This is article is long. It's not short and pithy. There are no quick fixes to depression and suicide. Quick, cliched, trite, pat answers don't work. Real answers take time and patience and lots of empathy and love.
I'm not going to list all the stats and signs and symptoms of depression and warning signs here--they are posted all over the Internet--no need to duplicate them. You can Google Search as well as I can. I am going to share some things here, though, that aren't elsewhere from my clients and my experiences together which may be helpful in addition to all the great information that is out there
On this page:
- Jonathan's presentation slides:
- ”Understanding Depression"
- “Mastering Stress & Other Strong Emotions”
- 11 Things to Know & Do When Responding to Suicide
- 5 Myths Some People Believe When They Feel Suicidal
- "Give me three reasons to live." I'll give you 20!
- 17th Anniversary of My Aborted Suicide Attempt: Letter to Past Self
- 13 Reasons Why NOT!
- Text exchange between therapist and depressed client who's feeling suicidal
- Teen client shares about teens, stress, depression, cutting
11 Things to Know & Do When Responding to Suicide
1. If they are talking about suicide that is a GOOD thing.
This may seem counter-intuitive, at first. Often people respond, "Don't say things like that." or "No you don't really feel that way." "It's not that bad." Now, I know they are well-meaning and are only trying to help, but what they don't realize is that the suicidal person just heard that you don't get it and you don't want to hear what's really going on and you don't want to talk about it--so the suicidal person stops talking about it. And that is what we DON'T want! I can help someone who's suicidal if I know they are suicidal. But if they aren't talking about it how can I help them?
I am way more worried when someone issn't talking about it, becasue then there's nothing we can do.
It also means if they are talking about it, even if they are really very serious about doing it, that there's a part of them that is hoping, even against hope, that someone, somehow might be able to save them.
2. So if someone tells you they are suicidal, LISTEN.
Listen. Be there. Don't freak out. Don't be reactive. Be patient. Let them just get it all out. Don't try to correct them or tell them how they should feel.
3. When someone is in crisis, don't you be in crisis, too.
4. Hear them. Love them. Accept them.
5. Give them REAL reasons to live (see my reasons below). No pat answers.
6. Better safe than sorry.
Maybe it's manipulative. Maybe it's attention-seeking. There are those who talk about suicide for those reasons with no real intention to actually kill themselves. But I would rather err on the side of caution rather than tragically say later when it's too late, "I didn't think they really meant it."
7. Teach them the "Comma, Yet..."
"I can't do it." is final. The brain doesn't care--as a computer it's accepting programming. Language is it's programming code. "I haven't figured it out" is final and it means "I haven't figured it out so I'll never figure it out and since I can't figure it things will never get better, so why continue to live like this forever?"
Instead, "I haven't figured it out, yet..." programs the brain differently as "comma, yet..." is not final, but allows for a the truth of the first part of the sentence to be validated, "It's true, I haven't figured this out in my life" and then allows for a pause, the comma, and then the "yet..." sends the most powerful message in that one little word: "But I'm not done yet. Just because I haven't figured it out yet, doesn't mean I won't ever figure it out. I just haven't, yet. But I still can." = hope and creative possibility thinking can not be activiated and leveraged. In fact, every success in every area of life is actually based on a progressive series of failures one after another until success occurs (see famous failures). We all "failed" at walking and talking at first, but noone ever saw that as a failure. People would just ask, "Is he walking, yet?" "Nope, not yet, but I he'll figure it out."
8. "We'll figure this out."
Remind them, "We'll figure this out. You're not alone. I'm here. It's going to be okay. I don't know how, but we'll figure this out together, okay?"
9. Friends don't keep dangerous deadly secrets.
10. Don't 'should' all over them
And don't let them 'should' all over themselves. The pressure of 'should' and 'have to' are guilt motivators, and guilt, like fear, are poor motivators. Instead, explore what they would like to do, want to do, could do, etc...
11. Give them reasons to live, not reasons to fear dying.
Inspiration is more motivating than fear. If they don't feel life is worth living, help them dream about and discover how to create a life worth living.
5 Myths Some People Believe When They Feel Suicidal
Myth #1: "I'll show them. It'll teach them a lesson."
Sometimes the person who is suicidal will think that thier death will be a sort of vengeance to those who have hurt them. This is not accurate. I've seen the other side of suicide and observed those who are left after the person has killed his/herself. Here's the truth: The ones you're hoping it will hurt it won't as it won't teach a lesson to those who don't care about you in the first place. It will cause immense pain to those who do love you and those you don't want to hurt.
Myth #2: "Everyone will get over it."
I have seen the long-term aftermath time and time again decade after decade after decade. Those you love and those who love you don't get over it. Ever.
Myth #3: "Everyone will be better off without me."
Again, I've seen the long-term aftermath too many times. People aren't better off without you. The ones who love you and whom you love suffer for years and years, even a lifetime, over your death.
Myth #4: There's a dark romantic quality to sucide.
There's nothing romantic about suicide. Romeo and Juliet romantizied killing oneself over lost love, but let's be honest: Romeo and Juliet were idiots. True love protects. True love is selfless and other-centered. False love is emotionally reactive and self-centered.
Myth #5: "It'll never get better"
I've been treating depression and anxiety, and intervening in suicide crisis situations for over 20 years, and I've worked with hundreds and hundreds of clients and family members. One thing I can tell you is that it does and it will get better. Go ahead interview
"Give me three reasons to live." I'll give you 20!
A mother who had been increasingly suicidal after years of sexual abuse as a child, and domestic violence and rape as from her former spouse, and has been dealing with lots of PTSD crap texted me, "I need three REAL reasons why it's better for me to be here for my kids... no BS reasons either!" I texted her back, "I'll give you you 20 solid no BS reasons:
- Your child needs you. You think being here is screwing them up? Each will have a hell of a life dealing with your suicide the rest of their lives.
- Ditto for your second child.
- Ditto for your third child.
- Ditto for your fourth child.
- Ditto for your youngest child.
- Me. This isn't just a job to me. I care for and love my clients dearly. I'm not clinically cold and detached. I connect with my clients and they with me. Your death will affect me and haunt me. Don't think for a minute that it won't.
- You. You simply matter. So much. Period.
- Others who will benefit from you once you are on the other side of these problems and strong. Of course, this # could be 1-1,000 reasons. Imagine if I gave up...
- This guy has 10 great reasons: (I seem to be missing the link here... I'll look for it...)
- You may be the reason another person is hanging in there, you never know—just as you've told me that just one word here or one text there has made all the difference. Things can change in a moment and you may miss your moment to make that difference if you leave too soon.
- Those who experience the greatest suffering have equal capacity for joy to the same magnitude.
- This too shall pass. Pain comes and pain does go.
- I need people like you to overcome to help fight against abuse since there are so many who also suffer in silence.
- Who will protect your kids from abuse if you are gone? Most people don't know what to look for nor how to respond.
- You can be one more light in a world of darkness. That light is SO needed. So few understand this while so many suffer. This world and people like me in it, need people like you you understand and have the compassion that only comes from suffering and overcoming. You will help others.
- I asked a teen boy who has been suicidal as well, has been hospitalized, and is slowly beginning to learn to want to live what reasons he'd give to live. He shared the following:
- "I would want to help whoever I can. What if you were able to help a person recover from suicidal thought wanting to kill themselves? What if you could help them see life in a whole other way? A more positive way. IDK, I think that feeling would be fantastic. Because I've been there where there's nothing left for me here. Always questioning why I'm here. Trying and suceeding on over-dosing hoping to escape the pain I am in. Somedays like today I still feel like that. But everybody has bad days. And everyday is a new day. You are able to make whatever of that day. If you make a mistake, thats alright because there's always another day where you can learn from your mistakes. :)"
- Can you see why I love and admire this young man? The courage it takes to live in the face of such overwhelming depression is no small feat, my friends.
- He followed up later with this text: "Hey Jonathan! You know how i forwarded that text to you last week? Well I was on Facebook today and i found another saying or thing its 'I want to inspire people. I want someone to look at me and say because of you I didn't give up." I think that's awesome and it would be awesome if someone did that to me!"
- Compassion Trip vs. Guilt Trip. Consider impact of ending your suffering as creating lots of long-term suffering for many people. This is not a guilt trip, I'm asking you to take a compassion trip: feel the horrific pain you are in now, and assuming you're a kind-hearted person who would never want anyone to have to feel what you feel...
- Don't die for the jerks. Live to free the sufferers. People sometime say, "this will show them--then they'll feel bad." I say, don't die for the jerks, or those that hurt you, or those who don't care, or those that don't get it. They won't care and they won't remember. Instead, live for the other silent sufferers who need your compassionate voice, your unique ability to understand their pain as someone who exquisitely knows their pain. Free them with your kindness, your example of persevering and overcoming, because you showed them a brighter path--a living way out.
- "A Reason" Site: please take a moment to read this brief site from an anonymous person first before you decide to end your life: http://areason.org/. I was so touched after reading this person's site "A Reason" that I wrote this letter to him or her:
Dear anonymous soul who put up such an important site,
Thank you. I am a licensed marriage and family therapist who specializes in mental health issues including suicide crisis intervention. I was recently responding to a suicidal mother who asked me for "three REAL reasons" why she should live. "NO BS!" she told me. Well, I gave her 15 great reasons. I also looked up what other reasons people online had to give, and your site came up first. I have to say, as a professional in this field your answers were great and right on! I've never tried to talk a suicidal person out of suicide, have empathized with them about why it's a decision that based on their level of pain makes sense, and bit by bit helped them find reasons why living made even more sense. Your site walks people through it in a very real, down-to-earth way. I am taking my responses to this client and turning it into a blog article for the benefit of others. I will be recommending your site as a "must read."
Just wanted to take a moment to give you due props and to express my gratitude.
17th Anniversary of My Aborted Suicide Attempt: Letter to Past Self
My Facebook friend, Andy Shermin gave me permission to share his Facebook post:
"Today marks the 17th anniversary of my aborted suicide attempt. I want to go back and tell Past Andy that, exactly seventeen years later, it'll also be the day he buys his incredible fiancee an appropriately gorgeous engagement ring.
"I'm not feeling terribly articulate about all of this right now, but please know that no matter who you are, no matter how hard things are, someone loves you and is there for you. Try to reach out if you need a hand—I, to say nothing of countless others more qualified, am here for you.
"I love you and am proud of you.
National Suicide Hotline: 800-273-8255
The Trevor Project: 866-488-7386
Trans Lifeline: 877-565-8860
Another Facebookf friend Paul Schultz saw this and shared this in response (and I'm sharing this with his permission).
"So this is brutally hard for me to admit — only a couple of people know this, but it's time to say it. It may save a life or two, or more.
"Several years ago I came home to a mostly gutted house after being promised it wouldn't happen. Almost everything was gone, along with my family. It changed from a home to a hellish prison.
"In the absolutely indescribable pain of that moment (there are literally no words to do it justice) I came within 5 seconds from removing myself from the planet.
"I chose instead to to reach out for help. So glad I did.
"To think about what I would have missed and what my kids would have missed is a scary heartbreaking thought.
"Having suicidal thoughts? Know someone who may be? Read this short post and take down the number at the bottom.
"You are loved and needed.
"Thank you Jonathan Sherman for sharing this."
Thank YOU, Paul and Andy! Thank you for sharing your stories. People need to know they aren't alone and aren't the only ones. THANK YOU FOR LIVING!!! You rock!
13 Reasons Why NOT!
Text exchange between therapist and depressed client who's feeling suicidal
The following text exchange is from a dear teen female client of mine I hadn't heard from in a while. We'll call her D. The text exchange is raw and unedited. I'm not worried about covering everything perfectly, as you'll see in my responses. I'm worried about mostly just being there and letting her know that I just simply care and give a damn and that there is help. I didn't try to talk her out of how she felt. I was just with her in her pain.
She's given me permission to share this (she's now an adult). D's texts are indented once, mine are indented twice.
Hey it's D...I'm really sorry to bother...but if u have time to talk on the phone..so I can talk to u and ask some really important things that would be greatly appreciated thank u!
Hi D. Just got your message. I'm not where I can talk now. What's going on?
Okay..idk..I just have a lot going on with school and friends and my depression is just getting worse..I don't know how to handle it anymore it's getting out of control..like the only I can find myself being happy is being dead..but I just can't die..
I'm so so sorry you're having such a hard time :-(. I'm glad you reached out and told me. At times like this it does feel like the only way to be happy is to die and just be done, huh? I know, kiddo. It sucks feeling that way. I'm actually writing a blog post about this very thing. I've been asking people who were depressed and suicidal as teens to share their stories with me so I can share them with others--others just like you, going through what you're going through right now. And you know what they tell me? "It gets better. It does. It doesn't seem like it ever can or ever will, but it does. Hang in there. Reach out. Get help. Don't give up. There is a way out of this and it's not death." Just a sec.... What can you do?
1. It sounds like it's time to tell your mom how you're really feeling and how bad it is and ask her to bring you back to counseling so we can really figure this out. I know you may not want to ask her or she may say no, but this maybe something you need to push for. Have her call me. We can work something out to make it work.
2. Start reading up on positive ways to deal with depression. There's lots of great info and ideas online.
3. Start watching inspirational and motivational videos on YouTube. You need to fill yourself with a larger perspective than the suffering you are in now, with positive thoughts, and with encouragement.
4. Look up things about "mindfulness". It's a helpful technique for managing thoughts and not letting emotions overtake us.
5. Stay connected with people who know how you're feeling and who care.
I've asked my mom over and over to call u back so I could come again but she won't. This counselor guy that I talk to at school is bull crap! I can't even trust him anymore without him reporting me..because even if I cut! One single scratch he tells on me and one time he reported me and then I got locked up..he doesn't know how to do his job..and so I don't talk to him at school anymore. He is pathetic..and doesn't help me at all. The only thing he does is report me now for my problems when I tell him. I feel so trapped. I feel like the only way out is death. Maybe for some people it gets better but I don't ever think it will for me...I've been talking to u for what 2-3 years now and it hasn't gotten better..it's just going down again getting worse..I just want to give up. I can't do it anymore. And I know u tell me not if u say that! The word (can't) but I've tried over and over and over and nothing is helping me...it's getting bad where I can hardly eat, where I feel sick to my stomach, where all I wanna do is cry..and die and end all this pain. I try to be happy. I really do. But I can't seem to be happy not even in my own skin.. I can't stand myself. Like I don't wanna deal with myself anymore..and u know I try so hard for the things I want in life..and try to be successful but it's not working..I just don't know how to go on anymore. Like why can't I just die? Why can't I end my pain and everyone else's? I mean by everyone else's like so they don't have to deal with me anymore. And waste their time. Ya know?..but idk..I just don't know where to go from here..like I just want to die. Or sleep forever.
Sorry to hear that counselor isn't helping :-( And while we've know each other 2-3 years, that doesn't mean we've been doing counseling that whole time, so I don't want you to think it wasn't helping--it kinda needs to be consistent for it to work consistently, ya know. And just so you know there is NOT one of those people who felt it would get better. They also said the same thing: "it may get better for others but it won't get better for me." And just because it hasn't yet doesn't mean it won't. I do believe that you've been trying hard. And I do believe you about how hard it is for you. :-(. I'm not going to tell you to not say "can't". I understand. I really do. I've been through horribly hard things in my life where there seemed to be no hope anywhere, ever. I really do understand. How you feel is very understandable. As for the 5 things I mentioned you answered the first thing. Will you try and work on the ideas 2-5?
Yes I'll try
Thank you. I know you might not want to do it for yourself sometimes so Please do it for me. I really do care and want to see you get past this someday and come out to the other side of the darkness you're in. There is another side and you can get there even though I know you don't see it or believe it now. I know you've asked your mom. I'm glad you've tried. Would it be okay if I call and ask her? I worry that she may not fully understand how serious this really is for you. I don't know if I can get her to understand but it's worth a try. What do you think? Can I?
Yes pls call and ask
Ok I will. Thank you. To try to help her really understand I'll need to be able to talk straight-forward with her about how you're doing and what you've shared with me. Do I have your permission to do so?
Why?.. She can't know what's going on with me... It will make it worse I can't pay and she can't either but I'm willing to find a way to work something out so that I could
Then how will I be able to convince her if she doesn't really understand? If I just say this is "Jonathan and D said she'd like to come back to counseling" of course your mom is going to ask "why?" And if she says well she can't afford it or whatever other reasons I can help her try to figure out ways to make it work, but if she doesn't understand how serious it is she'll probably just keep saying no, don't you think?
I guess she just doesn't understand I just don't want her knowing exactly why I need to come to counseling
Also, another thing as far as ideas and things you can do... So this is #6: when dealing with depression and suicidal thoughts it's important (as you know!) to not try to do it on your own. Just like a football team needs lots of players as the quarterback alone can't do it all, the same is true here. Some team members you can add are chat groups made just for this topic and also crisis lines: Go here: http://afsp.org/find-support/im-having-thoughts-of-suicide/. These are people who totally understand this stuff and you can contact anytime. Th Depression Team has 11 players (just like a football team). The D Team had mostly just had yourself, that's 1. It doesn't matter how hard you try, 11 payers will beat 1. And adding me in as you have has been good, but we're only 2. So we want to build up your team. So if you think of it this way: Your Team:
--Your mom (if we can get her on board).
--Chat support groups
--Friends (one or two who understand, are safe and supportive who won't encourage you to cut, etc)
--Other support groups--local or online.
--Also what about other counseling agencies like Wasatch Mental Health--they may be able to help for a lot cheaper and they'll have groups where you can get support, too. The idea is to build a team. So what do you think I can say when she asks "why?" that will get her to say ok? I talk to a LOT of parents and can probably do a better job of getting her to understand how serious this is and why you need help than you can, but I can't do it if I can't be straightforward and honest about it. You kind of have to let me talk openly with her if you want me to have a chance, ya know. Otherwise I don't know what I could say that would answer her questions or change her mind.
No it's alright. I got sent to vantage point in Provo and won't gO again..and honestly I think crisis lines are bullshit I tried with them. They never did anything. Just lie to her and say something so I'm able to come..lol But I have no friends now..and yeah..and my mom nooooo I'd rather die
What about online support groups--have you looked up any of them? They are just regular people, not professionals, each at different stages of dealing with this crap helping each other figure it out. I can give you some recommendations. Well I won't ever lie to you or anyone--hard to trust a lying counselor, right? ;-) I'd rather do whatever it takes to try to get you the help you need--even try to get your mom to truly get it. I'm happy to text but I can't counsel a minor without a parent's permission.
This is a GREAT group here--lots of options and supportive people. My sister who has been depressed, anxious and suicidal has found a lot of help and support here: http://www.dbsalliance.org/
But hey I'm not a minor anymore I am 18
Another great free support group is http://www.namiut.org/families-caregivers/free-support-groups
I'm not into those hahah I just nothing really helps me..or works for me..
Not into those? How can you know if you haven't tried--and since you can be anonymous online why not?
Cause I'd rather just talk to someone not through online... Idk..if it doesn't work out its okay..just don't wanna live this life anymore.. And I'm looking at idk..what it's called but...I can't and don't have anymore energy to go on.. I'm drained, I'm physically, emotionally, spiritually, mentally drained I'm tired I don't and can't go on and live anymore..I have no energy.. Like I'm so tired I can't even try anything anymore because nothing ever works for me..and I'm wasting time..
And also remember you also weren't into counseling at one point with me either, you HATED it! but once you tried it you changed your mind. So there! :-). Give it a REAL long try before you say you don't like it, because it took a long time with me before you opened up to it. And I'm not saying just do the support group but add it into your Team!
That's true! But online stuff I can't..I can't
Since you're 18 now and don't need permission to seek help, which is good news, can you drive and come to my office. There are also local in person groups too.
Yes I probably could..
Well let's set up a time when you can come in. I'm worried about you and am glad you trust me enough to reach out!
Okay great. We'll see that's the thing at this point I can't trust anyone..but..except for u because u helped me before..
Teen client shares about teens, stress, depression, and cutting.
One teenage girl* shared with me as we talked about the stress teens face, depression, suicide and cutting. I asked her advice for other teens and parents.
- "A lot turn to cutting. That's a huge part of it. IT's all around schools and the Internet. Everyone hears about it. When I was getting more and more stressed and depressed, I thought, others have tried it; maybe it will help me.
- She continued, "So some people get addicted to it after the first time they cut, or after a few times. It helped them feel better, so they do it again. Then they're addicted to it. It's that simple."
- "It doesn't make sense to why cutters would cut themselves because people normally don't cut themselves on purpose."
- "Every time I cut I became more numb to how deep i was cutting, until one day it was way too deep.
- "It just starts with one cut."
- She advised, "Make the choice now not to do it, otherwise when the choice, or stress, or peers come it will be harder to make the choice at that moment."
- "What really helps me to not cut now when I'm stressed is going downstairs and playing my musical instrument, singing, taking voice lessons, listening to music. My advice to others is don't be too lazy to learn an instrument. A friend of mine who was in the hospital for a suicide attempt took up learning to play an instrument and hasn't hurt herself since. She said the same thing I'm saying: when she feels that way she goes and plays and it occupies her mind and helps her feel better."
- "Music helps. Just laying on my bed, staring at the ceiling for an hour. It just brightens my mood so much."
- "Don't blame anyone else for your own mistakes. It doesn't fix anything, makes everyone else mad, causes unneeded and useless drama."
- "It sounds cliche, but it works: Don't let other's opinions hurt you because they don't really know you. They only know what they've heard from other people have made their own assumptions. But you know yourself. You know the truth. Let that be enough."
- "In fact, listen to the "cliches".... they've been around a long time for a reason and they have helped a lot of people."
- Why do people cut? She said, "I cut when friends hurt me. I realize now there's no point to it because friends come and go and they aren't worth my pain. Also, it's only temporary relief. There's no other relief that's more permanent than mental relief, self-control, self-mastery.
- Reasons not to cut? "Physical scars get you a bad reputation and people gossip, and end up only getting more negative attention, which causes more stress, which feeds the depression, which feeds the desire to cut... and there's the viscous cycle."
- "You don't have to cut to be emo. I still consider myself very emo--as far as dress, mindset, music, identity. I just don't need that aspect."
- She said to other teens, "you may think you're the only one fighting this by yourself. I used to think the same. You're not though. Many people understand and want to help. It's so much better when you can fight it with someone else, and report to each other how you're doing." Like positive peer pressure, I asked her. "Yes, exactly. That."
- "It's been easier to deal with stuff when I limited social media... It's fun but it could really put me in a bad mood. Seeing friend's posts that I wasn't tagged in led me to feeling left out and wondering why and making all kinds of negative assumptions."
A dear client who's daughter committed suicide after years of suffering from depression shared the following resource with me: "Young Lives Lost" which was a special newspaper in our local paper, The Daily Herald. I highly recommend it for the important stories, stats, resources and links it shares v
FWD: Whoever i can:) what if you were able to help a person recover from suicidal thought wanting to kill themselves. What if you could help them see life in a whole other way. A more positive way:) idk i think that feeling would be fantastic. Because ive been there where theres nothing left for me here. Always questioning why im here. Trying and suceeding on over dosing hoping to escape the pain i am in. Somedays like today i still feel like that. But everyboddy has bad days. And everyday is a new day. You are able to make whatever of that day. If you make a mistake, thats alright because theres always another day where you can learn from your mistakes :)
Hey Jonathon! you know how i forwarded that text to you lat week. well i was on facebook today and i found another saying or thing its "i want to inspire people. i want someone to look at me and say because of you i didnt give up" i think that awesome and it would be awesome if someone did that to me!!
Not sure who the therapist is, but found this poster online with this comment: "I'm a therapist and keep this poster in my waiting room. Apparently, it's saved a few lives." Source: http://m.9gag.com/gag/axj4992?ref=mfsidebar