Lesson 7: Mood Disorders and Suicide


Attention

Effective treatment of the Mood Disorders can help to prevent countless needless deaths in our country. Suicide is the 8th leading cause of death in those between the ages of 25-34. Approximately 30,000 Americans make the decision to end their own lives each year. Another 600,000 or so attempt it unsuccessfully during the same year. Around half in each of these groups suffer from some form of Mood Disorder at the time they made the decision. Sadly, most of us will know or love someone who attempts or completes suicide at some point in our lives. We need to understand the risk factors, warning signs, and treatment options to this insidious killer. After all, suicide is a permanent solution to a temporary problem.


Learning Outcomes

Upon completion of this lesson's material, students will be able to:

  • Develop a rudimentary treatment plan for a fictional case presentation.
  • Explain at least one etiological explanation for a mood disorder
  • Predict the suicidal potential of a case presentation.

Teaching

Chapter 7: Mood Disorders and Suicide

Mood Disorders can be incredibly deadly. In this lesson, we will look into the etiology and treatment of Mood Disorders as well as suicidality.

Given what you know about Major Depressive and Bipolar Disorders, the next step is to consider why an individual would develop one of these problems and what to do to help them. Most mental health clinicians tend to view depression as caused by neurotransmitter deficiencies (Psychiatry and Biopsychology), cognitive errors (Cognitive and Cognitive-Behavioral Psychology), unresolved past trauma (Psychodynamic theorists), blocks in the path of reaching one’s potential psychological growth (Humanistic Psychology), or a combination thereof (Integrative Models). Bipolar Disorder is usually perceived to be caused by neurotransmitter abnormalities and exacerbated by psychosocial stressors (Axis IV).

Regardless, many individuals who receive a diagnosis of MDD are given a course of antidepressant medications (usually SSRIs as a first line treatment) by their medical doctors. More well-informed physicians also refer their patients to a clinical psychologist or psychotherapist for some form of psychotherapy as well (often Cognitive-Behavioral Therapy). Research has indicated that recovery is faster and lasts longer when these two treatment approaches are applied concurrently. Bipolarity, however, can be much more difficult to diagnose and treat. Medication is indicated for most, if not all people who are diagnosed with this. Lithium Carbonate has been used with incredibly good results. As it is highly poisonous, a patient must have their blood levels monitored regularly. Other medication options are antipsychotics, anticonvulsants, and some antidepressants. Much of the time, these are prescribed in a “drug cocktail.” While some folks with mild to moderate depression can be medically managed by their general medical practitioners (often called Primary Care Physicians-PCP), those persons suffering with Bipolar Disorder should be under the care of a psychiatrist for medication management. If you have cancer, you wouldn’t ask your PCP to treat you would you? You would be referred to an oncologist to manage your illness.

One of the reasons that we don’t see as many referrals to psychiatrists, especially for depression, is the perception that they know enough to take care of the situation without incurring the expense of a specialist. Perhaps in mild to moderate cases, this may be effective (should they have the ability to monitor your progress at regular appointments and refer you to psychotherapy). Given the large number of patients that most PCPs manage, especially in HMO environments, as well as the suicide potential associated with these diagnoses, it makes more sense to simply refer the patient to a specialist who will be able to do this more effectively. It is imperative that patients advocate for themselves or their dependents. Please don’t be afraid to question your physician’s treatment plan. Any sensitive and effective physician will understand and listen to your concerns. If they won’t, it is time to change physicians.

 

Suicidal Thoughts


Assessment

Lesson 7 Assignment - Case Study

Open the Case Study labeled “Susan.” You have a case and a series of questions to answer. Do your best on the treatment plan. I don’t expect you to be experts. However, I do expect that you have the ability to make an educated guess.

Lesson 7 Discussion

  1. Review the video in the lesson titled "Suicidal Thoughts". Listen to the young woman’s story. Do you think she is looking for attention or does she have some serious risk factors for suicidality? If you think she is looking for attention, back up your point of view. If you think she shows some risk factors, then describe those that you see.
  2. As you know, it is illegal to attempt suicide. Anyone assisting someone in a suicide can be charged as an accessory to murder. Do you think that suicide should be a viable option for people suffering from psychological disorders? Why or Why not?