UTHealth Houston Harris County Psychiatric Center
Causes • Depression • Recognizing the Signs • What to Do
Aging is a complex physical, mental, social and spiritual process. It affects each individual differently. Some people remain alert and active well into their 90s. Others seem old in every way as early as their 60s.
For many people, senior years are a time to enjoy life, to travel, to do things they weren't able to before retirement. They look back on their lives with satisfaction. But for some others, growing older is a painful, difficult process. Physical and mental health begins to deteriorate. They see their lives as a series of unfulfilled dreams. They feel helpless and hopeless. This kind of outlook, along with other factors, may lead to consideration of suicide.
In fact, the highest suicide rate in the United States is among those over the age of 65. And, while "senior citizens" over 65 represent only about 12 percent of the total U.S. population, they account for more than 20 percent of the nation's suicides. Each year, more than 6,000 older Americans kill themselves.
Single men over the age of 65 have one of the highest suicide rates in the country. For them depression caused by retirement, death of a spouse or child, and the aging process are difficult to come to terms with. They, along with older women, are reluctant to seek the psychiatric treatment which could alleviate many of their signs of depression.
These people and others like them see suicide as the only solution. But feelings can be changed, and suicide can be prevented.
Suicide is not caused by any one factor, but likely by a combination of them. Suicide is often a result of depression, loss of self-esteem, and inability to see a positive future. Some factors that influence the attitudes and behaviors of older people include:
- Decline in physical, mental and emotional health
- Reduced mobility
- Fear of disability
- Economic and environmental limitations
- Change in relationships, particularly marital status (divorce or death of a spouse)
- Life situations; retirement
- Social isolation
- Substance abuse, especially alcohol
- Prior psychiatric illness, especially clinical depression
Any combination of these factors may lead an older individual to consider suicide as a solution to a problem or crisis that causes much emotional pain.
Depression is considered to be a highly common cause of suicide. About 75 percent of those individuals who commit suicide are depressed. People often mistake depression for "the blues," and therefore the illness goes untreated. Depression is caused by a number of factors, from chemical imbalances to psychological make-up to environmental influences. A person with depression will likely display one or more of the following behaviors:
- Feelings of worthlessness, hopelessness, helplessness, total indifference and/or unreasonable guilt
- Prolonged sadness; unexplained crying spells
- Jumpiness or irritability
- Withdrawal from formerly enjoyable activities or relationships
- Inability to concentrate or remember details; indecisiveness
- Noticeable change in appetite with sudden weight loss or gain
- Changes in sleep patterns: constant fatigue, insomnia, early waking, oversleeping
- Physical ailments that cannot be explained otherwise
- Thoughts of death or suicide attempts
Most cases of suicide in older adults are not impulsive, and therefore there is time to help a potential victim. A person who is considering suicide will probably:
- show signs of depression;
- talk about or seem preoccupied with death;
- give away important possessions;
- suddenly put personal affairs in order;
- neglect hygiene and self-care;
- stop taking medicines or following diets;
- acquire a weapon.
If you suspect someone is at risk of committing suicide, you should always take suicidal signs seriously. Ask the person if he or she is considering suicide. Become involved or offer support, hope, encouragement and understanding. Never dare the person to do it; he or she just might. Most importantly, take action immediately.
There are many resources available to help suicidal elders, including crisis intervention agencies and crisis hotlines, support groups and psychiatric hospitals.
Remember, Alzheimer's disease does not protect one from depression and suicide.