Experts say depressed people at greater risk of suicide

PESHAWAR: Mental health experts said Saturday those suffering from depression are at a 25-time greater risk of committing suicide than the general population.

They were speaking on the first day of the two-day training workshop on suicide prevention arranged at the Ibadat Hospital.

Horizon, a non-governmental organisation, Pakistan Psychiatric Research Centre, Fountain House Lahore, and the World Psychiatric Association Section on Psychiatry in developing countries joined hands to arrange the training.

Psychiatrists, clinical psychologists, academicians, students and civil society activists attended the programme.

Prof Dr Wajid Ali Akhunzada was the chief guest.

The speakers included Prof Dr Nazish Imran, head of the Department of Child and Family Psychiatry at King Edward Medical University and Mayo Hospital, Lahore, Prof Dr Imran Ijaz Haider from Fatima Memorial Hospital, Lahore, Dr Ali Ahsan Mufti, Associate Professor at the Jinnah Medical College, Peshawar and Executive Director of Horizon, Prof Dr Khalid Mufti, Dr Assad Khan and Mumlikat Zahir, a clinical psychologist with a speciality in Cognitive Behaviour Therapy.

Dr Ali Ahsan welcomed the participants. “We should take mental health seriously for our emotional and psychological well-being,” he said while welcoming the participants.

The speaker said people who are emotionally healthy are able to handle life’s challenges well, build strong relationships and lead productive, fulfilling lives. “When bad things happen to them, they are able to bounce back and move on,” added the host.

In his session, he talked of the physical effects of excessive stress such as headache, rash, breathlessness, panic attacks, aching joints, nausea, stomach pain, muscle cramps, sleep and eating issues while the emotional effects are nervousness, anxiety, anger, tension, fear, feeling worthless and the most important is depression. Dr Ali Ahsan Mufti mentioned the breakdown of family relationships, bereavement, changes in friendship, abuse, bullying, experiencing or witnessing violence and, of late, social media posts as some of the causes of excessive stress. He said excessive stress can lead to depression, eating disorders, self-harm, severe anxiety and even suicide.

Prof Dr Nazish Imran took up myths and misconceptions about mental health and suicide.

She called for exploring the differences between the myths and realities of mental illness, understanding the stigma surrounding mental illness, its impact on help-seekers and the role that healthcare professionals can play in the prevention of self-harm and suicide.

The expert touched on suicidal behaviours, suicide, such attempts, related ideation, non-suicidal self-injury, deliberate self-harm, suicide survivors, postvention and psychological autopsy.

Dr Nazish Imran said there are 10-25 suicide attempts for every suicide. Quoting from a study, she said a total of 2295 suicide cases were taken up for the study, of them 1420 were males (61.87per cent), and 875 were females (38.12 per cent).

The expert said most suicides occurred under age 30 (71.2 per cent) while 87.33 percent of subjects were married. She cited domestic conflicts, financial reasons or poverty, failure in love or marriage as the main reasons.

Dr Nazish Imran said people with suicidal ideation usually loses all hopes and see no other option. “Any act of self-harm needs to be taken seriously as it is mostly a cry for help by people in distress,” added the expert.

Prof Dr Imran Ijaz Haider called for understanding and identifying types of effective communication to tackle mental health challenges.

“A mental health practitioner should be friendly, attentive, non-judgmental and involve the person in distress to speak up and by offering empathy,” he said while urging that an environment should be created to facilitate open communication with the patients.

He talked of types of effective communication both verbal and non-verbal and laid stress on body language, eye contact, hand gestures, privacy and confidentiality as all this wins the trust of the patient. Mumlikat Zahir talked about the assessment of depression and its relationship with suicide psychological measurement.

The speaker said the lifetime risk of suicide among people with untreated depression ranges from 2.2 - 15 per cent. “Depression is present in at least 50 per cent of all suicides. Those suffering from depression are at a 25-times greater risk for suicide than others,” she added.

The speaker said persistent depressed mood and markedly diminished interest in activities for at least two weeks were among the core symptoms of depression.

Of the additional symptoms, she mentioned disturbed sleep or sleeping too much, significant change in appetite or weight (decrease or increase), the belief of worthlessness, excessive guilt, fatigue or loss of energy, reduced concentration, indecisiveness, talking or moving slower than usual, helplessness, suicidal thoughts or acts

She said a person is likely to have suicidal thoughts if he or she is in depression, feeling low mood, worthlessness, hopelessness, has a lack of interest in daily activities and is in self-isolation.