Dr Sumayya Nousheen Karigar
ABSTRACT: Suicidal behaviour is a matter of great concern for clinicians who deal with mental health problems of children and adolescents. The incidence of suicidal attempts reaches a peak during the mid-adolescent years, and mortality from suicide which increases steadily through the teens, is in many countries, one of leading causes of death at that age. Homoeopathy with its bio-psycho-social frame work can bring down this mortality rate.
KEY WORDS: suicide, suicidal ideation, mood disorders, bio-psycho-social model.
INTRODUCTION: Suicidal behaviour is a matter of great concern for clinicians who deal with mental health problems of children and adolescents. The incidence of suicidal attempts reaches a peak during the mid-adolescent years, and mortality from suicide which increases steadily through the teens, is in many countries, one of leading causes of death at that age.
The vast majority of the children and adolescents who complete suicide have some of psychiatric illness. The paediatricians and primary care providers should ask about depression and suicidal ideation at each adolescent visit and must be comfortable assessing suicidal risk and knowing when to refer children and adolescent for mental health care.
RISK FACTORS: the origin of suicidal behaviour can understood using a bio-psycho-social frame work.
Biological factors like heritable alterations in the serotonin system are associated with suicide completion.
Psychological and social factors must also be considered to be obtain a more complete picture of suicidal behaviour of children and adolescents who attempt suicide, 2/3 can name a precipitating event for their action. A remote or recent history of child maltreatment or sexual assault is associated with suicide. General association between family conflict sand suicidal attempts. In older adolescent, life events, such as relationship breakup, are commonly associate with suicidal attempts. Feeling of hopelessness / depression. Immigrants, suicidal ideation is associated with high levels of acculturative stress, is especially in the context of family dysfunction and perception of limited options.
MANAGEMENT OF SUICIDAL IDIATIONS:
The role of management is vital in case of management of suicidal behaviour to address many psychosocial problems, AMERICAN ACADEMY OF CHILD AND ADOLESCENTS PSYCHIATRY model shows how suicide occurs and highlights type of targeted preventive intervention which helps clinician to understand and target at various levels to prevent suicidal ideation and behaviour.
1. Find and treat
2. Hard line
3. Media guideline
4. Method control
The main causation and risk factors for suicidal ideation or behaviour can be understood by using bio-psycho-social model, as homoeopath considers patient at all three levels that is biological, psychological and social, Prescription based on totality of case and early intervention can help patient to cope up with suicidal ideation and prevention of suicidal behaviour.
SOME HOMOEOPATHIC REMEDIES:
- AURUM METALLICUM: LOATHING OF LIFE
The depression of Aurum is endogenous or organic, a recognition of the constitutional susceptibility of the type towards deep depression. Patient will continue to function efficiently in the world until the last movement, when he will either slip into hysterical weeping or be unable to collect his thoughts, or will commit suicide.
- ALUMINA: MENTAL INSTABILITY
Alumina is prone to powerful emotions, particularly despair and a relatively contented state, changing several times with in a day. Alumina have very characteristic impulse to kill herself when she sees a knife or other sharp object.
- KALI BROMIUM: RIGIDITY
Suicidal mania with tremulousness, depressed mood with sleeplessness due to worry and grief. Fits of uncontrollable weeping, depressed, low spirited.
- SILICEA: DELICATE AND DETERMINED
Loss of self-confidence, fixed ideas, disgust of life, wishes to drown herself, dread of failure.
Thinks only about pins and fear them.
- NUX VOM: THE CONQUEROR
Very irritable, sensitive to all impressions, impulsive behaviour, suicidal disposition, particularly by shooting himself with a gun or jumping from a height.
- SEPIA: THE INDEPENDENT LEADY
Wants to commit suicide, angry, sensitive, very irritable and easily offended and miserable, indifference to those love ones, aversion to occupation and family, weeps when telling symptoms, anxious towards evening, indolent.
- THUJA: SEXUAL GUILT
Emotional sensitive, music causes weeping and trembling. Fixed ideas, Thuja child grows up feeling she is very bad, and when she falls depression, she is tempted to kill herself, or just to stab herself till she bleeds.
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Dr Sumayya Nousheen Karigar
MD Part 1, Dept of Psychiatry
Father Muller Homoeopathic Medical College & Hospital,Mangalore.