A Maryland man apparently killed his wife and three young children, then shot and killed himself at the foot of the bed where his wife and 2-year-old daughter's bodies lay, authorities said Saturday.

A few months ago the Charlotte-Mecklenburg Police Department began to notice an increase in suicide attempts. So, for the first time, they tracked the cases to see if it was related to the economy.

By far the largest category was relationship issues -- 109 people told investigators that's what drove them to the brink. Depression was second with 87 and the economy a distant third with 16. But therapists say that's misleading.

"Unfortunately, they all dovetail in with one another and push us down," said Dr. Chad Ritterspach, a psychologist with CMC Randolph Behavioral Health.

Charlotte police say the total number of suicide attempts from July through February was 292. The number of actual suicides was 28.

Money and the state of the economy are the top sources of stress for 80 percent of Americans, according to the American Psychological Association's 2008 Stress in America survey.

In San Diego County, the Access and Crisis Line recorded a 5 percent increase in calls in the last three months of 2008 compared with the same period in 2007, an increase hotline staff attributed to callers' financial troubles.

Counselors there recently received special training on how to work with such callers, Dubois said.

“We have recognized this is becoming an increasing factor in people seeking intervention,” he said. “We want to be able connect with people.”

The daily dose of bad news – layoffs, stock market declines and the shaky real estate market – pummels the psyche and creates anxiety even for those with relative security, said Dr. Lynn Bufka of the American Psychological Association.

The rate of suicides in Clark County jumped by 10 percent from 2007 to 2008, a rise that experts attribute in part to the recession.

The increase is one of the most dramatic in the history of Clark County, whose suicide rate even before 2008 ranked as one of the highest in the nation.

Many signs point to the economic bust as a factor, experts said.

“Those folks that were on the ragged edge to begin with are now on no edge at all, so they have nowhere to turn and are taking their lives because of it,” Clark County Coroner Michael Murphy said.

The reason a person kills himself is usually a mystery because the only person who knows is dead. Only about three in 10 people who commit suicide leave a note.