bipolar

Day 326

Posted by

2

Prevention is better than cure.

Once it’s happened, suicide has no cure. In fact it can set off another wave of deep grief and vulnerability to further suicides.

Hence, prevention is everything.

The World Health Organisation has declared Thursday the 10th of September as World Suicide Prevention Day. It is an opportunity to raise awareness and break down stigma. Here are the main subheadings of the WHO document :

Reaching out

  • to those at risk of suicide
  • to those bereaved by suicide
  • to put people in touch with relevant services
  • to Suicide Prevention community.

Research suggests that 70 to 90 per cent of people who have made a lethal attempt, or died by suicide, were suffering from one or more unmanaged mental health issues – such as protracted depression or anxiety, bi-polarity, psychosis, and/or substance abuse. The presence of an unmanaged mental health issue is strongly associated with suicide.

Hence I would like to emphasise a few things here:

  1. Health-care services need to incorporate suicide prevention as a core component.
  1. Early identification and effective management of mental disorders and harmful use of alcohol and other drugs are key to ensuring that people receive the care they need.
  1. Close involvement, training and support for family and carers in the community.
  1. Education at every level – at schools, universities, religious communities, railway staff and general public.
  1. Give the issue of Suicide Prevention a place of prominence on the Public Health agenda as it is one of the biggest killers. Not limiting suicide prevention to writing documents that no one ever reads but making a proper awareness campaign which brings the issue to light in a way that everyone can see it – in the same way that road safety is addressed.
  1. Ensure that governments are fully engaged and every Local Authority has an effective Suicide Prevention Plan in place.
  1. Abolish internet chat rooms which help people with creative ideas on how to end their own lives.
  1. Stop under-recording the incidence of suicide at Coroner’s courts by not insisting on ‘criminal’ standard of proof as opposed to balance of probability.

While it may not be possible to prevent all suicides, let us do this like we mean it.

Every life lost through suicide is one too many.

Day 325

Posted by

7

wpid-t_suicideprevention

Make sense of it?

How?
It doesn’t make any sense.
It goes against any logic and every basic survival instinct.
It is not supposed to happen to anyone, especially kids.
Even the thought of it is harrowing.
There are no answers to most questions.
May be the ones who have passed had some answers.
May be they had no clue at all.
Was it impulse or was it planned?
Was it preventable or inevitable?
Would it have happened sooner or later anyway?
What if this or that or the other?
How could no one see it coming?
How long had the thoughts been there?
Why could he not open up to someone?

Did he really think that no one cared?
How could he think that?

How could I have gone to work that morning?
How could I be so oblivious to what was going on?
When did it all start?
Could I or anyone else have done anything to avert it?

Are there any answers?
How are we supposed to make sense of it?
Is it even possible?
Ever?

Every 41 seconds, someone is left…

Day 312

Posted by

2

Today I met this lovely little 70 years old lady at work. She had come in as a patient for a minor procedure under anaesthesia. She was well dressed and I couldn’t help but notice her hair. It was as though she had just walked out of a hair salon. It was beautifully styled. I could imagine her sitting with her rollers on under the hair dryer reading a magazine. I was impressed by the effort she had put into looking so good to come into a hospital for cancer surgery.

Instantly my mind flashed back to 2 days before Day 0. That day we had an appointment to see the GP. I had requested my son to shave as I gently woke him up reminding him of our planned visit. 10 minutes before we were to leave the house he came down the stairs. He had not shaved. I sent him right back and insisted he shave even if it meant we were a few minutes late. He really didn’t want to but he did. (Now I know how terribly difficult it must have been for him.) I was pleased to see him looking so neat and tidy.

The doctor’s report to the Coroner says – “He was well dressed, shaven and fresh. He made good eye contact. His speech was coherent and we had good rapport throughout. He said he had had a recent ‘set-back’. On being asked if he had suicidal thoughts he said yes but he had no plans. He said that he felt he would never recover from this illness. I reassured him that he would. He asked me how long it would take……. If other patients had returned to work….. There was nothing to indicate a relapse of psychotic features. The Citalopram was increased from 10mg to 20 mg daily.”

Despite the fact that during the previous visit 2 weeks prior, his PHQ9 (Patient Health Questionnaire 9, a monitoring tool for depression) score was 27/27, indicating the worst possible level of depression, the GP did not repeat the test on this visit. Was it because he looked ‘well dressed, shaven and fresh’? Would it have made any difference?

We will never know.

What we do know is that there is a huge need for education. Pills alone do not save lives.

Day 310

Posted by

4

This time last year, he was nearly ‘normal’ as he had responded really well to Olanzepine (Zyprexa), the antipsychotic medication. He was under the care of the Community Mental Health Team and everyone seemed happy with his progress.

I was relieved but was still reeling from the effect his behaviour during the episode of hypomania had had on me. That was proper psychosis, as defined by the medical dictionary – radical change in personality and a distorted or nonexistent sense of objective reality, caused by delusions and hallucinations.

I phoned the mental health team as I wanted to know more about what it means for us a family if our son has this type of an illness. The psychiatrist said, ”it could just be a one off.” That left me none the wiser, not knowing what to expect next or what to watch out for.

What came next was a gradual onset of low mood, him spending a lot of time by himself, him coming back from his placement abroad in 2 days as he was unable to function, upside down sleep pattern, difficult to talk to as he would barely speak much and a neglect of his appearance. He went to the gym everyday but I noticed that the time he spent there became shorter and shorter. Shaving his beard seemed like a herculean task to him.

I did not know it then but that was psychosis too – Psychotic Depression.

People with psychotic depression may be humiliated or ashamed of their thoughts and try to hide them. Doing so makes this type of depression very difficult to diagnose.

But diagnosis is important as its treatment is different to that for nonpsychotic depression. I suppose this is the kind of thing that specialists would know. I was only a layperson when it came to mental illness.

Day 279

Posted by

1

It was fancier than I thought it would be.

Broadcasting House was intimidating but once we stepped in we were met with nothing but politeness and sensitivity. They even arranged for a taxi to pick us up. I am not used to being so spoilt.

The cups of tea were much needed and lovingly offered. The inside of the premises were as modern as the outside of the building was old. A multitude of wall mounted flat screens, computer terminals, autocues, cameras and all kinds of efficient looking people walking around with headsets and hand-held radio sets filled the space in an elegant manner. I am not even sure of the proper names for some of the things that were there.

There were many interconnected corridors, mostly dotted with what seemed like a lot of make-up rooms. I was guided into one of them where a lovely lady called Julia made me BBC camera worthy.

I was at the studio for the live screening of a 17 minute slot on ‘Suicide’. There were 3 other panelists who shared their stories. Very moving and insightful. Although the format was informal, I was glad to note that the conversation had a definite suicide awareness and hence prevention emphasis.

On getting home from work, with slight nervousness I turned the TV on to watch the recording of the programme. I was happy but sad. I would have much preferred to spend the morning with my son at home. I wonder where the strength comes from! One part of my brain says, ”This cannot be happening. It is terrible!” Another says, “Something has to be done about this.” Yet another part is just vacant and wandering and watching the other two combat each other. The result varies from minute to minute.

I don’t know how I carry on.

It must be ‘Grace’. It is bestowed upon us for no particular merit. It flows through me as a result of the blessings of my parents and my Guru, the love and best wishes of near and dear ones, the support of all you good people out there and the good deeds of my fore-fathers and my son.

The first 17 minutes of the programme might be of interest to you.