Suicide prevention

By Dr. Alan Koenigsberg

There are many tactics to help prevent suicide. Being aware of what our children, as well as those closest to us, are thinking and feeling, gives us the best chance of avoiding catastrophic events.

There are many excellent articles and guidelines published about preventing suicide, and I recommend reading them. One aspect of prevention that I believe is often neglected is to look for underlying conditions that may make the child or adult more vulnerable to suicidal thinking and behavior, such as anxiety or depressive disorders.

One of the most effective tactics is to seek a professional evaluation as soon as possible if you suspect a child is depressed or chronically anxious. 

Everyone experiences sadness, grieving and bouts of anxiety during stressful times. What I’m referring to is unending grieving, apathy, lack of pleasure, lack of motivation, irritability, moodiness, distractibility, impulsive behaviors, lying and so on.

Much of the above is standard behavior for teens and adolescents, and may be difficult to distinguish from illness. A good relationship with one’s pediatrician is a cornerstone for health, much as when the children were babies and had fevers. For adults, consult with one’s internist.

Suicide prevention is effective when common disorders are recognized and treated early. The most common conditions in children and teens are depressive disorders, anxiety disorders, ADHD and eating disorders.

Effective treatments for those conditions — whether a blend of medications, psychotherapy, supportive counseling or a combination — go a long way toward helping children, adolescents and adults not only in coping with their situations, but in moving into health.

The prevalence of drug abuse, for instance, is much lower in children and teens who are treated for ADHD. The same holds true for adults with ADHD regarding dysfunctional relationships, jail and work.

If someone has already been diagnosed with some disorder, especially bipolar disorder, a parent or spouse can help by collaborating with treating physicians, as well as learning about the condition. 

Many people are unaware of the prevalence of these conditions, and are either skeptical or afraid of them and getting the care and treatment they need. Here is one way of looking at this: The brain is the most complex organ of the human body. It is just as vulnerable, if not more, to injury due to genetic inheritance, trauma, infection and so on, and needs expert care to have optimal outcomes.

If a child or relative has cancer, one marshals all of the available resources to help with those conditions. I suggest the same approach be considered here.

We probably cannot totally eliminate suicide in our society, but I suggest we can substantially decrease suicide by taking appropriate precautions as mentioned above.

Lastly, one tactic to prevent suicide by overdose of narcotics is to have a Narcan kit at home, available from pharmacies. Learning how to use this is relatively simple and lifesaving.

Alan Koenigsberg, M.D., is a practicing psychiatrist and clinical professor of psychiatry at UTSW Medical School in Dallas.

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