Some Thoughts on Suicide in Middle-Aged Women

No one knows for sure why deaths are spiking, but it's probably a combination of factors.

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When I first glanced at a new study reporting an increase in the U.S. suicide rate, I couldn't believe it was talking about white, middle-aged women. Yes, the rate of suicides in teens rose recently, most likely because of a drop in antidepressant use after black-box warnings were added to the drugs stating an increased risk of suicidal thoughts in youngsters who took them. But Johns Hopkins University researchers now find a spike in suicides—4 percent a year from 1999 to 2005—in white women ages 40 to 64, according to a study published in the American Journal of Preventive Medicine.

The study didn't explain the reason for the surge but did find that women are more likely to die by poisoning (compared with men, who are more likely to use guns). Perhaps women are simply getting better at poisoning themselves, searching the Internet to find out what sorts of medications are—morbid as this sounds—most effective. "In England, they've limited the amount of Tylenol a person can buy, for this very reason," says Carol Landau, a professor of psychiatry at Brown Medical School and author The New Truth About Menopause. She says that whereas women once tried to overdose on Valium, usually without success, they may be reading up on ways to commit suicide before they attempt it.

What is it about middle age that makes a woman more prone to suicide?

Full-blown depression or anxiety certainly factors in, says Landau. These problems could become more prevalent in menopause, especially now that many women shun hormone replacement therapy to combat hot flashes and mood swings. Women in their 40s and beyond are also more vulnerable to economic hardships. "Women still don't earn as much as men, and many are one divorce away from poverty," says Landau.

We're also still the primary caregivers for young and old, and those of us in the "sandwich generation" caring for elderly parents and children often find ourselves squeezed at both ends. And we're more likely to be overweight, which Seattle researchers recently linked to depression in middle-aged women. "Some women may experience disappointment in seeing that they can't have it all—perfect marriage, job, kids," says Ellyn Kaschak, a professor of psychology at San Jose State University. "I see a lot of women take that disappointment and make positive changes, but if this study is any indication, some may not." In fact, one 2006 survey found that only 19 percent of women ages 35 to 54 consider themselves very happy, compared with 34 percent of the general population.

So what the heck are we supposed to do? Landau suggests the following:

1. Don't put off seeing a doctor if you're feeling down: "Primary-care physicians have gotten much better at recognizing signs of depression," says Landau, "and they're pretty good at prescribing antidepressants or psychotherapy."

2. Take advantage of the new mental health parity law: Congress recently passed legislation (folded into the economic bailout package) that bars insurers from charging more for mental health issues than for other illnesses such as heart disease or diabetes or from setting stricter limits on treatment. This means you'll probably get some coverage for therapy visits to treat anxiety or depression.

3. Find a confidant: "Just talking to someone about your problems, whether it's a friend, family member, or clergyman, can be helpful," Landau explains. "Community involvement used to buffer women from depression in the past." In my opinion, instead of volunteering at school and church, we now spend way too much time in our cars commuting to and from work, doing errands, and driving in car pools. Hey, perhaps there's a plus to cellphones after all! (Just be sure to use a headset when venting about your day while driving—and no texting, none, nada.)

4. Take advantage of online resources: Landau recommends this American Psychological Association website. This site from the National Institutes of Mental Health may be useful, too.