Ask, Tell-Save a Life

Suicide, Ask, tell, Save a Life

This week, the 9-16^th of September 2019 marks Scotland Prevention Awareness Week , with International World Suicide Prevention Day falling on Tuesday the 10^th of September.

Each year, suicide is among the top 20 leading causes of death globally for people of ALL ages. Last year, it was the 15^th leading cause of death, accounting for 1.4% of ALL deaths worldwide.

2 people die each day in Scotland from suicide.

It is responsible for over 800,000 deaths per year which equates to 1 suicide every 40 seconds (Source International Association for Suicide Prevention).

15 out of every 100,000 men and 8 out of every 100,000 women die of suicide each year.

Suicide is the leading cause of death in15-24 year olds in the much of Europe and the second leading cause of death in the United States.

Suicide is also the LEADING cause of death for women during pregnancy and1 year after birth.

Depression is, by far, the most common psychiatric disorder in those who die by suicide.

Half of those who die by suicide each year in wealthy countries have a diagnosis of major depression at the time of their death.

There is a clear link between deprivation and suicide with numbers being 2.5 time higher in deprived areas.

Those invovled in the criminal justice system, in prison, with substance abuse problems and those from the LBGTQ (Lesbian, bisexual, gay, transgender, questioning)

Each and every on of these lives lost represents someone’s parents, child, friend, partner, neighbour or co-worker and the ripple effect of every life taken reaches far and wide, from close family to whole communities.

We estimate that 135 other people are affected by each suicide death and the risk of suicide among those close to someone who has taken their own life is significantly higher than for that of the general population.

There are many reasons for this including the trauma of having someone so close take their own life and shared familial and environmental risk factors.

But the picture is, sadly even more bleak. Statistics show that for every person who takes their own life, around 25 others make at attempt on their own life and countless more have serious thoughts of suicide (suicidal ideation).

The sense of loss and sadness is palpable at my work when news comes in that one of our patient’s has taken their own life.

Often, we, as a practice have known the person well but in many cases we have either not seen the person in a long time or have seen them but they haven’t disclosed how much they were struggling with their Mental Health.

In fact, 1 in 3 people who complete suicide have not been in contact with mental health services in the previous 12 months (NHS Scotland working together to prevent suicide)

Talk to their families and friends and they too have often had little idea of the mental torment faced by their loved one over the preceding weeks, months or years.

Suicide Myths:

Asking someone if they feel suicidal with increase their risk of killing themselves.

WRONG! Talking about suicide does not increase the risk and in fact it can help reduce the risk by offering them someone to open up to and look to for support. Asking someone about their thoughts on ending their life can be the key to intervening and stopping them from acting on their feelings.

If someone wants to end their life they will and there is nothing you can do to stop them.

WRONG! Most people do not want to die they just want to hurt less. Again offering help and support can help stop people from attempting to end their own life.

If someone has tried to harm themselves before they are unlikely to actually take their own life

WRONG! Those who have harmed themselves in the past have a far higher risk of completing suicide. They need support to try to reduce their thoughts of self harm.

People who talk about suicide never attempt or complete it.

WRONG! In fact many of those who take their own lives have disclosed their thoughts to someone eels in the few weeks leading up to their deaths. A willing ear and the offer of support at the time can help reduce the number of people who go on to complete suicide.

So, what can we do to try help those struggling with their mental health AND what can we do to try to improve our own mental wellbeing?

On a National level we can focus on several key areas including:

• Creating a National Suicide Prevention Programme: Scotland, England, Ireland and the United States have just launched their Second one
• Funding of treatment and support for those with depression and other mental health conditions including medical professionals and support groups
• Provision of other activities which support good mental health including walking groups, gym memberships, yoga, mindfulness and social events.
• \developing innovations in digital technology targeted at improving mental health and reducing suicide risk.
• Restriction of access to lethal means eg chemicals, guns
• School based Universal Prevention
• More accessible child and adolescent mental health support
• Integrated community, inpatient and crisis mental health services
• Encouraging communities to pull together to support those who are isolated or struggling and encourage people to actually ask each other if they are ok.

As a community we can:

• Educate ourselves to identify the signs that someone may be struggling with their mental health: do they appear obviously anxious, depressed or distressed, do they seem to be struggling to cope with everyday tasks, are they moody, distracted or becoming socially isolated, are they not eating, not sleeping well or drinking/smoking more?
• If we spot any of these signs, encourage ourselves to ask ‘Are you ok?’ and set aside a few minutes in a quiet space to REALLY LISTEN to what they have to say.
• Let others in the community know that we care. Get involved in local groups and invite and include those who you feel may need some company or support
• Encourage conversation with children and teenagers in the community to discuss their mental health with as much freedom as they discuss their physical health, what they watched on TV last night or what they have in their bags for lunch.

As an individual you can:

• Try to become more comfortable talking about your own mental health
• Encourage friends and family to talk about how they are feeling
• Lead by example and show your children and grand children that’s talking about mental health is a normal part of conversation and good for our wellbeing.
• Offer an ear to anyone you feel is struggling.
• If you think they might be contemplating ending their life and you feel comfortable ask them if they have ever thought about suicide. You won’t put the idea into their head or increase the risk of them harming themselves by doing so and you might just offer them the opportunity they needed to ask for help.

How can you improve your own mental health?

By making lots of the Small Changes we have talked about in past blogs.

Reduce your stress levels:

Stress is a major risk factor for depression which is the leading underlying cause of suicide.

Stress has been cited in both the UK and the US as ‘THE major health epidemic of the 21^st century’.

There are lots of things you can try to keep you stress levels under control.

Time management techniques such as prioritising your tasks and goals, writing lists, focusing on small goals rather than big ones and ensuring you schedule in regular breaks, including lunch breaks.

Regular exercise has been shown to reduce stress as well as improve your physical health. It’s also a good way of ensuring you have time for yourself throughout the week which can also be invaluable when trying to reduce stress.

Breathing techniques  are really useful if managing feelings of stress, anxiety and depression. There are many examples of simple breathing techniques online or you could consider adding in 10-15 minutes of mindfulness, meditation or yoga  to your daily routine.

Enjoy yourself:

Doing things that you enjoy is not selfish. It’s part of what you need to be doing to stay fit and well. Try to schedule time for things you enjoy like watching sports, seeing friends, going out for dinner r having five minutes alone with a good book or in a hot bath. All these small things can make a big difference to your mental health.

Cooking, dancing, singing, drawing or any creative pursuit can help increase production of the hormone relaxin and reduce cortisol production, thus reducing stress.

Some things that are may seem enjoyable at the time, for example eating a lot of ‘junk food’, binge eating or drinking too much alcohol may make you feel happy at the time but can leave you feeling more down.

Alcohol can also heighten emotions at times and can make you feel more angry, aggressive or tearful and people often experience increased anxiety and low mood in the days following on from a night of heavy drinking.

Similarly, recreational drug use such as legal highs. Cocaine and ecstasy can lead to irrational and risky behaviour when you are under their influence as well as feelings of low mood the following day. I often see people on a Monday morning after experiencing suicidal ideation following a night out involving alcohol or drugs at the weekend.

Work on your self-esteem:

The way we feel about ourselves has a massive impact on how much we value our lives and how well we are able to deal with stress.

Try to give yourself a break and focus on all the positive things you achieve in a day rather than the things that have been a bit more challenging.

Staying physically active can help massively when it comes to improving your self worth and bolstering a health body image.

Speak to your inner self in the same way you would speak to your best friend and try to create this positive atmosphere at home and at work as much as you can.

Move more:

Regular exercise has been shown repeatedly to increase levels of hormones that lift your mood while reducing levels of  the stress hormone cortisol.

Other benefits include improve body image, better sleep and reduced risk of cancer, heart disease, type 2 diabetes and vascular dementia.

Which exercise is best? Whatever you enjoy. As long as you are moving you are improving your wellbeing. The most important thing is to choose something you enjoy as you are far more likely to continue to do it on a regular basis if you are having fun.

Eat well:

What foods are best for you mood? The answer is a balanced mix of all of the main food groups. There is no ‘magic tea’ or ‘mood boosting superfood’ that will miraculously improve your emotional wellbeing.

There are no ‘bad foods’ but there are foods that are richer in vitamins and minerals than others and, as such should feature more often in our diet.

Adopting a diet rich in fruit, veg, nuts, seeds and whole grains with the addition of protein (from animal or non animal sources) alongside occasional crisps, sweets, chocolates, cakes and anything else that takes your fancy can be helpful in improving your overall wellbeing.

Again, alcohol should be drunk in moderation both from a mental and physical health point of view.

There is more information on how alcohol affects our health in a previous blog.

Sleep well:

Getting the recommended 7-8 hours of sleep per night can help maintain good mental health.

Poor sleep can make you less focused, more short tempered and less physically able as well as affecting your weight, appetite, ability to exercise an your libido.

Chronic sleep deprivation, and by that we mean even just under the recommended 7-8 hours per night has been shown to increase the risk of depression and anxiety.

Avoid caffeinated drinks as a means of keeping you more awake or alert during the day if you do not get enough sleep overnight. They can give you a short term boost but caffeine has a half life of 6 hours so much of it will still be in your system when you go to bed that night, leading to  further night of poor sleep. If the above happens on a regular basis you can run into long terms problems with sleep.

Alcohol can also seem like a good idea in terms of helping you nod off to sleep. However, as previously covered in one of our blogs, although you get off to sleep more quickly with alcohol, it affects your ability to get into the deep, restful phases of sleep and is detrimental in the long run.

If stress if a major factor try practising some yoga, mindfulness or meditation before bed.

Some people find relaxation podcasts helpful.

Why not try journaling or list writing to help ‘empty’ your mind before bed.

Similarly, writing a ‘to do’ list for the next day takes away the need to try to remebmber tasks as you are falling sleep.

Avoid the use of ‘blue light’ ie screens, phones and TV’s for at least an hour before bed. Several studies have demonstrated a link between this and poor sleep.

Try to stick to a regular bed time and a regular bedtime routine.

There are lots of other tips on ensuring a good night’s sleep in our sleep blog.

Talk more:

We have already stressed the importance of talking about Mental Health in terms of reducing the risk of depression and suicide for other people but talking about your emotional wellbeing is just as important for your own health as it is for that of others.

Try to chat to your friends, partner and family about how you are feeling. Share happy moments and well as sad ones and feel free to vent your frustrations after a particularly hard day or week.

There is truth in the adage ‘a problem shared is a problem halved’. We all feel better when we have offloaded our concerns or frustration onto someone else and often things we think are insurmountable seem less so when we hear them aloud or get someone else’s point of view.

Why not try and arrange a walk with friends once or twice a week.

Being active, surrounded by nature, with friends, sharing problems is a great way to ensure a good nights sleep and improve your mood.

For more information and support see your GP or check out your local support group.

Information also available from The Samaritans, Breathing Space and NHS websites.

©AYOSC 2019