Warning Signs


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New Warning Signs- Why People Kill Themselves?
Warning Signs of a Mental Health Condition

Common Mental Health Disorders in Children
What are the most common mental disorders affecting young adults ? Top Answers about Health (Anxiety disorders, attention deficit, hyperactivity disorder (ADHD, ADD), Autism Spectrum Disorders (ASD), Bipolar disorder (Manic-depressive illness), Coping with traumatic events, depression, disruptive mood dysregulation disorder, eating disorders, and more

Recognizing the Warning Signs of Suicide
Recognizing Warning Signs of Violence
Warning Signs
Suicide Warning Signs
New Youth Warning Signs: Experts Release Consensus Derived List of Warning Signs for Youth Suicide

Youth Suicide Warning Signs
For youth who may be assessing warning signs in a peer, the list is worded differently, specifically:
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Related topics: Are you feeling suicidal? Attempts, Crisis Text Line, Crisis Trends, Contagion/Clustering, Depression, Emergency Phone/Chat/Text Numbers, Facebook Live , Guns, How to Help, How to talk with your kids about suicide, Mental Illness, Need to Talk?, Online Depression Screening Test , Oregon Suicides 1990 to date, Prevention, Religion, Risk Factors, Safety Plan, Secrets No More, 741741, Semicolon Campaign, Stigma, Struggling Teen, Suicide, Suicide Internationally, Suicide Notes, Suicide Resources, Suicide 10-14 Year-Olds, Teen Depression, Teen Suicide, 3-Day Rule, 13 Reasons Why', Veterans, Warning Signs

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12 Warning Signs of Suicide
Warning Signs in Children and Teens
  • Feeling like a burden
  • Being isolated
  • Increased anxiety
  • Feeling trapped or in unbearable pain
  • Increased substance use
  • Looking for a way to access lethal means
  • Increased anger or rage
  • Extreme mood swings
  • Expressing hopelessness
  • Sleeping too little or too much
  • Talking or posting about wanting to die
  • Making plans for suicide

Source: CDC

  • Changes in eating or sleeping habits
  • Frequent or pervasive sadness
  • Withdrawal from friends, family and regular activities
  • Frequent complaints about physical symptoms often related to emotions, such as stomachaches, headaches, fatigue, etc.
  • Decline in the quality of schoolwork
  • Preoccupation with death and dying
  • Giving away cherished possessions
  • Stop talking about the future

Source: American Academy of Child and Adolescent Psychiatry

90% of men who die by suicide have a diagnosable mental health issue at the time of death.

62.9% had a current depressed mood
46.3% had an intimate partner problem
31.6% had a problem with alcohol
29.6% had a job problem
27.5% had a financial problem
24.3% had a physical health problem

Teen students are more likely to take their life when:

Alcohol or drugs are involved
If their parents are divorced
If they have access to a gun
Are failing education
Are involved in teen pregnancy
Hear of other teen suicides
Have low self-esteem
Are highly sexually active.
Source: brainblogger.com/2014/09/10/back-to-school-suicides/

Warning Signs (short-cut http://bit.ly/2oVIj7U)

Research shows that in 48% of the cases resulting in a suicide attempt, suicide was a spur of the moment decision. In the remaining cases, the days and hours before people kill themselves, there are usually clues and warning signs.

The strongest and most disturbing signs are verbal – ‘I can’t go on,’ ‘Nothing matters any more’ or even ‘I’m thinking of ending it all.’ Such remarks should always be taken seriously. Of course, in most cases these situations do not lead to suicide. But, generally, the more signs a person displays, the higher the risk of suicide.


  • Suffering a major loss or life change
  • Family history of suicide or violence
  • Sexual or physical abuse
  • Death of a close friend or family member
  • Divorce or separation, ending a relationship
  • Failing academic performance, impending exams, exam results
  • Job loss, problems at work
  • Impending legal action
  • Recent imprisonment or upcoming release


  • Showing a marked change in behavior, attitudes or appearance
  • Crying
  • Fighting
  • Behaving recklessly
  • Breaking the law
  • Impulsiveness
  • Abusing drugs or alcohol
  • Self-mutilation
  • Writing about death and suicide
  • Previous suicidal behavior
  • Extremes of behavior
  • Changes in behavior
  • Getting affairs in order and giving away valued possessions

Physical Changes

  • Lack of energy
  • Disturbed sleep patterns – sleeping too much or too little
  • Loss of appetite
  • Becoming depressed or withdrawn
  • Sudden weight gain or loss
  • Increase in minor illnesses
  • Change of sexual interest
  • Sudden change in appearance
  • Lack of interest in appearance

Thoughts and Emotions

  • Thoughts of suicide
  • Loneliness – lack of support from family and friends
  • Rejection, feeling marginalized
  • Deep sadness or guilt
  • Unable to see beyond a narrow focus
  • Daydreaming
  • Anxiety and stress
  • Helplessness
  • Loss of self-worth

New Youth Warning Signs: Experts Release Consensus Derived List of Warning Signs for Youth Suicide

According to the Centers for Disease Control and Prevention (CDC), suicide is the 2nd leading cause of death for youth 15-24 years of age and the 3rd leading cause for 10-14 year olds in the United States. Much needed attention has been given to developing suicide awareness and prevention programs for youth, in particular through the Garrett Lee Smith Youth Suicide Prevention grant program, an initiative supported by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA), however a solid understanding and agreement on the warning signs for youth suicide has never been accomplished.

To address this gap in knowledge, a panel of national and international experts convened to resolve this problem and help the public better understand the way youth think, feel, and behave prior to making life-threatening suicide attempts and inform them about how to effectively respond. The main goal was to determine what changes immediately preceded suicide attempts or deaths that are supported by research and rooted in clinical practice by experts and for the first time we can now confidently put forward that these are the warning signs that a young person might be at risk of suicide.

The newly agreed upon list of warning signs and additional resources for how to respond to recognized risk was released today and can be found at: www.youthsuicidewarningsigns.org

1.Talking about or making plans for suicide.

2.Expressing hopelessness about the future.

3.Displaying severe/overwhelming emotional pain or distress.

4.Showing worrisome behavioral cues or marked changes in behavior, particularly in the presence of the warning signs above. Specifically, this includes significant:

Withdrawal from or changing in social connections/situations

Changes in sleep (increased or decreased)

Anger or hostility that seems out of character or out of context

Recent increased agitation or irritability

Prior to the meeting, the experts reviewed and analyzed all available literature and conducted a survey of youth suicide attempt survivors, as well as those who lost a youth to suicide. The panel was then convened and consisted of researchers with extensive experience working with suicidal youth, public health officials, clinicians with decades of individual experience helping suicidal youth, school teachers, and various other stakeholders including individuals representing national organizations focused on suicide prevention. Following the consensus meeting, focus groups with youth and adults were held to gain their input on the findings and dissemination plans. The following organizations were involved.

  • Aevidum
  • American Association of Suicidology
  • Columbia University
  • Duke University Medical Center
  • George Mason University
  • Indian Health Service
  • National Center for the Prevention of Youth Suicide
  • National Institute of Mental Health
  • Substance Abuse and Mental Health Services Administration
  • Society for the Prevention of Teen Suicide
  • Suicide Awareness Voices of Education
  • The Trevor Project
  • Thomas Jefferson University
  • University of British Columbia
  • University of Chicago
  • University of Colorado, Denver Veterans Administration
  • University of Michigan
  • University of Tel Aviv, Israel
  • Weill Cornell Medical College


Dr. Dan Reidenberg at dreidenberg@save.org or (952) 946-7998 or Dr. Michelle Cornette at cornette@suicidology.org

Source: SOURCE SAVE - Suicide Awareness Voices of Education, www.prnewswire.com/news-releases/experts-release-consensus-derived-list-of-warning-signs-for-youth-suicide-300140396.html

Youth Suicide Warning Signs

  • Talking about or making plans for suicide
  • Expressing hopelessness about the future
  • Displaying severe/overwhelming emotional pain or distress
  • Showing worrisome behavioral cues or marked changes in behavior, particularly in the presence of the warning signs above. Specifically, this includes significant:
    • Withdrawal from or changing in social connections/situations
    • Changes in sleep (increased or decreased)
    • Anger or hostility that seems out of character or out of context
    • Recent increased agitation or irritability

For youth who may be assessing warning signs in a peer, the list is worded differently, specifically:

1. Are they talking about wanting to die, be dead, or about suicide, or are they cutting or burning themselves?
2. Are they feeling like things may never get better, seem to be in terrible emotional pain (like something is wrong deep inside but they can't make it go away) or struggling to deal with a big loss in their life?
3. Is your gut telling you to be worried because they have withdrawn from everyone and everything, have become more worried or on edge, seem unusually angry or just don't seem normal to you?

Warning signs of suicide

Coworkers, family members, and friends can all be valuable resources in identifying people in distress who may be at risk for suicide. Clues may be few or many, verbal or behavioral, direct or indirect, with any combination possible.

Threatening self. Verbal self-threats can be direct: “I’d be better off with a bullet in my brain.” or indirect: “Enjoy the good times while you can — they never last.”

Threatening others. Often, self-loathing is transmuted into hostility toward others, especially toward those believed to be responsible for the subject’s plight. Verbal threats against others can be direct: “I oughta cap that damn supervisor for writing me up.” or indirect: “People with that kind of attitude deserve whatever’s coming to them.”

Nothing to lose. The subject behaves insubordinately or obnoxiously, without regard to career or family repercussions: “I’ll come in to work whenever I damn please. What are they gonna do — fire me?” “Yeah, I called her a bitch — she’s gonna divorce me anyway and take the house and kids, so what do I care what she thinks?”

Surrender of weapons or other lethal means. The subject may fear his/her own impulses, but be reluctant to admit it: “I’m cleaning out my basement this week. Why don’t you hold on to these guns for me?” or “I’ve been a little forgetful lately, so I’m letting my husband hand me out my pills.”

Cry for help. “I’ve been feeling exhausted lately. Maybe I ought to check in to the hospital to see if there’s something wrong with me.”

Brotherhood of the damned. “You know that news story about the guy in Ohio who got fired and divorced and killed his boss, his family, and himself? I know how that poor bastard felt.”

Overwhelmed. “My girlfriend just left me, my kids won’t talk to me, my checks are bouncing, I’m drinking again, and the cops want to talk to me about some bullshit stolen car. I just can’t take all this.”

No way out. “If I go down for that stolen car thing, that’s my last strike. I could go to jail when I didn’t do nothing? No friggin’ way that’s happening.”

Final plans. Without necessarily saying anything, the subject may be observed making or changing a will, paying off debts, showing an increased interest in religion, giving away possessions, making excessive donations to charities, and so on.
Source: www.policeone.com/health-fitness/articles/3704525-Warning-signs-of-suicide/

Recognizing the Warning Signs of Suicide

Here is some information from the National Suicide Prevention Lifeline:

The following signs may mean someone is at risk for suicide. The risk of suicide is greater if a behavior is new or has increased and if it seems related to a painful event, loss, or change. All threats or talk of suicide should be taken seriously. If you or someone you know exhibits any of these signs, seek help as soon as pking about feeling hopeless or having no reason to live.

  • Talking about feeling trapped or in unbearable pain.
  • Talking about being a burden to others.
  • Increasing the use of alcohol or drugs.
  • Acting anxious or agitated; behaving recklessly.
  • Sleeping too little or too much.
  • Withdrawing or feeling isolated.
  • Showing rage or talking about seeking revenge.

Displaying extreme mood swings.ossible.

  • Talking about wanting to die or to kill oneself.
  • Looking for a way to kill oneself, such as searching online or buying a gun.
  • Tal

The National Association of School Psychologists (NASP) reminds us that these are some of the warning signs of suicide:

  • Suicidal threats in the forms of direct and indirect statements
  • Suicide notes and plans
  • Prior suicidal behavior
  • Making final arrangements (e.g., making funeral arrangements, writing a will, giving away prized possessions)
  • Preoccupation with death
  • Changes in behavior, appearance, thoughts and/or feelings.

To learn more about the characteristics of suicide, resiliency factors, what you can do, and community resources to address suicide, please visit our CCSD website and read about "Preventing Youth Suicide -Tips for Parents and Educators."

Warning Signs

Suicide takes the lives of over 47,000 Americans a year, nearly twice as many deaths as from gun violence. There are an estimated 8 to 25 attempts for every completed suicide.

Every 18 minutes someone dies from suicide. More than 50% of suicides are men between 25-65 years of age. For young people, 10-34 years, it is the second leading cause of death.

Despite these grim statisics, you need to know that suicide is preventable. Most people, about 80%, who die by suicide give verbal or behavioral clues to the impending event. The number one cause of suicide is untreated depression. The following are some “warning signs” of suicide.

Note: The diagnosis and treatment of depression and other psychiatric disorders requires trained medical professionals. The information provided below is to be used for educational purposes only. It should NOT be used as a substitute for seeking professional care for the diagnosis and treatment of any mental/psychiatric disorders.

Potential Emotional Indicators

  • Hopelessness/Helplessness
  • Panic/Anxiety
  • Feelings of guilt and/or shame
  • Depression
  • Moodiness
  • Irritability/anger
  • Increased crying
  • Persistently sad or “empty” mood
  • Sudden euphoria or happy/calm mood
  • Feelings of worthlessness

Potential Behavioral Indicators

  • Talking about suicide, making a plan or preoccupation with death
  • Giving prized possessions away
  • Change in weight/appetite
  • Increase or decrease in sleep
  • Dangerous or impulsive behavior
  • Self injurious behavior (i.e. cutting or burning oneself)
  • Drug or alcohol abuse
  • Previous suicide attempts
  • Family history of suicide attempts
  • Withdrawal from family/friends, isolating
  • Preparation for death (i.e. setting one’s affairs in order)
  • Loss of interest in things that normally one cares about

If you suspect a friend or loved one is considering suicide, take your suspicion seriously.
Source: crisisclinic.org/find-help/suicide-support/why-suicide/

Warning Signs

Four out of five teens who attempt suicide give clear warning signs.

Warning Signs of suicidal ideation include, but are not limited, to the following:

  • Talking about suicide
  • Making statements about feeling hopeless, helpless, or worthless
  • A deepening depression
  • Preoccupation with death
  • Taking unnecessary risks or exhibiting self-destructive behavior
  • Out of character behavior
  • A loss of interest in the things one cares about
  • Visiting or calling people one cares about
  • Making arrangements; setting one’s affairs in order
  • Giving prized possessions away

Along with these warning signs, there are certain Risk Factors that can elevate the possibility of suicidal ideation.

  • Perfectionist personalities
  • Gay and Lesbian youth
  • Learning disabled youth
  • Loners
  • Youth with low self-esteem
  • Depressed youth
  • Students in serious trouble
  • Abused, Molested or Neglected Youth
  • Genetic predisposition
  • Parental history of violence, substance abuse, or divorce

You may be the first and last person to see these signs in a young person.
Source: jasonfoundation.com/youth-suicide/warning-signs/

Suicide Warning Signs

  • Appearing depressed or sad most of the time.
  • (Untreated depression is the number one cause for suicide.)
  • Talking or writing about death or suicide.
  • Withdrawing from family and friends.
  • Feeling hopeless.
  • Feeling helpless.
  • Feeling strong anger or rage.
  • Feeling trapped -- like there is no way out of a situation.
  • Experiencing dramatic mood changes.
  • Abusing drugs or alcohol.
  • Exhibiting a change in personality.
  • Acting impulsively.
  • Losing interest in most activities.
  • Experiencing a change in sleeping habits.
  • Experiencing a change in eating habits.
  • Losing interest in most activities.
  • Performing poorly at work or in school.
  • Giving away prized possessions.
  • Writing a will.
  • Feeling excessive guilt or shame.
  • Acting recklessly.

It should be noted that some people who die by suicide do not show any suicide warning signs.

But about 75 percent of those who die by suicide do exhibit some suicide warning signs, so we need to be aware of what the suicide warning signs are and try to spot them in people. If we do see someone exhibiting suicide warning signs, we need to do everything that we can to help them.

If you or someone you know exhibits several of the suicide warning signs listed above, immediate action is required, so please read the information on the home page of this website and take action.

Always take suicide warning signs seriously.
Source: www.suicide.org/suicide-warning-signs.html

Suicide warning signs - Extended

Learn how to recognize the danger signals.

Be concerned if someone you know:

  • Talks about committing suicide
  • Has trouble eating or sleeping
  • Exhibits drastic changes in behavior
  • Withdraws from friends or social activities
  • Loses interest in school, work or hobbies
  • Prepares for death by writing a will and making final arrangements
  • Gives away prized possessions
  • Has attempted suicide before
  • Takes unnecessary risks
  • Has recently experienced serious losses
  • Seems preoccupied with death and dying
  • Loses interest in his or her personal appearance
  • Increases alcohol or drug use.

Feeling suicidal yourself? Call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or the Crisi Text Line text "SOS" at 741741.. This government hotline connects individuals in suicidal crisis to their nearest suicide prevention and mental health service provider.
Source: www.apa.org/topics/suicide/signs.aspx

Warning Signs for Vets

Learn to recognize red flags

People can experience an emotional or mental health crisis due to a wide range of situations. For some, it might be the end of a personal relationship. For others, it might be the loss of a job. For Veterans, these crises can be heightened by their experiences during military service.

When emotional issues reach a crisis point, Veterans and their loved ones should contact the Veterans Crisis Line.

Call 1-800-273-8255 and Press 1 | Chat online | Text 838255

Many Veterans may not show any signs of intent to harm themselves before doing so, but some actions can be a sign that a person needs help. Veterans in crisis may show behaviors that indicate a risk of self-harm. The following can all be warning signs:

  • Appearing sad or depressed most of the time
  • Hopelessness; feeling like there’s no way out
  • Anxiety, agitation, sleeplessness, or mood swings
  • Feeling as if there is no reason to live
  • Feeling excessive guilt, shame, or sense of failure
  • Rage or anger
  • Engaging in risky activities without thinking
  • Losing interest in hobbies, work, or school
  • Increasing alcohol or drug misuse
  • Neglecting personal welfare; a deteriorating physical appearance
  • Withdrawing from family and friends
  • Showing violent behavior, like punching a hole in the wall or getting into fights
  • Giving away prized possessions
  • Getting affairs in order, tying up loose ends, or writing a will

The following signs require immediate attention:

  • Thinking about hurting or killing yourself
  • Looking for ways to kill yourself
  • Talking about death, dying, or suicide
  • Self-destructive behavior such as drug abuse, weapons, etc.

Source: www.veteranscrisisline.net/education/signs-of-crisis?gclid=Cj0KCQjwse-DBhC7ARIsAI8YcWLpXrUWxt9ejHzulE-i43CCIIbQ1I8CtJgkv9QTGTo-uinY-c4B36YaAs6xEALw_wcB

Warning Signs of a Mental Health Condition

1. Feeling sad or withdrawn for more than two weeks.
2. Severe mood swings that cause problems in relationships.
3. Intense worries or fears that get in the the way of daily activities.
4. Sudden overwhelming fear for no reason.
5. Seriously trying to harm or kill oneself or making plans to do so.
6. Not eating, throwing up or using laxatives to lose weight.
7. Significant weight loss or weight gain.
8. Severe out-of-control risk taking behavior
9. Repeated use of drugs or alcohol.
10. Drastic changes in behavior, personality or sleeping habits.
11. Extreme difficulty concentrating or staying still.
Source: www.youtube.com/watch?v=zt4sOjWwV3M

10 Most Common Anxiety Symptoms

1. Headaches migranes
2. Dizziness, light-headed ness, might fall over.
3. Jelly legs or weak legs.
4. Heart Palpitations
5. Sweating
6. Tension and muscle aches
7. Shortness of breath
8. Digestive problems
9. Increased heart rate - Tachycarddia
10. Fatigue and exhaustion
Source: www.youtube.com/watch?v=SDPW3pdlnLk

Why Do People Kill Themselves? New Warning Signs

Latest research to predict who is going to commit suicide

The beeper next to my bed went off at 1:30 a.m. When I called the number, my supervisor said that my client was trying to kill herself. She was on the Canadian side of the Niagara Falls where she deliberately climbed over a railing, walked down a few feet and stood there, 100 feet above the Niagara River. Police cars, firefighters, ambulances, and a crowd of people stood in the dark, watching to see what happens. Does somebody save her? Is she willing to jump? Will she climb back up? She was a librarian, intelligent, with a dark sense of humor colored by an unremitting, depressive episode lasting over a decade. Before I started my car, I received a phone call that first line responders talked her off the ledge. She would attempt suicide two other times before I left the clinic and moved to another state. Every once in awhile those of us who worked at the clinic run into each other and when her name is mentioned, there is agreement that she is probably dead.

Suicide is newsworthy because life is precious. In 1993, a 6-year old girl living in Florida stepped in front of a train. She left a note saying that she "wanted to be with her mother" who recently died from a terminal illness. This is the power of the human mind. A girl in Kindergarten thinks of the past and imagines a future that is so bleak, so devoid of meaningful moments without her mom, that she takes her own life. The same mental tools that distinguish us from other animals, the same mental tools that allow us to solve problems and produce creative works that give us symbolic immortality are the same tools that allow a 6-year old to contemplate a future that is terrible enough to physically leap into an oncoming train. If a 6-year old has the cognitive capacity to kill herself, then we need to step up our efforts to understand and prevent it from happening.

There are a couple of instrumental studies that have helped make a dent in this problem.

1. Researchers dissected 20 suicide notes written by people who attempted suicide with 20 notes written by people who successfully killed themselves. The notes were evaluated on 5 dimensions: sense of burden (would my loved ones be better off without me?), sense of emotional pain (how much suffering is in my life?), escaping negative feelings (is death the answer to ending this pain?), altered social world (is death the answer to my troublesome social relationships?, and hopelessness (is there evidence that life is going to get any better?).

What they found deserves your undivided attention. The biggest difference was that the notes of suicide completers included much more detail about how they were a burden on other people and society at large compared to the attempters. In fact, this sense of burden was the only dimension that distinguished the suicide letters of these two groups. You might be as surprised as me that hopelessness, amount of pain, and the belief that death will end the pain were common themes in the letters of both groups. Other studies have replicated these findings.

In general, people do not commit suicide because they are in pain, they commit suicide because they don't believe there is a reason to live and the world will be better off without them.

2. But perhaps there is another piece of the puzzle that takes us back to the opening story. What is it that enables a person to be strong enough to follow through and swallow an entire bottle of pills, ingest poison, or push the chair out so that they dangle from a rope tied to the ceiling? It might be controversial to use the word courage, grit, or strength in this context. Nevertheless, a suicidal person often must overcome intense emotional distress to commit the final act. Leading suicide researchers speculated that a sense of burden is necessary but insufficient to understand who kills themselves. A person might also require the capacity to harm themselves. A person must be highly tolerant of pain and conflict to make room for the uncomfortable thoughts and feelings that arise when working toward the goal of ending life. This tolerance of distress must be acquired somewhere along the way. Researchers continue to find support for the notion that the greatest suicidal risk exists for people who believe they are a burden on society AND possess a history where they acquired the capacity to harm themselves. This acquired capability can arise in unusual ways such as:

  • playing violent and extreme sports
  • getting multiple body piercings and tatoos
  • shooting guns
  • getting in physical fights

These types of painful and provocative events offer a sense of fearlessness about lethal self-injury. A person might respond positively to items such as “Things that scare most people don’t scare me” and “I can tolerate more pain than most people.”

If you remain unconvinced about the importance of an acquired capacity to tolerate pain and distress, consider these sobering figures. One in 25 people who sought health care services at a hospital because of self-harm or self-injurious behavior will kill themselves in the next 5 years. By dealing with deep distress and emotional pain by harming yourself with acts such as cutting, burning, sticking objects in your skin, or intentionally preventing wounds from healing, you are becoming increasingly capable of suicide.

One of the odd things about this line of research is that in any other context, high pain tolerance is a strength, a gift, a form of emotional agility that allows a person to be more successful and satisfied with life. This is why I bring this research up. Look at the motives behind people's actions because what we might view as an admirable strength in another context, is a fatal risk factor.

Do not grow weary from the endless news stories of war veterans and emotionally distressed kids, teenagers, and adults who commit suicide. Let these stories be a call to action. And we have some valuable science to guide us in the right direction.

Carroll, R., Metcalfe, C., Gunnell, D. (2014). Hospital Presenting Self-Harm and Risk of Fatal and Non-Fatal Repetition: Systematic Review and Meta-Analysis. PLoS ONE 9(2): e89944. doi:10.1371/journal.pone.0089944

Joiner, T. E., Pettit, J. W., Walker, R. L., Voelz, Z. R., Cruz, J., Rudd, M. D., & Lester, D. (2002). Perceived burdensomeness and suicidality: Two studies on the suicide notes of those attempting and those completing suicide. Journal of Social and Clinical Psychology, 21(5), 531-545.

Van Orden, K. A., Witte, T. K., Gordon, K. H., Bender, T. W., & Joiner Jr, T. E. (2008). Suicidal desire and the capability for suicide: tests of the interpersonal-psychological theory of suicidal behavior among adults. Journal of Consulting and Clinical Psychology, 76(1), 72-83.

Dr. Todd B. Kashdan is a public speaker, psychologist, and professor of psychology and senior scientist at the Center for the Advancement of Well-Being at George Mason University. His 2014 book, The upside of your dark side: Why being your whole self - not just your “good” self - drives success and fulfillment is available for pre-order. If you're interested in speaking engagements or workshops, go to: toddkashdan.com
Source: www.psychologytoday.com/blog/curious/201405/why-do-people-kill-themselves-new-warning-signs

How to Help Someone Else

If someone is feeling depressed or suicidal, our first response is to try to help. We offer advice, share our own experiences, try to find solutions. We’d do better to be quiet and listen. People who feel suicidal don’t want answers or solutions. They want a safe place to express their fears and anxieties, to be themselves.

Listening – really listening – is not easy. We must control the urge to say something – to make a comment, add to a story or offer advice. We need to listen not just to the facts that the person is telling us but to the feelings that lie behind them. We need to understand things from their perspective, not ours.

Here are some points to remember if you are helping a person who feels suicidal.

  • They want someone to listen. Someone who will take time to really listen to them. Someone who won’t judge, or give advice or opinions, but will give their undivided attention.
  • They want someone to trust. Someone who will respect them and won’t try to take charge. Someone who will treat everything in complete confidence.
  • They want someone to care. Someone who will make themselves available, put the person at ease and speak calmly. Someone who will reassure, accept and believe. Someone who will say, ‘I care.’

What do people who feel suicidal not want?

  • They don't want to be alone. Rejection can make the problem seem ten times worse. Having someone to turn to makes all the difference. Listen.
  • They don't want to be advised. Lectures don’t help. Nor does a suggestion to ‘cheer up’, or an easy assurance that ‘everything will be okay.’ Don’t analyze, compare, categorize or criticize. Listen.
  • They don't want to be interrogated. Don’t change the subject, don’t pity or patronize. Talking about feelings is difficult. People who feel suicidal don’t want to be rushed or put on the defensive. Listen.

So, if you are concerned that someone you know may be thinking of suicide, you can help. Remember, as a helper, do not promise to do anything you do not want to do or that you cannot do.

First of all...

If the person is actively suicidal, get help immediately. Call your local crisis service or the police, or take the person to the emergency room of your local hospital. Do not leave the person alone.

If the person has attempted suicide and needs medical attention, call 9-1-1 or your local emergency services number.

The following are suggestions for helping someone who is suicidal:

Ask the person - "Are you thinking of suicide?" Ask them if they have a plan and if they have the means. Asking someone if they are suicidal will not make them suicidal. Most likely they will be relieved that you have asked. Experts believe that most people are ambivalent about their wish to die.

Listen actively to what the person is saying to you. Remain calm and do not judge what you are being told. Do not advise the person not to feel the way they are.

Reassure the person that there is help for their problems and reassure them that they are not "bad" or "stupid" because they are thinking about suicide.

Help the person break down their problem(s) into more manageable pieces. It is easier to deal with one problem at a time.

Emphasize that there are ways other than suicide to solve problems. Help the person to explore these options, for example, ask them what else they could do to change their situation.

Offer to investigate counselling services.

Do not agree to keep the person's suicidal thoughts or plans a secret. Helping someone who is suicidal can be very stressful. Get help - ask family members and friends for their assistance and to share the responsibility.

Suggest that the person see a doctor for a complete physical. Although there are many things that family and friends can do to help, there may be underlying medical problems that require professional intervention. Your doctor can also refer patients to a psychiatrist, if necessary.

Try to get the person to see a trained counselor. Do not be surprised if the person refuses to go to a counselor - but be persistent. There are many types of caregivers for the suicidal. If the person will not go to a psychologist, or a psychiatrist, suggest, for example, they talk to a clergyperson, a guidance counselor or a teacher.

Most suicide attempts are unsuccessful—except when it comes to guns.

Suicides in Oregon: Trends and Risk Factors - 2012 Report (49 pages)

Key Findings

In 2010, the age-adjusted suicide rate among Oregonians of 17.1 per 100,000 was 41 percent higher than the national average.

The rate of suicide among Oregonians has been increasing since 2000.

Suicide rates among adults ages 45-64 rose approximately 50 percent from 18.1 per 100,000 in 2000 to 27.1 per 100,000 in 2010. The rate increased more among women ages 45-64 than among men of the same age during the past 10 years.

Suicide rates among men ages 65 and older decreased approximately 15 percent from nearly 50 per 100,000 in 2000 to 43 per 100,000 in 2010.

Men were 3.7 times more likely to die by suicide than women. The highest suicide rate occurred among men ages 85 and over (76.1 per 100,000). Non-Hispanic white males had the highest suicide rate among all races / ethnicity (27.1 per 100,000). Firearms were the dominant mechanism of injury among men who died by suicide (62%).

Approximately 26 percent of suicides occurred among veterans. Male veterans had a higher suicide rate than non-veteran males (44.6 vs. 31.5 per 100,000). Significantly higher suicide rates were identified among male veterans ages 18-24, 35-44 and 45-54 when compared to non-veteran males. Veteran suicide victims were reported to have more physical health problems than non-veteran males.

Psychological, behavioral, and health problems co-occur and are known to increase suicide risk. Approximately 70 percent of suicide victims had a diagnosed mental disorder, alcohol and /or substance use problems, or depressed mood at time of death.

Despite the high prevalence of mental health problems, less than one third of male victims and about 60 percent of female victims were receiving treatment for mental health problems at the time of death.

Eviction/loss of home was a factor associated with 75 deaths by suicide in 2009-2010.

2 Investigators suspect that one in four suicide victims had used alcohol in the hours prece ding their death.

The number of suicides in each month varies; there was not a clear seasonal pattern. Baker, Coos, Curry, Douglas, Grant, Harney, Jackson, Josephine, Lincoln, Klamath and Tillamook counties had a higher than state average suicide rate; and Benton, Clackamas, Hood River, Washington, and Yamhill counties had a lower than state average suicide rate.

How to Tell if Your Teen is Being Bullied

There are many warning signs that may indicate that someone is affected by bullying—either being bullied or bullying others. Recognizing the warning signs is an important first step in taking action against bullying. Not all children who are bullied or are bullying others ask for help.

It is important to talk with children who show signs of being bullied or bullying others. These warning signs can also point to other issues or problems, such as depression or substance abuse. Talking to the child can help identify the root of the problem.

  • Signs a Child is Being Bullied
  • Signs a Child is Bullying Others
  • Why don’t kids ask for help?

Signs a Child is Being Bullied
Look for changes in the child. However, be aware that not all children who are bullied exhibit warning signs.

Some signs that may point to a bullying problem are:

  • Unexplainable injuries
  • Lost or destroyed clothing, books, electronics, or jewelry
  • Frequent headaches or stomach aches, feeling sick or faking illness
  • Changes in eating habits, like suddenly skipping meals or binge eating. Kids may come home from school hungry because they did not eat lunch.
  • Difficulty sleeping or frequent nightmares
  • Declining grades, loss of interest in schoolwork, or not wanting to go to school
  • Sudden loss of friends or avoidance of social situations
  • Feelings of helplessness or decreased self esteem
  • Self-destructive behaviors such as running away from home, harming themselves, or talking about suicide

If you know someone in serious distress or danger, don’t ignore the problem. Get help right away.

Signs a Child is Bullying Others

Kids may be bullying others if they:

  • Get into physical or verbal fights
  • Have friends who bully others
  • Are increasingly aggressive
  • Get sent to the principal’s office or to detention frequently
  • Have unexplained extra money or new belongings
  • Blame others for their problems
  • Don’t accept responsibility for their actions
  • Are competitive and worry about their reputation or popularity

Why don't kids ask for help?

Statistics from the 2008–2009 School Crime Supplement show that an adult was notified in only about a third of bullying cases. Kids don’t tell adults for many reasons:

  • Bullying can make a child feel helpless. Kids may want to handle it on their own to feel in control again. They may fear being seen as weak or a tattletale.
  • Kids may fear backlash from the kid who bullied them.
  • Bullying can be a humiliating experience. Kids may not want adults to know what is being said about them, whether true or false. They may also fear that adults will judge them or punish them for being weak.
  • Kids who are bullied may already feel socially isolated. They may feel like no one cares or could understand.
  • Kids may fear being rejected by their peers. Friends can help protect kids from bullying, and kids can fear losing this support.

Source: www.stopbullying.gov/at-risk/warning-signs/index.html

How to Tell if Your Teen is Being Cyberbullied

Only 10% of teenagers report they’ve been cyberbullied to their parents. When asked why they don’t report cyberbullying, they responded:

  • 40% were scared their parents would get involved
  • 36% worried what their parents would do
  • 32% said they felt ashamed

While parents know cyberbullying happens, approximately 94% underestimate the amount of conflict that occurs on social media sites, and only 7% of US parents actually worry about cyberbullying. Parents should be aware of the following signs that point to their teenager being cyberbullied:

  • Sudden loss of friends
  • Changes in eating habits
  • Avoidance of social situations
  • Sudden decrease in phone or computer use
  • Apparent nervousness when receiving a text, email, or instant message
  • Anger, depression, or frustration after phone or computer use
  • Hesitation when participating in favorite activities
  • Self-destructive behaviors such as self-harm or discussion of death or suicide
  • Asking to have social media accounts shut down
  • Having uncharacteristic behaviors
  • Frequently feeling ill
  • Decreased self-esteem

Source: www.rawhide.org/blog/wellness/teen-cyberbullying-and-social-media-use-on-the-rise/

Warning Signs of Abuse and Domestic Violence

The following questions ask you about your relationship. If you are not currently in a relationship, these are signs or “red flags” to assist people in identifying a potentially abusive person.

  • Do you feel nervous around your partner?
  • Do you have to be careful to control your behavior to avoid your partner’s anger?
  • Do you feel pressured by your partner when it comes to sex?
  • Are you scared of disagreeing with your partner?
  • Does your partner criticize you, or humiliate you in front of other people?
  • Is your partner always checking up on you or questioning you about what you do without your partner?
  • Does your partner control where you go or check the mileage on your car?
  • Does your partner repeatedly and wrongly accuse you of seeing or flirting with other people?
  • Does your partner tell you that if you changed, he or she wouldn’t treat you like this?
  • Does your partner’s jealousy stop you from seeing friends or family?
  • Does your partner make you feel like you are wrong, stupid, crazy, or inadequate?
  • Has your partner ever scared you with violence or threatening behavior?
  • Does your partner throw or break objects to intimidate you?
  • Does your partner make you feel scared by driving too fast and refusing to slow down when you ask?
  • Does your partner say, “I will kill myself if you break up with me” or “I will hurt/kill you if you break up with me”?
  • Does your partner make excuses for the abusive behavior? For example: saying, “It’s because of alcohol or drugs,” or “I can’t control my temper,” or “I was just joking”?
  • Does your partner brag about bullying or harming others or animals?
  • Has your partner abused or killed your animals?
  • Does your partner impose stereotypical gender roles?

You do not deserve to be abused. Create a safety plan or call someone to talk about your relationship. You may also want to contact the National Domestic Violence Hotline at (800) 799-SAFE to be contacted to a local organization.
Source: stoprelationshipabuse.org/educated/warning-signs-of-abuse/

Warning signs of mental illness

Every form of mental illness has its own symptoms but the National Alliance on Mental Illness, www.nami.org, reports that some common signs in adults and teens can include:

  • Excessive worrying or fear
  • Feeling very sad or low
  • Confused thinking or difficulty with concentrating and learning
  • Extreme mood changes
  • Strong feelings of irritability or anger
  • Avoiding friends and social activities
  • Difficulty understanding or relating to other people
  • Changes in sleeping habits or feeling tired
  • Changes in eating habits
  • Changes in sex drive
  • Difficulty perceiving reality
  • Inability to recognize changes in one's own feelings, behavior or personality
  • Substance abuse
  • Multiple physical ailments without obvious causes (such as headaches, stomach aches, vague and ongoing aches and pains)
  • Thinking about suicide
  • Inability to carry out daily activities or handle daily problems
  • An intense fear of weight gain or concern with appearance (mostly in adolescents

For young children, because they're still learning how to identify and talk about thoughts and emotions, their most obvious symptoms are behavioral, and may include:

  • Changes in school performance
  • Excessive worry or anxiety, for instance fighting to avoid bed or school
  • Hyperactive behavior
  • Frequent nightmares
  • Frequent disobedience or aggression
  • Frequent temper tantrums

Source: www.freep.com/story/life/family/2015/02/27/teen-mental-health-conference/24152679/

Veterans Warning Signs

  • Hopelessness; feeling like there’s no way out
  • Anxiety, agitation, sleeplessness, mood swings
  • Feeling like there is no reason to live
  • Rage or anger
  • Engaging in risky activities without thinking
  • Increasing alcohol or drug abuse
  • Withdrawing from family and friends

The presence of the following signs requires immediate attention:

  • Thinking about hurting or killing yourself
  • Looking for ways to kill yourself
  • Talking about death, dying, or suicide
  • Self-destructive behavior such as drug abuse, weapons, etc.

Even if there is no immediate danger, the Veterans Crisis Line is here for you. Crisis feels different for everybody and can stem from a wide range of situations. Some Veterans are coping with aging, stress, relationship problems, financial or legal issues, or lingering effects stemming from their military service, which were never addressed. Some Veterans have difficulty with their relationships or the transition back to civilian life.

Whatever’s got you down—chronic pain, anxiety, depression, sleeplessness, anger, or even homelessness—a Veterans Crisis Line responder can provide support, day or night.

Learn to Recognize the Signs

Many Veterans may not show any signs of intent to harm themselves before doing so, but some actions can be a sign that a Veteran needs help. Veterans in crisis may show behaviors that indicate a risk of harming themselves.

Veterans who are considering suicide often show signs of depression, anxiety, low self-esteem, and/or hopelessness, such as:

  • Appearing sad or depressed most of the time
  • Clinical depression: deep sadness, loss of interest, trouble sleeping and eating—that doesn’t go away or continues to get worse
  • Feeling anxious, agitated, or unable to sleep
  • Neglecting personal welfare, deteriorating physical appearance
  • Withdrawing from friends, family, and society, or sleeping all the time
  • Losing interest in hobbies, work, school, or other things one used to care about
  • Frequent and dramatic mood changes
  • Expressing feelings of excessive guilt or shame
  • Feelings of failure or decreased performance
  • Feeling that life is not worth living, having no sense of purpose in life
  • Talk about feeling trapped—like there is no way out of a situation
  • Having feelings of desperation, and saying that there’s no solution to their problems

Their behavior may be dramatically different from their normal behavior, or they may appear to be actively contemplating or preparing for a suicidal act through behaviors such as:

  • Performing poorly at work or school
  • Acting recklessly or engaging in risky activities—seemingly without thinking
  • Showing violent behavior such as punching holes in walls, getting into fights or self-destructive violence; feeling rage or uncontrolled anger or seeking revenge
  • Looking as though one has a “death wish,” tempting fate by taking risks that could lead to death, such as driving fast or running red lights
  • Giving away prized possessions
  • Putting affairs in order, tying up loose ends, and/or making out a will
  • Seeking access to firearms, pills, or other means of harming oneself

If you are a Veteran or know a Veteran who is showing any of the above warning signs, please call the Veterans Crisis Line , chat online , or send a text message today.
Source: www.veteranscrisisline.net/SignsOfCrisis/Identifying.aspx

Warning SIgns: The Chocking Game

Any suspicious mark on the side of the neck, sometimes hidden by a turtleneck, scarf or permanently turned-up collar.

  • Changes in personality, such as overtly aggressive or agitated.
  • Any kind of strap, rope or belt lying around near the child for no clear reason—and attempts to elude questions about such objects.
  • Headaches (sometimes excruciatingly bad ones), loss of concentration, flushed face.
  • Bloodshot eyes or any other noticeable signs of eye stress.
  • A thud in the bedroom or against a wall—meaning a fall in cases of solitary practice.
  • Any questions about the effects, sensations or dangers of strangulation.

How Can You Tell If Your Child Has Been Using Marijuana?

If someone is actually high on marijuana, there may be some visible signs that they are under the influence:

  • They may seem unsteady on their feet or appear dizzy
  • They could have bloodshot eyes
  • They might laugh inappropriately or seem silly for no reason
  • They may have difficulty remembering something that just happened
  • As the effects wear off, they may become sleepy

Evidence of Smoking Behavior

Even if they are not visibly high, there are some signs you can look for that linger after they have been smoking:

  • The smell. The odor will linger and cling to their clothes
  • Drug paraphernalia such as rolling papers or pipes
  • A sudden uncharacteristic use of eye drops
  • The use of incense or room deodorizers
  • Pro-drug slogans on t-shirts or posters
  • Evidence of smoking, such as lighters, ashes

Sudden Behavioral Changes

Although these behavioral changes could be related to other typical teenage issues, they also could indicate marijuana use:

  • Tiredness
  • Hostility or mood swings
  • Social withdrawal
  • Depression
  • Declining attention to hygiene, grooming
  • Deteriorating relationships

Changes in Interests

These signs could also indicate other teenage-related problems, they also could be prompted by the use of marijuana:

  • A change in friends or peer group
  • Declining grades in school
  • Increased absenteeism or truancy
  • Changes in eating habits
  • A change in sleep patterns
  • Loss of interest in sports or other activities
  • Behavioral problems at school
  • Brushes with the law

If you suspect that your child has been using marijuana, you may want to just sit down and talk to them about it. If your child is using marijuana, chances are he or she will deny it and blame any evidence you found on someone else.

But, carefully watch their reaction to your conversation with them. If they over-react, that too could be an indication of their involvement with marijuana or other drugs.

How about drug testing your child? There are home drug tests available that parents can use to test their children, but be aware that there are some drawbacks when parents decide to test their kids.


National Institute on Drug Abuse. "Marijuana: Facts Parents Need to Know. " Publications March 2014

Partnership for Drug-Free Kids. "If You Catch Your Teen Smoking Pot ."
Source: www.verywell.com/how-can-i-tell-if-my-child-has-been-using-marijuana-63542

Depression Symptoms and Warning Signs

Recognizing Depression and Getting the Help You Need

Feeling down from time to time is a normal part of life, but when emotions such as hopelessness and despair take hold and just won't go away, you may have depression. Depression makes it tough to function and enjoy life like you once did. Just getting through the day can be overwhelming. But no matter how hopeless you feel, you can get better. Learning about depression—and the many things you can do to help yourself—is the first step to overcoming the problem.

How do you experience depression?

While some people describe depression as “living in a black hole” or having a feeling of impending doom, others feel lifeless, empty, and apathetic. Men in particular may even feel angry and restless. No matter how you experience it, depression is different from normal sadness in that it engulfs your day-to-day life, interfering with your ability to work, study, eat, sleep, and have fun.

Some people feel like nothing will ever change. But it’s important to remember that feelings of helplessness and hopelessness are symptoms of depression—not the reality of your situation. You can do things today to start feeling better.

What are the symptoms of depression?

Depression varies from person to person, but there are some common signs and symptoms. It’s important to remember that these symptoms can be part of life’s normal lows. But the more symptoms you have, the stronger they are, and the longer they’ve lasted—the more likely it is that you’re dealing with depression.

Symptoms of depression include:

  • Feelings of helplessness and hopelessness. A bleak outlook—nothing will ever get better and there’s nothing you can do to improve your situation.
  • Loss of interest in daily activities. You don’t care anymore about former hobbies, pastimes, social activities, or sex. You’ve lost your ability to feel joy and pleasure.
  • Appetite or weight changes. Significant weight loss or weight gain—a change of more than 5% of body weight in a month.
  • Sleep changes. Either insomnia, especially waking in the early hours of the morning, or oversleeping.
  • Anger or irritability. Feeling agitated, restless, or even violent. Your tolerance level is low, your temper short, and everything and everyone gets on your nerves.
  • Loss of energy. Feeling fatigued, sluggish, and physically drained. Your whole body may feel heavy, and even small tasks are exhausting or take longer to complete.
  • Self-loathing. Strong feelings of worthlessness or guilt. You harshly criticize yourself for perceived faults and mistakes.
  • Reckless behavior. You engage in escapist behavior such as substance abuse, compulsive gambling, reckless driving, or dangerous sports.
  • Concentration problems. Trouble focusing, making decisions, or remembering things.
  • Unexplained aches and pains. An increase in physical complaints such as headaches, back pain, aching muscles, and stomach pain.

Is it depression or bipolar disorder?

Bipolar disorder, also known as manic depression, involves serious shifts in moods, energy, thinking, and behavior. Because it looks so similar to depression when in the low phase, it is often overlooked and misdiagnosed. This is a problem, because antidepressants for bipolar depression can make the condition worse. If you’ve ever gone through phases where you experienced excessive feelings of euphoria, a decreased need for sleep, racing thoughts, and impulsive behavior, consider getting evaluated for bipolar disorder. See: Bipolar Disorder Signs and Symptoms.

Depression and suicide risk

Depression is a major risk factor for suicide. The deep despair and hopelessness that goes along with depression can make suicide feel like the only way to escape the pain. If you have a loved one with depression, take any suicidal talk or behavior seriously and watch for the warning signs:

  • Talking about killing or harming one’s self
  • Expressing strong feelings of hopelessness or being trapped
  • An unusual preoccupation with death or dying
  • Acting recklessly, as if they have a death wish (e.g. speeding through red lights)
  • Calling or visiting people to say goodbye
  • Getting affairs in order (giving away prized possessions, tying up loose ends)
  • Saying things like “Everyone would be better off without me” or “I want out”
  • A sudden switch from being extremely depressed to acting calm and happy.

If you think a friend or family member is considering suicide, express your concern and seek help immediately. Talking openly about suicidal thoughts and feelings can save a life.

If You Are Feeling Suicidal...

When you’re feeling depressed or suicidal, your problems don’t seem temporary—they seem overwhelming and permanent. But with time, you will feel better, especially if you get help. There are many people who want to support you during this difficult time, so please reach out!

Read Suicide Help or call 1-800-273-TALK in the U.S. or visit IASP or Suicide.org to find a helpline in your country.

The symptoms of depression can vary with gender and age

Depression often varies according to age and gender, with symptoms differing between men and women, or young people and older adults.

Depression in men. Depressed men are less likely to acknowledge feelings of self-loathing and hopelessness. Instead, they tend to complain about fatigue, irritability, sleep problems, and loss of interest in work and hobbies. They’re also more likely to experience symptoms such as anger, aggression, reckless behavior, and substance abuse.

Depression in women. Women are more likely to experience symptoms such as pronounced feelings of guilt, excessive sleeping, overeating, and weight gain. Depression in women is also impacted by hormonal factors during menstruation, pregnancy, and menopause. Up to 1 in 7 women experience depression following childbirth, a condition known as postpartum depression.

Depression in teens. Irritability, anger, and agitation are often the most noticeable symptoms in depressed teens—not sadness. They may also complain of headaches, stomachaches, or other physical pains.

Depression in older adults. Older adults tend to complain more about the physical rather than the emotional signs and symptoms of depression: things like fatigue, unexplained aches and pains, and memory problems. They may also neglect their personal appearance and stop taking critical medications for their health.

Types of depression

Depression comes in many shapes and forms. Knowing what type of depression you have can help you manage your symptoms and get the most effective treatment.

Major depression

Major depression is much less common than mild or moderate depression and is characterized by intense, relentless symptoms.

Left untreated, major depression typically lasts for about six months.

Some people experience just a single depressive episode in their lifetime, but major depression can be a recurring disorder.

Atypical depression

Atypical depression is a common subtype of major depression with a specific symptom pattern. It responds better to some therapies and medications than others, so identifying it can be helpful.

  • People with atypical depression experience a temporary mood lift in response to positive events, such as after receiving good news or while out with friends.
  • Other symptoms of atypical depression include weight gain, increased appetite, sleeping excessively, a heavy feeling in the arms and legs, and sensitivity to rejection.

Dysthymia (recurrent, mild depression)

Dysthymia is a type of chronic “low-grade” depression. More days than not, you feel mildly or moderately depressed, although you may have brief periods of normal mood.

  • The symptoms of dysthymia are not as strong as the symptoms of major depression, but they last a long time (at least two years).
  • Some people also experience major depressive episodes on top of dysthymia, a condition known as “double depression.”
  • If you suffer from dysthymia, you may feel like you’ve always been depressed. Or you may think that your continuous low mood is “just the way you are.”

Seasonal affective disorder (SAD)

For some people, the reduced daylight hours of winter lead to a form of depression known as seasonal affective disorder (SAD). SAD affects about 1% to 2% of the population, particularly women and young people.

  • SAD can make you feel like a completely different person to who you are in the summer: hopeless, sad, tense, or stressed, with no interest in friends or activities you normally love.
  • SAD usually begins in fall or winter when the days become shorter and remains until the brighter days of spring.

Depression causes and risk factors

While some illnesses have a specific medical cause, making treatment straightforward, depression is more complicated. Depression is not just the result of a chemical imbalance in the brain that can be simply cured with medication. It’s caused by a combination of biological, psychological, and social factors. In other words, your lifestyle choices, relationships, and coping skills matter just as much—if not more so—than genetics.

Risk factors that make you more vulnerable to depression include:

  • Loneliness and isolation
  • Lack of social support
  • Recent stressful life experiences
  • Family history of depression
  • Marital or relationship problems
  • Financial strain
  • Early childhood trauma or abuse
  • Alcohol or drug abuse
  • Unemployment or underemployment
  • Health problems or chronic pain

    The cause of your depression helps determine the treatment

    Understanding the underlying cause of your depression may help you overcome the problem. For example, if you are depressed because of a dead end job, the best treatment might be finding a more satisfying career, not taking an antidepressant. If you are new to an area and feeling lonely and sad, finding new friends will probably give you more of a mood boost than going to therapy. In such cases, the depression is remedied by changing the situation.

What you can do to feel better

When you’re depressed, it can feel like there’s no light at the end of the tunnel. But there are many things you can do to lift and stabilize your mood. The key is to start with a few small goals and slowly build from there, trying to do a little more each day. Feeling better takes time, but you can get there by making positive choices for yourself.

What you can do

  • Reach out to other people. Isolation fuels depression, so reach out to friends and loved ones, even if you feel like being alone or don’t want to be a burden to others. The simple act of talking to someone face-to-face about how you feel can be an enormous help. The person you talk to doesn’t have to be able to fix you. He or she just needs to be a good listener—someone who’ll listen attentively without being distracted or judging you.

Get moving. When you’re depressed, just getting out of bed can seem daunting, let alone exercising. But regular exercise can be as effective as antidepressant medication in countering the symptoms of depression. Take a short walk or put some music on and dance around. Start with small activities and build up from there.

Eat a mood boosting diet. Reduce your intake of foods that can adversely affect your mood, such as caffeine, alcohol, trans fats, sugar, and refined carbs. And increase mood-enhancing nutrients such as Omega-3 fatty acids.

Find ways to engage again with the world. Spend some time in nature, care for a pet, volunteer, pick up a hobby you used to enjoy (or take up a new one). You won’t feel like it at first, but as you participate in the world again, you will start to feel better.

For more information, see: Coping with Depression

When to seek professional help

If support from family and friends and positive lifestyle changes aren’t enough, find a therapist who can help you heal.

Therapy can help you understand your depression and motivate you to take the action necessary to prevent it from coming back.

Medication may be imperative if you’re feeling suicidal or violent. But while it can help relieve symptoms of depression in some people, it isn’t a cure and is not usually a long-term solution. It also comes with side effects and other drawbacks so it’s important to learn all the facts to make an informed decision.

More help for depression

Parent's Guide to Teen Depression: Recognizing the Signs and Helping Your Child

Teenager's Guide to Depression: Tips and Tools for Helping Yourself or a Friend

Depression in Men: What it Looks Like and How to Get Help

Resources and references

Signs and symptoms of depression

Signs and Symptoms of Mood Disorders – Lists the common signs and symptoms of depression and bipolar disorder. (Depression and Bipolar Support Alliance)

What Does Depression Feel Like? – Provides a list of signs and symptoms and ways you might feel if you're depressed. (Wings of Madness)

When Depression Hurts – Article on the painful physical symptoms of depression, including what causes them and how treatment can help. (Psychology Today)

Male Depression: Don't Ignore the Symptoms – Learn about the distinct symptoms of depression in men and the dangers of leaving them untreated. (Mayo Clinic)

Types of depression

The Different Faces of Depression – Discussion of the different subtypes of depression, including atypical depression, melancholic depression, and psychotic depression. (Psychology Today)

Atypical Depression: What's in a Name? – Article on the symptoms, diagnosis, and treatment of atypical depression. (American Psychiatric Association)

Dysthymia: Psychotherapists and patients confront the high cost of “low-grade” depression – In-depth look at the causes, effects, and treatment of dysthymic disorder. (Harvard Health Publications)

Seasonal Affective Disorder: Winter Depression – Guide to seasonal affective disorder and its symptoms, causes, and treatment. (Northern County Psychiatric Associates)

Depression causes and risk factors

What Causes Depression? Page 1 & Page 2 – Learn about the many potential causes of depression, including genes, temperament, stressful life events, and medical issues. (Harvard Health Publications)

Depression and Other Illnesses – An overview of the mental and physical illnesses that often co-exist with depression, and how this impacts treatment. (Depression and Bipolar Support Alliance)

Co-occurring Disorders and Depression – How medical disorders can affect depression and vice versa. (Mental Health America)
Source: www.helpguide.org/articles/depression/depression-symptoms-and-warning-signs.htm

How to Respond

If you notice any of these warning signs in anyone, you can help!

  • Ask if they are ok or if they are having thoughts of suicide
  • Express your concern about what you are observing in their behavior
  • Listen attentively and non-judgmentally
  • Reflect what they share and let them know they have been heard
  • Tell them they are not alone
  • Let them know there are treatments available that can help
  • If you are or they are concerned, guide them to additional professional help

Are you still concerned? Here is how you can get more help.

If you think that your child or another youth may need help right now, call 24/7 the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or Text the National Crisis Text Line text "SOS" at 741741. Your call or text is free and confidential. Trained crisis workers in your area can assist you and the youth in deciding what they need right now.

Remember, if anyone is harming themselves now or has just harmed themselves, call 911 or take them to an emergency room immediately.
Source: www.youthsuicidewarningsigns.org/#!healthcare-professionals/cm0e

Police intervention and the suicidal subject: Principles of crisis intervention

How can police officers effectively intervene against citizens' attempted suicide?

I previously examined many of the facts and fictions associated with suicide, as well as some of the warning signs to watch out for when you come into contact with citizens who might have suicidal tendencies.

If the warning signs have been missed, the first chance to intervene with a depressed, suicidal subject may come when the crisis is already peaking. The intervener’s task now is to keep the subject alive long enough to get appropriate follow-up care, and this can be accomplished by applying some fundamental principles of crisis intervention.


Related article

Police intervention and the suicidal subject: Suicide facts and fictions

Define the Problem

While some personal crises relate to a specific incident, many evolve cumulatively as the result of a number of overlapping stressors, until a “breaking point” is reached. In such cases, the subject himself may be unclear as to what exactly led to the present suicidal state. By helping the subject clarify what’s plaguing him, nonlethal options and coping resources may be explored. It also shows that the intervener is listening and trying to understand.

SUBJECT: My life is out of control. I don’t see any way out.

INTERVENER: What’s out of control?

SUBJECT: Everything, man, everything. The job, my wife – it’s all crap.

INTERVENER: Can you give me an example? What about the job?

SUBJECT: I work like a slave all year, put in for extra overtime, volunteer for the boss’s pet programs, and then they tell me the city says there’s no more raises, overtime, or bonuses this year – that’s after we already put the down payment on the new house.

INTERVENER: Is that related to the wife thing?

SUBJECT: Yeah, so she’s all over me now because she’s scared we’ll lose the house. So it’s nonstop fighting. And on top of that, Human Resources is after me because of some bogus customer complaints.

INTERVENER: So you got caught by surprise with the no-raise thing, plus the HR complaint, and now all the family plans are backed up. And everybody’s freaked.

SUBJECT: Yeah, that’s about it.

Ensure Safety

Without seeming tricky or manipulative, the intervener should encourage the subject to put even a few short steps between the idea of self-destruction and the act itself.

INTERVENER: Is there anything in there with you that could hurt you?

SUBJECT: I got a Glock with a full mag. Yeah, that could hurt someone.

INTERVENER: Any chance of you putting the gun away while we talk?

SUBJECT: So what, so you can all bust in here and drag me away to the nut house?

INTERVENER: Actually, I just want to make sure you’re safe. If you’re gonna do something, then you’re gonna do it; but for right now, how about popping out the mag and the cap in the chamber, and putting everything on the table in front of you. That way, if you really want the gun, it’s right there, but at least you’ll give yourself a second to think about it.

Provide Support

Remember that the purpose of crisis intervention is not to solve all of the subject’s problems in this one encounter, but to instill just enough motivation for him or her to emerge from the danger zone. The intervener should keep the conversation focused on resolving the present crisis, perhaps gently suggesting that the larger issues can be dealt with later – which subtly implies that there will indeed be a “later.” In the meantime, just “being there” with the subject helps reduce his/her sense of isolation.

INTERVENER: When a lot of crap happens at once, it can seem like that’s all there ever was, even if there was some good stuff tucked away in there.

SUBJECT: Good stuff, what good stuff?

INTERVENER: Sometimes looking at things in a different way, trying things out you didn’t do before, sometimes just staying away from certain people or situations, things like that. At least it may be worth a shot. But right now, all I’m saying is I hear where you’re coming from, I hear a world of hurt, and I’m hoping you can get things together for yourself.

SUBJECT: I dunno, man, but hey, thanks anyway.

Examine Alternatives

Often, subjects in crisis are so fixated on their pain and hopelessness that their cognitive tunnel vision prevents them from seeing any way out. The intervener should gently expand the range of nonlethal options for resolving the crisis situation. Typically, this takes one of two forms: accessing practical supports and utilizing coping mechanisms.

Practical Supports

Are there any persons or groups that are immediately available to help the subject through the crisis until he or she can obtain follow-up care? The intervener must always be mindful of the risks and liabilities of relying on these support people instead of professional responders, and should be prepared to make the call to commit the subject involuntarily if he truly represents a danger to himself.

SUBJECT: I already told you, I’m not going to some damn hospital to be locked up and pumped full of drugs.

INTERVENER: Okay, let’s leave the hospital out of it. I know you told me about your problems with the job and your wife, but is there anyone you know out there who you trust, who could stand up for you and help you out?

SUBJECT: I dunno, maybe my friend Dave. We worked at the shop together, and we got to be buddies. He’s a good guy, down to earth.

INTERVENER: If Dave agreed to look after you for the rest of the weekend, till things cool off, would that be okay with you?

SUBJECT: I guess so.

Coping Mechanisms

These can consist of cognitive strategies, religious faith, distracting activities, accessing positive images and memories of family, or successful handling of crises in the past, that show the subject that hope is at least possible.

INTERVENER: You said something earlier about how you’ve had crap happen to you before. Can you give me an example?

SUBJECT: Well, about six years ago, I got fired from a job for stealing, but it was really some other guy who pinned it on me. Their investigation was sloppy, so I filed a union grievance, and we ended up working out a deal where I’d resign and the charges wouldn’t go on my record. Even though I wasn’t guilty, I took the deal. Now I couldn’t qualify for the security job I wanted, so that’s how I got this job, which ended up paying more and being a pretty good job – till this shit all started happening.

INTERVENER: So you went from almost being fired and busted to getting a better job. It was f’d-up to be falsely accused, but you handled it, and you made it come out the best way possible. When you put your mind to something, it seems, you’re able to work it out.

Make a Plan and Obtain Commitment

Again, this involves a combination of both practical supports and coping mechanisms, as well as both short-term and longer-term plans.

INTERVENER: Okay, I want to make sure I have everything straight. You’re gonna chill with Dave for the weekend, and first thing Monday morning, you’re gonna contact your EAP or go over to County Clinic so you can get some help in dealing with this, all right?

SUBJECT: Now I gotta see a shrink for the rest of my life?

INTERVENER: Probably not. But you may need a few sessions just to straighten things out. Let’s do this right, so that in a couple of months, it’ll all be just a bad memory, okay?

SUBJECT: It’s gonna be a long weekend, man.

INTERVENER: Hey, I respect what you’re doing; it’s not easy. But you’ll make it.

Post-Crisis Mental Health Intervention

When the acute crisis has passed, referral to a mental health clinician is crucial for two reasons. First, if this is a work-related issue, a psychologist may have to perform a fitness-for-duty evaluation to determine if the employee is able to return to work. Second, specialized psychotherapeutic techniques may be applied, that involve a combination of emotional exploration, realistic confidence-building, and practical problem-solving approaches.

As in any area of crisis psychology, there is no cookbook formula for dealing with suicidal subjects, either in the acute crisis stage, or at follow-up, but applying the fundamental lessons of effective crisis intervention may not only save the subject’s life in the short term, but even nudge his or her life in a more productive and satisfying direction.
Source: hwww.policeone.com/patrol-issues/articles/3704528-Police-intervention-and-the-suicidal-subject-Fundamental-principles-of-crisis-intervention/

Anxiety Symptoms

There are over 100 anxiety symptoms and signs for anxiety, anxiety attacks (panic attacks), and other anxiety disorders, including Generalized Anxiety Disorder (GAD), Social Anxiety Disorder (SAD), Obsessive Compulsive Disorder (OCD), Post-Traumatic Stress Disorder (PTSD), and phobias.

The following are some of the anxiety symptoms associated with anxiety disorder:

  • Numbness and tingling
  • Dizziness
  • Chest pain
  • Headaches
  • Neck tension
  • Stomach upset, nervous stomach
  • Pulsing in the ear
  • Burning skin
  • Fear of impending doom
  • Nausea
  • Shortness of breath
  • Electric shock feeling
  • Shooting pains in the face
  • Heart palpitations
  • Weakness in legs
  • Feeling like you are going crazy
  • Inability to rest
  • Sleep problems

There are a great many more anxiety symptoms. For a comprehensive list of anxiety symptoms with descriptions, including severe anxiety symptoms..
Source: www.anxietycentre.com/anxiety-symptoms.shtml

Warning Signs and Symptoms of Bipolar Disorder

What are the first signs of bipolar?

People with bipolar disorder often have cycles of elevated and depressed mood that fit the description of "manic depression." When a person's illness follows this classic pattern, diagnosing bipolar disorder is relatively easy.

But bipolar disorder can be sneaky. Symptoms can defy the expected manic-depressive sequence. Infrequent episodes of mild mania or hypomania can go undetected. Depression can overshadow other aspects of the illness. And substance abuse, if present, can cloud the picture.

Taken together, these factors make bipolar disorder difficult to diagnose when symptoms are not obvious. A few facts about bipolar disorder you may not know:

  • As many as 20% of people complaining of depression to their doctor actually have bipolar disorder.
  • About half of people with bipolar disorder have seen three professionals before being diagnosed correctly.
  • It takes an average of 10 years for people to enter treatment for bipolar disorder after symptoms begin. This is caused in part by delays in diagnosis.
  • Most people with bipolar disorder have additional psychiatric conditions (such as substance abuse or anxiety) that can make overall diagnoses more challenging.

Celebrities With Bipolar Disorder

About 3% of Americans may have bipolar disorder during their lifetimes. Here are 18 famous people who were diagnosed with bipolar disorder.

Bipolar Disorder Is Often Mistaken for 'Just' Depression

People with bipolar disorder are frequently misdiagnosed as having only depression. In bipolar II disorder, the milder form, manic episodes are mild and can pass by unnoticed. Time spent with depression symptoms, meanwhile, outnumbers time spent with hypomanic symptoms by about 35 to one in people with bipolar II disorder.

Time spent with depression symptoms also usually outweighs time spent with mania symptoms in bipolar I disorder by about three to one, although the more severe mania in bipolar I generally is easier to identify.

Major depressive disorder -- often referred to as unipolar depression -- is different from bipolar disorder II -- also called bipolar depression -- in that unipolar depression has no intervals of hypomania while bipolar II does have intervals of hypomania.

Anyone evaluated for depression should also be evaluated for a lifetime history of manic or hypomanic episodes.

Bipolar Disorder and Substance Abuse Can Go Hand in Hand

Substance abuse often complicates the diagnosis and treatment of bipolar disorder. Substance abuse is bipolar disorder's partner in crime. Some studies show that as many as 60% of people with bipolar disorder also abuse drugs or alcohol. Untreated substance abuse can make it virtually impossible to manage the mood symptoms of bipolar disorder if both disorders are present. It can also be hard to make a confident diagnosis of bipolar disorder when someone is actively abusing substances that cause mood swings.

Substances such as alcohol and cocaine can also cloud the picture in bipolar disorder. For example, people high on cocaine can appear manic when they're actually intoxicated, or have a depression "crash" when the drug wears off. Some people with bipolar disorder use drugs and alcohol as a part of the impulsivity and recklessness of mania. Others may have an independent substance use disorder, which requires its own treatment. Substance abuse may make bipolar episodes (mania and depression) more frequent or severe, and medicines used to treat bipolar disorder are usually less effective when someone is using alcohol or illicit drugs.

Does Your Teenager Have Bipolar Disorder?

Bipolar disorder commonly begins to show itself in the late teens. Bipolar disorder in the teenage years is serious; it's often more severe than in adults. Adolescents with bipolar disorder are at high risk for suicide.

Unfortunately, bipolar disorder in teens frequently goes undiagnosed and untreated. Partly, this is because while symptoms may begin in adolescence, they often don't meet the full diagnostic criteria for bipolar disorder. Some experts think that bipolar disorder also can be over diagnosed in children or younger adolescents, especially when symptoms involve just mood swings or disruptive behaviors rather than changes in energy or sleep patterns. Partly for that reason, the diagnosis of "disruptive mood dysregulation disorder" has come into use to describe teens who mainly have persistent irritability and severe temper outbursts or mood swings.

Symptoms of bipolar disorder in teens may be unusual -- not a straightforward "manic depression." ADHD, anxiety disorders, and substance abuse are often also present, confusing the picture.

Some symptoms that suggest a teenager might have bipolar disorder are:

  • Uncharacteristic periods of anger and aggression
  • Grandiosity and overconfidence
  • Easy tearfulness, frequent sadness
  • Needing little sleep to feel rested
  • Uncharacteristic impulsive behavior
  • Moodiness
  • Confusion and inattention

Other potential symptoms that may indicate the presence of a psychiatric disorder requiring evaluation may include feeling trapped, overeating, excessive worry, and anxiety. Other possible diagnoses in addition to bipolar disorder that should be considered in the setting of symptoms such as these include unipolar (major) depression, anxiety disorders, substance use disorders, adjustment disorders, attention deficit hyperactivity disorder, and personality disorders such as borderline personality disorder.

It's important to remember that sometimes some of these symptoms can occur in many healthy teens and adults. The time for concern is when they form a pattern over time, interfering with daily life. Children with symptoms that suggest bipolar disorder should be seen and evaluated by a psychiatrist or psychologist with expertise in mood disorder.
Source: www.webmd.com/bipolar-disorder/guide/bipolar-disorder-warning-signs#2

Crisis Intervention Training (CIT): An invaluable investment for law enforcement

In the aftermath of the recent Sandy Hook active shooter event in Connecticut, as well as other incidents across the country, the degree of awareness (and scrutiny) for signs and symptoms of mental instability has been heightened.

The tragic outcome of the horrific set of events in Newtown provides an even greater impetus for law enforcement agencies to prepare, educate, and train their officers in crisis intervention skills so they can be proactive in recognizing indicators of potentially problematic individuals, deleterious circumstances, and potentially lethal situations.

In 1988, the Memphis Police Department established the first Crisis Intervention Team (CIT). In partnership with the Alliance for Mentally Ill (AMI), mental health providers, and two universities, the department organized, trained, and implemented a specialized unit within the department that worked closely with the community in responding to mental health crises.


Related feature

Police intervention and the suicidal subject: Fundamental principles of crisis intervention How can police officers effectively intervene against citizens' attempted suicide?

The department became known for setting a standard of excellence with respect to the treatment of individuals with mental illness.

Throughout the nation, other law enforcement agencies observed the successful outcomes achieved in Memphis. Some adopted the program to meet the needs of their own communities.

Yes, Virginia, CIT Works

In Virginia, the Alexandria Police and Alexandria Sheriffs’ Department are two agencies that did just that.

Highly-skilled and specially-trained officers — equipped with knowledge of basic crisis intervention, traumatic stress, substance abuse, mental health, liability and legal issues, suicide intervention, active listening, special populations, verbal de-escalation, and cultural diversity — comprise the Crisis Intervention Team. Through the 40 hours of specialized training they receive, these officers are able to deal with crisis situations.

CIT training is designed to educate and prepare police officers who come into contact with people with mental illness. They are keenly aware of the divergent issues facing people on the street and in their communities. Trained officers are capable of de-escalating a situation by their understanding and ability to relate to what the person is going through.

For law enforcement agencies, this training is an invaluable investment when officers are able to readily de-escalate a crisis and settle a situation on scene with appropriate skills and pertinent knowledge combined with compassion and understanding.

Moreover, such training tends to reduce the anxiety an officer faces with the situation, reduces the possibility for physical confrontation, and reduces the possibility of injury to the officers. It also minimizes the amount of time officers spend out of service awaiting assessment and disposition, and reduces inappropriate arrests.

Importantly, officers skilled in crisis intervention strategies are provided a protocol to bring individuals in crisis to a therapeutic location rather than a jail or law enforcement facility.

Folks in Need of Special Attention

“We see people in crisis all the time. This is a different program than any other program out there. This is about being human again in law enforcement,” said Sgt. Courtney Ballantine, Team Leader for the CIT Team of the Alexandria (Va.) Police Department.

Ballantine pointed out that it is important to choose the right officers to serve on the team. Officers have to be identified who are not only open minded but well respected within the department as well as the community.

Following the training, officers are reportedly energized, and they recognize that the training is practical, helpful, and it can be utilized effectively on the street.

“Officers literally leave saying this is the best training they’ve ever had,” Jonathan Teumer, Emergency Services Team Leader for the Alexandria Virginia Community Services Board, said.

He pointed out that these are veteran and tenured officers who are offering the praise.

Officer Joe Kirby of the Alexandria Police Department is well versed in utilizing his crisis intervention training. He once went on a call requiring that he check on the welfare of an individual. He was notified the man was in crisis. When Kirby arrived, he talked to him and discovered the man was depressed and an alcoholic.

He established trust and rapport with the man, and he utilized information he had learned from the CIT training. Kirby introduced the man to the director of the local detoxification program who did an outreach to him, and the man entered into treatment. Kirby returned to the man’s house several times to check on him and follow up.

This proved to be a success story that evolved out of Kirby’s CIT training.

“It’s definitely given me a broader view of mental illness and emotional disorders. It’s a good program. I’m thankful that I got the training. It helped me figure out where the resources are,” Kirby said.

Lieutenant John Kapetanis of the Alexandria Sheriff’s Department, and a 30-year law enforcement veteran, works with operations command at the city courthouse.

“On occasion, we get folks in need of special attention. It’s valuable to know where these people are coming from,” he said.

He agrees with Kirby that the training was valuable. “It was, by far, the best training I’ve ever had. I was impressed. It was just outstanding,” Kapetanis said.

The training provides information on knowing what to do and who to contact. A significant portion of the training focuses on learning how to actively listen and how to talk to people. The legal component provides officers information on knowing what they legally can and cannot do.

This training is particularly helpful with special populations that encompass the homeless, intellectually disabled, and children in crisis, among others, as well as populations unique to specific communities. Officers are provided the flexibility in knowing how to apply the training they received in the most effective way.

The proactive approach to dealing with problems in the community with the assistance of CIT trained police officers serves as a successful strategy to eliminate problems that could potentially escalate to violence and victimization.
Source: www.policeone.com/emotionally-disturbed-persons-edp/articles/6078652-Crisis-Intervention-Training-An-invaluable-investment-for-law-enforcement/

Warning signs of a heart attack

Heart Attack Symptoms

Chest Discomfort - Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.

Discomfort in other areas of the upper body - Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.

Shortness of breath - with or without chest discomfort.
Learn more about
heart attack symptoms?

Stroke Symptoms - Spot a stroke F.A.S.T.

Face drooping - Does one side of the face droop or is it numb? Ask the person to smile.

Arm weakness - Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?

Speech difficulty - Is speech slurred, are they unable to speak, or are they hard to understand? Ask the person to repeat a simple sentence, like "the sky is blue." Is the sentence repeated correctly?

Learn more about stroke symptoms?


If the person shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get them to the hospital immediately.
Source: www.heart.org/en/about-us/heart-attack-and-stroke-symptoms

Heart Attack Warning Signs

  • Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
  • Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
  • Shortness of breath. May occur with or without chest discomfort.
  • Other signs: These may include breaking out in a cold sweat, nausea or lightheadedness
  • As with men, women’s most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.

If you or someone you’re with has chest discomfort, especially with one or more of the other signs, don’t wait longer than a few minutes (no more than 5) before calling for help. Call 9-1-1... Get to a hospital right away.

Calling 9-1-1 is almost always the fastest way to get lifesaving treatment. Emergency medical services staff can begin treatment when they arrive -- up to an hour sooner than if someone gets to the hospital by car. The staff are also trained to revive someone whose heart has stopped. Patients with chest pain who arrive by ambulance usually receive faster treatment at the hospital, too.

If you can’t access the emergency medical services (EMS), have someone drive you to the hospital right away. If you’re the one having symptoms, don’t drive yourself, unless you have absolutely no other option.

Cardiac Arrest

Cardiac arrest strikes immediately and without warning. Here are the signs:

  • Sudden loss of responsiveness. No response to gentle shaking.
  • No normal breathing. The victim does not take a normal breath when you check for several seconds.
  • No signs of circulation. No movement or coughing.

If cardiac arrest occurs, call 9-1-1 and begin CPR immediately. If an Automated External Defibrillator (AED) is available and someone trained to use it is nearby, involve them.

Stroke Warning Signs

The American Stroke Association says these are the warning signs of stroke:

Sudden numbness or weakness of the face, arm or leg, especially on one side of the body

  • Sudden confusion, trouble speaking or understanding
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance or coordination
  • Sudden severe headache with no known cause

If you or someone with you has one or more of these signs, don’t delay! Immediately call 9-1-1 or the emergency medical services (EMS) number so an ambulance (ideally with advanced life support) can be sent for you. Also, check the time so you’ll know when the first symptoms appeared. It’s very important to take immediate action. If given within three hours of the start of symptoms, a clot-busting drug can reduce long-term disability for the most common type of stroke.


People who have witnessed a suicide death

There is the timeworn adage, "a witness to violence is a victim of violence." Suicide is a form of self-inflicted violence and witnessing a suicide or finding someone after they have died, whether you know the person or not, can be very traumatic.

You may have intense feelings and reactions - this is a normal response to an abnormal event. Reactions may include but are not limited to:

  • Shock, numbness, detachment.
  • Sudden onset of physical symptoms.
  • Change in appetite or substance use.
  • Difficulty sleeping.nightmares.
  • Flashbacks/intrusive thoughts.
  • Depression, irritability, guilt.
  • Hyper-vigilance or anxiety.
  • Isolating or compulsive behaviors.
  • Avoidance of the area.
  • Time feels distorted.

Help is available

There is no "right" or "wrong" way to react to a trauma. While not everyone experiences symptoms, some people have symptoms that rise to the level of depression, intense anxiety, or Post Traumatic Stress. If you find your symptoms interfere with your daily functioning, you may want to seek help. Listen to your own needs. Help is available!


Mental Health Counselor. Request a trauma bereavement specialist at a private or community mental health center.

National Suicide Prevention Lifeline: Call or Text 988 for a free counselor available 24/7 Or the Crisis Text Line - text SOS to 741741

Recognizing Warning Signs of Violence

Targeted School Violence

The Violence Project / The Off-Ramp Project: School Violence Prevention Training • off-ramp.org/online-training/schoolviolence-prevention-training

Sandy Hook Promise: Know the Signs: You Can Prevent Gun Violence and Other Harmful Acts • sandyhookpromise.org/blog/teacherresources/know-the-signs-of-gun-violence


American Foundation for Suicide Prevention: Risk Factors, Protective Factors, and Warning Signs • afsp.org/risk-factors-protective-factorsand-warning-signs

The Trevor Project: Warning Signs of Suicide • thetrevorproject.org/resources/article/ warning-signs-of-suicide

Centers for Disease Control and Prevention: Risk and Protective Factors • cdc.gov/suicide/factors/index.html

Intimate Partner Violence

National Coalition Against Domestic Violence: Signs of Abuse • ncadv.org/signs-of-abuse

National Domestic Violence Hotline: Warning Signs of Abuse • thehotline.org/identify-abuse/domesticabuse-warning-signs


SPLC & PERIL: Preventing Youth Radicalization: Building Resilient, Inclusive Communities • splcenter.org/peril

The Office of the Director of National Intelligence: US Violent Extremism Mobilization Indicators • dni.gov/files/NCTC/documents/news_ documents/Mobilization_Indicators_ Booklet_2021.pdf


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