World Suicide Prevention Day

Commemorating World Suicide Prevention Day by living yet another day. There was a time when I didn’t want to live so this is a big accomplishment for me. Now, the script:

Learn more about suicide prevention and the warning signs of suicide through the “It’s On My Mind” page: http://www.facebook.com/itsonmymind.

Check out other World Suicide Prevention Day activities at http://www.iasp.info.

To learn more about mental health conditions and suicide, visit one of The Jed Foundation’s sites at http://www.jedfoundation.org, http://www.ulifeline.org or http://www.halfofus.com. You’ll find links to many other resources through these sites. If you or someone you know needs help immediately, please call the National Suicide Prevention Lifeline at 1-800-273-TALK.

Loose Screws Mental Health News: Suicide slide

A new study from the University of Manitoba shows people who regularly attend some kind of religious service are less likely to attempt suicide. The study, published in the Journal of Affective Disorders, surveyed 37,000 Canadians and their connection with spirituality, religious worship, and suicidal behavior. Those who simply said they were spiritual but didn’t attend religious services did not show a reduced risk of suicide attempts. However, I was dismayed to read that researchers didn’t investigate why regular church attendance decreases the risk of suicide attempts. (Note to self: Go to church each Sunday!) (pic via www.assumpta.fr)

Alison Go of U.S. News & World Report cites a study from Academic Medicine (originally reported by Inside Higher Ed) which suggests depression affects 21.2 percent of medical students. The rates is 11.2 percent higher than that of the general population. And unfortunately, 13 percent of black medical student reported suicidal ideation in the survey, suggesting that the demographic is more likely to suffer from suicidal thoughts.

And yet another study about suicide… The University of Gothenberg in Sweden performed a study on people who had nightmares following a suicide attempt and found out that they were five times more likely to try committing suicide again. The conclusion is based on a meager sample size of 165 patients but I suppose it’s a start.

While it appears that other sleeping obstacles do not raise the risk of multiple suicide attempts, patients who have attempted suicide seem to battle sleeping problems on a regular basis.

It is normal for patients that have attempted suicide to suffer from sleeping difficulties. Some 89 percent of the patients examined reported some kind of sleep disturbance. The most common problems were difficulty initiating sleep, followed by difficulty maintaining sleep, nightmares and early morning awakening.

Interesting observation considering that I have pretty much all of the common problems with the exception of early morning awakening.

Finally in a semi-cool story, a 22-year-old New Jersey guy who was friends with an 18-year-old Californian over the Internet called California police when he found out the 18-year-old said he would attempt suicide. Although it sounds like the teen (his name was not disclosed) is pretty upset about being saved (I know the feeling), it’s a (somewhat) happy ending compared to what happened in November when a Florida teenager streamed a webcast of him committing suicide by dying of a drug overdose. The Florida teen died before police arrived.

Emotional depression along with economic recession?

CNN has a story looking into whether suicides increase as the economy falls into a recession and investors begin to lose thousands of dollars in the stock market. According to a chart by the NIH & Bureau of Labor Statistics, there seems to be a correlation. Here are the latest high-profile suicides that seem to have been prompted by the economic downturn:

• Steven Good, a chairman and CEO of Sheldon Good & Co., a major U.S. real estate auction company, may have shot himself, according to police.

• Adolf Merckle, a 74-year-old German billionaire who was ranked the 94th richest person in the world by Forbes magazine, killed himself by walking in front of a train. According to the CNN article, “in recent months his empire had been near collapse.”

• Rene-Thierry Magon de la Villehuchet, a 65-year-old French investor, killed himself after losing $1.4 billion in the Ponzi scheme that Bernard Madoff ran.

• Kirk Stephenson, 47-year-old English financier  and COO of Olivant Ltd., jumped in front of a train in September (the real climax in the economic collapse).

The Centers for Disease Control and Prevention (CDC) estimates more than 32,000 people commit suicide each year but public health experts expect an increase upwards to an additional 1200 suicides because of the economic climate. Here are a few more stats that are worth reading:

• Calls to the National Suicide Prevention Hotline went from 412,768 in 2007 up to 540,041 in 2008.

• Unemployed people are two to four times more likely to kill themselves than those who are employed.

I have to admit, I found that following paragraph interesting:

So what about these wealthy and powerful men who have recently killed themselves? Mental health experts say it’s impossible to say why they did it, but they say that people who kill themselves have an underlying psychological issue, such as depression or bipolar disorder, so it’s not only about the money.

So I pose a question: Do all those who commit suicide have a mental illness? Or is it possible to kill oneself without being mentally ill?

The Art of Distraction

I babysat the 21-month-old son of a friend on Thursday. He's an adorable, sweet little kid. Very affable and social. With the addition of a new brother, he's been craving the attention that he used to have as an only child so he's always happy when someone takes the time to sit and play with him.

His mother had to go to court to contest a traffic ticket and she took the baby with her so I offered my (free) babysitting services. I'm not a babysitter and I normally don't offer to babysit kids alone because I'm not very good with them and most young children don't like me much. However, I've really grown to love my friend's son—we'll call him Danny—and felt like I could take care of him without too many problems.

We were upstairs on the second floor in his bedroom and I talked to his mother about a few logistics before she left. Finally, she kissed Danny goodbye and headed down the stairs. Since Danny's only 21 months, he needs to be carried down the stairs. When he saw his mother disappear, he began crying (much to my surprise and much to my dismay). My first thought was, Oh great. Now, he's crying for his mommy. This isn't going to be as easy as I thought.

I tried to sit down with him on my lap in the bedroom but he was extremely fidgety and got up and began running to the edge of the steps. Fearful of a fall (remember I don't have much babysitting experience!), I grabbed him, picked him up, and shut the door to the bedroom. Realizing this meant mommy wasn't coming back right away, he cried even harder. Now I was really at a loss of what to do.

I saw a little toy helicopter that he had been playing with earlier. The helicopter made noises and I tried to hand it to him and pressed all sorts of buttons to amuse him. He wasn't fazed. Danny kept right on crying.

Suddenly feeling desperate, my next thought was, I can't have this kid crying until his mother comes back. She's going to think I hurt the poor child. I searched around the room and found a teddy bear and handed it to him. He wasn't interested in that either. Finally, my eyes fell upon a toy set up like a two-level parking lot with a car ramp that twisted around to the ground. Several small cars sat on top of the lot. Remembering Danny loved to pick up cars and hand them to people one by one, I tried the tactic as a last-ditch effort.

I picked up the first car and held it open in the palm of my hand. He kept crying but looked down at it. I grabbed a second car. His crying began to die down and he began to look at the two cars with curiosity. I snatched another car. He stopped crying and simply looked at me with a blank stare, wondering what I'd do next. I picked up another car and held them flat out on my hands for a few moments, letting him take in the number of growing vehicles. Finally, he gave me a little smile. I started rolling a car up and down his belly and he began giggling.

Problem solved. We stayed busy until his mother came home. I expected him to run and cling to his mother after she got home but he gave her a quick glance and wanted me to keep playing with him because he was having so much fun. That was pretty satisfying and felt like my first solo babysitting gig had been a success.

Just like I'd distracted Danny from the sadness of his mother's disappearance, I'm finding that a lot of people in my life have been trying to distract me from the sadness and emotional pain that have been plaguing me lately.

FDA: No link between Singulair and suicidal behavior

On Tuesday, the FDA announced that an investigation into Merck’s clinical trial data did not discover a link between Singulair (montelukast) and suicidal behavior. The investigation, which began 9 months ago, was prompted by a number of reported suicides, especially that of 15-year-old Cody Miller who took the drug and appeared to have no history of mood or behavioral problems. (It is worth noting here that Singulair “is the top-selling drug for people under 17 years old” and Merck’s biggest seller with annual sales of close to $4.5 billion.)

In attempt to assess Merck’s data better, the FDA also investigated AstraZeneca’s Accolate (zafirlukast) and Cornerstone Therapeutics’s Zyflo (zileuton). Although the FDA did imply that “the data were inadequate to draw a firm conclusion” and said that the clinical trials were not set up to observe any psychiatric behavior. Here are the data the FDA discovered during their review of these trials:

Singulair: 41 placebo-controlled trials that included 9,929 patients

• Reports of suicidal thoughts: 1 (treated with Singulair)
• Attempted suicides: None reported
• Completed suicides: None reported

Accolate: 45 placebo-controlled trials that included 7,540 patients

• Reports of suicidal thoughts: 1 (placebo group)
• Attempted suicides: 1 (placebo group)
• Completed suicides: None reported

Zyflo: 11 placebo-controlled trials (number of patients unknown)

• Reports of suicidal thoughts: None reported
• Attempted suicides: None reported
• Completed suicides: None reported

Forgive me for being cynical but the data sounds fishy. I can’t pinpoint why but it does. The suicide numbers and patient involvement data seem to deviate some from the numbers listed in Merck’s PR issued last March. (I’m seeing 11,000+ patients vs. 9,929 patients.) Regardless of the clinical trial data, it appears that the FDA as of yet have not reviewed post-marketing data.

Scott Korn, a senior safety surveillance executive for Merck said in an article for Reuters:

“‘At the time we did not believe, and we still don’t think a link has been established’ between Singulair and the suicides.”

In the same article, Sanford Berstein analyst Tim Anderson had this to say about the possibility of the FDA finding a link:

“If the… safety review leads to a stern warning about behavioral changes in the Singulair label, this could frighten users of the drug or their parents and give Merck’s competitors ammunition to attack the brand.”

The Washington Post has Dr. David Weldon, director of the Allergy and Pulmonary Lab Services at Scott & White in College Station, Texas, on record saying that he had not “seen any increase in psychiatric problems with the drug but that some patients had complained of nightmares after starting on Singulair.” (Note: It appears that the closest conflict of interest Weldon would have here is that he served as a consultant and is honoraria for AstraZeneca.)

Dr. Rauno Joks, head of the SUNY Downstate division of allergy and immunology, made an interesting point in the Washington Post article:

“The physician really needs to review whether there are symptoms that have developed since patients started taking the medication, if there’s an underlying depression that was there before medication started.

Also, seasonal allergies in and of themselves can cause fatigue and lethargy, which makes it harder to assess, because those are some of the symptoms you have with depression.”

The FDA says they’ve completed analyses of submitted clinical trial data but their “safety review will continue” for several more months before they come to a concrete conclusion. For customer testimonials, check out medications.com that has over 2,300 people reporting side effects and askapatient.com that has an average 2.3 rating from 524 reviewers. The most commonly reported mood-related side effect on both of the sites is irritability.

Goal for 2009: Staying Alive

I’m being hit by suicidal thoughts again. Hard.

I’m not going to the hospital but if these thoughts keep pummeling me, it’ll become a consideration again. I’m walking a fine line here because my husband’s family has had a suicide hit close to home earlier this year and they don’t need to experience another loss. I try to keep in mind how important I am to many people that I know: my husband, my in-laws, my mom (I’m her only child). I try to visualize the grief my mother would experience losing her only kid. It’s worked so far. I can only pray that it lasts.

In the meantime, I’ve had my husband hide my belts. I ended up in the hospital in October 2006 after my husband woke up just in time to find me kicking a chair away in an attempt to hang myself from an air vent.

After what now seems like a short reprieve, I constantly glance up at the ceiling air vent in our bedroom thinking about trying the hanging thing again. I’m sure I could find something else to use if I really wanted to but I’m trying not to dwell on the idea too much.

The lies that used to convince me to try killing myself, oh say, three years ago, don’t work as well anymore. I can fight off most of them:

Lie #1: Nobody cares about you.
Answer: I have a husband, a big family, and wonderful friends who love and care for me. I’d be missed.

Lie #2: You don’t make a difference in this world.
Answer: I have a 98-year-old grandmother who loves me to pieces, I have a mother who I bring so much joy to, I have a husband who tells me I’m the best thing that’s happened to him, and I have a mother-in-law who thinks that I’m so cool, she wants to spend time with me. I do make a difference.

Lie #3: You’re worthless.
Answer: My husband tells me all the time that I’m worth something to him and that he’d be lost without me. If only for him, I’m worthwhile.

So the “lies,” or challenges if you will, have changed. Here’s the new one:

“You’re such a liar. You’re just looking for attention. You want people to pity and feel bad for you while you sit there and cry wolf. So, if you’re so serious about committing suicide, why don’t you show them that you’re not kidding and prove ’em all wrong?”

Hmm. Good question.

Mood rating: 3

Generic Lamictal (lamotrigine)

I'm on "Day I-don't-know" of lamotrigine (generic Lamictal). It's been at least 2 weeks. I haven't had any significant side effects except for extreme fatigue. I am often tired. Some days, I can give myself a boost of energy by playing the Wii Fit (which I snagged Saturday afternoon) and other days, exercising just wears me to out to the point where I head to the shower and then to bed. I can have 3 cups of coffee, never become fully awake, and still go to sleep at a decent time.

I'm still not sleeping well. Haven't slept well since before I went into the hospital in October 2006. I can't remember the last time I had truly restful sleep.

My symptoms remain at bay. I haven't had many suicidal thoughts or impulses. In fact, some days, I can go without thinking about suicide at all. I can't say it's all the medicine — my counseling and faith play a much bigger role — but I'm sure the medicine helps.

I've recently noticed that I'm not suffering from as much social anxiety. Again, I don't know if this is due so much to the medication as it is to the resurgence of my spiritual life. I ventured out on Sunday to a meetup writers workshop group that I'd never been to before. It was extremely weird. Not the situation, but the fact that I walked into a room full of strangers, made myself comfortable on the couch at the coffeehouse and offered input quite freely without worrying about what the others thought of me. I even had the audacity to network with a woman who works at a trade magazine in the area. How strange. I don't have balls. This is not me.

What the heck has happened to me?

Loose Screws Mental Health News

• Postpartum Progress reports that the Melanie Blocker Stokes MOTHERS Act bill did not pass. Spreading lies like this did not help.

• The FDA recently approved Stavzor, a valproic acid delayed release capsule, for the treatment of bipolar disorder, seizures, and migraine headaches. Wow. That’s covering the gamut. The drug looks like it’ll be competing directly with the Depakote brand.

The mastermind behind Stavzor is Noven Pharmaceuticals (in conjunction with Banner Pharmacaps Inc.). The new “small, easy-to-swallow soft gel capsule” is available in three strengths: 125, 250, and 500 mgs. The pills are are “up to 40% smaller than han Depakote® and Depakote ER® tablets at the 500 mg dosage strength.” From Noven’s PR:

Stavzor is approved for the treatment of manic episodes associated with bipolar disorder, as monotherapy and adjunctive therapy in the treatment of patients with complex partial seizures that occur either in isolation or in association with other types of seizures, and for prophylaxis of migraine headaches.

The drug will hit the market in mid to late August.

• A recent AP article notes that more than 22,000 veterans contacted the veterans portion of The National Suicide Prevention Lifeline hotline since its inception last July. The government reports that the hotline support has helped to prevent more than 1200 people from committing suicide. The Veterans Administration (VA) estimates that 6500 veterans commit suicide annually. In light of recent news regarding the increase in Marine suicides, the effectiveness of the suicide hotline is offers significant promise.

The hotline receives an average 250 calls each day from veterans that have fought in Iraq, Vietnam, and Afghanistan.

The issue of soldiers with mental illness has recently come to light with studies showing that 1 in 5 soldiers returning from Iraq and Afghanistan have shown symptoms of post-traumatic stress disorder. The issue of the high suicides rate has been a high priority of the VA since mental health director Ira Katz tried to hide the significant number of suicides committed by veterans.

The National Suicide Prevention Lifeline is available 24 hours a day by calling 800-273-TALK (8255); veterans should press “1” after being connected.

• Psychologists are now saying that hitting and yelling at children is causing an increase in mental illness, which has manifested in ages as young as 3 years old. News.com.au reports that 1 in 7 children are affected by a mental disorder.

“We have seen a 60 per cent increase in demand for our child anxiety classes in the past six months,” said [Dr. Kimberley O’Brien, of the Quirky Kids Clinic at Woollahra in Sydney].

It sounds more like the article is speaking of children who are exposed to constant physical and emotional abuse. If that’s the case, shouldn’t there rather be an increase in parenting properly classes?

• Finally, a bit of sad news: police in Connecticut report than 10-year-old killed herself apparently by hanging. Police do not believe that foul play was involved. I can’t imagine being 10 and feeling suicidal. It was tough enough at 14.

Pick a number: 20 or 9,000,000

20 people annually or 9,000,000 people annually.

Those are the numbers that the Golden Gate Bridge (GGB) Board of Directors will need to choose between in October.

GGB officials are considering a proposal to erect suicide barriers on the bridge. Public forums were held on Tuesday and Wednesday to gauge public reaction to the five options designed to deter suicides. The cost of erecting one of the barriers is estimated between $40–50 million.

Bridge officials have been culling comments about the barriers at the forums and through the site Golden Gate Bridge Suicide Deterrent Barrier. As of Wednesday, July 23, the San Francisco Chronicle reports:

[O]f the more than 900 tallied so far, an overwhelming 75 percent of the respondents said they prefer that no barrier be built at all. But a small, passionate group of proponents – many of them family
members of people who jumped to their deaths from the bridge – insist a barrier is needed. Any barrier.

“Overwhelming 75 percent” prefer no barrier? That’s not good.

Opponents of the barriers say it will ruin the aesthetic view of the bridge for the yearly estimated 9 million visitors.

I stumbled upon a blog, Bookworm Room, yesterday that brought the issue to my attention. This blogger likely represents the sentiment of the “overwhelming 75 percent.”

2-Year Anniversary: The Long and Winding Road

I’m aware that my blog has taken a significantly dark turn.  This may alienate some of my readers who seek happier, brighter topics. I don’t think my posts have been negative; on the contrary, I think they’ve been positive. Positive and educational.

I’ve been exploring the topic of suicide recently because it’s a subject that’s quite near and dear to me, now more than ever before.