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

Jun 29

Surviving teenage suicide

By Dr. Micaela Wexler
Teenage suicide is the most frightening event I have faced as a psychiatrist. It causes more pain and destruction than any other cause of death. The life cut short is often one full of promise and hope. In the aftermath of a teenage suicide, survivors are confused, consumed with guilt, overwhelmed with their feelings of anger, loss, betrayal, and fear. They really are not in the best position to ask for help.
The problem I have encountered as a psychiatrist is that survivors tend to be ignored, mostly because people do not know what to do. Or, they are scared of interfering. Or, they don’t realize just how fragile and in need of help survivors are.
So, how do we support these survivors? In this post I will share tips I have learned from my own experience as a psychiatrist, and at the end, I will give links to some helpful resources specifically for suicide survivors.
Parents, it is normal to feel tremendous guilt. It is very likely that you will become incapacitated by your grief. However, you are not at fault. Teenage suicide is a societal problem. If it was possible for a PARENT to prevent the suicide of their son or daughter, we wouldn’t HAVE a teenage suicide problem. When the funeral is over and all your child’s friends have disappeared, your feelings will worsen. Be careful who you reach out to. Reach out to someone with experience dealing with suicide: a professional, a medical doctor, clergy. Do not reach out to anyone who makes you feel at fault, and this includes family, friends, even your spouse. Ideally, you should reach out to other parents who have survived a similar loss, but that may be difficult to do in the immediate aftermath. Call 1-800-SUICIDE if you don’t know what else to do. Leave a post on this web site. Do not isolate yourself.
If you know a parent whose child has recently committed suicide, reach out to that parent ONLY if you can do it in a supportive manner. If you’re thinking to yourself: she shouldn’t have gone back to work, he shouldn’t have filed for divorce, they shouldn’t have pushed him so hard, etc, then DO NOT reach out yourself. Find someone else to offer that parent support. Only reach out if you are convinced you will be positive and supportive.
If you have a brother or sister who has recently committed suicide, your parents will not be there for you in the immediate aftermath. You will have to reach out to someone else: grandparents, relatives, your friends’ parents. If you have other brothers and sisters, reach out to them and be there for them. Your world has just been destroyed, and you may wonder what you did to contribute to your brother or sister’s actions. Most likely, you did nothing. Suicide has many causes; brothers and sisters are powerless to prevent such a monumental problem. Until you process your grief, the best thing you can do is talk about your brother or sister’s life. Do not hide your brother or sister’s cause of death. Ask your parents to send you to see a therapist, especially if you feel suicidal yourself. Call 1-800-SUICIDE.
Friends of the teenager need to reach out to each other. If you were a close friend, reach out to other close friends. Do not suffer alone. Go to the memorial services and the funeral. Make a Facebook page celebrating your friend’s life. You will blame yourself, this is normal, but do not hurt yourself. Call 1-800-SUICIDE if you are having a hard time coping with this. Give yourself a break: see if you can lighten school and work activities in the early days. Go see a therapist. And, remember that your other friends are entitled to their feelings, also. Some of them might be angry and blame the suicide victim, some may blame other people. This is all normal. What is not normal is to hurt yourself.
If your teenage child has lost a friend to suicide, your child needs you. Friends of a teenage suicide victim are at an increased suicide risk. Expect your child to be moody, angry, emotional, irresponsible, lazy, or completely in denial. Some teenagers are completely unable to confront a loss of this magnitude, and may behave as if nothing happened. That doesn’t mean they are not affected. A teenager who has recently lost a friend to suicide should not be left completely alone. Take all suicidal threats seriously. Watch your child for behavior out of the ordinary. Make sure your child has the support he or she needs.

Suicide is growing at an alarming rate, and affects everyone in our society. Caring for the survivors of suicide is an important job that requires everybody’s help. The obvious survivors of the teenage suicide include parents siblings, relatives, friends, acquaintances, teachers, coaches, clergy. But if we stop to think about it, we are ALL survivors because we are all negatively affected by teenage suicide. We are all forever deprived of the promise of that young person’s life.

The American Association of Suicidology has an excellent page with resources for survivors.

Alliance of Hope offers an online support group.

The following is an excellent book about surviving suicide:

No Time To Say Good-bye – Surviving the suicide of a loved one, by Carla Fine