Previously I’ve posted on the power of language in our work, and how important it is to use empowering and inclusive language. So I love (LOVE!) the idea of considering people who have survived an attempt to commit suicide as “overcomers.” Overcoming despair, overcoming hopelessness, overcoming depression, overcoming suicide – whether it’s for a day, a month, or a year –   is an achievement we should support and celebrate.

The data shows that someone who attempts suicide is more likely to attempt suicide again within the next 6-12 months. In Alaska, 819 people attempted suicide in 2007 and 149 people died by suicide. We focus on the lives we’ve lost, and the grief we feel over those losses – but shouldn’t we also celebrate and support the 670 people that lived?

What prevents us from supporting and caring for someone who has attempted suicide?

Are we afraid that if we talk about it, they will try again? (That’s just not true – research shows that talking with someone about their feelings of suicide and how to find help actually can prevent suicide.)

Are we afraid it might be our fault? (We can’t assume responsibility for the feelings of suicide experienced by someone else. We can take responsibility for helping, or choosing not to help, someone in crisis.)

Are we afraid we don’t know what to say? (You can find something to say. You can seek out training, like Mental Health First Aid or ASIST, to learn how to listen and what to say. Or, you can simply say “Your life matters to me.”)

If we acknowledge our own fears, and recognize that those fears are unfounded, we can then be brave and open our hearts to someone who needs support and love in their journey of overcoming.

A Quilt Made in Honor of Loved Ones Lost to Suicide

Listen

Too often we are busy thinking about what we want to say, rather than listening. But listening is one of the best things you can do for someone who has attempted suicide. In your listening, be honest and open with them and with yourself. Part of that is, if you say “you can call me anytime,” make sure your phone is on and you’re able to be there any time.

Learn

Learn what helps the person by listening and asking them “how can I help?” Then, support them in the way(s) that best help them. Learn what services and supports are available in your community so you can encourage the person to seek help and support (and you can seek help and support for yourself if you need it).

Love

The panelists who had attempted suicide shared the value of love in supporting someone who is at risk. Their advice: express care and concern for the person who has attempted suicide. Be brave and confront stigma and your own misunderstandings about suicide (part of that learning aspect). Take care of yourself, too. Know your own limitations and honor them – don’t take on more than you can handle emotionally or mentally.

Live

This was a surprising point made by the panelists, who warned against making supporting someone who has attempted suicide the central part of your life. It’s understandable that we would want to make the safety and health of someone we love the most important thing in our lives – but that turns out not to be helpful to the person who has attempted suicide. Living and sharing our own lives is an important way of supporting someone who has attempted suicide.

We can support a friend or loved one after an attempt. We can help them on their journey of recovery, if we are brave and honest in our efforts.

And if you are someone who has attempted suicide, know that you are courageous and strong. And on days when you feel hopeless and alone, know that there are people – many of whom have walked the same road you are on — who want to support and care for you.

Your life matters.

If you are interested in finding or providing support for yourself or someone who has attempted suicide, there are some resources available. While there are not formal support groups for attempt survivors in Alaska, the Peer Support Consortium can help you find a peer support organization in your community. NAMI has chapters in communities in Alaska. If you know about other resources, or are interested in developing supports in your community, email kate.burkhart@alaska.gov.

Interestingly enough, the same topic came up in several of this week’s discussions related to updating Alaska’s state suicide prevention plan. There was concern that the language we use in our planning and prevention work might be confusing or even off-putting to the very people we want to engage.

In suicide prevention, a “survivor” is someone who has lost a loved one to suicide. A person who survives an attempt to commit suicide is referred to as an “attempter.” So, in order for there to be a survivor, someone has to die. That just doesn’t make sense.

Suicide prevention is broken into three categories: prevention – intervention – postvention. When I started this work, I wondered “what the heck is postvention?” I learned it’s a label created for how we respond after a suicide to prevent the domino effect often seen after someone dies by suicide.  If the point is to prevent additional suicides, why isn’t it just “prevention?”

This laguage issue is a possible barrier to bringing primary care providers into the suicide prevention effort. Suicide prevention focuses on preventing death in a time of crisis – kind of like the way emergency rooms treat people.  This focus on the end, and the emergency nature of the end, of the spectrum has made it hard to get primary care providers involved in this work. Their job is to diagnose and manage diseases, not do triage and emergency medicine. So why would they focus on what are thought to be exclsuively mental health emergencies?

Maybe if we explained that suicide responds to the same protocols and interventions as other chronic diseases, that would make more sense. You wouldn’t treat hypertension without checking (and rechecking) a patient’s blood pressure. You wouldn’t treat hypertension without explaining to the patient what he can do to help lower his blood pressure. And you wouldn’t treat hypertension without connecting the patient to the services and supports he needs to improve his condition. All those things – screening, patient education, referrals  — work to help someone early on to prevent the crisis that can lead to suicide.

There is a movement to help people stay healthier so they avoid the health conditions that can end up in the emergency room (heart attacks, strokes, etc.), Shouldn’t suicide prevention include a similar focus, helping people stay mentally and emotionally healthy so they don’t end up in that place where they are considering suicide and need emergency services?  And shouldn’t we use common language?

Maybe we need to think about how we talk about suicide, and find ways to use empowering and common sense language in this work? If so, how would we do that?

So, what is “suicidology?” It’s a term for the research and study of suicide and suicide prevention. Many people see it as an area of study that crosses many disciplines, rather than being narrowly focused on psychology or psychiatry. The  American Association of Suicidology is a national organization of researchers, suicide prevention professionals, survivors of suicide and others committed to furthering research and evidence based prevention strategies.

I am honored to have been invited by the American Association of Suicidology to not only present at their annual conference in Portland, but to work with a rock star group of experts tomorrow to problem solve the integration of suicide prevention in primary care. This is especially exciting for me, given the work the Suicide Prevention Resource Center, Alaska Native Tribal Health Consortium, and the Boards have put in to developing a pilot project in Alaska.

The Suicide Prevention Resource Center has developed a primary care suicide prevention toolkit to help physicians and community health providers screen and respond to patients at-risk for suicide. (This is the tool I’m hoping we can pilot in Alaska.) The National Association of Pediatric Nurse Practitioners will soon have a new online resource for pediatric nurse practitioners (I got to meet the creator, Dr. Ginger Biddle tonight at dinner). These are just two examples of efforts to help family practitioners, nurses, optometrists, dentists, and other primary care providers serve as a resource for early identification of suicide risk and better intervention to save lives.

I’ll be blogging about AAS and everything I learn this week, so please check back and share your thoughts and ideas. Together, we can all act to prevent suicide in Alaska.

“The sun feels warm on my face.”
“The yummy smell of that soup on the stove reminds me of my grandma’s kitchen. I used to love to sit there and watch her cook.”
“My legs are sore after that workout, but I feel so much less stressed now.”

That sounds simple (and maybe silly), but think about all the times you looked down and your plate was clean but you had no idea how your dinner tasted.  Or looked up at 5:00 p.m. and wondered where the day went.  Or realized that you just hung up the phone and couldn’t remember what you and your friend had talked about.

A wandering mind will not lead you to happiness and well-being. According to recent research, people spend almost half their time (47%) thinking about something other than what they are doing. 

(Yes, I’m multi-tasking as I write this.  I’ll stop and come back later when I can pay better attention to it.)

. . .

All that day-dreaming and distraction, according to recent research reported in the Harvard Gazette and Science, can lead to unhappiness. Psychologists Matthew Killingsworth and Daniel Gilbert (both of Harvard University) reported that the “human mind is a wandering mind, and a wandering mind is an unhappy mind.” 

 That’s kind of depressing – we’re naturally disposed to woolgather, but that means we’re naturally disposed to being unhappy?

Their study involved 2,250 people aged 18-88.  According to the study, participants reported their minds wandered away from whatever they were doing nearly half the time.  What they were doing didn’t really matter – their minds drifted to other things 30% (or more) of the time.  The researchers found that people were happiest exercising, having a conversation with someone, and  . . . (yes, it’s what you think).  They were least happy when resting, working or using their home computer. 

So, the fact that you are vegging out on the couch reading this blog means you are probably less happy than you would be if you were at the gym or gabbing with a friend.

According to Matthew Killingsworth, “mind-wandering is an excellent predictor of people’s happiness.” How often our minds leave the present — and where they end up – is a better predictor of happiness than the activity we’re doing.  Which led him and his research partner to conclude that the idea that happiness is “in the moment” – and that being aware and present in the here and now is healthier than always thinking about what’s next or what was – is probably right.

Knowing that, how can we learn to be mindful? For some people, it can be as easy as slowing down, taking a breath, pausing. For others, it’s yoga or meditation. Mary, a participant in the Sound Minds in Sound Bodies campaign, shared that she is using basic yoga to help her boost her awareness of her mind and body, and she’s feeling happier: “I feel totally grounded and have way more energy.”  Just by making time to pay attention each morning (before the day’s distractions kick in.)

The common theme to these mindfulness-building exercises is single-mindedness. Not texting and talking. Not thinking about what’s for dinner while you wolf down your lunch. Not making your list of household repairs while your dad is trying to tell you about his colonoscopy.  (Okay, maybe you get a pass on that last one. . .)

The essential idea is that, by paying attention and noticing what’s happening around you and how you feel inside, you can actually increase your happiness, which boosts your mood and leads to better health.

When we first started talking about doing this campaign, it was a complete no-brainer for me.  In my daily (non-campaign) life I strive to get exercise, eat well, and make sure I am connecting with people around me.  I think these things are what really help me be a better “me.”  When I go without exercise for a couple days, either because of other obligations, lack of motivation or something else, I definitely feel the decline from my best self. I get grumpy and irritable, I take more things personally, I feel the stress more from even just small stuff. 

When I realize this is all happening, it reminds me that I need the people in my life who understand and care about me to be around me. I need to burn out the toxins (physical and psychic) and restore my energy by moving my body to exert energy.  These two together really sustain me.  Sustain, and entertain.

So here’s a funny story.  I love going out and doing something fun and physical with friends.  Last weekend, I skied both days with friends.  We battled the wind and hiked up onto the breathtakingly beautiful ridges around Eaglecrest, our local ski area.  Up there, the wind is cold as it blows over the mountain but the sun is warm on your face.  You can see the channel framed by more lovely snow capped peaks on the other side.

Despite the wind crust on the snow we had fun, touring the backside of the mountain. Skinning up and skiing down — my body felt heavier each time I went up and came down. On a trip back up the mountain, I was on a steep slope when my ski skin detached from my ski making it impossible to hold without sliding backwards. Two steps up, four steps back – grrrr!  Then, I got a little stuck.  Or . . . maybe a  lot stuck.

My crew was on up the hill, so I found myself digging out of a deep (and cold) hole in the snow, but not making much progress.  I started to feel alone, frustrated, goofy, bitter, angry . . . until my good friend Chris came to see why I was not right behind him still heading up the hill.  He had skied all the way back to find me, and what he found was a very frustrated and exhausted me fighting the snow (and not really winning).  He gave my predicament a chuckle, but then helped me get out of my snow trap and back on track. 

That’s what friends do.  When they find us in a hole, they help us dig ourselves out.  No matter how deep (or cold or foolish) that hole may be, I know that with a little help (and maybe sometimes a little laughter) from my friends, I can make it out again.

Now, this isn’t rocket science.  Six people go bowling, have a great time getting some exercise and hanging out.  Is that really related to our resiliency and psychological health?

Well . . . yes.  For example, one of our folks hadn’t had the best day that day.  So when we started, they were kind of sluggish and withdrawn.  By frame 6 of the first game, there was more pep in their step and by the end of the first game, they were smiling. 

Sure, there was some ribbing when the ball hit the gutter (isn’t there always?).  But there was also a lot of cheerleading and not a little coaching.  And then there are all those warm fuzzy feelings that come from celebrating together.

The point is that, unlike having to weigh your brussels sprouts and count your carbs, protecting your mental and emotional health is usually FUN!  You don’t need any fancy equipment or to see a special kind of trainer — all you need is someone else’s shoes and a crew who will cheer your strikes and not mock you too much for your gutter balls.

One of the five Sound Minds in Sound Bodies steps is to CONNECT — with friends, family and others.

It’s easy to think of friends as the people we watch the game with, go to the movies with, share a pizza with.  Not always, though, do we think of our friendships as the bonds that weave a strong net for when we swing out on that trapeze (and catch us if we fall), a warm blanket when we are cold and need comfort, a banner to proclaim our success. 

Hopefully, we all have someone we can call for comfort when our heart is broken or to help celebrate when we get a promotion.  It’s those friends that help us maintain – and even improve – our mental and emotional health.  They are our “sheltering tree.”

The health benefits of strong friendships include increased sense of belonging, reduced stress, increased self-esteem, and decreased risk of serious mental illness.  By helping us to weather life’s storms (divorce, loss of a loved one, etc.), friends help us capitalize on our own resilience and make it through.  By celebrating our triumphs (new jobs, new babies, new haircuts), friends support our feelings of happiness and self-worth.  Friends can also encourage us to adopt healthier lifestyles (like my friend who is always dragging me on speed hikes up and down the trails in Juneau).

Just like it’s easy to overlook the powerful effect of friends on our health, it’s also easy to forget how important it is to make new friends.  Connecting with new people helps us keep our minds open to new perspectives and new adventures (wear a helmet if that new friend wants to go skydiving). 

Earlier in the series, we explored the Move part of this mental health promotion campaign.  Move and Connect fit together really well.  Walking with a friend, playing a game of bocce ball, going to the Governor’s Inaugural Ball and dancing the night way – these are all ways to strengthen the connections with your friends AND get your body moving.  You can also make new friends while getting out and about – take a kayaking lesson or join a hockey team.  You might meet someone groovy and make a new connection.

Most of us have heard that regular physical activity can lower your blood pressure and cholesterol levels and can reduce the risk of illnesses such as type 2 diabetes or heart disease.  What you may not know is how physical activity affects your mental and emotional health.

According to Dr. Daniel Landers, research shows that exercise can reduce anxiety and depression — sometimes significantly. Since diabetes and heart disease are often co-morbidities (conditions that occur with, but are not a cause or result of, the primary diagnosis) of mental illness, the fact that movin’ and groovin’  reduces the likelihood or the severity of all three is pretty cool.

As part of the Sound Minds in Sound Bodies campaign, folks are getting at least 30 minutes a day of physical activity.  To help keep track — and stay motivated – folks are taking part in the President’s Active Lifestyle Challenge.  In addition to providing a tracking system and a points system to keep up all motivated, it provides lots of great information.

What are we doing to stay active?  Walking, running, shoveling snow, bowling, stretching, shoveling snow, vacuuming, skiing, shoveling snow. See how easy it is?  Just 30 minutes a day is all it takes.

What are the results? First, a greater awareness of how easy it is to move more.  One board member shared that, when she wore her cool AMHB and ABADA pedometer while cleaning house, she got nearly half her daily recommended steps.  Second, a greater to attention to how we feel (not just a little sore) after we get our activity.  Proud, happy, empowered, cool — just some of the feelings participants have shared so far.

Sound Minds in Sound Bodies isn’t about weight loss or body building, or trying to reach some socially accepted norm of beauty or health.  It’s about feeling better from the neck up AND from the neck down. 

Mental and emotional health is an integral part of our overall wellness, but not everyone thinks about it that way.  There are a lot of people — and doctors — who think of health in a “neck down” sort of way, leaving the “neck up” to psychiatrists and counselors.  But what more and more research and individual experiences are teaching us is that your health from the neck up is all part of your health from the neck down  — and vice versa.

The Alaska Mental Health Board and Advisory Board on Alcoholism and Drug Abuse are partnering in a mental health promotion campaign, Sound Minds in Sound Bodies.  The goal is to show people that they can take control of their mental and emotional fitness the way they can their physical health.  And it doesn’t take any extraordinary measures.

Research shows that, in just five simple steps, people can improve their overall mood, health, and feeling of happiness.  Board members invite everyone to try it out, and see whether or not (over eight weeks) they can improve their sense of well-being by:

1. Connecting with friends and family.

2. Moving your body 30 minutes a day.

3. Being mindful of your experiences, in the world and inside yourself.

4. Learning something new, take a class, or dust off an old skill set.

5. Giving to your community or someone in need by volunteering or sharing with others.

Research has found these actions effectively build the resiliency that helps people reduce or avoid serious mental health and substance abuse problems.

Want to get involved?  Here’s how:

• Follow examples on the Sound Minds in Sounds Bodies webpage and share your ideas here or on the AMHB and ABADA Facebook pages.

• Sign up for the AMHB and ABADA President’s Active Lifestyle Challenge group at http://www.presidentschallenge.org (group number 96386) and get moving 30 minutes a day.

Why are we really doing this?  Well, for some us, it’s to beat the wintertime blahs.  For others, it’s part of an overall focus on improving health – complete whole-person health. 

And for some of us, it’s to draw attention to the health needs of an estimated 55,000 Alaskans (adults and youth) who experience serious mental health issues and/or alcohol dependence each year.  There are ways to prevent those serious health problems, and promoting overall wellness is one of them.  If we can improve our health, one person at a time, we can start to make a dent in the more than $90 million the State of Alaska spent on mental health and substance abuse treatment services from mid 2009 to mid 2010.

Happier people and a healthier budget – what better reasons do we need?