Sunday, October 16, 2011

Trend Alert: Suicide in Later Life Women

Though suicide is the most preventable kind of death, more than 3,000 people die by suicide each day—more than all the deaths caused by accidents, wars, and homicides around the world, combined.

The largest growing number of completed suicides is occurring in later life, more specifically with women aged 50 and older. A recent study has shown a staggering 49% rise in emergency room visits for drug-related suicide attempts by females of this age population. The lethal drugs of choice are narcotic pain relievers hydrocodone and oxycodone.

This research makes the case that late-life suicide is a cause for great concern that warrants ongoing attention from researchers, health care providers, policy makers, and society at large.

Related Facts

  • Suicide is a significant risk for anyone with a mental illness, but is exponentially higher for people with depression.
  • Women attempt suicide more than men.
  • The steep rise in abuse of “narcotic pain relievers” by women is considered a public health crisis.
  • Physical pain can often mask a depressive disorder
  • Prescriptions for anti-anxiety medication and antidepressant medication have tripled over the last decade, while the seeking of psychotherapy has significantly reduced. This suggests pills are valued more-so than skills.
  • Economic stress presses heavily on baby boomers, creating a sense of vulnerability with regard to financial security.

The hard and cold truth is that not all suicides are preventable. Though many individuals plan and even leave clues regarding their objective, there are others that act on impulse, leaving no indelible imprint of their intentions. It’s crucial for family and friends of a person who has died by suicide not to blame themselves for “not knowing”.

10 Tips to Offset This trend

1) Know risks for suicide. Awareness can help identify at-risk adults :
• Previous suicide attempt(s)
• History of depression or other mental illness
• Alcohol or drug abuse
• Family history of suicide or violence
• Physical illness
• Sudden loss or significant change
• Feeling alone

2) Understand the true definition of depression. It’s essential to understand that depression is not just a disorder of mood. It is a disorder of thinking which infects the clarity of the mind like a virus attacks the body. It weakens your defenses, cripples your resolve, and leaves you vulnerable to corrosive thoughts. If you think someone is depressed, don’t rely on them reaching out to you. Instead, be proactive. Call them. Check in. Visit in person. And if you feel worried about them, don’t hesitate to call for help (Police, Fire Department, Family/Friends).

3) Perfecting Diagnosis. Primary care physicians and other health providers need to recognize that physical pain is often a symptom of depression. Better detection, diagnosis and follow up care are needed. In addition, professionals who prescribe narcotics, or any kind of medication, should monitor the frequency of requested refills. Family members should also be aware. This helps to sequester the lethality of the drugs.

4) Understand your life-cycle. The mental and physical health needs of women vary across the life span. We need to teach women what to expect when these changes occur. For example, low levels of estrogen have been linked to suicidal behavior in women. As women age, many go through the emotional process of a “life review” (measuring what they’ve done in their life as mortality approaches), which can heighten sadness. Social connections can wane with age, so isolation is a common experience in later life. It’s vital to encourage women to take an active role in monitoring their own health, so if confronted with these developmental experiences, alternatives can be explored.

5) Find balance. Interpersonal stress is a risk factor for suicide. Illness, job loss, or any kind of adversity can shake one’s feeling of hope and resolve. It’s important for women to keep a healthy diet and get plenty of sleep. Getting a good 30 minutes a day of natural sunshine boosts melatonin – and exercise releases mood pleasing endorphins. If you notice that someone you love is under stress and not tending to self-care, consider this a significant setback and risk factor.

6) Connect with others. A loss of personal control is another issue related to suicidal thinking in older females. For example, women who no longer feel important or necessary to family and/or children, or who no longer feel useful can lapse into self-destructive thoughts. A central way to combat this is to reinvest socially with others. Be it volunteering, finding a low-stress part time job, joining a book club, the goal here is to form new connections and feelings of self worth.

7) Pills are not skills. We need to return to recommending psychotherapy for skill building and problem solving when it comes to mental illness. We live in a disposable society, where medication is seen the quick fix. Medication is a tremendous tool for dealing with suicide and depression, but it’s not sufficient enough to help women navigate the challenges that present in later-life.

8) Choose life affirming experiences. Make sure to activate your senses. Touch. See. Smell. Taste. Listen. Re-engage to the world and it will refuel you. The goal here is to redirect negative thinking to more positive kinds of experiences.

9) Stay away from alcohol and drugs. This includes recreational, over the counter and prescriptive. They can blur your thinking and loosen inhibition.

10) Have a safety plan at-the-ready. Knowing what to do if suicidal thinking occurs can reduce death by suicide. Identify triggers that may lead to a suicidal crisis, such as an anniversary of a loss, stress from work, or a love relationship. Also include contact numbers for the person's doctor or therapist, as well as friends and family members who will help in an emergency. It’s also a good idea to share this safety plan with others.


Reference:
Substance Abuse and Mental Health Services Administration (2011). DAWN report: Trends in emergency department visits for drug-related suicide attempts among females: 2005 and 2009. Center for Behavioral Health Statistics and Quality, May 12, 1-6.