Definition of depression
severe, typically prolonged, feelings of despondency and dejection.
"self-doubt creeps in and that swiftly turns to depression"
synonyms:melancholy, misery, sadness, unhappiness, sorrow, woe, gloom,gloominess, dejection, downheartedness, despondency,dispiritedness, low spirits, heavy-heartedness, moroseness,discouragement, despair, desolation, dolefulness, moodiness,pessimism, hopelessness;
Major Depression, also known as clinical or unipolar depression, is one of the most common mental illnesses. In America over 9 million American adults suffer from clinical depression each year. This estimate is likely to be higher since depression commonly remains undiagnosed and untreated in a large percentage of the U.S. population. Major Depression is more than a temporary state of feeling sad; rather, it is a persistent state that can significantly impair an individual's thoughts, behavior, daily activities, and physical health.
Major Depressive Disorder impacts all racial, ethnic, and socioeconomic groups and can occur at any age. The average lifetime prevalence of depression is 17%: 26% for women and 12% for men. The mean age for a first episode is in the thirties. Demographic differences show that rates are higher in urban rather than in rural areas. No racial significance has been noted. Along gender lines, women suffer from depression at twice the rate of men. Statistics have shown that one out of every seven women will experience at least one depressive episode in their lifetime. This gender difference is best explained by looking at the interplay between biological, genetic, psychological, social, and environmental factors.
Classified as mood disorders, major depression, along with other depressive disorders such as dysthymia (a chronic less severe form of depression), and bipolar disorder (manic depression) fall along a spectrum. On one end of the spectrum is unipolar or major depression and on the opposite is bipolar disorder or manic depression, both with varying degrees of severity and duration. Along this spectrum, there are several categories of mood disorders, such as postpartum depression, seasonal affective disorder (SAD) and psychotic depression, as well as variants of bipolar disorder. Bipolar disorder is characterized by severe and disabling cycles of depression and mania.
Mood disorders are highly treatable conditions, with each type requiring different treatment approaches and forms. Antidepressant medications and psychotherapies offer useful treatment approaches and are commonly employed in treating the debilitating effects of depression. However, if mood disorders are left untreated for long periods of time, the debilitating effects of depression can lead to suicide.
SYMPTOMS OF MAJOR DEPRESSIVE DISORDERSymptoms of Major Depression represent a significant change from the individual's normal level of functioning. Together the symptoms cause significant distress or impairment in the individual's life and his/her ability to function. Depression symptoms can occur with either a sudden onset or in a more gradual fashion, with the severity of symptoms ranging from mild to severe.
A Major Depressive Episode is defined as having five or more of the following symptoms present for the same two-week period, and represents a change from the individual's normal level of functioning when well. At least one of the five required symptoms must be (1) depressed mood or (2) loss of interest.
- depressed mood experienced most of the day, nearly every day;
- diminished interest or pleasure in all or almost all activities most of the day, nearly every day;
- significant change in appetite (increase or decrease) or weight (loss or gain);
- insomnia or hypersomnia nearly every day;
- observable psychomotor agitation (feeling restless or fidgety) or retardation (feeling slowed down) nearly every day;
- loss of energy or fatigue nearly every day;
- feelings of worthlessness, or excessive or inappropriate guilt, nearly every day (not merely self reproach about being sick);
- diminished ability to think or concentrate, or indecisiveness, nearly every day (either subjective account or observed by others);
- recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
In psychotic major depression, the delusions and/or hallucinations only occur when the person is also experiencing significant depression. These symptoms do not occur when the person is no longer depressed. If one experiences these psychotic symptoms when they are not depressed, there are other diagnoses that would need to be considered.
SYMPTOMS OF DYSTHYMIC DISORDERThe differentiation of dysthymic disorder from major depressive disorder can be difficult. Key features of dysthymia are a mild to moderate depressed mood that has a chronic course (greater than 2 years). Dysthymia is characterized by the following:
- Depressed mood for most of the day, for more days than not, for at least two years.
- While depressed, there must be present 2 or more of the following: poor appetite or over-eating, insomnia or hypersomnia, low energy/fatigue, low self-esteem, poor concentration or difficulty making decisions, feelings of hopelessness.
- During the two-year period, the patient has never been without the symptoms in number 1 or 2 for more than 2 months at a time.
- No history of a major depressive episode, manic episode, mixed episode, hypomanic episode or cyclothymic disorder.
- The symptoms cause significant impairment or distress.
- Distinct period of abnormally and persistently elevated, expansive or irritable mood, lasting for at least one week (or any duration if hospitalization is necessary).
- During the period of mood disturbance, three (or more) of the following symptoms (four if the mood is only irritable) have been present to a significant degree:
- inflated self-esteem or grandiosity
- decreased need for sleep
- more talkative than usual or pressure to keep talking
- disconnected or racing thoughts
- increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation
- excessive involvement in inappropriate social behavior
- The mood symptoms cause significant impairment or distress, or severity of illness requires hospitalization to prevent harm to self or others, or there are psychotic features.
CAUSES OF DEPRESSIONThe exact etiology of depression is yet to be determined; however, multiple factors, including biological, psychological, and environmental factors are involved in the presentation of depression. For example, an individual who has a first-degree relative with depression has a four times higher risk of developing depression than the general population. Twin studies have shown that an individual with a monozygotic twin with depression has as high as a fifty percent chance of developing the disorder.
Major depression is caused by imbalance of certain neurotransmitters (chemical messengers) in the brain, such as serotonin research, norepinephrine, and dopamine. Antidepressants work either by changing the sensitivity of the receptors or by increasing the availability of neurotransmitters in the brain.
In addition to genetic components, there are many psychosocial factors that contribute to the development of mood disorders. For example, an individual with little or no social support will have fewer resources to handle stress and thereby will be at a greater risk of developing a mood disorder.
Our role model for why is DEPRESSION with the unforgettable PRINCESS DIANA
Princess Di, as she later became known to her adoring public, was born The Honourable Diana Frances Spencer, the youngest daughter of Edward John Spencer, the eighth Earl of Spencer, Viscount Althorp and Frances Spencer, Viscountess Althorp.
The couple had five children; Diana’s siblings are Elizabeth Sarah Lavinia (born 1955, now lady Sarah McCorquodale), Cynthia Jane (born 1957, now Lady Fellowes), John (died ten hours after birth, 1960) and Charles Edward Maurice (born 1964, currently the ninth Earl of Spencer). The family lived in Park House on the Sandringham estate.
By the mid 1960s, strain was beginning to show in the Althorp’s marriage and in 1967, when Diana was only six-years-old, her mother ran off with Peter Shand-Kydd, the heir to a wallpaper fortune. Two years later, the Althorps divorced in April 1969.
Lord Althorp fought for and won custody of the children. A short time after the divorce, Raine, Countess of Dartmouth, novelist Barbara Cartland’s daughter, moved in with the family. The children never liked her and nicknamed her ‘Acid Raine’. In 1969, Diana’s mother married Peter Shand-Kydd, becoming The Honourable Mrs Frances Shand-Kydd, and the couple went to live on the island of Seil, Scotland.
In 1975, when Diana’s father became eighth Earl of Spencer, the family moved from Park House to the 16th century ancestral home of Althorp and the following year, Diana’s father married Raine. Diana first attended school at Riddlesworth Hall Preparatory School in Norfolk and later, at West Heath Girls’ School (which subsequently has become the New School at West Heath, a co-educational special school) in Kent.
By self-admission, she was not much of an academic and left school in 1977, at age 16, after failing all her O-level exams. It was that same year that she met Prince Charles, a friend of her sister, at a hunting party. Following that, Diana’s father sent her off to a finishing school, the Institute Alpin Videmanette, in Rougemont, Switzerland. She showed some talent as an amateur singer and was a good sportswoman. In her heart, she always longed to be a ballerina but her height prevented this.
In 1979, Diana returned to London and moved into an apartment in South Kensington with three friends. She got her first job working as a part-time assistant at the Young England Kindergarten, a nursery school and day-care centre in Pimlico. The memorable photograph of the extremely shy Diana in a flimsy skirt, holding a young child, backlit by the sun, and showing the outline of her shapely legs, was taken by John Minihan during this time. Prince Charles had reached the age of 31 without finding a suitable partner and, as heir to the throne, was under pressure to do so. A list of candidates was drawn up and Diana was chosen from the shortlist. Diana met Prince Charles for the second time in 1980, when she and her family visited the Windsors during their summer holiday at Balmoral Castle, Scotland, and the royal romance began.
On 24 February 1981, Buckingham Palace announced the engagement of the 19-year-old Lady Diana Spencer to Prince Charles, Prince of Wales, 32-year-old heir apparent to the British throne. It was a fairytale in the making, and the blonde, blue-eyed beauty posed with her husband to be for official photographs showing off her enormous diamond and sapphire engagement ring that matched her eyes and her royal blue dress. Immediately, jewellers around the world scrambled to make copies of the ring, which were snapped up by adoring Diana fans. Following the engagement, Diana moved out of the flat she shared with friends and into Clarence House, the home of the Queen Mother, in order to be taught her royal duties.
The Royal Wedding, which took place on 29 July 1981 in St Paul’s Cathedral, London, was attended by 3,500 guests, photographed by Lord Lichfield, watched avidly by approximately one billion people on televisions around the world and marked as a national holiday in the UK. The fairytale Princess looked every bit the part, arriving at the church in a glass coach, wearing the family tiara and a massive silk wedding dress incorporating 10,000 pearls and sequins, with a 25-foot train, designed by David and Elizabeth Emmanuel. The Archbishop of Canterbury, Dr Robert Runice, married the couple in a traditional Church of England service. On Charles’ request, New Zealand soprano Kiri Te Kanawa sang a beautiful rendition of Handel’s ‘Let the Bright Seraphim’ during the ceremony. The married couple rode in the open-top state landau to Buckingham Palace for the kiss on the balcony the crowds had been waiting to see. The couple then joined their family and guests for a private wedding breakfast feast at the Palace. Diana’s new surname was Mountbatten-Windsor and her new title Her Royal Highness The Princess of Wales. She was ranked as third most senior woman in the United Kingdom, after the Queen and the Queen Mother. The newlyweds enjoyed their honeymoon on board the royal yacht Britannia.
Wasting no time in starting a family, Diana gave birth, on 21 June 1982, to the second in line to the British throne, Prince William Arthur Philip Louis Mountbatten-Windsor of Wales (Prince William or ‘Wills’ as he is sometimes known). Three months later, Diana made her first official appearance outside the UK, when she represented the Queen at the burial of Princess Grace of Monaco. It wasn’t long before the Princess began breaking royal protocol, when she insisted Prince William accompany her on her tour of Australia, much to the delight of the Australian public. Two years later, on 15 September 1984, Harry was born. He is third in line to the British throne and his full name is Prince Henry Charles Albert David of Wales. The Princess had her Prince and two healthy and beautiful young sons.
The fairytale continued, with Diana gaining huge popularity, not only in the UK, but also worldwide, and she became known as the ‘People’s Princess’, a celebrity in her own right. With her natural beauty, her height and her grace, her ease with people, her candid honesty and warmth, it was an easy task for personal stylists to help her become a fashion icon, a role model, and possibly the most photographed and famous woman in the world. In the winter of 1985, Charles and Diana made their first official visit to America. President Reagan held a gala party at the White House in their honour and it was the society event of the year.
Unfortunately, all was not as bright on the home front and Charles and Diana’s marriage was starting to break down. Diana’s popularity with the public and the media was beginning to overshadow that of her husband and, in photographs, he would often be seen standing glumly in the background whilst his wife was in the spotlight. Behind the scenes, more trouble was brewing. Having long known about Charles’ affair with Camilla Parker-Bowles, Diana was finding it increasingly difficult to hold up a strong façade for the public. In 1990, Charles and Diana moved into separate apartments and, during their state visit to India that year, it became obvious to the world that the marriage was in dire straits.
In March 1992, Diana’s father died at the age of 68, which greatly affected her. In a move to have her side of the story heard, when the papers were filled with conjecture about the ‘War of the Waleses’ and the failing royal union, Diana approached British author Andrew Morton to write her biography. ‘Diana: Her True Story’ was published in June 1992. The sequel, ‘Diana: Her New Life’, was published in 1994, with both books becoming best sellers in the UK and the US.
On 25 August 1992, British tabloid newspaper The Sun printed intimate taped telephone conversations between Diana and car dealer James Gilby that had taken place in 1989, an indiscretion that was coined ‘Squidgygate’ and possibly speeded up the end of the Wales’ marriage. Until that point, Diana had been seen as the wronged party, but now she had to shoulder some of the blame. However, she seemed to attract more sympathy than Charles did and, in fact, many believed her to be victim of establishment persecution, as the bugging of her phone had been undertaken by British intelligence agencies.
It was on 9 December 1992 that British Prime Minister, John Major, officially announced that Prince Charles and Princess Diana had separated. Her sons were everything to her and at this turbulent time of her life, Diana said she would have been lost without them. In 1993, Diana announced her withdrawal from public life, much to the dismay of her supporters. It transpired that Charles had also had a turn to have his telephone bugged and the taped conversations, between himself and Camilla on 18 December 1989, were splashed all over the tabloids in 1993. Things that he had said in ‘Camillagate’ left Charles blushing, open to ridicule, and with somewhat of a black mark against the public’s view of his character. He maintained in an interview to David Dimbleby that he felt justified that his affair with Camilla was not adulterous, as he saw his marriage as already being over at that point.
The next scandal Diana had to face publicly was her previous involvement with military man, James Lifford Hewitt, also known as the ‘Love Rat’. Having met at a party in 1986, they reportedly had an affair from 1987 to 1992, once Hewitt had become a personal riding instructor for William and Harry and was spending a lot of time with the Princess. In 1994, Hewitt sold his ‘kiss and tell’ story to the tabloids, forcing Diana to admit to the affair. She did this in an extremely candid 1995 ‘Panorama’ television interview about her ongoing fight against bulimia nervosa, her crippling post-natal depression, her doomed marriage to Charles, the mental cruelty she endured over his affair with Camilla Parker-Bowles, her attempted suicide attempts and her own promiscuity. Through all of this, her complete loyalty to her children was obvious and their upbringing was constantly her priority.
The Queen could not stand the scandal to the royal family any longer and, in December 1995, she asked Charles and Diana to end their marriage. Charles agreed immediately, whilst Diana delayed her decision for another three months, only agreeing on 28 February 1996. After fifteen years of marriage, the couple divorced on 15 July 1996 and it was legally finalised on 28 August 1996, following six weeks of discussion. Diana ceased to be the Princess of Wales and could no longer use the title Her Royal Highness (HRH). She was, however, as former wife of heir to the throne and mother of his sons, granted permission by the Queen to be known as Diana, Princess of Wales, and the given the right to live in Kensington Palace, remaining a member of the royal family. Custody of Princes William and Harry was granted to both parents and Prince Charles remained living at Highgrove House, his private residence in Gloucestershire.
Following her divorce, Diana became no less popular in the press. In fact, it could be said that media scrutiny intensified, with the world eager to know her next step. She was first linked to married art dealer Oliver Hoare, to whom she reportedly made anonymous telephone calls. She then had a brief involvement with England rugby player, Will Carling. They met at an exclusive London gym and shared intimate coffee mornings but denied any physical aspect to their relationship. Following that, she publicly dated heart surgeon Dr Hasnat Khan, for whom she had great respect and, according to friends, with whom she felt a ‘karmic’ bond and truly loved. Unfortunately, due to cultural differences, their relationship could not have a future. Dr Khan, being from Pakistan and believing in arranged marriages, would not get his parents’ approval to marry a divorced, Western, non-Islamic woman. Diana tried everything she could to persuade him that they should marry, including asking friend Imran Kahn, who himself had married a British aristocrat outside the Islamic faith, to speak to him. She approached his parents, writing letters and even travelling to visit them, but to no avail.
A few days after her break-up with Dr Kahn, Diana was photographed kissing Dodi Al-Fayed, son of Egyptian-born businessman Mohamed Al-Fayed, owner (amongst other things) of Harrods department store in Knightsbridge, London. They enjoyed a brief time together and in 1997, Diana flew with her sons to Saint Tropez to holiday with Dodi.
A month after her 36th birthday, on 31 August 1997, Diana and Dodi were in a fatal car crash in the Pont de l’Alma underpass tunnel in Paris. They were en route back to Britain, after spending time on his yacht. On 30 August, Diana and Dodi had enjoyed a romantic dinner at the Hotel Ritz Place Vendome, Paris. The couple left the hotel via the rear entrance shortly after midnight, accompanied by bodyguard Trevor Rees-Jones, and French driver Henri Paul. On 31 August, at 00:25, the black Mercedes S-280 bearing the Princess and her party had an accident in the Seine Tunnel, near the Eiffel Tower. Emergency vehicles rushed to the scene, where Dodi and Henri Paul died, whilst Diana and her bodyguard were seriously injured but still alive. They were immediately taken to the closest hospital, the Pite Salpa Triere, where after intensive attempts to save her life, Diana died at 04:15. Rees-Jones survived and he was the only occupant of the car wearing a seatbelt. That afternoon, the Royal Squadron flew Prince Charles and Diana’s two sisters to Paris to bring back her remains to Great Britain. The coffin, draped in the royal flag, lay in state in the Royal Chapel in St James’ Place.
Fuelled perhaps by the beliefs of establishment persecution Diana had suffered with the ‘Squidgygate’ affair in 1992, speculation of conspiracy was once again rife, with many believing that the car crash was an assassination rather than an accident, notable amongst them was Mohamed Al-Fayed. It later emerged that Diana had written a letter to her butler, Paul Burrell, in October 1996, the year before she died. In it, she claimed there was a plot to kill her and she feared that the brakes of her car would be tampered with to cause ‘an accident’ resulting in serious head injury. She believed this would be to get her out of the way in order for Charles to marry Camilla. Following the French investigation into the crash, it was ruled an accident, caused by driver Henri Paul being under the influence of alcohol and driving at high speed. British police are currently undertaking an inquiry into the circumstances surrounding Diana’s death and the report is expected in 2007.
The day before Diana’s funeral at Westminster Abbey on 6 September 1997, the Queen arrived back from her summer holiday at Balmoral Castle and made her first televised live speech concerning the death of Diana and praised her as ‘an exceptional and gifted human being’. The funeral was very moving and was watched by millions around the globe. Diana’s coffin, draped in the royal standard, was carried to the church on a gun carriage, behind which walked Prince Charles, Prince William, Prince Harry, Prince Philip and Diana’s brother, Earl Spencer, followed by representatives of all her charities. Prime Minister Tony Blair read the lesson at the service and it was Prince Williams’ idea to get Elton John to sing the unforgettable ‘Candle in the Wind’. The Earl of Spencer gave a particularly moving speech about his late sister, which received a standing ovation. Following the funeral, Diana’s coffin was taken to her family home, Althorp House, and buried on a small island in the middle of an ornamental lake, called The Oval, in the Pleasure Garden on the estate. This was to ensure protection of her remains and to provide a private place for her sons to visit her grave.
During her life, the Princess was known for her high profile charity work, starting with her support of AIDS charities campaigns in 1987. Diana was the first celebrity to be photographed touching a person with the HIV virus. She did this knowingly and willingly. In an instant, the photographs of her compassionate gesture went a long way to helping shift public awareness of AIDS. Diana often made unannounced visits to terminally ill patients in hospital but with the request that she remain out of the media on these occasions.
She also supported the International Campaign for a Ban on Landmines. Possibly best remembered was her International Red Cross VIP volunteer visit to Angola in January 1997, with the poignant photograph of her in a helmet with a visor, wearing a simple top and jeans, touring a minefield. She also visited Bosnia in August 1997, which was to be her last trip as ‘Queen of Hearts’, with the Landmine Survivors Network. Her special interest was in how the children are affected and often injured by buried landmines, long after the conflict has abated. She was actively involved in the Red Cross.
In a legacy to her unending support of children, the Diana Memorial Award was created. It is granted to young people who have unselfishly devoted themselves to causes the Princess herself defended. Mohamed Al-Fayed contributed £3 million to the foundation of The New School at West Heath, as a tribute to the late Princess Diana. The Diana, Princess of Wales Memorial Fountain is located in Hyde Park, London. It was designed by American landscape artist, Kathryn Gustafson, with children in mind and was opened by the Queen on 6 July 2004.
An inquest into Diana’s death opened and adjourned in January 2004. Former Metropolitan Police force chief Lord John Stevens was then asked to undertake an official Scotland Yard inquiry into whether or not Diana and Dodi Fayed were murdered. After nearly three years, the report by Lord Stevens was released in December 2006. It concluded that the allegations of murder were unfounded and the car crash that killed the pair in Paris on 31 August 1997 was a tragic accident. Stevens also confirmed that Diana had not been pregnant and was not engaged or about to be engaged at the time of her death.
A princess taken in her prime, who came into the royal family and the public spotlight as a shy young woman and grew into one of the most popular and copied women in the world. She brought an unexpected breath of fresh air into the Windsor household and helped to change public perception of monarchy. She reached out and touched so many people’s hearts, whilst hers was often breaking. Diana did have her antagonists and she was maligned for having an unclassified mental illness and for manipulating the media for her own gain. For all her faults, however, she always did what she thought best and her children came first above all. Her two sons have grown into fine young men, with much of their mother’s feisty spirit. Diana’s memory will continue to live on, as she truly became a legend in her own time and stamped an indelible mark on history.
So, our conclusion to a princess story is that Depression has no borders, it can attack anyone at anytime and any place in the world. We must understand where did Princess Diana get the emotional illness of being alone. As we can understand the emotional intelligence in humans, when a child has lost its mother, the care is missing and the human's core existence to life is neglected. Depression is the lack of motherly care in the heart of a human. THIS LACK OF CARE CAN RESULT IN SUICIDE -A brief overview:Most suicides appear to be associated with a long-lasting depression; they are often "a permanent solution to a temporary problem." In North America, they seem to peak annually in the early springtime. One theory is that individuals decide to commit suicide while profoundly depressed in the dead of Winter, but lack the ability to organize their own death. Later, when the weather improves and they feel more in control and are able to arrange their suicide.
Others who commit suicide are not depressed. They kill themselves because of terminal illness, intractable pain, and/or the loss of dignity, control, and autonomy -- or anticipated loss -- which often accompanies terminal diseases.
Emergency support services are available to help persons with suicidal ideation, often on a 24 hour basis. Suicide prevention hot lines (sometimes called distress centers, crisis centers, hotlines, Contact, Telecare, etc.) offer non-judgmental, confidential, caring support by trained volunteers. Telephone numbers are often listed on the inside front cover of local telephone books.
Throughout North America, the act of committing suicide is no longer a crime. Except for certain cases in the states of Oregon and Washington, assisting a person to commit suicide remains a criminal act.
Certain groups within the population are much more at risk for suicide. These include Aboriginals, persons who suffer from various mental disorders, lesbians, gays, and bisexuals Persons who are transgender and trans sexuals may be at the highest risk to commit suicide.
Some facts about suicide:
U.S. Suicide rates are highest in the western and rocky mountain states. They are are lowest in the Northeastern states.
Canadian suicide rates are similar: highest in British Columbia, on the west coast, and lowest in Newfoundland, on the east coast.
There were 31,204 deaths by suicide recorded in 1995; 30,535 in 1997; 33,000 in 2006 (the latest data available at 2009-SEP-10).
The actual number is probably significantly higher, because many suicides are recorded as accidents.
The most common method that men use to commit suicide (58%) involves firearms. Simply making firearms less easily accessible to a suicidal person can drastically reduce their chance of them taking their own life. Women more often choose poisoning (40%).
More females than males attempt suicide -- on average two to three times as often as men.
More males than females "succeed" at suicide, by a ratio of 4 to 1.
Comparison of groups within the U.S.:
The average suicide rate in the U.S. is about 11 per 100,000 per year. This amounts to one completed suicide every 16 minutes.
Between 1 and 2% of all the deaths in 1997 were by suicide. This compares to 31% from heart disease, 23 from cancer, 7% from stroke.
Whites commit suicide at a higher rate, than African-Americans, Asians and Hispanics. However, in 2007,
"Hispanic female high school students in grades 9-12 reported a higher percentage of suicide attempts (14.0%) than their White, non-Hispanic (7.7%) or Black, non-Hispanic (9.9%) counterparts."
Young Native Americans have a very high suicide rate. "Among American Indians/Alaska Natives ages 15- to 34-years, suicide is the second leading cause of death."
Older Native Americans commit suicide less often than do Whites of the same age.
Married folks have a lower rate of suicide than do divorced, separated, widowed and single people.
About one in three American teenagers has contemplated suicide. An Internet poll by About.com indicated that 50% of teens visiting that web site had considered it.
Suicide is the eleventh leading cause of death among the entire population.
Suicide has been reported as the second leading cause of death among teenagers, exceeded only by traffic accidents. However, the suicide rate among teens is actually lower than that of older persons. Teens tend to have few life-threatening illnesses. Teenage deaths from disease is quite low. Thus, the relatively few suicides among teens make suicide a leading cause of death.
The reported U.S. suicide rate for very young people (10 to 14 years of age) increased by 183% between 1970 and 1993. However, much of this increase may not be real. In the past, there was widespread denial that pre-teens could decide to end their lives.
Data concerning young homosexuals is somewhat unreliable. It appears that about one in three teen aged suicides is by a gay or lesbian. Since homosexuals represent only about 5% of the population, gays and lesbians are greatly over-represented.
Among the most common faith groups in the U.S., Protestants have the highest suicide rate; Roman Catholics are next; Jews have the lowest rate.
Followers of religions that strongly prohibit suicide, like Christianity and Islam, have a higher suicide rate than those religions which have no strong prohibition (e.g. Buddhism and Hinduism.)
A person has a higher risk of suicide if their parent, close relative or close friend has taken their own life
References:The following information sources were used to prepare and update the above essay. The hyperlinks are not necessarily still active today. Some sources may have updated their information since we last downloaded it.
- Doug Martin, "Suicide as Deviance," at: http://www.nwmissouri.edu/
- "Suicide," at: http://library.thinkquest.org/
- "What is the second leading cause of death among teenagers." at: http://www0.mercurycenter.com/
- "Suicide in the U.S.: Statistics and Prevention," National Institute of Mental Health, at: http://www.nimh.nih.gov/
- "Suicide: Facts at a Glance," Center for Disease Control and Prevention, 2009-Summer, at: http://www.cdc.gov
Introduction:The International Association for Suicide Prevention (IASP), and the World Health Organization (WHO) cosponsor the annual World Suicide Prevention Day on SEP-10 each year. The theme in 2009 was "Suicide Prevention in Different Cultures."
According to their news release, the purpose of World Suicide Prevention Day is:
"... to improve education about suicide, disseminate information, decrease stigmatization and most importantly, raise awareness that suicide is preventable."
The following is excerpted from their news release.
The magnitude of the problem:Suicide is a leading cause of death for people worldwide, and one of the three leading causes of death for young people under 25.
Every year, approximately one million people die by suicide - one death every two minutes. The World Health Organization estimates that by the year 2020, this annual toll of suicide deaths will have risen to one and a half million, and suicide will represent 2.4% of the global burden of disease.
Suicide deaths account for more than half of all violent deaths in the world - more than all deaths from wars and homicides combined.
Every year, many millions more people make serious suicide attempts which, while they do not result in death, require medical treatment and mental health care, and reflect severe personal unhappiness or illness. Millions more people -- the family members and close friends of those who die by suicide -- are bereaved and affected by suicide each year, with the impact of this loss often lasting for a lifetime.
Suicide exacts huge psychological and social costs, and the economic costs of suicide to society (lost productivity, health and social care costs) are estimated at many billions of dollars each year.
Because almost a quarter of suicides in the world are teenagers and young adults aged less than 25 years (250,000 suicides each year), suicide is a leading cause of premature death, accounting for more than 20 million years of healthy life lost.
Suicide is preventable: Causes of suicide: During the last three decades we have learned a great deal about the causes of this complex behavior. Suicide has biological, cultural, social and psychological risk factors. People from socially and economically disadvantaged backgrounds are at increased risk of suicidal behavior. Childhood adversity and trauma, and various life stresses as an adult influence risks of suicidal behavior. Serious mental illnesses, most commonly depression, substance abuse, anxiety disorders and schizophrenia, are associated with increased risk of suicide. Diminished social interaction increases suicide risk, particularly among adults and older adults.
Suicide can be prevented. Despite its often complex origins, suicide can be prevented. Communities and societies that are well integrated and cohesive have fewer suicides. Restricting access to methods of suicide (such as firearms or pesticides) reduces suicides. Careful media reporting of suicide prevents further suicides. Educating communities and health and social services professionals to better identify people at risk of suicide, encourage them to seek help, and providing them with adequate, sustained and professional care can reduce suicides amongst people with mental illness. Providing adequate support for people who are bereaved by suicide can reduce their risk of suicide.
Support for World Suicide Prevention Day:World Suicide Prevention Day (WSPD) provides an opportunity for all sectors of the community ‐ the public, charitable organizations, communities, researchers, clinicians, practitioners, politicians and policy makers, volunteers, those bereaved by suicide, other interested groups and individuals ‐ to join with the International Association for Suicide Prevention and [World Health Organization] (WHO) to focus public attention on the unacceptable burden and costs of suicidal behaviors with diverse activities to promote understanding about suicide and highlight effective prevention activities. Those activities may call attention to the global burden of suicidal behavior, and discuss local, regional and national strategies for suicide prevention, highlighting cultural initiatives and emphasizing how specific prevention initiatives are shaped to address local cultural conditions.
Initiatives which actively educate and involve people are likely to be most effective in helping people learn new information about suicide and suicide prevention. Examples of activities which can support World Suicide Prevention Day include:
Launching new initiatives, policies and strategies on World Suicide Prevention Day,
Holding conferences, open days, educational seminars or public lectures and panels.
Writing articles for national, regional and community newspapers and magazines.
Holding press conferences.
Placing information on your website.
Securing interviews and speaking spots on radio and television.
Organizing memorial services, events, candlelight ceremonies or walks to remember those who have died by suicide.
Asking national politicians with responsibility for health, public health, mental health or suicide prevention to make relevant announcements, release policies or make supportive statements or press releases on WSPD.
Holding depression awareness events in public places and offering screening for depression.
Organizing cultural or spiritual events, fairs or exhibitions.
Organizing walks to political or public places to highlight suicide prevention.
Holding book launches, or launches for new booklets, guides or pamphlets.
Distributing leaflets, posters and other written information.
Organizing concerts, BBQs, breakfasts, luncheons, contests, fairs in public places.
Writing editorials for scientific, medical, education, nursing, law and other relevant journals.
Disseminating research findings.
Producing press releases for new research papers.
Introduction:The International Association for Suicide Prevention (IASP) distributed a press release at the time of the World Suicide Prevention Day on 2009-SEP-10. The release contained information on suicide prevention programs in various countries of the world.
The following is excerpted from their news release.
Some programs in various countries to prevent suicide:Efforts to decriminalize suicide: In some cultures (e.g.: Lebanon and Pakistan) suicide is still a criminal activity. This status determines the way suicide is responded to. It stigmatizes the families of those who die by suicide, inhibits suicide attempters from seeking appropriate help and hinders efforts to establish suicide prevention programs. As a fundamental step in suicide prevention, efforts have been made in India to decriminalize suicide and the International Association for Suicide Prevention is collaborating with the World Health Organization to support and facilitate these efforts.
Reduction of suicide by pesticide in Asia: Culture influences the methods that people select to commit suicide. Most suicides in the world occur in Asia, which is estimated to account for up to 60% of all suicides. In many Asian countries (including China, India, Sri Lanka, Malaysia) a large proportion of suicides result from poisoning by swallowing agricultural pesticides. Suicide by this method is particularly common in females in rural areas. Given the large contribution to world suicide rates, reducing pesticide suicides could make a significant impact on global suicide rates. Current efforts to reduce pesticide suicide focus on removing the most toxic pesticides from sale, restricting access to pesticides by the use of locked storage boxes, improving access to emergency treatment and health care, educating about help‐seeking and providing crisis support for rural women in stressful situations.
Minimizing media reports of suicide methods. Culture shapes the way suicide is reported by the media. In Hong Kong, media reports of a novel method of suicide, charcoal burning, contributed to the rapid adoption of this method by people who did not previously make suicide attempts. Concerted efforts by suicide prevention experts in Hong Kong focused on persuading the media to adopt a more cautious and muted approach to reporting suicides by charcoal burning. At the same time, novel efforts were made to restrict access to charcoal by reducing access within supermarkets, and to train community accommodation owners to recognize people who might be at risk of suicide who were seeking a room in which to use charcoal burning to kill themselves. Implementation of these initiatives resulted in a significant reduction in suicides by charcoal burning.
Support for Immigrants. Increasing globalization, ease of international travel, and refugees and asylum seekers from war and disaster have swelled the number of immigrants worldwide. People who are alienated from their country and culture of origin are vulnerable to various stresses, mental health problems, loneliness and suicidal behavior.
Suicide prevention strategies, tailored to the specific needs of migrant groups, exist in many countries. These programs typically focus on understanding the specific cultural and religious attitudes to mental health and suicide of the migrant group, reasons for migration, and family and social structures.
Interventions include educational and social programs designed to identify stresses, teach coping skills, promote use of preventative health practices, improve access to health services and encourage socializing. Suicide prevention programs for migrants may require involvement, championship or leadership from religious or community leaders to be successful.
Promoting community enhancement, awareness and linkages to reduce indigenous youth suicide. In the US, Canada, New Zealand and Australia, rates of youth suicide are substantially higher amongst indigenous young people compared to their non-Aboriginal peers. Reasons given for this include the impact of change, colonization, disruption of family and social ties and a resulting lack of secure cultural identity. Suicide prevention programs for aboriginal youth focus on community gatekeeper training programs to better recognize at-risk youth and refer them for help, and promotion of activities to promote community involvement. An example is provided by the North Dakota Adolescent Suicide Prevention Project. Within a 4- year time span, this project demonstrated a 47 percent reduction in 10-19 year-old suicide fatalities, compared to the 10-year average in the 1990s, and a 29 percent decrease in suicide attempts in North Dakota youth. The project used a multi-faceted approach, including public awareness, education, gatekeeper training, and peer mentoring of teenagers.
Encouragement of safe drinking. Alcohol abuse is strongly related to suicidal behavior and population rates of suicidal behavior are influenced by population alcohol consumption levels, which in turn are influenced by cultural and religious attitudes towards alcohol consumption. Evidence from the Soviet bloc suggests that the imposition of regulations restricting access to alcohol dramatically reduced both alcohol consumption and suicide rates. Countries in which the dominant religion proscribes against drinking tend to have low suicide rates. Public education programs that encourage safe and moderate drinking may play a role in suicide prevention at a population level.
Mental Health de‐stigmatization programs. Cultural attitudes to mental illness influence people?s willingness to seek treatment or support for mental illness. Throughout the world investments have been made in public education campaigns tailored to meet the need of specific cultural groups. These programs are designed to promote awareness and
understanding of mental disorders. These types of campaigns may contribute to suicide prevention by encouraging better utilization of services and support for those with mental disorders.
Suicide rates in different countries:There are substantial variations in suicide rates among different countries, and, to some extent, these differences reflect cultural differences to suicide. Cultural views and attitudes towards suicide influence both whether people will make suicide attempts and whether suicides will be reported accurately.
Suicide rates, as reported to the World Health Organisation, are highest in Eastern European countries including Lithuania, Estonia, Belarus and the Russian Federation. These countries have suicide rates of the order of 45 to 75 per 100,000.
Reported suicide rates are lowest in the countries of Mediterranean Europe and the predominantly Catholic countries of Latin America (Colombia, Paraguay) and Asia (such as the Philippines) and in Muslim countries (such as Pakistan). These countries have suicide rates of less than 6 per 100 000.
In the developed countries of North America, Europe and Australasia suicide rates tend to lie between these two extremes, ranging from 10 to 35 per 100 000.
Suicide data are not available from many countries in Africa and South America.