This is a very sweet story about Anthony Bourdain that I ran across this morning. It’s about his championing for, not just people in parts unknown, but in our very heart of America.

I know I’m not the only one out there who is still very rattled by his suicide and this former Psychiatric RN, sister of a schizophrenic brother, and daughter of an often depressed father, has some things to say.

The continued posting of these “reaching out” memes and comments, although may be helpful to some, is a superficial response to this complicated issue of suicide. And, in some cases, it can make things worse for some people.

Depression with suicidal ideation has its own set of complex symptoms. Like a heart attack does–and, similarly, many of them are universal and identifiable. As heart attacks have warning signs like chest pain and pain down the left arm, so does suicidal depression.

One symptom of that kind of deep despair is that people have a clouded set of thoughts–that they truly start to believe that the world is conspiring against them and that their presence is detrimental, not only to themselves, but the world at large including their own loved ones. These symptoms become very real in their minds. They are not excuses or weaknesses or made up stories. THEY ARE SYMPTOMS OF THIS DISEASE.

One thing that can help ground a suicidal person is reminding them of this. That these thoughts are not who they are, but symptoms, just like chest pain is a symptom of a heart attack. SYMPTOMS THAT CAN PASS. Another symptom also being, that these symptoms will never pass. Do you see the drain they circle in?

One reality check I have given, even to myself, is “you are likely feeling that this is never going to end, and that is a symptom of the disease process you are immersed in right now, and even that set of thoughts is going to pass.” This helps to distance somewhat from the pervasiveness of it. Even for a second, a shift can begin, a life raft can be seen in the distance.

 Encourage them to look for change, even a change in a momentary thought or feeling–even if the change is a different kind of pain, but still pain. Change can equal movement out of what feels like a devastating stuck pit that will remain forever. The slightest change, can signal to the deep psyche that evolution is possible even when it has not registered yet to the conscious mind.

Expecting someone experiencing the throes of that kind of immobilized, pervasive symptomology–to rail against it completely and be able to reach out– is akin to asking someone in the throes of a full blown myocardial infarction to begin CPR on themself.

There is so much more than these trite “reminders” or “admonitions” to suicidal people to “reach out”. I think more has to be educated to THE REST OF US, to reach in. How to do it, what to say, when to intervene, how to intervene.

I’ve had to do it with my own family acutely for the last several years. Identify those moments when it is time to take over for them–get them in the hospital or to a doctor for medication. Not to “encourage them” but to simply sweep them up and say “we are going, now”. For both my brother and my father. Psychosis and depression have plagued my family my entire adult life. I know this world intimately. I have had to find and realize the strength to sit right there in a hospital or doctor’s office and say the words for them that they cannot say. Words like “he is hearing lots of voices telling him to harm himself” or “he is experiencing significant depression right now”. Words they were unable to utter, again, because they were consumed with the actual disease (or embarrassed, or in denial, or…).

So what if you get someone to be evaluated who ends up not hospitalized or deemed in need of that? It’s the same as if you take someone to the hospital who, may be having a heart attack, but in reality is experiencing indigestion. Ok, now you know. Now you’ve done something. Now you’ve communicated to them that they are not going to have to manage this distress alone.

And, yes, there are the Histrionics who cry wolf and have a whole different kind of mental illness issue going on, but don’t let them inhibit us and let the rest slip through the cracks. It’s pretty easy to discern these things when we are honest with ourselves.

People are often afraid to take action when mental illness is involved. I moved my brother to Arizona for that very reason–people where he was living were not taking action and he was drowning. He would not have survived it, and I could see that clearly. I could see it because I was not suffering in the ways he was. He is thriving so well right now, because he has a coalition of caring people watching him, every day. But that took years to craft and is still always being crafted.

None of us are afraid to step in and call 911 or start CPR with a person who is choking or having an obvious medical emergency. We need to get better with this when it comes to mental health. This responsibility should not solely rest on the acutely ill patient–I believe it rests more on the rest of us. We need to know more and have more encouragement to act. I’ve yet to see the memes instructing loved ones to call a suicide help line for someone they may be worried about.

Don’t get me wrong–no one is responsible for the devastating choice of suicide of another, just like no one is responsible for another person’s heart attack.. YET we need to understand it better and have deeper and more global interventions and take more steps to unburden our loved ones who are suffering before this becomes their only option. We need to find more oxygen masks, and use them. To unabashedly be unafraid to slap that right on their face and tell them to inhale. Then find people to take care of them, until they can breathe on their own again.

#reachin