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Suicidal Ideation: What You Need to Know

Suicide Ideation: What You Need to Know

(This content is being used for illustrative purposes only; any person depicted in the content is a model)

Author: Shernide Delva

I wish I were dead.
Dying seems so much easier.
I hope I do not wake up tomorrow morning.

Have you ever had thoughts like these?  You are not the only one. Thinking about death and dying is not uncommon. We all question life and death at one point or another. However, when these suicidal thoughts continue for days, months, even years, they are far from healthy. Do you think like this? You should not have to live every day wanting to die.

Suicidal ideations are thoughts about or an unusual preoccupation with suicide. Suicidal ideation varies in severity depending on the person. It is difficult to define what suicidal ideations feels like for everyone.

Still, the grim reality is many go to sleep at night hoping they do not wake up the next morning. If this sounds all too familiar, you need to get professional help. Fighting these thoughts on your own for too long can lead you down a darker path.

The Variations of Suicidal Ideation:

  • Fleeting Thoughts– Thoughts about suicide and/or dying that come and go.
  • Extensive Thoughts– Thoughts last for much longer and are much more poignant, eventually becoming unmanageable.
  • Detailed Planning– Planning or idealizing concrete ways in which the suicide or death would take place.
  • Role Playing – Acting the suicide out. An example would be standing on a chair with a noose, with no set plans to commit suicide that day.
  • Incomplete Attempts– Also known as Parasuicides. Suicide attempts that are “deliberately constructed to not complete or to be discovered, or may be fully intended to result in death, but the individual survives (e.g., in the case of a hanging in which the cord breaks).”

Most people with suicidal ideations do not go on to make suicide attempts, but it is still considered a risk factor.

In 2008-09:

“An estimated 8.3 million adults aged 18 and over in the United States, or 3.7% of the adult US population, reported having suicidal thoughts in the previous year. An estimated 2.2 million in the US reported having made suicide plans in the past year.”

As you can see, those results reveal that suicidal thoughts can become worse over time, developing into suicidal plans putting a person at risk of suicide.

What Causes Suicidal Ideation?

The reason for suicidal ideation varies on a variety of circumstances. As you can imagine, suicidal ideation is generally associated with depression and other mood disorders. For example, a person with borderline personality disorder may exhibit suicidal behavior and thoughts. In fact, one study revealed 73% of patients with BPD have attempted suicide, with the average patient having 3.4 attempts.

Scientists believe there may be a genetic component to suicidal ideation. Just like many mental illnesses, genes may make a person more susceptible. Other associations with suicidal ideation include life events, family events, and chronic pain that can cause a vulnerable person to become preoccupied with suicidal thoughts.

Fast Facts:

  • Most people with suicidal thoughts do not carry them out to their conclusions.
  • There are about 30,000 suicides each year in America.
  • Roughly 4 in 5 American suicide victims are male.
  • Almost all suicides are associated with mental illness
  • In America, there are more suicides than homicides: 2:1

As you can see, suicide is a serious problem. While suicidal thoughts do not necessarily lead to suicide, living with these thoughts can be very destructive to one’s emotional and physical wellbeing. Suicidal thoughts should not become part of who you are. You should thrive for a life free from these thoughts.

While many are vocal with their thoughts, some people with suicidal ideation keep it to themselves. They seem happy on the outside, but on the inside, their thoughts continue to fester. Keeping it in is dangerous. Over time, suicidal thoughts make a person feel hopeless and angry. They feel like their feelings are not being heard or understood. They begin to feel unable to handle the grief and challenges of life.  This sense of bleakness can cause a person to feel like death is the only answer.

The Most Dangerous Part

The dangerous part of having suicide thoughts is keeping them inside and not getting help. Unfortunately, those that struggle with suicide ideation often feel their symptoms are not severe enough to need help. Do you really want to live the rest of your life feeling this way? You deserve to feel better than you do right now.

Without professional help, these thoughts may eventually become worse. There are a variety of options to help you if you struggle with these thoughts. A combination of therapy, exercise, medication and support groups are useful for helping navigate these feelings. While you may have read about these options before, ask yourself, have you given them a chance? Most people will read about treatment options all the time, yet never try to get help.

Life is challenging. You should not have to do everything on your own.The reality is there are treatment options available to those who live day to day in this mindset. Professionals are waiting to talk to you now.  If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135.

Stress at Home and Veteran Alcoholism

Stress at Home and Veteran Alcoholism

Author: Justin Mckibben

The commonality of substance abuse among service veterans of the United States military is often assumed to be a byproduct of conditions such as PTSD caused during active combat, but what if the reality of veteran alcoholism was actually fueled by the opposite? The onset of alcohol abuse or more consistent alcoholism is one of the most likely mental health consequences of military service to be diagnosed among veterans returning from active duty.

Very similar to other full-time military personnel, risks for the development of alcohol addiction or alcoholism also impacts members of the National Guard who are called up for active duty. In a study scheduled for publication in 2014 in the American Journal of Preventive Medicine, researchers from 4 different universities in America examined elements specific to national guardsmen that make alcohol abuse and addiction more likely to occur. This study concluded that the factor contributing most to the development of alcoholism in these veterans is actually the stress related to the return to civilian life after a period of active service, and not the stresses of service itself.

Alcohol Use Disorder- Alcohol Abuse or Alcoholism

The term ‘alcohol use disorder’ (AUD) is a diagnosis for what is typically considered mild, moderate or severe cases of alcohol abuse or alcoholism. In 2013 the term ‘alcohol use disorder’ was created by the American Psychiatric Association to encompass everything from mild drinking problems to severe alcoholism, designed as part of a larger reorganization of the terms used to describe substance abuse issues and other forms of addiction not related to substance abuse.

To be diagnosed with an AUD an individuals must meet certain criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). In the current DSM anyone meeting any 2 of the 11 criteria during the same 12-month period receives a diagnosis of AUD. The severity of an AUD ranging from mild, moderate, or severe is typically based on the number of criteria met.

A person with ‘alcohol use disorder’ has potentially overlapping symptoms previously associated only with alcohol abuse or only with alcoholism. Due to a recent scientific consensus indicating that the symptoms of the two conditions are usually interconnected,  physicians now give equal consideration to both alcohol-related problems.

AUD in the Military

Military service has been labeled as a problematic element with excessive alcohol consumption, particularly for veterans involved in active combat or those who serve in an area where combat exposure remains a possibility. These prominent alcohol problems don’t often end when a soldier leaves active duty; in fact the problems can actually grow worse! The federal Health Resources and Services Administration has determined a number of reasons military veterans, whether they be full-time personnel in active duty or National Guard personnel, may run into more serious alcohol-related issues, or problems pertaining to other forms of substance abuse after returning home. Integration back into civilian life creates new stress, and starts to add  reasons for the development of AUD.

Military culture based largely around emphasizing and glorifying drinking, while de-emphasizing the legitimacy of drinking problems makes a massive contribution to the risk factors. The major stresses attributed to the return to civilian life include:

  • The relatively long tours of duty for today’s active personnel
  • Loss of the structure and military routine associated with active service
  • Lack of understanding of the mental health resources available after active service
  • Decision not to access available mental health resources after active service
  • Wanted to hide the presence of serious substance abuse issues

Problems for National Guard Personnel

Researchers from Columbia University, Case Western Reserve University, the University of Michigan and the University of Toledo used Ohio National Guard troops deployed for active duty in 2008 or 2009 to determine to narrow down the primary risk factors for AUD cases after active duty in their study for the American Journal of Preventive Medicine.

1,095 veterans were chosen for the survey, and every single one of them had served in either Afghanistan or Iraq. All of the veterans agreed to be interviewed on 3 occasions over the course of 3 years to track results. The researchers gathered information from all of the National Guard veterans on topics that included:

  • Habitual patterns of alcohol consumption
  • Exposure to significant service-related stress or traumatic situations (e.g., combat or seeing other people get injured or die)
  • Exposure to significant stress in the aftermath of service (e.g., marital or financial problems, legal difficulties or employment disruptions).

Surprising Results

Researchers found that an estimated 60% of the soldiers participating in the study had some significantly stressful or traumatic experience related to active combat. In addition an estimated 36% experienced significantly stressful events after returning to civilian life.

The peak rate for alcohol use disorder was roughly 13%, and according to research had occurred at the time of the initial interview sessions; the lowest rate being 5% had occurred at the time of the last interview sessions. After analyzing the relative AUD elements of combat-related stress and the stress of a return to civilian life, the researchers ultimately came to the conclusion that the stress experienced after active service was actually the chief contributing factor, and not stress experienced while in active service as typically expected.

The survey also took into account the alcohol use disorder-related impact of experiencing sexual harassment from other service personnel while on active duty. Surprisingly 17% of the study’s participants reported exposure to such forms of harassment. Thus it was concluded that exposure to at least one episode of sexual harassment also radically increased the chances that a National Guard veteran would develop AUD, which would either become an alcohol abuse issue or a more severe state of alcoholism.

These risks from civilian stress and sexual harassment were noted as they applied to people newly affected by alcohol abuse issues, not to people with previously existing alcohol problems. So through the course of this study researchers eventually came to understand that out of the population they had surveyed, more of the cases of alcohol abuse or alcoholism had developed out of stress and trauma from returning home after active duty, instead of as a direct result of experiences in active duty. Meaning that while much of the habits and a considerable variety of circumstances are related to a tour of duty, the things that a soldier experiences on the home-front are more instrumental in developing alcoholism.

So many men and women sacrifice so much for their country, and their service allows for the freedoms we as Americans are graced with today. It is a tragedy that so many men and women return home from active duty and suffer from such traumatic and stressful circumstances, and find themselves fighting a new battle with an enemy as cunning and insidious as substance alcoholism or addiction. But for those who have fought for our liberties, it is important to know this fight can be won, and it never has to be fought alone! If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135. We want to help. You are not alone.

In The News: Alcohol Abuse Increases After Weight Loss Surgery

The Journal of the American Medical Association published a new study about weight-loss surgery and the risk of those patients developing a drinking problem. The study examined about 2,000 obese adults before and after weight loss surgery. The study specifically saw an increase in alcohol-use disorder (AUD) in some procedures such as Roux-en-Y gastric bypass surgery (RYGB) and sleeve gastrectomy. RYGB and sleeve gastrectomy alter the pharmacokinetics of alcohol which can be the reason why some people feel intoxicated faster and longer than when they did pre operation. These feelings of intoxication are not due to binge drinking either, when given just a standardized quantity of alcohol, patients reach a higher peak alcohol level after surgery compared with case-controls or their preoperative levels. Patient surveys have revealed similar changes in alcohol sensitivity following RYGB (feeling intoxicated more rapidly, after drinking less, for longer as well as more difficulty controlling alcohol intake.  Alcohol sensitivity studies have not been performed in patients who have received LAGB, most likely because the anatomical and physiological changes from this procedure are less likely to affect alcohol absorption and metabolism. Some important things to consider about this study are:

  • The study was limited to a small sample of only 2,458 obese U.S adults
  • Of the 2,458 participants only 1945 completed preoperative and postoperative (at 1 year and/or 2 years) assessments between 2006 and 2011.
  • 78.8% Female; 87% Caucasian
  • The prevalence of AUD symptoms did not significantly differ from 1 year before to 1 year after bariatric surgery (7.6% vs. 7.3%; P = .98), but was significantly higher in the second postoperative year (9.6%; P = .01).
  • Higher rates in the second postoperative year were associated with male sex, younger age, and numerous preoperative variables such as smoking, regular alcohol consumption, AUD, recreational drug use, and lower interpersonal support and undergoing a RYGB bypass procedure.

[Reported by Journal of the American Medical Association]

The researchers can only speculate why the uptick in alcohol-use disorders was restricted to Roux-en-Y patients and took two years to become apparent. The most likely culprit is an increased sensitivity to alcohol, coupled with a gradual return to pre-surgery drinking habits, says lead author Wendy King, Ph.D., an assistant professor of epidemiology at the University of Pittsburgh Graduate School of Public Health.[Health, 2012]

It’s important to note that this study just shows a correlation not direct cause and effect so people should not be alarmed. It’s also important to note that alcoholics are generally advised against gastric bypass surgery. There needs to be more extensive studies done to find out more about exactly what type of surgery and patients are at a high risk (if there’s any) of developing AUD after bypass surgery.

Read more about the study here.

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