Saturday, September 30, 2017

Suicide Awareness - The Third of a 7-Part Series

"As the depression lifts, they may suddenly view previously acceptable questions or conversations as inappropriate and may be embarrassed by things they have confided to others. Try to avoid overstepping, and to allow the person a normal amount of privacy."

This is the third of a seven-part series. If you haven't already, you can find the first and second parts here.

Suicide Awareness: Practical Tips

The approaches below have actually helped various people during a suicidal crisis.

Ensuring Safety

Ask the suicidal person if they have planned or thought about how they would commit suicide, and determine whether they have the means (a weapon, pills, etc.) to follow through. If so, make every effort to take them to the emergency room. If that is not possible, remove the means from where the suicidal person is living and don’t leave them alone. Note: Extremely lethal means such as guns ***must*** be removed from the home. Locking them up is not enough.

Identifying Patterns

After his release from the hospital Tom noticed that although he was no longer suicidal he often felt extremely anxious and depressed late in the afternoon. At first he tried to nap during this time, but insomnia made that impossible. So instead, he wound up stuck in his darkest thoughts. It helped him to identify these patterns so he could plan to counteract them.

Identifying Patterns

Tom decided to go for a jog instead of lying down late in the afternoon, and this helped to mediate his anxiety. He also started going to yoga and found that he enjoyed it. For Tom, exercise alleviated anxiety; he discovered that his actions could influence his feelings.

Cognitive Behavioral Training

Carol’s therapist gave her some exercises to use at difficult moments:
  • To fight feelings of unreality or meaninglessness, engage with your surroundings through your senses—touch, smell, listen to, taste, and look at what’s around you.
  • Avoid black and white thinking and worst-case scenarios, which can feed anxiety. Some techniques to correct this type of distorted thinking include doing a cost/benefit analysis about the belief, looking for evidence of its accuracy, testing the theory, asking what you would say to a loved one who thinks that way, and rephrasing the belief in more neutral language. (These and other techniques are described in When Panic Attacks, by David Burns.)

Establishing Routines

Laura was fortunate to be admitted to a good psych ward, which provided structured activities as well as appropriate medication. But once she was released from the hospital, unstructured time made her anxious and all too aware of her disturbing thoughts. Weekend breaks from her outpatient program were especially difficult. With the help of friends and family members Laura created weekend routines involving exercising, socializing, and playing music.

Keeping Things Simple

It’s not useful to discuss complicated emotional issues during an existential crisis. Laura, who is an ex-Mormon, avoided challenging conversations about religion. Likewise, her love life had to be put on hold. She simply found emotional intimacy too stressful at that time. Simpler and less demanding relationships were easier to navigate.

Respect

During a mental illness a person may lose some inhibitions. As the depression lifts, they may suddenly view previously acceptable questions or conversations as inappropriate and may be embarrassed by things they have confided to others. Try to avoid overstepping, and to allow the person a normal amount of privacy. This will help as they begin to reclaim their ordinary life. In general, resist the impulse to advise about life decisions. Be respectful about the information that you share with friends. If you need to vent, choose a safe listener such as a therapist. Except in the most extreme circumstances, get the suicidal person’s permission before taking them to an emergency room or admitting them to a hospital.

Self Care

A suicidal person is in sheer, free-falling crisis. Unfortunately, so are that person’s loved ones. It’s terrifying to think of someone you love committing suicide. It’s horrifying to see them in that much pain. Much of the time, there is little friends and family can do but try to provide protection and emotional support as they wait for medication and therapy to take effect—yet that support is crucial. To help someone who wants to die is to sacrifice one’s own needs, time, energy, and emotional comfort in deference to theirs. The prolonged uncertainty can cause severe anxiety. Don’t complain to the suicidal person or ask them to comfort you. Deal with your own feelings constructively: exercise, keep a journal, work on a project, go outside, spend time with friends. And don’t be afraid to set some limits on what you’re able to do.

Tapir Signal is looking for volunteers in a variety of areas including housing, employment, and other practical concerns as well as LGBT issues and suicide awareness. Suicide awareness volunteers must be 21 or older. They should be mental health practitioners and/or have personal or close family experience with suicide.


If you are in need of help, you can reach us here.

If you are feeling suicidal, please call the National Suicide Hotline at 1-800-273-8255 or 1-800-784-2433.

If you are LGBT+ and need to talk, please contact the LGBT National Hotline at 1-888-843-4564 or find them online here.

Know you are safe and among friends and we will do whatever we can to help.

Lastly, if you would like to be involved or volunteer, you can reach out to us here.

Saturday, September 23, 2017

Cats, Unicorns, and German Chocolate

"He found out I liked cats, so he started sending me kitty pictures. I haven’t told him how many times those pictures and check-ins once or twice a week saved me." --Alex

Depression doesn’t care that you just graduated from college and landed your dream job, or that you escaped a controlling religion and are finally free. It doesn’t give a damn that you have people and pets you love and care about. It makes you feel empty, day after day. Depression isn’t sadness. It makes you unable to feel anything at all, really.

Alex has been dealing with it for most of her life.

“I call it ‘going numb’ – it’s like you are encased in a shell that is keeping those emotions out. You learn to fake them and paint pretty pictures on the outside of that shell, but the inside is the same disturbing silence,” she said.

Alex is 22 years old and holds a Bachelor’s degree from BYU. She’s an assistant genealogist working for on online genealogy service, her dream job. She owns an adorable cat and likes reading, writing, and music.

Three months ago, she posted to r/exmormon asking for help. Her depression was becoming overwhelming and she was contemplating suicide.

Finding the truth

Alex’s mother converted to the LDS church when Alex was five years old. She was baptized at age eight and hit all of her Mormon milestones, like serving in leadership roles in Young Women’s and attending BYU. During her senior year of college, though, Alex began to question her faith. She was working on the Nauvoo Polygamist Project at the time, an undertaking that researched Mormonism’s early pioneers – including the men and women involved in polygamous or polyandrous marriages. Alex had known about the LDS history of polygamy, but the polyandry was new and troubling. On top of that, she was horrified by the prejudice, racism, sexism, and homophobia she found at BYU.

Until then, Alex had avoided the exmormon subreddit, fearing it was “anti-Mormon.” But with all of her questions, she waded into the threads, looking for hard facts and truth about her religion. She found both, and decided to resign her membership after she graduated.

Reaching out

Faking a good Mormon life while she was still at BYU only strengthened Alex’s depression. After she resigned, the cold silence of her Mormon friends and neighbors, who were suddenly “too busy” to talk to her, didn’t help. Though she was free, the damage had been done, and she spiraled into planning her suicide. After she posted about it on the exmormon subreddit, volunteers sent up a Tapir Signal asking people to reach out to Alex.

“I was guided through what to do – what to expect. I was told that everything would be okay and to rely on the community. So I did, tentatively at first,” Alex said. “People reached out to me: Hiking1950, hasbrochem, a girl called _Emma_stoned_, and T_the_Initial. T was a big help for me. He found out I liked cats, so he started sending me kitty pictures. I haven’t told him how many times those pictures and check-ins once or twice a week saved me.”

He and his wife even took Alex out for dinner one night when she was struggling, reminding her that life is worth living.

Everything’s not magically better and her depression hasn’t disappeared, but Alex is finding good days mixed in with the bad ones. She was initially embarrassed that a Tapir Signal had been sent up just for her, but the more she’s worked with Signal volunteers, the more she’s come to appreciate them, she said.

“The volunteers showed me a love I hadn’t felt in a long time, even within the church: the love of non-judgmental support.”

She knows how difficult finding that can be, especially at BYU. If you’re enrolled and struggling, she said, “Leave if you can, but if you must stay, find an outlet, a healthy one. And remember that you aren’t alone.”



If you are in need of help, you can reach us here.

If you are feeling suicidal, please call the National Suicide Hotline at 1-800-273-8255 or 1-800-784-2433.

If you are LGBT+ and need to talk, please contact the LGBT National Hotline at 1-888-843-4564 or find them online here.

Know you are safe and among friends and we will do whatever we can to help.

Lastly, if you would like to be involved or volunteer, you can reach out to us here.

Sunday, September 10, 2017

Suicide Awareness - The Second of a 7-Part Series

"Acceptance doesn’t suggest that you endorse or encourage suicide as a solution. Rather, unconditional acceptance communicates that you hear and understand the other person’s feelings at this moment."

This is the second post of a seven-part series. If you haven't already, you can find the first part here.

Helping a Suicidal Person

My goal for this post is to begin a list of the things that have actually helped various people during a suicidal crisis.

Acceptance

Beyond reflective listening and accounting for basic safety, how can one navigate a relationship with a suicidal person and offer help without doing damage? It may seem counter-intuitive, but much of this amounts to acceptance. There are many ways to express unconditional acceptance of a suicidal person.

First, accept the suicidal person as they are now. What does that mean?
  • Accept rather than debate their desire to die.
  • Accept rather than debate the fact that death actually would eliminate pain.
Acceptance doesn’t suggest that you endorse or encourage suicide as a solution. Rather, unconditional acceptance communicates that you hear and understand the other person’s feelings at this moment.

Certain normal but unconstructive reactions can convey the opposite of acceptance:
  • Interrupting can break a depressed person’s train of thought when they are already having trouble focusing—and it may seem to dismiss their feelings.
  • Contradicting a suicidal person doesn’t help, even when they express self-destructive feelings. Avoid these reactions:
    • “Suicide is not an option!”
    • “But you’ve always been so happy!
    • “I just know you won’t do that.”
Such remarks can seem to minimize disturbing feelings. Instead, reflect such feelings back:
  • Don’t dismiss expressions of emotion. Empathizing can be hard, because most of us haven’t experienced truly suicidal feelings. The extremes of despair are unfamiliar and may even seem exaggerated.
  • Avoid “tough love.” In this situation, it can be dangerous.
  • Don’t assume that someone who expresses suicidal feelings is just trying to get attention.
  • No matter how shocking or dramatic or inaccurate such expressions are, don’t judge or overreact. Try not to provoke guilt and shame, which may be just beneath the surface. Guilt-tripping a suicidal person could make them feel even worse about their life.
  • Instead, let the person say terrible things, if necessary. By telling you the worst of what they feel, they are reaching out for help.
Finally, although it can be very difficult, tell the truth. Depression narrows and distorts a person’s view of life. Carol, who had some psychotic symptoms, asked family members over and over, “Are you real?” “Is this situation real?” “Am I crazy? Be honest.” She was directly asking for help, and she was willing to trust others’ perceptions when she wasn’t sure. In that situation, a reality check was helpful. While avoiding words like “crazy, answer these and other questions simply, clearly, and honestly rather than “humoring” the depressed person by saying what you think they want to hear. Telling the truth builds trust and clarity, two things that suicidal people desperately need.

The love of our neighbor in all its fullness simply means being able to say to him: “What are you going through?” --Simone Weil
Tapir Signal is looking for volunteers in a variety of areas including housing, employment, and other practical concerns as well as LGBT issues and suicide awareness. Suicide awareness volunteers must be 21 or older. They should be mental health practitioners and/or have personal or close family experience with suicide.


If you are in need of help, you can reach us here.

If you are feeling suicidal, please call the National Suicide Hotline at 1-800-273-8255 or 1-800-784-2433.

If you are LGBT+ and need to talk, please contact the LGBT National Hotline at 1-888-843-4564 or find them online here.

Know you are safe and among friends and we will do whatever we can to help.

Lastly, if you would like to be involved or volunteer, you can reach out to us here.


Sunday, September 3, 2017

Suicide Awareness - The First of a 7-Part Series

"Don't preach or attempt to educate. The reality of suicidal feelings will dwarf and distract from your efforts."

What Do You Say to Someone Who Wants to Die?

Some time ago a relative of mine—I’ll call her Laura—went through an existential crisis after taking a hallucinogen. Although Laura did not “go crazy,” she began to believe that everything and everyone around her was unreal and therefore meaningless. She thought about this constantly for weeks and couldn’t get it out of her mind. It was such an agonizing thought that it made her—an ordinarily happy, upbeat, and energetic person—suicidal. She mostly stopped eating and sleeping and lost almost twenty pounds in the space of a few weeks. She was in a psych ward for several days and followed that with an outpatient program. Then, slowly, she recovered.

In this first of several suicide awareness posts, I’ll try to offer a very basic response to the question in the title. r/TapirSignal and /r/SparlockSignal provide a comprehensive guide to understanding suicide in their sidebars, and /r/suicidewatch also has many resources. For a basic and inexpensive one-hour tutorial on how to talk to a suicidal person, you can also see www.qprinstitute.com/individual-training. My posts won’t attempt to replicate those efforts but rather will be a hit-and-miss personal reflection about what helped and did not help my relative Laura and my friends Carol and Tom, all of who experienced suicidal crises. I’ll share in this entry some aspects of communication and support that have been helpful to us. By far the best guide for us and probably for anyone else, however, is what we can learn from listening to and accepting the suicidal person and responding to what they tell us about their own experience.

Listening vs Fixing

When a loved one’s life is at stake, we urgently want to solve the problem. But helping a suicidal person isn’t a quick fix; it demands more of a “listen, don’t fix” approach. Since people experience depression differently, the best guide for those who want to help is the suicidal person him or herself.

Do...
  • Listen and empathize. Simply acknowledging difficulty affirms a suicidal person’s experience, builds trust, and encourages them to open up further
  • Ask directly whether the person has been thinking about suicide, and if so, whether they have a suicide plan. If the answer to either of these questions is yes, seek professional help immediately. Do not phrase the question as a negative (“You haven’t been considering suicide, have you?”) Instead, ask straightforwardly whether they have been thinking of suicide. For most suicidal people, it’s a relief to hear that question.
  • Be available
  • Check in at the times when someone is likely to be most distressed
  • Express love

Don't...
  • Preach or attempt to educate. The reality of suicidal feelings will dwarf and distract from your efforts
  • Contradict what the person says. A suicidal person’s beliefs may be highly inaccurate; depression can distort a person’s perceptions until they become entirely subjective, and objective “reality checks” may seem to invalidate their experience. While a therapist may be able to help with cognitive behavioral therapy, most of us probably can’t reason a very depressed person out of their irrational thoughts, and we don’t have to. All we have to do is acknowledge and respect them.
  • Put them down, accuse them of faking, or tell them to “snap out of it.”
  • Offer advice, unless the suicidal person specifically asks for it.


"Understanding"

When you’re around a person who is suicidal you may want them to feel that you understand, that you’re not overreacting or being insensitive, that you “get it.” That’s only human, but it’s misguided. Your job is not to prove that you understand. Your job is to listen, to empathize, and to offer whatever kind of support the suicidal person can use. Even if that means backing off once they are out of danger.

People who are suicidal are experiencing feelings and perceptions that fortunately are unusual. Most of us can’t fully understand and will never be able to. Even if you’ve been suicidal yourself, to say that you understand may be perceived as denying the uniqueness of the other person’s experience. It’s much better to ask how the other person feels, or to express empathy (“That must be hard”) than to assume you understand. Simone Weil expressed this beautifully:
The love of our neighbor in all its fullness simply means being able to say to him: “What are you going through?”
Tapir Signal is looking for volunteers in a variety of areas including housing, employment, and other practical concerns as well as LGBT issues and suicide awareness. Suicide awareness volunteers must be 21 or older. They should be mental health practitioners and/or have personal or close family experience with suicide.


If you are in need of help, you can reach us here.

If you are feeling suicidal, please call the National Suicide Hotline at 1-800-273-8255 or 1-800-784-2433.

If you are LGBT+ and need to talk, please contact the LGBT National Hotline at 1-888-843-4564 or find them online here.

Know you are safe and among friends and we will do whatever we can to help.

Lastly, if you would like to be involved or volunteer, you can reach out to us here.