Saving someone’s life involves seeing the signs and triggers according to MakatiMed

The challenge for anyone who knows of a friend or loved one thinking of taking their life is to be aware of their triggers and stressors, and observant of out-of-the-ordinary behavior.

 

The loss of the will to live, withdrawing from family and friends, a lack of interest even in activities and things that once sparked joy, and sleeping too much or too little are the classic symptoms of a person who may be courting suicidal thoughts. And yet, as beloved celebrities like chef Anthony Bourdain, comedian Robin Williams, and others who have taken their own lives have shown us, a happy and successful exterior can mask struggles with hopelessness and despair.

While suicide rates in the Philippines are lower than global statistics (an estimate 3.2 to 3.5 deaths per 100,000 Filipinos are by suicide, according to the Department of Health), they remain a serious cause for concern. Thirty percent of suicide cases are by individuals between the ages of 15 and 24, men are four times more likely to commit suicide than women, and whether they push through with it or not, 1 in 5 youths have seriously thought of ending their lives.

What would drive someone to resort to such an irreversible and permanent act? “Mental illness or personality disorder affect a person’s ability to make sound judgement,” says Carmina Charmaine G. Bernardo, MD, FPPA, FPCPsych, a psychiatrist and Head of the Mood and Anxiety Resource and Referral Center (MARRC), Institute of Neuroscience, from top hospital in the Philippines, Makati Medical Center (MakatiMed).

“But so can a traumatic life event like a bad breakup, death in the family, physical or emotional abuse, financial loss, or a ruined career. A person dealing with a painful illness or terminal disease may decide to end their suffering prematurely. Intense feelings of worthlessness, loneliness, and being a burden to others have also pushed people to take their own lives.”

“In other words, certain triggers or stressors compel people to take action and free themselves from what they perceive to be unbearable and unending physical or emotional pain.”

The challenge for anyone who knows of a friend or loved one thinking of taking their life is to be aware of their triggers and stressors, and observant of out-of-the-ordinary behavior.

“Of course, this is not always easy, as a person thinking of committing suicide can pretend that all is well so as not to arouse suspicion,” explains Dr. Bernardo. “Some even appear suddenly calm and happy after experiencing severe depression. This could mean that they are resolved with their decision to end their life.”

Looking out for a friend or family member with suicidal thoughts is a huge responsibility. Still, if you can prevent them from pushing through with it, you could actually save a life—and that is no mean feat.

Dr. Bernardo cites common triggers and warning signs:

Specific dates and occasions.

Everybody gets a case of the birthday blues: Maybe the special day reminds us that we are getting older or have no one significant to celebrate it with. “Birthdays, anniversaries, and special holidays can be sensitive times for suicidals,” reveals Dr. Bernardo. “In fact, an international team of researchers discovered that Monday has the highest risk of suicide mortality, as does New Year’s Day. Call a friend or loved one to check on how they’re doing or make

Reckless behavior.

Does your friend or family member drink too much, drive too fast, not watch where they are going, miss doctor appointments, or skip prescription medication? “A lack of regard for their safety, health, and well-being can mean they no longer value their life,” shares Dr. Bernardo. “Offer to accompany them to their appointments or drive them home when they are under the influence.”

Seeing people.

While suicidals tend to withdraw from the world, others will go out of their way to seek out certain friends or relatives. Perhaps they will forgive someone—or ask someone for their forgiveness. “It is likely a form of closure before they end things,” says Dr. Bernardo. Giving away prized possessions is another sign of “saying goodbye” by offering something to remember them by. “Simply accept the token and assure the person that it will be in your safekeeping for now. It’s a subtle way of saying you will give it back when things get better.”

Talking about suicide is never easy, both for the person contemplating it and the one who speculates a loved one is strongly considering taking their life.

“But it has to be done,” says Dr. Bernardo. “Ask them pointblank gently and coming from a place of concern and sincerity. And be prepared to listen—not judge, scold, or dismiss their feelings. Let them talk and express themselves as much as they want. Sometimes, venting provides them with much-needed relief from negative thoughts.”

For the emotionally vulnerable, knowing that someone genuinely cares for them and wants to help them get out of their black hole can be enough reason to live. “Offer hope and the prospect of better things ahead if they just give themselves and others a chance,” says Dr. Bernardo.

Most importantly, evaluate if a suicidal friend or family member is in immediate danger. Those at the highest risk already have a specific suicide plan, the means to carry out the plan, the time set, and an intention.

“If an attempt is imminent, make sure they don’t have access to lethal objects that they can use to harm themselves like drugs, guns, or knives. And never ever leave a suicidal person alone,” stresses Dr. Bernardo. “The best that you can do is to call emergency services or bring the person to the nearest hospital where they can get the necessary professional help.

For more information, please contact MakatiMed On-Call at +632.88888 999, email mmc@makatimed.net.ph, or visit www.makatimed.net.ph. Follow @IamMakatiMed on Facebook and Twitter.

The Scoop On Suicide: Deconstructing Depression

There was once a young model whom I've worked with a long time ago while I was still working as an intern in a popular magazine. I used to think she had everything a girl could wish for: a very pretty face, svelte figure, intelligence, wealth, gorgeous boyfriend, wonderful company of friends and a flourishing career. She was considered an "It-Girl", the kind of girl you'd love to hang out and be seen with because she's really fun to be with and very popular. You could see her face practically everywhere: in glossy magazine spreads, on TV, on the billboards--in fact, she's a celebrity on her own right. I'd love to be in her shoes because she really seemed to have been blessed in almost all aspects of life. But alas, one day she had shocked everyone when it was reported that she had jumped to her death from her condominium unit because of depression. She was supposed to have a bright future ahead of her--but she was gone too soon. And recently, Hollywood actor/comedian Robin Williams had also shocked everyone when he was found dead on his home who apparently committed suicide due to substance use disorder (addiction) and depression. In the local showbiz, even megastar Sharon Cuneta has publicly admitted that she's indeed going through "one of the lowest points of her life and career"--which quoting her own words, "a state of depression and loneliness". Now, come to think of it, isn't alarming that even Filipinos whom other Western countries considered as "one of the happiest people/race on  this planet" are also affected by depression? It only goes to show one thing, folks: NO ONE IS SPARED FROM DEPRESSION. 

What is depression? "Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depression, major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and depression may make you feel as if life isn't worth living," said Dr. Dinah Nadera, Psychiatrist, Consultant for Mental Health and Psychosocial Support, Office of the World Health Organization Rep for the Philippines during the recent Scoop On Suicide conference held at Serye Cafe Filipino, Quezon City Circle.  

More than just a bout of the blues, depression isn't just a weakness, nor is it something that you can simply "snap out" of. Depression may require long-term treatment. But don't get discouraged. Most people with depression feel better with medication, psychological counseling or both. Other treatments also may help such as pep talk therapy, art based intervention therapy among many others. 

Although depression may occur only one time during your life, usually people have multiple episodes of depression. During these episodes, symptoms occur most of the day, nearly every day and may include:

*Feelings of sadness, emptiness or unhappiness

*Angry outbursts, irritability or frustration, even over small matters

* Loss of interest or pleasure in normal activities, such as sex

*Sleep disturbances, including insomnia or sleeping too much

*Tiredness and lack of energy, so that even small tasks take extra effort

*Changes in appetite — often reduced appetite and weight loss, but increased cravings for food and weight gain in some people

*Anxiety, agitation or restlessness — for example, excessive worrying, pacing, hand-wringing or an inability to sit still

*Slowed thinking, speaking or body movements

*Feelings of worthlessness or guilt, fixating on past failures or blaming yourself for things that are not your responsibility

*Trouble thinking, concentrating, making decisions and remembering things

*Frequent thoughts of death, suicidal thoughts, suicide attempts or suicide

*Unexplained physical problems, such as back pain or headaches

*For some people, depression symptoms are so severe that it's obvious something isn't right. Other people feel generally miserable or unhappy without really knowing why.

In younger children, symptoms of depression may include sadness, irritability, clinginess, worry, aches and pains, refusing to go to school, or being underweight.

In teens, symptoms may include sadness, irritability, feeling negative and worthless, anger, poor performance or poor attendance at school, feeling misunderstood and extremely sensitive, using drugs or alcohol, eating or sleeping too much, self-harm, loss of interest in normal activities, and avoidance of social interaction.

Depression may occur with other mental health conditions, such as anxiety, eating disorders, substance abuse or attention-deficit/hyperactivity disorder (ADHD).

Long lasting or recurrent, severe, depression can lead to suicide. People with mild depression can still be treated without medicines. When depression is moderate or severe that's the only time that they may need medication & non-pharmacological treatments. 

Depression is not a normal part of growing older and it should never be taken lightly. Unfortunately, depression often goes undiagnosed and untreated in older adults, and they may feel reluctant to seek help. Symptoms of depression may be different or less obvious in older adults, including:

Memory difficulties or personality changes

Fatigue, loss of appetite, sleep problems, aches or loss of interest in sex, which are not caused by a medical condition or medication

Often wanting to stay at home, rather than going out to socialize or doing new things

Suicidal thinking or feelings, especially in older men

If you feel depressed, make an appointment to see your doctor as soon as you can. Depression often gets worse if it isn't treated. Untreated depression can lead to other mental and physical health problems or troubles in other areas of your life. Feelings of depression can also lead to suicide. If you're reluctant to seek treatment, talk to a friend or loved one, a health care professional, a faith leader, or someone else you trust.

You have to ADMIT first to yourself that you need HELP.  Reach out to a close friend or loved one. Contact a minister, a spiritual leader or someone in your faith community.

There are also several organizations which can help you by offering FREE and CONFIDENTIAL 24/7 telephone counseling such as IN TOUCH COMMUNITY SERVICES. There is HOPE at the other end of the line with their Crisis Line hotline. They can help you deal with depression, grief and loss, domestic violence, relationship problems, substance abuse, sexual assault, homosexuality, transitional adjustments, problems with school or career, stress, illness, thoughts of suicide etc. 

If you prefer a personal face to face counseling, In Touch Services also offers them. Psychiatrist, psychologist, social workers and experienced and trained counselors from

In Touch Community Services are waiting for your call at the other end of the line. 

Call CRISIS LINE hotline numbers —893-7603

GLOBE DUO: 0917-8001123/09175067314

SUN: 0922-8938944/0922-3468776

They could also be reached online via email: crisisline@i-manila.com.ph or log on to their site at www.geocities.com/crisislineph

InTouch Community Services is within the premises of Holy Trinity Church but they are non-sectarian. They welcome any religion. They are located at 48 McKinley Rd. Makati. 

Office Hours is from Monday-Friday from 9am-5pm.