Depression and Suicide
Is there always a risk of suicide in depression?
Yes. Caregivers, as well as primary care physicians and nurse practitioners must constantly be on the lookout for signs of suicide in those who are depressed and be prepared to act quickly. Most people who kill themselves have sent clear messages of their intention. The attentive spouse, parent or friend is often in the best position to detect the early signs that a loved one may be contemplating suicide.
All depressed people need to be assessed for their risk of suicide. It is better to be safe than sorry. The best way to do this is to get the topic right out in the open with frankness and the reassurance that death wishes are perfectly normal when one is depressed. It is not a sign one is crazy, nor does it mean one is serious about it. Sometimes, just this reassurance is enough to remove the risk.
If the person talks about or hints at specific suicide plans, consult a mental health specialist immediately. He or she will tell you what to do. Do not leave the depressed person alone at any time until you can get help.
Loved ones and caregivers should pay particular attention to these factors:
- Prior suicide attempts
- A family history of suicide
- A history of substance abuse
- General or severe medical illness
- Advanced age
- A profound sense of helplessness
Older Caucasian males who live alone are at greatest risk. Eighty percent of older people who kill themselves are white men, and most of them use guns. All firearms should, therefore, be removed from anyone who is at risk. If you cannot remove the guns, then hide the ammunition.
Older women are three times as likely as younger women to attempt suicide usually by overdosing themselves but they tend to be less successful than men. All medications should be removed from any older woman at risk.
Signs that someone is contemplating suicide
Behaviors may change. They become less interested in family, friends, hobbies and churchgoing. Some start drinking more. They become more secretive and withdrawn.
They may become more careless about personal appearance. They might give things and money away, buy a gun or stockpile pills.
Feelings may change. Suicidal people can become more lethargic, lose their appetite, or express more anger.
They may say things such as You'd be better off if I was dead, I won't be around much longer, or Life isn't all it's cracked up to be.
One important signal is when the person is depressed over a major loss and expresses intense anger. When these two are combined, there is a very high risk of suicide occurring.
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