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Suicide and tough times: Any link?

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Adams is a freelance writer.

A 45-year-old man in Porter Ranch killed himself and his family earlier this month after losing his job and money he had invested in the stock market.

One week later, a 53-year-old Pasadena woman was found dead in her burning home, an apparent suicide, after facing eviction from the house where she grew up. The house was foreclosed earlier this year.

Stories like these raise sober questions: Will economic hard times trigger more suicides? What kind of people are most likely to kill themselves over lost jobs, savings and homes? The risk factors for suicide have been well-studied by psychologists and sociologists, says Dr. Robert Simon, psychiatrist at Suburban Hospital in Bethesda, Md., and professor at Georgetown University School of Medicine in Washington, D.C. By far, the strongest risk factor is mental illness in the form of depression or anxiety disorders. Many studies have shown that about 90% of those who attempt suicide have a mental disorder.

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But there are documented economic risk factors too, including low income and unemployment, says Matthew Nock, a psychologist at Harvard University in Cambridge, Mass. Nock is coauthor of a July paper, published in Epidemiologic Reviews, that reviewed more than 1,000 published papers on suicides from all over the world and consistently found economically disadvantaged people at higher risk for suicide. Low educational achievement and unmarried status also play a role, he says.

A 2007 report is seemingly at odds with this well-accepted pattern of low social status begetting higher suicide rates. The paper, published in the Archives of General Psychiatry, showed that high-status people who experience a loss of job, income or marriage had the highest risk of any group of committing suicide. The study used data collected from 96,000 psychiatric patients in Denmark.

As with the low-status risk factors, specific causes underlying the big-fall phenomenon are not clear. “Is it some psychological factor, such as loss of identity?” Nock says. “I have a more practical view. This could just represent a huge stressor for a person.”

Generally, a number of stressors are involved. “Suicides are rarely if ever caused by just one thing,” says Simon. An impulsive personality “is one risk factor. If you’ve got a bunch of other ones, they start to add up.”

Adds Nock, “The No. 1 reason people give for making suicide attempts, pretty consistently across studies, is escape from some intolerable or humiliating situation.”

Often there is a trigger, some final stressor that may push a person to suicide.

There are protective factors as well, Simon says, such as a strong marriage, children in the household, good coping skills and self-esteem, moral and religious values, and even beloved pets.

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Stephen Stack, a professor of criminal justice at Wayne State University in Detroit, says that although unemployment is strongly linked to suicide, there are almost no data on loss of home or foreclosures. Stack studied 62 suicide case files in Detroit that had some element of economic strain and found that in 10 of those cases, victims had lost their homes, and seven of those had been evicted. Home loss often occurred with unemployment.

This suggests that a loss of home “may be just as bad as loss of job, but there is little research on it,” Stack says. The link between economic downturns and suicide rates is not straightforward. Says Brian Mishara, president of the International Assn. for Suicide Prevention and psychologist at the University of Quebec at Montreal: “Ireland’s suicides soared when unemployment decreased and standards of living increased. New Zealand suicide rates increased along with economic prosperity.” During the Great Depression, suicide rates rose dramatically. In the 1930s, suicides were the cause of nearly 16 deaths per 100,000 people, according to a 2002 report by the Institute of Medicine. “The rate hasn’t been that high since,” Nock says. “Now we’re at about 10 deaths by suicide per 100,000 people” -- back to the rate observed in 1920, before the Great Depression.

However, stories of people jumping from windows on Black Monday are largely myth. In other words, economic hard times may simply shine a brighter light on suicides even if there’s not much change in rate. Suicides today may appear more newsworthy as the media attempt to describe how the financial market crisis affects everyday Americans.

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(BEGIN TEXT OF INFOBOX)

Watch for the warning signs

* Observable signs of serious depression, such as unrelenting low mood, hopelessness, desperation, anxiety, and withdrawal from friends and family

* Increased alcohol or substance abuse

* Rage and uncontrolled anger

* Recklessness and impulsive risk-taking

* Threatening suicide or wishing to die

* Making plans, such as giving away prized possessions and buying a gun

WHAT TO DO

* Take it seriously and talk about it openly

* Be willing to listen without judging

* Take action by removing any guns or pills

* Get involved and seek professional help

WHERE TO GET HELP

Call National Suicide Prevention Lifeline, a 24-hour, toll-free suicide prevention service available to anyone in suicidal crisis. (800) 273-TALK.

-- Jill U. Adams

Sources: The American Foundation for Suicide Prevention and the American Assn. of Suicidology

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