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Lauren Lunsford along with a small group of volunteers collects and bags plastic bottles and other items for recycling at the Susan G. Komen Tulsa Race for the Cure in Tulsa. JAMES GIBBARD/Tulsa World |
Depression is the most common cause of suicide
By Omer Gillham
World Staff Writer
Why do people kill themselves?
Many suicide letters mention a feeling of hopelessness and severe emotional or physical pain. Some notes also contain apologies and express love for family members who will be affected by the suicide.
While suicide letters can offer some insight, the question of why remains for family and friends of suicide victims. Research shows that suicides occur for various reasons, but there appears to be a common risk factor in most cases: depression.
Medical experts interviewed by the Tulsa World said depression is one of the main risk factors in determining the seriousness of someone wanting to end his or her life.
What to do?
If someone is exhibiting identifiable signs of suicidal thoughts, ask them about it and listen for key risk factors that include feelings of hopelessness, self-criticism or pessimism about life, loss of interest in jobs or hobbies. Be specific. Ask the person if he or she is thinking about suicide. Does the person have a plan? Ask more than once. Ask if the person has a gun or access to other lethal means of self harm.
If despair is not present, watch for signs of the person giving away keepsakes and exhibiting a sense of peace after a lengthy period of personal turmoil. Contact a mental health professional for additional help.
Get training: Learn about Question, Persuade and Refer training. This is a simple, free training that will help you learn to ask someone about thoughts of depression and suicide and how to respond. The training takes about 90 minutes. Two organizations offer free QPR training. They are Community Outreach Psychiatric Emergency Services at 744-4800 and the Mental Health Association in Tulsa at 585-1213.
Signs of depression might include:
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Dr. Jeff Mitchell, vice president and medical director of Laureate Psychiatric Clinic and Hospital, said depression and suicidal thoughts are the two top reasons people are admitted to Laureate for psychiatric care. Laureate admits about 4,000 a people a year into its facility.
Some of the depressed patients do not survive once they are stabilized and released.
“Our staff reads the obituaries regularly, wondering if they will see a client’s name,” Mitchell said. “But for every one person that we lose, there are 10 others that we help and that brings hope.”
In one year, Laureate counted 12 suicides by former patients and six other deaths that could have been suicides, Mitchell said.
“This is the number we knew about through family members, reading the paper and being notified by the medical examiner,” Mitchell said. “It is reasonable to assume that it is an under-representation of the total deaths.”
Mitchell said that 15 percent of people diagnosed with depression within the general population will eventually commit suicide.
Of all suicide victims, 90 percent have an identifiable psychiatric disorder, said Robert Gebbia, executive director of the American Foundation for Suicide Prevention.
Suicide risk factors and warning signs include loss of a job, death of a spouse or family member, divorce, poor performance at work or school, financial problems, health problems and a history of suicide within the family. Additional risk factors can include symptoms of post-traumatic stress disorder associated with the armed services or traumatic events, including an abusive or neglectful childhood, experts said. Other factors include drug and alcohol abuse.
What causes depression?:
There are at least two schools of thought on the causes of chronic depression which does not always lead to self-harm. Additionally, not all depression is chronic and it can be a healthy signal for change, medical experts said.
But one theory suggests that chronic depression has a genetic link that is expressed in a chemical imbalance or deficiency in the brain. Another school of thought places more emphasis on family rearing practices, how children are traumatized or neglected and how they carry a sense of loss and despair into adulthood, resulting in chronic depression.
Dr. Vincent Felitti, an expert on the effects of childhood trauma and neglect on adults, said that family rearing practices are a stronger predictor of depression than genetics.
“Depression is not a disease nor is it caused by genetics,” Felitti said. “Depression is a normal response to an abnormal childhood and life experiences.”
While abuse and neglect can be obvious in homes with alcohol and drug abuse, it can also be present in families that appear well-adjusted, Felitti said.
Felitti is one of the primary authors of the Adverse Childhood Experiences research project, which is an ongoing collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente. The ACE Study is one the largest scientific research studies of its kind, analyzing the relationship between multiple categories of childhood trauma and health and behavioral outcomes later in life.
Felitti said that treating depression often begins with recognizing that childhood experiences affect the adult.
“The strongest argument for genetics is that genetics are not the causes for depression but they might modulate it once it is established,” Felitti said.
Mitchell said: “Depression can be caused by a variety of factors that include genetic predisposition, family trauma and neglect or other environmental and situational factors. Most depressions are episodic. Some individuals may have only one or two episodes in their lives and are usually triggered by stresses such as job loss, failing health, loss of a loved one or other similar losses.’’
Mitchell has extensive experience in depression research and publications, including 17 publications in medical journals. He has been the principle investigator on eight pharmaceutical trials treating depression and a co-investigator on three depression studies funded by the National Institute of Mental Health.
The good news is that, while 60 percent of depressed people think about suicide, only 1 percent actually move to the next stage, which involves developing a plan to do it, Mitchell said.
“One of the things to do to determine if someone is suicidal is to ask them about it,” Mitchell said. “Contrary to the myth, you won’t plant the idea in their heads by asking them about it. You may help save a life.”
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