Suicide causes depression confidence

Suicidal depression is a mental disorder that develops as a result of a prolonged stressful state. This disrupts the calm balance. This could be the result of some tragic event. In this case, the person feels depressed and looks at everything with pessimism. He is no longer pleased with joyful events, no positive emotions are manifested. Feeling hopeless and suffering mentally, a person begins to talk about how useless life is.

Content

1 Signs and symptoms
2 Scales
3 Risk factors
4 Mental disorders
5 Side effects of medications
6 Events in a person's life
7 Alcohol abuse
8 Family history and family relationships
9 Relationships with parents and friends
10 Prevention
11 Treatment
12 Psychotherapy
13 Hospitalization
14 Outpatient treatment
15 Use of medications
16 Incitement and incitement to suicide
17 Notes
18 Literature
19 Links

Signs and symptoms

Suicidal ideation is a term that has a simple definition: “thoughts about suicide,” but in addition to the thoughts themselves, there are also other signs and symptoms of a person’s concern about this topic. Some of these symptoms are comorbid conditions, such as unintentional weight loss, feelings of hopelessness, unusual fatigue, low self-esteem, excessive talkativeness, the pursuit of previously unimportant goals, and a feeling of being out of whack. The appearance of these or similar symptoms, coupled with an inability to get rid of them or cope with them and their consequences, as well as possible psychological inflexibility, is one of the signs that may indicate the emergence of suicidal thoughts. Suicidal thoughts can lead to psychological distress, repetitive behavior patterns; however, the opposite is also possible—psychological stress can lead to suicidal thoughts. Other possible symptoms indicating suicidal ideation include:

feeling of hopelessness;
anhedonia;
insomnia or hypersomnia;
loss of appetite or polyphagia;
depression;
severe anxiety disorders;
disturbances in concentration;
agitation (strong emotional arousal);
panic attacks;
heavy and deep feeling of guilt.

Relatives

For family and friends, this human condition becomes a real test. In many ways, the outcome of the disease will depend on them. During an exacerbation, it is important to be there to provide any support. It is especially important to support a morally close person; you should talk about your love more often, so that he feels that he is needed here, in this world, and does not strive to move to another.

An increasing number of people are experiencing suicide syndrome. Perhaps this is due to the unstable situation in society and global problems. Be that as it may, it is important that a person suffering from an obsessive disorder receives help. This is what you need close people for.

If you feel that a person is starting to somehow move away, withdraw into himself, and constantly think about death, there is no need to leave him in this state. First of all, he needs help, and if he can’t cope on his own, then seek help from specialists who will definitely be able to cope with this problem. There are many clinics that deal with problematic conditions of people. The sooner you notice the problem, the faster the treatment will be, and the result will be that the person will stop thinking about suicide and begin to live fully.

Mental disorders

A number of mental disorders are combined with the presence of suicidal thoughts or significantly increase the risk of their occurrence. The following list includes those disorders that have demonstrated a clear association with the occurrence of suicidal ideation. However, please remember that this list is not exhaustive. Mental disorders that increase the risk of suicidal thoughts include:

generalized anxiety disorder;
autism spectrum disorder;
Asperger's syndrome;
major depressive disorder;
dysthymia;
bipolar affective disorder (depressive or mixed episode)[1];
attention deficit hyperactivity disorder, abbr. ADHD;
post-traumatic stress disorder (PTSD);
personality disorders (in particular, borderline[1]);
psychosis (gross distortion of perception and reflection of the real world);
paranoia;
paranoid schizophrenia[1];
drug or alcohol abuse (for example, when abruptly stopping cocaine use[1]);
social phobia[1].

Suicidal depression

Suicidal depression is an imprecise and, in official terminology, a non-existent term. But it should be noted that almost any depression, as it progresses, can turn out to be suicidal.

Feelings of hopelessness, desperation, a sense of the meaninglessness of one’s own existence are those emotions that, with prolonged exposure, become completely unbearable for a person in a state of depression. Thus, suicidal depression is almost any depressive disorder, because according to global statistics, the overwhelming number of suicides are committed by people who are depressed.

Here we will look at two of the most important questions: how to recognize that a depressed person has suicidal intentions and what to do about it?

Side effects of medications

Some prescription medications, such as selective serotonin reuptake inhibitors (SSRIs), may cause suicidal thoughts as a side effect. Moreover, non-side effects themselves may lead to an increased risk of suicidal behavior, both in the case of one individual patient and when considering a group of patients. Among patients taking these medications, a certain proportion begin to feel so bad that they begin to think about suicide (or the consequences of suicide that exist in their minds), but do not attempt it because they are inhibited by symptoms of depression, such as lack of physical and moral strength and motivation. Among these people, there is a group who believe that the medications they take alleviate the symptoms of their depression (such as lack of motivation), and that lower doses of these medications alleviate the depression itself. Among these people, in turn, a group can be identified whose desire to commit suicide persists even when the obstacles to its commission have already been removed; Such people are at high risk for both suicide attempts and successful suicide.

What could be the reason?

Suicide is a form of behavior in which a person is capable of destroying himself. This may be a consequence of increased irritability, reluctance to communicate, and decreased social activity. After this comes a stage in which the person begins to plan how exactly to commit suicide. Suicidal behavior is divided into several groups, which determine the causes of suicidal thoughts.

Genuine suicidal actions. At the same time, a person comes to the idea that no one needs him, and life is completely worthless. A number of changes occur in behavioral and thought processes if a person actually decides to commit suicide. The plan is carefully thought out, all the little details are thought through. In this case, a person chooses the most effective and efficient method.
Suicidal behavior is demonstrative. Most often, a person does not really want to commit suicide. Most often it comes to the threats of this action. He may try to create an incident, knowing for sure that he will be saved. This is a sign that a person needs attention or help to solve some problem.
Suicidal behavior of the camouflage type. If the form is hidden, no overt attempts are made. Realizing that suicide is not the right thing to do, a person, without realizing it, begins to expose himself to danger. For example, he takes part in military conflicts or goes to the mountains, in general, he does everything that leads to suicide. This type of disease is the most dangerous and practically untreatable.
Affective state behavior. If a person cannot control himself in some situation, a state of passion may set in, and certain negative thoughts arise, which most often lead to suicide.

Timely support from family and friends will help protect a person who has suicidal thoughts from doing the wrong thing.

Alcohol abuse

Research shows that people who drink alcohol excessively (but not those who drink socially) tend to have suicidal thoughts.

Certain studies show a connection between the level of alcohol consumption and the likelihood of suicidal thoughts.

A number of studies also show not only a link between alcohol consumption and suicidal thoughts, but also a positive feedback loop: suicidal thoughts also contribute to drinking alcohol alone.

Unemployment;

Chronic diseases or chronic pain;

Loss of family and/or friends;

There are also studies showing a link between tobacco use and depression and suicidal ideation;

Unplanned pregnancy;

Bullying, including on the Internet;

Previous suicide attempts

If a person has attempted suicide, they are much more likely to consider suicide and try again;

Service in the armed forces

Military personnel exhibiting symptoms of PTSD, major depressive disorder, alcohol abuse, and anxiety disorders are more likely to contemplate suicide;

Violence from others

Undesirable changes in body weight

In women: increasing body mass index increases the risk of suicidal ideation

In men: a sharp decrease in body mass index leads to the same result.

In general, obese people have a higher risk of suicidal ideation than people of average weight.

Paying attention to words and images related to the topic of suicide.

Answers to questions about depression and suicidal thoughts

Question from Natalia, Moscow:

"Good evening! I do not live, but exist. Who am I? Can I get out of this swamp?

Alfiya Smakova, psychiatrist, psychotherapist, answers:

Hello! You are asking a question that people with a sound vector live with and are looking for an answer to.

Once upon a time, at the dawn of humanity, those who guarded the flock at night appeared among people. They had a keen hearing, so necessary for salvation from nocturnal predators. They could differentiate the slightest rustles, distinguish the sound of a running field mouse from a sneaking leopard. When listening to the world in darkness and silence, tension arises in the form of questions: “Who am I?”, “Why am I here?”, “What is my purpose?”, “Is there a meaning to my life?”

A person with a sound vector begins to pronounce these questions at the age of 5-7, perplexing adults.

The sound vector contains a large volume of the psychic, which constantly requires filling. Hundreds of questions seem to explode your head from the inside. But there are no answers. The feeling of vegetation occurs in cases where the lack of meaning in life and self-definition is not filled.

In an effort to overcome this painful feeling of emptiness, a sound artist may mistakenly withdraw into himself, immerse himself deeply in his thoughts, in his inner world. In this state, the feeling of connection with the material world is lost. But the improvements are only temporary, from silence and solitude. Then depression sucks in with greater force. Problems with sleep (constantly want to sleep but the fatigue does not go away, or insomnia), lack of desires, negative perception of the world. Even questions of physical needs irritate and perplex the sound engineer. In the sound vector - the only one of the 8 vectors - the mental and physical are not separated.

And in this state, bodily sensations may disappear. Sound artists describe their experiences something like this:

[Rus]: Feeling of incomplete presence in the left half of the body. It’s as if 50% of the sensations are turned off. It’s as if I want to merge into my hand, into my leg, torso, into my face, into my neck, as if I can’t, something is in the way and doesn’t allow me to dress my body in the left half. This condition is debilitating. There is a fear that nothing can be done about it.
Doctors do not take seriously at all the way I describe my condition. The state of helplessness is even more debilitating and exhausting.

Indeed, this condition is debilitating. We are born in order to enjoy life and be happy. When our true desires are not fulfilled, we experience suffering. The sound guy wants to find answers - and doesn't get them. Gradually, the psyche relearns “not to want” in order to stop suffering from dissatisfaction. But the state of happiness does not appear. The emptiness in the psyche grows, apathy and loss of strength appear, people around are annoying, the feeling of hunger and the need to go to the toilet are annoying. Why do I need this body? - Suffering is growing. The material world is burdensome. Suicidal thoughts arise that haunt you 24 hours a day. And it seems that if you get rid of bodily sensations, it will become easier.

[Asya]: “Is it possible to get out of deep depression with the help of training?”

[Guest]: “Guys, I’m afraid to commit suicide, how can I overcome this?”

It is impossible to overcome this condition. It goes away only when the underlying causes of suicidal thoughts are realized.

The training “System-vector psychology” by Yuri Burlan helps to get out of deep depression and constantly accompanying thoughts of suicide. The lectures provide a full disclosure of the psyche, the internal sound search is satisfied, because during the training it is possible to find answers to the questions: “Who am I? Why do I exist? What is a sense of life?"

Hundreds of people write and speak about their results in finding the meaning of life, the emergence of feelings of “aliveness”:

“...Literally after a month of training, my apathy towards life went away. I became very interested in life. People interested me. It became easy for me to be among them. I don’t fully understand them yet, but I don’t shy away from them like I did before the training.
Before the training, I had terrible irritation - everything at work irritated me, everyone irritated me. I had great envy at work towards people whom I considered more successful than me and this greatly irritated me. I thought that they were dumber than me, knew less and could do it than me, and got more than me. And this injustice bothered me. This state of affairs exhausted me, and I could not work normally.
After the training, all irritation at work and at home went away. I saw many other opportunities for myself and my anger and envy went away. I can work calmly now. It’s not even calm, but I’m just rushing from work. I have so much desire and strength to work that I complete my monthly plan in half a month, and even faster.
Now I can’t sit idle at work for a minute, I have to do and do. And that’s not all - one job is not enough for me, I wanted to find another additional job...”
Alina Sh., process engineer, Omsk

“...Before the “System-Vector Psychology” training, I had not lived a single day of my life.
I don’t remember well the events of that time, people’s faces, their names, dates. I confused what happened the day before yesterday and what happened years before. I don’t remember how I studied at school, at the university, the places where I lived and where I visited, with whom I communicated and worked, what I studied with, with whom I lived, I don’t remember the circumstances of the incidents. But I remember my internal states well, everything, whatever they may be. And they were always bad, with rare exceptions...
…Now I know what I want, I know what I need, and by taking action in the right direction, I am happy!
When I see the mental characteristics of other people, then I understand the reasons for their behavior and stop being offended, angry, hating, or expecting something that they cannot give. And there is a great opportunity to give them what they need. This is how hostility towards people went away; in the systemic perception of hostility, hostility cannot exist. And other people began to notice me and are the first to start a conversation, I stopped getting into unpleasant situations, no one is rude to me, they don’t complain about me, they don’t quarrel with me.
Read also: Guide to varicose veins and other vein diseases
Understanding the reasons for the world order, getting to know the world, other people and appreciating the simplest little things in life is so great!
Knowing and understanding myself, I can plan my actions in such a way as not to be disappointed by their consequences, but to get the maximum benefit. After the training, I became able to realize myself in my work and in any communication.
It’s a huge relief and joy to be in my place. I easily adapt to changes and feel confident in unfamiliar surroundings with new people...”
Ekaterina K., doctor, psychiatrist-narcologist, Kazan

“...I had no future. Never in 40 years. For as long as I can remember, I always wanted to die.
I watched films with murders with pleasure and envied the dying. I cried, why they, and not me, if the news reported someone’s death. I loved disaster films where people died in the thousands. Any difficulty seemed an insurmountable obstacle. I had no strength to live. There was no point in living. When everything was relatively good, it was going on in the background - it didn’t last long. And it's pointless. Constant expectation of bad, negative developments. I grew up. I didn't plan for the future. What's the point if I can leave the balcony today or tomorrow? And I'll go out. My reality was limited by the past - it was unchanging. And it made no sense. Pain, disappointment, sadness and loneliness. In the future - suicide...
... After the training, this is completely new and unusual for me.
My head has become much quieter, I can hear my thoughts and can concentrate. I constantly want to be with people. Not for emotional connections. I began to focus on people without contacting them. Watching. Just some kind of space.
I suddenly realized that I didn’t want to die. That this is not a solution to all problems, it is not liberation, it is a loss. Loss. A loss for me and for those around me. How can you miss life? Why not live in such an interesting world? There are still so many discoveries ahead.
A meaning appeared - continuous knowledge of others and oneself through them. The meaning is to reveal and observe the Creator's plan. The cause and effect of everything. I began to perceive the whole person, and not just his conscious part. People have feelings - they love, they are afraid, they have compassion. There are emotions. They experience pain and joy. People have become a part of my life. Stopped being dead flat pictures..."
Anonymous

It is possible to find a state of satisfaction from life and feel happy. For sound engineers, training is a long-awaited fulfillment of meaning. Enough with the head.

Author Alfiya Smakova Proofreader Galina Rzhannikova

The article was written using materials from Yuri Burlan’s online training “System-vector psychology” Section: Psychology

January 18, 2020 Comments: Views: 228 Tags: answers to questions

History of family and family relationships

Parental history of depression

Wallenstein and others studied 340 adults whose parents had a history of depression. The researchers found that 7% of the study group reported having suicidal thoughts in the past month.

Violence

In childhood: physical, emotional and sexual abuse;

During adolescence: physical, emotional and sexual abuse.

Domestic violence

Housing problems that occurred in childhood.

A number of studies show a positive relationship between suicidal ideation and relationship problems within the family.

Impulsive type of suicidal actions

PREDICTION OF SUICIDE Read more: Variants of suicidal psychogenic depression

4.1 Impulsive type of suicidal actions

It occurs most often and is characterized by the sudden emergence of auto-aggressive ideas and their rapid implementation into a poorly thought-out suicidal act. At the same time, as a method of attempting suicide, as a rule, means are used that are “at hand”, but often lead to serious somatic consequences.

Such suicidal actions are observed more often in young patients who, due to age and personality characteristics, are prone to maximalism in assessing life situations, uncompromisingness, and inability to predict the outcomes of conflicts that require behavioral flexibility. In addition, the impulsive choice of suicidal means is characteristic of patients with organic diseases of the central nervous system, psychopathy, often excitable and hysterical circles, and persons under the influence of alcohol.

4.2 Information-personal type of suicidal actions

Here, suicide attempts are distinguished by thoughtfulness and a certain level of preparedness. At the same time, the choice of method of attempted suicide is influenced, on the one hand, by available personal information about various types of suicidal acts and ideas about their lethality; on the other hand, moral, ethical and aesthetic criteria that are subject to psychological processing by this particular person. Such a choice of method of suicidal action is more often observed in middle-aged and elderly people experiencing a state of psychological crisis or depressive states of both psychogenic and endogenous origin. It should be emphasized that in this group there are also so-called “suggestive” suicides, in which the choice of method of auto-aggressive actions is “suggested” by cases of suicide in the family or other microsocial environment. Such suicidal attempts are characteristic mainly of young people who are characterized by psychological immaturity and suggestibility.

4.3 Suicide attempts

Suicidal attempts, the choice of method of which is determined by purely painful, often productive symptoms and is practically unrelated to the age and psychological characteristics of the patients. These suicide attempts are “pathological” in nature and are characterized by greater cruelty and the use of violent methods of auto-aggressive actions.

Thus, the peculiarities of the choice of methods of suicide attempts and their clinical, psychological and somatic consequences must be taken into account both when assessing the formation of auto-aggressive plans in the pre-suicidal period, and when determining the individual suicidological prognosis in the immediate post-suicide, taking into account which a therapeutic and readaptation program is built.

5. SUICIDE IN DEPRESSION

Depression is quite rightly considered a suicidal condition. However, in recent studies, the idea of a direct connection between suicidal behavior and depressive disorders has undergone significant revision. It should be recognized as substantiated the data indicating the complex mediation of suicidal manifestations by a complex of personal and situational factors, united by the concept of socio-psychological disadaptation (A.G. Ambrumova).

5.1 Manic-depressive psychosis

Suicidal experiences differ in varying degrees of formalization and affective intensity at certain stages of the clinical dynamics of the depressive phase in the vast majority of patients. At the same time, one cannot fail to note the complex ideological, socio-psychological context of these experiences, which makes it difficult to qualify them psychologically in traditional categories, in particular within the framework of obsessions, overvalued or delusional ideas. First of all, this applies to the most common experiences with depression, such as a pessimistic reassessment of one’s life, doubts about the significance of one’s own existence, thoughts about the desirability of death and ideas about unexpected death from an accident - as a morally acceptable deliverance from a painful state of mind.

As a rule, such thoughts are not accompanied by specific suicidal intentions and actions. In some cases, we can talk about contrasting obsessions in the form of fears of committing suicide due to “loss of control over oneself” in situations that facilitate suicide.

Thus, with circular depression, suicidal ideas relatively rarely meet the criteria for depressive delusions with a pathological justification for suicide. Suicidal experiences are invariably accompanied by a struggle of motives, indicating the generally positive role of the individual as a factor preventing suicidal intentions.

A kind of anti-suicidal barrier is primarily ethical motives: a sense of duty to loved ones, reluctance to cause them grief, or to cast a shadow on their reputation. Cultural, religious, aesthetic, and generally ideological alternatives to suicide as an act negatively assessed by society are also important. This allows us to believe that the realization of suicidal tendencies is opposed not so much by the instinct of self-preservation, but by the personality in its integrity, the stability of relationships and value orientations, the breadth and flexibility of adaptive capabilities. It is appropriate to mention here that patients with manic-depressive psychosis are usually characterized by a high level of social adaptation (E.P. Panicheva). The role of situational and environmental factors seems ambiguous. V.N. Sinitsky, Yu.L. Nuller, I.N. Mikhailenko believe that with unfavorable situational influences, the risk of suicide increases.

At the same time, the significance of situational factors largely depends on the stage of clinical dynamics of the depressive phase. The initial stages of the development of depression are characterized by nonspecific astheno-hyperesthetic symptoms with a general increase in individual reactivity and sensitization to various external influences. Noteworthy is the severity of emotional reactions (with violent vegetative accompaniment and physical discomfort) even under relatively ordinary unfavorable circumstances. It is in the structure of situational reactions, even before the development of the main manifestations of the depressive syndrome, that one or another suicidal manifestations are often discovered, in some cases bordering on suicidal actions. The latter applies to a greater extent to patients of involutionary and late age. At the same time, the content of suicidal experiences goes beyond a specific situational occasion and extends to a wide range of family, everyday and professional problems. Apparently, unfavorable situational and environmental factors have a more pronounced frustrating significance in the indicated age periods and reveal the general difficulties of an elderly person’s adaptation to changing life circumstances. The subsequent formation of a characteristic clinical picture of depression is accompanied by a general decrease in sensitivity to various external influences. The content of suicidal feelings also changes. They begin to appear in connection with the ideas of low value, self-blame, and the phenomena of painful mental anesthesia and, to a lesser extent, reflect the current situation. At the same time, as the clinical picture of depression forms with a “closed” (according to T.Ya. Khvilivitsky), relatively independent of external factors, structure of the depressive syndrome, suicidal experiences to a certain extent lose their effective intensity. However, they often reappeared during fluctuations in the severity of depression, phenomena of therapeutic resistance, or when the next therapeutic course was ineffective.

The next peak of suicidal manifestations occurs at the stage of reverse development of depression, which is characterized by the appearance of emotional instability of transient situational hypothymic reactions against the background of a reduction in the main effective, motivational-volitional and vegetative-somatic components of the depressive syndrome. In particular, at the end of the phase, despite the obvious improvement in condition, some patients exhibit certain suicidal manifestations, sometimes expressed in a demonstrative form. It is important to note that this kind of observation applies mainly to patients of involutionary and late age. At the same time, suicidal manifestations appear in the context of experiences of “failure”, difficulties in the family and everyday life, and their connection is established with the re-actualization of past or ongoing unfavorable life circumstances.

Thus, the improvement in the clinical dynamics of circular depression indicates the ambiguity of the connections between suicidal manifestations and the severity of the main components of the depressive syndrome. The socio-psychological mediation of suicidal experiences and their dependence on situational factors is revealed. The latter acquire special significance in involutionary and late age.

PREDICTION OF SUICIDE Read more: Variants of suicidal psychogenic depression

Information about the work “Attempted suicide and issues of their prevention among patients of psychiatric institutions”

Section: Medicine, health Number of characters with spaces: 109397 Number of tables: 0 Number of images: 0

Similar works

Forensic psychiatry

486339

... and diseases). Other psychiatrists tried to bring psychopathy closer to psychosis or established their dependence on constitutional characteristics and body type (Kretschmer E., 1956). Taking into account the needs of forensic psychiatry, the following forms of psychopathy are distinguished: excitable, hysterical, paranoid, asthenic, unstable, inhibitory, schizoid, etc. 20.2 Excitable psychopathy Excitable ...

Early prevention of juvenile delinquency

412143

... act more actively in a teenager as he grows up, which increases many times over with the negative influence of the micro- and macroenvironment. II.4. The principle of continuity in the early prevention of juvenile delinquency. Additionally formulating the content of the principle of the priority of spirituality in the RPPN is the provision on the need to take into account when developing provisions for early prevention...

Russian criminal law

609967

...crimes. Thus, in France, continuing crimes are defined as “extended over time and committed through the constant repetition of the original intentional act by the offender.” According to Russian criminal law, isolated crimes also include continued ones, i.e. those that consist of a number of identical or identical criminal acts, have a common goal, are covered ...

Suicide as a social problem of society

62641

...moreover, statistics indicate that this hidden epidemic is global. Thus, the problem of suicide is serious and relevant in our time. Durkheim also noted that the suicide rate is a consequence of factors acting on society. 1.2 Factors influencing suicide Experts count a large number of factors related to ...

Relationships with parents and friends

According to research conducted by Ruth X. Liu from the University of California at San Diego, there is a strong positive connection between a person's relationship with their parents during childhood and adolescence and the likelihood that that person will experience suicidal ideation. The study looked at emotional connections between mothers and daughters, fathers and sons, mothers and sons, and fathers and daughters. They found that the better the relationship between father and son during adolescence, the less likely the son was to have suicidal thoughts later on. Closeness to one's father in late adolescence shows a "strong association with the occurrence of suicidal ideation." Liu also explains the relationship she discovered between the occurrence of suicidal thoughts and relationships with a parent of the opposite sex. Her research found that boys were less likely to experience suicidal thoughts if they were close to their mother during adolescence; at the same time, for girls, the likelihood of such thoughts in the future is reduced due to emotional closeness with their father in adolescence.

In their paper published in 2010, Zappula and Pace show that they found a link between increased suicidal ideation in teenage boys and their isolation from their parents when the child was already depressed in childhood. The lifetime prevalence of suicidal thoughts for untreated adolescents ranges from 60%, and in many cases the intensity of these suicidal thoughts increases the risk of suicide.

Is this depression?.. How to distinguish clinical depression from sadness

Suicidal thoughts and depression are a dangerous combination. If a cry for help is not heard, the risk of suicide is very high. How to distinguish depression from sadness and bad mood? How to understand that you need help and not a comedy movie?..

Thoughts about suicide: degree of danger

Thoughts of suicide can occur to any mentally healthy person who has experienced mental trauma or is under severe stress. However, in this case, self-preservation instincts take over, and the risk of suicide is low. It is important that loved ones are nearby at this moment and help you survive the tragedy.

Questions from readers on

Midko Andrey Anatolievich

psychotherapy

Consultation

10 Nov 2018

Hello, in March I was in a psychiatric hospital, of my own free will. They didn’t tell me my diagnosis, they said it was just depression and told me to take the drugs Ketilept and Rispolept for 3 years. I read in the instructions that these drugs are not prescribed for depression. I need go for a consultation with another psychiatrist?

View answer ?Ask a question

It happens that obsessive thoughts about suicide are a manifestation of obsessive-compulsive neurosis. They arise against a person’s will and torment him; he fights them. Such obsessive thoughts are never realized, and to get rid of them, treatment with psychotherapeutic methods and medications is required.

It's a completely different matter if suicidal thoughts are a manifestation of depression or other mental disorders. In this case, the risk of committing suicide is very high, and urgent psychiatric help cannot be avoided.

Dangerous symptoms and signs

Depressive disorder is always accompanied by deep despair, a feeling of hopelessness of one’s existence and guilt towards loved ones. In this state, a person may come to the conclusion that suicide is the only way out of the current situation, a way to stop mental and physical pain.

Suicidal thoughts are the most dangerous sign of depression. 90% of people who committed suicide were severely depressed or had another mental illness. On the other hand, 15% of patients suffering from depression commit suicide. This usually happens 4-5 years after a person develops the disease.

Thoughts of suicide may occur in a person who suffers from minor depression, as well as in patients who are undergoing treatment for this disease. When they receive drugs that enhance their activity, the risk of attempting to commit suicide is quite high. The danger is that it seems to others that the patient’s condition has improved.

What words or behavior does a person really indicate that he is capable of taking his own life of his own free will due to depression?

The following behavioral features should alert you:

Talking about suicide or self-harm;
A person’s persistent conviction that his life is meaningless and hopeless, he is driven into a dead end with no way out;
An unnatural interest in issues of death: in the very topic of mortality, in stories about suicide, in ways to commit suicide.
Unjustifiably risky behavior when a person seems to be “playing with death.” For example, deliberately crosses the street at a red light;
Repeated phrases like “everyone would be better off without me”, “I would be better off without everyone”;
Sudden mood swings;
A person purposefully visits his relatives and friends (or calls up after a long break) and says goodbye to them; gives away things that are valuable to him; completes things; gives orders in case something happens to him.

The risk of committing suicide is especially high in people who have already made such attempts in the past, have a genetic predisposition to mental illness, alcoholism, drug addiction, or have been influenced by other people who are prone to committing suicide. If a person has experienced physical or sexual violence in the past, or if there have been cases of suicide in his family, he is also more likely to commit suicide.

Questions from readers on

Letyuchiy Gennady Ivanovich

psychiatry

Hello! I have an anxiety-phobic disorder

18 Oct 2013

Hello! I have an anxiety-phobic disorder. In the last month and a half, anafranil and gidazepam have helped quite well. But I want to get away from them for a while. Will there be withdrawal symptoms and how to deal with it?

View answer ?Ask a question

How to react

Statements about death and suicidal actions of a depressed person cannot be ignored.

Close people and friends need to ask about his plans for the future. If you feel that he is ready to commit suicide, you cannot argue with him, talk him out of these thoughts and convince him that he has something to live for. You need to let him know that you care about him, you care about him and are ready to listen and support him.

A person in such a state cannot be left alone. Hide any item that could potentially be used to commit suicide.

You need to seek help from a psychotherapist as soon as possible. It is advisable for the person to be accompanied by a relative or friend during this visit.

Symptoms and signs of a potential suicide are not a disaster, but only a cry for help. If these warning signals are heard in time, a person will not only get rid of obsessive thoughts about death, but will also return to normal life, reviving the ability to rejoice and experience pleasure from it.

Prevention

Early detection and treatment are the best ways to prevent the development of suicidal thoughts and suicide attempts. If signs, symptoms or risk factors are identified early enough, the person's chances of seeking help and treatment are increased. A study of suicide victims found that 91% suffered from one or more mental illnesses. However, only 35% of these people had received treatment in the past or immediately before their suicide. This relationship highlights the importance of early detection of mental illness; If a mental illness is identified, it can be treated and managed, which will help prevent a suicide attempt. Another study looks at intense suicidal ideation in teenagers. This study found that depressive symptoms preceded suicidal ideation in adolescents. Most people who have been contemplating suicide for a long time do not seek professional help.

The above-mentioned studies show how difficult it is for psychologists and other professionals to motivate people to ask for help and continue treatment. The following ways to solve this problem are possible:

— increase the availability of professional psychological assistance at the early stage of the disease;

— increase public awareness of issues of psychological assistance.

Those who face difficult life circumstances also show a significant tendency to develop suicidal thoughts, no less than those suffering from mental illness.

An Australian study designed to identify methods for early detection of suicidal ideation in adolescents shows that “the risks associated with suicidality require a focus on reducing self-harm to ensure safety— What needs to be done first, and only secondly, is to find out the etiology of the existing behavior.” The Psychological Distress Scale, also known as the K10, was distributed monthly to a random sample of people. According to the results obtained, 9.9% of the entire sample reported experiencing psychological stress (regardless of the reasons that caused it), while 5.1% of the same sample reported having suicidal thoughts. Those surveyed who described their stress levels as “very high” were 77 times more likely to experience suicidal thoughts than those who described their stress levels as “low.”

A year-long study conducted in Finland showed that only 41% of people who committed suicide had previously sought professional psychological help, most of them from a psychiatrist. Of these presenters, only 22% discussed their suicidal thoughts during their last visit to a psychiatrist or psychologist. In most cases, this last visit took place a week or less before the suicide, and most suicide victims suffered from depression.

There are many organizations that help people cope with suicidal thoughts. Hemelrijk and others' 2012 work shows that helping those suffering from suicidal ideation via the Internet is more effective than more direct forms of communication, such as telephone conversations.

Prevention[ | ]

— increase the availability of professional psychological assistance at the early stage of the disease;

— increase public awareness of issues of psychological assistance.

Those who face difficult life circumstances also show a significant tendency to develop suicidal thoughts, no less than those suffering from mental illness.

Hospitalization

Hospitalization allows the patient to be safe and under the supervision of specialists, which prevents suicidal thoughts from developing into a suicide attempt. In most cases, the person is given the opportunity to choose the form of treatment that best suits his or her needs. However, in some cases a person may be hospitalized involuntarily. Among such cases are:

Situations where a person’s behavior poses a threat to him/her and/or others. Hospitalization may also be the best option when a person is unable to care for themselves.
Situations where a person has access to something that they can use to cause death to themselves (for example, firearms or poison/medicines).
Situations when there is no one to support a person outside the hospital, when there is no one to monitor this person.
Situations when a person has a developed suicide plan.

The presence of concomitant mental disorders, such as psychosis, any kind of mania, etc.

Ambulatory treatment

Outpatient treatment allows a person to continue to live in their own home while receiving treatment when they need it, on a schedule. Living at home improves a person's quality of life, as he/she still has access to books, a computer, and freedom of movement. Before allowing a patient the freedom implied by outpatient treatment, the physician must first evaluate a number of factors. Among these factors we can highlight: the level of support from others that this person has at home; the degree of his/her impulsivity; a person's ability to evaluate his actions. When moving to outpatient treatment, a person usually must agree to a “no harm agreement.” This agreement is concluded between the doctor and the patient's family on the one hand and the patient himself on the other. The patient must agree not to harm himself, to continue to see the psychologist, and to always contact the psychologist if psychological problems arise. There is some controversy over whether such non-harm agreements are effective. Outpatients undergo regular psychological assessments to ensure that the patient is not self-harming and that he/she is avoiding dangerous behaviors such as drinking alcohol, driving without a seat belt, etc.

Use of medications

Using medications to combat suicidal thoughts can be challenging. One reason for these difficulties is that medications increase a person's energy level before improving his/her emotional state. This increases the risk that suicidal thoughts, before they have time to disappear, may turn into a suicide attempt. In addition, if a person simultaneously suffers from any mental disorder, it can be difficult to find a medicine that would help both suicidal thoughts and their accompanying illness.

Antidepressants may be effective in treating suicidal thoughts. Selective serotonin reuptake inhibitors (SSRIs) are often used instead of tricyclic antidepressants (TCAs) because the latter tend to cause more harm in overdose.

Antidepressants have been shown to be highly effective in treating suicidal ideation. One study compared rates of successful suicide among SSRI users in different countries. In countries where the use of SSRIs was higher, mortality rates due to suicide were significantly lower. In addition, a pilot study was conducted on patients with depression for a year. During the first six months of the study, patients were screened for suicidal behavior, including suicidal ideation. During the second half of the year, patients were prescribed antidepressants. During this six-month period of treatment, the experimenters found that the incidence of suicidal ideation decreased from 47% to 14%. Thus, it can now be argued that antidepressants may be useful in the treatment of suicidal ideation.

Although most studies indicate the usefulness of antidepressants in the treatment of suicidal thoughts, in some cases antidepressants are not a cure for suicidal thoughts, but a cause of their occurrence. A number of doctors indicate that when starting to use antidepressants, suicidal thoughts can sometimes suddenly appear. That is why the US Food and Drug Administration points out this fact in one of its documents. Medical research has also shown that antidepressants are especially effective against suicidal thoughts when used in combination with psychotherapy. Lithium medications reduce the risk of suicide in people with mood disorders. Preliminary evidence shows that in people with schizophrenia, the risk of suicide is reduced when using clozapine.

Bookitut.ru

5.5. Suicidal behavior in affective mood disorders.

About 70% of depressed patients have suicidal thoughts and tendencies, and in 10–15% of cases completed suicide occurs.
Suicidal risk can be caused by both situational and personal factors, and psychotic experiences. 5.5.1.Bipolar affective disorders.

Suicidal risk in bipolar affective disorders (according to the ICD-10 classification, manic-depressive syndrome is included in this category) is due to psychopathological phenomena and situational factors. In this regard, psychotic and situational variants of suicidal behavior are distinguished (A.M. Ponizovsky, 1980). At the stage of relapse of bipolar affective disorder, the suicidal behavior of patients is due to psychotic manifestations, at the initial stage and at the stage of recovery - situational.

1. In the psychotic variant, the basis of suicidal behavior is psychopathological experiences.

The most suicidal syndromes and conditions are the following : delusions of self-blame and self-abasement, delusions of guilt, inferiority, impoverishment, hypochondriacal delusions, mental anesthesia. Suicidal attempts of an impulsive nature are especially dangerous with melancholic ranthus.

2. In the situational variant, suicidal behavior is based on psychologically understandable psychogenic factors: interpersonal and social conflicts, professional and everyday difficulties, loss of significant loved ones, an attempt to draw attention to one’s condition and situation.

There are two types of situational suicidal behavior:

• arising as a result of conflict in the sphere of interpersonal relationships. This type of behavior is characterized by a variety of motives and methods of committing suicide, as well as instability of suicidal intentions.

• arising as a reaction to a disease and its medical and socio-psychological consequences. This option is formed, as a rule, when a depressive episode lasts more than 4 months, short intermissions and frequent relapses, with sharp fluctuations in the affective background during the period of recovery from depression. Characteristic is the prevalence of suicidal tendencies over attempts (N.E. Bacherikov, P.T. Zgonnikov, 1981).

The risk of suicide is also increased during the recovery period, when the patient’s criticism and energy potential are restored. During this period, paradoxical suicide is possible, that is, the suicidal intention of the period of illness is fulfilled. In this regard, at the outpatient stage of treatment, a doctor’s suicidal alertness to these patients and a strictly dosed, minimally sufficient amount of prescribed antidepressants (especially tricyclics) are necessary, since the most common method of suicide in these patients is poisoning with antidepressants.

5.5.2. Depressive episode.

Suicidal risk during depressive episodes (according to ICD-10, this category includes reactive depression, major depression without psychotic symptoms, single episodes of depressive reaction) is caused in most cases by situational factors similar to those in bipolar affective disorder. These patients are characterized by a predominance of suicidal tendencies over attempts (ratio 5:1).

Suicidal attempts can be both true and demonstrative-blackmail.

1. True suicide attempts are made, as a rule, at the asthenoneurotic stage of the development of depression. The period of formation of suicidal thoughts lasts from several days to several weeks. At the stage of preparation for suicide, “suicidal gestures” are possible - statements and actions that indirectly indicate suicidal intentions. Suicidologists note that in 8 out of 10 cases, suicidal people directly or indirectly spoke about their intentions.

2. Demonstrative-blackmail suicide attempts occur, as a rule, after mental trauma and are committed as a protest, revenge or appeal. Depressive symptoms develop or worsen after the attempt. It usually reaches a neurotic level and, in rare cases, a psychotic level. The likelihood of suicide is greatest in the initial stages of the disease.

An example of a true suicide attempt is the attempted suicide committed by M. Gorky at the age of 19. In the journal “Clinical Archive of Genius and Giftedness” (1925–1928) I.B. Galant carried out an analysis of M. Gorky’s mental state, the result of which was the conclusion that the cause of the writer’s suicide attempt was cyclothymia with severe depression. In his works, M. Gorky repeatedly described the psychopathological states he suffered. He writes about the fact of the attempt on his life in “My Universities” and “An Incident from the Life of Makar”: after numerous disappointments and sleepless nights, “a desire appeared to strengthen his sick soul, as he became disgusted with himself, condemned himself, the anxiety that appeared weakened the soul and It was getting heavier." During this period, he fell in love with two girls at once, but was rejected by them, which aggravated his condition; thoughts appeared about his own uselessness and worthlessness. “... remembering the hot speeches with which he had recently stunned people like himself, inspiring them with cheerfulness and awakening hopes for better days, remembering the good attitude towards him, ... he felt deceived and immediately decided to shoot himself.” “Having bought a drummer’s revolver loaded with four cartridges at the market, I shot myself in the chest, hoping to hit my heart, but only pierced my lung...”

Subsequently, in his works, Maxim Gorky repeatedly addressed the topic of suicide, which gave rise to talk about “Gorky’s literary suicide mania.” Let us give the names of just a few of his works, where the suicides of the heroes are psychologically and psychopathologically described: in addition to those mentioned above, these are “For the sake of Boredom”, “Three”, “Konovalov”, “Khan and His Son”, “The Story of Philip Vasilyevich”, “The Life of Matvey Kozhemyakin” , “Confession”, “The Life of an Useless Person” (A.M. Shereshevsky, 1991).

Table of contents

Incitement and incitement to suicide

In the criminal codes of many countries, including Russia (Article 110 of the Criminal Code of the Russian Federation), incitement and incitement to suicide is a criminal offense and is most often punished by imprisonment. Incitement to suicide can be both unintentional and deliberate, and in both single and multiple episodes. In 2020, in Russia, and subsequently in a number of other countries, the activities of the so-called “games” intensified, which for various purposes drove young people (mostly underage girls, less often boys) to suicide, since young men were much more resistant to threats from the curators of these games . After the suicide scandal and the introduction of the “Yarovaya package” on the VKontakte website and other social networks, the mass liquidation of such groups began. Groups and forums dedicated to methods of suicide were also eliminated.

Literature

Beck, AT; Steer, R. A.; Kovacs, M; Garrison, B (1985). "Hopelessness and eventual suicide: a 10-year prospective study of patients hospitalized with suicidal ideation." Am J Psychiatry. 142 (5): 559–563. PMID 3985195.
Uncapher, H (2000-2001). "Cognitive biases and suicidal ideation in elderly psychiatric inpatients." Omega. 42 (1): 21-36. doi:10.2190/6uu8-hk8e-hl0v-q4cu.
Uncapher, H; Gallagher-Thompson, D; Osgood, N. J. (1998). "Hopelessness and suicidal ideation in older adults." The Gerontologist. 38 (1): 62-70. doi:10.1093/geront/38.1.62. PMID 9499654