According to the American Foundation for Suicide Prevention, each year 45,000 Americans die by suicide. Some statistics show that one person dies by suicide every 12 seconds and a suicide attempt is made every 28 seconds.

We may not always be able to stop someone from trying to kill themselves, but knowing the signs of suicidal thoughts and behaviors can help. Some of them are:

September is suicide awareness month. Sometimes feeling suicidal is less about wanting to die than it is about wanting the emotional or physical pain one is in to end. So often, suicide is about not knowing how to make that pain stop.

So often, those who are suicidal feel like a burden on their friends and loved ones. It is our jobs as friends and loved ones to reassure the person who is considering suicide that they are not a burden on us. It is our job to reassure them that they are loved and worthy of belonging because more often than not, the person who is feeling suicidal feels alone in his pain.

So often, people who are feeling suicidal believe that their friends and loved ones would be better off without them. People who are suicidal believe that by killing themselves, they are doing their loved ones a favor by dying. We must tell them that they are not a burden to us, we must tell them we love and need them in our lives. We must tell them that our lives would never, could never, be the same without them in it.

Suicide is not about being selfish. Suicide is about making the pain one is in stop. There is help for people who are feeling suicidal. If you or someone you know is feeling suicidal, please call the National Suicide Prevention Lifeline at 800.273.TALK. Anyone who is feeling suicidal also can go to any hospital emergency room and receive help. There are people who care. There are people who want to help. You are not alone. You never are alone.

So often in my work, I see people in the throes of mental illness, substance use disorders, trauma and eating disorders who just want the pain of these ailments to end and are not sure how to make it stop. Sadly, there is no magic pill that will make these illnesses vanish. You have to work on your own recovery.

I do see so many people who take the first step in seeking treatment, going into the hospital to get stabilized from mental health crisis. In the hospital, patients are taught coping skills with DBT and CBT. People there learn about relapse prevention and are encouraged to continue treatment once discharged from the hospital. Sadly, for whatever reason, many people choose not to continue treatment once they get home. Perhaps they cannot afford to pay for outpatient services or medication. There are programs that can help with that, though, and many locations offer services on a sliding scale.

Last week, I met a woman who came to the emergency room after what she described as a “relapse” in mental illness. She told me that she had been working on her recovery for four years and had been feeling better. One thing led to another and she stopped participating in her own recovery and ended up in the emergency room. She felt defeated and discouraged by this relapse, but determined to get back on track with her mental health and vowed to seek outpatient services and perhaps new medication. That kind of determination inspires me and also reminds me that relapse happens long before one reaches a crisis, takes that first drink or participates in self-harm after years of abstinence. Relapse begins when one stops doing the work of recovery.

Relapse is not an event; it is a process that begins days, weeks, months before one finds oneself in crisis. Relapse begins when one stops going to therapy or stops taking one’s medications. Relapse begins when one ceases contact with an AA or NA sponsor. Relapse begins when one starts making excuses as to why one cannot make his regular AA or NA meeting.

Relapse often is preventable. One has to continue to participate in his own recovery for recovery to work. Recovery works if you work it. Moving from mental illness to mental wellness takes work and once well, recovery requires daily effort to stay well. There are things one can do to prevent relapse such as reaching out to your psychiatrist or primary care physician if you think your medications no longer are working and talking with that doctor about perhaps changing medication or adding something new to your regimen. Relapse can be prevented by making sure you keep appointments with your therapist or counselor even if you are feeling better. Relapse can be prevented by maintaining regular contact with your AA or NA sponsor. Relapse can be prevented by using your coping skills when needed.

I have said it before and will say it again: Recovery is work and requires daily effort. Are you not worth the effort it takes to get and stay well? Do you not deserve a life full of happiness and health? Do you not deserve to become the person you always were meant to be? Recovery works if you work it. Are you ready to put in the effort?

How many of us say to ourselves things along the lines of, “When I lose 10 pounds, I’ll be happy” or “When I get that job, I’ll be happy?” How often to we predicate our future happiness on things over which we have little control? How often do we hold off on letting ourselves be happy with the way things are right now? How often do we postpone our joy?

You deserve to be happy right now, in this moment, in the life that you are living. Sometimes, yes, that can be difficult if you are living with mental illness, substance use, eating disorders or trauma. But, try to remember, there are things in your life that are good, too, and be thankful for those things. Your happiness should not depend on something that has not yet happened.

It can be difficult to find joy when you are struggling with mental illness of any kind. But to some extent, once you make the decision to be happy, happiness often follows. Once you decide to make the move from mental illness to mental wellness, happiness will follow. Yes, it takes work, but there is joy to be found even as you journey toward wellness. The steps you take now to become well should be celebrated. There is joy to be found along the path to wellness.

What can you do today to find happiness in the things that you are doing to move from illness to wellness? Can you celebrate the fact that you got out of bed today and into the shower? Can you pat yourself on the back for getting dressed and making it to work? Can you congratulate yourself for sticking with your medication regime? There is joy to be found in these small things; celebrate them. You deserve to be happy now, today, as well as in the future. There is joy to be found every day. Sometimes, you may have to search a little harder to find the good, but there is good in every day.

 

How many of us are living with mental illness, substance use disorders, eating disorders or trauma our own worst critics? How many of us beat ourselves up for even the smallest transgression? Likely more than not, no one is meaner to ourselves than we are. The things we say to ourselves often are cruel and uncalled for.

It can be difficult to remember when living with mental illness to give ourselves credit for small victories and celebrate our accomplishments. It can be difficult for those living with mental illness to remember the good things that we do during the day or the good things that happen to us throughout the day because we are stuck in a pattern of negative thinking. It can be difficult for those living with mental illness to remember to be gentle with ourselves. It can be difficult to remember that we are doing the best that we can.

I recently met a woman living with major depressive disorder who confided in me that she is often cruel to herself, calling herself weak for having depression. Living with mental illness does not mean you have a flaw in character, it means you have a flaw in brain chemistry. If you are taking steps to find your way from illness to wellness, give yourself proper credit. You are doing the best you can.

We who live with mental illness are warriors, fighting a daily battle against the demons in our minds. We need to remember to give ourselves props for even the smallest things, like getting out of bed and into the shower and to work. We who fight the good fight must try to remember that we should celebrate those little victories. We who battle depression, anxiety, substance use, eating disorders and trauma need to be gentle with ourselves.

What can you do today to be kind to yourself? Can you take a walk or go for a run? Can you go for a bike ride in a nearby forest preserve? Can you jot down three good things from your day before you climb into bed at night? Can you take some time just for you to take care of yourself? Even just a few minutes a day of treating yourself to a kindness will make you feel better about yourself.

So often in my work, I see people who are in the throes of mental illness, substance abuse, trauma and eating disorders who are more than tired; they are deep down exhausted. I see people who are weary and uncertain as to how to move forward with their lives. They are stuck in the quagmire of illness. They have lost their fire.

Recovering from mental illness, substance use, trauma and eating disorders is difficult and takes daily effort. Sometimes, just getting out of bed is a victory and one that should be celebrated. Sometimes getting out of bed and into the shower is the most one can accomplish in a day and that, too, should be celebrated. Recovery takes effort but it is so worth it.

I recently met a woman who had been through treatment nine times and came to us seeking assistance again for mental illness and substance use disorder. I asked her what was different this time, what was going to make this journey through treatment different. She said this time, she was doing it for her. She was fighting for her life.

Recovery is about fighting for you, fighting for your life … a better life, the one you deserve. Recovery is about more than just wanting to be well, it is about taking the steps necessary to become well and maintain wellness. It is not an event that happens; it does not happen overnight. Recovery is a process that takes time and requires daily effort. Recovery starts with you coming to the understanding that you have to fight for you and that you are worth the fight, that you are worth the effort to become the person you were meant to be and that you are worth the effort to live the life you deserve.

Sadly, people living with mental illness, substance use, eating disorders and trauma think often think they are not worth the effort, that they are not good enough, that they are inherently flawed. They cannot see that they are people worthy of happiness and health. They cannot see that they are people who are wonderfully and beautifully made. They cannot see that they are worth the fight. I am here to tell you, you are worth the fight. You are worth the time and effort it takes to move from illness to wellness. You are worth the time and effort to cast aside the demons that plague you and become the person you were meant to be. Are you ready to step into the ring and fight for yourself?

The Mirriam-Webster dictionary defines resilience as “the capability of a strained body to recover its size and shape after deformation caused especially by compressive stress, or an ability to recover from or adjust easily to misfortune or change.”

In my work at a hospital, I am constantly amazed by how resilient people who live with mental illness, substance use, eating disorders and trauma are. People come to us when they are at their very worst. People come to us in the throes of psychosis, in the quagmire of profoundly debilitating depression, the muck of substance use and the horrors of trauma. Yet somehow these people manage to get themselves to our hospital to say they need help managing their symptoms. I commend them for doing so. It takes a lot of courage to ask for help.

People who live with mental illness of any kind often beat themselves up for being “weak,” but that is not what I see when they come to us for help. I see survivors, warriors on the front lines in the war against what ails them. I see people who have every right to celebrate the victory of managing to survive another day with severe mental illness. Living with mental illness is not easy and most people who do are so much stronger than they give themselves credit for. Managing mental illness takes a lot of daily effort.

I have said it before, but I will say it again. We who live with mental illness are champions. We live with mental illness because we are strong enough to handle it. We who manage to win the war against our symptoms every day are victors. We are the epitome of resilience. Do not forget how strong you are. So much more so than what you probably think.

 

 

 

 

 

 

I often find myself amazed and inspired in my work at a hospital. Seeing so many people come through the emergency room or intake offices struggling with suicidal thoughts, profound depression, substance use disorders and trauma who somehow find a way to carry on reminds me of the strength it takes to live with mental illness.

Living with mental illness can be debilitating, leaving one both mentally and physically exhausted. Depression can cause a lack of sleep or too much sleep, changes in appetite, trouble with concentration and memory. Substance use disorders literally can change the structure of the sufferer’s brain. Trauma can leave one with painful memories and flashbacks. The resilience of those living with these illnesses astounds me. To carry on takes courage and bravery.

Coming to the hospital to say you need help with mental illness can take a lot of effort. Many of the people I meet are at wit’s end and no longer can manage on their own. We try to get them the help they need, be it inpatient hospitalization, partial hospitalization, outpatient services or substance abuse treatment. Thankfully, many people follow our recommendations and get the help they need. Unfortunately, some people choose not to follow through on the doctor’s recommendations.

What I often see is people who come for treatment for only a short while and while they are in treatment, take their medications and speak with a therapist or counselor. Often, after leaving the hospital, patients choose not to carry on with therapy and medications. Frequently, these folks end up back in our emergency room wondering how things got so bad again. They fail to follow up with the doctor’s recommendation for continued care such as taking medications as prescribed, seeing an outpatient therapist and meeting with a psychiatrist for medication management. There are many reasons for this, but I urge you to follow your doctor’s recommendations following discharge from inpatient or partial hospitalization or substance use treatment. Believe me, you will be better off for it.

There should be no shame in seeking treatment and continuing to take medication and speaking with a therapist or counselor following hospitalization, but sadly there is stigma attached to treatment. Only you can decide to follow up with treatment. Only you can make the decision to move from mental illness to mental wellness. The future is up to you.

It pains me to see so many people stop taking their medication and stop talking to a therapist because they think they are “cured” of mental illness. Taking medication and speaking to someone about what troubles you is what gets and keeps you well. Please do not stop doing the things that keep you feeling better. Please take into consideration what the doctor ordered for you. We all want to see you get well and stay well. Medication and therapy, along with coping skills, exercise and proper nutrition, can keep you from sliding down the slippery slope back into mental illness. Follow the doctor’s recommendations and, more likely than not, you will continue on the path of recovery.

Every day at work I am reminded that you just never know what someone is struggling with, what challenges they face or what demons they battle on a daily basis. Every day, I am reminded of the courage it takes to rise to the challenge of saying to someone, “I need help. I cannot do this alone.”

I have said it before and I will say it again: It takes more courage to ask for help than it does to suffer in silence. This past week, I met several brave people who brought themselves in for treatment after suffering in silence with crippling depression and anxiety. I applaud them for doing so and hope I did right by them all. One of the amazing people I met was a woman who walked three days through the mountains of Mexico to come to the United States, only to find herself in an abusive relationship that has left her profoundly depressed. I reminded her how brave she was for bringing herself in for treatment.

Finding one’s way from mental illness to mental wellness is not easy nor does it happen overnight. The path to recovery can be a long one and taking the first step can be daunting. But there is hope in recovery and a promise of a brighter future if you are willing to do the work of recovery.

Recovery is work and one has to be all in for it to work. Recovery requires therapy and medication and proper nutrition and exercise and learning a new set of coping skills and practicing those skills when times get tough. One cannot simply take a pill and expect to be magically better. Talk therapy is necessary to work out problems that are at the root of mental illness, substance use, eating disorders and trauma. Proper nutrition is important to help your body work the way it should. Exercise releases ever-important endorphins that help you feel better. Coping skills are important for everyone to possess. It is okay to ask for help learning how to employ these things. There are people like me who care to listen and help you work through your problems.

I have had people tell me that they do not want to talk to a counselor or therapist because “they are paid to listen.” Yes, we get paid for our work but that does not mean we are not interested in hearing your story or in helping you write a better ending. We care and care deeply about helping you find your way to wellness. All you have to do is ask for help.

The woman I met last night who trekked through the mountains to come to the United States came here because she wanted a better life. Last night she climbed one more mountain to ask for help with depression. Her bravery astounded me, her courage inspired me. Can you find the courage to take the first step on your road to recovery? Are you willing to trek through the mountain of mental illness to find your way to wellness? Reach out today. There are people who very much want to help you succeed on your journey.

So often in my work, I see people desperately wanting to feel better, to be free of their mental illness, substance use, trauma and eating disorders. So often, I see people suffering in their symptoms, wallowing in misery and despair. I wish I could wave a magic wand and make everyone better.

Sadly, treatment does not work like magic. Treatment … recovery takes hard work and daily effort. Oftentimes, I see people who want to feel better but refuse to fully participate in their own recovery. Getting well takes more than simply wanting to feel better; it takes a commitment to doing the work of recovery. That could mean anything from inpatient hospitalization, participating in a partial hospitalization program, meeting with a therapist or counselor on your own and, more likely than not, taking medication. I have seen very few people living with mental illness recover without taking their medication.

What I do see frequently is people who stop taking their medication and then decompensating to the point where they no longer can function and must be admitted to the hospital for stabilization. People stop taking their medication for a variety of reasons. Perhaps they feel it no longer is working or they do not like the side effects. Some people in the throes of psychosis believe the medication is poison. Some people simply cannot afford to pay for their medication and stop taking it. I urge you to continue to take your medication as prescribed.

If you believe the cocktail of medication you have been prescribed no longer is working for you, instead of stopping usage, talk to your psychiatrist or primary care physician. Perhaps the doctor can try a different medication. It can take several tries to find what medications work best for you. It also can take several weeks for the medication to kick in. Do not stop taking your medication because you feel it is not working. It is possible it just has not started working for you yet. If you have concerns about your medication, please talk to your doctor instead of stopping usage. Your doctor can help you find what works best for you.

Recovery from mental illness, substance use, eating disorders and trauma is possible if you are willing to do the work of it. There is no magic trick to be performed. Recovery involves a combination of talk therapy and medication, as well as learning coping skills, exercise and positive thinking. Recovery works if you work it. Are you willing to take the steps necessary to find your way to wellness? Are you willing to take good care of yourself so that you can live the life you deserve?