Welcome October

September is over, but that doesn’t mean we stop being aware of the importance of suicide prevention. We must continue to check on each other and be there for friends and family. Being aware of suicide is a year-round necessity. As someone who has known the darkness of suicide ideation and attempts, I urge you to continue checking on each other.

October brings awareness to breast cancer. Knowing I was at risk from an early age, I have always taken breast cancer awareness seriously. Now, that I live with breast cancer, the month of October takes on new meaning for me. I have learned a special lesson as I have battled breast cancer. I think this lesson is important in the fight against breast cancer as well as the battle with depression. What is that lesson? LIVE IN THE MOMENT! Four simple words. We need to focus on living. We can’t wait for tomorrow. We need to live our lives in celebration of the wonder that is life. We need to live every moment. Say the things we want to say. Take the trips we want to take. Enjoy the little things. Hug our loved ones. Life needs to be lived because tomorrow isn’t promised. 

I spent my career working extra, always staying late or doing the extra task. Looking back, none of that meant anything. I missed out on living. If you have a choice between working overtime and attending your child’s game or concert, choose to be with your child. Work will still be there in the morning. 

I don’t have children, but I wish I had taken more time to do things for myself. Work didn’t care when I was diagnosed with breast cancer. The sick days ran out and I was kicked to the curb. Twenty-six years of doing all the extras and missing out on life went unnoticed and unrewarded. I was left with nothing. No health insurance. No income. Instead, I get a disability check that barely gets me by each month. I didn’t live when I had the opportunity. Instead, I was the “good” employee. If I could do it all over again, I would make so many changes. I would put me first and work second.

Live in the moment. That is my new mantra. With that in mind I am doing something this month that is just for me. Something I have put off for a long time. I am going to Italy. I will take in all the culture and beauty. I will explore the small towns where my family once lived before immigrating to the United States. I will live in the moment. I will try to push cancer and depression out of my mind so I can experience something new. I will follow where life takes me. I will enjoy food, art, history, and culture.

With that being said, I am taking a two week break from this blog. I’ll post again (October 21^st) when I return. Hopefully, my posts will be guided by a refreshed mind after my trip. 

It’s Okay to Ask for Help

                 As National Suicide Prevention Month ends and National Breast Cancer Awareness Month begins, two awareness calls that mean a lot to me converge. Today I would like to discuss a lesson I have learned in both of my battle with suicidal thoughts and my battle with breast cancer. It is a simple lesson, yet it is so hard to learn. That lesson is it is okay to ask for help.

I have spent a lifetime struggling with depression and suicidal thoughts. It took decades for me to understand that it was okay to ask for help. Even after I learned that I could ask for help, I still hesitated to ask for help. Often waiting until things became really bad before reaching out. I would wait until I came close to acting on the suicidal thoughts before asking for help. Many times, I should have reached out earlier. I’m learning. I know I need to reach out. I know there are people who not only can but want to help me. 

My breast cancer battle helped me learn that I need to accept help. I’ve discussed this battle a little on the blog. It has been a difficult battle. At times I wondered if I would make it through the battle. At times I became  weak and often needed help. In the beginning I didn’t want to have to rely on others. I wanted to be able to do what I have always done, take care of myself. Breast cancer and chemotherapy quickly taught me that it was no longer possible to do it all completely on my own. I needed to ask for and accept help. My aunt eased me into learning this lesson by being by my side every step of the way. She gently helped me and didn’t let me resist. She just did what needed to be done. It was a lot. The moments I treasure the most are when she just sat by my side letting me know I wasn’t alone. I learned that it was okay to need help. I learned that sometimes we can’t do it all on our own. 

Perhaps the lesson is that we live in community. There are people around us even when we try to isolate. We may not always know they are there, but people are beside us. Yes, some of us live lonely lives, but if we look, there are people beside us. Maybe at times it is just the mail carrier who keeps you connected by delivering your mail. Other times it is a friend or family member who sends a quick text. People are out there for each of us. We can reach out. It is important that we reach out. Whether it is suicidal thoughts or a cancer battle, we need others. 

How do we ask for help? How do we let our guard down and acknowledge that at times we can’t do it alone? It is probably different for each one of us, but I think there are some similarities. First, we need to admit to ourselves that we need help. We need to acknowledge that we need to let others in. I think the first step is saying to ourselves, “I am not doing well and I need a little help.” Maybe it means letting go of the shell that wraps around us. Maybe we only let that shell crack a little, just enough to let a little light in. 

Saying “I am not doing well” is difficult. It requires us to be vulnerable. What it also does is let someone else know that they are needed. It starts the process of accepting and receiving help. When I have been suicidal, I have reached out to my mental health team. If I hadn’t told one of them I needed help, I might not have made it through those times. In a similar way, I needed to tell my aunt when chemotherapy had me feeling like shit. If I hadn’t, she wouldn’t have known I needed a medication or something as simple as water. 

Asking for help is sometimes viewed as a weakness by society. That view couldn’t be further from the truth. Asking for help is a sign of strength. It shows that you know you are struggling or not doing well, but also that you recognize that with help you can get better. You are not afraid to be vulnerable. You are willing to allow others the opportunity to help you. All of this takes strength. No matter what is causing you to need help, asking for help is a sign of strength and a sign that you desire to get better.

It has taken me a long time to understand this. To be honest, sometimes I still struggle with it. I am human. There are going to be times when I struggle, times when each one of us struggles. It is okay. I try to remind myself to reach out. I am reminding you to reach out. No matter how put together your life is, there are times when you will need to reach out. The strongest among us still have times when they need to reach out. No matter what the need is, do not be afraid to say, “I need some help.” There is help out there. 

I started this post by acknowledging the convergence of two very important awarenesses in my life. I live with two illnesses, depression and breast cancer. These illnesses have led me to learn that it is okay to need help. It is okay to ask for that help. I encourage you to be aware of when you need assistance. Whatever is causing you to need help, know that you deserve that help and that it is okay to ask for it. We are stronger when we recognize our needs. 

 

National Psychotherapy Day

                  Yesterday was National Psychotherapy Day. It is celebrated yearly on September 25^th. Psychotherapy is an integral part of the treatment mental health disorders.  I have benefited greatly from psychotherapy over the years. Let’s take a look at what psychotherapy is and the role it plays in mental health care.

                  Psychotherapy dates back to the 9^th century. Purposeful and theory-based psychotherapy was first developed by the Persian physician and psychological thinker, Rhazes. According to Psychiatry Online, Rhazes combined psychological methods with physiological explanations. His use of psychotherapy was primitive, but it was the beginning of the field. He was director of a hospital in Baghdad where he established a special section of the hospital to treat people with mental illnesses. He is credited with the first instances of psychiatric aftercare. It is believed that he also started the first psychiatric consultation service in a general hospital. 

                  Today psychotherapy is defined as “variety of treatments that aim to help a person identify and change troubling emotions, thoughts, and behaviors.” (National Institute of Mental Health, NIMH). Psychotherapy takes place in a one-on-one setting with a licensed mental health professional. It can also take place in a group setting. 

                  Psychotherapy is used to treat different mental health disorders. It has helped me in my lifelong battle with depression and anxiety. It has given me space to learn about my illnesses and how to live with them. Psychotherapy has also provided me with a space to talk about what I am going through and how my mental illnesses impact my life. I am lucky to have been with the same psychologist for a long time, which has provided me with consistency and sense of familiarity. Being with the same provider has also allowed me to feel safe as we work on my mental health. I am grateful for all I have received through psychotherapy.  

                  According to NIMH there are several elements to psychotherapy. These include assisting a person to gain awareness of automatic ways of thinking that are inaccurate or harmful. Once there is an awareness psychotherapy helps the person question those thoughts and understand how the thoughts affect their emotions and behavior leading to change in self-defeating behavior patterns. Psychotherapy can assist a person in identifying ways to cope with stress and developing problem solving strategies. It can assist with social and communication skills. Learning to apply mindfulness and relaxation techniques can be a part of psychotherapy. A psychotherapist might help a person track emotions and behaviors to raise awareness of their impact on each other. Psychotherapy can provide supportive counseling and assist a person in exploring troubling issues and receiving emotional support. A psychotherapist might also help a person create a safety plan to help with self-harm or suicidal thoughts. 

                  There are different types of psychotherapy. It may take a few tries to find the approach that works best for an individual. Regardless, psychotherapy can be an integral aspect of the treatment of a mental health disorder. NIMH is a good resource for learning about the types of psychotherapy that can be useful for different disorders. You can also talk to your mental health provider about what they use and/or recommend for you. If you don’t have a mental health provider, start by having a conversation with your primary care provider. 

I believe, and I think most providers would agree, that psychotherapy is a commitment. It requires the patient to be willing to work on improving how they deal with their condition. When we are in psychotherapy, we must be honest and open. It doesn’t work if are not willing to do the work necessary to control our mental illness.

                  For me psychotherapy has been a lifeline. I am grateful beyond words for my psychologist and the treatment/support he provides. As I stated earlier it takes work. Commitment is required from both the individual and the provider. The work is not always easy. I have struggled at times, but I know the work is worth it. Psychotherapy is a part of my lifetime treatment. I need to work on my mental health to function in a healthy way. This is true for anyone with a mental health condition. Our illnesses don’t magically disappear. I liken it to someone with a health issue such as diabetes. A person with diabetes must watch their diet, they need to exercise and take medication or insulin throughout their life. When you a mental illness you need to take similar steps throughout your life. Psychotherapy is one of those steps. 

                  For National Psychotherapy Day I want to thank my psychologist and all who provide psychotherapy. You make a difference.

It’s Okay to Have Suicidal Thoughts

                  I’ve written about this phrase in previous posts and the phrase is often used on social media, “It’s okay, not to be okay.”  It is an important belief especially when we are dealing with suicidal thoughts. When suicidal thoughts are in our heads it is difficult to find a positive, which can make it hard to believe that what we are thinking or feeling is okay. I have learned that it is okay to have suicidal thoughts. It hasn’t been an easy lesson to learn. In fact, it has taken a lifetime.

                  Suicidal thoughts/ideation are symptoms of an illness. They are not a sign of weakness. I can’t stress this idea enough. For so long I believed that my suicidal thoughts meant that I was weak; that I was a bad person. I thought they meant that I didn’t deserve to live. I am sure I am not alone in these thoughts. When our thoughts become consumed with suicidal ideation, it is difficult to not place blame on ourselves. I, for one, feel isolated and cut off from others. There is a darkness that shrouds me. It prevents me from seeing the light of hope. I believe that I am not okay in these moments. These are all lies created by mental illness. 

                  It has been a struggle, but I have learned that I need to reach out for help when suicidal thoughts/ideation fill my mind. My mental health team has taught me that my life is worth living and that it is okay to reach out in those moments when I am struggling. I have learned to talk about these thoughts. By talking about my suicidal thoughts/ideation, I take away their power. I learn that I am okay. The thoughts are a part of my illness. Talking about them pulls me out of the darkness and allows me to find hope. When I have hope, I have a reason to live. I have realized that it is okay to have these thoughts, but I must reach out in these times. I must understand that I need help to deal with the thoughts. Just like with other illnesses, I need care when the symptoms are present. 

                  The fact that I have suicidal thoughts/ideation at times does not make me a bad person. It does not mean that don’t value my life. What it does mean is that I am hurting. I am suffering from an illness that needs treatment. I urge anyone who is having suicidal thoughts/ideation to reach out for help. You can call someone on your care team, 988, or a loved one. Reach out. You deserve help. It is not your fault that you have an illness. If you are able to, create a safety plan when the thoughts aren’t present or are not as strong. I discuss safety plans in my article on the NAMI Glendale website. I know I have brought this article up in other posts. I bring it up again because I believe having a safety plan is very important. It can save our lives. 

                  It is okay to have suicidal thoughts. The important thing is to reach out for help when those thoughts occur. We need help to prevent us from acting on the thoughts. Needing help is not a sign of weakness. I realize that when we are in darkness of suicidal thoughts it is difficult to reach out. We feel like we are not okay. We feel like we are a burden. Think of it this way, if you were having symptoms of a heart attack, you would call 911. You need to reach out for professional help when you have the symptoms, suicidal thoughts/ideation, of a mental illness. Each one of us deserves that help. We deserve help overcoming our illness. It is okay if you have these thoughts. The important part is what you do in response. Create that safety plan and reach out for help. It’s hard, but in the big picture, it is worth it. 

                  

Hope After Suicidal Thoughts

                 The pain of suicidal ideation is difficult to bear. It shrouds you in darkness. The pain is indescribable. I have been there several times. Each time I believe I won’t be able to escape the pain. Dying seems like the only viable option. I want the pain to end and can’t find any other way. During these times I struggle to let others into my thoughts. I believe no one else can understand. Hopelessness fills me. This is the pain of suicidal thoughts/ideation.

                  I have been lucky. I have found a way back from the edge of death each time. Hope has returned to my life. As I mentioned in an earlier post, the song “Let It Go” by Grace Slick (not the Frozen song) brought me back from the edge of suicide several times as a teenager. I had the opportunity to meet Grace Slick a few years ago. I thanked her for saving my life. She said something I will never forget. With a smile she looked at me and said, “you did that. You were strong.” That was an empowering statement. It made me realized that a part me has wanted to live even in the moments when life seemed to be at its bleakest. I’m still grateful to Grace Slick because her song guided me to find that strength.

                  Suicidal thoughts have followed me throughout my life. I often still turn to “Let It Go” in these times. You can listen to it here: "Let It Go". A song alone is not enough to defeat suicidal thoughts. I need help from mental health professionals. I now have a safety plan that includes reaching out to my mental health team when I am in crisis. They talk to me and help me fight the suicidal thoughts. They ensure that I am safe. They provide the support I need to get through the crisis. I also have a friend I can reach out to when I feel I need support. This is why I have a safety plan. It reminds me of what to do when I am fighting the suicidal thoughts. For more on safety plans read my article How a Safety Plan Can Ease a Mental Health Crisis on the NAMI Glendale website.

                  So, what happens when the crisis is over. How do you continue living after a suicidal crisis? It’s hard to explain how I come back from one of these episodes. It involves hope. Part of returning from the edge of suicide requires hope that I can heal. I think this is something that anyone fighting suicidal thoughts /ideation needs in order to overcome the thoughts. For me hope doesn’t emerge on its own. My mental health team provides me with hope. Often, I have held onto their hope for me as that hope develops in me. Wanting to die is the absence of hope. Therefore, when battling suicidal thoughts/ideation you need hope. Hope is the belief that there is light in our world. Hope is the belief that the suicidal thoughts are lying. Hope is the belief that you can get better. It is important to remember that suicidal thoughts/ideation are symptoms of an illness. With the right treatment we can get better. We need to trust in our care. That requires hope. 

                  Hope does not develop easily. That is why I have relied on the hope my team has for me to give me a push. Once I have held onto their hope it becomes easier to find hope for myself. Having others to help us makes it easier to climb out of the darkness of suicidal thoughts/ideation. When we latch onto their hope for us, we are better able to develop hope on our own. 

What if you don’t have someone to share hope with you? Unfortunately, this is a reality for some people. If you don’t have someone you can turn to, please know that I have hope for you. Know that you can turn to organizations like NAMI. You can call 988 and speak to a trained counselor. If you don’t have a mental health professional, reach out to your primary care provider. They can refer you to a provider who can help. It is important to know that you are not alone. You can find hope even in your darkest moments. 

                  Those of us with suicidal thoughts/ideation are not alone. Too many people suffer with these thoughts. Too many people act on these thoughts. That is why I am spending so much time writing about suicide this month. I know what it is like to be in the darkness. I have been on the edge of taking my life. I don’t want to go back to that edge, and I don’t want others to be on that edge. I encourage you to reach out. There is help and there is hope. 

 

 

 

Suicidal Ideation and Suicide Are Not Signs of Weakness

                   At times there is a misconception that suicidal ideation and/or suicide are signs of weakness. This couldn’t be farther from the truth. Suicidal ideation and suicide attempts are symptoms of an illness. Several mental illnesses can include suicidal ideation/attempts as symptoms. They result from the intense pain caused by mental illness.

                  I have been suicidal on several occasions. It is a very painful experience to feel that life is not worth living. This pain stems from the thoughts and emotions caused by mental illnesses. My personal experiences with suicidal ideation are a result of depression. So, as I write this post I am speaking from that experience, but other mental illnesses can lead to suicidal ideation and attempts. I can only speak from my perspective, but I want to emphasize that other mental illnesses are just as painful.

                  My suicidal thoughts began when I was a teenager. I didn’t understand what I was experiencing. I had not been diagnosed with depression at this point. So, I was struggling to get by on my own. Back then there were few, if any, resources for people experiencing suicidal thoughts. 988 didn’t exist. School personnel were not trained to provide assistance and resources. As result, I was left to live with my thoughts of ending my life. I came close several times. I credit a song by Grace Slick with getting me through those times. I used to play “Let It Go”, on my record player. I felt as if Grace Slick was singing to me, calling me back from the edge. I share this story in detail in my book Traveling the Healing Journey: Finding the Light in Mental Illness(available from your local bookstore or Amazon). 

                  When I look back on those times, I remember feeling alone, isolated. I remember having no hope for my life. I felt as if the emotional pain I was feeling would never end. I would “hear” thoughts in my head telling me I would be better off dead. All of this was too much for me as a teenager with no professional support. I believed that suicide was my only escape. I wrote a lot about dying. Most of my writing was poetry. It was very dark and filled with the pain I felt. My suicidal ideation was not a sign of weakness, though. It was a symptom of an illness that I had not yet been diagnosed with. Fortunately, I managed to get through those years without taking my life. I’m not sure how, but I am still here.

                  Being diagnosed with major depression at age 20 did not end my suicidal thoughts. These thoughts don’t magically disappear once our illness has a name. The thoughts are part of the illness for many of us. I still struggle with the thoughts at times 35 plus years after they first emerged. Thankfully, I have learned a lot about my illness since then and I have had the support of mental health professionals. Still, the thoughts can pop into my head without warning. With the help of my mental health team, I created a safety plan for when those times occur. I wrote about safety plans in an article on NAMI Glendale’s website, How a Safety Plan Can Ease a Mental Health Crisis. My safety plan includes when I need to seek help, who I need to reach out to, how I can reach out, and how my contact person can reach those who can provide professional help. 

                  My last major crisis with suicidal ideation was 16 months ago. The thoughts became loud in my head. Those thoughts were not a sign of weakness. They were a verbal expression of the emotional pain I was experiencing at the time. They were a cry for help. The thoughts were also plea for escape. I needed help. Thankfully, I knew to reach out for help. I was provided with the mental health help I needed to ease the symptoms of my illness. I was not treated as if I was weak. I was treated with respect and understanding. I was provided with the treatment I needed.  I was lucky. Not everyone has the resources to get the help needed. The lack of resources leads to high numbers of suicide in the world today. It is important to raise awareness and increase support for mental health resources so that we can provide help.

                  Mental Health First Aid is an important resource. People can be trained in Mental Health First Aid. Click on the link for more information about this important training. I went through the training. I would encourage others to get trained. You never know when you might need to use that training. I saw recent social media posts where singer Jon Bon Jovi and another woman were able to talk a woman out of jumping off a bridge. I don’t know what they said, but they showed that they cared and were able to get this woman safely off the bridge. Would you be prepared if you were in a similar situation? Mental Health First Aid can help you be prepared.

                  When a person considers taking their life or is attempting to take their life, they are not weak. Living takes strength when you have a mental illness. We are strong people who reach a point at which the weight we bear becomes too heavy. Death seems like the answer, but it is not. One person reaching out can make a difference. I am grateful that I have never been able to follow through on my thoughts of suicide. Those thoughts may be something I deal with throughout life, but I want to live. So do most, if not all people, who struggle with suicidal ideation. We just need a little support. Suicide is not a sign of weakness. It is a symptom of a mental illness. It shouldn’t be looked on with derision. Rather, we need people to reach out and provide help. Call the 988 crisis line. Be that person who listens. You may save a life. 

Suicide Warning Signs

                  One way to take action during Suicide Prevention Month is to learn the warning signs that someone may be at risk for attempting suicide. Often, warning signs are overlooked or not seen because suicide is something most people would rather not think about. Sometimes people treat the warning signs as being attention seeking and don’t realize the seriousness of these signs. It is important to know that these signs are not attention seeking and must be taken seriously.

                  Let me start by saying that people who are experiencing suicidal thoughts are not seeking attention. I have been there. I have sat in the depths of suicidal thoughts and in those moments, I have never been seeking attention. I have been suffering and feeling alone, isolated from the world around me to the point that I wanted to escape. So, please don’t believe for one moment that a person who is expressing the warning signs of suicide is just seeking attention. They are in crisis and need help.

                  I defined suicide in my last post (World Suicide Prevention Day Post). “Suicide is when a person harms themselves with the goal of ending their life, and they die as a result.” (the National Institute of Mental Health). A suicide attempt is when a person harms themselves with the intent of dying, but do not die.  

                  The National Institute of Mental Health lists the following as warning signs of suicide:

                  “·  Talking about wanting to die or wanting to kill themselves

·      Talking about feeling empty or hopeless or having no reason to live

·      Talking about feeling trapped or feeling that there are no solutions

·      Feeling unbearable emotional or physical pain

·      Talking about being a burden to others

·      Withdrawing from family and friends

·      Giving away important possessions

·      Saying goodbye to friends and family

·      Putting affairs in order, such as a will

·      Taking great risks that could lead to death, such as driving extremely fast

·      Talking or thinking about death often

·      Displaying extreme mood swings, suddenly changing from very sad to very calm or happy

·      Making a plan or looking for ways to kill themselves such as searching for lethal methods online, stockpiling pills or buying a gun

·      Talking about feeling great guilt or shame

·      Using alcohol or drugs more often 

·      Acting anxious or agitated

·      Changing eating or sleeping habits

·      Showing rage or talking about seeking revenge.”

 

It can be difficult to know if a person is suicidal, but these warning signs give an

indication that the person is considering it or may be ready to act. A change in behavior or a new, concerning behavior is an indication that there is need to get help as soon as possible.

                  Sometimes it is difficult to know if a person is engaging in some of these behaviors. For example, you may not know someone is stockpiling pills.  I stockpiled pills until I had significant amount, and no one knew. That is why it is important to have conversations with the person if you suspect they might be considering suicide. No one knew about my pills until I felt safe enough to tell one of my mental health providers. In the same way, you may not know a loved one has made a plan to attempt suicide. For that reason, it is important to watch for other signs. Noticing some of the other signs may lead you to finding out that they have made a plan. It is okay to ask a person if they are thinking about or planning to attempt suicide. Some people fear that bringing it up will put the idea in someone’s head. Research shows that it won’t. It is better to have honest conversations if you notice one or more of the warning signs. That will get the conversation started and lead to intervention. 

                  The times I have been asked if I was thinking about attempting suicide, I have been honest. That has led to getting me help. It did not make my thoughts worse or increase my likelihood of acting on my thoughts. Just asking is not enough. You need to get the person help. How do you do that?

                  First, stay with the person. Do not leave them alone. It is important not to tell the person you will keep their thoughts a secret.  You need to get help. Calling 988 for support is a first step. 988 is the Suicide and Crisis Lifeline. If there is an immediate, life-threatening situation you should call 911. Be sure to tell the person who answers that this is a mental health crisis and involves a possible suicide attempt. 

                  If there is not an immediate threat, 988 is the best option. You can call or text 988. You can also log on to https://988lifeline.org/. The 988 Suicide and Crisis Lifeline provides 24-hour, confidential support to anyone involved in suicidal crisis or emotional distress. You will be connected to a trained crisis counselor.

                  Today’s world has changed a lot. It is possible that you may learn someone is suicidal on social media. Some of the social media sites have a process to get the person help. You can find information on how to get help on the different social media platforms on the 988 Lifeline website at https://988lifeline.org/help-someone-else/support-on-social-media/.

                  If you are young person reading this, please never keep a friend’s suicidal thoughts a secret. It is important to reach out to a trusted adult if a friend expresses suicidal thoughts or intentions. Even if you are unsure of your friend’s intent, tell a trusted adult. 

                  I am not a professional. I am a person with lived experience. I have lived with suicidal thoughts. I have been in crisis. As I reflect on those instances, I don’t think I really wanted to die as much as I wanted to escape the emotional and mental pain I was experiencing. I needed help. I couldn’t do it on my own. Suicide often seems like the only escape, but suicide is not the answer. There is help available. I am grateful to those who have ensured that I received help over the years. 

                  So, if you see any of the warning signs in someone, take action. Stay with the person and reach out for help.