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“Barbara”
seemed like a happy, promising 16-year-old young woman.
She lived in a small, southeastern town, had many friends
and was active in her church. Her parents were kind and
understanding, and although her mother was sick with a
chronic disease, the family was always sharing,
communicating and involved in each other’s lives. So
when Barbara hung herself in the basement of her family’s
home, everyone was shocked. |
Few
people knew Barbara had been treated for depression, and even
those
who did thought she was on her way to a healthy recovery. What
they did
not know was that Barbara, like the 30,000 other Americans who
commit suicide every year, was caught in an emotional firestorm.
She was trapped by feelings
of hopelessness and fear, and felt she had no place to turn.
“These
are intensely personal crises where a person feels so isolated,
so depressed, that they see no way out,” says Nancy H.
Nielsen, M.D., Ph.D., an American Medical Association (AMA)
trustee and an internist in Buffalo, N.Y. “It’s a tragedy
happening across our country, with people of all ages,
particularly adolescents and the elderly. We need to ask, ‘What
can we as a society -- not just physicians, but as a society --
do to prevent this huge public health crisis?’”
*
Recognizing the warning signs
That
answer requires a thorough understanding of suicide’s
treacherous scope. As Nielsen said, the situation is
particularly alarming among young people -- in 1999, more
teenagers and young adults died from suicide than from cancer,
heart disease, AIDS, birth defects, stroke and chronic lung
disease combined.
Older
age groups are not immune. According to the National Institutes
of Mental Health, the highest death rate from suicide in the
nation is found among white men over the age of 85. A recent
study published in the “The Archives of General Psychiatry,”
a journal of the AMA, showed that factors such as birthplace,
socioeconomic status and sex may be linked to attempted suicide.
“I
think there is an increasing awareness about the incidence of
mental illness in general, and the problem of suicide in
particular,” says David Fassler, M.D., a child and adolescent
psychiatrist from Burlington, Vt. and author of “Help Me, I’m
Sad: Recognizing, Treating and Preventing Childhood and
Adolescent Depression.” “But I think the public still
underestimates just how many people are affected.”
The
good news, Fassler reports, is that much is known about the
early warning signs and risk factors of suicide. “An early
warning signal may be a lack of future planning. Someone who
appears to be putting their affairs in order by giving things
away, making arrangements for the care of pets, and making
overtly suicidal statements, such as ‘You won’t have to
worry about me much longer,’ may be considering suicide.
Risk
factors include a family history of suicide; mental illness,
depression, substance abuse, a previous suicide attempt, or even
simply a personal experience with suicide, be it a friend,
family member or acquaintance. Regarding gender, while women are
more likely to attempt suicide, males are more likely to have
successful completion. And although there is no empirical data
to support the widely-reported statistic that gay and lesbian
youth are two to three times more likely to commit suicide than
other youth, there is growing concern about such an association.
*
How families can cope
Sharon
Sweede, M.D., chair of the American Academy of Family Physician’s
Commission of Public Health and a staff physician at the Julian
F. Keith Alcohol and Drug Abuse Treatment Center in Black
Mountain, N.C., has witnessed first-hand suicide’s ugly and
far-reaching toll. In her role as part-time county medical
examiner, she is exposed to its physical aftermath. But it is in
her daily interactions with suffering patients and their
families that she sees the emotional impact; and it is here that
she has the opportunity to help families heal.
“Suicide
should not be a shameful secret that divides a family,” Sweede
said at a recent American Medical Association media briefing on
suicide in New York. She explained how the mental health of
surviving family members and friends affected by suicide is
essential for effective recovery and may even help lower risk
for future suicides.
Sweede
says, medical professionals believe suicides can be prevented.
Some tactics include talking to family members or loved ones
when it appears they are withdrawing; and realizing that when
someone is depressed, firearms should not be available. If a
teenager is withdrawn and not communicating, people who care
about them need to realize that sitting back and waiting might
not be enough.
*
Beginning to heal
“Healing
is possible. It doesn’t mean a family won’t ever be sad,
that they won’t still grieve on some level; but they can have
joy and productivity and good relationships with others who are
still living,” says Sweede.
For
starters, surviving friends and families need to open the lines
of communications and talk about the person who has killed
themselves. “You need to get through the grieving process and
out the other side, by remembering the good times. If you can’t
do that on your own, you need to get help from your church,
doctor, or other medical professional.”
As
for Barbara’s family, Sweede says they handled it as well as
could be expected. They had a memorial service, inviting
teenagers from around town to come together and share their
memories of Barbara.
“Suicide
can happen even when everybody’s doing what’s generally
recommended. As far as anybody could tell, things were going
well with her. We can’t control what another person does.
Suicide can still happen, but it’s possible to heal by doing
the things we know work -- sharing our grief, talking about it,
and letting each other know it’s okay to feel whatever we
feel.”
[Courtesy of ARA Content]
Here
are some statistics about suicide:
-
Suicide
is the eighth leading cause of death for all Americans and
the third leading cause in young people aged 15-24
-
The
most common method of suicide in the U.S. is by firearm
-
The
suicide rate is highest in the Western United States
-
More
people die by suicide than are murdered every year
-
Suicide
causes approximately 30,000 deaths annually in the United
States alone
-
Suicide
rates increase with age and are the highest among Americans
65 years of age and older, especially amongst elderly who
are divorced or widowed
-
Mental
disorders, particularly depression and substance abuse, are
associated with more than 90 percent of suicides
-
73
percent of all suicides are committed by white males
-
A
recent study showed there may be certain brain differences
in people whose suicide attempts are more likely to be fatal
Sources:
National Alliance for the Mentally Ill, Archives of Psychiatry,
the Surgeons General’s Call to Action to Prevent Suicide 1999,
Centers for Disease Control and Prevention, World Health
Organization
©2001-2006, Medi-Smart
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