By ARIELLE LEVIN BECKER
The Hartford Courant
July 11, 2009
Nearly a quarter of suicides in the U.S. occur on Wednesdays, about twice as many as almost every other day of the week, a new study has found.
The study, published in the journal Social Psychiatry & Psychiatric Epidemiology, contradicts earlier findings that suicides are more common on Mondays and left experts puzzling over what may be behind Wednesday's grim distinction.
Is it something about the middle of the week? Job stresses piling up, potentially overwhelming people who already see their problems as insurmountable?
"It may be just that it feels like there's no way out on Wednesday, [it's] too long to wait for the weekend," said Theodore Mucha, medical director at the Institute of Living at Hartford Hospital. Like other experts, he cautioned that his explanation was just a guess.
Researchers Augustine J. Kposowa and Stephanie D'Auria at the University of California, Riverside, examined data from U.S. death records from 2000 to 2004, focusing on adult suicides.
They found that 24.6 percent of suicides occurred on Wednesdays. The next-highest rates were 14.4 percent on Saturdays and 14.3 percent on Mondays. The fewest suicides occurred on Thursdays — 11.1 percent.
Kposowa and D'Auria also found that more suicides occurred in summer and spring than in fall or winter, contrasting with traditional thinking that winter months bring more risk of suicide.
Other parts of the study were consistent with previous research, showing that men are more likely to take their lives than women, and people who are divorced, white, educated or living in non-metropolitan areas have a higher risk of suicide.
The day of the week findings represent something new.
"This really does tell us something different," said Nina Heller, a social work professor at the University of Connecticut. "What it doesn't yet tell us is the why of that."
Heller said she had been "scratching my brain" since learning of the study, trying to think of a reason for the Wednesday peak in suicides. Maybe, she said, people who are already suffering from a mental illness and struggling to get through the week see Wednesday as a halfway point. "Perhaps they can't push any further," she said.
People who take their own lives often have lost perspective, becoming so despondent they lose track of things that might help them get through the day, said Charles Atkins, attending psychiatrist at Waterbury Hospital.
"One of the obvious speculations about Wednesday is that it's work-related, that people have become so caught up in the stress of the work week that whatever it is that's going on or is on their plate seems unsurmountable and suicide seems like a way out," he said.
Other national studies have indicated that working Americans typically list their jobs as their top source of stress, which Atkins said may lend weight to the idea that the Wednesday suicide peak could be related to the work week.
Kposowa also pointed to workplace stress as a potential explanation and believes changes in Americans' work and family life may be behind the shift in suicide's concentration from Mondays to Wednesdays.
Increased economic competition worldwide has threatened job security for many workers, heightening stress, frustration and even feelings of betrayal, said Kposowa, a sociology professor. "Individuals work harder and harder, but seem to be losing ground; they have little or nothing to show for their labor — especially among those who depend on others for wages," he wrote in an e-mail. "It is highly likely that the middle of the week (represented by Wednesday) is when these stressors and feelings of hopelessness are at their highest."
People may have once viewed Wednesday as the day you got over in order to look forward to a relaxed weekend, he said. But perhaps many Americans now see the next weekend as too far away.
Kposowa suggested that suicide prevention hot lines examine which days of the week call volumes are highest and consider placing more staff on Wednesdays, Saturdays and Mondays. Mental health workers might also consider scheduling more patient appointments on Wednesdays, he said.
Several mental health workers said they had not noticed a link between Wednesdays and an increased risk of suicide. More than 25,000 people kill themselves in the U.S. each year, an average of slightly more than one per day in each state, so trends that might be apparent from thousands of cases would not likely be noticed by individual mental health workers or programs.
A Courant analysis of Connecticut figures showed a different day distribution: from 2001 to 2004, no day stood out as sharply as Wednesday did in the national study. Most suicides — 16.7 percent — occurred on Tuesday, while 16.4 percent occurred on Monday and 14.5 percent on Wednesday. Thursday had the lowest occurrence, 12.1 percent. The data showed 966 adult suicides, a small fraction of the 131,636 in the national sample.
Seasonal suicide variations in Connecticut did reflect the national findings, with most occurring in summer and spring and fewer in winter and fall.
The seasonal figures contradict previous findings, but they didn't surprise Michael Levinson, director of clinical services at the Capitol Region Mental Health Center. He works nights in an emergency room and has gotten used to seeing more psychiatric emergencies in the spring.
"We always sort of look forward to spring gritting our teeth," he said.
While traditional thinking has focused on winter, with its cold weather and lack of sunlight, as a more common season for suicide, Levinson has a theory about why it may not be so: People think it's normal to be depressed in the winter. "Spring is the time of year when people are supposed to be rejuvenated and outside and enjoying themselves, and if you're not, it makes you feel comparatively worse than everybody else, which may make you feel more hopeless," he said.
