Now You See What I See

The Centers for Disease Control and Prevention (CDC) recently published a study on suicide among adults aged 35 to 64 years, based on National Vital Statistics System (NVSS) mortality data from 1999 to 2010.  On May 2, 2013, the Wall Street Journal reviewed the CDC study in an article by Timothy Martin titled, “Suicides Soar in Past Decade”.  “The number of deaths caused by suicide has risen precipitously in the last decade,” Martin writes, and adults aged 35 to 64 “are the group most responsible for the increase”.

What magnitude of increase did the CDC find?  “From 1999 to 2010,” they reported, “the age-adjusted suicide rate for adults aged 35-64 years in the United States increased significantly by 28.4%”.  Which group suffered the greatest increases?  Men in their fifties, who committed 49% more suicides, and women in their early sixties, who committed 60% more suicides.

In absolute numbers, according to the WSJ article, “suicide rates for working adults were double that of other demographics, with people in their 50s showing the highest numbers”.  “For suicides among the middle-aged,” Martin continues, “men outnumber women by a 4-to-1 ratio”.

What does the WSJ think might be going on?  Martin speculates, “Downturns in the economy have been correlated with rises in suicides, according to CDC research.  As people lose their jobs or work part-time, many struggle to make ends meet.  This last decade has been particularly punishing, as the worst recession in decades wiped out stock-market wealth, home equity, college savings and retirement funds for many workers—in addition to heavy job layoffs”.

Martin adds, “The suicide growth among middle-age adults has gone largely undetected.  ‘It’s been a creeping erosion that’s been difficult to see,’ said Eric D. Caine, director of the Injury Control Research Center for Suicide Prevention, a CDC-funded team, and a leading expert on suicide deaths.”

Undetected?  Difficult to see?  Not from where I sit.

I agree with Martin’s assessment of the background forces recently driving more men and women to suicide.  He’s right on.  But I disagree with Mr. Caine.  Since the start of our Great Recession about six years ago, this significant and disturbing trend of increasing stress, distress, burnout, and suicide has been immediately clear to me.  This tragedy has continued to play out in the lives of the patients who walk through my doors, hour after hour, day after day.  It has been one of the strongest motivating forces driving me to complete my recently-published book, Trauma: Healing the Hidden Epidemic.  The despair that many people feel now is a part of the hidden epidemic of my subtitle—an epidemic for which people desperately need healing and resolution.

These suicide statistics show just how desperate people, and particularly working men, have become.  Here’s how I describe our nation’s situation, from my chapter titled “Crises and Hard Times”:

“As I write this book, we are experiencing a strange and historic time.  The United States has been at war for more than a decade.  Thousands of men and women have lost their lives in this conflict, and those who survive return home broken with little hope for repair.  The U.S. economy is the worst it has been in eighty years.  Millions have lost their jobs, and hundreds of thousands more face foreclosure on their homes.  And those who haven’t are afraid that they will. People are scared.  They fear what is to come.  Worst of all, they feel powerless to change their circumstances.

“To say that these are ‘hard times’ diminishes the suffering and difficulty that many are going through.  Many people have had their worst fears come true.  They have no income but plenty of financial obligations.  They may have lost their homes and moved in with relatives or friends.  Or worse, they may have lost their homes and have nowhere to go.

“Things happen in the world that we cannot change or control.  But because these moments are unavoidable, the traumatizing nature of such events is often erroneously dismissed.  Financial hardship and drastic changes to a person’s surroundings and situation can be emotionally and psychologically unsettling.  Crises can arise in the form of financial adversity and familial conflict.  Millions are struggling with what could ultimately be the most difficult years of their lives.  If we want to emerge completely from this crisis—as individuals and as a nation—we must be willing to take care of each other and take control or our own emotional healing.”

How can we do that?—How in my own life and in the lives of my patients have I been able to help create emotional healing for modern-day stress and crises, so we don’t become suicide statistics?  That’s the topic of my book.  My message is one of hope and reinvention.  I’ll continue with this theme next time.