People aged 50 to 59 made up the largest proportion of suicide victims in Singapore last year, new figures show.
Last year, 57 men and 38 women in this age group took their lives, and there was also a worrying rise in suicides among people in their 60s and older.
"Those in their 50s experience significant life changes," said Gleneagles Hospital psychiatrist Adrian Wang . "They might be retrenched or have their jobs taken over by younger colleagues or they might experience the empty-nest syndrome when children leave home. Marriages might also take a turn for the worse because of these factors."
Multiple stress points could trigger depression and lead to suicide if the person cannot cope, he added.
People in their 50s have been among the top three age groups with the most suicides for four of the past five years. Suicide numbers among those aged 40 to 49 have also been significant.
Two out of three among all who killed themselves last year were men. Professor Kua Ee Heok, senior consultant psychiatrist at the National University Health System (NUHS) said men who live alone, have money problems and have poor social support are more prone to ending their lives.
Dr Alex Su, chief of general psychiatry at the Institute of Mental Health, said male rates have traditionally been higher because when they attempt suicide they use more extreme methods with a higher likelihood of guaranteeing death.
As for women, relationship problems are often a cause for depression. Ms Rachel Lee, assistant director of Fei Yue Community Services, said: "Many women in their 40s and 50s come to us with marital issues. It could be a combination of relationship problems and physical changes like menopause. Those with good support or fulfilling relationships with their friends or children tend to cope better."
The total number of suicides hit at least a 20-year high at 467 last year, national statistics show.
Last year 122 people aged 60 and above killed themselves, a rise from 105 in 2011. Reasons for elderly suicide could include feeling a burden to family, the death of a spouse, loneliness and financial issues, said private psychiatrist Chia Boon Hock.
Dr Kua from NUHS said: "Seniors may be more reluctant to talk about their feelings because they are traditionally towers of strength in the family."
A previous National University Hospital (NUH) study showed about 70 per cent of elderly people who attempted suicide here saw a doctor in the previous month.
All were prescribed painkillers or sleeping pills for headaches or insomnia when what they needed was treatment for depression.
"Old people often think that doctors cure physical problems. They tell you about headaches or insomnia but not how they are feeling," said Dr Kua. "Doctors assume that something is wrong with them physically when these may be early signs of depression."
NUH doctors last month started a programme to train eight junior doctors how to recognise and treat early symptoms of mental illness among the elderly. Methods will be adapted for an Asian community shy in voicing emotional problems.
The scheme will be expanded in January to train 40 doctors, nurses and social workers dealing with the elderly. It could eventually train medical professionals to help patients of all ages.
"Into every life, some rain will fail," said NUHS Associate Professor Goh Lee Gan, who specialises in family medicine. "We must encourage people to have broad interests, see the cup half full instead of half empty and provide good social support. After all in suicide, prevention is better than cure."