Jessica Fashano, a young woman had spend her professional life raising money to help others, walked into a New York skyscraper last Saturday, calmly took the elevator to the roof and then plunged to her death.
The dark-eyed, long-haired 27-year-old, an investment banking associate at Citi Global Markets, left no note and no clue as to why she ended her life. Friends said she was being treated for depression, but she had been in high spirits in the days leading up to her apparent suicide.
Fashano's end was utterly shocking and, unfortunately, utterly too common.
"Suicide surprises many families," said Dr. Timothy Lineberry, medical director of the Mayo Clinic Psychiatric Hospital and chairman of the board of the American Association of Suicidology. "But usually there are underlying problems that are unrecognized by even family members and friends."
"Some people have a public face, and for many people, the internal struggle and how they feel about themselves with depression may not be as evident to others," he said.
Fashano was a rising star in the banking world who organized fundraisers for the Acumen Fund, which invests in businesses that help the poor in the developing world.
"She was selfless with her time, generous with her heart and with her ability to always find that extra amount of time, love and support as a friend," said Michelle Javian, who graduated with Fashano from Georgetown University in 2005.
Javian was co-founder of Harboring Hearts Housing, one of the many charities Fashano supported.
Surveillance video at the residential tower on the west side of Manhattan showed Fashano walking into the building, which was about 16 blocks from her apartment and overlooked the Hudson River and New Jersey, where she grew up.
A resident returning from walking her dog rode up the elevator with Fashano, who asked the woman how to get to the roof, and said she seemed alert and aware, dressed for the cold in Ugg boots and a winter jacket.
One of the mysteries that still puzzles police is why she chose to kill herself at a building where she did not live.
Her friend Javian and a former co-worker, analyst Ramzi J. Ramsey, did not want to share any more details with ABCNews.com. Police also did not return calls to ABCNews.com.
Lineberry said that when doctors do a "psychological autopsy," after a suicide, interviewing family and friends and looking at medical records as a way of "rebuilding things," they find that psychiatric illnesses, like depression, account for 90 percent of all suicides.
That risk is compounded by substance abuse.
Though people commonly assume suicide rates spike during the holiday season, Lineberry said that is an "urban myth," as well as speculation that family and friends should have seen the suicide coming.
Suicide is a major health problem and the 11th leading cause of death in the United States, according to the http://oas.samhsa.gov/2k10/212/SuicidalThoughtsHTML.pdf " target="external">National Survey on Drug Use and Health. More than 34,000 Americans take their own lives each year and 8.4 million aged 18 and older seriously thought about suicide. The rates were highest among those aged 18 to 25.
Suicide Risk Factors Include Depression
Risk factors can include a family history, previous suicide attempts, a history of mental disorders, particularly clinical depression and physical illness or loss.
Clinical depression affects 6.6 percent of American adults in a given year, according to Behavioral Risk Factor Surveillance System (BRFSS) survey data from 2006 and 2008 gathered by the Centers for Disease Control and Prevention (CDC).
" target="external">Depression and anxiety, which often occur together, are the two major causes of death and illness among young people in the United States, and are associated with reduced quality of life, social functioning and excess disability, according to the CDC.
Any number of things can trigger a suicide in someone who is depressed, especially during the dark winter months, according to Carl Tishler, a clinical psychologist and adjunct associate professor of psychology at The Ohio State University.
"We are in the season for http://www.mayoclinic.com/health/seasonal-affective-disorder/DS00195" target="external">SAD (Seasonal Affective Disorder) and many people are more depressed," he said. "And it's sad to say, but people's therapists go away now. She may have lost her support system."
Lack of sunlight in susceptible people, onset or increase in medications, a loss or anniversary of a loss and even financial woes can send a person who is seemingly happy over the edge -- even a disruption of life's usual anchors, such as work or school.
"I try to see my patients more often over the holiday," said Tishler. "If they have to miss, that's their choice, but I try to stay around over Christmas and Hanukkah when people are off work and out of school. Going to work sometimes provides the motivation for people to stay alive."
Breaking up with a loved one or mourning the death or anniversary of a loss, like a miscarriage, an elective abortion or a pet, can be traumatic.
Tishler said the method of Fashano's suicide was also surprising for a woman -- jumping from a high-rise. Most choose poison or a gun, according to the CDC.
"I don't know this person, but more frequently they tell someone or call someone to say goodbye," said Tishler. "Most people tell you in some way, though you may not pick up on it at the time."
Psychologists are also aware of the so-called "Werther effect," the tendency of people to take their own life because they have seen others do so. It was named for Goethe's 18th century book, "The Sorrows of Young Werther," in which the protagonist kills himself. After its publication, police found copies of the book next to suicide victims.
Several copycat suicides were reported after the 1994 suicide of rock legend Kurt Cobain. After actress Marilyn Monroe's overdose, suicides went up, especially in New York City where several sympathizers threw themselves on subway tracks.
Financial woes can also be a factor in suicides.
Just this month, Mark Madoff, the 46-year-old son of convicted Ponzi-scheme financier Bernie Madoff, hanged himself with a black dog leash in his Manhattan apartment on the second anniversary of his father's arrest. The suicide came while the family faced mounting pressure to recover money for victims.
But Fashano's life seemed antithetical to Madoff's narrative, say friends.
Just last month, she spearheaded a charity event for Harboring Hearts, which provides low-cost housing for cardiac patients.
"Jessica became a pillar of strength for the organization and for the families she set out to help," said her friend Javian. "She was there for every event, every time she could help the organization or me as a friend. She will never be forgotten. Her commitment to the greater good and service to family and friends must remain part of her legacy."
Though Fashano was being treated for depression at the time of her suicide, it apparently did not make a difference.
Psychiatrist Lineman said the risk for suicide on antidepressants increases slightly up to age 24, but doctors are not sure why. But he said "strong proof" shows that the overall incidence of medication-related suicide is low.
"The biggest and easiest message is that you get effective treatment for depression," he said. "The focus is collaborating with the prescribing physician and trying to treat the symptoms until they resolve. And there should be clear plans and support from the family."
For more information on suicide go to the American Foundation for Suicide Prevention.
For help, go to the National Suicide Prevention Lifeline or call the toll-free number, 1-800-273-TALK (273-8255),
which is available 24/7, can be used anywhere in the
U.S. and connects the caller to a certified crisis center near where the call is placed.
To learn more about depression, go to the Centers for Disease Control and Prevention.