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Men such as Robin Williams face higher risk of suicide

Lt. Keith Boyd, assistant chief deputy coroner for the Marin County Sheriff's Office, speaks at a news conference about the death of Robin Williams in San Rafael, Calif., Tuesday, Aug. 12, 2014. Boyd said Tuesday that Williams killed himself by hanging with a belt at his San Francisco-area home. (AP Photo/Jeff Chiu)

Lt. Keith Boyd, assistant chief deputy coroner for the Marin County Sheriff's Office, speaks at a news conference about the death of Robin Williams in San Rafael, Calif., Tuesday, Aug. 12, 2014. Boyd said Tuesday that Williams killed himself by hanging with a belt at his San Francisco-area home. (AP Photo/Jeff Chiu)

If you tried to create a profile of someone at high risk of committing suicide, one likely example would look like this: A middle-aged or older white male toward the end of a successful career, who suffers from a serious medical problem as well as chronic depression and substance abuse, who recently completed treatment for either or both of those psychological conditions and who is going through a difficult period, personally or professionally.

In short, that person would look a lot like Robin Williams, the 63-year-old actor and comedian who, authorities said yesterday, hanged himself with a belt in the bedroom of his San Francisco Bay-area home a day earlier.

While certainly not the only group susceptible to suicide – 39,518 people took their own lives in 2011 – older white males with that cluster of characteristics have been on psychologists’ radar at least since federal statistics released last year showed an alarming spike in their suicide rate between 1999 and 2010. The suicide rate for white men increased by nearly 40 percent, to 34.2 per 100,000 people.

“This is certainly the demographic, middle-aged or older Caucasians,” said Dost Ongur, associate professor of psychiatry at Harvard Medical School. “And certainly men with medical problems.” Williams had said he suffered from heart problems.

Men account for only about 20 percent of suicide attempts but represent about 80 percent of completed suicides, statistics show, almost certainly because they choose more lethal methods: guns and leaps from high places instead of drug overdoses, Ongur said.

Beyond the mechanics of suicide lies a variety of risk factors that predispose men, particularly middle-aged men, to suicide, experts said.

“Men are much less likely to seek help than women are,” said Michelle Cornette, executive director of the American Association of Suicidology. And “apart from seeking help professionally, (men) utilize their friendships in different ways. Men are less likely to disclose to a male friend that they are struggling psychologically.”

At the same time, aging may take a larger toll on the male psyche. Older men who value their self-reliance may find themselves less able to cope as they age, when they are no longer in their prime physically, sexually and at work.

“I often refer to them as being developmentally unsuccessful, because they’re not equipped to handle the challenges of getting older if they are so tied into their masculinity . . . and making a lot of money,” said Christopher Kilmartin, a psychology professor at the University of Mary Washington.

“Things aren’t the way they used to be,” Ongur said. “The power you knew, the control you knew, aren’t the same.”

When depression, addiction and medical problems are added to the mix, the risk of a suicide attempt increases significantly. Williams was grappling with “severe depression,” according to his publicist – a condition that creates hopelessness and despair, frequent precursors to suicidal ideation. Substance abuse suppresses inhibition and can lead to an impulsive act.

Ironically, when depression is lifting or someone is released from rehab or treatment, they are also vulnerable to a suicide attempt, said Nadine Kaslow, a psychology professor and vice chairwoman of the Department of Psychiatry and Behavioral Sciences at Emory University School of Medicine. In recent months, Williams had gone through rehab again. In July, the Oscar winner spent a few weeks at the Hazelden addiction treatment center in Minnesota, participating in a program designed to reinforce sobriety. “After working back-to-back projects, Robin is simply taking the opportunity to fine-tune and focus on his continued commitment, of which he remains extremely proud,” his representative told the Los Angeles Times.

During rehab, people often feel safe and protected, Kaslow said, “but when they come out, they may be overwhelmed by the world around them.”

A toxicology report that would reveal whether Williams had any chemicals in his blood at the time of his death will be released in two to six weeks, according to the Marin County Sheriff’s Office.

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