Warning Signs of Depression

Symptoms of depression are often experienced by primary caregivers. These can include feeling empty, a growing inability to enjoy anything, hopelessness, loss of sexual desire, loss of warm feelings for family and friends, feelings of self-blame or guilt, and loss of self-esteem. Changes in behavior and attitude can include a general slowing down, neglect of responsibilities and appearance, poor memory and inability to concentrate. Physical symptoms may include sleep disturbance, such as early morning waking, sleeping too much or insomnia; lack of energy; loss of appetite; unusual weight loss or gain; unexplained headaches or backaches, stomachaches, indigestion, or changes in bowel habits.

A caregiver experiencing these symptoms would have a good reason to seek a psychiatric evaluation and to begin anti-depressive medication, and/or mental health treatment. Some people are needlessly opposed to any kind ?medication.? New medications have been developed with very few side effects, and no anti-depressive medication is addicting. That is not true for the anti-anxiety medications, which should be used very temporarily.

Warning Signs of Suicidal Behavior

People are naturally frightened by the threat of a loved one committing suicide. Though individuals with more severe disabilities may not be able to plan and carry through with a suicide, this might be a possibility with someone with mild to moderate disabilities. Even if the possibility is slight, it is sometimes a real fear for the caretakersor even a possibility for the caretakers themselves. Therefore, the following danger signs are provided below, in order to help identify the potential for self-harm and the need to intervene.

1. A severe reaction (or no reaction at all) to a recent loss of a close boy or girl friend, or divorce of one's parents, or death of a loved one.
2. The anniversary date of the death of a loved one, especially if suicidal thoughts were associated with the loss in the past.
3. Sudden changes in personality functioning that don?t fit with what you have known about the person, especially if they are prolonged over many weeks: withdrawal in despondency, inability to communicate if this is new, over-reaction to seemingly minor problems and irritations that were tolerated before.
4. Feelings of severe guilt or hostility toward others which are then turned upon one's self.
5. A sudden inability to sleep, or an extreme increase in sleep; crying spells for unknown reasons; loss of appetite, or neglect of personal appearance which was not the case previously.
6. Excessive use of alcohol and other drugs; repeated accidents, or increasing anxiety and panic accompanying increased responsibilities.
7. For teen-agers, chronic unresolved family arguments with escalating conflict; adolescent-parent crisis; romantic upsets; excessive statements about "going crazy" or "losing my mind."
8. Increased dependency on others which was not demonstrated before; inability to carry out one's responsibilities expressed by staying home from school or work; inability in securing a job (not a problem previously); or withdrawal from social groups (enjoyed previously).
9. The expression of a suicidal plan or preparation for an attempt including the collection of pills, the giving away of prized possessions, and the theme of death being prevalent in speech (or writing), directly or indirectly.
10. Expressions such as "I wish I were dead," and "I'm no good to anyone," or "The world would be better off without me," or "Life is not worth living."

We can Help to Prevent Suicide

Research shows no evidence that talking with a person about his or her suicidal feelings has increased the risk. In fact the reverse is true: talking about it and helping the person to process what is underlying these feelings is helpful. Avoid closing off remarks by trying to be ?upbeat? as in ?There, there, you?ll be OK!? If the person can communicate verbally, help by probing and allowing him or her to ventilate feelings. Most importantly, help explore other alternatives: is this the only way to deal with the situation? Why not try something else first? And second? And third?.? Make a plan to have someone stay with the person, if you feel it is necessary. Most suicidal crises have a time frame of only one or two days, but can be repeated. Severe or ongoing suicidal thoughts/actions would be reason for a course of mental health treatment, leading to psychiatric hospitalization if necessary.

Resources

The National Association for the Dually Diagnosed (NADD): NADD Web Site NADD is the leading North American expert in providing professionals, educators, policy makers, and families with education, training, and information on mental health issues relating to persons with intellectual or developmental disabilities.
DDMED Website by Alabama Department of Mental Health and Mental Retardation Web Site DDMED provides a roadmap for professionals and caregivers for persons with intellectual disability and other health problems such as mental illness or neurological disorders.
Attached is a Directory of Utah State Mental Health Services. Utah State Mental Health Directory.

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