4-48-Psychosis

In a certain sense, I feel like, that was her note, the play was her note. That was her goodbye, and she wanted people to know about her struggle, and she, her mind, I feel, was made up, she had made her choice, well ahead of time, she knew what she was going to do.

This is such a difficult part of suicide to talk about that. We don’t say that… there are people, many, many people out there that I believe that we reach, we help, that are feeling suicidal, that are depressed, that are going through a lot, and there are so many people that I see in and out of my life in both my personal and professional life that have struggled with this, and I am so grateful to everyone that continues to go on for one more day, no matter how hard it is. I also know, that sometimes, it’s too much for some people, and I don’t blame them, and I don’t feel that blaming them or maligning people for having made this choice helps anyone.

But I understand the anger of survivors and someone having left their lives and felt like, they feel abandoned, of course they do, the survivors feel abandoned. There is a place for that rage and anger. When I hear about these things happening, my first reaction is not anger, it is, it was that bad, it was that bad for that person at that time, that they did not feel that there was another way out and they made that choice in that moment.

I of course wish they had made another one, but sometimes we have to live with the fallout of that, as we live with the death of this author who made amazing works, and of course we think about what else could she have done then. Because I am sure she would have made many more amazing things had she lived, but we have what we have from her and I think we honour her by appreciating it and performing it in these plays and keeping her work alive.

Oh, the guilt that friends and family members have. Sometimes its important for them to process with their own therapist in order to be able to get through it. Survivors guilt is definitely a phenomenon that happens quite frequently. It’s being able to move through a grieving process, they get stuck, which by the way that’s a reference to something that happens in the play – She gets diagnosed with something called complicated grief – that means that she was stuck in the grieving process and she wasn’t able to move through.

I think its also a touchy subject because when does someone move on from the loss of someone or something important in their life, and I’m not saying its so much a timeframe, but when someone is so caught up that there’s so much grief over what they could have done versus looking at what has happened and being able to live their lives. I think that then they move over into a more unhealthy thought process where they aren’t really helping themselves or others around them, and they need more support at that time to get them past the grief over whoever they have lost in their lives.

Wasn’t there also a reference to [sic] hermself?

That was an interesting way of making a reference to a different type of pronoun that was not entirely feminine or masculine.

I have to tell you from a mental health perspective there were a lot of behind the scenes chatter among our own about that and who should see it and should we let teenagers see it or should let them (see it) and be supervised and we say that we need to talk about this and you can’t watch it without having a dialogue with an adult or with a therapist that’s already in your life already, to be able to process this, because I think that that is very sensitive material.

Adults – if we are talking about their children – need to make some hard decisions about what they are exposed to. But again I think its the dialogue that is the important bit here, because that is how we can take any potential glamour out of the situation and say: “Look someone was behaving really impulsively here by doing this and these actions have really negative consequences, so lets take a look at that.”

Being able to talk about it more really is important, and I think that there is this fear around talking about suicide. I think the biggest myth is that, if you talk about suicide with someone who is thinking about it that something is going to happen.

Just talking about it is not going to make someone make that decision, but it might help them think about it for a day longer if you were able to talk about it.

But I think that the topic is so scary for people that there is an instant panic, because we want to of course protect that person from making an action that would hurt themselves, whether it is lethal or not.

There is also reference to cutting and self harm in this play as well, so that is part of it, but I think that is an example again of non-lethal self harm – she wasn’t attempting suicide in that moment, she had obviously just cut up her arm. There is also a reference in there to the cry for help. Which I hear often taken in a very negative context.

We consider any type of self harm important because it is giving us a message, and yes it is a cry, in that way. but it’s about what we do with it, and the first thing I think that we have to say to ourselves is “let,s not panic” “Let’s talk about this and see where someone is at in the moment,” because there is a huge difference between “I’m just not feeling great about my life right now and I’m not sure whether or not I want to stay here” and “I’m making a plan and I am doing something about it tonight.”

Huge line. And that’s how we decide how to help people from our perspective as mental health professionals. we assess how serious the risk is at any given time. But I think that whether you come to someone like us or whether you are talking to your family, this should be a conversation that people should be allowed to have and this conversation should not be shut down because other people are made uncomfortable by it. Because I think that that shutdown only shows that person, “this is someone I can’t go to” this person cannot support me when I am feeling like this, which means that I have to try and find someone else or I have try to find something else.

I know that it seems like a really big responsibility, if you are not a mental health professional, and I am not asking people to assess those things if you are not in the profession that I am in of course. I think that just being able to talk to someone can help you and that person figure out what do we need to do in this moment. Are you just really depressed today and we can do some things together to try and help you get through it or is it really serious and we should maybe find a therapist or someone to talk to more immediately about what is going on.

I thought that was really powerful in the response being ask me why, don’t judge me.

Those side effects are what prevented her from having medication at the beginning because part of the play is the struggle to decide to even try medication because she is very resistant to it. And there’s good reasons for it because there are side effects for these types of medication and that’s because they act on all systems of the body, so you get things like dry mouth and stomach upset, and you’re like what does this have to do with the medication I’m taking for my depression, but that is because it’s acting on the brain and all other organs of the body, so sometimes there are unintended effects when you take these types of medications. And it takes time for them to get used to so the effects are more severe when you first start taking this type of medication.

I don’t prescribe medication, but obviously I work with a lot of people whom are currently on it and we do monitor what’s going on to see whether or not there needs to be changes to their medication when they go back to their prescribing physician.

Well, I don’t think we have nearly enough, and there is still stigma around getting help. So even if you are a caring loved one who is doing their best to support someone, if they can’t connect to the services they need, we have a real problem telling our loved ones the truth.

I wish that there was more that could be done and i believe that we have the tools and we have the resources to do it, but we need to allocate the resources to mental health, and we also need to work more on prevention and education. I mean I’m all for intervention, if there is a problem, let’s intervene, that’s why I do what I do. But I think that prevention is what prevents these types of illnesses from getting worse over time, because they do. Untreated illnesses get worse over time, and you can take any kind of medical illness for that, for instance diabetes, if you don’t treat diabetes appropriately, you will have severe repercussions for not treating it. it is the same with clinical levels of depression, if it goes untreated in any way it is going to get worse over time.

So I think education should start earlier, and and I think there is a place for it in schools in health class in high school, I think we should spend some time addressing that. But I think that it’s also something that parents should address with their children and I think that there are now age appropriate books in order to discuss these sorts of things with children, because of course, let’s not forget that there are children and adolescents in therapy as well going through things like trauma, and there are ways to talk about it outside of the therapy room, so that the only information people are getting is just, the time that they spend with someone like me, I think that there could be much more education that we could do outside of it, which is why I think a lot of community outreach centres focus on education and have speakers come by and do live talks at low cost or no cost, so that people can be more informed about the different things that other people – may or may not be their loved ones – experience.

So the thing is that let me just tell you we don’t get anywhere in therapy by someone saying this is how it is, and a doctor like me saying, “no it isn’t” that’s not going to work, that’s not effective, by the way that’s not how I do therapy.

What I know sometimes is I am tapping into their lived experiences and their experience and their feeling right now is that it is as if everything is hopeless, and there is no good in the world, and we work together to examine that to say, “Well is that really the case? Is it really true that there isn’t anything positive in the world?” And we try to find things to give evidence that it isn’t 100% that way. I’ll grant people that sometimes things are mostly bad in their lives. I feel like that is true, they can have a lot of what we consider negative events and situations going on in their lives and it is problematic for them and they are struggling and yet it is part of an illness of something like depression, where people tend to globally negatively attribute everything, where they see everything as hopeless and pervasively negative, which means they feel that its bad and nothing is ever going to get better, and then they lose the hope to want to do something about it.

And we are there as providers to hold the hope for people who are hopeless, it’s what we do, it is the main part of my job, and I will tell people that, I can understand you don’t have hope or faith, that these things are not going to work right now, and I understand that and I know that that is where you are, but I believe that something brought you here and that you are willing to do something, and that’s a start – that’s where we are going to start from and move on from there.

I believe that reality is yes, very much, somewhat subjective, but it depends on what lens we are seeing things from and it is important for all mental health professionals to tune into the lens through which our clients are seeing things and where they speak from, so that we can be with them and then help them through it the best that we know how to do with our tools and with our resources.

Oh, stats on that? It’s just over 3, it’s between 3 and 4, I don’t know about half people in statistics.

Let’s say we’re more conservative, let’s say it’s 1 in 4? Isn’t that still a fairly large number? And then for example, 1 in 10 are taking anti-depressants – that’s a huge number too. So I say to a lot of people, if you think your life hasn’t been touched by mental illness personally, look around you, to your loved ones, your friends, your co-workers, you know, other community members, because someone you know has either struggled or is currently struggling – and they might need your help.