Episode 7: Mental Health Diagnosis and the Impact on Suicide

People who are diagnosed with major depression, personality disorders and/or who are abusing substances are at a greater risk of suicide attempts or completion. Canadian studies indicate that more than 90% of suicide victims have a diagnosable psychiatric disorder (CMHA Fact Sheet). Although depression is more recognized as being a risk factor, individuals diagnosed with Borderline Personality Disorder have been noted to complete suicide at a rate of 10%. These mental health diagnoses, in combination with substance abuse increase the risk of death by suicide. In this learning module, you will have the opportunity to receive information from Yvonne Bergmans, a suicide intervention consultant who has considerable experience in the field of suicide research, teaching, crisis work, group intervention, and counselling. She describes the impact of a mental health diagnosis on suicide and provides distress line workers with effective strategies to support these callers. Questions for Further Consideration: What are the red flags that an individual may be misusing or abusing prescribed or over- the- counter medication? They have reported that they are on medication for depression but they don’t work, even when they take an extra dose They take medications like Gravol or Tylenol with Codeine because these meds help to calm them, or that they “just need to sleep” They report they got some medication from a friend that helps them better than the meds their doctor prescribed Callers report they are mixing their medication with alcohol When a caller reports symptoms of acute depression, how can active listening actually help them? It allows the caller to feel you are listening by validating their painful experience It helps the caller to put his/her feelings into perspective Assists the caller to label his/her feelings Why is it not necessary that the distressed caller provide you with a diagnosis? Each diagnosis will have its own manifestation, no two people are alike Need to work with what you are being presented; you need to focus on the person not the diagnosis Glossary Depression: Depression can present itself as an acute episode which is also known as a major depressive episode (MED). It can also present itself as chronic such as in the diagnosis of a major depressive disorder (MDD). You may hear callers identify it as clinical depression. The common symptoms of depression include: Considerable loss of interest in enjoyable activities. Constant sadness, anxiety or blues all the time. Sleeping problems, sufferer usually exhibits Insomnia Disorder. Insomnia causes difficulty to get off to sleep, early morning wake ups, less sleep than normal, disrupted sleep. Sufferer might exhibit considerable amount of weight gain or weight loss due to poor appetite. Loss of energy or fatigue is quite common symptom in major depression. Persistent feelings of worthlessness, hopelessness and guilt disturb the sufferer all the time. Restlessness or tiredness without any reason. Sufferers find it difficult to concentrate, as a result of which they find it extremely difficult to make decisions. Socially inactive behaviour. Suicidal thoughts or suicidal attempts are quite common in major depression. Physical symptoms such as headache and pain in the stomach areas are also quite common. Dysthymia: is characterized by depressive symptoms present most of the day for two years or more in adults and for one year or more in children and adolescents. Dysthymia is different from major depressive disorder because of the chronic, long term nature of the illness and because there are fewer depressive symptoms (two or three) than in major depressive disorder (four or more symptoms). Often people suffering from dysthymia have experienced depressive symptoms like hopelessness, poor concentration, sleep disturbances and low motivation for years. Some will never have been diagnosed with depression; and others may have the diagnosis alongside diagnoses of MDD or MDE, for some the symptoms begin to feel like a chronic state of being. People with dysthymia may outwardly appear to be coping well enough, and still seem very unhappy most, if not all, of the time. Borderline Personality Disorder: is a mental illness characterized by pervasive instability in moods, interpersonal relationships, self-image, and behaviour. This instability often disrupts family and work life, long-term planning, and the individual's sense of self-identity. Modulating Emotions: the ability to adjust, adapt, or regulate one’s emotions. Emotional Dysregulation: is an emotional response that is poorly modulated. Emotional reactions will frequently be considered to fall outside the bounds of “appropriate” emotional responses whether in a positive or negative way. Alexithymia: the inability to describe or process emotions literally meaning “without words for emotions”.