Depression and Suicide:
PREVENTION OF SUICIDE AND TREATMENT OF THE SUICIDAL PERSON
PREVENTION OF SUICIDE AND TREATMENT OF THE SUICIDAL PERSON
In the initial therapeutic interview with a depressed individual, suicide is the
overriding question in the back of the therapist's mind. If clear suicidal intent
and hopelessness are pervading themes, crisis intervention, close observation,
and hospitalization will probably ensue. If they are not, therapy will
proceed at a somewhat more leisurely pace, directed toward
careful understanding of the other depressive problems.
In the late 1960s, a network of more than 300 suicide prevention centers
was established in the United States to deal with suicidal crises. In addition,
hospitals and outpatient units set up hot-lines to deal with the crises of
acutely suicidal individuals. It was believed that if someone was available for
the suicidal individual to talk to, the suicide could be prevented.
In terms of prevention of suicide, once the suicidal person makes contact
with a telephone hot-line volunteer, a psychologist, a psychiatrist, a family
physician, a pastor, or emergency room doctor, evaluation of the suicidal
risk takes first priority.
Questions Commonly Asked Are:
Does the individual have a clear plan? Does he have
access to the weapon? Does he have a past history of suicidal acts? Does he
live alone? Once suicidal risk in a crisis is assessed, a treatment decision
must be hastily made: home visit, hospitalization, medication, the police, or
outpatient psychotherapy. In some cases, merely holding the person on the
phone may be appropriate action. Long-term follow-up and after-care must then occur.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Success of the suicide prevention centers is uncertain. Whereas the suicide
rate seems to have dropped in Britain in the areas in which centers exist,
no differences in suicide rate have yet been reported in the United States in
cities with or without prevention centers (Weiner, 1969, Schuyler, 1974; Fox, 1976).
In addition to suicide prevention, psychological intervention in the lives
of the surviving relatives is also important. As we have seen, the survivors
are themselves more vulnerable to later depression and suicide. They are
faced with shame, guilt, bewilderment, and stigma. This is a group that has
been neglected and that might benefit greatly from systematic care.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
SUMMARY Of Depression Info.
1. The affective disorders consist of three types: unipolar depression, bipolar
depression, and mania.
2. Unipolar depression consists of depressive symptoms only and involves
no symptoms of mania. It is by far the most common of the depressive disorders.
3. Bipolar depression occurs in individuals who have both periods of depression
and periods of mania as well.
4. Mania consists of four sets of symptoms: euphoric mood, grandiose
thoughts, over activity, and lack of sleep.
5. There are four basic symptoms of unipolar depression: emotional
symptoms, largely sadness; motivational symptoms, largely passivity; cognitive
symptoms, largely hopelessness and pessimism; and bodily symptoms,
including loss of weight and loss of appetite. Untreated, these
symptoms will usually dissipate within about three months.
6. Women are more at risk than men for depression. Depression becomes
slightly more common as an individual grows older.
7. Four theories-biological, psychodynamic, behavioral, and cognitive
-have all shed light on unipolar depression.
8. Biological models have generated three effective therapies; tricyclic
antidepressant drugs, MAO inhibitors, and electroconvulsive therapy (ECT).
The biomedical school holds that depression is due to depletions in certain
central nervous system neurotransmitters, most usually norepinephrine.
9. Psychodynamic theories concentrate on the personality that predisposes
one to depression. These theories hold that depression stems from
anger turned upon the self, and that individuals who are
predisposed to depression are over dependent on other people for their self-esteem.
10. The behavioral model holds that depression is caused by the reduction
of active responding and by insufficient amounts of response-contingent
positive reinforcement. Behavioral models have generated therapies
that teach depressives how to control the important goals in their lives.
11. Cognitive models concentrate on particular ways of thinking and
how these cause and sustain depression. There are two prominent cognitive
models: the view of Aaron Beck, which holds that depression stems from a
negative cognitive triad, and the learned helplessness model of depression.
12. Unipolar depression can now be effectively treated: nine out of ten
people who suffer a severe unipolar depressive episode can be markedly
helped either by drugs, ECT, or by cognitive therapy.
13. Bipolar depression, or manic-depressive illness, is the most crippling
of the affective disorders. It results in ruined marriages, irreparable damage
to reputation, and not uncommonly suicide. Eighty percent of bipolar depressions
can now be greatly helped by lithium. This disorder is best viewed
within the biomedical model.
14. Suicide is the most disastrous consequence of bipolar and unipolar
depression. It is the second most frequent cause of death among college students.
Women make more suicide attempts than men, but men actually
succeed in killing themselves more often than women. There are two fundamental
motivations for suicide: surcease, or desire to end it all, and manipulation,
or desire to change the world or other individuals by a suicide attempt.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Treating:
Depression
Post-Traumatic Stress Disorder (PTSD)
Social Anxiety
Generalized Anxiety
Panic Disorder
Major Depression Disorder
Agoraphobia
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
For the Therapy I recommend click here:
The Liberator Method
overriding question in the back of the therapist's mind. If clear suicidal intent
and hopelessness are pervading themes, crisis intervention, close observation,
and hospitalization will probably ensue. If they are not, therapy will
proceed at a somewhat more leisurely pace, directed toward
careful understanding of the other depressive problems.
In the late 1960s, a network of more than 300 suicide prevention centers
was established in the United States to deal with suicidal crises. In addition,
hospitals and outpatient units set up hot-lines to deal with the crises of
acutely suicidal individuals. It was believed that if someone was available for
the suicidal individual to talk to, the suicide could be prevented.
In terms of prevention of suicide, once the suicidal person makes contact
with a telephone hot-line volunteer, a psychologist, a psychiatrist, a family
physician, a pastor, or emergency room doctor, evaluation of the suicidal
risk takes first priority.
Questions Commonly Asked Are:
Does the individual have a clear plan? Does he have
access to the weapon? Does he have a past history of suicidal acts? Does he
live alone? Once suicidal risk in a crisis is assessed, a treatment decision
must be hastily made: home visit, hospitalization, medication, the police, or
outpatient psychotherapy. In some cases, merely holding the person on the
phone may be appropriate action. Long-term follow-up and after-care must then occur.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Success of the suicide prevention centers is uncertain. Whereas the suicide
rate seems to have dropped in Britain in the areas in which centers exist,
no differences in suicide rate have yet been reported in the United States in
cities with or without prevention centers (Weiner, 1969, Schuyler, 1974; Fox, 1976).
In addition to suicide prevention, psychological intervention in the lives
of the surviving relatives is also important. As we have seen, the survivors
are themselves more vulnerable to later depression and suicide. They are
faced with shame, guilt, bewilderment, and stigma. This is a group that has
been neglected and that might benefit greatly from systematic care.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
SUMMARY Of Depression Info.
1. The affective disorders consist of three types: unipolar depression, bipolar
depression, and mania.
2. Unipolar depression consists of depressive symptoms only and involves
no symptoms of mania. It is by far the most common of the depressive disorders.
3. Bipolar depression occurs in individuals who have both periods of depression
and periods of mania as well.
4. Mania consists of four sets of symptoms: euphoric mood, grandiose
thoughts, over activity, and lack of sleep.
5. There are four basic symptoms of unipolar depression: emotional
symptoms, largely sadness; motivational symptoms, largely passivity; cognitive
symptoms, largely hopelessness and pessimism; and bodily symptoms,
including loss of weight and loss of appetite. Untreated, these
symptoms will usually dissipate within about three months.
6. Women are more at risk than men for depression. Depression becomes
slightly more common as an individual grows older.
7. Four theories-biological, psychodynamic, behavioral, and cognitive
-have all shed light on unipolar depression.
8. Biological models have generated three effective therapies; tricyclic
antidepressant drugs, MAO inhibitors, and electroconvulsive therapy (ECT).
The biomedical school holds that depression is due to depletions in certain
central nervous system neurotransmitters, most usually norepinephrine.
9. Psychodynamic theories concentrate on the personality that predisposes
one to depression. These theories hold that depression stems from
anger turned upon the self, and that individuals who are
predisposed to depression are over dependent on other people for their self-esteem.
10. The behavioral model holds that depression is caused by the reduction
of active responding and by insufficient amounts of response-contingent
positive reinforcement. Behavioral models have generated therapies
that teach depressives how to control the important goals in their lives.
11. Cognitive models concentrate on particular ways of thinking and
how these cause and sustain depression. There are two prominent cognitive
models: the view of Aaron Beck, which holds that depression stems from a
negative cognitive triad, and the learned helplessness model of depression.
12. Unipolar depression can now be effectively treated: nine out of ten
people who suffer a severe unipolar depressive episode can be markedly
helped either by drugs, ECT, or by cognitive therapy.
13. Bipolar depression, or manic-depressive illness, is the most crippling
of the affective disorders. It results in ruined marriages, irreparable damage
to reputation, and not uncommonly suicide. Eighty percent of bipolar depressions
can now be greatly helped by lithium. This disorder is best viewed
within the biomedical model.
14. Suicide is the most disastrous consequence of bipolar and unipolar
depression. It is the second most frequent cause of death among college students.
Women make more suicide attempts than men, but men actually
succeed in killing themselves more often than women. There are two fundamental
motivations for suicide: surcease, or desire to end it all, and manipulation,
or desire to change the world or other individuals by a suicide attempt.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Treating:
Depression
Post-Traumatic Stress Disorder (PTSD)
Social Anxiety
Generalized Anxiety
Panic Disorder
Major Depression Disorder
Agoraphobia
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
For the Therapy I recommend click here:
The Liberator Method