Depression and SuicideDepression and Suicide What do you know?What do you know? What do you want to know?What do you want to know?

Scenario: Fred is your roommate. Lately, he has been sleeping a lot more, feeling down, and pulling away from others. He makes statements like “it would be better if I wasn’t here” and “I don’t care about anything anymore.” 1.What is wrong with Fred? 2.How would you handle this situation? 3.What if he has a plan?

Depression Facts 1.3 rd most common disorder 2.1 in 5 people will suffer an MDD episode across the lifetime 3.Almost twice as common in women 4.Costs businesses an estimated $33 billion in salary productivity per year 5.Most common in young adults and older adults 6.Expressed differently by culture and age E.g., Chinese – somatic complaintsE.g., Chinese – somatic complaints E.g, Children – anger/irritabilityE.g, Children – anger/irritability

Major Depressive Disorder Two weeks of 5 or more of the following: 1. Depressed mood and/or 2. Loss of interest 3. Weight loss or gain 4. Insomnia or hypersomnia 5. Psychomotor agitation or retardation (e.g., restless) 6. Loss of energy 7. Worthlessness/guilt 8. Concentration/indecision 9. Recurrent thoughts of death

Dysthymia Two or more of the following are present or at least 2 years: 1.Poor appetite or overeating 2.Insomnia or hypersomnia 3.Low energy 4.Low Self-esteem 5.Poor concentration/indecision 6.Feelings of hopelessness - MDD episode cannot be present in these 2 years

Differences between MDD and Dysthymia 1.Intensity 2.Time requirements 3.Symptom presentation Thoughts of deathThoughts of death Weight issuesWeight issues psychomotor effectspsychomotor effects 4.Presentation for treatment MDD more likelyMDD more likely

Warning signs 1. Changes in activity level1. Changes in activity level 2. Physical changes (e.g., weight)2. Physical changes (e.g., weight) 3. Emotional pain3. Emotional pain 4. Mood change (e.g., irritable, down, self- critical)4. Mood change (e.g., irritable, down, self- critical) 5. Changes in thought patterns (concentration, decision making)5. Changes in thought patterns (concentration, decision making) 6. Thoughts/mention of death6. Thoughts/mention of death

Activity Time!!!! Take out a piece of paper and answer “True” or “False” for the following statementsTake out a piece of paper and answer “True” or “False” for the following statements 1. Suicide is less common than murder.1. Suicide is less common than murder. 2. We should be gentle or tentative when approaching someone we think may be suicidal.2. We should be gentle or tentative when approaching someone we think may be suicidal. 3. Once someone is intent on committing suicide, there is no way to stop them.3. Once someone is intent on committing suicide, there is no way to stop them. 4. Psychologists and psychiatrists are the only people who can help someone who is suicidal.4. Psychologists and psychiatrists are the only people who can help someone who is suicidal. 5. Suicidal people are only seeking attention.5. Suicidal people are only seeking attention.

Suicide Facts 1.7 th or 8 th leading cause of death overall in the last decade 2.2 nd or 3 rd leading cause of death for adolescents and young adults 3.Most prevalent in adolescents and older adults 4.Twice as common in college students than non- college counterparts 5.Accounts for about 30,000 deaths annually 6.Women more likely to attempt, men more likely to complete 7.Suicidal thoughts and attempts difficult to count

Associated Risk Factors/Causes 1. Mood disorder1. Mood disorder 2. Gender2. Gender 3. Negative Life Event3. Negative Life Event 4. Neuroticism4. Neuroticism 5. Low self-esteem5. Low self-esteem 6. Low social support6. Low social support 7. Personality Disorder7. Personality Disorder **Most likely completed when mood is improving**Most likely completed when mood is improving

Warning Signs 1. Talking about dying 2. Recent loss 3. Depressive symptoms 4. Talking about loss of control/harming self or others 5. Withdrawal from relationships 6. Hopelessness 7. Previous attempt** 8. “Finalizing behavior” (e.g., Giving things away, tying up relationships, making out wills)

What should you do to help? 1. Educate yourself on warning signs1. Educate yourself on warning signs 2. Be direct2. Be direct 3. NEVER leave the person alone3. NEVER leave the person alone 4. Assess immediacy of threat – plan and means? Remove if needed4. Assess immediacy of threat – plan and means? Remove if needed 5. GET HELP!!!5. GET HELP!!! –University Counseling Center –University Psychological Clinic – TALK –DIAL 911

A helping hand for Fred… Recall that Fred has exhibited depressive symptoms and talked about death. How might you go about helping him?