The most common mental disorders associated with suicidality are called mood disorders.
These disorders can include depression, post traumatic stress disorder, bipolar disorder, schizophrenia and anxiety.
Crawford County Community Mental Health Center Clinical Director Amy Glines said these disorders interfere with functioning in daily life — it affects sleep, relationships, school or work.
Glines said all of the disorders are treatable, “that’s the hopeful part.”
Some people may have one episode in their life, but for others it is a disabling mental illness with life-long effects..
Research is being done, Glines said, including testing on genetics, medications and therapy.
She said technology gives people access to more specialists in areas which are lacking through telemedicine and video, along with 24-hour hotlines through phone and text, and support groups both online and off.
“There's getting to be more access in more creative ways,” Glines said.
Depression interferes with how a person functions, Glines said.
“Depression is not just sadness or sadness after a bad thing happens,” she said. “Depression gets to a point that it causes problems in our lives, even basic functioning.
“It’s really over and beyond a two week period in your life.”
When depression interferes with a person’s life, they may often cry, have no energy, or have changes in their appetite and sleep pattern. They may also have thoughts of suicide.
“There are big thought distortions with depression,” Glines said. “Thoughts of hopelessness is a very huge component to depression, excessive feelings of guilt and a loss of pleasure in the things they once enjoyed.”
A person dealing with depression may also feel hopeless, believing there are no solutions to their problems, Glines said. They may also experience excessive guilt.
“The thought changes which happen to someone who is depressed doesn’t look the same way to people who are not depressed so it's hard to understand them,” Glines said. “That connection isn’t there because we are not seeing it from the same way.”
People with depression should visit a regular physician first, Glines said.
“There are lot of medical conditions which could look like depression such as thyroid problems, vitamin deficiencies,” she said. “A really good physical exam with a doctor is what we would recommend to rule out other things and then if the doctor said the labs are good, they would recommend seeing a mental health professional.”
For example, Glines said, the lack of the vitamin B12 may cause lack of energy.
People with bipolar disorder have similar symptoms as a person with depression, but they have a phase of feeling “opposite” after a two-week bout of depression called mania, Glines said.
During a state of mania a person may experience excessive energy, decrease need for sleep or no sleep at all, Glines said.
They may also have “grandiosity,” where they believe their abilities are grander than what is realistic for them.
“You might see lots of projects started — businesses, house projects, theoretical perspectives and writings,” Glines said. “They get really intensely motivated, but they just don't have organization to finish it.”
People with bipolar disorder may do things “completely out of character for them,” which could interfere with their daily functioning.
“With two highs and lows, bipolar disorders come with functional impairments,” Glines said. “It impacts with relationships with family and friends, work, school and quality of life.”
People with the disorder may display abnormal risk taking behavior, Glines said, from spending loads of money to venturing to a far out place without a notice.
With the depression phase, along with the risky behaviors during the mania state, relationships may suffer.
“If you are depressed, you may not get daily showered,” Glines said. “That’s a daily function — if you’re not presentable you don’t go to your kid’s plays, don’t engage in your relationship with your spouse –– then relationships might suffer which could lead to divorce, breakups or fights.
“There’s consequences to all of these symptoms. A lot of people would get suicidal in response to that.”
Glines said one in 10 people with schizophrenia die by suicide.
“People with schizophrenia may have lived with either hallucinations or delusions for over six months of their life and have impacted their functionality,” she said. “They also have what is considered a loss in functioning — less communicative, might show less expression on their faces or might move a little slower.”
Glines said six months is a long time to deal with these symptoms.
“Suicidality comes in with this disorder because it is a miserable disorder,” she said. “If you imagine someone having hallucinations they can’t stop.
“They might be saying derogatory things, seeing things that are scary — don’t have control over that — it goes on when they try to sleep, it goes on when they go to the store, when they go to public places.
“There is a lot of fear, and like with many of the other mental disorders, people turn to substances to either mask or tone down, or numb these symptoms. Because drugs alter how we think and feel.”
However, Glines said, drug tolerance causes another issue for people who are self-medicating with substances.
“The problem is it’s temporary and that could create this addiction where it takes more chemicals to get the same response you used to,” she said. “It affects chemical makeup in their brains.”
Drug tolerance may cause other issues.
“Their body may stop producing chemicals and when they don’t have it there is a big deficit, and you feel horrible,” Glines said. “To not feel horrible, they introduce the chemical. It’s just this vicious cycle for people.”
Glines said addiction is progressive and may become fatal.
Glines said the National Center of PTSD Research Quarterly 2017 states, persons with PTSD had a 5.3 times rate of death from suicide than people without PTSD and persons with PTSD had 13 times the rate than persons without.
People diagnosed with PTSD have either witnessed or observed, or were a victim of something they consider traumatic which overwhelmed their ability to cope, Glines said.
PTSD also affects how a person functions impacting sleep, relationships, school or work.
“Common symptoms are reliving the experience during the day, nightmares during the night, sleeping problems, [as] a response to avoid anything associated with the trauma,” Glines said.
Anyone of any age or profession may be affected by trauma, including first responders and members of the military, or survivors of domestic violence, sexual abuse, car accidents and [even] weather related events, Glines said.
Anxiety is often linked with depression and suicide.
However, suicide is not “highly associated with suicide,” explained Glines.
“[It] usually isn’t a presenting problem with somebody who has anxiety,” Glines explained.
She said with most anxiety disorders, people have experienced high anxiety at one point in their life, where those feelings are more frequent and doesn’t match the situation.
“If I had to wrap up anxiety in that way, it's a feeling you feel when you’re nervous, but for them it is over happening,” she said. “It occurs with frequency and it doesn’t match the situation.
“It’s very similar how you did during those moments (going up to bat or up to the mic for a solo), but for someone with an anxiety disorder it happens with a frequency that doesn’t make sense. It gets to the point where it is interfering with their life.”
When anxiety interferes with a person's life, Glines said, they avoid doing things that create that feeling.
However, she adds, “If you avoid things enough, there are consequences.”
Those consequences, she said, may cause a spiral of other symptoms which could co-occur what’s feeding the suicidal thoughts - depression.
“It’s kinda cyclical,” she said, “a consequence that would create more symptoms which I would call a spiral effect of anxiety disorders.”
If you are in crisis, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or contact the Crisis Text Line by texting TALK to 741741.
— Stephanie Potter is a staff writer at the Morning Sun. She can be emailed at firstname.lastname@example.org or follow her on Twitter @PittStephP and Instagram @stephanie_morningsun.