Dr. Kevin Most: Suicide Prevention
We just completed suicide prevention week on Sunday and I thought spending a few minutes on this would be appropriate. Many of us have been touched by the tragedy of suicide, it may have been a family member or friend and even in the case of a celebrity the impact can be felt and affect us all. Personally one of my best friends going all the way back to 5th grade committed suicide a few years ago. He was a great friend, married with a very successful computer sales career. I did not see it coming and he did not reach out to any of his close friends. He makes an impact on me and the need for mental health awareness must be elevated to save the lives of these individuals who are struggling with mental illness. We must all gain an understanding that this is just like any other illness be it cancer , diabetes or pneumonia, It needs to be identified so it can be treated. We have to get away from the social stigma associated with depression.
Suicide should be eradicated in the US, just like we did with polio. It will be a journey but we should be seeing improvement as long as we all understand that we need to speak up. This is a disease where we as doctors need your help. Identifying the individuals and helping them get treatment is what will save lives. More on that later.
Let’s go over some statistics. Overall in the United States suicide is the 10th leading cause of death. Close to 45,000 Americans die by suicide each year. More importantly is that 25 try to commit suicide for everyone that actually dies by their own hand. Multiples of that are depressed and have considered or are considering suicide. There are even more patients impacted as many overdoses are not considered suicide but often accidental deaths.
In the state of Illinois, we had close to 1500 suicides last year. We rank 44th in our rate of suicides across the country. More importantly it is the leading cause of death in children aged 10-14 and the third leading cause of death in young adults aged 15-24. We hear each morning about the shooting and homicides in Chicago but do we realize that nearly TWICE as many individuals die from Suicide than by homicide.
This is a disease that can impact individuals of any age, recent studies have shown that suicide attempts are up among adults in the US and more concerning is that attempts are up highest in young adults and those less educated. The difference in the increased rate was found in individuals aged 21-34 y.o. and a large difference was noted in individuals with only a High School education versus those with a college degree. There is no definite cause however the concern is the lack of opportunity and financial burden this population feels.
Taking a minute can save a life, individuals who have attempted suicide often share that they were hoping for someone to intervene and ask them how they were doing. Most of these individuals share that they did not want to die, they wanted some help and hoped for intervention. Many of them said if someone had just taken a moment and truly asked how I was doing they may have never tried.
It is all of our responsibility to look out for anyone who is struggling, just as we hope others look out for us. Take a minute, check in with them, listen to them, encourage and aid them in getting help. Listen in a nonjudgmental way, listen with concern, it will make a difference.
The big message here is take a moment to reach out to someone you are concerned about or have noted a change that concerns you, by taking a minute you may save a life and change the course of lives for many. Don’t worry about not knowing the right answers or advice you should give, listen with empathy and concern, be there for support and help them get treatment
Knowing all of this we need to be aware and know what to look for in these patients. I cannot tell you how important it is for all of us to be aware and look for individuals suffering from depression that are un diagnosed and a special view on those diagnosed but appear to be struggling. Physicians are often the last to know, as some patients do not reach out to their doctor for help, they often will show signs in their day to day life but not in a physician’s exam room.
Identifying someone who may need help for depression requires each of us to know what to look for. Let’s go over some of the things you may see in normal life that the doctor may not see during an office visit.
· Loss of interest or pleasure in activities that the individual used to enjoy
· Weight loss or weight gain
· Major change in sleeping pattern
· Mood swings
· Irritability, crying inappropriately, profound episodes of sadness
· Social isolation
· Loss of self-esteem, often noted in dress or grooming habits
Reaching out to that friend or family member will assist them in getting help. One should be concerned if anyone talks that may be concerning for a suicidal patient.
· Talking about feeling hopeless,
· Talking about being a burden on others
· Are they giving away prize possessions
· Having no reason to live
· Talking about people who have committed suicide
· Talking about not wanting to be around, or ways to kill themselves
· Talking about not being around in a way that causes you concern.
Individuals who are thinking of committing suicide should get all of our attention. All deserve some attention and treatment, some more than others
· Do they have a suicide plan
· Do they have the means to do it, (own a gun, have medications they could take)
· Do they have a support system
· Do they seem to be relieved and happy ( these patients often have come to a conclusion that they will commit suicide and are now relieved with their decisions and their plan to move forward. These are the most difficult patients, and often the most successful)
· Have they done searches on line about suicide
· Are they isolating themselves from family and friends
There are many stories where an individual shares with a friend that they were on the edge of committing suicide and that the intervention a friend made pulled that from that edge, they may not know for weeks, months or in some cases years. There are stories of individuals saying, remember the day you asked me how I was doing and took me out for coffee to help me, I was planning on committing suicide that day and without your intervention I would have. Those are great stories and unfortunately there are hundreds a day where we missed that opportunity.
Often you may feel something is just not right with your friend or family member, look for the signs we discussed and intervene. The support that you provide may save a life. Remember depression is an illness and should not be seen in a socially isolating way, embrace and support that individual who is struggling. The difference you make will impact them as well as you in more ways than you would know.
Take a minute and reach out to anyone you are concerned about.
There are professionals that will talk to individuals who are considering suicide at the National Suicide Prevention Lifeline 800- 273- 8255, or chat on line at suicidepreventionlifeline.org, they are there 24/7/365.