Well-being is based on mental maintenance

Seeking support is not a weakness, it’s a necessity. Reach out. Get professional help. For some people, going through a difficult time in life will not require professional help, however for some, a qualified and experienced ear can be hugely beneficial when it comes to finding your way in this new world. It’s about processing your emotions around the situation and learning ways to navigate the tough times that are emotionally helpful. 

~ Fitzpatrick, PSI, 2018

Contact| Pieta 

SpunOut.ie - Ireland's Youth Information Website 

Samaritans Ireland

Depression Support | Depression Help Ireland | Aware

Mental Health First Aid Ireland - What is MHFA? (mhfaireland.ie)

See Change | Say No To Mental Health Stigma

Welcome to ReachOut.com | ReachOut Australia

A Lust For Life - Irish Mental Health Charity in Ireland

Living with Dementia

299.00 (F84.0)

Autism is a lifelong neuro-developmental disability that affects the development of the brain in areas of social interaction and communication. People with autism have difficulties in communicating and forming relationships with people, in developing language and in using abstract concepts. It also impacts on their ability to make sense of the world around them. It was first described by Leo Kanner in 1943. The following year in 1944, a German scientist named Hans Asperger describes a "milder" form of autism now known as Asperger's Syndrome. It wasn't until 1994 that Asperger's Syndrome was added to the DSM, expanding the autism spectrum to include milder cases in which individuals tend to be more highly functioning.

 

Over the years, the definition, classification and diagnostic specifics of autism have undergone many significant changes. In 2013 the DSM-5 folded all subcategories of the condition into one umbrella diagnosis of autism spectrum disorder (ASD). Asperger's Syndrome is no longer considered a separate condition. The severity levels for Autism Spectrum Disorder, 299.00 (F84.0) from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are outlined below.

Level 3: "Requiring very substantial support"

Social communication: Severe deficits in verbal and nonverbal social communication skills cause severe impairments in functioning, very limited initiation of social interactions, and minimal response to social overtures from others. For example, a person with few words of intelligible speech who rarely initiates interaction and, when he or she does, makes unusual approaches to meet needs only and responds to only very direct social approaches.

Restricted, repetitive behaviours: Inflexibility of behaviour, extreme difficulty coping with change, or other restricted / repetitive behaviours markedly interfere with functioning in all spheres. Great distress / difficulty changing focus or action.

Level 2: "Requiring substantial support"

Social communication: Marked deficits in verbal and nonverbal social communication skills; social impairments apparent even with supports in place; limited initiation of social interactions; and reduced or  abnormal responses to social overtures from others. For example, a person who speaks simple sentences, whose interaction is limited  to narrow special interests, and how has markedly odd nonverbal communication.

Restricted, repetitive behaviours: Inflexibility of behaviour, difficulty coping with change, or other restricted / repetitive behaviours appear frequently enough to be obvious to the casual observer and interfere with functioning in  a variety of contexts. Distress and / or difficulty changing focus or action.

Level 1: "Requiring support"

Social communication: Without supports in place, deficits in social communication cause noticeable impairments. Difficulty initiating social interactions, and clear examples of atypical or unsuccessful response to social overtures of others. May appear to have decreased interest in social interactions. For example, a person who is able to speak in full sentences and engages in communication but whose to-and-fro conversation with others fails, and whose attempts to make friends are odd and typically unsuccessful.

Restricted, repetitive behaviours: Inflexibility of behaviour causes significant interference with functioning in one or more contexts. Difficulty switching between activities. Problems of organization and planning hamper independence.

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'If they can't learn the way we teach, we teach the way they learn' ~ O. Ivar Lovaas 

An Ounce of Prevention

 

To guard adolescents against high risk behaviours such as substance abuse, they need to be surrounded by the right environment, a cohesive-supportive family, positive adult role-models, and schools that respond to the student's academic and social needs.

 

Benjamin Franklin ~ 'An ounce of prevention is worth a pound of cure.'

Suicide and Ireland

Figures from the Central Statistics Office show that the number of suicides registered in Ireland fell by 6% last year. The CSO's yearly summary shows 475 suicides were registered in 2013, compared to 507 in 2012. The CSO statistics show several counties recording rates of suicide well above the national average of 10.3 per 100,000 population. Males accounted for over 83% of all suicide deaths last year. The number of registered suicides in the 15-24 age group fell by 23% last year, however Ireland still has the fourth highest suicide rate in that age group in the European Union (RTE, 2014).

Women are likely to attempt suicide about three times more often than men, but men are, on average, three times more likely to actually kill themselves. These differences may be due to (1) a higher incidence of depression in women and (2) men's choice of more violent and lethal methods, such as shooting themselves or jumping off buildings. The suicide rate for both men and women is higher among those who have been divorced or widowed. Women's suicides are more likely to be triggered, although not certain to be triggered by any means, by failures in love relationships, whereas career failure more often prompts men's suicides (Shneidman, 1976). Further, a history of sexual or physical abuse significantly increases the likelihood of later suicide attempts (Garnefski & Arends, 1998).

Is suicide contagious?

Most people react to hearing the news of a suicide with sadness and curiosity. Some people react by attempting suicide themselves, often by the same method they have just heard about. Gould (1990) reported an increase in suicides during a 9-day period after widespread publicity about a suicide. Clusters of suicides (several people copying one person) seem to predominate among teenagers, with as many as 5% of all teenage suicides reflecting an imitation (Gould, 1990; Gould, Greenberg, Velting, & Shaffer, 2003). Suicide prevention charity Console has called for a real-time register of suicide data to be kept. It said it could then "act on timely and accurate statistics to put measures in place to prevent such phenomena as suicide clustering or contagion".

Why would anyone want to copy a suicide? First, suicides are often romanticized in the media: An attractive young person under unbearable pressure commits suicide and becomes a martyr to friends and peers by getting even with the (adult) world for creating such a difficult situation. Also, media accounts often describe in detail the methods used in the suicide, thereby providing a guide to potential victims. Little is reported about the paralysis, brain damage, and other tragic consequences of the incomplete or failed suicide or about how suicide is almost always associated with a severe psychological disorder. More important, even less is said about the futility of this method of solving problems (Gould, 1990, 2001; O’Carroll, 1990).

To prevent these tragedies, mental health professionals must intervene immediately in schools and other locations with people who might be depressed or otherwise vulnerable to the contagion of suicide. But it isn’t clear that suicide is ''contagious'' in the infectious disease sense. Rather, the stress of a friend’s suicide or some other major stress may affect several individuals who are vulnerable because of existing psychological disorders (Durand & Barlow, 2013).
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''The ability to be in the present moment is a major component of mental wellness'' ~ Abraham Maslow

Hedgehog's Dilemma

The hedgehog's dilemma, or sometimes the porcupine dilemma, is an analogy about the challenges of human intimacy. It describes a situation in which a group of hedgehogs all seek to become close to one another in order to share heat during cold weather. They must remain apart, however, as they cannot avoid hurting one another with their sharp spines. Though they all share the intention of a close reciprocal relationship, this may not occur, for reasons they cannot avoid.

 

From 'Studies in Pessimism' (Schopenhauer, p. 142);

''A number of porcupines huddled together for warmth on a cold day in winter; but, as they began to prick one another with their quills, they were obliged to disperse. However the cold drove them together again, when just the same thing happened. At last, after many turns of huddling and dispersing, they discovered that they would be best off by remaining at a little distance from one another.

 

In the same way the need of society drives the human porcupines together, only to be mutually repelled by the many prickly and disagreeable qualities of their nature. The moderate distance which they at last discover to be the only tolerable condition of intercourse, is the code of politeness and fine manners; and those who transgress it are roughly told - in the English phrase - to keep their distance. By this arrangement the mutual need of warmth is only very moderately satisfied; but then people do not get pricked. A man who has some heat in himself prefers to remain outside, where he will neither prick other people nor get pricked himself.''

                            

Both Schopenhauer and Freud have used this situation to describe what they feel is the state of individuals in relation to others in society. The hedgehog's dilemma suggests that despite goodwill, human intimacy cannot occur without substantial mutual harm, and what results is cautious behaviour and weak relationships.

 

The dilemma is also used to justify or explain introversion and isolationism. The concept originates from Arthur Schopenhauer's 'Parerga and Paralipomena'. It then entered the realm of psychology after the tale was discovered and adopted by Freud in 1921.

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Sometimes love can be a spiky situation.

When mood interferes with our ability to function

What is Major Depression?  Symptoms can include; weight loss, insomnia, a negative self-image and even suicidal thoughts. It's not the mood itself that denotes pathology, but its extent, severity, and duration. When left untreated, depression can often go away by itself, but for many people - it persists. Depression can begin as a reaction to specific life experiences, such as the death of a loved one, job loss, divorce, or reacting to growing old.

 

Many people with major depression think they have only physical problems, so they seek help from a physician, and in fact they may never get to a mental health practitioner at all. Depression can come in many forms from the mildest, that may go undetected, to the most acute, requiring hospitalisation. 

 

The milder forms of depression may be exemplified by a high executive who flies a corporate jet and who feels a lot of physical symptoms occurring over a period of time with a gradual onset.

 

They may feel a sense of malaise, decreased energy, or a decreased enjoyment of life, but can still work and function as far as others are concerned. But as far as he's concerned, he's only working at 30 or 40 percent of his usual capacity.

 

This person may be very unhappy, their life may be extremely difficult for them and others may not even notice. The fact is that many people are working and functioning in this state. This same person may respond to treatment and feel one hundred times better once their actively treated. But to the outside world, they may look exactly the same. That's the mildest form of the illness.

 

In acute or severe depression, the psychomotor retardation is even more intensified. The person moves slower, speaks slower. The person actively withdraws from social contacts, he doesn't want to be involved with other people, they just want to be left alone. They can no longer function as well as they could. They have no motivation to work, to be involved in anything. Nothing seems worthwhile.

 

In psychotic depression, there is a break with reality, here the person experiences delusions, usually associated with guilt or self blame - more extreme forms of what we see in milder forms of depression. They may have hypochondriacal delusions about their bodies, such as cancer. In the most pronounced forms of depression, called 'depressive stupor', all of the previous symptoms are aggravated. Here the same person does not respond to the outside world at all. Some are even spoon-fed to be kept alive.

 

In general, the subjective case of the depressed person is that they're living life beneath a cloud. People are hopeless that anything will take the pain away. It's like being tortured and seeing no way to get out of it, no way to end the pain. And that's when people not only consider suicide, but that suicide seems like a merciful exit for them, a way to get out of what seems to be a no-exit situation.

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''Out of suffering have emerged the strongest souls, the most massive characters are seared with scars''

                                                                                                                                               ~ Khalil Gibran

Stigma - A major barrier to Suicide Prevention

According to the WHO and the latest Burden of Disease Estimation, suicide is a major public health problem in high income countries and is an emerging problem in low and middle income countries. Suicide is one of the leading causes of death in the world, especially among young people.

Nearly one million people worldwide die by suicide each year. This corresponds to one death by suicide every 40 seconds. The number of lives lost each year through suicide exceeds the number of deaths due to homicide and war combined. These staggering figures do not include nonfatal suicide attempts which occur much more frequently than deaths by suicide.

                                                                                                                Suicides in Republic of Ireland from 2001-2013

2001 - 519
2002 - 478
2003 - 497
2004 - 493
2005 - 481
2006 - 460
2007 - 458
2008 - 506
2009 - 552
2010 - 490
2011 - 525
2012 - 507

*2013 - 475 (6% drop, with males accounting for over 83% of all suicide deaths last year.)

A large proportion of people who die by suicide suffer mental illness. Recent estimates suggest that the disease burden caused by mental illnesses will amount for 25% of the total disease burden in the world in the next two decades, making it the most important category of ill-health (more important than cancer or heart diseases.)

A significant number of those with mental illnesses who die by suicide do not contact health or social services near the time of their death. In many instances, there are insufficient services available to assist those in need at times of crisis. Lack of access to appropriate care is one of the many factors that magnify the stigma associated with mental illness and with suicidal ideation and behaviour. This type of stigma, which is deeply rooted in most societies, can arise for different reasons.

For some people, the term 'suicide' alone evokes panic and one of the causes of stigma is a simple lack of knowledge - that is, ignorance. This type of stigma can be directly addressed by providing a range of community-based educational programs that are targeted to specific subgroups within the society (that is, by age, educational level, religious affiliation, and so forth). Negative attitudes about individuals with mental illnesses and/or suicidal ideation or impulses (prejudice) is common in many communities. These negative attitudes often do not change with education about mental illnesses and suicidal behaviour.

Many health professionals who feel uncomfortable dealing with persons struggling with mental illnesses or suicidal ideation often hold negative, prejudicial attitudes towards such patients. This can result in a failure to provide optimal care and support for persons in crisis.

Stigma is also the underlying motive for discrimination - inappropriate or unlawful restrictions of the freedom of individuals with mental illnesses or suicidal behaviour. Such restrictions can occur at a personal, community or institutional level. One extreme example is the criminalization of suicidal behaviour, which still occurs in many countries. Discrimination can prevent or discourage people affected by mental illness and/or suicidal ideation or behaviour from seeking professional help, or from returning to their normal social roles, after receiving treatment for an episode of illness or crisis.

In both high-income and low and middle-income countries stigmatized conditions such as mental illnesses and suicidal behaviour receive a much smaller proportion of health and welfare budgets than is appropriate, given their huge impact on the overall health of the community.

Unless the stigma is confronted and challenged, it will continue to be a major barrier to the treatment of mental illnesses and to the prevention of suicide. Events like World Mental Health Day (October 10th) and World Suicide Prevention Day (September 10th) are ideal times to highlight and inspire people to work towards the goal of developing creative new methods for eradicating stigma and helping to save lives.
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Each morning when you open your eyes, say to yourself:  “I, not external people or events, have the power to make me happy or unhappy today.  It’s up to me.  Yesterday is gone and tomorrow hasn’t come yet.  I only have today and I’m going to be happy in it.”