It has been a while since I have tackled this subject. However, this morning the Psychiatrist in me woke-up. Suicide is still a major problem in our society. We have to continue having very open and straight forward discussions. The Monster Called Suicide. As you may or may not recall suicide was the 11th leading cause of death in 2008 and the 10th leading cause of death in 2009. We have to began looking at this medical dilemma with more seriousness in all of our communities.
Realizing that this is not a popular topic, I will try to be as direct, as well as, empathetic as possible.
Some of the risk factors that I have seen in private practice for suicide are;
- Divorced > Single and never married
- White>> African-American
- Chronic Mental Illness (i.e. Bipolar, Schizophrenia, Depression)
- Chronic Medical Illness (Cancer, AIDS, Chronic Pain Syndromes)
- Substance Abuse/Dependence Issues
- Major Financial Loss
- Major Occupation Decline/Loss
- History of Physical and Sexual Abuse during Adolescent Years
I take a different approach to handling my depressed patients than many of my, colleagues. For example, I use the bio-psycho-social-spiritual model. I guess this would be a good time to break-down my clinical process.
Biological (Bio)-I take a very good family history to see if there is possibly a biological component to the patient’s disease. Most times, there is evidence for this factor. A mother, father, grandmother or other also have mental illness. It is very important to illicit this information because when there is a biological component-the disease may be a little harder to treat.
Psycho-dynamic (Psycho)-What are some of the causative and dynamic stressors on the ego. For example is there a history of physical or sexual trauma? Is there current spousal abuse? Are we dealing with chronic issues of abandonment? All of these issues must be addressed. Understanding the psycho-dynamics of a patient is very important in the assessment of depression and risk for suicidality.
Social-What type of support does the patient have at the time of assessment? Is the patient isolated although living in the home with others? Are they a part of the neighborhood or any social clubs? When stressed, is it all maintained inside or do they have social interactions that may provide temporarily relief before the availability of a licensed or professional mental health caregiver? This is very important also in the initial work-up and assessment of a depressed and or suicidal patient.
Spiritual-I often times pray that there is a faith system of some sort around. This can make the treatment plan a little more hearty. Being able to meditate, pray and call on a higher being is very important in our cultures. Many patients are surprised to hear that I validate their beliefs and actually encourage a spiritual relationship. After all, when the illness is very serious, all hands need to be on deck.
I hope that helps you understand my theoretical framework a little better. Now let me ask you a couple of questions;
- Have you ever been really depressed?
- Are you currently taking an anti-depressant for your sad mood?
- Is your therapist or physician involved in your care or do you feel that they are unengaged?
- Do you believe that medications alone are helpful?
- Do you believe that therapy alone is helpful?
- Do you believe that is takes both medications and an engaged therapist to help with this medical problem?
Take a Peak at the Video below:
The problem of suicide has really become a problem in our schools and I would like for you to view the video, share with others and give me some feedback.
Yes boys, and girls suicide is a very serious problem in all of our communities, schools and even churches. It is now time for you to take action and began speaking out against this issue. Let someone know that there is HOPE and that there is HELP.
Questions for Review? True or False
- Suicide is the 11th most common cause of death in America?
- Suicide is a preventable disease?
- Medications do not help people with depression?
- A single male is more likely to complete suicide than a divorced male.
- Cocaine dependence is not a possible causative factor in suicide completion?
For more information on this topic please contact the American Association of Suicidology, 5521 Wisconsin Avenue, NW Washington, D 20015 Phone: (202) 237-2280 Fax: (202) 237-2280 Email: [email protected]