Loss of a loved one is always painful. The most painful loss of all may be a death by suicide.

The rates of death by suicide in the United States are rising across all demographics.

Twenty veterans die by suicide every single day. Suicide is the second leading cause of death among teenagers and young adults in the United States. The rate of suicide among farmers is among the fastest rising.

There has been and continues to be much debate about these trends, particularly about the causes and solutions.

It may come as a surprise that many, perhaps most, who die by suicide, are not depressed in the clinical sense. Nor do they have any diagnosed mental health issues. While many victims have shown some signs of emotional struggle or have been in treatment, many others have not. And the deaths often come as a surprise to loved ones and colleagues.

Despair, a sense of hopelessness and powerlessness, perhaps is the most common attribute of those who die by suicide.

That despair may be a result of sadness due to depression, or paranoia due to schizophrenia, or agitation due to anxiety.

But the despair may also be the result of lack of necessary services available to the veteran who once proudly served her country (the suicide rate among female veterans is 250 percent higher than that of civilian women). Or the farmer whose livelihood is threatened by climate change, tariffs or other conditions entirely out of his or her control. Or the child or adolescent who has been a victim of bullying. Or the young adult who is drowning in debt and sees no way to ever support him or herself. Or the addict who is desperate for a second chance but cannot access the resources needed to get clean. Or the professional who is chronically ill but does not have access to the health care needed without bankrupting his or her family.

And the fact is, those who died by suicide were often profoundly sensitive individuals. He or she may have been too aware of, or may have experienced the injustices, either directly or vicariously, that occur every single day in our world. Injustices that arguably are increasing at a rate that mirrors the suicide rate.

Viktor Frankl, survivor of a concentration camp during the Holocaust, psychiatrist, and author of "The Unheard Cry for Meaning: Psychotherapy and Humanism," defined despair as suffering in the absence of meaning, representing it by the simple formula of D=S-M. In his analysis, despair can be overcome by meaning.

Meaning gives us hope. Hope is the antidote to despair. Meaning comes from a sense of community, and from being involved, and from working with others toward a common goal.

Do what you can to get your children or grandchildren registered to vote. Check in on a neighbor. Donate time or services to charitable organizations. Learn about needs in your community or your schools and communicate with your elected officials about his or her role in addressing those needs. And if his or her response is not satisfactory, communicate again. Become informed. Vote.

Dr. Joshua Gear, M.D., is an adult, child and adolescent psychiatrist in private practice in Portsmouth.