Why the holiday suicide myth persists

By Kim Painter, USA TODAY

You could blame George Bailey. In the 1946 holiday film It's a Wonderful Life, that fictional character contemplated suicide on Christmas Eve, possibly giving birth to the idea that suicides climb during the winter holidays.
But moviemaker Frank Capra had it wrong: Study after study shows no such link; in fact, suicide numbers peak in the spring and may even dip in December, according to the U.S. Centers for Disease Control and Prevention. Still, the holiday suicide myth has amazing staying power.

For the past decade, Dan Romer, a researcher at the Annenberg Public Policy Center of the University of Pennsylvania, has been tracking mentions of suicide and the holiday season in stories published in U.S. newspapers from mid-November to mid-January. His first study, covering the 1999 holiday season, found that just 23% of stories debunked the myth and the rest reinforced it. By 2006, 91% of stories debunked the myth, and Romer took some credit: Publicizing the facts had nearly killed the myth, he thought.

He was wrong. In the 2007 season, the myth was back in half of stories, he says. And Romer just completed his analysis of 2008 holiday coverage. He found that 38% of stories supported the myth and 62% debunked it – an improvement he attributes partly to a myth-busting report published last December in the British Medical Journal.

He can't explain why nearly four in 10 stories still linked suicide and the holidays. "No one does it maliciously," he says. "I think they are trying to help people."

But the myth may harm people instead.

"It might unnecessarily put people on their guard or increase their anxiety," says Ronald Pies, a psychiatrist at Tufts University School of Medicine, via e-mail. Worse, he says, some people "on the brink" of self-harm might feel encouraged to follow through when they read or hear that holiday suicides are common. The myth might become a self-fulfilling prophecy.

Romer agrees: "You don't want to convey the message that this is acceptable or that there's a good reason to do it."

But why does this particular myth persist?

One reason may be that the holidays fall during a time of year that can be trying for many people, says Paula Clayton, medical director of the American Foundation for Suicide Prevention. People with seasonal affective disorder (SAD) tend to become depressed as days get shorter and darker. They come out of their depression in the spring.

Meanwhile, some people do suffer short-term blues linked directly to the hubbub and stress of the holidays, she says. People in mourning for a loved one can feel especially sad as special days come and go without that person, she says.

Pies adds: "I certainly would expect that, in the present financial crisis, the usual blues would be intensified for many families facing loss of savings, unemployment, etc."

But, experts say, suicide is almost always the act of someone who has endured deep depression or another mental illness for months or years – not someone with a passing case of the blues.

The holiday suicide myth may detract attention from the real needs of people who might consider suicide at any time of year, Clayton says: "There are a lot of untreated people out there."

Meanwhile, researchers continue to look for the real patterns in suicidal behavior, says Alexander Crosby, a CDC researcher. "That can help us in terms of finding protective factors," he says.

And one protective factor, he says, is "connectiveness" – that is, how connected people are to friends, families and communities.

Fittingly enough, that was the very thing (along with an angel) that saved George Bailey after all.

Copycat effects after media reports on suicide: A population-based ecologic study.

Authors: Niederkrotenthaler, D., Till, B., Kapusta, N., Voracek, M., Dervic, K., & Sonneck, G. (2009). Social Science and Medicine, 69(7), 1085-1090.

The authors explored whether the risk of an increased number of suicides after a media report on suicide is associated with the social characteristics of the person whose suicide was reported. Celebrity status of the person whose suicide was reported was the only variable associated with an overall increase in the number of suicides after the media report of a suicide. That is, a suicide report involving a celebrity resulted in an increase in the total number of suicides in the 29 days following the report. However, the study also revealed three factors associated with an increase in the risk of “similar” suicides (that is, suicides of persons of the same sex, in the same age group, or who use the same method as the person whose suicide was reported in the media) over that same time period.

• The first factor is celebrity status.

• The second factor is whether the person who was reported to have died by suicide was in the same age group as the people exposed to the support (that is, people seem to be more likely to imitate a suicide if the person who died by suicide was in their age group).

• The third factor was definitiveness. Definitively labeling a death as a suicide in a media report (rather than reporting it as a suspected suicide) increased the risk for similar suicides.

The study also revealed that media reports of the suicide of an individual convicted of, or suspected of, crimes were associated with a decrease in similar suicides. None of the variables were found to be associated with a post-media report increase in “dissimilar” suicides (that is, suicides by people in another age group, of the other sex, or who chose a different method). Nor was the density of media suicide reports found to be associated with an increase in suicides.

The authors concluded that increases in suicides after a media report of a suicide is most pronounced for:

• (1) people with social characteristics similar to the person whose suicide was reported, because they are more likely to identify with the deceased than other people; and

• (2) persons seen as socially superior (celebrities) and thus as role models to be imitated. Reporting a suicide of persons of whom society disapproves (i.e. criminals) was associated with a lower risk of copycat suicides.

The study also found that reports of the suicide of middle-aged people were more likely to be followed by similar suicides than reports of suicides of people in other age groups. The authors speculated that this may be a consequence of the fact that the study utilized newspaper reports and that most newspaper readers are middle-aged. They suggested that additional research should be conducted on media that target children, adolescents, and the elderly. The authors also noted that only a limited fraction of suicide reports in the media were followed by an increase in suicides. The research team used data on suicides from the nonprofit information center Statistics Austria during the period July 1996–September 2006 and reports on suicide in the 13 most widely read Austrian newspapers (which reach 74.2% of that country’s population) during the same time period. Among the celebrity suicides reported during this period were those of rock stars Falco and Michael Hutchence and British weapons expert David Kelly.

Survey Reveals Big Gap in Understanding of Depression

Arlington, VA— Americans do not believe they know much about depression, but are highly aware of the risks of not receiving care, according to a survey released today by the National Alliance on Mental Illness (NAMI).

See full survey results at http://www.nami.org/depression.

The survey provides a "three dimensional" measurement of responses from members of the general public who do not know anyone with depression, caregivers of adults diagnosed with depression and adults actually living with the illness.

• Seventy-one percent of the public sample said they are not familiar with depression, but 68 percent or more know specific consequences that can come from not receiving treatment—including suicide (84 percent).
  
• Sixty-two percent believe they know some symptoms of depression, but 39 percent said they do not know many or any at all.
  One major finding: almost 50 percent of caregivers who responded had been diagnosed with depression themselves, but only about 25 percent said they were engaged in treatment.
  
• Almost 60 percent of people living with depression reported that they rely on their primary care physicians rather than mental health professionals for treatment. Medication and "talk therapy" are primary treatments—if a person can get them—but other options are helpful.
  
  Fifteen percent of people living with depression use animal therapy with 54 percent finding it to be "extremely" or "quite a bit" helpful. Those using prayer and physical exercise also ranked them high in helpfulness (47 percent and 40 percent respectively).
  

When people living with depression discontinue medication or talk therapy, cost is a common reason, but other significant factors include a desire "to make it on my own," whether they believe the treatment is actually working and in the case of medication, side effects.

"The survey reveals gaps and guideposts on roads to recovery," said NAMI Executive Director Michael J. Fitzpatrick. "It tells what has been found helpful in treating depression. It can help caregivers better anticipate stress that will confront them. It reflects issues that need to be part of ongoing health care reform."

"There are many treatment strategies," said NAMI Medical Director Ken Duckworth. "What often works is a combination of treatments that fit a person and their lifestyle. Research indicates that the combination of medication and psychotherapy are most effective. But physical exercise, prayer, music therapy, yoga, animal therapy and other practices all can play a role. The good news is that 80 percent or more of the public recognize that depression is a medical illness, affecting people of all ages, races and socioeconomic groups, which can be treated.”

Harris Interactive conducted the survey for NAMI on-line between September 29 and October 7, 2009. Participants included 1,015 persons who did not know anyone diagnosed with depression, 513 persons living with depression and 263 caregivers of a family member or significant other diagnosed with depression. The survey was made possible with support from AstraZeneca, Bristol-Myers Squibb, Eli Lilly & Co. and Wyeth. NAMI does not endorse or promote any specific medication, treatment, product or service.

The National Alliance on Mental Illness is the nation's largest grassroots mental health organization dedicated to improving the lives of individuals and families affected by mental illness. NAMI has over 1100 state and local affiliates that engage in research, education, support and advocacy.

Antidepressants 'work instantly'

Antidepressants get to work immediately to lift mood, contrary to current belief, UK researchers say.

Although patients may not notice the effects until months into the therapy, the team say they work subconsciously.

The action is rapid, beginning within hours of taking the drugs, and changes negative thoughts, according to the Oxford University researchers.

These subtle, positive cues may add up over time to lift the depression, the American Journal of Psychiatry reports.

It may also explain why talking therapies designed to break negative thought cycles can also help.

“ We found the antidepressants target the negative thoughts before the patient is aware of any change in feeling subjectively ”
Lead researcher Dr Harmer

Psychiatrist Dr Catherine Harmer and her team at Oxford University closely studied the reactions of 33 depressed patients and 31 healthy controls given either an antidepressant or a dummy drug.

The depressed patients who took the active drug showed positive improvements in three specific measures within three hours of taking them.

These patients were more likely to think about themselves in a positive light, rather than dwelling on their bad points, the researchers said.

They were also more likely to see the positive in others.

For example, if they saw a grumpy person they no longer internalised this to think that they must have done something wrong to upset the person.

New drugs

This was despite feeling no improvement in mood or anxiety.

Dr Harmer said: "We found the antidepressants target the negative thoughts before the patient is aware of any change in feeling subjectively.

"Over time, this will affect our mood and how we feel because we are receiving more positive information."

She said the findings could help scientists looking for new drugs to treat depression.

Dr Michael Thase, a psychiatrist from the University of Pennsylvania, said the findings challenged conventional wisdoms and were potentially "paradigm-changing".

But he said much more research was needed.

"The highest research priority is to confirm that the rapid effects observed in this study are predictive of eventual clinical benefit."

He said it was possible that switching off the negative thoughts was a crucial part of the therapy.

Alternatively, it might merely be a sign that the drug was beginning to work at the cell level in the brain.

Paul Farmer, chief executive of Mind, said: "This research may contribute to our understanding of how our bodies respond to antidepressants, but the changes recorded can't always be felt by patients and it can be some weeks before they begin to feel the symptoms of depression easing.

"We must also remember that the side-effects of medication can often be felt straight away long before the benefits really kick in, and this will always affect people's experiences in the initial stages of treatment."

Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/health/8304782.stm

Published: 2009/10/26 00:37:16 GMT

Virtual reality tackles 'shell shock' By Fergus Walsh

A virtual reality computer programme is being used to treat Iraq war veterans in the US.

The soldiers are able to relive the sights, the sounds and even the smells of warfare.

In a small windowless room a US marine puts on a 3D headset and picks up a dummy rifle.

Sergeant Robert Butler has been a marine for nearly 20 years and done two tours of Iraq.

After his last stint he returned with post traumatic stress disorder - what was once called shell shock.

Now he can finally deal with painful memories of the horrors of war.

Sergeant Butler believes his psychological problems stem from a patrol in 2005 where he witnessed the death of a father and his teenaged son who were killed after being caught up in a fire fight.

His son was about the same age as the boy who died.

Recluse

"When I first came back I was just a complete recluse and avoided outside contact," he said.

Initially he was reluctant to join the virtual Iraq programme.

"I thought PTSD was something the doctors dreamed up for job security," he said.

“ Our different senses are very powerful cues to our memory ”
Commander Scott Johnston Clinical psychologist

"But I'd hit the point in my life where I felt I had zero control and was about to lose the one thing in my life that meant the most which was my family, so I was prepared to try anything."

Sergeant Butler demonstrates the computer scenario which was used to help him.

On a computer screen I can see the same image projected onto Sergeant Butler's visor.

He is in the front seat of a Humvee armed vehicle patrolling the streets of Iraq; each time he turns his head, the viewpoint on the screen changes.

Sights, sounds and smells

An explosion ahead cracks the front windscreen and you see that the virtual soldier sitting alongside him is wounded, blood streaming down his arm.

The platform, on which Sergeant Butler is sitting, vibrates, to add to the sense of reality.

And there are not just the sights, sounds and vibrations of war, there are also the smells.

These come from a machine which can release the scent of burning rubber, Middle Eastern spices, cordite, diesel fuel - even body odour.

Commander Scott Johnston, a clinical psychologist, runs the programme at the Naval Medical Center San Diego.

He said: "Our different senses are very powerful cues to our memory.

"Instead of allowing the person to continue to avoid these memories and haunt them, if we bring them out into the daylight and really face them we can decrease the negative effects on the individual."

Unlocking thoughts

This begins to explain how the programme is supposed to work.

The theory is that by repeatedly running the computer scenario it enables soldiers with PTSD to unlock and then discuss troubling wartime experiences which have been buried away.

After each thirty minute session on the computer, the soldiers have an hour of talking therapy with a psychologist.

"I'm a completely changed person", says Sergeant Butler.

"Am I 100%? No, because PTSD will always be part of my life; those memories never go away.

"But it definitely has helped me to take steps and file that information.

"It does come up, it gets processed like any other memory and I'm able to do the things a lot more now than before the war."

Commander Johnston says the preliminary results are exciting.

"We found that 30 out of 40 of our subjects were able to return to full duty so we are now starting to implement it across the different services for our returning warriors."

Many British as well as American troops have suffered psychiatric problems after serving in the Middle East.

But the Ministry of Defence in London has yet to be convinced by the virtual Iraq programme.

It says for some years it's been exploring the possible uses of virtual reality in treating mental health conditions, but this is still very much "work-in-progress".

Colleges See Rise In Mental Health Issues

October 19, 2009

They may not tell their roommates or even close friends, but on college campuses all across the United States, more students than ever before are seeking psychiatric help, according to recent national surveys of campus therapists.

And it's not just for homesickness and relationship problems, says the University of Michigan's Daniel Eisenberg. He directs the Healthy Minds Study, a multicenter study that queries primarily students, but also a sampling of college counselors, about mental health issues, including the prevalence of clinical depression, anxiety and eating disorders on campus. Eisenberg says his findings dovetail with those of a large national survey of counseling center directors, led by the University of Pittsburgh's Robert Gallagher.

For the full story, follow the link below:
http://www.npr.org/templates/story/story.php?storyId=113835383

8.3 Million U.S. Adults Considered Suicide Last Year

THURSDAY, Sept. 17 (HealthDay News) -- A national survey has found that more than 8 million adults in the United States seriously considered suicide last year, with younger adults the most likely to contemplate taking their own lives.

In addition to nearly 8.3 million thinking about committing suicide, 2.3 million made a plan to do so, and 1.1 million actually attempted it, according to a federal government study released Thursday.

The findings are from data collected in a 2008 survey of 46,190 people aged 18 or older. It's the first national scientific survey of its size to examine this public health issue, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).

The study found significant age-related differences in the risk of suicidal thoughts, planning and attempts. For example, adults aged 18 to 25 were far more likely (6.7 percent) to have seriously considered suicide than those aged 26 to 49 (3.9 percent) and those aged 50 and older (2.3 percent). Similar disparities were found in suicide planning and attempts.

Females had marginally higher levels of suicidal thoughts and behaviors than males. Only 62.3 percent of those who attempted suicide received medical attention for their suicide attempts, while only 46 percent of those who attempted suicide stayed in a hospital overnight or longer for treatment of their suicide attempts.

Substance abuse was associated with increased risk of seriously considering, planning or attempting suicide, the report showed. People with substance abuse disorders were more than three times as likely to have seriously considered suicide as those without substance abuse disorders -- 11 percent versus 3 percent. Those with substance abuse disorders were four times more likely to have planned a suicide (3.4 percent versus 0.8 percent) and nearly seven times more likely to have attempted suicide (2 percent versus 0.3 percent).

"This study offers a far greater understanding of just how pervasive the risk of suicide is in our nation, and how many of us are potentially affected by it," Eric Broderick, SAMHSA acting administrator, said in a news release from the agency.

"While there are places that people in crisis can turn to for help like the National Suicide Prevention Lifeline [1-800-273-TALK], the magnitude of the public health crisis revealed by this study should motivate us as a nation to do everything possible to reach out and help the millions who are at risk -- preferably well before they are in immediate danger," Broderick said.