HELP IN SUICIDE 
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MARIA DEL PILAR YAG�E, R.N.
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HELP IN SUICIDE
Not all people with depression will have all these symptoms or have them to the same degree. These are several questions and answers about the disease called depression. Please read all of these carefully, since it is very important that you understand your disease as thoroughly as possible.
l. WHAT IS DEPRESSION? It is a disease affecting the entire mind and body, causing a person to feel miserable in many ways. Changes in brain chemistry make it happen. It is a brain disease.
2. WHAT CAUSES DEPRESSION? We do not know. We used to think it was due to something unhappy in a person's life or to some psychological hang-up. We now know, however, that this disease happens to people who have no reason "to be depressed." In other words, depression can strike normal and healthy people.
3. DOES HAVING A DEPRESSION MEAN THAT A PERSON IS GOING "CRAZY"'? NO, but it will very often make him think he is.
4. IS IT A COMMON DISEASE? Yes, it is the most common disease seen in all of medicine; however, it is often confused with other illnesses. For example, many people who think, or who are told, they have low blood, vitamin deficiency, sinus headaches, low sugar, menopause, burnout, and "all run-down and need a rest" actually have depression that causes their troubles.
5. WHAT TROUBLE DOES A PERSON HAVE WHO HAS DEPRESSION? A person who has depression will usually feel most of the following things:
a. He will feel very tired all the time, even when he has not worked or exerted himself very much. He will be just as tired on days when he has rested as on days when he has worked hard. 6. IS THIS REALLY A SERIOUS DISEASE? Yes. In a mild depression. the person will often think he just has a case of the blues, or that he is just getting older. His efficiency will be affected. In a more severe depression, it is a very serious disease. This disease can cause a previously healthy and happy person to kill himself.
7. CAN A PERSON DO ANYTHING TO FIGHT BRAIN DISEASE? Not by his own efforts. This is a disease over which a person has no control, and it will do him no good to "try to fight this myself."
8. IS THERE ANY EFFECTIVE TREATMENT? Very much so. There are several medicines
which are usually very effective in treating depression. They are also very safe medicines.
9. ARE THERE MEDICINES TRANQUILIZERS, SLEEPING PILLS, PAIN PILLS, HORMONE
PILLS? NO, none of these. They are called antidepressants.
10. ARE ANTIDEPRESSANTS ADDICTING? Absolutely not. A person can not become addicted
even though he takes these medications for months or years. People who take insulin and
high blood pressure pills are not addicted; neither are people who take antidepressants. A
person who does not have depression would feel no effect if he took an antidepressant. They
work on the brain chemistry that gets out of balance and results in depression.
11. DO THEY HAVE SIDE EFFECTS? Unfortunately, they have pesky side effects; they rarely
have serious side effects. The chief side effects are dry mouth, constipation and drowsiness.
Dry mouth can be effectively overcome by drinking water or sucking non caloric mints.
Constipation is corrected by adding bulk to one's diet. The sleepy effects are taken care by
taking the medicine before bedtime. The body usually adjusts to all these side effects. Some
newer antidepressants do not have side effects.
12. ARE ANTIDEPRESSANTS THE SAME AS "PEP PILLS" OR "UPPERS?" Absolutely not.
Pep pills give anybody a sudden boost of energy whether they have depression or not. Pep
pills are all dangerous, and not used for depression. Antidepressant pills, on the other hand
will do nothing to a person without a depression, but will help a person who has depression
by returning his brain chemical to normal.
13. HOW LONG DOES A PERSON HAVE TO TAKE ANTIDEPRESSANTS? It varies. Sometimes as little as three months, other times longer than a year. These medications can be
taken safely for as long as they are needed, even for a lifetime.
14. DOES THIS DISEASE HAPPEN TO A PERSON WITHOUT ANYTHING IN HIS PERSONAL
LIFE CAUSING IT? Yes. However, many people have things in their personal life that are
bothering them a great deal, and if they happen to get depression while these things are
bothering them, then everything gets much worse. For example, if a person is having difficulty
in their marriage or job and they get a depression also, then the difficulties with the marriage
or job will get worse, because their ability to cope with their difficulties is impaired.
15. WHAT SHOULD I TELL MY SPOUSE OR RELATIVES ABOUT DEPRESSION? Have them
read this paper too. A person with depression will almost always find that their spouse or
relatives are very much affected by the way he feels. Most often relatives will not realize that
a person's symptoms are due to a disease, and will think you simply do not love them any more.
They may think the fault is somehow theirs. it is very important that they know that depression
is simply a disease - just as pneumonia or diabetes are diseases, and that you or they are
not responsible for it. We would welcome them to come back with you on your return visit
and discuss this with them in detail. it is a great help to have your loved ones understand what
is happening, why you need medication, etc.
2. Antidepressants must be taken regularly, not just when you feel like you need them. In other
words, never stop taking the medications because you feel better and think you no longer need
them. Stop them only when I tell you. Your treatment with antidepressants will last a minimum
of three months.
3. Take your medication all in one dose, and take them about four hours before you intend to go
to bed. That will put some of your side effects such as drowsiness while you sleep. There are
two exceptions' Trazodone (Desyrel) should be taken right at bedtime with a snack. Fluoxetine
(Prozac) should be taken after arising.
4. Most of the good effects of this medication will not show themselves for about two
weeks. Some of the medications will help you sleep right away, but all of the other beneficial
effects will be delayed for two weeks or sometimes longer. When the medication does begin
to work your headaches or other pain will go away. Your tendencies to cry and feel irritable will
go away; in other words, you will feel like you are back to normal.
5. When you do begin to feel back to normal, do not stop taking the medication. If you do, within
three or four days you will feel worse again.
6. It is extremely important that I see you again after the first two weeks of treatment in order
to evaluate whether the diagnosis and treatment is correct. Whatever you do, do not stop
taking the medication until you see me.
7. If anything troublesome happens which you think may be due to the medication, call and let me
know what is happening. Many times the problems will have nothing to do with the medication
at all. However, it is true that with a few people there may be such reactions as constipation,
blurring of vision, delay of urination. or a lot of perspiration... Such side effects are usually
temporary and can be controlled other ways.
8. You should be able to work, drive, and carry out your usual activities while taking the medicine.
When first beginning the antidepressant, you should use some caution about driving or
engaging in other hazardous activity until you see how the medicine will affect you. Usually you
can do anything you wish, especially after the first two or three days. If you are too sleepy after
that, or cannot sleep, it usually means that we need to change the type of antidepressant to
one that gives more or less drowsiness, and I can easily do that by phone. Call if there is any
problem.
9. You should be aware that the safety of these medications lies in the fact that you cannot hide
from troublesome life situations with them. If, for example, you do not have the true medical
disease of depression, but instead are only working too hard, you will receive no "energy" from
these pills. If you do not have a depression, but instead are simply unhappy with a life situation
that would make anyone unhappy, then the pills will give no happiness. If your headache or
stomach ache are due to some other disease, the pills won't help.
They only work when the disease depression is present, and in that situation they usually give
dramatic and gratifying relief to all of the symptoms. Thus you can see the basic difference
between these medications and such drugs as alcohol, "uppers", "nerve pills", sleeping pills and
the like. These medications cannot be used as an escape from life's problems. and are not habit
forming. The antidepressants cannot be used in that way, and that is their greatest safety
feature.
IF YOU HAVE THOUGHTS OF SUICIDE
Not all people with depression will have all these symptoms or have them to the same degree.
Recently, I intervened to prevent a friend from committing suicide.
My friend is alive and I have the satisfaction that I knew what to do and
had the opportunity to do it. That means a great deal to me because
I value my friend. Her decision to live redresses some of the loss
I feel because I was unable to prevent my son's death by suicide.
MOOD DISEASE. Stressful events cause temporary depression in most people.
Others suffer from major depression or manic depression, inheritable illnesses
that may lead to suicide. People with schizophrenia also may attempt suicide.
Accompanied by abnormalities in brain chemistry, episodes of depression
arise with or without apparent cause. Depression frequently goes hand-in-hand
with alcohol or drug abuse.
Fortunately, mood illnesses can be treated with medications and therapy;
unfortunately, they often go unrecognized, undiagnosed and untreated.
The risk of suicide sky rockets if depression is coupled with chemical
dependency. Historically, mental health and chemical dependency treatment
have traveled on separate tracks. One condition may be treated while
the other is ignored, depending on which type of program a patient enters.
Some people medicate their underlying depression with alcohol or drugs,
while others become depressed as a result of their addiction. It's
important to discover which is the case. When a person quits using
addictive substances, the underlying depression may overwhelm them.
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