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My prior post on this site, “Why Older Gay Men Are Attempting Suicide at a Higher Rate,” received a lot of attention. Because of that, Dr. Patricia Salber, the editor of the site, asked that I do a follow-up. I would like to broaden the focus of this essay beyond the LGBTQ community.

Suicide facts

Here are some basic facts about suicide that I included in that first essay:

Loneliness and hopelessness

I hear from a lot of (mostly) men who are despairing. Two common themes emerge: 

  • Loneliness
  • Hopelessness. 

They frequently occur together, and unfortunately, they also feed on each other. Here are two rather typical comments left on my earlier essay [edited for brevity]:

I feel a sense of having completed the challenges of life and am grateful for those experiences. I see being able to choose to end my life as a reward for having made it this far. Am I just afraid of facing one more new challenge, namely, learning how to face the final stages of my life alone? … I can’t see what I would gain by learning how to remain independent until I’ve reached some arbitrary age when it would be ‘acceptable’ to society for me to die. …If there was a sure-fire way that I could end my life quickly and predictably, I’d go for it.

Or this one:

I think that suicide can be rational. I’m not depressed, but I have no desire to continue to live either. … I spend almost all my time alone. … If anyone cared about me or needed me in any way I might feel differently. I don’t see the point in struggling with my health and finances just to reach some arbitrary number of years. Isn’t it better that I control the circumstances of my death while I’m still able to do so?

The comments I receive originate from men in various situations. Some are married and struggling with their same-sex attractions. Some are men who have been in long-term relationships and have lost their partners. Others are men who have been unsuccessful in finding a partner and are giving up on the idea they ever will.

Is suicide ever a rational choice?

The question, “Is suicide ever a rational choice?” comes up frequently. The ethical question boils down to this:

Is this state of despair temporary or permanent?

I think there can be times when suicide is rational. For example, when someone is facing a terminal, painful malignant condition with no hope of recovery.

Many of us would agree that a person suffering like that might justifiably begin to think of suicide as a way to end that awful pain.

Related Content: Suicide in America: Understanding the What and Why

Loneliness and depression often occur together

Loneliness and depression often occur together but they are not the same thing. I wrote about this in an article for Psychology Today called, “Loneliness is a Killer.”

Here is what I said:

Loneliness means [we feel] we’ve failed in one of the most fundamental human domains: relationships with other people.

Loneliness is epidemic in the United States. It carries with it risks to our mortality [that] are comparable to smoking and alcoholism and exceed those of physical inactivity and obesity.

Loneliness affects chronic health problems such as diabetes, hypertension, and coronary artery disease, as well as sleep, mobility, and even dental problems.

It can impact our cognitive processes and lead to reduced resistance to disease. It is associated with higher rates of hospitalization and nursing home admission.

Denial of loneliness can be horribly self-defeating.

Loneliness and depression need not be permanent

But loneliness and depression are not chronic illnesses for which there is nothing that can be done.

I often describe depression as if we’ve gotten Vaseline on our glasses. Our vision is distorted and we cannot bring things into focus until the Vaseline is removed. 

This is why, in these situations, suicide may look rational. But it is not rational because neither loneliness nor depression needs to be permanent and, therefore, as hopeless as they feel.

These conditions only appear that they will go on forever. But if one can hold on and make some changes, the pain can subside.

Here are things that you can do

The three things one must do are:

  1. Become identified with a larger group – social, religious, political, Alcoholics Anonymous or anything that gives your life meaning
  2. Become a part of a smaller group with frequent, unplanned interactions – The sexual orientation of the group is far less important that they are accepting of you.
  3. Find a chum, someone with whom you can bare your soul and share your secrets. In some cases, it may mean a therapist, at least for a while.

Medications may help

Medications may be indicated particularly if there is significant insomnia or a failure to function in most areas of one’s life.

Counseling may be helpful but choose carefully. A good therapist will not impose their values on their counselees. You have a right to interview the therapist about their attitudes and training before making a commitment to therapy.

One recurring theme

As I read through these correspondences, one theme keeps recurring. That is, finding a sexual partner and a soul mate will give my life meaning. But having a supportive group of family and friends is very important.

When families are not accepting, developing a “family of choice” may be essential.

The Internet has helped LGBTQ men and women who are isolated in rural areas or cultures with strong prohibitions against homosexuality find membership in a larger community. It also allows for an anonymous discussion of questions concerning sexuality. 

But far too many never come out from behind their computers to have face-to-face interaction with others.

Financial and medical problems are one of the major sources of difficulty for us as we grow older. I’ve been both poor and financially secure. And, I can tell you that financial security does not guarantee happiness.

I am absolutely convinced that happiness during our later years depends primarily (after our basic needs are met) upon having something that gives your life meaning and having friends (gay or straight) who accept us as we are.

A nation of weavers

As I was working on this essay, I read an opinion piece in the New York Times by David Brooks, “A Nation of Weavers.” 

Brooks writes,

“These different kinds of pain share a common thread: our lack of healthy connection to each other, our inability to see the full dignity of each other, and the resulting culture of fear, distrust, tribalism, shaming, and strife.”

He started Weave: The Social Fabric Project. The first core idea of the project was that social isolation is the problem underlying a lot of our other problems.

The second idea was that this problem is being solved by people around the country, at the local level, who are building community and weaving the social fabric.

Brooks believes, as I do, that there is too much emphasis in our culture on the idea that life is an individual journey toward personal fulfillment. But Weavers share an ethos that puts relationship over self.  And emphasizes that the measure of our life is in the quality of our relationships.

I believe that many of these men and women who are so desperately lonely and unhappy could find a sense of meaning by focusing less on their personal needs and looking for ways to serve others. 

Brooks writes of “radical mutuality”:

We are all completely equal, regardless of where society ranks us.

Some final thoughts

I’m nearly 76 now. I write, speak and continue to see patients because these things give my life meaning.

At this point in my life, I can say that there is “an emptiness in striving,”

When I’m climbing that ladder of success it is far more meaningful to me to pull someone up instead of putting all my efforts in seeing how high I can climb.

More by this author: Older Gay Men and the Risk of Suicide

Loren A. Olson, MD
Dr. Loren A. Olson completed his undergraduate degree at the University of Nebraska at Lincoln NE and then continued his education in medical school at the University of Nebraska Medical Center in Omaha. He spent an internship year at Bryan Memorial Medical Center in Omaha. After medical school, he spent four years in the Navy as a Flight Surgeon during the Viet Nam era. After his discharge, he entered his psychiatry residency at Maine Medical Center in Portland Maine. During his final year he served as Chief Resident in Psychiatry. He has been board certified by the American Board of Psychiatry and Neurology since 1975.

Dr. Olson is a Distinguished Life Fellow American Psychiatric Association for exceptional service to the profession of psychiatry. He has received awards from the American Psychiatric Association for his writing and editing from the APA. Dr. Olson received the Exemplary Psychiatrist Award from the National Alliance on Mental Illness.

Dr. Olson has presented at the World Congress of Psychiatry in Prague, the Gay and Lesbian Medical Association, and the Association of Gay and Lesbian Psychiatrists. He is also a member of the American Medical Association. Dr. Olson “retired” from Innovative Psychiatric Services in June 2018. His love for the practice of psychiatry, pulled him out of retirement to work as an independent contractor for United Community HealthCare in Des Moines. His most recent position has been practicing adult outpatient psychiatry for Mercy One Psychiatry in Waterloo, Iowa.

Dr. Olson came out as gay at the age of forty and began to wonder if his experience coming out in midlife was like others who came out later in life. His research let to the publication Finally Out, first published in 2011 with a second edition published in 2017. The second edition won the Ben Franklin Gold Award for the best LGBT non-fiction book from the Independent Book Publishers Association in 2018.

After publication of Finally Out, Dr. Olson began speaking to groups throughout the United States and Canada. Not only did he speak about his story but also through personal interviews and correspondence, expanded his exposure to the lives of hundreds of mature gay men from many different cultures and socio-economic groups around the world.

Dr. Olson has always enjoyed the challenges of writing, initially focusing on subjects related to psychiatry. After coming out, his primary interests have been writing about LGBT experiences and the challenges and opportunities that come with growing older.

Dr. Olson’s essays in Psychology Today have been accessed over one million times. He has also written for The Advocate, Huffington Post, Medium, and many other local and national newspapers

He has been interviewed many times for the print, radio and TV media, including an appearance on ‘Good Morning America.”

Loren A Olson MD is a gay father, psychiatrist, popular speaker, and author of Finally Out. Dr. Olson helps people find ways to keep emotional pain from becoming needless suffering.

Dr. Olson's former wife, Lynn, and his now husband, Doug, have been known to cook Thanksgiving dinner together for their children and grandchildren. Their children and grandchildren just shrug their shoulders and smile when asked why they have two grandmothers and three grandfathers.


  1. A lovely piece, but Please replace the term “successful suicide” with “completed suicide”.

    Thank you for your important work.


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