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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.

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