Depression is a major cognitive disorder that becomes deadly if not treated early. Severe symptoms of depression can lead patients to self-harm behaviors such as suicide. About 7% of men and 1 percent of women who have suffered depression commit suicide (W.H.O, 2021). Men with severe depression are more likely to commit suicide than women. The patient, in this case, is female hence lower suicide risk compared to whether it would have been male. However, middle-aged populations such as the patient have a higher probability of committing suicide. Prior suicide attempts, substance and alcohol abuse, social isolation, lack of mental care, access to lethal means, and comorbidity are the risk factors of suicide for people with severe depression. To prevent the high likelihood of suicide, I would recommend appropriate mental care, strong family and friend support, behavior monitoring, good problem-solving skills, and restricted access to lethal means.
Severe depression patients who have attempted suicide before face the highest risk of committing suicide. Prior suicide attempts make people develop suicide ideation, tremendously increasing their likelihood of committing suicide. I would inquire about the family and the patient’s previous history of attempted suicide or self-harm. Moreover, I would investigate if the patient abuses alcohol or other drugs. According to Pillon et al. (2019), 29% of suicide victims in America have a history of alcoholism. Alcohol and drugs have unpredictable mood effects and make depressed patients hyper-impulsive. If the patient has a habit of alcohol and substance abuse, I will urge her to stop the habit to mitigate suicidal thoughts.
Social isolation makes depressed people cut off from the world and not connected to other people increasing the risk of suicide. When people with severe depression self-isolate, they focus on the negative thoughts stressing them and are likely to resolve suicide (Hughes, 2019). Loneliness is therefore positively related to suicide ideation. Suicide in severe depression is often associated with disparities and lack of mental care. Most people with severe depression who commit suicide have never seen a mental counselor or even get diagnosed with the condition. Mental health care is vital in severe depression to identify and mitigate suicide risks by monitoring intent and access to lethal means. People with Suicide ideation exposed to lethal means such as harmful objects elevate the risk of suicide.
Appropriate mental health care is the protective factor to prevent suicide among the severely depressed. Mental care is critical for the diagnosis and treatment of depression. Mental nurses offer the appropriate psychological support to allow patients to express their pain and problems (Zhang et al., 2019). Nurses assist in cognitive restructuring to help them focus on their reasons for living to replace negative thoughts with positive attitudes. Apart from nursing support, family and friend support is elemental in depression management to assist the patient in adopting coping mechanisms. Family comfort offers empathy and promotes good feelings and happiness, eliminating the risks of suicide. I would connect the patient with The National Alliance on Mental Illness (NAMI) in the absence of the family.
The severely depressed patient needs improved surveillance and monitoring of suicide and suicide attempts. I would request family support to identify behavioral signs of suicidal intentions. Monitoring preparatory behaviors to complete suicide behaviors significantly reduces the chances of suicide. The environment surrounding the depressed person should also be checked to restrict access to lethal means of committing suicide.
Hughes, C. D., King, A. M., Kranzler, A., Fehling, K., Miller, A., Lindqvist, J., & Selby, E. A. (2019). Anxious and overwhelming effects and repetitive negative thinking as ecological predictors of self-injurious thoughts and behaviors. Cognitive Therapy and Research, 43(1), 88-101. Web.
Pillon, S. C., Vedana, K. G. G., Teixeira, J. A., Dos Santos, L. A., de Souza, R. M., Diehl, A.,… & Miasso, A. I. (2019). Depressive symptoms and factors associated with depression and suicidal behavior in substances user in treatment: Focus on suicidal behavior and psychological problems. Archives of psychiatric nursing, 33(1), 70-76. Web.
W.H.O. (2021). “Depression.” World Health Organization, World Health Organization, Web.
Zhang, J., Liu, X., & Fang, L. (2019). Combined effects of depression and anxiety on suicide: A case-control psychological autopsy study in rural China. Psychiatry research, 271, 370-373. Web.