By Richard P. Holm, MD
Years ago, a family brought a 25-year-old farmer into the emergency room with a gunshot hole over his heart and with no pulse or breathing for more than ten minutes. It was a self-inflicted wound and this young farmer would farm no more. The family was besides themselves with loud and sorrowful wailing that wrenched my soul. They told me that the impending harvest looked poor, the loan was coming due, and he had been isolating himself, drinking more and getting angry at every little thing. They had no clue he was at risk of suicide. Sure, he was a little down, but not this! He picked a permanent answer to a temporary problem.
Significant thoughts of suicide occur in one of four women and one of eight men. Although there are more attempts by women, more deaths occur by men. In 2017 there were 1.4 million attempts and 47,000 deaths due to suicide, and despite these high numbers, the money invested in depression and suicide research is sadly low.
Risk factors for suicide include family history or prior experience of depression or manic depression, a history of being abused or being an abuser, excessive use of alcohol, sleeping pills or substance dependence, a recent emotional loss or a significant medical illness. Also, there is higher risk during local epidemics of suicide in youth especially on reservations. Sometimes depression and suicide have no reason whatsoever.
How can any of us help ourselves or a person at risk? First, remember it never hurts to ask, “Are you thinking about suicide?” Those words will NOT bring it on but could encourage the person to find someone to give lifesaving assistance. If you sense there is an emotional downward change happening, encourage that person to get help. If depression is milder and NOT at the suicide level, nonmedicinal treatment can give relief. Examples abound such as daily 30-minute walks, regular interaction with friends and family and the regular opening of one’s heart to spiritual connectedness. If more help is needed, talk with your physician or care provider and consider medicines that effectively work for depression. Although two thirds of people with depression do not seek or receive help; when the one third who do get help are treated, four out of five of those folks are better in a month. Get help if needed.
Finally, if you are in crisis, call the Suicide Prevention Lifeline at 1-800-273-TALK (8255) which is available 24/7. Please don’t chose a permanent answer to a temporary problem.
Richard P. Holm, MD is founder of The Prairie Doc® and author of “Life’s Final Season, A Guide for Aging and Dying with Grace” available on Amazon. For free and easy access to the entire Prairie Doc® library, visit www.prairiedoc.org and follow Prairie Doc® on Facebook featuring On Call with the Prairie Doc® a medical Q&A show streaming on Facebook and broadcast on SDPTV most Thursdays at 7 p.m. central.
