This is the first installment by Susan M. Gray, M.D.
First of all, please do not mistake anything you read on this website for treatment. Although I am a physician, I am offering general information for education purposes only, not treatment advice or treatment recommendations specific to anyone in particular.
I am not writing the above because I HAVE TO, but because IT IS TRUE. While it is great to read and educate yourself with what resources are out there, no amount of reading—be it on the internet or from books—can replace AN ACTUAL TREATMENT RELATIONSHIP. Whether it is with a physician or therapist with another kind of training, nothing can replace that very special relationship of you seeing someone who gets to know you, makes recommendations, and offers treatments BASED ON YOU AND YOUR PRESENTATION TO THAT TREATMENT PROVIDER.
That being said, I recently joined the board of the Life Is Priceless Foundation (LIPF), and Tim asked me to write something for the website that people who are in need or who are worried about their family members could read to educate themselves about depression, trauma, and mental health in general.
First off, if you are sitting in front of your computer reading this or reading this on your smartphone and you are ACTIVELY FANTASIZING about taking your own life and thinking about how you are going to do it or sitting there with the means within reach (e.g. gun, enough pills to OD on, etc.), please call 911. Let them know what is going on with you, and let them take you to the closest emergency room. You could also take yourself to the closest emergency room and walk yourself in. In the emergency room, doctors, nurses and social workers will talk with you about what is going on and help you. If you are too ambivalent to do either of those things, please call the Suicide Prevention Lifeline at 1-800-273-TALK (8255) and talk to someone before doing anything. Remember: Suicide is a permanent problem to a temporary problem.
I love the very name of this organization: Life is Priceless Foundation. I truly believe that everyone’s life can have meaning and that even if you are not able to find the meaning in your own life right now – your life still has meaning to someone else – and what your life is worth, that meaning, is not something that can be quantified. Once it’s gone, it can’t be replace. If you are like Tim and maybe read this website because you are a survivor and have already lost a loved one to suicide, please go to the American Foundation for Suicide Prevention’s website (www.afsp.org) and look at their section on “Surviving Suicide Loss.” There is a similar section on the American Association of Suicidology’s website (www.suicidology.com), and they actually sponsor an annual conference called “Healing After Suicide,” which will be held in Austin, TX this year. Connecting with other people who have lost loved ones to suicide (like reading Tim’s blog) can be invaluable, as you sometimes feel like no one really understands what you are going through. Also, please be aware that if you are a survivor and you have lost a first degree relative (a parent or a sibling), statistically your chances of committing suicide yourself GOES UP. I’m not saying that to freak anyone out – I’m saying it because I hope it highlights that you should take your own mental health very seriously and should consider both seeking support from blogs like Tim’s but also being active in your own treatment.
A few thoughts on mental health: Mental health is like physical health. There are all kinds of ailments which can afflict us physically from the common cold, to a chronic knee pain, to a severe pneumonia, to a cancer. Mental health problems exist on a similar spectrum. The same way all people will at some point get cold in the winter, all people will at some point get “stressed out,” have an “off day,” or go through brief periods of extreme emotion with or without difficulties controlling their behaviors. There are lots of things that influence our feelings, thoughts, and behaviors – from our genetic make-up at birth, the environment we were raised in, the environment we currently live and work in, as well as our own thoughts and feelings that can often act as a feedback loop – sort of like the way your level of physical activity can feedback on your physical health. It’s really hard to exercise if you are obese and tired all the time – but if you don’t exercise, you might become obese and feel tired all the time. It works similarly with your mind.
Just like the way all of us have to attend to our physical health, we all have to attend to our mental health. For some, this is less work and less urgent than it is for others. The same way, there are some thin people who seem to be able to eat whatever they want and barely exercise and not gain much weight and be pretty healthy, there are people who are resilient and generally mentally stable. And the same way there are people who can carefully watch their diet and work out a lot and still have to watch their weight and blood pressure and worry about their cholesterol – there are some people for whom maintaining their mental health is going to be much more of a challenge than for others, usually for a few different reasons (again, genetics + childhood environment + current stressors/situation). And, like our physical health, we all have a breaking point where we can have mental health problems and even the healthiest person, given the right circumstances, can become severely mentally ill.
The good news is that there are lots of mental health practitioners out there who can and want to help everyone stay as mentally healthy as possible.
Mental health problems that are treatable include all kinds of things, including, but not limited to
- changes in your mood (too down or too up!)
- having extreme anxiety, including panic attacks
- the changes that often come after a trauma (like nightmares, not being able to sleep, feeling hyperalert or numb)
- having unusual experiences like hallucinations or feeling like others can read your thoughts, thinking people are out to get you.
Substance abuse also goes in this group – if you find that you have difficulty controlling your drinking or are using drugs. As a result of many of these changes, particularly when they are severe, people can have thoughts of harming themselves and/or others or find that they are unable to function – going to school or work may be difficult, attending to things like your personal hygiene or feeding yourself may become challenging. This is severe and serious and requires treatment by someone who specializes in treating people with mental health problems!!!
So – what to do if you or someone you love is struggling with depression, substance abuse, trauma, suicidal thoughts, or other mental health problems?
The main thing you want to do is get into a treatment relationship with a treatment provider who specializes in mental health. (Did I already say that? Maybe more than once? This is obviously the take home message, right? GET TREATMENT.)
There are a couple different ways to do this:
1. Consult your general practitioner, your primary care physician, your internist – whatever you call that person that you go to for your annual physical, call when you are sick, get your flu shot from, etc. Ladies, if your only doctor is your ob/gyn, then go to see your ob/gyn. They will not necessarily be able to help you (although many primary care docs, and ob/gyn’s for that matter, prescribe antidepressants and sleeping aids that can be helpful), but they can refer you to someone who can provide you with treatment.
2. If you live in a city like New York or LA or Chicago, you might not need to see your primary care doc to get a referral. Let friends or family know what is going on with you and that you want to see someone – you will most likely get a referral to someone good that either a friend or a friend of a friend is seeing.
3. Get out your health insurance card and call the number on the back of the card – ask them how to find a mental health provider in your area that suits your needs. The bonus is that whoever they recommend will be covered by your insurance!
4. If you don’t have insurance, you can do an online search for things like “low fee psychotherapy” or “low fee mental health services” and then put the name of your town or city.
5. In New York, we have a great service called LifeNet (1-800-Lifenet, 1-800-543-3638) that offers brief emotional support and helps people find referrals.
I could write a lot more! But I won’t. I’m going to occasionally write blog entries on this website. I’m thinking about writing on topics like:
- what’s the difference between different kinds of mental health providers
- different kinds of medications
- stigma
- working while managing a mental health problem
- the role of alcohol and drugs in mental health
…and maybe topics suggested by your comments and e-mails.
In the meantime, there are a lot of great online resources about mental health, if you want to further educate yourself, please check them out. Many of them have lots of stats about how many suicides there are each year and that sort of thing, which, if you haven’t already seen them, you should definitely check out.
www.mantherapy.org – a truly great website aimed at men who think they are too cool and too tough for therapy
www.nami.org – National Alliance for the Mentally Ill – primarily for families who have a mentally ill family member – lots of great education and information
www.afsp.org – American Foundation for Suicide Prevention
www.suicidology.org – American Association of Suicidology
www.thetrevorproject.org – specifically aimed at decreasing suicide completions and attempts amongst LGBT youth
Don’t forget about AA (www.aa.org) and Al-Anon (www.al-anon.alateen.org)!!! Drug and alcohol addiction are serious mental health problems that can contribute to other kinds of mental health problems and lead to suicide and violence. Meetings are a great place to get connected to others and get support.
