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T M C » P U L S E | A U G U S T 2 0 1 8 22 Suicide in Middle Age Isolation, illness and caring for children and elderly parents can contribute to suicidal thoughts M ary Jane Pita had a tough 2002. After 25 years as a compliance officer at a bank, her once-comfort- able life began to crumble when her husband's construction company went under. The couple were forced to file for bankruptcy, and Mary Jane felt she could no longer work at the bank where the loans she and her husband, Charles, had taken out for his business had been processed. At 50 and 69, respectively, the Pitas were not sure what to do next, so they took a chance and moved to Spain. Soon after the robbery, Mary Jane tried to commit suicide, the first of three attempts. "I took pills and I had to go the hospital," she said. An alarming trend Suicides across all age groups have skyrocketed over the past two decades. Each year, 250,000 people in the United States attempt suicide and 45,000 succeed. "Nobody knows why people commit suicide," said Asim Shah, M.D., professor and executive vice chair in the Menninger Department Mary Jane Pita attempted suicide for the first time at age 50. "We lost everything," Mary Jane said. "The only things I have from my previous life are the clothes and suitcase I packed it all in." Once in Spain, troubles contin- ued to plague the couple. "One night, I was robbed as I was walking, and they stole my purse," Mary Jane recalled. "I had my debit card in there and because I could never remember anything, I had to write down my PIN number with the card, so they took everything. My husband was just really mad. I thought, 'This is all I can take— I've had it.'" B y B r i t n i r . M c A s h a n of Psychiatry and Behavioral Sciences at Baylor College of Medicine. "Obviously we can't go in the mind and see what hap- pened. One theory that is widely accepted is that suicidality is an act of impulsivity." Mary Jane was 50 years old at the time of her first suicide attempt, more than a decade before she sought help at The Menninger Clinic. The recent suicides of fashion designer Kate Spade, who was 55, and celebrity chef Anthony Bourdain, who was 61, have shined a public spotlight on suicide in middle age. "This is the age group that has the maximum risk," said Vineeth John, M.D., professor and vice chair for education in the Department of Psychiatry and Behavioral Sciences at the McGovern School of Medicine at The University of Texas Health Science Center at Houston. "The group with the highest risk is around age 45 to 55 and then those over 85, but the question is, why at that age?" To answer his own query, John explained the U-shaped happiness curve over the course of a lifetime. We tend to start our lives happy, but that contentment begins to wane around 18 and then reaches a low in our 40s, he said. In our 50s, happi- ness levels often begin to rise again and keep going up, though they may drop in the final years of life. According to the U.S. Centers for Disease Control and Prevention, suicides in women ages 40 to 65 increased by 80 percent between 1999 and 2014, and suicides in men ages 40 to 65 increased by 60 per- cent over the same time period. Instability in the workplace,