Can Memory Loss be cured?

Memory Loss: Can it be Cured?

By Majid Fotuhi, MD

Memory loss is a frightening occurrence for anyone who finds the records of their lives fading away, whether it's minor forgetfulness or the devastating effects of Alzheimer's disease.

Here is a memorable discussion about preventing and treating memory loss.

(you should consult your personal physician as this is meant for informational purposes only.)

Moderator:

Is memory loss an inevitable part of aging?

Fotuhi: No. People may have slower rate of learning and memorizing things, but they should not lose their memory. Some degree of forgetfulness is normal with aging, but people should maintain the ability to function in their jobs and remember names of their spouses, children, friends, and so on.

The only thing they should not forget is the names of their close relatives and their friends. That would be abnormal.

Moderator: How can one determine what is causing short-term memory loss?

Fotuhi: The most common cause of memory loss is stress and anxiety. The second most common cause is depression. The third most common cause is medical issues. Only the 10th or 11th on the list would be Alzheimer's disease.

Ninety percent of older adults who complain about memory loss do not have Alzheimer's disease. Most of them have depression, stress, anxiety, fatigue, and lack of sufficient amount of sleep or medical issues.

Member question: What, if any, is the difference between dementia and Alzheimer's disease?

Fotuhi: That is a very good question. Dementia means memory loss plus deficit in one or more area of cognition, such as getting lost, confusion of time, or inability to do the usual hobbies a person may have.

There are many causes for dementia, such as high blood pressure causing vascular dementia. The most common cause of dementia is Alzheimer's disease. So Alzheimer's is one of several different types of dementia.

Moderator: So what would be the first step a person should take if they feel they are losing their memory?

Fotuhi: The first thing they should do is to check the things I mentioned, such as stress, fatigue, lack of sleep, and most importantly, depression. They should discuss their memory loss with their physician.

Most doctors can determine whether a person's memory loss is due to medical issues or if it is due to dementia. So check your causes of memory loss and talk with your doctor.

Member question: Dr. Fotuhi, my mother suffered a stroke at age 69 and since has developed vascular dementia. Having had a stroke myself at age 50 am I at a higher risk to develop vascular dementia?

Fotuhi: Yes. People who have vascular risk factors are at a higher risk or developing dementia. Having high blood pressure, high cholesterol, and high homocysteine all contribute to developing heart attacks, a stroke, and vascular dementia.

Fortunately, all these risk factors are treatable and they should be treated aggressively. Once they are treated, a person is no longer at risk for developing dementia, especially if they start in their midlife.

Member question: I am a 52-year-old woman. How can I tell if the memory problems that I have been experiencing over the last year or so are some form of Alzheimer's or not? My grown children talk about events from their childhood that I just don't recognize. I also forget things as soon as I hear them and I lose words --I know what I want to say, but cannot remember the words. At times, familiar places become foreign to me and I can get lost or disoriented walking or driving.

Fotuhi: That is actually worrisome for dementia. However, the cause of dementia may be depression, which can be treated with medications, so I strongly recommend that you discuss this issue with your doctor.

Member question: I am 48 years old. I remember faces of students taught but not their names. Sometimes I scan my memory to remember something that has just happened but everything is blank. I call someone to pass on a message; by the time the person turns around (a matter of seconds)

I have already forgotten the message to be passed. I had a surgical hysterectomythree years ago. Could it be the cause of memory loss? I tend to preserve the long-term memory but the short term one -- it's almost chaotic.

Fotuhi: Hysterectomy does not cause memory loss. The kinds of memory lapses you describe are very common. In other words, you may lose memory temporarily but you can retrieve that memory later. The kind of memory loss that would be concerning would be the type that the person would completely forget all the information.

For example, it would be OK to forget the name of a movie you saw last weekend. However, it will not be OK for you to forget that you saw a movie at all

Again, there are many causes for short-term memory loss; the most common causes being stressful lifestyle, lack of sleep, anxiety, and depression. The chance that you have Alzheimer's disease in your 40s and 50s is extremely low. My advice to you is "forget about Alzheimer's."

Moderator: What is the usual age range for the onset of Alzheimer's?

Fotuhi: Alzheimer's disease is not as common as people think it is. Only one in 100 of those in their 60s develop this disease. Among those in their 70s, only two or three out of 100 develop Alzheimer's. The numbers are much higher only for those in their 80s and 90s.

Member question: I have memory loss due to an accident where I fell and hit my head. Amnesia. Can it be reversible?

Fotuhi: Head trauma associated with coma is one of the many risk factors for memory loss that comes with aging. However, other risk factors, such as high blood pressure, high cholesterol, high homocysteine, lack of exercise, lack of education, and depression, are more likely to contribute to memory loss than a single head trauma.

If you did have a serious head trauma, you should focus on reversing your other risk factors, since you cannot reverse having had a head trauma.

You can also make sure that you prevent the chance of having a future head trauma for yourself and especially for your children by making sure that they wear their seat belts and wear protection for their head when they are involved in contact sports.

It is very important to wear a helmet when you or your children are skateboarding, biking or especially of you're on a motorcycle.

Member question: Can menopause cause memory loss?

Fotuhi: There are a lot of controversies regarding menopause and memory loss. I think if a woman is experiencing her menopause and also having problems with her memory, she should check her risk factors and make sure that she has taken care of all her reversible causes of memory loss.

For example, low thyroid levels are common and will need treatment. Taking hormone replacement therapy is now shown not to be effective, and it is also associated with increased risk of heart attacks, strokes, and breast and ovarian cancers.

So the short answer is, check your reversible risk factors and try to maximize your memory ability by exercise and better diet.

Moderator:�What is the role of exercise and diet in memory loss?

Fotuhi: Exercise improves memory in two ways:

� It improves your heart function. This means that your heart can pump the blood better and profuse your brain with a rich supply of blood.

� By direct increase of growth factors in the brain. Growth factors are proteins that naturally nourish the brain cells and help them repair small injury and remain in good health.

� By increasing the levels of these growth factors, exercise makes your brain a better working machine.

Member question: What are these growth factors?

Fotuhi: One of them is called BDNF, which stands for brain drive neurotrophic factor. Another growth factor is called nerve growth factor or NGF. Both these growth factors have been shown to increase with exercise and to improve memory.

Member question: I am 55 years old now, have three grown children. I was treated for clinical and postpartum depression in my 20s with medication and ECT -- quite a bit of ECT -- over a period of five years, but not constant for those five years. Umpteen professionals told me that I would only have short-term memory loss and that it would return. Well, they either lied, mislead me, or did not know what they were relaying to me because ECT erased 98% of my memories of my children's childhood.

Can you give me an honest answer as to why I lost my memories? Also, my memories of me growing up were erased. I live in the present and it is very upsetting to me that I cannot discuss my kids growing up with them. To say the least, I am angry and very sad.

Fotuhi: I appreciate how frustrating it must be to have a very poor memory. To the best of my knowledge, there is no formal study that has shown ECT to be associated with memory loss. I recommend that you discuss with your physician the other reversible causes for memory loss I mentioned earlier.

You may also need to have a brain MRI. Depression, as I mentioned earlier, is one of the main causes of memory loss. So the difficulties you have with your memory may still be due to depression. I think that you do need a full medical workup to identify the cause of your memory loss.

Member question: What vegetables/herbs do you recommend for helping progressive memory loss. Items that I can grow myself here in southern Texas. Assuming I can remember where I last left the shovel and hoe.

Fotuhi: I have a list of foods that are rich in antioxidants and vitamin in my book, The Memory Cure. I can give you a short list, and those include:

�Spinach

� Oranges

� Beets

� Avocados

� And especially blueberries or other berries

I also recommend two or three servings of fish a week. Several studies have shown that people who eat fish two or three times a week have a lower risk of developing Alzheimer's disease. You also need plenty of B12 and folate in your diet. Again, a complete list of these is on page 104 of my book.

Moderator: Let's talk about preventing memory loss. You mentioned foods. How about education and activity?

Member question: Do you agree with the "use it or lose it" philosophy for preventing memory loss, such as playing chess, reading, and doing puzzles?

Fotuhi: The answer is absolutely yes. Use it or lose it really applies to your brain as much as it applies to your muscles. Several studies in the past two or three years have confirmed this notion. People who do more crossword puzzles, play chess, or enjoy activities that require thinking, are less likely to develop Alzheimer's disease.

I often find it surprising on how well my patients do if they had a strong history of education and if they maintain an interest for learning. Even when they do develop Alzheimer's disease in their brain, they continue to function fairly well.

Sometimes when we look at the brains of some of our participants in the Alzheimer's disease research center after they die, we find that they had Alzheimer's disease in their brain, but did not have any signs of dementia when we last saw them.

In summary, those who actively use their brains and enjoy hobbies and participate in volunteering activities, social activities and enjoy going to museums, going to the aquarium, or taking dance lessons do very well as they age.

Moderator: Can you address the issue of various herbs that claim to improve memory?

Fotuhi: The only vitamin supplement I recommend is vitamin E. I also strongly recommend to my patients and family to eat five pieces of fruits and vegetables a day.

The studies showing the effects of various herbs, such as gingko biloba are controversial.

There are several studies now under way to once and for all determine the effectiveness of these herbs. My recommendation is that if you are taking these herbs and you do find them helpful, you can continue taking them. However, if you are considering which of the several different supplements to take, I recommend vitamin E and eating five pieces of fruits and vegetables a day.

Member question: How can the average person determine what is normal forgetfulness that comes with age and what is a sign of something more serious?

Fotuhi: There are several tests that help doctors distinguish between normal forgetfulness that comes with aging and the worrisome forgetfulness that is associated with a disease. My quick way of determining the difference is to ask my patients if they have stopped doing their routine activities because of memory loss.

If they have stopped some of their hobbies or if they cannot complete their job responsibilities, I worry for their memory. Again, the cause of memory loss may be depression. Memory loss is not synonymous with dementia or Alzheimer's disease. I also have a list of questions on page 150 of my book to help people determine if their memory loss is significant and worrisome.

Member question: My 64-year-old husband has just been diagnosed with Alzheimer's and started on Aricept. Do you really think that Aricept can slow down the progression of this disease?

Fotuhi: There are several studies to determine whether any of the Alzheimer's medications slow down their progression of the disease. So far, none of the medications have made a significant difference in survival of patients with Alzheimer's disease.

They are very helpful in reversing the symptoms associated with Alzheimer's and may reduce the progression of the disease to a small degree, but they are not the magic drugs that everybody would love to have.

Fortunately, there are at least a dozen new medications in different stages of development, which may, indeed, slow Alzheimer's disease and help patients tot fight the disease for many more years. I am very optimistic.

Member question: What do you know about memantine/Ebixa, which has been in use in Europe for 12 to 15 years? Will it be available in the U.S. soon? When? I have personal experience with it with friends and family members in Germany, and it has worked miracles in all cases.

I was also able to obtain some for my stepfather who is in the moderate to severe range and it has turned life around for my mother who is the caregiver. Life has improved immensely and Dad has become more pleasant and helpful and considerate.

His sister began taking it in 1995 when she began wandering from home, sometimes in the nude, going to the cemetery to talk with her deceased husband. Since being on memantine she caries on in a more normal fashion and "behaves" as a more normal, more pleasant and functioning person.

If this drug does work so well, why does it take our FDA so long to help people (and their caregivers) who are at the end of their rope already? In this case, why shouldn't Americans have the same opportunity to use a medication that makes daily life more bearable for both patient and caregiver?

Fotuhi: FDA has very high standards for safety of the medications that reach the American households. However, we expect memantine to be available in our pharmacies in the next few months, and definitely by January 2004.

This drug is most helpful for patients in their mid to late stages of Alzheimer's disease.

Some of my patients do try to obtain memantine from Europe. I usually have no objection if they can obtain this medication.

There are several other medications that are also under development and we should see a list of new medications in the next three to five years.

Member question: My aunt was diagnosed with Alzheimer's in her 50s, my uncle in his late 60s, and my father died from complications of the disease in his late 70s. Has it been shown that a genetic link definitely exists at this point, and if so are there any reliable estimates of how absolute that association is?

Fotuhi: People who have a family member with Alzheimer's disease are at a higher risk of developing this disease as well. However, it is important to keep the numbers in mind:

�The risk for people in their 60s is 1 in 100.

� The risk for people who have a family member with Alzheimer's and who are in their 60s is 2 in 100.

So the risk is doubled, which means 1%-2%. However:

� Having high blood pressure increases the risk more than two or three times.

� Having high cholesterol also doubles the risk.

� People who lack a diet rich in vitamins also have a higher risk of developing dementia.

� Depression doubles the risk as well.

� People who lack intellectual stimulation and watch TV most of the time are also at risk of developing dementia.

So my recommendation to adults who have family members with Alzheimer's disease is to check their risk factors, which are:

� High blood pressure

� Sedentary lifestyle

� Lonely lifestyle with no fun hobbies

� Intellectual laziness

� Low vitamin diet

� Depression

�Daily stress

If you answered yes to any of the above questions, you have the opportunity to lower your risk and make it less than those who do not have a family member with Alzheimer's disease.

Member question: Are the number of vascular dementia patients increasing or is it a direct result of people just living longer?

Fotuhi: That is an excellent question. The longer a person lives the higher will be his or her chance of developing dementia. Often people have a mixture of vascular dementia and Alzheimer's disease. If you live to be 120 years old, you have more than a 90% chance of being demented.

The goal of current studies is to find the best ways to postpone the onset of dementia. And several studies have shown that people who reduce their vascular risks during their midlife protect their brains against Alzheimer's when they get into their 80s and 90s.

With the current trend toward preventing dementia, I suspect that when the current baby boomers reach their eighth or ninth decade of life they will be able to keep their brains sharp and develop Alzheimer's when they pass their 100th anniversary.

I think it is possible for people to be proactive to protect their brains and memories in the decades to come and ward off dementia until the very last year of their life.

Moderator: What should you do if you think a medication may be affecting your memory?

Fotuhi: There are many medications that cause memory loss as one of their side effects. Fortunately, there are different alternatives for each medication and if you think that starting a medication coincided with your memory difficulties, you can ask your doctor to consider an alternative medication.

Moderator: Dr. Fotuhi, we are almost out of time. Before we wrap up for today, do you have any final comments for us?

Fotuhi: People take it for granted knowing that eating hamburgers every day, constant stressing over minute details, spending weekends as a couch potato, smoking, and obesity increase the risk for developing heart attacks and strokes. Now there is a revolution in the field of memory research and Alzheimer's.

The results of several studies in different countries all point to the fact that risk factors that cause heart attacks and strokes also increase a person's chance of developing Alzheimer's.

It is important for baby boomers to take an active approach to protect their brain against dementia. They need to check their list of risk factors and start doing it today. I recommend to people to stop complaining about their memory and start doing something about it. They have many opportunities to do so. If they want, they can read my book to learn all about it.

Source: http://www.medicinenet.com

A WebMD Live Events Transcript
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Suicide Prevention Resources on Facebook

Suicide Prevention Resources on Facebook

Suicide Prevention Resources on Facebook

17 September 2013 at 22:30

Joe Sullivan is Facebook’s Chief Security Officer and is a Member of the National Action Alliance for Suicide Prevention’s Leadership team.

At Facebook, where our mission is to help make the world more open and connected, we are committed to decreasing suicide globally by connecting people in need with the resources and people who can help them best.  As the place where people share with their real-life friends, we have a unique opportunity to give people the tools to respond to calls for help.

The World Health Organization reports that every year almost one million people die from suicide¹.   That is tragic.  And the impact goes much further—studies show that each suicide intimately affects at least 6 other people².  That means that globally, the impact of suicide is felt deeply by many millions of people each year.

Today we are sharing an Infographic that shows how people can quickly get suicide prevention resources and/or submit a report to Facebook about their distressed friend.  The three ways a person can get resources on Facebook desktop are:

-      Clicking “Report” on the upper-right corner of a post:  in addition to resources and the option to submit a report, we also provide a suggested Facebook message for a person to send directly to their friend letting them know their concern.

-      Searching “Suicide” in the search bar.

-      Going to the Facebook Help Center and typing “suicide.”

On mobile, people can also report suicidal content in a post directly from their phone.

In order to ensure we reach more people with this important information, we will be running a public service announcement across Facebook directing people to the Infographic throughout the rest of suicide prevention month.

We have also partnered with 33 suicide prevention organizations across the world.  In addition to providing direct support through channels like phone, email, chat or SMS, many have Facebook Pages where people can get additional information.  For example, SADAG has frequent Q&As with psychologists on their Facebook Page. The National Suicide Prevention Lifeline educates people about suicide prevention on their Facebook Page by awarding “badges” to people who learn a new tip.  Check out and “Like” your local suicide prevention organization’s Facebook Page to get additional information.  These organizations and the dedicated employees and volunteers who help power them are the real inspirational leaders in the fight to prevent suicide.

If you would like more information about how to identify suicide-warning signs, please read a blog post we published last week authored by Dr. Dan Reidenberg. In addition to doing extensive patient work and holding leadership positions on suicide prevention organizations globally, Dr. Dan is also a recognized expert in advising technology companies on implementing suicide prevention best practices.

Please join me, in recognition of World Suicide Prevention Month, and take a couple minutes today to download and read the Infographic about how you can get suicide prevention resources on Facebook and together we can connect those in need with the resources to best help them.

- Joe Sullivan, Chief Security Officer, Facebook

Footnotes:

(1) World Health Organizationhttp://www.who.int/mental_health/prevention/suicide/suicideprevent/en/

(2) American Association of Suicidology 2010 data
(3) Aasra   www.aasra.info
http://www.suicidology.org/stats-and-tools/suicide-statistics    

Very valuable information for all the expectant and the new Mothers.

Very valuable information for all the expectant and the new Mothers. 
Don't forget to share, it can really help lot of people. 
Postpartum depression (PPD), also called postnatal depression, is a type of clinical depression which can affect women, typically after childbirth. Few coping tips for postpartum depression.

Aasra in the Wall Street Journal

http://blogs.wsj.com/indiarealtime/2013/06/11/indias-suicide-problem/
Saturday, June 15, 2013 13:53:0 GMT
 

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• June 11, 2013, 2:00 PM

India’s Suicide Problem

 

 

By Atish Patel

Agence France-Presse/Getty Images

Shown, Jiah Khan.

The apparent suicide of 25-year-old Bollywood actor Jiah Khan last week was greeted with shock in India, a country where suicide is the second-most common cause of death among people aged 15 to 29, according to a study in The Lancet.
Of the 114,800 males who took their own lives in India in 2010, 40% were aged 15 to 29, while 56% of the 72,100 women were in that age bracket, the study said. The report’s lead author, Vikram Patel, a psychiatrist and joint director of the Centre for Global Mental Health, says female suicides in India are often linked to relationships, including domestic violence and forced marriage. For men, the major reasons were related to work and financial difficulties, he told India Real Time.
“It reflects the general role of men and women in India,” Mr. Patel said.
In India, people carry out suicide mainly by self-poisoning with pesticide and hanging, which are more lethal than methods typically used in the West like overdosing on non-prescribed drugs, Mr. Patel said.
Public health interventions such as restricting access to pesticides might help prevent many suicide deaths in India, Mr. Patel wrote in The Lancet report, which said there were about 187,000 suicides in India in 2010, the second highest in the world after China. The fact that these two nations have the most suicides is in itself unsurprising given their large populations.
India’s suicide rate is about 16 per 100,000 people a year, the study said. The rate in the U.S. in 2010 was 12.4 per 100,000 people, according to Centers for Disease Control and Prevention, while in the U.K. in 2011 it was 11.8 per 100,000, the Office for National Statistics said. Countries with higher rates include South Korea, Greenland and Eastern European nations like Lithuania, reports show.
Through rapid urbanization, India has witnessed a change in family structure, with people moving out of joint families into nuclear families. Although the effect of this change has not been studied in detail, some experts believe this has impacted India’s suicide rate.
“Families now are fractured and the support systems in place earlier are not working,” said Johnson Thomas from Aasra, a Mumbai-based organization that runs a 24-hour suicide prevention helpline.
The confidential helpline, which has been operating for 15 years, gets 35 calls a day, Mr. Thomas said. That adds up to about 12,775 a year. The majority of calls are from men, who struggle more than women to express their feelings, Mr. Thomas added.
“Indian society doesn’t allow men to be emotional… they don’t really have anyone to confide in,” he said.
In a study published in 2011, an international team of health researchers said India had the worst rate of severe depression of 18 countries surveyed, with 36% of respondents showing at least five symptoms, such as loss of appetite and a sense of worthlessness, for a period of two weeks or more.
That study also showed that women were twice as likely as men to suffer from depression.
There is a lack of specialist mental health experts and psychiatric clinics in rural India, where more suicides occur. According to The Lancet report, suicide rates in rural India are about twice as high as in urban areas. The problem is exacerbated by the easy availability of pesticides and a lack of emergency care, the report noted.
Clinics addressing mental health issues like depression have opened in cities in recent years. But there is a stigma in getting psychiatric treatment, doctors and experts say.
“People continue to have a closed mindset related to mental illness,” said Sanjay Chugh, a New Delhi-based psychiatrist who runs his own private clinic.
“Mental illness is still understood as a form of disease which will be ‘fixed’ by faith healers, a divine intervention or through rituals or prayers,” he added.
Also, suicide is a crime in India.
In a 2011 ruling, India’s Supreme Court asked Parliament to consider quashing the law, but no action has been taken. Under the law, a suicide survivor can be sentenced with a one year prison term or a fine, or both.
In a 2007 report in the Indian Journal of Psychiatry, Lakshmi Vijaykumar, who runs a suicide prevention network called Sneha in the southern Indian city of Chennai, said that making suicide illegal has proved counterproductive.
“Emergency care to those who have attempted suicide is denied as many hospitals and practitioners hesitate to provide the needed treatment fearful of legal hassles,” she wrote in the report.
“The actual data on attempted suicides becomes difficult to ascertain as many attempts are described to be accidental to avoid entanglement with police and courts,” she added.
Last year, the government drafted a bill to decriminalize the act of attempting suicide but it hasn’t yet been introduced for discussion in Parliament.
“More than legalization of the act, what is needed is spreading knowledge and making people more mindful and sensitive toward mental health as a field, as it would automatically open doors for devising means and methods to combat it,” Mr. Chugh said.
Worldwide, up to one million people die by suicide every year, according to the World Health Organization. In the last 45 years, suicide rates have increased by 60%, says the WHO, and suicide is among the three leading causes of death among people aged 15 to 44.
A post-mortem report said the cause of Ms. Khan’s death was asphyxia due to hanging. It ruled out foul play.

Atish Patel is a London-born multimedia journalist based in Delhi. You can follow him on Twitter @atishpatel.
Follow India Real Time on Twitter @IndiaRealTime.

Aasra in Governance Now magazine

 http://governancenow.com/news/regular-story/elegy-jiah-khan-yeh-hai-mumbai-meri-jaan

Elegy for Jiah Khan: Yeh hai Mumbai meri jaan

Famous at 19, gone at 25: why is life a strife for the young and restless in Bollywood, and Mumbai in general?

Geetanjali Minhas | Mumbai | June 06 2013

If Jiah Khan’s suicide has taught us anything, it is the uncertainty of life. But shorn of the philosophical touch, it’s a tale gone horribly wrong for a young aspirant in the Maximum City.
While Jiah’s suicide by hanging at her flat in Juhu, an upscale suburban, has got the media spotlight for obvious reasons – the showbiz connection – what cannot be overlooked is the fact that Mumbai, for young outsiders itching to make a career, can be good and evil, inviting and foreboding, warm and cold, enticing and frightening. And all at the same time.
Also read: Jiah death brings to fore life, strife of young India
For the sake of attention, if nothing else, we might talk about Bollywood, but minus a few details here and there it could well be relevant to any struggling, striving, talented youth in Mumbai – more so those coming from outside.
Exactly 20 years and 2 months after the mysterious death of actress Divya Bharti – she died after falling from fifth floor of a building, allegedly jumping off in an inebriated state on April 5, 1993 – Jiah’s suicide has brought to focus the issue of depression, disillusionment and loneliness in the showbiz industry of a city that is said to never sleep.
At first glance, the two deaths are as different as chalk is from cheese. Divya Bharti, then 19, was a more successful actor, married to producer Sajid Nadiawala, had plum projects on hand and was said to be on way to a glorious Bollywood career when she died.
In contrast, Jiah Khan, 25, started off with a bang as a teen (she acted opposite Amitabh Bachchan in Nishabd in 2007, and even bagged the Filmfare best debutant nomination), and then headed nowhere (supporting roles opposite Aamir Khan in Ghajini and Akshay Kumar in Housefull, in 2010; and nothing thereafter). Jiah was also reportedly undergoing problems in her relationship with her boyfriend: actor Aditya Pancholi’s son Suraj.
And if those weren’t enough, Jiah’s mother Rabiya Amin, a small-time Bollywood actor in early ’80s, has said that Jiah had auditioned for a film in Hyderabad  on Sunday and was unhappy about it.
All this leads to one conclusion: she was under stress, immense stress. Those who knew Jiah say she was also despondent and disillusioned about her career and personal life. All three are adjective boxes that Divya Bharti might have checked had she been asked to state her state of mind towards her last days — if the industry grapevine is to believed, she was  being pressured to ‘compromise’ with underworld elements.
Why is Bollywood/Mumbai so tough to crack?
Charmed by stories of success by rank outsiders – Shah Rukh Khan and Akshay Kumar in films and in every other arena of professional life – and the opening of more doors in television, fashion, beauty pageant, and reality show circuits, tens of hundreds land in the city of dreams. In showbiz, an abysmal 1 to 3 percent make  it.
While there is no success formula, ‘casting couch’ is said to come as a package deal in getting a break in  Bollywood – insiders call it an “accepted fact”, though most established  actors choose to deny it.
The film industry’s larger-than-life image dwarfs the perils and vices, and the ‘villains’ who come in many shades and hues –in the garb of misleading casting agents, secretaries, producers, directors and hangers on. In a hugely cut-throat competitive industry, there are no true friends.
And then there’s money, a key to struggle for both showbiz aspirants and others in professional life: house rents are high, clothes and accessories are expensive, and you need a good car to flaunt your status. Barring the handful who make it, it is a struggle for the rest to maintain  this façade.
Industry insiders say ingenious ways are invented  to  keep the wheel moving: those with a thick skin, a strong mind  and nerves of steel can withstand the multiple pressures, while the vulnerable and the gullible get sucked deeper in the  muck and grime and often get into alcohol, substance abuse and give in to sexual exploitation.
Not that all these cases lead to suicide, but many do – and it’s a fact writ large enough for us to wake up and smell the coffee. According to a report in aasrasuicideprevention.blogspot.in, a site on preventing suicides and addressing depression, a study on suicide mortality in India published by The Lancet last year pointed out that suicides were the second leading cause of death among 15- to 29-year-olds. The National Crime Records Bureau reported 1,35,585 suicides in 2011.
In many sense, Bollywood is no different from any other high-pressure profession in Mumbai today, and suicides are not that uncommon a social phenomenon. Poignant but true, Mumbai is no place for the fainthearted. Like that Johny Walker song put it so aptly, “Aye dil hai mushkil jeena yahan, zara hatt ke zara bachke, yeh hai Bambai meri jaan.”

Aasra in the Midday (05 June 2013)

http://www.mid-day.com/entertainment/2013/jun/050613-expert-speak-girl-interrupted.htm

Expert speak: Girl, interrupted

With suicide cases on the rise in the country, psychology experts speculate on what could have driven Jiah Khan to end her life

June 05, 2013

Mumbai

Shakti Shetty

 

 

 

 

Ever since the news about Jiah Khan started doing the rounds, what’s everyone thinking about is what could have driven the young actress to end her life so abruptly. And what’s more alarming is that with every passing year, there seems to be more and more suicide cases being reported in the country.
Photos: Jiah Khan - Snapshots from the past

In a medical study published in 2012, the estimated number of suicides in India in 2010 was about 1,87,000. A large proportion of adult suicide deaths were found to occur between the ages of 15 years and 29 years. Incidentally, of the five lakh people reported to die of suicide worldwide every year, 20 per cent are Indians.
While in an industry where one-upmanship is rife, there is always pressure to perform. The entertainment industry has always been demanding but to what extent? We spoke to psychology experts to get their views on what could have prompted the 25-year-old to take such a drastic step.
Missing Plan B?
Seema Hingorrany, clinical psychologist and author, points out the lack of planning in case of professional disasters. “In a metropolitan city like Mumbai, depression often goes undetected. There’s a deep sense of loneliness that even the immediate family or friends can’t see.


Especially, in the case of an actress like Jiah who has seen some instances of success only to face a downward slide in her acting career. So what she didn’t have was a Plan B. Unfortunately, she was left with a Plan A that simply didn’t work.”
Photos: Who was Jiah Khan
Turns out the toughest part in showbiz is not to bag stardom but to sustain it. Johnson Thomas of Aasra, a helpline against suicide, says several factors could have contributed to the actress’ drastic decision. “The young actress in question did seek stardom and even received some with her debut film. Later, she was seen in minor roles. Sadly, the film industry seems great provided you’ve got work and it turns cruel as soon as you run out of work.”
Clinical psychologist Varkha Chulani emphasises on the overwhelming possibility of depression. “From a clinical point of view, we don’t know yet whether it was an impulsive suicide or a depressive suicide.

The former is a phase where a person decides that life is not worth living and the latter is a case of elongated hopelessness. In Jiah’s case, we’ve read about her break-up and struggling career but then she also reportedly went to audition for a Telugu film. Someone with a severe case of depression won’t even be able to think of work.”
Life’s like that
Lata Shenava, counsellor and educator, takes a different route while explaining the more deep-rooted problem related to parenting. “There’s something structurally wrong with the way kids are raised nowadays. For the most part, they are put in a comfort-oriented environment and expected to grow strong, which is impossible. As a result, we see youngsters not being able to face challenges.” 

Aasra helpline in Lokmat Newspaper

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Suicide second-leading cause of death among Indian youth

 What is triggering this distressing trend in India? Illustrations: Uttam Ghosh

The day the Class X exam results were announced, Dhanalakshmi rushed back home from work in the afternoon.
She had found out by checking online that her daughter, 16-year-old Sridevi, had failed the exam and she was worried she might not be able to handle the disappointment.
But when she reached their two-room house in the crowded quarter of Jogupalaya in Bangalore, it was to discover the body of her son, 19-year-old Shekhar, hanging from the ceiling.
A week after the incident, Dhanalakshmi cannot bring herself to talk about it -- her sobs prevent her.
Her sister, O Jayalakshmi, and daughter try to explain, perhaps to themselves as well, why Shekhar took this drastic step while she gazes at the photograph of her son, and the small lamp burning in front of it.
Shekhar, they said, had been very close to his sister and had big plans for her. "He told me he would support me in whatever I wanted to do," says Sridevi, speaking softly.
Two lanes away in the same neighbourhood, where tiny houses jostle for space with each other, another family is grieving the death of their 15-year-old, Dileep Kumar.
Kumar had failed five subjects in the board exam and, worried that he had disappointed his father, a contractor and president of the Ambedkar SC/ST Welfare Society in the area, consumed pesticide.
"Before he died, he apologised to his father, and told him he had not wanted to let him down," says Kumar's mother Veni, who has been working as a nanny in Kuwait for the last 15 years. Her husband, who she says was very close to their son, hardly speaks during our meeting.
Kumar's and Shekhar's are hardly isolated cases.
Last year, a study on suicide mortality in India published by The Lancet pointed out that suicides were the second leading cause of death among 15- to 29-year-olds (the number one cause being road accidents in males, and maternal mortality for women).
And in March, the University of Washington's Institute for Health and Metrics Evaluation reported in the British Medical Journal that suicide was the leading cause of death for women in India aged between 15 and 49 years.
India's own National Crime Records Bureau reported that there were 135,585 suicides in 2011, the latest year for which the figures are availab#8804 that's more than the number of lives lost to HIV in the same year (116,000, according to the National AIDS Control Organisation).
The figure could also be under-reported because of the stigma attached to suicides and the fact that attempted suicide is a criminal offence, though the government has begun steps to delete this section from the Indian Penal Code.
What drives them to commit suicide?
The reasons, experts say, are varied -- from loneliness and alcoholism, to depression and economic factors.
"But our studies have shown that usually, it is a combination of one or more of these factors," says H Chandrashekhar, head of the department of psychiatry, Bangalore Medical College and Research Institute.
Anita Gracias, a volunteer at suicide helpline Sahai, who answers calls with a warm 'Good evening, Sahai, may I help you?', says most of the calls she receives are from people who are lonely.
"People call and ask me where they can go to make friends," says Gracias, who has been a volunteer since 2002, adding that the age of callers has been reducing. Her youngest caller is a 15-year-old.
"The number of suicide attempts among the youth in India and in developed nations might be similar, because this is the group that is at the highest risk the world over due to a number of factors, such as youth being more impulsive. But unlike in the West, the suicide mortality rate in India is much higher because here, people have easy access to lethal methods and access to emergency medical care is limited," says Vikram Patel, professor of international mental health at the London School of Hygiene and Tropical Medicine and one of the authors of the Lancet study.
The number of suicides, across age groups has also been increasing, points out G Gururaj, head of the department of epidemiology, National Institute of Mental Health and Neuro Sciences.
"There has been a three-fold increase over three decades -- from around 40,000 in the 1980s to over 135,000 now. And for every completed suicide, there will be 10 to 15 attempts."
But most worrying, perhaps, is that despite these numbers, policymakers have failed to recognise suicide as a public health problem.
"India is one of the few countries that continues to treat suicides as a purely sociological or economic or political issue, when they are actually a national public health issue," says Patel.
Acknowledging this would mean putting in place a national suicide prevention policy and programme, which would include a number of interventions.
Both Gururaj and Patel emphasise that because suicide is not restricted to any particular group in terms of region, age, income or any factor, for that matter, there can be no "one-size fits all" solution.

There are, however, certain policies adopted by various countries that have proven to be effective. Among these would be creating awareness which would help in early recognition of the symptoms, and restricting access to lethal means, such as pesticides.
"If you can delay the impulse to commit suicide by making it difficult to buy a drug or pesticide, you can change their minds," says Patel.
"If they don't get it at the first store, it's unlikely that they'll visit more."
Countries around the world have tried this, and succeeded.
Following a rise in the number of paracetamol overdoses and deaths due to paracetamol poisoning, England passed a law in 1998 restricting the number of tablets that could be sold and reducing the packet size.
The Centre for Suicide Research at Oxford found that suicide deaths from paracetamol and aspirin fell by 22 per cent the year after the legislation was passed, while overdoses fell by 20 per cent in the second and third year.
Closer home, Sri Lanka, which once had the highest suicide rates in the world, managed to reduce it by half in two years by restricting access to pesticides, says Patel.
In India, meanwhile, 15-year-old Kumar could kill himself by buying a pesticide used against bed bugs from his neighbourhood grocery store for Rs 35.
There is also insufficient research into suicides in India, says Gururaj.
"It's a hidden phenomenon. Nobody wants to invest in research because there is no profitable drug that's going to come out of it."
Other countries, says Patel, have managed to bring down their rates of suicide and there is no reason why we can't either.
"Unfortunately, we just discuss and debate the issue, instead of doing something about it."
Warning signs of suicide

• Sudden change in personality, increased pessimism
• Person becomes withdrawn
• Giving away of personal effects, valuables without reason
• History of depression, psychiatric illness

Steps to reduce number of suicides

• Creating awareness of suicidal behaviour, so that it can be recognised early
• Limiting access to lethal pesticides and drugs
• Early detection of mental health problems
• Establishment of crisis intervention centres and suicide helplines

• http://www.wired.co.uk/news/archive/2013-03/27/suicide-women-india
  

  Suicide is number one cause of death among young women in India

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Self harm has replaced maternal disorders as the leading cause of death among women aged between 15 and 49 in India, a study covering 187 nations has revealed.

Analysis of the University of Washington's Institute for Health Metrics and Evaluation report was published in the British Medical Journal on 26 March, and covers data recorded between 1990 and 2010. It reveals a 126 percent rise in suicides among young women across that period. The shocking statistics support a growing body of evidence that indicate it's an increasing problem in the country.

Last year a Lancet study estimated there were 187,000 suicides in India among over 15s in 2010, or three percent of all deaths recorded that year. It represented a more than 50,000 increase on official National Crime Records Bureau figures, attributed to under-reporting of cause of death possibly due to social concerns over what remains a taboo subject. Compare this with the 5,608 suicides that occurred in over 15s in the UK in 2010. India's population is nearly 20 times that of the UK's, meaning equivalent figures would set Indian suicides at about 112,000 -- 75,000 less than the Lancet article's estimates.
According to the study, 40 percent of those suicides among men and 56 percent among women occurred between the ages of 15 and 29, and rates were higher among well-educated young people in wealthier areas, suggesting economic strife is not the overriding cause behind the increase. This may instead correlate to social pressures surrounding issues of marriage at that time in life.
According to the World Health Organisation, suicide is the seventh top cause of death globally among women aged 20-59 years. Top causes of death in the UK are attributed to circulatory and respiratory disease, and cancers. By comparison, the top causes of death among women in India are maternal disorders (child birth and pregnancy), tuberculosis, diarrhoea and, troublingly, fire. Death caused from HIV and Aids rose by 1,000 percent, and from 68th to 6th position.
But how can the government even begin to tackle such a staggering problem? The Lancet report called on public health authorities to limit access to harmful substances such as pesticides -- half of all the suicides were by poisoning. This could combat a growing number of suicides among farmers, which has been on the rise since the 90s due to a number of socioeconomic factors squeezing the sector. 14,000 committed suicide in 2011, according to government figures, and the agriculture ministry responded by saying it would increase investment in the sector and raise minimum crop prices.
The escalating issue of sexual discrimination and the consequent violence towards women may also be a contributory factor. In response, the country's parliament has just passed a new law to offer more protection for women and harsher penalties for their attackers. A sign of the kind of social taboo surrounding the issue was made clear with an inclusion in the law to make it a crime for police to refuse to open a case based on complaints by women about sexual attacks. "The main social determinants for suicide in women are interpersonal violence (for example, marital violence) and economic difficulties," Vikram Patel, Wellcome Trust Senior Research Fellow in Clinical Science and coauthor on the Lancet study, told Wired.co.uk.
In India, as in most place across the globe, mental health remains a taboo issue. Another report published 26 March by the Royal College of Psychiatrists called for equal levels of access to treatment to become the norm for both mental and physical illness. According to the study, just 24 percent of people with mental disorders and 28 percent with post-traumatic stress disorder get treatment, compared to 91 percent of people with high blood pressure. This is despite mental health disorders shortening life expectancy by an average of 15 to 20 years. The number of deaths caused by mental or behavioural problems also increased by 10.52 percent from 2009 to 2010, according to the NHS.
The stats speak for themselves -- treating mental illness as a taboo subject, of less importance than something we can physically see or measure, is no longer an option. Providing those in need with a support network that can be easily accessed is essential, and we are seeing more of this in India. In 2011 Facebook set up a system whereby friends can alert the relevant authorities if they think a friend on the social network is contemplating suicide. By linking them up with the Aasra suicide prevention helpline, they might be helping prevent a handful of deaths. Changing the social, cultural and economic factors that contribute to the growing pressure on young people, pushing them to contemplate taking their own lives, will not be quite so simple.

Edited by Olivia Solon