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Understanding Risk for Teens, Elderly, and Military Veterans

Understanding Risk for Teens, Elderly, and Military Veterans

While the overall rate of suicide is highest for ages 45-64, we see spikes in the number of suicides within certain groups. Teens, the elderly, and military veterans have disproportionately high rates of suicide.1,2 Understanding some of the special issues that these groups face can help keep you alert for problems. Keep the following cautions in mind, along with general warning signs3 and risk factors.

Elderly4

They may be at greater risk because:

  • Increased loss and loneliness: Many of the changes that come with aging involve loss. Seniors may face retirement, death of loved ones, and loss of independence. Many elders find themselves more and more cut off from support and emotional connection. Without help, loneliness and sadness can contribute to thoughts of suicide.
  • Losing sense of future and purpose: The hopelessness of feeling that one is no longer useful and the days are numbered can develop into depression.
  • Struggling with illness and pain: Chronic pain, health issues, and fear of conditions, such as Alzheimer’s, can spark depression. Depression may also be a side-effect of medication. In addition, seniors may be less likely to admit that they have mental health problems or to seek help.
  • Signs of depression may be misread: Depression can make older adults confused or forgetful, which can be misdiagnosed as a memory loss problem or dementia. Pulling away from others and loss of joy may be wrongly thought of as normal in an elderly person.

What you can do

Don’t assume that being sad is a normal part of getting older–it is not. Try to have conversations that touch on emotions and feelings. Encourage activity and socializing. Watch for stockpiling of pills or interest in getting access to a gun. Share any concerns with your elder’s doctor.

Unhappy teenage girl looking at her smartphone in the backseat of a car

Military veterans

They may be at greater risk because:

  • Adjustment issues: Getting used to civilian life after deployment can be extremely difficult, even if the person was not in combat. Along with adjusting to a different pace and focus, returning military must re-establish relationships and roles. They must find work and cope with any emotional and physical damage. It can be overwhelming.
  • At risk for post-traumatic stress disorder (PTSD): The experiences, emotions, and impact of deployment can cause ongoing mental stress. For some, this results in a diagnosis of PTSD and a higher risk of suicide as a result.

What you can do

Returning from deployment is a process, not an event. Give returning vets plenty of time to readjust to civilian life. Watch for unusual focus on weapons or other aspects of their military role, such as wearing their uniform or part of the uniform, such as boots. Be alert for obsession with war news, visits to graveyards, or overprotectiveness. Use the special help offered to veterans and other professional support as needed.

Teens

They may be at greater risk because:

  • Face more potential triggers: Teens are going through many emotional, mental, and social changes. At the same time, they face a high need to fit in. The stress of a new school/classes, bullying, gender identity concerns, or body image issues could be a trigger. Failing a test or a romantic breakup could be a tipping point.
  • More reactive to triggers and act more impulsively: Compared to adults, who typically do more planning, teens are quicker to act when stressed. This can add to the risk when faced with more potential triggers.
  • Vulnerable to imitation: Teens are more susceptible to suicide “contagion” as compared to adults (attempting suicide after learning of a suicide).5 Risk exists even if the teen didn’t personally know the person who committed suicide.6 In the intense aftermath of a suicide, they may interpret the action as an acceptable or heroic way to deal with distress.
  • Warning signs may not be as clear: It’s normal for teens to go through emotional ups and downs. It may be more difficult to spot moods or behaviors that point to suicide. Poor grades, explosive anger, acting out sexually, or even boredom may actually be a sign of depression. Warning signs of suicide may include running away from home or doing risky things, such as driving while drunk or abusing drugs.

What you can do

Keep lines of communication open. Watch for changes. Trust your instincts. Seek help from a professional (such as your doctor or a therapist) who can assess and treat your teen. If available to you, your Employee Assistance Program (EAP) can offer guidance and information on resources in your area.

Men, depression, and suicide7

Many men experience depression, but some of the outward signs may be different from what you might expect to see. While both men and women feel the hopelessness of depression, women tend to express it as extreme sadness while men may appear angry and irritable. Men are also more likely to have problems sleeping and do risky things. They tend to escape into work or sports even though these activities have lost meaning. Men may have more physical symptoms, such as headaches, stomach problems, and unexplained pain. These symptoms may not match our expectations of what a depressed person looks like.

In addition, men tend to be more likely to think of depression as weakness. They may be less likely to seek help. Instead, they may pull away from others and use drugs or alcohol. These unhealthy coping behaviors can increase the risk of suicide.

1Suicide: Facts at a glance. Centers for Disease Control and Prevention (CDC), 2015, http://www.cdc.gov/violenceprevention/pdf/suicide-datasheet-a.pdf

2Suicide risk among 1.3 million veterans who were on active duty during the Iraq and Afghanistan wars. Kang, H.K., Bullman, T.A., Smolenski, D.J., Skopp, N.A., Gahm, G.A., and Reger, M.A. (2015). Annuals of Epidemiology, 25(2): 96-100. http://www.ncbi.nlm.nih.gov/pubmed/25533155

3Signs of suicide: How to help. Defense Centers of Excellence for Psychological Health & Traumatic Brain Injury, https://www.military.com/benefits/veterans-health-care/signs-of-suicide-how-to-help.html

4Depression–Symptoms in older adults. http://www.webmd.com/depression/tc/depression-in-older-adults-topic-overview

5Youth suicide: Risk and protective factors. Flick, J., 2011, http://www.ncleg.net/DocumentSites/Committees/NCCFTF/Intentional%20Death%20Prevention/2011-2012/Suicide%20Risk%20%20Protective%20Factors%20handout%20Dr%20%20Flick%2010-10-11.pdf

6The contagion of suicidal behavior. Contagion of Violence: Workshop Summary. Gould, M.S. & Lake, A.M. (2013). Washington (DC): National Academies Press, http://www.ncbi.nlm.nih.gov/books/NBK207262/

7Male depression: Understanding the issues. Mayo Clinic Staff, 2013. http://www.mayoclinic.com/health/male-depression/MC00041

This information is for educational purposes and intended to promote consumer health. It is not medical advice and is not a substitute for proper care provided by a physician. Cigna assumes no responsibility for any circumstances arising out of the use, misuse, interpretation, or application of any information.