Seventy-year-old Tasmanian man Bill Johnson* has attempted to take his own life four times as a result of a deep depression that left him in a “psychological black hole”.

“The first time I tried to kill myself, my wife and I had been having a chat, then she went out into the garden. I can remember sitting on a bench above the beach but that’s all.

“I was found later that night on someone’s doorstep in another suburb. I can’t imagine what I felt or thought. I don’t know why I wanted to die. All I can think of was that I wanted to sleep.”

Sadly Mr Johnson’s story is not unusual. Australian men aged over 70, and women aged over 80 are among the most likely to take their own lives.  

Elderly men at high risk

According to the Australian Bureau of Statistics, 190 men aged 70 years and over died by suicide in 2011, the latest year for which figures are available.

And the trend is global, with international suicide rates in people aged over 75 three times higher than people aged under 25, according to Brian Draper, conjoint professor of psychiatry at the University of New South Wales.

The American Association of Suicidology estimates that an elderly person takes their own life every 97 minutes in the US. And experts predict that these figures will rise as the population ages, leaving Australia with a significant public health issue.

A 2010 government inquiry, The Hidden Toll: Suicide in Australia found that “[d]espite a reduction in overall suicide rates, RANZCP (Royal Australian and New Zealand College of Psychiatrists) expected the number of suicides among older men to rise given they constitute a fast-growing segment of the population”.

Suicide is already a leading cause of death in Australia with around 2000 people taking their own lives each year, and a further 60,000 people attempting suicide. Men are four times more likely to end their own life than women. Worldwide 900,000 lives are lost to suicide annually.

With media attention often focussed on the issue of youth suicide, the suicide of older Australians is largely overlooked or confused with the separate issue of euthanasia. However, Professor Draper said only 10 per cent of late life suicides featured an element of euthanasia.

It’s not euthanasia

The chief executive officer of Suicide Prevention Australia, Sue Murray, said there were clear differences between suicide and euthanasia.

“What we are seeing (in this age group) are some of the common themes for people facing suicide, like disconnectedness and social isolation,” Ms Murray said.

“There could be a change in life circumstances, a person could be in poor health because of the ageing process, or their poor health restricts their ability to do things they would previously do, which could also increase loneliness and social isolation.

“They might also be dealing with loss and grief from the death of people around them or a loss of lifestyle.”

She said men in the 75-and-above age group were considered a particularly high suicide risk group.

Undiagnosed depression, or depression that has not responded to treatment, is overwhelmingly the cause of these deaths according to researchers who say older people mistakenly believe that depression is a normal part of ageing.

It gets worse

Bill Johnson’s depression intensified over many years until he found himself, “staring into space in a deep pit of depression, unable to see a way out”.

“It’s like you’re in a submarine and…you just glide to the bottom, you can feel yourself gradually gliding down, down and it feels like there’s nothing you can do about it. When you’re in there your mind is at zero, it just switches off,” he said.

“I can’t equate depression, and the pain of it, with any other illness I’ve ever suffered. There’s nothing as bad.”

Professor Draper has said that underreporting of late life suicide is also an issue.

“Suicide is likely to be under-reported in the elderly with GPs and other doctors being more likely to record deaths in frail elderly as being due to natural causes to avoid stigma for families and possibly in some circumstances to cover up assisted suicides,” he told the government inquiry.

While it may seem that late life is a time of inevitable poor health, loneliness and suffering, research consistently shows that later life is a time of greatest contentment and happiness for the majority.

Older people not respected

Ms Murray from Suicide Prevention Australia says that there is anecdotal evidence that suggests our culture does not respect and revere older people. There is a sense that there is more to gain from saving the lives of younger people.

“Culturally it seems to be more acceptable to allow older people to die,” she said, however, “The implications of losing older people are many and varied including social, economic and cultural.”

RANZCP says society is not meeting the needs of a rapidly ageing population and the media has missed the true tragedy for older Australians. “Suicide is not a reasonable option for any age group and suggestions that an older person’s death is any less of a tragedy is unfortunate and ageist,” according to Dr Rod McKay, chair of the faculty of Psychiatry of Old Age at RANZCP.

“Australians are now living longer than ever and our population as a whole is ageing. However we are not appreciating the importance of preparing our society to meet the needs of these people.

“We should be a society that expects people to age wisely, recognises the ongoing contribution of older people and is quick to provide support when it is required,” Dr McKay said.

For Bill Johnson a variety of factors including regularly seeing a psychologist, the company of his dog, his faith in Christianity, volunteering several days of the week and giving up alcohol have led to him effectively managing his depression.

“The sun is shining again and I feel good,” he said. “I’m so pleased to be living.”

For help or information on depression and suicide:   

• Lifeline: 13 11 14

• Suicide Call Back Service: 1300 659 467

• MensLine Australia: 1300 78 99 78

• Beyondblue support service: 1300 22 4636

• Lifeline: 13 11 14

• SANE Australia Helpline 1800 18 SANE (7263)

* The interview subject’s name has been changed.

Michelle Hamer is a Melbourne author and journalist