It gets better: Facing the symptom of suicidal thoughts

Run to Remember 5K 2013

A 40 year old woman finds a lump in her breast.  "It's cancer" she thinks to herself.  She tries to ignore the thought, but it rips through the lining of her thoughts all day.  She can't sleep at night.  She considers her life, family, friends. "How can this be happening to me?" She has responsibilities, people depend on her.  She thinks of the women she knows who have had cancer, some have lived, some have died.  She goes over and over these thoughts for several days before she says the words aloud "I need help."

A 15 year old girl begins to have suicidal thoughts.  "I'm crazy" she thinks to herself.  She tries to ignore the thoughts, but they are unstoppable.  Suicidal thoughts follow her down the halls at school and into her bedroom at night.  She considers her life, family, friends. "Why do bad things always happen to me?"  Her family is mad  because of her dropping grades and "attitude." Her friends have all been ignoring her since the bad break up with her boyfriend, who won't even look at her in class.  What's the point she wonders.  She goes over and over these thoughts for several weeks before she says the words aloud "I need help."

Both women are dealing with symptoms.  Ignoring a symptom doesn't make the problem go away, in both of these cases ignoring a symptom can be fatal. 

The 40 year old has had enough life experience to know that sometimes bad things happen, but she has hope that good things are still possible.  She realizes that she cannot evaluate the symptom without the helped of a trained person. The 40 year old has an idea about what will happen next.  She will consult with a trained physician who will diagnose the symptom and recommend treatment.  Knowing what the symptom means will relieve a lot of stress, even if her worst fears are true.  It gets better.

The 15 year old doesn't know anyone who has suicidal thoughts, because no one talks about it.  She doesn't realize that her parents are worried about her, not angry, and her friends are too busy thinking about their own problems to show her how special she is to them.  The boyfriend, well, he doesn't wish her harm.  She believes that she is weak and broken to even have the thoughts but she can't stand the pressure anymore and is compelled to ask someone for help.

This is what happens AFTER the 15 year old asks for help. 

Assuming she asks the right person, she will be referred to a qualified evaluator.  This could be the family care physician who has known her all of her life, or a licensed counselor.  If she asks for help at 2 am, it will be the Emergency Room doctor.

The physician, psychologist, or counselor will explore other symptoms and get a context for how the 15 year old is functioning, aside from the thoughts.  The evaluator will then assess risk, what is the availability of lethal means for self harm? What is the 15 year old's support system? What has triggered the suicidal thoughts?

The 15 year old does not know that the mental health of a person is based on many factors besides the presence or absence of suicidal thoughts. a lot of adults don't know that either. Suicidal thoughts can be fleeting, or obsessional.  They can be passive "I wish I wasn't here anymore" or active "I have a clear plan about how to kill myself and I am considering when I will do it."  All suicidal thoughts are disturbing and stressful when they cannot be easily dismissed. 

If the 15 year old is at low risk- the treatment plan will include counseling and the education of family members and may include medication. (Medication alone will not improve coping, but it will relieve symptoms)

Finding the "right fit" with a mental health person is important.  Changing behavior is difficult, especially when a teenager is anxious and/or depressed. The 15 year old will be encouraged to increase involvement in meaningful activities and be assisted to improve support systems.  A form of monitoring will be put in place to help the teen return to improved coping that is maintained over time.  It gets better.

If the 15 year old is at high risk for suicide- hospitalization or intensive outpatient counseling and medication will be considered.  Hospitalization is sometimes used to stabilize a young person and remove the risk by providing safety in a controlled setting.  It is a last resort but has its place when needed to save a life.  Intensive outpatient counseling could include day treatment (removal from school with structured activities throughout the day which include academic credit, the teen returns home at night), or multiple sessions per week at a counseling center.  Once the 15 year old is feeling more "like herself" with less symptoms she will be transitioned to a low risk treatment plan. It gets better.

September is Suicide Awareness Month.  Get informed.  Get Better.

Please forward this to someone you know who needs the information. 

Crisis Numbers:

• Heartline: 405-848-CARE (Oklahoma)
• National Hot line: 1-800-273-TALK

Ode to Creativity and Madness

 

The Worrell Gallery

After a week in beautiful Santa Fe at the Creativity and Madness Conference, I am renewed in my commitment to promote mental health/ wellness, and fight the stigma of mental illness.

I am also refreshed.  It is an inspiring place and an incredible conference. I wish you could've come with me, but maybe this month we can virtually travel together.

Take a deep breath and smell the fresh sage, the mountain air.

What do composer Sergei Rachmaninoff, artist Frida Kahlo, native american leader Crazy Horse, and entrepeneur Steve Jobs all have in common? Each were creative, outstanding in their life work, and had a diagnosible mental illness. 

Out of the all of the artistis that we studied this past week, only one- Rachmaninoff- sought treatment for symptoms of mental illness. His treatment was brief and successful in removing his writer's block, but social stigma discouraged him from continuing his therapy once his creativity returned.  Racmaninoff''s depression was debilitating. 

Our society has come a long way in the effectiveness of treatment and recognizing the value of intervention, but we have a long way to go. 

Historically, learning disabilities were considered a sign of ignorance and certain students were deemed"unteachable." Traditionally unsuccessful students Albert Einstein and Thomas Edison to name a few, inspired attention and research to assist unconventional learners.  Looking at the least restrictive environment model, many gifted, learning disabled, and gifted/LD students are now thriving with modified styles of teaching. 

This conference reminds me of the greatness that is possible within unconventional thinkers, who have needs that are often ignored. 

This month I will share insight and information from the conference. I hope you will share my enthusiasm for creativity, wellness, and appreciation of mental illness as a diversity in our culture.

Finding the Silver Lining

Mom, Chris, me, & Kate

"Every cloud has a silver lining." Loving someone with mental illness is unpredictable, stressful, scary at times, . . .  and also  wonderful. 

There is mental illness in my family (quite a bit in fact if you look closely).  My brother Chris turned 40 this year and he has been managing Bipolar Disorder for 22 years, and its symptoms for much longer.  I am so proud of Chris, but it wasn't always easy being his sister.

For years my parents took Chris from doctor to doctor to control his "hyperactivity" and "mood swings" and "imagination." Something was different, maybe wrong with him.  His symptoms added stress to our family.  He was Chris, I thought, what more did they need to know?

Once when I was 16 my new friend spent the night at my house after a late evening.  Chris (5 years old) had never met her before and did not know we had an overnight guest.  In the morning she came downstairs in her black pajamas with her long brown hair frizzed out from hairspray and sleep. Chris rushed to the sink and filled a glass of water and threw it on her.  He thought she was the wicked witch from Oz.  It's funny now.

I remember setting my alarm to watch the Smurfs cartoon on Saturday mornings in the dorm lobby when I went out of state to college.  It helped us both with separation anxiety.  We loved doing that together even when we were apart.

Then the phone call when he was hospitalized for the first time.  The supervised visits to a locked unit, with doctors I didn't always trust and medication with horrific side effects.

Sometimes life is like a dark cloud that bocks out the sun, but if you look very closely you will see a ray of sunshine on the outer edge of the cloud. It is the silver lining. It represents the hope that there will be better days ahead. 

The silver lining in loving my brother and living with mental illness in the family is it formed me into a compassionate and nonjudgmental person.  These qualities clearly help me in my role as a psychologist, but they have also been handy in my roles as daughter, wife, mother, citizen, and friend.  I have also met some incredible people that have helped me and my brother journey together.  People like Bonnie Dunn at Transition House in Norman, and Gail Isreal with NAMI Oklahoma. 

Have you watched the movie Silver Linings?  I watched it Friday night at the urging of my daughters.  I loved it- it made me laugh, and cry (always a good thing for me in a movie) added bonus -the psychiatrist is helpful and not very nutty.

 

Do you have a silver lining in loving someone with mental illness?  Please share! 

Walk The Walk

Nearly 60 million Americans have a diagnosable mental illness.  That is one in four adults and one in ten children, who are in need of counseling and or medication and stabilization.  Even in this informational age those numbers are hard for people to accept, and even harder to understand.

Communities are quick to reach out to families impacted by tragedy with offers of support, compassion, and kindness.  But what is the community response to the isolated teenager? Or the homeless guy who talks to himself? The typical response is to look away, and often to walk away.

Let's walk together instead. 

Mental illness can be treated. Families can receive support.  Communities can help.

 

The National Alliance on Mental Illness (NAMI) is our nation's largest grassroots organization dedicated to education, advocacy, and support for the mentally ill. Local NAMI affiliates "talk the talk"  through educational groups, advocacy, and family to family support.  If you go to one of these meetings, even once, it will change your perspective about mental illness.  There is hope, recovery, and true quality of life for families dealing with mental illness on a daily basis.  Find a meeting, you will be glad you did.

 

NAMI also helps communities "walk the walk." 2013 is the 11th anniversary of NAMIWalks which is a nationwide fundraising and awareness event. Last year NAMIWALKS raised almost $10 million to support local programs to improve the lives of persons impacted by mental illness. 

 

Take the first step today to reach out to the millions of families effected by mental illness.  Come join the walk!

 

We walk to celebrate recovery, raise awareness, memorialize loved ones, and fight the stigma of mental illness. I hope to see you there (Suki is coming too)!

 

NamiWalk 5K OKC: Saturday May 18, 2013

Stars and Stripes Park

3701 South Lake Hefner Drive

Registration: 8:00 am

 

Got Girlfriends? 5 great reasons why you should!

Some of my "girlfriends"- The Inklings Critique Group

March is National Women's History Month
http://womenshistorymonth.gov/about.html. Lets celebrate by focusing on women's issues all month long. In my opinion you can't address women's issues without talking about female friendship.  In addition to the fun and shared interests there are many health benefits to building strong relationship bonds with other women.

 In a lab at UCLA two female researchers were commenting on how when their male counterparts where stressed they would typically isolate to work out a problem.  In contrast, these researchers found themselves cleaning up the lab, making coffee, and talking to one another about the problem to find a solution.  Sound familiar? This keen observation led Drs. Klein and Taylor to evaluate the research on stress and sure enough the research subjects were typically male.  A new research line was born to examine the unique stress responses of women.  In addition to the traditional "fight or flight" responses of men, women also demonstrated a "tend and befriend" response.  When we women are under stress we have a biologically driven instinct to take care of our children and seek out the support of other women.  (And clean the house- or is that just me?)

Female friendship also has proven health benefits:

1. Lowered blood pressure and cholesterol.
2. Longer life span.
3. Improved adjustment from the death of a spouse.
4. Increased psychological well being.
5. Improved relaxation response through the release of oxytocin, a strong neurochemical associated with maternal bonding.

This past fall my father was diagnosed with terminal lung cancer. Trying to balance the additional responsibility of attending to my dad and helping my mother left me little time to "tend and befriend."  I am forever grateful that friends provided constant support and encouragement through texts, voicemails, and cards.  It was a sacred journey that strengthened the bonds of our friendship. 

The research collected in this post will hopefully encourage us all to resist the urge to reduce our contact with friends when times get challenging.

Leave a comment to further the discussion of the benefits of girlfriends.

Also, if you enjoyed this post consider "befriending" my blog.  Simply type your email address in the "follow" box and you will be notified whenever there is a new post (typically Mondays). I will never try to sell you anything or send you spam- promise!








 

What does a psychologist do?

The question “what do you do?” often comes up in social situations.  My answer typically draws some attention.  Reactions are varied and range from interest to skepticism.  I have had several people ask if I can read minds.  Sometimes I wish that I could . . . but darn it, they don’t teach us that in graduate school.

The shortest explanation of what I do as a psychologist is that I work in partnership with my clients (young and old) to facilitate change. 

For many people change is a scary concept.  We are all more or less comfortable in our familiar routines in life and then all of a sudden something shifts- a death in the family, a super strict teacher, a bully moves into the neighborhood, a major medical diagnosis.  When life happens in an unexpected way we use our very best skills to cope.  Sometimes those skills are outdated.  Sometimes those skills push others away from us.  In many cases new skills have to be developed.

As a psychologist I am an active listener, creative problem solver, teacher, encourager, and support.  My role is to provide the right conditions for positive change to take place.

“How many psychologists does it take to change a light bulb?” Only one, but the light bulb has to want to change.  This is an old joke, but it does explain a key factor about counseling.  It is not a passive process; both the psychologist and the client are working hard in the session.  I often give “homework” to my clients to ensure that they are also working outside of the session.

Therapy with a child often involves teaching how to identify, express, and receive comfort from past hurts or disappointments.   The aggressive child needs to learn more socially acceptable ways to get his/her needs recognized.  The bullied child benefits from acknowledgement and tools of assertiveness.  The depressed child is looking for a perspective of hope.  The anxious child is given an opportunity to develop skills of self-reassurance and soothing.  Life is tricky- we need lots of tools in our toolbox to manage ourselves through change. 

Throughout my twenty years in partnership with clients I continue to be inspired on a daily basis by the transforming power of change.  It is a privilege to journey with another person through their most challenging life moments.  Every client is different and every problem has a multitude of creative solutions that is unknown at the beginning of treatment. 

Did you notice there is no mention of blaming the parents?  Despite difficult family situations my job is to empower each child to take responsibility for their own success or failure in coping with change.  If parents are open to making changes too- Bonus!

I LOVE my job.  I hope you love yours.   

Your questions and comments are always welcome.