Considering suicide: Don't let despair obscure other options
MayoClinic, April 15, 2004
Depression and hopelessness can cloud your thinking, and you may consider taking your own life. Learn about healthy coping strategies to get through a crisis.
When life doesn't seem worth living anymore or your problems seem insurmountable, you may think that the only way to find relief is through suicide.
You might not believe it, but you do have other options, options to stay alive and feel better about your life. Maybe you think you've already tried them all and now you've had enough. Or maybe you think your family and friends would be better off without you.
It's OK to feel bad, but try to separate your emotions from your actions for the moment. Realize that depression, other mental disorders or long-lasting despair can distort your perceptions and impair your ability to make sound decisions. Suicidal feelings are the result of treatable illnesses. So, try to act as if there are other options, even if you may not see them right now.
No, it probably won't be easy. You may not feel better overnight. Eventually, though, the sense of hopelessness can lift. You can find support, appropriate treatment and reasons for living.
When you need immediate help
If you're considering suicide right now and have the means available, contact someone for help. The best choice is to call 911 or your local emergency services number.
If you simply don't want to do that, for whatever reason, you have other choices for reaching out to someone:
-Contact a family member or friend.
-Contact a doctor, mental health professional or other health care professional.
-Contact a minister, spiritual leader or someone in your faith community.
-Go to your local hospital emergency room.
-Call a crisis center or hot line.
Crisis centers or suicide hotlines are often listed in the front of your phone book or on the Internet. They offer trained counselors, usually volunteers, who can help you through an immediate crisis. Some crisis centers with an Internet presence offer e-mail contact, but remember that responses may not be as prompt as with telephone support.
Talking to someone about your feelings, connecting with them, can help relieve the burden of despair and isolation, even temporarily. It may help you shift perspective and more clearly see your other options.
Daily coping strategies
You may struggle with suicidal feelings frequently, perhaps many times a day. Develop a strategy to cope with those feelings in a healthy way. Consider asking a doctor, family member or friend to help create a strategy tailored to your specific situation.
It may mean doing things you don't feel like doing, such as talking to friends when you'd rather hole up in your bedroom all day with the curtains drawn, or going to the hospital for a mental health evaluation. But stick to your strategy, especially when you're in the grips of despair and hopelessness.
As part of your strategy, consider these measures:
-Keep a list of contact names and numbers readily available, including doctors, therapists and crisis centers.
-If your suicide plans include taking an overdose, give your medications to someone who can safeguard them for you and help you take them appropriately.
-Rid your home of knives, guns, razors or other weapons you may consider using for self-destructive purposes.
-Schedule daily activities for yourself that have brought you even small pleasure in the past, such as taking a walk, listening to music, watching a funny movie, knitting or visiting a museum. If they no longer bring you at least a modicum of joy, however, try something different, particularly if these familiar activities induce painful reminders.
-Get together with others, even if you don't feel like it, to prevent isolation.
Avoid drug and alcohol use. Rather than numb painful feelings, alcohol and drugs can increase the likelihood of harming yourself by making you more impulsive, more open to giving in to self-destructive or despairing thoughts.
-Write about your thoughts and feelings. Remember to also write about the things in your life that you value and appreciate, no matter how small they may seem to you.
Some organizations recommend creating a "plan for life" or similar plan of action that you can refer to when you are considering suicide or are in a crisis. This is a checklist of activities or actions you promise yourself to take in order to keep yourself alive or stay on course with treatment. For instance, it may stipulate that you contact certain people when you begin considering suicide. It may also include commitments to take medication appropriately, attend treatment sessions or appointments, and to remind yourself that your life is valuable even if you don't feel it is.
Also, consider creating a list of specific activities to try when you're feeling suicidal or just feeling bad. The key is to engage in self-soothing for a range of negative feelings, not just when you reach the point of suicidal thoughts. Make sure they're activities that would normally offer enjoyment and that can help comfort you, not cause additional stress. Then, do each item on your list until you feel like you can go on living. It can include such things as:
-Practicing deep-breathing exercises
-Playing an instrument
-Taking a hot bath
-Eating your favorite food
-Writing in a journal
-Going for a walk
-Contacting family, friends or other trusted confidantes
Even if the immediate crisis passes, consult a doctor or mental health professional, or seek help through an emergency room if your area isn't served by mental health professionals. They can help make sure you're getting appropriate treatment. Medication and psychotherapy, either individual or group, are often effective treatments for depression, anxiety, substance abuse and other mental disorders, and they can help you feel better about yourself and your life. Although you may not want to consider psychiatric hospitalization, it can help protect you and give medication and psychotherapy a chance to work more effectively.
Seeing beyond the despair
The despair and hopelessness you feel as you consider suicide may be the side effects of illnesses that can be treated. These emotions can be so overpowering that they cloud your judgment and lead you to believe that taking your own life is the best, or only, option.
But even people with long-standing suicidal thoughts can learn to manage them and to develop a more satisfying life through effective coping strategies. Take an active role in saving your own life, just as you would help someone else. Enlisting others for support can help you see that you have other options and give you hope about the future. Suicide isn't a solution, it's an ending.
Sunday, July 30, 2006
Wednesday, July 26, 2006
Housing and Mental Illness
Link: Housing and Mental Illness
It is estimated that 1/3 of the homeless population suffers from some form of mental illness.
This number increases to 75% for homeless single women.
Homelessness is not considered a major cause of mental illness but does increase its' duration and severity.
Two thirds of the homeless will have a lifetime experience with mental illness, three times higher than the general population.
75% of homeless people with mental illness will also have a substance abuse problem.
Correctional facilities are increasingly becoming ‘home’ to people with serious mental illness who are more likely to be detected and arrested and incarcerated for non-violent and nuisance offences. There is widespread agreement that people with mental disorders are increasingly and often unintentionally, caught in the justice system.
It is estimated that 1/3 of the homeless population suffers from some form of mental illness.
This number increases to 75% for homeless single women.
Homelessness is not considered a major cause of mental illness but does increase its' duration and severity.
Two thirds of the homeless will have a lifetime experience with mental illness, three times higher than the general population.
75% of homeless people with mental illness will also have a substance abuse problem.
Correctional facilities are increasingly becoming ‘home’ to people with serious mental illness who are more likely to be detected and arrested and incarcerated for non-violent and nuisance offences. There is widespread agreement that people with mental disorders are increasingly and often unintentionally, caught in the justice system.
Thursday, July 13, 2006
What Causes Depression?
Link to: What Causes Depression?
We still do not know for sure what causes depression. However, research suggests there may be more than one cause and most likely, it is a combination of factors, which leaves some individuals more vulnerable to developing a depressive disorder. The "kindling theory" suggests that the more factors that combine together the more at risk an individual is to developing a major depressive illness.
Some known factors, which contribute to depression, include:
We still do not know for sure what causes depression. However, research suggests there may be more than one cause and most likely, it is a combination of factors, which leaves some individuals more vulnerable to developing a depressive disorder. The "kindling theory" suggests that the more factors that combine together the more at risk an individual is to developing a major depressive illness.
Some known factors, which contribute to depression, include:
Genetic factors- depression does runs in families.
Medical research demonstrates that people with depression have a chemical imbalance of neurotransmitters, the important chemical messengers in the brain.
A history of childhood physical and emotional abuse, trauma, or parental loss is associated with higher rates of depression.
Women are twice as likely to develop depression, which can be associated menstruation, childbirth, and menopause suggesting hormones may play a role.
There are times in life when family and work pressures are higher and during which time people are more likely to get depressed.
Depression can follow significant losses such as the death of a loved one, an unexpected job loss, or retirement.
Depression is also strongly associated with medical illness and chronic disability.
Temperament and personality also plays a role. Those who are more pessimistic and negative in their interpretation of life events, less resilient to change, perfectionist and lack a supportive social network are at greater risk of developing depression.
Some prescription and non-prescription drugs are also known to cause depression by interfering with important brain neurotransmitters.
Depression is also found to be more common in those with low income, are unemployed, unmarried or divorced.
Alcohol is a known central nervous system depressant and prolonged use is associated with a greater incidence of depression.
http://www.cpa-apc.org/Publications/Clinical_Guidelines/depression/clinicalGuidelinesDepression.asp
Wednesday, July 12, 2006
Facts About Mental Illness In The Workplace
Link to: Facts About Mental Illness In The Workplace
o Percentage of Canadian employers who consider the continuous rise in employees’ mental health claims to be a top concern: 56%
o Percentage of short term disability claims related to mental illness in Canada: 75%
o Percentage of long term disability claims related to mental illness in Canada: 79%
o Percentage increase in long term disability costs: 27%
o Percentage of employers who track disability claims costs as a percentage of payroll: 28%
o Percentage of employers who have plans to address mental health and mental illness in the workplace: 31%
o Fastest growing category of disability costs to Canadian employers: Depression
o Annual losses to the Canadian economy due to mental illness in the workplace: $33 billion
o Amount employer will save, per employee per year, for those who get treatment: from $5000 - $10,000 in average wage replacement, sick leave and prescription drug costs.
Source: Mental Health Works, Mental health facts. Available at:
http://www.mentalhealthworks.ca/facts/index.asp
o Percentage of people with serious mental illness who are unemployed: 70 – 90%
o Percentage of people with serious mental illness who want to work: 80%
Source: World Health Organization (2000). Mental health and work:
Impact, issues and good practices. Available at: www.who.int/mental_health/media/en/712.pdf
o Percentage of Canadian employers who consider the continuous rise in employees’ mental health claims to be a top concern: 56%
o Percentage of short term disability claims related to mental illness in Canada: 75%
o Percentage of long term disability claims related to mental illness in Canada: 79%
o Percentage increase in long term disability costs: 27%
o Percentage of employers who track disability claims costs as a percentage of payroll: 28%
o Percentage of employers who have plans to address mental health and mental illness in the workplace: 31%
Source: Mental health claims on the rise in Canada: Watson Wyatt’s
Staying @ Work Survey (Sept 2005). Available at: www.watsonwyatt.com/canada
Staying @ Work Survey (Sept 2005). Available at: www.watsonwyatt.com/canada
o Fastest growing category of disability costs to Canadian employers: Depression
o Annual losses to the Canadian economy due to mental illness in the workplace: $33 billion
o Amount employer will save, per employee per year, for those who get treatment: from $5000 - $10,000 in average wage replacement, sick leave and prescription drug costs.
Source: Mental Health Works, Mental health facts. Available at:
http://www.mentalhealthworks.ca/facts/index.asp
o Percentage of people with serious mental illness who are unemployed: 70 – 90%
o Percentage of people with serious mental illness who want to work: 80%
Source: World Health Organization (2000). Mental health and work:
Impact, issues and good practices. Available at: www.who.int/mental_health/media/en/712.pdf
Tuesday, July 11, 2006
Stigma has serious health and social consequences
Link: Stigma has serious health and social consequences
· Mental illness and addiction is common (one in five Canadians) however because of stigma and the fear of discrimination only one third seek treatment. [ii]
· People deny painful symptoms and are reluctant to seek help at an early, more treatable phase of their condition, resulting in delays in beneficial treatment making treatment more complicated, less effective resulting in greater disability.
· The drop-out rate for psychiatric treatment is estimated to be one half because people do not want to be seen attending psychiatric treatment - leading to relapse and greater disability. [iii]
· People with mental illness and addictions often hold the same negative attitudes of society at large and blame themselves for their illness and the resulting social and economic losses.
· The major way people cope with the effects of self-stigma and shame is by withholding information from family, friends, employers and treatment providers, leading to feelings of emptiness, alienation and rejection which can further trigger depression and substance abuse and relapse. [iv]
· Consumers expect to be rejected by the community. This perception interferes with their sense of belonging and is more acutely felt by those with less social support and greater social skills deficit. [v]
· Stigma, discrimination and the resultant social withdrawal has been found to have a greater impact on the quality of life than the actual symptoms of illness. The loss of friendships and socio-economic status affects people long after their symptoms are treated.
· The elderly experience the double stigma of being old and mentally ill. Although they have high levels of illness they are also the least likely to seek medical treatment because of feelings of embarrassment and shame. They also have the lowest rates of detection of a mental illness because the belief that depression and anxiety are a normal part of the aging process[vi].[vii]
· Family members are also harmed by stigma and are blamed for causing or contributing to the illness with the result that they will also withdraw from social engagement, become isolated and experience higher levels of depression, anxiety and substance abuse.[viii]
· Community attitudes and discriminatory behaviours can negatively influence the degree and speed of recovery.
· Mental Health professionals are also stigmatized holding a diminished status in the eyes of other medical professions making recruitment challenging.[ix], [x]
· Many mental health professionals share negative attitudes towards people with mental illness and addictions and hold a reduced belief in their capacity to work, cope with stress, achieve advanced education or make a contribution to their community. These diminished views contribute to propagating self-stigma.
· The diminished attitude towards consumers is applied to self-help and peer-support programs. Identified as an element of ‘best practice’ this modality is ignored by clinicians, consistently under-funded by governments, and an under researched area of practice.
· People with mental disabilities suffer “double disadvantage”, having to cope not only with the disability itself, but with the added burdens of compromised health and inaccessible, inadequate health-related services. People with mental illness and addictions are less likely to be treated for medical conditions and research identified that they are more vulnerable to poverty and not treated equitably across health care systems.[xi], [xii]
· Institutions, governments and policy makers also contribute to stigma by systematically under-funding mental health and addictions services proportional to their degree of prevalence, morbidity and mortality.
· Discrimination towards people with mental illness and addictions is widespread resulting in diminished employment opportunities and educational opportunities including unemployment, lack of career advancement, hostility in the workplace resulting in increased self-stigma and increased disability. Although most people with mental illness and addictions are willing and able to work the rate of unemployment is estimated to be between 80% and 90%.[xiii]
· Discrimination is also experienced through a loss of human rights including forced treatment, finding or keeping housing, the right to parent, access to loans, immigration, denial of insurance coverage, and over representation in the criminal justice system.
· Stigma contributes to persistent under-funding of research and treatment services. Despite extremely high burden of illness, research funding has lagged behind other diseases such as cancer and heart disease when considering morbidity and mortality. This is particularly true in research about addictions and co-occurring disorders. [xiv]
· Canada’s Aboriginal, Inuit and First Nations Communities suffer a disproportionate burden of the stigma and discrimination of mental illness, mental health and addictions that exists.
· Stigma and discrimination occurs in many different guises throughout Canada, in our urban centres, our rural communities, our ethnic communities, among others and thus, regional consultations are a necessity.
· Mental illness and addiction is common (one in five Canadians) however because of stigma and the fear of discrimination only one third seek treatment. [ii]
· People deny painful symptoms and are reluctant to seek help at an early, more treatable phase of their condition, resulting in delays in beneficial treatment making treatment more complicated, less effective resulting in greater disability.
· The drop-out rate for psychiatric treatment is estimated to be one half because people do not want to be seen attending psychiatric treatment - leading to relapse and greater disability. [iii]
· People with mental illness and addictions often hold the same negative attitudes of society at large and blame themselves for their illness and the resulting social and economic losses.
· The major way people cope with the effects of self-stigma and shame is by withholding information from family, friends, employers and treatment providers, leading to feelings of emptiness, alienation and rejection which can further trigger depression and substance abuse and relapse. [iv]
· Consumers expect to be rejected by the community. This perception interferes with their sense of belonging and is more acutely felt by those with less social support and greater social skills deficit. [v]
· Stigma, discrimination and the resultant social withdrawal has been found to have a greater impact on the quality of life than the actual symptoms of illness. The loss of friendships and socio-economic status affects people long after their symptoms are treated.
· The elderly experience the double stigma of being old and mentally ill. Although they have high levels of illness they are also the least likely to seek medical treatment because of feelings of embarrassment and shame. They also have the lowest rates of detection of a mental illness because the belief that depression and anxiety are a normal part of the aging process[vi].[vii]
· Family members are also harmed by stigma and are blamed for causing or contributing to the illness with the result that they will also withdraw from social engagement, become isolated and experience higher levels of depression, anxiety and substance abuse.[viii]
· Community attitudes and discriminatory behaviours can negatively influence the degree and speed of recovery.
· Mental Health professionals are also stigmatized holding a diminished status in the eyes of other medical professions making recruitment challenging.[ix], [x]
· Many mental health professionals share negative attitudes towards people with mental illness and addictions and hold a reduced belief in their capacity to work, cope with stress, achieve advanced education or make a contribution to their community. These diminished views contribute to propagating self-stigma.
· The diminished attitude towards consumers is applied to self-help and peer-support programs. Identified as an element of ‘best practice’ this modality is ignored by clinicians, consistently under-funded by governments, and an under researched area of practice.
· People with mental disabilities suffer “double disadvantage”, having to cope not only with the disability itself, but with the added burdens of compromised health and inaccessible, inadequate health-related services. People with mental illness and addictions are less likely to be treated for medical conditions and research identified that they are more vulnerable to poverty and not treated equitably across health care systems.[xi], [xii]
· Institutions, governments and policy makers also contribute to stigma by systematically under-funding mental health and addictions services proportional to their degree of prevalence, morbidity and mortality.
· Discrimination towards people with mental illness and addictions is widespread resulting in diminished employment opportunities and educational opportunities including unemployment, lack of career advancement, hostility in the workplace resulting in increased self-stigma and increased disability. Although most people with mental illness and addictions are willing and able to work the rate of unemployment is estimated to be between 80% and 90%.[xiii]
· Discrimination is also experienced through a loss of human rights including forced treatment, finding or keeping housing, the right to parent, access to loans, immigration, denial of insurance coverage, and over representation in the criminal justice system.
· Stigma contributes to persistent under-funding of research and treatment services. Despite extremely high burden of illness, research funding has lagged behind other diseases such as cancer and heart disease when considering morbidity and mortality. This is particularly true in research about addictions and co-occurring disorders. [xiv]
· Canada’s Aboriginal, Inuit and First Nations Communities suffer a disproportionate burden of the stigma and discrimination of mental illness, mental health and addictions that exists.
· Stigma and discrimination occurs in many different guises throughout Canada, in our urban centres, our rural communities, our ethnic communities, among others and thus, regional consultations are a necessity.
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