Natural anti-depressants (and no pills!)

Hi all:

Here is part of my growing list of natural anti-depressants that have worked for me.  Of course, I can write lists all I want and if I don't use them, they do me no good.  I have looked back into my childhood and forward to think of all the things that just used to tickle me or get a good belly laugh.  Here they are.  Tweak to your personal preferences:

SAD light (buy on Amazon) and read/have coffee in front of it for 20 minutes per day.

Walking.

Walking for 20 minutes in the sun gets you your daily requirement of Vitamin D (that is what the SAD light does as well).

Don't watch sad movies or TVs.  Ask people for their recommendations.  Right now, mine are 30 Rock, Arrested Development and Modern Family.

Watch the Ellen show and dance when she dances in the beginning of the show.

Find a smell that you love and inhale/spray/huff whenever you need a boost of your mood.

Funny books:  The Cursing Mommy's Book of Days (made me pee in my pants) and now reading Bossy Pants from Tina Fey.  It is also a belly buster and pee squirter.

What you did for fun (real fun) when younger:  I want to go roller skating.  I mastered a cartwheel last year, didn't keep up and now am working on mastering it again.  Go sledding if you have snow.  Go somewhere you can go sledding if need to.  On the sunny side, snorkling was one of the coolest things I have ever done and I hope to do it again some day.  In the sunny regions/seasons, going down a great water slide at a water park made me laugh with glee all the way down.  I have done this several times yet not for many years so this summer, I have a goal of going at least once a month if not more.

In the am, turn on the news.  Just having a "talking head" works wonders.  You also will be reminded that there is a world out there other than the little world that exists inside your head.

Accept all offers of Company.  Company is the precious and effective anti-depressant there is.  Note:  this does not include people who tell your to pull your boot straps up or cheer up or some silly ass thing like that.

I need more ideas.  Please communicate with me!

Jacque

We all want Company...

In Motivational Interviewing, we attempt to guide the person through Behavior Change by working with their ambivalence.  There is no greater ambivalence than someone who is contemplating ending their life.

I have interviewing, formally and informally, many attempters.  I actually think they should be called the "survivors" rather than the family/friends of someone who has completed suicide.  While I know it creates great pain and grief to those folks, I believe that suicide is preventable yet there must be understanding by family/friends about depression and suicidality.  There should be a willingness to "step into the mind of the attempter" to explore their pain, their dilemmas and what could be done with them to decrease their suffering.

In my interviews, all the attempters said that they would not like to have been hospitalized on a locked psych unit.  They would have preferred being somewhere safe (and they define that) and they all prefer Company.  Not anyone to watch them like a hawk or try to talk them out of their suicidality yet just a person that will listen if needed and provide a presence of Company.  All human beings prefer to end their lives with a loved one holding their hand.  While depression causes isolation, there is nothing more attempters want than to be with someone.  It is like when we are very sick as kids, and we want our Mommy.  When you are suicidal, you are sick, you are in great despair and you want your Mommy.

Sometimes these Mommies (or any loved one) are not available.  They may be pissed at the attempter because they want them to "snap out of it" or the parent/loved one may be dead or divorced and not available geographically.  Finding someone to provide Company is essential.  In a way, this is provided on a psych unit yet think of how less intrusive it would be to be at home or someone's home and just knowing the Company is in the next room watching TV, ready to respond if you need a cup of tea or toast or someone to watch TV with.

It is the physically presence of a compassionate person who need not have any other qualification other than the willingness to be there.

What about liability, you might ask?  Since 10% of attempters attempt suicide while IN the locked psych unit, the fact is that if someone is determined to kill themselves, they will.  The idea is to have a less intrusive safe place.

If there was a MI practitioner skilled with working with suicidal folks, this would be the ideal treatment follow-up possible.  If the practitioner will make home visits, they deserve a Medal.  Yet even telephonic or Skype sessions work well.  Just think:  suicide hotlines have been around over 50 years and their intervention is done over the telephone.  Fast:  most suicide attempters don't call suicide hotlines.  Why?  You would have to ask them.  Most do reach out to people yet often can't get ahold of anyone who would make them feel safe or they are rejected by the people who they thought would support them.  This rejection greatly increases the suicidality.  Greatly.

We need some Company.  Thoughts?

And can we talk about how suicide attempters are treated?  A friend of mine shared with me today that her sister attempted suicide several years ago.  She went to see the sister in the hospital, walked into her room and said "How selfish can you be? Your ex-husband would get custody of your kids and we would never see them again!"

Since that time, my friend has experienced crippling depression and anxiety herself.  She had to be hospitalized briefly and while on the unit talking with many attempters.  her judgment on suicide shifted.  She thought she would never experience depression so severe that she was catatonic, and she begin to think about what she had said to her sister.  Her sister had never imagine being in such anguish that she would make a suicide attempt, either.  It's not as though one wakes up one day and says "Gosh, I can't wait to be a depressed/suicidal psych patient!"

The stigma is incredible and much stronger than substance abusers.  Everyone has opinion on suicide yet you never know what you yourself would actually do until you are in the midst of it yourself.  It is like the third rail issue of abortion:  no woman will truly know what she will decide to do until she finds herself faced with an unplanned pregnancy.   Since there is so much judgment about suicide and people feel very free to voice these judgments to the attempter, they cannot believe the damage they are doing to the attempter.  It increases their suicidality and their determination to end their lives.  The comments that family/friends make to an attempter often INCREASES their determination to end their lives.

Here are some things that attempters have shared with me that their family/friends said to them after the attempt:
"You are so selfish."  "You are a coward."  "It is a sin." "If you were really serious, you would have gotten it right this first time."  "You are doing this only for attention."  "What the fuck were you thinking?" "Call someone who cares."  "Stop this silliness." "Things will get better." "Stop doing that shit." "The world does not revolve around you." "You are lying and making all these attempts up."
"I am calling the police."  "I am calling 911."

While it may seem as though the last 2 statements are what would be expected, you have to know what happens when 911 and the police are called in.  The police arrive, they do not like suicide attempters, they treat the attempter as a criminal, they stand around the attempter asking stupid and insensitive questions and then the EMTs arrive.  These folks are more kind and compassion as they work with lots of suicidal folks.  You get to the ER, and most ER staff are annoyed by attempters.  They share many of the same judgements as the general public.  It is only when you arrive on the locked Psych unit that staff are understanding and compassionate.  No asshole staff allowed on these units.

What would suicidal attempters really like to hear from someone when acutely suicidal?

"I will be right over."  Often times 911 would not have to be called if the suicidal person has trusted company.  That is all they want anyway:  company.  Depression makes people isolate yet every fiber of their being wishes they had company.  They believe they would not kill themselves if some compassionate person came over and spent the night.  This provide the emotional safety that acutely suicidal people are yearning for.  They are yearning for it.

10% of hospitalized attempters made a suicide attempt while in the locked psych unit.  90% of all attempters make another suicide attempt just 1 week after discharge, 75% after 1 month and 50% after 6 months.

Why do once seemingly normal people continue over and over again to end their lives? It is estimated that for every successful completions, there were 15 attempts prior to that.  It is harder to kill yourself than one would imagine.

Let me end with this quote from Dr. David Conroy:
"Suicide is not chosen; it occurs when pain exceeds resources for dealing with pain."

Amen and pass the basket.

Where are people to go after being discharged from a locked psych unit?

I have found that when a person who has made an attempt or was admitted for suicidal ideation, very little is done with them on the unit itself.  They have "groups" yet they are vague and often run by the techs on the floor.  Attendance is sporadic.

When the discharge date arrives, there is a flurry of activity.  The social worker sits down with the patient and makes sure you have some sort of plan ("Use the coping skills you learned here.") yet there is no specific or detailed safety plan drawn up.  They are told to follow-up with their psychiatrist, which almost always happens because they have your medications.  There is a sense that your getting better relies almost completely on taking your meds.  The SW  makes sure you have an appointment with your therapist and if not, they had you a resource sheet of therapist in the area.  Very few of these therapist take Medicaid, have no sliding scale and increasingly, are self pay.  That means even if you have insurance, you have to pay them their full amount and they give you the receipt with diagnosis so you can send it into your insurance company.  This is done so you have to wait for reimbursement rather than them.

That's it.  No treatment resources specific to suicide, no family sessions to discuss safety and what support look like for the patient, occasional referrals to NAMI support groups and viola, you are back in the real world again from which you just tried to escape from with your suicide attempt.

What is wrong with this picture?