Stigma & Mental Health: Please stop trying to guilt people out of feeling suicidal…

I am so pleased that the stigma around mental health is starting to be addressed. As awareness is raised it becomes easier for those of us who struggle with mental health issues to get taken seriously. However, there are still three areas that don’t seem to be readily understood.

The first is that mental health is actually a physical problem, just as much as a broken leg is. There is good research that demonstrates that our brains are actually affected by mental health conditions.

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So, just like many other conditions, mental health is an invisible disability.

For some people, finding the right medication is a case of trial and error, but once found it makes all the difference.

For others, medications aren’t effective at all and can actually make symptoms worse.

Cognitive Behavioural Therapy (CBT), Dialectical Behavioural Therapy (DBT) and Eye Movement Desensitization and Reprocessing (EMDR) are all proving to be effective for many people sometimes on their own, sometimes in combination and often in partnership with medications.

More recently, we’re also seeing the use of Service Dogs for mental health becoming more common. In the USA they differentiate between Emotional Support Animals (ESA), which are dogs that provide comfort for people with mental health concerns but that don’t need the support of a dog in public, and service dogs. This designation of an ESA is needed to assist people having pets in not pet-friendly housing.

In Canada, we just have Psychiatric Service Dogs. That is dogs that are highly trained for public work that are also trained specifically in tasks that help with their handlers psychiatric disability.

Initially, such dogs were being trained for Post Traumatic Stress Disorder (PTSD) in veterans and first responders. However, as the majority of PTSD is actually not caused by combat but from other sources of trauma, we’re starting to see Psychiatric Service Dogs being used by non-veterans too. IMG_7991

The second area that still needs a lot more attention is the medical profession themselves. Unfortunately, there is still a huge tendency within the medical profession to assume that somebody presenting with physical symptoms, who also has a mental health diagnosis, is somatising their illness. Somatization is where somebody presents with physical symptoms that are actually caused by mental health issues.

While somatization is a real issue what many professionals seem to forget is that often mental health conditions have come about because of physical illness, to begin with.

For example, there is a very high correlation between depression and people with hearing loss.

Similarly, just because you have a mental health condition you don’t magically become invulnerable to physical illness. Therefore, it is very unfair (and potentially unsafe) for health professionals to assume that a patient with a mental health condition does not have a physical illness as well. Unfortunately, it tends to happen a lot.

There are horror stories of patients presenting in the Emergency Room with chest pain and being placed in a mental health observation room without ever being placed on a heart monitor, simply because they have a history of mental health conditions.

This is not acceptable. Mental health conditions need to be considered in just the same way as any other health condition when assessing patients and standard protocols (such as putting all patients complaining of chest pain on a heart monitor) need to be followed regardless of the mental health conditions of the patient.

The last area that concerns me is often considered more sensitive: suicide. Despite the increasing awareness of mental health, suicide remains the one area that is the least understood.

A friend posted the following piece today. It’s not the first time that I’ve seen it and I’m sure it won’t be the last. However, I hate it. To me, it is about piling guilt on top of somebody who is already suffering.

I understand that that isn’t what’s intended. That the point is to try and get somebody to realise that their life does impact other people and that their death would have consequences for others. However, it is obviously written by somebody who has never seriously contemplated suicide; (It’s also obviously aimed at a teenager).

You wanna know what happens
once you kill yourself?

Your mother comes home from work and finds her baby dead and she screams and runs over to you and tries to get you to wake up but you won’t and she keeps screaming and shaking you and her tears are dripping onto your face and; your dad hears all the screaming and runs into the room and he can’t even speak because the child that he loved and the child that he watched grow up is gone forever and; finally your little sister runs into the room to see what all the fuss is about and she sees you dead.

The person she looked up to and loved. The person she bragged about to her friends, the person she wanted to be just like when she grew up, the person that made her feel safe. But she’s never really going to get to grow up and smile and laugh and love because she’ll always be consumed with this feeling of missing you.

And now there’s something missing from your family and they can barely look at each other anymore because everything reminds them of you but you’re gone and hurts more than anything. And you think that your mom never cared because she was always busy and yelling at you to finish your homework and clean your room and forgot to say I love you sometimes but really, she loved you more than anything and she doesn’t leave the house anymore, she can’t even get out of bed and she’s getting thinner and thinner because it’s too hard to eat.

Your father had to quit his job and he doesn’t sleep anymore, every time he closes his eyes he sees his baby dead, and the image never goes away no matter how much alcohol he drinks.

And at school your best friend sees that your seat is empty and she gets this sick feeling in her stomach and that’s when she hears the announcement. You killed yourself.

And suddenly she’s screaming and crying in the middle of class and no one even bothers comforting because they’re all busy sitting there staring at your empty seat with tears dripping down their cheeks and all she wants is for you to hug her and tell her it’s gonna be okay like you always did, but this time, you’re not there to do it, everything is dark now that you’re gone and her grades are slipping, she barely goes to school anymore and she ended up in hospital after taking too many pills because she wanted to see you again.

The girls who used to make fun of the way you dressed feel their throats get tight, they don’t talk to each other anymore, they don’t talk to anyone, they’re all in therapy trying so hard not to blame themselves but nothing works.

Your teacher who always gave you a hard time stares blankly at the wall, she quits her job a few days later.

And then your boyfriend hears the news and he can’t breathe, he still calls you a lot just to hear your voice and he talks to you on Facebook but you never message him back, he can’t fall in love again because every girl he meets reminds him of you, he’s never going to get over you, he loved you and he cries himself to sleep every night, hating himself and slicing his skin because he couldn’t save you and he’s never going to hold you in his arms or hear you laugh again.

Now everyone who knew you, whether they were a big part of your life or someone you passed in the hallway a few times a week, they carry this aching feeling around inside them because you’re gone, and they miss you, and they don’t know why you left but it must’ve been their fault and they should’ve stopped you and they should’ve told you they loved you more and that feeling is never going to go away. And so you killed yourself but you killed everyone else around you too.

Author Unknown.

Somebody who is suicidal sees no other way out.

There is no understanding that their life matters.

There is no awareness that anybody cares for them.

All they can see is a continuation of so much pain and hurt that no other option makes sense.

Their death is not about being selfish.

Suicide is the most selfless act a person can take.

A suicidal person truly feels that the world will be a better place without them.

That their death will not only bring them peace but more importantly will bring peace for others.

So pieces such as this actually do the opposite of what’s intended. A suicidal person will not read this as “Please don’t die, you matter”, they will hear this as “See, all these people are hurt by you, they’ll be better off without you”.

These articles pile on the guilt and shame that a suicidal person already feels.

Instead of taking responsibility for how we treat others and the impact that that might have on them, these articles place the burden on the one already suffering.

Consequently, the suicidal person is less likely to open up and talk; not more likely.

If you truly want to help prevent suicide: always treat everybody with kindness. Show people that you love them, don’t just say it. Don’t assume the worst of people; give them the benefit of the doubt.

Everybody is dealing with things that the rest of us have no idea about.

Be kind.

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2 Replies to “Stigma & Mental Health: Please stop trying to guilt people out of feeling suicidal…”

  1. Yes, it is a powerful piece. What you say about somatization, in particular, has helped me to understand what might have been happening with a relative of mine.Linda

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