“At 54, I Don’t Feel As Hopeful”: The Untold Story of Suicide in the U.S.
The sound was so loud it shook the bed. As her eyes burst open she found a bare pillow where her father lay just an hour ago. Three-year-old Kathryn scooted her tiny legs off the end of the mattress, felt her feet hit the floor, and searched for him, room by room. She wandered around until she reached the basement door, wrapped her fingers around the brass knob and pulled — once, twice, again and again — but the wooden door wouldn’t budge.
Kathryn walked to the window at the front of her small, ranch-style house that afternoon, and felt hot tears run down her cheeks. She cried to comfort herself until finally, she saw her mother’s red Nash Rambler pull in the driveway. Kathryn heard yelling. More cars in the driveway. Lights flashing red, blue, purple.
On that early spring day in 1959, as Kathryn searched the house for her dad, she had no idea that he was in the garage, lying on a bloody mattress, dead from a gunshot wound to the head. It remained a family secret for years.
Esther explained to her daughter that God needed her dad. That’s why he left. And that’s what Kathryn believed until she was on the bus to first grade three years later.
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“I know how your dad died,” the other kids teased. “He shot himself.”
She came home from school sobbing. Her mother admitted that yes, her father had killed himself. He was sick. “That was pretty much the start and end of the discussion with her,” Kathryn says today.
Kathryn’s father, Nicholas Valentino, was 41 years old when he took his own life. Just two years prior, in 1957, the U.S. suicide rate had hit its lowest point since 1900, at 9.8 per 100,000 people, according to the Centers for Disease Control and Prevention (CDC). Today’s reports out of the CDC are far more dismal: Between 1999 and 2016, America’s suicide rate increased by 28%, up from a national average of 10.5 to 13.4 per 100,000, taking about 45,000 lives every year — the tenth leading cause of death in America. Even more unsettling is that the CDC says these statistics only reflect part of the story: “substantially” more people are hospitalized or treated in emergency settings for non-fatal suicide attempts.
While overall suicide rates have increased in nearly every U.S. state over the past two decades, they have been rising in one particularly surprising demographic: middle-aged people. In fact, according to a report from the CDC released last June, suicides among middle-aged adults are climbing at a much higher rate than almost any other age group — and they’re not slowing down. While men in the U.S. are now most at risk after hitting age 65, the middle age years fall closely behind (32.3 and 29.2 per 100,000, respectively), and the suicide rate for men 45 to 64 increased 37% between 2000 and 2016. The uptick among women was even more pronounced, up almost 60% during the same time period. Female suicides are now most concentrated between ages 45 to 54.
Between 1999 and 2016, America’s suicide rate increased by 28%.
The demographic driving middle-aged suicide is whites without a college degree, according to the Wall Street Journal. When you look at the numbers by race, whites and Native Americans/Alaska Natives have historically had higher suicide rates than other ethnicities. “Family connectedness and religious ties have been associated with lower suicide rates among African-American and Hispanic populations in the U.S.,” says Dr. John Draper, executive director of the National Suicide Prevention Lifeline, though he adds that underreporting may be more prevalent among these ethnic groups (with some of the explanations for this related to cultural norms and stigma related to suicide).
This year, two notable lives were lost to suicide — Kate Spade, at the age of 55, and three days later Anthony Bourdain, at 61, both white Americans in middle age. We also lost actor and comedian Robin Williams at 63, designer L’Wren Scott at 49, and writer David Foster Wallace at 46 all within the last decade. While Spade and Bourdain’s recent deaths have highlighted the rising suicide rates among middle-aged adults (classified by Merriam-Webster as 45 to 64, though standard definitions vary), media coverage of suicide often focuses on the young, and for good reason: It’s a vulnerable time, and never before has online bullying been so commonplace. And while there are several well-known mental health non-profits dedicated to helping at-risk teens and young adults, including the Society for the Prevention of Teen Suicide and the Trevor Project, it’s rare to hear hopeful stories from people in middle age. Most aren’t as quick to admit that middle age can be an equally fraught time, considering health issues like menopause, divorce and family separation, and financial hardships.
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This topic also hits a personal nerve. Kathryn is my mother. She’ll turn 63 this month, and in the years since her father’s suicide she has raised two children and earned a Ph.D. in social work, yet she still struggles with what happened to her at age 3. Until I reported this piece, we hadn’t had a proper conversation about it. I felt I owed it to her, and to others, to learn why people nearing and in middle age are at a greater disadvantage when it comes to suicidal thoughts — and how to help them.
“IT’S THE WILD WEST OUT THERE”
Severin S., 53, who asked that his last name not be disclosed for privacy reasons, fought his first battle with severe depression after graduating from college but it wasn’t until he turned 40 that he was diagnosed with Bi-Polar 1. Around that time, he had lost a child to SIDS and was going through a messy divorce. Severin had already survived three suicide attempts, but he made a fourth attempt in 2000. “The way I’d describe how I felt at the time is like you’ve fallen through ice, and you can look up and see the world and it’s pretty clear. You just can’t touch it anymore, and you drown,” he says.
Severin was hospitalized and released to live with his uncle. By then both sets of grandparents had passed away as well as his father. At his uncle’s, he received more devastating news: His mother had taken her own life while he was in the hospital for treatment.
You’ve fallen through ice, and you can look up and see the world and it’s pretty clear. You just can’t touch it anymore.
“My uncle was a rock for me,” Severin says now. He estimates that he’s spent well into the six figures on treatment over the years. “If I didn’t have the resources to privatize my own healthcare, I would not be speaking to you today,” he says. “It’s the Wild West out there in terms of what [insurance companies] are obliged to do, and not do.”
Men are already at a disadvantage when it comes to identifying that they need mental health treatment, and Severin believes access to mental health care in the U.S. has to improve in order for the suicide rate to decline. The data backs him up: There is only one mental health care provider for every 529 individuals, according to Mental Health America, a community-based non-profit, and more than 125 million people live in areas or population groups designated to be experiencing a shortage of mental health care professionals.
Kathleen Waters, 57, was so frustrated by the process of finding a prescription solution to her severe depression that she finally drove herself to the local emergency room one night in 2012 because she was so worried she was going to end her life.
Kathleen struggled with depression and suicidal thoughts from the time she was a teenager, growing up in Scottsdale, Arizona. First at home, and then in the military, she attempted suicide several times. She was in and out of therapy and eventually got a prescription for Prozac in the early 2000s, which helped.
Around 2011, as a mom of two children, “I was in a really great space,” she recalls. “I felt like I could conquer the world.” So she decided to stop taking her medication. The suicidal thoughts returned soon afterward — she fantasized about driving her car off a cliff.
It’s not like she’d fallen on hard times. “There was nothing catastrophic in my life,” she says. “I had a small circle of friends. I had two children that I shared with my ex.” But she had moved into a lucrative new career, “and I have a tendency to self-sabotage.”
“The thoughts were constant, consuming most of my day,” she says.
But when she called around for a new anti-depressant, most providers told her it would be a 3- to 6-month period before she could get in to see someone. Waters became frustrated, and more withdrawn due to that frustration. It reached a tipping point that night in 2012, when she went to the ER. “That was my only option to get help that I knew of at the time,” she says.
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Jill Gleeson, 51, felt similarly frustrated when she arrived at her local emergency room in 1998. “I got into therapy as quickly as I did because I told them I was suicidal,” says Gleeson, who lives in Pennsylvania. “I said, ‘If you don’t find me a clinician or someone I can talk to, I don’t know what’s going to happen.’”
Gleeson has been open about her struggles with severe depression and suicidal thoughts (she first wrote for GoodHousekeeping.com after Kate Spade’s suicide in June) and notes that by middle age, one’s support network has sometimes dwindled.
2016 Suicide Rates by State
“When I was in my twenties, I had this safety net under me because my parents could pick me up if I fell,” she explains. “You get to be in middle age, and particularly if you are a single or divorced or widowed woman, or a man, you don’t have that support system. Even if your parents are still alive, chances are they’re not capable of providing support. You are supporting them.”
What makes it worse, adds Gleeson, is the stereotyped notion that your glory days are over. “I think this can really drive depression, at least in my own case,” she says. “It’s just this sense that we’re already middle aged and still not well, and what really is there ahead at this point?”
“IT’S NEVER JUST ONE THING”
When you look at a person with suicidal thoughts, there are usually multiple factors at play, explains Dr. Jane Pearson, Ph.D., chair of the National Institute of Mental Health’s Suicide Research Consortium in Bethesda, Maryland. “You might have a substance abuse problem,” she says. “You might have an early sexual abuse history that we know can put some people at risk. You may have had a mental health problem that wasn’t accurately diagnosed, evaluated, or treated.”
Women in particular are looking at a set of unique circumstances. “You have women who are having kids later in life, and that means that they’re not only responsible for the care-taking of their children at that age, but they’re also often care-taking for their parents,” says Dr. Draper. He adds that women in this age range are also expected to be wage-earners (the CDC cites economic and financial strain as a risk factor for suicide) — and of course there’s the M-word: menopause. It affects women biochemically in addition to putting them under additional sociocultural pressures.
For Nancy Hamilton, 54, it was a combination of financial stress, severe depression, and the guilt of feeling like a “bad mom” that influenced her depression in middle age. She’s struggled with depression since the age of 15 and attempted suicide for the first time in college. She says she wishes she had found more help when she was younger.
“At 54, I don’t feel as hopeful as I might have when I was in my thirties,” she says. “But when you’re young, you’re not well-versed in bureaucracy, and it’s really daunting. You just think, screw it. You’re already feeling depressed, and then you’re asked to go through all of these hurdles like filling out extensive paperwork and waiting for months at a time in order to get help.”
Hamilton’s children have encouraged her to seek treatment in the past, but during severe bouts of depression, being a mother has caused her panic. In a way, knowing that she could never leave her children the way my grandfather left my mom, through suicide, made her feel trapped in misery. “I felt like I really wanted to kill myself, but I was like, I can’t do that because I have kids,” she says. Then I got very panicky thinking, I’m stuck on this earth feeling this way, which made me feel even more desperate.”
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On Thanksgiving Day in 2015, Hamilton excused herself after dinner to go to her bedroom, where she had a breakdown. Her children joined her and asked that she call her doctor, who said she needed to go to the ER. Hamilton, who lives in Central Pennsylvania, was admitted to the mental health unit of her local hospital, and after a few days she was transferred to Geisinger Medical Center, where she was given 12 electro-shock therapy treatments.
Today, she takes various dosages of Remeron, Prozac, Wellbutrin, Lamictal, Abilify, and Adderall — a cocktail that she says keeps her functioning but makes her uncomfortable.
“I don’t like being on so many medicines, but I don’t want to mess with it right now. It’s better than not functioning or killing myself,” she says.
For Rebecca Bingham, 63, it was a combination of substance abuse and unhappy marriage. She grew up in a small town in Louisiana, where her family lived what she calls “the plastic southern lifestyle.” With a father in the Rotary Club and a “Miss Everything” mother, Bingham describes her upbringing as learning to “put on your pearls and your happy face.”
But her family had a history of alcoholism and as time went on, Bingham developed a drinking problem of her own. In 2002, the same year she got married, she also decided to get sober. “I didn’t consider myself an alcoholic, but I said I don’t want to become one. I don’t want the consequences of what might happen,” she says.
Bingham was successful in her sobriety, but her marriage started breaking down around 2011, after nine years together. Instead of self-medicating with alcohol, Bingham sought the help of a therapist, who counseled her on how to work through the issues with her husband.
One night, during a weekend trip to Florida with her husband and his parents, she tried to discuss some ground rules that, at the suggestion of her therapist, would help the couple agree on ways to talk through their issues. Instead of helping, the entire family ended up in a “knock-down, drag-out verbal fight,” according to Bingham. After everyone else had gone to sleep, Bingham found herself alone in the living room of their rented condo, devastated.
For every middle-aged person who dies by suicide, 161 middle-aged people think seriously about suicide but don’t kill themselves.
“If there had been alcohol available that night, I would have thrown away nine years of sobriety, because I was ready to get plastered,” she says. But she didn’t have a car, and she felt trapped. “I said to myself, if living sober is going to be this miserable, then I don’t want to live.”
Bingham walked toward the eleventh floor balcony, and, shaking, bumped into a dresser, causing a few items to fall. Standing outside, she leaned over the railing and watched her tears fall to the ground. She thought about ending her life. Then, she turned and noticed one of the items on the floor back inside: a book she’d recently read called Peace From Broken Pieces by Iyanla Vanzant.
In it, she remembered a story about a mighty lion who had lost his way, because the lion forgot what it was. “And I thought, that’s it. I have completely lost who I am,” she says. Bingham went back inside.
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“I decided that if I could just get home, I would get help,” she says. Bingham drove back to Hot Springs, Arkansas, the next day and went to an Alcoholics Anonymous meeting. She and her husband had worked on their marriage for three more years, but just last month, in August, their divorce was finalized.
Ever since her first and only suicide attempt, Bingham has participated in the You Are Beautiful campaign. For $6 a month, You Are Beautiful will send you a set of stickers, and the goal is to hand out one sticker per day. Bingham says it’s as much for her as it is for the people in her community.
“I was in Walmart just a couple of days ago, and the girl behind the counter goes, ‘You’re the You Are Beautiful Woman!’” she says. “I never take for granted that I have the opportunity to speak one thing into somebody’s life that might help them hang on for one more day.”
In 2016 alone, almost 20,000 middle-aged people died from suicide, but it’s important to know there is hope. “For every person between the ages of 40 and 64 who dies by suicide, there are 161 who think seriously about suicide but don’t kill themselves,” says Dr. Draper.
One thing friends and family members can do to help is what Dr. Draper calls listening intently and nonjudgmentally. “I can’t tell you how many people who’ve been through suicidal experiences say it’s the most important thing anybody ever did, ask me how I am doing, and take any thoughts I had about suicide seriously,” he says, and adds that part of doing so requires calming your own anxiety. “It’s a really natural response to think, ‘I want to fix this,’ or ‘I am really scared that this person is going to hurt themselves,’ so I’m either going to try to minimize it, and say it’s not as bad as they think it is, or let me try to fix this,” he says. “It’s just not helpful.”
Instead, Dr. Draper says a better approach is to summarize back to them what they said and follow-up with things like: I’m so sorry you’re feeling that way. I can understand how that is making you feel so terrible. I, too, would feel that kind of pain if I were in your situation. “This is important because, in the moment, they feel understood,” he says. “They feel someone is listening to them, and they are connected. Feeling connected is the biggest suicide prevention buffer that we have. If the person feels cared about and understood, they are no longer alone.”
Severin, who was an adult when his mother died, says he’s learned to have empathy for his mother: “I think having been through it, and realizing that she felt like she couldn’t ask for help, I learned from that, and it saved my life.”
My mom says she was angry for a long time. “I had no idea where my dad went other than God needed him. Like I didn’t?” she says. And while family history of suicide is an increased risk factor, she wanted the pain of being abandoned by a parent through suicide to end with her.
“I never wanted you and your brother to feel the way I did,” she tells me over the phone. “No matter what I’ve been through, I’ve always said it’s temporary, so I don’t want a permanent solution.”
In 2016, when Gleeson says she was in free fall, she re-gained hope through small acts. “You try to get enough sleep, you try to eat right,” she says. “You take the meds you need to take, and you don’t apologize or think badly of yourself for taking them.” She started exercising, and made a goal: “I decided I was going to mountain climb. Within one year, I needed to be on the top of Kilimanjaro.” For her, it was something to work toward, something to look forward to. And just like she planned, in 2017, she was on top of that mountain.
“It saved my life,” she says.
If you or someone you know needs help, call the National Suicide Prevention Lifeline at 1-800-273-8255.