Fears of Losing Mental Control in Psychosis Linked to Suicide

Psychiatrists should emphasize a recovery-focused approach and an optimistic outlook when working with people with psychosis.

Negative thoughts about psychotic experiences and fears of losing mental control may heighten the risk of suicide in patients with psychosis who were not taking antipsychotics, suggests a report posted November 2 in Schizophrenia Bulletin.

“Overall, our findings emphasize the importance of clinicians promoting a recovery-focused and appropriately optimistic outlook when working with people with psychosis, taking care to avoid providing information that might heighten negative illness appraisals and/or fears of losing mental control,” wrote Paul Hutton, Ph.D., of the Edinburgh Napier University in the United Kingdom and colleagues.

They analyzed data on the effect of “metacognition” on suicidal thinking. Metacognition refers to knowledge and beliefs relating to the structure and integrity of the self and one’s own cognitive processes.

In their report, they noted that estimates of suicide rates among individuals diagnosed with schizophrenia spectrum disorders range from 5 to 10 percent, making it a leading cause of premature death in this population.

“Given antipsychotics have their strongest effects on the positive symptoms of psychosis, it is plausible that individuals not taking this medication may have greater positive symptom severity than those who do—and that this accounts for their increased suicide risk,” Hutton and colleagues wrote. Yet the researchers said evidence on the contribution of positive symptoms to suicide risk remains unclear, with some studies suggesting no association.

Other studies, however, have found that the way a person interprets or “appraises” their psychotic experiences may be more important than symptom severity for predicting suicidal behavior. For instance, a review published in the British Journal of Psychiatry in 2005 found that people with psychosis who die by suicide were more likely to have “fears of mental disintegration” than those with psychosis who did not die by suicide.

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‘Pansexual’ became one of the most looked up words of 2018 after Janelle Monáe came out

One of the runners up in the 2018 Merriam-Webster’s word of the year data analysis is “pansexual”. The term is defined as “characterized by sexual desire or attraction that is not limited to people of a particular gender identity or sexual orientation,”

Pansexual, as a term, gained a lot of popularity that can be attributed in part to Janelle Monáe, the singer and actress who said she identified as pansexual in an interview with Rolling Stone.

Merriam-Webster’s word of the year was “justice”. The word saw a rise in searches on the dictionary’s website this year, which was looked up 74% more than last year, according to the publisher.

Merriam-Webster is one of the main dictionaries to name a word of the year in recent weeks.

Last month, Oxford Dictionaries named their word of the year, “toxic”, which is frequently used to describe the current administration and masculinity.

Dictionary.com gave the title to “misinformation,” citing the rise of fake news, political ads and planted conspiracy theories.

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Anti-Anxiety Drugs Could be a Hidden Epidemic in the Making

As someone who struggles with anxiety, I can understand the desire to find something that can help protect yourself from haunting feelings of dread that cripple your peace of mind. Anxiety is a complicated condition that can creep in from the most unexpected places, and people experience it in many different ways. While some may think it’s based in fear or weakness, the reality is far more complex. Those people may say all you need to overcome anxiety is a more grounded and positive outlook. But the truth for most people with an anxiety disorder is that battling anxiety goes a lot deeper than promoting optimism. Especially when your condition convinces you that all levity is just you lying to yourself. Sometimes, you need a little outside help, and anti-anxiety drugs can be very useful when a physician and an individual decide on the right route to take.

However, anti-anxiety medications can also be dangerous. These anti-anxiety drugs may not be in the spotlight the way opioids are, they are commonly abused, extremely addictive and can be just as lethal.

With recent reports showing a rise in deaths associated with anti-anxiety medications, some experts are saying there is a hidden epidemic being overshadowed by the opioid crisis.

ANTI-ANXIETY DRUGS UNDERESTIMATED
It is true that opioids are doing massive damage all across the country, but that doesn’t mean the death rates due to anti-anxiety drugs should be ignored. While focusing on prescription opioids, heroin and synthetic opioids is important, we should also keep in mind the other dangerous medications out there.

The usual suspects are benzodiazepines, which include drugs like:

  • Valium
  • Klonopin
  • Librium
  • Ativan

While these anti-anxiety drugs may be useful in helping some people, they still carry their risks, which can be devastating and even lethal.

According to the director of the Scripps Mercy Hospital emergency department Dr. Roneet Lev, benzodiazepines are responsible for more drug deaths in San Diego County than people may expect. She says,

“THAT COMES FROM PEOPLE WHO COME INTO OUR TRAUMA CENTER FROM CAR ACCIDENTS BECAUSE THEY’RE ON BENZODIAZEPINES, PEOPLE WHO COME IN BECAUSE THEY’RE FALLING DOWN BECAUSE THAT AFFECTS THEIR BALANCE AND COORDINATION ON BENZODIAZEPINES,”
“WE’VE SEEN TERRIBLE WITHDRAWALS, WHEN THEY’RE USED TO HAVING IT, WITH SEIZURES, THAT END UP IN THE ICU.”
And it isn’t just people who are buying these drugs off the street. Concerning drug-related deaths by legal prescriptions, benzodiazepines are not as far behind opioids as people may think. Dr. Lev adds that while oxycodone is the number one prescribed drug associated with death, hydrocodone is second, and benzodiazepine is in third place.

But San Diego County is definitely not the only area experiencing a surge in benzodiazepine-related deaths. According to the National Institute on Drug Abuse (NIDA), deaths involving these anti-anxiety drugs have more than quadrupled between 2002 and 2015.

Something that does make these medications even more treacherous is when they are mixed with opioids.