From gym memberships and daily vitamins to doctor visits and athletic physicals, we spend endless time and money to improve our physical health and the health of our loved ones. So why does mental health take a back seat to physical health when depression and suicide are on the rise?
HealthScene Ohio spoke with Dr. John Campo, head of the psychiatry department at The Ohio State University Wexner Medical Center, about the heavy topic of mental health. From warning signs to preventive action, Dr. Campo adds insight to the discussion surrounding the suicide epidemic.
HealthScene Ohio: Why does depression go unnoticed in so many suicide cases?
John Campo: Although there is no single cause for suicide, depression is likely the most important remediable risk factor for completed suicide and the mental disorder most commonly associated with suicidal behavior. Unfortunately, it is easy to miss depression in a loved one, and depression commonly gets in the way of its own treatment, with sufferers sometimes mistakenly believing that their situation is hopeless or that they deserve to feel as they do. Some individuals struggling with depression may be reluctant to share the pain they are experiencing for a variety of reasons, including concerns that they might be perceived as weak, and some depressed individuals may not appear overtly sad, sullen or irritable to others. Another common issue is that family members may personalize changes in a depressed loved one’s behavior, thinking that perhaps they are upset or angry with them or simply stressed due to work or school. Finally, stigma is pervasive, and it is sometimes difficult for friends and family members to believe that a valued loved one could indeed be suffering from depression.
HSO: What should someone do if his or her loved one starts talking about suicide?
JC: The first thing to do is to listen and to take the individual seriously. Do your best to understand what they are saying, experiencing and thinking about. Be willing to ask questions to better understand what the person is thinking or feeling, and do not be concerned that talking about suicide will somehow put the idea in their head. Avoid simply dismissing or deflecting a statement about suicide as “silly” or “crazy.” It is important for suicidal people to feel heard and understood.
HSO: Can mental illness and depression be treated like a physical illness?
JC: Patients struggling with depression have every reason to be hopeful and have positive expectations about the future. Depression is a highly treatable condition, and we are every bit as successful in treating depression as we are managing other medical illnesses such as asthma, diabetes or hypertension. There are now many scientifically proven treatments for depression, including psychotherapies such as cognitive behavioral therapy, antidepressant medications and other medical treatments such as transcranial magnetic stimulation and electroconvulsive therapy.
HSO: What types of signs and signals can people watch for?
JC: Individuals who are at risk for suicide may exhibit a number of warning signs, including talking about being in unbearable pain, feeling trapped or being a burden to others. They may increase their use of alcohol or other drugs. At-risk patients may appear to be depressed or anxious, show little interest or joy in previously valued activities, isolate themselves, become more socially withdrawn, or appear irritable, angry or aggressive. They may talk directly about killing themselves or speak about not having a reason to live. Changes in sleep patterns are also common – either difficulty sleeping or sleeping more than usual – and reports of fatigue, low motivation, and poor concentration are common. Some individuals contemplating suicide may also visit or call loved ones to say goodbye or to give away prized possessions.
HSO: Whom does depression affect more, men or women? Is there a certain age demographic more affected? If so, is there a reason or science behind that?
JC: Both males and females can suffer from depression. Depression becomes more common in females starting in adolescence and is more common in women than men thereafter.
HSO: Are there other causes of suicide besides depression?
JC: Other mental disorders are risk factors for suicide, including bipolar disorder or manic-depressive illness, schizophrenia and psychotic disorders, personality disorders such as borderline or antisocial personality disorder, conduct disorders, and anxiety disorders. Alcohol use disorder and substance abuse are also major risk factors for suicide. General medical conditions, particularly serious chronic physical health disorders and chronic pain are also risk factors for suicide. It is also worth noting that stressful life events such as a death, divorce or loss of a job can be associated with suicide risk.
Patients struggling with depression have every reason to be hopeful and have positive expectations about the future. Depression is a highly treatable condition, and we are every bit as successful in treating depression as we are managing other medical illnesses such as asthma, diabetes or hypertension
HSO: Is the lack of recognition for mental illness in society today contributing to suicide cases?
JC: So-called “psychological autopsy” studies tell us that over 90 percent of people who complete suicide suffer from a significant mental or addictive disorder, yet many individuals who kill themselves have never been recognized to be suffering from such a disorder and have not been seen or evaluated by a professional. While lack of recognition is indeed a problem, it is also important to realize that most individuals with recognized mental and addictive disorders fail to receive any services and that many of those who do fail to get treatment that is appropriate to their condition, in either type or quantity.
HSO: How can someone respectfully tell a loved one that he or she needs to seek medical help for thoughts about suicide and other signs of depression?
JC: Genuine caring provides the foundation for successfully helping a suicidal individual, and persistence is often rewarded. Most, if not all, individuals who are experiencing suicidal thoughts are ambivalent about taking their own life and are open to another person coming alongside them to help, support and problem-solve. Individuals struggling with suicidal thoughts need to understand that treatment can – and most often does – make a difference and that there is an excellent chance that their suffering can be relieved. It is often useful for them to understand that keeping them safe and alive is the first step in ensuring successful treatment.
HSO: Are there any signs of suicide and/or depression that usually go unnoticed?
JC: More often than missing signs of depression or suicide, we may fail to ask or inquire about whether an individual is thinking of suicide or have made a previous suicide attempt. It is important to remember that the best predictor of future behavior is often past behavior, and the history of a prior suicide attempt is a serious risk factor for completed suicide in the future.
Jenny Wise is a contributing writer. Feedback welcome at feedback@cityscenemediagroup.com.
About the Expert
Dr. John V. Campo is Sinsabaugh Professor and Chair of the Department of Psychiatry and Behavioral Health at The Ohio State University College of Medicine and the OSU Wexner Medical Center. He is board-certified in pediatrics, psychiatry and child and adolescent psychiatry. He completed medical training at the University of Pennsylvania, followed by residencies in pediatrics at the Children’s Hospital of Philadelphia and psychiatry and child and adolescent psychiatry at the Western Psychiatric Institute and Clinic and the University of Pittsburgh Medical Center. Campo has been honored as a NAMI Exemplary Psychiatrist and as a recipient of the American Academy of Child and Adolescent Psychiatry’s Simon Wile Leadership in Consultation Award. He is the former Chief of Child and Adolescent Psychiatry and Medical Director of Behavioral Health at Nationwide Children’s Hospital. Research interests include suicide prevention, the integration of mental health and general medical services, and psychosomatic medicine.
Hotlines to Remember
Free Crisis Hotline: 1-800-273-TALK (1-800-273-8255)
Suicide Hotline: 614-221-5445
Seniors’ Suicide Hotline: 614-294-3309
Franklin County Youth Psychiatric Crisis Line: 614-722-1800
Mental Health of America: 614-221-1441 (free counseling)
Netcare Access Hotline: 614-276-CARE (614-276-2273)
