Mental illness is dumber

[Portia]

As to your rhetorical question, I think it makes a lot of sense that our brains are hardwired to scan for social rejection and threats to our safety. Dealing with an extremely complex social environment where you interact with more people in a semester than your ancestors would have in their lives seems like a perfect storm for a negative feedback loop.

[Zedability]

"Hey something bad is happening I'd better shut down all executive functions." *gets eaten by lion* - our ancestors, probably.

[mic0]

I've heard it called "fight, flight, or freeze."

[Portia]

I have some interesting stories from the "flight" column. :-P 0/10 would not recommend

[Zedability]

Yayyyy it got approved.

[Emiliana]

Yayyyy it got approved.

Yaaaaaaay!

[Portia]

So after a night of (1) ridiculous, palpable loneliness when my boyfriend is down south with friends (2) one cocktail too many over the saddest of the Fitzgerald stories (it was two, okay, I'm a lightweight) and (3) feeling particularly foolish upon discovering a crush from freshman year is, in fact, gay, and deciding to read the incredibly gushy correspondence about that time...

I finally had The Discussion that should have happened at least a year ago with The Engineer (as he's known in these parts). He's at a wedding of some other ex of his, and I decided that once and for all, I needed to say, no, you can't come to my wedding, you can't expect to be "just friends" if I'm marrying someone else, for crying out loud. You wrecked any chance of that happening.

It was a difficult discussion but I feel like it could end up like this and who wants that.

[Katya]

Yayyyy it got approved.

Yaaaaaaay!

I will toast you with my glass of water (that I am using to take my own anti-anxiety medication).

[Violet]

Yayyyy it got approved.

Yay! That sounds like such a relief.

[TheBlackSheep]

Yay, Zedability!

Today was a tough mental health day around these parts. I know I've been severely depressed forever and so I'm less likely to be freaked out by suicide-like ideas, but I wish there was some way to talk about it without making everyone go into "you have so much to live for!" mode. Not that I don't appreciate the compassion. It's just... gah. It takes a lot of energy to reassure those people. I need a code word, maybe.

Shout out to Marduk for talking to me and being supportive with no "you have so much to live for!" mode. I'm sorry I didn't make it down to your place, but I'm doing better.

[autosurf]

I wish there was some way to talk about it without making everyone go into "you have so much to live for!" mode. Not that I don't appreciate the compassion. It's just... gah. It takes a lot of energy to reassure those people. I need a code word, maybe.

I really enjoy Hyperbole and a Half's thoughts on the matter in this blog post- http://hyperboleandahalf.blogspot.com/2 ... t-two.html
"I didn't want it to be a big deal. However, it's an alarming subject. Trying to be nonchalant about it just makes it weird for everyone. "

[Zedability]

Somehow "I keep thinking about ways to kill myself but I doubt I'll actually do them do don't be stressed" doesn't convince people to not be stressed. I agree there needs to be a code word or something.

[Portia]

Shout-out to Zed for not judging me and having decent ideas about feeling your emotions. Maybe she can borrow some of mine, since I have too many.. :-)

[TheBlackSheep]

autosurf, I LOVE her comics on depression. It gave me a language to talk to my then-boyfriend (whose skill set definitely did not include dealing with my mental illness in any way) about depression. "The fish are dead. They are just dead. There is nothing to do about it. They are dead and it's hard and I don't know why they are dead they just are." Somehow this worked for us. And she's right on the money about suicidality.

Zed, right? I know it's hard for support people to hear that, and having been a supportive person to many mentally ill people I can empathize. It is just that sharing is really good for us mentally ill folks. I obviously still haven't mastered it after 16 years, but it seems to go better for me if I can enlist help with something like this: "I want to tell you something really personal and it could be kind of scary. What would help me is if you could understand it as a symptom of what's going on and not freak out." Of course, when I get into super depressed headspace that goes out the window a little. By which I mean I may or may not have opened a conversation with Marduk asking if he believed in an afterlife. Not alarming at all. (Doing better.) Depression is WEIRD.

[Whistler]

so, if you have the energy for it (no one's under any obligation to explain themselves, I'm just curious), what's a good way to support someone with suicidal thoughts? Figure out how detailed the plans are to see how serious it is? Talk about something else? Say validating things?

[Zedability]

I just never know how to balance the benefits that come from sharing things vs the benefits of not feeling guilty for inducing ridiculous levels of anxiety in my husband.

Depression is so weird. I was actually rereading those comics last night and they're so perfect. It's weird because not being able to feel things is actually so much worse than it would sound.

[TheBlackSheep]

It's weird because not being able to feel things is actually so much worse than it would sound.

Yuuuuuup.

so, if you have the energy for it (no one's under any obligation to explain themselves, I'm just curious), what's a good way to support someone with suicidal thoughts? Figure out how detailed the plans are to see how serious it is? Talk about something else? Say validating things?

So, I have a lot of experience in this, professionally and personally, so I get that not everyone is going to feel comfortable making the judgment calls I make. If in doubt, call 911. However, unless I hear 1. an imminent plan, 2. intent, and 3. means, I don't feel the need to pry or alert anybody, whether it's the authorities or whatever. Means is less important, I guess, but unless someone tells me, "I'm going to kill myself," or something similar (especially with a timeline) I don't freak out or do anything really. I don't even necessarily validate. I just sit quietly and listen with an engaged, calm manner and show I am actively listening once and again. I think that's what most people need (and what I want, when I'm in the same room with someone). That and physical closeness if they are okay with it. Stuff that shows they are neither scary nor all that crazy. During the conversation and at the end of the conversation I will ask that person if they are safe and that's it. No, "PROMISE TO CALL ME IF YOU EVEN THINK ABOUT EVER HURTING YOURSELF EVAAAAAAAAAR" because that's overwhelming. Again, use your best judgment. Me, I'd tell you if I wasn't safe if you asked because I have rules about my suicidality. Others maybe you don't trust so much. YMMV.

Of course it goes without saying that I'd always encourage these people to get help, including meds and psychotherapy. I would probably be more interested in doing more digging or calling 911 if the person did not have a therapist they were seeing at least every week. That's just because someone else (a clinical professional) has eyes on the situation at least every seven days, which is actually a lot in actual suicide planning.

If you really know someone you can try and point out where their thinking errors are, gently. The problem is that wanting to die is rarely rational (at least how non-depressed people would see it... seems rational to me a lot of the time), so trying out out-rational someone often just feels condescending and like the person isn't listening to the problem. Done right, though, it can be immensely helpful. Also heaping praise upon a person (you are so special! you are so smart! you have so much going for you! everyone loves you so much!) very rarely helps. It always just makes me feel worse or like I'm not being listened to. Platitudes like "suicide is a permanent solution to a temporary problem" are right out. So is telling the person that they would hurt other people if they killed themselves. They know that, they probably already feel guilty about it even if they have no real intent, and nobody would tell that to a cancer patient whose possible symptoms would eventually include death. It's completely unhelpful and unempathetic. It's true, we know it, we get it, we feel awful about it, etc., but the pain is incredibly real and we get to own the solutions, whatever they are. A guilt trip at such a critical moment is so unhelpful.

Things that do seem to help me when I'm suicidal:
1. physical touch (when appropriate... I am not a touchy person in general)
2. quiet companionship and calm validation
3. gentle encouragement to call my shrink, take my meds, eat, etc.
4. encouragement to change up my surroundings (sometimes that really does help snap my brain out of it a little bit) -- road trips, visiting the right friends, or even just changing the room where I've made my current nest
5. intense physical sensation in appropriate ways -- hard back rubs, hot showers, etc.
6. sparse verbal affirmations of what I'm doing right -- "You haven't self harmed" or "You are letting me share this experience with you"

I'll probably think of more I wanted to say about it, but I think the most important thing is to not freak out. Even if you decide you have to call 911, be calm about it. Tell the person that you love them but that you think there needs to be additional help. Keep an even tone. If you don't decide to call 911, stay calm anyway. We know we sound crazy. We probably secretly fear that we are REALLY crazy. The truth is we're not all that crazy for being suicidal. It's not unreasonable to feel you aren't up to surviving intense psychological pain forever. Treat us like it makes sense. That doesn't mean thinking it's a good decision, but treating us like we are ticking time bombs doesn't help. You absolutely get to have your feelings about it (I know I have) but that moment is not the right time to express them to the suicidal person. Wait until after and talk to someone else, or wait until much after and talk to the person when they are doing better. Use your own coping skills on your own time. Worst case, tell the person that this is a lot and you need to help them call someone else to help to back you up so they can be supported, and then leave if you need to. The truth is that I have been suicidal more times than I remember, and I remember lots and lots and lots of times. I have attempted suicide exactly once out of all of those times. Your loved one needs help if they feel that way, and they need to know they are loved. If they have a therapist, have at least considered/tried meds, and are doing other things to address their mental illness and if they do not have an imminent plan and intent, this is probably just one hell of a terrifically bad day. (I don't say that to minimize it. Their feelings are very real. All I mean is that you are probably not the only thing between them and death.) Don't freak out and make it even worse.

That was ramble-y. Sorry about that, heh. I'm leaving on self-care road trip the second I submit this, and so you can probably guess that this is all a little fresh to me right now.

[TheBlackSheep]

Oh, and. Use your own judgment, but telling someone it is going to get better is not necessarily helpful advice. It's okay to point out that good things will come of their continuing to fight, but there is no guarantee that it is going to get better or even easier. I might be an odd duck on this one, but this advice sounds condescending, patronizing, and just untrue to me. My mental illness and I have been together a long time. I have gotten so much better about managing it and I have been a very good little depression patient. The feelings, however, are just as painful as when I attempted suicide when I was 20 or when I self-harmed the first time when I was 11. I do feel proud of what I've accomplished as far as managing the mental illness, the but feelings are NO EASIER. If anything, they are harder. Not everyone's depression is that way. Lots of people have one good bout and then it's over. Lots of other people's symptoms are addressed really well by CBT and meds. For some of us, though, the depression isn't going anywhere. It feels better to me to finally admit that than to pretend that maybe this is the last time I'll feel this way. I can focus on what I can do about it, but someone telling me it will get better makes me feel like they are trying to make themselves feel better more than they are trying to listen to me.

[TheBlackSheep]

I thought of another thing! Apparently I have feelings about this.

In my experience, it is always better to be honest than to act like you know something you don't know. Being calm is the most important thing, but it's cool to admit that this is something outside of your comfort zone or whatever. "This is a really hard thing and I'm not sure what to do or say, but I care about you and I'm going to be with you right now." Something like that. We know it's hard, and it's better to acknowledge that than worry about putting on a perfectly brave, perfectly competent, perfectly whatever facade. But for the love of pete stay calm.

[Whistler]

thanks for the run-down! you'd think with a degree in psychology I'd know all this stuff, but I don't. Baby steps!