NEW YORK -- The Centers for Disease Control and Prevention (CDC)Thursday on suicide. Nearly 45,000 Americans took their lives in 2016, more than those who died in car accidents or opioid overdoses. The issue is receiving heightened attention after this week.
A medical examiner on Thursday determined Spade, 55, died from suicide by hanging.
Family and friends remember one Kate Spade, but the light that shined through for the cameras came with a darker side behind closed doors that many did not know or understand.
Her husband,, said "there was no indication and no warning that she would do this" and that his wife "was actively seeking help for depression and anxiety over the last 5 years."
"It's about mental illness," said writer Dorri Olds, who said she understands what Spade must have been feeling.
The 56-year-old says she tried to commit suicide multiple times before getting help.
"Even with the best intentions, I don't think Kate could have snapped herself out of it," Olds said. "When you're suicidal, you're not thinking about anybody else, and it's not because your selfish, it's because you're not well."
The CDC study released Thursday shows half of the country has seen a more than 30 percent increase in suicide rates from 1999 to 2016. Among women, 45- to 64-year-olds have the highest rate.
Approximately half of those who committed suicide did not have a known mental health condition. And for those who did, "circumstances such as relationship problems, job/financial or physical health problems ... contributed to their suicide," the report said.
In Spade's case, her husband says the two had been living apart for the last 10 months.
"Any life stressors that are weighing on someone who has a history of or is currently struggling with their mental health -- that's a person who you have to be worried about," said psychiatrist Catherine Birndorf.
Birndorf says she hopes Spade's suicide brings awareness you can't always see.
"I hope people pay attention to those around them," Birndorf said. "That if they see someone who is suffering or acting unlike themselves or despairing, hopeless, withdrawing from social activities that they check in on them. They make sure that they are getting the help that they need."
The report says suicide is rarely caused by a single factor. It suggests many deaths follow relationship problems, substance use or financial issues. Experts say talking to a professional and getting help is the first step toward preventing suicide.
For immediate help if you are in a crisis, call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), which is available 24 hours a day, 7 days a week. All calls are confidential.