Psychological Disorders

1
Chapter 12

• Psychological Disorders
• Nearly 1 of every 4 Americans are diagnosed with
  a mental heath disorder each year.

2
Section 1 Defining What Is Normal

• Psychopathology
• Scientific study of
  
  mental, emotional, and behavioral disorders
• Term used to refer to a disorder
• Concepts in Normal vs. Abnormal Behavior
• Subjective Discomfort
• Private feelings of anxiety, depression, or
  emotional distress
• Statistical Abnormality
• Having extreme scores on some dimension, such as
  intelligence, anxiety, or depression (see graph)
• Social Nonconformity
• Disobeying societal standards for normal conduct
  may lead to destructive or self-destructive
  behavior
• Situational Context
• Social situation, behavioral setting, or general
  circumstances in which an action takes place
• Is it normal to walk naked around strangers? If
  you are in a locker room and in the shower area,
  yes!
• Cultural Relativity
• Judgments are made relative to the values of
  ones culture

3
There is no absolute normal or abnormal behavior,
therefore criteria were established to help
determine if a behavior is abnormal for an
individual.

• Three criteria for determining abnormal behavior
  (book lists only 2)
• All three criteria do not have to be met for a
  person to be diagnosed with a psychological
  disorderdiagnoses involve value judgments
• Deviant - does it violate societal norms
• Maladaptive - does it impair a persons everyday
  behavior
• Causing personal distress does the person
  experience discomfort, stress or pain of some
  kind from the behavior
• A continuum of normal/abnormal
• Antonyms such as normal vs. abnormal imply that
  people can be divided into two distinct groups,
  when in reality, it is hard to know when to draw
  the line

4
Disordered Behavior

• Mental Disorder
• Significant impairment in psychological
  functioning is present
• Psychotic Disorder
• Severe psychiatric disorder characterized by
  hallucinations and delusions, social withdrawal,
  and a movement away from reality
• Organic Mental Disorder
• Mental or emotional problem caused by brain
  pathology (e.g., brain injuries or diseases)

5
Neurosis

• Archaic term
• Once used to refer to excessive anxiety,
  somatoform, dissociative disorders, and some
  kinds of depression

6
Classifications of Major Disorders

• The diagnoses of disorders are made on Axes I and
  II, with most falling on Axis I.
• The remaining axes are used to record
  supplemental information. A persons physical
  disorders are listed on Axis III, and the types
  of stress they have experienced in the past year
  on Axis IV. Axis V estimates the individuals
  current level of adaptive functioning.
• The goal of this multiaxial system is to impart
  information beyond a traditional diagnostic
  label.
• Axis I Clinical Syndromes
• Axis II Personality Disorders or Mental
  Retardation
• Axis III General Medical Conditions
• Axis IV Psychosocial and Environmental Problems
• Axis V Global Assessment of Functioning

7
Types of Mental Disorders Defined in The DSM
(Diagnostic and Statistical Manual of Mental
Disorders)
8
General Risk Factors for Developing a Mental
Illness

• Social Conditions
• Poverty, homelessness, overcrowding, stressful
  living conditions
• Family Factors
• Parents who are immature, mentally ill, abusive,
  or criminal
• Poor child discipline
• Severe marital or relationship problems
• Psychological Factors
• Stress, learning disorders, and low intelligence
• Biological Factors
• Genetic defects or inherited vulnerabilities
• Poor prenatal care, head injuries, exposure to
  toxins, chronic physical illness, or disability

9
Insanity VS. Mental Disorder

• Insanity
• A legal term referring to an inability to manage
  ones affairs or to be aware of the consequences
  of ones actions
• An insane person can not determine right from
  wrong
• Can only be established though testimony of an
  expert witness in a court of law
• May be psychologist, psychiatrist, and so on
• Mental Disorder
• Any mental, emotional, or behavioral abnormality
  causing distress or interfering with a persons
  ability to function

10
Use of the insanity defenseReality VS Perception
11
Types of Mental Disorders Discussed in this
Chapter
12
Personality Disorders

• CHARACTERISTICS
• Maladaptive personality traits
• Patterns usually begin during adolescence or
  childhood
• Deeply rooted and span many years
• Types of Personality Disorders Listed in the DSM
  (Diagnostic Statistical Manual of Psychological
  Disorders)
• Cluster A (odd or eccentric)
• 301.0 Paranoid personality disorder
• 301.20 Schizoid personality disorder
• 301.22 Schizotypal personality disorder
• Cluster B (dramatic, emotional, or erratic)
• 301.7 Antisocial personality disorder
• 301.83 Borderline personality disorder
• 301.50 Histrionic personality disorder
• 301.81 Narcissistic personality disorder
• Cluster C (anxious or fearful)
• 301.82 Avoidant personality disorder

13
Antisocial Personality Disorder (APD)

• Definition
• A person who lacks a conscience
• Typically emotionally shallow, impulsive,
  selfish, and manipulative toward others
• Oftentimes called psychopaths or sociopaths
• Characteristics
• Many are delinquents or criminals, but many are
  NOT crazed murderers as displayed on television
• Create a good first impression and are often
  charming
• Cheat their way through life
• May be blind to signs of disgust in others
• Tend to be thrill-seekers
• Possible Causes
• Childhood history of emotional deprivation,
  neglect, and physical abuse
• Underarousal of the brain
• Very difficult to effectively treat
• Will likely lie, charm, and manipulate their way
  through therapy

14
Additional Personality Disorders

• Borderline Personality Disorder
•  Emotionally unstable personality disorder 
• prolonged disturbance of personality function
  characterized by depth and variability of moods.
• typically involves unusual levels of instability
  in mood "black and white" thinking, or
  "splitting"
• chaotic and unstable interpersonal relationships,
  self-image, identity, and behavior
• disturbance in the individual's sense of self.
• Histrionic Personality Disorder
• characterized by a pattern of excessive
  emotionality and attention-seeking, including an
  excessive need for approval and inappropriate
  seductiveness
• individuals are lively, dramatic, enthusiastic,
  and flirtatious.
• may be inappropriately sexually provocative,
  express strong emotions with an impressionistic
  style, and be easily influenced by others.
• Narcissistic Personality Disorder
• "a pervasive pattern of grandiosity, need for
  admiration, and a lack of empathy."
• described as turning inward for gratification
  rather than depending on others
• excessively preoccupied with issues of personal
  adequacy, power and prestige.
• closely linked to self-centeredness

15
Anxiety-Based Disorders Adjustment Disorders

• CHARACTERISTICS
• When ongoing stressors within the range of normal
  experience cause emotional disturbance and push
  people beyond their ability to effectively cope
• Are usually temporary, symptoms disappear when
  circumstances improve
• Adjustment disorders
• 309.9 Unspecified
• 309.24 With anxiety
• 309.0 With depressed mood
• 309.3 With disturbance of conduct
• 309.28 With mixed anxiety and depressed mood
• 309.4 With mixed disturbance of emotions and
  conduct

16
Anxiety-Based Disorders Anxiety Disorders

• CHARACTERISTICS
• Anxiety is defined as feelings of apprehension,
  dread, or uneasiness
• In an anxiety disorder symptoms are ongoing and
  seem to be out of proportion relative to the
  persons circumstances
• Usually suffer sleep disturbances, irritability,
  and depression
• Anxiety disorders
• 300.02 Generalized anxiety disorder
• Panic disorder
• 300.21 With agoraphobia
• 300.01 Without agoraphobia
• 300.22 Agoraphobia without history of panic
  disorder
• 300.29 Specific phobia
• 300.23 Social phobia
• 300.3 Obsessive-compulsive disorder
• 309.81 Posttraumatic stress disorder
• 308.3 Acute stress disorder
• Anxiety disorder
• 293.89 Anxiety disorder due to... indicate the
  general medical condition
• 300.00 Anxiety disorder

17
Anxiety Disorders

• Generalized anxiety disorder
• marked by a chronic, high level of anxiety that
  is not tied to any specific threat
• free-floating anxiety
• Phobic disorder
• marked by a persistent and irrational fear of an
  object or situation that presents no realistic
  danger
• Specific focus of fear
• Particularly common are acrophobia fear of
  heights, claustrophobia fear of small, enclosed
  places, brontophobia fear of storms,
  hydrophobia fear of water, and various animal
  and insect phobias
• Panic disorder and agoraphobia
• characterized by recurrent attacks of
  overwhelming anxiety that usually occur suddenly
  and unexpectedly
• These paralyzing attacks show the physical
  symptoms associated with anxiety.
• After a number of these attacks, victims may
  become so concerned about exhibiting panic in
  public that they may be afraid to leave home,
  developing agoraphobia or a fear of going out in
  public.
• Obsessive compulsive disorder
• Obsessions - persistent, uncontrollable
  intrusions of unwanted thoughts
• Obsessions often center on inflicting harm on
  others, personal failures, suicide, or sexual
  acts
• Compulsions - urges to engage in senseless
  rituals
• examples of compulsions include constant hand
  washing, repetitive cleaning of things that are
  already clean, and endless checking and
  rechecking of locks

18
Anxiety-Based Disorders Dissociative disorders

• CHARACTERISTICS
• Sudden temporary alteration of memory function
• Breaks in consciousness awareness of self
• 300.6 Depersonalization disorder
• 300.12 Dissociative amnesia
• 300.13 Dissociative fugue
• 300.14 Dissociative identity disorder
• 300.15 Dissociative disorder NOS
• Dissociative Amnesia
• Inability to recall ones name, address, or past
• It is defined by the presence of retrograde
  amnesia or the inability to retrieve stored
  memories and events leading up to the onset of
  amnesia and an absence of anterograde amnesia or
  the inability to form new long term memories.
• In most cases, patients lose their
  autobiographical memory and personal identity
  even though they are able to learn new
  information and perform everyday functions
  normally. Other times, there may be a loss of
  basic semantic knowledge and procedural skills
  such as reading and writing.5
• Dissociative Fugue
• Sudden travel away from home and confusion about
  personal identity
• characterized by abandonment of personal
  identity, along with the memories, personality
  and other identifying characteristics of
  individuality.

19
Dissociative Identity Disorder (DID)

• Person has two or more distinct, separate
  identities or personality traits
• The diagnosis requires that at least two
  personalities routinely take control of the
  individual's behavior with an associated memory
  loss that goes beyond normal forgetfulness
• Symptoms cannot be due to substance abuse or
  medical condition.
• There is controversy around the existence, the
  possible causes, the prevalence across cultures,
  and the epidemiology of the condition.
• Previously known as Multiple Personality Disorder
• Sybil or The Three Faces of Eve are good
  examples
• Often begins with horrific childhood experiences
  (e.g., abuse, molestation, etc.)
• Therapy often makes use of hypnosis
• Goal Integrate and fuse identities into single,
  balanced personality

20
Anxiety-Based Disorders Somatoform disorders

• CHARACTERISTICS
• Present with somatic symptoms that resemble
  physical illness
• No organic cause is present
• 300.81 Somatization disorder
• 300.81 Undifferentiated somatoform disorder
• 300.11 Conversion disorder
• Pain disorder
• 307.89 Associated with both psychological factors
  and a general medical condition
• 307.80 Associated with psychological factors
• 300.7 Hypochondriasis
• 300.7 Body dysmorphic disorder
• 300.81 Somatoform disorder

21
Somatoform Disorders Hypochondriasis

• Person is preoccupied with having a serious
  illness or disease
• Interpret normal sensations and bodily signs as
  proof that they have a terrible disease
• No organic cause can be found
• constant self-examination and self-diagnosis, and
  a preoccupation with one's body.
• Many individuals with hypochondriasis express
  doubt and disbelief in the doctors' diagnosis,
  and report that doctors reassurance about an
  absence of a serious medical condition is
  unconvincing, or un-lasting.
• Many hypochondriacs require constant reassurance,
  either from doctors, family, or friends, and the
  disorder can become a disabling torment for the
  individual with hypochondriasis, as well as his
  or her family and friends.

22
Somatization Disorder

• Person expresses anxieties through numerous
  physical complaints
• Many doctors are consulted but no organic or
  physical causes are found
• (also Briquet's disorder or, in antiquity,
  hysteria)
• Patients with Somatization Disorder will
  typically visit many doctors trying to get the
  treatment they think they need.

Pain Disorder

• Pain that has no identifiable organic, physical
  cause
• Appears to have psychological origin

23
Conversion Disorder

• Severe emotional conflicts are converted into
  physical symptoms or a physical disability
• Caused by anxiety or emotional distress but not
  by physical causes
• Conversion disorder can present with any motor or
  sensory symptom including
• Weakness/paralysis of a limb or the entire body
  (hysterical paralysis or )
• Impaired hearing or vision
• Loss/disturbance of sensation
• Impairment or loss of speech (hysterical aphonia)
  
• Psychogenic non-epileptic seizures
• Fixed Dystonia unlike normal dystonia
• Tremor or other movement disorders
• Gait problems (Astasia-abasia)

FIGURE 12.4 (left) Glove anesthesia is a
conversion reaction involving loss of feeling in
areas of the hand that would be covered by a
glove (a). If the anesthesia were physically
caused, it would follow the pattern shown in (b).
(right) To test for organic paralysis of the arm,
an examiner can suddenly extend the arm,
stretching the muscles. A conversion reaction is
indicated if the arm pulls back involuntarily.
24
Munchausen Syndrome by Proxy
Anxiety-Based Disorders Factitious Disorders

• CHARACTERISTICS
• involve "illnesses" whose symptoms are either
  self-induced or falsified by the patient.
• 300.19 With Combined Psychological and Physical
  Signs and Symptoms 300.19 With Predominantly
  Physical Signs and Symptoms 300.16 With
  Predominantly Psychological Signs and Symptoms
  300.19 Factitious Disorder NOS 307.59 Feeding
  Disorder of Infancy or Early Childhood

Munchausen Syndrome

• When a person fakes disease, illness, or
  psychological trauma in order to draw attention
  or sympathy to themselves.
• It is also sometimes known as hospital addiction
  syndrome.

• When a person fakes the medical problems of
  someone in his or her care

25
Theoretical Causes of Anxiety Disorders

• Psychodynamic (Freud) anxiety caused by
  conflicts among id, ego, and superego
• Humanists Unrealistic self-image conflicts with
  real self-image
• Behavioral Anxiety symptoms and behaviors are
  learned, like everything else
• Conditioned emotional responses that generalize
  to new situations
• Cognitive When distorted thinking causes people
  to magnify ordinary threats and failures, leading
  to anxiety and distress

26
Section 3Psychosis, Delusional Disorders, and
Schizophrenia

• Schizophrenia and other psychotic disorders
• Schizophrenia
• 295.2 Catatonic type
• 295.1 Disorganized type
• 295.3 Paranoid type
• 295.6 Residual type
• 295.9 Undifferentiated type
• 295.4 Schizophreniform disorder
• 295.7 Schizoaffective disorder
• 297.1 Delusional disorder
• 298.8 Brief psychotic disorder
• 297.3 Shared psychotic disorder
• 298.9 Psychotic disorder
• Psychotic disorder due to... indicate the
  general medical condition
• 293.81 With delusions
• 293.82 With hallucinations

27
Common Symptoms of Psychosis and Schizophrenia
Disorders

• Psychosis loss of contact with shared views of
  reality
• Delusions and hallucinations are core features of
  psychosis
• Delusions
• False beliefs that individuals insist are true,
  regardless of overwhelming evidence against them
• Hallucinations
• Imaginary sensations, such as seeing, hearing, or
  smelling things that do not exist in the real
  world
• Most common psychotic hallucination is hearing
  voices
• Note that olfactory hallucinations sometimes
  occur with seizure disorder (epilepsy)
• Flat Affect
• Lack of emotional responsiveness face is frozen
  in blank expression
• Disturbed Verbal Communication
• Garbled and chaotic speech
• Word salad
• Personality Disintegration
• Uncoordinated thoughts, actions, and emotions

28
Psychotic Disorders

• Organic Psychosis
• Psychosis caused by brain injury or disease
• Dementia
• Most common organic psychosis serious mental
  impairment in old age caused by brain
  deterioration
• Archaically known as senility
• Experiences could really occur!
• Paranoid Psychosis
• most common delusional disorder
• Centers on delusions of persecution
• Alzheimers Disease
• Symptoms include impaired memory, confusion, and
  progressive loss of mental abilities
• Ronald Reagan was perhaps the most famous
  Alzheimers victim
• Common Causes
• Circulatory problems, repeated strokes, and
  shrinkage and atrophy of the brain
• Delusional Disorder
• Marked by presence of deeply held false beliefs
  (delusions)
• May involve delusions of grandeur, persecution,
  jealousy, or eroticism

29
Schizophrenia

• Psychotic disorder characterized by
  hallucinations, delusions, apathy, thinking
  abnormalities, and split between thoughts and
  emotions
• Does NOT refer to having split or multiple
  personalities

30
The Four Subtypes of Schizophrenia

• Disorganized Type
• Incoherence, grossly disorganized behavior,
  bizarre thinking, and flat or inappropriate
  emotions
• Catatonic Type
• Marked by stupor, rigidity, unresponsiveness,
  posturing, mutism, and sometimes agitated,
  purposeless behavior
• Paranoid Type
• Preoccupation with delusions
• Also involves auditory hallucinations that are
  related to a single theme, especially grandeur or
  persecution
• Undifferentiated Type
• Any type of schizophrenia that does not have
  paranoid, catatonic, or disorganized features or
  symptoms

31
Causes of Schizophrenia

• Environment
• In utero exposure to the flu
• Malnutrition during pregnancy
• Complications during birth
• Psychological Trauma
• Psychological injury or shock, often caused by
  violence, abuse, or neglect
• Disturbed Family Environment
• Stressful or unhealthy family relationships,
  communication patterns, and emotional atmosphere
• Heredity
• Biochemical Abnormality
• Disturbance in brains chemical systems or in the
  brains neurotransmitters
• Dopamine
• Neurotransmitter involved with emotions and
  muscle movement
• Works in limbic system
• Dopamine over-activity in brain may be related to
  schizophrenia

32
FIGURE 12.8 Dopamine normally crosses the synapse
between two neurons, activating the second cell.
Antipsychotic drugs bind to the same receptor
sites as dopamine does, blocking its action. In
people suffering from schizophrenia, a reduction
in dopamine activity can quiet a persons
agitation and psychotic symptoms.
33
Section 4 Mood Disorders

• Bipolar disorders
• Bipolar disorders
• 296.80 Bipolar disorder NOS
• Bipolar I disorder, most recent episode depressed
  
• 296.56 In full remission
• 296.55 In partial remission
• 296.51 Mild
• 296.52 Moderate
• 296.53 Severe without psychotic features
• 296.54 Severe with psychotic features
• 296.50 Unspecified
• 296.40 Bipolar disorder I, most recent episode
  hypomanic
• Bipolar disorder I, most recent episode manic
• 296.46 In full remission
• 296.45 In partial remission
• 296.41 Mild
• 296.42 Moderate
• 296.43 Severe without psychotic features
• 296.44 Severe with psychotic features

• Mood disorders
• edit Depressive disorders
• 300.4 Dysthymic disorder
• Major depressive disorder
• Major depressive disorder, recurrent
• 296.36 In full remission
• 296.35 In partial remission
• 296.31 Mild
• 296.32 Moderate
• 296.33 Severe without psychotic features
• 296.34 Severe with psychotic features
• 296.30 Unspecified
• Major depressive disorder, single episode
• 296.26 In full remission
• 296.25 In partial remission
• 296 21 Mild
• 296.22 Moderate
• 296.23 Severe without psychotic features
• 296.24 Severe with psychotic features

34
Mood Disorders

• Major disturbances in emotion or mood, such as
  depression or mania
• Depressive Disorders
• Sadness or despondency are prolonged,
  exaggerated, or unreasonable
• Bipolar Disorders
• Involve both depression, and mania or hypomania

35
Milder Mood Disorders

• Dysthymic Disorder
• Moderate depression that lasts for at least two
  years
• Cyclothymic Disorder
• Moderate manic and depressive behavior that lasts
  for at least two years

36
Major Mood Disorders

• Lasting extremes of mood or emotion and sometimes
  with psychotic features (hallucinations,
  delusions)
• Major Depressive Disorder
• A mood disorder where the person has suffered one
  or more intense episodes of depression
• One of the more serious mood disorders

37
Major Mood Disorders

• Bipolar I Disorder
• People who experience extreme mania and deep
  depression
• Mania
• Excited, hyperactive, energetic, grandiose
  behavior
• Bipolar II Disorder
• Person is mostly depressed, but has had one or
  more hypomanic episodes
• Hypomania is not as severe as mania

38
Endogenous Depression

• Depression that seems to be produced from inside
  the body (perhaps due to chemical imbalances) and
  NOT from reaction to life events

39
Maternity Blues

• Mild depression that lasts for one to two days
  after childbirth
• Marked by crying, fitful sleep, tension, anger,
  and irritability
• Brief and not too severe

40
Postpartum Depression

• Moderately severe depression that begins within
  three months following childbirth
• Marked by mood swings, despondency, feelings of
  inadequacy, and an inability to cope with the new
  baby
• May last from two months to one year
• Part of the problem may be hormonal

41
Seasonal Affective Disorder (SAD)

• Depression that only occurs during fall and
  winter
• May be related to reduced exposure to sunlight
• Phototherapy
• Extended exposure to bright light to treat SAD

42
(No Transcript)
43
Some abnormal behaviors are culturally driven
and unique to a specific society, we call
theseCultural Maladies
Culture and Mental Health

• Amok
• Men from Malaysia, Laos, Philippines, and
  Polynesia who feel they have been insulted will
  brood then erupt violently
• Susto
• Insomnia, irritability, phobias, and an increase
  in sweating and heart rate affecting Latin
  Americans who are frightened by a black magic
  curse
• Ghost Sickness
• American Indians who become preoccupied with
  death and the deceased
• Symptoms include bad dreams, confusion, feelings
  of futility, and a sense of suffocation
• Koro
• A fear of the genitals receding into the body
  experienced by people in southern and eastern
  Asia
• Zar
• When spirits posses an individual resulting in
  shouting, laughing, weeping, or singing
• Seen in North Africa and Middle East
• Dhat
• In Indian society, dhat is the fear of the loss
  of semen during nocturnal emissions

44
Section 5 Suicide

• Major Risk Factors
• Drug or alcohol abuse
• Prior suicide attempt
• Depression or other mood disorder
• Availability of a firearm
• Severe anxiety or panic attacks
• Family history of suicidal behavior
• Shame, humiliation, failure, or rejection

FIGURE 12.15 Suicidal behavior usually progresses
from suicidal thoughts, to threats, to attempts.
A person is unlikely to make an attempt without
first making threats. Thus, suicide threats
should be taken seriously (Garland Zigler,
1993).
45
Factors Affect Suicide Rate

• Gender
• Men are more likely to complete suicide, but more
  women attempt
• Ethnicity
• Rates vary from country to country, but
  Caucasians have higher suicide rates
• Native Americans have highest suicide rate in
  country
• Age
• Suicide rates increase with age
• Marital Status
• Married individuals have lower suicide rates

46
Common Characteristics of Suicidal Thoughts and
Feelings (Shneidman)

• Escape
• Unbearable Psychological Pain
• Emotional pain that the person wishes to escape
• Frustrated Psychological Needs
• Such as searching for love, achievement, or
  security
• Constriction of Options
• Feeling helpless and hopeless and deciding that
  death is the only option left

47
The Psychology of SuicideAdapted from Suicide
and Crisis Intervention Service, MemphisTraining
Manual

• The suicidal person dose not fear death less than
  others they do fear something in life more.
• Those who fear death fear more the process than
  the result, by choosing suicide they pick the
  manner of death.
• People with terminal or chronically painful
  illness may choose suicide out of self-love.
  They do not wish to put themselves through
  seeming needless pain.
• People who have committed an act they consider
  reprehensible may choose suicide out of
  self-hate. They perform a self conviction and
  execution.
• Someone in extreme conflict with another may
  choose suicide out of hatred for another. They
  kill themselves to punish the other person, in a
  sense they accuse/blame the other person for
  their own death.
• Someone suffering from psychosis may not choose
  suicide, but rather not realize that death will
  be the result of their actions.
• People in need of other attention or assistance
  may commit a near-suicidal act to secure
  attention. Unfortunately they may be more
  successful than they intended.

48
The Signs of SuicideAdapted from Suicide and
Crisis Intervention Service, MemphisTraining
Manual

• Lack of concern about their appearance, grooming,
  health, or clothing.
• Withdraws from social contact.
• Feels there is no way out of conflict, failure,
  or pain. Perceives a real threat to happiness.
• Acts impulsively.
• Overwhelmed by guilt or shame.
• Blames or punishes self for any mishap.
• Reduced fantasy or living capacity. Can not find
  joy in anything.
• Talks symbolically of death or may even have a
  plan for their own death.
• Signs are not limited to the ones above, any
  major change in behavior may signal a problem.

49
What Can You Do to Prevent A SuicideAdapted
from Suicide and Crisis Intervention Service,
MemphisTraining Manual

• First, protect your own psyche you can not
  really prevent or cause others actions. You are
  not responsible for others decisions.
• Once you understand the above statement you can
  proceed to try to help someone else. Some
  suggestions
• Always try to get the person profession help.
• Listen empathetically and non-judgmentally to the
  person.
• Identify what they really fear and help provide
  HOPE for overcoming the problem.
• Help the person identify real solutions that they
  can DO. (Never leave a solution with a dont
  only, that behavior needs to be replaced with
  something a do.)
• Check on the person as often as you can until the
  crisis has been resolved.
• Follow up with professional help yourself if
  needed, dont find yourself being drawn in to
  hopelessness.