Restless leg syndrome (RLS) — also known as Willis Ekbom Disease — is classified as a sensorimotor disorder that causes those affected to have an unstoppable urge to move their legs. It’s often caused by end-stage renal disease and hemodialysis, as well as iron deficiency, medication side effects, alcohol, nicotine, caffeine, pregnancy, and nerve damage.

For those who suffer from RLS, moving their legs is a way to ease pain and discomfort in the lower extremities. Symptoms of RLS often flair up in the late afternoon, evening, or at night when someone is trying to sleep. In turn, people with RLS often don’t receive adequate sleep — resulting in mood changes and inability to concentrate.

Researchers find a connection between RLS and death by suicide

According to a study conducted by researchers at Penn State, there may be a link between RLS and suicide risks. The connection between RLS and suicide is currently unclear but RLS often accompanies sleep deprivation, depression, heart disease, ADHD, obesity, and overall poor quality of life.

The Penn State study involved approximately 169,373 participants (both with and without RLS) across the United States and found that those with RLS are at a 2.7-fold greater risk of death by suicide or self-harm than those without the condition. None of the participants in the study had prior cases of attempted suicide or self-harm. Throughout the study, however, approximately 119 cases of death by suicide or self-harm were identified during a mean follow-up of 5.2 years.

While research scrutinizing sleep disorders is limited, researchers believe that sleep disturbance, insomnia, and obstructive sleep apnea may elevate suicide risks in people with RLS. Depression, however, was ruled out as a suicide risk factor.

Finding a solution to RLS-related suicide may require further research

Death by suicide has risen by 30 percent since 1999, according to the Centers for Disease Control and Prevention. In addition, nearly 45,000 people in the U.S. died by suicide in 2016. These statistics are alarming. In a time when death by suicide is at an all-time high, studies such as the one conducted by researchers at Penn State help shed light on the possible risk factors we should be addressing.

About five percent of the population in Western countries is impacted by RLS. The condition can be debilitating for those who suffer from it. In the meantime, pinpointing the central cause of death by suicide and self-harm among people with RLS will require further research. Therefore, it’s critical that doctors don’t dismiss this condition as merely a nuisance.

If you lost a loved one to death by suicide that could have been prevented, it’s crucial that you take legal action. Knowing where to start, however, can be overwhelming and confusing, especially when dealing with the death of a loved one.

Nationally-recognized suicide lawyer and counselor Skip Simpson at The Law Offices of Skip Simpson helps families of those who died by suicide seek answers and justice. If a doctor or other medical professional failed to act promptly and effectively when they should have, speak to our experienced and compassionate legal team as soon as possible.

You can contact us online to schedule your free case evaluation or call (214) 618-8222.

Even though the majority of people with depression don’t die by suicide, statistics show that roughly 30 percent who are unaffected by multiple antidepressant drugs or therapy make at least one attempt in their lifetime.

A common misconception about depression is that it must be treated as a single condition. However, it often involves multiple ailments that can heighten the risk of suicide, according to Science Mag. Researchers are currently trying to identify several depression subtypes by comparing the neural circuits that light up during certain tasks with actual depression symptoms. These efforts are part of a larger initiative to delve deeper into brain biology and mental health.

Identifying subtypes of depression that are most often linked to suicide

While the ultimate goal is to identify suicide risks through biological means, researchers hope to develop effective strategies for care that extend far beyond conventional psychiatry. This effort includes Research on Anxiety and Depression-Anhedonia Treatment (RAD-AT), which enrolls volunteers with certain subtypes of depression that put them at a heightened risk of suicide.

The study — which is led by Leanne Williams, a Stanford clinical neuroscientist — pioneers a method of treatment based on brain circuitry. In addition, the study hopes to link symptoms of depression to brain biology in order to help those who have had no previous success with treatment.

For more than 20 years, Williams has studied how depression manifests in the brain and has worked to collect thousands of brain scans from people with depression. After losing a patient early in her career, and recently, a loved one, she has dedicated herself to preventing death by suicide in people with depression.

After extensive research, Williams has identified at least six subtypes of depression, each of which is generated by unusual activity in the brain that effects certain sets of circuits responsible for regulating mood and cognition. Three key subtypes were found to be linked to suicide risks. These include:

• A subtype that affects a circuit called the default mode network, which creates aimless mental chatter and negative thoughts while the brain is in neutral.
• Another subtype, also called anhedonia, affects the reward networks — causing those affected by it to feel little or no pleasure.
• A third subtype associated with attention, planning, and impulse (called cognitive control) often doesn’t respond adequately to depression treatment.

The link between brain biology and suicide has been studied since the early 1980s, particularly by neuroscientist John Mann of Columbia University. After examining the brains donated by families of those who died by suicide, he found that levels of serotonin were significantly lower than depressed people who died in other ways.

What other research has concluded

Mann recently joined Maria Oquendo, a psychiatrist at the University of Pennsylvania, to further study the link between low serotonin levels and suicide. In a 2016 study, Mann and Oquendo compiled data from positron emission tomography (PET) imaging, which tracks serotonin levels in the brain by using radioactive labels.

The study, which included 100 participants who were depressed or suicidal, found a significant biological difference between people with low-serotonin levels and those who experience circumstantial suicidal thoughts.

Another study, which was led by neuroscientist Irina Esterlis at Yale University focused exclusively on the link between post-traumatic stress disorder (PTSD) and suicide. The study also used PET imaging, which found that people with PTSD who experienced suicidal thoughts were deficient in the signaling molecule glutamate. Esterlis’s finding also explores the possibility of treatment with a drug called ketamine, which may help with glutamate deficiency.

Skeptics believe that there is no one way to identify depression subtypes. Some research suggests indicators of depression subtypes may be based on distinct symptoms, response to treatment, genetics, hormones, and gut bacteria.

What we do know is, suicidal thoughts often occur in people who, otherwise, live seemingly satisfying lives. For this reason, conventional psychiatry may not be effective at mitigating the risk. You can’t simply ask a person suffering from depression why they feel depressed. The biological markers in the brain simply can’t be expressed in words.

We hope that the findings from this research lead to effective measures of identifying biologically related suicide risks and administering effective treatment.

If you have lost a loved one due to death by suicide, you may be looking for answers and closure. An experienced Texas suicide lawyer at the Law Offices of Skip Simpson can help you through these difficult times. We’re dedicated to helping families seek justice. Contact us online today to schedule a free case evaluation with our legal team.

Predicting suicide ideation is a critical precursor to providing intervention and treatment to at-risk individuals. In patients who suffer from depression and other disorders that impact mood, antidepressants are often the standard method of treatment.

Antidepressants have the potential to make matters worse, however. In 2004, the U.S. Food and Drug Administration (FDA), prompted a Black Box Warning on selective serotonin reuptake inhibitors (SSRIs) that acknowledges the risks of suicidal thoughts in children, teens, and young adults.

Patients who are treated with antidepressants should be regularly screened for suicide ideation through follow-ups. The results of recent research conclude that prediction may be possible.

Identifying treatment-worsening suicide ideation

Doctors may soon be able to identify suicide ideation in patients receiving antidepressant treatment, according to a study in the Journal of Clinal Psychiatry.

The study analyzed data collected from 2007-2011 involving 237 patients ages 18-75 with major depressive disorder (MDD). Patients in the study received either 60 mg of duloxetine (an antidepressant drug) or placebo.

Researchers examined the link between treatment-worsening suicide ideation (TWSI) and clinical and biological factors.

TWSI involved a 1-point increase on the Montgomery-Asberg Despression Rating Scale (MADRS) item 10, which identifies suicidal thoughts.

The MADRS is a ten-item questionnaire used by psychiatrists to evaluate a patient’s level of depression. For example, zero points indicate that a patient is happy, whereas six points indicate that a patient is at risk of dying by suicide.

Researchers zeroed in on item 10 over the course of eight weeks while assessing suicide ideation. They then assessed overall depression severity by adding up total scores from all items found in the MADRS. In addition, they assessed anxiety severity by using the Hamilton Anxiety Rating Scale and a familial psychiatric history questionnaire.

When assessing from baseline, researchers used blood samples to analyze a link between or overlap of messenger RNA (mRNA) and microRNA (miRNA) – both of which are genetic codes transcribed in patients’ DNA. They were then able to create TWSI predictive models based on clinical factors, mRNA, miRNA, and combined factors.

Nearly 10 percent of patients who received duloxetine exhibited TWSI at baseline analysis, however, TWSI was not predicted in patients who received a placebo.

Urging healthcare providers to do the right thing

Signs of depression and suicide ideation aren’t always clearly exhibited. The stigma placed on individuals who are at risk of dying by suicide has enabled a culture where individuals may go to great lengths to mask their suffering. Thus, identifying suicide ideation, and even depression, may be impossible in some cases. The signs may only become apparent after a person has attempted suicide or lost his or her life.

As researchers continue to identify prediction methods, our medical system is inching closer to effective solutions that could save lives. It’s critical that doctors and other medical professionals are properly trained to identify suicide risks and proceed with proper intervention measures.

The Law Offices of Skip Simpson has been closely watching emerging medical developments and we urge hospitals and doctors to do the right thing. If you have lost a loved one to suicide because of someone else’s failure to provide intervention, contact us online to discuss your matter. We’re dedicated to representing families of mental health patients and holding negligent parties accountable.

Young people across the United States are among the most vulnerable when it comes to suicide risks. In fact, it is the second most common cause of death among youth ages 10-19 – taking more than 85,000 lives from 1975-2016.

A Nationwide Children’s Hospital study posted in JAMA Network indicates that the suicide rate among girls ages 10-14 was “three-fold” from 1999-2014, according to Forbes.

The study pulled data from the Centers for Disease Control and Prevention (CDC) showing the need to scrutinize the increased suicide rates among young females – especially suicide by suffocation or hanging. Historically, females had higher rates of only contemplating or attempting suicide, while males had a higher rate of actually dying by suicide.

“Overall, we found a disproportionate increase in female youth suicide rates compared to males, resulting in a narrowing of the gap between male and female suicide rates,” said Donna Ruch, PhD and lead author of the study, in a press release.

Youth suicide and its connection to social media

The development and socialization of young females, as well as the prevalence of social media among tweens and teens, is considered a risk factor that should be scrutinized. The prevalence of social media has raised some concerns regarding how it impacts the mental health of adolescents.

Excessive use of social media not only inhibits the ability of children and teens to develop a healthy social life, it opens the door for exclusion and cyberbullying.

“Kids text all sorts of things that you would never in a million years contemplate saying to anyone’s face,” said Dr. Donna Wick, a clinical and developmental psychologist.

In addition, Dr. Catherine Steiner-Adair attributes the risk to low self-esteem to the need for adolescent females to compare themselves to others.

“Girls are socialized more to compare themselves to other people, girls in particular, to develop their identities, so it makes them more vulnerable to the downside of all this,” she said.

For adolescents in general, acceptance and “being liked” is a monumental part of their identity. Adolescent females mostly care about their appearance and may spend hours scouring through photos to decide which ones to post on social media. Simply not getting enough “likes” in comparison to someone else, or receiving negative comments, can be enough to make adolescent girls feel alienated.

Behaviors and warning signs to watch out for

It’s important that parents monitor what their children do on social media. Feelings of hopelessness or being excluded can manifest in ways that may seem rather subtle.

There are several behaviors and warning signs that may indicate contemplation of suicide, according to Healthline.

These include:

• Making threats or comments about taking own life
• Socially withdrawing from friends, family, and community
• Abusing alcohol or drugs
• Engaging in aggressive, impulsive, or reckless behavior
• Exhibiting dramatic mood swings, anxiousness or agitation
• Talking, writing or thinking about death
• Expressing feelings of hopelessness, loneliness, or being trapped
• Giving away possessions

Adolescent years can be a difficult time, especially among females. It may be difficult to see their point of view and why the need for social acceptance is so important for teenagers – it’s an inevitable a part of their development and identity.

Parental involvement simply isn’t enough to curtail the suicide rate among teens. Suicide prevention takes cultural change and awareness in our schools and communities.

The Law Offices of Skip Simpson not only seeks to promote such awareness in our culture but treat cases of adolescent suicide with the utmost care and help families find answers. If you have lost a loved one to suicide, we’d like to discuss your matter with you. You can contact us online to schedule a free case evaluation.

According to the Centers for Disease Control and Prevention, the suicide rate in the United States has increased by 33 percent from 1999-2017 and suicide takes an average of 40,000 lives per year. The rate among children and teens, however, is even higher.

The CDC said death by suicide among children ages 10-17 his increased by 70 percent between 2006-2016.

Following a slew of deaths by suicide among children – including an eighth-grade boy and 8-year-old boy from Cincinnati – adolescents are being taught how to identify the warning signs of suicide in their health classes.

Cincinnati Public Radio’s Cincinnati Edition features an audio interview with three school officials: Culture and Safety Manager Dr. Carrie Bunger of Cincinnati Public Schools, Public Information Officer Tracey Carson of Mason City Schools, and Assistant Professor Dr. Jennifer Wright-Berryman of the University of Cincinnati College of Allied Health Sciences School of Social Work – all of whom are familiar with the devastation of suicide.

The ripple effects

Suicide among children and teens can devastate school peers, as well as an entire community. One concern expressed by school officials is contagion. It’s a “ripple effect” that can lead to more than one suicide within a community. According to U.S. News & World Report, teens ages 15-19 are the most susceptible to contagion after being exposed to suicide.

In the interview, Carson discusses the contagion effects of suicide:

“There is no worse day than the day that you come in and you call your staff together to share that your student has died by suicide. It’s just truly one of the worst things that happens in a school community, but it ripples out, because when we have a young person who dies by suicide, it doesn’t just end at school. It impacts an entire community.”

Providing social and emotional support to grieving students

When addressing death by suicide, school officials must be explicit about what happened, while accommodating the emotional needs of those who are affected. It starts with identifying those students who are grieving and prompting teachers, counselors, and other school faculty to provide support.

It is important that school districts avoid prolonged memorials of a student who died by suicide.

“To impact contagion, to romanticize, and for those students, for the living, that may be at that cusp of ‘I’m feeling a level of despair’,” Bunger said. “It is something that we have been very mindful of in terms of honoring the living and making sure that we are providing proactive strategies to help support those students that are with us and coming through the school walls.”

Identifying the signs and providing early intervention

According to Wright-Berryman, there are several suicide red flags school faculty and students can watch out for. The primary cause of suicide among children and teens is the feeling of being excluded and isolated.

The signs often include:

• Sudden behavior changes
• Sudden substance abuse
• Social isolation
• Academic failure
• Academic success (in some cases)
• Social media activity that raises red flags
• Giving away prized possessions
• Suddenly quitting a sports team, musical activity, or other extracurricular activity
• Talking about suicide or self-harm

According to the school officials in the interview, children and teens who are suicidal are most likely to reach out to their peers rather than adults. Giving students the tools they need to identify the warning signs and to refer their peers to adults is critical.

Part of the problem among children and teens, as well as in society at large, is the cultural view of intervention. There seems to be a social stigma surrounding mental health that deters many individuals from seeking help.

We expect our school systems and communities to promote a culture of suicide awareness and early intervention. If the signs are there, it’s up to responsible parties to intervene, if they can. They should be held accountable. That’s why it’s important for a child’s loved ones to contact suicide lawyer Skip Simpson for a free consultation.

If you know someone who lost a loved one due to suicide, you’re not alone. According to the Centers for Disease Control and Prevention (CDC), there were approximately 47,173 suicides in the United States in 2017.

Suicide is often viewed as a taboo subject that many people would rather keep quiet about to avoid invoking more grief. This can cause a friend or loved one to feel abandoned during a troublesome time.

What you say to a friend or a loved one who is grieving may not always provide comfort. Self Magazine says finding the words isn’t easy and offers these tips that might help. Read more here.

You may have seen him on Saturday Night Live, cracking jokes and sporting a jokers’ grin. You may have heard of him in the tabloids after a highly public split with pop sensation Ariana Grande. And, if you are familiar with the trademarks of borderline personality disorder, you aren’t surprised by the whirlwind romance that came to an abrupt end.

Pete Davidson has taken the internet’s attention once again after the end of the relationship, but this time with a series of words on Instagram that brought out just how deadly the disorder can be.

“I really don’t want to be on this earth anymore.
I’m doing my best to stay here for you but I actually don’t know how much longer I can last.
All I’ve ever tried to do was help people.
Just remember I told you so.”

Ending the message with a heart emoji and deleting his Instagram, the celebrity drew concern from all corners of the globe. Some blamed Ariana, his recent ex (who herself just lost a former boyfriend to drugs) as if women are rehabilitation centers for troubled men, and as if her decision to leave a relationship was worth blaming another death on. Pete Davidson was accounted for, unharmed. And he was speaking up. Approximately 5.9% of adults in the US has BPD, according to NAMI. It’s time we learned about it.

What is Borderline Personality Disorder?

Profoundly misunderstood by the healthcare community, BPD is not an abbreviation for bipolar disorder, which is a severe disorder mostly affecting moods, but is a personality disorder that can change someone’s very worldview. Often described as unpredictable (and also often co-morbid in those with bipolar disorder) this disorder takes life away from sufferers. They view things in extremes, their hobbies and interests can flip at a moment’s notice, and their lives are a rollercoaster of unstable relationships.

How they view themselves and others is a constantly changing, never settling process.

Thought to stem from childhood abandonment, abuse, unstable relationships or other adversity such as poverty or an unstable home, BPD is deadly and acts quickly. Symptoms may include:

• Chronic feelings of emptiness
• Inappropriate, intense anger
• Difficulty forming bonds and trusting
• Self-harming behavior such as cutting, picking, or substance abuse
• Recurrent suicidal thoughts or threats
• Dissociative feelings, feeling cut off from reality
• Sudden, severe mood swings
• Sudden, fast moving relationships that end just as quickly
• Pushing people away intentionally, only to cling to them

People with BPD are often vilified. Seen as abusive, uncontrollable and people to stay away from, Pete Davidson has done the community a sincere service by addressing his illness. He’s spoken about his time in rehab, in which he thought that drugs induced moments of blind rage and breakdowns which impaired his memory. After first receiving a diagnosis for bipolar disorder, and another mental breakdown, he was properly diagnosed with borderline personality disorder.

How different are bipolar disorder and BPD?

Pete had been tweeting his support for Kanye West in speaking about his mental health, which had been a hot topic as the celebrity stumbled through the political sphere and often seemed like a puppet to some. His internet presence made very little sense. His grandiose behavior and recent history with extreme debt seemed like red flags to some, but humor for others. Kanye spoke up finally about his history with a bipolar diagnosis, making a dent in the stigma against mental illness (especially for men, and men of color) and it had given Pete the courage to talk about his own struggles.

Bipolar Disorder and BPD can be housed in the same brain, creating what must only be a truly painful daily experience for a sufferer, but their key differences are:

• Shorter, more frequent mood swings for BPD-a bipolar person can be hypomanic or manic or exhibit depression symptoms for weeks to months, BPD exists on a constant swing
• BPD produces more feelings that have the sufferer question who they are, and a fear of abandonment. This severely affects familial bonds, close friendships and relationships
• Borderline is a personality disorder, affecting some parts of the brain separate from a mood disorder like bipolar. Recovery and maintenance can be different.
• Fear of abandonment and unstable personal relationships are more unique to BPD as a symptom, whereas bipolar patients can have them as a product of their disorder.

Suicidal Ideation and Passive Suicidal Thoughts

Many people with various mental health conditions exist in a permanent state of wanting death. This can take the form of an ideation, almost like a yearning daydream, or a reoccurring thought that the sufferer simply wants life to end. This may not be accompanied by a plan or action, or even self-harm, but as a welcome intrusive thought that has made itself home among day to day activities.

Imagine every waking moment gagged by wanting life to end. Every anniversary dinner, every birth of a child, every morning coffee is dull and flat because you are alive and hate every moment of it. This is merely another symptom of BPD that is incredibly hard to control, as it can occur in any mood. Living in the public light has given Pete Davidson the opportunity to do several things that put a dent into the stigma around mental illness: ask for help, voice his feelings, and freely share his diagnosis while lifting up another performer.

Finding Hope

Though Ariana Grande begged fans to “be gentle” with her ex after he cited online bullying as a trigger for his disorder, Davidson has been publicly struggling. Ironically, that publicity has reached thousands diagnosed with the disorder, thousands more wondering if they’ll soon join statistics. Men especially are not encouraged to show mental “weakness” and too often live in a culture that would rather see them dead than in therapy.

Pete Davidson, Kanye West and many others are challenging that. Davidson himself wrote:

“I’ve spoken about BPD and being suicidal publicly only in hopes that it will help bring awareness and help kids like myself who don’t want to be on this earth…to all those holding me down and seeing this for what it is – I see you and I love you.”

Currently, the go-to therapy method for addressing BPD is DBT-dialectical behavioral therapy. Unlike CBT or cognitive behavioral therapy, which helps people identify  and change core beliefs and behaviors, DBT is skills-based.  Learning how to cope, and learning how to live, are two things that some patients may need to learn.

Offering a message of hope from such a large platform to anyone struggling with their mental health or suicidal thoughts is something that an entire massive online audience needed to hear. Thank you, Pete Davidson for your humor, entertainment, and helping your brothers and sisters of the world in a way only you could do. Don’t go anywhere; we desperately need you.  You are giving folks hope where there was none, and left us laughing too. What a gift to us.

Pet lovers have long believed that the companionship that comes with having a pet has real benefits from the owner. Now, a systematic review of research puts hard evidence behind that belief.

The review, led by Dr. Helen Louise Brooks of the University of Liverpool and published in BMC Psychiatry, suggests that pets do indeed provide benefits to people with mental health conditions.

A distraction, a sense of purpose, unconditional support – how pets benefit people at risk of suicide

Americans were estimated to have spent over $69.35 billion on their pets in the year 2017, reaching a new high. While the love for our furry friends is well acknowledged, their services can make the difference between life and death for some.

In the review, “pets were perceived as providing unconditional love and support” – something that people struggling with mental health issues often cannot get from friends and family. In the face of the often overwhelming challenges that come with living with a  mental illness, that level of love and support is invaluable.

Pet owners were also found to draw strength, self-worth and meaning from their pets. Multiple pet owners said that taking care of their pets gave them something to like about themselves. Another spoke directly about an experience with suicidal ideation: “The thing that made me stop was wondering what the rabbits would do.”

One of the most persistent myths about suicide is the idea that a person who is determined to die by suicide is inevitably going to do so. The reality is that the suicidal urge is an acute problem that does not last forever. Pets have been shown to provide an important distraction, a grounding that allows suicidal people to step outside their own thoughts and focus on caring for or interacting with the pet. That’s often enough to save a life.

Some pets, such as dogs, were also shown to force positive behavior from their owners. Simple acts necessary to dogs such as going outside, engaging with the community and participating in physical activity are all known to have significant mental health benefits. For a person struggling with depression or another mental health issue, the simple fact that the dog has to go outside is a powerful source of motivation. Many people that struggle with taking care of themselves often find solace in taking care of another.

Different animals serving different purposes

Hospitals frequently utilize the talents of therapy dogs, who offer calming presences and physical affection to patients in care. This unconditional love can make a world of difference to someone with a psychiatric disability, especially when navigating often cold and unfamiliar settings of an inpatient unit, especially to those who may not have any visitors otherwise.

Psychiatric service dogs come with their own set of legally protected regulations. Specially trained to assist one person, these dogs can enter areas that regular pets cannot (such as restaurants and establishments that have a “no pets” rule in place) and usually wear identifiers such as tags, collars and vests to let others know they are “on duty.”

Emotional support animals can include dogs and often do, but could theoretically be any animal that offers an ailing owner comfort in their time of need. Deeply attuned to their owners moods and behaviors, these animals can be allowed (with a “prescription” note from a psychiatrist) to live in places with a “no pets” policy and are protected under the ADA. However, they do not have the training of a service animal and are not allowed to enter the same spaces as designated service dogs.

The benefits of tackling mental health treatment with animal assistance are documented through research, and patients often feel more at ease with a furry companion than an all-too-often unfamiliar and anxiety inducing environment of a hospital.

Patients who disassociate or hallucinate can be calmed and grounded with animal intervention, whether it comes from a trained service dog or engaging tactile grounding techniques petting the family cat. Depression and anxiety can be calmed, and traumatic episodes can be interrupted by the unconditional bond between humans and pets or service animals.

Pets need to play a role in care plans for people at risk of suicide

While further research is clearly needed into the specific benefits of pet ownership and the types of interventions that are most effective, the evidence clearly shows that pets have an important role to play in mental health care. As one of the researchers pointed out, introducing pets is potentially a very powerful intervention because it invites patients to get involved in their own care, creating an opportunity to have an open discussion about what works best for the individual patient.

Obviously, not every patient will respond well to pets, but for those who do, having an animal companion can be the difference between life and death. This is an avenue of treatment that family members, friends and mental health professionals alike need to explore to make sure that people struggling with mental health problems have access to all of the resources and support they need.

So many people at risk of dying by suicide are told “it’s all in your head.” Those words are never true, and they’re never helpful – but they’re perhaps never worse than for people living with chronic pain.

It’s a prevalent problem. The National Center for Complementary and Integrative Health (NCCIH) reports that 25.3 million American adults suffer from chronic pain. And the unfortunate truth is that people who are living in pain every day are at elevated risk of dying by suicide. A study in the United Kingdom found that nearly one in 10 deaths by suicide occurs in people with chronic pain.

It’s not just about the pain – it’s the impact on a person’s life

You might imagine that someone with chronic pain might die by suicide because suicide is a final means of making the pain stop. While there’s some truth to this idea, the pain per se is only part of the story. To see the full picture, we have to examine the full impact of chronic pain on a person’s life.

“It’s a matter of what chronic pain takes away,” writes Erin Midgol of The Mighty. Chronic pain can damage friendships and family relationships because the person with pain is not always able to spend time with others. It can restrict hobbies and activities, limiting enjoyment of life. For many people who live with pain, even getting out of bed in the morning is hardly a guarantee.

Often, people with chronic pain are failed first by the healthcare system. They may be shuffled from doctor to doctor before someone finally takes them seriously. Even then, it can take months or years to find a treatment plan that will make the pain bearable – and even then, the method that works may not be covered by insurance. Meanwhile, chronic pain can make it difficult or impossible to work and earn a living – and many conditions that cause pain do not qualify for disability benefits.

For some, the stigma can be life-threatening

Mental health should be thought of as part of our physical health, and taking care of it should be a priority. However, many groups suffer under the “it’s all in your head” stigma and go without treatment for whatever ailment may be the source of their pain. A staggering 25% of Americans experience chronic pain, and a large number of them are women, possibly due to a high number of autoimmune conditions that affect them more than men.

Members of the LGBT community, who already have a mind-blowing rate of depression and other devastating mental health concerns, may avoid doctors due to fear of discrimination or misgendering. People of color may suffer cultural stigma, particularly men, who tend to not seek out mental health treatment as frequently as their white counterparts.

Pain is not treated on a scale of believability. The way it is treated today echoes past centuries where women’s pain was treated as hysteria, and little was done about any of it. The physical and mental anguish leaves many patients wondering if their pain is simply imaginary, isolating themselves, and severely affects their mental health. We must do better. We must change.

We need to reform our attitudes toward people with pain

The opioid crisis, while certainly a major public health problem that needs to be addressed, has had the unfortunate side effect of exacerbating toxic attitudes toward people with chronic pain. People with chronic pain endure the constant message that they’re abusing their medications – when in fact they’re taking them responsibly.

Beyond that specific issue for this moment in history, people with chronic pain face generations of ingrained messages that they need to “toughen up.” They’re used to being dismissed by society, by doctors, and even by friends and family. It’s no wonder that when mental health issues co-occur with chronic pain, they’re hesitant to seek help. (Not to mention, seeking help for mental health issues carries its own stigma.)

It’s time to break this cycle and change the way we think about chronic pain. There should be absolutely no shame in seeking help for physical and mental health issues alike. We have the means and the capacity to take care of anyone in need of treatment for chronic pain. As we mark the end of Pain Awareness Month, let’s be reminded that the stakes couldn’t be higher.

Youth in our nation could lose their lives

Much has been made of the current administration’s decision to detain migrant children – in fact, the administration recently moved to detain children with their families indefinitely, according to ABC News.

That’s troubling for a host of reasons, the least of which is that putting children in detention facilities has been linked to depression, post-traumatic stress disorder (PTSD), and other mental health problems that can lead to an elevated risk of suicide.

There is much we don’t know – but what we do know isn’t good

As the New York Times reports, child psychologists and human development experts have raised the alarm about the conditions migrant children face in detention facilities. Even the best institutional setting, the Times says, is a poor substitute for a family.

Children need personal connections, stability and consistency in order to thrive, and a detention facility can provide none of those things. Turnover is high among the adult staff, who may be detached and impersonal. Each adult in such a setting is responsible for a large number of children, further limiting the amount of attention each child can receive. In short, detained children – especially migrants in an unfamiliar place and with potential language barriers – are left to long for the care they need, which may not come for a long time, if at all.

In addition to the pure psychological issues, being in a detention facility or institutional setting at an early age can lead to health issues, such as heart disease, later in life. Those physical health issues, in turn, can lead to co-occurring mental health problems such as depression, anxiety, deadly eating disorders, and elevated risk of death by suicide.

The true long-term consequences of being in detention facilities are harder to predict, but the damage is real. Research suggests that a longer stay at a later age may require the longest recovery period. Some children may prove to be more resilient than others, but every child who is detained is at risk.

A glimmer of hope: potential for growth

Shocking and terrible experiences, such as being placed in a detention facility, have a deep and profound effect on the mind. In far too many cases, that effect is permanently damaging, leaving scars that never fully heal – and may later be realized in a death by suicide. But there is potential for survivors to emerge stronger than before, and our hope is to see that potential realized.

Post-traumatic growth (PTG) is the idea that victims of trauma can discover new personal strength, deeper meaning in life and a stronger sense of purpose. According to an NBC News article on the topic, PTG is not the opposite of PTSD; rather, it can happen alongside post-traumatic stress as the victim finds new ways to cope. And it’s more common than you might think – one study showed that 30 to 70 percent of trauma survivors report at least one sign of PTG.

While post-traumatic growth still needs substantial additional research, research suggests that children as young as seven can and do experience PTG – and that there are practical steps adult caregivers can take to nurture them along the way, such as:

• Hearing out a traumatized child’s thoughts and feelings without judgment
• Helping them to understand and process the meaning of traumatic events in a supportive setting.
• Narrative exposure therapy – a clinical technique that encourages survivors to create personally meaningful stories of their experience – can also move children (and adults) on the road toward post-traumatic growth.

It’s possible, even in the darkest of times, to find opportunities to grow and build resilience that will protect the survivor against future mental health issues and the potential risk of death by suicide. But in order to protect these children and help them to find new meaning after trauma, we first need to stop subjecting them to additional trauma, either by reuniting them with their families or finding them new, supportive homes. And then we need to make an immediate and sustained investment in the mental health services and resources they need.

Early intervention is the key to suicide prevention, most of all among those who have experienced severe trauma. These children deserve nothing less.

The collective wisdom of this country knows everything detailed in this blog.  Why do stupid things that hurt children?  What is the point?