Which Comes First? Depression, Drug Abuse, and Suicide

"Suicide is a major public health problem in the United States. In 2003, suicide was the 11th leading cause of death among adults...18 or older" (link to the Office of Applied Studies - OAS - report "Suicidal Thoughts, Suicide Attempts, Major Depressive Episode, and Substance Use among Adults, 2006).

Of Adults experiencing a major depressive episode (MDE)

• 56.3% thought that it would be better if they were dead
• 40.3% thought about committing suicide
• 14.5% made a suicide plan
• 10.4% made a suicide attempt

The Drug Abuse Warning Network (DAWN), a program of the Substance Abuse and Mental Health Services Administration (SAMHSA), collects data on drug related emergency hospital visits, analyzes the information, and publishes it in the form of reports indicating current trends in drug use and abuse, related health hazards, and the impact on the nation's health systems. Emergency cases involving drugs are divided into the following categories

• suicide attempt;
• seeking detoxification;
• alcohol only, in patients younger than 21;
• adverse reaction;
• overmedication;
• malicious poisoning (e.g., drug-facilitated sexual assault, product tampering);
• accidental ingestion; and
• other.

Diagnostic Criteria for Major Depressive Episode (MDE) from The Diagnostic and Statistical Manual of Mental Disorders, or DSM-IV, indicates "a period of 2 weeks or longer during which there is either depressed mood or loss of interest or pleasure and at least four other symptoms that reflect a change in functioning, such as problems with sleep, eating, energy, concentration, and self-image."

"In 2004, an estimated 106,079 emergency department visits were the result of drug-related suicide attempts by persons aged 18 or older. A psychiatric condition was diagnosed in 41% (43,176) of the drug-related suicide attempts treated in the emergency departments. The most frequent psychiatric diagnosis was depression" (Suicidal Thoughts...link).

"Adults with a past year major depressive episode who reported past month binge alcohol or illicit drug use were more likely to report suicidal thoughts and suicide attempts than their counterparts with past year depression who did not binge drink or use an illicit drug in the past month" (Suicidal Thoughts...link).

"Alcohol dependence is 4 times as likely to occur among adults with mental illness than adults with no mental illness (9.6 percent vs. 2.2 percent). Furthermore, the rate of alcohol dependence increases as the severity of mental illness increases" (link to the Data Spotlight, a publication of the National Survey on Drug Use and Health, Alcohol Dependence is More Likely Among Adults with Mental Illness than Adults without Mental Illness).

"Adults aged 55 or older with past year MDE were less likely than their counterparts in other age groups to have made a suicidal plan. Adults aged 18-20 were more likely than adults in all other age groups to have attempted suicide" (Suicidal Thoughts...link)

"Adults age 18 or older who reported binge alcohol use were more likely to report past year MDE than their counterparts who had not engaged in binge drinking (8.7 vs. 7.3%). In addition, adults with past year MDE and past month binge alcohol use were more likely to report past year suicidal thoughts and past year suicide attempts than those with MDE who did not binge drink" (Suicidal Thoughts...link)

"Simalarly, adults aged 18 or older who reported having used illicit drugs during the past month were more likely to report past year MDE than adults who had not used illicit drugs during the past month (14.2 vx. 7.1%). Rates of past year suicidal thoughts and suicide attempts were also higher among adults with past year MDE who had used illicit drugs during the past month tan adults with past year MDE who had not used illicit drugs" (Suicidal Thoughts...link)

Our society is set on the quick fix, the pill for the headache, the tonic for the rheumatism, the shot for the nausea, changing the channel when we don't like the programming, or giving more money when we need more information.

Unfortunately, life does not always respond the way we want. Negative emotions are not easily stopped without incresed effort. Prevention techniques do not work on the drop of a dime. The more we prevent; however, the more our minds and bodies build the antibodies needed to deal with the negative things that happen. Key elements of prevention include the following:

• Proper nutrition and exercise - eat right, keep fit, and get enough sleep. Your emotional difficulty will decrease dramatically.
• Support networking - a support network is a group of people connected together to form a safety net for the individual. When positive things happen, they rejoice. When negative things happen, they gather closer together to keep the individual from hitting bottom. Religious organizations, clubs, hobby groups, extended family, and friends with similar hopes and dreams all provide strength and support.
• Communication - talking to others about what is happening in life is necessary for the problem solving process. People who isolate themselves from others loose their ability to change their perspective by listening to others' points of view. The sharing of thoughts, feelings, experiences, and difficulties enables burdens to be shared and saves the back of the one carrying them.
• Covenants - covenants are promises made with others in exchange for priveleges. Social groups that have membership requirements use covenants as a way to save their resources for a limited few. Covenants of safety and obedience are made when children enter the public school system. Breaking these covenants results in either punishment or abolishment from the organization. Covenants bind people together and keep them connected.
• Time - time is a great healer. Sometimes, it is simply a matter of waiting until things are better. Waiting with others is better than waiting alone. Finding ways to spend time productively in positive activies is better than using alcohol or drugs. Read, play a musical instrument, watch something uplifting, find someone who needs help and you will feel important and needed.
• Music - music is a great way to lift the spirits, enjoy work, be inspired, and learn. Music has a magical quality that can bring a person down in the depths of depression or take one soaring into the clouds. If you are feeling down, check what kind of music you are listening to and find something better.
• Journaling - journaling helps to get your feelings out on paper, whether positive or negative. When journaling is done on the computer, it can include clip art or changes in the size, color, and formation of the font. Journaling enables words to speak without saying them aloud.
• Thought Stopping - putting up a stop sign in the mind is a great way to stop difficult thoughts from taking over.
• Visualization - visualize your problems as objects and your fears as animals. As you figure out what to do with them, you will find what you can do to make the fear go away or solve the problem.
• Shift of Focus - do something different for a few minutes. Take a walk, ride a bike, go up and down the stairs, or read something aloud. Let your mind change its focus to something different and the presenting issue will subside in importance.
• Deep Breathing and Relaxation - take five minutes to close your eyes, breathe deeply, and relax your body. It will help slow down your heart, drop your blood pressure, and keep you from saying or doing things you regret.

Dealing with our feelings decreases the need for medications associated with mental health issues, as well as the temptation to use drugs and alcohol to solve life's problems. The more resources we have at our disposal, the more likely we are to choose life!