Suicide: Know the Warning Signs

suicide signs Dollarphotoclub_79868445Each year more than 34,000 individuals take their own life, leaving behind thousands of friends and family members to navigate the tragedy of their loss.

Suicide is the 10th leading cause of death among adults in the U.S. and the 3rd leading cause of death among adolescents.

Suicidal thoughts or behaviors are both damaging and dangerous and are therefore considered a psychiatric emergency. Someone experiencing these thoughts should seek immediate assistance from a health or mental health care provider.Having suicidal thoughts does not mean someone is weak or flawed.

Following are Seven Warning Signs

  • Threats or comments about killing themselves, also known as suicidal ideation, can begin with seemingly harmless thoughts like “I wish I wasn’t here” but can become more overt and dangerous
  • Increased alcohol and drug use
  • Aggressive behavior
  • Social withdrawal from friends, family and the community
  • Dramatic mood swings
  • Talking, writing or thinking about death
  • Impulsive or reckless behavior

See more at the NAMI National Site.

Reducing the Risk of Suicide in Individuals with BPD

NAMI is pleased to announce that Dr. Marsha Linehan will be one of the outstanding speakers who will join 2,000 NAMI members at the 2015 NAMI National Convention in San Francisco this July. Scheduled to speak on Monday, July 6 in the “Advancing Recovery” track, Dr. Linehan will share her latest research on dialectical behavior therapy (DBT), including the results of her latest study. In this study, Dr. Linehan and coauthors set out to evaluate the importance of the skills training component by comparing three treatment groups: skills training plus case management to replace individual therapy; DBT individual therapy plus activities group to replace skills training so therapists instead focused on the skills patients already had; and standard DBT, which included skills training and individual therapy. The authors found that all three treatments reduced suicide attempts, suicide ideation, the severity of intentional self-injury, use of crisis services due to suicidality and improved reasons for living. The results also showed that inverventions that include DBT skills training are more effective thatn DBT without skills training. Read the full study.

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New Mobile App to Provide a Safety Net and Lifeline for Suicidal Individuals

As part of a comprehensive Suicide Prevention Initiative, the California Mental Health Services Authority (CalMHSA) has launched a new Mobil app, “MY3” which will help individuals at risk for suicide to quickly connect to their support network, and their own plan to stay safe.

The MY3 app has three fully customizable features that can be used at the first signs of emotional distress; 1) A phonebook with three primary contacts to call for support, in addition to phone numbers to connect individuals to the National Suicide Prevention Lifeline and 911, 2) a step-by-step plan and 3) tailored resources.

MY3 was created in partnership with the “Know the Signs” statewide suicide prevention campaign.

The MY3 app is funded by counties through the voter approved Mental Health Services Act (MHSA) (Prop. 63).

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Depression and Migraine

Both depression and suicidal thoughts are much higher among individuals with migraine, a new study found, and the prevalence of depression among those with migraines is approximately twice as high as for those without the disease.

More than 8% of men with migraines suffer from depression, compared to just over 3% of men without migraines, more than 12% of female migraine-sufferers experience depression, compared to less than 6% of women who do not have migraines.

In a paper published online in the journal, Depression Research and Treatment, investigators also reported that younger migraine sufferers were particularly a risk for depression.

The study investigated the relationship between migraine and suicidal thoughts. For both men and women, those with migraines were much more likely to have “ever seriously considered suicide or taking their own life”  People under the age of 30 had four times the odds of lifetime suicidal thoughts in comparison to people who suffered migraines aged 65 and older. Other factors associated with suicidal thoughts included unmarried status, lower household income and greater activity limitations.

“We are not sure why younger migraineurs have such a high likely hood of depression and suicidal thoughts,” said the co-author and former graduate student Meghan Schrumm. “It may be that younger people with migraines have not yet managed adequate treatment or coping mechanisms.”

Screening for Suicide Risk

From Psychiatric News Alert: While there is no screening tool proven to identify people at risk of suicide, a new study suggests that the commonly used Patient Health Questionnaire (PHQ-9) depression-assessment instrument may be a useful screening tool for detecting suicide risk.

In particular, Item 9 of that questionnaire (“Over the last two weeks, how often have you been bothered by thoughts that you would be better off dead, or of hurting yourself in some way” or a question to that effect depending on the version) was a strong predictor of suicide attempt and suicide death over the following year.

Even after accounting for treatment history and demographic factors, “item 9 remained a strong predictor of any suicide attempt,” the researchers said. In their report “Does Response on the PHQ-9 Questionnaire Predict Subsequent Suicide Attempt or Suicide Death?” in the December Psychiatric Services, Gregory Simon, M.D., M.P.H., and colleagues explained that the immediate risk of suicide attempt was low but increased over several days and continued to grow for several months, indicating a need for follow-up care to address ongoing risk. “Suicidal ideation should be viewed as an enduring vulnerability rather than simply a short-term crisis,” they said.

To read more about recent research on suicide risk, see the Psychiatric News article “Psychotic Symptoms Found to Be Strong Suicide Risk Factor in Teens.”

Study of Suicide Motivations to Advance Prevention

From UBC News: A University of British Columbia study sheds important new light on why people attempt suicide and provides the first scientifically tested measure for evaluating the motivations for suicide.

Published in the official journal of the American Association of Suicidology, the work gives doctors and researchers important new resources to advance suicide prevention, improve treatments, and reduce the likelihood of further attempts.

The study finds that suicide attempts influenced by social factors – such as efforts to elicit help or influence others – generally exhibited a less pronounced intnet to die, and were carried out with a greater chance of rescue. In contrast, suicide attempts motivated by internal factors – such as hopelessness and unbearable pain – were preformed with the greatest desire to die.

Prof. David Klonsky

“It may be surprising to some, but focsing on motivations is a new approach in the field of sucide research – and urgently needed, says Prof. David Klonsky”. “Until now, the focus has been largely on the types of people attempting suicide, their demographics, their genetics, without actually exploring the motivations. Ours is the first work to do this in a systematic and comprenhensive way.

The study’s 120 participants were outpatients and undergraduate students who had attempted suicide with “intnet to die” within the past three years.

Lead author Alexis May, UBC Psychology

For the study, participants completed a questionaire related to 10 different motivations for attempted suicide. The resulting questionaire is now available for clinical use. The Inventory of Motivations for Suicide Attempts (IMSA) is the most accurate and first scientifically tested tool for evaluating a person’s motivation for suicide.

Despite massive prevention efforts, suciide rates have increased globally over the past 50 years, with almost one million people taking their lives, annually.

September is Suicide Prevention Awareness Month

More than 90 percent of people who have died by suicide were living with one or more mental illnesses. While making up less than 1 percent of the population, military veterans represent over 20 percent of suicides each year. The hard reality is that our nation faces a suicide crisis. During Suicide Prevention Awareness Month, NAMI will continue our efforts to provide education, resources and support to individuals and families in need.

One conversation can change a lifetime

Maintaining strong connections among family, friends and in your community is one of the best ways to prevent suicide. Supporting NAMI through a donation today enables you to extend your circle of support and become part of a national movement to end the stigma of mental illness and remove barriers to treatment. One person making a difference can change a life. When we all work together we can change a nation.

Each of us is in a unique position to recognize someone at risk for suicide and to take action to get them the help they need. Recognize some of the common warning signs:

  •  Depression, feelings of hopelessness, or suicidal thoughts
  • Impulsiveness, extreme anxiety, agitation, irritability, or risky behavior
  • Withdrawal from others; giving away treasured belongings
  • Loss of interest in activities that were once enjoyed
  • Abuse of alcohol, drugs, or other substances

Remember, if you are concerned about a co-worker, friend, or a family member, and you think they may be considering suicide, you can ACT to prevent suicide.

 A – Ask the question – “Are you thinking of killing yourself?”

C – Care for your co-worker – Listen with compassion and voice your concern.

T – Take action – Seek professional help.

If you, or someone you know, are thinking about suicide, call the National Suicide Prevention Lifeline at (800) 273-TALK. This number can be dialed toll-free from anywhere in the United States 24 hours a day, seven days a week.