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Week 8: Depression and suicide

Welcome to the 8th edition of the Depression Programme.

This week we're talking about the very real problem of depression and suicide.

Suicide is a real risk in many cases of mood disorders, and is something that should always be taken seriously.

Warning signs
Are you concerned that you may not be able to recognise someone with suicidal tendencies? Look out for the following warning signs:

1. Previous suicide attempts
Between 20% and 50% of people who kill themselves had previously attempted suicide. Those who have made serious suicide attempts are at a much higher risk for actually taking their lives.

2. Talking about death or suicide
People who commit suicide often talk about it directly or indirectly. Be alert to statements such as, "My family would be better off without me". Sometimes those contemplating suicide talk as if they’re saying goodbye or going away.

3. Planning for suicide
Suicidal individuals often arrange to put their affairs in order. They may give away articles they value, pay off debts or a mortgage on a house, or change a will.

Depression
Although most depressed people aren’t suicidal, most suicidal people are depressed. Serious depression can be manifested in obvious sadness, but often it’s expressed instead as a loss of pleasure or withdrawal from activities that had once been enjoyable.

Be particularly concerned about depressed persons if at least five of the following symptoms have been present nearly every day for at least two weeks:

• Depressed mood, a change in sleeping patterns
• Change in appetite or weight
• Speaking and/or moving with unusual speed or slowness
• Loss of interest or pleasure in usual activities
• Decrease in sexual drive
• Fatigue or loss of energy
• Feelings of worthlessness, self-reproach or guilt
• Diminished ability to think or concentrate, slowed thinking or indecisiveness
• Thoughts of death, suicide or wishes to be dead

Additional factors that point to an increased risk for suicide in depressed individuals are:

• Extreme anxiety, agitation or enraged behaviour
• Excessive drug and/or alcohol use or abuse
• History of physical or emotional illness
• Feelings of hopelessness or desperation

What should you do if someone is suicidal?
If you suspect someone could be suicidal, here’s what to do:

1. Take it seriously
Seventy-five percent of all suicides give some warning of their intentions to a friend or family member. All suicide threats and attempts must be taken seriously, even those of teenagers among whom such threats are more common.

2. Be willing to listen
Take the initiative to ask what’s troubling them, and attempt to overcome any reluctance to talk about it. Even if professional help is indicated, the person you care for is more apt to follow such a recommendation if you have listened to him or her. If your friend or relative is depressed, don't be afraid to ask whether he or she is considering suicide, or even if they have a particular plan or method in mind.

Don’t attempt to argue anyone out of suicide. Rather, let the person know you care and understand, that he or she isn’t alone, that suicidal feelings are temporary, that depression can be treated, and that problems can be solved. Avoid the temptation to say, "You have so much to live for", or "Your suicide will hurt your family".

3. Seek professional help
Be actively involved in encouraging the person to see a doctor or mental health professional immediately. Since suicidal people often don't believe they can be helped, you may have to do more. You can make a difference by helping those in need find a knowledgeable mental health professional or a reputable treatment facility.

4. In an acute crisis
Take the person to an emergency room or walk-in clinic at a psychiatric hospital. Don’t leave the person alone until help is available. Remove from the vicinity of the potentially suicidal person any firearms, drugs, razors or scissors that could be used in a suicide attempt.

Medication and/or hospitalisation may be indicated and may be necessary at least until the crisis abates. If a psychiatric facility is unavailable, call your local emergency number. Chances are the dispatcher can help you locate immediate psychiatric treatment.
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