Suicide epidemic has no end in sight

Katherine K. Dahlsgaard, lead psychologist of the Anxiety Behaviors Clinic at Children's Hospital of Philadelphia, wrote this for the "Healthy Kids" blog.

Robin Williams' suicide on Monday, like all suicides, was shocking. He was funny, successful, rich, beloved.

At 63, he was also middle-aged, white, male, depressed, and had a history of substance abuse. Those are some of the major risk factors for suicide. Combine them with where we are at this point in American history, and he may have had a target on his back. For, we are in the midst of a suicide epidemic, one that is hitting the baby- boomer generation hardest.

We've been hearing a lot about epidemics, from bird flu to Ebola. But no one's talking about the suicide epidemic among the middle-aged, even though it has been going on for 15 years. I asked seven health providers, including two psychologists, whether they knew about it. All said no.

But the numbers are horrifying. According to CDC data released last year, the rate of suicide among Americans 45 to 64 rose 30 percent from 1999 to 2010. The rate for white, middle-aged men increased 50 percent. Suicide is the third leading cause of death among adolescents, and the fourth among adults 18 to 65. Beginning in 1999, more Americans killed themselves each year, from 29,199 to 39,518 in 2011. For the first time since the rise of the car, Americans are now more likely to die by their own hand than in a car crash.

There are various theories about the cause. Boomers are aging at a time when better care prevents or delays death by infections or chronic disease, leaving more people more time to commit suicide. Add stressors from the economic downturn. And then there are those black-box warnings the FDA imposed about a decade ago stating that some antidepressants were linked to more suicidal behavior. The warnings led fewer doctors to prescribe those drugs and fewer people to take them. Recent studies suggest that decline fueled the undertreatment of depression - and the surge in suicide.

Post-mortem studies have suggested that more than 90 percent of people who commit suicide are mentally ill, mostly depressed. There is effective care for depression, but not enough people can get it quickly enough to overcome those temporary feelings of hopelessness.

More chilling, research suggests that suicide rates will keep rising, even among younger people.

In other words, there's no end in sight.

That's scary. So let's start talking about it: The National Suicide Prevention Lifeline is 1-800-273-TALK; visit the American Foundation for Suicide Prevention at www.afsp.org

How might you prevent a suicide? First, know there is no evidence that talking about the subject with a suicidal person makes him or her more likely to try. And don't accept the notion that you can't stop a person who is thinking about serious self-harm. "Because so many suicidal people are ambivalent about it, you can help just by being there, talking about it openly, destigmatizing it," says Cory Newman, director of the Center for Cognitive Therapy at the University of Pennsylvania. "You can absolutely make a difference, especially if your care, concern, and support encourages the person to take the all-important step of seeking professional help."