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Why would he kill himself?  He had so much to live for, so many who love him.

8/18/2014

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After such a great loss, the national discussion has turned to mental illness again. 

We've lost the king of comedy, Robin Williams.  Why?  What happened? 

There are so many questions.  Many people are speculating.  Talk shows, political leaders, friends, Facebook, Twitter, newspapers are buzzing.

People are confused, angry and sad.  If you have never been suicidal or experienced soul sucking depression, it makes no sense.

To understand how a person becomes suicidal, remember your worst day.  It may have been because of a divorce, death of a loved one, loss of a job or business or some other kind of event.  Remember what it felt like the next day.....the day after......the day after that....the week after that....the month after that.  You can't eat, or sleep.  You keep thinking about sad, discouraging things.  Nothing is fun.  You can't make decisions.  You are exhausted all the time.  You don't want to do anything.  You don't want to be around people.  You want to be left alone, but then again, you don't.  You can't concentrate.  You forget appointments.

Imagine feeling that feeling every day.  Every morning when you wake up.  Every night when you try to go to sleep.  Every Monday, Tuesday, Wednesday and every other day of the week.  Every holiday, birthday, vacation and workday.  During times you should be happy, times you are rich and times you are poor.  During times when you have loving friends and family and times you are alone.  Let yourself remember that feeling and imagine it dragging on.  It almost never goes away..

How do you deal with that much pain every day?  You don't want to infect anyone else with the depression.  Other people don't want you to feel that bad either.  They say the wrong things.  Eventually they stop saying anything at all.  You feel hopeless and alone.  Day after day after day.

You try everything you can think of to feel better.  If it works at all, it's temporary.  When the depression hits again, you feel even worse.

At some point you can't stand it.  You want the pain to stop no matter how.  Dying becomes an option.  It starts with, "It would be better if I just didn't have to live this way."  "If I die tomorrow, I don't care."  As you feel more helpless and hopeless it changes to, "Well, if I were to kill myself, how could I do it?"  It gets worse and you get everything ready, just in case you do decide to end it.  You think about family and friends and what you can do for them before you go.  You may give things away.  You wrap things up.  You make the decision.  It's such a relief to know that it will soon be over you feel almost happy.  Everyone thinks you are finally getting better.  You take action.

And here we are, those who are left behind, wondering what in the world happened and what we could have done, or what you should have done, or what professionals should have done to keep you alive.  While next to us in line at the bank, a man stands, feeling hopeless and alone. 
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This is why I do what I do.

2/28/2014

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"There are times these days this experience feels almost like a dream.  Truthfully the suffering and inner tangle feels more like a memory than something I actually experienced.  You were correct when you said that would be the case.

A life I was determined to end, hmmm.  Thank you a thousand times for not giving up.  Being the professional, kind, understanding, non-judgmental and sympathetic human that somehow in all my misery I was able to find.  I am so grateful that you never once made fun of or dismissed my genuine suffering. ... I couldn't have asked for a better outcome.  Even though the situation hasn't changed, I have.

You have done more for me than was imaginable in just six short months.  My life has taken some incredible turns during our time together and knowing you were there has been a tremendous comfort.  I would be lying if [I didn't say] what lies ahead has me a bit terrified but my brain feels unscrambled so I will deal. . . . Thank you Jeanne."
                                      - H 2/5/14
I volunteered as a Mental Health Counselor at the Wellness Project in Vancouver, WA.  The Wellness Project accepts clients who do not have mental health insurance and need counseling and/or medication.  I do so as a way to give back to the community, as well as have regular contact with other professionals.  Having a private practice is wonderful in so many ways, but it can be isolating.  I miss working with a team.

I worked with a woman for about six months.  This is average for clients at the Wellness Project.  When we finished our work together, she surprised me with a letter.  Her experience is what brings me satisfaction and happiness.  I feel blessed that I was able to work with her, that she was able to heal so much, and that she shared her feelings with me.  This client told me I could post her whole letter, but this is an excerpt, taking out any information that could identify her.
 
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Depression.  More than feeling depressed.

5/14/2013

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It feels like being in a Black Hole.  There is no light and you just keep getting sucked in further and further  There is no way out.
Black HoleLet me out!!


Snap out of it! 
Things are not that bad!


How many times has someone been impatient with you feeling negative and gloomy?  How many times have you given up trying to explain, because it doesn't make any sense?  There's no particular reason you feel so bad, you just do.  Then you don't want to be around your friends and family because you can't explain why you're not happy AND being around happy people just makes it worse.  You feel more and more alone.  You start feeling like everyone would be better off if you just weren't around.  So you stay away.  Eventually people stop trying to pull you out of your isolation and depression.  Being around you is a bummer.  "You see the dark cloud in every silver lining."   

You feel better when you're sleeping, so you sleep as much as you can.  Or the opposite happens, when you can't sleep.  You either can't get to sleep, can't stay asleep or wake up way too soon.  Then you're tired all the time.  You have no energy.  Nothing is fun.  Nothing is funny.  You can't concentrate.  Things seem harder and harder.  Food tastes bland.  Sometimes you eat anyway.  Sometimes you have no appetite.  Sometimes you snap at people and hate the world.  Sometimes you cry when you "should" be happy.  You know there's something wrong, so does everyone else.  Everyone's attempt at trying to help pisses you off.  Even your dog looks at you with pity.  You just want to be left alone......but not really.


Depression is like walking around with no skin. 
Everything hurts.  Anything that brushes up against you causes pain.  A hug feels bad.  Regular, normal things that happen to everyone throughout the day are at the least irritating, at most painful.  You spend your time avoiding anything that could hurt.  People say things that you take personally.  You get your feelings hurt easily.  Everything seems huge.  It requires so much effort, it often doesn't seem worth it.  You feel like Eeyore all the time.  You hate it, but nothing helps.  You lose hope that it will ever get better. 

Does anything help?
The short answer is yes.  We know some things that can help someone with depression feel better.

When I drink or get loaded, or have sex I feel normal.
What that tells us is that when your brain chemistry changes the symptoms get better.  That is a very important clue!  It is definitely the right idea, just not the right chemicals.  Addiction has a way of biting us in the rear and causing our lives to be miserable....not to mention hurting the people we care about most.

I'm not taking those pills!  I don't want to be a guinea pig.
Medicine is not right for everyone.  If medicine is necessary, there is no blood test to determine which one will help the most.  Prescribers discuss the symptoms you are having and match you with the medicine that will alleviate the most of them.  Mental health treatment is not an exact science.  Sometimes if one medicine doesn't work, another one will.

This is what we know.  There is a difference between feeling depressed and having a clinical depression.  Feeling depressed is only one symptom of clinical depression.  There are several forms of depression.  Some depression is fatal, resulting in suicide or death from risky behavior.  Treatment for depression must take into consideration which type of depression you have. 

Sadness is not depression.  Grief is not depression.  If you have lost something or someone important to you, you will feel sad.  This is normal and healthy.  There is not a set period of time for people to grieve.  Grieving comes in waves.  Sometimes you feel better, then it hits you again.  It does get better over time. 

According to the National Institute of Mental Health, symptoms of depression may include the following:

  • Difficulty concentrating, remembering details, and making decisions
  • Fatigue and decreased energy
  • Feelings of guilt, worthlessness, and/or helplessness
  • Feelings of hopelessness and/or pessimism
  • Insomnia, early-morning wakefulness, or excessive sleeping
  • Irritability, restlessness
  • Loss of interest in activities or hobbies once pleasurable, including sex
  • Overeating or appetite loss
  • Persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment
  • Persistent sad, anxious, or "empty" feelings
  • Thoughts of suicide, suicide attempts

Types of depression:

1.  Major depression:  When the bottom drops out, sometimes people are unable to work or parent.
2.  Dysthymia:  Just generally feeling blah, washed out all the time for no particular reason
3.  Bipolar I:  A cycle, extreme mood swings, sometimes the depression takes over followed by times of feeling great, almost too great,
4.  Bipolar II:  Times when the bottom drops out, followed by a time when things feel a little better, but still not good. Sometimes for a while there is a lot of energy, people can't sleep, are very distracted, talk fast and then for a while everything slows down.
5.  Postpartem:  A major depressive episode after having a baby.
6.  Seasonal Affective Disorder (SAD)  Feeling more depressed in the winter or when the weather is gloomy.

It is extremely important to have a professional determine which type of depression you are experiencing especially if you are considering taking psychiatric medication.  Medication meant for a unipolar depression, major depressive disorder, dysthymia or post-partem depression will probably make Bipolar I & II much worse.  It easy for someone to get a wrong diagnosis with Bipolar because they usually ask for help when they are experiencing the depression symptoms, not the manic or hypomanic symptoms.

Types of treatment:
Nonmedical
    Exercise
    Distraction
    Spending time with people you love
    Getting involved in something important to you
    Vitamins
    Healthy nutrition
    Good sleep
    Being outside
    Working with animals

Clinical
    Talk therapy
    Cognitive/Behavioral Therapy (changing the way we think and behave)
    Skills training (Dialectical Behavioral Therapy, stress management, etc)
    Hypnosis
   
Medical
    Various types of medicines, from SSRI's, SSNRI's, mood stabilizers to tricyclics and MAOI's
    Biofeedback
    ECT
    Sleep disorder treatment with medication or CPAP
    Pain management
    Hospitalization either for crisis stabilization, or longer term if symptoms do not respond to treatment

  The most important thing to know is that depression is treatable.  You are not the only one who has experienced it.  You do not have to be alone.





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Jeanne L. Meyer, LMHC, LPC, MAC
Choices Counseling
(360) 949-2524

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    Jeanne L. Meyer, LMHC, LPC, MAC is a private mental health therapist in Vancouver, WA.

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