Session held at St. Vladimir’s Seminary in Crestwood, NY. The document was prepared by the SCOBA Social and Moral Issues Commission (SMIC). The Letter offers pastoral perspectives, consistent with both Holy Tradition and current medical and psychological thought, to clergy and laity alike on this human tragedy and how best to minister to those whose lives are so deeply affected by it.


The SCOBA Spring 2007 Session at Crestwood, NY.
The SCOBA Spring 2007 Session at Crestwood, NY.

A Pastoral Letter on Suicide

The tragedy of suicide has been a part of the human story from very early on, and it continues to affect the lives of our faithful today. As Hierarchs of the Standing Conference of Canonical Orthodox Bishops in the Americas, we are asked frequently to clarify the Church’s teachings on this critical issue. Our desire is to offer a pastoral perspective that is consistent with both the Tradition of our Orthodox Church and our improved understanding of the medical and psychological factors that might lead one to take his or her life.

The Sacredness of Life

As Orthodox Christians, we believe that life is a gift from God. The All-Holy and Life-Giving Trinity created all things and granted life to all living creatures. Out of His love, God made us, human beings, in His own divine image and likeness, entrusting us as stewards – not owners – of our lives, blessing us with the capacity of freedom, and calling us to a life of loving communion.

The exile of Adam & Eve.
The exile of Adam & Eve.

Our ancestors’ original rebellion against God was a misuse of freedom, which ushered in the reality of both spiritual and physical death. Throughout history, God has acted to redeem the fallen race and to restore the communion and life that had been forfeited. Indeed, our Lord Jesus Christ identifies the very purpose of His incarnation and earthly mission with the gift of life, proclaiming, “I came that they may have life, and have it abundantly” (John 10:10). Remaining faithful to the Lord’s Gospel, the Orthodox Church invites all human beings to enter into the living body of Christ, to be sustained through the life-giving sacraments, and to preserve and perpetuate both spiritual and physical life.

Suicide and the Orthodox Tradition

While a precise and unproblematic definition of “suicide” is difficult to articulate, we can say that the type of suicide here being addressed pertains to the intentional causing of one’s own physical death through a decisive act. Understood in this way, suicide is regarded generally within the Orthodox Tradition as a rejection of God’s gift of physical life, a failure of stewardship, an act of despair, and a transgression of the sixth commandment, “You shall not kill” (Exodus 20:13).

Historically, the Church was called upon to address the issue of suicide from the outset. When the Gospel was first being preached, philosophical and religious teachings prevalent in the Greco-Roman world tended both to disparage the body and to endorse suicide in circumstances of severe hardship. The Cynics, Epicureans, Stoics, and Gnostics, for example, all endorsed voluntary death for reasons consistent with each group’s broader ethical vision. The early Church’s condemnation of suicide, as reflected in the teachings of Clement of Alexandria, Lactantius, St. Augustine, and others, thus served to affirm teachings that were sharply different from those of the broader culture: the sacredness of each human being, the holiness of our bodies as Temples of the Holy Spirit, and, especially, the call for each one of us to maintain faith and hope even in the midst of extreme adversity. While these core teachings provided a Christian witness to Greco-Roman society, they also were reflected internally, to the members of the early Church, through the condemnation of all attempts to hasten one’s entry into the Kingdom by self-sought martyrdom. Clement of Alexandria, for instance, condemns both suicide and such martyrdom when he writes, “He who presents himself before the judgment-seat becomes guilty of his own death. And such is also the case with him who does not avoid persecution, but out of daring presents himself for capture. Such a person…becomes an accomplice in the crime of the persecutor” (Stromateis 4.77.1).

Notwithstanding its strong general stance against the moral permissibility of suicide, the Church, historically, has offered a balanced teaching on this issue. On the one hand, the Church has maintained the normative position described above by condemning acts of suicide and by declining to offer a funeral service and burial to suicide victims. This dimension of the Church’s teaching has underscored the sacredness of physical life and the responsibility of human beings to express proper self-love, gratitude, and hope. This dimension has also served as an intended deterrent for those suffering suicidal thoughts.

On the other hand, in her wisdom, the Church has acknowledged the complex etiology and emotionally charged character of a suicide. The corruption of human nature, brought about by the ancestral sin, carried profound implications for both the spiritual and physical dimensions of the human person. While human freedom was not annihilated in the fall, both spiritual factors, like acedia (spiritual torpor), and physical factors, like depression, can severely compromise a person’s ability to reason clearly and act freely. In regard to suicide, the Church has taken very seriously such spiritual and physical factors, and has responded pastorally by offering a funeral service and burial to suicide victims whose capacities for judgment and action were found to be significantly diminished. Thus, Canon 14 of Timothy of Alexandria states that liturgical services should be offered, “if a man having no control of himself lays violent hands on himself or hurls himself to destruction.” And the patristic interpretation of this teaching states that services should be offered when a suicide victim “is not of sound mind, whether it be as a result of a demon or of an ailment of some sort.” Question XIV of the 18 Canons of Timothy, Archbishop of Alexandria. Pedalion, p. 898

Suicide and Science

Through advances in science we now have a better understanding of the relationship between suicide and depression, as well as a more accurate account of the causes of depression. Depression is an illness caused by both medical and psychological factors. It is characterized by feelings of marked worthlessness and hopelessness and is often accompanied by physical changes such as loss of appetite, weight loss, or in some cases, weight gain. Both insomnia and hypersomnia are common symptoms.

Current medical knowledge helps us to understand that all depressions are multi-factorial. Genetic, hormonal, neurochemical, environmental, and psychological contributions can combine to create a depressive picture. Furthermore, depression can present as the only expression of an underlying physical illness such as occult cancers, thyroid dysfunction, and drug reactions.

Sometimes depressions are very severe and psychotic in nature. These can be accompanied by delusions, hallucinations, and an altered sense of reality. In most instances, the depressed person is less impaired. Nonetheless, in all cases, depression is determined by non-rational psychological and physical internal events. Even an apparently rational and clear-thinking person may have his or her outlook and choices strongly affected by those non-rational internal events.

Pastoral Recommendation

In light of the above theological and scientific reflections, it is clear that the articulation of a proper Orthodox response to the tragedy of suicide is both acutely needed and particularly challenging. We are sensitive to the difficulty of maintaining a balance between the call of every human person to responsible stewardship of his or her physical life and the call of the Church to consider how advances in medical knowledge impact Orthodox pastoral ministry. Conscious of this need for discernment, we offer the following guidelines for ministering in the wake of a suicide.

First, we must remain mindful that the primary focus of the Church and its pastoral ministry in cases where a suicide has taken place is on the living, the family and friends of the deceased. We should maintain a certain humility while remembering that the state of the suicide victim is and must remain in the hands of God. Those left behind carry a great burden – of hurt, guilt, and often shame – with the realization that their loved one has taken his or her own life. They look to the Church and, especially, to the parish family, for strength and hope regarding the deceased, and for the support and love they themselves so urgently need. In addition to their personal pastoral response, clergy should direct grief-stricken family and friends to crisis counseling resources in the area, which can complement the healing ministry of the Church.

Second, as we have studied this issue, it has become clear to us that far more cases of suicide than have previously been recognized involve spiritual and/or physiological factors that significantly compromise a person’s rationality and freedom. While not removing moral culpability from all suicide cases or changing our general stance against suicide’s moral permissibility, we affirm the deep relationship between physical and spiritual factors in human agency and we acknowledge that, in most instances, the complex web of causes contributing to a suicide lies beyond our full understanding.

Finally, because of the complexity of suicide, both in terms of determining causes and in terms of ministering to those most affected, the parish priest should always consult with his diocesan hierarch in order to discern the proper course of action, the general pastoral recommendation being that a church burial and memorial services could be granted unless there were an absence of significantly diminished capacities.


In his beautiful description of the Church as the “body of Christ,” St. Paul writes, “If one member suffers, all suffer together; if one member is honored, all rejoice together.” (1 Cor 12:26) The suicide of an Orthodox Christian is a tragedy that is suffered by the entire Church. As hierarchs of the Orthodox Church, we are acutely mindful of the need to maintain a perspective on suicide that is consistent with our identity and mission as the unified body of Christ. We believe that the perspective outlined in this statement, which reflects our common mind, accomplishes this purpose by drawing from our Holy Tradition as well as our deepened understanding of suicide’s causes.

We extend our fervent prayers for the victims of suicide and for all whose lives and faith have been shaken by the suicide of a loved one. Furthermore, as Orthodox bishops and members of SCOBA, we affirm that we will work together rigorously in order both to prevent suicides from occurring and to provide a unified pastoral response when they do, one characterized by the faith, hope, and love made possible by God, in Whom “we live and move and have our being.” (Acts 17:28)

The suicide of Judas (detail).
The suicide of Judas (detail).

Sleep disturbances and suicide risk: A review of the literature (Rebecca A. Bernert and Thomas E. Joiner)

A growing body of research indicates that sleep disturbances are associated with suicidal ideation and behaviors. This article (1) provides a critical review of the extant literature on sleep and suicidality and (2) addresses shared underlying neurobiological factors, biological and social zeitgebers, treatment implications, and future directions for research. Findings indicate that suicidal ideation and behaviors are closely associated with sleep complaints, and in some cases, this association exists above and beyond depression. Several cross-sectional investigations indicate a unique association between nightmares and suicidal ideation, whereas the relationship between insomnia and suicidality requires further study. Underlying neurobiological factors may, in part, account for the relationship between sleep and suicide. Serotonergic neurotransmission appears to play a critical role in both sleep and suicide. Finally, it remains unclear whether or not sleep-oriented interventions may reduce risk for suicidal behaviors. Unlike other suicide risk factors, sleep complaints may be particularly amenable to treatment. As a warning sign, disturbances in sleep may thus be especially useful to research and may serve as an important clinical target for future suicide intervention efforts.
Keywords: suicidality, sleep, nightmares, suicide risk factors

The side effects from missing sleep.
The side effects from missing sleep.

Suicide is a leading cause of death. Approximately 30,000 people die by suicide each year in the United States alone (Murphy 2000). Suicide kills more Americans annually than homicides, and although rates vary substantially by age, suicide ranks as the 11th most common cause of death. Attempted suicides are believed to far exceed this number. It is estimated that 10 to 25 nonlethal suicide attempts occur for every completed suicide (Maris 2002). Moreover, such attempts are responsible for more than 400,000 emergency room visits annually (Doshi et al 2005). Taken together, suicidal behaviors represent a complex, yet potentially preventable public health problem, with far-reaching personal and societal consequences. Improvements in the identification of risk factors for suicidal behaviors thus ultimately enhance our ability to intervene and prevent death by suicide.

The Dangers of Sleep Deprivation.
The Dangers of Sleep Deprivation.

Acute and chronic suicide risk is associated with social, psychological, and biological variables (Lewinsohn et al 1996; Mann et al 2001; Rowe et al 2006), and such factors are often further divided into precipitating and predisposing causes (Mann 2002). One growing area of research includes the study of sleep complaints and suicidality. Increasing evidence suggests that disturbances in sleep are associated with an elevated risk for suicidal behaviors. Both sleep disorders and general sleep complaints appear to be linked to greater levels of suicidal ideation and depression, as well as both attempted and completed suicide (Krakow et al 2000; Agargun et al 1997a; Fawcett et al 1990). In consideration of these findings, sleep problems and more specifically, significant changes in sleep, are now listed among the top 10 warning signs of suicide from the Substance Abuse and Mental Health Services Administration (SAMSHA) (National Mental Health Information Center 2005).

Interestingly, this is the mindset that ascetical texts encourage a monk to acquire, though it is labelled differently, "lowliness of mind," "self-reproach," "remembrance of death,"  "dispassion," etc.
Interestingly, this is the mindset that ascetical texts encourage a monk to acquire, though it is labelled differently, “lowliness of mind,” “self-reproach,” “remembrance of death,” “mourning,” “dispassion,” etc.

Clinical and epidemiological investigations of self-reported sleep disturbances and suicidal behaviors
Poor sleep quality, insomnia, and hypersomnia

Though sleeping schedules differ from monastery to monastery, it averages from 4-5 hrs sleep before vigil (if one actually can fall asleep right away). And 2-3 hours after vigil.
Though sleeping schedules differ from monastery to monastery, it averages from 4-5 hrs sleep before vigil (if one actually can fall asleep right away). And 2-3 hours after vigil.

Fawcett and colleagues conducted one of the first studies to prospectively examine sleep, depression, and suicide (Fawcett et al 1990). In a group of depressed patients, symptoms of global insomnia were more severe among those who completed suicide within a 13-month period. This finding suggested that insomnia may be considered a clinical indicator of acute suicidal risk, perhaps particularly when it appears in the midst of a depressive episode. Agargun et al (1997a) demonstrated a similar link between suicidality, depression, and sleep complaints. Depressed subjects suffering from either hypersomnia or insomnia showed significantly higher scores on measures of suicidality. In a separate study, these authors also examined self-reported sleep quality among depressed patients (Agargun et al 1997b). Subjective sleep quality was significantly more disturbed among suicidal versus nonsuicidal patients.

Types of Sleep Disorders.
Types of Sleep Disorders.

An association between poor sleep quality and completed suicide has been prospectively studied in several community samples of men and women. Among a large group of elderly participants, for example, poor self-reported sleep quality was linked to suicide within 10 years. Although depression showed the strongest link with suicide, poor sleep quality increased the risk for suicide by 34% (Turvey et al 2002). A recent investigation conducted in Japan demonstrated similar findings. Fujino et al (2005) showed that, among 13,259 middle-aged adults, only difficulty maintaining sleep at baseline, compared to other sleep disturbances (eg, difficulty initiating sleep, nonrestorative sleep), significantly predicted death by suicide 14 years later. In both of these studies, depression was not accounted for when examining the association between sleep and completed suicide. Such information would elucidate whether sleep disturbance stands alone as a risk factor for completed suicide or, conversely, whether such sleep complaints simply vary with increased depressive symptoms.

Suicide risk factors.
Suicide risk factors.

Similar to insomnia symptoms, nightmares are more common among suicidal versus nonsuicidal individuals with major depression. Research indicates that depressed patients with self-reported repetitive and frightening dreams are more likely to be classified as suicidal, compared to those without frequent nightmares (Agargun et al 1998). A similar relationship recently emerged in a prospective, population-based study conducted in Finland. Tanskanen et al revealed an association between nightmare frequency at baseline and completed suicides at follow-up 14 years later (Tanskanen et al 2001). Compared to subjects reporting no nightmares, those reporting occasional nightmares were 57% more likely to die by suicide. Among those with frequent nightmares, the risk for suicide increased dramatically; those endorsing frequent nightmares were 105% more likely to die by suicide compared to those reporting no frightening dreams.

Monsters don't sleep under your bed, they sleep in your head.
Monsters don’t sleep under your bed, they sleep in your head.

Bernert and colleagues (2005) investigated the frequency and severity of nightmare symptoms, depression, and suicidality among 176 clinical outpatients using several validated symptom inventories. Results indicated that nightmares predicted elevated suicidal ideation, and this effect was independent of depression. Although this relationship emerged as a nonsignificant trend (p = 0.06), these findings suggest that nightmares may constitute a unique risk factor for elevated suicidality. More recently, Agargun and colleagues (2007) examined nightmare frequency, insomnia symptoms, and suicide attempt status among depressed patients with and without melancholic features. Depressed patients with melancholic features (N = 100) were compared to depressed patients without these features (N = 49). Participants were categorized further as having a history or no history of suicide attempts. Results revealed that melancholic patients with a history of suicide attempts showed higher rates of nightmares and insomnia symptoms compared to melancholic patients without a history of attempts. This study did not assess sleep variables using objective sleep tests; however, it is perhaps the first investigation to examine melancholic depression, suicidality, and sleep disturbances. The authors theorized that feeling worse in the morning as opposed to later in the day, a hallmark symptom of melancholic depression, may be associated with dream content, more negative affect, and in this way, greater risk for suicidality.

Many monks and nuns frequently experience this contradiction.
Many monks and nuns frequently experience this contradiction.

The entire paper can be read here:

Sleep Deprivation and Disease - Effects on the Body, Brain and Behavior.
Sleep Deprivation and Disease – Effects on the Body, Brain and Behavior.

The recent publication of Sleep Deprivation and Disease – Effects on the Body, Brain and Behavior is also an useful research manual:

Geronda Ephraim use to read WWII strategy books to help him understand the art of war. The US  military has recently published manuals on Combat Stress, Sleep Deprivation & Suicide.
Geronda Ephraim use to read WWII strategy books to help him understand the art of war. The US military has recently published manuals on Combat Stress, Sleep Deprivation & Suicide.

As well, Combat Stress (FM 6-22.5) Sleep Deprivation, Suicide Prevention, a manual published by the U.S. Army, U.S. Military, Department of Defense, is also of interest in this subject. It is well known that Geronda Ephraim read WWII battle strategy books while he was on Mount Athos, “to help him understand the strategies of warfare.” If monks are soldiers in a heavenly army, and are in ceaseless battle until their last breath, perhaps manuals about suicide and sleep deprivation applied to physical and earthly warfare may also help: