In her Psychology Today blog, Promoting Hope, Preventing Suicide, Elana Premack Sandler, LCSW, MPH shared a mnemonic developed by the American Association of Suicidology to help people remember these signs:

IS PATH WARM?

I Ideation
S Substance Abuse

P Purposelessness
A Anxiety
T Trapped
H Hopelessness

W Withdrawal
A Anger
R Recklessness
M Mood changes

Ideation, the first item on this list, refers to the ideas or thinking a person displays when they are considering suicide. The person may threaten to hurt or kill himself, or talk of wanting to do so. He or she may try to obtain a weapon, stockpile pills that could cause a fatal overdose, or obtain another means of suicide. If someone begins talking or writing about death, dying, or suicide in a way that is unusual for them, this is also of great concern.

Signs of suicidal ideation require immediate action, which may include taking the person to the closest hospital emergency room or contacting their therapist or psychiatrist.

Several items on this list do not necessarily indicate risk of suicide by themselves. However, if qualities such as increased anxiety or withdrawal are accompanied by expressions of hopelessness or loss or purpose, it is a good idea to frankly discuss your concerns with the person you are worried about. If they are not suicidal, you will not give them the idea by bringing this up. If they are considering hurting themselves, they will appreciate your concern and the chance to talk about it.

The person you care about is not alone, and neither are you. The National Suicide Prevention Lifeline is available 24 hours a day, 7 days a week at 1-800-273-TALK (8255).

IF YOU ARE CONSIDERING SUICIDE, PICK UP THE PHONE AND CALL 1-800-273-TALK.

IN ANN ARBOR, CALL 9-1-1 OR THE PSYCHIATRIC EMERGENCY ROOM AT 734-936-5900.


No one understands the anguish of a suicidal person like someone else who has been there. That’s the reason that the National Suicide Prevention Lifeline established The Lifeline Gallery: Stories of Hope and Recovery.

The Gallery features brief recorded messages from survivors of suicide attempts who have recovered hope. With avatars based on their own features, these survivors speak of what led up to their attempts and how they have since transformed their lives.

Amanda, who has struggled for years with suicidal thoughts, talks about how she calls the National Suicide Prevention Lifeline (1-800-273-TALK) whenever she feels suicidal: “they’re informed, and not judgmental.”

Kevin relates how, after several attempts, he came to terms with the reality of having bipolar disorder. He now manages his illness instead of denying it, and urges his listeners to “put the number in your cell phone!”

Quix tells us how he came back from the brink by reminding himself “I can make it to tomorrow, and there are always new options to try.” He came to realize that he needs to involve himself in a cause to make his life worthwhile. Like many speakers in the Gallery, he now works in suicide prevention efforts.

The Gallery also carries the messages of people who have lost a loved one to suicide. Professionals who help those at risk are featured as well. Their stories are compelling. Spread the word, because the Gallery could help save lives.

IF YOU ARE CONSIDERING SUICIDE, PICK UP THE PHONE AND CALL 1-800-273-TALK.

In Ann Arbor, you can also call 9-1-1 or the Psychiatric Emergency Room at 734-936-5900.

Whether dealing with temporary disappointments, a difficult grief process, or clinical depression, there are ways to ease sad feelings. Let’s look at three basics for blues management.

Get active. Exercise is one of the most effective ways to lift a mood. Research has demonstrated that exercise is as effective as antidepressant medication in relieving mild or moderate depression

Volunteering. Leaving the house and being around people is very hard during difficult times. However, staying alone at home worsens a depressed mood considerably. Volunteering helps in at least four ways: it gets a person dressed and out of the house, provides for focused conversation, shifts thinking to something positive, and provides a sense of purpose.

Consider helping at The Humane Society. Holding and petting animals and caring for their basic needs feels very good. Animals make few demands on us. Dogs (and many cats) love attention and are generous with affection.

Eating healthy food. Loss of appetite or overeating on junk food both go hand in hand with sadness. When eating very little, food needs to count nutritionally even more than usual. And given that overeating and gaining weight make most people feel worse, fresh produce is a very good choice for those who eat more when they are feeling bad.

Good places to buy fresh, healthy food are farmers markets in Ann Arbor and Ypsilanti. Talking with the sellers provides manageable, focused, friendly conversation. It also feels good and can provide a sense of meaning to support local growers, especially in a challenging economy.

Even though setbacks, grief, and depression are not simple problems, very simple strategies can help tremendously.

There are important differences between sadness, grief, and depression. Each one calls for a different response.

Sadness is a normal, healthy part of life. Many things cause it: disappointments, losing something important, and self-critical thoughts, to name a few. We often want to just get rid of sadness, or to avoid it by distracting ourselves. Unfortunately, this makes it last longer and even makes the problem worse. The best thing we can do when we get sad is to let ourselves feel it and know that it will pass on its own.

Grief is also a normal part of life. When someone important to us dies, we go through a process of grieving that generally lasts up to a year or more. The terrible sadness we feel shows how important that person was to us. If we don’t push grief away, it will also pass, and eventually we will no longer feel so empty. It is important to have caring people to talk with, and support groups can be especially helpful. In the Ann Arbor area, Arbor Hospice provides groups and workshops for adults, adolescents, and younger children who have lost loved ones.

Depression is a medical illness. Even though it feels almost just like sadness or grief, the brain and brain chemistry are involved in a very different way. Unlike sadness or grief, depression does not go away naturally. Someone with depression may feel worse when well-meaning loved ones say to cheer up, because this person is biologically unable to do so. Medication may help, and is often used only temporarily. It is not a “crutch,” but more like taking medication for thyroid conditions, high blood pressure, or other medical problems.

During a period of sadness, it can be hard to tell if one is experiencing sadness, grief, or depression. Very generally speaking, sadness comes and goes, grief is lessened when one is around family or friends, and depression is constant. For some ideas on how to feel better, this article on what to do about a blue mood may be helpful.

If a low mood persists, especially if there is no apparent reason for it, or if you or a loved one is troubled by ongoing, seemingly insurmountable problems, it is a good idea to consult a therapist. I am experienced helping people deal with these types of problems — please call me.

A study published in August 2010 in the Proceedings of the National Academy of Science showed that meditation is effective in managing anxiety and depression.

Drs. Michael Posner and Yi-Yuan Tang led the study of a type of mindfulness meditation called integrative body-mind training (IBMT). Adapted from traditional Chinese medicine by Dr. Tang, it uses a focus on present-moment experience rather than on a mantra.

After just 11 hours of IBMT, brain scans showed significant favorable changes in white matter around the anterior cingulate, a part of the brain involved in managing emotions and self-control. These changes did not take place in the brains of control group participants who practiced relaxation techniques.

A University of Oregon news release said that Drs. Posner and Tang found in 2007 that students who did IBMT for five days before a test showed low levels of the stress hormone cortisol. They were also better able to pay attention, and had less anxiety, depression, anger, and fatigue than those in the relaxation control group.

In the United States, IBMT is only taught to the University of Oregon students involved in the study. Speaking on NPR’s Science Friday, Dr. Posner recommended practicing any form of mindfulness meditation, and also said they hope to release material about learning IBMT in the coming months. Dr. Tang’s website also provides information on IBMT.

Worry is draining. You try to get busy, but your mind keeps going back to the same thing. You forget about it for a while, and then a sick feeling in your stomach brings it all back. You can’t enjoy your family and friends because you aren’t really present. Popping awake at 3 am and knowing that you’ll lie there for the next two hours gives you something new to worry about.

What can you do to stop worrying and effectively solve your difficulties? The first step is to realize that worry is a problem in itself. The situation troubling you may well be serious, but worry keeps you from thinking clearly and taking effective action. Once you get a better handle on your worry problem, you’ll be better able to solve your other problems.

These suggestions may help you exit the worry trap:

  • Do some exercise — it’s very effective for reducing worry. Next, take a hot shower or bath.
  • Decide that for 15 minutes, whenever you catch yourself worrying, you will gently return your mind to the business at hand. Tell yourself that you can worry later if you wish, but right now, you’re going to focus on what you’re doing.
  • Without realizing it, you’re probably repeating over and over, “What if……what if…..what if?” Get a little distance from this by stepping back and telling yourself: I’m thinking “what if?”
  • Remind yourself that, whatever your problem is, many other people have faced the same difficulty and figured out a solution. You will, too.

Your solutions may include talking to a therapist, especially if you find that you cannot stop worrying despite using strategies like these. If so, please call me. I am experienced in helping people with a variety of worry and anxiety problems. Things really can get better.

The ways we spend and don’t spend money have such rich information about both our internal landscapes and how we interact with the world.

The next time you’re standing in a store and you see something you want, try this short exercise:

Move out of the aisle into a quiet spot, or go into the rest room. Look at or visualize your object of desire. Now, find where it is in your body that you want. It may be a watering in your mouth, a fluttering in your stomach, some muscle tension.

This sensation is not good or bad. There is no need to figure out if the sensation is telling you “buy” or “don’t buy.” Your only job is to notice that this is what your body is creating in response to this desire, today, in this store.

Notice if any statements like these come into your mind:

The kids need this.

The kids would like this.

“You spend too much!”

I never get to have anything!

I should get this.

“You don’t need this!”

Check in again with your body. What are you feeling now, in your chest, your gut, your arms, your face?

There is no hidden agenda here of “spend less money, you over-consumer!” You may, in fact, do well to spend more, especially on certain things. How can you know how much to spend if you don’t know your internal landscape? Right now, we just want to see what’s there. You’ll learn how to access your own internal wisdom to guide you in spending decisions. If there is any “agenda,” it would be to learn to give yourself what truly satisfies you.

Jean did the mindful spending exercise I wrote about in Mindful Spending, Part 1.  She had this experience a few days later:

“I realized I was driving behind a Mercedes when the driver stopped for no apparent reason.  I began judging: rich, entitled people. Bad.

When we both got to the stoplight, I noticed there were three women in it. Rich, snotty people. Arrogant. They think they’re better than you. They don’t need cars like that. Nobody needs to spend that kind of money on a car.

Next I noticed I was judging, so began to just look at the car. I thought, good quality. I asked myself if I’d like one, a pertinent question as I’m in the process of buying a new car.

I then became aware of feeling very uncomfortable. Status symbol, status symbols are bad, ostentatious display of wealth, wealth is bad, is wealth bad? “

When we want to find the roots of our “ancient, twisted karma,” there is such benefit to first seeing what is in our internal landscapes before doggedly making ourselves spend less. Jean was surprised to discover these thoughts and feelings within herself, as she’ been working on her “poverty mentality” for quite some time. Maybe there are times she should spend more money than she initially feels comfortable with. But she won’t know that, either, until she learns more about her poverty consciousness, the beliefs that maintain it, and whether or not she wants to continue holding these beliefs.

“In the meantime, though, I still need a new car,” she said. “My raggedy ’97 Chevy has the paint wearing off on the roof, and I’m embarrassed for my co-workers to see it. Talk about the embodiment of poverty mentality!

“There’s no need for me to get this all figured out first. The point is, I’m working on it.”

Here’s some good news for people who suffer with anxiety. A recent study published in the Archives of Internal Medicine found that exercising for at least 30 minutes significantly reduces anxiety.

The authors analyzed 40 studies that involved 2,914 sedentary people with chronic anxiety. That translates into a lot of people who probably used to hate exercise. However, the pain of ongoing anxiety is a strong motivator.

The research abstract does not specify what the “exercise training” consisted of, but “training” implies vigorous effort. If you decide to start exercising for anxiety relief, get some moral support. You are much more likely to stay with it when you have other people to encourage you and provide accountability. And get the go-ahead from your primary care doctor before you begin.

You may not believe it now, but you have powerful internal resources to free yourself from anxiety’s vice grip. Even if you are exhausted from the daily struggle to control fear, try exercise anyway. Do it as an experiment. You have nothing to lose and much to gain.

Anxiety, stress, worry — whatever we call it, many of us are much more familiar with it than we would like to be. Our natural tendency is to fight it, try to make it go away, or distract ourselves with activities that waste our time or even harm us. Unfortunately, this just makes it stronger. If we learn to fear the first inklings of anxiety, it can quickly take over our lives.

A mindful approach to anxiety, even when it is severe and persistent, starts with acceptance. Does this mean just giving up and feeling miserable or gritting your teeth and enduring it? No. Mindful acceptance of anxiety is a very active approach. It is quite different, though, from how most of us naturally try to do battle with worry or tension. And the good news is that, paradoxically, it lowers your fear and helps you feel much better.

How can you use mindfulness to work with anxiety? One method involves locating a place in your body where you feel fear, tension, or worry. You may feel it as a cold pit in your stomach, “butterflies,” or tightness in your chest, back, or jaw. Close your eyes, take two or three deep breaths, and go to that place. Feel the sick feeling, tightness, trembling, burning. Sit with the feeling like you would with someone you love who is in the hospital, with warmth and caring. Do this for a few minutes without looking for any particular outcome. Just see what happens, see what you notice.

A friend who is troubled by mild yet bothersome panic attacks finds that going in this way to the “awful feeling” in her chest quickly lowers her discomfort. You may or may not experience relief so readily. The important thing is that you are developing a new relationship with anxiety. Rather than trying to get rid of it, you are going towards it with kindness and attention. Your symptoms of stress and anxiety may well be trying to give you some important information that your body and mind cannot communicate in any other way.

There is no need to run from anxiety, and medication is very often not necessary. Your fear may simply be inviting you to make changes that will bring you greater happiness and peace of mind.

To contact me, please call (734) 355-8325.
Follow

Get every new post delivered to your Inbox.