Depression is the disease that most destroys and drains the human will. Depression will bring two consequences, one is a serious reduction in the quality of life, and the patient's life is worse than death; The second is that the patient will really die, that is, commit suicide.

How to intervene in the suicide of depressed patients is a serious issue. Many people don't understand depression, only have good intentions, and make blind ideas, which often have little effect or even backfire.

Based on my personal experience, I offer several suggestions for intervention in suicide in patients with depression.

First of all, we must actively seek treatment. The fact of blood tells us: depression must be treated. Many relatives and friends of patients believe that depression is just a psychological and emotional problem, and as long as they talk, counsel, and "open the knot", they can "get out". This is really ignorance of science.

As for the patient himself, he suffered from depression and did not know it at first; After a lot of time, he hesitated to embark on the road of seeking treatment. At that time, he was not psychologically prepared, and when the doctor told him that the course of treatment was very long, at least more than half a year, or even two or three years, and that he would have to keep going back to the clinic and re-examination, he would be afraid, hopeless, and resistant, and often could not adhere to the treatment, which eventually led to tragedy.

According to a survey, 62.9% of people with depression in China have never sought medical attention, and only 10% have received formal medication.

Once you've gone the long haul of therapy, friends and relatives will come up with ideas and suggestions: Western medicine, Chinese medicine, psychology, practice, yoga, spirituality, mantras, and so on. Which one works? Here I can responsibly tell you: Western medicine has the most accurate efficacy; Psychotherapy should be effective, but it is difficult to grasp due to many constraints; Whether TCM is effective or not has yet to be scientifically verified. As for exercises, spirituality, yoga, mantras, and the like, they are basically unreliable.

Therefore, once you find out that you have depression, don't hesitate to see a Western doctor immediately; Depending on the severity of your condition, ask your doctor to decide whether to take Western medicine or see a psychologist. Don't waste your precious time. In the early days of depression, time is of the essence.

Second, to intervene in the suicide of depressed patients, the most critical thing is to determine when the patient is most likely to commit suicide.

There are three steps to suicide: suicidal ideation, suicide attempt, and suicide execution. Almost every person with depression will have suicidal ideation and attempts, but to get to this point, objective conditions are needed.

According to the clinical symptoms of depression, depression is medically divided into three stages: mild, moderate and severe. Patients with mild depression are depressed, lose interest and pleasure, are easily fatigued, overthinking, have low self-esteem and are negative, and have a variety of physical discomforts for no reason; In the moderate stage, brain function block and psychomotor block will be added, and patients feel that their brain thinking, action and social functions are reduced, and they dare not see people, and interpersonal communication is impaired; In the severe stage, the patient is extremely depressed, unable to perceive joy, anger and sorrow, and severely slows down his thinking and movements; The speed of speech is slow, the voice is low, the volume of speech is small, the response is slow, and in severe cases, it can be a state of stupor. During the day, I often don't say a word, don't move or eat.

So, is major depressive disorder the most dangerous for suicide?

No. This is what makes depression unique: people with depression commit suicide, often in stages that worsen from mild to moderate and get better from severe to moderate. Truly severe patients do not commit suicide.

The reason for this is that drug treatment for depression is characterized by improving the patient's motivation first, and then the patient's mood. Suicide requires two conditions, namely, the willingness to commit suicide and the motivation to carry it out. Severe patients often have a blank brain, lack of physical strength, and do not have the ability to commit suicide; Once the drug is effective, the patient's brain is first relieved of inhibition (motivation), but the improvement of mood is a week after (suicidal ideation is still there), and suicide often occurs at this stage.

Maybe if the patient persists for another day or two, he will be able to break free from the darkness and usher in the light. However, he couldn't see the dawn ahead, and gave up at the last moment, which made people sigh!

To intervene in suicide, it is necessary to learn to recognize the threshold of the patient's deterioration from mild to moderate, especially from severe to moderate. During these two periods, it is best to keep an eye on the patient. Once there is a mistake, there is no regret!

A patient's family once came to me and said that the patient had been taking medicine for a month, but it was ineffective, and recently he refused to take the medicine, causing a lot of trouble at home. I immediately realized that the patient had the strength to make a fuss, and maybe the medicine was going to work. I told my family that he should make trouble, no need to persuade him, only need to do two things: one is to urge him to take medicine every day, not one pill less; The second is to seal the balcony and windows at home and never leave people. A few days later, the family told me that he was cured.

Patients with strong wills should have a sense of self-help. Suicide often occurs at the thought of suicide, and in many cases it is difficult to resist the urge to commit suicide by the will alone. At this time, it is necessary to consciously make yourself unqualified for suicide. Generally speaking, it is painful to cut the pulse, it is not easy to take poison and find medicine, it is difficult to find it on the surface of the river, and the self-hanging procedure is too complicated. Only jumping off a building is simple and easy. So, be sure to keep yourself away from high places to prevent the urge to jump off. As long as it is not so easy to die, the suicidal impulse will decline and be exhausted.

After recovering from his illness, one patient told me that he was about to commit suicide by jumping off a building, but the balcony was so tightly sealed that he couldn't push it away after pushing it a few times, and he sat on the ground crying in frustration. After that, I don't want to die.

During the course of the day, people with depression often commit suicide in the early hours of the morning. This is because the patient's mood changes in the morning and in the evening. Patients tend to wake up early, when they are at their most depressed, and suicidal thoughts flood in at the thought that a long, painful day is about to begin and when it will end.

Third, as mentioned above, during the period of high incidence of suicide, patients need to be cared for, and it is best to stay at the same time. So, how do you fulfill your duty of care? My experience is that companionship, not preaching.

Many people believe that depression is a psychological problem, and it is necessary to "open the knot" for patients. As everyone knows, depression is essentially an organic problem, and in the moderate and severe depression stages, it is useless to persuade him to "think about it" and "don't die". It is necessary to focus on companionship, do not talk about big truths, and know that the most indispensable thing in the world is truth; Let the patient know that he is there when he needs it; When you don't need it, you can be quiet. Don't bother him, don't babble, don't make a fool of yourself.

I remember when I was sick, my colleagues tried countless ways to save me. Jieqi forcibly came to the door to deliver sashimi; Zhang Xiang coaxed me to travel to Qingdao; Teacher Xu Xiao forced me to see a psychiatrist; Jiwei coerced me to participate in the gathering of cultural people; Shu Li arranged for me to make some manuscripts to restore my self-confidence, and even planned to find a farm in Shunyi for me to live in, and participate in agricultural labor like Tolstoy did in his later years. Its heart can be felt, but its effect is nothing.

I once saw a psychiatrist who talked for an hour. I watched her get more and more energetic as she talked, her mouth was like a river, her eyes lit up, and she thought: Who is treating whom?

There was also a former female subordinate who came to see me, and as soon as they met, they forced me to go out for a walk. I was faltering by then; She took me by the arm and kindly explained me a lot of things. As she spoke, she suddenly stopped, looked at me stunned for a few seconds, and said as if she had just woken up from a dream, "Hey, what am I talking to you about!" Didn't you teach us all this before? ”

At this point, I would like to conclude with a purely technical question: try to arrange a sunny and brightly colored room for the patient. In my experience, when depression is severe, the patient's vision changes, and everything is gray. Keeping the patient's room bright and bright can help improve mood.