It's hard to imagine anything more shattering than losing a child. And when that child chooses death, the pain cuts even deeper. Parents and loved ones are forever haunted by questions: Why? Did I contribute? Could I have stopped it?
Thousands of people in the U.S. have been touched by this trauma. While most grieve in private, others meet in small, emotional bereavement groups in churchs. We call ourselves, suicide survivors. Because of the stigma of suicide, some survivors tell friends the death was a homicide or accident. Some forgo funerals to avoid public scrutiny or shame. Some discuss the anguish not only of losing a child, but of coping with the public suspicion that they must have done something wrong to have this child die by suicide.
Each year, the federal government estimtates, at least 276,000 teenagers across the nation seriously attempt suicide and fail.
SUICIDE MYTHS
People who commit suicide always leave notes.
FACT: Most people don't leave notes. Only a small percentage leave any type of explanations about why they've chosen to kill themselves.
People who commit suicide don't warn others.
FACT: Out of 10 people who kill themselves, eight have given definite clues to their intentions. They leave numerous clues and warnings to others, although some of their clues may be non-verbal or difficult to detect.
People who talk about suicide are only trying to get attention. They won't really do it.
FACT: WRONG! Few commit suicide without first letting someone know how they feel. Those who are considering suicide give clues and warnings as a cry for help. In fact, most seek out someone to rescue them. Over 70% who do threaten to commit suicide either make an attempt or complete the act.
Once someone has already decided to commit suicide, nothing is going to stop them. Suicidal people clearly want to die.
FACT: Most of the time, a suicidal person is ambivalent about the decision; they are torn between wanting to die and wanting to live. Most suicidal individuals don't want death; they just want the pain to stop. Some people, seeing evidence of two conflicting feelings in the individual may interpret the action as insincerity, saying "he really doesn't want to do it." People's ability to help is hindered if they don't understand the common suicidal characteristic of ambivalence.
Once the emotional states improves, the risk of suicide is over.
FACT: The highest rates of suicide occur within about 3 months of an apparent improvement in a severely depressed state. Therefore, an improvement in emotional state doesn't mean a lessened risk.
After a person has attempted suicide, it is unlikely they will try again.
FACT: People whom have attempted suicide are very likely to try again. 80% of people who commit suicide have made at least one previous attempt.
Don't mention suicide to someone who's showing signs of severe depression. It will plant the idea in their minds and they will act on it.
FACT: Many depressed people have already considered suicide as an option. Discussing it openly helps the suicidal person sort through the problems and generally provides a sense of relief and understanding. It is one of the most helpful things you can do. (I wish so bad I would have discussed this with Josh.)
An unsuccesful attempt means that the person wasn't serious about ending their life.
FACT: The attempt in and of itself is the most important factor; not the method.
* Every 4 hours a child commits suicide.
* 28% of the students surveyed have
considered suicide.
* 21% have made a plan to commit suicide.
* 11% of the students surveyed have
attempted suicide.
* Every 38 seconds, a teenager will attempt
suicide - that's 2,274 teens attempting to
kill themselves each day !!
All of the above is sad, but true.....
![[IMAGE]](images/twinkl_1.gif)
Here are some links regarding suicide and depression
Bipolar Disorder/Manic Depression
Depression Information Forum
The Suicide Paradigm
Depression
ADOL
SPAN HOMEPAGE
Emergency numbers for Help
* Youth Crisis Hotline. Counseling and and referrels for teens in crisis. 1-800-448-4663
* Covenant House Nineline. Crisis intervention and information services for troubled teens and families. 1-800-999-9999
* Teen Help Adolescent Resources. Refers struggling teens to long-term residential programs. 1-800-400-0900
* Child Help USA. (National Child Abuse Hotline) Information, emergency counseling, and referrels to local facilities. 1-800-422-4453
* National Runaway Switchboard. 24-hour hotline for runaway and homeless youth and their families. 1-800-621-4000
* National Clearinghouse for Alcohol and Drug Information. Alcohol & Drug info and referrels. 1-800-729-6686; or www.health.org
The following is graphic but true...
SUICIDE? Let's Reconsider
Source: Buffalo News ("Ask Ann", Tuesday December 5, 1995)
Dead Ann Landers: Several months ago, a reader said he had a rotten, miserable life, he was a burden to family and friends, and the world would be a better place without him.
He had already started to save up pills and was just about to do the deed when he picked up an old copy of Reader's Digest. His eyes fell on an article that changed his mind.
Lately, I have been having suicidal thoughts and think maybe that article might be helpful. Will you please print it? Zydo
Dear Zydo: I've had more that 500 requests for that article, which originally appeared in June 1985. I am certain it saved lives. Here it is.
Before you kill yourself
You've decided to do it. Life is impossible. Suicide is your way out. Fine - but before you kill yourself, there are some things you should know. I am a psychiatric nurse, and I see the results of suicide. - when, it works and, more often, when it doesn't. Consider, before you act, these facts:
Suicide is usually not successful. You think you know a way to guarantee it? Ask the 25-year-old who tried to electrocute himself. He lived. But both his arms are gone.
What about jumping? Ask John. He used to be intelligent, with an engaging sense of humor. That was before he leaped from a building. Now he's brain damaged and will always need care. He staggers and has seizures. He lives in a fog. But worst of all, he knows he used to be normal.
What about pills? Ask the 12-year-old with extensive liver damage from an overdose. Have you ever seen anyone die of liver damage? You turn yellow. It's a hard way to go.
What about a gun? Ask the 24-year-old who shot himself in the head. Now he drags one leg, has a useless arm and has no vision or hearing on one side. He lived through his "foolproof" suicide.
Who will clean your blood off the carpet or scrape your brains from the ceiling? Commercial cleaning crews may refuse that job - but someone has to do it. Who will have to cut you down from where you hanged yourself or identify your bloated body after you've drowned? Your mother? Your wife? Your son?
The carefully worded "loving" suicide note is no help. Those who loved you will never completely recover. They'll feel regret and an unending pain.
Suicide is contagious. Look around at our family. Look closely at the four year old playing with his cars on the rug. Kill yourself tonight and he may do it ten years from now.
You do have other choices. There are people who can help you through this crisis. Call a hot line. Call a friend Call your minister or priest. Call a doctor or hospital. Call the police.
They will tell you that there's hope. Maybe you'll find it in the mail tomorrow. Or in a phone call this weekend. But what you're seeking could be just a minute, a day or a month away.
You say you don't want to be stopped? Still want to do it? Well, then, I may see you in the psychiatric ward later. And we'll work with whatever you have left.
QUESTIONS AND ANSWERS ABOUT MAJOR DEPRESSION
Instructions to Patients to be Read Before the Patient Leaves His Office
Joseph H. Talley, M.D.
These are several questions and answers about the disease called depression. Please read all of these carefully, since it is very important that you understand your disease as thoroughly as possible.
l. WHAT IS DEPRESSION? It is a disease affecting the entire mind and body,
causing a person to feel miserable in many ways. Changes in brain chemistry
make it happen. It is a brain disease.
2. WHAT CAUSES DEPRESSION? We do not know. We used to think it was due to something unhappy in a person's life or to some psychological hang-up. We
now know, however, that this disease happens to people who have no reason
"to be depressed." In other words, depression can strike normal and healthy people.
3. DOES HAVING A DEPRESSION MEAN THAT A PERSON IS GOING "CRAZY"'? NO, but it will very often make him think he is.
4. IS IT A COMMON DISEASE? Yes, it is the most common disease seen in all
of medicine; however, it is often confused with other illnesses. For example, many people who think, or who are told, they have low blood, vitamin deficiency, sinus headaches, low sugar, menopause, burnout, and "all run-down and need a rest" actually have depression that causes their troubles.
5. WHAT TROUBLE DOES A PERSON HAVE WHO HAS DEPRESSION? A person who has depression will usually feel most of the following things:
a. He will feel very tired all the time, even when he has not worked or
exerted himself very much. He will be just as tired on days when he has
rested as on days when he has worked hard.
b. His sleep will usually be affected in one of two ways. He will either go to
sleep and then wake up during the night and remain awake, or else he will sleep too much - even during the day. He will not get restful sleep.
c. He will feel very irritable. He will get upset very easily over
little things that ordinarily would not upset him.
d. He will feel very sad for no reason, and, in fact, may break into
tears without knowing why.
e. His normal sex drive will be decreased; in fact, it often will go
away altogether.
f. He will often have a headache that is present most of the time.
Almost any chronic pain elsewhere such as in the stomach or back can be
caused by depression. These pains are not imaginary; they are quite real
and often severe.
g. He will find it difficult to enjoy things. He will feel little enthusiasm even for things he used to look forward to.
h. Hs will often be constipated or have other digestive symptoms such
as abdominal pain or diarrhea. He may lose or gain weight.
i. He will find it difficult to concentrate, make decisions, remember
things and getting things done.
j. He will feel like he is an ineffective, worthless person, even
though there is no reason to feel that way.
6. IS THIS REALLY A SERIOUS DISEASE? Yes. In a mild depression. the person
will often think he just has a case of the blues, or that he is just getting older. His efficiency will be affected. In a more severe depression, it is a very serious disease. This disease can cause a previously healthy and happy person to kill himself.
7. CAN A PERSON DO ANYTHING TO FIGHT BRAIN DISEASE? Not by his own
efforts. This is a disease over which a person has no control, and it will
do him no good to "try to fight this myself."
8. IS THERE ANY EFFECTIVE TREATMENT? Very much so. There are several
medicines which are usually very effective in treating depression. They
are also very safe medicines.
9. ARE THERE MEDICINES TRANQUILIZERS, SLEEPING PILLS, PAIN PILLS, HORMONE PILLS? NO, none of these. They are called antidepressants.
10. ARE ANTIDEPRESSANTS ADDICTING? Absolutely not. A person can not become addicted even though he takes these medications for months or years.
People who take insulin and high blood pressure pills are not addicted; neither are people who take antidepressants. A person who does not have depression would feel no effect if he took an antidepressant. They work on the brain chemistry that gets out of balance and results in depression.
11. DO THEY HAVE SIDE EFFECTS? Unfortunately, they have pesky side
effects; they rarely have serious side effects. The chief side effects are dry mouth, constipation and drowsiness. Dry mouth can be effectively overcome by drinking water or sucking non caloric mints. Constipation is corrected by adding bulk to one's diet. The sleepy effects are taken care by taking the medicine before bedtime. The body usually adjusts to all these side effects. Some newer antidepressants do not have side effects.
12. ARE ANTIDEPRESSANTS THE SAME AS "PEP PILLS" OR "UPPERS?" Absolutely not. Pep pills give anybody a sudden boost of energy whether they have depression or not. Pep pills are all dangerous, and not used for
depression. Antidepressant pills, on the other hand will do nothing to a person without a depression, but will help a person who has depression by returning his brain chemical to normal.
13. HOW LONG DOES A PERSON HAVE TO TAKE ANTIDEPRESSANTS? It varies. Sometimes as little as three months, other times longer than a year. These
medications can be taken safely for as long as they are needed, even for a
lifetime.
14. DOES THIS DISEASE HAPPEN TO A PERSON WITHOUT ANYTHING IN HIS PERSONAL LIFE CAUSING IT? Yes. However, many people have things in their personal life that are bothering them a great deal, and if they happen to get
depression while these things are bothering them, then everything gets much worse. For example, if a person is having difficulty in their marriage or job and they get a depression also, then the difficulties with the marriage or job will get worse, because their ability to cope with their difficulties is impaired.
15. WHAT SHOULD I TELL MY SPOUSE OR RELATIVES ABOUT DEPRESSION? Have them read this paper too. A person with depression will almost always find that their spouse or relatives are very much affected by the way he feels. Most often relatives will not realize that a person's symptoms are due to a disease, and will think you simply do not love them any more. They may think the fault is somehow theirs. it
is very important that they know that depression is simply a disease - just
as pneumonia or diabetes are diseases, and that you or they are not responsible for it. We would welcome them to come back with you on your return visit and discuss this with them in detail. it is a great help to have your loved ones understand what is happening, why you need medication, etc.
ANTIDEPRESSANT MEDICATIONS
Please read the following directions until you are certain that you
understand them thoroughly, but call if there are any questions about your
medications.
1. The name of your antidepressant medication is circled below. The
bold italicized names are the chemical names for the brand names listed
under them:
Imopramine Desipramine Amitriptyline Trazodone Protripyline Fluoxetine
Sertraline Tofranil Norpramine Elavil Desyrel Vivactil Prozac
Zoloft Tofranil-PM Pertofrane Endep Imavate Janimine Pramine Trimipramine Nortipyline Doxepin Maprotiline Amozapine Paroxetine Presamine Surmontil Aventyl Adapin Ludiomil Asendin Paxil Pamelor Sinequan
2. Antidepressants must be taken regularly, not just when you feel like
you need them. In other words, never stop taking the medications because
you feel better and think you no longer need them. Stop them only when I
tell you. Your treatment with antidepressants will last a minimum of three months.
3. Take your medication all in one dose, and take them about four hours
before you intend to go to bed. That will put some of your side effects
such as drowsiness while you sleep. There are two exceptions' Trazodone
(Desyrel) should be taken right at bedtime with a snack. Fluoxetine (Prozac) should be taken after arising.
4. Most of the good effects of this medication will not show
themselves for about two weeks. Some of the medications will help you
sleep right away, but all of the other beneficial effects will be delayed
for two weeks or sometimes longer. When the medication does begin to work your headaches or other pain will go away. Your tendencies to cry and feel irritable will go away; in other words, you will feel like you are back to normal.
5. When you do begin to feel back to normal, do not stop taking the
medication. If you do, within three or four days you will feel worse again.
6. It is extremely important that I see you again after the first two
weeks of treatment in order to evaluate whether the diagnosis and treatment
is correct. Whatever you do, do not stop taking the medication until you
see me.
7. If anything troublesome happens which you think may be due to the
medication, call and let me know what is happening. Many times the
problems will have nothing to do with the medication at all. However, it
is true that with a few people there may be such reactions as constipation, blurring of vision, delay of urination. For a lot of perspiration... Such side effects are usually temporary and can be controlled other ways.
8. You should be able to work, drive, and carry out your usual activities while taking the medicine. When first beginning the antidepressant, you should use some caution about driving or engaging in other hazardous activity until you see how the medicine will affect you. Usually you can do anything you wish, especially after the first two or three days. If you are too sleepy after that, or cannot
sleep, it usually means that we need to change the type of antidepressant
to one that gives more or less drowsiness, and I can easily do that by phone. Call if there is any problem.
9. You should be aware that the safety of these medications lies in the
fact that you cannot hide from troublesome life situations with them. If,
for example, you do not have the true medical disease of depression, but
instead are only working too hard, you will receive no "energy" from these pills. If you do not have a depression, but instead are simply unhappy with a life situation that would make anyone unhappy, then the pills will give no happiness. If your
headache or stomach ache are due to some other disease, the pills won't help.
They only work when the disease depression is present, and in that
situation they usually give dramatic and gratifying relief to all of the symptoms. Thus you can see the basic difference between these medications and such drugs as alcohol, "uppers", "nerve pills", sleeping pills and the like. These medications cannot be used as an escape from life's problems. and are not habit forming. The
antidepressants cannot be used in that way, and that is their greatest
safety feature.
JOSEPH H. TALLEY, M.D.
GROVER, NORTH CAROLINA
Compliments of:
SA\VE
P.O. Box 24507
Minneapolis, MN 55424
(612) 946-7998
WHAT TO DO IF SOMEONE YOU KNOW BECOMES SUICIDAL
By Elizabeth Lofgren
Recently, I intervened to prevent a friend from committing suicide. My
friend is alive and I have the satisfaction that I knew what to do and had
the opportunity to do it. That means a great deal to me because I value
my friend. Her decision to live red!
resses some of the loss I feel because I was unable to prevent my sons
death by suicide.
Suicidal Behavior runs on a continuum -- a long process during which
suicidal people try various ways to reduce their profound emotional pain.
Ambivalent, they have contradictory desires to live and to die and the
balance between the two shifts back and fo!
rth.
SIGNS TO WATCH FOR
Deepening Depression -- Stressful life events cause temporary depression in
most people. But some people suffer from major depression and
manic-depression, inheritable illness which may lead to suicide. Caused by
chemical imbalances within the brain, epis!
odes of depression may arise with or without apparent cause. Fortunately,
mood illness can be treated with medications and therapy; unfortunately,
they often go unrecognized, undiagnosed and untreated. A depressed,
uncommunicative, withdrawn person is at !
risk for committing suicide. The risk increases when depression goes
untreated or if it is combined with alcohol or drug abuse. Although
stressful life events do not cause depressive discuses, people who have
these illness are more vulnerable.
Final Arrangements - A person puts their affairs in order, change a will,
gives away possessions, talks vaguely of going away.
Sudden Elevated Mood -- Paradoxically a depressed suicidal person may
suddenly appear better after they made a decision to end life, as if a
burden has been lifted.
Risk Taking Or Self Destructive Behavior -- may represent a death wish.
The person isn't ready to make their own life but tempts fate by reckless
diving for instance.
Presuicidal Statements -- Direct or indirect statements about suicide,
hopelessness or death. Suicidal people pick rescuers. Despite what they
say, they want these people to help them. A rescuer who picks up on these
signs will ask direct questions.
Ask "ARE YOU THINKING OF SUICIDE?" -- Contrary to popular belief, you
aren't putting ideas into this person's head. You need to assess how
likely a suicide attempt may be. Ask more questions.
DO YOU HAVE A PLAN? A METHOD? A MEANS? -- Is it deadly? Is it available,
such as a gun or enough pills for an overdose? WHEN? Today, next week, a
vague future time?
Do not think you can talk a person our of committing suicide. Be
supportive by letting the person know you care. Listen to them
with respect for their profound despair. Do not make moral judgments.
TAKE CHARGE - Do not worry about invading someone's privacy even though
they try to get you to promise secrecy... this is not a test of friendship
but a cry for help. Don't leave it up to them to get help on their own.
Sec that arrangements arc ride for!
professional evaluation and treatment.
Don't challenge or dart a person to commit suicide dunking you will shock
them out of the idea. Don't think suicide is a rational decision that you
should leave the person free to make. Suicide is usually due to
depression, an illness. Suicide is much mo!
re likely if the depression is not treated medication and psychotherapy.
After you have assessed how acute the danger, take appropriate step.
Arrange for professional evaluation and treatment. Get support from family
members and friends.
IF THE CRISIS IS ACUTE -- Call 91l, a hot linet, or take the person to a
crisis center, hospital emergency room, mental health center, their
psychiatrist or family doctor. DO NOT LEAVE THE PERSON ALONE.
Do take the signs seriously. If you don't feel equipped to manage a crisis
yourself, find another person to help you or turn it over to someone
you turn. Let the person's therapist know you are worried and
why. It is not a breach of confi!
dentially for you to tell the therapist that you're worried about the
behavior of your friend. Though the therapist cannot talk about the
person, he or she can listen to you.
Remember, you would intervene if some one had a heart attack. The suicidal
impulse is just as deadly.
There is no certain way to prevent suicide. Do your best, then hope.
Adina Wrobleski warns that you may find "resistance...from the people you
select to help you." The taboo against suicide causes ...some people,
including professional, [to] be reluctant!
to do the normal things a person should do to help someone who is sick and
in danger of dying. Nevertheless, be persistent. That persistence by
friends and family will eventually put pressure on doctors and mental
health professional to do better interv!
ention, diagnosis and treatment.
I am indebted to Adina Wrobleski for much of this article. Particularly
her Suicide: What Do I Do?" (two pages) I also drew from a pamphlet
published by the National Institute of mental Health, "Useful Information
on SUICIDE" and from my own experience.
Adina Wrobleski's two books, SUICIDE WHY." 85 Questions and Answers About
Suicide ($12.95) and "Suicide: Survivors; A Guide For Those Left Behind"
($14.95) arc available in bookstores and libraries.
WHAT TO DO IF SOMEONE YOU KNOW BECOMES SUICIDAL
By Elizabeth Lofgren
Recently, I intervened to prevent a friend from committing suicide. My
friend is alive and I have the satisfaction that I knew what to do and had
the opportunity to do it. That means a great deal to me because I value
my friend. Her decision to live red!
resses some of the loss I feel because I was unable to prevent my sons
death by suicide.
Suicidal Behavior runs on a continuum -- a long process during which
suicidal people try various ways to reduce their profound emotional pain.
Ambivalent, they have contradictory desires to live and to die and the
balance between the two shifts back and fo!
rth.
SIGNS TO WATCH FOR
Deepening Depression -- Stressful life events cause temporary depression in
most people. But some people suffer from major depression and
manic-depression, inheritable illness which may lead to suicide. Caused by
chemical imbalances within the brain, epis!
odes of depression may arise with or without apparent cause. Fortunately,
mood illness can be treated with medications and therapy; unfortunately,
they often go unrecognized, undiagnosed and untreated. A depressed,
uncommunicative, withdrawn person is at !
risk for committing suicide. The risk increases when depression goes
untreated or if it is combined with alcohol or drug abuse. Although
stressful life events do not cause depressive discuses, people who have
these illness are more vulnerable.
Final Arrangements - A person puts their affairs in order, change a will,
gives away possessions, talks vaguely of going away.
Sudden Elevated Mood -- Paradoxically a depressed suicidal person may
suddenly appear better after they made a decision to end life, as if a
burden has been lifted.
Risk Taking Or Self Destructive Behavior -- may represent a death wish.
The person isn't ready to make their own life but tempts fate by reckless
diving for instance.
Presuicidal Statements -- Direct or indirect statements about suicide,
hopelessness or death. Suicidal people pick rescuers. Despite what they
say, they want these people to help them. A rescuer who picks up on these
signs will ask direct questions.
Ask "ARE YOU THINKING OF SUICIDE?" -- Contrary to popular belief, you
aren't putting ideas into this person's head. You need to assess how
likely a suicide attempt may be. Ask more questions.
DO YOU HAVE A PLAN? A METHOD? A MEANS? -- Is it deadly? Is it available,
such as a gun or enough pills for an overdose? WHEN? Today, next week, a
vague future time?
Do not think you can talk a person our of committing suicide. Be
supportive by letting the person know you care. Listen to them
with respect for their profound despair. Do not make moral judgments.
TAKE CHARGE - Do not worry about invading someone's privacy even though
they try to get you to promise secrecy... this is not a test of friendship
but a cry for help. Don't leave it up to them to get help on their own.
Sec that arrangements arc ride for!
professional evaluation and treatment.
Don't challenge or dart a person to commit suicide dunking you will shock
them out of the idea. Don't think suicide is a rational decision that you
should leave the person free to make. Suicide is usually due to
depression, an illness. Suicide is much mo!
re likely if the depression is not treated medication and psychotherapy.
After you have assessed how acute the danger, take appropriate step.
Arrange for professional evaluation and treatment. Get support from family
members and friends.
IF THE CRISIS IS ACUTE -- Call 91l, a hot linet, or take the person to a
crisis center, hospital emergency room, mental health center, their
psychiatrist or family doctor. DO NOT LEAVE THE PERSON ALONE.
Do take the signs seriously. If you don't feel equipped to manage a crisis
yourself, find another person to help you or turn it over to someone
you turn. Let the person's therapist know you are worried and
why. It is not a breach of confi!
dentially for you to tell the therapist that you're worried about the
behavior of your friend. Though the therapist cannot talk about the
person, he or she can listen to you.
Remember, you would intervene if some one had a heart attack. The suicidal
impulse is just as deadly.
There is no certain way to prevent suicide. Do your best, then hope.
Adina Wrobleski warns that you may find "resistance...from the people you
select to help you." The taboo against suicide causes ...some people,
including professional, [to] be reluctant!
to do the normal things a person should do to help someone who is sick and
in danger of dying. Nevertheless, be persistent. That persistence by
friends and family will eventually put pressure on doctors and mental
health professional to do better interv!
ention, diagnosis and treatment.
I am indebted to Adina Wrobleski for much of this article. Particularly
her Suicide: What Do I Do?" (two pages) I also drew from a pamphlet
published by the National Institute of mental Health, "Useful Information
on SUICIDE" and from my own experience.
Adina Wrobleski's two books, SUICIDE WHY." 85 Questions and Answers About
Suicide ($12.95) and "Suicide: Survivors; A Guide For Those Left Behind"
($14.95) arc available in bookstores and libraries.
