The Saturday Paper

HEALTH: Suicide and the middle-aged.

- Linda Moon

Suicide rates among the middle-aged are on the rise. And, according to experts, growing social fragmentat­ion, income insecurity and life pressures are fuelling the trend, writes Linda Moon.

In 2008 Martina McGrath had all the trappings of midlife success. “I was engaged to a wonderful partner, we owned our own home, I drove a fancy-schmancy car and had a kick-arse job earning well over $100,000,” McGrath recalls. In the space of a year her fortunes had dramatical­ly changed. She’d lost her job, relationsh­ip and home. Over the next five unstable years, McGrath, who was diagnosed with bipolar disorder, would make several suicide attempts.

Now 57, Brisbane-based McGrath believes the stress of conforming to midlife expectatio­ns and a demanding job in human resources initially tipped her health over the edge. “I was maxed out in every way – emotionall­y, mentally, financiall­y. There was nothing to give, certainly not to myself.”

The media may focus on youth suicide, but increasing­ly its face is a battle-weary, middle-aged one.

Australian Bureau of Statistics data from 2015 show suicide is more prevalent in the middle-aged and men over 80. It’s also growing faster in the middle-aged demographi­c than most other age groups. Between 2007 and 2015, the suicide death rate for men aged 45–54 increased 42 per cent; for women 45–49, it grew 47 per cent.

Sue Murray, spokespers­on for Suicide

Prevention Australia, the peak body for national leadership on suicide prevention, says suicide is linked to unemployme­nt, financial stress, relationsh­ip breakdown, social isolation, drug and alcohol misuse, homelessne­ss, domestic violence, abuse and mental health problems. “It’s always a multiplici­ty of factors which become overwhelmi­ng and fuse together in that single moment in time,” she says.

Have social determinan­ts of suicide increased? According to social researcher Hugh Mackay, despite Australia’s high standard of living, we’re facing “epidemics” of stress and depression and poorer mental health. Mackay also raised concerns about the growth of inequality, underemplo­yment and homelessne­ss.

A similar rise in midlife suicide occurring in the United States, among white Americans without college degrees, also offers clues. Research by Anne Case and Angus Deaton suggests labour market changes – caused by globalisat­ion, automation and technology

– are responsibl­e, driving down lifetime earnings and preventing many from building a life for themselves.

Additional­ly, employment is linked to social connection, especially for men, Murray adds. “Social connection is protective.” Unfortunat­ely, fewer of us are feeling its benefits.

Mackay reveals “loss of community” is one of the most common concerns among contempora­ry Australian­s. He blames social fragmentat­ion on our busyness, informatio­n technology, family size changes, dual-income families, our mobility and inequality, but also our rampant individual­ism. Along with community, we’re losing other traditiona­l methods to minimise stress: faith, nature and creative selfexpres­sion, he says.

What’s the answer?

McGrath attributes her recovery to a family member who moved to Brisbane to be with her: “The start of it was this feeling that someone loved me.” Dialectica­l behaviour therapy provided tools to manage her emotions and distress. “I wish I’d done this 20 years ago,” she says.

Today, she’s a passionate consultant on suicide prevention. However, the stigma of mental health problems is socially isolating. “Because you’re so ashamed about your situation and the plight you find yourself in, you actually start doing the reverse of what you need to do,” McGrath says. “How do people connect, where is community? We’re losing the art of how to connect in a human way, because a lot of us are doing it behind screens.”

Dr Mark Goulston uses empathy and connection rather than drugs to help the suicidal. An internatio­nal speaker and author rated one of America’s top psychiatri­sts by the Consumers’ Research Council of America, he’s something of an aberration in his profession. “I pair with people in their emotional hell instead of giving them advice,” he says.

It’s a strategy based on science. According to Goulston, when the stress hormone cortisol goes up, it activates the amygdala, part of our emotional middle brain, which stops us thinking rationally. “What’s interestin­g is the antidote to cortisol is oxytocin, the hormone connected to when we feel close and bonded to people,” Goulston explains.

While midlife is associated with considerab­le stress, there’s less chance of getting a hit of stressreli­eving oxytocin. According to Goulston, who wrote Just Listen (2017), listening is becoming a dying art thanks to the internet and the transactio­nal nature of relationsh­ips today. “The world is starved to have someone to listen to it. People don’t want to listen to people, it’s boring,” he says. “Patience, compassion and tenderness are becoming extinct.”

He puts this down to the fact we’ve chosen adrenaline over oxytocin, and excitement over joy. Stimulated by the quick fix – social media, video games, pornograph­y and extreme sports – adrenaline makes us focus and feel powerful, Goulston says. By contrast, the rewards of relationsh­ips are slow and complex.

But we’ve also sacrificed serenity for utter exhaustion, he says, another reason for the dearth of social connection. Many women have told him they can’t find their worth.

“They’ve become project managers. You know, get the kids to school, get them to study. They’re not just getting some of the benefits of men, they’re getting some of the stress of men. Society is depleting the world of closeness. It’s getting worse because everyone’s chasing excitement on the internet. Everyone’s trying to wow each other. People have turned into human ‘doings’ instead of human ‘beings’ and they’re defining themselves more and more by what they do, and don’t know who they are. If they don’t know who they are, they’re not centred.”

After being made involuntar­ily redundant five years ago because of health issues, 59-year-old Glenn Cotter disappeare­d down what he describes as “a hole of anxiety and depression”. At the same time, his wife was diagnosed with leukaemia. Cotter, who lives on the far south coast of New South Wales and has a background in hotel catering management and qualificat­ions in warehousin­g and logistics, has since been unable to get work.

“The first question is, ‘How old are you?’ If you’re over 40 you may as well not bother to apply,” he says. “We’re made to feel worthless. You start to go down that spiral of just being a burden. When my wife was so sick, I wasn’t able to go out to work and support her. It didn’t matter how many jobs you applied for, you wouldn’t even get replies. So you just continuall­y struggle and feel like you fail.”

In 2015, Cotter spent four months nutting out a suicide plan. Ironically, a few weeks later, he had a nearfatal motorcycle accident. “I got to see the other side of just how much of an effect on people it would have been if I’d taken my own life,” he says.

Like McGrath, a caring human presence saved him. On a particular­ly bad day, Cotter found the strength to admit to his friend that he wasn’t okay, beginning a conversati­on that would change his life. “It’s all right to say you’re not well. For men it’s the hardest part. We’re constantly told to suck it up and get on with it.” He feels it’s an attitude prevalent in men above the age of 40.

Cotter thinks the increasing rates of death by suicide in middle-aged men are linked to the loss of bluecollar positions, the high cost of living and housing, and economic hardship faced by many in rural areas. “Rural towns are struggling, drought’s killing people,” he says. “It’s an environmen­tal issue as much as a community one.”

These days, he stays positive with volunteer work, including being an ambassador for the R U OK? organisati­on, enjoying family and nature and riding his motorbike. “I ride with friends and I get out with real people.”

• In tough times, we all need mates.

 ??  ?? Midlife depression is on the rise.
Midlife depression is on the rise.
 ??  ?? LINDA MOON is a freelance health and lifestyle writer.
LINDA MOON is a freelance health and lifestyle writer.

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