Depression/Suicide - All You Need To Know...

This was sent in by a UK based Nigerian Doctor and it is a must read....

''My own contribution towards the sad news regarding the recently reported completed suicide by the 36 year old medical doctor who jumped into the lagoon in Lagos is to briefly highlight some of the risk factors to suicide and also discuss the depression which is the commonest risk factor. By risk factor here I mean the factors that increase your likelihood of committing suicide.

It is always sad when a loved one takes their live even after euthanasia. A few times I have been asked by patients to advise them on how to achieve euthanasia but due to my faith and morality I always declined. These patients were quite elderly, oyibo suffering from terminal illnesses that caused them so much suffering and disabilities. 

Ordinarily their request appeared justified but since euthanasia is illegal where I ply my trade and it's against my belief I always declined. For those that don't know, euthanasia is a medically assisted suicide also referred to as mercy killing.

Back to suicide , the common risk factors are as follows
* depression ( most common )

* severe anxiety

* acute stress due to any reason including marital breakdown, job losses etc

* severe adjustment reaction

* drug and alcohol abuse

* side effect of certain prescribed medication eg certain anti- depressants

* psychotic illnesses eg schizophrenia

* other mental illness like mania and personality disorders

* Suffering from serious physical illnesses

* previous suicide attempt and family history of suicide

* Cultural and religious beliefs

* Lack of supportive social cycle

*** Several other reasons

Being that depression is the major risk factor of deliberate self harm, attempted and completed suicide, let me briefly highlight some salient points about depression.


The most symptoms of depression are as follows :
* Feeling low in mood for most of the time for at least 2 weeks. We all feel low and sad from time to time but for it to be significant this has to go on for most of the time for up to 2 weeks.

* Loss or lack of pleasure or reduced pleasure in doing things especially things that you used to enjoy and again this has to be most of the time for up to 2 weeks ( known as anhedonia)

The above 2 are the most cardinal symptoms. Other associated symptoms are

* Getting tired so easily

* Poor sleep or sleeping too much

* Poor appetite or over eating

* Poor sex drive/libido

* Erectile dysfunction

* Lack of concentration that doing common things like watching

 TV or reading newspaper is a chore
*Poor self hygiene

* Poor or reduced motivation

* Speaking in very low tone and volume that you are hardly audible
* Moving or walking so slowly that you appear very sluggish

* You may also speak or walk a lot faster than usual

* Feeling that you have let yourself, family or friends down

* Feeling that life is no longer worth living that you may feel like hurting or killing yourself

* You may also start hearing voices telling you that you are useless, dirty, failure or even telling you to harm or kill yourself.

* There are other minor symptoms that time and space won't allow me to enumerate here.

Please if you or a loved one has a few of these symptoms, they are likely to be suffering from depression and must seek help urgently . There are available ways to help them.
These may be

* Counselling and other forms of psychotherapy including cognitive- behavioural therapy CBT. This may be the only treatment they require especially in reactive depression where the stressful event is known.

* They could need medications known as antidepressants . Most of them especially the newer ones SSRI and SNRI work if taken regularly at approximately same time for several months. It may take a couple of weeks before the benefits are noticeable. I can assure you that they do work.

* You may also require both psychotherapy and anti-depressants

* If you are hearing voices or displaying some psychotic tendencies, anti-psychotics like Seroquel , Olanzapine may be added.

* In very severe cases of depression or in psychotic depression like above where immediate response is required, you may receive shock treatment known as electro-convulsive therapy ECT. This is hardly administered these days but it works. Personally when I was a senior trainee in psychiatry In the UK I administered that treatment on several hopeless cases and I saw them transform overnight.

So seek for help as soon as possible'',

Thank you

Dr Chin Akano
UK.