Nov. 16--Dave and Nancy returned to their Panama City Beach home after having dinner at a function for a local politician. Their two young daughters were asleep upstairs, while Ben, Dave's son from a previous marriage who was visiting that weekend, was sitting on the couch.

Nancy sat down next to Ben to ask him how his stepsisters behaved that night. Dave headed upstairs and told his wife he needed to change his clothes.

"We heard a plop on the floor, and Ben said 'I think Dad fell down,' " Nancy said last week. "He had shot himself in our closet. The girls, thank God, didn't hear a thing."

Nancy sat at a table outside a Panama City Beach coffeehouse as she recounted how her husband had killed himself last September. A pretty, perky brunette who once worked in public relations, she turned her head away when she mentioned her daughters. Nancy's brown eyes rimmed red with tears.

"I did not see it. ... He was showing pictures to people. He had plans to take his other son college-shopping the next month. He wanted him to go to Florida, of course," she said.

Losses such as Nancy's have become more common in this region in 2009. The 14th District Medical Examiner's Office, which covers Bay, Gulf, Holmes, Jackson, Washington and Calhoun counties, has had 57 confirmed suicides this year, already equaling the total from 2008. With more than six weeks left in the year, Medical Examiner Dr. Michael Hunter estimates his office could end up with 75 to 80 suicides in 2009. As recently as 2006, District 14 had only 40 suicides all year.

Hunter is cautious to draw conclusions from what could be a statistical aberration, but he did mention one theme that has been surfacing in media reports of suicides across the globe this year.

"A lot of the increase, I think, you can attribute to the economy," Hunter said. He has had several cases this year where a suicide victim owned a business that had failed in the previous year, or had just lost his or her job.

"Those are terms we just haven't heard much of before, and I've been doing this for 10 years," he said.

The factors

Hunter is 42, but if you ignore his Jay Leno-ish gray and white hair, he could pass for 30. Fit and dressed in a long-sleeved orange Polo shirt and brown corduroy pants in his Panama City office last Thursday, he looked more like a highschool history teacher than a man who deals with dead bodies every day.

Hunter, who finished his first full year here in July, said his overall caseload is up considerably from 2008, with 462 cases as of Friday, already topping the 443 in all of 2008. But he found the upswing in suicide particularly troubling.

"Oftentimes, the initiator of suicide is drug and alcohol dependency or a psychiatric problem. I think the financial situation right now, with people out of work, people who can't find work ... I think, financially, people are stressed," he said.

TheAmericanAssociation of Suicidology has a position paper on its Web site about the correlation between the economy and suicide.

"Historically, U.S. suicide rates have shown no clear association with times of economic recession," it begins. Economic struggles beget rising unemployment, though, and experts agree there is a correlation between joblessness and suicide.

"It's pretty clear that when you have a significant increase in mass unemployment, the suicide rate goes up pretty quickly," said Steven Stack, a professor at Wayne State University in Detroit, Mich., who has studied suicide and homicide extensively.

The U.S. suicide rate was 11.1 per 100,000 people in 2006, the last year available for nationwide statistics. The historical peak for that number came in 1933, at 17.4, when unemployment the previous year had hit 25 percent. The national unemployment rate was 10.2 percent as of October.

Florida's suicide rate has hoveredaround13per100,000 people for the last decade. Its low mark was 12.2 in 2005, and it has climbed back to 13 as unemployment has risen from 6.2 percent in 2008 to an all-time state high of 11 percent this September.

In Bay County (where more than half of District 14 lives), unemployment also has gone up, from a 5.5 percent average in 2008 to 8.9 percent in September.

Stack said there is another possible factor that has been studied far less than unemployment: home foreclosure.

"Losing your home is about as severe a blow, psychologically, as losing a spouse," Stack said. "It's a really large, yet understudied stress factor."

The crash of the real estate market has made foreclosure a signature effect of the economic downturn. The Florida Panhandle is one of the epicenters of spiraling foreclosures. Bay County had 33 foreclosures in 2006, 75 in 2007, and 599 in 2008, according to data compiled by Metro Market Trends, a real-estate information company in Pensacola. The county is on pace for 730 this year.

However, no expert suggests suicide is an issue simple enough to peg solely on financial problems.

"The biggest factor with suicides is psychiatric illness," said Dr. Timothy Lineberry, board chairman for the American Association of Suicidology (AAS). Lineberry said psychological autopsies have found mental illness in 90 percent of those who commit suicide, with alcohol dependency also common.

He doesn't dismiss the potential effect of unemployment or foreclosure on an already unstable person, though.

"It may be a factor in putting more people at risk than who are already at risk," he said. National suicide statistics generally lag by about three years, as numbers are compiled from state to state, so researchers won't know the real effect of the latest recession on suicide rates for some time.

If calls to the National Suicide Prevention Lifeline are any indicator, though, more Americans are thinking about suicide. The phone line peaked this year with 57,625 calls answered in July. The line's 2008 apogee was 50,868 in October; it never had topped 40,000 calls before last year.

"Right now, it's too early to know if we have seen trends," Lineberry said. "The economy might be a small factor, but the bigger issue is psychiatric illness, and getting people help."

Coping with the loss

Dave's suicide in 2008 doesn't really fit into any of the possible trends. He was a civil engineer, and his business struggled as construction slowed to a standstill, but Nancy said she doesn't think that was it. The family lived comfortably; she was able to quit her part-time job to focus on the completion of their dream home.

Dave also doesn't fit into any of the traditional suicide profiles, outside of being a white man (who are four times more likely to kill themselves as white women, and twice as likely as nonwhite men, according to 2006 data compiled by the AAS). He never discussed suicide, or described feelings of hopelessness to his family and friends, and didn't have a diagnosed mental illness.

Nancy said she did not notice any change come over her husband in his last few months. She could sense when he was stressed, she said, but she didn't sense any nervousness last September. She does think his tendency to internalize negative feelings contributed to his death.

"He bottled things up; he wasn't a very good communicator. He'd communicate fine about the house, the family, the kids or job, but when it came to things that were negative or stressful, he never started a conversation," she said.

Lineberry said for some people, particularly men, coming to terms with the despair that leads to suicide often is difficult to verbalize.

"There are a lot of things that keep you from getting help," he said. "Cost, stigma, showing weakness, it really takes a lot of courage to get help."

Locally, people can turn to the Life Management Center of Northwest Florida, which provides behavioral health and family counseling services for Bay and surrounding counties. But Nancy laments there isn't a local suicide survivor's support group, for people such as her and her children.

Nancy and her daughters have turned to their church for counseling. They cope with their loss by trying to keep Dave's memory alive in their home.

"I'm a die-hard LSU fan, and he was a die-hard Gator fan, and I'm keeping everything as-is," she said, and motioned to her dark sports utility vehicle in the parking lot, which is adorned in Florida Gator license plates.

Nancy said she thinks Dave experienced a fit of temporary insanity, that years of bottled up emotions erupted in one tragic act. There was no note, no evidence of a plan, no explanation.

"I've learned through this process that all you can do is speculate. We'll never know," she said, before repeating, "We'll never know."

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