SUICIDE AND ITS INTERVENTION SUICIDAL TENDENCIES IN TEENAGERS

The teen years are an anxious and unsettling period, as boys and girls face the
transition into adult hood. Adolescence is a period of transition in life that Is characterized
by confusion, leaving teens isolated from family and peers. Unfortunately, some teenagers
at this point develops a wrong thinking that suicide is a permanent answer to problems that
are more often and recurrent.

According to a review of reported cases in attempted suicides from the three

largest hospitals in Benin city (specialist, Uselu Psychiatric Hospital and the University
Teaching hospital) indicated that the commonest age group of suicidal attempts was among
teenagers aged 15-19 years . (34.9%). the most important predisposing factors reported
were mental illness (32%) and parental conflict (24%). In a six month prospective study of
thirty-nine cases of deliberate self-harm reported in the three major hospitals in ibadan;
Odejide. et. Al found out that nearly eight in ten (76.9%), were under the ages of 30 and just
over half (51.3%) were students, while 25.6% were manual workers.

In the last four years in Obafemi Awolowo University Ile-ife, about 5 suicide cases have been
reported, with majority of the reasons attributed to Academic frustration.

Suicidal idetion and remedial measures

Pre-suicidal tendencies and the contemporary youth

Suicide- a wrong antidote to failure

Identity crisis and suicidal thoughts among teenagers

Suicide does not just happen, it takes a series of events which leads a person to depression.
talking about depression;

DEPRESSION

Depression, is a common mental disorder, that presents with depressed mood, loss of
interest or pleasure, decreased energy, feelings of guilt or low self-worth, disturbed sleep or
appetite and poor concentration . These problems can become chronic and recurrent and
poses a huge threat of impairments in an individual’s daily functioning (Marcus et. Al 2012)

The America psychiatric association, defined depression as acommon and serious medical
attention that negatively affects how you feel, the way you think and how you act.
Depression causes feelings of sadnress and loss of interest in activities that were once
enjoyable and pleasurable and it can lead to a host of emotional and physical
complications, decreasing the affected’s functioning at work and home. . At its worst,
depression can lead to suicide. According to (WHO, 2012), almost 1 million lives are lost
yearly due to suicide, which translates to 3000 suicide deaths every day. For every person
who completes a suicide, 20 or more attempts to do the same.

According to the APA, of people diagnosed with major depressive disorder, who are treated
and recover, at least half are likely to experience a recurrent episode sometimes in their
future.

TYPES OF DEPRESSION

People often feel sad, blue, or ‘depressed’ from time to time. These feelings are usually
short lived, and do not interfere with daily life. Major Depressive Disorder, on the other
hand, is a serious medical condition that affects the mind and body impacting more than
350 million people around the world. It is an illness in the same way that diabetes, heart
disease and cancer are and is not, as many people believe, a bad attitude or ‘all in the head’.

The primary difference between feeling sad, and Major Depressive Disorder, is time and
duration. If the following symptoms are persistent and last longer than two weeks, start to
interfere with daily life, and are negatively impacting relationships, it may be Major
Depressive Disorder and time to talk to a doctor.

One in five people will suffer from depression during their lifetime, and it is the leading
cause of disability worldwide. The good news is that depression is treatable. While we have
a long way to go in understanding the brain, there are effective therapies and we are
learning more and more every day to provide effective treatment to those in need.

Types of Depression / Symptoms

1. Major Depression (Also known as Major Depressive Disorder, Chronic Major

Depression or Unipolar Depression)

Major Depression is manifested by a combination of symptoms that interferes with the

ability to work, study, sleep, eat and enjoy once pleasurable activities. A Major Depressive
episode may occur only once; but more commonly, several episodes may occur in a
lifetime. This disorder is characterized by the presence of the majority of these symptoms:

Symptoms of Major Depression include:

 Feelings of guilt, worthlessness, helplessness

 Loss of interest or pleasure in hobbies and activities that were once enjoyed,
including sex
 Decreased energy, fatigue, being “slowed down”
 Difficulty concentrating, remembering, making decisions
 Trouble sleeping, early-morning awakening, or oversleeping
  Appetite and/or weight changes
2. Dysthymia
Dysthymia is characterized by an overwhelming yet chronic state of depression, exhibited by
a depressed mood for most of the days, for more days than not, for at least 2 years. (In
children and adolescents, mood can be irritable and duration must be at least 1 year.) The
person who suffers from this disorder must not have gone for more than 2 months without
experiencing two or more of the following symptoms:

Symptoms of Dysthymia

 Appetite and/or weight changes

 Trouble sleeping, early-morning awakening, or oversleeping
 Decreased energy, fatigue
 Low self-esteem
 Poor concentration or difficulty making decisions
 Feelings of hopelessness
In addition, no Major Depressive Episode has been present during the first two years (or one
year in children and adolescents) and there has never been a Manic Episode, a Mixed
Episode, or a Hypomanic Episode, and criteria have never been met for Cyclothymic
Disorder

3. Bipolar Disorder

Another type of depressive illness is bipolar disorder (in the past described as manic-
depressive illness). Bipolar disorder is characterized by cycling mood changes: severe highs
(mania) and lows (depression), often with periods of normal mood in between. Sometimes
the mood switches are dramatic and rapid, but usually they are gradual.

4. Mania often affects thinking, judgment, and social behavior in ways that cause
serious problems. For example, the individual in a manic phase may feel elated, full
of grand schemes that might range from unwise business decisions to romantic
sprees and unsafe sex. Mania, left untreated, may worsen to a psychotic state.

Symptoms of Mania

Unusual irritability
 Decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
 Increased talking or pressure to keep talking
 Flight of ideas or subjective experience that thoughts are racing
 Inappropriate social behavior
5. Depressive episodes are characterized by symptoms described above for Major
Depressive Episode.

6. Persistent Depressive Disorder

A depression that lasts over 2 years, involving symptoms that come and go in
severity. The key is that the symptoms must be present at least two years

7. Seasonal Affective Disorder (SAD)

A depression starting in the winter months, usually stemming from low natural sunlight and
often lifting in the summer months. Sad may be effectively treated with light therapy (Full
Spectrum Lighting), but about half do not respond to treatment and benefit from a
combination of therapy and medication.

8. Psychotic Depression

A severe depression where the person has some form of psychosis along with other
symptoms. This psychosis can include having disturbing false beliefs or a break with reality
(delusions), or hearing or seeing upsetting things that others cannot hear or see
(hallucinations).

9. Postpartum Depression

This depression occurs right after giving birth. It is much more than the “baby blues” that
many women experience after giving birth, when hormonal and physical changes and the
new responsibility of caring for a newborn can be overwhelming. It seriously interferes with
the woman’s daily activities. It is estimated that 10 to 15 percent of women experience
postpartum depression after giving birth.

10. Substance Induced Mood Disorder (abuse or dependence)

Substance-Induced Mood Disorder is a common depressive illness of clients in substance

abuse treatment. It is defined in DSM-V-TR as “a prominent and persistent disturbance of
mood…that is judged to be due to the direct physiological effects of a substance (i.e., a drug
of abuse, a medication, or somatic treatment for depression, or toxin exposure). The mood
can manifest as manic (expansive, grandiose, irritable), depressed, or a mixture of mania
and depression.

Generally, substance-induced mood disorders will only present either during intoxication
from the substance or on withdrawal from the substance and therefore do not have as
lengthy a course as other depressive illnesses. However, substance use disorders also
frequently co-occur with other depressive disorders. Research has revealed that people with
alcoholism are almost twice as likely as those without alcoholism to also suffer from major
depression. In addition, more than half of people with bipolar disorder type I (with severe
mania) have a co-occurring substance use disorder.

Men are more likely than women to report alcohol and drug abuse or dependence in their
lifetime; however, there is debate among researchers as to whether substance use is a
“symptom” of underlying depression, or a co-occurring condition that more commonly
develops in men. Nevertheless, a substance use can mask depression, making it harder to
recognize depression as a separate illness that needs treatment.
SYMPTOMS OF DEPRESSION

The common symptoms of depression, according to the diagnostic Statistical Manual (DSM-
IV) include;

 Depressed mood most of the day, nearly every day as indicated by either subjective
REPORT (e. g feels sad or empty) or observation made by others ( e. g appears
tearful)
 Markedly diminished interest or pleasure in all, or almost all activities of most of the
day,
 Loss of weight(observed by others) and in some people, weight gain.
 Insomnia or Hypersomnia every day
 Psychomotor agitation or retardation nearly every day (observable by others, not
merely subjective feelings of restlessness or being slowed down)
 Fatigue or loss of energy every day.
 Feelings of worthlessness or excessive or inappropriate guilt (which may be
delusional) nearly every day (not merely self-reproach)
 Diminished ability to think or concentrate, or indecisiveness, nearly everyday
 Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation
without specific plan, or a suicide attempt, or a specific plan for committing suicide.

FACTORS THAT CAUSES DEPRESSION

Depression can be stimulated by a number of factors, ranging from biological to

Circumstantial or Environmental factors. Some Common factors are;

 Early childhood trauma: some devastating events that might have happened, in an
individual’s early stage has great potentials of causing depression. some of these
events, impact the way the body reacts to stressful situations similar to that which
have happened in the past.
 Health/medical conditions: Certain medical conditions, may put an individual at
higher risk of depression. such conditions include; insomnia, chronic pain or
attention-deficit-hyperactivity disorder.
 Family history: If depression or some other mood disorders can be traced back to
the bloodline of an individual, there is propability that such individual might develop
depression.
 Drug use: Depression can be influenced, by the addictive use of drugs. Depression
has been identified by experts as one of the withdrawal symptoms that an individual
may encounter when withdrawing from drug or substance.
 Brain structure: There might be risk of depression , if the frontal lobe of one’s brsin
is less active. However, scientists haven’t ascertained if this happen before or after
the onset of depressive symptoms.
 SUICIDE

What is suicide?

Suicide is death caused by injuring oneself with the intent to die. A suicide attempt is
when someone harms themselves with the intent to end their life, but they do not die as a
result of their actions.

Several factors can increase the risk for suicide and protect against it. Suicide is
connected to other forms of injury and violence, and causes serious health and economic
consequences. For example, suicide risk is higher among people who have experienced
violence, including child abuse, bullying, or sexual violence. Protective factors like family
and community support, or “connectedness”, and easy access to health care can help
decrease the risk for suicidal thoughts and behavior.

Suicide and other forms of violence can be prevented by using a public health approach that
addresses risk and protective factors for multiple types of violence. For more information
about self-directed violence definitions please How big is the problem?

Suicide is a large and growing public health problem. Suicide is the 10th leading
cause of death in the United States. It was responsible for more than 47,000 deaths in 2017,
resulting in about one death every 11 minutes. Every year, many more people think about
or attempt suicide than die by suicide. In 2017, 10.6 million American adults seriously
thought about suicide, 3.2 million made a plan, and 1.4 million attempted suicide.

Suicide affects all ages. Suicide is a problem throughout the life span. It is the second
leading cause of death for people 10 to 34 years of age, the fourth leading cause among
people 35 to 54 years of age, and the eighth leading cause among people 55 to 64 years of
age.
Some groups have higher rates of suicide than others. Suicide rates vary by race/ethnicity,
age, and other population characteristics, with the highest rates across the life span
occurring among non-Hispanic American Indian/Alaska Native and non-Hispanic White
populations. Other Americans disproportionately impacted by suicide include Veterans and
other military personnel and workers in certain occupational groups like construction and
the arts, design, entertainment, sports, and media field. Sexual minority youth bear a large
burden as well, and experience increased suicidal ideation and behavior compared to their
non-sexual minority peers.

What are the consequences?

In addition to the number of people who are injured or die, suicide also affects the
health of others and the community. When people die by suicide, their family and
friends can experience shock, anger, guilt, and depression. The economic toll of
suicide on society is immense as well. Suicides and suicide attempts cost the nation
almost $70 billion per year in lifetime medical and work-loss costs alone.

People who attempt suicide and survive may experience serious injuries, such as broken
bones or brain injury. These injuries can have long-term effects on their health. People who
survive suicide attempts may also experience depression and other mental health problems.

Many other people are impacted by knowing someone who dies or by personally
experiencing suicidal thoughts. Additionally, being a survivor or someone with lived
experience increases one’s risk of suicide.

CDC has developed a technical package, Preventing Suicide: A Technical Package of Policy,
Programs, and Practices pdf icon[6.11 MB, 62 Pages, 508] that provides information on the
best available evidence for suicide prevention. Also available in Spanish pdf icon[34 MB, 64
Pages, 508]. The technical package can be used to inform a comprehensive, multi-level and
multi-sectoral approach within communities and states. It includes strategies to prevent
suicide in the first place, by decreasing suicide risk factors and increasing protective factors.
Strategies range from a focus on the whole population regardless of risk to strategies
designed to support people at highest risk. This technical package includes strategies and
approaches that go beyond individual behavior change to better address factors impacting
communities and populations.

References

View Page In:pdf icon Preventing Suicide Factsheet [590 KB, 2 Pages, 508]

Sources:

National Institute of Mental Health

World Health Organization

American Psychiatric Association (2013). Diagnostic and statistical manual of

mental disorders. 5th edition. Washington, DC: American Psychiatric Association.

Depression and Suicide in Children and Adolescents. Surgeon General’s Health

Report