Why suicide keeps rising for middle-aged men

Suicide rates in the U.S. continue to rise, and working-age adults – particularly men – make up the largest increase, according to the Centers for Disease Control and Prevention. Middle-aged men in the 45 to 60 range experienced a 43 percent increase in suicide deaths from 1997 to 2014, and the rise has been even sharper since 2005. Untreated mental illness, the Great Recession, work-related issues and men's reluctance to reach out for help converge to put them at greater risk for taking their own lives. And because men are more likely than women to use a gun, their suicide attempts are more often fatal.

[See: 9 Things to Do or Say When a Loved One Talks About Taking Their Life.]

Historically, suicide rates have always been higher for men, says Dr. Alex Crosby, surveillance branch chief in the CDC's Division of Violence Prevention. "But what we've seen in these past few years is rates have been going up among males and females," he told journalists attending a National Press Foundation conference in September. "Still, rates are higher among males – about four times higher." For suicide attempts that don't prove fatal, the balance changes, with two to three times more females than males trying to take their own lives.

"In about half of the suicides in the United States, the mechanism or the method was a firearm," Crosby says. Males are more likely to use firearms, while poison is more common for females. However, he notes, "When you look at suicide in the military, females choose firearms almost as much as men."

Clinical depression in individuals and economic depression (and recession) in society are tied to suicide risk. "The highest rates of suicide we ever had in the United States was in the 1930s," Crosby says. The Great Depression made a tragic impact. Since 2005, even before the Great Recession was "official," the then-worsening economy was tied to a rise, although less dramatic, in suicide rates.

Mental illness – particularly untreated mental illness – makes people much more vulnerable. "Bipolar disorder, depression, anxiety disorder – any of the mood disorders – are the key contributors" in terms of diagnoses, says Dr. Dan Reidenberg, executive director of SAVE – Suicide Awareness Voices of Education – and managing director of the National Council for Suicide Prevention. Schizophrenia and eating disorders – in men and women – are related, although less frequent, diagnoses. "For some, especially males, especially under high-stress situations, the opioid epidemic and overdose has become a significant contributing factor to [suicide]," he says.

Midlife Stress

Can a loss of hope for the future and fresh beginnings contribute to vulnerable middle-aged men taking their lives? "We know that as people become adults and they face these stressors – some that they can't get through; they can't overcome – it does increase their risk of suicide," Reidenberg says. "It weighs heavily on their brain that they've either been downsized and out of a job or they can't provide for their family. Or in recent times with the economic crisis, they've lost their retirement; they've lost their future."

Steve Anderson, now 62, was approaching middle age when he attempted suicide at 40 in 1992. Anderson, who lives in the small town of Benson, Minnesota, suffered from depression, anxiety and alcohol abuse. His early adulthood was marked by one job loss after another.

"I was depressed pretty much my whole younger life, and I carried it into adulthood," Anderson says. "I didn't realize I was a depressed person; I always thought I was different than everybody." His Introduction to alcohol around age 16 "really changed things," Anderson recalls. For a while, he felt "invincible."

[See: 7 Health Risks of Binge Drinking You Can't Ignore.]

Anderson became a chronic alcoholic and drank for nearly three decades. "It just came to a point with depression, alcoholism and no self-esteem or self-worth, and I just cracked," he says. "And I said, 'I can't do this anymore,' and all I came up with [was] I needed relief from life."

As an avid deer hunter, Anderson had means – a shotgun – close at hand. "I thought about this for years," he says. "It just kind of passed my mind that life would be better without me and people would be happier without me." He kept his internal pain to himself.

The day came when Anderson reached his breaking point, pulled the trigger and shattered his jawbone – but somehow survived. After the attempt, he spent a month in the hospital, where his facial reconstructive process was just beginning. "It took my jawbone out," he says. "I've got a piece of titanium in there now."

Anderson's spiritual and emotional transformation was a gradual process. "I went to a lot of counseling, went to a lot of therapists and did a lot of talking. And spent a lot of time in [Alcoholics Anonymous] meetings," he says. "And today I've got 15 years of sobriety. It took a while, but I found it. And being sober with a clear mind has changed my outlook."

Today, Anderson volunteers with AA and SAVE, where he shares his experiences with others. "The thing is, there is a way out," he says. "There is hope for every one of us. You've got to find the people. You've got to reach out."

[See: Coping With Depression at Work.]

Certain occupational groups – notably farming, fishing and forestry, followed by construction and extraction – have the highest suicide rates, according to a CDC report released in July. Work is inextricably tied to feelings of self-worth and identity – possibly more so for men.

"We need to, in our workplaces in particular, do much more to engage in conversations and make it OK to talk about suicide," Reidenberg says. "So that when these situations come up for men – and that's where it's happening mostly, is men in the middle ages at work– that they are OK saying, 'Something is wrong. I need help.'"

SAVE is developing a workplace certification program to help companies create their own programs to cover suicide prevention and awareness, interventionand postvention. That includes efforts to help suicide attempt survivors reenter the workplace. "If we can get employees to understand that there is treatment, there's hope, there's recovery and they don't have to live like this forever – there's a really good opportunity to prevent a tragedy," Reidenberg says.

If you have thoughts of suicide – or concerns about a family member or friend – reach out to a local resource or call the National Suicide Prevention Lifeline at 800-273-TALK or 800-273-8255.