Answer to Question 1
For Joiner, social factors can set the stage for thoughts or motivations of suicide, but psychological events lie at the core of suicidal behavior. Emotional stress and hopelessness are central features of many individuals who actually attempt suicide. Joiner, and others, consider the common elements of suicidal psychology to focus on an attempt to escape from unbearable psychological pain, often the pain associated with prolonged frustration of basic psychological needs. Most important are the needs for affiliation and competence. People who view themselves as having failed in these domainsthose who are low in belongingness or high in burdensomenesswill experience intense negative emotional states, such as shame, guilt, anger, and grief. Suicide then becomes a somewhat logical route to escape this on-going pain caused by these psychological states. Of particular association with the act of suicide are the belief and experience of being socially isolated and being a burden to others.
Answer to Question 2
There are several different kinds of antidepressant medications, but they are generally equal in terms of effectiveness, with positive responses being shown by 50 to 60 percent of depressed patients. Cognitive therapy and antidepressant medication appear to be equally effective for people who suffer from depressive disorder, including major depressive disorder and dysthymia. Medication and psychotherapy also appeared equally effective in randomized trials conducted in primary care settings, with 64 percent of patients recovering from an episode of depression after 11 weeks of treatment with either an SSRI or problem-solving therapy.
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