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Friday, August 15, 2014

Suicide Prevention Tips from a Survivor

[Today's guest post by Sarah Terzo is part of our paid blogging program. Sarah is a pro-life atheist, a frequent contributor to Live Action News, a board member of the Pro-Life Alliance of Gays and Lesbians, and the force behind ClinicQuotes.com.]

The suicide of Robin Williams has shaken just about everyone, but for those of us who suffer with depression, bipolar disorder, or other mental health issues, it is especially hard. I want to address the difficult topic of suicide from the point of view of someone who has struggled with it. First, I’m going to talk about some reasons why you should't do it. Second, I’m going to walk you through what happens when you reach out for help.

There are many, many reasons why a person should not commit suicide. I’m going to talk about just a few.

Reasons you shouldn’t do it. 

Suicide is devastating for the people who love you. Any death is tragic, and everyone has loved ones who will mourn their passing. But suicide is so much harder for people to deal with. It brings up such intense emotions of guilt (Why didn’t I stop her/him? Why didn’t I see it how depressed she was?) anger (how dare he do that to us) and intense grief. Also, when a person commits suicide, it becomes much more likely that one of their loved ones will do the same. Copycat suicides are a real phenomenon. Studies show that family members of suicide victims are more likely to commit suicide themselves. Even for people who are not close to you, there is an impact. You can leave behind a legacy of suicide. If any of your friends struggle with suicidal feelings, it will hit them especially hard.

A book I read once said that suicide is like throwing a hand grenade into a room full of people who know you. You can’t control who will be hurt or killed by the shrapnel.

You might fail at suicide, and things could get a lot worse. The truth is, the majority of suicide attempts fail. You might survive your suicide attempt, and be left with long-term, life altering health problems. Every form of suicide can leave a person permanently damaged rather than dead. Taking pills can destroy your kidneys and liver. Hanging can cause permanent brain damage from lack of oxygen, leaving a person mentally disabled (what callous people call “retarded”) and far worse off than they were before. Jumping can shatter your bones and leave you permanently paralyzed. And guns–let’s not even go there. There is no form of suicide that is 100% guaranteed to result in death.

You will never know if things would’ve gotten better. No one knows the future. Things could get better. Especially if you seek help. One thing about depression is that when you are in it, it seems like it will last forever. That’s one of the symptoms of depression, one of the lies it tells you. You tend to believe that you will be miserable for the rest of your life and that suicide is the only way out. For the vast majority of people, that isn’t true.

Reaching out 

If you are feeling suicidal, call a friend. If you don’t feel you can do that, call a hotline: 1-800-273-TALK (8255). Or you can do an online chat at SuicidePreventionLifeline.org. There is also an excellent forum where you can post anonymously about your suicidal feelings and get support, SuicideForum.com. It’s an active forum with an online chat room where you can get support for your suicidal feelings and give support to others.

If you are about to do it–if you’re at the point where you feel you can no longer fight your suicidal feelings, when the temptation is overwhelming, and you know you can’t fight anymore–you have to do the bravest thing you may ever have to do in your life. You have to call 911.

This is an intimidating thing. I’m going to walk you through exactly what happens if you call 911 or the police to help yourself, or if someone calls them on your behalf. That way, if you find yourself in the situation, it won’t be quite as scary.

First of all, I have a friend who works as a 911 dispatcher. She told me that the training manual they all study has an entire chapter on dealing with people who call because they feel suicidal. It’s okay to call 911 if you’re feeling suicidal. People do it all the time. The 911 operators are trained as to what to do. The operator will ask you a few questions, do you have a weapon, do you have a plan, etc., and then she will send someone to come and talk to you.

Police and paramedics will come. They will ask you to come with them to the hospital. You will not be put in handcuffs or a straitjacket. You will not be locked up and put in the back of a police car. The only exception to this is if you threaten the police or become violent towards them. They are not there to arrest you and lock you up–they are there to help you. As scary as this is, as hard as it can be–if it saves your life, it’s worth it. Think of your loved ones. Think of it as a gift to them and yourself–you are going through this in order to save your life and spare them the pain of losing you.

So what happens next? Well, they’ll take you to the hospital. At the emergency room, they will put you in a room of your own and you will wait for a psychiatric evaluation. The nurses and doctors will check in on you every now and then to make sure you’re safe, and they will probably take blood. This helps them check to see if your depression has a physical cause–for example, a thyroid disorder can cause depression. They may also ask for a urine sample. This is a good time to tell them about any prescription medicines you are taking and any health problems you have.

Here’s a tip–you’ll probably be waiting in the emergency room for a long time. Once they know you’re safe, the doctors and nurses will be busy dealing with people who are having heart attacks, strokes, or who come in with serious injuries. You will have to wait until these people are treated before you are screened. I recommend that before the ambulance drives you to the hospital that you grab a book or something else to keep you occupied. Because it can be hard to sit in the ER for hours with just your own thoughts.

When you are screened, a psychiatrist or psychologist will sit down with you and ask you about your suicidal feelings. It’s a good idea to be honest. After all, you’re getting help, and you won’t get it if you’re not honest. Tell him or her the truth. Some of the questions he will ask you include, do you have a plan to commit suicide? Have you ever attempted before? Do you suffer from any chronic mental health issues? Are you under the care of a counselor or psychiatrist? (If you are, they will usually notify them.)

The screener may decide that you’re okay to go home. Or, he may think that you need to be somewhere to keep you safe for the next couple of days. If this happens, he or she will offer you a chance to go into an inpatient unit. As long as you are cooperative, you will usually be placed in this unit voluntarily. This means you will be able to sign yourself out as long as they don’t think you’re in imminent danger of committing suicide. Occasionally, if they are really worried, they may give you an ultimatum–as in, we think you are in danger, so you can go in voluntary or if you resist, we will commit you. Go in voluntarily. If you become violent, or if they think you are in so much danger that you need to be watched constantly, they may commit you. This is an extremely scary thing–but even if they do commit you, there are very strict laws about how long you can hold a person without giving them the option to leave on their own. They will not lock you up and throw away the key. It’s unlikely that this will happen if you come in voluntarily, however. It usually only happens to people who are taken in against their will, who just made a serious suicide attempt, or who are violent and abusive toward staff.

It’s a very scary thing to go to a psychiatric hospital. But the truth is, it’s not so terrible. It’s something you can survive and get through, and it might help you. First of all, you can rest assured that no one has to know you were hospitalized unless you tell them. There are very strict laws about this. They won’t tell your parents. They won’t tell your boss. They won’t tell anyone unless you give them written permission to do so. If, while you’re inpatient, someone calls and asks for you, even a close friend or family member, they will tell them that they can’t confirm that you are in the unit. They give out no information about patients unless you sign a waiver saying that they can. If a nurse or mental health worker tells someone you in the unit without your written permission, she or he will be fired and the hospital can be sued. They won’t risk that.

Things that happen in the hospital 

You will meet with a psychiatrist. He or she will want probably to put you on medication, probably an antidepressant, if you’re not already on one. Taking psychiatric medication can be very helpful. It will not change your personality, it will merely, in most cases, cause your depression to lift or at least become more manageable. Sometimes it takes a little while to find the right medication, but it can definitely be useful tool in fighting depression. No one has to know you are on psychiatric medication unless you tell them.

You have the right to refuse to go on the medication. Even if they pressure you to agree that you will take it while you are in the hospital, it is always your choice to continue taking it when you get home. No one can force you to be on a medication long-term.

You will go to group therapy. In some hospitals the sessions are mandatory; in others, you can choose whether or not to go. These groups will allow you to talk about the things that brought you to the hospital. They will be led by a psychologist or mental health professional. If you feel you can, you will be given the opportunity to share openly among people who often can relate to the issues you’re going through. You will probably never see these people again, unless you choose to keep in touch with someone, so you can be free to be honest. In other groups, they will teach you about different aspects of fighting depression, anxiety, and other issues. There may be an anger management group, a group on substance abuse, a group on handling suicidal feelings, etc. Some groups may be more helpful to you than others.

You will have a lot of downtime. Between groups, there will be a lot of free time. You can take advantage of the free time by journaling. Journaling can help you get in touch with your emotions and work things out. Usually they have a television on the unit, though since there are so many people there you probably won’t get a choice of what you want to watch. It’s a good idea have a book or two with you to read. You will not be allowed a cell phone, tablet, or other device while in the hospital. They will hold onto them for you until you leave. You can also sleep and get some rest.

The good thing to remember is that, even if your experience of the hospital is absolutely terrible, you won’t be there for long. The average hospital stay is 3 to 6 days. The days of long commitments and locking people up for extended periods of time are over. Nowadays, treatment at hospitals is geared towards getting you out and back to your life as quickly as possible. They will be watching for signs of improvement. Generally speaking, as soon as you can tell them that you no longer feel suicidal, they will let you go. Being in the hospital costs insurance money, and insurance companies don’t like to cover extended stays–sadly, that is another reason why hospital stays tend to be short. Oh, speaking of insurance–if you don’t have it, you can still go in the hospital–there are often a lot of different types of financial help offered such as Charity Care, for people in hospitals. And even if you do get stuck with a bill, remember, it’s worth it to save your life.

The other thing that the hospital will do for you is set you up with ongoing mental health treatment. If you don’t already have a therapist, they will find you one. They may tell you where you can get more group therapy, if you find it helpful. They may tell you about support groups you can go to in the community. They will set you up with some kind of long-term treatment so that you can continue fighting your depression outside the hospital. They will not send you out of the hospital unless you feel ready to go and you have a place to go to for ongoing treatment.

This is the basic story of what will happen if you call 911 or friend calls 911 on your behalf. My hope is that if you need to get help, this article will make you more willing to do so. It’s easier when you know what to expect, when you’re not heading off into the unknown. Reaching out for help is not a sign of weakness. Rather, it is a side of extraordinary bravery and strength. Asking for help does not mean you are a weak person–it means you are strong person. Everyone needs help throughout the life about certain things. Accepting this, and reaching out, is tremendous sign of maturity and courage. Your life is worth fighting for.

11 comments:

JDC said...

Great post. I wish I could say more than that, but that is all there is to say.

John Whitehead said...

An amazing piece, on a very important subject. I have been lucky enough never to suffer from serious suicidal feelings, but I have vivid memories of friends and others who have been through these kinds of experiences. Thanks for writing this.

Coyote said...

Thank you very much for writing this article.

Ann Morgan said...

The problem with anti-depressents here, is that you are making a big assumption that the person has no valid reason to be depressed. That is not always the case, and a chemical solution is inappropriate and ineffective for an existential problem.


Also, your 'hospital' is going to make things worse for most people, by putting them seriously in debt.

sarah5775 said...

I agree with you that medications are not always needed to treat depression.

This post was based on my personal experience. I am talking to people who have just taken steps to end their lives or who are absolutely about to end their lives – in those cases, going to the hospital is much, much preferable to death. In some cases, it may put a person into debt – but debt can be managed. Death cannot.

conversate said...

Is it ethical to force suicidal rape victims to give birth?

prolifemama said...

Sarah, wonderfully informative post. My dad was a psychologist, so I know the benefits of counseling (great getting listened to for free, too! :)
I am very interested in what kind of a response you'll give "conversate", who replied a day ago to this post, asking the question "Is it ethical to force suicidal rape victims to give birth?"
Thanks again for sharing this valuable information, especially since you've experienced this situation firsthand.

fiona64 said...

a frequent contributor to Live Action News

Hardly a upvote for journalistic integrity, despite the importance of the topic.

Nevertheless, I appreciate your sensitive discussion of a difficult subject.

fiona64 said...

And that's to say nothing of the fact that Big Pharma has known for *decades* that those meds only help about 13 percent of patients ... and that they cause significant side effects that may become permanent.

A couple of sources: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2253608/?tool=pubmed


http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0050045

conversate said...

Of course, you have to wonder if the concern for suicidal people extends to pregnant rape victims:

http://whyevolutionistrue.wordpress.com/2014/08/18/catholic-barbarity-in-europe/

Leaven for the Loaf said...

Thank you for putting down a straightforward guide to dealing with the crisis moment. I only wish we could all depend on prompt screening. When someone dear to me was in desperate shape, I called the local community clinic, which referred us to the nearest general hospital. Screening resulted in admission with a three-day wait for a fifteen-minute session with the psychiatrist who "rides circuit" in that area, covering the hospitals that have no behavioral health unit. My loved one spent those three days in a safe environment, and was treated kindly, but it was a long wait. Still - the most important thing he did in a low moment was call and say "I need help." He's alive and well because he made that call.