Life

Unhappy Birthday

For some people, birthdays can increase depression, anxiety, and even the risk of suicide. Isn’t it time to blow the candles out on this tired tradition?

A birthday cake is canceled.
Photo illustration by Slate. Photo by Getty Images Plus.

I’ve always been a curmudgeon about my birthday. Even when I was a child, my parties would inevitably end in tears due to the attention overload and sugar crash. Aging hasn’t helped. Since I’ve gotten older, I’ve only found it more embarrassing to take credit for something my parents mostly accomplished with their genitals. If it weren’t for the promise of cake, I’d avoid the occasion completely.

But despite downplaying my own birthdays, bad ones have always had a way of finding me. I’ve witnessed friends and acquaintances start vicious arguments, get dumped, fight bartenders, and lose their phones, all in the name of their “dirty 30s.” I once saw a man sobbing at the Kingston Mines, a blues bar in Chicago. I looked at his buddy, who shrugged and said, “It’s his birthday.”

Advertisement
Advertisement
Advertisement
Advertisement

I felt his pain. Birthdays are one of the few paradoxical times when you’re supposed to be happy but also encouraged to throw a tantrum and cry if you want to. To wit, the Lesley Gore song “It’s My Party” was featured in a 1999 commercial for Burger King’s 99 Cent Menu to motivate those in the throes of a birthday meltdown to eat something. Decades later, people are still making sad birthday songs about people getting emotionally wrecked on what’s supposed to be their special day.

It’s hard to quantify how common bad birthdays are, as surveys suggest that most adults in the U.S. are neutral about their own. That said, they’re a well-established trope. FriendsRachel Green famously imploded about her relationship when she turned 30. Harry Potter wrote “happy birthday” to himself in a sad patch of dust. A lonely Lisa Simpson meekly sang happy birthday to herself, a sentiment reflected by hundreds of people on YouTube. Along with all the cat memes about your “empty existence full of endless failure and bad decisions,” pop culture has made it abundantly clear that sometimes, birthdays are hard to do.

Advertisement
Advertisement

They’re so hard, in fact, that they can occasionally lead to something called “birthday depression” or “the birthday blues.” These aren’t exactly medical diagnoses, but experts say they can be a serious mental health concern. The warning signs include many of the same symptoms as depression—difficulties with sleep and concentration, increased rumination and anxiety, and low confidence and self-esteem. The only difference is that these feelings spike leading up to a person’s birthday, and are layered on top of already-increased anxiety about parties, personal achievements, aging, loneliness, and mortality.

Advertisement

Stacey Freedenthal, a psychotherapist, author, and associate professor at the University of Denver Graduate School of Social Work, suggests that this might be the result of social pressure for achievement and status by a certain age. “Some people tend to take stock of their life on their birthday in the same way that people resolve to do things differently at the start of each new year,” she told me.

Advertisement
Advertisement
Advertisement

This can be especially difficult for people already struggling with feelings of inadequacy or depression. As multiple studies have shown, a person’s suicide risk can increase anywhere from 6 to 40 percent on their birthday. This effect is particularly strong on milestone birthdays like 30 or 50—that’s when people tend to take stock of their lives and consider what they have (or haven’t) accomplished. The risk is even stronger for men over 35, who are already nearly four times more likely to die by suicide.

The tragic association befell country musician Mel Street, who died in 1978 of a self-inflicted gunshot wound on his 43rd birthday, as well as sports writer Martin Manley, who shot himself in 2013 on his 60th birthday (but not before blogging extensively about his plans). In 2020 New York Giants outfielder Drew Robinson attempted suicide four days before his 28th birthday, but he survived.* Out of the 74 major league baseball players who’ve died by suicide, 17 attempted to kill themselves within 28 days of their birthday.

Advertisement
Advertisement
Advertisement
Advertisement

Much of this has to do with the weight we put on birthdays, especially in the U.S. In an essay for the journal Time & Society, Hizky Shoham, a cultural studies professor at Israel’s Bar-Ilan University, suggests that industrialization is to blame. Prior to that, birthdays were a pagan tradition observed in ancient Egypt, Greece, and Mesopotamia, who were among the first to track patterns of time and develop early calendars. These early celebrations were mostly exclusive to nobility until the third century, when ancient Romans encouraged everyone to honor individuals with cake, wine, and incense. Eighteenth-century Germans then tailored this tradition towards children with kinderfeste, or “kids’ party.”

Birthdays made their American debut in the late 19th century, after the decline in Puritan influence, which had discouraged elaborate celebrations. During this time, children became less appreciated for their economic potential (more hands on the farm!) and more for their emotional value (cute baby!), so wealthy families began celebrating their birthdays. Not long after the song lyrics to “Happy Birthday to You” were drafted in the early 1900s, children’s birthday parties trickled down to the middle class and eventually became the norm. At the same time, the use of clocks and time zones, which had increased throughout the 19th century, became standard. This made people more time-conscious than ever, and inspired them to more deeply contemplate—or perhaps over-contemplate—the significance of birthdays.

Advertisement
Advertisement
Advertisement

It’s worth noting that some experts also point to this period in American history as the source of mental health issues like anxiety, depression, psychotic disorders, and addiction—conditions thought to stem from the social isolation that came from highways, suburbanization, and people living farther apart, particularly in areas where massive resource extraction took place. (Chemical exposure from industrialization is also thought to worsen mental health.) But if depression is considered a “disease of modernity,” then birthdays appear to be the celebratory side of the same precarious coin—a way to bring people back together in a world that increasingly keeps them apart.

Not everyone wanted to celebrate, though. In the early 20th century, some American Christians mounted an opposition to the mainstreaming of birthdays, citing concerns that the custom could turn children into greedy consumers. They may have been on to something—the average parent drops roughly $400 on a birthday celebration for their child—but their anti-birthday protests missed something crucial: No one, including them, was really worried about the psychological burden such obligatory celebrations would place on adults. It wasn’t until the 1970s that researchers began to take notice of the correlation between people’s birthdays and “self-inflicted death,” and to caution people about the grave consequences of “birthday stress.”

Advertisement
Advertisement
Advertisement

Understandably, social media has made all of this worse. As much as it’s the only way most of us remember anyone’s birthdays, it’s also increased the impulse to compare ourselves with everyone around us. Study after study has demonstrated that this leads to depression and anxiety—it’s just another way to confirm our worst fear: Everyone is doing better than I am.

There are a growing number of organizations advocating better social media habits for the sake of mental health, but there are no comparable movements mobilizing against the tradition of birthdays. Thus, the anti-birthday resistance occurs on a micro level, where individuals have been quietly bowing out of theirs for years. Just look at Reddit, where an increasing number of threads from people canceling their birthdays has cropped up, many of which cite the cost, stress, and strained psyches as reasons to do so.

Advertisement
Advertisement
Advertisement

On his most recent birthday, Josh, a 33-year-old electrician in Brooklyn, New York, decided to do the same. His family had never been able to afford to throw parties for him as a kid, so he tried to make up for lost time as an adult. But each time he attempted his own celebration, he found himself disappointed. “There was a super low turnout,” Josh told me. “Feeling like I had to do something was not helping my mental health.”

Advertisement

This year, he decided not to plan anything for his birthday, aside from a much-needed therapy session. After his appointment, Josh bought himself a gently used desk off Craigslist and spent the rest of his birthday watching wrestling. “It was my best birthday so far,” he said.

Advertisement

Of course, for every person who’s embraced the mental health win of ditching their birthday, there are just as many people who benefit from celebrating it. Research shows that birthday celebrations aid in cognitive development and help young children learn how to keep track of their peers’ ages; some medical students, who are at an increased risk of suicide, actually report feeling better and more loved on their birthdays compared with other days. And despite some research from Japan, Switzerland, and the U.K. showing an increased risk for birthday suicide, other population-based studies have not shown the same link.

It’s a mixed gift bag, which is why therapists like Freedenthal aren’t fully down on birthdays, regardless of the increased risks they sometimes entail. In fact, she suspects the negative emotions they provoke would persist either way. “All special occasions have the potential to activate feelings of grief, loss, inadequacy, and so on,” Freedenthal explained. Since those feelings are valid and need to be processed, people can’t avoid them by simply skipping the day. “It would be better to promote education, awareness, and treatment for people prone to birthday blues,” she concluded.

Rather than treating them like a day of assumed celebration, Tetsuya Matsubayashi, a professor of public policy at Osaka University who studies the birthday-suicide connection, recommends approaching birthdays as a delicate time to check in. “The takeaway is that those who have no strong social connection with others should be carefully monitored as their birthday approaches,” he told me over email.

With this in mind, throw a big party for yourself if you’re a birthday person, but don’t project that expectation onto other people who might feel sensitive about it. At the same time, just because you’re not into the anniversary of your birth, that doesn’t mean you shouldn’t acknowledge the birthdays of others, when a small gesture could prevent a large existential crisis.

For this reason, I try to keep track of those who maintain lower profiles about their birthdays. Just because they don’t want to coordinate a big group dinner doesn’t mean we can’t get a casual bite to eat and cry when they want to.

Correction, March 2, 2023: This article originally misstated that outfielder Drew Robinson played for the New York Giants. He played for the San Francisco Giants.

Advertisement