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Chronic Invisible Illness and Suicide

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Understanding the Relationship between Chronic Illness and Suicide

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Chronic Invisible Illness and Suicide

  1. 1. Understanding the Relationship between Chronic Illness and Suicide Cathy L. Pederson, Ph.D. Professor of Biology, Wittenberg University Founder, Standing Up to POTS®
  2. 2. Chronic Invisible Illnesses • Chronic illnesses: Prolonged, don’t resolve spontaneously, and are rarely cured completely –Debilitating, but not fatal • Invisible: Lack of diagnostic tests –Blood tests normal –Urine tests normal –MRI, CT, ultrasounds normal •Found predominantly in women https://upload.wikimedia.org/wikipedia/commons/e/ee/Vacutainer_blood_bottles .jpg Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To
  3. 3. Chronic, Invisible Illness: Postural orthostatic tachycardia syndrome (POTS) • 500,000 to 3 million cases in US • 75% cases in women age 15-50 • ~ 1% of teens have POTS • Triggers • Viral infection • Pregnancy • Surgery or other trauma • Characterized by • Increased heart rate by 30 (adult) or 40 (children) beats per minute upon standing with no significant change in blood pressure http://standinguptopots.org/learning/pots-causes Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To
  4. 4. Chronic, Invisible Illness: Postural orthostatic tachycardia syndrome (POTS) • Dysfunction of autonomic nervous system that affects • Heart rate  tachycardia • Blood vessel diameter  blood pooling, lightheadedness, dizziness, headaches • Pupil diameter  light sensitivity • Food movement in digestive tract  gastroparesis • Body temperature  hot flashes, chills http://standinguptopots.org/livingwithpots/profiles Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To
  5. 5. Chronic, Invisible Illness: Myalgic encephalomyelitis and chronic fatigue syndrome • 1 million cases in US – Most often in adult women • Triggers include – Viral infection – Hormonal imbalances • Dysfunction of – Central nervous system – Immune system – Cellular energy metabolism – Ion transport http://bigeddyfilmfest.com/unrest/ Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To
  6. 6. Chronic, Invisible Illness: Myalgic encephalomyelitis and chronic fatigue syndrome • Symptoms – Unrefreshing sleep Fatigue – Headaches – Loss of memory/concentration – Enlarged lymph nodes – Unexplained muscle/joint pain – Extreme exhaustion more than 24 hours after physical or mental exercise Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To https://uppercervicalawareness.com/myalgic- encephalomyelitis-chronic-fatigue-syndrome-basics/
  7. 7. Chronic, Invisible Illness: Ehlers-Danlos Syndrome • Genetic condition that affects connective tissues that support skin, bone, blood vessels, most organs • Range from mildly loose joints to life-threatening complications • 13 different types, most include hypermobility – 1 in 5,000 people have EDS (all types combined) http://nimbusmassage.com/2018/05/01/massage-ehlers-danlos-syndrome/ Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To
  8. 8. Chronic, Invisible Illness: Ehlers-Danlos Syndrome • Disrupts connective tissue that results in – Loose joint articulation  subluxations, dislocations – Soft, velvety skin  stretchy, bruising, abnormal scarring – Tearing of blood vessels  internal bleeding, organ rupture (particularly vascular type) https://mastcellblog.wordpress.com/journey/edsphotos/ Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To
  9. 9. Chronic, Invisible Illness: Fibromyalgia • ~4 million people in US – 75-90% are adult women • Triggers – Physical trauma – Surgery – Infection – Significant psychological stress https://prsrehabservices.com/patcenter/articles/dry-needling-fibromyalgia/ Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To
  10. 10. Chronic, Invisible Illness: Fibromyalgia • Symptoms – Widespread pain > 3 months • Both sides of body • Above and below waist – Fatigue – Cognitive difficulties • Trouble concentrating https://modiht.com/what-we-treat/fibromyalgia/fibromyalgia-pain-cycle/ Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To
  11. 11. Chronic Invisible Illness: Lyme Disease •~ 300,000 people diagnosed annually •Transmitted by bite of infected black legged (deer) ticks •Early symptoms •Fever •Headache •Fatigue •Bullseye rash •Cured with antibiotics if caught early http://www.michiganradio.org/post/its-tick-season-again-heres-what-you-should-look-out https://www.bayarealyme.org/blog/lyme-disease-bullseye-rash/ Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To
  12. 12. Chronic Invisible Illness: Lyme Disease •Symptoms of chronic Lyme –Severe headaches –Dizziness –Problems with short term memory –Neck stiffness –Facial palsy –Rashes –Arthritis –Intermittent pain in tendons, muscles, joints and bones –Heart palpitations Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up ToInformation from https://www.cdc.gov/lyme/ https://www.lymedisease.org/lyme-basics/lyme-disease/symptoms/
  13. 13. Significant Impairment in Quality of Life •Problems with –General health –Sleep –Brain fog –Bodily pain •Neuropathic pain •Migraine headaches •Abdominal pain •Muscular and joint pain –Physical and social functions Pederson, C. L., & Brook, J. B. (2017). Health-related quality of life and suicide risk in postural tachycardia syndrome. Clinical Autonomic Research, 27(2), 75-81. Schmaling, K. B., & Betterton, K. L. (2016). Neurocognitive complaints and functional status among patients with chronic fatigue syndrome and fibromyalgia. Qual Life Res, 25(5), 1257-1263. Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To 0 5 10 15 20 25 30 35 Dayspermonth POTS Mean Control Mean Pederson, C. L., & Brook, J. B. (2017). Health-related quality of life and suicide risk in postural tachycardia syndrome. Clinical Autonomic Research, 27(2), 75-81.
  14. 14. Significant Impairment in Quality of Life •Significant minority (30%) require help with activities of daily living –Eat –Bathe –Brush teeth/hair –Dress –Move around house Pederson, C. L., & Brook, J. B. (2017). Health-related quality of life and suicide risk in postural tachycardia syndrome. Clinical Autonomic Research, 27(2), 75-81. Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To https://www.advancedrm.com/measuring-adls-to-assess-needs-and-improve-independence/
  15. 15. Common Symptom of Chronic Illness: Chronic Pain • Pain is self-reported – No good diagnostic tool – Not objectively quantified • Neuropathic pain – Shooting – Stabbing – Burning – Stinging • Headaches • Abdominal pain • Chest pain • Joint pain http://img.medscape.com/thumbnail_library/dt_150916_chronic_pain_headache_migr aine_800x600.jpg https://dfzljdn9uc3pi.cloudfront.net/2013/37/1/fig-1-full.png Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To
  16. 16. Common Symptom of Chronic Illness: Chronic Pain • Central sensitization to pain –Pain pathways increase with use –More pain, increased sensitivity to pain –Critical to treat pain in first 6 months • Factors that increase sensitization –Autonomic nervous system dysfunction –Genetic predisposition –Infections/inflammation –Trauma –Psychological factors –Poor sleep https://www.painscience.com/imgs/knob-pain-m.jpg Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To
  17. 17. Common Symptom of Chronic Illness: Chronic Pain • Prevalent in • Myalgic encephalomyelitis, chronic fatigue syndrome (ME, CFS) • Ehlers-Danlos syndrome (EDS) • Fibromyalgia • Lyme disease • Postural orthostatic tachycardia syndrome (POTS) • Chronic pain – Interferes with activities of daily living – Increases suicide ideation and attempts1,2 https://www.7ad.com.au/martin-agatyn/martins-interviews/83430- health-matters-july-23-chronic-pain Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To 1. Legarreta, M., Bueler, E., DiMuzio, J., McGlade, E., & Yurgelun-Todd, D. (2018). Suicide behavior and chronic pain: An exploration of pain-related catastrophic thinking, disability, and descriptions of the pain experience. J Nerv Ment Dis, 206(3), 217-222. 2. Racine, M. (2017). Chronic pain and suicide risk: A comprehensive review. Prog Neuropsychopharmacol Biol Psychiatry, pii: S0278-5846(17)30467-0, 1-12.
  18. 18. Common Symptom of Chronic Illness: Sleep Disturbance • Decreased sleep efficiency • Insomnia • Nightmares • Can be related to: – Pain – Sympathetic surges – Lack of exercise – Poor sleep hygiene • Increases risk of suicide1 http://www.reilycenter.com/wp-content/uploads/blogs/sleep.jpg 1. Pederson, C. L., & Brook, J. B. (2017). Sleep disturbance linked to suicidal ideation in postural orthostatic tachycardia syndrome. Nat Sci Sleep, 9, 109-115. Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To
  19. 19. Common Symptom of Chronic Illness: Fatigue • Unrelenting exhaustion not relieved by rest – Not the same as being tired • Reduces – Energy – Motivation – Concentration – Emotional wellbeing • Often the most debilitating symptom of chronic illness http://standinguptopots.org/ Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To
  20. 20. Common Symptom of Chronic Illness: Depression • Link between chronic medical illness and depression – Heart disease – Cancer – Other well understood illnesses • 50 % of people with chronic pain are depressed1 • 35% of those with POTS reported severe to extreme depression2 https://mydiaryofaquarterlifer.wordpress.com/2017/02/24/is-there- such-a-thing-as-part-time-depression/ 1. Nicholas, M. (2011). Depression in people with pain: There is still work to do. Scandinavian Journal of Pain, 2(2), 45-46. 2. Pederson, C. L., & Brookings, J. B. (2018). Suicide risk linked with perceived burdensomeness in postural tachycardia syndrome. Journal of Health Science & Education, 2(1), 1-8. Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To
  21. 21. Common Symptom of Chronic Illness: Depression • Must be diagnosed carefully – Most depression screenings include questions about physical symptoms • Chronic illness symptoms artificially increase depression scores – Overlapping symptoms, including changes in • Appetite • Weight • Sleep • Fatigue • Ability to work • Worry about health • Interest in sex https://medworksmedia.com/product/zung-self-rating-depression-scale/ Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up ToPederson, C., Gorman-Ezell, K., & Mayer, G. (2018). Assessing depression in those who are chronically ill. Counseling Today, 60(9), 38-43.
  22. 22. Challenges for the Chronically Ill • Lack of quality medical care – Difficult to diagnose – Difficult to treat – Best case: manage symptoms well • Stigma – Not really sick, “all in your head” – Symptoms from psychological rather than physical problems • Physical barriers – Decreased mobility – Poor memory – Confusion – Poor quality of life http://standinguptopots.org/learning/pots-symptoms Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To
  23. 23. Challenges for the Chronically Ill • Grieving the loss of a healthy body • Feelings of isolation and loneliness • Struggling to find a new role in school, work, and relationships • Loss of hope • Perceive themselves as a burden – Feel judged – Withdrawal of love and/or support • Financial pressures from – Medical bills – Medication – Inability to work http://www.nerdgirl.com/wp-content/uploads/2013/03/ 480628_571779489523061_818166877_n.jpg Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To
  24. 24. U.S. Suicide Statistics • 10th leading cause of death in US for all ages – 44,965 suicides in 2016 – 1.3 million made attempts – One suicide every 13 minutes • Women attempt suicide 3x more than men • Highest % with serious suicidal thoughts – 18-25 (8.8%) – 26-49 (4.2%) http://www.cdc.gov/violenceprevention/pdf/suicide-datasheet-a.PDF Statistics taken from National Institute of Mental Health https://www.nimh.nih.gov/health/statistics/suicide.shtml Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To
  25. 25. Risk factors for suicide • Major physical illness • Sense of isolation • Hopelessness • Job or financial loss • Loss of relationships • Lack of good health care • Stigma with asking for help • Easy access to lethal means • History of trauma or abuse • Previous suicide attempt • Family history of suicide or knowing others who died by suicide http://67.media.tumblr.com/1b019e134c0785b4303066c8aeb6e751/tumblr_nqpvszbP7I1u5go9do1_500.gif Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To
  26. 26. Suicide Not Always Related to Depression •Many with chronic illness have no mental health diagnosis1 •Response to suffering •Mechanism to permanently relieve distress2 •Life weariness3 •Negative treatment by healthcare practitioners4 https://www.healthline.com/health/depression/talking-about-depression-at-work 1. Ahmedani, B. K., Peterson, E. L., Hu, Y., Rossom, R. C., Lynch, F., Lu, C. Y., . . . Simon, G. E. (2017). Major physical health conditions and risk of suicide. Am J Prev Med, 53(3), 308-315. 2. Alderson, S. L., Foy, R., Glidewell, L., McLintock, K., & House, A. (2012). How patients understand depression associated with chronic physical disease--a systematic review. BMC Fam Pract, 13, 41. 3. Newton-John, T. R. O. (2014). Negotiating the maze: Risk factors for suicidal behavior in chronic pain patients. Current Pain and Headache Reports, 18(9), 1-7. 4. Jason, L. A., Corradi, K., Gress, S., Williams, S., & Torres-Harding, S. (2006). Causes of death among patients with chronic fatigue syndrome. Health Care Women Int, 27(7), 615-626. Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To
  27. 27. Factors that Increase Suicide Risk • Physical illness1 • Multiple physical illnesses2 • Chronic invisible illness3 • Functional disability4 • Chronic pain5 • Sleep disturbance6 http://images.wisegeek.com/bedridden-woman.jpg 1. Cheung, G., & Sundram, F. (2017). Understanding the progression from physical illness to suicidal behavior: A case study based on a newly developed conceptual model. Clin Gerontol, 40(2), 124-129. 2. Ahmedani, B. K., Peterson, E. L., Hu, Y., Rossom, R. C., Lynch, F., Lu, C. Y., . . . Simon, G. E. (2017). Major physical health conditions and risk of suicide. Am J Prev Med, 53(3), 308-315. 3. Pederson, C. L. (2018). The importance of screening for suicide risk in chronic invisible illness. Journal of Health Science & Education, 2(4), 1-5. 4. Fässberg, M. M., Cheung, G., Canetto, S. S., Erlangsen, A., Lapierre, S., Lindner, R., . . . Wærn, M. (2016). A systematic review of physical illness, functional disability, and suicidal behaviour among older adults. Aging Ment Health, 20(2), 166-194. 5. Nicholas. 2011. Depression in people with pain: There is still work to do. Scandinavian Journal of Pain 2(2): 45-46. 6. Pederson, C. L., & Brook, J. B. (2017). Sleep disturbance linked to suicidal ideation in postural orthostatic tachycardia syndrome. Nat Sci Sleep, 9, 109-115. Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To
  28. 28. Increased Risk of Suicide in these Chronic Illness Populations • Increased risk of suicide documented – Second leading cause of death in ME, CFS1 • 20% of ME, CFS patients die by suicide2 – 48% with POTS were at high risk for suicide3 – 33% with fibromyalgia experience suicidal ideation4 – 4% with hypermobile EDS attempted suicide5 – 1,200 deaths by suicide chronic Lyme6 1. Jason, L. A., Corradi, K., Gress, S., Williams, S., & Torres-Harding, S. (2006). Causes of death among patients with chronic fatigue syndrome. Health Care Women Int, 27(7), 615-626. 2. Smith, W. R., Noonan, C., & Buchwald, D. (2006). Mortality in a cohort of chronically fatigued patients. Psychol Med, 36(9), 1301-1306. 3. Pederson, C. L., & Brook, J. B. (2017). Health-related quality of life and suicide risk in postural tachycardia syndrome. Clinical Autonomic Research, 27(2), 75-81. 4. Triñanes, Y., González-Villar, A., Gómez-Perretta, C., & Carrillo-de-la-Peña, M. T. (2015). Suicidality in chronic pain: predictors of suicidal ideation in fibromyalgia. Pain Pract, 15(4), 323-332. 5. Cederlöf, M., Larsson, H., Lichtenstein, P., Almqvist, C., Serlachius, E., & Ludvigsson, J. F. (2016). Nationwide population-based cohort study of psychiatric disorders in individuals with Ehlers-Danlos syndrome or hypermobility syndrome and their siblings. BMC Psychiatry, 16, 207. 6. Bransfield, R. C. (2017). Suicide and Lyme and associated diseases. Neuropsychiatr Dis Treat, 13, 1575-1587. Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To
  29. 29. Warning Signs for Suicide • Talking about – Wanting to die – Feeling trapped – Feeling hopelessness – Burdening others – Unbearable pain • Extreme mood swings • Saying goodbye • Giving away prized possessions • Actively developing a plan http://az616578.vo.msecnd.net/files/2016/06/04/636006642408487502-34369144_suicideeee.jpg Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To
  30. 30. Health Practitioners Can Help Prevent Suicide • Of those who attempt suicide – 64% visited healthcare practitioner in previous month – 38% visited the previous week1 • Actively screen chronically ill patients for suicidal thoughts – Online questionnaires – Ask during appointment https://blog.medmee.org/the-relationship-between-health-care- professionals-and-patients-consumers-varies-from-region-to- b04391e6f5e6 Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To 1. Ahmedani, B. K., Stewart, C., Simon, G. E., Lynch, F., Lu, C. Y., Waitzfelder, B. E., . . . Williams, K. (2015). Racial/Ethnic differences in health care visits made before suicide attempt across the United States. Med Care, 53(5), 430-435.
  31. 31. Health Practitioners Can Help Prevent Suicide • Give contact information for national organizations – National Suicide Prevention Lifeline 1-800-273-TALK – Hopeline 741741 and text “start” – National Alliance of Mental Illness in your community • Create a contact list of professionals who understand chronic illness – Social workers – Counselors – Religious leaders – Suicide support groups Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To
  32. 32. Healthcare Providers can Reduce Suicide Risk Factors by Treating •Chronic pain –Medications –Acupuncture/Massage –Biofeedback –Meditation –Physical Therapy –TENS Units •Targeted therapy may revolutionize pain treatment https://www.everydayhealth.com/hs/psoriasis-treatment-management/treatment-overview/ Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To For more tips and tricks, visit http://standinguptopots.org/treatment/pain
  33. 33. Healthcare Providers can Reduce Suicide Risk Factors by Treating •Sleep disturbance –10,000 lumen light in morning –Sleep supplements •Magnesium •5-HTP –Sleep medications •Clonidine •Klonopin/Xanax if anxious –Meditation/relaxation techniques –Limit stress/caffeine in evening –Avoid exercise 3 hours before bed http://mentalpod.com/archives/4773 For more tips and tricks, visit http://standinguptopots.org/treatment/insomnia Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To
  34. 34. Healthcare Providers can Reduce Suicide Risk Factors by Treating •Depression –Exercise, if possible –Medication •Antidepressants can also help chronic pain –Tricyclics like Amitriptaline –Serotonin norepinephrine reuptake inhibitors like Cymbalta –Psychotherapy with counselor that understands chronic illness –Electroconvulsive therapy https://web.wellness-institute.org/blog/whats-the-best-way-to-treat-depression- medication-psychotherapy-or-hypnotherapy Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To
  35. 35. Health Practitioners Can Help Prevent Suicide • Practice compassionate care – BELIEVE patients when they talk about their illness • Recent studies show physical anomalies for – Myalgic encephalomyelitis, CFS1 – Lyme disease2 – POTS3 – LISTEN without judgment – BE GENUINE in your concern – INSTILL HOPE for the future https://woundcareadvisor.com/compassionate-care-the-crucial- difference-for-ostomy-patients_vol2-no5/ 1. Loebel, M., Grabowski, P., Heidecke, H., Bauer, S., Hanitsch, L. G., Wittke, K., . . . Scheibenbogen, C. (2016). Antibodies to β adrenergic and muscarinic cholinergic receptors in patients with Chronic Fatigue Syndrome. Brain Behavior and Immunity, 52, 32-39. 2. Strle, K., Sulka, K. B., Pianta, A., Crowley, J. T., Arvikar, S. L., Anselmo, A., . . . Steere, A. C. (2017). T-Helper 17 cell cytokine responses in Lyme disease correlate with Borrelia burgdorferi antibodies during early infection and with autoantibodies late in the illness in patients with antibiotic-refractory Lyme arthritis. Clin Infect Dis, 64(7), 930-938. 3. Ruzieh, M., Batizy, L., Dasa, O., Oostra, C., & Grubb, B. (2017). The role of autoantibodies in the syndromes of orthostatic intolerance: a systematic review. Scand Cardiovasc J, 51(5), 243-247. Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To
  36. 36. Health Practitioners (and others) Can Prevent Suicide • Recommend online support groups – Decrease isolation and hopelessness • Promote counseling with someone who understands chronic illness/pain • Learn warning signs for suicide • Encourage caregivers to – Learn about specific chronic illness – Guard their own health – Find a support group http://4.bp.blogspot.com/-_- cBdSLVUG8/T3tChzIvNsI/AAAAAAAAANk/3bIEdnXF8fg/s1600/online- support-network1-300x200.jpg Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To
  37. 37. Health Practitioners (and others) Can Prevent Suicide •Identifying suicidal thinking in early stages gives time for –Medications and other treatment –Counseling –Improving relationship dynamics •Decreasing feelings of burdensomeness •Increasing socialization via text, phone, or home visits Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To https://listovative.com/top-10-reasons-why-socializing-is-very- important/ Pederson, C. L. (2018). The importance of screening for suicide risk in chronic invisible illness. Journal of Health Science & Education, 2(4), 1-5.
  38. 38. The Interpersonal Theory of Suicide •Perceived burdensomeness –Feeling like a burden to family and friends –97% of POTS patients limited by illness1 •30% need help with basic personal care •25% so disabled can’t work or attend school –Elevated in chronic pain patients2 Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To 1. Pederson, C. L., & Brook, J. B. (2017). Health-related quality of life and suicide risk in postural tachycardia syndrome. Clinical Autonomic Research, 27(2), 75-81. 2. Kanzler, K. E., Bryan, C. J., McGeary, D. D., & Morrow, C. E. (2012). Suicidal ideation and perceived burdensomeness in patients with chronic pain. Pain Practice, 12(8), 602-609.
  39. 39. The Interpersonal Theory of Suicide •Failed belongingness –71% of POTS patients reported failed belongingness –76% reported high/very high levels of loneliness •Physical limitations •Different life experiences https://positivitypost.com/isolation-and-loneliness-pose- dangerous-health-threat/ Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up ToPederson, C. L., & Brookings, J. B. (2018). Suicide risk linked with perceived burdensomeness in postural tachycardia syndrome. Journal of Health Science & Education, 2(1), 1-8. https://miamioh.edu/cas/academics/departments/psychology/
  40. 40. The Interpersonal Theory of Suicide •Perceived burdensomeness –May be more important suicide risk factor than •Failed belongingness1, 2 – Feeling that you don’t belong in a social group •Loneliness1, 3 •Depression1 Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To 1. Pederson, C. L., & Brookings, J. B. (2018). Suicide risk linked with perceived burdensomeness in postural tachycardia syndrome. Journal of Health Science & Education, 2(1), 1-8. 2. Zullo, L., Horton, S., Eaddy, M., King, J., Hughes, J., Diederich, A., . . . Stewart, S. (2017). Adolescent insomnia, suicide risk, and the interpersonal theory of suicide. Psychiatry Res, 257, 242-248. 3. Van Orden, K. A., Cukrowicz, K. C., Witte, T. K., & Joiner Jr., T. E. (2012). Thwarted belongingness and perceived burdensomeness: Construct validity and psychometric properties of the Interpersonal Needs Questionnaire. Psychological Assessment, 24(1), 197-215. http://www.klein-kraepelin.com/
  41. 41. How Can YOU Help? •Believe them when they talk about symptoms and suffering –Don’t try to fix their illness •Stay in contact •Be understanding when plans get canceled •Plan fun activities in their home •Take talk of suicide seriously http://riverpodcast.com/church-family-healing-family-wounds/ Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To For more information, visit http://standinguptopots.org/living withpots/suicide-prevention
  42. 42. Questioning Suicidal Thinking • Are you getting the best medical care? • Do you have someone you can talk with about this? • Do you have hope for the future? • Are you lonely? • Do you feel like a burden? • Does thinking about suicide provide you with comfort? •Do you really want to die? http://cdn2.momjunction.com/wp-content/uploads/2015/03/Teen- Suicide.jpg Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To
  43. 43. Call to Action • Educate others about chronic illnesses – Looking fine ≠ feeling fine • Consider suicide, even if not depressed – Ask about suicidal thinking – Decrease feelings of perceived burdensomeness, failed belongingness, loneliness – Actively pursue treatments for sleep issues, chronic pain, and depression – Join a support group • Be the one who listens and tries to understand – you could save a life http://medsin.org/public/images/diagram.png Standing POTS® Raising awareness for Postural Orthostatic Tachycardia Syndrome Up To

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