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Amy's Thoughts...

What to do if your friend is considering suicide.

12/3/2012

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I recently spoke to a group of high school students about suicide.  As I was speaking, I came to the realization that a lot of people are uncomfortable talking about it.  In fact, the teacher asked me to come in to address the class because she herself was unsure about how to broach the subject.  Suicide rates (including both attempted and completed) among Canadian young adults and adolescents are alarmingly high.  Check out the Statistics Canada information here if you are interested in the figures.

One of the problems is the stigma so often attached to the topic.  No one wants to talk about it.  If someone does commit suicide family members and friends speak about it in hushed tones.  Everyone judges the "suicidal girl" at school (or the colleague with "mental problems" in the work place).  But, considering suicide is something that can happen to any person, no matter their socio-economic status or past history it is worthwhile for every person to know what to do or say to a friend or loved one who is at risk.  After all, would you rather have a somewhat awkward conversation or a dead friend?

Do's 
Ask direct straightforward questions in a calm manner: “Are you thinking about hurting yourself?  Have you been thinking about killing yourself?”  These questions are very hard to ask in the moment, but could save a life.

Be a good listener and be very supportive without being fake.  You probably won't be able to come up with a solution for them right away, so the best thing you can do is listen to their concerns.

If they aren’t in any immediate harm try to persuade the person to get professional help and assist them in trying to get the help.

Try to figure out how serious they are.  A lot of people think about killing themselves, but don’t have a plan.  Ask them questions about their feelings, important relationships, who else they’ve talked to about it and if they have thought of a plan.  If they have a precise plan (e.g. "I’m going to use a gun, I’m going to hang myself, etc"), it is an emergency and you should call someone immediately.


Dont's
Don’t refuse to talk to the person about it if they approach you.  Also, Don’t react with humour, disapproval or repulsion.  It may seem awkward at first, but they sought you out for a reason. 

Don’t say “everything’s going to be fine,” or “you’ll get over it.”  If the solution were that easy, they wouldn’t have come to you in the first place.


Don’t ignore the conversation and pretend it never happened.


Who to call?
911 - Local emergency services

Your friend's parent or loved one

If you are in the Fredericton area:
Mobile Crisis Team – after hours (4 PM-1 AM) – (506) 453-2132

For the rest of New Brunswick, the Chimo Helpline can put you in touch with resources in your community:
Chimo Helpline – 1-800-667-5005

A great number of people who commit suicide do so without talking to a professional first.  Friends and family are usually the first to notice that something is amiss.  Keep your eyes open for warning signs like depression, hopelessness, increased isolation, and self-blame.  And don't be afraid to ask if they are thinking about killing themselves.  You could save a life.
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Climbing a Mountain

5/29/2012

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My somewhat eccentric, but altogether inspirational 80-year-old grandfather decided that he would climb Mount Katahdin this spring.  I had never hiked a mountain and decided to accompany both him and my father on the trip.  I am by no means a hiker or an outdoor enthusiast.  My typical fitness endeavours include walking up the stairs at work and mowing my lawn (it's not a big lawn).  I did nothing to mentally or physically prepare for this trip and suddenly found myself at the bottom of a 4902 ft mountain.  To put it in perspective, the CN tower is 1815 ft tall.  And to make matters worse, we decided to hike on a weekend when the easiest trails were closed.  The trail we hiked was one of the most difficult on the mountain - almost vertical the entire way (4902 ft in 3.2 miles).  In the 8 hours that ensued, I had plenty of time to muse about my experience and how it resembles the process of overcoming mental health difficulties.  Allow me to explain.

Often times you aren't prepared.
As I mentioned above, I was in no shape to climb a mountain.  I hadn't prepared for this.  I suppose I could have trained, but life is busy and I decided to do it on a whim.  Mental health difficulties can take us by surprise.  We usually aren't prepared for emotional problems that arise and don't know effective strategies to deal with them.

Sometimes your only option is to take the hardest trail to the top.
It would have been much easier if we were able to take an less difficult trail, but unfortunately, they were covered in snow and dangerous for hikers.  When I got home, I talked to many people who had reached the summit on other occassions, but managed to do so by taking a less strenuous path.  This option was quite simply unavailable for us.  

When mental health problems arise, some people are able to recover more quickly than others and do so with minimal effort.  For example, some people respond very favourably to a particular medication or therapeutic modality and find relief rapidly.  Others struggle for years to find the right formula for recovery and stumble along the way.  Some of us have to take a more challenging route.


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First view of the summit.
From the bottom it seems impossible.
The trail did not start off easy.  It was difficult from the beginning.  The first hour was the hardest because I couldn't stop thinking about how much further I would have to go.  I was also worried about what was ahead.  I kept telling myself, "I'll never be able to do this," "Who am I kidding?," I'm not in good enough shape for this," "My hiking boots are from Walmart; everyone is going to know I'm a fraud."  

When you are at your lowest point and you see how far you have to go, it's easy to give up and start doubting yourself and your abilities.  You may think, "I'm never going to get over this depression," or "I'm not brave enough to face my fears."  Fear or negative predictions about the future can limit us before we even get started.  We all feel weak at the bottom of the mountain.

Keep the summit in your mind - Don't give yourself a way out.
As I started to hike, a little thought entered my mind: "I could turn around at any time if I really need to, go back down the hill and relax in the comfort of my car."  Focusing on that thought made the hike that much harder.  I wasn't keeping my mind on the goal - I was trying to find an easy way out of the climb.  When I realized this, I changed my thought to "I will go as far as my 80 year-old grandfather goes."

It's easy to give up when it gets tough.  If you tell yourself that there is a way out, it's hard not to take advantage.  Sure mental health problems are difficult to live with and nobody likes living with them, but drastically changing our lives is just as hard - if not harder.  It can be easier to slip back into old habits and routines when the going gets tough.  It's important to keep your eyes on the summit and challenge the little thoughts that urge you to give up.

Keep your eyes on your feet.
Before I climbed a mountain, I pictured myself looking at the summit and striving towards it.  Kind of like that little mountain climber on the Price is Right.  But, after actually experiencing a climb, I realized that you have to keep your focus entirely on your feet.  You can't look at the scenery or the destination because you will fall.  Each step is important and you have to be conscious and aware of your footing.  Getting to the top takes a series of carefully planned and executed steps.  If you don't pay attention, it's easy to stumble and scrape your knee.

So often when attempting to overcome problems in our lives we spend a lot of energy looking at the scenery.  The scenery could be your problematic past (the path behind you) or your ambiguous and therefore, terrifying future (the path ahead).  But the only thing that we can truly control are the careful steps we take every moment.  The decisions and choices we make each day.  It's important to stay in the present for 3 reasons: 1) if you focus on the past or the future, you will stumble 2) it's the only thing we can control 3) it takes a succession of small steps to make it to the top.

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Some boulders are bigger than others.
Boulders come in all shapes and sizes.  Some were as small as a pebble and others were bigger than my entire body.  Some steps were easy and others were extremely difficult.  It's much the same on the journey to recovery from mental health problems.  There are some obstacles that are significantly difficult to overcome, while others may seem effortless.

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Climb together.
I would not have made it up the mountain were it not for my climbing companions.  We commiserated together, helped each other up when one of us stumbled, and cheered each other on.  The journey to the top was an individual achievement. And I didn't make it up as fast as the others, but they helped me to get to the top.

Supportive interpersonal relationships are crucial on the road to recovery.  We need people by our side to act as cheerleaders, nurses and supportive listeners.  It can be hard to reach out to others and ask for support, but trying to climb a mountain alone is miserable and isolating.  It's possible, but it makes the journey much harder.

Keep these things in mind as you climb your mountain!

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    Amy Otteson

    Licensed Psychologist in Fredericton, N.B.

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