Tuesday, October 16, 2018

Rick Jason

Rick Jason was an American actor most remembered for starring in the ABC television drama Combat!

Jason attended the American Academy of Dramatic Arts. He was cast in numerous films and television shows during his career. Fox signed him for the male lead role in The Lieutenant Wore Skirts (1956) and later signed for a multi-picture contract. His first project was an adaptation of John Steinbeck's The Wayward Bus (1957) with Jayne Mansfield and Joan Collins, which earned him critical acclaim.

His TV career went well in the 1970s and 1980s, when he appeared in shows like Matt HoustonPolice WomanMurder, She WroteMoonlightingWonder WomanFantasy IslandAirwolf and Dallas, and The Young and the Restless.

According to authorities, Jason became despondent over 'unspecified personal matters.' He died by suicide on October 16, 2000. Rick Jason was seventy seven years old when he died.

Rick Jason 
May 21, 1923 – October 16, 2000

Sunday, October 14, 2018

Rules and Straight Lines

Steve Leonard lives in Edmonds, Washington. He is a fellow member of my Spouse/Partner Survivors of Suicide Loss group. This is a guest post, written by him. His words are very wise. I wish I'd read something like this when my loss was fresh. He is writing about what it is like to navigate the beginnings of a heartbreaking loss to suicide. It is helpful to read now, and it would have been helpful then. Here it is:

So there are no rules or straight lines when it comes to dealing with this shit. That’s what this is. Shit. I think that all of us are unique and have to deal with this differently but there are some things that are universally similar to all of us. 

I think there should be a rule book for someone to read when the loss is new. This isn’t old hat for me. It’s new. I’m new. I’ve lost people before. Blood and death aren’t new. Katie being gone is new. I should have seen it coming. Not really though. 

For me it broke me. I wouldn’t admit it but it did. It took everything and left me at my base level. The bottom. I’d like to think that I’m strong and that I can deal with anything but I know better. 

I think that anything can be a lesson. You just have to find what it is. For those that are new, I think that once you are ready, these steps should be followed. Ok. Here goes:

1. Accept that it’s not your fault. You didn’t want this and we can’t control what other people do.

2. Take care of yourself. Eat. Shower. Pay bills. Sleep. Work out. Keep moving. Realize that you are still here. Don’t be a douche. 

3. Feel the pain. Try to understand it. Try to grow. I say try. The question you want answered will never be answered. It’s not ok but it’s ok because it doesn’t matter. What’s done is done. 

If you are here, then you are still in the game. 

Act accordingly.

4. Lose any shame you have. It doesn’t do you any good. As long as you try and have good intentions, it’s hard to do harm. You have to have a brain and at least you’re trying. Have a brain!

5. Move. A change of environment can be helpful. You get to pick in this new reality. You don’t have to abandon the good with the bad. Take the good. Cherish it. The bad? Leave it at the door. It’s about you now. You get to pick. Life’s not fair. Sometimes that’s a good thing.
I could go on forever. I think burn parties are helpful. That kind of shit. Join a group for survivors of suicide loss. Those groups can be so helpful. I joined one and I'm glad. 

Like I said. I was at my base. Less than zero. This thing equals instant PTSD if you saw what many of us saw. That has to be addressed as well but general steps to push forward are what makes life livable. 

Gratitude toward everyone is not a bad stance to have

Just a thought. It’s real. It’s not leaving. It’s not fair. Deal with it. Nobody can understand. There is a power in that. 

Friday, October 12, 2018

As survivors of suicide loss, if we focus on the love we had for the person we lost, we can also focus on the healing they would want for us.

If we feel regret or if there were words of anger prior to losing someone to suicide, we can focus on the forgiving that we'd want to receive from the person we lost, and learn to forgive ourselves.

If we are angry at our loved one or if we are caught up in blaming another, we can focus on the absolution we can still offer - the same absolution we'd want extended toward us in the midst of our own suffering.

In whatever way we can extend love to ourselves and others, we are honoring the love we have for the person we have lost.

Thursday, October 4, 2018

Jill Bennett

Jill Bennett was an English actress. Although she experienced fame and success in England in both theater and film, Bennett struggled with depression. Following a fourth marriage, her mental illness worsened and she was no longer able to manage the depression.

Jill Bennett died by suicide on October 4, 1990. She was fifty eight years old.

Jill Bennett
December 24, 1931 – October 4, 1990

Wednesday, October 3, 2018

Looking for a way to make a difference in the fight against suicide? Volunteering your time or talents to an organization that is actively working toward suicide prevention has benefits not just for those who are looking for a way to support the cause, but studies have shown that volunteering can be helpful if you are recovering from depression, or if you are enduring the grief of suicide loss.

If you aren't sure where to start, there are some tips compiled here.

And if you are unable to do regular volunteer work right now, remember that there are always opportunities to do good. Every act of kindness has the potential to change lives for the better, and we can all make an effort to be kind.

Sunday, September 30, 2018

Day 30 - Grace's Arrival

I wish that grace and healing were more abracadabra kinds of things.
Also, that delicate silver bells would ring to announce grace's arrival.
But no, it's clog and slog and scootch, on the floor, in the silence, in the dark.
- Anne Lamott

Today is the last day of Suicide Prevention Month. Of course, for those of us whose lives have been touched by suicide, we know that this only means so much. The pain, frustration, grief, and fear around suicide are always there. For many of us, we learn to live with an acceptance. For survivors of suicide loss, we must come to an understanding that this tragic loss happens, and that it has happened to us. For survivors of suicide attempts and for those with suicidal ideation, we must come to accept that there are times when the strength required of us in the face of emotional torment, is deeply unfair and heartbreaking. In fact, no matter who or where we are on the spectrum of having been impacted by suicide, those two things are true: it is unfair and heartbreaking.

Still, I must say this. In my life, in all matters that have involved great pain, there is a profound grace in coming to an acceptance. It is nearly always the first step in allowing comfort in. Acceptance of our pain is the first step in asking for help. Acceptance of the pain of others is the first step toward the life saving graces of compassion and empathy. Acceptance of having been broken by something, is the first step toward healing.

Over the past few years, with the help of a great many caring people, I have come to understand that there are times when we must admit that we are powerless. The irony is, it is only in this admission that we being to find our strength. And I have learned that telling your truth has the capacity to heal not only you, but also others. These lessons have been profound gifts to me. They are in large part, why I share myself so publicly, today.

Let me tell you more about where I find my strength and why I share.

My life is in danger.

Not in immediate danger. But close enough. And the reason is this: when combined, my overall risk of suicide is devastating. I should be wearing a medical ID bracelet. Really. Instead of explaining that I have diabetes or a seizure disorder, it should say:

"This woman's will to live is potentially in peril. Remind her that she is strong and brave."

Let's look at the totality of my risk factors:

I suffer from PTSD. That places my risk at 20%+ higher than the general population.

I have an eating disorder. Specifically, I suffer from restricting anorexia. Eating disorders have the highest mortality rate of all mental illnesses. Their mortality rate is higher than that associated with schizophrenia, bi-polar and major depressive disorder. And of eating disorders, anorexia has the highest rate of completed suicides. I am in remission, but as all of us with and eating disorder know, this does not guarantee a lifetime free of relapses.

I am an alcoholic and drug addict. This puts my risk factor at 10% - 15% higher than the general population. I am in recovery, so I am at the lower end of that percentage rate, but abstinence alone does not negate the increased risk of suicide for those of us with a chemical dependency.

I have had two past suicide attempts. One of the more concerning risk factors. Among those who report suicidality, once an attempt has been made - their risk factor of eventually dying by suicide is increased tenfold.

I have been hospitalized numerous times. Another risk factor that could be seen as particularly ominous. For those of us whose mental illnesses have incapacitated us to the point of psychiatric hospitalization - our suicide rate is 44 times that of the general population.

I am a survivor of suicide loss. Times two. Having lost a mother and having lost a partner/spouse puts me in two of the highest categories of increased risk.

I am a survivor of severe childhood bullying. Suicide is the second leading cause of death among young people and half of all those suicides have been deemed to have a direct correlation with having been bullied.

I am a survivor of past sexual abuse.

I've had two head injuries. Once when I was 12 years old, I was hit in the head with a bottle. It knocked me unconscious. To this day I can feel a bump on the back of my head where stitches left a scar. And then a second time 20 years later. I broke my nose (while surfing of all things). Studies have shown that for those of us with even just a single concussion, our suicide risk is three times that of the general public.

At the time of my suicide attempt five years ago, I didn't understand the totality of my risk factors. My belief up until that point was that I would be able to make a final decision to live and that I could stop being selfish, stop being broken, stop being bad, and not be suicidal ever again. Every time my suicidal feelings returned, those feelings of being selfish, broken, and bad were cemented internally. Every time I reached a point of desperation again, every time my suicidal thoughts presented themselves, I truly believed that I had failed myself, and I had failed those who loved me. Living with that sense of failure and the resulting shame, made my finding a will to live that much more difficult.

It has taken me many years to understand that it is those risk factors and not an inherent brokeness on my part, that leads to my suicidal ideation. Some of my risk factors can be managed and therefore mitigated, but none of them will ever go away, entirely. Until we better understand how to address the damage done to the synapses in the brain when physical/emotional/mental trauma occurs, it will be very difficult to mitigate those risk factors in their entirety.

My acceptance looks like this:

If I could make the decision to never be overtaken by suicidal feelings again, I would have. In fact, I have made that decision many times. But this issue is only partially about the decisions that I am making. Much of this is out of my hands. So the decision I must make on a daily basis, is to understand the degree to which my life is at risk, and to always reach out for help. Always. Always. Always.

I say this thing. It is figurative. But it is the truth as well. In the first year after John died, I didn't drink, but I didn't manage to stay sober. I didn't live through it, but I stayed alive. I relapsed into my eating disorder, but I did not die of starvation. Here is why:

I only survived because other people held me up. I stayed sober because other people stayed sober for me. I stayed alive because other people stayed alive beside me. I lived through my eating disorder relapse, because other people told me, over and over again, how important it was that I not let it kill me.

I didn't live through the past year and a half. Other people held onto me and lived through it for me.

One of the most poignant conversations I had following John's death, was with his mother. She was reminiscing about a time when she was young. She shared about the hopes she had then, of getting married one day, starting a family, having children of her own. When she shared this she looked wistful at first, and then her face fell. She looked down. She was thinking of her two boys, David and John, I know.

"How could I have known that this is what would happen to my children? To my family?"

So I thought about her words and the memories of who we all were in the past, before heartbreak befell.

My father has long told me that when I was a baby, I was always smiling. That in and amongst the chaos of having a mother who was so often lost in her own incapacitating mental illness, I was always smiling.

I thought about it for this reason. Because John's mother does have a beautiful family. And her children are beautiful. All three of them. Living or not. I never met David, but I can say with certainty that so far as John is concerned, the world is a better place because of his having lived in it.

And along those same lines, I now understand that I get to let go of the hand of innate brokeness that I held onto for so long. At my core, I no longer have to be a broken person. The core of who I am, I know, is that smiling child who somehow found a way, even in bleak circumstances, to live in a place of joy, in this broken hearted world.

So, it is with that in mind that I will reiterate my commitment to keep up this fight. Not just for my life, but for the lives of everyone who has been touched by suicide. I am fighting for the memories of those who are no longer with us, I am fighting for those who are struggling with thoughts of suicide right now, and I am fighting for the survivors of suicide loss who are enduring a pain like no other.

Perhaps I don't need that medical alert bracelet after all. In many ways, because of my risk factors I live a life that is in peril. But I know that with the love and support of others, I am able to live that life with strength and bravery, too. That, is where I find my grace.

Perhaps the little girl that I once was, smiled so often because she knew that so long as she was able to face another day, she was also able to welcome grace's arrival.

Remember: End the stigma. Have the conversations. Make resources available. Fund the research. Begin now.

Saturday, September 29, 2018

Day 29 - You.

A reminder for you.

If you are:

a survivor of suicide loss,
a survivor of suicide attempts,
a person who struggles with thoughts of suicide,
or a person who loves and supports others whose lives have been touched by suicide,

then the words above belong to you.

Friday, September 28, 2018

Day 28 - A Whole Body Tragedy

PTSD is a whole-body tragedy, an integral human event 
of enormous proportions with massive repercussions.
― Susan Pease Banitt

Let's talk about Post-Traumatic Stress Disorder (PTSD). Our internal response to trauma is often the platform for suicidal thinking, behaviors, and completions. If we do not understand and address the role trauma plays in the lives of individuals who die by suicide, we won't achieve comprehensive suicide prevention.

To better understand the connection between suicide and PTSD, let's start with a definition. Post-traumatic stress disorder (PTSD) is a psychiatric condition
 that can occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, rape or other violent personal assault. PTSD can also occur after sudden severe emotional trauma such as experiencing the unexpected loss or death of a loved one. Finally, PTSD can also occur after prolonged exposure to environments in which a person is being bullied, neglected, or suffering abuse (physically, sexually, mentally, emotionally, or otherwise).

To put this into perspective, let's look at some data:

  • An estimated 70 percent of adults in the United States have experienced a traumatic event at least once in their lives and up to 20 percent of these people go on to develop PTSD.
  • An estimated 5 percent of Americans—more than 13 million people—have PTSD at any given time.
  • Approximately 8 percent of all adults (1 of 13 people in this country) will develop PTSD during their lifetime.
  • An estimated 1 out of 10 women will get PTSD at some time in their lives. Women are about twice as likely as men to develop PTSD.
And again, putting the suicide/PTSD link into perspective, when we look at those who are the highest risk of suicide, a diagnosis or probable diagnosis of PTSD is pervasive:

Those serving in the military.
First responders.
Those having been bullied.
Individuals who identify as part of the LGBTQ community.
Those having suffered sexual abuse.
Those having suffered a head injury.
Survivors of suicide loss.

Given the close connection between trauma and death by suicide, we have to look at what is happening to the brain, during severe or prolonged traumatic events.

Many people incorrectly assume that PTSD is related to purely mental/emotional reactions to these events. This misconception is not only highly stigmatizing - it is also inaccurate. Unfortunately this stigma impairs our ability to prioritize the research needed to improve treatment of PTSD. Stigma suggests that PTSD only happens to those who are not emotionally strong enough to manage their feelings during and after trauma. This belief is very damaging because it further shames those who are suffering, and profoundly denigrates the deceased.

Here is a graphic that shows what is actually happening at the inception of PTSD:

What the graphic shows is that during trauma, your emotions and reactions are dictated by physiological responses and not by rational thinking. Survival mode is not conducive to well thought out rational behavior. By matter of necessity, we react based on sights, sounds and emotional stimuli. We are not reacting based on thoughts or access to cognitive information. Our behavior becomes singularly oriented toward avoidance of further pain and trauma. Our actions are guided by physiological changes in the brain, not thought processes. Here are the most important words in the graphic above, as they apply to our traumatic events:

This is NOT a cognitive choice.

The physical and mental response to trauma has nothing to do with thought, cognition, decision making, personality, weakness, or strength. It has everything to do with a brain's physiological response to the trauma.

Following trauma, some brains are unable, without effective treatment, to maintain consistent physiological stability. Some reasons are known, many more are not. More research is desperately needed.

For those with PTSD, they may have periods of significant stability, where they are able to manage many of life's normal ups and downs with appropriate levels of pain and frustration. When their PTSD is activated however, their reactions to normal stressors may seem heightened to a level that appears unreasonable. Some of the symptoms of PTSD include ongoing emotional distress, personality disturbances and/or changes, severe anxiety/aggression/depression and poor impulse control. All of these symptoms, while seemingly based in 'thought processes', are actually dictated by the same brain changes that occurred at the inception of the PTSD.

Some of the most successful treatments for PTSD involve behavioral therapies, not necessarily cognitive therapies. In other words, we are seeing success in treating those with PTSD when we work to provide them with skills for recognizing and managing symptoms when they occur. Traditional 'talk therapy' that encourages a person to remember and discuss events in their life, has shown a propensity for re-traumatizing those with PTSD. We must make long term and easily accessible behavioral (skills based) therapies available to all individuals who are suffering from PTSD.

There are other significant developments in PTSD research. Researchers have found that the condition can be detected via brain scans.

"Brain imaging studies have shown alterations in a circuit including medial prefrontal cortex (including anterior cingulate), hippocampus, and amygdala in PTSD. Many of these studies have used different methods to trigger PTSD symptoms (eg, using traumatic cues) and then look at brain function. Stimulation of the noradrenergic system with yohimbine resulted in a failure of activation in dorsolateral prefrontal, temporal, parietal, and orbitofrontal cortex, and decreased function in the hippocampus.173 Exposure to traumatic reminders in the form of traumatic slides and/or sounds or traumatic scripts was associated with an increase in PTSD symptoms, decreased blood flow, and/or failure of activation in the medial prefrontal cortex/anterior cingulate, including Brodmann's area 25, or subcallosal gyrus, area 32 and 24, as measured with positron emission tomography (PET) or functional MRI (fMRI)"

What do all those words above amount to? Again:

PTSD induced behaviors and 'decisions' or 'choices' actually reflect the physical impact of traumatic events on the brain's ability to respond, and do not reflect decisions or choices.

PTSD is a formidable enemy when it comes to suicide, but there is hope. With more research, we will be able to further streamline finding the best behavioral therapies to support those with PTSD symptoms, and we may be able to identify other treatments that could have a restorative effect on the damaged brain functioning that occurs when PTSD is present.

If you suffer from PTSD, know that your symptoms are not your fault and not a product of your being weak, or selfish, or 'unable' to handle your problems. Know that there is hope and there is help, and that many people are fighting to ensure that better treatments are on their way.

If you love someone with PTSD, please keep all of the above in mind, educate yourself further, advocate for your loved one so that they have access to support services and treatment of their own, and reach out for support for yourself. And always have the suicide prevention lifeline phone number (1-800-273-8255) on hand. (There is a special number for those in the military, as well.)

And if you have lost someone to PTSD, let me say this: For my generation and all of those prior, we have spent our entire lives conditioned to believe that when someone dies by suicide, they made a 'choice' of some kind. We take that belief and compare and contrast the 'choice' to die with a choice we think they could have made to stay alive and be a part of our lives.

The questions we are asking are agonizing. They are also inaccurate. With PTSD, the accurate question, is this:

What impacted my loved one's thought processes so that they were unable to make the choice to live?

That is the question that we must answer. Those answers will lead us to the solutions that will begin to appreciatively save lives.

We must end the stigma. Have the conversations. Make resources available. Fund the research.


Thursday, September 27, 2018

Day 27 - Brain Injury and Suicide Risk

Tiaina Baul "Junior" Seau Jr.
January 19, 1969 - May 2, 2012

NFL linebacker.
10-time All-Pro. 
12-time Pro Bowl selection.
Named to the NFL 1990s All-Decade Team. 
Elected to the Pro Football Hall of Fame.
In 2012 Seau died by suicide. 
He was diagnosed with CTE posthumously.  
Junior Seau was 43 years old when he died.

The link between brain injuries and suicide is undeniable. Studies have shown that both major and minor traumatic brain injuries (TBI) increase suicide risk. Chronic Traumatic Encephalopathy (CTE), a degenerative brain disease often associated with athletes, is the result having suffered multiple head traumas.

The list of those with CTE who had no prior history of mental illness, and then began exhibiting symptoms and/or died by suicide, is extensive. Here is a partial list of Former NFL players with confirmed CTE:

The list above is woefully incomplete. At present, CTE can only be diagnosed post mortem. Some families are not comfortable donating the brains of their loved ones for autopsies related to CTE research. Also, understanding how to identify CTE is relatively new. Recognizing and diagnosing the condition has only been possible since 2002. Prior to that, the degenerative brain disease was not yet understood.

CTE was initially identified by the pathologist Bennet Omalu, MD, who performed the autopsy on former NFL player Michael Webster.Webster was 50 years old when he died. Webster had slowly developed increasingly significant symptoms of mental illness during his career in the NFL and following his retirement. After extensive research, Dr. Omalu was the first to discover abnormal proteins in his brain, referred to as neurofibrillary tangles. Today, brain imaging scans show the  permanent impact that concussion related CTE has on a brain:

For those living with the disease, the symptoms are devastating.

(Image above from the Patrick Risha Stop CTE Awareness Foundation)

Given this, understanding and addressing the risk of dying by suicide when a person has suffered a head injury is critical to overall suicide prevention. We must do more research on how to identify brain injury, as often a person who has incurred an injury initially has no (or very minor) outward symptoms.

It is absolutely imperative that people understand that the physiological response to (even minor) head injuries can have a profound impact on long term behavioral symptoms. The two are inextricably linked. Recent studies have shown that having suffered just one concussion leaves a person with a suicide risk that is three times that of those who have not had a head injury at any time during their life.

The urgency of needing more research speaks for itself. Postmortem is not an acceptable time to diagnose a fatal disease.

As a survivor of suicide loss, I also need to say this. The discovery of CTE makes a very important statement about the impact of stigma on suicide. Consider that until CTE was diagnosable, the public perception of of those who suffered from the related symptoms of mental illness and/or died by suicide, was accusatory and ugly. Like all who have struggled with these issues or lost their life in this way - those with CTE were often considered weak of character. Many athletes who died by suicide were deemed selfish and unappreciative of their success.

The pervasive belief that individuals suffering from symptoms of mental illness and who die by suicide are at 'fault' for their death is often wholly inaccurate.

The vast majority of the public still believe that a person who dies by suicide was making a 'choice' that they had entire control over. This is a belief that leads to agonizing questions asked by those left behind. This stigma is believed by the majority of the public, including those who have lost someone to suicide and those who are directly suffering from mental illness. Considering the fact that even one concussion raises suicide risk, why aren't we making diagnosis, awareness, and treatment of CTE and related conditions more of a priority?

Why aren't we comforting those who have lost someone to suicide by telling them that there are often definitive physiological reasons behind years of erratic behavior and suicidality?

Survivors of suicide loss torment themselves with guilt and rage related to questions around why the person they lost did not love them enough to stay alive, or why their own love wasn't enough to keep someone alive.

Again, it is critical that we do more research and that we develop better tools for diagnosis, treatment, and management of all factors that contribute to suicide risk, CTE and head injuries included.