today on larry king now the truth about suicide dr drew pinsky dr dan roddenberry cesar milan and pattie mallette live for the mail on mental illness we know that ninety percent of people who die by suicide have some kind of psychiatric disorder or substance abuse problems at the time of their death there's even some evidence that some of that may be genetically based there's actually suicide genes out there share their personal struggles with suicide i just took every pill i found at home and just said it didn't kill it had a purpose in life anymore by landfill a really passionate and there moment in my life and what we could do to breathe and it if you combine medications and psychotherapy you've got about an eighty five to ninety percent chance of success in treating and that's far better than many others and that is a plus the problem today is that where you go has your partner care down there and he or she has almost no training in deal with this yet it's very likely you're

going to pass the primary care person through criminalist with sister part and you need to get psychiatric care might if you have bought a vital question all next on larry king now. welcome to another edition of larry king now in january a twenty two year old rapper named freddy easy committed suicide tweeting leading up to was death some of his final tweets read i'm sorry and god please forgive me and i love you mom and finally it's all bad y'all putting a finger on the trigger it's got us thinking about something we don't often discuss suicide our panel includes dr drew pinsky the board certified physician addiction specialist and host of his own syndicated radio show loveline and dr drew on call

which is on h.b.o. and nightly pattie mallette patty is the author of the new york times best selling memoir nowhere but up. she's also justin bieber's mother dr dan rottenberg is a clinical psychologist the executive director of save suicide awareness voices of education a nonprofit we're going to prevent suicide and help suicide survivors is also managing director of the national council for suicide prevention and is the united states representative for the international association for suicide prevention and cesar milan the dog behaviorist star leader of the pack on the nat geo wild show and people of course as the famed dog whisperer friday use social media that surprise you dr that he use ocean media no really it is in limited notes well it surprises me as someone representing projet aeration it doesn't surprise me given the generation he came from everything is projected out through social media right

now it's almost as though for people his age what they're experiencing who they are doesn't exist unless exist in facebook on twitter not today and surprise you not at all not only that we've been seeing the increase in the us using social media to report on suicide and we had a case of a young man in florida about five six years ago who actually was on you to live streaming his suicide so it is on the increase it plain surprised me you know both patty and caesar attempted suicide with talk of lent a little about that let's get into it why did she try to kill you so that's a lot of question i for me i had you know a lot of stuff leading up to it from abuse in my childhood to at the time a lot of drug and alcohol abuse and bad relationships and and and a lot of stuff this is before justin was born yes how did you attempt it. what method i actually of ran out in front of a vehicle selfishly. you know the small bit of my sister she had been killed by

a car when she was five and in the moment you know being from canada i didn't have a gun i just wanted to die instantly and that's the first thing that i could think of which would have been the most painful moment. the thing play yeah. much more when you badly injured you know miraculously. you know when i jumped out in front of the truck there was a side street and he slammed on the brakes and tilted and landed in the saatchi and it didn't even touch me you ever tempted me again you know she's a moron how and why first why. i feel rejected you know oh. two years ago. i was the worst thing you can do to a dog is rejected from his back and that's how i felt it as their own to a dog death and that to me i feel rejected i feel a failure now did you try to kill you so i just took every pill i found at home and

just didn't feel it had a purpose in life anymore what saved you a god. you don't want me to die i was and it was not my time they found you to get a hospital they took me to a psychiatry because but yeah the hospital then psychiatric hospital because like you say i want to die i want to go to the ranch and die with my dog and you know my dog just the way before i left england and i didn't have a chance to mourn him we've been together for sixteen years and then all the sudden my pack just disappear. like kids eggs in my dogs so i don't like either key here nobody ever doing shows on suicide for fifty years and every time it happens or hear about it the obvious question is. why would someone want to kill it well there are various ways to think of it some people do it because the pain there it is so overwhelming that they can't consider any other way

out but fundamentally i think the way i like to think about it is it's not a normal brain state you're in so what is an irrational choice suddenly seems rational and what if i'm fascinated by both their stories is the context is very different cesar develops classic symptoms of depression and no one notices that the depression becomes serious enough that a symptom emerges suicidality paddy context is trauma abuse drug abuse gets depressed no one identifies it and suicidality emerges in fact there's even some evidence that some of that may be genetically based there's actually suicide genes out there so why does one person yeah why does one person who's depressed get suicidal and one doesn't you can probably talk about that it's still speculative at this point is it is there that we're looking at six very different genes that might be connected to suicide because when you look at the number so we take depression fatigue and forecast the possible shows and we're not quite there just possible for a hundred years from might get there but if you look at twenty million people

living with depression any one time and about thirty eight thousand dying by suicide sixty percent of those having depression it's a small number so we have a lot of people that are able to get through the depression but then we have some circumstances like this where the brain seems to get closer and closer to this this line and it crosses a line and it's in this time that we have to get somebody into safety and security because up until that line we're not really sure if they're going to cross it or not could we have done something about fairly easy when he was tweeting absolutely absolutely absolutely no medical there will be leaders out that's a medical emergency just as if you're saying i'm having chest pain or i'm sure what i what do you do you exactly take them you haven't that's right you know people are afraid and they don't want to talk about and so. and to our whole being put in a psychiatric universe three days and that happens all the time but the reality is what we need to do is when the brain is that is firing the neurons so fast and so out of control as you heard dr drew say earlier the brain goes into overdrive we

need to get them into a safe environment where they can be maintained safely reduce the stimulation and keep them safe pass through that phase and they stop they tend to get i don't want to put a graph up on the board and on to them to comment on what are we seeing her in what you're seeing here is a on the left side the normal brain where you see great blood flow lots of blood activity brain activity going on on the right side you see depression the brain literally gets depressed and see less blood flow this is a pet scan and we can take a picture of the spinal cord as well the reason this is really important for people to see is that we want people to understand this is truly a medical disease there's biology there is genetics there's chemical reactions going on in the brain that change when somebody suffering with a mental illness is every person diagnosed with bipolar or depression get a cat scan them or home go should they not today we're not quite there yet this is from harvard this is testing state but as it is not out of the general does not in

the general public at some point it will be but what this shows is that it hurts and so when people go to their regular doctor and they talk about their headaches in their back aches their neck if their stomach aches it often can be depression that's causing it and let me just say why we're talking about depression which is the i'm sure we're going to stay focused but a real i want to make sure to remind people that if they have bipolar disorder or they have a loved one with bipolar they're actually slightly more likely to kill themselves when they're manic which is something the why when they're on the high side as well and possibly kill themselves and people don't treat mania with quite the same. care is depression in terms of its suicidal potential new and often we have people that go to the go to a physician when they're depressed and they truly have bipolar disorder they get put on an antidepressant because of the lights them into a manic phase and then they kill themselves and then they kill themselves do you ever think have you know what it's going to do to your loved ones. at the time you know all i could see was my pain and you know being

a selfish teenager and i was always so full of it as it really was so as you think of your loved ones. and we just went to a selfish day then there's still a buddy at that time and my codependency is coming to rescue you guys from this notion of being selfish what a human is in pain severe pain that's all they can think about whether it's a physical pain or emotional pain they become focused on that pain why do we hear a lot more on core to the center for disease control more people die from suicide and homicide that's true homicide why why don't we hear why isn't suicide discussed more there's still a stigma around suicide there's still some shame around suicide even or a mental illness is in general people still don't want to talk about them they feel it's a character flaw we have a generational gap we have those older than twenty or thirty that still think just pick yourself up and go to work and the younger generations they see it differently so long time ago i did an interview with someone who worked only was suicides and according to them or trying to remember the two states i think california and

florida to do an autopsy of a suicide trying to find out why someone and that there are six different types including an instant suicide someone gets bad news jumps over a bridge and halfway down doesn't want to go and by that that there are different types of techs absolutely absolutely there's an impulsivity factor to a lot of suicides but not all of them some are planned out in foxborough more they get closer and closer to this place where the brain just can't take the pain any longer and everything else becomes a blur everything else fades away they've pulled away from everybody in their family all their loved ones and so the loved ones don't often see some of the symptoms that are going on do you remember what the moment was like this is for probably the season before you ran out the door i feel like i i couldn't breathe and i you know i. i just all i could think of was that i want to die i just i want to die i want to die well we choose or the moment you to i can relate

to that and also a feeling really happy feeling inside where you like is an emptiness but it's. you know and the only thing you can think of is ok so this is i got a we're losing this leave it by killing me we're losing. a veteran today in america more people have killed themselves than to been killed in afghanistan and iraq and we're losing eighteen veterans a day a team that is an active duty service man every day what. well we do have a problem dr general talking about this with the military with post-traumatic stress disorder we have a tremendous problem right now and we don't have a great way to to treat it and identify it but in the military there's this code of silence and you just don't talk about it you're afraid of losing your rank and you're afraid that your unit won't want to go out with you any longer. there are true it is tremendous stigma about talking i want to i'm going to modify that little bit and say it because it has i think i've been price about

a lot of to see the change in how the military deals with p.t.s.d. they've done a remarkable job trying to deal with it or i felt frustration is the gentleman the men typically have dealing with with p.t.s.d. don't get retained in treatment they don't want to go they don't like having to talk about their feelings that it's painful and they require from it and then they go down or that she wants a vailable and they're encouraging it's a dose range you do it less that she is worth the pain you guys know if those two just that in world war one the world war two we just didn't talk about it nobody called it shellshock we did well the suicides of the world war two yes yes you know there's been suicides since the beginning of time we can go back two thousand and three thousand years and see suicides depicted on walls so i think it's been around for a long time when we come back how do you know if someone you love is in danger. to some of the sons and i just. couldn't take three. or four charges. range month free.

download free birth video for your media project free media oh don darty dot com. wealthy british sign on. time to write. markets why not. get in the. find out what's really happening to the global economy with max cons or run no holds barred look at the global financial headlines tune in to kaiser report on r t ok. i dave across. to ted you're oliver. it's a little while in the middle of the chesapeake bay kind of

a genocide. county. a rampager all in the chesapeake bay probably one of the best areas in the country all fred. this is. your island before the channel was. here. way up there. as go all. right here are some of the headstones from graves that for here this is a fruits that's what we don't want happen to taint your all and we want to get some protection and make sure that we don't go into the chesapeake bay like uppers did in other communities.

with one suicide or one of those some of them to look for. well i can do the two most important things more things or anybody that is thinking about suicide is talking about it somehow they're communicating about it now that might be in writing might be in the music they're listening to but they're somehow communicating their intent and the second most important thing we want people to look at is that they're looking for a way to die they might look for pills they may look for alcohol they might look for a place to go jump from so those are the two most important things we know research tells us depends you know about people who say i want to kill myself i want to take it very very seriously it's a little with well if it's put whether it's passive or active or you take it very seriously but i would take a further step back and start looking for symptoms of depression i mean cesar you use your you went down the list of the typical depressive symptoms isolation irritability change in appetite sleep disturbances hopeless as worthless as guilt

shame all that stuff i feel you know i start feeling like life isn't worth living things used to be enjoyable and alive and joyful that is a all the way down the checklist if you see somebody like that they have the medical problem the in those brains we just showed up there now here's the problem there is a medical solution the problem today i'm going to take as may go off course you're a bit is it where you go is your primary care doctor and he or she has almost no training in deal with this yet it's very unlikely you're going to pass the primary care person for your treatment unless you insist upon it so one of the things i hope comes out of this conversation today is patients insist on getting a referral to a psychologist psychiatrist not the primary care person goes there's experts that can help you when you go for help. a lot of afterwards i did i mean why not before i don't know the shame you know and me being so young probably i didn't really understand what was going on i just knew that. you know i was depressed and and in

a lot of pain failure i just feel like a failure. so you will go now you are going to see i'm very passionate about my failure so i hold on to the failure you know and i feel. rejected by god and i blame god and i blame me and i blame the whole world i went into really passionate and moment in my life understand we have a map. i would say go of the mountain ducted and why is suicide higher in some parts of the country than others what do we look at the map here shows that particularly the states in red mountain midwest states where suicide rates are higher worse more rural where there's less access to medical care as we just heard where there's less access to support system where is the lowest well the last places really are in the most highly populated areas you look at california they have very low rates around new york washington c they have low rates of far northeast very low rates so it's population based the government figures out soon

as they did a hundred thousand people but where it's more rural you see more suicides and you have to do with whether some people say the suicides in seattle because it rains or seasonal affective disorder could contribute it doesn't terms of the mental illness but i'll give you an example in minnesota if we lose about six hundred people a year to suicide in florida they lose about twenty five hundred people a year to suicide now is that because it's an older population which is a whole special group great to talk about that's right elder the elderly are a special special problem right now that's right yeah you have children if you have children obviously you worry about there being something genetic in this i just heard about the. situation they know but. as i went through it i can see the signs you look for signs in your children oh yeah yeah bare hands on dad so i know the patterns and i know what is the lines you know it's these busy you know i keep them busy you see any signs now now i worry about it i do worry about it you know we

talk about i talk about everything with him i talk about my past experience and and try and keep him. and the dialogue. why this is absurd to me why is it a crime. what do we punish people who fail at suicide do we put them in jail we don't put him in jail and it used to be actually illegal in most states not anymore no but there used to be this theory that if it was a crime that that would prevent you from taking your life or for attempting a really damn thing to do with that if you were going to die it didn't matter if you were going to go to jail because your intent was as you heard to die the intent was to get out of the pain and the family left behind feel guilt what could i have both my goodness yes i mean any time that there is any consequence mental illness people start asking what did i miss where i missed it is it is suicide gutsy or chicken. i'll tell you takes a lot of courage actually that i would like and so we are hardwired to live and if

you think fight or flight we are hardwired to fight for our lives so to get to the place where you can actually take yourself out is a hard place to get into the get to guts to do it. i don't also i don't know if it was guts just to look keep saying is this failure and i see my kids are going to do it we've got the evidence now when i hear about it it's like they have no alternative it's just this is a matter of fact this must happen now you're doing something with facebook susan we are we're we're we're trying to look at whether or not there's a group of people who died by suicide if there's any pattern to what happened with them so that we can better predict how we can get them to help earlier we all hear about antidepressants there are a hope there will surely but i think what's missed these days is they are alluded to earlier that they get prescribed by a primary care doctor may have had zero training it is not just treating depression formally but contextualize of the pressure for all the other can comment was there not and so you have to care that you need to get psychiatric care my opinion if you

have bought a fight depression they to be referred and medication art is the answer to everything there needs to be talking therapy and so psychological for referral to me is paramount as well no that's right i mean we do know and from the largest research study done that if you combine medications and psychotherapy you've got about an eighty five to ninety percent chance of success in treating it and that's far better than many others of medicine do you have any medication or therapy they want to try to gave me medication right after you know after a year once i was in the hospital i woke up and they can with a little cup full of pills and they said if i don't die why would i take some more so i was ready to get out of there but they said the stay that was really shot were the you're alive yeah we've shown. yeah i was even i had off for about a month and angry that you didn't do it i was i was angry. and and i i was on medication afterwards for

a long time and we have some social media questions kevin fifty nine tweets with dead great so high i want most health professionals required to complete suicide prevention training that is your area your question to the world i wish we had an answer to that if this should be required the american medical association should require training for people in medical school and continue to american psychological association to do the same if there's a lot of confusion competing interest out there for our attention and that's what we should be trying to w.v. polos chic via twitter as does a viable profile exists that would help in predicting those at risk viable profile sure we know that ninety percent of people who die by suicide have some kind of psychiatric disorder or substance abuse problem at the time of their death so we can start there is a base then we can look at some of the other kinds of things that you heard about today and we can see somebody who might be getting closer and closer to that so yes there is a profile and i would say to this is a little bit of a corollary to that as you mention the substitute issue again before going to

primary care person if you're giving a medication you may be missing what's really going on in my world addiction is so much the underlying issue it leads to the suicidality and if you don't treat the addiction you can't treat the depression you can expect in a rehab the suicide rhona barrymore and facebook gas what are the statistics of suicide survivors attempting suicide again varies it's from anywhere from well you know about twenty five percent there will return to within a year you haven't been another twenty five percent within two years so it is very high and in the recurrence of depression even a well treated precious fifty sixty percent so if you tried again betty you know now is right begins you know i'm going to great place. as the number of soldiers who die from suicide. dramatically out number of combat death cases how do you think these soldiers should be perfet before they're sent and then after they come back. i'm not sure you can prepare them for this more about when the

after they come back and there's resiliency training now that's a very big thing within the military. and helping them learn coping skills but it is more about when they come back and we don't do enough for them. google plus jay bybee stevens wants to know why aren't schools don't have a section where teachers talk about suicide. i think i think i sort of there needs to be a life class that includes all mental illness and suicidality of relationships ideas so many areas that we don't educate our kids about because well that's in the home and now we turn to an old guest a minute as to a dr kevorkian and many consider a hero well you think some people have a right to die and should die if they wish to die and they're in pain and that's clearly a debate that's coming about as more and more today. life is it anyway and who gets to decide that ed what point to may decide that what we know is that for the

majority of the people to die by suicide something is wrong in their brain if we could keep them alive long enough and we could treat them then they would want to what would be wrong and you have pain if you're in intolerable pain why would that's logical to want to do you treat the pain of the suicide the only goes away and you can expect to treat the pain then that's not a rational choice anymore so more days by the way i believe in the right to die i do. but and i believe we treat dogs better when it comes the other their lou gehrig's disease they don't have a right to if they wish i think this is all the issue of how do you a gating to death how do you make sure that somebody is not responding to depressive symptoms or even the stress of the circumstance of their own or actually even physical pain or emotional pain as opposed to the reality of their life coming to an end those are two very different thank you very different questions what do you think of dr kevorkian. i think you have a little. but but the whole idea needs to be really good to go i agree i think that he took it too far but the idea behind it we have a choice when we are consciously aware and rational and our brain is functioning

normal and can think logically that's a different different set of circumstances it's a derivation of the word suicide what does it mean which is not zero yeah it's a behavior actually suicide is defined it's a behavior it is a behavior that's not a diagnosis it is a it is a behavior you have to engage in it to make it happen. do you think banks also of the occasion paddy. i do lately because i've been sharing my story a lot i just wrote it and i know both but. you know how i'd share my story in helps and helps to help other people who've been in similar circumstances because i'm not there anymore and i've come to it and think about it often says is only two years ago and only two years ago i used it as a so way of helping you know making a difference with fascinating to me that people that really come through and grow through

a mental health experience often part of the healing is giving back downs and there is horton and i that's for the last stage of recovery and i am president already thanks to our guests dr drew pinsky pattie mallette dr dan rottenberg and cesar milan if you need immediate help please call one eight hundred two seven three talk one eight hundred two seven three talk that's the national suicide prevention lifeline sometimes they want to proceed they talk maybe even find me on twitter at kings things see you next. well. science technology innovation all the list i'm elements from around russia we've got this huge area covered. i know c.n.n.

m s n b c and fox news have taken some knots lately but the fact is i admire their commitment to cover all sides of the story just in case one of them happens to be accurate. that was funny but it's closer to the truth and might think. it's because when full attention and the mainstream media works side by side with joe actually on here. and our team we have a different thread. because the news of the world just is not this funny i'm not laughing dammit i'm not going. to the jets will handle that.

ok. i democratically a welcome here to tangier island virginia it's a little while and the middle of the chesapeake bay aren't of a genocide and i come back county for a population around four hundred seventy people give or take. ever motion or pay for independent water money from our fisherman crabbers and other twenty percent are where our tug boat captains are our tanker mine are are our second mates on the tugs. so far we're holding onto our show but erosion has taken taking us away slowly but other than dad everybody saves of a contending right now worried by to future but in a water main you are a day by day and night not you can't worry about tomorrow you have to will get by today and dad you hope through.