Transcript SAVING LIVES: Understanding Depression & Suicide in Our

NOTICE ME!
Understanding Depression
and Suicide
Summit County Suicide Prevention Coalition
Summit County ADM Board
Andrea Denton
September, 2011
WHY ARE WE HERE?
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We care about what is happening to our
community….our families and our friends.
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We don’t want any more tragedies.
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We want to make a difference.
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AND BECAUSE…
We are some of the people that others look up to for
answers when life is confusing.
We are trying to figure out why someone would find
life so painful that death becomes the way to
resolve the situation.
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WHAT WE HOPE TO LEARN
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The impact of suicide within the community.
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The connection between depression and suicide
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The myths and misconceptions about suicide.
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The risk factors and signs of suicidal behavior.
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Finding help for those at risk.
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A BASIC UNDERSTANDING…
Many people are uncomfortable discussing suicide.
We fear the topic.
We don’t understand it
BUT, KNOWLEDGE IS POWER!
The more we know…the more we can help.
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OUR LANGUAGE MATTERS
We can take the judgment out of our language by
using phrases like:
“died by suicide”
“death by suicide”
“completed suicide”
Instead of saying “committed suicide”
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A PERSPECTIVE ON SUICIDE
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It ranks 11th as a cause of death in America.
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As many as 25% of adolescents and 15% of
adults consider suicide at some point in their
lives.
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More people die using firearms than by any other
method.
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A suicide attempt is a desperate cry for help
to end hopelessness and excruciating,
unending, and overwhelming pain.
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Suicidal people don’t necessarily want to die.
They want their pain to end.
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IS SUICIDE REALLY AN ISSUE?
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94.8 people die by suicide every day in the U.S.
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34,598 people died of suicide in 2007 in the U.S.
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65 people died of suicide in Summit County in
2010.
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Nationally, one person dies of suicide every 15.2
minutes.
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THE SIZE OF THE PROBLEM

These statistics are the best we have, but
there may be as many as 2 to 3 times more
people who complete suicide than are
reported.
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For every 1 homicide, 2 people complete
suicide.
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U.S. SUICIDE STATISTICS - 2007
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Rates per 100,000
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National Average
Caucasian Males
African American Males
Caucasian Females
African American Females
Elderly (65+ years)
Children (5-14)
Youth: (15-24)
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11.5
20.5
8.4
5.4
1.7
14.3
.5
9.7
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GENDER ISSUES
Females:
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Make attempts 4 times as often as men.
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Their risk rises until midlife, then decreases.
Males:
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Complete suicide 4 times as often as women.
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Their risk is always higher than women and
continues to rise until end of life.
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DEPRESSION AND
SUICIDE
Their Relationship………..
THE STORY
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It is estimated that as many as 90% of suicidal
people suffer with a depressive illness, either
diagnosed or undiagnosed.
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Upon reaching puberty, statistics show girls are
affected by clinical depression twice as often as
boys. However, some feel that perhaps boys are just
not diagnosed as quickly or easily.
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FAULTY WIRING
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Just as a person with diabetes has low insulin
production, a person with depression suffers from
the mind’s inability to function correctly.
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Depression and stress can cause changes in the
physical structure of the brain and damage to
brain cells.
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The symptoms of depression can be mild to severe
for any individual person.
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SUICIDE HAS BEEN VIEWED AS…
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A moral failing
A spiritual weakness
“The coward’s way out”
A selfish act
But, after years of brain research, we now know
that the symptoms of depression have a
biological basis.
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TREATMENT FOR DEPRESSION
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Medications help to repair the damage to nerve
connections. It may take 4 to 6 weeks for them to
be effective.
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Counseling helps to teach new coping and problemsolving skills and different ways to interpret
stressful events. Counseling can change negative
ways of thinking that can lead to suicidal thoughts.
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For most people, the best treatment is medication and
counseling combined.
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Some people can also benefit from group therapy,
support groups and other social supports.
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Treatment is designed specifically for the
individual.
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Watch the person carefully for at least six months.
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WITHOUT TREATMENT?
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Risk of increased alcohol and drug use.
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Significant relationship issues.
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Lost school days or work days and inability to
plan for future.
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Higher risk for suicidal thoughts, attempts and
death.
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WHAT DO WE WATCH FOR?
Depressed or Irritable Appearance
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Frequent crying
Unhappy presentation
Angry outbursts
Wears dark or monotone clothing
Writes, reads or listens to music with violent or
depressive themes
Truancy becomes a problem
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AND……
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Withdrawal from favorite activities or people
Changes in friends
Poor hygiene
Moves more slowly or can’t sit still
Rapid changes in weight
Changes in sleeping habits
No energy to manage duties
Physical complaints
Inability to concentrate
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MORE PROBLEM BEHAVIORS
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Acting out a will
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Talking about death and dying
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Making verbal threats: “I’m no good to anyone”;
“I can’t go on without____”; I wish I were dead.”
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Looking for methods, weapons…creating a plan.
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LISTEN!
“What is wrong with______? He or she seems so
different from the way they used to be.
If this happens, look at the patterns of behavior
and see what your gut reaction tells you.
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BE ESPECIALLY WORRIED IF…
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The person made a prior suicide attempt.
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They lost someone to suicide.
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They are using or abusing substances.
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They have had a recent loss (relationship,
family death, job, pet, freedom).
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They are in trouble anywhere.
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OR…
They are struggling with sexual orientation issues.
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Four times higher risk for suicide than their
heterosexual peers
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More frequent and more lethal suicide
attempts
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Significantly higher rates of depression,
substance abuse and suicidal ideation
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OR……
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They have an illness that makes them feel
different, especially if it is newly diagnosed.
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They express hopelessness about life.
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They are in emotional pain and can’t see that
things will improve.
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RISK FACTORS
AND PROTECTIVE
FACTORS
RISK FACTORS
GENETICS
 Depression can run in families.
 A family history of suicide increases risk by 6 times.
ENVIRONMENT
 People are affected by psychological trauma, abuse,
chronic illness, medications or the problem-solving
techniques of others.
SITUATIONAL FACTORS
 Violence, illness, sudden loss or any severe shock to the
system can bring on suicidal feelings.
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MORE SITUATIONAL FACTORS
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Substance use
Access to firearms or other lethal means
Significant loss (like death, separation, divorce,
break up, etc.)
Social isolation, feeling alone or picked on.
Feeling trapped or like a burden
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History of violence, aggression or impulsiveness
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PROTECTIVE FACTORS
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Restricted access to lethal means.
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Support of family and friends.
Having coping skills
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Community support like belonging to
church, groups or organizations.
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Ongoing medical and/or mental health
care relationships.
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AND…
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Beliefs that discourage suicide and support selfpreservation
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Future plans; sees self in the future
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Sense of purpose
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Is ambivalent (struggling with whether to live or die)
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Is able to connect with people and seek help
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MYTHS AND FACTS
MYTHS AND FACTS
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Sorting out the truth……..
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Knowing what to believe…..
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Sharing your expertise……
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FACT vs. MYTH…
MYTH: A person who threatens suicide won’t
really follow through.
FACT: Almost 80% of people who complete
suicide have talked about it with someone
before they die by suicide. Students are
particularly good at sharing with friends so
friends need to be told to not keep someone’s
suicidal feelings a secret.
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FACT vs. MYTH…
MYTH: No one I know would do that.
FACT: Suicide is an equal opportunity killer.
Rich, poor, successful, unsuccessful,
beautiful, ugly, young, old, popular, and
unpopular people all die of suicide.
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FACT vs. MYTH…
MYTH: Once a person decides to die nothing can
stop them. They really want to die.
FACT: Most people actually want to be stopped.
Most individuals want to end the pain, not their
lives. They often feel there is no hope.
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FACT vs. MYTH…
MYTH: Asking someone if they are suicidal might
cause a person to think about suicide or to
attempt suicide.
FACT: It is helpful to talk openly with someone who
is having suicidal thoughts. Many people are
relieved at the chance to talk about the thoughts.
You will not put the idea of suicide into
someone’s head.
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FACT vs. MYTH…
MYTH:
They are just trying to get attention.
FACT:
They are trying to get help. We must recognize
that need and respond to it.
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AMBIVALENCE
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I’M NOT A
PSYCHIATRIST…
…WHAT CAN I DO?
WHAT CAN I DO?
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Think of depression as an illness, like heart
disease.
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Try to understand that the person is feeling
serious pain.
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Think of suicidal thoughts as a crisis in that
illness, like a heart attack.
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WHAT IF…
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We weren’t afraid to ask for help for ourselves
and the people we care about?
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We no longer had to feel ashamed of feelings of
despair and hopelessness, but recognized them as
symptoms of a brain disorder?
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WHY DON’T WE HELP?
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Most of us are afraid of getting a “yes” answer if
we ask about suicide. We think we don’t know
how to help.
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Some of us believe that suicide and depression are
not our business or responsibility.
Remember that most suicidal people are very
ambivalent. They want help for the pain but
don’t know how to ask for it.
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A METHOD WE CAN USE
Dr. Paul Quinnett suggests learning QPR,
similar to CPR:
Question
Persuade
Refer
for those times when we realize that someone
needs help for dealing with their pain but
they don’t know how to ask for it.
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ASK QUESTIONS…BE CURIOUS
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“You seem pretty down today.”
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“Do things seem hopeless to you?”
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“How do you plan to deal with your problem?
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“Are you thinking about suicide?”
If you get a “yes” answer, ask more questions.
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HOW MUCH RISK IS THERE?
To find out if the person is in immediate danger. Ask or
think about…
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Has the person attempted suicide before?
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Does the person have a plan?
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How specific is the plan?
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Does the person have access to means of suicide?
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DO…
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Do remain calm, relaxed and rational.
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Do look and listen for warning signs and get
help early.
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Do get involved and stay involved.
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Do talk openly about suicide and encourage
expression of feelings.
Do get the person to explain what hurts so
badly.
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DO
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Do listen with empathy; show interest and
support.
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Do take action and remove means.
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Do offer hope that alternatives are available.
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Ask if they ever felt like this before and how
they got through that situation.
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DON’T..
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Don’t make moral judgments.
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Don’t argue, lecture, or encourage guilt.
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Don’t be sworn to secrecy or make promises you
can’t keep.
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Don’t offer empty reassurances (“You’ll get over
this”).
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Don’t minimize the problem (“All you need is a
good night’s sleep”).
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Don’t keep the information secret.
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Don’t dare or use reverse psychology.
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Don’t leave the person alone.
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Never Go It Alone
Collaborate With Others
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Family/friends
School personnel
Emergency room staff
Law enforcement
Family doctor
Mental health professionals
Clergy
Crisis hotlines
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Community Resources
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Know how and where to get help before a
crisis happens. Have a resource list.
Find out who to go to in your agency or school.
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Refer the person for professional help and
help them get there.
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For immediate danger, call 911 for help from
the police and/or paramedics.
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Ask if there is a Crisis Intervention Team (CIT)
officer available.
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If person is not in immediate danger and can be safely
transported, take them to:
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Children’s Hospital Medical Center (under age 18)
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Any hospital emergency room or Portage Path
Emergency Services (over age 18)
For guidance and support: crisis hotlines (24/7):
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SUPPORT Hotline (Summit County) (330) 434-9144
Lifeline (From Anywhere)
(800) 273-TALK
PIRC Program (Children’s Hospital) (330) 543-7472
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FINAL THOUGHTS
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You may know people with depression.
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Have an open discussion about depression and
suicide. Invite them to talk.
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You would perform CPR if you saw a heart attack
victim, remember QPR for suicide emergencies.
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Don’t be afraid to “interfere” when someone is
dying more slowly of depression.
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BECAUSE OF YOUR POSITION
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You might be the only person who recognizes that a
person needs help.
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Follow your “gut reaction.”
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Help reduce the stigma placed on mental illness,
suicide and depression.
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Be aware of your own vulnerability to depression.
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THE MOST IMPORTANT THING YOU
CAN DO
IS TO INSTILL A FEELING OF HOPE
THAT THE PERSON WILL
GET THROUGH THIS ROUGH TIME.
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A PERSON MAY NEVER HAVE
EXPERIENCED A DIFFICULT TIME
PREVIOUSLY AND SO THIS MAY FEEL
LIKE THE END OF THE WORLD.
DON’T LET IT BE.
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THANKS SO MUCH FOR ALL YOU DO
EVERY DAY TO MAKE THIS A BETTER
WORLD FOR PEOPLE IN THESE
TURBULANT TIMES.
The world is a better place because you care.
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