The recent tragic suicide of comedian Robin Williams shed light on an uncomfortable subject that, unfortunately, is more common in America than most of us realize.  That subject is suicide in men over 60. Since September is National Suicide Awareness/Prevention Month, I’d like to talk to you about how you can help the over-60 man in your life avoid this tragic end.

Your Father, Brother, Spouse – Help Them Prevent Suicide    

The world was shocked a few weeks back to hear of the untimely death of brilliant comedian, TV and Film actor, Robin Williams, at the young age of 63. Watching the news unfold on television, his world of fans just couldn’t get their heads around the idea that someone who seemed to have everything going for them would take his own life.

Yet, despite the fact that Robin was a hugely successful entertainer, he battled depression and struggled with the same life issues that affect many over-age 60 men in America today. In his life, Robin always lent his name, and his talent, to support a good cause. And, in his death, he continued to do that by drawing more attention to something that happens everyday in America – suicide, especially in men over age 60.

While suicide also occurs in women, the rates for it typically decline the older a woman gets.  Just the opposite is true for men, however.  According to the Administration on Aging, over-age 60 men die from suicide at a rate 7 times higher than women. And, the older a man gets, the more his chances for suicide increase.  Why? There are several factors that seem to affect men more as they get older:

• Declining role.  Over-60 men are often looking at retirement and see it as the “end of the road” not only for their career but their life.  It causes them to lose their sense of purpose.  In addition, kids are likely grown and out of the house with families of their own and his role as the “head of the family” or “protector” has dwindled significantly.

• Health problems/Recent Surgeries. Older men may be living with chronic pain or physical dysfunction from health problems and/or recent surgeries.  He may be more frail and not able to take care of himself, needing to rely on others. He may have restricted driving privileges or lost a driver’s license, and has become dependent on others for transportation.  The anxiety and fear of going through a major surgery can create serious stress and deep depression.  Like Robin, who recently had open heart surgery before his death, these health concerns can generate high levels of anxiety about independence and/or ability to support themselves and their spouse/family.

• Access to Drugs, Alcohol, Firearms. Many over-60 men with chronic pain problems have easy access to pain-relieving drugs that can be used in suicide attempts.  In addition, a man who starts drinking heavily from depression, who also owns firearms, also has more motivation, and means, to commit suicide.  Firearms account for the most common means of suicide in older adults.  They are involved in suicides of over-age 60 men twice as much.

• Social Isolation/Loss of Spouse. Some over-60 men have retired, or moved away from former friends, and may have lost their spouse recently. The social isolation and depression that these situations can carry can be overwhelming. A man is less likely to reach out to family and friends for emotional losses than women.

What Can You Do To Help The Older Man In Your Life?

SAMSHA, the Substance Abuse and Mental Health Services Administration of the U.S., reports that suicide attempts are almost always more successful in older adults with less chance of being rescued successfully.  They recommend that suicide prevention interventions should be aggressive with multiple methods used.  Once someone attempts suicide, the likelihood of them attempting a subsequent time, and succeeding, is much higher.

Prevention is always the key in dealing with suicide risk. Recognizing an older man who is at risk for suicide and taking the appropriate action is crucial.  For anyone with an over-60-age man in their life, it’s imperative to not ignore symptoms/behavior that may indicate possible suicidal thoughts:

• Depression, and/or a sense of hopelessness or loss of purpose, conveyed by things they say about themselves.  Do they make remarks about “ending it all”, or they’d be “better off dead”, etc?

• Disturbed sleep patterns, too much or too little.

• Isolating themselves, not wanting to be part of family get-togethers, visit with friends in person or by phone, go out of the house, or ignoring their pet’s needs.

•  Grooming changes. Not bathing, not shaving, not getting dressed all day, not cleaning their home.

•  Eating, drinking disorders. Not eating, constant overeating, or binge-drinking.

• Giving away cherished belongings or contacting people to make amends for past transgressions, or just seeming to say “goodbye”.

Here are some positive steps you can take to help your loved one whom you feel may be at risk for suicide:

• Ask them to stay with you. If possible, it may be helpful to have your loved one stay with you for a while until their symptoms seem to improve – especially if they live alone.  This also removes their access to firearms they may own as well.  Feelings of depression/suicidal thoughts can be strongest right after a traumatic event, loss of spouse, injury, major surgery.  These feelings usually start to life after some time has passed.

• Talk to their doctor. Relay your loved one’s concerning behavior/conversation to their doctor. Make an appointment for depression/suicide screening.  Many older men will not admit their thoughts of suicide to you, or anyone. They often see it as a sign of being “weak” and prefer to just act, and/or they don’t want anyone to interfere with their plan.  As SAMSHA explains, getting them to a professional skilled in suicide screening can help identify what thoughts, plans they may be masking.

• Social Connections. Find social services that can come and help your loved one in their home with their condition.  This cuts down on the feeling of dependency on family and friends.  Also, help find some social/recreational outlets for your loved one. Help them connect with a group of same-aged people doing something they used to enjoy can give them a new outlook on their life.

Suicide is a highly preventable tragedy.  If you have an over-age 60 man in your life who seems to be struggling with depression and, possibly, suicidal thoughts, please make every effort to get them the help they need. Just knowing that you care enough to intervene may be all they need to pull them out of their dangerous thoughts and actions.

Stay Well,
Mark Rosenberg, M.D.

Preventing Suicide in Older Americans http://www.aoa.gov/AoARoot/AoA_Programs/HPW/Behavioral/docs/Older%20Americans%20Issue%20Brief%204_Preventing%20Suicide_508.pdf