Male suicide rates in Russia, Belarus, Ukraine and the Baltic countries increased substantially in the early 1990s and are now the highest in the world. To what extent is this suicide epidemic explained by the macroeconomic instability experienced by these countries in that period? Fixed effects regressions across 22 transition economies indicate that male suicide rates are highly sensitive to the state of the macroeconomy, suggesting that the steep and prolonged declines in GDP in the western countries of the former Soviet Union may have been partly to blame for the suicide epidemic. Evidence also indicates that the general adult male mortality crisis in the region had a ‘feedback’ effect on suicide rates, with the loss of a spouse or friend - or declining life expectancy itself - contributing to rising suicide rates. Female suicide rates, in contrast, are insensitive to the state of the macroeconomy and are more strongly related to alcohol consumption.