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The coronavirus outbreak has upended nearly every aspect of people's lives — and their mental health is no exception. A new paper in JAMA Psychiatry speculates that the risk of suicide may rise in the U.S. during the pandemic, as people increasingly grapple with economic challenges, social isolation, decreased access to community and religious support, and other daily disruptions.
Older adults may be at particular risk for suicide, the paper's authors note, possibly because they're more likely to have medical problems that are insufficiently treated or that worsen during the crisis. Studies show that a variety of health conditions — including cancer, chronic pain and dementia — “precipitate about 50 percent of suicides among adults 65 or older,” says lead author Mark. A. Reger, chief of psychology services at VA Puget Sound Health Care System and associate professor of psychiatry and behavioral sciences at the University of Washington School of Medicine in Seattle.
Though it is unknown whether a coronavirus infection is a risk factor for suicide among older adults, health care workers and families should “remain vigilant,” especially “given the prior research on the association of health problems with suicide,” Reger says.
Social isolation takes a toll on older adults
This concern about suicide during the pandemic is occurring against a backdrop of suicide rates that have already been increasing over the past two decades. From 1999 through 2018, suicide rates among women were highest in those between the ages of 45 and 64; the rates were highest for men age 75 and older, according to the Centers for Disease Control and Prevention (CDC).
"Many of us can imagine life after this [pandemic], but some older people don't have that future orientation,” says Marjorie E. Weishaar, clinical professor of psychiatry and human behavior at the Alpert Medical School at Brown University. “Many older adults are aware that they don't have the stamina and vigor they used to have, or they feel trapped by a sense of uselessness during this time. In assisted living facilities, some older adults are aware that death is more imminent for them. Also, the death of friends is really a blow, and it contributes to survivor guilt."
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Nevertheless, the biggest risk factors are related to social isolation, which, Weishaar says, “makes everybody's mood worse and it makes clinical depression worse.”
"Without access to family, social or religious activities, older adults are painfully isolated,” agrees Sandra Swantek, M.D., chief of geriatric psychiatry at the Rush University Medical Center in Chicago. “In that setting a person could lose sight of the future and become hopeless and potentially suicidal."
