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The Other Health Risk For Middle-Aged Men: Suicide

Societal suppression of male emotion contributes to the 4th leading cause of death that no one talks about.

Written by Sarah Gaer, Suicide Prevention Specialist, Riverside Community Care for The Good Men Project.

Congratulations! If you are between 45 -54 years old, you are officially “middle aged!” With this dawning of a new age comes new concerns, things perhaps you haven’t worried a lot about before. Your primary care physician is probably telling you to be more conscious of your diet as your risk for diabetes is increasing. You are being encouraged to have a prostate exam at your next visit too. Your friends are even sending you emails about how to detect a stroke. Uplifting for sure! But let me ask you, who is talking to you about depression and suicide?

It’s ironic isn’t it? We will warn of you of diabetes, which is the 8th leading cause of death for your age bracket; make sure you know the signs of the 12th leading cause of death, a stroke; and even prostate cancer which is the 30th cause of death. Yet people are still afraid to talk to you about the 4th leading cause of death for your age group: suicide.

As a suicide prevention specialist at Riverside Trauma Center in Needham, Massachusetts, I have been given the task of developing suicide prevention and depression awareness programs specific to middle-aged men. This is ironic in itself, as I am a relatively young (and charming) female, however the reality is that suicide is one of the most preventable tragedies our culture faces and yet we continue to avoid the much needed conversations about it. “Why is this?,” you may ask. The answers are many and complex. I think one of the most powerful causes is the stigma around suicide. I can remember a time when we would only say the words “AIDS” and “prostate cancer” in a hushed voice, and it seems as though we have made such progress in these areas.

Most of us now can speak openly, albeit not comfortably, about either topic, though not likely at a dinner party. But still the word “suicide” remains one said behind closed doors. Our fear of speaking the word is rooted in the underlying false belief that if we speak of it, somehow we increase the likelihood of it happening. In the context of that fear and false belief, we in public health and mental health struggle to have the discussion needed to increase suicide prevention. In this silence, we also send the message to those feeling depressed or considering suicide that they cannot talk about their experience.

This is only one of the problems, though. I believe the other even more devastating and damaging element is that feeling alone, sad and hopeless is simply not “manly.” At the same time, feeling angry (which is a common symptom of depression in men and boys) is seen as manly. What are some of the other common symptoms of depression you ask? Aggression, MANLY! Promiscuity, MANLY! Drinking beer (or any of your other favorite adult beverages), also MANLY! Men are discouraged from uttering the words “I feel,” often times leaving them feeling even more isolated and fearful of asking for help. This difficulty asking for support is especially challenging in the earliest stages of depression, which actually is the best time to deal with it.

Just to complicate it all a little more, men don’t tend to check in with each other. Don’t get me wrong: you will gladly ask if your pal saw the Pats game or if they heard Bruce Springsteen’s new, and might I add fantastic, album. But when is the last time you called your friend and said, “Hey, I haven’t seen you in a while. How are things going? Really man, are you doing alright?” That doesn’t happen nearly enough and sometimes those few words can save a life.

As you read my words, I’ll bet you can picture at least one friend that fits my description. He hasn’t been out with the guys – golfing, bowling or watching Sunday night football. He doesn’t laugh as much as he used to and he is somewhat of a downer. Maybe you know he hates his job, or he and his wife haven’t gotten along in years. Maybe he looks tired or never answers the phone anymore. So the real question becomes, how do you, as good men, take good care of one another?

So, if you are reading this and it makes you think of someone you know, call him. Check in. Tell him you miss seeing him. Reach out. Invite him to join you for an activity. Depression and suicidal thinking are not contagious. I am not just making this idea up; it’s based on a suicide prevention model called Question, Persuade, Refer (QPR).

The model encourages you to not only ask people how they are, but, if you see warning signs or if you are concerned about friends or co-workers, ask if they have thoughts of suicide. Then persuade the person that suicide is not the only option, and get him/her to someone who can help him if needed, seek immediate safety for the individual by calling 911. This model is intended to train non-mental health people how to help people who are suffering with despair, hopelessness and who may be contemplating taking their own lives.

Other options? I would also encourage you to check out “Man Therapy” at: It is a website geared towards men that uses humor and even takes place in Dr. Rich Mahogany’s manly office. It has great resources and is just plain fun to surf whether for yourself or with someone you care about in mind.

If you are that guy I described-feeling down, things don’t matter any more, maybe you can’t see things ever getting better- reach out to someone. Make plans. Treat the depression. Having spent time with way too many survivors (those left behind due to suicide), I promise you, there are people who care. You have many options. You can speak with your physician, you can find a counselor, you can call the National Suicide Prevention Lifeline (1-800-273-TALK.)

Calling a hotline or a counselor too big a step for you? Consider other things that might help: look at self-help resources online, volunteer to help others, call an old friend or relative who you’ve not talked to in a while, make a list of things for which you are (or have been) grateful, get a pet, play with that pet daily. Trouble sleeping? (Which is often part of being depressed?) Ask your doc for ideas about better sleep habits, or check out online for some suggestions.

In 2009, there were nearly 37,000 lives lost to suicide and countless others left behind. That’s 37,000 lives cut short, dreams forever extinguished. That’s countless more who are left knowing that there will be no new memories, no more birthdays or holidays with their loved one. Suicide hurts everyone. It is our intention and hope that through education, increased awareness and most importantly an increase in compassion, we can help people see that there are other choices. We want me to see that there are more reasons to keep fighting and living then not. Will you join us in this mission?

For more resources, please explore the following articles/websites or call 1-800-273-talk:

Suicide Prevention:

Signs of Depression:

For Veterans:

The Other Health Risk For Middle-Aged Men: Suicide




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