How to Coach Yourself and Others Empowering Coaching And Crisis Interventions | Page 154

This book is in B&W, not color - Print page in Grayscale for Correct view! Just as there are factors that create a higher risk for suicide, there are factors that lessen the probability of suicide. Protective Factors  Effective and appropriate clinical care for mental, physical, and substance abuse disorders  Easy access to a variety of clinical interventions and support for help seeking  Restricted access to highly lethal methods of suicide  Family and community support  Support from ongoing medical and mental health care relationships  Learned skills in problem solving, conflict resolution, and nonviolent handling of disputes  Affective coping techniques  Cultural and religious beliefs that discourage suicide and support self-preservation instincts All of the perpetuating, risk, and protective factors listed are important considerations in assessing a person's ability to cope and gain assistance during periods of crisis. There are two, however, that deserve special consideration: Depression and alcohol/ drug use. What makes depression and alcohol/drug abuse important? Studies have shown that roughly 90% of those who complete suicide have a diagnosable behavioral health disorder, commonly a depressive disorder or a substance abuse disorder.18 Most of us can relate to depression because we have felt a bit of the low mood, listlessness, restlessness, helplessness, and hopelessness that accompanies depression. However, true depression is far more intense than a blue mood. The Diagnostic and Statistical Manual of Mental Disorder, 4th Edition, Text Rev/sad (DSM-IV-TR) identifies criteria for a Major Depressive Episode. A condensed version of these criteria follows. Five or more of the following symptoms have been present nearly every day during the same 2-week period and represent a change from previous functioning:  Depressed mood most of the day  Markedly diminished interest in all or almost all activities most of the day  Significant weight loss or significant weight gain without attempting to either lose or gain weight, or a decrease or increase in appetite  Insomnia (inability to sleep or stay asleep) or hypersomnia (need for more sleep than usual)  Psychomotor agitation or retardation (as noted by observation by others)  Fatigue or loss of energy  Feelings of worthlessness or excessive or inappropriate guilt  Diminished ability to think or concentrate or indecisiveness  Recurrent thoughts of death, suicidal ideation or a suicide attempt These symptoms must cause significant distress or impairment in functioning. (One depression sufferer described the effects of depression as having so little energy that lifting a pencil became an overwhelming task.) For many people, alcohol and other drug abuse is both a risk factor and a symptom. Alcoholism is a primary diagnosis in 25% of people who complete suicide. Self-medication to relieve symptoms of depression or other mental illnesses is not uncommon. It is estimated that approximately 50% of people who have a serious and persistent mental illness (SPMI) also abuse substances. For [email protected] Property of Bookemon, do NOT distribute 154