The deaths of celebrity chef Anthony Bourdain and fashion designer Kate Spade highlight a troubling trend — rising suicides among middle-aged Americans.
Mental health problems, often undiagnosed, are usually involved and experts say knowing warning signs and who is at risk can help stop a crisis becoming a tragedy.
A new US report shows the nation's suicides had risen by 30 per cent since 1999, and that the crisis was a growing problem. Nearly 45,000 Americans took their own lives in 2016.
Adults aged 45 to 64 had the largest increase, according to the Centres for Disease Control and Prevention report.
Previous studies have suggested economic downturns and the nation's opioid crisis contributed to the rise in middle-aged suicides.
Dr Christine Moutier, a psychiatrist and chief medical officer for the American Foundation for Suicide Prevention, said it was important everyone knew the warning signs and to intervene when someone appeared troubled.
She said hearing about one suicide may make others who are already at risk turn to self-harm.
Moutier said celebrity suicides also prompt an increase in calls to help lines.
WHERE TO GET HELP:
If you are worried about your or someone else's mental health, the best place to get help is your GP or local mental health provider. However, if you or someone else is in danger or endangering others, call 111.
If you need to talk to someone, the following free helplines operate 24/7:
DEPRESSION HELPLINE: 0800 111 757
LIFELINE: 0800 543 354
NEED TO TALK? Call or text 1737
SAMARITANS: 0800 726 666
YOUTHLINE: 0800 376 633 or text 234
There are lots of places to get support. For others, click here.