County officials say 392 San Diegans committed suicide in 2011. That's the highest number in 23 years.
The vast majority of county residents who committed suicide last year were white men. The highest rate of suicide was among men 85 and older.
Dr. Glenn Wagner is the county's Chief Medical Examiner. He said the biggest rise in suicides was among people in the 20 to 45 age group.
"(Suicides in tha group) presumably are driven probably by the economic downturn as much as anything," Wagner said. "And, of course, we've got the returning military and the post-traumatic stress."
Mental health professionals say suicide has multiple causes. Some of the warning signs include isolation from family and friends, and an increase in alcohol or drug use.
The county operates a toll-free crisis line 24 hours a day, seven days a week, at (888) 724-7240.