Facing multiple losses of loved ones and decreasing ability to be independent, the elderly face an increasing risk of depression and suicidal thoughts, with baby boomers next in line.
Dan Reidenberg, executive director of SAVE, or Suicide Awareness Voices of Education, and chair of the American Association for Psychotherapy, spoke with journalist Rhonda Miller during a conference on mental health and suicide in Washington, D.C.
Q: You have expertise in sort of specific populations with depression and suicide, but mostly in terms of depression. There seems to be conversation that the rate of depression or suicide is going up in the baby boomer generation and in the elderly. Can you review that?
REIDENBERG: Sure. Depression is not a normal part of aging. It does happen for a lot of people, but it’s not a normal occurrence, and that’s why we want people to pay attention to that, both as they age through their 40s, 50s and 60s, as well as when they become seniors at 65 and older.
So we do know that depression is happening and it happens frequently, but it isn’t a normal, common occurrence. We want people to recognize what some of the warning signs are. When the depression lasts longer than just two or three weeks, might be longer than a month. When it becomes significant that they’re impaired in their ability to function, their ability to either work or participate in family activities, maybe leave the house, their appetite changes, their sleep patterns become extremely disrupted, they start talking about suicidal thinking. Those are the kinds of things we want people to pay attention to in those that are baby boomers and seniors that would be out of the typical norm for depression that might just happen as a result of significant losses.
One of the really interesting things about seniors is that we know the older we get, those who are 90-plus, 85, 90, 95-plus, they’ve experienced significant losses in their life. They may have lost family members, children. They may have lost grandchildren, all kinds of death. They may have experienced lots of physical ailments and might be looking at their own physical limitations themselves.
They’ve lost their ability to earn an income and provide and give back. As these things increase for those as we get older, we do get concerned that they start thinking about suicide because they don’t have a great future in front of them, and that’s what they believe. So instead of taking a normal course of life, their depression really increases substantially as they start worrying about their ability to contribute and their ability to function without care. A lot of seniors today don’t want to function with care. They want to be pretty independent. These are the things that make us concerned about that as they age.
Q: There is apparently a reported increase or spike in suicide among the elderly or male seniors. Is that accurate?
REIDENBERG: Not necessarily. It depends on what age group you’re talking about and what time frame you’re talking about. What we’re really looking at in this increase is men in the middle ages, the 45-to-54-year age, and you can even go up to the 64-year age range. That is the group that we’re seeing a fairly significant spike in suicides, recently, in probably the last four or five years. That’s something all therapists and all family members need to really pay attention to. It’s not limited just to men. Men have higher numbers of suicide in our country, so we’re also seeing more of that because there are more suicides by men. But we’re actually also seeing higher numbers of suicide of females in that same age group. So we do have to pay attention to that.
There’s a smaller increase, but still an increase, in those males that are 65-to-85 years of age as well. So we are seeing general increases in those areas. Now if we look over 10 years, 20 years, what you’ll see is that it’s fairly flat. But if we look at small time frames, then we see significant increases.
Q: Are these significant increases in the last few years? Are there reasons for that? Do we have an idea of the causes of that?
REIDENBERG: It’s important for people to understand that trends are what really tell us what’s happening and trends take more than just two or three years to designate that something really is going on. So if we look one year to another year, we might see a point-five increase in suicides in one category, depending on the age group we’re looking at and the gender. That isn’t necessarily a problem, but it may play out that way, either through the media or through just public reports about this. But we know that there are slight increases and we need to pay attention more to them as the baby boom generation, which has the largest number of people moving into the highest rate category. Seniors 65 and older have the highest rates of suicide per 100,000, age adjusted.
Q: Are you finding that therapists are seeing these people? Is this group of males particularly, are they seeking treatment?
REIDENBERG: No. Unfortunately, males in general don’t seek treatment. They don’t ask for treatment. They don’t respond very well when they go to therapy. They don’t like it very much. Stereotypically and in practicality and reality when they get there, it’s not something that they really enjoy doing. It’s not true of all males, but for a large percentage of men, they don’t voluntarily, willingly come out and say, “I need help.” They are more, “Let me just buckle down, let me power through this and get through it,” unfortunately.
Q: Are there particular types of therapy that work better with this particular age group, maybe the middle to the older age of males, because now there’s information about yoga and mindful breathing and different types of therapies?
REIDENBERG: It’s really still cognitive behavioral therapy. That’s the one evidence-based program that we know of. There are some new types of treatment that are coming out relative to, I wouldn’t say depression as much as I would say suicide prevention, that involves a collaborative approach. That shows a lot of great promise for us, both for suicide prevention but also for depression.We really think that collaborative approach to managing and assessing suicide risk can be expanded to other diagnoses as well.
Resources: For more information go to the SAVE website. Anyone experiencing a mental health crisis or having thoughts of suicide, or family or friends concerned about a loved one can call the National Suicide Prevention Lifeline at 1-800-273-8255.
Note: Rhonda J. Miller is a journalist based in Providence, Rhode Island. She spoke with Dan Reidenberg at the conference “Covering Suicide and Mental Health,” held Sept. 15-17, 2014 in Wasington, D.C., sponsored by the National Action Alliance for Suicide Prevention and The Poynter Institute, a journalism training organization based in St. Petersburg, Florida.