Suicide Prevention, We Need to do More….

I had this great person, and I failed to protect him. I failed to help him feel good about himself, to help him be successful at whatever he wanted to do; to feel supported. I failed to provide a safe place for him to share his suffering. I failed to see the signs.

I have been attending a suicide survivor support group for nearly four months.  During the sessions, I connect with fellow survivors who are living through the grief after a loved one took their own life.  

In a recent session, families were asked to share their loved one’s interactions with the behavioral health care system.

We learned that all of our loved ones had some degree of treatment or interaction with the system, including inpatient care.  You know their ending; the treatment was unsuccessful.

Their experiences varied, but we were able to draw some conclusions:

  • There aren’t enough behavioral health resources.   
  • Our loved ones were not appropriately diagnosed.  
  • When loved ones did seek care, providers were unable to emotionally make a connection with them to take treatment seriously. 
  • Our adult loved ones did not take action to seek or continue treatment on their own accord, after in-patient care.  There was no provider follow-up to continue engagement.
  • Providers were unable to find the right medication and dosage before time ran out.
  • Therapists, psychiatrists, and facility doctors did not provide coordinated care.
  • Our loved ones were not taught how to seek treatment during a crisis. 
  • They were not taught that it is normal and healthy to seek treatment.
  • For those over 18, patient privacy laws hinder the family’s ability to interact with their loved one’s health care providers (while still maintaining some privacy).
  • None of our loved ones voluntarily dialed 911, called a suicide hotline, or called their therapist.
  • And of course, navigating the healthcare system is just foreign and cumbersome for young adults.

I had this great person, and I failed to protect him.  I failed to help him feel good about himself, to help him be successful at whatever he wanted to do; to feel supported.  I failed to provide a safe place for him to share his suffering.  I failed to see the signs.  Of the signs I did see, I failed to understand the seriousness of what they meant.  

I have written about his before, but it weighs on me every second of every day.

There is a strong link between depressive disorders and suicide.

There was a mental health professional on the radio today who was bringing awareness to suicide prevention.  He said there is a strong link between depressive disorders and suicide.  He said that depression can come from a chemical imbalance between serotonin [ser’ a  toe’ nin] and norepinephrine [nor-eh’-pin-ef’-rin].  That did not mean much to me, so I did some research.  My master’s degree should be good for something; having taught me how to research and to write (though professionals may find the latter debatable). I am not a medical professional, so you may want to do your own research, but this what I found:

“Serotonin [ser’ a toe’ nin] is widely known for playing a major part in regulating moods.  It has been called the body’s natural “feel-good” chemical because it’s involved in your sense of well-being. However, that’s only true when your serotonin level is within the normal range.” (Salters-Pedneault, Kristalyn P, 2018).  

“Norepinephrine [nor-eh’-pin-ef’-rin] is a stress hormone.  It’s mainly stored in the neurons (nerve cells) of the sympathetic nervous system with small amounts also stored in the adrenal tissue, which lay on top of your kidneys.  As a hormone, norepinephrine is released into the bloodstream by the adrenal glands and works alongside adrenaline (also known as epinephrine) to give the body sudden energy in times of stress, known as the “fight or flight” response.  As a neurotransmitter, norepinephrine passes nerve impulses from one neuron to the next.” (Purse, Marica, 2018).

“An imbalance of these two chemicals can lead to the person not understanding the options available to help them relieve their suffering. Many people who suffer from depression report feeling as though they’ve lost the ability to imagine a happy future, or remember a happy past. Often they don’t realize they’re suffering from a treatable illness, and seeking help may not even enter their mind. Emotions and even physical pain can become unbearable. They don’t want to die, but it’s the only way they feel their pain will end. It is a truly irrational choice. Suffering from depression is involuntary, just like cancer or diabetes, but it is a treatable illness that can be managed.” (Suicide Awareness Voices of Education, SAVE.org 2018).

There needs to be more research on mental illness and prevention needs to start in the pediatrician's office. There needs to be more education for parents and teachers.

There needs to be more research…on how to detect this chemical imbalance in the primary care doctor’s office.  When you go in for your annual physical, medical providers should be able to detect this imbalance through a simple blood draw.  

It should start when our children are in the pediatrician’s office.  Parents and educators who interact with diagnosed children should take seriously all mental health diagnosis.   

Parents and educators should be required to know the signs of suicidal ideation. Schools should be staffed with mental health advocates. 

My son was smoking and ingesting street marijuana.  We know he ingested the “day of.”  I have asked my psychiatrist to help me understand what impact marijuana has on the body.  My psychiatrist, along with every therapist I have talked to, said it is a drug, and it alters the brain. Street marijuana typically contains synthetics which adds an additional variable.  

My question is; does marijuana also contribute to the imbalance in the brain?

My question is; does marijuana also contribute to the imbalance in the brain?  

My son was a scholar and sought out information.  I came across material on marijuana that was in the viewing history of his computer.  These videos were neutral towards marijuana, but for obvious reasons, I grasped onto specific findings.  I have summarized what I think is relevant to my son’s situation. 

“Ingesting marijuana binds to receptors in your brain, making them continually fire and causes your imagination, thoughts, and perceptions to magnify, making every thought and feeling, feel like a significant one. Smoking marijuana has effects within minutes and lasts for two to three hours. Heating up marijuana in oil and digesting it delays the effect as it first needs to metastasize through the liver. It can last four to eight hours and adds an additional compound not found in smoking that increases its potency and lasts longer.  It takes one to two hours to feel the effects and it is harder to control the intensity of the high, ending up higher than you intended to.” (AsapSCIENCE, 2017). 

I read the comments posted on this video, which included people discussing their own experiences. Some users said,  “When they ingested marijuana, they experienced hallucinations.” I think the experience can vary by the person based on their brain composition, how much they ingest, and other compounds found in the drug. 

A second video my son watched said this about marijuana and mental health:

“There is moderate evidence, for people with mental health issues, it worsens symptoms, cognitive performance, and suicidal ideation and attempts.” (Healthcare Triage, 2017).

Some say marijuana is just for social gatherings or “fun”. It may have started that way for my son, but according to the medical community, if you have a mental illness (e.g. depression, anxiety, ADD/ADHD) it hasnegative consequences.

At my request, the National Alliance on Mental Illness (NAMI) gave me resources on marijuana and suicide.  One of the medical journals reported on a study which found that “early and frequent use of cannabis is associated with the major depressive disorder (MDD) as well as suicidal thoughts and behaviors, a large twin study suggests.” (Yasgur Swift Batya, 2017).

  • Marijuana worsens the ability to conduct executive functioning (to organize cognitive processes like planning ahead, prioritizing, stopping and starting activities, shifting from one activity to another and monitoring one’s own behavior).
  • It also hampers the working memory (the ability to store and manage information for a short period of time).  
  • Frequent use of marijuana can also lead to not caring about things that are important, such as school or work. Kids and young adults using marijuana are less likely to keep up with their medication. 
  • Marijuana for some can increase anxiety, including paranoia. Street marijuana is usually stronger than medical marijuana as it may contain other chemicals. 
  • People with attention deficit disorder or attention deficit hyperactivity disorder (ADD/ADHD) are 2.5 times more likely to develop a substance abuse problem. (understood.org 2018)

Some say marijuana is just for social gatherings or “fun”.  It may have started that way for my son, but according to the medical community, if you have a mental illness (e.g. depression, anxiety, ADD/ADHD) it has negative consequences.

I found these statistics on SAVE.org 2018 about suicide:

  • Suicide is the 10th leading cause of death in the US for all ages. (CDC)
  • Every day, approximately 105 Americans die by suicide. (CDC)
  • There is one death by suicide in the US every 12 minutes. (CDC)
  • Depression affects 20-25% of Americans ages 18+ in a given year. (CDC)
  • Suicide takes the lives of over 38,000 Americans every year. (CDC)
  • Only half of all Americans experiencing an episode of major depression receive treatment. (NAMI)
  • 80% – 90% of people that seek treatment for depression are treated successfully using therapy and/or medication. (TAPS study)
  • There is one suicide for every estimated 25 suicide attempts. (CDC)
  • These statistics have led the medical community to call the cause of death by suicide a “crisis.” I never thought it (suicide in my family) would happen to us. Don’t be afraid to talk. Be there for someone else.  Learn the signs.  Help remove the stigma.

Share what you think.  What has been your experience?  Leave  a comment at the end of this post.

To honor my son, his sister, father, and I will be walking to raise money for NAMI, Team Willpower! We would be honored if you joined us in whatever way you feel comfortable. 

REFERENCES

AsapSCIENCE (2017, March 23). Our Brain on Edible Marijuana, video recording, YouTube, viewed 20 August 2018, <https://www.youtube.com/watch?v=pUhJnKKQDTE>.

Healthcare Triage, What We Know About Pot in 2017 (2017, February 13), video recording, YouTube, viewed 21 August,2018, <https://www.youtube.com/watch?v=yewlM8CtbQU&t=345s>.

Purse, Marica (updated 2018, May 03). What is Norepinephrine’s Role in Treating Mood Problems?. verywellmind.com 2018, viewed 21 August 2018, Retrieved from <https://www.verywellmind.com/norepinephrine-380039>.

Salters-Pedneault, Kristalyn P, (updated 2018, July 9). How Serotonin Regulates Different Body Functions, verywellmind.com 2018,  Retrieved from <https://www.verywellmind.com/what-is-serotonin-425327>.

Suicide Awareness Voices of Education (SAVE.org) 2018, Depression, viewed 21 August,2018, Retrieved from <https://save.org/about-suicide/mental-illness-and-suicide/depression/>.

Suicide Awareness Voices of Education (SAVE.org) 2018, Suicide Statistics and Facts, viewed 21 August 2018. Retrieved from  <https://save.org/about-suicide/suicide-facts/>.

The Understood Team, understood.org 2018, Experts Weigh In: Marijuana and ADHD, viewed 21 August 2018.  Retrieved from <https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/add-adhd/marijuana-and-adhd>.

Yasgur Swift Batya, MA, LSW, (July 31, 2017).  Heavy Cannabis Use Associated With Depression, Suicidality. Medscape 2017, viewed 21 August 2018. Retrieved from < https://www.medscape.com/viewarticle/883614?src=soc_fb_share>.