Day 890

UNIVERSITIES MISS CHANCE TO IDENTIFY DEPRESSED STUDENTS
– A study from Chicago, by Marla Paul in Jan 2011.

This study surveyed 1,622 college students. One out of every four or five students who visits a university health center for a routine cold or sore throat turns out to be depressed, but most centers miss the opportunity to identify these students because they don’t screen for depression, according to new Northwestern Medicine research.

About 2 to 3 percent of these depressed students have had suicidal thoughts or are considering suicide, the study found.

“Depression screening is easy to do, we know it works, and it can save lives,” said Michael Fleming, professor of family and community medicine at Northwestern University Feinberg School of Medicine. “It should be done for every student who walks into a health center.”

The consequences of not finding and treating these students can be can be serious and even deadly. “These kids might drop out of school because they are so sad or hurt or kill themselves by drinking too much or taking drugs,” Fleming said.

“Things continually happen to students – a low grade or problems with a boyfriend or girlfriend — that can trigger depression,” Fleming said. “If you don’t take the opportunity to screen at every visit, you are going to miss these kids.”

The frequency of depression and suicidal thoughts among campus health clinic users was nearly twice as high as rates reported in general college samples.

Depressed students need treatment, which may include counseling and medication. These students are more likely to drink, smoke and be involved in intimate partner violence, the study found.

With new technology, screening students is simple. While waiting for an appointment at the health center, the student could answer seven simple questions – a depression screening tool that that could be immediately entered into his electronic health record. “They can answer those seven questions in a minute,” Fleming said. Universities typically separate mental health treatment from primary care treatment. If a student comes to a campus health center and complains about depression, he is referred to a counseling center.

“If we screen, we can try to find every student that is depressed.”

Historical perceptions and biases against preventive screenings are that kids who need treatment the most don’t go to campus health centers, and they won’t tell the truth about their depression.

That’s wrong. “Students will tell you the truth,” Fleming said. “If they are sad and depressed, they will tell you that. And, kids who are drinking too much or who are suicidal do go to the campus health centers.”

 

Day 881

The school project entailed each student discussing what they would put in Room 101 and why. Room 101 is where the bad things go.

For Saagar, it was translucent curtains. He thought they were pointless. They didn’t keep the sun out. They didn’t hold any warmth in. They blew in the wind. They annoyingly got in the way. Close up they were see-through. They twitched in the hands of old ladies. Their flimsy paperiness didn’t have a pleasant texture. They collected dust. They looked like nothing much. As far as he was concerned, they didn’t serve any purpose They definitely belonged in Room 101.

When I look back to my younger days, I can see me making similar arguments. At that time things fell into distinct boxes – good and bad, right and wrong, beautiful and ugly, royalty and commoner, black and white – concepts inspired by fairy tales, cartoons and films, Cinderella and Snow White to name a couple.

As the years went by, I learnt that a lot of life happens in grey zones, many rights and wrongs are based on a given context, some things can be beautiful and ugly at the same time, royalty can be common and the good and the bad resides in all of us.

Maybe his young mind told him there were only two available choices – life or death. Maybe if he was a bit older he would have known that there are other choices, one of them being, waiting it out.

“Nothing worked but the passage of time … It’s an illness and it ran its course. I had always described myself as melancholy or depressive but I hadn’t a clue. Anything I had before was a blue day by comparison. This was altered perceptions, a mental illness.” Says the Irish novelist, Marian Keyes, 53, about her severe depression in 2009. Writing was her “rope across the abyss”. She started with short stories and her 13th novel is soon to be released.

 “Have patience with all things but first of all with yourself.”
-Saint Francis de Sales.

Ref:

Room 101 : http://www.definitions.net/definition/ROOM%20101

Novelist Marian Keyes reveals fight against constant ‘suicidal impulses’ : https://www.theguardian.com/books/2017/mar/12/novelist-marian-keyes-reveals-fight-against-constant-suicidal-impulses

Day 851

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“The university did not ring and tell us that she had been admitted to hospital critically ill. We were in the dark for hours as to what had happened. We found out off Facebook” says Nikki, mother of Miranda.

Miranda Williams 19. Student of Philosophy.
Daniel Green 18. Student of Law.
Kim Long 18. Student of Law.
-Deaths by suicide, first term of first year at the same University.

Lara Nosiru 23. Student of Neurosciences.
-Died by suicide, Final year at the same University.

All these lovely young people died within a few months of each other. On the surface of it the deaths do not seem to be related to each other.

At least 1600 families face this nightmare every year and at least 1600 beautiful young lives are wasted year on year with no sign of a drop in numbers, only a rise.In 2007, there were 75 university students died of suicide in England and Wales. In the ghastly year of Saagar’s death, 2014, the number went up to 130, nearly 75% higher.

Why?

Underdiagnosed anxiety and depression at school.
Problems identified but not dealt with.
Stigma stopping young people from asking for help.
Unfamiliar surroundings.
Being away from home/family/friends for the first time.
Excessive drinking culture.
Trying their best to start off Uni on the right foot.
Debt / financial pressures.
Academic pressures.
Suddenly being treated like ‘adults’.
Trying to cope with pressures all alone.
Too proud, worried or ashamed to ask for help.
Not enough help available at Uni.
(“During Kim Long’s inquest this week, it was revealed that more than 600 Bristol University students were referred to support services by their tutors last year because they were deemed at “high risk”.)
Improper use of ‘Confidentiality’.
New students not being identified as high-risk.
Poor understanding and management of depression in the community

1600!!!

Ref: https://www.thesun.co.uk/news/2838174/is-a-cocktail-of-ballooning-costs-stigmatisation-of-mental-health-problems-and-academic-pressure-killing-our-kids/

Day 779

Psilocybin is the active hallucinogenic compound in ‘magic mushrooms’. It was banned in the 1960s but recent preliminary research has shown that it may have potentially beneficial effects in patients with anxiety and depression. The subjects for this research were cancer patients, 40-50% of whom will have a diagnosis of anxiety and/or depression.

A team at Johns Hopkins in Baltimore conducted studies where patients were randomly administered the drug or a placebo. They were then encouraged to focus on their internal experience. Those who received Psilocybin had a significant improvement in depression, anxiety and mood disturbances. They also showed a higher level of optimism, a better quality of life and acceptance of death.

The main feature of the experience was a feeling that everything is connected. People felt they’ve learnt something that is of deep meaning. It caused a change in their value systems, in how they approach life and interact with other people. Some patients described the experience as a spiritual awakening.

The single feeling of connectedness with everything is the key to well-being. Many spiritual practices aim to manifest this feeling of oneness with all creation. My beloved spiritual leader Sri Sri Ravi Shankar says, ‘From somebody become nobody and from nobody become everybody.’

Ref:https://www.drugs.com/news/magic-mushroom-compound-triggered-positive-personality-change-study-33958.html (ps: This study is far from conclusive and does not wish to encourage the use of hallucinogens. )

Day 738

“How are you?”
“Exhausted!”

This is the answer I get more often than not. It seems like a wave of tiredness is sweeping across town. 20% of road accidents have fatigue as a contributing factor (Source: Dept of Transport). 15% of Britons suffer from fatigue lasting at least 6 months (Source: Fatigue Science for Human Health). 5.6 hours per week of productive work is lost through fatigue (Source: Journal of Occupational and Environmental Medicine, Vol 49).

Apparently this is not a new phenomenon. Over the centuries, it has been attributed to the misalignment of the planets, ungodliness and even a subconscious desire to die. According to Freud, a very strong part of us longs for a state of permanent physical and mental rest.

Lack of good quality sleep, sensory overload, inappropriate diet, low physical activity, disregulation of the Suprachiasmatic nucleus (responsible for maintaining the circadian rhythm), hormonal imbalance (low dopamine and/or low serotonin levels as in Parkinson’s Disease and depression) are the usual culprits. Inflammation is emerging as a common pathway linking all the above. But it is not the complete answer as fatigue is seen to persist even after the inflammatory markers have normalised.

Fatigue sits perfectly in the mind-body spectrum of conditions. It is not surprising that it is poorly understood and has been the subject of very little serious research. This article by Harrington offers some answers: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3479364/

Many ‘boosting remedies’ and ‘re-energising potions’ line the shelves of pharmacies – Iron, Vitamin B and C, Flavinols, hormones, pro-biotics and and other magic supplements. Dehydration , even mild is said to induce tiredness. So, aqua is a simple remedy.

While the search for an optimal solution is on, we struggle on, waiting patiently.

Day 732

As I stepped out of the door early this morning I was struck by a big huge sphere in the sky, a pale silvery moon on a pinkish blue canvas seemed to be sitting just at the end of my street. It was so close, I felt I could reach out and touch it.

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(Saagar’s last message on facebook)

It was the same moon as on 8th october 2014. It was in the same phase too. Full!
He saw it and probably felt it’s energy strongly enough to comment on it.
There is a clear co-relation between high tidal waves and a full moon night. We are made up of roughly 70 % water. So, it must have some effect on us too. Is it possible that the sub-conscious mind finds greater expression on a full moon night? Some psychiatrists and mental health nurses swear that they see more patients around this phase but scientific research does not support that.

The article below shines some light on the subject. It goes on to say that there is a higher incidence of animal bites at this time and some police forces put a larger number of staff on duty on full moon nights as they expect more trouble. Some studies have shown that people report a relatively poor quality of sleep around this phase. After all, the term ‘lunatic’ has its roots in ‘lunar’.(http://www.bbc.com/future/story/20131029-does-a-full-moon-make-people-mad). But there are no clear answers.

 Shall we just blame it on the moon?

Day 728

A landscape of musical notes emanated from four musical instruments inspired by movement of people across the globe in search of a land of gold. When I closed my eyes, I could feel the magical textures at my fingertips and sense the turbulent river flowing and a lone vessel struggling to carry a tonne of isolation and desperation across to a place of hope. Vibrant colours could be heard and pathos felt in the core of my heart and every pore on my skin. The conversations and unison between those colours filled the space with absolute empathy for those forced to leave their homes, a cry against injustice of the refugee crisis. Crossing the Rubicon….dissolving boundaries…reunion…last chance…a boat to nowhere…

Land of Gold – an ode to those displaced.

Find the kind heart,
Rest your feet and soul.
May your kind heart
Find the land of gold.
Pay attention, say your name
Listen closely and keep warm.
Gentle hands, you are brave,
Look at me and carry on.
All is good, I love you.
You can hear me, you can call.
Sing your song with ease and pride.
I’ll be there, not far behind.
Tell them I walked
Tell them I walked your way
Tell them I walked
Tell them I walked your way

– By Anoushka Shankar

(https://www.youtube.com/watch?v=8MO1Ziql48w)

Day 727

aberfan_cemetery_geograph-3377917-by-stephen-mckay

We got the TV installed just before my parents came to stay for a few weeks. We hardly ever watch it. This evening I happened to switch it on as I was alone at home. I watched a film on the Aberfan disaster, a catastrophic collapse of a coal mine spoil tip in a small Welsh village. This occured in October 50 years ago and claimed the lives of 116 primary school kids. One of the snippets showed the utter chaos of it and mothers standing in a long row, passing rubble and bricks away from the disaster site. The mums, now in their 70s and 80s choked up while relating the experience and shared the pictures and sweet little belongings of their kids. They also remembered the great difficulty they had in surviving this immense loss. They wondered what their wee ones would be like as grown ups. They would be in their 50s now!

Wow! What must that be like!

It’s strange that while I actively seek out programmes on mental health related issues and thus manage my deep sense of loss, when I am not seeking anything out, the radio, TV or life bring me face to face with it.

12th of October 2014 was a Sunday. Diwali, the festival of lights was less than 2 weeks away. Diwali signifies joy, love, reflection, resolution and knowledge and represents victory of good over evil and light over darkness. The annual Diwali Mela was being celebrated at Trafalgar Square. Saagar and I went along to that and ran into a photographer friend who took a few pictures.

I had no idea that those would be our last pictures together. Was I in darkness then and now I am in light? Or was I in light then and now I am in darkness? I don’t know.

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This is one of those pictures. This is what a terminally ill person looks like.

With all due respect to parents whose kids have suffered cancer, I sometimes wish Saagar had cancer. It would have been taken seriously and looked after by specialists. I would have been given some facts, figures and things to watch out for. I would have had a chance to tell him how much I love him. I would have had a chance to say good-bye.

Day 723

“Random thoughts”, he said, looking perplexed. “I keep getting these random thoughts.”
“Thoughts of what exactly?” I would ask.
“Just random….”
I didn’t know how to explore any further.

He confided in at least 3 men he trusted about his suicidal thoughts and none of them knew what to do.
Not surprising.
He specifically told them not to tell me about it. He even shared his plan with one of them. But he did not know what to do.
Not his fault.
No one is taught what to do in a situation like that.

How would you feel if some one came up to you and said they were seriously considering ending it all?
Overwhelmed? Panicked?
Calm and confident knowing exactly what to do as if you were being asked to do CPR?
What would you do?
Break into a sweat?
Think they are kidding?
‘Fix it’ for them?
Call 999?
Take them to A&E?
Ask them to see their GP?
Connect them to the Samaritans?
Tell them to get over it because life is beautiful?

Yesterday I watched a video of a skilful conversation between a suicidal person and a person in a position to help. It was a caring and respectful exchange designed to model an evidence based framework which has been developed over 30 years by LivingWorks whose mission is to create a life-affirming suicide-safer world (https://www.livingworks.net/programs/asist/). It made me cry floods of tears as I was reminded why the poor bugger didn’t have a hope in hell. Even his doctor didn’t know CPR or what would be CPR for him. The video was a part of the ASIST Course (Applied Suicide Intervention Skills Training). Regardless of prior experience LivingWorks enable ordinary people to provide suicide first aid. They have training programmes lasting from 90 minutes to 2 days. Shown by major studies to significantly reduce suicidality, LivingWorks courses teach effective intervention skills while helping to reduce stigma and raise awareness.

While speaking with the trainers of ASIST it emerged that the most difficult group to train is GPs as they can never make time. The last General Practice who contacted them wanted them to come at lunch time for half an hour and provide training and lunch for all staff members in that time.

Top priority. Eh?

 

Day 717

Sunday lunch at the start of autumn on a warm day of blue skies and a warm sun, sitting under a wise old carob tree with supported branches and multiple dried brown beans hanging from a wide umbrella of dark green leaves with friends and strangers making introductions followed by conversations, smiles and laughter, references to this and that, occupations, travels and hobbies, daughters and mothers, food and wine, so on and so forth …. as if straight out of a film set infused with a sweet subtle smell of eucalyptus.

All of it completely meaningless, empty, futile, feckless, inane and pointless. Words, words and more words! Exhausting! I had to get up and walk away with my i-pad and take pictures of something. Anything.

In 2 weeks time he will be dead. Around this time 2 years ago he was scoring max on his depression scores and he gave it in writing to his GP in the form of a PHQ-9 form but got no help. No escalation of care. No attention. No mention of ‘suicide’ to us and yet holding a firm belief that a safety plan was in place. Sent home with the suggestion, “It will get better. Give it time. Rome was not built in one day” and a piece of paper.

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It was early autumn then and it is early autumn now.
I lived in what I thought was our world then.
I live in a world of my own now. It sort of overlaps with this one in places but most of this one is irrelevant to me.

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