It's Time to Discuss This Taboo Topic

There's a killer in folks 65 and older that we don't talk about.

It's an epidemic that carries so much stigma, no one wants to talk about it. Doctors are reluctant to discuss it with patients and few senior centers do enough to raise awareness and provide support.

In fact, if you mention it to someone, especially those 80 and older, you'll likely get a dismissive scoff or shrug. And we know some 90-year-olds who think the underlying cause is a lot of "hogwash."

But it's not hogwash. And it's not a subject we can avoid any longer.

I'm talking about suicide.

With the recent deaths of fashion designer Kate Spade and food and travel guru Anthony Bourdain, Americans have finally started a conversation about suicide.

Suicide is the 10th leading cause of death in all adults. In 2016 (the latest year with complete figures), we lost 45,000 Americans to suicide.

In a new report from the Centers for Disease Control and Prevention (CDC) last week, we saw that suicide rates in the U.S. have increased more than 25% since 1999.

But these broad numbers often overlook older Americans. That's dangerous, as people over 65 make up about 12% of the American population, but they account for 17% of all suicides. Worse, folks 85 and older have a 50% higher rate of suicide than the total population.

Part of the concern is a lack of understanding about mental health. Folks who lived through the Depression and World War II are survivors. They don't want to ask for help.

What's more, they grew up in an age when you didn't talk about mental health problems.

Older adults often miss a diagnosis of depression. We've written before about symptoms that folks 65 and older are more likely to experience. These include changes in behavior like irritability, trouble sleeping, appetite loss, aches and pains, memory loss, and feeling like a burden to friends and family.

Many times, a chronic illness like cancer or diabetes may also bring on severe depression. However, according to a study in the Journal of the American Geriatric Society, once researchers adjust data for mood disorders, there's no connection between physical health and suicide.

And although depression is a major and severe risk factor, about 54% of all suicides occur in folks who don't have a history of mental illness.

According to the director of the National Institute of Mental Health, Joshua Gordon, that number is misleading. As he told the Washington Post, "When you do a psychological autopsy and go and look carefully at medical records and talk to family members of the victims, 90 percent will have evidence of a mental health condition."

Too few people who have depression receive a diagnosis. Even fewer seek treatment. In fact, in seniors, only about 10% of those with depression receive treatment.

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Steps to Take If You Suspect Someone Is Suicidal

1. Check in. Socialization is an important step to staying healthy. It keeps our minds sharp and helps combat loneliness and depression. So if you know someone struggling, try to get them to engage in activities that fight depression. Have them join you for a walk in the sunshine or take an exercise class with you. Ask them how they are doing and listen to them.

And if you ever hear anything like "I can't see a way out," or "Everyone would be better off with me being a burden," take it seriously. Even joking about it could indicate suicidal intentions.

2. Talk about it. We understand the stigma surrounding mental health. But we need to break through that if we're going to get proper treatment for folks who need it.

If you suspect someone might consider suicide, talk to them. You won't push them into it by bringing it up... Many psychologists report bringing it up and allowing the person to discuss it without judgment is one of the best ways to help.

3. Manage stress. We've written before about caregiver stress. But we didn't mention that about 58% of all caregivers suffer from symptoms of clinical depression. They may feel like they're complaining if they seek treatment. But that's simply not true. If you're caring for a parent or loved one, take care of yourself – including your mental state.

Make time for stress-relieving activities like walking, meditating, and yoga. And join a support group for other caregivers. Similarly, if you've lost someone to suicide, find a group for other survivors to get the help and support you need.

It's also a good idea to figure out which mental-health providers are available. Medicare covers some mental-health services, so use its service to find a provider or look through other insurance providers. Psychology Today offers a searchable directory that makes the process a bit easier. Find it here.

4. Give them information for crisis lines. Make these available for anyone who might need them.

U.S. National Suicide Prevention Lifeline (1-800-273-8255) or online chat:

Text-based service: Text NAMI to 741741

Veterans' Crisis Line: 1-800-273-8255 and Press 1 or chat online at

5. Know when to seek immediate help. If you someone tells you they're considering suicide, there are four steps you need to take...

  • Find out if they have a plan.
  • Determine their access to pills, a gun, etc.
  • Ask if they have a timeline.
  • Check if they intend to carry out the plan.

If someone has a plan with these pieces considered, get immediate help. Call 911 and do not leave them alone.

Suicide sometimes comes out of the blue, but often you might see some warning signs. Take the time to help your friends, family members, and yourself. Understand what to look for and don't be afraid to start the hard conversation.

What We're Reading...

Here's to our health, wealth, and a great retirement,

Dr. David Eifrig and the Health & Wealth Bulletin Research Team
June 14, 2018