Sunday, September 25, 2011

Some positive words about suicide prevention

Over 2,000 Australian lives are lost each year to suicide according to official records, though this number is probably in reality much higher. It is now the biggest killer of people aged 15-24, accounting for one in four of all deaths in this age group. According to the stats, men are up to four times as likely to die this way than women. These numbers provide more than an ample reason for me – a twenty-something male with some insight into this terrible problem – to speak constructively about it.

I admit expressing thoughts about this topic is difficult because suicide is so rarely discussed that I – like everyone else – have not been in the habit of articulating my thoughts about it. Such is the culture of silence around the topic of suicide that even on a blog like mine which is focused on mental health, it was only this week that I decided I should raise the topic in my writing. What prompted me were two national awareness days both taking place this month: R U OK? day and To Write Love On Her Arms day.

A major aim of both events is to raise awareness in our society about the need for more openness in friendships, families, schools and workplaces about the reality of suicide in order to see people receive the help they need.

2010 Australian of the Year, Pat McGorry, has been a leading voice in Australia on the issue of suicide prevention among youth. He said the following in an article he wrote in April this year: "Our lack of conversation around the topic has only endorsed the silence that surrounds our young people who often feel too ashamed, too guilty and too stigmatised to put up their hand and ask for help. They are trapped in a bubble: a cone of silence which neither they nor those around them can easily penetrate."

For those who know something of my story, it is probably not a great surprise to tell you that my life was in danger in the period immediately prior to my admission to hospital in 2004. Like so many young (or for that matter any age) males I was tight lipped about what was going on inside me and I was able to mask things pretty well. Yet the reality was that I, like most people experiencing suicidal thoughts, was dying to tell someone how I felt.

McGorry says "By asking a young person about these feelings we will give them permission to talk, and in most cases they will feel relieved and better able to overcome periods of suicidality. If effective help is provided suicidal urges almost always subside."

This was certainly true in my case. If you'll permit me to use this description, my mind was like a giant infected wound full of toxic thoughts that simply needed to be burst and exposed to the air around it so that the black thoughts could run out of me and into a drain, never to be seen again.

It is worth keeping this image in mind when thinking about this topic. It fits with the "bubble" image that McGorry talks about. And the amazing thing is that you – the friend, the family member, the acquaintance, or even someone you've just met – could be just the person to prick the bubble and let the puss run out. It is as simple as being aware of those around you, and not being afraid to ask if someone is feeling OK.

Here is a relevant song I like by Third Eye Blind

Thursday, September 15, 2011

The non-linear world of managing body and mind

I recently had the privilege of interviewing American political journalist James Fallows about his thoughts on Barack Obama. Since Fallows was a speech writer for President Jimmy Carter I was aware his opinion would probably be quite insightful. The first thing he said was that being a president involved having to monitor and respond to a thousand variables all at once. It struck me that this observation also applies to many of us who are less prominent, not least those who struggle with mental illness.

So far on my blog I have written about my own story of mental crisis, breakdown, recovery and ongoing life-management. While the overarching narrative has resembled this positive arc I want to today discuss how living with a mental condition is seldom a simple linear story. I think the picture of a president running a country is helpful in explaining what I mean by this. This is because despite the best thought out plans and strategies, I with my bipolar disorder and Obama with his presidency have to deal with things that are sometimes (or indeed often) out of our control.

Obama thinking
Crises have no respect for one's present circumstances. I remember in the early days of coming to terms with my diagnosis I wished I could press a pause button on the world around me while I got better (I think many can relate to this sentiment regardless of their mental circumstances). I imagine Obama has had this thought more than once as he has gone through having to deal with a series of troubles both natural and man-made.

I have learnt to deal with the "pause button" wish by picturing another helpful image - that of a school or dwelling place undergoing major reconstruction whilst having to continue operating at the same time. Most of us can relate to the challenges such a situation brings. We know what life was like before the interruptions began and want things to be comfortable and predictable again. Where are the students to have assembly while the main hall is out of action? What will become of my job as I struggle with this bout of depression?

Part of the answer to such questions is to square up with the reality of one's situation and then resolve to limit the amount of time you spend thinking "if only" this and "if only" that. The image of reconstruction is most helpful here: I may be inconvenienced now, but just wait until I reclaim that building. How much better will life be when I have dealt with that troubling memory that has tripped me up for so long, even if dealing with it hurt a little? 

I think many of us experiencing mental trouble could use a self-esteem boost. Going through mental trials can be every bit as difficult as managing an economy and a nation, so coming back to the president metaphor for a moment, why not consider oneself with the esteem we so readily give to heads of state? 

Thursday, September 1, 2011

Panic attacks - the mental earthquake

I recently watched a documentary about the earthquake that earlier this year devastated northern Japan. It included footage taken by someone in Tokyo who happened to have their camera out when it happened. The footage showed the ground around the person's feet cracking open.

I was surprised to find myself a little disturbed by seeing the footage even though there was no sign of harm to the person doing the recording or anyone in the vicinity. It made me think about a time earlier in my life where watching TV footage caused one of the most frightening experiences in my life. 

Early in the morning of September 12, 2001 (Sydney time) I awoke to my normal routine of getting up, making breakfast and preparing for work. As usual I switched on Andrew Denton's breakfast show on Triple M and instantly noticed a very different demeanour from the usually chirpy radio host. Something was wrong. I quickly went to the living room and turned on the television. There was an American news anchor fronting the camera with what looked to be the late afternoon skyline of New York City in the background. Again there was something wrong with what I was seeing.

The next image confirmed the rising dread I felt: a black plane (I would later that day learn it was a passenger jet in shadow) was shown flying low over Manhattan and crashing into one of the Twin Towers. I instantly recognised the buildings not only because they were world famous but three years earlier I had stood atop the viewing deck of one of them as an excited teenager.

What followed was a recap of what had happened some six or seven hours earlier but was fresh to my eyes because I had been sound asleep when the attacks took place. Before my eyes the World Trade Center crumbled. It may as well have been live.

What happened next was I had a panic attack (also known as an anxiety attack). How to describe this? Picture the world ending combined with your own life flashing before your eyes and you get a sense of where my mind was at that moment. Physically I was shaking, desperately wishing I could undo whatever it was I had done wrong to cause my life to be ending. Next I imagined myself in a jungle somewhere with an automatic rifle - a conscript in the armed forces fighting whichever country or countries it was who had sent the black (and presumably military) planes I had watched fly into the World Trade Center. Thoughts and images came quickly, unregulated by reason and totally horrifying. I was alone and beyond help, or so it seemed. 

I looked out the window from my apartment and saw a woman in the neighbouring high rise block shaking a rug out of her window. It was probably the jolt of reality that returned me to earth. The next thought I had was who could be doing something so mundane when the world seemed to be collapsing? It was an image that has stayed with me ever since.

But back to the panic attack for a moment. In a lot of ways a panic attack is an internal earthquake. After experiencing it the mind becomes cracked and traumatized. And much like seismic activity it leaves a person's mental terrain fractured and fragile. On top of all this there are aftershocks - fresh panic attacks to return and terrify the person affected, complete with their sensations of Armaggedon/holocaust. 

The person suffering from panic attacks is in many ways like a city attempting to recover from a massive quake but knowing another one could come at any moment and devastate everything again.

The application point of me sharing this is that a significant proportion of people experience panic attacks, and many people go a long time not realising them for what they are - a mental issue that can be explained and treated and recovered from. Many people are afraid of getting the help they need because they don't know what is happening to them, or think that they are going crazy or are beyond help.

The good news is that panic attacks begin to lose their power once the person affected comprehends that what they are going through is explainable, containable and are common to many people. This is not to say that panic attacks are trivial or a minor ailment. Even after identifying them a person can go for a long time still experiencing them in all of their horrible power. But knowing there were others out there experiencing what I was going through helped me a great deal. Knowing I was not alone made a huge difference to me.