Category: Suicide

We Need to Talk – and DO – More about Suicide

Posted on by Dana Goldman

I’m not into fashion (obviously, my clients would say) but the suicide of designer Kate Spade was big enough news to enter my orbit last week. I was still reeling from

the news, as I do with any news of a suicide, wrestling with the same questions as everyone else – namely, how can someone look so successful and yet feel so terrible as to take their life? – when chef Anthony Bourdain killed himself.

It’s so easy to believe that loads of money or fame or professional recognition should or would inoculate any of us from isolation and despair. But these tragic deaths are reminders that depression and suicidal thoughts don’t just hit those of us down on our luck. Financial wealth is not a guarantee of happiness or ease. Fame is not a guarantee of happiness or ease. Depression is real, and needs real treatment. There are myths about depression that are widespread, but it’s important to know the facts. 

The writer Andrew Solomon’s book about depression, The Noonday Demon: An Atlas of Depression, chronicles his experiences with depression and those of others – as well as looking at various treatments and interventions. For clients, the stories Solomon tells are a reminder that depression – as terrible as it can be – doesn’t have to stay a stagnant part of life. Things can get better.

What Information Should Families Have If Their College-Age Kid is Depressed?

Posted on by Dana Goldman

I read with sadness but not surprise this article about suicide on college campuses. A big question the article talks about is when and if parents should be informed if their age 18+ kid  is struggling.

I’ve written before about the rise in anxiety and depression in teens and the general public. The news on the subject continues to be disturbing, with a 33% rise in depression diagnoses between 2013-2016.

I’m so glad that depression is continuing to be identified more quickly, and that more and more people are willing to seek help. But these numbers – and the stories behind these numbers – speak to a pretty terrifying moment for young adults and those who love them.

Anytime I work with a new client, we talk openly and honestly about confidentiality. Lots of us have had the terrible experience of having someone betray our trust and confidence, and I’m committed to keeping therapy a private space. It’s impossible to get the most out of counseling if we’re worried about someone out of the psychotherapy office knowing what we’re talking about.

BUT – I tell everyone – if I start getting worried about a client in an immediate life-or-death kind of way – I will tell that client directly, not going behind their back, and we’ll talk about if my concerns are justified or not. If so – if a client agrees they’re in a scary moment – together we’ll figure out a way to pull in someone from their life who cares about them, and loves them, and desperately wants and needs them alive.

I love being a therapist, and I take the responsibility of it incredibly seriously – both in figuring out when and how to support someone to get more help, if needed, and when to uphold and protect confidentiality if more support isn’t needed.

 

A Counselor’s Thoughts on Anti-Depressants and Other Meds

Posted on by Dana Goldman

Happy? Antidepressants?New therapy clients often wonder where I stand about anti-depressants. Will I be pushing them? Completely against them? Chances are, your own thoughts about anti-depressants put you in one of three categories:

a. You see anti-depressants as similar to other meds that you might take for medical conditions like high blood pressure, migraines, or a bad cold. If this is you: You may have friends and family who have been open about struggling with depression, panic attacks, and anxiety. You may know people who’ve benefited from meds.

b. You want to avoid anti-depressants at all costs. If this is you: You believe you should be able to handle how you’re feeling without drugs; you may think it will mean something negative about you if you decide to try meds for awhile. You may also have known someone who’s had a negative experience on an anti-depressant (or perhaps you have had a negative experience in the past). You may worry that you’d be on a med for life, and you definitely don’t want that.

c. You’re wary, but open to anti-depressants if needed. “If needed” may mean that things would need to get unbearable for you to consider meds. If this is you: You may know people who’ve gotten some use out of meds, but others who may not have. You may have had some bad experiences of your own. You may have lots of mixed feelings and see the possible benefits but may have significant concern about possible side effects.

So where do I stand when it comes to anti-depressants and their psychopharmacology siblings? I’m pretty cautious about meds, but I don’t think they’re evil. I see medications as a tool that should be used thoughtfully and under close supervision. Here are some facts for you to know:

  1. Every person is different. Most people can benefit from counseling, and, sometimes, medications can help people get more out of counseling and make progress more quickly (especially in the case of severe depression).
  2. I always, always want to rule out a medical condition that may be causing anxiety or depression. Funkiness with the thyroid can often lead to depression and anxiety symptoms. I often ask that new clients go have a physical to rule out medical conditions as a cause for low or anxious moods. 
  3. If you’re struggling with basic daily tasks like going to work or school — and counseling hasn’t helped you with these tasks after a chunk of time, then a medication consult may be appropriate. 
  4. There are lots of alternatives to medications. Exercise, meditation, social time, meaningful activities, consistently getting good sleep, the much-derided self care, and some supplements can often be as helpful as medication.
  5. Most people who take medications for anxiety and depression don’t stay on them forever. You always, always get to decide whether to stay on a med or not. (That said, going off cold-turkey is never a good idea!)
  6. I always want any client trying a new medication to have a good psychiatrist or physician and to be in close contact during the first weeks of taking it. Most people do quite well on meds but we never want to take that for granted.

I’m always happy to talk with you about therapy and medication. Feel free to call or email  if you want help figuring out what’s going to be most supportive for you at this time.

Warmly,

Dana

Blog Hodgepodge: ACE Scores, Bias, Lived Experiences, and A Radio Interview

Blog Hodgepodge: ACE Scores, Bias, Lived Experiences, and A Radio Interview

Posted on by Dana Goldman

I got to talk on the radio recently about depression, suicide, and teenagers. I’m glad to continue to spread the message about adolescent mental health concerns, even though it’s always sobering to consider how mental and physical health issues can be created or exacerbated by so many preventable factors.

I’m a big fan of the Adverse Childhood Experiences (ACE) Scale as a quick way to look at what sorts of factors may have been present – or absent – in my clients’ lives that may impact them to this day. None of us exist in a bubble. There’s good research on how trauma, neglect, race, class, immigration status, gender and gender identity, and so much else plays into how others treat us, brain function, and how we end up feeling about ourselves. (Here’s a recent reminder of racial bias affecting views toward young black girls.)

In my work as a therapist, I continue to be committed to seeing my clients as individuals whose own stories and experiences are a part of a larger social and cultural framework.

Some helpful stats about the importance of ACEs.

 

Separating Suicide Facts from Myths

Posted on by Dana Goldman

My heart has been hurting these past few weeks as I’ve been following a terrible story unfolding in the news. A teen was suicidal; his girlfriend urged him, via text messages, to actually kill himself. He did. She’s now been found guilty of involuntary manslaughter.

Everything about this story is awful, and this tragedy likely could have been avoided. Many people experience thoughts of “I just want this to end” at some point in their lives, and we know that most people who survive suicide attempts and live to recover from depression end up incredibly glad that they are alive.

Based on my professional experience, I want to mention a few specific points that are important for us all to know:

  1. If you think a loved one may be depressed or suicidal, it’s always, always, always worth getting them evaluated by a therapist or at a hospital. Here’s a good resource on identifying warning signs. There is no reason to wait. 
  2. No matter our age, depression and anxiety almost always cloud our judgment. For teens, add in a still-evolving sense of self, lack of control (here’s a great YouTube video my teen clients often like on the subject) and a still-developing brain and it’s a recipe for potential trouble. 
  3. You don’t need to tiptoe around the topic of suicide. It’s okay to say “have you been having suicidal thoughts?” This will not plant the idea of suicide in anyone’s mind and it may be a relief to have someone ask directly.
  4. The suicide case that I started this post with is the exception, not the rule. Many of the teens I’ve counseled over the years have risked important friendships by telling a parent or teacher when a friend has been depressed or suicidal. On the whole, teens, like adults, typically do the right thing — even when it has the potential for major social consequences.