Paul Nestadt, MD, a psychiatrist and epidemiologist at the Johns Hopkins School of Medicine, discusses suicide.

Transcript (edited for clarity)

Suicide is a leading cause of death in the US. In fact, it is the second leading cause of death in Americans under 40. And the rates have been steadily increasing, with a 30% increase since 2000.

Lets start with some basic epidemiology:

Suicide attempts are far more common in women but almost 80% of suicide deaths are men, who tend to use much more violent methods, like guns, in their attempts.

In fact, even though firearms are only used in 5% to 6% of attempts, they are responsible for half of all suicide deaths and are by far the most common method of suicide. And in turn, suicide is by far the most common manner of gun death in the US, far outpacing homicides and accidents.

To understand why the method matters so much, you have to understand a little of the phenomenology of suicide.

We know that suicide is most often an impulsive act. People may be depressed for a time, but studies have found that in 87% of cases, the decision to die and the attempt itself happen in the same day. In a quarter of cases, the act follows within 5 minutes.

When that suicidal impulse comes, if what you have in the nightstand is a bottle of pills, an overdose will have a fatality rate of only about 2%. You will probably survive. If you have a gun, the chance of death approaches 90%.

But, if someone survives an attempt, won't they just try some other way? No.

This is a myth. Several studies have followed attempt survivors for decades after they survive a serious attempt and found that 93% never go on to die by suicide. If you survive that impulsive act, you will probably continue to survive to a ripe old age, likely because depression is eminently treatable, and the attempt may be followed with good treatment. Most who do die have never attempted before.

So the difference between being one of the 1.4 million Americans each year who attempt suicide but survive and thrive, versus being one of the 47,000 who die, essentially comes down to the method used.

That may be why a NEJM study last week found that rates of suicide are over 3 times higher in male firearm owners compared to male non-owners. Among women, firearm owners are 7 times as likely to die by suicide. That is all driven by the firearm use itself; there is no increased rate of suicide by other means among firearm owners in those models.

In other countries, banning lethal pesticides or bulk packages of paracetamol have reduced suicides significantly. In the US, the most lethal and accessible common method, the gun, is more politically untouchable

So what can we do as physicians? Well, there are other risk factors for suicide, such as the presence of a psychiatric illness.

But although psychological autopsy studies have shown that over 90% of suicide decedents had been suffering from a psychiatric illness, large scale chart reviews found that only about half of these decedents had a mental illness formally diagnosed and documented before their death.

This means that we dont always know, on an individual level, who is at risk. If we did, we could intervene much more effectively, because doctors are commonly seeing these patients in the weeks leading up to their suicides. Last week, a large French study found that the majority, 60% ,of suicide decedents had seen a doctor in the month of their death. Clearly individual risk assessments, though sometimes helpful, are inadequate. We need a public health based approach to suicide.

What does that look like?

Gun access is tangible. We should be screening all of our patients for firearm access so that we know their risks if a crisis looms. We should educate them regarding the numbers above, reminding them to store their firearm safely, without giving free access to others in the home who may enter into a crisis. Or when the owner himself is in a crisis, they must make sure that they are not holding the keys to the gun safe.

COVID has brought with it a dramatically increased risk of suicide at the population level, with increases in isolation, unemployment, economic turmoil, decreased access to care, and grief both for loss of a way of life and for actual lost loved ones: all risk factors for suicide. During the 2003 SARS epidemic in Hong Kong, suicides increased by 30% among the elderly, those most impacted by isolation and grief. Here, this high risk context tinderbox was heated up when, during the first month of the pandemic, there was a record run on firearm sales. More new guns were bought in March than all but one other month in the history of our keeping track. And anecdotally, these are largely new gun owners.

Its important to ask if your patient is one of these new gun owners, impulsively arming themselves without adequate training or knowledge of the risks and the importance of safe storage.

Those conversations are lifestyle interventions, much like discussing a healthy diet or seatbelt use, or smoking cessation. And just like those interventional conversations, the firearm safety conversation can save your patients life.

Read the rest here:
Suicide by the Numbers: Myths and Facts - Psychiatric Times

Theres no denying it. You are stressed out. We all are.

The COVID-19 pandemic is taking a toll on each of us in myriad ways. A lot of folks have lost their job or know somebody who has. Many people in our area are working long hours donning PPE as essential workers. Families are mostly cooped up at home watching tragic TV news reports and reading negative newspaper headlines, with limited access to the healthy foods and rigorous fitness regimens we enjoyed as recently as early March.

Most discouraging of all, were missing our friends, families and countless milestones.

And all of that is piled on top of our already stressed lives. One pre-pandemic study by the American Psychological Association found that nearly 1 in 4 Americans feel highly stressed.

Our stress is having a significant effect on our mental health and physical well-being. Dont get us wrong, stress can be a great stimulant and motivator, but too much of it drains our energy, keeps us up at night, causes weight gain and sexual dysfunction, and contributes to high blood pressure. It also can impact our relationships with family and friends, given our sometimes less-than-pleasant demeanor due to cabin fever or reduced social interaction during the pandemic.

What can we do? As the pandemic continues to unfold over the summer, there are a number of steps we can take to reduce our stress:

Eat healthy foods. While we discussed the benefits of eating healthily on your immune system in a previous column, each of those recommendations can actually do wonders for managing your stress. By supporting our body with a balanced and nutritious diet and consuming more brain foods for instance, polyunsaturated fats like fish oil and sunflower oil that are rich in omega-3 fatty acids we can strengthen the nervous system and brain.

Step away from the computer and phone and connect with the earth. Several studies have shown us that hours upon hours of screen time is detrimental to our stress levels, anxiety, sleep patterns and mental health. Couple this with the barrage of bad news from the global pandemic, and we have a tougher situation. We recommend taking time every day to step away from screens, whether its the big flat screen in the living room or the little gadget buzzing in our hands. In those moments, find time to relax, meditate, walk around the block, or try earthing, also known as grounding. This is a simple technique to connect you to the earth by either laying down on the grass or removing your shoes and going barefoot for about 20 minutes. Many people say they notice a sense of calmness and make it a daily routine to reduce stress.

Exercise. Until gyms reopen, this may be the most difficult thing to work on. Many people have lost access to their go-to gym or fitness classes, but there are plenty of exercises that can be done in the comfort of your home or right outside the door. Virtual yoga sessions, workout classics like sit-ups and push-ups, or a simple 30-minute walk or bike ride (while wearing a mask when necessary) all can reduce stress through the stimulation of your brain. Keep moving to boost energy, burn fat and promote sleep.

Supplements and other natural remedies. While theres no magic pill that can reduce your stress, sometimes supplements can help us get over the hump of reducing anxiety and help us relax. Given the importance of sleep to managing stress, taking melatonin, lavender, or CBD oil may help you fall asleep after a long day of working from home. Because stress can impact our immune system, supplements like vitamin C, zinc, elderberry, andrographis and astragalus can give our immune system the support it needs during the pandemic.

Be social, safely. While this can be a challenge as we keep our distance for health reasons, building and maintaining a supportive social network of friends and family can help us cope. Calling a friend after a rough day, conversing with a friendly neighbor during your walk and video chatting with family are great ways to de-stress. People who will lend an ear or a virtual shoulder to lean on can support us and help alleviate our anxieties. If you are suffering from severe anxiety or depression, seek advice or treatment from a health care professional.

Remember, we are all in this fight together. We hope that these tips can help you take a step back, relax, breathe and face this challenge head on.

Gary Kracoff has a degree in naturopathic medicine and is a registered pharmacist and John Walczyk is a compounding pharmacist at Johnson Compounding & Wellness in Waltham, Mass. For more information, visit http://www.naturalcompounder.com. Readers with questions about natural or homeopathic medicine, compounded medications, or health in general can e-mail gary@naturalcompounder.com or call 781-893-3870.

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OVER THE COUNTER: How to reduce stress during the pandemic - Wicked Local Franklin

Piling on the pounds in lockdown? Or just bored and want to try a new diet? Try this keto diet plan. Research shows that following a keto diet is an efficient way to send your body into 'fat-burning mode' so you will be slimmer faster, and this 1-week keto diet plan is a great way to start.

I am actually a bit of a fan of the keto diet as it does seem to work well admittedly I exercise quite a lot, but that's been less easy recently than before all this 'situation' kicked off.

So, I put together a 1-week keto meal plan to help you get started in your weight loss journey. Starting the keto diet can seem daunting but with the sample keto meal plan below, it should seem doable at least.

How to lose weight with fasting from 16:8 to 5:2

When you try to put your own keto diet meal plan together, you will need to remember that in order for your body to go into ketosis a metabolic state when your body mainly uses ketones from fat for fuel as opposed to glucose from carbohydrates you will need to keep your carbs levels low each day. And we mean really low: calories from carbs should be under 5% of your total calorie intake and definitely under 50 grams a day. Strict keto even goes a step further and requires you to keep the carb levels as low as under 20 grams a day.

Best keto meal delivery services: ketogenic diet made easier with freshly prepared keto snacks and foods

Sure, following an effective keto diet meal plan means you will have to say goodbye to potatoes, rice, fruits and sweets, but in return, you can also say goodbye to body fat, cravings, mood-swings, insulin spikes and much more. Once you get over the initial 'keto flu' which is only a possibility, not a certain side effect you will feel more balanced overall and won't miss any of the sweet treats you used to have as a pick-me-up.

Best jerky: beef, vegetarian and vegan jerky and biltong for high protein and low guilt

And although you have to let go some of the popular food items when you're on keto, you will be rewarded with being able to eat more cheese and meat than you ever thought you could. Better still, even if you follow a relatively strict keto diet meal plan, you can still have a wide variety off food and take in ample amount of micro and macro nutrients.

How to get a six pack: a six-pack of top tips plus the best abs exercises to tone up to a flat stomach

(Image credit: Fresh n Lean)

Modern day ketogenic diet was introduced and still use for today to treat neurological diseases like epilepsy and therefore it has been researched extensively. Apart from epilepsy, there are studies showing that following a keto diet meal plan can help reduce risk of heart disease, treat cancer, reduce symptoms of Alzheimer's and Parkinson's disease and even to treat acne.

Lose weight at home: you MUST follow this top nutritionist's lockdown weight loss advice

As well as all that, keto can reduce insulin levels in the blood (lack of carbs/sugar spikes throughout the day) and many people claim keto diet made them more relaxed and "less on the edge".

From a dietary point of view, the effects of keto is similar to fasting: due to lack of carbs, your body will start breaking down fat into ketones and use that as fuel. Once you are on keto for a while, your body will get more efficient in breaking down fat, let it be dietary fat or the ones stored in your body, making you lose weight faster.

Most types of meat and cheeses are allowed on keto, so are eggs, cream, butter and healthy oils like avocado or olive oil. You could also have black coffee and green tea without any sugar.

Things to avoid: processed and low fat dairy products have additives and plenty of sugar in them, making them unsuitable for keto (and generally not healthy). Milk also has lactose (milk sugar) in it so be careful not to introduce too much milk into your keto diet meal plan.

Most of the green vegetables are good to go but bear in mind that many types vegetables will add to your carbs mainly, so thread them lightly. Try to keep them varied, even throughout the day so you won't get bored with any one of them.

Things to avoid: root vegetables such as potatoes, carrot, parsnip etc. All types of grains and rice.

Pro tip: spinach is best to have raw (washed, however), since wilted spinach just doesn't have the same mouthfeel. 100 grams of raw spinach with some olive oil, salt, pepper and a teaspoon of balsamic vinegar makes an excellent base for a salad.

PLEASE NOTE: The below carbohydrate content is /100grams.

Modern day fruits have been engineered through selective crossbreed crops to be super sweet and less fibrous so popular fruits such as apples, pears, grapes, oranges are not allowed on keto diet. Good news is, after the initial period of sugar deprivation, you won't crave for these anymore.

Either way, even the fruits listed here should only be eaten in small portions throughout the day.

Things to avoid: banana, grapes, mango, pineapple, pear, apple, kiwi, orange, peach etc

Pro tip: berries are great in smaller quantities and contain plenty of vitamins and some fibre too

PLEASE NOTE: The below carbohydrate content is /100grams.

Feel free to snack on dried meat like jerkies or biltongs

(Image credit: Getty Images)

You won't find any sugary sweets here, but you can have plenty of nuts, dark chocolate and a range of dips, too. Try making your own dips to avoid at home from fresh vegetables and avoid processed food with preservatives and high sodium content.

Things to avoid: sugary snacks, biscuits, milk chocolate, cashews etc.

Pro tips: to make the best salsa, cut up a larger, ripe tomato and make sure you don't waste pulp, that'll make the salsa less dry.

PLEASE NOTE: The below carbohydrate content is /100grams.

(Image credit: Bulk Powders)

Should you feel the need to supplement your diet, there are plenty of keto-friendly supplement options on the market today. These high fat and most usually high protein products can effectively top your vitamin and micronutrient levels. We have also listed some options to replenish electrolytes and introduce even more green goodness into your keto diet.

(Image credit: Fresh n Lean)

When assembling this 1-week keto meal plan, we followed these guidelines:

Each day has around 2,000 calories-worth of food

Daily carbohydrate amount is under 40 grams

We used a low-carb, moderate-protein and high-fat template for each day (5% carbs, 20-25% protein and 70-75% fat)

Pro tip: try to portion your food out into five 400-calorie rations so you can eat five times a day which will help you feel more sated in the initial transition period.

PLEASE NOTE: this is not a medical diet and if you need to go on a keto diet for medical reason, please consult your doctor first. Also, going from a high-carb diet to a low-carb one can result in side effects such as nausea, light-headedness and headaches. The preferred way is to gradually reduce carbs in order to reduce the impact of keto diet on your metabolic system.

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Feel better and lose weight in 1 week with this keto diet plan. Not as hard as you think - T3

It is all about finding food that brings you back to the table

by: Hanna Erdmann

(WKBN) With summer just around the corner and stay at home orders lifted, there is no better time to start thinking about eating better.

Dr. Ben Biteman from Mercy Health explained helpful tips on how to focus on a better diet.

He says those looking to try different diets should find something that works for them; not every diet is the same for every person.

You want to find something that, you know, if someone decides to go on an all-protein diet, and they dont eat meat, its more difficult. If somebody decides they are going to go on an all-vegetable diet, and they hate vegetables, it is just not going to work, said Dr. Biteman.

Dr. Biteman says focusing on eating things that you know you like will help you achieve success.

Snacking is a common problem for many people. However, making small changes can make a big difference.

Choosing things that will keep your blood sugar up longer and less of a peak is probably a better way to snack, said Dr. Biteman.

Some types of snacks can help, including cheeses, small meat meals like chicken or tuna, nuts and avocados.

A popular diet that doctors say can work is intermittent fasting, where you eat all your calories in a small portion of the day and fast for the rest. Dr. Biteman says this can be a great plan, as long as you are consuming the right amount calories each day.

Drinking water is also very important. Not only is it good for metabolism and digestive health, but it works to keep us fuller, longer.

Health experts say the average person should be drinking 65 ounces each day.

A concern for people can be how much more money it is to buy healthier food options. There are ways to save money and not waste food.

Buying frozen or canned fruits and vegetables can last a little bit longer, but it is smart to keep some fresh options around as a treat.

Canned beans and meats are also smart to keep in your pantry to have options that will last a bit longer.

The best advice is all about finding food that brings you back to the table.

Read more here:
Local health expert weighs in on better eating habits for summer - WKBN.com

Simply put, this diet involves matching a person with food best suited for their blood type. For example, its recommended that someone with type A blood eat primarily soy, seafood, and vegetables

(Newswire.net -- June 17, 2020) --

Have you ever wanted to lose weight but find the vast choice of available diets confusing? Or maybe youve tried dieting, but it never works. It seems that theres a new fad or type of food available every week, so let us guide you through some of the more popular and effective ones.

The first thing to consider when talking about dieting is what type it is. You might have heard of vegan diets (cutting out all animal products, including eggs and milk) or of going vegetarian, but what about other common ones?

This has gained popularity over the last few years and is primarily considered a natural way to eat. In a paleo type of diet, processed food and dairy are out, and grass-fed and organic food is in. Think of it as being an ethical omnivore.

Simply put, this diet involves matching a person with food best suited for their blood type. For example, its recommended that someone with type A blood eat primarily soy, seafood, and vegetables in order to lose weight.

Another veggie-friendly diet type, this promotes the use of oil as an alternative to salad dressings and marinades, as well as cutting back on (not eliminating) red meat from your daily meals.

Some of these diets come from well-known companies, others are based on a type mentioned above, but all have been proven effective in some way.

Coming from perhaps the most famous weight loss company in the world, this diet involves a point system. Every type of food has points appropriate to its nutritional value, and the idea is to eat a set number of points a day/week to meet your desired weight.

The keto diet is one of the more popular diets on this list, as various celebrities champion it. Effectively, it involves a high fat intake and a very, very low amount of carbohydrates.

In a nutshell, this diet involves completely cutting out certain food groups of your choosing for a solid thirty days. If you feel better after the month, keep avoiding those foods. Otherwise, try eliminating something else for another thirty days.

By all accounts, losing weight just got easier with this modern diet plan. It takes the form of two phases and is designed to make your body generate more hormones in order to burn fat. This diet emphasizes food and drinks with high antioxidants, such as green tea.

Diets based on a different countrys food culture are gaining popularity these days, and this is one of them. A macrobiotic diet is based on the Asian concept of balance. For example, if you have a meal of fish, you should also include food from the land on your plate, such as vegetables. Easy!

It almost goes without saying, but diets are very much an individual thing. What works for one may not work for another. Even so, there are some diets you might be best to avoid altogether.

Replace one meal every day for two weeks with...mushrooms. Just mushrooms. Suffice to say; anyone would get bored of this very quickly. Plus, it deprives your body of nutrients since youre eating an awful lot of mushrooms and not a lot of anything else.

You guessed it. Willingly put a tapeworm inside your body to help you lose weight! Obviously, this is a terrible, disgusting idea.

In theory, drinking nothing but juice and smoothies for a (little) while is an excellent way to detox while still getting vitamins and nutrients. However, many of these diets promote lengthy fasts - anything up to two weeks, in some cases. Two days, perhaps, but not much longer than that.

When we talk about healthy eating, a balanced diet is the best way to succeed in maintaining an ideal weight. However, bear in mind that sometimes food culture dictates whats best for us. For example, a typical Colombian diet is carbohydrate-heavy, while an Australian diet favors barbecued meat and fresh smoothies. If none of the above diets take your fancy, why not try following the diet from another country? You might be surprised at the results!

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5 Ways to Diet That Really Work - Newswire