Question

1. On a warm and sunny February morning, a college student is found hanging from a tree outside a dormitory, dead of an apparent suicide. The evening before he had broken up with his girlfriend. What symptoms might he exhibit before completing suicide? Which factors make him at risk? You are his friend. What interventions might you make if you suspected his intentions? What will you do now as a suicide survivor?
2. Why do we say that violent behavior is a cycle? What would you look for if you suspected a child was being physically abused at home? What intervention would you make?
3. Medications help relieve psychiatric symptoms. What would you say to a client who needed mediation intervention but was reluctant to take any? Which medications are commonly used for depression?

Answer 1

Suicide rates among college students are escalating day by day. A student committing suicide after having broken up from a relationship the earlier day might have talked about feeling empty or worthless. He could have intoxicated himself, could be in guilt or shame. He must have isolated himself for the evening. Generally, a person is filled with remorse and feels as if no other option is available and nothing can be done right now, life cannot get worse. Relationship break up should be the biggest factor here, but there are many factors that can push a person to take this decision. A prior suicide attempt, or family history, any mental disorder, for example, mood disorder or history of trauma and abuse, constant feeling of worthlessness and hopelessness. There could be a chance that his relationship could be toxic, codependent or abusive. His life history, coping mechanisms, and social life will provide us with more clues. If I would've suspected his intentions beforehand I definitely wouldn't have left him alone. I would've asked if he wants to talk to some professional or would've provided him with other alternatives. I would've thrown all the sharp objects and kept him away from toxins. Most importantly would be with him the whole night and connected him with support in the morning. As a suicide survivor, the first thing is to start therapy. Second, appreciating life and all the support I have, and working on the present issues through problem-solving. Continuous follow-ups and keeping in touch with family and friends would be on my list as well.

Violent behaviour is a cycle because the perpetrator goes through three stages. First is 'tension build-up', where strain between two people or group starts increasing and when it reaches to a point where it is difficult to contain, there is 'acute explosion' where the tension is released through violence and it gradually becomes a behaviour. The third stage is the 'honeymoon stage' where he might feel remorse, guilt and might make promises of never repeating the behaviour; this stage ends with a gap of denial, where no processing of emotions or conflict is done, which leads to tension starts building up again and the cycle repeats itself. It could be an adult with an abusive childhood or a child who was bullied in school, takes it out his sibling, or any other interpersonal issue, but the violent behaviour has a vicious cycle which needs to be broken to intervene.

If I suspect a child is being abused at his home, first of all, I would look at the marks or signs of abuse on the body. I would notice any changes present in his mood or behaviour in general, for example, if he is jumpy or anxious or has become passive and withdrawn. I will look at parents' behaviour and attitude towards child and if any signs of neglect are present. I would focus on what the child talks about and if he reports any trauma or negative thoughts. If I am sure about my symptoms I will report the crime to the local child support authorities. I would try to understand the home environment and parents' life history and provide them with counselling opportunities. I will take care of the child by admitting him to a trauma facility and providing him with the necessary good medical and mental health support.

Medical interventions are very necessary for clinical mental health issues, there could be many reasons why a patient is reluctant to try it. Sometimes, they worry or fear side effects, is already taking too many pills, or misunderstand the need for medication. It is necessary to take the help of a confidant who the patient respects to make them understand the need and importance of medication in their case. Education and full transparency about the side effects eliminates them from looking it up and getting misinformation which triggers the fear. A proper schedule and a coping card to remind them about the need and benefits also can help.

The most common medications for depression are Zoloft, Prozac, Citalopram, Fluoxetine, Xanax, Paroxetine and other mood stabilizers.