18 a day....

By Rick Mays for the Army Times

Troubling new data show there are an average of 950 suicide attempts each month by veterans who are receiving some type of treatment from the Veterans Affairs Department.

Seven percent of the attempts are successful, and 11 percent of those who don’t succeed on the first attempt try again within nine months.

The numbers, which come at a time when VA is strengthening its suicide prevention programs, show about 18 veteran suicides a day, about five by veterans who are receiving VA care.

Access to care appears to be a key factor, officials said, noting that once a veteran is inside the VA care program, screening programs are in place to identify those with problems, and special efforts are made to track those considered at high risk, such as monitoring whether they are keeping appointments.

A key part of the new data shows the suicide rate is lower for veterans aged 18 to 29 who are using VA health care services than those who are not. That leads VA officials to believe that about 250 lives have been saved each year as a result of VA treatment.

VA’s suicide hotline has been receiving about 10,000 calls a month from current and former service members. The number is 1-800-273-8255. Service members and veterans should push 1 for veterans’ services.

Dr. Janet Kemp, VA’s national suicide prevention coordinator, credits the hotline with rescuing 7,000 veterans who were in the act of suicide — in addition to referrals, counseling and other help.

Suicide attempts by Iraq and Afghanistan veterans remains a key area of concern. In fiscal 2009, which ended Sept. 30, there were 1,621 suicide attempts by men and 247 by women who served in Iraq or Afghanistan, with 94 men and four women dying.

In general, VA officials said, women attempt suicide more often, but men are more likely to succeed in the attempt, mainly because women use less lethal and less violent means while men are more likely to use firearms.

Suicide attempts among veterans appear to follow those trends, officials said.

10 Ways to Reduce Anxiety... Part 2

3. Don't fight the craziness.
You may occasionally have thoughts that lead you to think you'll do something terrible ("I'm attracted to him. Does that mean I'll have an affair?")or that you're going insane (a client of mine who is an attorney kept imagining herself screaming in court.) Remember - our minds are creative. Little synapses firing away at random,and every now and then a "crazy" thought jumps out. Everyone has them. Instead of judging yours, describe it to yourself like it's a curious object on a shelf and move on.

4. Recognize false alarms.
That fear of your house burning down because you left the iron on has never come true. That rapid heart beat doesn't mean you're having a heart attack; it's your body's natural response to arousal. Many thoughts and sensations that we interpret as cues for concern - even panic - are just background noise. Think of each of them as a fire engine going to another place. You've noticed them; now let them pass by.

Ed. note: Part of a series by Robert L. Leahy, PhD and director of the American Institute for Cognitive Therapy in NY, NY. See the first part here.

you CAN die from it

Do you know someone who always brings a ray of sunshine into the room? I'm talking a person with a razor wit, an infectious grin, always willing to listen to you whine, quick with scalding sarcasm at her own expense or a painful groaner of a pun? I get to see the friend who fits this description every other Wednesday from ten until noonish - the bright spot of my Wednesday workday - and while I filled her nails we would talk about the kids, our husbands, our mothers and pets, and all the ups and downs of our lives just as we have for the past ten years or so. Occasionally we would hook up to go for a walk, getting as much exercise from the laughter as from the mileage. She once helped me reupholster a chair - I stiffened her spine when she tried to talk herself out of going to her 30th class reunion. We exchanged hysterical birthday cards and Christmas presents. I held her hands every other week.

On March 26th she took her own life.

My friend did not attempt suicide. She made a methodical, intelligent plan - dotted all the i's and crossed all the t's - timed it and executed her exit from this life with the same precision she showed in the miniature rooms that she painstakingly created as a hobby. There was no detail unattended to. She was 48 years old. My age.

Five days before I posted to this blog about the social isolation of mental illness. At her memorial service, the pastor read from the Book of Job and pointed out that in Jobs culture, it was customary to sit in front of your home dressed in sackcloth and covered in ashes - to put grief and misery on display - but that in our culture, one is expected to hide grief; to put on a smile and always keep up appearances. She was a master of deception because she felt it was expected of her; she was always smiling, laughing, joking, because it hid her pain. I held her hands every other week. I never saw it.

And now I am keeping up appearances and hiding my broken heart. I miss her so much. And it occurs to me that her pain really didn't end... it merely moved... to all who loved her.

If you've ever thought about it... think about it.

What Is "Hearts & Minds?"

The NAMI Hearts & Minds program is an online, interactive, educational initiative promoting the idea of wellness in both mind and body. Wellness is an ongoing process of learning how to make choices that support a more successful, healthy life.

Engaging in a wellness effort can make a huge difference in the quality of your life. One study, published in the Journal of the American Medical Association, showed that taking the wellness approach can result in a 17 percent decline in total medical visits and a 35 percent decline in medical visits for minor illnesses.

Wellness is about the individual; you can decide what parts of your life you would like to change and you can determine your own success. The Hearts & Minds program includes information on medical self advocacy, smoking and substance abuse, healthy eating and exercise suggestions including sample journals and work sheets to download. Check out something new for your "tool box" here.

Cause of death....

There are days that I think I could die of it. Wonder what they'd put down as the cause of death if you just stopped breathing in the sheer, vast, emptiness of isolation? Yeah, yeah, yeah - I know that social isolation is one of the extreme effects of mental illness, but frankly, I wonder if it isn't just the extreme effect of our social culture? Even when I'm out of my house I'm amazed at how little we interact with the people around us.

So yesterday I volunteered some of my time to help get donations for the Salvation Army and the Prenatal Care Center. Every March the Soroptimist Clubs of Anacortes and Fidalgo Island team up for a Community Baby Shower and hit the local markets encouraging folks to pick up some baby food, or diapers or such and donate it for folks that are struggling to make ends meet. It is really an easy sell; even people disinclined to contribute to the poor (perhaps buying into the idea that they must have done something wrong to be poor or homeless in the first place,) have no problem opening up their wallet for a baby. My job was to ambush shoppers at the door and present them with a list of possible contributions that they could pick up while shopping. And it was interesting to see how generally uncomfortable people are with talking to a 'stranger' - how smiling and greeting someone automatically seems to put them on the defensive. I was pretty uncomfortable, too, even though I genuinely believed that most of them would be inclined to contribute - and there were people that I couldn't bring myself to greet, as they seemed almost hostile.

Okay, so we did pretty well in the donation department nonetheless. But I marvel that anyone connects with anyone in a world where speaking banal pleasantries to someone that you do not actually know seems awkward at best. Everywhere I go I see people talking to a little square of plastic, or typing furiously on it. But where do people talk? Not at the market, not at the dinner table, not in the car, or the bus, or the train. So.... where?

As I write this I'm at home... alone... on my computer. I wonder if you can die from it...

Depression has an upside?

"The mystery of depression is not that it exists — the mind, like the flesh, is prone to malfunction. Instead, the paradox of depression has long been its prevalence. While most mental illnesses are extremely rare — schizophrenia, for example, is seen in less than 1 percent of the population — depression is everywhere, as inescapable as the common cold. Every year, approximately 7 percent of us will be afflicted to some degree by the awful mental state that William Styron described as a “gray drizzle of horror . . . a storm of murk.” Obsessed with our pain, we will retreat from everything. We will stop eating, unless we start eating too much. Sex will lose its appeal; sleep will become a frustrating pursuit. We will always be tired, even though we will do less and less. We will think a lot about death.

The persistence of this affliction — and the fact that it seemed to be heritable — posed a serious challenge to Darwin’s new evolutionary theory. If depression was a disorder, then evolution had made a tragic mistake, allowing an illness that impedes reproduction — it leads people to stop having sex and consider suicide — to spread throughout the population. For some unknown reason, the modern human mind is tilted toward sadness and, as we’ve now come to think, needs drugs to rescue itself.

The alternative, of course, is that depression has a secret purpose and our medical interventions are making a bad situation even worse. Like a fever that helps the immune system fight off infection — increased body temperature sends white blood cells into overdrive — depression might be an unpleasant yet adaptive response to affliction. Maybe Darwin was right. We suffer — we suffer terribly — but we don’t suffer in vain."

Read the rest of this excellent article by Jonah Lehrer here. Found this to be a great companion piece to this previous post on Virginia Woolf.

Blue Days

You can tell by the vast amount of posting I've done of late that I haven't been my usual verbose self. On the heels of the holidays, comes the natural let down - my business slows and with it I feel like I'm shrinking. Without a million gajillion things to be done, without a constant source of busywork... I slip into the blues. It doesn't happen overnight, (although sometimes it does,) and it isn't life threatening. I don't take to my bed (although sometimes I want to.) I go to work, I eat (usually too much or things guaranteed to make me feel bad about myself,) I sleep (sorta...)Everything gets... dim. Time seems to go really slowly, but the weeks can burn right by. I haven't any energy. I haven't any joy. I don't have much of anything... but a pulse and regular respiration, bills that need paying and pets that need feeding.

In the past, if this goes on long enough, or if I start feeling bad enough (where taking to my bed becomes more of a possibility) I will cave to the lure of a fix - and seek some medication. Never had too much trouble talking a doc into Prozac or Lexapro.... They love to write me a script. I know it will take the edge off of the darkness. I will feel ... better, but of course it comes with a price tag - weight gain or no interest in sex or something. And a real price tag, too, as I don't have insurance that will cover the prescription. Sometimes I just opt to wait it out or I find some project to throw my time at - volunteer work and the like - something to keep me out of my head and into exhaustion at the end of the day. And eventually business will pick up and I'll be back to working 50 hours a week at my unfulfilling, but ever so demanding job.

I'm currently still in the 'wait it out' mode of this vile cycle. I don't want medication. I'm trying the whole gamut of 'self care' that I religiously preach to my support group - get enough sleep, eat right, exercise - yadda, yadda, yadda. I've made an appointment with a new counselor - and I have mixed feelings about that. And I wonder if this is really all I can expect out of life - this eternal cycle of sort of okay, and then not okay. I really feel guilty even saying this as I know so many people who live with grave mental illness - so many brave souls who have demons that make my problems look like an ingrown toenail. I'm lucky in so many ways - I have a job, I make a living, my kids are grown and on their own, I'm relatively healthy. So is it wrong to think that I would sell my soul to wake up each morning with a smile on my face looking forward to my day? Cuz I would. I really would.