Thursday, August 19, 2010

Healthy Coping Skills to Appeal to All Your Senses

Listening to music
Taking a bath
Exercise
Yoga
Kickboxing
Taking a nature walk
Writing in a journal
Writing a song, poem, story, etc.
Scrapbooking
Gardening
Cooking a delicious meal
Volunteering
Stretching
Writing a letter to someone you love
Writing a letter to someone who hurt you
Visiting a museum, zoo or art gallery
Taking a creative class: cooking, singing, language, dancing, etc.
Watch a funny movie or TV show
Screaming in your car (rather than at others)
Punching a pillow or a bean bag
Drinking a cup of tea or coffee
Playing a musical instrument
Joining a support group
Talking to supportive friends or family
Eating healthy
Meditate
Caressing a pet
Dancing
Singing
Getting a massage or pedicure
Getting a haircut
Scrubbing the bathtub (helps release tension and anger)
Drawing
Painting
Throwing water balloons at the side of your house
Putting on your favorite article of clothing

Talking to Kids About Suicide

Many parents struggle with how to talk to their children about death. They wonder what vocabulary to use, how much detail they should give, what questions to answer, etc. A death by suicide can complicate things even more and it usually increases the parents' anxieties. They worry that by talking openly about suicide, it will give their children the license to kill themselves. So, many parents end up keeping the truth from their children, believing they are protecting them. However, a suicide is an important part of a family's health history, and having that truth will help their own physical and mental health. A better way to protect your child is to comfort them, reassure them and answer their questions openly and honestly.

Here are some ways to help parents talk openly about suicide:

Tell the truth
Research shows that more than 90 percent of people who commit suicide have a diagnosable mental illness at the time of their death. These mental illnesses are not always identified beforehand, but many suffer from depression, bipolar disorder, schizophrenia and/or substance abuse. A mental illness can complicate a person's thoughts, causing them to feel hopeless, helpless, and make desperate decisions. So, it's safe to say that what caused the suicide was an "illness in the brain" much like a heart problem causes a heart attack or a malignant tumor causes cancer.

Starting out
When talking to your child about suicide, find a time and place where you can talk quietly without interruptions. Choose your words carefully, depending on the age of the child. (See another post which describes the appropriate vocabulary to use with different age groups: http://mentalhealtheducation.blogspot.com/2010/05/talking-to-children-about-death.html)

Allow the child to lead the conversation, and remember they will be more focused on what the loss means to them rather than the cause of death.

Preparing for later
It has been said that children don't run from grief, they walk slowly toward it, which means you may find yourself having these important conversations over several periods of time. Be prepared to talk about suicide multiple times, and encourage them to return to you if they have any more questions. Also, be sure to "check in" with them to see how they are coping with their loss.

Take care of yourself
Enlist the help of a counselor or find a support group for people who are experiencing similar losses. There are many resources available through your local hospice, university, hospital and community mental health center.

Forget the Sticks and Stones...Words Can Be More Painful

I was shopping at Target yesterday with my toddler in tow. At times, he got a little cranky, wanted to keep moving or wanted something to drink. I accomodated his wishes while still trying to fulfill my own retail desires, until I finally gave in and decided to take him home.

I was in the check-out line behind another mom who was obviously very overwhelmed by her own toddler. He was standing up in the grocery cart and she kept asking him to sit down. My son must have witnessed this because he began to stand up in the cart's seat, so I went ahead and secured his seat belt a little tighter to avoid any accidents. Meanwhile, Overwhelmed Mom kept telling her little guy to sit down, sit down, sit down.

Then I heard her say something that really stopped me in my tracks. She began to call him a "bad baby." Instead of using his name, she said, "Sit down, bad baby. No bad baby. You can't have that bad baby." The child seemed unfazed; I think I took it harder than he did. Then again, as a therapist, I imagined him as an adult with self-esteem issues, trying to obtain the approval of others.

My heart did go out to Overwhelmed Mom too. It was apparent that the stress had gotten to her, which it does for most people. She was trying to get her shopping done while taking care of her active child, and who knows what else she was juggling. Other children? A partner? A job? Elderly parents?

This mom reminded me of the importance of self-care. Take time for yourself! Many people who read this will probably say, "What time? I have no time!" These same people probably rearrange their lives to accomodate others. While that is noble and generous, I urge you to be just as accomodating to yourself. Even if it's 15 minutes, at least that time is yours. (Visit another post for further tips: http://mentalhealtheducation.blogspot.com/2010/04/feeling-overwhelmed-by-daily-tasks-here.html)

I wanted to talk to Overwhelmed Mom, tell her I understand, and provide her a little education on how words can be so powerful. Instead, I sent positive thoughts her way, wishing her a little peace, and looked at my own son and told him what a good boy he is. Every parent makes mistakes, but if we just took a little time to take care of ourselves, our children will be better for it.

Saturday, May 29, 2010

When a Celebrity Dies

I've often heard that bad news comes in 3s. I hear this more often when someone dies. The media has reported two recent celebrity deaths and already people are holding their breath for the third.

Many dedicate their Facebook statuses, tweets and blogs to memorialize the actors and singers who have died. They share their favorite songs from the artist or their favorite movie depicting the actor. While memorializing someone who has died is a normal part of the grieving process, I wonder if these same people do something similar when a family member or friend dies.

As a society, we are growing more and more comfortable with death, though it has been a slow process. So many still don't know what to say when they hear of a death, so they say nothing at all. Why not share a favorite memory, a quality you admired, much like people do when they hear of a celebrity death. Why should we restrict this honor to people we have never even met?

On this Memorial Day weekend, let us honor the fallen soldiers, but also remember our loved ones who have died. Today I choose to remember my grandfather and the silent strength he held during World War II. I choose to remember his blue eyes every time I look into my son's. And I choose to remember how he jokingly put an onion in a gum wrapper and passed it off as Juicy Fruit. (To this day I will not eat onions!)

Who will you choose to remember?

Wednesday, May 19, 2010

Talking to Children about Death

Working with grieving children has been the most rewarding aspect of my career. It's so powerful for children to have the opportunity to express their grief and for parents to allow them to explore all emotions associated with it with compassion and security.

There are those that believe if we shield our children from grief, then they won't experience the variety of painful emotions that come with it. As well-intentioned this protection may be, it only sends a negative message to children. It tells them their feelings don't matter, or that death is something to be feared or not discussed. It adds to the sadness, anger, shame, fear, etc. that they are already experiencing.

Some parents come to my office and wonder just "how much" to tell their children about the death of a loved one. They worry that their child won't understand or their child may have nightmares. It's important to keep in mind the age and maturity of each child when discussing death with them, and this article will provide some helpful information to help you along.

Preschool Understanding -- ages 3 to 5 years
Children of this age believe death is temporary or reversible. They believe their loved one is living under different circumstances and they will come back. They have a "magical" way of thinking, which is why it's so important to use words like "dead" and "died" rather than euphemisms. If a child hears he "lost his grandfather" he may wonder why no one has found him. Or if he has been told that "he's gone to a better place" it leaves him wondering what's wrong with this place.

A child may also ask questions such as, "How will Uncle Pete read his newspaper if he's dead?" It's important to explain to the child what "dead" means: that Uncle Pete does not need to eat or drink or read the newspaper or go to work anymore. Again, you want to consider the child's age and maturity level. Answer questions honestly, but don't give anymore information than what is being asked.

Latency Understanding -- ages 6 to 8 years old
Children of this age understand that death is permanent and irreversible. They will ask more questions during this time, such as how Mom died, what happened to her body, etc. As I stated before, answer these questions honestly. The information they receive will give them stability and security.

Pre-Adolescent Understanding -- 9 years to 12 years old
Children in the pre-adolescent stages have an adult understanding of death. They tend to intellectualize the loss (i.e. "Daddy had a brain tumor that really hurt, but now it doesn't hurt him anymore.") in order to help them cope. They also wonder how their world will change afterward, such as who will give them a ride to school, who will play ball with them, etc. While the family dynamic and roles will change, it's important for the child to continue to feel safe and secure.

Children may also begin to fear that someone else they love will die too. If Mom has died in a car accident, a child may be afraid that Dad will die in a car accident too. A healthy answer for this question can go something like this: "Everyone dies sometime, but I'm going to do everything I can to protect myself because I want to take care of you and live to be very, very old."

Adolescent Understanding -- 13 years to Adult
Teens are already at a very critical time in their lives, exploring their thoughts, their environment, their relationships. When a death occurs, they may become blaming ("It's the doctor's fault that grandma died") or philosophical ("Why did my cousin die in the war? What is the meaning of this war?").

Teenagers may even exhibit more risky behavior because they feel immortal and invincible. They may think even though their loved one died, it can't happen to them, so they will drive fast or drink too much alcohol or take drugs. It is important for parents to keep a close eye on these behaviors, and as with all children, to provide the love and security they need.

For more information, read "Children and Grief: When a Parent Dies" by William Worden

Tuesday, May 4, 2010

An Outstanding Read for Consumers and Counselors

Imagine being a child and not being able to sleep for days. Imagine being terrified of being alone with your thoughts. Imagine drinking yourself into oblivion just to get through the day. Imagine dragging a blade across your arm, only to cut so deep you had to be hospitalized for a suicide attempt.

Unfortunately, many of you may have actually experienced these events first-hand. Some of you may have experienced more than one. Marya Hornbacher experienced them all, and more.

Marya Hornbacher is a thirty-something who was not diagnosed with bipolar disorder until her twenties, though she had a history of serious symptoms since childhood. She chronicles her pursuit of optimum mental health in Madness.

In her book, she details the dark, sleepless nights she had as a child which would usually end in violent sobs and rivers of tears as her mother tried her best to comfort her. In her teens, while battling an eating disorder, she was diagnosed with depression and placed on an SSRI (a type of anti-depressant which targets the serotonin levels in your brain), which she later found out would send her into severe mania. Her manic episodes would usually consist of excessive spending, risky sexual behavior and heavy alcohol consumption. At the end of her mania, she would sink into a deep depression, sending her into psychiatric hospitals on several occassions.

The book is a brutal account of a severe mental illness and its effects on a highly intelligent and creative woman. At times it was dark and disturbing. Other times it was confusing. But, overall, it provided a great insight into the realities of mental illness, good psychiatric care and the value of a positive support system.

**A big thank you to my husband for buying this book for me!**

Saturday, May 1, 2010

Suicide Prevention and Education

I attended a very valuable conference last week on Healing Grief After Suicide. There was discussion about the importance of suicide prevention and education in our school system. Naturally, this got me thinking about my own high school experience with suicide.

As we all know, rumors abound in the high school hallways. Who's dating who, who cheated on the test, who's smoking pot by the tree, etc. But, sometimes these rumors became more serious and unfortunately were based on fact. I remember hearing about a young freshman at our school who was hospitalized. She was not that popular, though she tried to be. She would dress in trendy clothes, talk to the popular crowd, join the social clubs. I often heard people complain about her, calling her a "wanna-be" and a "suck-up."

Then one day I heard she cut her wrists. She tried to kill herself, and was hospitalized for an unknown period of time. I don't remember if she came back to our school. Now, mind you, I heard the rumor and was merely an acquaintance of hers, so I can imagine the whole school heard about it.

After this girl tried to take her own life, I was talking to a close friend of mine about the situation. He revealed he tried the same thing over the summer. He stated a relative caught him with a gun under his chin and stopped him. I was at a loss for words. I couldn't believe I almost lost this good friend of mine. I couldn't believe he didn't know to ask for my help.

But, what would I say? Suicide was never addressed at my school. The guidance counselors were much too busy with class schedules. Our Life Skills class was too focused on telling us the dangers of sex (i.e. pregnancy, STDs) rather than the dangers of depression. And, it was more important to hold pep rallys for the football team and award ceremonies for the academic achievers than to educate the students on what to say if a classmate tells you she wants to kill herself.

Did you know suicide is the 3rd leading cause of death among 15 to 24-year-olds? And 50 to 75 percent of all suicides give some warning of their intentions to a friend or family member.

So, what do you do if someone tells you they are thinking of suicide?

Start by telling the person you are concerned and give him/her examples.

If he/she is depressed, don't be afraid to ask whether he/she is considering suicide, or if he/she has a particular plan or method in mind.

Ask if they have a therapist and are taking medication.

Do not attempt to argue someone out of suicide. Rather, let the person know you care, that he/she is not alone, that suicidal feelings are temporary and that depression can be treated. A

Avoid the temptation to say, "You have so much to live for," or "Your suicide will hurt your family."

Be actively involved in encouraging the person to see a physician or mental health professional immediately.

If the person is in immediate danger, call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK. (www.afsp.org)

I can only imagine how many young lives can be saved if we just started talking about suicide, instead of hiding it, being ashamed of it, or thinking it will "just go away." Living in a world of secrecy, the unmentionable becomes unmanageable.

What are your own experiences with suicide?