Depression and Suicide: Don't Hesitate to Take Help!!

SUICIDE WARNING -- Depression carries a high risk of suicide. Anybody who expresses suicidal thoughts or intentions should be taken very seriously. Do not hesitate to call your local suicide hotline immediately.

The best way to minimize the risk of suicide is to know the risk factors and to recognize the warning signs of suicide. Take these signs seriously. Know how to respond to them. It could save someone's life.

How Prevalent Is Suicide?

Suicide is a potentially preventable public health problem. In 2009, the last year for which statistics are available, suicide was the 10th leading cause of death in the U.S. That year, there were nearly 37,000 suicides, and 1 million people attempted suicide, according to the Centers for Disease Control. Its need to be understood that attempt to suicide is different from successful suicide.

Men take their lives nearly four times the rate of women, accounting for 79% of suicides in the U.S. 

Are There Risk Factors for Suicide?

Risk factors for suicide vary by age, gender, and ethnic group. And risk factors often occur in combinations.

Over 90% of people who die by suicide have clinical depression or another diagnosable mental disorder. Many times, people who die by suicide have an alcohol or substance abuse problem. Often they have that problem in combination with other mental disorders.

Adverse or traumatic life events in combination with other risk factors, such as clinical depression, may lead to suicide. But suicide and suicidal behavior are never normal responses to stress.

Other risk factors for suicide include:

• One or more prior suicide attempts
• Family history of mental disorder or substance abuse
• Family history of suicide
• Family violence
• Physical or sexual abuse
• Keeping firearms in the home
• Chronic physical illness, including chronic pain
• Incarceration
• Exposure to the suicidal behavior of others
• Anxiety about preferences and choices in life as Homosexuality and marked opposition by the society in large.

Are There Warning Signs of Suicide?

Warning signs that someone may be thinking about or planning to commit suicide include:

• Always talking or thinking about death
• Clinical depression -- deep sadness, loss of interest, trouble sleeping and eating -- that gets worse
• Having a "death wish," tempting fate by taking risks that could lead to death, such as driving fast or running red lights
• Losing interest in things one used to care about
• Making comments about being hopeless, helpless, or worthless
• Putting affairs in order, tying up loose ends, changing a will
• Saying things like "it would be better if I wasn't here" or "I want out"
• Sudden, unexpected switch from being very sad to being very calm or appearing to be happy
• Talking about suicide or killing one's self
• Visiting or calling people to say goodbye

Be especially concerned if a person is exhibiting any of these warning signs and has attempted suicide in the past. According to the American Foundation for Suicide Prevention, between 20% and 50% of people who commit suicide have had a previous attempt.

What Should I Do if Someone I Know Shows Warning Signs of Suicide?

First, if someone you know appears to be depressed and is contemplating suicide, take that person seriously. Listen to what he or she is saying. Take the initiative to ask that person what he or she is planning. But don't attempt to argue him or her out of committing suicide. Rather, let the person know that you care and understand and are listening. Avoid statements like: "You have so much to live for."

If someone you know appears to be depressed and talks about suicide, makes a suicidal gesture, or attempts suicide, take it as a serious emergency. Listen to the person, but don't try to argue with him or her. Seek immediate help from a health care professional.

Depressed people are often suicidal. It is a key symptom of the disease. Some studies show that the neurotransmitter serotonin plays a central role in the neurobiology of suicide. Researchers have found lower levels of serotonin in the brainstem and cerebrospinal fluid of suicidal individuals.

In addition, suicidal behavior sometimes runs in families. Remember, any talk of suicide is always an emergency. Have the person talk with a health care professional immediately.

Where Can I Get Help for Suicide and Depression?

Encourage a suicidal or depressed person to seek the help of a mental health professional. Because the person may feel so hopeless that they may not think it's possible to be helped, you'll probably have to be persistent and go with that person.

If your loved one appears to be in imminent danger of committing suicide, do not leave him or her alone. Remove any weapons or drugs he or she could use. Accompany him or her to the nearest emergency room or call the nearest police station at 100 or .

During treatment, be supportive. Help the person remember to take antidepressants or other prescribed medications and to continue any other therapy that's been prescribed.

If you are able to take this person for half an hour of walk or run, for sure it would help to enhance the serotonin level in the blood. Also, half an hour of morning sunbathe, called photo-therapy, can be effective antidepressant. More ever as the depression has its psychosocial root, change in family as well as living environment can have a striking effect in dealing with depression.

Let him remember, "Don't Hesitate to Take Help!! No one is as invincible as to take all the matters of life on his own!!!"

Last Reviewed by: Klub Psychology

From: WebMD Medical Reference

Reviewed by Joseph Goldberg, MD

Seasonal Affective Disorder in Children ( SAD)

At first, Maggie's parents thought she was slacking off. After the Thanksgiving break, she couldn't concentrate in class, and after school all she wanted to do was sleep. Her grades began to drop, and she rarely felt like socializing anymore. They were upset with her, but figured it was just a phase — especially because her energy finally seemed to return in the spring.

But when the same thing happened the next fall, and Maggie's mood and her grades plummeted again, they took her to the doctor, who diagnosed her with a type of depression called seasonal affective disorder (SAD).

About Seasonal Affective Disorder

A form of depression that follows a seasonal pattern, SAD appears and disappears at the same times each year. People with SAD usually have symptoms of depression as winter approaches and daylight hours become shorter. When spring returns and the days become longer again, they experience relief from the symptoms and a return to a normal mood and energy level.

Signs and Symptoms

Like other forms of depression, the symptoms of SAD can be mild, severe, or anywhere in between. Milder symptoms minimally interfere with someone's ability to participate in everyday activities, while more severe symptoms can interfere much more.

The symptoms of SAD are the same as those of depression, but occur during a specific time of year. It's the seasonal pattern of SAD — the fact that symptoms occur only for a few months each winter (for at least 2 years in a row) but not during other seasons — that distinguishes it from other forms of depression.

Symptoms of SAD may include:

• Changes in mood: sadness, irritability, and/or feelings of hopelessness or worthlessness most of the time for at least 2 weeks; tendency to be more self-critical and more sensitive than usual to criticism; crying or getting upset more often or more easily
• Lack of enjoyment: loss of interest in things that are normally enjoyable; feeling like tasks can't be accomplished as well as before; feelings of dissatisfaction or guilt
• Low energy: unusual tiredness or unexplained fatigue
• Changes in sleep: sleeping much more than usual (which can make it difficult for kids with SAD to get up and get ready for school in the morning)
• Changes in eating: craving simple carbohydrates (i.e., comfort foods and sugary foods); tendency to overeat (which could result in weight gain during the winter months)
• Difficulty concentrating: more trouble than usual completing assignments on time; lack of usual motivation (which can affect school performance and grades)
• Less time socializing: spending less time with friends in social or extracurricular activities

The problems caused by SAD — such as lower-than-usual grades or less energy for socializing with friends — can affect self-esteem and leave people feeling disappointed, isolated, and lonely, especially if they don't realize what's causing the changes in energy, mood, and motivation.

Causes of SAD

It's believed that with SAD, depression is somehow triggered by the brain's response to decreased daylight exposure. How and why this happens isn't yet fully understood. Current theories focus on the role of sunlight in the brain's production of certain key hormones that help regulate sleep-wake cycles, energy, and mood.

Two chemicals that occur naturally in the body are thought to be involved in SAD:

1. Melatonin, which is linked to sleep, is produced in greater quantities when it's dark or when days are shorter. Increased production of melatonin can cause sleepiness and lethargy.
2. Serotonin production increases with exposure to sunlight. Low levels of serotonin are associated with depression, so increasing the availability of serotonin helps to combat depression.

Shorter days and longer hours of darkness in fall and winter can increase melatonin levels and decrease serotonin levels, which may create the biological conditions for depression.

Who Gets It?

About 6 in every 100 people (6%) experience SAD. Although it can affect kids and young teens, it's most common in older teens and young adults, usually starting in the early twenties. Like other forms of depression, females are about four times more likely than males to develop SAD, as are people with relatives who have had depression. Individual biology, brain chemistry, family history, environment, and life experiences also might make certain people more prone to SAD and other forms of depression.

The prevalence of SAD varies from region to region, and it's far more abundant among people who live in higher latitudes. For instance, one study found the rates of SAD were seven times higher among people in New Hampshire than in Florida, suggesting that life farther from the equator is a risk factor for SAD.

However, most people don't experience seasonal depression, even if they live in areas where days are much shorter during winter months. Those who do might be more sensitive to the variations in light, and undergo more dramatic shifts in hormone production depending on their exposure to light.

Treatment

Treatment for SAD, which varies depending on the severity of the symptoms, includes:

Increased light exposure. Because the symptoms of SAD are triggered by lack of exposure to light and tend to go away on their own when available light increases, treatment for SAD often involves increased exposure to light during winter months. For someone with mild symptoms, it may be enough to spend more time outside during the daylight hours, perhaps by exercising outdoors or taking a daily walk. Full-spectrum (daylight) lightbulbs that fit in regular lamps can help bring a bit more daylight into winter months and might help with mild symptoms.

Light therapy (phototherapy). More troublesome symptoms may be treated with a stronger light that simulates daylight. A special lightbox or panel is placed on a tabletop or desk, and the person sits in front of it briefly every day (45 minutes or so, usually in the morning) with eyes open, glancing — not staring — occasionally at the light (to work, the light has to be absorbed through the retinas). Symptoms tend to improve within a few days or weeks. Generally, light therapy is used until enough sunlight is available outdoors. Mild side effects of phototherapy might include headache or eyestrain.

Lights used for SAD phototherapy must filter out harmful UV rays. Tanning beds or booths should not be used to relieve symptoms of SAD. Their ultraviolet rays can damage skin and cause wrinkles and age spots, and even lead to skin cancer such as melanoma. Phototherapy should be used with caution if someone has another type of depressive disorder, skin that's sensitive to light, or medical conditions that may make the eyes vulnerable to light damage.

Like any treatment, phototherapy should be used under a doctor's supervision.

Medication (pharmacotherapy). Medications, which might be used in combination with talk therapy and light therapy, may be prescribed for a child or teen with SAD and should be monitored by a doctor. Antidepressant medications help to regulate the balance of serotonin and other neurotransmitters in the brain that affect mood and energy. Tell your doctor about any other medications your child takes, including over-the-counter or herbal medicines, which could interfere with prescription medications.

Talk therapy (psychotherapy). Helping to ease the sense of isolation or loneliness, talk therapy focuses on revising the negative thoughts and feelings associated with depression. It also can help people with SAD understand their condition and learn ways to prevent or minimize future bouts.

What Parents Can Do

Talk to your doctor if you suspect your child has SAD. Doctors and mental health professionals make a diagnosis of SAD after a careful evaluation and a checkup to ensure that symptoms aren't due to a medical condition that needs treatment. Tiredness, fatigue, changes in appetite and sleep, and low energy can be signs of other medical problems, such as hypothyroidism, hypoglycemia, or mononucleosis.

When symptoms of SAD first develop, parents might attribute low motivation, energy, and interest to an intentional poor attitude. Learning about SAD can help them understand another possible reason for the changes, easing feelings of blame or impatience with their child or teen.

Parents sometimes are unsure about how to discuss their concerns and observations. The best approach is usually one that's supportive and nonjudgmental. Try opening the discussion with something like, "You haven't seemed yourself lately — you've been so sad and grouchy and tired, and you don't seem to be having much fun or getting enough sleep. So, I've made an appointment for you to get a checkup. I want to help you to feel better and get back to doing your best and enjoying yourself again."

Here are a few things you can do if your child or teen has been diagnosed with SAD:

• Participate in your child's treatment. Ask the doctor how you can best help your child.
• Help your child understand SAD. Learn about the disorder and provide simple explanations. Remember, concentration might be difficult, so it's unlikely your child will want to read or study much about SAD — if so, just recap the main points.
• Encourage your child to get plenty of exercise and to spend time outdoors. Take a daily walk together.
• Find quality time. Spend a little extra time with your child — nothing special, just something low-key that doesn't require much energy. Bring home a movie you might enjoy or share a snack together. Your company and caring are important and provide personal contact and a sense of connection.
• Be patient. Don't expect symptoms to go away immediately. Remember that low motivation, low energy, and low mood are part of SAD — it's unlikely that your child will respond cheerfully to your efforts to help.
• Help with homework. You may have to temporarily provide hands-on assistance to help your child organize assignments or complete work. Explain that concentration problems are part of SAD and that things will get better again. Kids and teens with SAD may not realize this and worry that they're incapable of doing the schoolwork. You may also want to talk to the teachers and ask for extensions on assignments until things get better with treatment.
• Help your child to eat right. Encourage your child to avoid loading up on simple carbohydrates and sugary snacks. Provide plenty of whole grains, vegetables, and fruits.
• Establish a sleep routine. Encourage your child to stick to a regular bedtime every day to reap the mental health benefits of daytime light.
• Take it seriously. Don't put off evaluation if you suspect your child has SAD. If diagnosed, your child should learn about the seasonal pattern of the depression. Talk often about what's happening, and offer reassurance that things will get better, even though that may seem impossible right now.

Reviewed by: D'Arcy Lyness, PhD
Date reviewed: October 2010

Our Motto: One step ahead; everyday.

SEASONAL AFFECTIVE DISORDER (SAD ): THE WINTER BLUES

The gloom of winter seems to get inside some people, the dark affecting their moods as well as their days. Known as seasonal affective disorder (SAD), this form of depression affects about 1% to 2% of the population. Although it strikes all genders and ages, women are more likely to develop SAD than men, and young people are more likely to develop it than older people.

SAD seems to be triggered by decreased exposure to daylight. Typically, it arrives during the fall or winter months and subsides in the spring. Symptoms are similar to general depression and include lethargy, loss of interest in once-pleasurable activities, interpersonal problems, irritability, inability to concentrate, and changes in sleeping patterns, appetite, or both.

Experts don’t fully understand the cause of SAD, but leading theories place the blame on an out- of-sync body clock or on improper levels of either the hormone melatonin or the neurotransmitter serotonin.

Some crisis event which may have taken during winter may drag this mood disorder every winter. Particularly there is not so much of suicidal ideation but a feeling of underachievement may continue to ruminate along with acute fear like in panic disorder. (Klub Psychology)

The mainstay of SAD treatment is light therapy, also called phototherapy. Phototherapy involves daily sessions of sitting close to a special light source that is far more intense than normal indoor light. The recommendation is typically to get 30 minutes of exposure to light at an intensity of 10,000 lux each day, but optimum dosing remains a major question. Some people need more light exposure than this, others need less.

The light must enter through the eyes to be effective; skin exposure doesn't seem to work. Some people feel better after only one light treatment, but most people require at least a few days of treatment, and some need several weeks. You do not need a prescription to purchase a light box to treat SAD; however it’s best to work with a professional to monitor the benefits of the treatment.

Some SAD light boxes look like medical equipment, while others are more like regular table lamps. The prices vary. Although professional groups and government agencies endorse light therapy, your insurance company may balk. If you are counting on coverage, better check first.

Source: Harvard Medical School

Reviewed by: Klub Psychology

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A Restless and Excitable Child

For parents, care giver and anyone who works with young people

• Kate talks about her 7 year old

About this factsheet

This is one in a series of factsheets for parents, teachers and young people entitled Mental Health and Growing Up. The aims of these factsheets are to provide practical, up-to-date information about mental health problems (emotional, behavioural and psychiatric disorders) that can affect children and young people. This factsheet looks at the reasons behind why some children are more restless and excitable than others, gives advice about how to deal with an overactive child, and suggests where to go to get extra help if you feel you are unable to cope on your own.

Introduction

Young children are often restless and excitable. Their noisy liveliness is usually just a part of being young. Although it may be tiring, it is usually nothing to worry about.

Sometimes youngsters may be so active and noisy that it makes life difficult for their parents and other children. A child like this may be demanding and excitable, and chatter away nineteen to the dozen. They may be noisy, may not do as they are told, and will probably find it difficult to sit still. Adults may say that he's ‘hyperactive’, but the trouble with this word is that professionals use it to describe extreme, and sometimes dangerous behaviour, such as running out into a busy road.

What makes children overactive?

There are many things that can make a child overactive. The following should give you some guidance as to the reasons for your child's behaviour. Finding the reasons may help you to come up with some solutions to deal with them.

• Being a parent

If parents are unhappy, depressed or worried, they tend to pay less attention to their children. They may find they can't spend the time they need to help them play constructively, or they may find that when they do play with them, they spend a lot of time telling them to be quiet. Children learn from this that they have to be naughty or noisy to get any attention from their mum or dad.

• No clear rules

It is important to have simple rules about what is allowed and what is not. If two parents are involved, they both need to agree about the rules, and be consistent and fair when they say ‘no’. This will help the child to know what is expected and to learn self-control (see our Factsheets on good parenting and on behavioural and conduct problems).

• Child’s temperament

We are all born with different temperaments. Some children are livelier, noisier and more outgoing than others. They may prefer going out and being with other people than quietly reading a book or playing with toys by themselves. Quite often, children who are active like this are also excitable and may go over the top while playing. Although this can be a nuisance, it is nothing to worry about, but you may need some help in finding ways to help your child calm down.

• Learning and other problems

Some children find it hard to learn things that other children find easy. They may need special help at school. They may seem quite young for their age and find it hard to concentrate on work or control their behaviour as well as other children.

Some children may be affected by attention-deficit hyperactivity disorder (ADHD). If this is the case, seek help.

• Hearing problems

Glue ear (ear infections) is a common example of a hearing problem. If a child has glue ear, they will find it hard to hear what other people say, will tend to shout and may want the television turned up very loudly.

• Food

Some children do seem to react to certain foods by becoming restless and irritable. This is not as common as some people think, but occasionally it can be a real problem.

How can I get my child to calm down?

Try to make sure you spend time with your child on their own, so that they know you are interested in them. This will give you the chance to plan and praise.

• Plan

Spend time with your children doing something they enjoy. Get into a routine and plan what they are going to be doing for the day or the weekend. It is helpful to arrange to have friends to come and play, (encouraging their social development) and gives you a break when they are invited back! It is also helpful to engage them in regular activities such as football or trampoline sessions, cubs, brownies etc. because this gives you a chance to meet other parents who can provide an informal support network. You can also make clear times when you expect them to play quietly on their own.

• Praise

Take every opportunity to praise your child. Be as clear as possible. It is vital that they understand exactly what they have done to please you. For example, “you've been playing so quietly on your own … what a good boy you are” or “what a good footballer you are”.

Where can I get help?

Lively, excitable behaviour is a common problem for parents. Your health visitor will be used to giving advice about this. If there seems to be a problem with your child's hearing, or if there seems to be a reaction to foods, your general practitioner should be able to help and refer to a specialist if required. If they think that there might be a learning difficulty or a hyperactivity disorder, they will refer you to a clinical psychologist, paediatrician or Child and Adolescent Mental Health Services (CAMHS) (see our factsheet on CAMHS).

YOG, particularly ASANAS can consume more of RESTLESS ENERGY in a child, sports and exercise can be good aid to channelize this energy. Using this energy in creative fields like art and craft, music, creative writing can slow down and stabilize the pace and psyche of the restless child. Avoiding fatty and junk food is best. Chewing 2 leaves of Ocimum Sanctum (Holy Basil leaves) twice a day can have an Ayurvedic effect making the child adaptive to stress. (Klub Psychology)

Source: The Leaflet Department, The Royal College of Psychiatrists

Adjunct information by: Klub Psychology

Our motto: One step ahead; everyday.

A festive season starts today in Nepal

WISH YOU A VERY COLOURFUL DASHAIN 2069! SHUVA DASHAIN!!

May the blessings and partyings be the everyday life from now onward!

Our motto: One step ahead; everyday.

Two ear to listen and one mouth to talk!

Neuroscience explains why your voice is more persuasive than a pen or keyboard. So When It's Important: Don't Write, Talk!!

If you have something important to say to someone, you already know that you should show up in person or pick up the phone. Don't send an email or text. But do you know the science behind why? It's not that your words might get misinterpreted. Sure, that's possible, but that's not the real reason why speaking to someone is more persuasive than writing to them. And it's not that emails are seen as less formal. Although that's true too, it's not the reason why you should speak to someone.

It's all about the brain -- When you listen to someone talking your brain starts working in sync with the speaker. Here's what researcher Greg Stephens discovered: He put some participants in his research study in an fMRI machine and recorded them speaking. He also recorded their brain activity. Then he had other participants listen to the recordings while they were also in an fMRI machine, and he recorded their brains too.

Brain syncing -- What he found is that as someone is listening to someone else talk, the brain patterns of the two people mirror each other. There is a slight delay, which corresponds to the time it takes for the communication to occur. He compared this with having people listen to someone talk in a language they did not understand. In that case the brains did not sync up.  

Syncing + anticipation = understanding -- In Stephen’s study, the more the brains were synced up the more the listener understood the ideas and message from the speaker. And by watching what parts of the brain were lighting up, Stephens could see that the parts of the brain that have to do with prediction and anticipation were active. The more active they were, the more successful was the communication.

Social parts light up too -- Stephens noted that the parts of the brain that have to do with social interaction were also synced, including areas known to be involved in processing social information crucial for successful communication, including the capacity to discern the beliefs, desires, and goals of others.

There is always the release of comfort hormone Endorphin when we interact in a live manner rather than using electronic gadget like cell phone. The release of this social hormone let you feel backed up, secure, lively and accelerate communication to a further level and also relieves some physical signs. This particular idea has a great therapeutic value in treating Autism Spectrum Disorder. (Klub Psychology)

So the next time you have something important to say, say it, don't write it. Hearing someone speak is more powerful and persuasive than reading.

Uh oh, I guess that means I should have recorded this blog post! 

What do you think? Have you experienced a difference in written vs. spoken communication?

By: Susan Weinschenk, Ph.D. in Brain Wise

Revised by: Klub Psychology

Our motto: One step ahead; everyday.

STRESS ASSSESMENT AND PSYCHOSOCIAL SURVEY QUESTIONNAIRE

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gfd÷Name:.......................................................            gful/s÷Nationality:.................................

pd]/–ln·/Age–Sex:..............................................         Period of stay in Nepal:.............................

a}aflxs l:ylt÷Marital status:...............................           i) Since:.....................................................

lzIff÷Education:..................................................        ii) For/ Purpose:........................................

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ii) c:yfoL÷Temporary:............................................................................................

Od]n÷Email ID:....................................kmf]g÷Phone No.:..................... ldlt÷Date:................

Stress Asssesment and Psychosocial Survey Questionnaire:

A.  Stress Asssesment / tgfj ljZn]if0f

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      List 3 major life events that occurred within 15 days and have created an unbearable stress on your day to day living.

      i)_________________________________________________________________________________________

      ii)________________________________________________________________________________________

      iii)________________________________________________________________________________________

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      List 3 major life events which have elevated your anxiety since 6 months.

      i)_________________________________________________________________________________________

      ii)________________________________________________________________________________________

      iii)________________________________________________________________________________________

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      Do you have your own coping mechanisms and solutions towards these stressful situations and anxieties? If any, list some of them.

      i)_________________________________________________________________________________________

      ii)________________________________________________________________________________________

B.   PSYCHOSOCIAL SURVEY / dgf];fdflhs ;j]{If0f

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     s] s:tf] ljifodf cGt/lqmof ug]{ jf hfgsf/L kfpg] tkfO{df OR5f 5 <                                                                     

      Do you want to participate in interactions about mental or medical health ?                                                           Yes/No  

       Have you ever participated in such talks before ?                                                                                                          Yes/No

      Let us know the topic you would like to interact about.                                                                                       

      __________________________________________________________________________________________

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      Can you share how much do you, your family, friends & neighbour know about the mental health ?

      Have you ever tried to know the psychosocial scenario of your village, town, region, etc. before? How? When?

     __________________________________________________________________________________________

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     __________________________________________________________________________________________

$=  o:tf ;d:of ePsf sf]xL 5g\ eg] M  If you know any one of them please tell us their:

      Name / gfd M_____________________________________Age / pd]/ M ___________            Sex / lnª M ________________            Adress / 7]ufgf M_______________________________________________________            Phone / kmf]g M______________    

C.  YOUR SUGGESTION / tkfO{sf ;'emfjx? M

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     o;nfO{ cem k|efjsf/L agfpgsf] nflu s]xL /fo ;'emfj n]lvlbg'xf];\ .===============================================================================================================

      How do you rate our orientation and interaction progrmme?______________________________________________

      Can you helps us to make it more effective? __________________________________________________________

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