The Time and Courage to Heal

Healing takes time, and asking for help is a courageous step. — Mariska Hargitay

                  There are so many quotes available online. Sometimes I like to read quotes on various topics. I find it encouraging to read the words of others. As a writer it is important for me to read the words of others and reflect on them. Even more so as a person with a mental illness, I think it is important to search for encouragement. I found the above quote in one of my searches. I thought I would share this quote and my thoughts on it with you.

                  Healing takes time. I see healing as a journey rather than a definitive destination. I have been on a healing journey most of my life. That may make it seem like I am not healing, but I believe I am healing. Each day, each moment I move forward is step toward healing, The thing about healing is that it is not linear. Sometimes there are steps backward or sideways. Healing is messy. There is no one path. 

                  Allowing healing to take its time is important. One way to do this is to focus on taking small steps. A small step might be scheduling a therapy appointment. It might be taking our medication. Employing a coping strategy can be a small step. Once we take one small step, we are more likely to continue taking steps in the direction of healing. As steps build, our relationship with healing grows. We learn to make the choices that allow us to grow. We find ourselves healing.

                  Another key point that provides healing is asking for help. Hargitay calls asking for help “a courageous step”. It takes courage to ask for help. Sometimes when we struggle with mental illness, we find it difficult to ask for help or find ourselves not knowing how to ask for help. Maybe we are embarrassed that we need help. Or maybe we are unsure who to ask. Whatever the reason, asking for help is not easy. That is where courage comes in. Mental illness shrouds us in darkness, but the ability to say, “I need help” or “I cannot do this on my own” is a flicker of light. That light is the presence of courage. It is a light that puts us back on the path to healing. 

                  It may seem easy for me to say that we just need to ask for help. However, I say it from a place of understanding. Asking for help is essential when we are struggling. I have been stuck in those dark moments when I feel like I have no way out and no one to help me. It is a painful place. I have had to learn to reach out. That does not mean I do not struggle with asking. In my darkest moments I questioned if I am worth receiving help from others. What I know is that if I had not asked for help in my dark moments, I may not be here today. 

                  Since asking for help can be very difficult, I believe it is important for those of us living with mental illness to have a safety plan. What is a safety plan? Simply put a safety plan is map of what to do when you find yourself struggling to a point where you need help or at a point where you might hurt yourself. For more on safety plans you can read my article Creating a Safety Plan for Times of Suicidal Crisis on Recovery.com.  A safety plan gives you a concrete plan of action for when you are struggling. You do not need to be in suicidal crisis to benefit from having a safety plan. 

Sometimes we just need assistance asking for help. As an example, I was struggling the other day. My anxiety had taken me into a spiral. I could not get the anxious thoughts to stop. I was not going to hurt myself, but I knew I was going to continue spiraling if I did not get help. I reached out to a member of my mental health team. She helped me find a way out of the anxiety spiral by reminding me of how I could reach out to one of my oncology providers to ease the anxiety that was building. Left on my own, I would have continued to struggle with the growing anxiety. The interaction with this person was brief, but it made a difference. It took courage for me to ask for help. I had to let go of the thought that I should be able to cope with my anxiety on my own. I needed to understand that it is okay to say, “I am not okay, and I need help.”  Once I reached out and heard back from my oncology provider my anxiety eased and I felt better.

                  Asking for help is part of the healing journey. While asking for help is difficult, it shows a commitment to healing. When we are committed to our healing, we are able to move forward on our healing journey. Asking for help is a sign of courage. I believe that everyone living with mental illness has courage. We live with struggle but continue to fight. Even when it seems like we are not moving forward or that the darkness is consuming us, our strength is there.  Sometimes it is just that little flicker, but we can develop the courage to ask for help and to believe that we deserve that help. Courage is that flickering light that continues to burn despite the darkness.

Hope and a Plan

        This month I have focused on suicide. I realize that it is a heavy topic. However, as I said on Monday, we need to talk about suicide. We cannot close our eyes and expect people to be okay. We can’t just send good wishes and have the suicide rates decrease. As September nears a close, I am not finished writing about suicide. It will be a topic on my blog periodically because I know the importance of talking about suicide. 

                  There is a saying that is shared frequently on mental health social media posts: It’s okay not to be okay. I think this saying is something we all need to internalize. There are going to be times for all of us when we are not okay. It is not limited to people with mental illness. That is a key thing to remember. We all go through difficult times. We can all feel hopeless. In those moments we need to remember that it is okay to not be okay and know that there is help available.

                  Suicidal ideation is a sign that a person is suffering. The person needs help. We have come a long way in finding ways to provide support. World Suicide Prevention Month provides attention to that support. Being aware in September is great, but it is not enough. There are many groups out there providing support year-round. Organizations such as NAMI and the American Foundation for Suicide Prevention  work diligently to provide support and raise awareness. Check out the links for more information on these organizations and how you can get involved.

                  Turning this personal, I know the pain of suicidal thoughts. I have been on the edge where I have needed support. I am grateful to the people who have been there for me. They showed me there is hope. Knowing there is hope is not enough on its own. It is important that we know what resources are available. If you have a mental illness, it is a good idea to have a safety plan. You can read about safety plans in my article Creating a Safety Plan for Times of Suicidal Crisis. Safety plans can save a life. My safety plan has saved my life. 

                  Hope combined with the presence of a safety plan can save lives.  Add to those open discussions about suicide and we can make a real difference in people’s lives.  It is the willingness to break down the stigma surrounding suicide that will allow hope and safety plans to be their most effective. 

When you are on the precipice, when life seems to be too much, I hope you will hear the whisper of hope. It is there in our darkest moments. Unfortunately, it’s really hard to hear, but trust me it is there. I have heard the whisper of hope. It is different for each one of us, but hope is there. So, when life is at its bleakest call out to hope. Whisper, scream. Whatever you can do. Know that hope is there. It may not be easy as you climb down from that precipice, but I believe you can. I know it is difficult. Hanging onto hope is worth it. You have an unfinished story within you. Allow that story to be written.

 

If you are having suicidal thoughts or contemplating suicide, please reach out to a therapist, psychologist, or psychiatrist. If you do not have one, you can reach out to 

988

911

Or go to the nearest emergency room.

 

 

Living with Depression

                  My last post was short. It reflected how my mood had been affecting me. Depression is a difficult illness to live with. Sometimes the weight of depression weighs heavier than other times. Unfortunately, for the last couple of weeks that weight has been heavy on me. I try to fight through it, but sometimes depression just makes a person step away from what they may ordinarily be doing. 

                  I would like to say that I am back to my baseline mood, but I am not quite there yet. I am making progress, but I still feel some of depression’s weight. Over the years, actually decades, of living with depression I have learned that there are going to be times when I am not doing well. There will be times when I am numb to all around me. Therapy helps. The non-traditional treatments that I receive help. Unfortunately, nothing can prevent the depression from taking control when it wants to be in charge. I think that is one of the ways that we know depression is an illness. Depression can nix the efficacy of treatments meant to ease it. It is powerful. 

                  Most people with depression can tell you that there are times when the depression feels heavier than others. I was doing well and then depression reared up and drew me into its lair. I was surrounded by darkness. I had to reach out for support. Luckily, I have that support system in place. I got through the worst of it this time. 

                  One of the things that helped me was writing. I know I have discussed writing a lot. While I was struggling, I journaled a lot. I also wrote haiku poems. I find that writing this type of poem is helpful for me. I need to focus to ensure I am getting the correct syllable count for each line. That occupies my brain and pushes some of the depression-fueled thoughts into the background. While my haikus were dark, they were also a reflection of where my mind was at during this time. Getting my thoughts out on paper made them concrete, which allowed me to process them. 

                  I also created some art. I did paint pours over two vases. Art helps me calm my thoughts and center myself. The act of pouring the paint, watching the colors flow, releases some of the numbness. I like watching the paint flow down the glass. I try to imagine the depression dripping off the vase (or canvas if I am working with one). 

                  As I think about it, these strategies, writing and painting, provide me with a sense of externalization. The depression loads my brain with negative thoughts and feelings. Writing and creating art provide a place for those thoughts and feelings to go. As I visualize them leaving me, I begin the process of regaining control. It can be a slow process. Allowing the process to happen is healing. 

                  My main point in this post is that when we live with depression, we are going to have times when the depression becomes very dark and heavy, but we can get through those times. We need a plan to cope when the depression is at its worst. Having a safety plan for the bad times is a good start. I wrote an article about safety plans. It can be found on Recovery.com (Creating a Safety Plan for Times of Suicidal Crisis). Knowing who you can reach out to is important. It is also important to have coping strategies. For me those strategies include writing and creating art. 

                  I can’t stress the importance of being ready for the difficult times enough. This recent episode of heavy depression caught me off guard. It was difficult, but I engaged in my coping strategies. I reached out for support. You can do this, too. Depression wants to rule our lives. We do not have to let it.

 

                   

                  

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. 

                  

Passive Suicidal Ideation

                  Today I want to discuss a topic that is close to my heart. It is something I relate well to because I have dealt it for most of my life. I want to talk about passive suicidal ideation. The word passive is misleading. It doesn’t feel passive. Passive suicidal ideation is a serious problem and one that needs to be discussed. 

Passive suicidal ideation is when someone wishes they were dead or has thoughts about killing themselves without making a direct plan. (source: GoodRx.com) Even though the person does not have a plan, passive suicidal ideation needs to be taken seriously. It requires the attention of a mental health professional. 

Thoughts that a person with passive suicidal ideation might have include:

 

·      “I can’t do this anymore.”

·      “I don’t want to wake up tomorrow.”

·      “Everyone would be better off without me.”

·      “I wish I could just disappear.”

·      “I hope I get in a car crash.”

·      “I just want to sleep and never wake up.”

 

These thoughts may include a desire to die or not exist. The person may feel

hopeless. They may also feel trapped. Giving up seems to be the answer. The person may talk of feeling numb to everything around them. 

The difference between passive suicidal thoughts and active suicidal thoughts is that with active suicidal thoughts there is an intent and a plan to die. Even though there is no plan with passive suicidal thoughts, it is important to get help. Those thoughts can become active. Passive suicidal thoughts become overwhelming. There seems to be no escape from the pain they cause. Without help passive thoughts can become active. 

I don’t want to get too personal with my passive suicidal thoughts, but I have struggled with them. I have a safety plan for when they enter my mind. One key is recognizing their presence. When I can identify the thoughts, I am better able to reach out for help. One thing I have noticed is that I need to reach out for help early. If I allow the thoughts to fester, they become more difficult to fight. I think having a safety plan is important. It allows me to get help when I need it. My designated friend knows what to do if I share with her that I am having these thoughts. The safety plan provides an opportunity for my mental health team to intervene.

Passive suicidal thoughts are difficult to share with others. When these suicidal thoughts enter our minds reaching out can be the last thing we want to do for many reasons. These include embarrassment, fear of hospitalization, feelings of being a burden on others, and frustration. I have learned that these feelings are normal. Just as important, these feelings are okay. Passive suicidal thoughts are a part of the illness. Not everyone experiences them, but those of us that do, need to know that it is not our fault. Creating a safety plan and having conversations with our mental health providers are keys to fighting passive suicidal ideation. For more on creating a safety plan see my article at: https://namiglendale.org/how-a-safety-plan-can-ease-a-mental-health-crisis/

I know that at times my mind is going to go there. It is something that my mind has been doing for as long as I can remember. It took a long time to learn how to deal with these thoughts and how to trust others to help me. If you only take away one thought from this post, I hope that you take away that the thoughts are not your fault and that you deserve help. Knowing this is not going to stop the thoughts, but it will make the battle easier. 

 

 

Talking Back to Depression

                  Depression brings with it many difficulties.  One difficulty that can be particularly troublesome is negative thoughts.  I have struggled with negative thoughts my whole life.  The depression takes control, and it tells me things that are either not true or are overexaggerated.  These negative thoughts can easily take control and put me in a tailspin.  The tailspin can lead to suicidal thoughts, which then puts me in crisis.  I know I am not alone in this process.  People with depression struggle with negative thought patterns.  We need strategies to stop these thoughts.  

                  Over the years I have had a lot of help learning how to tell the thoughts to stop or to talk back to the thoughts.  Therapy has played a key role in teaching me these strategies.  I have learned these strategies from each of the members of my mental health team.  I am not perfect at using them.  Knowing the strategies is not enough.  They must be utilized in time to avoid a downward spiral.  I would like to share some of the ways I talk back to the negative, depression-fueled thoughts.  I would caution you that this is just what I have tried.  Sometimes I still struggle with it.  Depression is an illness.  It doesn’t just go away because we tell it to or because we want it to.  It requires constant effort.  Sometimes there will be failure.  That is okay.  As with any illness, depression requires constant care.  If one of these phrases doesn’t work, try another.  Remember there will be times when you need to reach for support either from loved ones or mental health professionals.  That is okay.  I can’t stress this enough.  It is okay to reach out when you are struggling.  

                  My go-to word when I notice the negative thoughts is simply, “stop”.  I say it in my head.  I try to tell the thought to stop.  I don’t try to argue with it or persuade it to be different.  I simply say “stop”.  This is an interruption strategy.  I am trying to interrupt the negative thought to get it to stop.  This is most effective if I catch the thought early.  When this works, I then try to replace the thought with something more positive or at least something neutral.  

                  The single word “stop” is sometimes not enough.   This is when I try to tell my thoughts that I know it is the depression talking and I am not going to listen.  This is a little harder than just saying “stop”.  I find myself saying something like, “I hear you telling me that life isn’t worth it, but I am not going to listen this time.”  I usually need to repeat it a few times to get the message across.  Sometimes I pair it with the word “stop.”  I may repeat that I am not listening.  At times I say, “Depression, I know you are trying to take control, but I am not going to allow that to happen.”  This is by no means easy.  It is often frustrating.  The voice of depression is loud.  It is also strong.  

                  Another phrase I use in my head is “Hey, Depression, I know you want control, but I can’t let you have control.  This is my life.”  I know it sounds strange to have conversations in my head. I am not talking out loud.  These are my thoughts talking back to the depression in my head.  It is a strategy that can be employed when the thoughts get strong.

                  When these phrases don’t work, I try writing.  If I can write my thoughts in my journal or on my computer, I can give them a sense of control.  I can also get the negative thoughts out of my head and make them concrete.  Sometimes just getting them out on paper is enough for me.  Other times I need to share what I have written with someone.  I usually share these written thoughts with one of the members of my mental health team.  If this strategy sounds good to you, know that you could also share your written words with a trusted loved one.  However, if the thoughts turn suicidal, I would recommend reaching out to a mental health professional.

                  There are times when talking back and writing are not enough.  Remember, depression is an illness.  It can vary in its strength from day to day or even moment to moment.  Another strategy I try is distraction.  For me music is a solid distractor.  When I am listening to music to distract myself from depression’s voice, I focus on listening to the lyrics.  Usually, I choose songs that I know resonate with me.  If I can get my mind to focus on the words of the song, those words can replace the thoughts in my head.  When I use this strategy, I like to lie in bed and close my eyes.  Other times I listen to the music while walking in my neighborhood.  I only do this when I feel safe enough to leave my house.  If the thoughts are too overwhelming or they are getting into that suicidal territory, I prefer to keep myself in my bedroom, where I have established a safe zone.  

                  Depression is often a solitary illness.  There is a lot of aloneness to it.  Despite this, it is important to remember that depression cannot be defeated alone.  So, when the thoughts get to be too much for me to handle on my own, I know I need to reach out.  For example, if I am having thoughts of hurting myself and they don’t respond to my initial attempt to stop them, I know I need help.  It is at this point that I will call my psychologist and leave him a voicemail, which I know he will receive because we have talked about this as a safety plan.  Depending on your situation, you might want to reach out to your mental health provider, a loved one, or to the 988 helpline. If the person you plan to reach out to is a loved one, you should create a plan in advance that lets the person know how to respond.  A simple safety plan might include what that person should ask you or say to you and who he or she should contact if necessary.  The plan should also include an explanation of when the person needs to reach out for professional help.  I have a plan and have shared it with the people in my life, who I would reach out to in if the self-harm or suicidal thoughts are in control.  

Reaching out is a sign of strength.  It took me a long time to realize that.  It is a lesson I needed to learn.  Often when we suffer with depression, we believe no one else understands.  To some extent it is true that people who don’t live with depression don’t understand, but that doesn’t mean they don’t want to understand or that they aren’t willing to help.  That is perhaps one of the greatest lessons I’ve learned in recent years.  Even in our darkest moment, those moments where the depression has taken complete control, there are ways to get help.  I encourage you to make plans for these times when you are not in the midst of depression’s stranglehold.  Discuss it with someone when you are in a place where things aren’t as bad.  This will allow you to have a plan for those darkest moments.  On the other side of the darkness, you will be glad you had a plan. 

Living with the thoughts depression creates is never going to be easy.  We need to make plans.  Think of it as a prescription for living with depression.  Not all prescriptions are for medication.  Knowing how to talk to depression and how to reach out are important parts of our treatment.  You might need to practice talking back to your thoughts with a mental health professional.  That is okay.  It is normal.  Your provider will understand and will help you.  Don’t allow depression to gain complete control.  Make a plan for dealing with the varying stages of the illness.  Ask for help.  Depression is an awful illness, but we can fight back.

I will leave you with this thought.  Depression is an awful illness, but it is one we can fight when we make plans and have strategies for dealing with it.  I encourage you to talk to your loved ones and mental health professionals about how you will talk back to depression and how you will reach out when necessary.