The Suicide Prevention Conversation No One Is Having About Midlife
A note before you read this: this post deals directly with suicide, including personal loss. If you're struggling right now, you don't need to finish reading first — call or text 988 (Suicide & Crisis Lifeline), free and confidential, 24/7.
Last week I told you we were spending two posts on the mental health side of what we do here, and that this week would be more direct. Here it is.
Everybody's attention on suicide prevention goes to teenagers, and it should — it's a real crisis. But it's left a massive blind spot in the middle of the age chart, right where most of you reading this live. The data on adults 45 and older, men and women both, is worse than most people know, and almost nobody's talking about it out loud. I'm going to.
I lost my daughter to suicide seven years ago. Three years later, I lost one of my best friends the same way. I've talked about both with clients here more times than I can count, because I'd rather have this conversation in the open than let it stay the thing nobody brings up. If normalizing it helps even one person reach out instead of going quiet, that's the whole point of this post.
The Numbers Nobody Expects
Adults 35–64 account for almost half of all suicides in the U.S., and suicide is the sixth leading cause of death in that age group.¹ That alone should reframe who most people picture when they hear "suicide risk" — it's not primarily a teenager. Increasingly, it's someone your age, in your gym, at your dinner table.
For men, the risk climbs steadily with age and keeps climbing. Men 45–54 die by suicide at a rate of about 29.5 per 100,000; men 55–64 are close behind at 29.3.² It gets worse from there — men 75–84 are at 38.2 per 100,000, and men 85 and up sit at 55.7, more than 16 times the rate of women the same age.³ Adults 80–84 have the highest suicide rate of any age group in the country.¹ This is the opposite of what most people assume: the risk doesn't fade as men get older and supposedly "settle down." It rises, and it's been rising for two decades — a trend researchers have called largely overlooked, precisely because public attention skews so heavily toward youth.³
Women's absolute rates are lower across the board — roughly 8–9 per 100,000 in the 45–64 range, well under a third of the male rate at the same age.⁴ But two things about women's risk deserve equal attention, not a footnote. First, midlife female suicide rates have been climbing faster, proportionally, than men's for years — in the most recent full-year comparison, the age-adjusted rate rose 4% year-over-year for women versus 1% for men.⁵ Second, and this is the part that almost never comes up: one study found women in the perimenopausal transition had close to a seven-fold increase in suicidal ideation compared to women before or after that transition — and compared to men of any age.⁶ That elevated risk showed up independent of whether someone had a diagnosed mood disorder, which suggests something physiological is happening on top of whatever else is going on in a woman's life at that age. That's not a small finding, and I don't hear anyone talking about it.
Two Different Risk Stories, One Blind Spot
Here's the honest way to say it: this isn't one problem; it's two, and we miss them for different reasons.
Older men's risk is tied to loss of purpose, structure, and connection — retirement with nothing to replace it, a divorce late in life, kids gone, a body that doesn't work the way it used to, a social circle that's quietly shrunk because nobody's organizing anything anymore. It doesn't announce itself as a crisis. It looks like someone going quiet.
Midlife women's risk is tied to that same list of life stressors, plus something the list doesn't capture: a hormonal transition that appears to move the needle on suicidal thinking on its own, not just as a stand-in for depression. If you're only screening for "does she seem depressed," you can miss it. That's part of why the "Training Through Menopause" work we've done matters beyond hot flashes and joint pain — this falls squarely within that same window of a woman's life.
Both stories get missed because the public conversation about suicide prevention is built almost entirely around adolescents and young adults. That's not wrong. It's just incomplete, and the gap lands directly on the age group this gym serves.
Warning Signs Worth Knowing
These aren't secret. They're just easy to miss if you're not looking, especially in someone who's good at holding it together in front of other people.
Withdrawal — skipping things they used to show up for consistently, going quiet in a group they used to be part of.
Giving away possessions or tying up loose ends that don't need tying up yet.
Talking about being a burden, even in a joking or offhand way.
A sudden sense of calm after a period of visible crisis — sometimes read as "they're doing better" when it can mean the opposite: they've made a decision, and the weight of deciding is gone.
Increased or worsening substance use, especially alcohol. This one doesn't get talked about enough as a warning sign in its own right, rather than a separate problem sitting next to the real one. Both people I lost were also struggling with addiction in the years before they died. Looking back, it wasn't a separate thread from what was happening with their mental health — it was part of the same picture. The research backs that up: substance use disorders are one of the strongest known risk factors for suicide, and they compound everything else on this list.
If you notice more than one of these in someone you know — or in yourself — that's the moment to say something, not wait for more evidence.
What Actually Helps (and What Doesn't)
I'm not going to overclaim here, because that's not how we do things at EXL, and this subject deserves it least of all. A 2023 meta-analysis pooling 17 randomized controlled trials found that exercise interventions significantly reduced suicide attempts — roughly a 77% reduction in the odds of an attempt.⁷ It found no significant effect on suicidal ideation — the thoughts themselves. The authors were upfront that the studies were small and called for better research.
Read that carefully: movement and the structure around it appear to be a real protective factor against acting on suicidal thoughts. They are not a treatment for having those thoughts in the first place, and I won't tell you otherwise.
What looks protective, consistently, across this research: purpose, routine, and connection to other people who'll notice if you disappear. That's not a sales pitch for a gym membership — it's the actual mechanism. A place where you're expected somewhere, where people ask where you were if you miss it, where being physically capable is the explicit goal — that's a structural defense against the isolation that sits underneath so much of this. It's also exactly why we built EXL the way we did, ego-free and community-first, long before I connected those dots to this specific subject.
Why I'm Telling You This
I don't share this for sympathy. I share it because I've seen what happens when this stays unspoken, and what happens when it doesn't.
My daughter and my friend both struggled with addiction in their final years, on top of everything else. I don't say that to reduce either of them to it — they were both far more than what they struggled with. I say it because if I'd understood then what I understand now about how those things connect, I might have asked different questions, sooner. That's why I keep bringing this up with clients instead of leaving it as something we don't discuss at a gym. It's also why this post exists.
If you've lost someone this way, you already know there's no clean way to talk about it. I'm not claiming to have found one. I'm just choosing to talk about it anyway, because the alternative — everyone carrying this alone and quiet — is worse.
What to Actually Do
Ask directly. "Are you thinking about suicide?" does not plant the idea. The research is consistent on this — asking directly reduces risk; it doesn't increase it.
Check on the quiet one. Especially a man over 50 who's recently retired, divorced, or lost someone close. He is statistically the person least likely to bring it up himself.
Don't leave someone alone in a crisis. Stay with them, or make sure someone else does, until help arrives.
You don't need the right words. Presence matters more than a perfect script. "I'm here, and I'm not going anywhere" is enough to start.
Call or text 988 — the Suicide & Crisis Lifeline. Free, confidential, available 24/7, for you or for someone you're worried about.
The Bottom Line
The public conversation about suicide prevention has a blind spot in the middle of the age chart, and it lands squarely on the people this gym trains: men whose risk keeps climbing well past the age most people stop worrying about it, and midlife women carrying a risk that's rising fast and tied to something physiological, not just circumstantial. Exercise and community are real protective factors — not a cure, and I won't pretend otherwise. What helps is purpose, routine, and people who notice when you go quiet. I've lost two people I loved to this. Talking about it plainly is the only response I've found that does any good.
References
Centers for Disease Control and Prevention (CDC), National Center for Health Statistics — Suicide Data and Statistics.
CDC, National Center for Health Statistics, Vital Statistics Rapid Release Report No. 34 (November 2023).
Fields, S. (2025, July 17). "Suicide rates rising in older men, CDC data reveal." STAT News.
American Foundation for Suicide Prevention (AFSP), Suicide Statistics.
CDC, National Center for Health Statistics — Changes in Suicide Rates in the United States From 2022 to 2023 (NCHS Data Brief).
Usall, J., Pinto-Meza, A., Fernández, A., de Graaf, R., Demyttenaere, K., Alonso, J., et al. (2009). Suicide ideation across reproductive life cycle of women: Results from a European epidemiological study. Journal of Affective Disorders, 116(1–2), 144–147.
Fabiano, N., et al. (2023). The effect of exercise on suicidal ideation and behaviors: A systematic review and meta-analysis of randomized controlled trials. Journal of Affective Disorders
→ Book a free intro session at EXL Fitness If any part of this hit home — for you or for someone you're thinking of right now — the same thing that helps with training helps here: not doing it alone. A free intro session is a low-stakes way to build in the structure and people this post is actually about. Book yours here.
Mat Gover, BS, CSCS, is the owner and head coach of EXL Fitness & Performance in Orem, Utah. With nearly 30 years of coaching experience and a specialization in strength and performance for adults over 40, Mat brings science-backed training and a no-fluff approach to every session. When he's not coaching, he skis the Wasatch, mountain bikes the Uintas, or explores the red rock around the San Rafael Swell.
