1. Understanding Depression and Suicide prevention 9 MEH 2.1-2.2

2. Why talk about depression? Recent surveys suggest, according to Mental Health America – 1 in 5 teens suffers from Clinical Depression – Each year almost 5,000 young people (ages 15-24) commit suicide – Rate has tripled since 1960 – 3 rd leading cause of death in adolescents and 2 nd leading cause of death among college age

3. What is Depression? Sadness is a normal reaction to life’s struggles, setbacks, and disappointments. Depression is different from normal sadness by: – Engulfing your day-to-day life, – Interfering with your ability to work, study, eat, sleep, and have fun. The feelings of helplessness, hopelessness, and worthlessness are intense and unrelenting, with little, if any, relief.

4. Common Signs and Symptoms Feelings of helplessness and hopelessness Loss of interest in daily activities Appetite or weight changes Sleep changes Anger or irritability Loss of energy Self-loathing Reckless behavior Concentration problems Unexplained aches and pains

5. Changes in behavior and thinking These may include: – General slowing down – Neglect of responsibilities and appearance – Poor memory – Inability to concentrate or think clearly – Suicidal thoughts, feelings, or behaviors – Difficulty making decisions – Negative attitude and outlook

6. Depression in teens Some appear sad – most appear irritable Poor performance in school Withdrawal from friends and activities Anger/rage Overreaction to criticism Suicidal thoughts Poor self-esteem or guilt Substance abuse or acting out to avoid feelings

7. Risk factors Loneliness Lack of social support Recent stressful life experience Family history Early childhood trauma/abuse Substance abuse Health problems or chronic pain

8. Link between anxiety and depression Anxiety and depression are believed to stem from the same biological vulnerability Often go hand in hand Depression can make anxiety worse (and vice/versa) Important to recognize both conditions

9. Managing Your Depression – Directions: Pay attention to the video! Directions: Pay attention to the video! – https://www.youtube.com/watch?v=9s2W89KRY-Y

10. Warm-Up – You do NOT need to copy down this question! Studies have said that people living in wealthier nations are more likely to have experienced depression than those of poorer countries. Why do you think this is true?

11. Depression Around the World They found that regardless of location, women are almost twice as likely to experience depression. In wealthy nations, income levels are another predictor of depression. Causes: – Income Differences – Low level of awareness about mental illness in poorer countries.

12. Countries with highest Levels of Depression 1)France: 21% One in five people in France reported having experienced at least one depressive episode in their lifetime. 2)USA: 19.2% A little more than one in five people in the US reported having experienced a depressive episode. 3)Brazil: 18.4 A little more than one in five people in the Brazil reported having experienced a depressive episode. 4)Netherlands: 17.9% About one in six people in the Netherlands reported having experienced a depressive episode. 5)New Zealand: 17.8 About one in six people in New Zealand reported having experienced a depressive episode.

13. Suicide Prevention 9 MEH 2.1-2.2

14.  People no longer use the phrase ‘committing suicide’ because it is not ‘committing a crime’. Instead say “dying by suicide.”  Why do people take their own lives?  There are many reasons why people get so low they feel they can’t go on living.  Sometimes it can be a big life event like a death in the family.  However, often it is a series of little things that knock a person’s emotional health lower and lower.  If one thing after another goes wrong people may already feel very low and at the end of their line.  When that happens even a relatively small thing can push someone over the edge emotionally.

15. Intervening with a depressed friend Be empathetic and understanding Don’t try to “cheer up” a depressed person by minimizing their concerns Avoid critical or shaming statements Empathize with feelings of sadness, grief, anger and frustration, but… Challenge expressions of hopelessness

16. Don’t argue about how bad things are Don’t insist that depression or sadness are the wrong feelings to be experiencing Don’t become angry even though your efforts may be resisted or rejected

17. Common misconceptions about Suicide FALSE – People who talk about suicide won’t really do it FALSE – People who talk about or attempt suicide want to die FALSE – Anyone who tries to kill him/herself must be crazy FALSE – If a person is determined to kill him/herself, nothing is going to stop them FALSE – Talking about suicide may give someone the idea

18. Suicide warning signs Talking, writing, or joking about suicide or death Giving away prized possessions Making final arrangements Depressive symptoms Sudden, unexplained recovery from profound depression Marked feelings of helplessness or hopelessness

19. Risk-taking behavior Self-mutilating behavior (sometimes) A suicide plan Significant change in behavior Previous suicide attempts Significant loss Chemical (drug or alcohol) abuse

20. What NOT to say… “This will make you stronger” “Time heals all wounds” “ I know how you feel” “It could be worse” “It will work itself out”

21. Suicide Intervention Dont’s Don’t minimize the person’s feelings or situation Don’t leave the person alone if they have a plan and/or lethal means Don’t use reverse psychology with suicidal people Don’t try to be a hero – GET HELP! Don’t promise to keep the secret – PROMISE HELP! Don’t argue about the “right to suicide”

22. How to help LISTEN Show empathy and concern Offer to call or talk to a parent, counselor, or other trusted adult with them Encourage them to get ongoing help for their depression If they are immediately at-risk, call a suicide hotline or 911

23. TO DO NOW! Suicide Starters Worksheet

24. If you Really Knew Me: Have you ever thought about what you have said or done? Do you know what goes on in everyone else’s lives? Do you really know what other people go through? You think you know, but you have no idea!!!

25. Mental Disorders 9 MEH 2.1-2.2

26. Causes of Mental Disorders Traumatic or Stressful Situations/experiences Inherited Caused by an injury or a physical disorder Chemical imbalance

27. What is a mental illness? It is when someone lacks the ability to manage day to day events and/or control their behavior so that basic physical and emotional needs are threatened or unmet.

28. Mental illnesses are not the result of a personal weakness, lack of character, or poor upbringing. These disorders can affect persons of any age, race, sex, religion, or income.

29. What is mental illness like? Mental illness is a physical condition just like asthma or arthritis. But still society believes that a person who is mentally ill needs to show more willpower - to be able to pull themselves out it.

30. ….. It is also like telling a person who has an amputated leg to run across the room. But a person who has mental health issue has a “broken brain”.

31. Myths of Mental Illness Mental illness is caused by bad parenting. Fact: Most diagnosed individuals come from supportive homes. The mentally ill are violent and dangerous. Fact: Most are victims of violence. People with a mental disorder are not smart. Fact: Numerous studies have shown that many have average or above average intelligence.

32. Mental Illnesses in our Community Depression Mania Schizophrenia

33. Mania (bipolar disorder)

34. What is Mania? Mania is part of a condition called bipolar disorder, also known as manic-depression. Bipolar disorder usually causes a person’s mood to alternate between symptoms of depression and mania, a heightened energetic state. This mood disorder affects more than two million Americans.

35. Signs and Symptoms of Mania Increased physical and mental activity & energy Excessive irritability, aggressive behavior Decreased need for sleep; without experiencing fatigue Exaggerated optimism and self-confidence Racing speech and thoughts; flight of ideas Impulsiveness, poor judgment Reckless behavior: erratic driving, sexual indiscretions, spending sprees Grandiose delusions

36. What Causes Mania? The neurotransmitters: Norepinephrine, dopamine, and serotonin, have been studied since the 1960s as factors in mania and depression. For example, during a manic episode, clients with bipolar disorder have a significantly higher Norepinephrine and epinephrine levels than a depressed or euthymic (normal mood) person. Norepinephrine and epinephrine are responsible for “fight or flight” responses.

37. How Can I Help a Person Who is Manic? Use a firm and calm approach when communicating: “Lower your voice Don, or you will lose ______ privilege.” Remain neutral; avoid power struggles and don’t cast judgments. Firmly redirect energy into more appropriate and constructive behavior. Do not yell or sound threatening, the goal is to try to keep anxiety down in a person who exhibits mania.

38. Schizophrenia

39. What is Schizophrenia? Schizophrenia is a chronic and severe brain disorder. It is a disease that makes it difficult for a person to tell the difference between real and unreal experiences, to think logically, to have appropriate emotional responses to others, aspects of memory and to act appropriately in social situations. The World Health Organization (WHO) has identified schizophrenia as one of the ten most debilitating diseases affecting all human beings.

40. Symptoms of Schizophrenia The severity of symptoms varies from one person to another, and typically symptoms will decline and then reappear. Symptoms are divided into Positive and Negative symptoms.

41. What Causes Schizophrenia? There is no one cause to this complex and puzzling illness, but it is believed that some combination of genetic, biological (virus, bacteria, or an infection) and environmental factors play a major role. There is currently no reliable way to predict whether a person will develop the disease. John Nash, a famous Schizophrenic. His life story made into a film, A Beautiful Mind.

42. What Occurs in the Brain of Someone with Schizophrenia? Researchers believe an imbalance of neurotransmitters may cause the symptoms of schizophrenia. Two neurotransmitters that have most been implicated as abnormal in schizophrenia are dopamine and serotonin. The ability to produce images have helped in identifying structural and functional differences in a schizophrenic brain versus a normal brain.

43. From The Looks of It Brian imaging has shown a difference in: Enlargement of the ventricle Decrease in the hippocampus (controls emotional and working memory) Decrease in overall size Abnormal development of pre-frontal cortex (forehead region; controls information process, motivation, problem solving, decision making, and thinking speed) Schizophrenic brainNormal brain Ventricles

44. Treatment With all three of these illnesses, treatment, with the right combination of medications and/or therapy, can help stabilize the moods that interfere with a productive life.