DEPRESSION & SUICIDE

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 DEPRESSION
a potentially life-threatening mood disorder

a state of low mood & aversion to activity by someone

who experiences feelings of sadness, helplessness &
hopelessness

more common in people who live in difficult social and

economic circumstances.

More women are affected by depression than men.

(WHO, 2021)

Depression can lead to suicide (WHO, 2021).

Depression has recently become the leading cause of
disability worldwide (WHO, 2017).

About 3.3 million Filipinos are experiencing depressive

symptoms based on the 2015 population estimate
(Philippine Statistics Authority, 2016).

Depression ranked as the 8th single largest cause of

disability in the country (Institute for Health Metrics and
Evaluation, 2017).
 Characteristics of Children/Adolescent
with Depression Behavior
 Predominantly sad facial expression with absence or diminished range
of affective response
 Solitary play or work, tendency to be alone, lack of interest in play with
friends
 Withdrawal from previously enjoyed activities and relationships
 Lowered grades in school; lack of interest doing homework or achieving
in school, refuses to wake up for school
 Diminished motor activity; tiredness
 Tearfulness or crying
 Inability to concentrate
 Dependent and clinging or aggressive and disruptive
 Characteristics of Children/Adolescent
with Depression Behavior
Internal States
• Utterance or statements reflecting lowered self-esteem, sense
of hopelessness, or guilt
• Suicidal ideations
Physiology
• Constipation
• Loss of energy, Fatigue
• Nonspecific complaints of not feeling well
• Change in appetite resulting in weight loss or gain
• Alterations in sleeping pattern, sleeplessness, or hypersomnia
Contributing Factors

• Depression results from a complex interaction of social,

psychological, and biological factors.
• People who have gone through adverse life events
(unemployment, bereavement, traumatic events) are
more likely to develop depression.
• Depression can, in turn, lead to more stress and
dysfunction and worsen the affected person’s life
situation and the depression itself.
Prevention
• School-based programs to enhance a pattern of
positive coping in children and adolescents
• Exercise programs for older persons
Treatment

• behavioral activation
• cognitive behavioral therapy
• interpersonal psychotherapy
• antidepressant medication such as selective serotonin
reuptake inhibitors (SSRIs) and tricyclic
antidepressants (TCAs)
 SUICIDE

The deliberate act of self-injury with the intent that the

injury results in death.
Key Facts (WHO, 2021)
More than 700 000 people die due to suicide every
year.
For every suicide there are many more people who
attempt suicide. A prior suicide attempt is the single
most important risk factor for suicide in the general
population.
Suicide is the fourth leading cause of death among 15-
19 year-olds.
77% of global suicides occur in low- and middle-
income countries.
Ingestion of pesticide, hanging and firearms are among
the most common methods of suicide globally.
 SUICIDE

One of the leading causes of death in children 10-19 years of

age
Adolescent males commit suicide 4x more than do girls, but
girls attempt suicides 5x more often than do boys.
Boys have more violent means of committing suicide than do
girls & thus are successful more often.
Children who have attempted suicide once have a high risk of
attempting it again, perhaps more effectively
Terminologies

Suicidal ideation
 involves a preoccupation with thoughts about committing
suicide & may be a precursor to suicide
 should be taken seriously & an assessment conducted for
appropriate referral
Suicide attempt or Parasuicide
 intended to cause injury or death but is unsuccessful
 refers to behaviors ranging from gestures to serious
attempts to kill oneself
 a deliberate act that might inflict self-harm but results in a
nonfatal outcome
Factors Associated with Suicide Risk
 History
 Individual
 Family
 Social and Environmental
Clinical Manifestations

• verbalize hopelessness
• may begin giving away prized possessions
• appear suddenly elated after a long period of acting
dejected.
Nursing Diagnosis

• Risk for violence, self-directed, related to symptoms of

depression or expressed desire to hurt oneself.
Nursing Management
In caring for young persons who express suicidal feelings,
the nurse’s first responsibility is to ensure their safety.

Degree of Suicidality Assessment

 Specificity
S-L-A-P  Lethality
 Accessibility
 Proximity
Nursing Management

• demonstration of understanding and caring is extremely

therapeutic
• expressing a commitment to keep them safe until they
no longer feel sad is a helpful nursing action
• the adolescent should not be left alone if feeling
actively suicidal
• demonstrate care, open communication, and
understanding
• referral to appropriate mental health services
Prevention
• advocating for social programs that reduce social isolation among
young people
• enhance opportunities for social support
• must be alert to the warning signs of adolescent suicide
• health education on the importance of seeking help when feeling
sad or depressed, sources of available help for depression,
warning signs of suicide
• all youth should be taught that, when a peer talks of suicide, they
must alert someone who is in a position to help, such as: a parent,
teacher, or guidance counselor
 NEVER IGNORE AN ADOLESCENT WHO
THREATENS TO COMMIT SUICIDE.
ASSUME THE ADOLESCENT IS SERIOUS
& ACT ACCORDINGLY.
Expected Outcome

• Client expresses feelings of depression to health care

providers or other adults; states he/she will contact
support person should the desire to commit suicide
become overwhelming.