Speak Up for the Women Who Suffer Perinatal Mood Disorders

Hey there World of Psychology readers.

You’re probably saying to yourselves “This is NOT Dr. John Grohol. I detect a Southern accent.” Very intuitive.

My name is Katherine Stone and I write Postpartum Progress, the most widely-read blog in the U.S. on perinatal mood disorders, including postpartum depression, antepartum depression, postpartum OCD and postpartum psychosis. For some reason, Dr. Grohol has seen fit to give me the keys to his blog. Before he changes his mind, I thought I’d sneak in and talk to you while I had the chance …

The timing of my post is very important. Later this week, the United States Senate may be voting on the Advancing America’s Priorities Act. This package of bills, introduced by Senator Harry Reid this morning, includes the Melanie Blocker Stokes MOTHERS Act, which would fund increased research into the causes of perinatal mood disorders, better training of healthcare providers and more public awareness. I can’t tell you how important this is.

Of the 800,000 women in the U.S. who get postpartum depression each year, only 10% of them are ever diagnosed and treated. As I wrote on my blog today, we know from research that untreated perinatal mood disorders are a serious public health threat –they can lead to chronic depression in the mother, behavioral problems in the child and stress-related health problems in both. This is an enormous financial cost to our health system and even bigger social cost to our families and communities now and into the future. It will continue on perpetually until we break the cycle and take the lead to proactively educate pregnant mothers, conduct more research and train our doctors. I know this because I am the child of a mother who went through PPD. Her mother, my grandmother, had it as well, and I suffered postpartum OCD myself. I also know because I hear from hundreds of women across the country who read Postpartum Progress and send me emails about their terrible experiences and the lack of knowledge shown by many in the healthcare community.

If you’d like to help, please visit the Depression & Bipolar Support Alliance’s Advocacy in Action Alert and send a letter right now to tell the U.S. Senate to pass this bill. Along with DBSA, it is supported by Postpartum Support International, the Association of Women’s Health, Obstetric & Neonatal Nurses, the March of Dimes, Mental Health America, the Suicide Prevent Action Network, the Children’s Defense Fund, the American College of Obstetricians & Gynecologists, the American Psychiatric Association, the National Alliance on Mental Illness and many others.

Not every mother gets PPD. But the ones who do need and deserve effective help. And just so you know, the bill does not advocate any specific treatment for perinatal mood disorders and neither do I. What I care about is mothers recovering as quickly as possible so they can have healthy relationships with their children, regardless of whether it’s via therapy, meds, a combination of both or some other method.

I hope you will support those of us who go through this and speak up. Thanks for listening.

Suicide and the Japanese

On Sunday, USA Today published an article detailing the epidemic of suicide that is gripping Japan. Unfortunately, like many stories on suicide, the article is thin on actual data to back this idea of an “epidemic.”

When crossing international boundaries, one has to understand different cultures’ takes on taboo topics. Suicide is one such topic, and one where culture has a significant impact on how it’s viewed. For instance, in Japan suicide has practically been raised to a virtue, where committing suicide is seen as the honorable thing to do when one’s life seems to be going wrong:

A suicide fad is sweeping Japan: Hundreds of Japanese have killed themselves this year by mixing ordinary household chemicals into a lethal cloud of poison gas that often injures others and forces the evacuation of entire apartment blocks.

The 517 self-inflicted deaths by hydrogen sulfide poisoning this year are part of a bigger, grimmer story: Nearly 34,000 Japanese killed themselves last year, according to the Japanese national police. That’s the second-highest toll ever in a country where the suicide rate is ninth highest in the world and more than double that of the USA, the World Health Organization says.

Honor or not, suicide is not the answer. An economic downturn takes your job? Guess what? An economic upswing is just around the corner and virtually everyone finds another job in time. Girlfriend or wife leaves you? That’s no reason to end your life when a million other women are out there waiting for you. Suicide is an immediate reaction to a momentary life question that will haunt your friends and family for a lifetime.

But the problem isn’t just in Japan. It plagues many Asian cultures, including the South Korean one, where things are far worse. South Korea has the unlucky distinction of having the highest suicide rate amongst developed countries: 24.7 deaths per 100,000 people.

The solution? Make people better appreciate the life they have now by sending them on a “fake funeral” of their own. The Financial Times has the story:

“Korea has ranked number one in many bad things such as suicide and divorce and cancer rates, so I wanted to run a programme for people to experience death,” says Ko Min-su, a 40-year-old former insurance agent who founded Korea Life Consulting, which offers fake funerals as a way to make people value life.

Korean corporations — from Samsung Electronics and Hyundai Motor to Kyobo Life Insurance and Mirae Asset Management — send their employees on Mr Ko’s courses regularly, partly to encourage them to question their priorities in life and partly as a suicide prevention measure.

People who experience the course first-hand find the experience terrifying and eye opening at the same time:

Yoon Soo-yung, a manager at the Cheonnam Educational Training Institute, who was considering sending her staff on the course, said the experience was terrifying. “I felt like I was suffocating. I cried a lot inside my coffin,” she told the FT. “I regretted so many things that I had done in my life and mistakes that I had made.”

While some experts are skeptical:

Some medical experts are less convinced of the value of such programmes as a suicide prevention measure. “I think treating the fundamental causes like depression and impulsive behaviour is more important and should come before such programmes,” says Chung Hong-jin, professor of neuropsychiatry at the Samsung Medical Centre in Seoul.

My take? The suicide issue is very different in these cultures and the rate is so high, creative techniques like this may hold some potential. The real test is conducting a simple study on the course, assessing participants’ thoughts and attitudes toward suicide before and after, with a random sample of people (those who work in high stress, competitive jobs, and those who do not). It would be a simple study to conduct and one that would show whether there’s more than anecdotal evidence to support the course’s use.

Sadly, the president of the company marketing the course appears to be more interested in expanding into additional markets rather than examining whether his course actually works.

I think such interventions, possibly categorized under the treatment techniques of “psychodrama” (an established field here in the U.S. and Europe, though not well understood or popularized), have potential. Death holds a terrifying mystery to many people. By experiencing first-hand the ceremonial rites associated with death, it may be enough to reach people on an emotional, irrational level as a response to irrational feelings of killing oneself.

It’s an intriguing concept and one I’d like to see the research done on. Because anything that helps change people’s minds about taking their own lives is something that should be more widely understood and disseminated.

Read the full USA Today article about Japanese suicide: Suicide epidemic grips Japan
Read the full Financial Times article: When death is a reminder to live or view the photo gallery, which takes you on an eery step-by-step tour of the fake funeral process

Depression’s Many Treatments

Therese Borchard over at Beyond Blue wrote about the disconcerting “either/or” artificial dichotomy that some researchers and doctors set up about treatments for mental conditions such as depression. Medications for depression are either evil and the root cause of all of society’s problems, or they are saviors and rescue people from a lifetime of suffering. Depression is either a problem with living and one’s life, or it’s a biological disease we simply don’t yet understand.

Psychiatrist James Gordon is the subject of the ire, because he’s promoting his new book over in a Newsweek interview suggesting that alternative treatment methods are the preferred treatment approach for mild to moderate (e.g., most people’s) depression. And that antidepressants should only used as a last resort — “There are better ways to do that than taking drugs, which have side effects and don’t address the underlying message that depression is bringing—that our lives are out of balance and significant change is necessary.”

Uh-huh. Yeah, right…

One would assume that before one suggests changing all of the best-evidence clinical guidelines for treatment of the most common mental illness, one might have a couple of meta-analyses or some large-scale clinical trials conducted with adults that show the effectiveness of the treatment program one is recommending.

Alas, Gordon’s research relies on a single published study on 139 war-ravaged teens, and another study “coming out soon.” And while I agree that many of the individual techniques might, individually, have research backing for specific areas, one might be a little more conservative in one’s opinion before suggesting medications are over-prescribed and everyone should just try his New and Improved treatment program. But you can see Gordon is more of a marketer than a researcher by this statement alone:

Individually, these techniques work at least as well as antidepressants for people with mild to moderate depression. Together they are likely to be far more effective.

Sorry, that’s not how research works. You can’t just throw together five of your favorite techniques and assume they will have some sort of magical power of multiplication to become ever more effective just by being combined.

Well, you can, of course, but you shouldn’t then make such pronouncements in national publications without actually having any relevant research data to back you up.

And what’s this misinformation still being regurgitated, and apparently, agreed with by a psychiatrist (who should know better)?

Newsweek: But people with depression do have imbalances in levels of neurotransmitters.

James Gordon: Some people do, I wouldn’t deny that. What I’m saying is that there are many ways to address those changes that do less harm and may be more productive in the long run because they give people the sense of control that comes from helping themselves.

Well, I would deny it only because science has already shown this theory to be incorrect and a useless simplification of brain processes. That Gordon doesn’t know this is telling.

But anyways, back to the point. There is no single method or single magical approach that is going to work for everyone. Cognitive behavioral therapy is not some cure-all panacea, and neither is Zoloft. And while Gordon’s approach may very well effective for some, it probably will not work for a significant portion of people. Why? Because no treatment in the history of depression treatments has ever found to be effective for everyone. None.

Depression is complicated and complex, just like the humans who experience it. It, like us, does not live in a world of black and white dichotomies. It is messy, it often has no reason, and it doesn’t always like to wake up in the morning. If not caused by some underlying biological condition, it definitely has a measurable effect on our brains. And what works for one person’s depression may have no effect on another’s. This is the nature of depression, like most mental illnesses, and has always been.

Dichotomies might be nice to sell a book or one’s new treatment approach, but it has little basis in reality — the data from the research and the front-line clinicians and people who experience these concerns.

We agree with Borchard — depression is very real and not only do drugs help many with depression, they have proven to be a lifeline for some. And while not an ideal treatment, they are one of the tools we have in our treatment arsenal and should not be demonized (or idealized).

Read the full entry: Don’t Get Stuck on “Unstuck”: Depression Is Real, and Drugs Help Me

Delving Into Your Unconscious Mind to Prevent Suicide

Suicide is one of those problems that a lot of smart minds have thought about, yet few answers satisfy. Instead, we rely on a patchwork of suicide prevention methods (like fences on bridges) and suicide hotlines, staffed by ordinary people trained in crisis interventions.

And while the number of people committing suicide over the past two decades has remained consistent (around 30,000 people a year commit suicide in the U.S.), the suicide rate has enjoyed a steady decline of approximately 0.7% per year (a 13% drop from 1985 to 2004)(Barber, 2004). The decline hasn’t been brought about by superior public health policy, government action, or even the Internet. It’s largely been brought about by the decline in firearm suicides, the leading method of suicide (followed by suffocation and then poison). Men are 3 1/2 times more likely to commit suicide than women.

Guns are a huge risk factor for a successful suicide, because they are one of the most lethal methods available. 90% of those who survive a nonfatal attempt do not go on to die by suicide, meaning that the impulsive, irrational act of a suicidal attempt is what we must try and stop. Hence the reason for the fences and suicide hotlines. If we can get most people past the crisis point, the vast majority of them will live.

But what about those people who are suicidal and make it to the emergency room after a failed attempt? Could we do something more to help the 10% of people who do end up successfully committing suicide?

A column in today’s Boston Globe Magazine today presents the poignant story of the writer, Peter Bebergal, who lost his brother to suicide, and how a group of researchers at Harvard are working to better identify people who are still suicidal when in a hospital:

What clinicians need is some other measure beyond external evidence that could assess whether someone like Eric is capable of suicide in the near future. Four years after my brother’s death, Harvard researchers at MGH are experimenting with a test they think could help clinicians determine just that. It focuses on a patient’s subconscious thoughts, and if it can be perfected, these researchers say it could give hospitals more of a legal basis for admitting suicidal patients.

Of course, I can’t help thinking about whether such a test could have saved my brother. But I also wonder: Would it have been ethically right - or even possible - to save him even if he didn’t want to save himself?

This missing piece in the suicidal puzzle is what prompted the innovative research study now in its final phase at MGH. The study, led by Dr. Matthew Nock, an associate professor in the psychology department at Harvard University, is called the Suicide Implicit Association Test. It’s a variation of the Implicit Association Test, or IAT, which was invented by Anthony Greenwald at the University of Washington and “co-developed” by Dr. Mahzarin Banaji, now a psychology professor at Harvard who works a few floors above Nock on campus. The premise is that test takers, by associating positive and negative words with certain images (or words) - for example, connecting the word “wonderful” with a grouping that contains the word “good” and a picture of a EuropeanAmerican - reveal their unconscious, or implicit, thoughts. The critical factor in the test is not the associations themselves, but the relative speed at which those connections are made.

The research is still ongoing, so we don’t know whether this type of psychological testing will actually work or not. But it’s intriguing to imagine that our unconscious minds might give away our “true” thoughts when it comes to something like suicide. It could become as valuable a test as the ones we use to assess whether someone had a stroke and is at greater risk for a future stroke.

The next step, Nock realized, was to use the test to determine, from a person’s implicit thoughts, whether someone who had prior suicidal behavior was likely to continue to be suicidal. It would give doctors a third component, along with self-reporting and clinician reporting, and result in a more complete picture of a patient. Nock doesn’t assume that a test like the IAT would be 100 percent accurate, but he believes it would have predictive ability.

I believe any tool that can be used to better predict future behavior is a potentially valuable one. Especially when that future behavior might be the taking of one’s own life.

Read the full article: On the Edge

Reference:

Barber, C. (2004). Trends in rates and methods of suicide: United States, 1985-2004 (PowerPoint presentation). Harvard Injury Control Research Center.

Depression is Real

But you already knew that, because you read this blog. For millions of people in the world, however, depression still isn’t viewed as a “real” health problem. These people think it’s just something you have to “get over.” Some even think you can “catch” depression, like you can catch a cold. The number of misconceptions out there is amazing.

Anchor Magazine recently published an article on this topic, basically reminding us that mental illness is still not as widely accepted as we would like, but how much progress we’ve made in just the past 20 years. It starts by describing the story of Keith Anderson, a Canadian lawyer who grappled with depression:

Anderson’s depression affected every aspect of his life, including his family, his relationships, his self-confidence, and his self-worth. But on top of all the symptoms of depression, Anderson also became the victim of stigmatization from former colleagues, friends, and even neighbors.

“It’s amazing the people who stand by you, and it’s amazing the people who don’t,” he says.

At a time in his life when he was looking for support and acceptance, Anderson faced rejection and isolation from many people.

Every time someone he knew walked by him without saying hello or sharing an embrace, it sent him further into depression.

“It was really troubling, and at the time I was pretty shaky, so when someone snubbed me it threw me for a week. It hurts when you think, ‘Gee, they were people who had had their own troubles personally and professionally who I had helped, and the one time I’m in a situation, they’re long gone.’”

Anderson’s experience is not unique. Thousands of people across North America who suffer from depression also become the victims of stigma and discrimination from those around them.

It’s a good article that gives a broad perspective on how far we’ve come, what efforts are ongoing, and how much further we have to go in destigmatizing mental health concerns.

I’m not a big fan of medicalizing mental illness, but in terms of reducing the stigma, it seems to have helped people understand these are “real” concerns and problems people face. But these simple messages bring their own problems, too. For instance, in simplifying the message, it simplifies the expectations about treatment. I’m not sure that’s a good thing, but I know it is a good thing that more people think of concerns like depression just like other health concerns today.

Read the full article: Learning to accept mental illness in today’s society

Suicide Barriers are Effective

Suicide is one of those irrational acts that is still misunderstood and stigmatized, even amongst people who otherwise are okay with mainstream mental health concerns. Most people still don’t understand how someone could ever feel so despondent and depressed that they would want to end their own lives. I also suspect that at one time or another, a significant minority of people have thought about suicide, even if just in passing.

The New York Times Magazine had an article this past weekend about a different approach to suicide. Instead of only looking to help treat people most at risk for suicide (people who suffer from depression, for instance), public health officials are also looking at the common means in which suicide is committed.

One of those common means is jumping off a bridge. And one of the easiest preventions of jumping off a bridge is a simple, inexpensive fence. We’ve written previously about how we believe that bridges should be proofed against suicide and that a human life is more than a slightly-obstructed view.

Opponents to fences on bridges (known as a “suicide barrier” in these discussions) cite the belief that people will just find another way to commit suicide. And yet all of the research data we have suggests that for the vast majority of people, that is simply untrue. It’s one of those repeated false beliefs that has no backing of actual data.

That’s because suicide is an irrational act, but people engage in discussions about people who are temporarily suicidal as though they were making rational decisions and choices. “Hey, if they find a fence on our bridge, they’ll just go home and shoot themselves,” is one common refrain from opponents. Luckily for most people, this isn’t the case. People choose very specific means to end their lives, and they generally don’t switch between methods. And most don’t find other methods.

Richard Seiden, a professor emeritus and psychologist at the University of California, published a study showing that the vast majority of people who are thwarted from jumping from a bridge don’t go on to commit suicide:

In the late 1970s, Seiden set out to test the notion of inevitability in jumping suicides. Obtaining a Police Department list of all would-be jumpers who were thwarted from leaping off the Golden Gate between 1937 and 1971 — an astonishing 515 individuals in all — he painstakingly culled death-certificate records to see how many had subsequently “completed.” His report, “Where Are They Now?” (PDF) remains a landmark in the study of suicide, for what he found was that just 6 percent of those pulled off the bridge went on to kill themselves.

He also published a ground-breaking article (Seiden & Spence, 1982) that looked at the suicide rates between the two bridges in San Francisco, the Golden Gate and the Oakland Bay Bridge, and wasn’t surprised to find the Golden Gate is the more popular suicide magnet. One in which over 2,000 people have jumped to their deaths from since its opening in 1937.

Need more evidence? Another study conducted in England also found a significant reduction in suicides (more than 50%) after a fence was installed on the local bridge (Bennewith et al., 2007). Just as importantly, they also found no evidence of increased jumping from other sites in the geographic region due to the erection of the fences.

Now, despite this evidence, opponents still suggest that people simply go on to other means. Again, assuming that people are acting and thinking rationally. Which they aren’t (duh!):

“At the risk of stating the obvious,” Seiden said, “people who attempt suicide aren’t thinking clearly. They might have a Plan A, but there’s no Plan B. They get fixated. They don’t say, ‘Well, I can’t jump, so now I’m going to go shoot myself.’ And that fixation extends to whatever method they’ve chosen. They decide they’re going to jump off a particular spot on a particular bridge, or maybe they decide that when they get there, but if they discover the bridge is closed for renovations or the railing is higher than they thought, most of them don’t look around for another place to do it. They just retreat.”

Now, while we can’t prevent all suicides, we can certainly make certain types of suicide a thing of the past. In one study about suicide in New York City (Gross et al., 2007), for instance, researchers found nearly a quarter of all successful suicides were from jumping from a tall structure, such as a bridge. A simple, tall fence would eliminate the vast majority of all of these jumping suicides overnight. It would be more effective than banning guns, knives, pools and bathtubs (drowning), or drugs, as it is the second most used method of suicide in this study (behind hanging and asphyxiation).

“The more obstacles you can throw up, the more you move it away from being an impulsive act. And once you’ve done that, you take a lot of people out of the game. If you look at how people get into trouble, it’s usually because they’re acting impulsively, they haven’t thought things through,” noted Matthew Miller, the associate director of the Injury Control Research Center, in the New York Times article. Time. That’s what most people who are thinking irrationally need. And that’s what a suicide barrier provides.

This misperception that we cannot stop people from hurting themselves is false — research data shows that we can. Because suicide is often an irrational, in-the-moment act, simple barriers are extremely effective in helping a person make the choice to live another day until the crisis has past.

The good news is that the Golden Gate Bridge District is moving forward with its work on choosing an appropriate design for a suicide barrier on the biggest suicide destination bridge in the world. While by no means a “sure thing,” it is good they are continuing their progress toward making the bridge suicide-proof. You can view the 5 designs here, 4 of which are fences (I like the openness of the third fence) and one of which is a net. The net is probably the option that provides the least interference with the aesthetics of the bridge, but I don’t see how it would prevent someone from simply climbing out of it and continuing on their downward journey.

In the meantime, 10 more people have died from the Golden Gate Bridge so far this year. Dozens more will die before a design is selected, money raised, and the barrier built.

This “band-aid” approach, as mentioned in the New York Times article, is relatively new in the public health sector and one that we support. While we can’t remove all methods of suicide and people will always commit suicide, we can take a common-sense approach and work to reduce some of the more popular and easy-to-fix methods.

Read the full article: The Urge to End It - Understanding Suicide

References:

Bennewith, O., Nowers, M. & Gunnell, D. (2007). Effect of barriers on the Clifton suspension bridge, England, on local patterns of suicide: Implications for prevention. British Journal of Psychiatry, 190(3), 266-267.

Gross, C. et al. (2007). Suicide tourism in Manhattan, New York City, 1999-2004. Journal of Urban Health, 11(1), 1-11.

Seiden, R.H. (1978). Where Are They Now? A Follow-up Study of Suicide Attempters from the Golden Gate Bridge. Suicide and Life Threatening Behavior, 8(4), 1-13.

Seiden, R.H. & Spence, M.C. (1982). A tale of two bridges: Comparative suicide incidence on the Golden Gate and San Francisco-Oakland Bay Bridges. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 3(1), 32-40.

Another Brain Fad for Depression?

We’ve all heard the theory — a chemical imbalance in your brain causes depression.

Although researchers have known for years this not to be the case, some drug companies continue to repeat this simplistic and misleading claim in their marketing and advertising materials. Why the FTC or some other federal agency doesn’t crack down on this intentional misleading information is beyond me. Most researchers now believe depression is not caused by a chemical imbalance in the brain.

How did we come to this conclusion? Through years of additional research. But now some are jumping on the next brain bandwagon of belief — that depression is caused by a problem in the brain neuronal network.

Jonah Leher makes the case in today’s Boston Globe:

In recent years, scientists have developed a novel theory of what falters in the depressed brain. Instead of seeing the disease as the result of a chemical imbalance, these researchers argue that the brain’s cells are shrinking and dying. This theory has gained momentum in the past few months, with the publication of several high profile scientific papers. The effectiveness of Prozac, these scientists say, has little to do with the amount of serotonin in the brain. Rather, the drug works because it helps heal our neurons, allowing them to grow and thrive again.

Okay, I’m game… But Leher fails to bring any sort of balance to his article. It’s another love letter to the brain scientists studying in this field, but ignores the decades’ worth of research showing that non-medical treatments are also effective in treating depression. Like, you know, psychotherapy.

The obvious answer is that psychotherapy also helps in some way to help “heal our neurons.” Which begs the question — if healing our neurons is key, there are likely dozens of possible ways to do so. Why only focus and mention the medical cures?

Because of Leher’s deification of the power of medicine:

The progress exemplifies an important feature of modern medicine, which is the transition from a symptom-based understanding of a disease - depression is an illness of unrelenting sadness - to a more detailed biological understanding, in which the disease is categorized and treated based on its specific anatomical underpinnings.

This would be true if mental disorders were pure medical diseases. But they are not and have never been. They are human constructs of aberrant behavior or emotions. They are by no means universal (although some of the big ones, like depression, can be found in most human societies).

This new scientific understanding of depression also offers a new way to think about the role of drugs in recovery. While antidepressants help brain cells recover their vigor and form new connections, Castren says that patients must still work to cement these connections in place, perhaps with therapy. He compares antidepressants with anabolic steroids, which increase muscle mass only when subjects also go to the gym.

Yeah, because that’s how all medical treatments work, right? You need some encouragement for a drug to take effect? This is nonsense. Drugs either work or do not, they do not need to be “cemented” to the brain through therapy.

It also contradicts all of the extensive body of research that shows psychotherapy that works for depression without any drug whatsoever. What magical process occurs simply through talking with another human being that can change the very structure of your brain’s neuro networks?

Perhaps one day science will tell us. But these love letters in the media to neuroscientists have got to stop. Neuroscience will one day provide us the “keys to the kingdom” of understanding our brains. But until studies are done on humans (most of the studies Leher cites in his article — but fails to mention but once — are done on rats, not humans; a rat’s brains and a rat’s “depression” may be nothing like ours), we should approach this most recent theory with a healthy dose of skepticism.

Many researchers staked their professional careers and reputation on the theory that a “serotonin imbalance in the brain” caused depression. This was incorrect. This may also be the case of this latest fad brain theory to see the light of day and in another decade, may also be proven to be equally untrue. Until then, folks (especially the media) should keep a healthy skepticism about rat brain studies and new brain theories on depression. And ensure they account for or have a reasonable explanation for the effectiveness of psychotherapies such as cognitive-behavioral therapy (CBT) for depression.

Read the full article: How Prozac sent the science of depression in the wrong direction

Guns Are a Lethal Choice

I don’t mean to be insensitive to the potential for destructive nature of a gun in the home, but there was a spate of news articles yesterday regurgitating a statistic which is neither new nor news — that more than half of firearm deaths in the U.S. are suicides. From the Associated Press:

Public-health researchers have concluded that in homes where guns are present, the likelihood that someone in the home will die from suicide or homicide is much greater.

This isn’t news, however, as for the past 25 years, 80% of the time suicide has outranked homicides and accidents as the number one handgun killer.

Why do so many people turn to a handgun when they want to end their lives?

Perhaps it’s because nothing else in this world is quite like a handgun. A handgun’s only purpose is to kill or hurt someone. So it has an allure to many people to use it for its purpose. (A knife or rope or drugs, while all potential tools of suicide, also serve many other ordinary purposes, such as cutting up celery, tying down some luggage on the car rack, and treating a headache.) Also, in the throws of depression and suicidal thinking, the easiest, most lethal option may seem like a good choice.

But research notwithstanding, the right to bear arms is guaranteed by our Constitution, which the Supreme Court upheld as a fundamental right in this country last Thursday. Whatever public health concerns public health officials might have with firearms have to be weighed and balanced against that right. (And to be clear, this right wasn’t some reactionary amendment tacked on a few decades ago. It is a core element of our history for fear of being ruled once again by a repressive government.)

Researchers argue that if less lethal means are available, then less people’s suicide attempts will end in death. You can’t argue with that reasoning.

But to make this argument on the heels of the Supreme Court decisions seems to suggest that D.C.’s ban on private ownership of handguns was to stem the tide of suicides committed by handguns. However, that was not the case for the D.C. ban in the first place — it was to curb that city’s out-of-control murder rate (earning it the nickname of “the murder capital of the U.S.”). While suicide is a tragic component of handgun ownership, this news story is simply riding the coattails of the Supreme Court decision apparently in order to increase public awareness of this 25-year concern.

I think that’s okay (sometimes you need to find a “hook” to grab people’s attention), but I also think it’s stretching the point of “news” to package this as something new or different.

One of the most important components of the article was buried at the end:

The CDC traditionally was a primary funder of research on guns and gun-related injuries, allocating more than $2.1 million a year to such projects in the mid-1990s.

But the agency cut back research on the subject after Congress in 1996 ordered that none of the CDC’s appropriations be used to promote gun control.
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Vernick said the Supreme Court decision underscores the need for further study into what will happen to suicide and homicide rates in the district when the handgun ban is lifted.

Today, the CDC budgets less than $900,000 for firearm-related projects, and most of it is spent to track statistics. The agency no longer funds gun-related policy analysis.

This is the real outrage — that politics are used to drive a public health agency’s agenda. Research-driven prevention agencies like the CDC really should not be directed by the whims of ever-changing politics. They, and agencies like the NIH, should be shielded from any direct (or indirect) politics directing what studies they should or shouldn’t pursue. That’s scientists’ jobs, not politicans’.

Read the full article: More than half firearm deaths are suicides

Heather Locklear in Treatment for Depression, Anxiety

People magazine broke the story that actress Heather Locklear, 46, has checked into an Arizona treatment facility for psychological treatment of anxiety and depression.

“Heather has been dealing with anxiety and depression,” Locklear’s spokeswoman Cece Yorke said in a statement to Reuters. “She requested an in depth evaluation of her medication and entered into a medical facility for proper diagnosis and treatment.”

Yorke also said the matter was confidential and no other statements would be released.

Locklear is probably best known for her starring roles in the television series “Dynasty” in the 1980s, and “Melrose Place” in the early 1990s. She also starred in 62 episodes of the Michael J. Fox comedy, “Spin City,” in the later 1990s and has made guest appearances in “Scrubs,” “Two and a Half Men” and starred in a short-lived drama called LAX in 2004-2005.

Her most recent marriage ended in divorce in 2005 from Bon Jovi guitarist Richie Sambora, with whom she had her only child, a daughter. She had previously been married to Motley Crue drummer Tommy Lee. Locklear has reportedly begun dating Jack Wagner, her former “Melrose Place” co-star.

In March 2008, a man claiming to be Locklear’s doctor called 911 and asked for assistance.

“I have a patient and I have a feeling she’s suicidal,” he said to the 911 operator. “I would want someone to go and check on her.”

Locklear’s publicist downplayed the incident at the time, adding that the actress was “fine” and “never requested medical assistance.” The paramedics who visited her home in response to the 911 call left almost as quickly as they arrived after determining that everything was all right.

Wyeth’s Dr. Phil Ninan on Pristiq

This is the inaugural entry of a new occasional feature we’ll have here on World of Psychology, On the Couch with Dr. John Grohol. These entries will be interviews with various movers and shakers in the world of psychology, mental and behavioral health, and psychiatry. The schedule is to do at least one a month, so if there’s someone you’d like to see interviewed, please drop us a note!

Last Wednesday, I had the chance to sit down and talk to Dr. Phil Ninan, the Vice President of Wyeth’s Medical Affairs, Neuroscience on the telephone about their newest antidepressant medication, Pristiq. Pristiq is a “chemical cousin” of Wyeth’s existing successful antidepressant, Effexor (and its descendants like Effexor XR).

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