Depression is great risk factor in suicide


 Depression is a most significant risk factor in suicide. In today’s busy, impatient, materialistic, and fast-paced society, people are subjected to various stressors in life everyday. Encumbered by their personal circumstance, some are unable to adjust and cope, and develop depression. Suicide is a senseless option and a preventable alternative.

What is depression?

Depression is a state of emotion where the individual has some or all of the following senses, feelings, or moods: downhearted, unhappy, anxious, irritable, unable to concentrate, socially withdrawn, empty inside, has inordinate fatigue and reduced interest in activities which used to be fun, hopelessness, indecision, impaired sleep, misery, helplessness, confusion, monosyllabic speech or abnormally quiet.

What is the prevalence of depression?

In the United States, about 9 percent, or 28 million American adults “have feelings of hopelessness, despondency, and/or guilt that generate a diagnosis of depression,” according to the U.S. Centers for Disease Control and Prevention. Three percent or 9.6 million of adults have major depression, a chronic and severe form of depression. In the Philippines, the rate is about 5.3 percent. Worldwide, the rate is between 2.6 percent to 29.5 percent, a pandemic, actually, according to an international study conducted by the World Health organization. In general, women are 70 percent more prone to develop depression, in part due to hormonal changes, especially during menstruation, after pregnancy, and menopause. In the past 50 years, the rate has catapulted from 3.33 percent to 7.06 percent, from 1991 to 2002. The rate for the various types of depression in the United States are: Postpartum – 10 to 15 percent; SAD (Seasonal Affective Disorder) – 4 to 6 percent; Bipolar – 2.6 percent; Dysthymia (minor depression that lasts 2 years or longer) – 1.5 percent; Psychotic depression (most severe form) – 5 percent.

Are there screening tests for depression?

Yes, there are. Mental health specialists can administer preliminary tests such as the BDI (Beck Depression Inventory), or the HRS (Hamilton Rating Scale), which is composed of 20 questions to screen the patient. Today, computerized phone interviews are gaining effectivity as a screening tool. These tests are only a small part of the evaluation process, because the specialists have the symptoms of the patient and other criteria to aid them make the correct diagnosis.

Don’t we all get depressed sometimes?

To some degree, some situations in life trigger depression, and normal people develop a mild form of depression, which is transient, self-terminating, and not a disease. As long as the resultant symptoms are trivial and temporary, and do not debilitate the person, the condition is not clinical illness and does not need any medical treatment

What foods relieve depression?

Foods that are high in tryptophan, an amino acid involve in serotonin production, provide relief to some people with depression.  Niacin (Vitamin B3), which is essential in the production of tryptophan, can be found in dried peas, beans, whole grains, dried fortified cereals, and especially in oily fishes like salmon and mackerel. It is reported that Omega-3 polyunsaturated fatty acids in fish oil may actually reduce depression.  PMS Escape, a high carbohydrate drink, was claimed to increase tryptophan level and would control the depression related to pre-menopausal syndrome has been found to have impurities by the FDA and subsequently withdrawn from the market. Calcium supplements and Vitamin B-12 have been reported to reduce pre-menstrual depression. Also, some studies showed that among depressed people who drink caffeinated beverages have a lower incidence of suicide, which seems to suggest that coffee or tea reduces depression.

How about exercises?

Believe it or not, physical exercises may be as effective as psychotherapy in the management of mild to moderate depression. Prolonged aerobic workouts lead to higher levels of serotonin, adrenalin, endorphins and dopamine in the brain (producing the popular term “runner’s high”). Physical exercises, brisk walking, ballroom dancing, yoga, tae-bo, etc. lead to better emotional health. As an extra bonus from physical exercises, weight loss and improved muscle tone lead to the sense of well-being and higher self-esteem. Those individuals with strong spiritual faiths have a relatively lower predisposition to depression. These people might benefit from meditation, yoga, and other techniques for obtaining spiritual security, inner peace and happiness. Severe depression needs medical treatment.

Does depression play a role in suicides?

Yes, very significantly. Depression is present in about 90 percent of the more than 40,000 suicides that take place in the United States annually, and for every two homicides, there are 3 suicides. Suicide is the 10th leading cause of death in the United States overall and the second leading cause of death in the age group 10 to 34. According to CDC, 1.3 million adults attempted suicide in 2014. About 78 percent of them are men, more than 4 times the rate for women. Depression lowers the mental threshold for self-destruction.

Do you have depression?

If you do, it is most prudent to seek medical help, not necessarily psychotherapy. The first thing to do it to consult your family physician, who can help guide you. With early proper medication and/or advice, depression in most cases can be managed effectively and eliminated faster than one can imagine.  Physicians today have invaluable tools in their armamentarium for the diagnosis and treatment of depression. Many individuals with depression, who have sought medical care, are so “cured” with simple oral medications that they look, behave, function and live as normally and happily as anybody else, lost in the sea of anonymity.

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Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA,  a 501(c)(3) humanitarian foundation in the United States. Email: scalpelpen@gmail.com

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