Tag Archives: Depression

Straight, No Chaser: Suicide Data – Understand the Threat

The death of beloved comedian Robin Williams has hit many like a lead balloon. So successful was he, with seemingly so much for which to live. He was enjoying ongoing success with a hit TV series, upcoming movies and had a loving family. Therein lies the rub. Depression and suicide don’t discriminate by social status, yet we continue to stigmatize those with depression and other mental disorders in a way that we don’t when it comes to disorders of other parts of the body – so much so that his depression seemingly couldn’t be revealed in a way that would have allowed him to truly get the help that could have saved his life. Allow me to honor his death by reviewing depression and suicide in a few Straight, No Chaser posts. Thanks for the memories, Robin. We thought your acting represented the tears of a clown. We never knew your laughs actually masked the pain. You will be missed.suicidemap
There are amazing, shocking and saddening facts about suicide.  It is equally amazing that we aren’t discussing this as an epidemic.  Consider the following information provided by the Centers for Disease Control and Prevention:
There were an average of 105 suicides a day in the U.S. (over 38,000 for 2010).
An estimated 8.3 million adults reported having suicidal thoughts in the past year.
Suicide is the third leading cause of death among those aged 15-24, the second among those aged 25-34, the fourth among those aged 35-54, and the eighth among persons aged 55-64.
For those committing suicide:

  • 33.3% tested positive for alcohol.
  • 23% tested positive for antidepressants.
  • 20.8% tested positive for opiates (such as heroin and prescription pain killers).
  • There is one suicide for every 25 attempts.

Females are more likely than males to have had suicidal thoughts, but suicide among males is four times higher than among females (in other words, females think about it and try more often, but males complete the act more often.).
Among Native Americans aged 15-34, suicide is the second leading cause of death, fully 2.5 times higher than the national average.
There are some topics that aren’t amenable to Blogs.  Depression and suicide are among them.  They can’t be done justice.  What I can try to do is break components of the conversation into bite size pieces and give you information to work with.  I’ll do this in three parts.  Above, I’ve shown you the magnitude of suicide.  In the next post, I will help you understand what clinical depression looks like, then finally, I’ll review some Quick Tips to help you prevent falling into the deepest levels of depression and to help you know when immediate attention is required.  Just remember: this isn’t the type of depression that involves having a bad day.  I’m talking about when your downward mood interferes with your activities of daily living.  I’m describing depression that introduces suicide and homicide as an option.  If you don’t read these for yourself, read them for knowledge.  Someone you know may be affected.
I welcome any questions, comments or thoughts.
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Straight, No Chaser: Suicide and Suicide Risks in College Students

Suicide-Rates-Among-College-Students

I just had the privilege of engaging many wonderful students at my alma mater. Among many other things discussed, I was shocked by the extent to which college suicides have become present on college campuses. I wonder when things changed. Isn’t college supposed to be the “best four years of your life?” It really doesn’t take much though to appreciate how this becomes the case.

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Suicide is the second leading cause of death among college-age students in the United States and the third leading cause among those aged 15-24. There are approximately 1,100 deaths by suicide occurring in this age group each year. A recent study from Johns Hopkins and the University of Maryland went in-depth in surveying and analyzing why students may have thoughts on suicide. Here is a summary of some of the study’s findings:

  • 12% of those studied admitted that they had thought of committing suicide.
  • Of this group of 12%, approximately 25% of them said they had those thoughts repeatedly.
  • Depression and lack of social support appeared to be major factors contributing to thoughts of suicide.

If you actually think about it, college brings together a lot of risks for suicide.

  • Late adolescence and early adulthood represents the period of highest risk of developing a major psychiatric disorder.
  • The academic environment can be a stress-producing inferno for some, who may find themselves overwhelmed and feeling lost and as if they have nowhere to turn.
  • For many, the college experience represents the first time many are away from home and/or completely detached from the family and friends they’ve had their entire lives. Unless and until a sufficient new social network is established, levels of isolation can be overwhelming.
  • Even among those with social networks, the academic failure and any social rejection that may occur could be perceived by students as having life-long consequences, so much so that hopelessness and thoughts of suicide could set into a young adult’s mind.

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Practically, how might you consider the risk in any one individual? The presence of any of these risk factors should prompt implementation of a support system to counter feelings of suicide.

  • It shouldn’t be difficult to appreciate how the lack of social support is one of the most powerful predictors of persistent suicidal thoughts. Someone who expresses or has feelings of being unappreciated, unloved and uninvolved with family and friends should be considered at risk – even in the absence of any other risk factors.
  • A history of clinically diagnosed depression or other psychiatric diagnoses
  • The exposure to domestic violence (either witnessing or having been abused) in childhood
  • Having a mother with a history of clinical depression

There are many Straight, No Chaser posts that address suicide prevention, diagnosis and treatment. Feel free to use the search box on the right for additional information.If you are a college student or a family member of a college student, you would do well to review your college’s support system and learn about services and support available for those in need of mental/behavioral health services. College should represent the beginning of one’s adult life, not the place where it ends.
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Straight, No Chaser: The Holiday Blues – Tips to Deal with Depression and Stress This Time of Year

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I don’t mean to bring anyone down during what is supposed to be the ‘most wonderful time of the year’, but in reality there are many people hurting. For some, life’s tragedies happen this time of year the same as they might any other time. For others, this may have already happened, and this time of year is a permanent reminder of an unfortunate experience. For others still who struggle with depression, anxiety and mental illness all year, the holiday season can exacerbate these feelings and may make holidays especially long, depressing and potentially dangerous times.
My goal today is not to drag you into the dumps but to empower you with tips to assist you in the event this is a difficult time for you. By the way, I’m extremely thankful that you’ve chosen to give me moments of your day and life. I take that gift seriously and hope you continue to find it a worthwhile use of your time.
Here’s five tips for your holiday mental health:

  1. Remove yourself from stressful environments and avoid situations you know will create conflict, mental duress and/or danger. I can not emphasize this enough. If you put yourself in a bad situation, you can not be surprised when bad things happen.’
  2. Find support. Specifically, have ‘go-to’ friends and family that provide you comforting support. There’s a time and place for tough love, but in the midst of depression or suicidal ideation, ‘buck up’ is not good advice. Know where your support lies and be sure (in advance) that it will be accessible if you need it.
  3. Find success and happiness where it is. During the holidays, people tend to lament what isn’t. That’s not a formula for success. Yes, all of your family may not be around, but celebrating happy memories with the ones you can often fills the room with the joyous presence of loved ones not around. Enjoy the pleasures and successes you do have access to, whether big or small. Focusing on the positive keep you positive.
  4. If you’re struggling, admit it.  You already know you’re hurting. Often the first step to getting past it is acknowledging it. Once done, then you can put coping mechanisms in place to address your feelings.
  5. Avoid holiday activities that will create post-holiday angst. This applies to eating, drinking, shopping and personal interactions. Some use the holiday as an excuse to overindulge as if the consequences won’t be there afterwards. Reread #1 above.

Know when you need professional help. If your support system doesn’t sufficiently address your needs, and you’re feeling severely depressed, can’t function or are suicidal or homicidal, find a physician or mental health professional ASAP. Of course, you can always contact your SterlingMedicalAdvice.com expert. If you type mental health, depression or other keywords into the search bar above, you can access many other Straight, No Chaser blogs on behavioral health concerns that may provide you the support you need. I wish you all the best today and throughout the year, and hopefully the picture below will reflect the only type of blues you’ll have to deal with this year.
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Straight, No Chaser: Depression Quick Tips – How to Avoid It, When to Get Help

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As a physician, I’m not willing to advise you on how to ‘care’ for yourself at home if you’re clinically depressed.  I can discuss how to avoid depression (to the extent possible) and what warning signs should prompt emergent access to care.  If you’re good at accomplishing the items listed below, you have less of a chance of being unhappy and clinically depressed.

  • Avoid alcohol and other mood-altering drugs.
  • Eat healthily.
  • Exercise regularly.
  • Get enough sleep.
  • Remove yourself from negativity, including your choices in friends, mates and work environments.
  • Surround yourself with positivity, including your choices in friends, mates and work environments (Please note this is a different consideration than the previous bullet point.).
  • Learn how to relax and where to go to relax (These considerations include such things as yoga, meditation and your religion/spirituality, not the business end of a bottle or drug use.).

Look out for these potential warning signs for suicide: Remember that approximately 30% of suicides are preceded by the individual declaring intent.  Be alert for the following additional considerations:

  • Increasing levels of depression, withdrawal, reckless behavior, alcohol and other drug use, and/or desperation.
  • Notice activity that could be a prelude to a suicide attempt, such as obtaining knives, firearms or large quantities of medication.
  • Changing one’s will and settling one’s life affairs in the midst of depression
  • Ongoing comments about lack of worth and desire to end it all.

The following considerations should prompt an immediate visit to an emergency room or other treatment facility.

  • You have a compelling, overwhelming feeling that you want to hurt yourself, with or without an actual plan.
  • You have a compelling, overwhelming feeling that you want to hurt someone else, with or without an actual plan.
  • You hear voices or see things or people who are not there.
  • You find yourself crying often and uncontrollably for no apparent cause.
  • Your depression has affected your activities of daily living (work, school, consistent forms of recreation or family life) for longer than 2 weeks.
  • You think your current medications are affecting you abnormally and are possibly contributing to making you feel depressed.
  • You have been told or believe that you should cut back on drinking or other drug use.

I wish you and your loved ones all the best in avoiding and/or dealing with this disastrous condition.  I welcome any comments, thoughts or questions.

Straight, No Chaser: Are You Depressed and/or Suicidal?

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I have a strong distaste for do-it-yourself websites that want to ‘screen’ you for depression.  Folks, if you’re wondering whether you’re clinically depressed, you don’t need validation from some makeshift online questionnaire.  That said, if you’d like to learn something, go ahead and find one.  More importantly, seek assistance immediately from a qualified counselor or therapist.  They do wonderful work and can get through to you before you get to yourself.  Instead of a quiz, I will simply give you common signs and symptoms consistent with the diagnosis.  Note the progression in the symptoms.  The bottom line is: odds are, you already know if you need help.  Yes, there are different depression syndromes; I’m not getting into that.  You and a psychiatrist or therapist can sort that out.  Don’t be reassured by a quiz when you already know better.
You may be depressed if…

  • You feel sad, hopeless, empty, or numb to the point where you wallow in these emotions, and they dominate your existence.
  • You have a loss of interest in your normal activities of daily living.  It’s not just that you don’t enjoy things.  You don’t even want to be bothered with them.  You don’t want sex.  You don’t enjoy your friends.  You don’t want recreation.  You can’t eat.  You can’t sleep, or you can’t stop sleeping.  You can’t breathe (because of your crippling anxiety).  You might actually be depressed if you have these symptoms and didn’t get the ideas from listening to the lyrics of a Toni Braxton song.
  • You find yourself exceedingly irritable and/or anxious. These feelings are explosive and over the top.  You’re waiting, ready and looking for a reason to embrace gloom, doom or anger.
  • You have difficulty moving forward and making decisions. This occurs for many reasons.  Your attention may be shot.  Your interests aren’t there.  You’re overwhelmed.  Stuck in a rut is not only where you are, it’s where you want to be.
  • You feel worthless and blame yourself for any and everything.  Again, these feelings are explosive, dramatic and over the top.
  • You have thoughts of death and suicide. This is where things get beyond scary.  You may simply have a passive wishing that things would end and a belief that your friends, family and the rest of the world would be ‘better off’ without you.  You may have fleeting voices that aren’t your own suggesting or commanding suicide as an option.  You may see visions of people telling you to harm yourself.  You may have an active plan.  When depression gets to this point, nothing good is going to happen without intervention.  Never allow someone to make such comments and then pretend as if they were insincere.

Now consider these most common precipitants for suicide:

  • Problems with one’s intimate partner
  • Problems with one’s physical health
  • Problems with one’s job
  • Problems with one’s finances

You will have a lot better chance getting someone help at a warning stage than preventing someone from doing something once they have a weapon in their hands.  Approximately 30% of suicides result after the individual has expressed an intent to do so.  Listen up…  Take the signs of depression and any expressed thoughts of suicide seriously.
I welcome your comments, thoughts or questions.

Straight, No Chaser: The Grief of it All

stages-of-grief
It’s never easy discussing death. Bereavement is the state of mourning and sadness we endure after the death of a loved one. Grief is that process we endure, either in anticipation of death or in bereavement. Humans have been shown to systematically show grief in a predictable way. This Kubler-Ross model famously describes the response of those dying.

  • Denial, accompanied with simultaneous emotional numbness
  • Anger over the loss
  • Bargaining, as if the possibility of staying alive exists
  • Depression and intense mourning
  • Acceptance

The real point of bringing up the grieving process is to point out that the loss of a loved one is an extremely dangerous time for those left behind. In fact, the death of a spouse is the single highest risk factor for one’s own death. I’m sure many of us can think back to an elderly couple who died months apart.
The period of bereavement is a time when people need to come together, provide support and take care of each other. It’s very important that you and your loved ones know that the emotions you will experience are universal and normal. Try to keep that in mind when the time comes. Be reminded that normal grief can last over a year. Don’t feel abnormal because of the difficulties you may be having moving on. It’s healthy to work through your pain.
Common psychological thought describe four trajectories we take in bereavement.

  • Resilience – the attempt to ‘stay strong’ through it all
  • Recovery – evolution toward an healthy honoring and appreciation of the life of the lost
  • Chronic dysfunction – the unfortunate circumstance of being stuck in the mourning process such that it cripples your existence
  • Delayed grief or trauma – the subsequent release and expression of those suppressed emotions

Grief is to be considered a necessary and healthy part of a recovery process that we should learn to embrace.

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