Wabash, Ind. – Oct. 21, 2019 – The topic of suicide prevention and mental health has received heightened attention across the nation this fall. Suicide is a difficult topic, but it’s crucial that all adults recognize the importance of discussing it openly and honestly, because every community is affected.
Depression is the underlying factor in suicide, and the more people who are aware of the signs and symptoms – and when a person might be at greatest risk for suicide – the better.
Michelle Starnes, MSW, LCSW, works with older adults in her role as manager of the LifeBridge Senior Program at Parkview Wabash Hospital, and she has eye-opening information to share about suicide risk.
“Many people tend to think of suicide as a ‘young person’ or ‘middle-aged adult’ issue,” says Starnes, “so it might surprise them to learn that suicide rates in America are highest among older adults, especially in men over 85. And for seniors who live in rural communities, the risk is greatly increased.”
According to the Centers for Disease Control and Prevention (CDC), male farmers and ranchers have a suicide rate six times the national average, says Starnes.
“This is due to a greater risk for social isolation and the lack of resources for mental health support in rural areas,” she notes.
Male farmers are also at higher risk due to:
- Socialization, as men tend not to ask for help or seek healthcare
- Substance abuse
- Declining health and/or ability to do the physical labor
- Uncontrollable stressors including weather-related crop loss,
price fluctuations and changing regulations - Financial pressure not to lose the family farm
- Emotional stress as the provider for the family
- Lack of close confidants
- Stress-driven onset of depressive disorder
- Access to firearms
In older adulthood, grief may accompany the changes and challenges of aging – such as losing a spouse – but prolonged, debilitating depression is not normal, and it can lead to suicidal thinking.
“Symptoms of clinical depression in older adults often go unnoticed by family and friends,” says Starnes, “or they can be minimized as simply related to aging. The older adult may have difficulties identifying their own depression and may downplay symptoms they are experiencing, which can be different from those younger people experience.”
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Those symptoms include:
- Sleeping more or less than usual, or having difficulty falling asleep or staying asleep
- Loss or decrease of appetite
- Worry over the future/fear of death
- Increased substance use
- Physical illness, including digestive issues, frequent headaches, aches and pains
- Increased trips to the emergency room or doctor’s office for minor issues
- Feeling like a burden to family or friends
- Agitation, irritability
- Loss of interest in previously enjoyed activities
- Social isolation
- Memory loss or difficulties with concentration
- Feelings of helplessness, hopelessness or worthlessness
“When a depressed older adult begins to consider suicide, they tend to give verbal and behavioral clues to their state of mind,” says Starnes. “They may make indirect statements about feeling like ‘a burden’ or that they wish they were dead. They may give instructions like, ‘You’ll need to look after your mother after I’m gone,’ or ‘When I’m gone, I want you to have my tractor.’ While it may be tempting to think these statements are just attempts to get attention, you shouldn’t downplay them. You should ask that parent or friend or neighbor, in a non-confrontational way, if they are thinking about suicide.”
Behavioral clues can include giving away prized possessions, stockpiling guns or medications, suddenly putting personal affairs in order, or a significant change in mood, such as appearing happy after a period of depression.
Starnes says it’s an unfortunate truth that older adults most at risk for suicide are the least likely to ask for help. It is crucial for family and friends of seniors, especially of men who farm, to be able to recognize the signs of depression and suicidal thinking. The more signs that are present, the greater a person’s risk for moving from suicidal thoughts to action.
Intervention saves a life
Starnes gives an example. Bob, a respected business owner and farmer from Huntington County, came to see her at the Parkview LifeBridge Senior Program because he was overwhelmed by severe depression, anxiety, Post-Traumatic Stress Disorder (PTSD), nightmares, paranoia and psychosis. He was having suicidal thoughts and had planned out how he would end his life if therapy didn’t help him. Bob had never seen a therapist before and was not comfortable opening up to others – not even his wife – about his feelings.
“He was at serious risk of becoming a statistic,” says Starnes, “and I could tell he needed immediate intervention.”
Bob found healing through Rapid Resolution Therapy, also known as RRT. This innovative therapy takes only one to two sessions – working with both the conscious and subconscious parts of the mind – to provide healing and resolution of issues such as trauma, PTSD, depression, anxiety, panic, phobias, grief and substance cravings.
For Bob, the experience was life-changing, and he has given Starnes permission to share his comments
about it: “I was directed to LifeBridge at Parkview Wabash by my doctor due to severe major depression. I was having thoughts of suicide and getting worse by the day. My therapist, Michelle, dug deep into my problem and, realizing I needed help quickly, she recommended RRT to dislodge my PTSD and put it into the back of my mind for good. After only one RRT treatment, I was completely rid of my PTSD and can now talk about it without emotion. Michelle and RRT saved my life that day. I continue to see her for therapy and joined a group that helps keep me grounded and believing there is hope and life after PTSD. I highly recommend that anyone with PTSD or trauma that is affecting their life reach out to LifeBridge and get the help needed. The help will be relevant and rewarding for you.”
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Take positive action
Starnes suggests several ways anyone can help protect people who are important to them from having a crisis like the one Bob had.
“Learning about the signs and symptoms of suicide risk is a basic step anyone can take,” says Starnes. “Parkview Wabash and Parkview Huntington recently hosted educational sessions to train community members in a technique called QPR, for ‘question, persuade and refer.’ It’s simple to learn and can help save lives. Anyone who is interested in QPR training is welcome to contact me.”
A certified QPR trainer, Starnes can be reached at 260-569-2111. She will also be at the LifeBridge booth at Parkview Huntington Hospital’s (PHH) Healthy Steps health fair, Saturday, Oct. 26, 7 – 11 a.m. PHH is located at 2001 Stults Road in Huntington.
Another step, she says, is helping someone who may be at risk build a sense of social connectedness.
“Isolation can make depression much worse,” she says. “Check in with them regularly to show you care about them. Introduce them to social groups that get them involved in activities, maybe through a senior center or other organization.”
Most rural communities have senior centers where older adults can connect with others through exercise, arts and crafts, and meals, in addition to educational presentations and social events. Some centers also partner with mental health clinicians to provide added support while attendees are at the center. Senior centers may be helpful in connecting farmers with each other, too, since there is a lack of support groups or programs that specialize in the issues related to farming.
The third step, according to Starnes, is to remove any access to weapons the depressed person may have.
“Men usually choose guns to follow through on thoughts of suicide,” she notes, “so it’s wise for a trusted friend to hold guns for safekeeping, or place them in a lock box with the key kept off site by someone responsible.”
Finally, encourage the person at risk for suicide to seek treatment for mental health issues.
“Any of us can find ourselves stuck in depression, anxiety or grief,” says Starnes. “Sometimes life can be really tough. It’s so important to reach out for help. No one should have to worry about being judged because they are struggling to cope. But older adults, who grew up in an era in which personal problems were not discussed, can find it difficult to ask for help. And men may especially find it tough to seek help if they are reluctant to open up to a female about their problems. The majority of therapists tend to be women, and not many are familiar with issues experienced by farmers.”
“What Bob did,” she continues, “in coming to our program for help, took courage – and the result of his courage was that we were able to lift his burden so he could feel more like himself again.”
Rapid Resolution Therapy, the therapy that was so effective for Bob, is one of half a dozen treatment types Starnes says can alleviate depression, trauma, anxiety and grief in older adults. LifeBridge also offers a supportive group environment in which members can enjoy shared activities and form new friendships. If you or a loved one is experiencing depression or considering suicide as an option, please reach out in one of these ways:
- Contact the Parkview LifeBridge Senior Program at Parkview Wabash Hospital at
260-569-2111 or at Parkview LaGrange Hospital at 260-469-9270. - Call the Parkview Behavioral Health HelpLine at 260-373-7500 or 800-284-8439.
- Visit the Park Center Walk-In Clinic at 2710 Lake Ave., Fort Wayne, 260-471-9440.
- Call the Suicide Prevention Lifeline at 800-273-TALK.
Most of this article is reproduced from a blog by Michelle Starnes, Parkview LifeBridge Senior Program, that originally appeared on the Parkview Health Facebook page and in the “Parkview Blog” section of www.parkview.com.