Sunday, September 9, 2018

The black dog—How to talk about suicide and mental health


I tried to commit suicide when I was 17.

For 10 years, I’ve been carrying around this secret, and recently, I felt the need to share it. I usually don’t share this because I don’t want people pitying me or thinking I am incapable or overly emotional. But I do recognize that in recent months, there have been a string of high-profile suicides and a growing conversation on teenage suicide.

Before I go on, I want to assure everyone who is reading this that I am absolutely fine now. I’m happy with my life, and I have the emotional skills to handle anxiety, depression, and trauma.

I realize that talking about this sensitive issue is something that could potentially save lives and ease the suffering of those who have been affected by suicide. If we don’t talk about it, people won’t know what to do when this plague affects their lives. It’s time to break my silence.

DISCLAIMER: I want to make it clear that this post comes with a mild **trigger warning**. I use a series of personal anecdotes which include the details of my internal struggles. Understandably, these experiences might be disturbing to some. The purpose of this post, however, is to give hope to people who are struggling with depression and support the loved ones of people who are depressed. I speak only from my own experience, and I cannot speak for others.

I won’t speak explicitly about how I tried to kill myself or other things that were deeply traumatizing. I want to avoid triggering anyone who is vulnerable and susceptible to hurting themselves. I also want to be clear that I have forgiven anyone who mistreated me and I do not harbor any hard feelings against them.

Please use your best judgment in deciding whether or not to proceed.

My journey

Before getting to the point of this post, I would like to share a few words about my journey through depression as a 17-year-old.

I have struggled with anxiety and depression for most of my life. It usually comes in episodes that last a few months, and in some cases, over a year. I’ve gotten to a point where I can manage it comfortably, but that hasn’t always been the case. My most intense episode of depression started when I was 16 and lasted a full year, ending with me being hospitalized in an emergency psychiatric unit for adolescents.

Throughout that year, I had gone through some intense relationship struggles. My aunt had died. I had started dating for the first time, and the first boy I had dated had been severely emotionally abusive to me. I started dating someone right after that relationship had ended, and that relationship fell apart as well. I had been so emotionally damaged from the first relationship, that I did not have the emotional skills to deal with the second. On top of that, the friends of the boys I had previously dated began to bully me. Soon after, my own friends and acquaintances started to bully me.

Finally, one morning it all came crashing down. Someone said something unkind, and it was the straw that broke the camel’s back. I was sick of not sleeping. I was sick of feeling like I wanted to crawl out of my skin. I was sick of crying until I had a headache every day. I was sick of feeling like I didn’t deserve to live. I was sick of being so angry all the time. I was sick of begging God to take away these feelings of worthlessness. I was just done, and I had hit rock bottom.

The best part about being at rock bottom, however, is that you have nowhere to go but up. By some sort of miracle, some true friends found me in time and called an ambulance. They saved my life. And if I’m going to be completely honest—this experience was the best thing that ever happened to me. I would not trade it for anything.

I don’t want anyone to believe that you have to go through these things to heal—none of this should have ever happened, and I would never wish it on anyone else. But the reality is for me, it did happen, and I was able to learn from it.

Of course, there were some bright spots throughout this whole experience. I had a great Spanish teacher, math teacher, and seminary teacher, who all reached out to me. They called my parents to let them know I showed up to class in tears every day. I had two amazing friends who by nothing short of a miracle found me and called the ambulance. I am so very lucky to have a family who loved and cared about me enough to be involved in my life.

After this episode, I was able to get the help I needed. The hospital I went to had the most validating people to talk to. I was able to unload everything that had been bothering me throughout that year in one week without feeling judged. I had some great therapists, and I was able to learn coping skills that I still use to this day.

This experience made me into a person whom I now love.

I want to point out that people do not kill themselves because of their circumstances. They kill themselves because they don’t have the emotional, mental, and social resources and support to deal with those circumstances. This was very much the case for me.

I didn’t have the emotional maturity to deal with the relationships that exploded in my face; my mind was in a fog from the depression and anxiety I suffered with, and my poor parents and teachers (who must have felt so helpless) didn’t know what to do with me. As an adult, I realize how overwhelmed the adults in my life must have felt, and I am so sorry they didn’t have the information on what to do. I’m hoping this post can help point people in the right direction to get help.

What to do about depression

The point of this post is not to tell you how to live your life. If you are someone who struggles with suicidal thoughts—I am not a doctor, therapist, or an expert of any kind, and I have no authority to give such advice. My goal is just to share what has helped me and to provide you with a hope that things really do get better with time.

I’ve also included a section for people who have been affected by suicide and who are possibly having a hard time grappling with it. Again, it is not my goal to tell you what to do. I fully recognize that my suggestions are not the silver bullet to all of these problems—and there are probably a million things other people can add.

First off, to those who have struggled with depression, suicidal thoughts, or anything related to it:

#1 Your life has meaning

You are not the first person to go through this.

You will not be the last person to go through this.

You do not have to go through this alone.

Whether or not you can see it right now, there are people who love you. Whether or not you see it, your life has immeasurable value. You are wanted and needed—even if you can’t see it.

I might not know some of you who are reading this right now, but I have an unshakable knowledge that you are valuable, and you have worth regardless of the good or bad you have done in your life. I know that your life can change, and it can get better.

Keep holding out until it does.

#2 Ask for help

I will admit, throughout my struggles with anxiety and depression, not all of the advice and help I got was helpful. I had a lot of well-meaning friends and family members who would try and help but sometimes ended up making things worse. However, not asking and never getting help is worse than getting help that is hit or miss.


It’s all too often hard to see when you’re struggling with your mental health how the people around you feel about it. I remember spending so much time wondering why people didn’t reach out to me or didn’t understand how I felt until after I came out of an episode of depression. I realized that my symptoms weren’t as evident to others as they were to me, and I had to learn how to talk about what I was feeling.

I understand that asking for help and talking about your feelings is easier said than done. Nonetheless, you are worth helping, and the people around you have the responsibility to listen to you and validate how you feel.

#3 Find a therapist that works for you

The first step is talking to someone. Talking to someone who is trained to know what to do about depression works miracles. There are no off-limits conversations with a therapist—you can talk about anything without fear of judgment. And just so you know, it’s okay to go to multiple therapists. If you find that one just isn’t working out or you don’t connect, find one who does.

I remember through my bout of depression as a teenager how often people would give me advice but zero instructions on how to do just that. Therapy was a complete 180 turn for me. Suddenly, instead of people telling me “to just be happy,” I had a therapist who listened to what was bothering me but didn’t judge me for how I felt. That same therapist would help me break down my thoughts and feelings into bite-sized, manageable portions, and then we would work through each one. Therapy had given me tangible instructions for dealing with my emotions.

Sometimes therapy can be hard. I remember having a friend who suffered from severe trauma. She was encouraged to go to therapy. She’d periodically came back to me to tell me how it was going, and she said that she didn’t realize how much trauma she had on lockdown. Talking about it sent it spewing out, and I suspect that was very painful for her.

I’ve had similar situations where a therapist challenged me, and it brought up a lot of things I never dealt with. In the end, it has been so good for me to have that challenge.

Keeping things hidden doesn’t mean they are taken care of. Learning how to talk through them will help you when you are faced with similar situations in the future. Also, remember: It’s a process. It takes time to work through these things.

#4 Talk to a doctor

Depression (as well as other mental health issues) is just as much a medical problem as other diseases. Depression is no more an “attitude problem” than leprosy or cancer—while positive thinking and pulling yourself up by your bootstraps are great things, an attitude change won’t necessarily fix a disease.

I can’t say I’m an expert on all of the science behind the issue, but taking medical intervention can really help. This can come in many forms. For me when I’ve been depressed or anxious, medication has been able to make my mind a lot less foggy. It freed up my mental energy so I could work through my problems. It might take a long time to find one that works.

My doctors, among other things, have also recommended exercise to relieve some of my anxiety or getting to bed at an earlier time.

I want to point out that medication is not the silver bullet that will solve all of your problems. But research has proven time and time again that medicine paired with therapy has the best results. (Although, you should speak to your therapist and doctor for the best course of action.)

One last note about therapy: One of the most important skills I’ve learned for helping me avoid feelings of crisis and managing my mood long-term is self-care. In therapy, you’ll often learn techniques to help you move through a moment of crisis, but one of my therapists also taught me that self-care is a way to reduce your crisis moments (or at least make them more manageable).

I think there might be a misconception about what self-care is—it’s not just treating yourself to artisan chocolates and luxurious bubble baths (although those are great, and I thoroughly recommend them). Self-care means actually taking care of yourself—exercising, meditating, expressing self-love, being kind to yourself, getting enough sleep, etc.  

#5 Spirituality is key

My journey through depression has been a profoundly spiritual one. I was raised in a family that taught me to believe in Jesus Christ, and I am so grateful for that constant belief I could hold to. Although I can’t ever say that I fully understood what it meant to me until just after my suicide attempt.

In my religious community growing up, I always heard things like “God loves you,” and “Jesus Christ died for your sins,” and “Trust in the Savior’s atonement.” (In Christian theology, atonement is a word to describe the sacrifice Christ made on the cross making it possible for all of us to be forgiven of our mistakes and be resurrected after death. In my particular faith, we also believe that it was intended to help heal us from the pain we suffer in this life).

As I started to go through depression as a teenager, I began to resent when people would tell me these things. I remember regularly getting on my knees and begging God to take away my depression. I remember praying, “If you really loved me, you would not let me suffer like this. What did I do to deserve this?”

After my hospitalization, my relationship with God had improved, and I began to receive answers, but it didn’t happen all at once. Slowly I started to understand what people meant by “Trust in the atonement.” My therapists had been telling me that pain is inevitable, but suffering is a choice. After my suicide attempt, it clicked that my Savior suffered my pains so I would not have to. I would always have setbacks and trials in my life, but I could choose how I was going to react to them.

But an even bigger answer came to me years after my suicide attempt. I was serving a mission for my church, and I came across a story in the New Testament that touched me like never before:

“And as Jesus passed by, he saw a man which was blind from his birth. And his disciples asked him, saying, Master, who did sin, this man, or his parents, that he was born blind? Jesus answered, Neither hath this man sinned, nor his parents: but that the works of God should be made manifest in him.” John 9:1-3

I had spent so much of my life thinking I was defective because of my depression and anxiety. I thought I brought it on myself because of my mistakes. I believed that I was defined by these mistakes and my condition.

These verses made me realize that I was the vessel for a glorious miracle. My depression doesn't define me, but the miracle of my healing does.

I feel like the Lord has blessed me immeasurably by allowing me to live in a day in age and in the position where I can receive medical and emotional help. I feel blessed that we have a good relationship with each other. I realize this is not the case for everyone—I feel indebted to Him, and I want to provide others with these opportunities as well. I hope that this post serves as a source of knowledge for those who don’t know where to go.

I also realize that not everyone has the same beliefs as me, and I absolutely respect that—we’re all on different journeys, and I have always found beautiful and profound truths in everyone else’s beliefs. I merely want to stress the importance of nurturing your spirit in the face of depression.

The act of being spiritual is learning to connect with yourself, others, and the universe around you. It’s connecting to the things that are bigger and grander than yourself and allowing them to shape you.

I often look back on my episodes of depression and anxiety and realize how foolish I was to think I could do everything myself and that everything depended on me. I caused myself so much anxiety and pain thinking I had to do everything perfectly, and I hated myself everytime I failed at those things. I thought my mistakes sent the universe out of balance and that I was a broken vessel that could never be repaired.

The day I realized that all of this just wasn’t about me changed my life. I depended more on God and the people who loved me. I recognized not everything was my fault. I learned to forgive myself for the things that were.

At the end of it all, I still had trials, but nurturing my spirit gave me the strength and hope to ride the wave instead of fight against it.

Nurturing your Spirit can look like a lot of things: praying, meditating, serving others, scripture study, getting out in nature, reading good books, seeking truth, engaging in your community, engaging in art and music—the list goes on. When you’re hurting, it feels like you’re so tightly focused on all that is wrong in your life, but nurturing your spirit helps relieve that grip. And as you focus and connect with the people and universe around you, the context of your own life becomes clear, and you find meaning and purpose.

#6 Learn to forgive unconditionally

This is very much related to the last point. Nurturing your spirit means letting go of the things that hurt you.

There’s a big misconception about forgiveness. Forgiveness in no way implies that the mistreatment, violations of trust, and mistakes you have suffered at the hands of others are in any way right or good, it simply means you have chosen not to let others mistakes define you. Forgiveness means learning not to suffer for other people’s mistakes.

And just so you know: You do not have to have a relationship with people you have forgiven. Having boundaries is okay. Also, it takes time to forgive. Be patient with yourself on that process.

A friend once explained forgiveness to me by saying, “Holding a grudge is like drinking poison and waiting for the other person to die.” Holding onto your anger hurts you the most. Your anger will define your life and your actions, it’ll take control of your thoughts, and it will make you miserable. And the reality is that the person who harmed you may never care to apologize to you. You cannot control their life, but you have the power to determine your own path. Forgiveness will empower you.

Sometimes forgiveness is not just about forgiving others but also forgiving yourself. I am no expert in this, but I do know that we all make mistakes and we all want to be forgiven. I also know that our mistakes do not define us. Learn to love yourself. To quote someone I worked with about a year ago, “Be kind and know you are loved.”

What to do about someone you love who is depressed

I’ve been on both sides of this struggle, and I know how hard it can be. For those of you who love someone who is struggling—especially if you’ve never struggled with depression or anxiety yourself—it can be hard to understand. The purpose of this section is to help you understand the people you are trying to help as well as give some ideas on how you can be most helpful to them. I also recognize loving people with mental health problems can be difficult, so I added some points to help you take care of yourself.

#1 It’s not your fault

One thing I have learned from my experience with depression is there are a lot of things which are out of your control.

You cannot control other people.

You cannot make people do the right thing.

You cannot take away your loved one’s suffering—you can only walk beside them and help carry their load.

It’s not your fault.

As good of a friend or family member as you may be, the responsibility to work through their problems is theirs alone. It is only your responsibility they do not go through it alone. Even if you make mistakes, be there for them, and realize that this is their journey.

#2 But that’s not to say your words and actions don’t matter

What you say and do does matter. Learn as much as you can about depression and what the afflicted person is going through. That will give you a good starting point to know how to talk to them.

Learn about the things you might say and do (even if you are well-intentioned), that aren’t helpful to them. Learn how not to judge them. Learn about why they might be more sensitive to some things than other people are. Be gentle and understand that you don’t know everything that is going on with them.

I remember in highschool I went to my guidance counselor to tell her what was going on. I had spoken with her before, but I hadn’t had much luck—I couldn’t ever seem to talk to her without being interrupted—but this was a particularly negative experience. As I was trying to explain how I felt, she stopped me and said: “If you want to know what real problems are, you should go and volunteer in a rape crisis center.”

This did nothing but shatter the trust I had in her. I came to her in a vulnerable moment, and her words and actions told me “Your feelings don’t matter. You don’t matter. I don’t have time for you.” The only time I went back into her office after that for 5 minutes to clear my name for graduation.

Keep that in mind. The next few points are ways you can be more aware of what depressed people are feeling, and what you can do about it.

#3 Stop. Giving. Advice.

Seriously. Stop it.

Before I get to the meat of this point, I need to clarify one thing. Unless you are a therapist, doctor, or spiritual leader, you are not qualified to give a mentally ill person advice. And if you are one of those people, you can ONLY give advice on the subject you ARE qualified in.

For example, if you are a priest and someone comes to you for help, you are ONLY qualified to give spiritual advice. Acting as a therapist or doctor when you have no training can have serious consequences—please refer them to someone who can adequately treat the medical and emotional side of the disorder.

Also, a lot of the advice—however well-meaning it might be—usually misses the mark. I remember when I was going through my worst bout of depression, I can’t even count the number of times people told me to “Just be happy” or “Don’t take things so seriously.” And really, if it were that simple, I would absolutely have chosen that route, but depression is so much more complicated than flipping a switch and “being happy.”

When you are depressed, it seems like you live in a world of unsolicited advice, judgment, and shame. I distinctly remember feeling like I could never properly verbalize what I was feeling because it somehow got deflected by someone telling me to “just be happy," or someone saying “It’s not that bad, you’re being too sensitive,” or someone insinuating that the reason I felt the way I did was because I did something wrong. I always felt like there was some painful, invisible object inside of me that I needed to pull out, but couldn’t.

I remember the first time I felt validated was with the crisis worker in the ER after my suicide attempt. This was after a full year of being depressed. I remember this older lady with bright red hair holding my hand as I sobbed. She said such soothing things like “I’m so sorry that happened to you,” “That really must have felt bad,” and “I’m sorry that you’re so sad.” Everything she said led me to believe that she actually seemed to get what I was saying.

It was the first time I remember where I didn’t feel like someone was interrupting me or minimizing how I felt. It’s like that invisible object that I couldn’t seem to get out of my body just vanished.  

#4 Learn how to listen and serve the person who is suffering

With everything in mind from the last point, one of the best things you can do is learn how to be an active listener. Learn how not to interrupt. Learn how to ask good questions. Learn how to show compassion and empathy for their situation, even if you don’t fully understand it.

There’s a unique element to this kind of listening: It’s called validation. Learning how to validate people’s emotions takes some practice. It does not mean accepting without question everything they do and feel as perfect and with no need for change. Validation is being a non-judgemental listener and verbalizing that the other person’s feelings are valid.

I’ve heard plenty of people say that they can’t validate someone’s emotions because that other person is doing things “wrong.”

This type of thinking thoroughly misses the point of validation.

Validating someone’s feelings means regardless of whether or not you like the other person’s actions or how they live their life, that you acknowledge that the person’s feelings are hurt. You do not, under any circumstance have to accept or love that person’s actions.

For example, if someone were to cause an accident and gets a concussion, you wouldn’t ignore their injury and instead lecture them on their driving habits. You would acknowledge that they were injured and call an ambulance. The same principle applies when you need to validate someone. You don’t have to validate what they did, but you do have to validate how they feel. And you have to validate EVERYONE. There are no exceptions.

You focus on the feelings of the person, not the person’s situation.

It’s also important to understand that while someone who is depressed needs to talk and communicate so they can begin their healing process, you should never pressure or force people into talking to you—that can cause a lot of damage. Merely be available for them if they need someone.

You cannot be everything for your loved one who is suffering, but you can serve them. I still have vivid memories of small kindnesses people showed me when I was depressed: People sending me cards, letting me play with their puppy after school, sending me kind text messages…

These people may never know how much those things meant to me.

By far, the best thing you can do to serve someone who is suffering from depression and anxiety is to express and show your love frequently. Always tell them how much you love them, and when you’ve done that, show them.

#5 Educate yourself about depression and mental illness in general

Most of the time when I tell someone that I’ve struggled with depression, I get this response in return: “Really? But you’re always so happy!”

I know that people are very well-intentioned about this, but I don’t like this reaction. This response means that as a society, we don’t actually know what depression looks like.

Take a look at the person you see in the photos I included in this post. Each of these photos represents a time in my life where I really struggled with anxiety, depression, and crippling self-hatred. Outward appearances do not give you an accurate picture of what is going on in someone’s life.

You will have an increased ability to help people who are struggling with depression if you know more about it. Let me give you a small crash course:

  • Depression doesn’t just look like someone who is sad and despondent all the time. Depression can manifest itself in sudden bursts of anger, mania (excitement), and other ways. Sometimes depressed people can seem pretty happy on the outside.
  • Mental illness is a medical issue just as much as it is an emotional or spiritual one. All too often, I hear people say that depressed people should “think more positively” or “eat more holistically” or “be more righteous.” And if they did, they would not be depressed. If it were so simple, no one would be depressed.
  • Depression is not the consequence of a bad moral character. Indeed, bad decisions like lying or cheating can exacerbate symptoms of depression like salt on a wound, but they are not the primary cause. Depression is a medical issue and a thinking disorder, and it needs to be treated as such.

This, of course, is not an exhaustive list. There are many other places you can learn about depression and other mental disorders like the NIH, Suicide Prevention Lifeline, or even from someone who has suffered depression themselves.

#6 It’s okay to have boundaries

I understand much of what you just read can feel overwhelming. We are all growing and learning at our own rate. For what you lack in perfection and expertise in helping your loved one, you can make up in love. Be kind to yourself on this journey.

But also understand that it is absolutely okay to set boundaries and it is okay to enforce those boundaries. You are also a human being with a limited emotional capacity. You do not have to sacrifice your own health, sanity, or safety helping someone if you are not capable of doing so. You are also not the only person who is capable of supporting them, and it is okay to shoulder that responsibility with people.

A wise person once reminded me of something in airplane safety videos. There is a part where they explain oxygen masks that might drop down in the middle of the flight if the cabin pressure changes. They make it very clear that you are to secure your own mask before helping others.

I’m sure many pure-hearted people are reading this who would instinctively go around putting a figurative oxygen mask on everyone who looked like they are struggling. But this wise person reminded me that I'm of no use to others if I'm passed out due to lack of oxygen. The same principle applies when helping loved ones with depression. Take care of yourself. Set boundaries. Put on your oxygen mask.

Conclusion

This post was not easy for me to write. When I started it, I didn’t realize how long it would be, how much emotional energy it would take out of me, and how much it would send me flashing back to my own episodes of depression.

As hard as this is to write, it is more important that we talk about rather than ignore it. I told my sister that I would be writing this, and she very wisely mentioned that there are so many people who do not know how to talk about depression. Consequently, they do not know what to do when it affects them. They often feel ostracized when they talk about it—depression and mental illness is still too taboo in our society.

Reader, you can change this.

So if you have read this far, I want to invite you to be more open. I want to invite you to seek help, ask questions, learn to listen, and—most importantly—learn to listen without judgment.

I also want to open myself up. If you need someone to listen or if you have questions about my experience, let me know. Text, email, message, or meet up with me. I am not a perfect person, but I want you to know that you are loved and you have worth. (Keep in mind that since I am not an expert, I cannot offer advice, but I’m happy to listen).

And finally, if you or someone you know is struggling with depression or suicidal thoughts, you can take action. A great place to start is the National Suicide Prevention Lifeline (1-800-273-8255). You can call or chat here.