Stress ,depression ,suicidal ideation

Introduction:

The present day educational system is extremely competitive in nature. Every student is faced with a high demand to surpass oneself. Failure to do so may often be considered as a mark of the failure of one's existence by the youngster, whose limited life experience does not permit him/her to seek an alternative. Adolescents thus see themselves in highly conflicting situations as they often expect to perform their best in the academic field. They often get so frustrated, angry and hopeless that suicide becomes their only escape.

It is important to realize that stress affects memory and the psychological well being of students. Academic stress particularly among students has been assessed as one of the most important causal factors for among adolescents suicide. In fact, according to the American Academic of child and Adolescent Psychiatry (2004) suicide is found to be the third leading cause of death between ages15-24 and college students are most likely than the general population to attempt suicide.

Stress

The word 'stress' is defined by the Oxford Dictionary as "a state of affair involving demand on physical or mental energy". A condition or circumstance, which can disturb the normal physical and mental health of an individual. Hans Selye (1974) defined stress as a response of the human body to any stimulus that disrupts the individual's homeostasis. Any experience that affects one's homeostasis is considered to be stress (Rice, 1992).Social scientists have expanded Hans Selye's notion of physiological stress to include social, cognitive, and psychological or mental stress. Lazarus (1993) contended that the extent to which individuals experience stress is determined by their subjective evaluation of their experiences. Therefore if individuals appraise an event as traumatic they experience more stress than the individuals who appraise the event as non- significant. Stress can take its toll in many ways, producing both biological and psychological consequences. Often the most immediate reaction to stress is biological. Exposure to stressors generates a rise in certain hormones secreted by the adrenal glands, an increase in heart rate and blood pressure, and changes in how well the skin conducts electrical impulses. These responses can be adaptive because they produce an "emergency reaction" in which the body prepares to defend itself through activation of the sympathetic nervous system.

Stress is a common problem that affects almost all of us at some points of our lives. Stresses bombard us everyday from all directions. Stress is the mental, physical and emotional reactions you experience as a result of demands of your life. We might have experienced stress at onetime or another whether you know its definitions, types or not. Without stress, there would be no life (Rosen & Stith, 2002). However, excessive or prolonged stress can be harmful. Stress is unique and personal. A situation may be stressful for someone but the same situation may be challenging for others. Some persons have the habit of worrying unnecessarily. According to Richard S Lazarus, stress is a feeling experienced when a person thinks that "the demands exceed the personal and social resources the individual is able to mobilize".

From adults to teens to children, everyone has stress in everyday life. Adults have the stress of a job, the stress of caring for families, and the stress of paying bills. Children at a younger age also face stress when parent's fight, divorce, or when they are not capable of learning as rapidly as other kids. Teens also face a lot of stress. Teenagers often have a harder time dealing with stresses because they are at an age when it does not seem appropriate, or "cool", to ask adults for help; emotions and hormones are out of control; and sometimes they just don't understand that stress causes it. Academic pressure, work related problems interpersonal difficulties, death of loved ones, illness, loss of relationship have been found to be significant stressors on young people

High level of stress can prevent people from adequately coping with life. People under a lot of stress also become less able to deal with new stressors. Along with having issues with self-esteem, those going through adolescence find it to be a very stressful time in their life ( Davis, 1983). Stress might be another factor related to suicidal ideation. Besides the stress of the present, teenagers are also forced with making decisions about their future. They have to succeed in high school so as to be accepted into the prestigious college of their choice. Along with great grades in high school, students also have to be sure to do well on the S.A.T.s (Scientific Applications Technology). Studying for this huge test can cause an enormous amount of stress, if not done correctly. The student needs to focus and study, but also needs to balance that studying with breaks and chances to relax and focus on something else, even for just a moment. Although still very young, high school is a time when young men and women need to start considering what they might want to do for a living when they get older (2002, DMCA)

Researchers (Bussels &Berman, 2002) have noted the importance of reducing stress by helping youth develop positive perceptions of the self in order to avoid catastrophic socioemotional outcomes such as suicidal behaviour. Relaxation techniques such as meditation, physical exercises, listening to soothing music, deep breathing,personal growth techniques, visualization and massage,various natural and alternative methods, are some of the most effective of the known- invasive stress buster.

Along with having issues with self-esteem, those going through adolescence find it to be a very stressful time in a person's life (Davis, 1983). Stress might be another factor related to suicidal ideation. Overholser et al. (1995) asserts that adolescence often is a time of self-criticism and turmoil. These stresses may put a strain on a young person's self-concept and self-esteem. Adolescence is a stage that is correlated with a great number of life changes. Frequent daily negative experiences and negative life events are common in an adolescent's life. They begin dealing with lives that are unscheduled and non-normative, with new experiences of heterosexual events, peer events, school events, and extracurricular activities.According to Adams and Lehnert, stressful events such as divorce, death, relocation, family arguments, traumatic stresses such as child abuse and natural disasters, and legal problems are important risk factors that can lead an individual to suicide. These acute and chronic stressors can have additive effects on adolescents, which may lead them to engage in suicidal behaviors.

The oxford dictionary (2000) defines depression as a medical condition in which a person feels very sad and anxious and often has physical symptoms such as being unable to sleep etc. The rapid development in the world in every sphere of life puts a lot of pressure on people to adjust to the situation. Inability to do so leads to stress and this begins to wear out people and the result is most often depression. Stress is the major factor influencing depression. Depression is a state of Emotional Dejection( Thomas Jefferson) Depression is characterized by more extreme feelings of hopelessness, sadness, isolation, worry, withdrawal and worthlessness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration. These problems can become chronic or recurrent and lead to substantial impairments in an individual's ability to take care of his or her everyday responsibilities. At its worst, depression can lead to suicide, a tragic fatality associated with the loss of about 850 000 lives every year.

Early in the 20thcentury, it was believed that children and adolescents could not suffer from depression. Later in the century, psychologists changed their minds and accepted that children can get depressed; however, many agreed childhood depression is different from adult depression (Clarizio, 1989). A major cause or trigger of depression in adolescents is thought to be stress. A predisposition to depression may also play a role; nonetheless, the additive stresses of everyday adolescent life often appear to trigger depression (Clarizio). "There is a complex relationship between depression and suicide. Many depressed patients are suicidal, and, conversely, most but not all suicidal individuals manifest depressive mood and symptoms if not depressive illness" (P feffer, 1989, p. 63).

People with depressive illnesses do not all experience the same symptoms. The severity, frequency and duration of symptoms will vary depending on the individual and his or her particular illness. People with depressive illnesses do not all experience the same symptoms. The severity, frequency and duration of symptoms will vary depending on the individual and his or her particular illness. The Symptom of depression according to National Institute of Mental Health(2007) include:persistent sad, anxious or "empty" feelings, feelings of hopelessness and/or pessimism, feelings of guilt, worthlessness and/or ,helplessness, irritability, restlessness,loss of interest in activities or hobbies once pleasurable, including sex, fatigue and decreased energy,difficulty concentrating, remembering details and making decisions,insomnia, early-morning wakefulness, or excessive sleeping,overeating, or appetite loss,thoughts of suicide, suicide attempts,persistent aches or pains, headaches, cramps or digestive problems that do not ease even with treatment.

Depression, even the most severe cases, is a highly treatable disorder. As with many illnesses, the earlier that treatment can begin, the more effective it is and the greater the likelihood that recurrence can be prevented. But, most depressed people never get the help they need. And, when depression isn't treated, it can get worse, last longer, and prevent you from getting the most out of your life. Treatments for depression in modern times offered with effective and differing medications, offering hope to sufferers (John M. Grohol, 07 Nov 2005 ). The first step to getting appropriate treatment is to visit a doctor. The most common treatments are:medication,psychotherapy,electroconvulsive therapy ,genetic research.

Suicide is a very serious issue. Far too often, adolescents end their lives through suicide. According to Horowitz et al. (2001), adolescent suicides in the US have tripled since the 1950's, and suicide now ranks as the 3rd leading cause of death in this age group. Also, according to Horowitz et al., 53% of children ages 13-19 have had suicidal thoughts. Each year, 250,000 adolescents attempt suicide, and 8%-10% of adolescents in the US. attempt suicide at sometime in their life. In 1997, 20.5% of adolescents thought about suicide, 15.7% had a plan, and 7.7% actually made a suicide attempt (Horowitz et al.). In another survey of 300 students, as many as 20% admitted that they performed suicidal behaviors in the past year (Rubenstein, 1989).

Suicide is a very complicated issue. There are many difficulties associated with the identification of individuals at risk for committing suicide. It can be difficult because Suicidal Ideation individuals resort to suicide for so many different reasons. No matter the reason, any individual thinking about suicide is considered to be in the at risk group. Gould, Fisher, Parides, Flory and Shaffer (1996) reported that stressful life events have been associated with completed suicide in adolescence even after controlling for psychiatric symptoms. Death of a parent and early parental loss in general seem to be particular life events that increase the risk of attempted and completed suicide (Nordentoft & Mortensen, 2002; Overholser, 2003).

Suicide is the third leading cause of death among young people; however the incidences attempted suicide is much more. It has been observed that after puberty, rate of suicide increases with age until it stabilizes in young adulthood. This increase in suicide may be associated with the onset and increase in depressive and other disorders during adolescents as compare to childhood (Shaffer, 1996) as well as greater suicidal intent with age (Brent, Baugher, Bridge, Chen & Chiappetta, 1999). As compare to adult males, adolescent male's complete suicide at rates approximately five times higher than rates for adolescents females (Kochanek, Murphy, Anderson & Scott, 2004). The reason for the lower rates of death in females than in males is due to less lethal preferred method of attempt for suicide.

Suicide rates in India have shown a gradually increasing trend. The rate in 2005 was 10.3 per lakh. The striking aspect of Indian data is the large variation in different parts of India in relation to attempted/ committed suicide. The states and cities with rapid social change are associated with higher suicide rates, such as the states of Kerala and Tripura, and cities like Pondicherry and Bangalore. The number of suicides in country during the decade (1995- 2005) has recorded an increase of 27.7 percent. The population has increased by 20.4per cent during the decade. The 35.3 % of suicide victims were the youths (15-29 years).There has been a slightly increase of 0.1% in suicide in the country in the year 2004 as compared to 2003 (Accidental Deaths and Suicides 2005, NCRB).

Adolescence can be a difficult time in a person's life. There can be a lot emotional upheaval and stress. Adolescents can experience stress from family discord at home as well as having difficulties with peer relationships at school. All of these may lead a person to suicide (Rubenstein et al., 1989). Some causes of suicidal are give below:

Chemical Imbalances

Chemical imbalances within a person's brain, such as decreased levels of Serotonin, may be related to the prevalence of suicidal thoughts. During a rehabilitation process, an abuser of illegal drugs, alcohol or prescription drugs may also experience thoughts of suicide ideation as a result of chemical imbalances in the brain.

Environmental Pressures

Environmental pressures, such as ailing economic conditions or a sudden spike in celebrity suicides, may cause otherwise sane people to contemplate suicidal thoughts.

Heredity

A person's heredity may predispose him or her to consider suicide as an option. In addition to emulating the thoughts and behaviors of a depressive parent, this subject may also be affected by a condition such as schizophrenia or autism. Suicidal thoughts are common to subjects who are afflicted with these conditions.

Culture

Vincent Mark Durand and David H. Barlow, authors of the text Essentials of Abnormal Psychology, suggest that certain suicidal behavior are culturally acceptable, "such as the ancient custom of hara-kiri in Japan, in which an individual who brought dishonor to himself or his family was expected to impale himself on a sword."

Psychological Factors

Depression and suicide often result from psychological factors, such as low self-esteem. Sociologist Emile Durkheim categorized three types of suicide that involved a subject's psychologically based suicide ideation: egoistic suicides, anomic suicides and fatalistic suicides

Adolescence is a stressful developmental period filled with major changes - body changes, changes in thoughts, and changes in feelings. Strong feelings of stress, confusion, fear, and uncertainty, as well as pressure to succeed, and the ability to think about things in new ways influence a teenager's problem solve and decision making abilities. For some teenagers, normal developmental changes, when compounded by other events or changes in their families such as divorce or moving to a new community, changes in friendships, difficulties in school, or other losses can be very upsetting and can become overwhelming. Problems may appear too difficult or embarrassing to overcome. For some, suicide may seem like a solution. When feelings or thoughts become more persistent are accompanied by changes in behavior or specific plans for suicide, the risk of a suicide attempt increases.

Henry, Stephenson, Hanson, and Heirgett (1993) reported that serious suicide attempts seem to be higher among students who experience considerable academic success and less serious suicide attempts more indicative of students who are failing at school because more successful students feel more pressure to maintain their level of performance. This pressure may cause them to increase the lethallity of their suicidal intent. On the one hand, Petzel and Riddle (1981) observed that the majority of suicidal students in both high school and college are percieving passing scores in their academic classes and indication that academic performance is not the only signifigant factor that contribute to the occurrence of suicide.Some of the Symptoms of suicide ideation are: Hopelessness, Anhedonia, Insomnia , Severe anxiety, Impaired concentration ,Psychomotor agitation, Panic attack.

Recognition and early intervention of mental and substance abuse disorders is the most effective way to prevent suicide and suicidal behavior. According to the American Foundation for Suicide Prevention (AFSP), it is important to learn the warning signs of teenage suicide in order to prevent an attempt. Maintaining open communication with your teenager and their friends provides an opportunity for helping as needed.Depression is present in more than half of suicides, but in the majority of these suicides it has remained untreated at time of death. Even after a suicide attempt, depression often remains unrecognized, untreated or undertreated (Oquendo., 2002).

According to Davis (1983), there are many very different motivations for individuals to commit suicide. He asserts that in order to help a suicidal person, one must first know the underlying motivation. One reason someone may commit suicide is to escape an unbearable situation. A second is to try to manipulate or change someone else's behavior. A third is to use suicide as a vehicle to communicate significant Suicidal Ideation to others just how unhappy they are and they need help. People often have no intention of dying, but due to unavoidable circumstances lead them to suicide. One is an inherited familial susceptibility to suicidal tendencies. Poor mental health or having a mental disorder like depression or schizophrenia is other factors. Death or loss of a loved one could precipitate depression and lead to suicide. Issues with drug abuse and poor grades also can be precursors to suicide. Suicidal behaviors were higher among students who were potential dropouts. Social isolation, having poor social skills and being unable to establish relationships can lead to social withdrawal and ultimately suicide.

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