When looking at the 10 leading causes of death in America, there’s been a promising trend: The death rates for the big ones—including heart disease, cancer, stroke, and diabetes—have been declining.
But there’s one big exception: suicide.
According to a new report released by the Centers for Disease Control and Prevention (CDC), suicide rates overall have increased by 24 percent from 1999 to 2014.
And in middle age men, the spike is even higher. Suicide rates for men ages 45 to 64 jumped by 43 percent during that time period.
What’s Responsible For the Suicide Rise In Middle Aged Men?
Unfortunately, there isn’t one cause that can explain the spike in suicide rates for middle age men, says Christine Moutier, M.D., the chief medical officer for the American Foundation for Suicide Prevention.
There’s likely a convergence of multiple factors within men in this age group that makes them especially vulnerable, she says.
For instance, guys in general tend to be more resistant than women are about getting mental help in the first place.
And that may be one reason why men continue to die from suicide at more than three times the rate as women, as the new report showed.
Many men behave stoically in the face of health issues—especially for those regarding mental health—and operate under the belief that they can get through them on their own, Dr. Moutier says.
“The protective thing to do is reach out and connect with people, both interpersonally for social support, but also to access mental health care,” she says.
Men of all ages tend to struggle with that, but the economic stress over the past decade or so—recessions, job losses, and downsizings—may have packed a greater punch to older guys than their younger peers.
“Men in the older part of middle age will probably feel the stress of that more overall, just in terms of not having enough time to make up for those losses later on,” Dr. Moutier says.
Another possible explanation? The increase in deaths by opioid overdoses.
According to a separate CDC report released in January, overdose deaths by opioids—including narcotic pain relievers—have increased by 200 percent from 2000 to 2014.
When You Should Seek Mental Help
Many times, men don’t show the stereotypical symptoms of depression.
“Sometimes it’s not going to be feeling sad or blue first, or maybe even at all during the mental health crisis or the depression,” says Dr. Moutier.
Instead, signs that guys may notice include changes in sleep patterns, a loss of energy, less interest in sex, or feeling less of a purpose in life or less of a connection to it.
An increase in substance abuse is also common, too. Lots of guys might find themselves drinking more, she says.
If you can check a couple of those symptoms off the list—and they don’t go away on their own after a few days, or they disappear but keep popping back up—you should make an appointment with your primary care doctor. (You can also call the National Suicide Prevention Lifeline at 1-800-273-TALK if you are in a state of distress.)
Your primary care doctor will likely start by running a bunch of tests, like to check testosterone or thyroid function, to make sure there isn’t a physical cause for your symptoms, Dr. Moutier says.
If it turns out to be depression, your doctor can start you on antidepressants, or refer you to a therapist or psychiatrist. You may also be treated with a combination of medication and counseling.
What Can You Do If You Think a Loved One Is a Suicide Risk?
If you notice a loved one displaying some of the symptoms above—as well as additional behaviors like isolating themselves from friends or family, or giving away prized possessions—they may be at risk.
Start by opening up a private, caring conversation with the person you are concerned about, says Dr. Moutier.
Tell them you’ve noticed they don’t seem to be themselves lately, and give them concrete examples explaining how.
Ask them what’s going on in their lives, Dr. Moutier says—and then be prepared to listen.
“Let them talk,” she says. “The impulse we have is to go in there and try to solve their problems.”
If the conversation raises more concerns, your next step is following up: Encourage them to get help, and if you think it’ll make it easier, even offer to go to the doctor’s or the counseling with them.