In Focus: Suicide in America

The death of Robin Williams has brought suicide and depression back into the forefront of the national conversation. The nature of Williams’ career presents a particularly painful juxtaposition between how the public perceived the comedic actor and the tremendous persona turmoil he most have suffered. The Italian opera about the sad clown, Pagliacci, has been alluded to by many to describe Williams’ death.

If any good can be taken from Williams’ death it is that the issue of suicide is getting some necessary attention. Suicide presents a very real problem in the United States — and a problem that is getting worse. In 2000, there were 10.4 suicides per 100,000. In 2011: 12.4. There are disparities amongst which age groups are most prone to suicide. It is an easy assumption that teenagers would be highest demographic, but that is incorrect. Those most likely to take their own lives are 45 to 59 years old.

The next logical examination of this data is to break it down by gender. Studies related to depression have consistently reported woman are twice as likely to be depressed than men. Also, women are more likely to have suicidal thoughts. Those statistical trends, when taken at face value, are in great contrast with the fact that men are about four times more likely to commit suicide.

So why the disparity? If more woman are depressed and having suicidal thoughts, why is it that men succeed at suicide at a much higher rate. The answer indicates how challenging an issue mental health is in America.

Men and women experience depression differently. Researchers at Vanderbilt University have determined that men and women can experience drastically different symptoms. They found that depressed men are more likely to report, “anger attacks/aggression, irritability, substance abuse and risk-taking behaviors”. The signs of depression we traditionally think off (crying and sadness) are not always present and therefore make it less likely to be diagnosed and reported. Adding these often overlooked indicators to the list of symptoms, depression rates amongst men and women are about the same.

So men and women experience depression differently but at around the same frequency. However, men commit suicide almost four times as often as women. Or, more accurately, men are four times more successful at committing suicide. We turn now to the methods, rather than motivations. Men are more likely to use methods with a high success rate — hanging and firearms. In comparison, women often use poison, where the likelihood of resuscitation is higher. In 2011, over 3/4 of suicides committed by men between 35 and 64 years old involved firearms or hanging (77 percent). Suicides amongst women that same year involving hanging and firearms accounted for 49 percent. 40 percent of suicides among women involve poison, but only 15 percent among men do.

Unfortunately, we are left with more questions than answers. Why do men prefer more lethal means of suicide? Do statistics of gun ownership correlate? How does gender relate to the likelihood of the individual seeking professional help? Knowing that suicide rates are rising in the United States, these are questions that need answers.

from Peter Orszag Healthcare


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