Tuesday, March 9, 2010

Suicide: Has it become the prescription for depression?

Recently countless famous people have committed suicide: Michael Osmond, Joshua Andrew, Koenig,Lee, Alexander McQueen, James Victor "Vic" Chesnutt, Ryan Alexander Jenkins, Roh Moo-Hyun, Lucy Gordon, Phyllis Hyman, and David B. Kellermann to name a few.

Many have attempted suicide: Halle Berry, Alexa Ray Joel, Greg Louganis, James Stockdale, Donna Summer, Drew Carey, Mike Wallace, Paul Robeson, Elizabeth Taylor, Fred “Rerun” Robert Young, Maxene Andrews, Adam Ant, Mary Astor, Tai Drew Barrymore, Brigitte Bardot, Danny Bonaduce, Maria Callas, Martine Carol, Diana, Princess of Wales, Walt Disney, Micky Dolenz, Patty Duke, Eminem, Marianne Faithfull, Peter Fonda, Clark Gable, Stan Getz, Dwight “Doc” Gooden Mariette Hartley, Susan Hayward, Houston, Betty Hutton, Michael Jackson, Billy Joel, Elton John, Sally Kirkland and countless others. Why so many people who seem to have it all feel helpless? What does this say about our ability to handle life’s pressures? Did anyone hear their cries for help?

In addition to fame, these celebrities have in common various forms of depression and a cry for help. Most people with depression, particularly those with extreme depression, don’t commit suicide; however, it is important that it is addressed. Depression is a neutral disease that is unbiased to gender, race, or class. Depression does not exempt even celebrities with all the fame and fortune from falling victim. In fact, these deaths and attempts of suicide are a microcosm of larger mental health and social problem.

What is depression?
According to the National Institute of Health Publication and Dept of Health and Mental Hygiene, depression is a disorder of the brain and body's ability to biologically create and balance a normal range of thoughts, emotions, and energy. It is a potentially life-threatening mood disorder that affects up to 12% of the population or approximately 17.6 million Americans each year. Unfortunately, depression can lead to suicide. It’s important to recognize one doesn’t need to be diagnosis with chronic depression to attempt or commit suicide. The following data from the National Institute of Health Publication and Dept of Health and Mental Hygiene provided context for suicide prevalence in the United States:

• 15% of those who were clinically depressed died from suicide.
• In 1997, suicide was the 8th leading cause of death in the United States. 10.6 out of every 100,000 persons died by suicide. The total number of suicides was approximately 30,535.
• In 1996, there were an estimated 500,000 suicide attempts.
• There are an estimated 8 to 25 attempted suicides to 1 completion; the ratio is higher in women and youth and lower in men and the elderly.
• More than four times as many men than women die by suicide. However, women report attempting suicide about twice as often as men.
• In 1997, suicide by firearms was the most common method for both men and women, accounting for 58%.
• 72% percent of all suicides and 79% of all firearm suicides were committed by white men. The highest suicide rates were for white men over 85 years of age-65 per 100,000 persons.

Why do some individuals who suffer from depression commit or attempt suicide and others do not? This is a complex question. There is a variation in people with suicidal ideation and various demographics have been correlated with certain suicidal behaviors. Research suggests that 90 percent of those who commit suicide have depression or another diagnosable mental, emotional, or substance abuse disorder. Further research points to physiological reasons, such as the alterations in neurotransmitters like serotonin are associated with the risk for suicide. Decreased levels of serotonin have been found in patients with depression, impulsive disorders, a history of violent suicide attempts, and also in postmortem brains of suicide victims. The highest risk factors for attempted suicide in adults are depression, alcohol abuse, cocaine use, and separation or divorce.

Forlornly, life’s challenges in combination with other strong risk factors, such as depression may lead to suicide. It’s important to know that suicide ideation and attempts are not normal responses to life’s stress and the average person who experiences challenges in life don’t commit suicide. The following is a list of potential risk factors for suicide:

• One or more diagnosable mental (e.g., major depression) or substance abuse disorders
• Impulsivity
• Adverse life events
• Family history of mental or substance abuse disorder
• Family history of suicide
• Family violence, including physical or sexual abuse
• Prior suicide attempt
• Firearm in the home
• Incarceration
• Exposure to the suicidal behavior of others, including

Be aware of possible signs of depression and seek help. Many of the signs can be the result of other health related problems, contact your health care provider. However, people with depression have certain visible behavioral symptoms that, generally affect the body’s feelings, thoughts, and actions. The following is a list of potential signs of depression:

• Persistently sad, anxious, or empty moods
• Loss of pleasure in usual activities (anhedonia)
• Feelings of helplessness, guilt, or worthlessness
• Crying, hopelessness, or persistent pessimism
• Fatigue or decreased energy
• Loss of memory, concentration, or decision-making capability
• Restlessness, irritability
• Sleep disturbances
• Change in appetite or weight
• Physical symptoms that defy diagnosis and do not respond to treatment (especially pain and gastrointestinal complaints)
• Thoughts of suicide, death, or suicide attempts
• Poor self-image or esteem (as illustrated, for example, by verbal self-reproach).

Durkheim in his seminal work on Suicide (1897) asserted that it's the lack of social integration which may induce suicide. This means when social integration of a person is at a high level it could prevent the person from committing suicide and that small levels of integration implies the predispose to suicidal behavior. It is believed that people need social supports; however, alienation and isolation are clearly social conditions that contribute to possible suicide.

Lastly, because there is a strong correlation between depression and suicide, seek help and encourage those you know to seek help from a mental health professional. Another drink or using illicit drugs will not heal the internal pain of depression. Confronting depression and treating it like any other disease is the only attempt for cure. Life challenges will continue to occur, but how one handles and responds to these challenges make living with them less stressful. Many people think it's impossible to be helped, but a combination of treatments to include therapeutic and pharmacological approaches are available.

American Psychiatric Association
1400 K Street, NW
Washington, DC 20005
phone: (202) 682-6220
web site: http://www.apa.org/

American Psychological Association
750 First Street, NE
Washington, DC 20002-4242
phone: (202) 336-5500
web site: http://www.apa.org/

National Suicide Hotlines USA
United States of America
1-800-SUICIDE 1-800-784-2433
1-800-273-TALK 1 (800)-273-8255
Deaf Hotline 1 (800)799-4TTY (4889)
Toll Free 24 hours a day 7 days a week

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