Your column today (12/1/07) was especially poignant. I am deeply sorry for your loss. The emotions you expressed have been experienced by those of us who have also lost friends to suicide. Since 1990, six of our friends -- good friends to professional colleagues -- have committed suicide.

In each case, we wondered if there was more that we could have done. Each time, we pored over the individual's history and talked with family and other friends. All of the people we knew had no financial problems -- some were millionaires. While some were single, others had incredible spouses and outstanding children. All had received medical treatment for depression, ranging from medication to electroshock therapy. This did not prevent multiple suicide attempts by each one. The only thing that became apparent was that the mental pain they experienced daily was overwhelming. It is difficult, if not impossible, for those of us who do not suffer from such torment to understand what they experience.

Very sorry to read about your friend, depression is very hard to handle as I know. I think it's the high standards that we place on ourselves only to fall short in our own eyes.

Mental Disorders in America

Mental disorders are common in the United States and internationally. An estimated 26.2 percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year. When applied to the 2004 U.S. Census residential population estimate for ages 18 and older, this figure translates to 57.7 million people.

Even though mental disorders are widespread in the population, the main burden of illness is concentrated in a much smaller proportion — about 6 percent, or 1 in 17 — who suffer from a serious mental illness.1 In addition, mental disorders are the leading cause of disability in the U.S. and Canada for ages 15-44. Many people suffer from more than one mental disorder at a given time. Nearly half (45 percent) of those with any mental disorder meet criteria for 2 or more disorders, with severity strongly related to comorbidity.

In 2004, 32,439 (approximately 11 per 100,000) people died by suicide in the U.S. More than 90 percent of people who kill themselves have a diagnosable mental disorder, most commonly a depressive disorder or a substance abuse disorder. The highest suicide rates in the U.S. are found in white men over age 85. Four times as many men as women die by suicide; however, women attempt suicide two to three times as often as men.

Utah is the most depressed state in the country, according to a nationwide study released Wednesday. The first-of-its kind examination of the "level" of depression and actual outcomes for those seeking help to treat it, ranks Utah 51st — last in the nation.

Hawaii, Illinois, Maryland and New Jersey are the healthiest states in terms of depression and suicide. Along with Utah, Idaho, Nevada, Wyoming and West Virginia are the least, according to the study.

Other states have a higher suicide rate — Alaska has the highest; Nevada the second — but the four factors combined in the study places Utah last on the list.

James Brush, a Monfort Heights psychologist, said Ohio's job losses, coupled with high foreclosure rates, are putting a damper on the state's mood.

"I think it comes down to jobs and financial security for so many people," Brush said.

"In Ohio, if you lose a good-paying job, it's not necessarily true that you're going to find another one. And a lot of people as they get older can't move or don't want to move or won't be considered for jobs that pay as well as the jobs they lost and end up working at much lower pay rates. But their bills don't go down and their mortgages don't go down, and now people that might be in over their heads can't get rid of their houses."

Other studies have shown that people in Ohio and Kentucky don't take very good care of themselves, he pointed out; the states rank high for obesity, as well as heart disease, diabetes and other related diseases.

"When people aren't healthy, they're depressed," Brush said.

The study ranked Utah as the most depressed state, and South Dakota as the least.