With all the talk of Robin Williams’ recent death, and the renewed focus on clinical depression and suicide, it seems really important to address depression in people with schizophrenia. Sometimes people forget, or never think of, how often people with schizophrenia have depression. Over three dozen research studies have examined this very thing, and though rates between different studies varied, most often in these studies, at least 25% of people with schizophrenia had depression at some point in their lives, and sometimes the numbers were much higher. There are several ideas of why this is (though that discussion is for another day), but the important thing is the “occurrence of depression in schizophrenia has often been associated with worse outcome (5), impaired functioning, personal suffering (6), higher rates of relapse or rehospitalization (7–10), and even suicide (8,11, 12).” (Am J Psychiatry 2000;157:1379-1389. doi:10.1176/appi.ajp.157.9.1379)
Yesterday I came across a NAMI blog addressing Mr. Williams’ death and the things we all can do to identify, treat, and support people struggling with this disorder (see link). As you read it, please keep in mind that you or your loved one can get depression on top of schizophrenia, but that it is treatable and people get better. Many people in my practice struggle with depression at times, and I and their psychiatrist help them through it. Signs of depression to look for (some of which occur in schizophrenia, too, so talk to a mental health professional to be sure) include having the following for two weeks or more:>
- sad, empty, or irritable mood for a lot of the day
- having trouble enjoying things, everything seems “blah”
- a big change in sleep patterns
- a big change in appetite, or a major weight change without a change in eating
- low energy or being really tired
- problems with memory or concentration
- lots of negative thinking, like “I’m no good, nothing will ever get better, and this is all my fault”
- feeling sluggish or slow, or sometimes, feeling really jittery
- thoughts about death or suicide, whether or not you’d actually do it
If these symptoms sound familiar, take action. Get help. Don’t listen to the lies depression tells you. Talk to someone—your therapist, psychiatrist, a family member, call a crisis/suicide prevention hotline, or call 911. Don’t let depression take another person from us.
The following is a list of resources for suicide prevention:
- if you need immediate assistance call 911
- go to a hospital emergency room.
- 24-HOUR HOTLINE & HELPLINE INFORMATION
- National Hopeline Network 1-800-784-2433 (1-800-SUICIDE)
- National Suicide Prevention Helpline 1-800-273-8255 (1-800-273-TALK)
- Local Suicide Prevention Line: 612-347-2222
- Crisis Connection: 612-379-6363 or 1-866-379-6363
- Dakota County Crisis Line: 952-891-7171
- Fairview University Crisis Line: 612-672-6600
- Ramsey County Crisis Line: 651-523-7000
- Hennepin County Crisis line: 612-873-2222
Websites:
- http://www.hopeline.com/
- www.crisis.org (the Crisis Connection website)
- www.crisischat.org
- www. suicidal.com
- www.the-bright-side.org
- Suicide Hotline Listing by State http://www.suicidehotlines.com/
- American Association of Suicidology http://www.suicidology.org/
- American Foundation for Suicide Prevention http://www.afsp.org/
- Prevent Suicide Now http://www.preventsuicidenow.com/
- Suicide prevention resources, worldwide hotline links:
http://www.psycom.net/depression.central.suicide.html - http://www.befrienders.org/
- Families for Depression Awareness http://www.familyaware.org/
- Suicide Prevention Action Network USA http://www.spanusa.org/