Monday, November 07, 2005

Advice on suicide & depression: warning signs - by Travis Meeks

Advice on suicide and depression, and the warning signs that are many times evident, is obviously a matter of life and death.

The concept of suicide and depression seem to be inextricably linked. However there are other warning signs and there is far more to be discussed when looking at suicide as a concept, beyond that of the classical motivation of being depressed. This article will examine common warning signs of suicide as well as signs of depression. In addition it will look at how anger and revenge can be a driving motivational factor or rationale for suicide. It is also important to look at the seperate parts in planning and acting on suicidal ideas. Evaluating these key actions and others assist in determining the seriousness of the attempt, although professionals should always be consulted immediately. While suicide and depression are linked, concepts such as revenge and anger cannot be ignored.

First and foremost let us look at one of the major linking causes of suicide, the most common, depression. Signs of depression can include (based on a description of symptomology from the DSM IV "Diagnostic and Statistical Manual of Mental Disorders Fourth Edition):

Dysthymic Disorder:

A. Depressed for two years in an adult, at least one year in children and adolescents.

B. 2 or more of the following

* poor appetite or overeating

* insomnia or hypersomnia

* low energy or fatigue

* low self esteem

* poor concentration or difficulty making decisions

* feelings of hopelessness

There are many different forms of depression and some of these symptoms are only examples without the complete detail or depth that one might find by consulting a variety of sources.

Major Depression (some symptomology)

2 weeks of a depressed mood with a loss of interest or pleasure in nearly all activities.

With children the mood may be irritable rather than sad.

Often described as depressed, sad, discouraged, hopeless, or down in the dumps. Loss of interest or pleasure is always present to some degree. Appetite and sleep disturbance. Psychomotor changes, such as agitation, pulling or rubbing of the skin or clothing, slowed down speech or thinking or body movements, increased pauses before answering. Decreased energy, tiredness and fatigue. Sense of worthlessness or guilt. Impaired ability to think, concentrate or make decisions, may include memory difficulties. Interference in social, occupational, and important areas of functioning.

Many of the symptoms one finds with depression may cause the individual to fall below a threshold of rational thought, where they seek cessation from pain through harming themselves. They do not think through the consequences of their actions in many cases. As depression deepens some state that they just want to go to sleep and never wake up, for example. Others display signs such as cuts on their arms, self destructive behavior, burn marks or attempt overdoses or other dangerous acts. Trying to list all the possible signs is an impossible act because suicide can be approached in so many different ways by different people. However spotting signs of depression can be a vital clue as well as threats or thoughts of suicide by a person with depression. These should always be taken seriously and assessed by a professional.

Furthermore one should look at anger and revenge as possible motivators for suicide. It has been said that suicide in some cases is anger turned 180 degrees. Meaning that the person is angry with someone and cannot kill them and so decides as an act of revenge to kill themselves. Also called murder 180 degrees. Looking at these motivations and any threats or attempts by a person can be another clue for suicidal ideation (suicidal ideas).

Actually examining the process and looking at the person's actions as well as their threats is also important. There are several stages. If a person indicates that they have thought about suicide and killing themselves, that is an indicator or represents if there is serious intent suicidal ideation (suicidal ideas). If the person has these thoughts frequently or obsessively then it is a stronger indicator for a potentially dangerous situation. The second area to look at is if the person has a definite plan. Do they know how they might kill themselves? Is there a specific plan that they have formed and do they have access to the weapons or drugs or what have you? Finally one should look at the most serious aspect of all: have they attempted to commit suicide, and if they have how many times? These are all major factors in determining and screening for serious intent in patients and looking at suicidal ideation. Professionals in the field should be consulted as they are equipped to take appropriate followup action and know many subtle signs. For example, how shallow are the cuts on the arm?? Are there any marks?

Legally the laws differ from state to state, although there are usually laws in place that not only make it against the law to attempt to commit suicide but allow authorities to take action to have the person placed in a safe facility for further evaluation. In the State of Florida, where this author resides, the particular act is called a Baker Act, where a person indicates they will harm theselves or others and then can be committed to a hospital facility. In many cases this might require witnesses or have to be done with serious intent in front of a police officer or other official. In some cases it might have to be ordered by a judge, by a petition to the court.

In conclusion we must look at suicide, depression, and anger as being linked and realize that there are many other factors involved as well. It is a complex subject touching on the very value and importance of life. One should always consult a professional if they suspect suicidal ideation (a person displays suicidal ideas) or threats of suicide or remain depressed. It is a complex issue not easily discussed or handled. Mental health issues, suicide in particular display an element of stigma or negative labeling. Many think it must be a matter of willpower or a basic weakness of character. However, as we have seen in some of the symptoms it is a far different story. It is a matter of biology and psychology and in no way simple. Consulting professionals with experience is part of the key. Perhaps the words of Alexander Dumas from his book the "Count of Monte Cristo" are most fitting for an ending to this article, that key to the life we hold dear "Where there is life, there is Hope."

Written by Travis Meeks