Suicide.  Self-inflicted death. The pain that drives an individual to commit suicide is mirrored by the pain experienced by those left behind to mourn.

In the past year, suicide has touched a number of families and individuals in our community. Two newly married men.  A high school boy. A college student. A friend. We react with shock that spirals into grief punctuated by a simple question: Why? And “was there something we could have done? Or noticed?”

Suicide is on the rise, both in the military and within our communities. By a margin of 2-1, it outstrips homicide as a cause of death in the United States, and is the 11th ranked cause of death in the United States. Statistically, more men actually succeed in killing themselves, while more women attempt suicide but do not die, in part because  men typically use more violent means (guns, hanging) to end their lives than women, who often use failure-prone methods such as overdosing.

Suicide may occur for a number of reasons, including depression, shame, guilt, desperation, physical pain, emotional pressure, anxiety, financial difficulties, or other undesirable situations. The World Health Organization noted that over one million people commit suicide every year, and that it is one of the leading causes of death among teenagers and adults under 35. There are an estimated 10 to 20 million non-fatal attempted suicides every year worldwide. It is estimated that each suicide in the United States leaves an average of six people intimately affected by the death, either as a spouse, parent, significant other, sibling, or child of the deceased person. These people are referred to as survivors.

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The predominant view of modern medicine is that suicide is a mental health concern, associated with psychological factors such as the difficulty of coping with depression, inescapable suffering or fear, or other mental disorders and pressures. Suicide is sometimes interpreted as a “cry for help” and attention, or to express despair and the wish to escape, rather than a genuine intent to die. Most people who attempt suicide do not complete suicide on a first attempt; those who later gain a history of repetitions have a significantly higher probability of eventual completion of suicide.

Common Suicide Risk Indicators

• A previous suicide attempt, even if it seemed staged or designed to get attention, or boasts of past or secret suicide attempts.
• Talking about being dead or wishing they were dead, how others would be happier if he/she were dead or how much better off others will be when he/she is gone.
• Repeatedly engaging in very risky or dangerous thrill seeking behavior.
• “Getting the house in order” – making plans for the care of loved siblings, parents, relatives or pets and giving away cherished belongings to close friends.
• Extreme mood swings; very depressed episodes followed by happy episodes with no clear reason for the change.
• Regular expressions of worthlessness, helplessness, sadness and/or loneliness.
• Drastic changes in habits, friends, or appearance, ie: new friends, skipping school, dropping out of favorite activities, and no longer caring about appearance or cleanliness.
• Changes in weight, sleeping habits, and physical activity.

A risk-assessment quiz designed for teenagers is available online.

When someone dies by suicide the people left behind can wrestle with a terrible emotional pain. Teens who have had a recent loss or crisis or who had a family member or classmate who committed suicide may be especially vulnerable to suicidal thinking and behavior themselves.

If you’ve been close to someone who has attempted or committed suicide, it can help to talk with a therapist or counselor — someone who is trained in dealing with this complex issue. Or, you could join a group for survivors where you can share your feelings and get the support of people who have been in the same situation as you.

What if this is you?

If you have been thinking about suicide, get help now. Depression is powerful. You can’t wait and hope that your mood might improve. When a person has been feeling down for a long time, it’s hard to step back and be objective.

Talk to someone you trust as soon as you can. If you can’t talk to a parent or a friend, talk to a coach, a relative, a school counselor, a religious leader, or a teacher. Call a suicide crisis line (such as 1-800-SUICIDE or 1-800-999-9999) or your local emergency number (911). These toll-free lines are staffed 24 hours a day, 7 days a week by trained professionals who can help you without ever knowing your name or seeing your face. All calls are confidential — no one you know will find out that you’ve called.

What if this is someone you know?

It is always a good thing to start a conversation with someone you think may be considering suicide. It allows you to get help for the person, and just talking about it may help the person to feel less alone and more cared about and understood.

Talking things through may also give the person an opportunity to consider other solutions to problems. Most of the time, people who are considering suicide are willing to talk if someone asks them out of concern and care. Because people who are depressed are not as able to see answers as well as others, it can help to have someone work with them in coming up with at least one other way out of a bad situation.

Even if a friend or classmate swears you to secrecy, you must get help as soon as possible — your friend’s life could depend on it. Someone who is seriously thinking about suicide may have sunk so deeply into an emotional hole that the person could be unable to recognize that he or she needs help.

Trauma, PTSD, and Suicide

In a survey of 5,877 people across the United States, it was found that people who had experienced physical or sexual assault at some point in their life also had a high likelihood of attempting to take their own life at some point:

• Nearly 22% of people who had been raped had also attempted suicide at some point in their life.
• Approximately 23% of people who had experienced a physical assault had also attempted suicide at some point in their life.

These rates of suicide attempts increased considerably among people who had experienced multiple incidents of sexual (42.9%) or physical assault (73.5%). They also found that a history of sexual molestation, physical abuse as a child, and neglect as a child were associated with high rates of suicide attempts (17.4% to 23.9%)

People with a diagnosis of PTSD are also at greater risk to attempt suicide. Among people who have had a diagnosis of PTSD at some point in their lifetime, approximately 27% have also attempted suicide.

Suicide has also become an item of serious concern within the military, which has recorded epidemic levels of suicide in the past year. The stress of repeated deployments  on both military personnel and their families has triggered a surge of emotional/psychiatric issues, including surges in both suicide and domestic violence. The surge in numbers has  forced the Pentagon to focus more intently on suicide prevention among its personnel.

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Source Material:

• TeensHealth: The Nemours Foundation
• World Health Organization
• SAVE: Suicide Awareness Voices of  Education
• Suicide.com
• National Suicide Prevention Lifeline
• National Institute of Mental Health

An April report from the Centers for Disease Control and Prevention in Atlanta found that African American mothers, who are less likely than white or Latina women to breastfeed, have reversed that trend and are now doing so in impressive numbers. Sixty-five percent of black women have nursed their infants at some point. This compares to a 36 percent rate 14 years ago. Still, only 20 percent of black mothers reach the government’s target goal of exclusively breastfeeding when their infants are six months old. Breastfeeding can help address health problems that plague both African American mothers and infants alike. Breastfeeding is the most natural and beneficial way to strengthen your baby’s immune system and provide the best possible nutrition for yourself, as a mother, and your baby.

“Breastfeeding has many benefits ranging from creating an important mother/baby bond to ensuring baby gets natural nutrients,” said Pam Noreiko, a lactation specialist at Baptist Hospital.

Baptist Hospital suggests six reasons why women should consider breastfeeding:

1. Breast milk is the most complete form of nutrition for infants. A mother`s milk has just the right amount of fat, sugar, water and protein that is needed for a baby`s healthy growth and development. Breastfed infants are seven times more likely to maintain a healthy weight gain and formula-fed infants. Breastfeeding also reduces infants’ risk of asthma, diabetes, infections and sudden infant death syndrome, all more common among African American infants.
2. Breastfeeding helps form a significant bond for mother and baby. Physical contact is important to newborns and can help the newborn feel more secure, warm and comforted.
3. Nursing uses up extra calories- 500 calories a day, making it easier to lose the pregnancy weight. It can also help ward off obesity and diabetes for which African American women are at higher risk. Breastfeeding also helps the uterus to get back to its original size and lessens any bleeding a woman may have after giving birth.
4. Breastfeeding lowers the risks of breast and ovarian cancer, and possibly the risk of hip fractures and osteoporosis after menopause. The health benefits continue through the next generation: Studies show breastfed daughters have lower rates of breast cancer when they grow up.
5. Breastfeeding makes your life easier. It saves time and money. There is no need to purchase, measure and mix formula continuously.
6. Breastfed babies score higher on IQ tests later in life, especially babies who were born prematurely.

All across the nation, advocates are offering wider education, tools and models for breastfeeding to make nursing the norm among black women. CDC officials are promoting “Healthy People 2010″ objectives that include having seventy-five percent of all mothers initiate breastfeeding and having fifty percent of all infants exclusively breastfeeding at 6 months.

The federal Office of Women’s Health has made “An Easy Guide to Breastfeeding for African American Women” available online. Thus far, 65 hospitals and birthing centers nationwide have worked to earn “Baby-Friendly” status from the World Health Organization and the United Nations Children’s Fund. This designation is awarded to facilities which offer “optimal” lactation support to patients. Such efforts include:

• breastfeeding videos playing in prenatal clinics’ waiting rooms,
• staff members who interact with patients receiving 18 hours of training in breastfeeding basics and lactation consultants meet with every new mother,
• moving infants out of the nursery into the mothers room, and providing free breast pumps to patients who can’t afford them.

Baptist Hospital’s Lactation Department has the medical knowledge and expertise to answer any questions that would help mothers breastfeed successfully. The department can be reached at (615) 284-3381. The Lactation Boutique at Baptist Hospital also offers a complete line of breastfeeding supplies, pumps and nursing bras to make the breastfeeding experience successful. Hours are Monday through Friday, 10 a.m. to 3 p.m. Please call 615-284-MILK (6455) for more information.

Details for this story was drawn from Baptist Hospital’s website media press releases and The Tennessean’s Healthtalk coverage and The Chicago Sun-Times.

Yes, the models will still be tall, thin, willowy, perhaps angular, but emaciated is OUT. It is a long-needed move toward better health with a long range goal of changing the perception of beauty from bone-baring thin to a more healthy shape.

In Hollywood films, on every TV channel, and in thousands of pages of fashion magazines, the icon of beauty for the past 20 years has been the ever-diminishing body mass of models. The concern exploded into public consciousness a few years ago with the skeletal form of TV’s Ally McBeal, and cross cuts social strata in the form of bulemia and anorexia, the health-endangering weight loss tactics used by too many women and girls in their efforts to be fashionably thin or meet some unrealistic standard of beauty.

This week the Cibeles show in Spain rejected three young models whose BMI was less than 16. The show requires a minimum BMI of 18. The models, from Italy, France and Poland, may have been healthy, but were deemed “too thin.” Cibeles barred “too thin” models from its runways in 2006, and that move is being emulated in the fashion houses in Milan and other couturier cities. Spain has also launched an effort to resize store mannequins away from the super-thin size -0- trend. The ban on low BMI models was spurred by concern for the health of models and the impact that thin body image has on teenagers as manifested in the form of eating disorders. In 2006, models in Brazil and Uruguay died on starvation in their quest for thinness.

England (London) has not joined this effort, although fashion leaders in that country have banned models under age 16 and also require health certificates for all models. The World Health Organization defines a BMI of 18.5 as underweight.

In a related story, Spain was reportedly taking the lead in an effort to create a standardized sizing system that will make clothes for women that actually fit. A recent study scanned 10,000 women and found that sizes of four in ten of those women could not be matched up with clothes available on store racks, and found most garments to small or too tight. “Vanity” sizing, the act of putting smaller size numbers on clothing, is just one of the mind games played out in the fashion industry. The result or the study: abolishment of the current sizing system.

Several fashion houses are sitting down with British government leaders to devise a new set of standards for the sizing of clothing that will factor in measurements of height, waist, bust, and hips. Standardizing those sizes could end the guesswork for millions of women. British planners hope their sizing standards will be adopted by countries across Europe. The sizing issue is being launched in the venue of women’s clothing, but menswear is next on the agenda. Another 10,000 people will be scanned in the near future — Men.

The studies unearthed disturbing findings: most women classified as too thin were actually “severely” underweight and should have medical help in dealing with their body image issues.

While on the surface and in light of global agendas, this whole issue of thinness may seem superficial. But the root of the studies and the recent implementation of BMI standards in fashion houses is a result of an alarming trend toward eating disorders and unrealistic perceptions of beauty.