Robin Williams’s death: A reminder that suicide and depression are not selfish

News of Robin Williams’s death due to apparent suicide, said to be a result of suffering severe depression, is terribly sad. But to say taking your own life because of such an illness is a ‘selfish’ act does nothing but insult the deceased, potentially cause more harm and reveal a staggering ignorance of mental health problems

Robin Williams in Man of the Year (2006)

News broke today that Robin Williams had passed away, due to apparent suicide following severe depression. As the vast majority of people will likely have already said, this was terribly heart-breaking news. Such aniconic, talented and beloved figure will have no shortage of tributes paid to him and his incredible legacy. It’s also worth noting that Robin Williams was open about his mental health issues.

However, despite the tremendous amount of love and admiration for Williams being expressed pretty much everywhere right now, there are still those who can’t seem to resist the opportunity to criticise, as they do these days whenever a celebrated or successful person commits suicide. You may have come across this yourself; people who refer to the suicide as “selfish”. People will utter/post phrases such as “to do that to your family is just selfish”, or “to commit suicide when you’ve got so much going for you is pure selfishness”, or variations thereof.

If you are such a person who has expressed these views or similar for whatever reason, here’s why you’re wrong, or at the very least misinformed, and could be doing more harm in the long run.

Depression IS an illness

Depression, the clinical condition, could really use a different name. At present, the word “depressed” can be applied to both people who are a bit miserable and those with a genuine debilitating mood disorder. Ergo, it seems people are often very quick to dismiss depression as a minor, trivial concern. After all, everyone gets depressed now and again, don’t they? Don’t know why these people are complaining so much.

I’ve said it before, and I’ll say it again; dismissing the concerns of a genuine depression sufferer on the grounds that you’ve been miserable and got over it is like dismissing the issues faced by someone who’s had to have their arm amputated because you once had a paper cut and it didn’t bother you. Depression is a genuine debilitating condition, and being in “a bit of a funk” isn’t. The fact that mental illness doesn’t receive the same sympathy/acknowledgement as physical illness is oftenreferenced, and it’s a valid point. If you haven’t had it, you don’t have the right to dismiss those who have/do. You may disagree, and that’s your prerogative, but there are decades’ worth of evidence saying you’re wrong.

Depression doesn’t discriminate

How, many seem to wonder, could someone with so much going for them, possibly feel depressed to the point of suicide? With all the money/fame/family/success they have, to be depressed makes no sense?

Admittedly, there’s a certain amount of logic to this. But, and this is important, depression (like all mental illnesses) typically doesn’t take personal factors into account. Mental illness can affect anyone. We’ve all heard of the “madness” of King George III; if mental illness won’t spare someone who, at the time, was one of the most powerful well-bred humans alive, why would it spare someone just because they have a film career?

Granted, those with worse lives are probably going to be exposed to the greater number of risk factors for depression, but that doesn’t mean those with reduced likelihood of exposure to hardships or tragic events are immune. Smoking may be a major cause of lung cancer, but non-smokers can end up with it. And a person’s lifestyle doesn’t automatically reduce their suffering. Depression doesn’t work like that. And even if it did, where’s the cut-off point? Who would we consider “too successful” to be ill?

Depression is not ‘logical’

If we’re being optimistic, it could be said that most of those describing suicide from depression as selfish are doing so from a position of ignorance. Perhaps they think that those with depression make some sort of table or chart with the pros and cons of suicide and, despite the pros being far more numerous, selfishly opt for suicide anyway?

This is, of course, nonsensical. One of the main problems with mental illness is that is prevents you from behaving or thinking “normally” (although what that means is a discussion for another time). A depression sufferer is not thinking like a non-sufferer in the same way that someone who’s drowning is not “breathing air” like a person on land is. The situation is different. From the sufferers perspective, their self-worth may be so low, their outlook so bleak, that their families/friends/fans would be a lot better off without them in the world, ergo their suicide is actually intended as an act of generosity? Some might find such a conclusion an offensive assumption, but it is no more so than accusations of selfishness.

The “selfish” accusation also often implies that there are other options the sufferer has, but has chosen suicide. Or that it’s the “easy way out”. There are many ways to describe the sort of suffering that overrides a survival instinct that has evolved over millions of years, but “easy” isn’t an obvious one to go for. Perhaps none of it makes sense from a logical perspective, but insisting on logical thinking from someone in the grips of a mental illness is like insisting that someone with a broken leg walks normally; logically, you shouldn’t do that.

Stephen Fry, in his interview on Richard Herring’s podcast, had a brilliant explanation about how depression doesn’t make you think logically, or automatically confide in friends and family. I won’t spoil it by revealing it here, but I will say it involves genital warts.

Accusations of selfishness are themselves selfish?

Say you don’t agree with any of the above, that you still maintain that for someone with a successful career and family to commit suicide is selfish. Fine. Your opinion, you’re entitled to have it, however much we may disagree.

But why would you want to publicly declare that the recently deceased is selfish? Especially when the news has only just broken, and people are clearly sad about the whole thing? Why is getting in to criticise the deceased when they’ve only just passed so important to you? What service are you providing by doing so, that makes you so justified in throwing accusations of selfishness around?

Do you think that depression is “fashionable?” And by criticising the sufferers you can deter others from “joining in”? Granted, we hear more about depression than we used to these days, but then we know what it is now. We see a lot more photos from Mars these days, because we have the means of doing so now, not because it’s suddenly trendy.

Perhaps you are trying to deter anyone else who might read your views from considering suicide themselves? Given that statistics suggest that one in four people suffer some sort of mental health problem, this isn’t that unlikely an occurrence. But if someone is genuinely depressed and feels their life is worthless, seeing that others consider their feeling selfish can surely only emphasise their own self-loathing and bleakness? It suggests that people will hate them even in death.

Maybe you know some people who have “attempted” suicide purely for attention? Fair enough; a debatable conclusion, but even if you’re right, so what? Surely someone who succeeds at committing suicide is a genuine sufferer who deserves our sympathy?

Perhaps you feel that those expressing sorrow and sadness are wrong and you need to show them that you know better, no matter how upsetting they may find it? And this is unselfish behaviour how, exactly?

A brilliant but tortured individual has taken his own life, and this is a tragedy. But levelling ignorant accusations of selfishness certainly won’t prevent this from happening again. People should never be made to feel worse for suffering from something beyond their control.

Making Healthy Decisions When You Have Bipolar Disorder

“When you have bipolar disorder, it can often feel like you’re at the mercy of your emotional states — like you’re the passenger in the car, just along for the ride,” writes Sheri Van Dijk, MSW, in The Dialectical BehaviorTherapy Skills Workbook for Bipolar Disorder. But “this doesn’t have to be the case.”

In the book, Van Dijk shares how individuals with bipolar disorder can learn to act — rather than react and make smart decisions. (I personally think these insights and advice are valuable for all readers, regardless of whether you struggle with bipolar disorder.)

 Finding the Balance Between Emotions & Logic

According to Van Dijk, in order to make healthy choices, we need to find a balance between our emotions (emotion mind) and our logic (reasoning mind). This balance is called “wise mind,” a concept from dialectical behavior therapy (DBT).

Wise mind means that you’re able to feel your emotions while still being able to think straight, she writes.  It’s possible to make smart decisions based both on your feelings and your thoughts about a situation.

Everyone has a wise mind. According to Van Dijk, you’ve used this wise mind whenever you’ve gotten out of bed even though you felt depressed, or gone to work even though you felt anxious or taken a walk even though you wanted to watch TV and be alone.

Telling the Difference Between Wise Mind & Emotion Mind

It can be tough to tell if you’re making a decision based on your wise mind or your emotion mind, because, as Van Dijk writes, both include emotions.

She suggests assessing the strength of your emotion. If your emotion is intense or overwhelming, you’re likely in emotion mind. If it’s not overpowering, you’re likely in wise mind.

Also, making a decision from your wise mind means sitting with it. If you find yourself vacillating, you’re probably letting emotion mind take over. That just means that you need to give yourself more time.

An Exercise to Be More Effective

A wise mind will help you be more effective in life, according to Van Dijk. In other words, this involves “doing what it takes in a situation to get your needs met.”

Think about it this way: How many times have you acted in a way that felt great in the short term but not so great in the long term?

Van Dijk uses the example of stopping your medication. Let’s say you’re experiencing unpleasant side effects. Instead of telling your psychiatrist that the side effects are bothering you, you just stop abruptly. The side effects do go away in the short term. But you end up in the hospital because of a manic episode.

Van Dijk says that several things can interfere with acting effectively and making good decisions: your thoughts, or how you wish a situation was; not knowing what you want out of a situation; and thinking short-term needs vs. long term.

For instance, as Van Dijk explains, “While you might get some satisfaction out of yelling at an employer whom you feel didn’t treat you with respect, in the long run, you must remember that you need that person to say good things about you to help you get to the next job.”

Also, consider the earlier example about stopping medication abruptly. There, you were letting your emotions make your decision. If you were to consult your “reasoning mind,” you’d realize that not taking your medication can lead to a relapse and other risks.

When you think with both your emotions and reasoning, you’re able to identify your goals (making sure that they’re not at the expense of others). As Van Dijk writes, you might say: “I’m frustrated with the side effects and have decided that [they’re] not acceptable. I need to book an appointment with my psychiatrist to inform her of this request that she prescribe a different mood stabilizer.”

Van Dijk suggests readers practice by thinking of a situation that requires a decision. She suggests asking yourself the following questions (and recording your responses):

  • Describe the situation
  • What are the emotions you are experiencing about this situation?
  • What is your urge in this situation? (What is emotion mind telling you to do?)
  • What is your long-term goal in this situation?
  • What would be a helpful action for you to take in this situation? (In other words, what can you do that would make it most likely for you to meet your long-term goal?)

Other Ways to Be Less Reactive

According to Van Dijk, there are other things you can do to be less reactive, so you don’t let emotions rule your decisions. These include: improving your sleep habits (key for bipolar disorder — shaky sleep can trigger manic or hypomanic episodes); avoiding drugs and alcohol; practicing good self-care; reducing your caffeine intake; not skipping meals; getting nutrients from your diet; and participating in physical activities you enjoy.

This article is originally posted at PsychCenral By 

9 ways to care for yourself when you have depression

depressed-woman-400x400
Depression is an illness that requires a good deal of self-care,” writes psychologist Deborah Serani, PsyD, in her excellent book Living with Depression: Why Biology and Biography Matter along the Path to Hope and Healing.

But this might seem easier said than done, because when you have depression, the idea of taking care of anything feels like adding another boulder to your already heavy load. Serani understands firsthand the pain and exhaustion of depression. In addition to helping clients manage their depression, Serani works to manage her own, and shares her experiences in Living with Depression.

If you’re feeling better, you might ditch certain self-care habits, too. Maybe you skip a few therapy sessions, miss your medication or shirk other treatment tools. According to Serani, as some people improve, they get relaxed about their treatment plan, and before they know it are blinded to the warning signs and suffer a relapse.

Because skimping on self-care is a slippery slope to relapse, Serani provides readers with effective tips in her book. As a whole, the best things you can do to stave off relapse are to stick to your treatment plan and create a healthy environment. I’ve summarized her valuable suggestions below.

1. Attend your therapy sessions. As you’re feeling better, you might be tempted to skip a session or two or five. Instead, attend all sessions, and discuss your reluctance with your therapist. If changes are warranted, Serani says, you and your therapist can make the necessary adjustments.

Either way, discussing your reluctance can bring about important insights. As Serani writes:

Personally, the times I skipped sessions with my therapist showed me that I was avoiding profound subjects — or that I was reacting defensively to something in my life. Talkinginstead of walking showed me how self-defeating patterns were operating and that I needed to address these tendencies.

2. Take your meds as prescribed. Missing a dose can interfere with your medication’s effectiveness, and your symptoms might return. Alcohol and drugs also can mess with your meds. Stopping medication altogether might trigger discontinuation syndrome. If you’d like to stop taking your medication, don’t do it on your own. Talk with your prescribing physician so you can get off your medication slowly and properly.

Serani is diligent about taking her antidepressant medication and talks with her pharmacist frequently to make sure that over-the-counter medicines don’t interfere. With the help of her doctor, Serani was able to stop taking her medication. But her depression eventually returned. She writes:

…At first, it was upsetting to think that my neurobiology required ongoing repair and that I’d be one of the 20 percent of individuals who need medication for the rest of their lives. Over time, I came to view my depression as a chronic condition — one that required me to take medication much like a child with diabetes takes insulin, an adult with epilepsy takes antiseizure medication, or someone with poor eyesight wears glasses…

3. Get enough sleep Sleep has a big impact on mood disorders. As Serani explains, too little sleep exacerbates mania and too much sleep worsens depression. So it’s important to keep a consistent sleep and wake cycle along with maintaining healthy sleeping habits.

Sometimes adjusting your medication can help with sleep. Your doctor might prescribe a different dose or have you take your medication at a different time. For instance, when Serani started taking Prozac, one of the side effects was insomnia. Her doctor suggested taking the medication in the morning, and her sleeping problems dissipated.

For Serani, catnaps help with her fatigue. But she caps her naps at 30 minutes. She also doesn’t tackle potentially stressful tasks before bed, such as paying bills or making big decisions.

(If you’re struggling with insomnia, here’s an effective solution, which doesn’t have the side effects of sleep aids.)

4. Get moving. Depression’s debilitating and depleting effects make it difficult to get up and get moving. Serani can relate to these effects. She writes:

The lethargy of depression can make exercise seem like impossibility. I know, I grew roots and collected dust when I was anchored to my depression. I can still recall how getting out of bed was a feat in and of itself. I could barely fight gravity to sit up. My body was so heavy and everything hurt.

But moving helps decrease depression. Instead of feeling overwhelmed, start small with gentle movements like stretching, deep breathing, taking a shower or doing household chores. When you can, add more active activities such as walking, yoga or playing with your kids or whatever it is you enjoy.

It might help to get support, too. For instance, Serani scheduled walking dates with her neighbors. She also prefers to run errands and do household chores every day so she’s moving regularly.

5. Eat well. We know that nourishing our bodies with vitamins and minerals is key to our health. The same is true for depression. Poor nutrition can actually exacerbate exhaustion and impact cognition and mood.

Still, you might be too exhausted to shop for groceries or make meals. Serani suggests checking out online shopping options. Some local markets and stores will offer delivery services. Or you can ask your loved ones to cook a few meals for you. Another option is Meals-on-Wheels, which some religious and community organizations offer.

6. Know your triggers. In order to prevent relapse, it’s important to know what pushes your buttons and worsens your functioning. For instance, Serani is selective with the people she lets into her life, makes sure to keep a balanced calendar, doesn’t watch violent or abuse-laden films (the movie “Sophie’s Choice” sidelined her for weeks) and has a tough time tolerating loud or excessively stimulating environments.

Once you pinpoint your triggers, express them to others so your boundaries are honored.

7. Avoid people who are toxic. Toxic individuals are like emotional vampires, who “suck the life out of you,” according to Serani. They may be envious, judgmental and competitive. If you can’t stop seeing these people in general, limit your exposure and try having healthier individuals around when you’re hanging out with the toxic ones.

8. Stay connected with others. Social isolation, Serani writes, is your worst enemy. She schedules plans with friends, tries to go places she truly enjoys and has resources on hand when she’s somewhere potentially uncomfortable, such as books and crossword puzzles.

If you’re having a difficult time connecting with others, volunteer, join a support group or find like-minded people online on blogs and social media sites, she suggests. You also can ask loved ones to encourage you to socialize when you need it.

9. Create a healthy space.According to Serani, “… research says that creating a nurturing space can help you revitalize your mind, body and soul.” She suggests opening the shades and letting sunlight in. There’s also evidence that scent can minimize stress, improve sleep and boost immunity. Lemon and lavender have been shown to improve depression.

Serani says that you can use everything from essential oils to candles to soap to incense. She prefers lavender, lilac, vanilla and mango. If you’re sensitive to fragrance, she recommends diluting essential oils, buying flowers or even using dried fruit.

You also can listen to music, meditate, use guided imagery, practice yoga and even de-clutter parts of your home a little each time.

Serani’s last point involves empowering yourself and becoming resilient. She writes:

By learning about your biology and biography, following your treatment plan, and creating a healthy environment, you don’t allow anyone to minimize you or your depression. Instead of avoiding struggles, you learn from them. You trust your own instincts and abilities because they are uniquely yours. If you experience a setback, you summon learned skills and seek help from others to get back on-point. If a person’s ignorance on mental illness presents itself in the form of a joke or stigma, you clear the air with your knowledge of neurobiology and psychology.

Check out Serani’s award-winning blog, Dr. Deb, and learn more about her work here.

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