One of my blogging friends wrote this and I thought it was excellent. I thought you might too.
Take Suicide Off the Table
byDavid Michael
When life is dark and dreary,
and pain is deep within your soul;
thoughts of death and destruction emerge
and depression takes its toll.
Solutions may be hard to find,
and optimism seems too cavalier;
find a space between your thoughts
before spiraling down in fear.
Take suicide off the table;
it's not an option for your pain.
Open your mind to possibilities
there is so much to gain.
Suicide is not painless,
those who are left behind will say,
Suicide is severely painful,
and it never goes away;
it never goes away.
Monday, January 09, 2006
Friday, January 06, 2006
Antidepressants Work and Don't Boost Suicide Risk
Antidepressants Work and Don't Boost Suicide Risk
Sun Jan 1, 2005
by Steven Reinberg, HealthDay
SUNDAY, Jan. 1 (HealthDay News) -- Contrary to what has been feared, the antidepressants known as serotonin reuptake inhibitors (SSRIs) are initially effective in as many as one-third of depressed patients and don't appear to increase the risk of suicide, two new studies claim.
The reports, both of which were funded by the National Institute of Mental Health, appear in the January issue of the American Journal of Psychiatry.
The suicide findings seem to challenge a 2004 advisory by the U.S. Food and Drug Administration that warned that suicidal behavior may increase after treatment with SSRIs. However, the study did find that suicide attempts were higher among teens than adults, a finding borne out by other research.
The first report is based on early data from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial, the largest study of its kind. This research looked at the benefits of antidepressants in "real world" settings.
About a third of the patients achieved remission," said lead researcher Dr. Madhukar Trivedi, director of the Mood Disorders Research Program and Clinic at the University of Texas Southwestern Medical Center, in Dallas. "An additional 10 to 15 percent achieved a response."
The object of the study was to provide physicians with guidelines for treating depression, Trivedi said. "The goal is to have patients provided with an adequate dose of medication for an adequate time," he explained. "Treatment would be tailored for each individual patient to get the most benefit from treatment."
For the study, researchers looked at the results of prescribing the SSRI Celexa to 2,876 patients with major depression. These patients also had other physical and psychological problems. The researchers found that about a third of the patients had their depression cured during the first 12 weeks of treatment.
In addition, another 10 percent to 15 percent of the patients showed a response to the medication, or reduction of at least half their symptoms. For patients who did not improve, later phases of the trial will use other medications or combinations of medications to see what might help those who did not benefit from the drug used in the first phase of the trial.
"These antidepressants in routine clinical care produce outcomes comparable with what is seen in research settings," Trivedi said. "These treatments do work in routine clinical care. There also has to be careful monitoring of side effects. In addition, you have to monitor dose and duration of the treatment, based on the patient's progression."
One expert thinks this study will eventually provide guideposts for treating depression that physicians can follow.
"This study, when it is all finally published, will give us a very good idea of how to treat treatment-resistant depression, and what the next step is after the SSRI fails," said Dr. David L. Dunner, director of the University of Washington's Center for Anxiety and Depression.
In the second study, researchers found the risk of suicide attempts and of successful suicides actually dropped in the weeks following the start of SSRI therapy.
"The risk of a serious suicide attempt in people who start taking antidepressant medication is, fortunately, quite low -- less than one in 1,000," said lead author Dr. Greg Simon, a researcher at the Group Health Cooperative, in Seattle. "The risk actually goes down after people start antidepressant medication."
The study also found no increase in suicide risk with the newer antidepressants, such as SSRIs, Simon added. "If anything, our data suggests that with the newer antidepressants there is less risk than with the older antidepressants," he said.
For the study, Simons's team collected data on 65,103 patients who had prescriptions for antidepressants between 1992 and 2003.
The researchers found the number of suicide attempts dropped by 60 percent in adults in the first month after starting treatment. The suicide rate continued to drop in the succeeding five months.
Among all the patients, there were 31 suicides in the six months after starting antidepressant therapy. That rate did not change from one month after starting treatment or in subsequent months.
However, teens had more suicide attempts than adults. Simon's group found that in the first six months of antidepressant treatment, the suicide rate was 314 attempts per 100,000 in teens, vs. 78 attempts per 100,000 in adults. For teens and adults, the rate was highest in the month before treatment and dropped by about 60 percent after treatment began, the researchers found.
In its 2004 warning, the FDA said people taking antidepressants should be closely monitored because of the risk of suicide.
"People should be closely monitored, but not because these drugs are especially risky," Simon said. "The real problem in the treatment of depression is that people start medicine and the medicine has side effects or the medicine doesn't work right away, and they get discouraged and they drop out."
Dunner agreed that close monitoring is essential when prescribing patients antidepressants. "Monitoring depression is very important," he said. "Often people come in for treatment when they are starting to get worse."
Monitoring is needed more for side effects from the drugs than to watch for suicidal behavior, Dunner said. "Suicide is a pretty rare event," he said. "It is more important to monitor for side effects and adherence to the medication."
Sun Jan 1, 2005
by Steven Reinberg, HealthDay
SUNDAY, Jan. 1 (HealthDay News) -- Contrary to what has been feared, the antidepressants known as serotonin reuptake inhibitors (SSRIs) are initially effective in as many as one-third of depressed patients and don't appear to increase the risk of suicide, two new studies claim.
The reports, both of which were funded by the National Institute of Mental Health, appear in the January issue of the American Journal of Psychiatry.
The suicide findings seem to challenge a 2004 advisory by the U.S. Food and Drug Administration that warned that suicidal behavior may increase after treatment with SSRIs. However, the study did find that suicide attempts were higher among teens than adults, a finding borne out by other research.
The first report is based on early data from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial, the largest study of its kind. This research looked at the benefits of antidepressants in "real world" settings.
About a third of the patients achieved remission," said lead researcher Dr. Madhukar Trivedi, director of the Mood Disorders Research Program and Clinic at the University of Texas Southwestern Medical Center, in Dallas. "An additional 10 to 15 percent achieved a response."
The object of the study was to provide physicians with guidelines for treating depression, Trivedi said. "The goal is to have patients provided with an adequate dose of medication for an adequate time," he explained. "Treatment would be tailored for each individual patient to get the most benefit from treatment."
For the study, researchers looked at the results of prescribing the SSRI Celexa to 2,876 patients with major depression. These patients also had other physical and psychological problems. The researchers found that about a third of the patients had their depression cured during the first 12 weeks of treatment.
In addition, another 10 percent to 15 percent of the patients showed a response to the medication, or reduction of at least half their symptoms. For patients who did not improve, later phases of the trial will use other medications or combinations of medications to see what might help those who did not benefit from the drug used in the first phase of the trial.
"These antidepressants in routine clinical care produce outcomes comparable with what is seen in research settings," Trivedi said. "These treatments do work in routine clinical care. There also has to be careful monitoring of side effects. In addition, you have to monitor dose and duration of the treatment, based on the patient's progression."
One expert thinks this study will eventually provide guideposts for treating depression that physicians can follow.
"This study, when it is all finally published, will give us a very good idea of how to treat treatment-resistant depression, and what the next step is after the SSRI fails," said Dr. David L. Dunner, director of the University of Washington's Center for Anxiety and Depression.
In the second study, researchers found the risk of suicide attempts and of successful suicides actually dropped in the weeks following the start of SSRI therapy.
"The risk of a serious suicide attempt in people who start taking antidepressant medication is, fortunately, quite low -- less than one in 1,000," said lead author Dr. Greg Simon, a researcher at the Group Health Cooperative, in Seattle. "The risk actually goes down after people start antidepressant medication."
The study also found no increase in suicide risk with the newer antidepressants, such as SSRIs, Simon added. "If anything, our data suggests that with the newer antidepressants there is less risk than with the older antidepressants," he said.
For the study, Simons's team collected data on 65,103 patients who had prescriptions for antidepressants between 1992 and 2003.
The researchers found the number of suicide attempts dropped by 60 percent in adults in the first month after starting treatment. The suicide rate continued to drop in the succeeding five months.
Among all the patients, there were 31 suicides in the six months after starting antidepressant therapy. That rate did not change from one month after starting treatment or in subsequent months.
However, teens had more suicide attempts than adults. Simon's group found that in the first six months of antidepressant treatment, the suicide rate was 314 attempts per 100,000 in teens, vs. 78 attempts per 100,000 in adults. For teens and adults, the rate was highest in the month before treatment and dropped by about 60 percent after treatment began, the researchers found.
In its 2004 warning, the FDA said people taking antidepressants should be closely monitored because of the risk of suicide.
"People should be closely monitored, but not because these drugs are especially risky," Simon said. "The real problem in the treatment of depression is that people start medicine and the medicine has side effects or the medicine doesn't work right away, and they get discouraged and they drop out."
Dunner agreed that close monitoring is essential when prescribing patients antidepressants. "Monitoring depression is very important," he said. "Often people come in for treatment when they are starting to get worse."
Monitoring is needed more for side effects from the drugs than to watch for suicidal behavior, Dunner said. "Suicide is a pretty rare event," he said. "It is more important to monitor for side effects and adherence to the medication."
Wednesday, January 04, 2006
What to Do if Someone You Know is Suicidal
What To Do if Someone You Know is Suicidal
MayoClinic, April 16, 2004
Talking to someone about suicide won't plant the idea in their mind. Instead, your support and guidance may help someone find treatment — and renewed hope.
Hearing someone talk about suicide may make you uncomfortable. You may not be sure how to step in and help or even if you should take them seriously.
Not everyone who thinks or talks about suicide actually attempts it. But it's not true that people who talk about suicide won't really try it. That's why it is important to take them seriously, especially if they have depression or another mental disorder or are intoxicated or behaving impulsively.
Potential warning signs
You may notice possible indications that a friend or loved one is thinking about suicide. Here are some typical warning signals:
MayoClinic, April 16, 2004
Talking to someone about suicide won't plant the idea in their mind. Instead, your support and guidance may help someone find treatment — and renewed hope.
Hearing someone talk about suicide may make you uncomfortable. You may not be sure how to step in and help or even if you should take them seriously.
Not everyone who thinks or talks about suicide actually attempts it. But it's not true that people who talk about suicide won't really try it. That's why it is important to take them seriously, especially if they have depression or another mental disorder or are intoxicated or behaving impulsively.
Potential warning signs
You may notice possible indications that a friend or loved one is thinking about suicide. Here are some typical warning signals:
Talking about suicide, including such statements as "I'm going to kill myself," "I wish I was dead" or "I wish I hadn't been born."
Withdrawing from social contact and increased desire to be left alone
Wide mood swings, such as being emotionally high one day but deeply discouraged the next
Preoccupation with death and dying or violence
Changes in routine, including eating or sleeping patterns
Personality changes, such as becoming very outgoing after being shy
Risky or self-destructive behavior, such as drug use or unsafe driving
Giving away belongings or getting affairs in order
Saying goodbye to people as if they won't be seen again
Some people don't reveal any suicidal feelings or actions. And many who consider or attempt suicide do so when you think they should be feeling better — during what may seem like a recovery from depression, for instance. That's because they may finally be able to muster emotional energy to take action on their feelings.
Questions to ask
The best way to find out if someone is considering suicide is to directly ask. Asking them won't give them the idea or push them into doing something self-destructive. To the contrary, your willingness to ask can decrease the risk of suicide by giving them an opportunity to talk about their feelings.
You may have to overcome your own discomfort to discuss the issue. Here are some questions you can ask someone you're concerned about:
Are you thinking about dying?
Are you thinking about hurting yourself?
Are you thinking about suicide?
Have you thought about how you would do it?
Do you know when you would do it?
Do you have the means to do it?
Remember, you're not trying to take on the role of doctor or mental health professional or to conduct psychotherapy sessions. But these questions can help you assess what sort of danger your friend or loved one might pose to themselves.
Don't swear your discussions to secrecy. Not only is that an unwanted burden for you, but if you do make such a promise, you risk having to betray that trust if you need to enlist professional help. Don't worry about losing a friendship to mistrust when it's a life that could be lost.
Do be supportive and empathetic, not judgmental. Listen to their concerns. Reassure them that help is available and that with appropriate treatment they can feel better. Don't patronize them by simply telling them that "everything will be OK," that "things could be worse" or that they have "everything to live for."
If possible, assess their home for potentially dangerous items. You may have to remove items that could become weapons of self-destruction, such as guns or knives. But don't put yourself in harm's way, either.
Getting help
If the person is at imminent risk of suicide, call the police or emergency personnel, or take them to a hospital emergency room if possible. Some people who are a danger to themselves may need to get help against their will, such as involuntary hospitalization. If possible, find out if they are under the influence of alcohol or drugs or may have taken an overdose.
If the danger isn't imminent, offer to work together to find appropriate help, and then follow through. Someone who is suicidal or has severe depression may not have the energy or motivation to find help. You may be able to make phone calls to set up medical appointments or go along with them, or help sort through health insurance policies for benefits information.
Many types of help and support are available. If your loved one doesn't want to consult a doctor or mental health professional, suggest finding help from a support group, faith community or other trusted contact.
Offering new options
There's no way to predict for sure who will attempt suicide. And although you're not responsible for preventing someone from taking their own life, your intervention may help them see that other options are available.
Direct questioning, supportive listening and gentle but persistent guidance can help you bring hope and appropriate treatment to someone who believes suicide will offer the only relief.
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