Published Jan 1, 2010 8:00 AM
The U.S. suicide rate is on the rise. That might not qualify as shocking news in these troubling economic times, except that the latest numbers reflect a period before the financial meltdown that began in September 2008. What's more, the bulk of the increase hasn't been in teens or in the elderly— two groups generally found to be at the highest risk — but among middle-aged adults.
A study by Johns Hopkins University researchers published in the American Journal of Preventive Medicine reported a nearly 16-percent surge in suicides between 1999 and 2005 among people ages 40-64. This accounted for much of the overall increase of 5 percent during that period, after suicide rates had declined between 1986 and 1999. Although rates since the economic downturn aren't yet available, it's safe to assume the upward trend has only accelerated. The National Suicide Prevention Lifeline, for example, reported a 27-percent higher call volume in January 2009 than in January 2008.
While it's unclear what's driving the increase, Dr. Ian A. Cook, director of the UCLA Unipolar Depression Research and Clinic Program, believes the stresses of modern life may be the culprit.
More than in the past, Cook says, we are living with uncontrollable and unpredictable threats, a situation only exacerbated in the throes of economic hardship. "The stock markets are much more volatile, and people who once thought they had job security find that even big companies are not as stable as they once were," he notes.
Tools people can use to take care of their mental health during the current economic distress can be found at Beat Recession Depression. You can also get help from the UCLA Unipolar Depression Research and Clinic Program and the American Foundation for Suicide Prevention.
How to prevent going from stressed-out to severely depressed and, for some, beginning a downward spiral leading to suicidal thoughts? There are many things we can do to make ourselves more resilient. By now, we know that regular physical exercise has been shown to calm the mind and body. Psychologically, Cook recommends that we focus on the future, rather than dwelling on what we might have done differently. Just keep expectations realistic and adapt to new realities.
"Maybe it's no longer reasonable to expect that retirement will be filled with endless golf games and travel, but life can still be enjoyable," Cook says. Develop hobbies, cultivate interests and take pride in roles such as parenting and volunteering.
About 15 percent of the population suffers from clinical depression at some point during their lifetime, and despite being a highly treatable condition, depression is too often unrecognized or untreated. Although most depressed people aren't suicidal, untreated depression is the leading cause of suicide; attending to depression and other psychiatric illnesses is the best prevention strategy.
Of course, not everyone with depression or other mental-health problems seeks treatment, and those who are suicidal are not always quick to volunteer the information. What are the warning signs that a friend or loved one is a suicide risk, and what should we do if we see them? Cook offers these tips:
Recognizing the signs
For most people who are suicidal, classic symptoms of severe depression include consistently low mood, hopelessness, lethargy, change in sleep patterns, altered appetite or weight, social withdrawal and lack of interest in previously enjoyed activities. Does the person seem to have a plan? Regardless of whether he or she says so, look for any sudden purchase of a gun or other potential means of carrying out the act. Many who contemplate ending their lives will begin to give away valued possessions and/or make offhand remarks suggesting they aren't concerned about future events or where they will be in six months. Verbal threats of suicide or expressions of wishing to die should never be ignored. And, of course, someone who has ever attempted suicide before is at particularly high risk.
Bringing it up
Don't be afraid to introduce the topic. "There's nothing to suggest that asking people their thoughts about death and suicide will suddenly make them consider it if they haven't been thinking about it already," Cook says. While using the word "suicide" might make some people recoil and become guarded, Cook says, the same information can be obtained by using other terms, such as asking if the person thinks life is worth living and, if not, whether he or she has ever thought about doing something about it. Find out if the person has a plan or method in mind, and if the person has sought professional help.
Continuing the discussion
It's very difficult to talk someone out of being suicidal, Cook says, but you can offer compassion and support, and the wisdom that suicidal feelings will abate with treatment. "Acknowledge how much distress the person is in and use that as a point of agreement that he or she needs to get help," he says. "And it's not unreasonable to say, 'It sounds like you think you're at the end of your rope. I am still hopeful. But you can't do it on your own.' "
Because it's common for people who are suicidal to feel they can't be helped, a gentle suggestion is often insufficient. Active involvement might entail helping the person find a knowledgeable mental-health professional or reputable treatment facility and driving him or her to the appointment; in a case where there is resistance, it might necessitate talking to the person's primary care physician. (Although the physician can't disclose information about the patient, there is nothing to prevent communication going the other way.) If the friend or loved one doesn't seem receptive to seeking help and you're not sure whether you should intervene, it's best to err on the side of overreacting. "A layperson should never have to make the call," Cook says. "It's far better to get a health professional involved in assessing the situation."
Acting in an emergency
If suicide appears imminent, do what you can to make sure the friend or loved one isn't alone and that anything that might be used in a suicide attempt — guns, sharp objects, drugs — is removed. If you are with the person, take him or her to an emergency room; if that's not possible, call 911 or the National Suicide Prevention Lifeline (1-800-273-TALK).