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Suicide Prevention: Identifying Risks and Finding Help

Harshitha Chaganti 
September 2024

Trigger warning: This article mentions topics regarding self-harm and mental health 

In honor of September being suicide awareness month….

With the growing presence of social media, bullying (whether online or off), and other stressors, surround the lives of the youth.  Due to this, they are unfortunately placed at a higher risk of either suicidal thoughts or attempting suicide. Social media can create unrealistic comparisons, amplify feelings of inadequacy, and expose individuals to cyberbullying, while traditional bullying can reinforce the feeling of isolation among peers adding to the burden. Combined with academic pressures, family issues, and peer-related stress, these factors can create a perfect storm of psychological strain, making it increasingly difficult for young people to find relief or support. 

The term suicide has become alarmingly common in modern society, especially among teens and children, who often use it casually without fully grasping the gravity behind it. In many cases, it is spoken about lightly in conversation or as part of dark humor, which diminishes the true weight of the subject.

What many aren’t aware of is that there are multiple types of suicide, each with its own psychological and sociological causes. As reported by, French sociologist Émile Durkheim, who was one of the first to systematically study suicide, these types can be categorized into four distinct forms: egoistic suicide, altruistic suicide, anomic suicide, and fatalistic suicide.

Egoistic Suicide occurs when individuals feels profoundly disconnected from their social environment, experiencing deep isolation and lack of purpose. Altruistic Suicide happens when individuals, deeply integrated into a group or society, sacrifice their own lives for what they believe is a greater good or cultural obligation. Anomic Suicide is associated with significant societal or economic disruptions that lead to feeling of normlessness and instability, making individuals feel disoriented and overwhelmed. Fatalistic Suicide arises from extreme regulation and control over one’s life, leading to a sense of entrapment and hopelessness, often in highly restrictive or oppressive condition^[2] 

Those who are considering self-harm often exhibit several warning signs, which can vary in intensity. Common indicators are: 

• Behavioral Changes: Sudden withdrawal from social groups, changes in eating and/or sleeping patterns, as well as a noticeable decline in work performance are telling signs of suicidal thinking.
• Emotional Distress: People who are suicidal tend to have expressions of deep sadness, worthlessness, hopelessness and incressed irritability/ mood swings.
• Physical Signs: Unexplained cuts, bruises, or burns, often hidden under clothing, or frequent wearing of long sleeves and pants, even in warm weather.
• Preoccupation with Death: An unusual focus on themes of death or dying, including talking  about or engaging with violent or morbid content.

Noticing these signs is important for getting help quickly. If you or someone you know shows these signs, it’s crucial to seek help from a mental health professional. Early support can make a big difference in managing these issues and preventing harm. 

If you or someone you know is struggling with self-harm or suicidal thoughts, it’s important to get help right away. Start by talking to a trusted friend or family member, and seek support from a mental health professional like a therapist or counselor. For immediate help, call a crisis hotline such as the National Suicide Prevention Lifeline at 1-800-273-TALK, or use other local hotlines. You can also visit a healthcare provider for advice and referrals. Online resources and counseling services are also available for immediate support. Taking these steps can connect you with the help and support needed. 

In conclusion, it’s crucial to recognize the signs of self-harm and suicidal thoughts and seek help quickly. Talking to trusted people, contacting mental health professionals, and using crisis resources can provide the support needed to address these challenges and find hope. Remember, reaching out for help is a positive step towards recovery.      

References

[1] Facts About Suicide | Suicide Prevention. (2024, April 25). CDC. Retrieved September 14, 2024, from https://www.cdc.gov/suicide/facts/index.html

[2] Singh, A. (2020, March 30). Four Types of Suicides – MDIS Blog. Management Development Institute of Singapore (MDIS). Retrieved September 14, 2024, from https://www.mdis.edu.sg/blog/four-types-of-suicides/

[3] Warning Signs of Suicide – Suicide Prevention Resource Center. (n.d.). Suicide Prevention Resource Center. Retrieved September 14, 2024, from https://sprc.org/warning-signs-for-suicide/

The Green Drink Scam: Is AG1 Worth the Buy? 

Green drink ‘superfood’ powders have taken the US by storm with the supposed ability to act as a multivitamin, a multimineral, a prebiotic, an adaptogen (i.e. foods that help people respond to stress, anxiety, etc.), and the list goes on. AG1 is one of the most well-known of these ‘superfood’ powders, but it’s extremely costly with a monthly subscription costing 79 dollars.^[1][2] Are these ‘superfood’ powders truly beneficial or another fad? 

AG1 is a 3rd Party Tested Drug, meaning that the product is certified via an independent organization. AG1 is said to be tested by NSF International, an organization that does annual checks of sanitation and safety of food, water, and consumer products.^[6] Therefore, AG1’s product is not tested for effectiveness, only that it meets the company’s safety standards. Still, the fact that AG1 is certified by NSF makes it safer than non-tested options such as Bloom Greens. 

Despite being only 3rd Party tested, AG1 still is transparent with its ingredients if one is willing to research what is listed. The ingredients are publicly listed on their site. AG1 additionally posted some of its own peer-reviewed studies about newer ingredients. There is proof that AG1 has shown to change a human’s digestive and intestinal genome through probiotics in the product. The phytochemicals provided by AG1 have been proven to change the microbiome from studies done on mice as well as in vitro studies, in some cases decreasing the biodiversity of certain groups of the microbiome but increasing in others.^[5]To be sure of AG1’s effectiveness and safety, more research must be done preferably from multiple unbiased sources. 

The probiotics for AG1 primarily come from apple fibers, inulin and probiotic bacteria, Lactobacillus acidophilus and Bifidobacterium bifidum along with other probiotics used and studied, (e.g. faecalibacterium prausnitzii, Waltera intestinalis and Arthrospira), have been shown to aid in anti-inflammation, and digestion in model studies but should be taken with a grain of salt.^{[1][4][10][11][12]}This shift in biodiversity through these probiotics has yet to show any favorability in humans, as the only studies available to the public, seem to only to be an in vitro study based on colonic activity in a human^[5]. 

Nutrition is a fairly new concept, which is why any vitamin, health food or health fad should be taken with a grain of salt. Still, it is undeniable that micronutrients are required for a healthy, functioning body. This is why milk is fortified with vitamin D and salt with iodine.^[7] AG1 has been shown to be more effective for certain minerals such as Magnesium, Calcium and Zinc than a supplement tablet, but when it comes to the bioavailability and bioaccessibility, certain micro vitamins such as Magnesium, Calcium and Zinc would increase anyways due to the increased surface area a powder brings compared to a tablet.^[8] Other nutrients incorporated such as folate, vitamin B12, vitamin E, etc are essential for a person to stay healthy but, most people don’t actually need them form a supplement as their diet is more than adequate.^[3] 

Taking too much of certain micronutrients could be dangerous. For example, high doses of calcium can lead to body aches, digestive issues and kidney problems. The vitamins and minerals in AG1 are over 100% of the recommended daily value for a 2000 calorie diet.^[3] A micronutrient is called a micronutrient for a reason. Rather than supplements or vitamins, it would be more optimal and healthier to try and get these micronutrients from one’s daily diet. 

So is AG1 a scam? Yes and no. There is proof that the drink can act as a multivitamin and possibly remedy nutritional deficiencies. Unfortunately, AG1 is too expensive for most people who would need the drink.^[8][9] Rather than a superdrink, it may be cheaper and safer to go with a multivitamin approved by USP, to get the boost of the certain nutrient you need without messing with your body’s delicate biogenome.

References: 

[1]Athletic Greens. (2024). High-quality ingredients optimized for impact│ AG1. AG1. https://drinkag1.com/en-eu/about-ag1/ingredients/ctr. 

[2]Cleveland Clinic. (2022, February 10). What are adaptogens & types. Cleveland Clinic. https://my.clevelandclinic.org/health/drugs/22361-adaptogens. 

[3]Columbia University. (2024, July 25). What supplements do you need? Probably none. Columbia University Irving Medical Center. https://www.cuimc.columbia.edu/news/what-supplements-do-you-need-probably-non e. 

[4]Ferreira-Halder, C. V., Faria, A. V., & Andrade, S. S. (2017). Action and function of faecalibacterium prausnitzii in health and disease. Best Practice & Research Clinical Gastroenterology, 31(6), 643–648. https://doi.org/10.1016/j.bpg.2017.09.011. 

[5]Kirby, T. O., Sapp, P. A., Townsend, J. R., Govaert, M., Duysburgh, C., Marzorati, M., Marshall, T. M., & Esposito, R. (2024). AG1® induces a favorable impact on gut microbial structure and functionality in the simulator of human intestinal microbial ecosystem® model. Current Issues in Molecular Biology, 46(1), 557–569. https://doi.org/10.3390/cimb46010036.

[6]NSF. (2017, December 19). What is NSF certification?. NSF. https://nsf.org/knowledge-library/what-is-nsf-certification. 

[7]The President and Fellows of Harvard College. (2024, May 9). Vitamins and Minerals. The Nutrition Source. https://nutritionsource.hsph.harvard.edu/vitamins/.

[8]Sapp, P. A., Townsend, J. R., Kirby, T. O., Govaert, M., Duysburgh, C., Marzorati, M., Marshall, T. M., & Esposito, R. (2023). AG1®, a novel synbiotic, demonstrates superior mineral bioaccessibility and bioavailability compared to a tablet multivitamin and mineral supplement using an in vitro model of the upper gastrointestinal tract. Applied Biosciences, 2(4), 656–667. https://doi.org/10.3390/applbiosci2040041. 

[9] Shifler Bowers, K., Francis, E., & Kraschnewski, J. L. (2018). The dual burden of malnutrition in the United States and the role of non-profit organizations. Preventive medicine reports, 12, 294–297. https://doi.org/10.1016/j.pmedr.2018.10.002. 

[10]WebMD LLC. (2023a). Bifidobacterium bifidum: Overview, uses, side effects, precautions, interactions, dosing and reviews. WebMD. 

https://www.webmd.com/vitamins/ai/ingredientmono-1666/bifidobacterium-bifidum.

[11]WebMD LLC. (2023b). Lactobacillus acidophilus: Overview, uses, side effects, precautions, interactions, dosing and reviews. WebMD. https://www.webmd.com/vitamins/ai/ingredientmono-790/lactobacillus-acidophilus. 

[12]Wylensek, D., Hitch, T. C. A., Riedel, T., Afrizal, A., Kumar, N., Wortmann, E., Liu, T., Devendran, S., Lesker, T. R., Hernández, S. B., Heine, V., Buhl, E. M., M D’Agostino, P., Cumbo, F., Fischöder, T., Wyschkon, M., Looft, T., Parreira, V. R., Abt, B., Doden, H. L., … Clavel, T. (2020). A collection of bacterial isolates from the pig intestine reveals functional and taxonomic diversity. Nature communications, 11(1), 6389. https://doi.org/10.1038/s41467-020-19929-w.

Making Survivors Feel Comfortable with Natural Processes 

A traumatic experience such as sexual violence can drastically affect people’s lives. Even if a traumatic experience occurred during childhood, it can still significantly affect people when they become adults and throughout their lifetime.^[1] According to the Centers for Disease Control and Prevention, one in four women has experienced completed or attempted rape, and one in three women faced sexual harassment in a public place.^[2] Sexual violence is not just an issue that affects women, given that men and LGBTQIA+ individuals also face the threat of sexual violence.^[2] Nevertheless, natural biological processes of the female body, namely, menstruation, pregnancy, childbirth, and breastfeeding could bring unique challenges and opportunities for female survivors of sexual violence. 

Menstruation 

Sexual violence can affect the menstrual cycle. Survivors’ menstrual cycles can become irregular and they may miss their periods.^[3] Also, there can be increased premenstrual symptoms, along with more pain and heavier bleeding during menstruation.^{[3, 4]} Periods can be a difficult time, especially for survivors who may find the bleeding and cramps trigger thoughts of the sexual violence they faced.^[5] More specifically, some survivors who once used internal menstrual products, like tampons to manage monthly bleeding, find it challenging to continue using internal menstrual products since they can trigger flashbacks of the tremendously traumatic experience.^[5] Periods can be a more sensitive time for survivors, especially if they have low self-esteem, negative body image, and guilty feelings following the traumatic experience.^[5] There are a variety of strategies to make this monthly occurrence more comfortable and support survivors’ health and wellness during menstruation. For instance, survivors could consider using less invasive menstrual products like pads and period pants, while they are still healing from trauma.^[5] Survivors are recommended to be aware of, accept, and acknowledge their emotions honestly during monthly periods.^[5] Survivors are encouraged to practice more self-care and relaxation activities during menstruation, such as wearing comfortable clothes, watching a movie, listening to music, drinking a favorite tea, and eating chocolate if desired.^{[5, 6]} Moreover, survivors should try to track their menstrual cycle so they feel more prepared.^[6] Loved ones of survivors could try to support them during menstruation by bringing pads and comfort food, and just being there to talk.^[6] Similar care, relaxation, and support strategies could be considered for survivors experiencing postpartum bleeding.

Pregnancy and Childbirth 

Sexual violence is associated with an increased risk of pregnancy-related concerns such as pelvic pain, pre-term birth, and low birth weight.^[7] Nonetheless, pregnancy and childbirth can promote resilience, empowerment, and healing among survivors if they have a positive and supportive birthing experience.^[7] One of the first and most important steps to fostering positive birthing experiences for survivors is to effectively educate healthcare workers on sexual trauma and how it affects patient health and well-being, especially during a vulnerable and critical period like childbirth.^[7] Pregnancy and childbirth can be stressful for survivors of sexual violence especially due to the association of certain feelings with traumatic memories.^[7] For example, among some survivors, pelvic pain and fetal movement could trigger stressful memories of their traumatic experiences.^[7] Also, some survivors share how they felt that their healthcare provider dismissed and invalidated their concerns about discomfort and trauma during childbirth, especially during vaginal examinations and procedures, where survivors felt ignored and like they had no control over their bodies.^{[8, 9]}It is essential for survivors and their medical providers to establish and maintain trust. Based on research conducted, many survivors feel it is important for their healthcare team to be aware that they have sexual trauma, however, oftentimes they are not asked about it.^[9]Interestingly, there is no one standard birthing method that all survivors prefer; some survivors feel more comfortable with Cesarean sections (C-sections) and some with vaginal deliveries. For instance, some survivors prefer C-sections to prevent possible vaginal tearing and avoid vaginal examinations.^[9] On the other hand, some survivors prefer vaginal deliveries since they feel more in control of their bodies, are uncomfortable with the idea of surgery, and avoid taking numerous medications.^[9] Trauma-informed medical care practices can help survivors feel more comfortable during pregnancy and childbirth, which can safeguard both their health and their baby’s health. Diverse trauma-informed care practices can be utilized, including allowing the survivor to have a support person if possible, allowing the survivor to uncover her body on her own, starting with the least invasive medical procedure if possible, and ensuring the survivor properly understands the process and importance of medical procedures in advance.^[7] 

Breastfeeding 

Some survivors of sexual violence have low self-esteem and negative body image, which can cause hesitancy about breastfeeding, especially in public settings.^[10] This, in turn, further contributes to lower levels of self-esteem as they often feel bad and ashamed about not being able to effectively breastfeed their babies.^[10] Moreover, in medical settings, survivors can feel retraumatized particularly if healthcare workers touch them without warning or invitation to help initiate the breastfeeding process after childbirth.^[10] Furthermore, the over-sexualization of women’s breasts and undermining of their function to nurture new life significantly contribute to survivors’ discomfort and difficulty breastfeeding. For example, some survivors resent and feel ashamed of their breasts as a result of over-sexualization, ridicule, and hurtful comments about their breasts, and may perceive their breasts to be the cause of the traumatic experience.^[10] Simultaneously, the ability to breastfeed can be a transformative experience for survivors and empower them on their healing journey. For instance, some survivors find the changes pregnancy and childbirth bring to their breasts wondrous.^[10] Their body image can shift from negative to positive, as they become more aware of the power they hold to breastfeed and nurture new life. This, in turn, encourages them to embrace their breasts, and the process of breastfeeding, as healthy, impactful, essential, and auspicious rather than something to be ashamed of.^[10] Additionally, access to social support, such as breastfeeding support groups and initiatives to promote breastfeeding, helps facilitate positive and encouraging experiences for survivors.^[10] Making survivors feel more comfortable and confident with breastfeeding simultaneously ensures the new generation of infants are able to get the benefits breastfeeding offers. 

Interventions to help survivors who have experienced very traumatic experiences of sexual violence and have difficulty coping include antidepressant medications and psychotherapy.^{[11, 12]} Sexual violence is a critical and prevalent societal concern. Managing normal biological processes occurring in the female body could be difficult for survivors recovering from a traumatic experience like sexual violence. Being aware of the unique challenges survivors face, and how to mitigate them, can help create safe, supportive, positive, and healthy environments for survivors, and simultaneously empower them on their healing journeys. 

References 

[1] Brunton, R., & Dryer, R. (2021, January). Child Sexual Abuse and Pregnancy: A Systematic Review of the Literature. ScienceDirect. 

https://www.sciencedirect.com/science/article/abs/pii/S0145213420304579

[2] Centers for Disease Control and Prevention. (2024, January 23). About Sexual Violence. Centers for Disease Control and Prevention. 

https://www.cdc.gov/sexual-violence/about/index.html#:~:text=Sexual%20violence%20is%20co mmon%3A,experienced%20completed%20or%20attempted%20rape 

[3] Golding J. M. (1996). Sexual assault history and women’s reproductive and sexual health. Psychology of women quarterly, 20, 101–121. 

https://doi.org/10.1111/j.1471-6402.1996.tb00667.x

[4] Romito, P., Cedolin, C., Bastiani, F., Beltramini, L., & Saurel-Cubizolles, M. J. (2017, May 31). Sexual harassment and menstrual disorders among Italian university women: A cross-sectional observational study. Sage Journals. 

https://journals.sagepub.com/doi/abs/10.1177/1403494817705559?journalCode=sjpc

[5] Somerset and Avon Rape and Sexual Abuse Support. (n.d.). The impact of trauma and menstruation. Somerset and Avon Rape and Sexual Abuse Support. https://www.sarsas.org.uk/the-impact-of-trauma-and-menstruation/

[6] UC Santa Cruz Center for Advocacy, Resources & Empowerment. (2023, October 16). De-mystifying your period after trauma. UCSC CARE. 

https://care.ucsc.edu/resources/your-period-after-trauma.pdf

[7] Ward L. G. (2020). Trauma-Informed Perinatal Healthcare for Survivors of Sexual Violence. The Journal of perinatal & neonatal nursing, 34(3), 199–202. 

https://doi.org/10.1097/JPN.0000000000000501

[8] Montgomery, E., Pope, C., & Rogers, J. (2015, August 26). The re-enactment of childhood sexual abuse in maternity care: a qualitative study. BioMed Central. 

https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-015-0626-9

[9] Lissmann, R., Lokot, M., & Marston, C. (2023, November 16). Understanding the lived experience of pregnancy and birth for survivors of rape and sexual assault. BioMed Central. https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-023-06085-4 

[10] Wood, K., & Esterik, P. V. (2010, April). Infant feeding experiences of women who were sexually abused in childhood. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2860840/ 

[11] Rothbaum, B. O., Ninan, P. T., & Thomas, L. (1996). Sertraline in the treatment of rape victims with posttraumatic stress disorder. Journal of traumatic stress, 9(4), 865–871. https://doi.org/10.1007/BF02104108 

[12] Tull, M. (2023, December 6). Understanding PTSD After Sexual Assault. Verywell Mind. https://www.verywellmind.com/symptoms-of-ptsd-after-a-rape-2797203#toc-treatments-for-ptsd -after-sexual-assault

Emotional and Physical Effects of Miscarriage

Miscarriage is often described as the unexpected end of a pregnancy during the first 20 weeks of the gestation period. Though it can be difficult to understand the feeling in depth, it is essential to acknowledge the several negativities that come with a miscarriage. Every woman’s experience with it is different; however, several clinical specialists regard it as a traumatic experience that can evoke dreadful feelings of guilt, shame, and even symptoms of Post Traumatic Stress Disorder (PTSD).^[1] 

Causes of Miscarriage 

There are several reasons surrounding the cause of a miscarriage. Due to this, the phenomenon of miscarriage is quite common. In fact, around 10-20% of all pregnancies unfortunately result in a miscarriage.^[2] Contrary to most beliefs, mental health problems, exercise, and minor injuries are not what causes miscarriages. If the miscarriage occurs during the first trimester, which about 50% of miscarriages do, it is due to the fertilized egg containing an unusual amount of chromosomes. Another factor could be if the mother has a severe and abnormal disease or infection, such as unmanaged diabetes, immune system disorders like lupus, kidney disease, heart disease, and thyroid disease.^[3] Another very possible component of miscarriage is old age. 

These causes can lead to a few different types of miscarriage. Inevitable miscarriage is when the cervix opens up early, leaking amniotic fluid. Complete miscarriage is when the fetal tissue passes, leaving the pregnancy sac empty. Missed miscarriage occurs when there are no shown symptoms of a miscarriage, but the fetus has no heartbeat. Lastly, an incomplete miscarriage occurs when some pregnancy tissue has passed, but some tissue still remains in the uterus.^[4] 

Emotional Responses to a Miscarriage 

The time it takes to recover from a miscarriage is largely dependent on the person. Some couples come and accept the terms just within a few weeks, whereas others could take longer. Everyone endures grief differently; some find it better to talk about it, whereas others find it too miserable. Feelings of anxiety, depression, shock, guilt, anger, and resentment are common among individuals who recently miscarried. About 20% of women who miscarried became diagnosed with depression and/or anxiety, with impactful symptoms that lasted 1 to 3 years.^[5] After pregnancy loss, a large hormonal shift comes straight afterward. The sudden change in hormones contributes to an impactful amount of emotions. On average, it takes about 2 to 8 weeks for hormone levels to recuperate. 

Physical Responses to a Miscarriage 

Emotional tolls are not the only thing that comes with the cost of miscarriage. Several symptoms such as fatigue, loss of appetite, and difficulty sleeping are extremely common the weeks after a miscarriage. Like the emotional toll that comes with miscarriage, the physical process that comes afterward is experienced differently depending on the individual and the type of miscarriage they had. Painful period-like cramps are expectant; this usually occurs because the uterus is still squeezing out the leftover content that remained in the pregnancy sac.^[6] Some women even experience labor contractions. It is also likely for women to bleed heavily and even pass out. Treatment and symptoms for a woman who miscarried in her second trimester are a bit different. Since the fetus is more developed in the second trimester, hospitalization is a hundred percent necessary. Miscarrying in the second trimester also puts you through a more notable and real experience of labor. Miscarriage may also put you through certain discomfort like breast soreness and headaches. 

How to Heal 

Learning to heal is a different process for everyone. It is a distinctive and personal process that takes time and strength. It is crucial to consider reaching out to a mental health professional after a miscarriage, especially with a notable history of depression. A miscarriage therapist can help sort through dreadful and complicated emotions an individual might be going through. Getting in contact with someone who could help emotionally could be extremely beneficial to the woman suffering. After a miscarriage, it is especially key to make sure you are thoroughly practicing self-care. This is essential to make a good and healthy recovery. Physical activity is a great way to bring yourself joy and even let go of any emotional stress. 

References 

[1] Roxby, B. P. (2020, January 15). Miscarriage can lead to “long-term post-traumatic stress.” https://www.bbc.com/news/health-51093999 

[2] What is a Miscarriage? | Causes of Miscarriage. (n.d.). Planned Parenthood. https://www.plannedparenthood.org/learn/pregnancy/miscarriage 

[3] Professional, C. C. M. (n.d.). Miscarriage. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/9688-miscarriage

[4] Healthdirect Australia. (2024, May 8). Miscarriage. Types, Symptoms and When to See a Doctor | Pregnancy Birth and Baby. https://www.pregnancybirthbaby.org.au/miscarriage 

[5] Nynas, J., Narang, P., Kolikonda, M. K., & Lippmann, S. (2015). Depression and anxiety following early pregnancy loss. The Primary Care Companion for CNS Disorders. https://doi.org/10.4088/pcc.14r01721 

[6] The Miscarriage Association. (2024, January 25). The physical process – The Miscarriage Association.https://www.miscarriageassociation.org.uk/information/miscarriage/the-physical-pro cess/