Suicide and Depression in Older Adults: Greater Awareness Can Prevent Tragedy

The statistics on suicide in people older than age 60 are frightening. We must increase public awareness of the signs and risk factors for suicide among this population, and learn how to help those who experience them.It's still hard to believe that Robin Williams- beloved comedian, actor, father, and friend-is no longer with us. To the public and even to close friends, he appeared to be happy and upbeat, and he was financially stable-all factors that seemed to shape a life worth living for. Yet, on August 11, 2014, Williams, age 63, took his own life. Behind the energetic public persona was a man who had battled addiction to alcohol and drugs, was struggling with depression, and was in the early stages of Parkinson's Disease, a known risk factor for depression.Unfortunately, Robin Williams' tragic story is all too common. The statistics on suicide among people older than age 60 are frightening. The Centers for Disease Control and Prevention (CDC) estimate that in 2011, more than 9,000 older adults died by suicide. Although the rate of suicide for women typically declines in older age, it increases with age among men. According to the CDC, older men die by suicide at a rate more than five times higher than older women (27.83 per 100,000 for men, and 5.09 per 100,000 for women) (CDC, 2003). Risk FactorsThere are several reasons for these figures. First, suicide attempts often are more lethal in older adults. Older people who attempt suicide often are more frail, more isolated, more likely to have a plan, and are more determined to die than younger people (Administration on Aging [AOA] and Substance Abuse and Mental Flealth Services Administration [SAMHSA], 2012). We know that as people age, they often have chronic medical conditions that can significantly limit function or life expectancy. Depression is associated with the disease course of some chronic conditions such as arthritis, cardiovascular disease, and cancer- conditions that disproportionately affect older people. And depression can be a side effect of some of the medicines commonly taken by older adults, such as statins, beta-blockers, and corticosteroids (Neel, 2012). Recent research also indicates that economic insecurity plays a role in suicide among older adults, particularly men (U.S. Preventive Services Task Force, 2014). As people age, many of them have fewer financial resources and more uncertainty about their future. These factors, coupled with depression, social isolation from family, friends, and the community, along with functional impairment, physical illness, and pain can lead to despair in many older adults (Van Orden and Conwell, 2011). Misunderstandings and Misconceptions About DepressionDepression is not just being sad, and it is not a character weakness or personal failing. It is a real disease that can impact all facets of a person's life, including the lives of their loved ones. It can rob individuals of their perspective on life and it can make it seem that life is no longer worth living. Sadly, because of public misconceptions about the disease, people with depression often try to conceal their condition until it becomes too much to bear.No family is immune from the risks of depression in older adults. Both of us have had personal experiences with depression and suicide among those we know and love. And, unfortunately, our stories are not unique; depression in older adults is a real problem. It is difficult to overstate how important this issue is to our culture, in general, and to older adults and their families across the nation.Robin Williams was in the prime of his life. Yet we know that men ages 45 to 64 have one of the highest suicide rates of any age group-rates that, according to the latest national data, grew by 40 percent between 1999 and 2011 (U.S. Preventative Services Task Force, 2014). But there is more: As the population of older adults grows-and we expect it to more than double by 2050-these figures will increase if we do not do something now. …