60-80% of patients with severe depression have suicidal thoughts and behaviors. They may end their lives sooner or later.
According to a survey on non-communicable diseases across 7 different ecological regions, the rate of depression in Vietnam is 4%. Globally, this figure stands at 20%, which includes patients with both typical and atypical symptoms.
Additionally, global statistics reveal that among 100 deaths, aside from traffic-related factors, approximately 70-80 cases are associated with depression. Associate Professor Dr. To Thanh Phuong, former deputy director of Central Psychiatric Hospital 1 (Hanoi), remarked: “This rate is alarming and calls for us to find ways to prevent patients from deteriorating to the point of suicide.”
Cumulative Depression Leading to Suicidal Behavior
Associate Professor Phuong stated that depression arises from 4 main causes:
- Family issues.
- Weak or unbalanced personality.
- Psychological impacts from social environment.
- Chronic illness.
Among these, psychological impacts from the social environment are the most common cause. Individuals with depression related to this factor account for 60-70%. This condition can stem from failed business ventures, academic pressure, polluted environments, high noise levels, or children addicted to gaming.
Patients with severe depression feel their lives are not worth living and decide to commit suicide.
According to Professor Phuong, many patients with severe depression belong to the non-psychotic group; they are aware of their illness but often feel sad and pessimistic. They perceive their lives as not worth living and make the decision to end it.
“I once treated a female patient from an ethnic minority who developed depression after getting married in Hanoi and giving birth. This case exhibited auditory hallucinations, with a voice in her head repeatedly saying ‘you should not eat.’ It was not until her third hospitalization that she was completely cured,” he shared.
For the psychotic group, patients may not recognize their illness and can engage in self-destructive behaviors or even commit homicide. Patients with anxiety and diffuse disorders often feel restless and agitated, unable to sit still. When overwhelmed, these individuals may harm themselves by cutting veins, self-inflicting wounds, or hanging.
The former deputy director of Central Psychiatric Hospital 1 affirmed that 60-80% of patients with severe depression have suicidal thoughts and behaviors. These cases may decide to commit suicide regardless of timing, triggered by life circumstances or crises.
Professor Phuong advised: “When someone mentions they will commit suicide, they are not joking; the opportunity just hasn’t arrived yet. Therefore, in such cases, we need to take them to a psychiatric hospital for immediate intensive treatment.”
The Mistake of Not Recognizing Depression as an Illness
In Vietnam, many people view depression as ridiculous or even stigmatizing. This leads those suffering from depression to quickly fall into chronic conditions due to concealment and fear of family and community judgment.
Professor Thanh Phuong noted: “In principle, after experiencing a psychological trauma, we need to resolve the issue decisively within the first two weeks. This is the acute phase of the illness and is easier to address. After two weeks, if the issue persists, it becomes a criterion for diagnosing depression, recognized as a pathological condition. When problems accumulate, depression can worsen into a chronic state, leading to suicide.”
Associate Professor Dr. To Thanh Phuong notes that many families in Vietnam do not recognize depression as a medical condition. (Photo: Quoc Toan).
This expert shared that he has encountered a student patient with severe depression who responded very well to treatment in the first month due to his mother’s attention. However, in the following month, the father directly messaged him, threatening to sue the doctor, believing that his son was not ill.
According to Professor Phuong, if families do not perceive the situation accurately, they may become the cause of depression and adversely affect the treatment process.
Patients with Depression Need Care and Treatment
“We should confront depression like other diseases such as heart disease, hypertension, diabetes, and cancer… Depression is also a medical condition. It is no different from common illnesses and is completely treatable. Many cases have fully recovered,” Professor Phuong stated.
He emphasized the significant role of family, especially parents, in supporting patients with depression. We need to listen and strive to resolve issues for patients within the first two weeks after an incident. Additionally, everyone should encourage and avoid putting pressure on them.
Associate Professor To Thanh Phuong guides patients in psychological assessments. (Photo: Quoc Toan).
Moreover, if patients exhibit severe symptoms, family members need to take them to the hospital for intensive treatment as soon as possible.
The 3 Main Symptoms of Depression:
- Persistent sadness lasting over 2 weeks.
- Loss of interest in previously enjoyed activities.
- Chronic fatigue, especially in the morning.
7 Secondary Symptoms of Depression: Decreased concentration, lack of self-confidence, a bleak outlook on the future, disordered intentions, sleep disturbances, poor appetite, and suicidal behaviors.
In the hospital, doctors will identify the type of depression the patient has, allowing for appropriate treatment methods. For those with psychogenic depression (due to psychological causes), the responsible doctor must inquire thoroughly to resolve the issues, often in conjunction with medication.
“The most important factor is whether the patient is cooperative. In some cases with hallucinations, patients deny their illness. At this point, doctors need to administer medication through food or drinks to help them regain clarity before addressing the situation,” Professor Phuong explained.
Additionally, the process of approaching and conversing to identify the causes of depression is the most complex stage. Typically, patients with severe depression upon hospitalization may not listen to or follow doctors’ instructions, making it difficult to extract information from them.
At this juncture, doctors often gather insights from those closest to the patient to identify issues and provide psychological interventions to help them out of their condition.
Professor To Thanh Phuong stated: “Depression has many different forms and is very difficult to detect. We need to correctly identify the type of depression, treat according to protocols, and allow sufficient time for recovery to prevent recurrence and chronic progression.”
