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Mental Health Professionals and Suicide

Suicide – Threat of Liability for Mental Health Professionals

Suicide is the third most common cause of death for young adults – and the ninth highest for the general adult population.  This means that a large percentage of mental health professionals will have a patient that commits suicide. It may be as high as 80 percent of psychiatrists, psychologists, social workers, and other therapists, that eventually have a patient who commits suicide.

Serious Mental Health ProfessionalYou might think that professionals are insulated against emotions that come with the death of a friend or acquaintance – but they aren’t.  Many health professionals report that even when death is expected (natural causes), they spend a great deal of time going over their treatment of the patient. They try to find out if they could have done anything different, (given another treatment) in order to help.

But, what may be surprising is the number of liability lawsuits filed against mental health professionals, when a patient commits suicide.  In fact, it is the number-one cause of responsibility lawsuits brought against mental health providers.
The threat of lawsuits, and also the stigma against people working it in the mental-health profession, has led to many psychiatrists refusals to treat the chronically suicidal. The profession sees it as a failure of the doctorMental health professionals are also less likely to see additional suicidal patients after they have had a patient succeed at suicide.

When a therapist or physician is unable, or unwilling, to treat a suicidal patient – it leaves the patient in the lurch.  It produces feelings of failure and hopelessness, without a doubt, compounding the fact that they are suicidal.  It may also be difficult for an extremely suicidal patient to find a new therapist or doctor.  Many patients report that the mental health professionals suddenly “don’t have time”.

We don’t think much about the way suicide will affect those around us – and certainly the professionals are way down the list of people whose feelings are important.

Mental health professionals also report that there is a lack of training on how to deal with suicidal patients, and processing the death of a patient.  More than half of professionals surveyed also Knocking on Heavens Doorstated that they really don’t believe they can prevent a patient from committing suicide.

Oddly, the complaint process against physicians has been shown to increase the risk of the physician becoming depressed. One of the consequences of this will be a worsening of the situation for mentally ill people. (Chronically suicidal patients)

This is a complicated process with no easy answers, but you should know that it is likely that all psychiatrists, therapists, social workers and other counselors probably need to be in counseling themselves.  When you find a new doctor or therapist – you might want to ask.

Even if you aren’t suicidal, you need to know that your counselor is as mentally healthy as possible, certainly healthier than you.

Melissa Lind

Mental Health Professionals Report a Lack of Training on How to Deal With Suicidal Patients

Cutting – An Actual Mental Disorder

Non-Suicidal Self-Injury

A lot of people are shocked and horrified at the thought of self-mutilation and for many years “cutting” was categorized only as a symptom of Borderline Personality DisorderBPD, as you may know, has symptoms of unstable personal relationships, impulsivity, and extreme mood changes (different from Bipolar disorder as they can change on a dime and swing wildly).

The new issue of the American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth Edition or DSM-5, includes it as a separate diagnosis of Non-Suicidal Self-Injury (NSSI).  Research has suggested that NSSI can occur independently of BPD but is also often a co-existing or co-morbid illness, occurring alongside BPD, Bipolar Disorder, one of the many anxiety disorders or with other disorders such as anorexia or bulimia.

Cutting DisorderI am the mother of pre-adolescent children – who are beginning to believe they know all about people who act “weird” or do “weird” things (their words, not mine).  My daughter has recently talked about the “EMO” kids – which as a dumb mom, I had to figure out was a social group of kids who were “emotionally dark.”  She includes in her description of an “EMO” as “you know, like kids who are cutters.”  It is stereotypical to think that they all wear black clothing and heavy eyeliner – as some may – but many do not.

Some people who have the disorder would never be suspected of such – but then we are also sometimes surprised when someone who seems to have everything commits suicide, only to find that under the polished exterior was extreme anguish.  Often, cutting will be dismissed as a “stage” and it may be a “stage” – but often it is not.  Many patients – have arms or hips full of patterned scars – proving that it is often a condition all to itself.

Cutting Disorder - Mental IllnessSelf-mutilation most often starts in the early teen years when adolescent emotions are at their height – but often extends well into adulthood.  The majority of “cutters” are female – but not all.  There is often a co-existing mental illness and may have a family history component – but also often occurs following events of abuse – including sexual, physical or emotional abuse.  Sudden life changes such as unemployment or divorce – and isolation may trigger an occurrence.

People who “cut” often express a desire to “feel” as if they cannot truly attach to their own emotions.  Others will say they “cut” to kill the pain – this is because the act of producing pain also causes the body to release endorphins (the body’s natural painkiller) that makes them feel better.  Unfortunately, even though the action may induce temporary euphoria – it is often followed by guilt and a return of the negative feelings.

NSSI is defined as:

• 5 or more days of intentional self-inflicted damage to the surface of the body without suicidal intent – in the past year.
Patients must be intending to:
o Seek relief from negative feelings or thoughts and/or
o Resolve interpersonal problems and/or
o Induce a positive emotional state
• The behavior must be associated with 1 of:
o Interpersonal problems
o Negative thoughts or feelings
o Premeditation
o Ruminating on injury (obsession)

NSSI includes not only “cutting” but also burning, hitting or punching, head banging, biting, non-aesthetic piercing or carving of skin (tattoos and body piercing don’t apply), pulling out hair or other “topical” mutilation.  If a patient has expressed suicidal thoughts or shows suicidal tendencies – it is not classified as NSSI as the intent of a person with NSSI is not to commit suicide.
NSSI should be first viewed as a serious medical condition that truly requires treatment.  It may be resolved by treating an existing co-morbid psychiatric condition – but likely it will also require psychotherapy to resolve some of the underlying issues.

Definition of Self-injury/cutting (Mayo Clinic)

Cutting and Self-Harm: Warning Signs and Treatment (WebMD)

If you see signs of NSSI or “cutting” in a child, teen, or adult that you know – encourage them to seek help.

Melissa Lind (WriterMelle)

An Actual Mental Disorder – Cutting

Drugs, Alcohol, Depression — A Deadly Mixture

Avoid drugs and alcohol completely if you are depressed

Depression is an extremely serious illness that requires treatment. Without treatment, depression can, and often does, lead to suicide or, at the very least, attempted suicide.
Unfortunately, many people do not seek treatment and instead turn to “self-medicating” with drugs and alcohol.

People who suffer from depression do not enjoy it. They are not just trying to get attention. They really do want to feel better — unfortunately, however, they can’t see a way to do that. Then, if they use drugs or alcohol, they have a brief period where they are feeling better — while the drugs or alcohol are in effect.

BecDepressed and Drunkause they really do want to feel better, and they have experienced feeling better with the drugs or alcohol, they will often use the drug of booze over and over again to either maintain or re-experience “feeling good again.” Unfortunately, this leads to huge problems.

Obviously, addiction and other health concerns come into play with the use of alcohol or drugs. But these substances can also increase the risk of suicidal attempts — and successes, as well. Alcohol is a depressant — not an antidepressant.

It is true that when one starts drinking, they feel a “buzz” of sorts, but as they continue to drink, the alcohol will actually bring them down even further, from a mental viewpoint. The buzz quickly passes — but when they look back at it, all they either remember or allow themselves to think about is that brief buzzed feeling. The same is true with many drugs.

But once the “buzz” has passed, and the drunkenness or drugged state progresses, the depression actually deepens. In a drunken or drugged state, the person may not be able to see any bit of hope, and they are more likely to try to commit suicide.

If you are depressed, avoid drugs and alcohol completely. Talk to your doctor, and get the rundown on how these substances, as well as other substances, may affect your depression, and hinder your treatment.

If one is in a depressed state; avoid alcohol and drugs!

Twelve Days of Seasonal Depression

The Twelve Days of Seasonal Depression – and How to Survive Them

Happy New Year, fellow freaks!

Congratulations on surviving the holidays. This time of year is rough on lots of folks. It’s so bad that psychologists actually had to come up with the term Seasonal Affective Disorder to give a label to the depression many people feel during this time of year. Statistically speaking, more people commit suicide during the holidays than any other time of year.

Bi-polar-2In case you can’t think of a good reason to be bummed, here’s a list. In fact, since we’re all so freakin’ festive, let’s sing it!

The Twelve Days of Holiday Depression (opus 42)

On the twelfth day of Christmas, my true love gave to me:

  • Twelve pounds of gained weight
  • Eleven in-laws bitching
  • Ten hours of sunlight (if I’m lucky)
  • Nine days snowed-in
  • Eight (eight, I forget what eight was for)
  • Seven months of payments on my…
  • Six maxed-out credit cards, and (deep breath)
  • FIVE EXISTENTIAL CRISES wherein I wonder if I’m celebrating for no reason other than to pad some corporation’s bottom line because there just might not be a God after all and this one life might be all I get and I’m wasting it just like my mother always said I would after I dropped out of law school to become an artist and now I have to look her in the eye and tell her “sorry, I couldn’t afford to get you anything this year, but I hand-painted you a card and no, it’s not supposed to be a fish, it’s supposed to be a Christmas tree so I guess you were right all along, so I think I’ll have cup after cup of eggnog until the gift you find under the tree tomorrow will be me, face down in a pool of my own vomit, but what the hell, it’s not like it matters anyway because Santa was a lie you told to get me to behave which makes me wonder if God might be one toooooo! (Pant… pant… pant…)
  • Four calling birds (birds piss me off, OK?)
  • Three French hens (enough with the damn birds, already!)
  • Two turtle doves (See? My TRUE LOVE gave me BIRDS! It’s like she doesn’t even KNOW me!)
  • And a partridge in a pear tree (sigh)

To make matters worse, you could be singing about all these things your true love got you and be single… on Christmas… again. So, now that we’ve had our little sing-along, here’s a bullet list for people who don’t have time for such silliness.

88% Nonsense-Free Checklist of Causes of Seasonal Depression (v2.0)Bipolar?

  • Weight gain leads to lowered self-esteem
  • Debt due to holiday overspending
  • Cabin Fever due to cold weather conditions
  • Stress (due to shopping, family, travel, debt, etc.)
  • Little exposure to sunlight
  • Religious doubt
  • Loneliness
  • Alienation, feeling like an outsider
  • Birds

If even “normal” people tend to get the blues in the winter, just think of how it can affect someone with bipolar disorder! With all of these forces conspiring to make angst the reason for the season, what can you do to avoid the deluge of yuletide despair?

  1. Set a spending limit. Does Uncle Frank in Hoboken, New Jersey really need that 88” plasma TV? Didn’t he get you a bird last year? Send him a more reasonably-priced gift. Don’t have an anxiety attack over whether or not you spent the same amount on someone as they spent on you. That’s not the point! If he or she is the kind of jerk who is going to judge you based on how much you spent on their gift, well… that’s one less person to buy for next year, now isn’t it?
  2. Take time off from shopping to talk with friends and family. Instead of buying someone a gift that will most likely “accidentally” get thrown out with the wrapping paper, take them out to dinner or a movie, something you BOTH can enjoy. Chances are, they need a break from shopping, family, etc. too.
  3. Slow down! Admit that you are human and cannot possibly attend each of the seventeen Christmas events in four different countries you’ve been invited to. Go ONE place Christmas Eve, and ONE place Christmas Day.
  4. Buy full-spectrum light bulbs. Fluorescent bulbs may be more energy-efficient, but they can completely suck your will to live. Full-spectrum bulbs are special bulbs used in light therapy treatments. They produce light that is nearly identical to sunlight. Natural light will work WONDERS for your mood. Seriously. I can’t stress this enough. FULL-SPECTRUM LIGHT BULBS. I keep one in my bedside lamp year-round.
  5. If you live someplace with terrible winters, get out of the house BEFORE the storm hits and again as soon as the roads are clear. Facebook will be there when you get back. I promise.
  6. If you ARE snowed in with your family, play in the snow. It’s exercise, which is good for your mood anyway. Consider having a snowball fight. It’ll relieve some of that pent-up frustration. If you live alone, launch a surprise snowball attack on an unsuspecting neighbor. The ensuing chase will provide a few extra moments of fun, and hey, technically, the police count as having company. Make sure to have plenty of cocoa on hand.
  7. Buy a cat. Petting a cat can lower your stress level. Your partridge, on the other hand, will not be pleased.

These are only a few ideas I’ve got on how to beat the wintertime blues. Can you think of any? If so, let us know in the comments section below. If they’re serious suggestions, great! We can use the help. If they’re silly, great! We can ALWAYS use a laugh. When it comes to depression, laughter might just be the best medicine.

Until next time, keep warm, and keep fighting!

-Bruce Anderson

Read more from Bruce: How I Became the Freak in the Corner

Dispelling a Few Myths about Bipolar Disorder

Dispelling myths about Bipolar Disorder

Hello again, fellow wackos and electronic rubberneckers!Bipolar?

If you’re here because you’re like me—just a little “off”—then welcome. If you’re here to learn about bipolar disorder, stick around, because I know a thing or two and I like to talk. If you’re here to watch the train wreck happen, hoping I’ll melt down and post something crazy about the talking wombats that live in my refrigerator and their TV viewing habits… well, you’ll probably be a little disappointed. I may be a freak, but I’m not crazy.
Yeah, that’s right. I just called myself a freak. I figure if other people are going to call me that, I can probably get away with saying it myself. Wacko, nutcase, loony, psycho… There are lots of things people say about bipolar disorder, and many of them just aren’t true. Let’s take a look at a few of those things right now.

Bipolar Myth #1People with bipolar disorder aren’t really sick.
Bipolar SkelletonSome people say that bipolar disorder is “all in your head.” They say things like “everyone gets depressed. You just need to suck it up and deal with it like everyone else.” If this is true, then diabetics just need to get over their illness, too. I mean, too much sugar is bad for everyone, right?
Just as a diabetic’s body doesn’t process sugars properly, a person with bipolar disorder’s brain doesn’t process dopamine, serotonin and norepinephrine quite right.
Don’t take my word for it, though. Take it from research scientists at the University of Michigan who’ve studied Abnormal Brain Chemistry Found in Bipolar Disorder. They know what they’re talking about.
I’m just some freak, remember?
So, you can tell me I don’t have a “real” disease and that I just need to deal with it, but first you gotta tell Ms. Diabetic to eat six Twinkies and deal with it. Go ahead. I’ll call 911 while she’s chewing.
This myth is so prevalent that insurance companies are allowed to treat it—or more accurately NOT treat it—like it isn’t a “real” disease. The last health insurance I had would pay for 80% of the bill if I had to have major surgery, but only 50% if I saw a doctor for bipolar disorder. Also, they limited the number of times I could see a doctor for treatment to 12 times a year. Tell you what… let’s limit diabetics to 12 insulin shots per year and see how well they do.
What? We shouldn’t do that because they could get sick and die?
Well, people with bipolar disorder die, too. In fact, without proper treatment, 20% of them commit suicide. That’s one in five, folks. I’d say that constitutes a serious health risk. Maybe this bipolar thing is a real disease after all.

Bipolar Myth #2People with bipolar disorder are beyond hope.
He’s got bipolar disorder. He’s crazy. He can’t be helped. He’s a lost cause. Or is he?
The fact is—he isn’t. Bipolar disorder is one of the EASIEST conditions to treat. There are several effective medications, some of which have been in use for quite a while. Lithium, for example, has been around since the 1950’s. Lithium doesn’t work for everyone, though. That’s why there’s Lamictal, Depakote, Zoloft, Tegretol, Wellbutrin, Prozac, Effexor, and a partridge in a pear tree. A psychiatrist can tinker with medications until he finds a combination that works.
Medications can help, but so can just talking. Talk therapy did me more good than any pill ever did. However, without the pills, I probably wouldn’t have listened to anything when I was at rock bottom.
The point is this: people with bipolar disorder CAN be helped. So if you have bipolar disorder or know someone who does, don’t give up. There is hope.
Well gang, it looks like I’m over word count. I told you I like to talk! We’ll talk some more next time when I dispel a few more myths about bipolar disorder.
So to all my friends and fellow freaks, until next time… keep fighting!

Bruce Anderson

Read more here: Words As Weapons And Another Bipolar Myth Dispelled