Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
National Suicide Prevention Hotline
800-SUICIDE (784-2433)
http://www.suicide.org
National Suicide Prevention Lifeline
800-273-TALK (8255)
National Youth Violence Prevention Resource Center
866-SAFEYOUTH (866-723-3968) http://www.safeyouth.org
Hours: Monday through Friday, 8 a.m.-6 p.m. Eastern time
Substance Abuse and Mental Health Services Administration (SAMHSA) http://www.samhsa.gov
How to best assess the risk of someone committing suicide continues to be an
elusive challenge for health professionals, so this is an appropriate goal for future
research. The best way to achieve the balance between using psychiatric
medication to treat any underlying conditions that may result in suicidal
thoughts and the potential side effects of those medications is an ongoing issue
in suicide prevention.
Suicide At A Glance
Suicide is the process of purposely ending one's own life. How societies
view suicide varies by culture, religion, ethnic norms, and the circumstances
under which it occurs.
Nearly 1 million people worldwide commit suicide each
year -- about 30,000 each year in the United States.
Self-mutilation is the act
of deliberately hurting oneself without meaning to cause one's own death.
Physician-assisted suicide is defined as a doctor ending the life of a person
who is incurably ill in a way that is either painless or minimally painful for
the purpose of ending the suffering of the individual.
The effects of suicide on
the loved ones of the deceased can be devastating, resulting in suicide
survivors enduring a variety of conflicting, painful emotions.
Life
circumstances that may immediately precede a suicide include the time period of
at least a week after discharge from a psychiatric hospital, a sudden change in
how the person appears to feel, or a real or imagined loss.
Firearms are the
most common means by which people take their lives. Other common methods include
overdose of medication, asphyxiation, and hanging.
There are gender, age,
ethnic, and geographical risk factors for suicide, as well as those based on
family history, life stresses, and medical and mental-health status.
In children and teens, bullying and being bullied seem to be associated with their committing suicide, and being bullied may put them at risk for committing murder-suicide.
Warning
signs that an individual is imminently planning to kill him- or herself may include
the making of a will, getting his/her affairs in order, suddenly visiting or
writing letters to loved ones,
buying instruments of suicide, experiencing a sudden change in mood, or writing
a suicide note.
Many people who complete suicide do not tell any health
professional of their intent in the months before they do so. If they communicate a
plan to anyone, it is more likely to be a friend or family member.
The assessment of suicide risk often involves an evaluation of the presence,
severity, and duration of suicidal thoughts as part of a mental-health
evaluation.
Treatment of suicidal thinking or attempt involves adapting immediate treatment to the sufferer's individual needs. Those with a strong social support system, who have a history of being hopeful and have a desire to resolve conflicts may need only a brief crisis-oriented intervention. Those with more severe symptoms or less social support may need hospitalization and long-term
outpatient mental-health services.
Treatment of any underlying emotional problem using a
combination of psychotherapy, safety planning, and medication remains the
mainstay of suicide prevention.
People who are contemplating suicide are encouraged to talk to a doctor or other health professional, spiritual advisor, or immediately go to the closest emergency room or mental-health crisis center for help. Those who have experienced suicidal thinking are commonly directed to keep a list of people to call in the event that those thoughts return. Other strategies include having someone hold all medications to prevent overdose, removing any weapons from the home, scheduling frequent stress-relieving activities, getting together with others, writing down feelings, and avoiding the use of alcohol or other drugs.
Techniques for coping with the suicide of a
loved one include nutritious eating, getting extra rest, writing about their emotions, talking to others about
the experience, thinking of ways to handle painful memories, understanding their
state of mind will vary, resisting pressure to grieve by any one else's time
table, and survivors doing what is right for them.
To help children and
adolescents cope with the suicide of a loved one it is important to ensure they
receive consistent caretaking, frequent interaction with supportive peers and adults, and
understanding of their feelings as they relate to their age.
REFERENCES:
Adams, K. "Managing Grief Through Journal Writing." Center for Journal Therapy.
2006.
Alexander, R.E. "Stress-Related Suicide by Dentists and Other Health Care Workers: Fact or Folklore?"
Journal of the American Dental Association 132.6 (2001): 786-794.
Aseltine, R.H. and DeMartino, R. "An Outcome Evaluation of the SOS Suicide
Prevention
Program." American Journal of Public Health 94.3 (2004): 446-451.
Bender, E. "Suicide Expert Calls for More Aggressive Screening." Psychiatric
News 38.11 June 6, 2003: 28.
Brown, H. "Suicide by Cop: When It Happens to You, There's Almost Always
Police
Stress as a Result." Police Stressline, 2003.
Center for Suicide Prevention. "Grief After Suicide: Notes From the Literature
on Qualitative Differences and Stigma." SIEC Alert 46, November 2001.
Conwell, Y., Duberstein, P.R., Connor, K., Eberly, S., Cox, C. and Caine, E.D.
"Access to
Firearms and Risk for Suicide in Middle-aged and Older Adults." American Journal
of Geriatric Psychiatry 10 Aug. 2002: 407-416.
Cuellar, J. and Curry, T.R. "The Prevalence and Comorbidity Between Delinquency,
Drug
Abuse, Suicide Attempts, Physical and Sexual Abuse, and Self-Mutilation Among
Delinquent Hispanic Females." Hispanic Journal of Behavioral Science
29.1 (2007): 68-82.
Eliason, S. Murder-suicide: A review of the recent literature. Journal of the American Academy of Psychiatry and the Law 37.3 (2009); 371-376.
Fawcett, J. "Treating Impulsivity and Anxiety in the Suicidal Patient." Annals
of the New York Academy of Sciences 932 (2001): 94-105.
Frierson, R.L., Melikian, M. and Wadman, P.C. "Principles of Suicide Risk
Assessment.
How to Interview Depressed Patients and Tailor Treatment." Postgraduate Medicine
112.3 Sept. 2002.
Frileux, S., Lelievre, C., Munoz Sastre, M.T., Mullet, E. and Sorum, P.C. "When
Is Physician
Assisted Suicide or Euthanasia Acceptable?" Journal of Medical Ethics 29
(2003): 330-336.
Gibbons, R.D., K. Hur, D.K. Bhaumik, and J.J. Mann. "The Relationship Between Antidepressant Prescription Rates and Rate of Early Adolescent Suicide."
American Journal of Psychiatry 163 Nov. 2006: 1898-1904.
Hem, E., A.M. Berg, and O. Ekeberg. "Suicide Among Police Officers." American Journal of Psychiatry 161 Apr. 2004: 767-768.
Horowitz, M.J., Siegel, B., Holen, A., Bonanno, G.A., Milgrath, C. and Stinson, C.H.
"Diagnostic Criteria for Complicated Grief Disorder." Focus 1 (2003):
290-298.
JAMA Patient Page. Suicide. Journal of the American Medical Association 293.20
(2005).
Johansson, L, Lindqvist, P, Eriksson, A. Teenage suicide cluster formation and contagion: implications for primary care. Biomedical Central Family Practice 2006 May; 7: 32.
Kim,
Young-Shin. "Bullying and Being Bullied Linked to Suicide in Children, Review of Studies Suggests." Science Daily. July 19, 2008.
Klonsky, E.D., Oltmanns, T.F. and Turkheimer, E. "Deliberate Self-Harm in a
Nonclinical
Population: Prevalence and Psychological Correlates." American Journal of
Psychiatry 160 Aug. 2003: 1501-1508.
Mayo Foundation. "Suicide: Coping When a Loved One Takes Their Life." 2007.
Mayo Foundation. "Suicide: Don't Let Despair Obscure Other Options." 2007.
Melhem, N.M., Day, N., Shear, K., Day, R., Reynolds, C.F. and Brent, D. "Traumatic
Grief Among
Adolescents Exposed to a Peer's Suicide." American Journal of Psychiatry
161 Aug. 2004: 1411-1416.
National Institute of Mental Health. "Suicide in the United States: Statistics
and Prevention." Oct. 3, 2007.
Neimeyer, R.A., Prigerson, H.G. and Davies, B. "Mourning and Meaning." American
Behavioral Scientist 46.2 (2002): 235-251.
Osterweil, N. "APA: Simple Screen Improves Suicide Risk Assessment." Psychiatric
Times May 25, 2007.
Palmer, L.I. "The Legal and Political Future of Physician-Assisted Suicide."
Journal of the American Medical Association 289 (2003): 2283.
Pfeffer, C.R. "Death." Psychiatric Times 17.9 Sept. 2000.
Qin, P., Agerbo, E. and Mortensen, P.B. "Suicide Risk in Relation to Socioeconomic,
Demographic, Psychiatric and Familial Factors: A National Register-Based Study
of All Suicides in Denmark, 1981-1997." American Journal of Psychiatry
160 Apr. 2003: 765-772.
Rao, K.N., C.Y. Sudarshan, and S. Begum. "Self-injurious Behavior: A Clinical Appraisal." Indian Journal Psychiatry
50.4 Oct.-Dec. 2008: 288-297.
Rask, K., Kaunonen, M. and Paunonen-Ilmonen, M. "Adolescent Coping With Grief
After
the Death of a Loved One." International Journal of Nursing Practice 8(3)
June 2002: 137-142.
Reinherz, H.Z., Tanner, J.L. and Berger, S.R. "Adolescent Suicidal Ideation as
Predictive
of Psychopathology, Suicidal Behavior and Compromised Functioning at Age 30." American Journal of Psychiatry
163 (2006): 1226-3122.
Reuter-Rice, K. "Male Adolescent Bullying and the School Shooter." Journal of School Nursing
24.6 (2008): 350-359.
Russell, S.T., and K. Joyner. "Adolescent Sexual Orientation and Suicide Risk: Evidence From a National Study." American Journal of Public Health 91.8 Aug. 2001: 1276-1281.
Shain, B.N. "Committee on Adolescence. Suicide and Suicide Attempts in
Adolescents." Pediatrics 120.3 Sept. 2007: 669-676.
Sher, L. "Preventing Suicide." Quarterly Journal of Medicine 97.10
(2004): 677-680.
Silva, M.J. and Vitiello, B. "The Treatment for Adolescents With Depression
Study
(TADS): Methods and Message at 12 Weeks." Journal of the American Academy of
Child and Adolescent Psychiatry 45 (2006): 1393-1403.
Soreff, S. "Suicide." eMedicine.com. Sept. 28, 2006.
United States. Centers for Disease Control and Prevention. "National Suicide Statistics at a Glance 2009." Sept. 30, 2009. <http://www.cdc.gov/violenceprevention/suicide/statistics/aag.html>.
van Houwelingen, C.A., and D.G. Beersma. "Seasonal Changes in 24-Hour Patterns of Suicide Rates: A Study on Train Suicides in the Netherlands." Journal of Affective Disorders 66.2-3 Oct. 2001: 215-223.
Washington State Legislature. Initiative Measure Number 1000. The Washington Death with Dignity Act 2008 January.
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Anorexia is an eating disorder characterized by markedly reduced appetite or total aversion to food. Anorexia is a serious psychological disorder and is a condition that goes well beyond out-of-control dieting. With anorexia, the drive to become thinner is actually secondary to concerns about control and/or fears relating to one's body. There are psychological and behavioral symptoms as well as physical symptoms of anorexia including: depression, social withdrawal, fatigue, food obsession, heart and gastrointestinal complications, kidney function, flaky skin, brittle nails, and tooth loss (this list is not exhaustive).
Alcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law.
Post-traumatic stress disorder (PTSD), a psychiatric condition, can develop after any catastrophic life event. Symptoms include nightmares, flashbacks, sweating, rapid heart rate, detachment, amnesia, sleep problems, irritability, and exaggerated startle response. Treatment may involve psychotherapy, group support, and medication.
Schizophrenia is a disabling brain disorder that may cause hallucinations and delusions and affect a person's ability to communicate and pay attention. Symptoms of psychosis appear in men in their late teens and early 20s and in women in their mid-20s to early 30s. With treatment involving the use of antipsychotic medications and psychosocial treatment, schizophrenia patients can lead rewarding and meaningful lives.
Bipolar disorder (or manic depression) is a mental illness characterized by depression, mania, and severe mood swings. Treatment may incorporate mood stabilizer medications, antidepressants, and psychotherapy.
Borderline personality disorder is a serious mental illness characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior. This instability often disrupts family and work life, long-term planning, and the individual's sense of self-identity. Originally thought to be at the "borderline" of psychosis, people with borderline personality disorder (BPD) suffer from a disorder of emotion regulation.
Dissociative identity disorder (formerly known as multiple personality disorder or split personality disorder) is a mental illness in which a person has at least two distinct personalities. Symptoms and signs include lapses in memory, feeling unreal, blackouts in time, hearing voices in their head that are not their own, not recognizing themselves in the mirror, and finding items in one's possession but not recalling how they were acquired. Treatment usually involves psychotherapy, medications, and sometimes hypnosis.
Drug addiction is a chronic disease that causes drug-seeking behavior and drug use despite negative consequences to the user and those around him. Though the initial decision to use drugs is voluntary, changes in the brain caused by repeated drug abuse can affect a person's self-control and ability to make the right decisions and increase the urge to take drugs. Drug abuse and addiction are preventable.
Obsessive compulsive disorder (OCD) is an anxiety disorder that causes a person to suffer repeated obsessions and compulsions. Symptoms include irresistible impulses despite a person's realization that the thoughts are irrational, excessive hand washing, skin picking, lock checking, or repeatedly rearranging items. People with OCD are more likely to develop trichotillomania, muscle or vocal tics, or an eating disorder. Treatment for OCD includes psychotherapy, behavioral therapy, and medication.
Antisocial personality disorder (ASPD) has many symptoms, signs, and causes. Therapy is one treatment option for antisocial personality disorder. It is closely related to other personality disorders (PD), such as borderline personality disorder and narcissistic personality disorder.
Grief is the feeling one experiences after a loss (of a friendship, death of loved one, job). Complicated grief refers to grief that lasts for more than a year. Mourning describes the customs and rituals that help a bereaved individual make sense of their loss.
Attention deficit hyperactivity disorder (ADHD) is a behavioral disorder characterized by the symptoms hyperactivity, impulsivity, and inattention. Treatment for ADHD may involve behavioral therapy and psychostimulant or antidepressant medication.
Insomnia is the perception or complaint of inadequate or poor-quality sleep because of difficulty falling asleep; waking up frequently during the night with difficulty returning to sleep; waking up too early in the morning; or unrefreshing sleep. Secondary insomnia is the most common type of insomnia. Treatment for insomnia include lifestyle changes, cognitive behavioral therapy, and medication.
Alcohol is the most frequently used drug by American teenagers. Teens that drink are more likely to drive under the influence, have unprotected sex, and use other drugs, like marijuana, cocaine, and heroin. Symptoms of alcohol abuse in teens include lying, breaking curfew, becoming verbally or physically abusive toward others, making excuses, smelling like alcohol, having mood swings, and stealing.
Agoraphobia is a fear of being outside or of being in a situation from which escape would be impossible. Symptoms include anxiety, fear, disorientation, rapid heartbeat, diarrhea, or dizziness. Treatment may incorporate psychotherapy, self-exposure to the anxiety-causing situation, and medications such as SSRIs, benzodiazepines, and beta blockers.
Seasonal affective disorder is a type of depression that tends to occur as the days grow shorter in the fall and winter. Symptoms of seasonal affective disorder include tiredness, fatigue, depression, irritability, body aches, poor sleep and overeating.
Bulimia is an eating disorder characterized by episodes of secretive excessive eating (bingeing) followed by inappropriate methods of weight control, such as self-induced vomiting (purging), abuse of laxatives and diuretics, or excessive exercise. Purging and nonpurging are the two types of bulimia. There are five basic criteria in the diagnosis of bulimia.
Drugs commonly abused by teens include tobacco products, marijuana, cold medications, inhalants, depressants, stimulants, narcotics, hallucinogens, PCP, ketamine, Ecstasy, and anabolic steroids. Some of the symptoms and warning signs of teen drug abuse include reddened whites of eyes, paranoia, sleepiness, excessive happiness, seizures, memory loss, increased appetite, discolored fingertips, lips or teeth, and irritability. Treatment of drug addiction may involve a combination of medication, individual, and familial interventions.
Separation anxiety disorder is a common childhood anxiety disorder that has many causes. Infants, children, older kids and adults can suffer from symptoms of separation anxiety disorder. Common treatment methods include therapy and medications.
Schizoaffective disorder is a mental illness that features schizophrenia and a mood disorder, either major depression or bipolar disorder. Symptoms include agitation, suicidal thoughts, little need for sleep, delusions, hallucinations, and poor motivation. Treatment may involve psychotherapy, medication, skills training, or hospitalization.
Cocaine is an addictive stimulant that is smoked, snorted, and injected. Crack is cocaine that comes in a rock crystal that is heated to form vapors, which are then smoked. Cocaine has various effects on the body, including dilating pupils, constricting blood vessels, increasing body temperature, heart rate, and blood pressure.
Childhood depression can interfere with social activities, interests, schoolwork and family life. Symptoms and signs include anger, social withdrawal, vocal outbursts, fatigue, physical complaints, and thoughts of suicide. Treatment may involve psychotherapy and medication.
Dysthymia is a less severe form of chronic depression. Symptoms and signs include insomnia, suicidal thoughts, guilt, empty feeling, loss of energy, helplessness, sluggishness, and persistent aches and pains. Treatment may involve psychotherapy, electroconvulsive therapy, and antidepressants.
Good parenting helps foster empathy, honesty, self-reliance, self-control, kindness, cooperation, and cheerfulness, says Steinberg, a distinguished professor of psychology at Temple University in Philadelphia. It also promotes intellectual curiosity, motivation, and desire to achieve. It helps protect children from developing anxiety, depression, eating disorders, antisocial behavior, and alcohol and drug abuse.
Mental illness is any disease or condition affecting the brain that influence the way a person thinks, feels, behaves, and/or relates to others. Mental illness is caused by heredity, biology, psychological trauma and environmental stressors.
Compulsive gambling is a disorder that affects millions in the U.S. Symptoms and signs include a preoccupation with gambling, lying to family or loved ones to hide gambling, committing crimes to finance gambling, and risking importance relationships and employment due to gambling. Treatment may incorporate participation in Gamblers' Anonymous, psychotherapy, and medications like carbamazepine, topiramate, lithium, naltrexone, antidepressants, clomipramine, and fluvoxamine.
Anabolic steroids are synthetic substances that are related to testosterone and promote skeletal muscle growth and the development of male sexual characteristics in both men and women. In the 1930s, it was discovered that anabolic steroids could promote skeletal muscle growth in lab animals, which lead to anabolic steroid abuse by bodybuilders and weight lifters.
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