Treatment of suicidal conditions. Suicidal thoughts: what to do?

Any depressive disorder is accompanied by severe melancholy and apathy, self-flagellation, against the backdrop of which there is often a desire to solve everything “in one fell swoop” and commit suicide. According to statistics, about 17% of people suffering from this illness have thought about suicide at least once. There is no such thing as “suicidal depression” in the International Classification of Diseases, but psychiatrists use this term to describe severe depressive syndromes that require not only immediate medical intervention, but also hospitalization. Specialists at the Leto specialized clinic offer patients both. We provide consultations from experienced, practicing doctors, and if necessary, you can stay in our hospital, where comfortable conditions for therapy have been created.

Independent struggle

To organize the most effective treatment of suicidal conditions, it is recommended to use the following methods:

1. Organize communication with new people. To radically change your lifestyle, it is important not only to eradicate bad habits, but also to expand your social circle. A new and fresh look at old problems will help improve your psychological state, as well as jointly organize an effective fight
2. A change of scenery. Traveling is one of the best types of self-therapy, allowing you to get new positive emotions, start an affair or communicate with new people.
3. Change your place of work. It is optimal to resolve this issue without material losses. Sometimes a person cannot really assess his own abilities and does not continue to develop himself
4. Change your place of residence. To start life with a new leaf, changing the city, region, region will also be beneficial. Although a person may experience stress as a result of moving, such a decision often has a beneficial effect
5. Self-hypnosis. This will require internal moral strength to set the right attitude for yourself. Training experts recommend fighting such emotional manifestations as anger, cruelty, and hatred.

However, such methods are, as a rule, additional methods that support the work of specialists or medication treatment.

Use of medications

If a person is unable to cope independently with the manifestations of a suicidal state, the following groups of drugs can be used:

1. Antidepressants. With their help, it is possible to block reactions to negative factors. Before choosing medications on your own, it is imperative to consult with a specialist. The most commonly used drugs are Afobazole and Mirtazapine.
2. Sedative group of drugs. Some medicines are made on an organic basis using medicinal herbs, while others are made using synthetic substances. For example, among the most popular are Glycine, Dormiplanta
3. Complex of vitamins. Often, suicidal thoughts arise as a result of a lack of important substances for the body. To replenish it, it is advisable to use Complivit, Daily Formula
4. Means of traditional therapy. A tincture based on peony will be effective. Therapy involves a weekly course, and adding 5 drops per day is sufficient.

Psychotherapy is an equally effective way to deal with suicidal thoughts. First of all, a specialist will help you find out what causes the condition. Depending on the severity, hypnosis, therapeutic techniques, and individual conversations may be used. As a rule, several tests are first used to determine the development of the pathological condition.

Symptoms

The symptoms of any type of depressive disorder are the “depressive triad.” This is a depressed emotional sphere, a depressed cognitive sphere, a weakened psychomotor sphere. With neurotic depression, mental and physical symptoms are present:

• chronic headache;
• heart rhythm disturbances, chest pain;
• breathing problems, suffocation or shortness of breath;
• digestive problems;
• sleep and appetite disorders;
• a feeling of anxiety, impending danger, arising without external reasons or explanations at any time;
• increasing irritability;
• suicidal thoughts, plans, intentions;
• possible auto-aggressive behavior;
• lack or decreased libido;
• tunnel thinking;
• negative assessment of the world and people;
• social isolation.

ICD-10 does not have a separate code for the neurotic type of depression. The pathology, depending on the phase of the course and severity of symptoms, is classified as subsection F33 “recurrent depression” or F34.1 “Dysthymia”.

Suicide attempt and consequences

Before suicide, the patient has corresponding thoughts. He is preparing to commit suicide. That is why such people give away their things and put all their affairs in order. They say goodbye to their friends as if it was the last time. The patient considers his actions and chooses a method of suicide. Depending on it, medicines are purchased, weapons or poisonous substances are purchased.

Morally a person is ready for suicide. Therefore, if he survives a suicide attempt, he remains alive, then this leads to terrible depression. It seems to a person that he is so insignificant that he could not even commit suicide. In addition, the patient feels guilty. If help is not provided to him in a timely manner, he will repeat his suicide attempt.

Signs, causes and dynamics of development of suicidal behavior

Signs of impending suicide

A combination of several signs indicates a possible suicide.

1. Putting your affairs in order - distributing valuables, packing. A person could be messy, and suddenly he begins to put everything in order. Making final preparations.
2. Parting. May take the form of expressing gratitude to various people for their help at different times in life.
3. External satisfaction is a surge of energy. If the decision to commit suicide has been made, and a plan has been drawn up, then thoughts on this topic cease to torment, and an excess of energy appears. Outwardly he relaxes - it may seem that he has given up the idea of ​​suicide. A state of high energy can be more dangerous than deep depression.
4. Written instructions (in letters, notes, diary).
5. Verbal instructions or threats.
6. Anger outbursts in impulsive adolescents.
7. Loss of a loved one followed by the above symptoms. Losing a home.
8. Insomnia.

Reasons for suicide

The causes of suicide in childhood and adolescence may be the following:

1). Unformed understanding of death. In the understanding of a child, death does not mean the irrevocable cessation of life. The child thinks that everything can be returned back. In adolescents, understanding and awareness of the fear of death is formed no earlier than 18 years of age.

3). Early sexual activity leading to early disappointments. In this case, a situation arises, in the opinion of the teenager, that is incompatible with the idea of ​​“how to live further” (loss of a loved one, the onset of an unwanted pregnancy, etc.), i.e. there is a loss of purpose. Suicidal behavior in adolescents is often explained by the fact that young people, having no life experience, cannot correctly determine the purpose of their life and outline ways to achieve it.

4). Disharmony in the family.

5). Self-destructive behavior (alcoholism, drug addiction, criminalization of society).

6). In the overwhelming majority of cases, suicidal behavior under the age of 15 is associated with a protest reaction, a particularly common source of the latter being disrupted intra-family, intra-school or intra-group relationships.

70% of teenagers cited various kinds of school conflicts as the reason that pushed them to attempt suicide. But the reason is usually family dysfunction. However, this “trouble” is not external, but substantial: first of all, parent-child relationships are disrupted. School situations play the role of the “last straw”, since school is the place where the child spends a significant part of his time.

7.) Depression is also one of the reasons that leads a teenager to suicidal behavior.

Many of the traits that indicate suicidality are similar to those of depression. Its main symptom is the loss of the ability to receive pleasure and experience pleasure from those things in life that previously brought happiness. Actions and mood seem to fizzle out and become tasteless. The psyche is deprived of strong feelings. The person becomes overwhelmed by hopelessness, guilt, self-judgment and irritability. Motor activity noticeably weakens or, conversely, attacks of loud, fast, sometimes incessant speech occur, filled with complaints, accusations or requests for help. Sleep disturbances or wave-like fatigue are common. Somatic signs of anxiety include trembling, dry lips and rapid breathing. Unexplained somatic disorders appear in the form of pain in the head, side or abdomen. People suffering from depression constantly feel undesirable, sinful, and worthless, which leads them to conclude that life has no meaning.

Psychogenic causes of depression are often associated with loss: the loss of friends or loved ones, health, or some familiar things (for example, a place of habitual residence). It may occur on the anniversary of the loss, and the person may not be aware of the approaching date.

It is important to remember that there is almost always a physiological and psychological explanation for depression. Depression does not necessarily mean that a person is psychotic or suicidal.

There is no one reason for suicide. Particular vigilance should be taken into account the combination of dangerous signals if they persist for a certain period of time.

Adolescents at risk for suicide include:

• with impaired interpersonal relationships, “loners”;
• alcohol or drug abusers, characterized by deviant or criminal behavior, including physical violence;
• with a prolonged depressive state;
• teenagers who are hypercritical of themselves;
• those suffering from recent humiliation or tragic loss, from chronic or fatal illnesses;
• frustrated by the discrepancy between expected successes in life and actual achievements;
• teenagers suffering from illness or abandoned by their environment;
• from socially disadvantaged families - leaving the family or divorce of parents;
• from families in which there have been cases of suicide.

Dynamics:

The first stage is the stage of questions about death and the meaning of life. Before committing a suicidal act, in most cases there is a period characterized by a decrease in adaptive abilities (this can manifest itself in a decrease in academic performance, level of interests, limited communication, increased irritability, emotional instability, etc.). During this period, suicidal thoughts themselves are formed, which can manifest themselves in the form of statements that “I’m tired of this life,” “I wish I could fall asleep and not wake up,” the emergence of interest in the problems of life and death, etc. At this stage, the teenager has passive thoughts about taking his own life, suicide. This stage is also characterized by ideas, fantasies and thoughts about one’s death, but not on the topic of taking one’s life. An example is statements like: “It’s better to die than live like this,” “I want to fall asleep and not wake up,” etc. According to studies of suicide among adolescents, similar statements occurred in 75% of cases of suicide attempts and suicides. At the same time, the significance of such statements is underestimated or perceived in a demonstrative and blackmailing aspect.

Almost everyone who seriously thinks about suicide, one way or another, makes it clear to others about their intention. Suicides often do not occur suddenly, impulsively, unpredictably, or inevitably. They are the last straw in the cup of gradually worsening adaptation. Among those who intend to commit suicide, from 70 to 75% disclose their desires in one way or another. Sometimes these will be subtle hints; Often the threats are easily recognizable. It is important that most people who commit suicide seek opportunities to speak out and be listened to. However, very often they do not meet a person who will listen to them.

The second stage is suicidal ideation. This is an active form of manifestation of the desire to commit suicide, it is accompanied by the development of a plan for the implementation of suicidal plans, the methods, time and place of committing suicide are thought out. Teenagers tend to make statements about their intentions.

The third stage is suicidal intentions and the actual suicide attempt. A formed decision (attitude) and a volitional component are attached to the idea of ​​suicide, inducing the direct implementation of external forms of suicidal behavioral acts.

The period from the onset of thoughts of suicide to attempts to carry them out is called pre-suicide. Its duration can be calculated in minutes (acute presuicide) or months (chronic presuicide).

With acute presuicides, an immediate manifestation of suicidal thoughts and intentions is possible immediately, without previous steps.

After a suicide attempt, there comes a period when the child is treated with increased attention and care. During this period, recurrence of suicidal acts is unlikely. After three months, adults, seeing that the child is outwardly calm, does not express thoughts of suicide and does not try to repeat the attempt, cease to be attentive to the child and pay him due attention, and begin to lead their usual lifestyle, because... They believe that the child has overcome the crisis and everything is fine with him. But, if the situation that led the child to suicidal action was not worked out together with adults, the child is still at risk of making a second suicide attempt. And at the moment when adults stop worrying about the child’s condition, as a number of researchers note, repeated suicide attempts are made. Therefore, it is necessary to monitor the child for a long time, provide him with support, talk with him and carry out other preventive actions.

(From open sources of information)

Psychiatrist Leskovskaya E.I.

After suicide

In order to reduce the risk of a second suicide attempt, it is recommended to ensure the full support of family, friends and loved ones. Such patients are strictly prohibited from taking alcoholic beverages and drugs. Psychotherapists and relatives of the patient must do everything possible to ensure that the patient has contact with the outside world.

It is recommended to provide the patient with adequate sleep, the duration of which is 7-8 hours. Good results come from attending a self-help and support group. A person’s loved ones should hide all weapons, pills and other items that could cause harm to themselves. Relatives need to seek help from professionals who will develop an effective therapeutic regimen.

Suicidal thoughts

Suicidal thoughts appear in people during stressful situations and depression. A person has thoughts that he is in a situation from which there is no way out. A person is isolated from the outside world and does not make contact even with family and friends. When suicidal thoughts arise, people engage in risky behavior. They are careless when driving a car or operating a variety of serious machinery.

With suicidal thoughts, a person never has positive emotions. The patient strongly repents and develops pronounced self-criticism. With pathology, the appearance of depression, panic attacks, and mental disorders is observed. With suicidal thoughts, the patient's personality traits change. Such people are constantly excited, they are diagnosed with increased anxiety. With pathology, frequent mood swings are observed. The person is overly preoccupied with the topic of death. He experiences emotional pain that he cannot tolerate.

Signs of suicidal depression

A typical manifestation of the disorder is extreme melancholy, which patients describe as a feeling of complete emptiness inside, an unwillingness to do anything and even to get out of bed in the morning. Total apathy occurs: the patient ceases to be interested in anything, be it family, work or personal problems. It seems that he wants only one thing, not to be touched, which is why even the most innocent remarks and requests are accompanied by outbursts of anger and aggression.

Appearance and behavior change. Pay attention to unkemptness and sloppiness, neglect of hygiene. The facial expression takes on a gloomy appearance: the corners of the lips are constantly drooping, and a vertical, deep wrinkle appears above the bridge of the nose. Also characteristic is stooping, restraint of facial expressions and movements. General inhibition is often noted, although sometimes it can be replaced by affective attacks reminiscent of hysteria.

For people suffering from suicidal depression, almost constant, causeless anxiety and restlessness, lethargy, weakness, and general loss of strength are typical. Patients very often complain about sleep disturbances: usually it is extremely difficult for them to fall asleep in the evenings, but they also cannot get enough sleep in the morning - they wake up long before the alarm clock rings. The patient is constantly haunted by anxious, pessimistic thoughts, sad reflections about mistakes made in the past.

Characteristic changes in eating behavior. Sometimes appetite completely disappears, and a person eats almost forcefully; in other cases, on the contrary, psychogenic overeating develops as an attempt to compensate for increasing psychological discomfort with food.

When to see a doctor immediately

Unlike hysterical disorder, with suicidal depression the patient never threatens suicide or makes demonstrative attempts to commit suicide. Spontaneous suicide is also not typical for this type of depressive disorder. Usually, after a person has made a fatal decision, his behavior changes dramatically.

Doctors strongly advise paying attention to the following symptoms:

• cold calm and equanimity;
• high spirits, which replaced despondency and melancholy;
• putting things in order: a person goes through all his things, giving many of them to friends and relatives (getting rid of clothes, expensive equipment, jewelry);
• dismissal from work, disinterest in further employment;
• requests for forgiveness.

Treatment of child suicide anonymously in Moscow

For suicidal tendencies in children, it is recommended to seek professional medical help. By providing timely psychological assistance, suicide is prevented and the child’s life is preserved. The Moscow clinic employs highly qualified psychologists and psychotherapists who initially diagnose the child’s condition. Thanks to the use of special techniques, they find out the causes of suicidal tendencies and develop an effective treatment regimen that is aimed at eliminating them.

During the diagnosis, neuropsychic disorders, mental disorders and psychosomatic diseases are determined, against the background of which suicidal thoughts appear. Their treatment requires taking medications and using psychocorrection.

Treatment of children is carried out in a hospital setting, which eliminates the possibility of suicide. The clinic employs qualified and communicative staff who provide 24-hour patient support. To treat a child, universal psychocorrectional techniques, individual and group lessons are used. If necessary, drug therapy is used. The choice of treatment method is made by the doctor in accordance with the individual characteristics of the patient and the severity of the pathology.

How to recognize suicidal-depressive tendencies in a person

If you notice that something wrong is happening to someone around you, try to convince him to see a specialist as soon as possible. This must be done very carefully, without applying any “pressure” on the psyche or rudeness. The category of depressants are very vulnerable people. Behavioral traits of a depressed person that should alert you to:

• against the background of constant mental depression, statements about the hopelessness and meaninglessness of life;
• frequent memories of dead people, conversations that “my turn is coming,” drawing analogies with those who are no longer there;
• isolation, loss of interest in everything, withdrawal from communication, or vice versa - making visits of a negative farewell nature;
• use of drugs or drinks containing alcohol;
• history of suicide;

Treatment of persons who have attempted suicide in hospital

If a patient has attempted suicide, the hospital provides him with step-by-step psychological assistance. Initially, the psychotherapist establishes emotional contact with the patient and gives him the opportunity to talk about everything that is on his soul. After suicide, most patients talk about their failures, after which they calm down.

At the next stage, the specialist determines the reasons for suicide, which led to a deep psychological crisis. At this stage, the psychotherapist does everything possible to distract the patient from thoughts of suicide. He helps a person find a way out of the situation. For serious psychological problems and severe emotional states, drug therapy is used along with psychocorrectional techniques. After the patient realizes that he can overcome all the problems in life, the psychotherapist develops measures that will prevent a crisis situation.

Tip the scales against suicide

Initially, the therapist’s task is reduced to “delaying time” and waiting for the end of the dangerous period. If the patient is fully involved in the therapeutic process, he will want to know where the therapist is leading him, and he may decide to “hold off” on his suicidal intentions. Therefore, it is necessary to constantly awaken and maintain the patient’s interest in therapy. At the same time, it is extremely important to observe the principle of continuity of therapy and ensure continuity of the content of sessions. To build a bridge from one session to another, the therapist can, for example, raise some question from the patient and respond to it something like this: “You have touched on a very interesting topic. I have some thoughts on this, but I will tell you about them in the next session. Maybe you can briefly write down what you think about this?”

We consider it unnecessary - and in most cases impossible - to require a promise from the patient that he will never attempt to kill himself. Equally senseless seems to us the practice of concluding an “agreement” with the patient, in which he undertakes to “postpone” the execution of suicidal intentions for two or three weeks: if a person feels an irresistible desire to die, no obligations will stop him. From our point of view, the most effective approach is to encourage the patient to objectively analyze his suicidal desires and bring him to the realization that these desires may be unfounded; In this way, the therapist can motivate the patient to continue the exploration.

The decision to commit suicide should be seen as the result of a struggle between the desire to live and the desire to die. Just as in a declaration of war, an irreparable decision is sometimes made by a margin of one vote, and so the therapist must concentrate his efforts on creating a margin in favor of life.

Having achieved the patient's agreement to weigh the pros and cons of suicide, the therapist asks him to list the reasons for living and the reasons for dying. Of course, it is difficult for the patient in his current state to argue for life, but he can remember what made him live before, when he was not depressed. For clarity, you can write these arguments in two columns on the board or on a piece of paper. After this, the therapist asks the patient to name which of the “past” arguments are relevant in the present or may be valid in the future. It should be noted that suicidal patients tend to cancel the positive moments that were or are present in their lives: they either forget, ignore, or devalue them. By helping the patient to remember positive factors or by directly pointing out them, we create a counterbalance to his many arguments in favor of death.

However, we consider it necessary to warn therapists against an overly assertive approach. If the patient feels that the therapist is simply trying to “talk” him out of suicide, negativism may awaken in him. A spirit of experimentation should be evident in the therapist's suggestions and actions, as if he were telling the patient: “Even though you are convinced of the correctness of your decision, it is still worth listing the positive points to find out your attitude towards them.”

After listing the positive factors, the therapist and patient list all the pros and cons of suicide. As a result of this procedure, the patient usually takes a more objective view of things, and the arguments in favor of committing suicide no longer seem as compelling to him as before.

The patient's arguments for death must be taken seriously by the therapist; he has no right to dismiss them, even if they seem trivial or irrational. Statements like “If you feel like it, go ahead and kill yourself” are also unacceptable. This kind of “trick” can have the most dire consequences.

Forced treatment

In accordance with the current legislation of our country, compulsory treatment is allowed after a suicide attempt. if relatives try, they are advised to call an ambulance. The patient is hospitalized in a hospital. He is undergoing treatment in the psychosomatic department.

During the first few days, relatives and friends are not allowed to see the patient. After the patient regains consciousness and recovers a little, he can be visited in the presence of a medical professional. First, the doctor gives recommendations to relatives on how to behave with the patient. After a certain time, the clinic staff will establish contact with the patient and instill in him a desire for life, thanks to the use of special psychotherapeutic techniques. Compulsory treatment after suicide is recommended to be carried out without fail, which will eliminate the possibility of relapse.

Principles of treatment for suicidal depression

With this form of depressive syndrome, timely consultation with a doctor is more important than ever. In the initial stages of the disorder, outpatient therapy with antidepressants is possible, but in the presence of obvious suicidal tendencies, hospitalization and treatment with antipsychotics are indicated. Subsequently, as the patient’s psychological state stabilizes, they are transferred to antidepressants.

The prescribed medications are continued for at least 1.5–2 years. Only in this way can the patient’s psycho-emotional status be fully restored and relapse avoided. Drug treatment is necessarily complemented by psychotherapy.

Suicidal depression is a very dangerous disease that can have fatal consequences. So don't hesitate, make an appointment right now! Call us any time 24/7 8(969)060-93-93.