Suicide rates since 1999 have risen sharply in nearly every state, including Georgia, the U.S. Centers for Disease Control and Prevention announced last week. The CDC is now revealing more disturbing news: The trend is worse among women.
Suicide among women in Georgia increased 30 percent from 2000 to 2016, the latest year available, according to figures the CDC released this week. Nationwide, the increase among women was 50 percent. That’s more than double the increase for men — which was itself a shocking increase at 21 percent.
“We’re seeing even in these younger females the rates start going up,” said Nadine Kaslow, the chief psychologist at Grady Memorial Hospital and a professor at the Emory University School of Medicine. “We saw these rates for females start increasing at age 10.”
Women have historically died from suicide attempts at much lower rates than men. However, she said, “obviously, if we keep going at this rate, it’s going to equalize.”
Scientists have theories, but they don’t know why. Unlike some other health problems, suicide has not sparked a major national campaign of research.
Some of the theories scientists suggest stem from major national trends. Women increasingly bear the financial burden of supporting a household, and women are more likely to need multiple jobs to do it. For both men and women, the past two decades have seen the worst economic downturn since the Great Depression, stagnant wages, wars in Afghanistan and Iraq, an opioid crisis, and troubles with access to health care.
And even if they themselves did not serve abroad or lose a job, women are often the social supporters who take in the emotions going on around them.
Compulsion and hope
Lydia Russo could easily have been part of the trend.
She remembers with clarity the moment in a Target dressing room, with her mom standing guard nearby, when her compulsion to kill herself started to ease.
She’d dropped weight and her mom insisted on getting her out for new clothes. Now, on a November day in 2009, something was lifting, just slightly. And Lydia was agreeing to go for ice cream.
She’d lived with this powerful engine to destroy herself for more than two months. She doesn’t know what set it off. She had anxiety, but with minor medication, she was fine. She was bubbly, energetic. Her best guess is that after she successfully fought off breast cancer for a year, the stress finally broke loose with a vengeance.
Asked whether any of the big social stressors of the times affected her, she at first insists they didn’t. Her charmed life included a loving husband and a wonderful job. Then, pressed further, she realized that her job at the time, in career services at a law school in the middle of the Great Recession, had become a grim round of seeing bright, ambitious, hardworking students whose dreams just might be dashed.
“I had a job I used to love and would bring me such joy,” she said. “But during that period of time my mind was telling me ‘Yeah, there’s no hope for them either.’ ”
Her boss had a friend who committed suicide, and she knew enough to ask outright whether Russo was suicidal. Russo, relieved to have it out in the open, said yes and went home. The boss alerted the family, and then Russo began weeks of intense therapy and medication while her husband and her mother switched off on a 24-hour watch to keep her from killing herself until hopefully something worked.
Finally, the right combination of medications took hold.
“There is hope,” Russo said this week in her now springy voice. “There are interventions that work. But when you’re depressed your brain does not believe that. Not one bit of your brain believes that.”
“That day I tasted mint chip ice cream again, and it tasted a little good,” she said. “I was like, wow, a little bit of me is coming back.
“I was able to write in my journal that day. Things that seemed like impossible to me, I was doing.”
She started back to work part time a month later, and not long after that she was working full time.
“I was totally my normal self again,” Russo said. “It’s the craziest, craziest thing.”
She expects to be on a maintenance dose of Prozac for the rest of her life, which is fine. She went on to get a promotion to a bigger institution, at Emory University Law School, but then decided to get a degree to help others facing suicide. She and her husband now live in Candler Park with their beloved dog, Ollie.
Limited funding for research
Russo realizes not everyone has the resources she did. So many things worked right for her: The boss who got educated the hard way through a friend’s suicide and faced the issue head-on. The family that had the resources to keep watch and the stamina to keep working with her. The health care access to get therapy and drugs. And determining the drugs that worked.
“Suicide has not been a major recipient of funding for research in the U.S., notwithstanding it being a public health crisis,” said Roland Behm, the board chairman for the Georgia chapter of the American Foundation for Suicide Prevention. “We need to study what is happening, why it’s happening and what we need to do.”
He raises the example of ketamine, a substance that in some test subjects lifted the compulsion of suicide for a short period. Scientists don’t know why it worked or if it would work in the broader population, he said.
Behm and other mental health advocates expressed concern about coverage for mental health care. First off, people need to have health insurance, they said, as required by law. Health insurance right now is required to cover pre-existing conditions such as mental health care, although a lawsuit just backed by the Trump administration would strike that as unconstitutional.
Behm also suggests a requirement for suicide-specific training for mental health professionals.
One of his colleagues at the foundation, Christina Owens, its director, adds that one of the most powerful things people can do is simply reach out to others with the right language. She frequently speaks to groups, who often sit silently when she asks for questions, then finally one person opens the floodgates. She’s done it at a debutante retreat. She recently spoke to a group of at-risk kids.
The notion that bringing up suicide will just give someone the idea is “a myth,” Owens said. If you’re wrong they’ll just know you’re the type of person they can reach out to. “At the end,” she said, “they were actually giving me hugs.”