Aug 29

1-800-273-TALK – every college student should know this number

By Dr. Micaela Wexler

WexlerPsychiatryWinter

34,000 people die from suicide in this country every year; 1100 of them are college students. Suicide is the second leading cause of death for college students.

With these statistics, why isn’t the number to the National Suicide Prevention Lifeline, 1-800-273-TALK, easily accessible to every college student?

For every person who dies from suicide, 6-7 are left behind with deep lasting pain. For college students, that number is much higher, especially for high functioning students “who had everything to live for.” Students who are bright and popular leave a frightening and persistent feeling of confusion in their fellow students, even in those they had never met personally. When Kyle Ambrogi committed suicide at U Penn October 2005, his team mates were unable to focus, and lost four consecutive games, giving U Penn its first 5-loss season in 6 years.

For me as a psychiatrist it is a tragedy that in an environment such as a university, with so many resources and knowledge, the information about mental health treatment and it’s effectiveness remains elusive. My work has brought me into contact with many suicide attempt survivors who emphasize to me the life saving power of treatment. There is a way to make the pain go away. There are therapies and medications that really do work.

Sadly, most college students do not know where to turn for help. Others fall prey to the stigma of mental illness that persists, even at universities where mental health professionals are trained. They are afraid to seek help for fear they will appear weak, or will suffer consequences, such as loss of friendships, or expulsion from organizations, or even expulsion from school.

The pain of suicide is too great for this to continue. The death of a college student to suicide is a tragic loss for our society as a whole. All students should have 1-800-273-TALK, the National Suicide Prevention Lifeline, written on their bathroom mirror. Students and professors should know the warning signs for suicide: IS PATH WARM (Ideation, Substance Abuse, Purposelessness, Anxiety, Trapped, Hopelessness, Withdrawal, Anger, Recklessness, Mood Swings).

The reasons behind suicide are varied and complex. College students should know that this is a preventable cause of death. The American Foundation for Suicide Prevention is a good resource for those who have been affected by suicide and want to know the “why” behind this painful event, as well as steps we can all take to prevent such future tragedies.
Early diagnosis beneficial in AD
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Appointment information for Dr. Micaela Wexler: wexlerpsych.com

Mar 13

Madison Holleran: we must increase the dialogue about depression

MadisonHolleran
by Dr. Micaela Wexler

On January 17, 2014, Madison Holleran, an accomplished athlete and student at U Penn, jumped to her death. She seemingly had everything going for her. She was popular; she had a family who was close and supportive; she was academically gifted, having earned a 3.5 GPA her first semester at an Ivy League university; and she was a talented athlete, running on the school’s cross country team. An hour before her death, she had been making dinner plans with friends.

“You can’t really understand why a girl who seemingly has everything going for her would want to end it,” her father said.

Her death shocked so many in her college community as well as her home town who reported there had been no clues, no warning signs. People all across the country have been saddened by her death, not only because this is a tragic loss to our society, but because her death strikes fear in so many that this could happen to one of their loved ones.

As a psychiatrist, I treat a large number of people who have been left permanently scarred by the death from suicide of a loved one. Several people have expressed the fear that if suicide could claim the life of someone “who had everything,” what is to keep their loved ones safe?

One of the reasons Madison Holleran’s death by suicide was so shocking is that relatively few people in her life were familiar with the facts of her depression. Those who were found themselves at a loss as to how to help her, and were not aware of the serious risk depression poses to those it affects. The stigma of mental illness is so great that people who struggle with depression suffer in silence and isolation.

As a society, we do not know how to help people with depression. Many people do not recognize that when a person has become irritable, is feeling unmotivated, has lost interest in things that were once enjoyable, is complaining of having low energy and not being able to sleep, that person is not being lazy or “needy;” that person is most likely depressed. That person is potentially in danger of losing his or her life to suicide.

There is not enough dialogue about depression for most people in the midst of their despair to know that there is treatment available that works, that will make them feel better. This was illustrated a while back by a patient who came to see me for his monthly follow up in the clinic. He was a college professor at that time, in his 50’s. He was (most likely still is) bright, witty, very popular with his students, and a joy to see in clinic. Two years earlier, he had become acutely suicidal, and his wife had the wisdom to bring him to me for an emergency visit. She was able to petition to have him admitted to the inpatient psychiatric unit against his will. Several months later, he again became suicidal, but at that time, he entered the psychiatric unit voluntarily.

One day, as I asked my routine questions about suicidal ideation, he said to me, “That first time, I just didn’t see how it was possible to feel anything but despair. There was just too much going on in my head for me to have anything resembling a rational thought. To me, suicide was rational. Then you put me on the mood stabilizers, threw me into those groups, and by the end of the week, I was feeling better. Suicide became a ridiculous idea. The next time it happened, I knew that I would feel better. I knew that this feeling of despair would go away , that as soon as I changed my medications and got some therapy, it would go away. I just needed to get to that place.”

As a college professor who had himself been suicidal, suicide among college students was something my patient thought about regularly. He mentioned it every month at his regular visits. “There has to be a way to let EVERYONE know that there is stuff that WILL make that desperate feeling go away, that there are medications, and that you can spend a few days going to groups and coloring and talking to people and you’ll feel better!”

For me, as a psychiatrist, the greatest tragedy of Madison Holleran’s death by suicide is that even though she was in an environment with so many resources and knowledge, the information about treatment and its effectiveness remained elusive to her and her family. As so many patients tell me, “that desperate feeling is so painful, you finally just snap and want to make it go away!” They always emphasize to me how important to their lives it is to know how to get treatment.

There is a way to make the pain go away. You don’t have to jump off a building or jump in front of a car. There are therapies and medications that really do work. Suicide is the SECOND leading cause of death among college students. This is a tragedy that should not be happening on college campuses. Information about depression and treatment should be ubiquitous.

All students and professors should know the warning signs for suicide: IS PATH WARM (Ideation, Substance Abuse, Purposelessness, Anxiety, Trapped, Hopelessness, Withdrawal, Anger, Recklessness, Mood Swings).

Mental health services need to be made truly accessible. Every student, parent and professor should know the numbers to call if someone they know is depressed. The number 800-273-TALK should be on everyone’s bathroom mirror and refrigerator. Substance abuse on college campuses needs to be addressed. We need to recognize that it is not a benign part of college life, but rather a potential warning sign of depression and a risk factor for suicide.

Need help? In the U.S., call 1-800-273-TALK (8255) for the National Suicide Prevention Lifeline.

Need help with substance abuse or mental health issues? In the U.S., call 800-662-HELP (4357) for the SAMHSA National Helpline.

Early diagnosis beneficial in AD
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Appointment information for Dr. Micaela Wexler: wexlerpsych.com

Oct 05

College students and mental health

By Dr. Micaela Wexler
As a family psychiatrist, I have noticed this is the time of the semester when college students first face mental health challenges. These can include issues like homesickness, anxiety about exams, alcohol abuse, difficulty with focus and concentration, romantic break ups, roommate conflicts, insomnia and time management challenges. Though these are common, and not considered serious, they can interfere with a student’s progress. These issues are easily treated, and should be addressed by students and the people in charge of supporting them.

The mental stress that is part of the college experience can trigger episodes of serious mental disorders. It is at this time of the semester, when first exam grades have been posted and class withdrawal deadlines are approaching that students with issues like bipolar mood disorder, eating disorders, severe OCD, or more rarely, psychoses or delusional disorders are especially overwhelmed. A significant number of people with these disorders are not diagnosed until early adulthood, so if they are in college when the first episode occurs, they usually find themselves alone, without psychiatric care.

It has become routine on college campus for a review of mental health services to be part of new student orientation. Many colleges offer a number of free counseling sessions to every student. However, when students are faced with an actual mental health crises, their thinking process tends to be derailed and they don’t always know what do to. The most frustrating aspect of mental health care is that oftentimes, even people with severe mental illness may fail to recognize they are at risk and need help.

College students can play an important role when it comes to mental health by being attentive to their peers. Students should trust their instincts and take action when they sense a fellow student is under mental duress.

All students should know the warning signs for suicide. An easy mnemonic has been developed by the American Association of Suicidology: IS PATH WARM (Ideation, Substance Abuse, Purposelessness, Anxiety, Trapped, Hopelessness, Withdrawal, Anger, Recklessness, Mood Swings). Students should know where to turn for immediate help if they suspect a fellow student is suicidal.

Students do not need to sense a problem is as serious as suicide to take action. If a fellow student seems down, or has stopped eating, is losing or gaining weight rapidly, or getting intoxicated frequently, that person may need help. Help can take many forms. A student could ask a peer directly, “are you ok?” If that feels awkward, a student could bring up the topic in a general way, ie, by talking about something they heard in class, or on the news, ie, “I heard that severe stress in college can trigger (an eating disorder, a drinking problem, severe OCD, hearing voices). What do you think?”

Or, a student could say to a peer, “you have seemed really worried lately. Would you like to talk about it?”

A student should not take it upon themselves to be the sole source of support for a student in need. Before approaching the student in need, a college student should speak to a professor, resident assistant, a mental health provider, just in case the situation is more serious. This can easily be done in a way that protects the other student’s privacy and dignity.

On the other hand, talking with other students about the student having problems without ever offering support to the person who is depressed or behaving erratically is not only unkind, but potentially dangerous. There is still a great deal of stigma regarding mental health issues, and contributing to this should NOT be part of the college experience. Nowadays there are effective treatments for even the most serious of mental health challenges. Taking positive action in the face of mental duress can be rewarding for college students. Preventing mental health tragedies is something which will enhance the college experience for everyone involved.