During my first two decades of life, I strongly held the belief that suicide was the ultimate act of failure - at least for myself. Looking back on the suicides that entered my life when I was younger, I don't remember ever feeling disdain for the victim, but I do remember feeling very confused by their acts. My views on suicide became a little less black and white when a friend of mine took a job in a toxicology lab at a local hospital. Her greatest surprise was finding out that many people who overdosed on their medicines or sleeping pills weren't actually trying to end their life. When questioned after being revived, most of them were operating on the misjudgment that if they could sleep a few days straight or just increase their dosage, their bodies and/or minds would be healed and they would be able to live productive lives again. As she put it, "These people could have killed themselves and have no idea of what they had done until they entered the hereafter."
Another loosening of my views on suicide came when I entered treatment for clinical depression. I insisted quite fervently to my psychologist that not only was I not suicidal, but I would never even considered taking my own life because "that would mean that I screwed up my life so badly that not even God could fix it." He looked at me for a moment and then asked me if I had ever had any self-destructive thoughts or acts. I burst into tears. Despite my beliefs, I had indeed had those thoughts - to the point where I could not leave sharp knives out in the open, because I would have visions of me cutting myself in ways that would have lead to my death, had I done them. It was something I guarded against diligently. Every time I used a knife, it was either washed right then and put back in the drawer, or went immediately into the dishwasher. If neither option was available at that moment, it went under a dishcloth. It had to be out of my sight. I even moved my sharp knives to a separate drawer, so I wouldn't see them while getting other utensils. This experience taught me that even people who believed strongly against suicide, could have those type of thoughts.
Sociologist Emile Durkheim studied the social factors of suicide back in the late 1800s. While we tend to think of suicide as a highly individualistic act, it occurs within a social framework that shapes those acts. His research proposed four types of suicidal acts:
Egotistic suicide - These are people who are not well-integrated into the social network around them. Without the social bonds to fall back on for support and guidance, they are left to face their problems alone. These people can be disaffected for a variety of reasons: they're part of undesirable social group; they're highly individualized people; or they have an illness or disorder that makes creating social bonds difficult.
Altruistic suicide - These are people who are overly integrated into the social network around them. This is the kamikaze pilot, the suicide bomber, and the self-martyr. These people kill themselves in the belief that it will save others.
Anomic suicide - This happens when someone loses their standing in their social network. They are no longer guided by the rules they had come to depend upon, because those rules are either no longer relevant or have completely failed them. These are the people who suddenly lost their jobs or social positions, due to things like financial downturns, divorce, or scandal. Not knowing where they now fit into society, they decide that they no longer have a place in it.
Fatalistic suicide - These people are overly controlled by society, whose only real "freedom" is killing themselves. These people include slaves, prisoners and those oppressed by a totalitarian regime.
But social networks are not the only factor in suicidal behavior. Age and level of development is also a great influence on how and why suicide is committed. While it is a difficult concept for even professionals to come to terms with, pre-adolescent children do commit suicide. It's rare, but it does happen in situations where the family bond is weak (strong families rarely tell each other they wish that other family members were dead), especially if the child knows of others who have committed suicide. Children are more likely to commit suicides that can be dismissed as accidents, such as running into traffic or falling from high places. That's not to say that every child that dies this way has committed suicide--far from it. Accidents still are a major reason for childhood deaths; however, for a child who wants to end his/her life, doing similar acts on purpose is the easiest way to achieve their goal.
Adolescents are one of the most likely groups for committing suicide. It is the second highest cause of death for those between the ages of 15 to 24. The lack of problem solving skills among adolescent suicide victims, as well as the lack of parental bonding and guidance probably explains the cut-off point around age 24, which is around the time that the frontal lobes in the brain have finished developing. So it's possible that even those who have an elevated risk will have improved judgment by then. Rick factors include: poor parental-attachment; deficient problem-solving skills; alcohol and drug use in the family; seeing themselves different than their parents; socio-ecomonic adversity; exposure to sexual abuse; high rates of neuroticism; novelty; depression; anxiety; and conduct disorder. There is also a social element involved. Adolescents are more susceptible to cluster suicides--suicides triggered by other who have committed suicide. The attention give to the first suicide victim after the fact can appear to be the type of validation the following victims hope for, though they fail to take in account that they won't actually benefit from it. For this reason, some psychologists are warning Cornell University to be careful how they memorialize the students who have recently comment suicide there.
Adults over 25 who commit suicide are another class, altogether. For one thing, they are less likely to state their suicidal intentions in direct ways. Instead they will talk about not being useful or not being able to stand their current situation anymore. While some, due to delayed development, will behave similar to the adolescent group, most suicidal people from ages 25 to 65 suffer from anomic stressors like job losses, financial and health problems, loss of a loved one, as well as drug use, depression, and hopelessness. Behavioral signs are very similar to clinical depression, with the exception of gettings one's affairs in order. They tend to withdraw from others and start having troubles with sleeping, concentrating, and eating.
Elderly people are largest group to commit suicide and that's not even including those who commit chronic or passive suicide by letting their illnesses have their way or just stop eating and drinking. The group most likely to commit overt suicide in the US are 85 year old white males. The elderly are the most successful at their attempts and the least likely to give any warning of their intentions. Unlike younger people, the elderly rarely use suicide as a threat. Their reasons are often more calculated than emotional. Lack of finances and increases in health care cost often figure prominently in their decision, though depression, isolation, and lack of activity can be major factors. They will often have everything in order to make things easier on their loved ones. During my gerontology studies, a classmate gave a presentation on senior suicides. I will never forget the story she shared of a couple in their 80s, who not only had a file near them containing all their important papers and instructions for their children, but even went as far as laying on trash bags to make the clean up easier. Even my death, dying, and bereavement textbook gives a similar example of elderly suicide.
One type of suicide risk not covered so far is one I'm not sure the mental health industry really has a proper name for - suicidal thoughts caused by medication. Granted, most of these people probably have other risk factors, but based on personal experience, this is not something to tack on just as a footnote. A few years ago, I was placed on blood pressure medication because while my blood pressure wasn't in the danger zone, it was high enough to cause concern with my other medical problems. The first medication I was put up seriously messed with my attention and memory. I stopped driving my car because twice I forgot how to drive. Luckily, both times were in parking lots, and after a few moments I could call up enough of my memory to get me back home. When it became obvious that this side effect was not going to go away, I was switched to another medication. Within a day, I started to have suicidal thoughts. As a precaution, I put my knives out of easy reach. I challenged the thoughts each time they surfaced. Two days later, I took myself off the medication because not only were the thoughts coming just minutes apart, but when I tried to supress them, I began to get suicidal images. Within sixteen hours, I was no longer having those persistant thoughts. I later brought my blood pressure down dramatically by severely limiting the time I spent with negative relatives.
If you experience something similar, it would probably be a good idea to follow the first aid guides at WebMD for suicidal thoughts and not follow my example too closely.
And a final note: Recent studies have shown that animals do commit suicide. While I expected there to be suicides along the lines as the passive suicide done by seniors, having seen a few beloved pets go through this, I had not expected the evidence of animals committing altruistic suicides to protect their population. I do appreciatiate the following statement: "The big difference is that in modern humans that calculation can go wrong. There are some acts of suicide that do save lives. But most of the millions or so human suicides each year worldwide benefit no one, [Thomas] Joiner explained. They are acts that perhaps used to serve a purpose in early human societies, he said, but have lost their function in the modern world."
Showing posts with label depression. Show all posts
Showing posts with label depression. Show all posts
Monday, March 22, 2010
Monday, March 08, 2010
Tipping Points
A couple of weeks ago, a commenter directed me to Change Therapy, a free online book about marketing "soft skills" like therapy by David P. Diana. I'm a little leary of promoting things from sources I'm not sure of, so my first action after seeing the comment was to email the link to a friend of mine who has been a practicing psychologist for over 40 years. His response was not only positive, but there was the hint that it would do me some good too.
I did enjoy reading the book. Among the gems within it, was a revisitation of Malcolm Gladwell's 10,000 hours rule. In a nutshell, 10,000 hours of practice is the tipping point of making one an expert at a skill. Diana extended the rule into an exercise program for one's career.
Yesterday, I visited Positivityratio.com, Dr. Barbara Fredrickson's site. Fredrickson found through her studies that "that experiencing positive emotions in a 3-to-1 ratio with negative ones leads people to a tipping point beyond which they naturally become more resilient to adversity and effortlessly achieve what they once could only imagine." Knowing that negativity is one of my worse inner demons, I've decided to track my positive/negative ratio on her site.
Most of my life, I've been told that it takes 21 days to create a new habit. I've have started several "habits" this way, only to have them get squashed by major life upheavals months later. The thing is I don't want new habits, I want an effective lifestyle where I take better care of myself than I do now. I can't do this by being a "habitist". That's how I developed my toolbox of immediate stress relievers. What I need to do is to become an expert - a master - of personally dealing with stress and depression.
So, how can I apply the 10,000 hour rule here? Well, to make it more manageable, I've decided that I would focus on two things - becoming an "expert" at realistic positiveness and becoming an expert at visual processing. The first is for my health; the second is for a career. If I were to assume that I could apply myself to one of these goals 16 hours a day, then it would take me 625 days or about 22 months to gain expertise. Though that is hardly a realistic expectation, especially since I have health concerns that bring the Spoon Theory into play. If I did an hour a day, it would take me a little over 357 months or close to 30 years to achieve the 10,000 hours by rough estimate. After a few more calculations and based on the fact that I tend to have 5 year cycles in my life, I've decided to make a goal of doing at least 2000 hours of effort to my mastery of these two fields, per year. This means about 5.5 hours a day or 38 hours a week. Luckily for me, I can integrate these tasks in with my other activities, and in fact, I already am to some extent. It might take me a little while to get that going strong, but I suspect that once I do, the 5.5 hour practice will naturally extend itself. And on those days when it's harder, I will remind myself that even if I have been doing it for several months, I still have to reach that 10,000 hours.
I did enjoy reading the book. Among the gems within it, was a revisitation of Malcolm Gladwell's 10,000 hours rule. In a nutshell, 10,000 hours of practice is the tipping point of making one an expert at a skill. Diana extended the rule into an exercise program for one's career.
Yesterday, I visited Positivityratio.com, Dr. Barbara Fredrickson's site. Fredrickson found through her studies that "that experiencing positive emotions in a 3-to-1 ratio with negative ones leads people to a tipping point beyond which they naturally become more resilient to adversity and effortlessly achieve what they once could only imagine." Knowing that negativity is one of my worse inner demons, I've decided to track my positive/negative ratio on her site.
Most of my life, I've been told that it takes 21 days to create a new habit. I've have started several "habits" this way, only to have them get squashed by major life upheavals months later. The thing is I don't want new habits, I want an effective lifestyle where I take better care of myself than I do now. I can't do this by being a "habitist". That's how I developed my toolbox of immediate stress relievers. What I need to do is to become an expert - a master - of personally dealing with stress and depression.
So, how can I apply the 10,000 hour rule here? Well, to make it more manageable, I've decided that I would focus on two things - becoming an "expert" at realistic positiveness and becoming an expert at visual processing. The first is for my health; the second is for a career. If I were to assume that I could apply myself to one of these goals 16 hours a day, then it would take me 625 days or about 22 months to gain expertise. Though that is hardly a realistic expectation, especially since I have health concerns that bring the Spoon Theory into play. If I did an hour a day, it would take me a little over 357 months or close to 30 years to achieve the 10,000 hours by rough estimate. After a few more calculations and based on the fact that I tend to have 5 year cycles in my life, I've decided to make a goal of doing at least 2000 hours of effort to my mastery of these two fields, per year. This means about 5.5 hours a day or 38 hours a week. Luckily for me, I can integrate these tasks in with my other activities, and in fact, I already am to some extent. It might take me a little while to get that going strong, but I suspect that once I do, the 5.5 hour practice will naturally extend itself. And on those days when it's harder, I will remind myself that even if I have been doing it for several months, I still have to reach that 10,000 hours.
Sunday, March 07, 2010
Living with Depression
While I don't feel qualified to make conclusions about happiness, I have spent most my life dealing with depression and anxiety. Over a year ago I wrote the following poem to my depression.
Hello Depression
by Amanda D. Barncord Doerr
Hello there.
I know, we've already met.
In fact, we've been together most of my life.
But I decided it was time for a formal introduction.
You see, I've been operating under a pretext,
The idea that I would one day be free of you.
All I had to do is find the right things to think,
And get the right type of help and support.
But you would just wait until I let my defenses down.
Ambushing me like a tiger in wait.
Giving me a double blow. Sending me into a spiral.
Causing me to doubt my abilities to deal with you.
I've finally accepted that you are a part of me.
That when I fail, it isn't because I am a loser.
It's because you are hard-wired into me.
Through genetics, trauma and happenstance.
Even though you are part of me--you are not me.
I just wanted to make that clear.
Those thoughts or doom and despair are not mine.
They are you speaking to me.
And that's all right.
You can speak to me.
Because when you speak,
I have forgotten something.
However, I have the final word.
Things are never as bad as you say they are.
I want to make sure you know that.
It is time I give you credit for your ideas.
So, here's the head up.
I'm not going to play your games.
We will have to work together instead.
Trust me. It's better this way.
People tell you that admitting the problem is half the battle. They're wrong. It's more like a quarter of the problem, assuming that you're admitting the right problem in the first place. After you've admitted there is a problem and determined what the problem is, you still have to learning how to deal with the problem for the long haul and know the quick fixes for the emergency relapses.
It's like living in neighborhood with a gunman around. Now, admitting you have a gunman around is going to keep you safer than pretending he's not there. You can keep a vigilent eye out for him and take evasive measures, but it still doesn't change the fact that there is a homicidal creep with a deadly weapon around. There's always the chance that you will be caught by surprise. If that happens, there's still the chance that you might survive if you can get first aid and medical attention. But the only sure way to get rid of the gunman is to bring in authorities and change the dynamics of the neighborhood. And if the job is only partially done with no thought and effort beyond the immediate situation, there's no guarantee that the gunman won't return or another gunman won't show up. The solution must have awareness, emergency aid, policing, AND a change of the dynamics of the neighborhood itself through long term planning, which increases the social networking and bonding within the community itself.
Depression is a biological part of me that can only be managed like diabetes. That doesn't mean I am doomed to be depressed and anxious--only that I have to be aware that I am susceptible to it when I don't take care of myself. Realizing that part after attending a NAMI presentation made a very big difference for me, because it was then I realized that I was not a failure, but working under the false notion that I could cure myself from depression permanently.
Of the previous stated needs for a solution, I have the first two down pretty well. I have an amazing toolbox for stress emergency aid. What I don't have is a good social and economic network for myself. I'm not completely without a network, and many a time it has stood between me and total despair, but I am not firmly enmeshed in it, nor is it enough for my needs. What I have is an emergency network, something that is essential, but is more for saving my neck than keeping me from getting that bad in the first place. What I need is a preventative network - or more of one.
Building a preventative social network isn't easy for those of us who never really had one to begin with. The longest I've ever lived in one place is six years. Social networks take time to build. You need to be comfortable with the people around you and they need to feel comfortable with you - or at least not be uneasy around each other. You also have to know your neighborhood and be a part of your community. It's the little strings within the network that can often give us the strongest sense of belonging. Nothing says "you belong here" like being able to recognize local merchants and city workers, and running into church/association members in the checkout line. Being an introvert definitely impedes this process, but even an introvert over a period of time can still develop a strong social network.
A strange thing I've noticed over the past few years of being aware of my interaction with the social networks around me, you don't actually have to have everyone know your problems for it to have a positive affect on your sense of security. The restaurant owners near me have no idea of my daily struggle to keep depression at bay, yet that doesn't stop me from feeling valued as I visit their places and chitchat with them. Granted, I still need people I can talk to and confide in when things get bad and I have to deal honestly with people. Promoting a lie never helps mental health. But somehow when I make an effort to just be more visible within my community, things seem just a little less horrible.
Rereading this post, I realized that in my pride, I have neglected to mention/admit that I do need some policing in regards to my mental health. I spend a lot of time self-policing my thoughts, but it probably wouldn't hurt if I got some extra help as I had in the past. Nothing like having your words public to insure you re-evaluated yourself. In my defense, I am in the midst of improving the policing of my depressive behaviors. One thing I am doing is taking advantage of some of the online resources available for monitoring my moods. Another thing I am doing is being aware of all my moods and selectively talking to different friends when I am very disturbed by something in order to gain an understanding of the situation in positive ways.
Hello Depression
by Amanda D. Barncord Doerr
Hello there.
I know, we've already met.
In fact, we've been together most of my life.
But I decided it was time for a formal introduction.
You see, I've been operating under a pretext,
The idea that I would one day be free of you.
All I had to do is find the right things to think,
And get the right type of help and support.
But you would just wait until I let my defenses down.
Ambushing me like a tiger in wait.
Giving me a double blow. Sending me into a spiral.
Causing me to doubt my abilities to deal with you.
I've finally accepted that you are a part of me.
That when I fail, it isn't because I am a loser.
It's because you are hard-wired into me.
Through genetics, trauma and happenstance.
Even though you are part of me--you are not me.
I just wanted to make that clear.
Those thoughts or doom and despair are not mine.
They are you speaking to me.
And that's all right.
You can speak to me.
Because when you speak,
I have forgotten something.
However, I have the final word.
Things are never as bad as you say they are.
I want to make sure you know that.
It is time I give you credit for your ideas.
So, here's the head up.
I'm not going to play your games.
We will have to work together instead.
Trust me. It's better this way.
People tell you that admitting the problem is half the battle. They're wrong. It's more like a quarter of the problem, assuming that you're admitting the right problem in the first place. After you've admitted there is a problem and determined what the problem is, you still have to learning how to deal with the problem for the long haul and know the quick fixes for the emergency relapses.
It's like living in neighborhood with a gunman around. Now, admitting you have a gunman around is going to keep you safer than pretending he's not there. You can keep a vigilent eye out for him and take evasive measures, but it still doesn't change the fact that there is a homicidal creep with a deadly weapon around. There's always the chance that you will be caught by surprise. If that happens, there's still the chance that you might survive if you can get first aid and medical attention. But the only sure way to get rid of the gunman is to bring in authorities and change the dynamics of the neighborhood. And if the job is only partially done with no thought and effort beyond the immediate situation, there's no guarantee that the gunman won't return or another gunman won't show up. The solution must have awareness, emergency aid, policing, AND a change of the dynamics of the neighborhood itself through long term planning, which increases the social networking and bonding within the community itself.
Depression is a biological part of me that can only be managed like diabetes. That doesn't mean I am doomed to be depressed and anxious--only that I have to be aware that I am susceptible to it when I don't take care of myself. Realizing that part after attending a NAMI presentation made a very big difference for me, because it was then I realized that I was not a failure, but working under the false notion that I could cure myself from depression permanently.
Of the previous stated needs for a solution, I have the first two down pretty well. I have an amazing toolbox for stress emergency aid. What I don't have is a good social and economic network for myself. I'm not completely without a network, and many a time it has stood between me and total despair, but I am not firmly enmeshed in it, nor is it enough for my needs. What I have is an emergency network, something that is essential, but is more for saving my neck than keeping me from getting that bad in the first place. What I need is a preventative network - or more of one.
Building a preventative social network isn't easy for those of us who never really had one to begin with. The longest I've ever lived in one place is six years. Social networks take time to build. You need to be comfortable with the people around you and they need to feel comfortable with you - or at least not be uneasy around each other. You also have to know your neighborhood and be a part of your community. It's the little strings within the network that can often give us the strongest sense of belonging. Nothing says "you belong here" like being able to recognize local merchants and city workers, and running into church/association members in the checkout line. Being an introvert definitely impedes this process, but even an introvert over a period of time can still develop a strong social network.
A strange thing I've noticed over the past few years of being aware of my interaction with the social networks around me, you don't actually have to have everyone know your problems for it to have a positive affect on your sense of security. The restaurant owners near me have no idea of my daily struggle to keep depression at bay, yet that doesn't stop me from feeling valued as I visit their places and chitchat with them. Granted, I still need people I can talk to and confide in when things get bad and I have to deal honestly with people. Promoting a lie never helps mental health. But somehow when I make an effort to just be more visible within my community, things seem just a little less horrible.
Rereading this post, I realized that in my pride, I have neglected to mention/admit that I do need some policing in regards to my mental health. I spend a lot of time self-policing my thoughts, but it probably wouldn't hurt if I got some extra help as I had in the past. Nothing like having your words public to insure you re-evaluated yourself. In my defense, I am in the midst of improving the policing of my depressive behaviors. One thing I am doing is taking advantage of some of the online resources available for monitoring my moods. Another thing I am doing is being aware of all my moods and selectively talking to different friends when I am very disturbed by something in order to gain an understanding of the situation in positive ways.
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