Suicidal Ideation: The Red Flags and How You Can Help

(Also published in ‘Bonjour France Magazine’ July, 2017)

PLEASE NOTE : **Although the author of this personal blog is a psychologist, this article is aimed to provide further information and is not the equivalent of therapeutic intervention. If you believe you or someone you know might be suffering from depression/suicidal thoughts, please contact your local suicide support line or a healthcare professional**

For every attempted suicide, there is thought to be one or more people where the thought of suicide is still very present but has never resulted into an actual attempt. With over a half a million people making a suicidal attempt each year, this translates into a huge problem that largely gets ignored.

Suicide or Suicidal thoughts are very complex. They are often a symptom of mental health concerns such as depression paired with life stressors that only exacerbate the idea of feeling hopeless, being lost or feeling like a burden.

Often people who attempt suicide don’t actually want to die, but see it as their only way out.  Sometimes, such attempts might be viewed as a ‘cry for attention’, but they can’t be ignored.  If you’re concerned about someone who might be suicidal or harbor these thoughts, it’s important to take them seriously.

One of the common misconception about suicide states that someone who is determined to end their life will do it one way or another; this is not true. More often than not, people who contemplate suicide give out warning signs (intentional or not) and you may be in a position to help them before they make a decision that can never be taken back.

Even if you see it as merely a ‘cry for attention’ , it is still a cry for help, regardless, and needs to be addressed.

The following signs are no sure indicators that someone will in fact attempt, but they are red flags to keep in mind and address:

Signs of Possible Red flags Concerning Suicidal Thoughts

1.Talking about suicide

One of the most obvious red flags). They might seriously conciser it or casually mention it’s on their minds, but listen. Sometimes (especially amongst teenagers) it could be seen as ‘getting attention’ or being ‘dramatic’. Regardless of our own prejudges or whether we things the person is just going through a bad spell, it’s important to take this seriously and listen to what they have to say.

2. Alcohol and drug abuse.

Often people who are suffering from depression or anxiety turn to alcohol or drugs as a temporary relief of some sorts. Although this might be a quick fix, more often than not substance abuse only escalates the depression/anxiety as the underlying reasons or not addressed. A band aid might stop the bleeding but eventually it peels off. The risk of suicidal thoughts turning into a more realistic action is greatly increased with substance abuse … someone who may not take that step sober, might find themselves with the ‘liquid courage’ or diminished reasoning to push themselves over the edge and take their own lives.

3. Withdrawal from others.

Another red flag is when someone decides to cut themselves off from their friends and family. They become withdrawn and don’t want to talk to anyone about it as they don’t feel it’s worth the effort. Although the withdrawal might again be a temporary fix, it only enhances their isolation and feeling that they are handling all of this on their own

4. Not seeing a future.

When someone says they can’t see a clear future, sometimes may indicate that they have lost all hope for what’s ahead… they might not find themselves strong enough or worthy enough to get out of this bad period they find themselves in. Again, just because someone doesn’t see a clear cut out future, doesn’t make them suicidal, but put together with some of the other signs we are mentioning here, it could also be a red flag

5.’Saying goodbye’

This isn’t always in a form of a letter or note that has come to be so largely associated with suicide. Sometimes people will make fleeting comments like ‘I won’t be around to bother anyone for much longer’, there’s just no way out of this or giving away personal possessions or getting their affairs in order … These may be indicators that they are contemplating life without them in it

6. They are no longer sad, they are numb, which somehow seems worse

Sometimes an eerie ‘calmness’ might come over someone who has made the decision to take their own life. When someone who is usually very social and outgoing suddenly becomes withdrawn and isolated , take note. When someone who is usually rational and careful, displays reckless behaviors. Take note. When someone seems to ‘not care anymore’ about anything. Take note. Perhaps they’re going through a rough time and suicide is not on their mind at all… but you won’t know that for sure until you listen and talk to them

What can I do to help?
You don’t need to be a mental health professional in order to be part of helping someone who is contemplating suicide. Of course professional help is highly recommended to support someone through the underlying issues that are causing them to feel like there are no other options. But before getting them to see a therapist, doctor, counsellor or any other health professional, here are a few things you could do to help them get there:
     1. Be prepared

Make sure you yourself are ready to hear the possible answer that they are indeed planning to end their own life. What actions would you take to help them and prevent them from making that choice. What are your own beliefs around the topic and how would you handle supporting them)

2. Be direct

You may not want to offend them (because we live in a society where we all step on eggshells around each other when it comes to certain topics) but be direct.  People who have such thoughts may not always know how to ask for help, and they might try and push people away as they try and process what’s going through their own minds.  Ask them if they are thinking of suicide… don’t be vague. If the answer is no, that doesn’t mean they don’t need help … Prevention is not only about stopping a planned attempt, but about helping someone before they even get to that place

3. Don’t panic and stay calm

Focus on asking questions and get as much information on what is happening in their life that got them to feel they have no way out. Panicking could only escalate the situation and add extra misery to an already chaotic mind. Tough love comments such as ‘the coward way out’, it’s selfish and idiotic can backfire as it will only reinforce their own thoughts of feeling useless and unworthy.  Stay calm and help them through this

4. What can I (not) say

As mentioned before, you don’t need to be a healthcare professional in order to help someone you know or care about, just being supportive and a listening ear can be a great start. However, be mindful about the following : a) don’t be judgmental or guilt-trip: they already feel pretty low about themselves b) saying things like ‘don’t worry, it will get better’ may be said with the best intentions, but it may also make them feel like you are minimizing what they are going through or feeling. What may seem trivial or ‘not as serious’ to you, may feel like the end of the world for them. Try and focus on giving examples of how they could work through this c) Everyone’s story is different so don’t tell them you know what they are going through (even if you had a similar experience). This isn’t about you, it’s about them and acknowledging that you hear it’s tough for them rather than claiming you already know what it’s like.

5. Most importantly, encourage them to seek professional help.

Be it a hotline, a general practitioner or a mental health professional. Show them that they have you there for support no matter what, but that speaking with someone could help them work on possible outcomes to work through this…. A network is stronger than one individual.

Responding in a Crisis Situation

When you feel someone’s suicidal thoughts might be putting them at immediate risk of harm, ask the following questions:

– Do they have a suicide plan

– Do they have the means to carry our their plan? (eg: pills, knives, guns, …)

– Do they know when they would do it?

– Do they intend to take their own life?

If a suicide attempt seems imminent, contact your emergency services or take them to the hospital. Remove all weapons, knives, medication or other potentially lethal object from their environment, and never, under any circumstances, leave a suicidal person alone.                                                                              (source: helpguide.org) 

At any one time, people may exhibit many of the warning signs mentioned above, without harboring suicidal thoughts. But a lower rate in a larger population is still a lot of people – and many completed suicides had only a few of the conditions listed above. In a one person to another person situation, all indications of suicidal ideation need to be taken seriously.

Remember, nothing is more terrifying than battling with your own mind every single day.

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We’ve got to stop this “Parent Shaming”

We have got to stop this parent shaming !!!

By a show of hands, who here has been judged, at some point, on their parenting. Now by the same show of hands, who here has judged other parents (*no… you don’t actually have to raise your ha*….. you see what I’m trying to get at here). Call it assessing competition/compatibility or just being plain bitchy, but we’re all guilty of at least thinking it.

Now back in the good old days, judging was done behind each other’s backs and we could just stick to our little groups of people who handled their kids the same way we did. However, fast forward to the Internet age, and on a daily basis my Facebook feed is flooded with propaganda, health articles and ‘new research’ that seems to show me exactly how bad I am doing at this whole parenting thing.

Not only do we have the ‘facts’ (and I use that term oh so lightly), but with that come the many voices that suggest to the rest of us that we’re doing a crappy job. In the age of oversharing on social media and a false sense of anonymity online, people seem to have taken it upon themselves to judge, criticize and sometimes just plain bully others ,without accounting for the consequences their words might bring.

Of course shaming each other seems to be somewhat of a global issue ranging from our religious/political choices, how we view our body image and what foods we prefer to eat (spoiler alert…. it ALL gives you cancer.. apparently.)  With that, I’d like to focus in particular on parent shaming and some of the issues I’ve stumbled upon in my short 3,5 years as a parent of two children (yes, based on the above criteria, that now makes me an expert  😉

1. ‘Fed is best’ (phrase taken from an existing Facebook page)

Both my girls have been bottle fed (*gasp*). They didn’t get any breast milk from the very start (*double gasp*). With the second one we even gave up within the first month (*exists and slams door*). But did you know that I was never able to produce the milk to begin with…. and yes we tried every tip/suggestion/hint we could find or were given… nothing worked. I had the storage… just not the stock. My girls were frustrated, hungry and missed out on bonding with their mom because each feeding session caused more and more stress for all of us (at one point I had a nurse milking me like a cow while another tried to attach my baby to the boob…. very sexy.. and relaxing) In the end, feeding them formula made them just as happy and healthy and we could focus again on the key issue of getting them fed and enjoying the time to bond and love them.

A number of friends have breastfed their babies in public (*gasp*)… they didn’t use a feeding schedule (*double gasp*) and some are even still breastfeeding their toddler (*the crowd goes wild*). But did you know that it makes them feel so much closer to their little ones.. and yes they know formula could do the trick just as much to give them a break…. but they don’t need nor want it. This is their choice and they are happy about that and I don’t see the kids complaining either.

Everyone has their own prerogative on how they feed their children and damnit.. as long as these babies are fed healthy (meaning breast or formula… not whiskey) then they’ll be just fine!

2. Dad’s don’t babysit, they parent

Ok, the breastfeeding can be more relatable to moms (in account of the whole ‘having boobs’ thing) but for too long have I seen the dads be pushed on the bench when it comes to ‘knowing how hard it is to be a parent’. So with this, I would like to do a little shout-out to all the papas out there. Being parents is about being a team, and like any team, everyone has their own strengths and weaknesses that we bring to the field. There is no superhero and the silly side-kick when it comes to parenting (although it’d be fun to start wearing our underwear on the outside).

It bothers me when people refer to daddies ‘babysitting’ to give mom a night out, but I don’t see us paying them at the end of the night and sending them on their jolly way for a good night’s sleep afterwards.

And believe it or not, when mommy’s not there, daddy also knows how not to kill the baby, what lyrics go with ‘Do you want to build a Snowman’ and that ‘snugglebut’ is the only teddy that helps them sleep better.

Just like moms no longer want to be seen as the 1950s housewife who gets excited about the new washing machine, dads no longer want to be seen as the authoritarian parent who couldn’t tell the front or back of a diaper if their life depended on it.

3. What if I told you that our babies slept through the night without using controlled crying nor co-sleeping…

When it comes up that our girls slept through the night from 3/4 months onward, I am often immediately greeted with the “Oh, I could never listen to my baby cry it out”. Often, one style of parenting is joined with a number of assumptions linked to that style and we don’t look at the background of the situation or most importantly…. is the kid happy?

We used somewhat of a schedule when feeding our girls (of course if they were really hungry before their scheduled time… we fed them… duh). But having a bit of a routine for both of them when it came to feeding and bedtime seemed to really work for us and them and of course I also take into account the immense amount of luck we’ve had with good nighttime sleepers… a lot of luck.

In saying that, parents who do decide on controlled crying are not sadists who sit outside their baby’s bedroom door and giggle every time the child cries out … like the rest of us, they are just trying out what works best for everyone involved in finding the right way to get our babies to sleep. We might not always agree on other people’s methods, but everyone is trying to just figure it out as we go..

I also know a number of parents who co-sleep, and even though it’s not something we did ourselves, we seen their kids as happy and healthy mini-humans. Yes, the parents are tired, I can’t think of any parent who isn’t, and no, none of them have gotten squashed just yet.. they’re fine!

Again, as long as the kids are happy it’s ok to find a schedule or a method that works for both the parents and the children. Sleep deprivation is just part of the game… find your own way to make it manageable.

4. If you have found the solution, share, don’t shame

I applaud those parents who have found the light and the only true way to parent their babies effectively. I even more so enjoy their regular social media blasts where they share their newfound enlightenment with the clear assumption that the rest of us are all still in the dark and know nothing or are ignorant and resistant to change.

If you find some interesting articles out there, or new research that could interest others, by all means, do share the love! But don’t shame the rest of us for not knowing this obvious valuable piece of information (even though you just read about it only 2 weeks ago yourself).  I’m glad people have found the light and maybe it is indeed the best way to go… if so, give the rest of us a chance to get their on our own … because your smug attitude will just make we want to rebel even more.

(*side note: not everyone sharing an article on parenting is considered a douche, we’ve got the right to speak our minds (this blog post being case in point)

5.  Don’t make up statistics or facts to prove a point

This is where fictional information on the Internet comes to play, or as our buddy D. Trump calls it ‘fake news’. Some people out there are good at relaying their personal opinions as hard facts. An example, chocking and SIDS (Sudden Infant Death Syndrome) is a big worry for all parents, so please don’t tell a parent that their way to put their child to bed can lead to SIDS unless you have the scientific facts to back you up. We have been told that our use of ‘sleep positioners’ (to stop baby from rolling) could lead to SIDS… bullshit. Some of my co-sleeping friends have been told they could squash and choke their baby while they sleep…. bullshit. We’ll always find that one case where a baby did die etc, but don’t use someone’s horrible (and most likely rare) experience as a statistic to support your opinion on.

6. If you feel very strong about something, that’s fine, but does it need to be said?

In saying that, I feel strongly about this, but vaccines do not cause autism (I’m sorry that is just a scientific fact, we really can’t dispute that one can we?). That doesn’t mean I’ll go hunt down the parents that choose not to vaccinate, nor will I ever confront them about it (however hard it can be). The same goes for people who choose not to have medical, life-saving, interventions for their children because of their religion… I admire doctors who have to deal with this on a regular basis because I know I would struggle at keeping my mouth shut. Again though, this is the parents choice and it sucks big time to see this happen no matter how strongly we disagree with it (I know I do… just write a blog about it instead :p )

As usual, these are all just a compilation of my own personal opinions and suggestions (this being a personal blog and all). If I’ve offended some people with what I wrote please know this was not my intention, but it can be seen as such a ‘taboo’ topic these days that it’s hard to know what you should and shouldn’t write. I guess the main objective I’m trying to get at here is to try and live in a community where we support each other, not to make each other feel bad because we do things differently.

We can’t stop from judging… it’s in our nature.. but think before you speak … is it necessary to say out loud or could we just think it to ourselves?

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*(yep, these our kids watching TV… whaaaaaa?! 😉

Responding to Survivors of Sexual Assault /Abuse

A topic many would like to avoid if they could, sexual assault and sexual abuse are occurring far too often still on a global scale. This post is not within the usual genre of taking a funnier perspective on life situations, but rather to raise awareness and provide information on the signs and ways to respond to and support survivors of sexual assault.

Recent events in the news got be thinking how, even though we do hear about it, many cases still go unreported. When working in the field with abused children as well as later in private practice, the regularity of sexual assault/abuse cases is far too high..
I hope the information in this post will benefit anyone interested in the topic, be it a mental health professional, a teacher, as a parent, a friend, or even the victim/survivor. I will be using the term ‘survivor’ as well as ‘victim’. I do not intend to separate to two, but rather use both terms to indicate that although someone can be a victim of the crime itself, they have survived the experience.. and that takes guts!

There are many myths out there around sexual assault and they seem to be passed on from generation to generation. When these myths are finally challenged, survivors’ own experiences begin to tell us about the realities of rape.

Myth –> Rape is a sexual crime
Reality: Rape is a violent assault that is acted out, in part, sexually. Through psychological, verbal and physical abuse, rape violates someone’s personal integrity and their sense of safety and control of life is compromised.

Myth –> Rape happens when the attacker loses self-control
Reality: Attackers who rape, know very well what they are doing, rape is an act of control

Myth –> Most rapes involved people of different race.
Reality: Most rapes involve people of the same cultural background, however, some rapists do rape out of racial hatred we well as hatred towards women.

Myth –> Rape only happens to women by men, not the other way around.
Reality: There are many cases where a woman is the perpetrator and a man the victim.

As mentioned earlier, the rate of under reporting is the highest when it comes to rape and sexual assault. There can be many reasons why someone would not report rape. Some of the reasons given by the people I have worked with in the past include: they told someone else, fear, shame and many didn’t really know why they chose not to report it.

I don’t mean to scare anyone with these statistics, but would rather like to raise an awareness of what can be out there and how we could recognize the possible signs if someone we know has been assaulted and how we could approach and support them.

Being sexually assaulted is an overwhelming experience which can lead to a whole range of emotions. It is also a very personal experience and there is no right or wrong way to react, as everyone is different. The following are based on the responses from people who have survived a sexual offence and who have identified these impacts. (Please note that survivors of sexual assault/abuse may display some of the impacts or may not display any initially).

– Shock and Disbelief (in the days following the assault, some may feel a sense of shock or a general feeling of numbness)
– Fear (after the assault, some are known to be afraid of people, afraid to be alone or afraid the attacker will come back. Some also have a fear of not being believed)
– Anger (people may be angry for many reasons. The anger is not necessarily a negative emotion as they have every right to feel angry about what happened. It is important to work out a safe way to express this anger)
– Shame and Embarrassment (some people feel ashamed and feel others can tell what has happened even without knowing the story.)
– Guilt (for a variety of reasons, people who have been assaulted feel guilty and tend to blame themselves)

Child sexual abuse

Unfortunately, rape doesn’t only occur amongst adults and the staggering and ever changing statistics of child sexual abuse is something I’ll never get used to. In the larger percentage of child sexual abuse cases, the perpetrator is known by the child. Unfortunately it is a very hard fact to prove and from the numerous cases I have investigated, very few attackers were prosecuted and sentenced.

Sexual abuse in children is most commonly observed through emotional and behavioral indicators. Such indicators may be subtle and are attributed to other concerns or problems that the child may be experiencing. The presence of the below indicators should not be considered in isolation. Although it is important to be aware of some of the signs, there may be a number of explanations, aside from child sexual abuse, to account for some of these behaviors. Some of the indicators that may suggest abuse (in collaboration with each other) include:
– Anxiety and Aggression
– Arousal /Promiscuity (sexualised behaviors)
– Sexual pre-maturity (age- inappropriate knowledge on certain sexualised behaviors)
– Change in mood and/or Emotionless
– Smearing faeces or blood on the alleged location of sexual abuse
– Sudden bed wetting
– Detachment and Isolation
– Eating Problems
– Suddenly reverting back to being a younger child (e.g.: sucking thumb again, talking in a baby voice etc)

If you are concerned that your child may have experienced some form of abuse, look at the bigger picture and get all the information first. If your child does disclose any information that may suggest they have been harmed, it is important to contact the correct authorities who have been trained in obtaining all the evidence and can help you in supporting your child.

Supporting survivors of sexual assault/abuse

There is definitely not a black and white ‘How To’ Guide to tell us the exact steps to take to support each victim of sexual assault, as every person is different and every survivor copes differently. So what can we do when someone we know tells us they have been sexually assaulted? These are some suggestions I have found useful in the past when working with survivors of sexual offences.

– Try to contain your shock (this is especially important with children. If they are met with a sudden outburst of anger, confusion and rage, they are likely to shut down more and not want to disclose any further information)

– Believe (actively listen to them and don’t interrupt their story. Ask open ended questions where needed eg: “Then what happened?”)

– Remind them it is not their fault (don’t ask them what they were wearing or why they didn’t fight back).

– Don’t tell them what to do (as much as you want them to get the right help and support, telling them what they ‘need’ or ‘have’ to do, is stripping them from their power, just like the perpetrator did. Asking genuinely if they feel they should get medical attention or talk to a professional can be a good start).

– When dealing with child abuse – contact the correct authorities (Police and Child Safety Services)

– Remind them that there is no wrong or right way to react after being assaulted and that your door is always open for you to listen to them.

– Be aware of ‘secondary trauma’. As a witness or supporter to someone who has experienced such a traumatic event, we can’t help but take some of the emotional pain in as well. It is important to acknowledge that this will also affect you and that this is a normal reaction to have. Finding appropriate coping strategies to manage this will not only give you a greater understanding of the topic but can prevent interference in providing your support to the survivor themselves.

Again, this post did not focus on the usual aim to take a lighter look on life, but I thank you for taking the time to read this regardless, and to raise further awareness on the every growing number of sexual assault cases out there.

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