Depression is more common than AIDS, cancer, and diabetes combined, and nearly 400,000 people attempt suicide in the U.S. every year.
But even though it's a common and serious problem, many people don't know that much about depression and suicide—including who's at the greatest risk, why, and when they are most likely to be vulnerable.
Here are 15 myths and facts about depression and suicide.
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Suicides peak during holidays
"There is a time of year when suicides are more common," says Marcia Valenstein, MD, research scientist at the Department of Veterans Affairs Health Services Research & Development Service. "But it's not when everyone thinks."
Most people think the winter holidays are a risky time, but suicides are lowest in December and peak in the spring.
It's not clear why, but it could be due to changing levels of natural light. "It could be that they have more energy to attempt suicide," says Dr. Valenstein, who is also an associate professor of psychiatry at the University of Michigan Depression Center, in Ann Arbor.
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Suicide rates climb with altitude
The greater the elevation of a person's home, the higher the risk of suicide, according to a recent study. Suicide rates are about 70% higher in regions 2,000 meters in elevation, for example, compared to at sea level.
The effect appeared to hold even after researchers accounted for risk factors such as greater gun ownership and lower population density.
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Teens are at greatest risk
Teenage suicides make headlines, but the elderly are more likely to take their own life than any other age group, says Dr. Valenstein.
At particularly high risk are white men over the age of 85, who have a suicide rate of 49.8 deaths per 100,000, compared with about 14 per 100,000 in people over 65, and 11 per 100,000 in the general population.
Still, teenagers remain a high-risk group. One in five high school students says he or she has considered suicide in the past year and 1 in 12 attempts to take his own life. (The suicide rate for 15- to 19-year-olds is 6.9 per 100,000.)
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Whites attempt suicide more often than other races
Suicide is more common among whites in the U.S. than blacks, Asians, or Hispanics.
"No one is quite sure why whites are at a higher risk," says Dr. Valenstein. "It might have to do with differences in social support."
The only group at higher risk is American Indian/Alaskan Natives, who have a suicide rate of 14.3 per 100,000 compared to 13.5 per 100,000 for whites and about 5 to 6 per 100,000 for other groups.
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Writing style is linked to suicide risk
Creativity, depression, and suicide have long been linked, so it may come as no surprise that some of history's most creative individuals suffered from a mental illness. Depression affected great minds such as Charles Dickens, John Keats, and Tennessee Williams.
Several famous writers have committed suicide, including Ernest Hemingway, Sylvia Plath, and David Foster Wallace. This group also has something else in common: They all wrote in the first person, which has been suggested to be a sign of suicide risk.
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Depression is always the cause of suicide
Two of every three people who commit suicide are depressed at the time they take their life. However, alcoholism plays a role in 1 in 3 completed suicides.
Major depression is the psychiatric diagnosis most commonly associated with suicide, with about 20 times the risk found in the general population.
"With much more active screening and treatment, depression carries less of a stigma now, but it remains one of the big risk factors for suicide," says Dr. Valenstein.
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Your family affects risk
A family history of depression increases the chances that a child will suffer the same by a factor of 11.
But families (and friends) can also play a significant role in preventing suicide. Strong social support is known to lower suicide risk.
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Poor countries have higher suicide rates
In fact, many rich countries have higher suicide rates than developing nations.
Some of the lowest rates can be found in Latin American countries, such as Brazil and the Dominican Republic, while richer countries (based on their GDP per capita), such as Russia, Japan, and France, are among the highest. These nations report numbers between two and three times as high as the U.S.
Approximately 54 of every 100,000 men in Russia, for example, commit suicide every year. (The region's high rates of alcohol consumption may be partly to blame.)
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Most suicide attempts fail
Fortunately, only 1 in every 10 to 25 attempts actually results in death, according to Dr. Valenstein.
To further lower that rate, Dr. Valenstein suggests "taking away the means."
"Make sure people you're concerned about don't have stockpiles of meds or access to guns," she says. "You want to make it difficult for them to enact a persistent suicidal thought."
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Suicide is more common than in the past
Suicide rates in the U.S. have remained relatively constant over the past several decades, and may even have slightly decreased.
Still, youth between the ages of 15 and 24 are more than twice as likely to commit suicide today compared to 50 years ago. And, worldwide, suicide rates have increased by about 60% in the last 45 years, according to the World Health Organization.
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Treatment cuts suicide risk
"There are not a lot of ways to prevent suicide at this point," says Dr. Valenstein. "But successful treatment of any underlying psychiatric disorder is very important and can reduce suicidal thoughts, particularly among older people."
She adds that a popular concern that antidepressants can actually raise the risk of suicide among patients under the age of 25 is most relevant during the first few weeks of therapy.
"If you successfully treat depression," notes Dr. Valenstein, "suicidal ideation declines."
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Suicides can trigger "copy cat" attempts
Exposure to others who have committed suicide may "reduce some of the barriers to people thinking of doing it," says Dr. Valenstein.
She points out that this link has helped write new rules for responsible journalistic reporting. For example, journalists now typically refrain from going into detail or sensationalizing death from suicide.
"They usually finish up any story with a reference to a hotline so that distressed people reading it will reach out for help rather than being tempted to emulate," Dr. Valenstein adds.
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Fewer people are calling hotlines
One way to reach out for help is to call a suicide hotline. Use of this support has been on the rise among veterans in recent years in response to increased publicity, says Dr. Valenstein.
Veterans can call the general hotline at 800-273-TALK and press "1".
"But anyone can call the hotline for advice, even if they are worried about someone else," adds Dr. Valenstein.
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Suicides are more common on weekends
While Wednesdays are notorious for being "bumpy," and Tuesdays, in some studies, have been found to be the deadliest for suicides, Dr. Valenstein and her colleagues identified a different weekly peakMonday.
In an unpublished study that they recently completed, they found that the most suicides fall on Mondays.
Dr. Valenstein says that, while it is not clear from studies so far which day is most common for suicides, they do seem to occur near the beginning of the week. "I would assume that the start of the work week is a more stressful time for people."
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Men are at greater risk
While three times more women than men attempt suicide, four times more men than women actually kill themselves.
More than half of suicides in the U.S. are completed with guns. This violent and usually irreversible route is the choice of most men. However, Dr. Valenstein notes that the most common method among women is poisoning, typically an overdose of medication, the result of which is less often lethal.
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