Suicide Prevention for Seniors and African Americans

By Gina N. Duncan, M.D.

Don Cornelius’s death shocked many of us. The report that his death was a suicide has made it all the more tragic. Best known as the founder of Soul Train, Don was an icon in American music history. Unfortunately, as noted by others commenting on his death, the “Love, Peace, and Soul” he promoted as a public figure may have eluded Don in his personal life, particularly in his later years.

Now we are further shocked by the untimely death of Whitney Houston. Her battle with drug abuse was well known, though the cause of her death has not yet been determined. In our sensational, media-driven culture, the very personal details of celebrities’ mental, emotional, and family struggles are often on display for public entertainment, sympathy, judgment, and criticism. In recent years, with the tragic losses of Michael Jackson, Amy Winehouse, Heath Ledger, and others, the dangers of illegal and prescription drug abuse have been given an increasing spotlight in the media.
 

Don Cornelius’s death, however, highlights two mental health issues that are significantly under-discussed in the public: suicide in African Americans and in seniors.

Depression is under-diagnosed in older adults. It often co-occurs with medical illnesses such as heart disease, diabetes, stroke, and cancer, and can be associated with the social difficulties and financial strain many older adults experience. Because of this, we tend to accept depression as a natural consequence of aging, but this is not so. When depression is present, it not only diminishes a person’s quality of life but also increases his / her risk of death by delaying or worsening recovery from the medical illness or by suicide. Depression is also under-recognized and under-treated among African Americans and other minorities. 

I recently spoke at a National Alliance on Mental Illness (NAMI) program called "Sharing Hope: Understanding Mental Health" in Augusta, GA. “Sharing Hope” is an educational program designed to raise awareness of mental health issues in African American church congregations. One woman there told us that her brother had died from suicide not long ago. She explained that he had been troubled for some time and had made threats before but not acted on them. She asked: Were there signs she and her family missed? Was there some way they could have prevented it? She expressed feelings of guilt and shared that she and her family blamed themselves for not having done more, yet at the same time, they didn’t know what more they could have done. 

My heart goes out to her and to anyone who has been affected by the suicide of a loved one. Feelings of guilt, self-blame, and shame are common. Perhaps some consolation can be found in the recognition that it’s impossible to fully control the decisions and actions of another adult. There are support groups for survivors of suicide that provide a place to express these complex emotions. Seek support from your faith if that is relevant to you, and tune out those who would make negative remarks about your loved one's fate after death, as none of us have the final say in that matter. 

The best suicide prevention is early recognition and treatment of depression. Depression may be masked by factors such as medical illness, dementia, personality style, and other mental illnesses, so understand the symptoms. 

If you are concerned about a loved one, please follow these suggestions:

1)  Do not be afraid to ask if they are considering suicide--you will not plant the thought in their mind by asking.

2)   Stage an intervention if necessary, where you can express your concerns and encourage them to get treatment.

3)  Take any and all threats or gestures seriously--seek help from their doctor immediately or call 911.

We should celebrate the achievements of Whitney Houston, Don Cornelius, and the other amazing talents we’ve recently lost; our lives are richer for their contributions. I hope that by raising awareness of these critical mental health issues, their untimely deaths will cause others to seek help and to heal. 

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Towards A Healthier View of Happiness: Human Fulfillment

By Roberto A. Blanco, M.D. 

I believe that mistaking what one would call pleasure or joy with happiness is causing people a lot of unnecessary pain.  In popular culture and the media, “happiness” is the feeling when you open a brand new bottle of soda, when you have a party with your friends, or when you get a new car.  Consumer culture has subtle but noticeable effects on people’s beliefs to the point where most people buy into these images or ideals consciously or unconsciously to some extent.  

But, this is not the meaning of happiness for which we should be striving.  This is because pleasure, while it may be fun, is superficial and impossible to sustain.  Even for people who live a “charmed life," it is impossible to find pleasure or joy in all events in life.  In fact, unless there is some larger or longer-lasting definition of happiness such as human satisfaction that fills our lives, it is likely that we won’t be able to find joy in anything.  Events that should provide joy will lose their effect eventually without some deeper meaning.

This may be why many people become depressed.  A lot of us put pressure on ourselves to be “happy” all of the time.  Because we confuse pleasure for happiness at times, the fact that we are not “happy” all of the time can lead to more dissatisfaction with life or lack of fulfillment.  If happiness equates with pleasure or joy, how can we be happy and happy with ourselves when we are going through difficult but worthwhile transitions?  What about during periods of grief? 

It is often very difficult to sustain superficial happiness especially when the inevitable thoughts of ‘why am I feeling bad?’ or ‘why am I not happy?’ creep into the mind.  These thoughts often cause people to feel guilt and then as if they are failures.  To be joyful and smiling all of the time is just an unrealistic goal and we should not feel bad about ourselves if we happen to be in a difficult stage of life.  We need to keep in mind that it is all part of a larger plan or goal of development, human fulfillment or self-actualization.

The search for a good definition of happiness is not a new idea and certainly not one that I thought of.  Over 300 years before Christ and in his book entitled NicomacheanEthics, Aristotle proposed his definition of happiness to the ancient Greek people and laid out his arguments for the meaning of happiness.  He argued that having true happiness is the best and final aim for human activity.  Aristotle called true happiness “eudaimonia” which was a type of long-lasting happiness more consistent with human fulfillment or satisfaction.  Aristotle also believed that happiness should be human fulfillment and not confused with joy or pleasure when he wrote:

For one swallow does not make a spring, nor does one sunny day;
similarly, one day or a short time does not make a man blessed and happy.

I agree that human fulfillment is a loftier goal than joy because when someone is having a difficult time or fallen on hard times, they can still be working towards human fulfillment. During these formative or growing experiences, we can still feel as we are fulfilled or fulfilling our own self-actualization even if we aren’t joyous.  When we take into consideration human fulfillment, we no longer need to feel guilty or as failures during difficult times, transitional periods, or episodes of grief.  We begin to see life from the wide angle of human fulfillment rather than from the small picture of pleasure.

Kahlil Gibran, the famous Christian mystic poet from the early 20th century, also believed in eudomainia.  When Almustafa, the all-knowing visitor in the poem The Prophet, answers a woman’s question on pain, he exemplifies this belief in the beauty of human fulfillment and long-lasting satisfaction despite these painful episodes:

And could you keep your heart in wonder at the daily miracles of your life, your pain would not seem less wondrous than your joy;
And you would accept the seasons of your heart, even as you have always accepted the seasons that pass over your fields.
And you would watch with serenity through the winters of your grief.

As people living in a society where mental illness is so common, we must seek to understand happiness and human fulfillment.  In the hopes of making happiness something more meaningful and sustainable, what we should be striving for is an eternal, longer-lasting form of happiness which is known as human fulfillment or as the Greeks called it eudaimonia.  This is because human fulfillment rather than joy or pleasure allows for the different stages of our lives and growth without having to feel guilt or as if something is wrong.  If we make human fulfillment the goal, we will live happier and more satisfying lives.  Now the obvious question becomes, how do we achieve it?

1.  Aristotle (1999).  Nicomachean Ethics. (Martin Ostwald Trans.)  Upper Saddle River, New Jersey: Prentice Hall, Inc.
2. Gibran, Kahlil (1964).  The Prophet .  New York: Alfred A. Knopf.
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Make Mental Health Your Priority Every Month

By Felicia Wong, M.D

As the month of May comes to an end, make a promise to yourself that personal mental wellness will remain a daily priority.  Mental Health America has been working for 100 years to promote well-being for all Americans and recently developed a resource called 10 Tools to Live Your Life Well based on extensive scientific evidence.

Each day, we face all sorts of demands and drama which can lead to insomnia, lack of concentration, problems in our relationships, and other mental health issues. 

These "10 Tools" provide proven, healthy ways to cope with stress and boost your overall well-being.  Make a commitment to follow this list and feel more relaxed, fulfilled, and focused long after Mental Heath Month is over. . .  

1) Connect with Others. People who feel connected are happier and healthier--and may even live longer.

2) Stay Positive. People who regularly focus on the positive in their lives are less upset by painful memories.

3) Get Physically Active. Exercise can help relieve insomnia and reduce depression.

4) Help Others. People who consistently help others experience less depression, greater calm, and fewer pains.

5) Get Enough Sleep. Not getting enough rest increases risks of weight gain, accidents, reduced memory, and heart problems.

6) Create Joy and Satisfaction. Positive emotions can boost your ability to bounce back from stress.

7) Eat Well. Eating healthy food and regular meals can increase your energy, lower the risk of developing certain diseases, and influence your mood.

8) Take Care of Your Spirit. People who have strong spiritual lives may be healthier and live longer. Spirituality seems to cut the stress that can contribute to disease.

9) Deal Better with Hard Times. People who can tackle problems or get support in a tough situation tend to feel less depressed.

10) Get Professional Help if You Need It. More than 80 percent of people who are treated for depression improve.

So now you know the tools. . . Today is the perfect time to start incorporating this list into your day-to-day routine.  For more information, go to http://www.liveyourlifewell.org/ . 
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Faith & Mental Wellness in the African American Community

By Gina N. Duncan, M.D.

For many in the African American community, faith is an integral part of life.  In one study, approximately 85 percent of African American respondents described themselves as “fairly religious” or “religious” and considered prayer a common way of coping with stress.   

My training as a psychiatrist coupled with my background enables me to have a unique perspective on the field of psychiatry as it relates to the African American community.  I come from a Southern, deeply religious African American family of educators.  My grandfather, a gifted musician, suffered from depression for most of his adult life.  While it did not prevent him from having a successful career as a school principal, civic leader, and church member, it did prevent him from enjoying his blessings more fully.  This has had a ripple effect in my family, which continues to be felt even three generations out.  Fortunately, because of the struggles we observed in our grandfather, the younger members of my family have become much more vocal about our own stresses, and are determined to not let history repeat itself.

For many of us, emotional issues and mental illness are inextricably linked to issues of faith.  Some may view depression as a punishment for sin, psychotic illness as the presence of demons, or anxiety as a lack of faith in God’s ability to provide.  As a person of faith myself, I can say that faith provides a holistic view of life and of the meaning behind our individual experiences and struggles.  However, that does not mean that we cannot make use of all the resources available to us.  After all, if we have a headache we take Tylenol, right?  And if your doctor tells you to take medicine for your diabetes and high blood pressure, you listen.

Some emotional problems can be fully resolved with talk therapy and support.  However, more serious problems such as recurrent depression, thoughts of suicide, schizophrenia, or bipolar disorder often require medication in addition to other forms of treatment.  This is an exciting time in the field of psychiatry and brain science, as we learn more and more about the biological basis of many mental illnesses.  And the good news is that there are many proven, effective treatments.

African Americans are a resilient people.  In honor of Black History Month, let’s make a commitment to living our best lives.  That means getting the help you need.  If you think you are suffering from depression, anxiety, or another mental illness, please know that it does not affect you alone.  It impacts your spouse, your children, and your community.  There are a lot of resources on HealthyMinds.org to help you get started.

Let your light shine—don’t let it be diminished by a treatable condition!

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