Depression and Suicide

What Is Depression?

Everyone feels down at times. The breakup of a relationship or a bad grade can lead to low mood. Sometimes sadness comes on for no apparent reason. Is there any difference between these shifting moods and what is called depression?

Anyone who has experienced an episode of depression would probably answer yes. Depression, versus ordinary unhappiness, is characterized by longer and deeper feelings of despondency and the presence of certain characteristic symptoms. This distinction is important, because in severe cases, depression can be life threatening, with suicide as a possible outcome. Depressed people may also fail to live up to their potential, doing poorly in school and staying on the social margins. Depression is frequently ignored or untreated; the condition often prevents people from taking steps to help themselves. This is unfortunate, as effective help is available.

Signs of Depression

Anyone who feels down most of the day nearly every day for weeks or months may be clinically depressed. Depressed individuals may experience:

• Loss of pleasure in virtually all activities
• Feelings of fatigue or lack of energy
• Frequent tearfulness
• Difficulty with concentration or memory
• A change in sleep pattern, with either too much or too little sleep; the person may wake up in the night or early morning and not feel rested the next day
• An increase or decrease in appetite, with a corresponding change in weight
• Markedly diminished interest in sex
• Feelings of worthlessness and self-blame or exaggerated feelings of guilt
• Unrealistic ideas and worries (e.g., believing no one like them or that they have a terminal illness when there is no supporting proof)
• Hopelessness about the future
• Thoughts of suicide

What Causes Depression?

There is growing evidence that depression is in part an illness with a biological basis. It is more common in individuals with close relatives who have been depressed. Research on the physiology of the nervous system suggests that the level of activity of neurotransmitters, such as norepinephrine and serotonin, changes in longstanding depression: Antidepressant medicines probably work by correcting a "chemical imbalance" of this kind. One type of imbalance is associated with bipolar disorder (previously called manic depression), characterized by dramatic mood swings from depression to irritability or euphoria and other symptoms. A number of physical illnesses can also lead to depression: An examination by a medical clinician may be helpful to rule out medical causes of depressive symptoms.

While depression does appear to have biological components, it is certain that psychological and social factors also play a vital role. The loss of a loved one or a disappointment may trigger a depression; past losses, perhaps not fully acknowledged, often make someone more vulnerable to depression. For complex reasons, some individuals find themselves enmeshed in negative ways of thinking, which can contribute to depression. Other environmental components are a lack of social support and the absence of avenues for fulfillment.

Suicide

Suicide is the second leading cause of death in young people. A major cause of suicide is mental illness, very commonly depression. People feeling suicidal are overwhelmed by painful emotions and see death as the only way out, losing sight of the fact that suicide is a permanent "solution" to a temporary state—most people who try to kill themselves but live later say they are glad they didn't die. Most people who die by suicide could have been helped. An individual considering suicide frequently confides in a friend, who may be able to convince them to seek treatment. When the risk is high, concerned friends and relatives should seek professional guidance.

Suicidal thoughts may be fleeting or more frequent, passive (e.g., "What if I were dead?") or active (e.g., thinking of ways to kill oneself, making a plan). Preparations for death, such as giving away possessions or acquiring a gun, are cause for great concern. A sudden lift in spirits in a depresed person can be a warning sign that they are planning to kill themselves. Any level of suicidal thinking should be taken seriously.

How Can You Tell if Suicide Is a Possibility?

While suicide is often hard to predict, there are some warning signs:

• Being depressed or having other mental disorders
• Talking directly or indirectly about wanting to die or “not be around”
• Increased social isolation
• Significant changes in appearance and hygiene
• Giving away valued possessions; making other preparations for death
• A sudden change in mood

While anyone can become suicidal, there are certain risk factors that make suicide more likely:

• Previous suicide attempt(s)
• Having a family member or friend who recently killed themselves; multiple suicides in the community
• Other recent, significant losses, such as the loss of a relationship or job
• Cultural and religious beliefs supporting suicide (e.g., belief that suicide is a noble resolution of a personal dilemma)
• Alcohol and drug abuse (as this can lower inhibitions and increase impulsiveness)
• Feelings of hopelessness
• Access to means of suicide (e.g., a gun, a quantity of pills)
• Unwillingness to seek help and/or barriers to accessing mental health treatment

Reference: caps.ucsc.edu/resources/depression.html image: workingmother.com