Stigma Can Be Deadly

Many people were touched by the death of Robin Williams in many ways. I myself was moved to tears when I heard about it in a text from a family member. The movie "Patch Adams" is my favorite movie of all time and a source for inspiration about the type of doctor I want to be. His comedy and talent has touched my own life in many ways. Many of the clients walking through my door recently have been deeply affected by the loss or affected by the coverage of his death.There was a flurry of articles on other blogs, in the news, and social media exploded. The details of the death were detailed, gruesome, and some might argue insensitive to the family's privacy. I considered when the right time might be for posting about this on the PSYowa blog and what the post might say. The issue of suicide is a sensitive topic, however many issues in psychology and concerning mental health are sensitive. This doesn't mean that we shouldn't talk about them or give voice to their importance.

As a friend reminded me when I was struggling with what to say in this blog, Robin Williams death should be kept private. As we would want the death of any of our own loved ones to be. There have been many discussions throughout all of this about the selfishness of suicide and the character of those who choose to complete suicide. I am not going to address that. The situations involved in each individual's choice to take their own lives are different and there is not enough time or space to give light to their stories in a respectful or meaningful way. The important thing that we should take from this tragedy is the very public fact that mental illness can affect anyone. Rather than shaming and stigmatizing mental illness we can make a choice to embrace that it is a part of humanity and address how to get help to so many who need it.

For some people who commit suicide we may never know why. For others it may be an apparent journey with the struggles of depression. By lessening the stigma and having conversations about mental illness we can create a safe environment where people do not feel afraid or ashamed to ask for help.

One way to decrease stigma is to be vigilant for people in your own lives who may be struggling and to reach out to them in a compassionate way. For those of you who are not familiar with the signs of depression they can include:

• A sad mood 
• Irritability 
• A change in sleeping patterns (either too much or too little)
• Significant changes in weight or appetite 
• Loss of interest in things they usually enjoy
• Increased anxiety
• Withdrawal from family or friends
• Loss of energy
• Difficulty concentrating 
• Feelings of guilt or worthlessness
• Thoughts or comments about death
• Hopelessness 
• Inability to see positive aspects of situations 

Depression can look very different in different people. While there are a set of symptoms that are common, the ways in which people show them can depend on their personality, environment, and culture. If you are unsure don't be afraid to ask a friend or family member how they are feeling. When you ask, listen without judging. This can be very hard when it is someone you love but remember this is about them, not you. Be ready to hear things that you might not like or that you may not want to hear. Just listening and creating a safe environment for them to talk can make a lot of difference. It is important that you allow them to feel what they are feeling without telling them they are wrong. You may want to say affirming things like "you're right, that's difficult." Arguing with them that they are wrong may only make it more difficult for them to talk. Being affirming is important when you are talking to someone that is going through depression. Point out whatever you can to help them to see that they aren't broken or defective and that there is hope. They may need your help to see that depression is just a part of human life and whatever the situation may be it isn't permanent.

Another important thing is to not fear asking questions about their safety. Asking about suicide will not cause someone to kill themselves. Let them know you are asking about suicide because you care about them. It can be hard but the best way is just to ask someone about their safety is to be direct.  It is important to ask things like "Have you been thinking about killing yourself?" Being tentative or saying things like "You haven't thought of doing something stupid like killing yourself have you?" can make a person feel unsafe telling you or can make it easier for them to say "no."

Having this conversation with a friend, co-worker, or loved one may be hard. It also may save their life. It may be one step towards making the world a safe place to share our difficulties and get the support we need.

If you are immediately concerned about someone in your life you can call the police and ask for a health and welfare check or call 911. If you are considering suicide or need to talk to someone you can call the National Suicide Hotline at 1-800-273-TALK. You can also utilize the American Psychological Association's Psychologist Locator here: http://locator.apa.org/ to find a psychologist near you.

Thank you to Lori Schoh, TMHC from Capstone Behavioral Healthcare for volunteering to serve as guest reviewer/editor on this post.