Learning and Performing Under Pressure

*Trigger Warning: this post discusses suicide and suicidal thoughts. Please read at your own discretion.*

This post is for all mental health providers, professionals, physicians and dentists. I’m writing with a few people in mind- coworkers I’ve lost to suicide, and one that I admire deeply for being an attempt survivor and psychologist. Colleen, Scott, Austin, Jake and Don Ceo, this one is for you. The five of you were great to work with- I just wish it could have been longer. You were all awesome people in your own ways.

Josh, I’m so grateful you lived for many reasons, one being so that we could become friends. I had no idea what you’d been through right before we met. You’ve been able to help a lot of people in a career that you love deeply. I’m always here for you, but you know this.

The Research Is Out There

I had to do quite a bit of research for this post. I was aware that going into the medical field, no matter what specialty, comes with a lot of stress. Medical school, practicums, clinicals, theses, and other expectations can really throw a lot at a student.

That’s not counting other things that happen while in college and beyond- marriage, children, family issues, and so on. What happens if your thesis is thrown out? What if you don’t get the residency you wanted? What if your grades aren’t what everyone, including yourself, expected? So many questions and thoughts can run through a student’s mind. I wasn’t aware, however, of the statistics of physician suicide.

I’m using the term “physician” as a general term, but it is meant to cover all medical professionals. It’s a very stressful career. According to WebMD one physician completes suicide a day, making it the highest suicide rate of any profession. The general population rate is about 12.3 per 100,000, but in physicians, it is 28-40 per 100,000.

Many of these physicians have underlying untreated mental health issues. This shows a large need for early diagnosis, outreach and treatment. Up to 30% of residents have shown symptoms of depression. Depression is affecting up to 12% of males and 19% of females in this profession. It’s dangerous for anyone to ignore their mental health, and even more for those that care for us. More information about this topic can be found in The Dangers of Ignoring Mental Illness

The main, and possibly unique factors in physician suicide are:

• high demands/extreme stress
• competitiveness
• long hours/lack of sleep
• substance abuse
• stigma of seeking help because of fear of losing their job- this is a major issue
• access to lethal means- highly powerful medications
• patient deaths/malpractice suits
• burnout

You can read about the stigma of men seeking help for mental health issues in Men and Mental Health

What Is Being Done?

Many facilities and medical schools are trying to pick up on this important issue and help those that are struggling. Many physicians have lost a colleague to suicide, which is a feeling I know all too well. In their case, however, they don’t get the time to grieve. Male anesthesiologists are at the highest risk, according to Washington Post due to the medications they have access to. Like many others that die by suicide, many physicians are very skilled at disguising their feelings. They may appear happy but yet suffering on the inside.

There is a stigma within the medical community with seeking help for mental health issues. Many are afraid that they will lose their job and/or license. They fear that their care won’t remain confidential. Some go to different cities or towns and pay cash to keep from having to report to the state boards. They also have little time away from their demanding schedules to get the care they need. These physicians care so much for others, including their own families, they barely have time for themselves.

Facilities are beginning to create cultures in which employees feel comfortable talking about what they are dealing with, minus consequences. This shows physicians do have feelings, they are not robotic. They need to support each other. More research is being done in this area to help gather more understanding for the future.

Some facilities and schools are creating peer support groups so that students/employees feel less alone during rough times. Work/life balance is also being encouraged a lot more in workplaces. Medical schools are incorporating self-care into their professional development classes. They are also teaching classes on how to notice changes in their co-workers. This can be so beneficial. This information can be found on Physician Leaders

Experience Led Me Here

In a decade of work, I’ve worked with a lot of people in a variety of places. I never thought about someone I worked with completing suicide. Someone dying in a car crash? Maybe. Cancer or another devastating illness? Okay. For some reason, suicide didn’t enter my mind. It did when Colleen died, and to this day, I still can’t listen to anything by The Beatles without feeling sad. They were her favorite band, and “Let it Be” was played at her funeral.

The last mental health facility I worked at, sadly, has left me changed forever. One suicide occurred months after I started (Scott), then in 2015, two happened- less than a month apart. Everyone was incredibly sad- how does this happen? Austin and Jake are missed terribly by those that loved and cared about them, myself included. I missed Austin’s visitation and funeral because I was sick, but Jake’s was standing room only. He would have been surprised to see how many people cared about him.

Recently, another former co-worker from there died by suicide, and everyone is wondering the same thing- how does this happen? I don’t think there is an exact answer. It is hard to know what people go through daily, even when they seem well put-together.

A Message

Be kind. You never know what the person next to you is going through. They may not be in a deep depression, but might just be having a very hard day. If someone you know is struggling, do what you can to help, even if that’s just listening to them for a while.

If you’re reading this and you are a mental health professional/physician, please reach out if you need it. We need you.

Pics courtesy of Unsplash

Suicide and the Media

**Trigger warning: suicide and its terminology is mentioned in this post. Please use your own discretion in reading this post.**

Just about everyone has access to the Internet these days. If you’re reading this post, you have it, unless someone printed it out for you. The Internet is full of information- some of it is utterly useless, some is great. I’m constantly using it for research for this blog, because I admittedly don’t know everything about the topics I write about. That’s partially why my Resources page exists.

A High-Profile Life, But What Lies Beneath?

I choose topics for certain times for a reason- this is Suicide Prevention Week and I wanted to highlight how the media handles discussing suicide. Over the summer, two very high-profile celebrities, Kate Spade and Anthony Bourdain, completed suicide. Both were well known in their fields.

Kate was a very talented fashion designer and Anthony was a chef. It was known that Anthony struggled with substance abuse issues, but Kate was struggling privately. Before her death, she was seeing a mental health provider and taking medication. This does not equal the end of suicidal thoughts and/or ideations, as her death shows.

What does lie beneath?

How does the media handle this?

I read a lot. Some outlets are changing their wording from “committed suicide” to “completed suicide” or other phrases, which is a positive change. This is making suicide look less like a criminal thing (“committed” is usually a term used in criminal circumstances, and suicide is not a crime) and more of a personal term. The media still has a lot of work to do. The community still has a lot of work to do as a whole.

How Can Reporting and Discussing Change?

According to an article on Psychology Today there are ways that the media and community can do better in this discussion.

Leaving out the means or method of suicide. Personally, I think this is deeply disrespectful to speak about. I have been told the entire story of Jake’s death, but I’d never go public with it. He was a private person and I couldn’t do that. Plus, his family would be very upset with me.

Many suicides, like Jake’s, aren’t a story that people want to talk about. If there was a note, that is helpful to note, but not to include specific information. That is better left for the family. Basically, report the minimum and leave the deeper knowledge of what happened to the family.

Trying to avoid language that inflates the prevalence of suicide. This is one that I am trying to work on myself. I believe I said in a post that this is a heartbreaking epidemic. I may go back and edit it, but in case I don’t (because many of you know my memory is atrocious) please know that has been noted. I’ll work on that in the future.

When reading about suicide, some may think that this is an acceptable option to their issues. I don’t want anyone reading this blog to ever think that, because that’s what I am trying to avoid.

Focus on the deceased’s life- not just their death. I am a huge fan of this. This keeps their memory alive. This way, they are not remembered for how they died, but how they lived. This also means to leave out pictures of visibly upset friends or family, or photos of the scene. (Who does that?)

How Can Individuals Do More?

Continue the conversation. Some are afraid to talk about mental health issues and/or suicide because of the fear of stigma. The real change occurs, however, when people do talk. It makes a more comfortable climate in which to discuss these things and the stigma (hopefully) fades. This can help the discussion keep going after the news cycle ends.

Remember that mental health issues and suicide doesn’t discriminate.

Encourage that anyone that is having suicidal thoughts seek help. Also, if anyone you know needs other mental health assistance, please help them however you can. This may mean help with finding a therapist, transportation, etc.

The Crisis Text Line (text HOME to 741741) is available 24/7

National Suicide Prevention Lifeline 1-800-273-8255 (veterans press 1)

You can also go to a nearby ER or mental health care facility.

It’s a rough world out there, let’s make it a bit easier on each other.

Pics courtesy of Unsplash Pinterest

If This is You

This Is Me

I started this blog in August 2017 and is now a year old. It became an idea after losing one of the most important people in my life. I thought it was important that I share my story of grief, loss and coming back to life after losing Jake. I wanted others to know they aren’t alone in this loss, in this life.

The mission behind this blog has been to educate others about mental health, suicide awareness, and prevention. This is so that hopefully someone out there thinks again before attempting to take their own life. Jake did not, and having to live without him has been one of the hardest things I have ever lived through. I’ve often said two years was not and never will be enough.

My other hope is to help others so that another family does not have to go through the extreme anguish Jake’s family has been through- twice. They are a family of faith (mostly), and I’m pretty sure that’s what has helped them move forward.

No family should lose a child to suicide and somehow, this family has moved forward after losing two. Josh and Sara have been two of my biggest cheerleaders.

I cannot begin to explain the sheer devastation, sadness, and anger that I felt after his death. Some days are still hard. I still cry. I still have a hard time with the “why”. There was no note. There was no goodbye. I had to say goodbye to my blue-eyed Superman at his casket.

People have said that suicide is a selfish, cowardly act. I have never been able to believe this. I have lost others to suicide besides Jake, including an uncle, and my own father attempted when I was a kid (I was the one that found him).

I have no attempts myself. It is far from cowardly and selfish. Most that attempt or complete suicide are looking for a way to somehow end the pain they are in physically, emotionally, or even both.

While working in the mental health field, I’ve heard some incredibly sad stories about attempts and/or losing loved ones to suicide. It is a heartbreaking epidemic. I also don’t believe that people always show signs. I used to- but in light of a few deaths by suicide, I no longer do.

Some show signs and some are out of nowhere. Jake’s was a very sudden suicide, and while many of us left behind have our own thoughts on why, we will never know what exactly happened in the last few moments before Jake made the worst decision of his life.

Three years have passed since Jake’s death. I finished therapy, put myself (and my marriage) back together and am pretty much living my best life since before he died. I hope every day that he would be happy with the life I have. I hope he would be proud of me.

When he died, I made two promises: to live the life that he made me strong enough to live and to finish the work he started. I have done both. The first is a lifetime promise because I will spend the rest of my life being the strong person he helped me become. The second was completed the day I finished therapy.

If This Is You (Suicide Loss Survivors)

• My heart is so sad for you. This kind of loss is crushing. It will take time for you to heal, and it doesn’t happen overnight. It took a year for me to even begin living again. Take all the time you need to heal. If you need counseling, get it. If you need other changes, make them. Just don’t do anything you will regret. (I quit the job that I was working when Jake died, but that was a matter of my immediate mental health.) Take care of yourself.
• Find support. Those that are closest to you can be a great support, but sometimes support comes from the weirdest places. I met Sara at Jake’s visitation and we have become best friends. We’ve walked each other through a lot. There are support groups for suicide loss survivors. See the resources at the end of this post or my resources page.
• Find a healthy outlet. This can be a very good thing. My therapist suggested coloring, journaling and meditating. These helped my severe anxiety and depression. There are many ways to let out the emotions you are feeling- art, sports, music, etc. Talking can also be a great outlet if you have someone you can trust.
• Take the grieving process one day at a time. Sometimes it’s one hour at a time. I spent whole days in bed for months after Jake’s death. I also drank heavily. (Thankfully, I am now 20 months sober.) Some days will be great, some days will be horrible. There will be memories that shatter your heart for a long time, but they will pop up again and make you smile. Songs, scents, and other things will do the same. I cried my way through most of Taylor Swift’s music for months, but now I smile and sing along.
• If you want to get involved in something to make a difference, try the Out of the Darkness Community Walks. I’ve walked in Louisville since 2011 (off and on) and in 2015, threw a team together in Jake’s memory. I let Josh take over in 2016- he and his wife have done a great job with it. They changed it to Team Jake and Jared (for the brother they lost in 2002) and have raised a lot of money. There are other ways to get involved-this is just one.
• There will be a day in which you can tell your story and not cry. This does not mean you don’t care, it means you are healing. This shows progress.
• Healing does not mean forgetting. This can be a struggle.
• Know that you are changed forever. This didn’t really sink in for me until Jake’s death, but losing someone you care deeply about suicide will change how you see the world and others around you forever. I’ve become a lot more selective on who I let in my life and I had no problems cutting people out, including people I’d worked with and cared about for years.
• It’s okay to get counseling. Grief can get bigger than you think- I was in therapy within a month of Jake’s death. My therapist wasn’t a grief counselor but there are many. Grief can and will consume you.

I feel that those we lose remain with us in their own ways. Jake is with me all the time- cheering me on and making sure I don’t forget what he taught me.

At the AFSP Community walk in Louisville on 11/3/18. #ForMySuperman

World Suicide Prevention Day is September 10, 2018. (This is also my wedding anniversary. The irony.) If that is a rough day for you, as it will be for many, please know you are not alone.

Resources:

AFSP

NAMI

The Dangers of Ignoring Mental Illness

Mental illness can lead to difficult situations if left untreated, but yet millions do so. Why?

Reasons To Not Find Help

1. Shame. This leads many to hide symptoms. In many minority communities, mental health issues aren’t discussed very often, if at all. Those who do have issues are made to feel that something is “wrong” with them. You can read about this in Men and Mental Health and Breaking Down while Black.
2. Poverty. Many don’t have money and/or health insurance to cover the costs of therapy and/or medication. This can be another major stumbling block. I was very lucky in that I had insurance to cover two years of therapy for a very low co-pay. Julian is on state health insurance. It’s hard to get help when you can’t afford it.
3. Embarrassment. This is still a big reason that people avoid treatment. I’ve been very open about my struggles with mental health, drinking, and loss. Many people, however, want to hide that they have a drinking problem or anxiety. It makes them “look weak”.
4. Side effects from medications and/or not feeling comfortable with a provider. Side effects from psychiatric medications are less than fun. Some are so bad that people simply stop taking them. It’s recommended that they don’t without speaking to the prescribing doctor, but this is not always done. It also helps if you feel like you can open up to your mental health provider. If you can’t, it makes you less likely to want to go back. It’s okay to want to switch. There’s someone out there for you.

The Dangers Below the Surface

When you leave your mental health unchecked, things can go very bad. The things on this list are possibilities:

1. Worsening mental health status. As time goes by, your mind can go into some dark places if left unchecked. It may become harder to treat the issues. Longer and more intensive treatment may be needed.
2. Unexplained physical symptoms. Sometimes our bodies begin to show wear after a certain amount of time of not being cared for. Our muscles stay tense, sleep becomes restless or harder to come by, eating may become irregular.
3. Job and home instability. During a severe mental health episode, it may become difficult or even impossible to go to work. This can lead to losing a job and/or home.
4. Incarceration. During episodes, there may be behaviors that lead to arrests, like indecent exposure, assaults, etc. These would not occur otherwise but in an altered state, people may not think clearly. There are millions sitting in jails and prisons with mental illnesses, many with severe mental illness (SMI).
5. Victimization. Sadly, some with mental illness are more likely to become victims of violence than others due to past incidents and/or altered levels of functioning.
6. Suicide. Many suicides are attributed to untreated mental illness. It’s not a failure or a lack of coping skills. Sometimes you get stuck in a moment you literally cannot see yourself getting out of. That’s when tragedy strikes.

Mental health treatment is well worth the time and money. You are worth the time and money.

Have you had problems with accessing mental health services?

For more information on accessing online therapy, please see Better Help

Pics courtesy of Unsplash

Information courtesy of Psychology Today

Happy Birthday, Shortstack Blogs!

One year ago, I created a blog. I had no idea if I would stick with it, or just write a few posts and let it fade. I love to write and I’ve always wanted to do something big with it so here I am.

Zoo day with Julian and Lily

Progress Report #2

I haven’t made a penny from this blog. I haven’t gone self-hosted. Why? I’m focused mainly on getting views and loyal readers. I’d rather have that right now. I’d like to know people are reading my work than make money and not have people care.

I write about heavy topics. I know my writing voice is not for everyone and I’m totally okay with that. I’m not for everyone. I do think about my audience when I’m writing. I do appreciate the comments. It hasn’t been easy to build my audience- like most writers, I struggle with confidence. I almost trashed a few posts but put them up anyway. Weirdly enough, those have been some of my best-read posts.

My stats are going up- one month, I hit almost 1200 views. I’m at over 500 likes on Facebook and almost 900 on Instagram. This is growth. I’ve slowed on my guest posting due to the kids being on summer break. The memes I post are no joke- it’s been an interesting summer. I do plan to get back to outside projects once they go back to school- the cats are much quieter. They are great writing mascots.

Miss Purr.. sleeping as usual

My posts have gotten longer and more in depth. This is thanks to research, growth in my writing skills and lots of thought. I try to give lots of info without being boring. I’ve been working on my graphics to make those more eye-catching- people like that.

I do have goals- I set new ones every three months. They include posting to mom blog sites once a month, working on a secret project, a course with Savannah from Millennial Mrs. and Mom, along with other things.

I didn’t realize how far my talents go until I started being approached by other bloggers to collaborate on projects. Wow. Me?

My Blog Is a Toddler

I have a one year old blog. It can’t walk or talk but I’m sure WordPress can throw tantrums. I started this blog as a way of helping others- mental health and suicide prevention and awareness. The parenting part… obviously I have a lot to say there, because this is not easy.

I wish so much I didn’t feel the need to write about suicide. There is a heaviness, a hole in my heart that will never be fixed. I write about it so that others know they are not alone. Grief is a horrible thing- losing someone to suicide is something that is difficult to put into words.

I write so that hopefully others think again- I lost a few that didn’t. I write so that people have information to pass along to others if they need it. If one person thinks again, or my mental health related posts help in any way, then I have fulfilled my purpose. I think Jake would be proud of me- he always encouraged me to do what makes me happy.

September 1 is coming quickly and there will be a very special post on September 4.

There’s more to come this year. Thanks so much for reading my blog. I appreciate it more than you realize.

The words I will never forget #lifelessonsfromjake