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When discussing suicide: Sharing stories of hope and recovery

I talked a lot last week about the CDC Technical Packet I read on suicide, and I have one more item in it that I want to discuss.

There’s a section in the packet (“Lessen Harms and Prevent Future Risk”) which applies to anyone who has ever walked down the dark path of suicidal ideation – or even suicide attempts – and come back. Under the approaches subheading, the report says:

Safe reporting and messaging about suicide. The manner in which information on a recent suicide is communicated to the public (e.g., school assemblies, mass media, social media) can heighten the risk of suicide among vulnerable individuals and can inadvertently contribute to suicide contagion. Reports that are inclusive of suicide prevention messages, stories of hope and resilience [italics added by me], risk and protective factors, and links to helping resources (e.g., hotline), and that avoid sensationalizing events or reducing suicide to one cause, can help reduce the likelihood of suicide contagion.

Later, in the evidence section, the report notes:

Finally, research suggests that not only does reporting on suicide in a negative way (e.g., reporting on suicide myths and repetition) have harmful effects on suicide, but reporting on positive coping skills in the face of adversity can also demonstrate protective effects against suicide. Reports of individual suicidal ideation (not accompanied by reports of suicide or suicide attempts) along with reports describing a “mastery” of a crisis situation where adversities were overcome [italics added by me] was associated with significant decreases in suicide rates in the time period immediately following such reports

So, let’s talk about that for a second, because this is important. Many have discussed suicide, and whenever there is a high profile suicide in the media, reports often discuss specific methods and details. That’s bad.  As the report above clearly demonstrates, the way in which suicide is discussed in society can have an extremely positive or negative affect on impact rates.

And here’s the part which specifically touches all of us who have been there: There’s something potentially life saving about sharing your story.

Describe it. Tell people about your darkness. Tell them how suicide was something you considered. Maybe even attempted. Tell them the truth – be open and honest with your experiences. But don’t just emphasize the sadness. Talk about how you found your way back. Talk about how you fought your demons, and thanks to X, Y and Z, are now in recovery. You don’t have to pretend that everything is perfect – in that, that likely won’t ring true. But what I think people can and should say is that they no longer want to end their lives – that they want to live, to fight on, and to lead a good life. This is what I tried to do when I shared my specific story of suicidal ideation in the aftermath of the Anthony Bourdian and Kate Spade suicides.

If you can, I’d encourage you to tell your story, and do so as noted above. I truly believe that doing so can save lives.

How the Center for the Disease Control says we can stop suicide

Yesterday, I wrote a little bit about a really insightful technical package offered by the Centers for Disease Control. It’s a long document, but for those of you who care about how we can stop suicide and are looking for ideas (if you are involved in the government or not!), I think it’s a great read.

I don’t want to get insanely in-depth into what sort of recommendations were contained in the document. But I do think it’s worth reviewing the broad outlines of it, just in case you don’t have time to read a 60 page governmental white paper. Broadly speaking, it broke down it’s recommended solutions into a few categories:

  • Strengthening Economic Supports: This one was the topic of my entry yesterday, and I’d argue the most important for both suicide and protecting vulnerable people in our society. This specifically deals with making sure that people who may be at risk for suicide as a result of economic conditions have access to the services that they need to recover, and includes items like robust unemployment benefits, medical benefits, foreclosure assistance and more.
  • Strengthen Access & Delivery of Suicide Care: Here’s where things start to align with what I think most people would expect. This includes the obvious systemic changes needed to be made to our mental health system, including improvements to the insurance system (parity between physical and mental health), reducing provider shortages (a huge issue of mine which, unfortunately, largely needs to be dealt with at the federal level), and broader changes to the mental health care system in order to better address mental illness and suicide prevention.
  • Create Protective Environments: Here’s where what I’ll call “stop-gap” methods really come into play. This includes means reduction (guns are  huge issue here, but this also includes restricting access to suicide hotspots) and improving organizational/social systems to promote protective environments (particularly in at risk locations) and addressing excess alcohol use (which is connected to suicide).
  • Promoting Connectedness: Thanks to phones and technology, we are more connected than ever before. Except we’re not. And as social connectedness breakdown, suicide rates will continue to increase. This specific approach recommends addressing suicide by establishing peer norm programs and engaging in increased community engagement activities.
  • Teaching Coping & Problem Solving Skills: One of the keys to surviving any bout of mental illness – and I’ve written about it before – is building resilience, or an ability to cope. This includes creating social/emotional learning programs and addressing parenting and family relation skills.
  • Identify and Support People at Risk: This includes training gatekeepers, improving crisis intervention and broad-based treatment for people at risk of suicide.
  • Postvention: The aftermath of a suicide attempt can have a dramatic impact on both the victim and those around them. This section of the report deals with postvention for those who were close with a suicide victim and addresses safe reporting/messaging in the aftermath of a suicide.

This is really comprehensive, and again, worth a read. If you have any thoughts or questions, I’d love to hear them! Leave your questions or comments in the section below.

Here’s the first chapter of Redemption!

Alright, alright, alright!

I had a few folks ask for it without the Email gate, so, here you go. Click here to download the first Chapter of Redemption. If you want to buy the book, here’s the Amazon link, and here’s the page on my website for other formats and how to buy a signed copy from me.

Enjoy!

The next time there’s a high profile suicide, don’t just tweet a phone number. Do this instead.

As part of my legislative work, I just finished reading a technical package from the Centers for Disease Control. The topic was suicide. It was some pretty heavy reading. At the same time, it was informative for many reasons, as it included a wide array of programs that people in government and the non-profit world can enact in order to reduce suicides.

Something, in particular, was highly instructive about the packet. It contained a wide array of information dealing with numerous public policy areas. But let me talk about the first chapter in terms of specific recommendations about suicide reduction. What do you think it was? Was it access to mental health care? The need for more research into better drugs? Controlling access to means of suicide?

Nope. It was economic supports.

Suicide rises in times of economic strife. The connection is clear. So, the first two specific recommendations within the packet:

  • Strengthening household financial security via programs like unemployment benefits, temporary assistance and livable wages.
  • Enacting programs that reduce foreclosure risk.

The report went on to note that ample evidence exists showing that stronger social safety net programs can reduce the risk of suicide.

Other areas of this report also showed the strong demonstration between public policy, public health and reducing suicides rates. Various sectors of our society are critically important as well, of course, but government can be – and should be – a primary actor when it comes to suicide reduction.

Let me go back to the title of this blog entry. Like many others, when there is a high-profile suicide, I’ll tweet out the “thoughts and prayers” line, as well as information on the National Suicide Prevention Hotline. That’s good, and it’s helpful. But it’s not enough. I want to start treating suicide in public the way we treat gun violence. It’s not enough to tweet support. We have to demand action from our policy makers:

Look, I’m a flaming progressive, so this may just be my political orientation, but I think we need more common sense gun reform measures in the worst way – things like red flag laws (which would allow for a temporary removal of weapons from people who are a danger to others or themselves), universal background checks and more. And I’m glad now that, whenever we have yet another tragic shooting, it’s not just “thoughts and prayers” but “thoughts, prayers and CAN WE PLEASE ACTUALLY DO SOMETHING ABOUT THIS.”

I want to take this mantra and apply it to mental health and suicides. Let’s stop pretending that suicides are a problem of an individual or their family. They aren’t. They are a societal, communial and governmental problem. We need to do more at the societal level to address mental health and suicide, and that means doing more than just working to improve mental health. If we can acknowledge that, we can make a change.

So, I say to you, dear reader: Don’t just tweet the suicide hotline numbers. Demand that policy makers make the changes necessary to save lives.

Get the first chapter of Redemption for free!

Hiya!

If you’ve read the blog before, you’ve heard me talk about Redemption. For those of you who are curious, good news! You can now download the first chapter of the book for free. To do so, you can sign-up for my newsletter, and the welcome Email will have a link to download the book.

Do you already get the newsletter? Well, just check the link in there to access the first chapter.

Enjoy!

Science Fiction and Mental Health:The Lost Opportunity

In the course of writing my book, I made an assumption – one which I would ultimately find to be incorrect: That mental illness and science fiction would be very popular subgenres. They are not. I’ve been surprised by this. In fact, thus far, I’ve only been able to find one other book which intermixes mental health, science fiction and young adult – Portals by Kristy Acevedo. That’s a REALLY great book, by the way – if you liked Redemption, you’ll like Portals – Kristy Acevedo was kind enough to do a blog interview with me. That’s here.

I thought the two genres would go much better together. The reason? The sheer freedom of it. I’ve written two books now – Tweets and Consequences (which was a non-fiction look at social media, politicians and epic failures) and Redemption. Obviously non-fiction is a little bit more limiting. But, even fiction can be very constraining. If you write a regular YA book, for example, you are limited by the realities of the genre. For example, It’s not a good or consistent book if your YA character suddenly grows wings and flies away.

Science fiction and fantasy, of course, are different. All bets are off. You set up your world, it’s limits, and then you go from there. In Redemption, I created a Lord of the Flies-like world – on a space ship – and we were off to the races. The extremes of the world in Redemption allow me to explore the mental illness of the main character, Ash. Clearly, it’s science fiction, but the constraints of the world are still pretty similar to this one. As such, I get the opportunity to explore mental illness in a whole new light, but one that is simultaneously interesting/entertaining (at least, I hope!) and relevant to the reader.

Portals does a similar exploration – it creates a fantasy world with aliens from the future who are trying to save the world. The main character has debilitating anxiety issues, and the extreme stress of the world has major impacts on her mental health, her limits, and what she learns about herself and those around her.

But again, I’ve been surprised. I haven’t seen a ton of interaction between these subjects, and that, in my estimation, is a lost opportunity. Science fiction allows you to break traditional boundaries. I’ve actually always thought that the best science fiction just takes advantage of the weird elements it creates. Star Wars isn’t about space, it’s about good vs. evil. Star Trek (which one reviewer on the Amazon page was kind enough to compare Redemption to!) isn’t about the damn United Federation of Plants, it is about social justice and an exploration of the galaxy and the human psyche. It seems like mental illness and it’s related topics would be a perfect fit for this universe, but alas, unless I have been mistaken, this is not a topic which has seen much interaction.

Am I wrong? I’d love to be wrong. If I am wrong, please correct me – leave your best book recommendations in the comments below!

TMS Update

Well, as I type this I am 10 sessions into the 30 session Transcranial Magnetic Stimulation sessions. 1/3 of the way there. Woohoo!

How’s it going so far? Well…maybe better? Honestly, yeah, starting at the beginning of the 2nd week, it did start to feel like I was feeling a bit better, but let me define what I mean. Birds did not start singing. The sky is not the bluest it has ever been. Depression is still there. Life is not perfect.

But, to some extent, I have to say, it does feel like things have gotten a bit better. My life hasn’t dramatically improved, but there does seem to be a bit less…pressure. Like, the ceiling of depression which pressured down on me seems a bit lighter. That’s the best way I think I can put it.

To be clear, this may be placebo. The readings that the Doctor gave me showed that depression probably wouldn’t start to improve until week four. When I mentioned this to him, he said some people did feel better in week two, but for many it was longer, and it is certainly possible that this is just placebo. So I guess we will see!

Some other notes:

  • For me, there are no side effects. Even the slight headaches that during the treatment have become more tolerable. I haven’t taken a Tylenol before a treatment since it started, and my head has not hurt a soon as the treatment has ended.
  • You really do build a resistance to the minor pain caused by the treatment. Of the ten times I’ve had it, I’ve fallen asleep three of them, which is kind of funny.
  • I went through the math in my head the other day. As I said in the last entry on this subject, the magnet taps your head for four seconds, then rests for twelve. During the four seconds in which you get tapped with the magnet, it makes contact 40 times. A session is twenty minutes, so you get tapped 3,200 times a session. Multiply that by the 30 sessions, and congratulations, you’re getting smacked by a magnet 96,000 time over six weeks!

Only 64,000 taps to go!

The futility of gratitude – and why it’s so important

I had an interesting realization in therapy the other day, and it led to this blog entry. Stay with me for a second.

My therapist and I were talking about trying to change my mindset from both a depression and anxiety perspective. I think a great deal of anxiety comes from a fear of “not being able to handle” any given situation – be that going to school, work, travel, whatever. I’m not quite sure what “not being able to handle” means, save for turning into a blubbering ball of sad and fear, but whatever. Now, by and large, that’s a silly fear. There’s no such thing – not really – as “not being able to handle” something. Sure, there are some life events and experiences that go better than others, but short of dying, you get through life.

This sort of fear in stressful situations can manifest itself in many ways. One of them is that it causes a shift in mindset. You no longer engage in new experiences to enjoy them or learn from them – instead, you do so in order to say “I survived” them. This mindset can be damning for so many reasons. You start an experience not looking to enjoy it, but to get through it. This kind of bunker-mentality can absolutely destroy your ability to get any joy. To try new things. To adventure or gain new experience. Indeed, it makes you afraid, and it makes you far less willing to be adventurous. You live in a constant state of looking over your shoulder, wondering when the anxiety attack will hit. Wondering when you will get cripplingly sad. Wondering what goes wrong next.

This way of thinking, of living – survival versus gratitude – can be absolutely crippling. And it leads me to the point of today’s entry: I don’t want to just survive. I want to thrive. I want to learn and to live. Don’t you?

How do you do that? Hahaha, yeah come on, you know I don’t have an answer. I only have a piece of one. That’s this: Try to change the way you approach new situations. Approach them from a perspective of gratitude and gaining new experience. Instead of entering an anxiety-provoking situation from the perspective of, “Oh, God, how am I gonna get through this?” ask yourself, “Okay, what can I learn from this?” or better yet, “How can I be grateful for this experience?”

Now, I titled this entry, “The futility of gratitude” because I am not an idiot. When you are depressed or anxious and someone tells you to “Be grateful,” you probably want to punch that person in the face. Grateful? For the crippling fear and sadness? That’s madness.

But, that’s exactly why it’s so important.

The only way to break anxiety and depression is to change the way you think. The way you process thoughts and emotions. And the only way to do that is to shift your mindset. So, just try this. Try, every now and then, asking yourself this question: “How am I learning from this new and difficult situation?” or “What can whatever I am experiencing right now teach me so I don’t encounter these problems in the future?” Fear is only crippling is it denies you the chance to grow, to learn. And there’s no such thing as an experience you can’t handle.

So, try to ask yourself that. Try to ask yourself what you can be grateful for. What you can learn. Shift your mind, and maybe you can shift your emotions too.

“A woodpecker on steroids” – My experience, so far, with Transcranial Magnetic Stimulation

So, for the first time in my multi-decade battle with depression, I’m trying a new type of therapy (other than talking and taking pills). It’s Transcranial Magnetic Stimulation (TMS), and I’ve written about it before.

Here’s the basic gist of how it works:

Transcranial magnetic stimulation (TMS) is a method whereby an electromagnet placed on a scalp transmits magnetic pulses or waves to a small portion of the brain. Repetitive transcranial magnetic stimulation (rTMS) delivered at a low frequency (once per second) has been shown to reduce the reactivity or excitability of the part of the brain stimulated and other brain regions functionally connected to the region stimulated.

I started it Monday, and it is time intensive – not so much in how long you have to sit there (my sessions are only twenty minutes), but in terms of how long you have to do it – for me, it’s six weeks, five days a week. I had to wait until vacation was over and for a break in my calendar to make it happen.

As for how it works: Honestly, it’s not hard. You sit there. You get yourself into a nice and comfy chair and they adjust a couple of things by your head. The right side of your head is lined up with a pad to keep your head still. The left side of your head is where the action is at – a magnet, enclosed in some equipment, is aligned in the right spot. It’s desired location is your frontal cortex, which is the area of your brain where depression apparently can be adjusted. They send one magnetic pulse into your head, and if your hand twitches, they have the right spot.

Once they have the right spot, they save the settings and that’s where you sit. If it’s aligned right, you may feel a little discomfort or pressure during the actual treatment. The actual treatment consists of your head being tapped with a magnet (not directly, but through padding) for four seconds, followed by a rest of twelve seconds. That continues for twenty minutes.

Is it painful? No. The first alignment can be – if it’s misaligned, it hits a nerve and OUCH. It just stings for a few seconds. They readjust, and then it’s fine. Now, is it comfortable? Nah. But you do build a resistance to it. I had a headache and took Tylenol the first three days. By days four and five I barely noticed. They also give you earplugs. Those are optional, but if a Doctor gives you ear plugs, use them, okay?

It’s a strange experience, described to me by the nurse as being hit by a woodpecker on steroids. I love that description, and it’s accurate. I mean, you’re basically getting tapped by a magnet or roughly 30 times over four seconds. It’s weird, but not painful. I’ll putz on my phone, close my eyes and chill, whatever. Honestly, its not that bad. The session ends and you go back to work. There are no after effects, except for maybe a slight headache that Tylenol can bop right out. You can drive, think, function, etc. I’ve left therapy sessions where I’ve been more disoriented.

When am I supposed to see results? The literature I read said week four. They said they thought they had seen some people get more depressed as the placebo effect wore away in week two. I’m hoping I don’t go through that, because I have no illusions that this will work until at least week four.

So, one week down, five to go. Here’s to hoping.

As always, I’d love to hear your thoughts and experiences, and as the process goes on I’ll share more, including some pics. Let us know about your TMS experiences below!

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SIDE NOTE: First, again, I’m not a doctor or medical professional – I’m a damn politician and writer. I’m certainly doing my best to write an accurate description, but if you have any questions or concerns, please contact a medical professional. Second, this probably goes without saying, but I’m going through this treatment like any other normal person and paying with my insurance. I am not receiving any compensation or consideration whatsoever for sharing my experiences.

The incredibly sweet tribute to a mental health hero in Zelda: Breath of the Wild

I’ve written about video games before, but never quite like this.

Yesterday, I was watching this video on Zelda: Breath of the Wild (awesome game, by the way). In the course of watching, I came across this:

For those of you who don’t watch the video, here’s the basic gist: Link, the game’s hero, walks to the edge of a Proxim Bridge in the game. He is confronted by a character named Brigo, who stops you from jumping off of the bridge and says things to get you to stay put. He even offers to stay with you to keep you company.

Okay, kind of random, right? Brigo is likely inspired by Kevin Briggs:

Kevin Briggs.jpg

Briggs is a fascinating man: He spent decades working for the California Highway Patrol, which he retired from in 2013. During much of that time, he patrolled the Golden Gate Bridge, and by his estimates, stopped over 200 people from jumping to their death.

This is a truly kind tribute to a man who clearly deserves it.

If you want to watch the entire scene, it’s below: