Risk Factor Stress, Depression and Suicide

Presented by:

IRENE S. VELASCO
School Principal 1
Masagana High School
 This topic will cover:
• Definition of Risk Factor Stress, Depression and Suicidal Risk
• Myths and Facts about Stress, Depression and Suicide
• Risk factors, Warning signs & Protective Factors
• Basic intervention skills to use with suicidal behavior
• Resources for help
 Definitions
STRESS- “The reaction people may have when presented with demands and pressures that are NOT
matched to their knowledge and abilities and which challenge their ability to cope.”
-World Health Organization
• (Civil Service Employee Assistance Service, 2015)

DEPRESSION - It is a mood disorder that causes a persistent feeling of sadness and loss of interest in
activities once enjoyed. It affects how you feel, think and behave and can lead to a variety of
emotional and physical problems.
-American Psychiatric Association

SUICIDE - Death caused by self-directed injurious behavior with an intent to die as a result of
the behavior.
Suicidal ideation
Thinking about, considering, or planning suicide.
Suicide attempt
A non-fatal, self-directed, potentially injurious behavior with an intent to die as a result of the behavior;
might not result in injury.
-Center for Disease Control and Prevention
 Definitions
Risk Factors- Stressful events or situations that may increase
the likelihood of a suicide attempt or death. (Not predictive!)
Protective Factors- Personal and social resources that
promote resiliency and reduce the potential of suicide and
other high-risk behaviors.
Warning Signs- the early observable signs that indicate
increased risk of suicide for someone in the near-term.
(Within hours or days.)
 Myths vs. Facts (Stress)

• Stress is the same for everybody.

MYTH
Completely wrong. Stress is different for each of us. What
is stressful for one person may or may not be stressful for
another; each of us responds to stress in an entirely different
way.
 Myths vs. Facts (Stress)
• Stress is always bad for you.
MYTH
According to this view, zero stress makes us happy and healthy.
Wrong. Stress is to the human condition what tension is to the violin
string: too little and the music is dull and raspy; too much and the
music is shrill or the string snaps.
• Stress can motivate people to prepare or perform, like when they
need to take a test or interview for a new job. Stress can even be life-
saving in some situations. In response to danger, your body prepares
to face a threat or flee to safety. In these situations, your pulse
quickens, you breathe faster, your muscles tense, your brain uses more
oxygen and increases activity—all functions aimed at survival.
 Myths vs. Facts (Stress)
• Long-term stress can harm your health.
FACT
According to this view, zero stress makes us happy and healthy.
Wrong. Stress is to the human condition what tension is to the violin
string: too little and the music is dull and raspy; too much and the
music is shrill or the string snaps.
Stress can motivate people to prepare or perform, like when they
need to take a test or interview for a new job. Stress can even be life-
saving in some situations. In response to danger, your body prepares
to face a threat or flee to safety. In these situations, your pulse
quickens, you breathe faster, your muscles tense, your brain uses more
oxygen and increases activity—all functions aimed at survival.
 Myths vs. Facts (Stress)
• Long-term stress can harm your health.
FACT
Health problems can occur if the stress response goes on
for too long or becomes chronic, such as when the source of
stress is constant, or if the response continues after the
danger has subsided. With chronic stress, those same life-
saving responses in your body can suppress immune,
digestive, sleep, and reproductive systems, which may cause
them to stop working normally.
 Myths vs. Facts (Stress)

• There are ways to manage stress.

FACT
Stress can be the kiss of death or the spice of life.
The issue, really, is how to manage it. Managed stress makes
us productive and happy; mismanaged stress hurts and even
kills us. The effects of stress tend to build up over time.
Taking practical steps to manage your stress can reduce or
prevent these effects.
 Myths vs. Facts (Stress)
• Stress is the same for everybody.
MYTH
• Stress is always bad for you.
MYTH
• Long-term stress can harm your health.
FACT
• Only major symptoms of stress require attention.
MYTH
• There are ways to manage stress.
FACT
 Myths vs. Facts (Depression)
•Depression distorts your thinking.
FACT
When you are depressed, your mind can play tricks
on you. If you have thoughts of suicide, please call
someone immediately. Don't let a temporary glitch in
your thinking cause you to harm yourself or another.
 Myths vs. Facts (Depression)
• Only Women Get Depressed
MYTH
According to the National Institute of Mental Health, women experience
depression at roughly twice the rate of men. Many factors contribute to
women’s depression, such as hormonal fluctuations, especially in the
childbearing ages, and social stresses, including family responsibilities.
However, approximately 6 million men in the US experience depression each
year. Although the symptoms used to diagnose depression in men are the same
as in women, men cope with depression differently than women, making male
depression more difficult to diagnose. For example, men tend to be more
irritable and angry, versus sad and weepy. They are more apt to engage in
reckless behavior and turn to drugs and alcohol. Men often report more
physical symptoms than women, like backaches, chest pain, headaches, and
digestive problems.
 Myths vs. Facts (Depression)
• If You Eat a Good Diet, You Won’t Be Depressed
MYTH
There is much benefit in eating a good diet. However,
they aren’t enough to protect me from depression
entirely. A 2014 review published in the American Journal
of Clinical Nutrition examined the link between diet and
depression risk and found that a diet consisting mainly of
fruit, vegetables, fish, and whole grains was significantly
associated with a reduced risk of depression. However, to
say that good nutrition is all you need to avert depression is
a dangerous myth.
 Myths vs. Facts (Depression)
• Untreated Depression Is the Most Common
Cause of Suicide
FACT
The proper diagnosis and treatment of depression is
very important in preventing suicides. According to the
Substance Abuse and Mental Health Services Association
(SAMHSA), 90 percent of those who commit suicide are
suffering from some sort of mental illness. And, most of
these people have depression which is either undiagnosed,
untreated, or undertreated.
 Myths vs. Facts (Depression)
• Depression distorts your thinking.
FACT
• Only Women Get Depressed
MYTH
• If You Eat a Good Diet, You Won’t Be Depressed
MYTH
• Untreated Depression Is the Most Common Cause of Suicide
FACT
-Mental Health America
 Myths vs. Facts (Suicide)
•Talking openly about suicide will cause it.
MYTH
-What we know is that talking openly about suicide in a responsible
manner can have the opposite effect on those who are struggling.
Finally, someone sees their struggles and is willing to help them get
the support they need.
Preventing suicide starts with our comfort in acknowledging and
talking about suicide.
 Myths vs. Facts (Suicide)
•Anyone can learn to help someone who is
struggling with thoughts of suicide.
FACT
-The only limitation is our own belief about whether
or not suicide is preventable, our ability to recognize and
intervene with a potentially suicidal person, and our
own comfort around the topic. Suicide prevention is up
to us ALL.
 Myths vs. Facts (Suicide)
•If someone talks about suicide they don’t need to be
taken seriously.
MYTH
Most often, a person that’s considering suicide doesn’t
really want to die-they just want to end the unbearable pain
they’re experiencing. They are often looking for someone to
help them with their distress. Up to 90% of suicidal people
speak to at least one person about their distress before
making a suicide attempt. It allows us to get help!
 Myths vs. Facts (Suicide)
•There are signs that we can look for that may
indicate someone is considering suicide.
FACT
We call these warning signs and, over 80% of the
time, they are in place when someone chooses suicide.
The difficulty is in recognizing those warning signs for
what they are. Warning signs offer a reason to ask if
someone is OK.
 Myths vs. Facts (Suicide)
• Talking openly about suicide will cause it.
MYTH
• Anyone can learn to help someone who is struggling with thoughts of suicide.
FACT
• If someone talks about suicide they don’t need to be taken seriously.
MYTH
• There are signs that we can look for that may indicate someone is considering
suicide.
FACT
 The Reality of Suicide in the Philippines
21

• Manila (CNN Philippines Life) — Close to 800,000 people die due to

suicide every year. For every suicide, there are many more people
who attempt suicide every year. A prior suicide attempt is the most
important risk factor for suicide in the general population, according to a
World Health Organization (WHO) fact sheet, updated August 2017.
• From 2012 to 2016, there were 237 suicide cases among children aged
between 10 and 14, according to Ericta.
• Of 2,413 suicide cases recorded in 2016, more than 2,000 were male and
the rest female, according to the Department of Health.
Attempted Suicides
 Risk Factors
Warning Signs
Protective Factors
Risk factors are found in different domains….

Family Risk Factors

Personal/Behavioral Risk Factors

Environmental/Social Risk Factors

What Are Some Risk Factors For Suicide?

 Long Term Long Term Triggers
Risk Factors (Unchanging) (Modifiable)

Family history of: Unrealistic parental Major family conflict

 Suicide Exposure to suicide of family
Family expectations
 Mental illness member
 Substance abuse Abuse (emotional, physical, Anniversary of death
Race sexual) Moving often
Gender

Previous suicide attempt Extreme perfectionism Rejection

Personal Relationship break-up

Loss through death,
Behavioral abandonment, divorce
Inconsistent, neglectful or
abusive parenting
Social/ Sexual orientation
Environmental Gender identity
Experience of repeated loss
Mental illness
Substance abuse
Poor coping/social skills
Impulsivity
Chronic severe stress
Ongoing harassment
Current acute mental illness
Severe stress/anxiety
Isolation
Increased use of substances
Bullying, Harassment
Arrest/Incarceration
Active suicide cluster in
community
Access to lethal means
Protective Factors
 Protective Factors
• Skills to think, communicate, solve problems, manage anger and other
negative emotions,
• Purpose & value in life; hope for the future, pets, work/ life focus
• Personal characteristics- health, positive outlook, healthy choices,
spirituality or religious belief
• Supports- parents, friends, mentors, and other caring adults
• Safe Environment – restricted access to lethal means; positive school
climate
 Warning Signs

These are changes in behavior or appearance that

indicate someone is in crisis!
 Clear Signs Of A Suicidal Crisis
1. Someone threatening to hurt or kill themselves
2. Someone looking for the means (gun, pills, rope etc.) to kill
themselves; has a clear plan.
3. Someone showing signs of distress/ agitation/ anxiety

Get the facts and take action!

 Adolescent Warning Signs for Suicide
Is the youth (up to age 20) :
• Talking about or making plans for suicide
• Expressing hopelessness about the future
• Displaying severe/overwhelming emotional pain or distress
• Showing worrisome behavior or changes particularly in the presence of the above
warning signs.
• Specifically:
o Withdrawal from or changes in social connections
o Recent increased agitation or irritability
o Anger or hostility that seems out of character or context
o Changes in sleep (increased or decreased)
AAS Consensus group, 2014
 Suicide in the Young ( under 15 y.o.)

Warning Signs (very similar to Risk Factors:

previous list): • More than one mental health
• Change in usual behavior diagnosis & untreated MH concerns
• School refusal • Early trauma or stressful events
• Risky behavior
• Negative school experience (bullying)
• Talk of intent to die
• Self harm (may be seen as recurrent • Loss of early primary attachments
“accidents”) (death, placement in foster care etc.)
• Verbal clues of suicidal thoughts • Internalizing distress vs. externalizing

If a child mentions suicide (or not wanting to be around anymore)-take it seriously!!!!

 Keep Your Eyes and Ears Open
Direct clues: Less Direct clues:
• I wish I was dead • Life’s just too hard
• I’m going to end it all • You’d be better off
without me
• I’m going to kill
myself • What’s the point?
 From a Suicidal Person’s Point of View
• Crisis point has been reached
• Pain is unbearable
• Solutions to problems seem unavailable
• Thinking is affected

HOWEVER:
• Ambivalence exists
• Communicating distress is common
• Invitations to help are often extended
 Invitations to Help
FEELINGS
Desperate Worthless THOUGHTS
Angry Lonely
“All of my problems will end soon”
Guilty Sad
Worthless “I just can’t take it anymore”
Hopeless
“I wish I were dead”
“You’ll be better off without me”
“I can’t do anything right”

ACTIONS
Giving away possessions
Withdrawal
Abuse/use of substances
Reckless behavior
PHYSICAL
Extreme mood swings Lack of interest in appearance
Increased impulsivity Changes in appetite, weight
Self-injury (maybe) Change in sleep patterns
 Why People Hesitate to Ask for Help
• Unwilling to admit needing help
• Afraid to upset/anger others
• Unable describe their feelings/needs
• Unsure of available help or resources
• Struggling with symptoms of depression
• Don’t know what to expect
• Shame, fear of stigma
• May prefer to confide in peers
 Why People Hesitate to Help

• Not sure about how severe the risk is; what if they’re wrong?
• Worry about doing/saying the “right” thing
• Feelings of inadequacy
• Afraid to put the idea in
someone’s head
• Feel it’s not “their issue”
• Bystander Effect
 Intervention:
A bridge to help
 What IS Helpful
1) Show You Care—Listen carefully—Be genuine
“I’m concerned about you . . . about how you feel.”

2) Ask the Question—Be direct, caring and non-confrontational

“Are you thinking about suicide?”

3) Get Help—Do not leave him/her alone

“You’re not alone. Let me help you.”
Resources for Help

What are YOUR resources?

 School Resources (examples)
• School Counselor
• School-Based Health Centers/Nurse
• Crisis Team Members
• School Gatekeepers
• Administration
• School Resource Officer
• Who else…?
 Thank you for
learning with me…

STAY HAPPY !!!