DEPRESSION &

SUICIDEMrs.B.Kavitha M.Sc (N)

Associate ProfessorAswini College Of Nursing

Thrissur

Suicide is a deliberate act of taking or completing

one’s own life

INCIDENCE & PREVALENCE

30,000 people end lives each year8th leading cause of death among adults3rd leading cause of death among adolescents

1.2 lakh/yr suicidal deaths4 lakh/yr attempt suicideMajority of suicide (37.8%) -< 30 yr age gp.77 % suicide - < 44 yr age- huge burden

ABOUT SUICIDE AND DEPRESSION……

Major depression is the psychiatric diagnosis most commonly associated with suicide

About 2/3 of people who complete suicide are depressed at the time of their deaths

One out of every 16 people who are diagnosed with depression eventually go on to end their lives through suicide

ABOUT SUICIDE AND DEPRESSION……

The risk of suicide in people with major depression is

about 20 times that of the general population

People who have had multiple episodes of depression are

at greater risk for suicide than those who have had one

episode

People who have a dependence on alcohol or drugs in

addition to being depressed are at greater risk for suicide

Depression distorts a person's thinking

Make them to focus only on their failures and disappointments &

Exaggerate the negative things.

The loss of pleasure and the low energy that is part of depression can make every problem (even small ones) seem like too much to handle.

Low energy The loss of

pleasure

HelplessnessHopelessnes

s

Suicide Attempt

Isolation

Anhedonia

Hopelessness

Physical illness

Global Insomnia

Financial / social loss

Irritability & Agitation

Aggressive tendencies

Anxiety / Panic Attacks

Family history of suicide

Previous suicide attempt

Easy access to lethal methods

Talk About Suicide /A Prior History Of Attempts/Acts

PEOP

LE W

HO A

RE D

EPRE

SSED

AND

EXHI

BIT

THE

FOLL

OWIN

G

SYM

PTOM

S

ARE AT PARTICULAR RISK FOR

SUICIDE:

METHODS OF

COMMITTING SUICIDE

Hanging ( 31.7 %)

Poisoning –pesticide, drug overdose etc (34.8%)

Firearms – (8 %)

Drowning

Wrist cutting

Jumping from height Vehicular impact-rail or traffic

collision

 SUICIDE MYTHS•Fact  :Most people who commit suicide have talked about or given definite warning signs of their suicidal intentions.

Myth: People who talk about suicide do not

commit suicide.

•Fact : There are almost always warning signs, but others are often unaware of the significance of the warnings or unsure about what to do.

Myth: Suicide happens without

warning.

•Fact: Suicide is preventable. Most suicidal people desperately want to live; they are just unable to see alternatives to their problems.

Myth: Suicidal people are fully intent on dying. Nothing

others do or say can help.

•Fact: Most suicidal people are suicidal for only limited periods of time. However, someone who has made an attempt is at increased risk for future attempts.

Myth: Once someone is suicidal, they are

suicidal forever.

•Fact :Many suicides occur several months after the beginning of improvement, when a person has energy to act on suicidal thoughts.

Myth: Improvement after a suicidal crisis means that the risk of suicide is over.

•Fact: Suicide cuts across social and economic boundaries.

Myth: Suicide strikes most often among the rich, or

conversely, among the poor.

PROTECTIVE FACTORS Appropriate treatment for mental, physical

and substance abuse disorders Family and community support Restricted access to highly lethal method of

suicide Learned skill in problem solving, conflict

resolution cultural and religious belief that discourages

suicide ideation

GENERALLY Ask pt. directly, “Have you thought about harming

yourself in any way?” “If so, what do you plan to do?”. “Do you have the means to carry out this plan?”

Create safe environment; remove all potentially harmful objects; supervise closely; room searches

Formulate short-term verbal or written agreement that pt will not harm self; when time seek another; secure pt will seek staff when feelings of self harm

Maintain close observation; 1:1 or q15, room close to nurse station, no private room, accompany to toilet if needed

Special precaution in administering medication Rounds at frequent irregular intervals Encourage pt expression of honest feelings, including

anger

Encourage the person to seek treatme

nt.

Help the person get assistance

. Facilitate open

communication &

Be respectful of the person’s feelings.

Don’t be patronizi

ng or judgmen

tal.

Never promise to keep

someone’s

suicidal feelings a secret.

Offer reassuran

ce.

Encourage the person

to avoid alcohol

and drugs.

What you can do:

SUICIDE IS NOT A SOLUTION TO ANY PROBLEM