What is Project Semicolon?

I could explain the misunderstood nature of the semicolon, but The Oatmeal does it so much better.

“Project Semicolon is an organization dedicated to the prevention of suicide. Our work is based on the foundation and belief that suicide is preventable and everyone has a role to play in preventing suicide. Through raising public awareness, educating communities, and equipping every person with the right tools, we know we can save lives.”

Why use a semicolon as a logo for suicide prevention? Because a semicolon is where an author could have ended a sentence; instead choosing to continue the story.

The idea is that we are all authors of our lives; those that attempt suicide metaphorically attempt to put a period at the end of theirs.

I tried to put a period on my life a couple times; I did not succeed.

A few years ago, I saw someone with a tattoo of a semicolon on their wrist. I was unsure of what it symbolized, other than an affinity for generally-misunderstood punctuation. So I went up to this person and asked… I’m kidding, I Googled it.

That search led me to Project Semicolon and to a wealth of stories that mirrored mine. As a fan of tattoos, it was not long before I walked into Read Street Tattoo and asked for one on my wrist.

Yes, that is a Llama in tree pose. My sister painted it, and it’s the best Llama painting in the world. http://caitlincorsetti.com/

http://theoatmeal.com/comics/semicolon

You may notice that my semicolon is not oriented correctly (this makes it an Arabic semicolon). That is mainly so the sweeping tail of the punctuation covers a scar on my wrist. I earned that scar due to stupidity; putting my hand through a window in anger.

What I have come to deeply appreciate about my tattoo is that some people will ask me about it, but others will see it and say, “me too,” or “my wife.”

Or I’ll trade a subtle head nod with someone waiting in line at the grocery store.

Despite the use of a semicolon as a moderate pause in speaking; it has generated a great deal of memorable conversations.

So now you know what a semicolon tattoo means. Someone may have made an attempt. Someone may know a friend or family member who tried to die by suicide. It means the story isn’t over.

Gordon tried to die by suicide; he survives.

https://projectsemicolon.com/ - beautiful in style and placement.

The Mysterious Melancholy of Meriwether Lewis

This day I completed my thirty first year, and conceived that I had in all human probability now existed about half the period which I am to remain in this Sublunary world. I reflected that I had as yet done but little, very little indeed, to further the happiness of the human race, or to advance the information of the succeeding generation. I viewed with regret the many hours I have spent in indolence, and now sorely feel the want of that information which those hours would have given me had they been judiciously expended. But since they are past and cannot be recalled, I dash from me the gloomy thought and resolved in future, to redouble my exertions and at least endeavor to promote those two primary objects of human existence, by giving them the aid of that portion of talents which nature and fortune have bestowed on me; or in future, to live for mankind, as I have heretofore lived for myself.

- Meriwether Lewis, Journals - August 18, 1805

Emotional tunnel vision - see a magnificent sight, and be unable to appreciate it.

Lewis wrote that on his birthday, at the continental divide. He wrote those words after seeing a sight that no white, non-native man had ever seen.

He had gone further than any American of his time, charting a course with his fellow explorer, William Clark, from the western-most border of the young American states, to the actual west cost of the North American continent.

Today, there is lively debate among historians as to Meriwether Lewis’ mental health and the true circumstances surrounding his death.

The quoted passage from his expedition journals, and observations from his friends, lend a good bit of weight to the argument that Lewis lived with Bipolar Disorder. By most accounts, he was prone to bouts of depression where he could not get out of bed, but also showed incredible vigor and drive.

Though we cannot accurately diagnose someone who lived over 200 years ago; it is fascinating to look through the lens of a historical figure’s personal thoughts, and get the sense that our ancestors dealt with many, if not the exact same, issues we deal with today.

For the sake of comparison, imagine that astronaut Buzz Aldrin stepped off the lunar lander and onto the surface of the moon. Instead of his famous quote, “One small step for man, one giant leap for mankind,” he said, “I have done very little to further the happiness of the human race.”

Getting to the continental divide in 1805, was the equivalent of landing on the moon in 1969. The distances were mind-boggling, the environments treacherous, and the planning complex. These were nearly impossible accomplishments! If Buzz had said something so depressing at that moment, Houston might have replied, “Buzz, you okay?”

Why dig up 200 year old journal entries for a blog in 2018? I believe it is valuable to show people today that those who came before us lived with mental illness just as they also lived with ear infections, tooth decay, strokes, and high blood pressure. We are not so far removed from those that lived before us, and examining the recorded thoughts of important historical figures, demonstrates that mental illness does not prevent a person from achieving great things.

Imagine getting here! Farther than any of your contemporaries, and simultaneously thinking that you have done nothing to “advance the information” of the next generation.

How Someone Chooses a Location for Suicide

I write this in an abundance of caution.

Before I go further, if you are planning suicide, I highly encourage you to call the

National Suicide Prevention Lifeline at 1-800-273-8255.

---

“He feels pessimistic about any future. Some time ago, early in his life, he formed a fixed idea, a flawed concept of what tolerable happiness might be, but his great tragedy was that he defined it in such a way that he could never attain it. It is present from the very beginning, in the very first few sentences. It is the pain, the enduring psychological pain that darkens his life. It is a pain that, in his psyche, is unbearable, intolerable, unendurable, and unacceptable. In his terms, it is better to stop the cacophony in his mind that to endure the unbearable noise.” - Edwin Shneidman, Autopsy of a Suicidal Mind

Dr. Shneidman, the father of modern-day suicidology, researched why people killed themselves in an attempt to find reliable indicators that medical professionals could use to recognize when someone may be at risk for suicide.

A friend asked me why someone might choose to end their life by suicide in a particular place. I can speak from personal experience, as well as from what the historical research into suicide can elucidate.

2,000 deaths since 1968, with 100-200 saved from jumping every year.

In the United States, we are familiar with the high rate of suicide at the Golden Gate Bridge, but you may be unfamiliar with the Nanjing Yangtze River Bridge in China.

The beauty of an expanse of water is a romantic human notion. We are drawn to the possibility of something beyond, and it requires very little imagination to see that dying by jumping off a bridge can, “merge the needs for nurturance and death that occurs in the suicidal mind” (Joiner).

If you believe someone snaps, and jumps off a bridge or slits their wrists in a bathtub; let me disabuse you of that idea.

The act itself may be impulsive, but everything that led up to the attempt was planned. I planned to kill myself by hanging in my basement apartment of my parents house. 

Why? Did I not care that my family would be the first to find me? Of course I cared, but my thinking was so distorted that those thoughts barely registered in my mind.

I planned to die in my home for two simple reasons. One, I was comfortable there. Two, I knew the rhythms. I knew when everyone was asleep, or when the house was deserted. I could plan, intimately, the details of exactly where I wanted to end my life.

Joiner again says it best,

“Planfulness regarding episodes of self-harm represented a significant risk factor for later completed suicide. Planfulness requires competence, which in my model is a key aspect of the acquired capability for lethal self-injury.”

Someone may choose to jump off a memorable bridge or building for a degree of flair, but also because they have read about people dying, and succeeding, at these locations. Whereas another person might choose to end their life in their home or their office, because that is where they are most comfortable.

Still others, myself include, might get a hotel room. Where there is a semblance of home, combined with the knowledge that no one will disturb you if you put that little sign on your door.

Reasons for choosing a location are as varied as our preferences for why we choose to move, or the work on which we embark. It may be due to convenience, to allure, comfort, control, accessibility; the list is truly endless.

These are all answers that we can consider if we are faced with the terrible question, why? Why did my friend, spouse, child, coworker kill themselves? Why there?

I will tackle these questions and more as I explore my own experiences, in the hopes that my search for better answers will help others. 

Impulse Control

“As for impulsiveness, a volume could be written about the disastrous consequences of this symptom. It has ruined many a business, many a marriage, and many a life.”

- Karl Menninger

Before I turned twenty-five I had:

• Committed early to college to play lacrosse

• Blew all of my money skydiving

• Changed my major multiple times

• Enlisted in the Marine Corps

• Moved into an apartment without steady income

• Attempted suicide three times

I was impulsive, and I was young. My prefrontal cortex was still developing.

In fact, some research indicates that, “the frontal lobes, home to key components of the neural circuitry underlying ‘executive functions’ such as planning, working memory, and impulse control, are among the last areas of the brain to mature; they may not be fully developed until halfway through the third decade of life” (Johnson, Blum, & Giedd).

Kids, I get to call them that now that I’m thirty, do not have the mental hardware to deeply consider anything beyond their immediate future.

Many adults look at the behavior of adolescents with bemused concern. Surprised at what we consider silly behavior, we ask: “don’t they think about the consequences?” They do! Just not like adults with fully developed frontal lobes.

Kids, for the most part, have a dial-up connection to their impulse control center. Adults have a 4G connection. It is no wonder that young people will think through a decision, experience slow loading times, and decide to do what they want.

The lack of impulse control may be why we see that, “suicide is the 2nd leading cause of death in the world for those aged 15-24 years.”

15-24. Ages where a young person goes through at least three different learning environments, experiences vast changes to their bodies, simultaneously juggles youth and adult personas, and, as if to add more to their plate, every adult asks what they plan to do with the rest of their life.

Add in the potential for bullying, social isolation, poverty, physical and sexual abuse, mediocre parenting, poor parenting, or no parenting, and you can see that kids, despite our adult objections to the contrary, do not have it easy. To say otherwise demeans them, and calls into question the validity of our own growing pains.

Are you worried about your child, but do not know where to start? The American Foundation for Suicide Prevention has an excellent list of resources that will help: https://afsp.org/campaigns/talk-about-mental-health-awareness-month/teens-and-suicide-what-parents-should-know/

https://afsp.org/about-suicide/suicide-statistics/

Keep Walking

I bartended the summer before my sophomore year of college. Legal to do in Georgia, as long as you were over eighteen. It turned out to be the perfect job for me, even though I considered myself socially awkward and anxious in most social settings.

Why would bartending appeal to me? Well, I had three feet of granite separating me from everyone else, and the more drinks I served, the funnier and more charming I became to my patrons.

I operated in a safe environment that alleviated my anxiety, and I could practice interacting with people. At the end of the summer, I decided to get a new tattoo. This time of Johnnie Walker’s Striding Man with the company’s tagline: “Keep Walking” below the logo.

As you will see in the gallery below, the advertising campaign was of the Striding Man walking in a straight line, far beyond a variety of earlier obstacles.

The word “stride” means to, “walk with long, decisive steps in a specified direction,” or to, “cross an obstacle with one long step.”

I always took this to mean that action, movement, and incremental forward progress will always create a measure of distance from previous struggles. This is supremely practical advice because everyone can relate to the feeling of being stuck in a situation.

“Caught in a rut” is another familiar phrase that encapsulates how frustrating it is to feel as if you are trapped. I think this harkens back to our evolutionary past. When our ancestors risked exploring new environments because wherever they were living, was no longer sufficient to their long-term survival.

Whether we evolved to move, or we moved and then evolved is beside the point. We feel better when we act, and we feel confident when we act with purpose. My purpose is to live a disciplined life, and share the methods I use to move from living with an affliction, to living well with mental illness.

Eight things NOT to Say

Sticks and stones may break my bones, but words will never hurt me.

What a lie. What a terrible, terrible lie we tell kids.

“I think the saddest people always try their hardest to make people happy because they know what it’s like to feel absolutely worthless and they don’t want anyone else to feel like that.”

Words cut deeper than any sword, leave invisible bruises, and take far, far longer to heal than a physical injury. We quote things like:

No matter what people tell you, words and ideas can change the world. - Robin Williams

And then we tell kids, “don’t listen to what she said; words cannot hurt you.”

Can it be true that words have the power to change the world, and at the same time, have no power over an individual?

No.

This is why I remember three separate times I split my head open before I turned seven, but, twenty-three years later, I can only recall the facts; I can barely remember how I felt. But, I can still remember, with HD clarity, the comments a few kids used to put me down in middle school.

What many people without depression do not understand is the level of shame that accompanies the disease. I never wanted to feel confined to my bed, unable to summon the energy to wash my face, or the willpower to eat something. Then you hear, “well, you should just think more positive.” If I had the energy, I would positively throttle you.

View full lesson: http://ed.ted.com/lessons/lessons-from-auschwitz-the-power-of-our-words-benjamin-zander

Here is what I heard over the years:

1. Get over it

2. It could be worse

3. Life isn’t fair

4. Snap out of it

5. Don’t think about it

6. I know how you feel

7. Quit being so lazy

8. It will be okay

There are dozens of articles explaining the failure of these, and other phrases, with somewhat snide retorts: “You know how I feel? How could you possibly know how I feel?” I would like to demonstrate the limiting nature of these statements in a different way.

Depression, has been described as grief absent context. Let’s take that a bit further.

Imagine, if you will, how you felt the moment you learned that someone close to you had passed. If you do not have that experience, then please imagine how you think you would feel if you heard that news.

Then someone you know, or don’t know, comes by and says: “What’s wrong with you? Snap out of it.” How would you feel immediately after hearing that? I’ll wager not good. Probably worse than if you had not heard it at all.

“The fire is all in your head!”

Perhaps another scenario, taken to an absurd extreme: You are walking next to a good friend or family member, when they spontaneously combust! We all know what to say in a situation where someone is on fire. It’s been drummed into us since grade school: “Stop, drop, and roll!” How idiotic would it be for you to shout: “It could be worse!”

We would not even consider saying anything else, other than also shouting for help, when someone is on fire. We know what we are supposed to say. The problem with mental illness in our society is that we are growing out of our infancy about how we should help someone we care about.

Old habits and fossilized beliefs die hard. Just look at Dr. Semmelweis, who, in 1847, proposed that doctors should wash their hands before delivering babies. Was he celebrated as a wise forward thinker who saved the lives of newborns and their mothers? No! He was vilified by his contemporaries; who were aghast that he would accuse them of being the primary cause of death to new mothers. Taken aback by the forceful denunciation of his peers, Semmelweis had a nervous breakdown and later died in an insane asylum.

Today, in the case of mental health, we are caught between what we think works, and what we know works. Telling someone who is suffering that, “It’s all in their heads,” may be medically accurate, but it does more harm than good.

Simply being next to the person. Telling them that you are there for them, and asking “how can I help?” or “what do you need?” is far more effective.

The person you care about is caught in a mental typhoon. They do not need advice on how to get to shore, they need a life preserver.

Be the life preserver.

Why I Dress Nice

When my dad was a kid, his mother, my nana, would tell him to go to the deli, and get some “nice ham”. Not just any ham, “nice ham”. That became a running joke in my family. If we bought some cold cuts, invariably, one of us would ask, “did you get the nice ham?”

With my sister’s BF, Nick, in Fells!

My coworkers commented on my change of style to a nicer, even quite dapper, look at the office. Since I have always felt like I should have been born in the 1960s or earlier, I quite like the idea of rocking a debonair look.

A few days ago a friend said he liked my new look, and was curious why I was walking around in nice shoes, a buttoned down shirt with cufflinks, and a vest. Was it to “look good, and feel good”?

Almost, but not quite. I dress this way for two reasons.

First, changing my clothes after work is a custom-made mental doorway. Have you ever walked into a room of your home, and stopped with no idea why you are now in that room? There are some fascinating studies on the doorway, or “threshold”, effect on the human mind. The hypothesis is that crossing a barrier frees the mind from the constraints of the previous environment.

Establishing mental dominance over my sister’s BF.

This is why the first few days of a vacation feel awesome, and the last day is considerably less awesome. The mind has a sense of where you are, and when you are in an environment where you have work and personal stressors, there will be thoughts in your subconscious relevant to your regular surroundings.

My “nice” look gives me something to shed when I get home from work. I step across the threshold of my front door and change into something more relaxed. I have noticed a much smoother transition out of “work-mode” and into “do whatever I want” mode.

The second reason is more personal. I know my anxious and depressive triggers. I know them very well, but sometimes I miss one. Before I can raise my defenses, I might be on slippery mental ground.

My dapper look means more time for me to notice pre-depressive and pre-anxious indicators. If I do not feel like ironing my shirt in the morning, which is a lovely moving meditation, I can ask myself why. If I do not feel like taking some care in how my tie matches the rest of my ensemble, I can analyze why. If I do not want to shine my shoes, I can examine why.

All of these are new personal measures to combat mental slippage into stress and depression, with the pleasurable side-effect of compliments on my appearance.

https://projectsemicolon.com/

Plus, I get to wear my semicolon tie clip!

PANIC Attacks!

Not to be confused with worry or concern. Panic, is concentrated fear.

The symptoms can include some, or all, of the following:

• Palpitations, pounding heart, or accelerated heart rate

• Sweating

• Trembling or shaking

• Sensations of shortness of breath or smothering

• Feelings of choking

• Chest pain or discomfort

• Nausea or abdominal distress

• Feeling dizzy, unsteady, light-headed, or faint

• Chills or heat sensations

• Paresthesia (numbness or tingling sensations)

• Derealization (feelings of unreality) or depersonalization (being detached from oneself)

• Fear of losing control or “going crazy”

• Fear of dying

Panic attacks are extremely unpleasant and can be very frightening. As a result, people who experience repeated panic attacks often become very worried about having another attack and may make changes to their lifestyle so as to avoid having panic attacks. 

https://adaa.org/understanding-anxiety/panic-disorder-agoraphobia/symptoms

All of this sounds bad, but the symptoms and description of “extremely unpleasant’ and “very frightening” does not quite encapsulate what a panic attack truly feels like.

If you have never experienced a panic attack, I wish that you never do. But, you can imagine what one feels like.

Pretend that you are relaxing in front of the television, watching your favorite show; when all of a sudden, a 700 pound Siberian Tiger bursts into your living room. It roars, and your brain quickly realizes that you just got knocked down to the bottom of the food chain. The tiger sits back on it’s haunches, coiling it’s powerful rear legs, and then leaps across the room directly at you.

“I’m going to f____ you up.”

It’s mouth is wide open, large teeth clearly visible, and right before you realize you are about to die, the tiger vanishes into a wisp of smoke.

Then, a 700 pound Siberian Tiger bursts into your living room. Roars, leaps, is about to tear you about apart, and then it disappears.

Roar. Leap. Death. Fade.

Roar. Death. Fade.

Death. Fade.

Death. Death. Death. Death. Death.

Panic attacks are the psychological equivalent of this imagined scenario. You constantly ride the edge between life and death, almost 100% certain that you will die. That your death will be both agonizing and slow.

What would you do if a massive tiger leap at you right now? Fighting it is useless. You have no chance of running away. All you can do, is be frozen in place while you get yourself right with your maker.

See how horrifying that is? It is no wonder that a panic attack can be debilitating in the moment, but the effects can linger.

Say the tiger vanishes and does not reappear. Your mind is ready for it to pop back into existence to end yours. But it does not. Tentatively, you stand up, arms in front of your torso to give your vulnerable belly some measure of protection.

Imagine your mind on fire.

Your senses are heightened, blood is pounding, and fear compels you to either sprint or freeze.

At that point, you don’t think that you have to pick up your kids from school later that day. You aren’t worried about that staff meeting at 2pm.

Your brain is on overdrive, trying to find the TIGER THAT WILL KILL YOU!

It takes some time to come down from that state.

In my experience, there is no immediate “snapping out” of a panic attack. You need to let it run its course. It will be awful, but, I promise you, it will end. You will be okay.

Life in a Psychiatric Hospital - Part 5 of 5

It took my fourth hospitalization before I realized the folly of lying to expedite my release.

During my first three hospitalizations, I learned the rules and then acted accordingly. Doctors, nurses, and other caretakers are, in my experience, personally invested in a person getting well. I had many wonderful interactions with compassionate and empathetic professionals at each hospital where I spent time. That said, the medical business is a business.

Insurance companies are not keen on paying for beds for patients who are stable. A hospital cannot be financially sound if patients are kept on the ward until their caretakers are absolutely sure a patient is capable of taking care of themselves, or at the very least, not in any danger of self-harm.

It is a system that constantly cycles people in and out. Because it is a system, though, it can be gamed.

I am exceptionally good at putting on a facade to the world. In my first hospitalizations, I lied.

Told the nurses I felt great. I smiled. I held doors open for other patients. I politely requested shaving privileges, and did my very best to be of no concern to those running the ward. This strategy worked brilliantly to get me released because there was no behavior the doctors or nurses could point to where I demonstrated the desire for self-harm.

I appeared psychologically “stable,” and that meant I should be released, and my bed given to someone at more acute risk of overdose, self-harm, etc.

I knew the system. I had read about emergency psychiatric hospitals and insane asylums. The best patient is typically one that causes no problems. So I lied and became the best patient I could at the expense of my health.

At this point someone might rightly condemn me: “How could you lie to your doctor? Didn’t you want to get better?” Spare me.

If everyone told their doctor the truth, there would be no medical drama category on Netflix.

I wanted out of the hospital, and I was willing to sacrifice my long-term health for short-term freedom.

There are no quick fixes for mental illness, and lying can only be maintained for so long. Eventually, I did not have the energy to keep the facade going. My mask of normality crumbled away.

My last hospitalization was a result being committed following my outburst in the seclusion room. I stayed in my bed for days. A nurse kept coming into my room to encourage me to venture out and interact, but I stubbornly stayed under my sheet. After a while, though, it was pretty boring by myself, and I shuffled outside.

Six years after my first hospitalization I had finally had it with putting on a show of normality. It was exhausting and counter-productive. Once I stopped playacting and started working on my recovery, life got better.

It is realistic to expect that I will be back in a psychiatric hospital someday in the future. I learned that fact from a delightful older woman who checked herself into the hospital every year or so for a couple of weeks. She knew that when she did not feel safe, she should be in the safest place possible.

That was a great lesson to learn. I can use the hospital just like any other treatment. That understanding makes it much more bearable to willingly be locked into a ward, watch Law & Order SVU reruns, eat poor food, and talk with doctors.

Using the system, as opposed to gaming the system, was the lesson I wish I knew years and years ago.

Life in a Psychiatric Hospital - Part 4

Group is a regular part of every day in a psych ward. The type of groups may differ between facilities, but they are invaluable to the patients and to the caretakers.

Facilities have different rules on expected behavior. Ridgeview required me to attend all groups in order to get the privilege of dining in the mess hall. Those that avoided group, got their food delivered to the ward in a styrofoam box. At St. Joseph, food was delivered to the unit so there was no real penalty if you did not attend group, but, since group is a primary method for determining a person’s readiness to leave, attendance is a good idea if you want to get past the locked door at the front of the building.

Most of us went to group begrudgingly. If nothing else, it passed the time. Also, the staff turned off the television during group time.

Looking back, I would say that Ridgeview’s groups were focused on everyday life skills, and St. Joseph’s groups were focused on communication and interpersonal skills.

Behold! My awesome hot plate!

I definitely enjoyed group more at St. Josephs, because they were more fun.

Reminiscent of a kindergarten class. Feel like coloring? Go color! Want to play with blocks? We have all the blocks! I even learned to grout and made my own hot plate over a three day period.

At this point, some readers may be wondering, “Really? Coloring books? This is supposed to make you better?” No. Group does not make a person better. It facilitates recovery because human beings are social creatures.

Isolation can destroy a person. Ask any prisoner who has spent time in solitary. Or, just watch this video about Harry Harlow’s Pit of Despair experiments with rhesus monkeys:

Now, I am an introvert’s introvert. I find nothing more enjoyable than reading a book on a lazy Sunday afternoon, and never saying a word to anyone for the entire day. That said, I am human, and I do not do well with extended periods of isolation. No one does.

Group, in the context of psychiatric care, establishes a place where someone with a frayed mind can get their bearings under controlled circumstances. The depressed person who cannot speak can, at least, listen.

The person coming down from a manic episode can ease out of it with people who won’t judge. The addict who just got through the worsts of withdrawal can talk about their experiences.

The hospital is not real life, and group allows for an approximation of life. As such, it gives insight into a person’s state of mind around other people that is objectively measurable by those providing care.

For instance, for the two days that I avoided group entirely and stayed in my bed, I was not ready to leave the hospital. Because I likely would have gone home, got into bed, and avoided my life. But, oh how a nurse’s face lights up when you walk out of your room and sit down in group! Even if you do not say anything, your presence shows a willingness to engage with others.

Group is a means to an end. It gives patients the opportunity to experience time with people in a controlled setting. Combined with daily therapy, consistent medication, a good diet, and sleep, the whole treatment becomes greater than the sum of it’s parts. It is a staggeringly simple idea, but that is why it works. Put a human being in varied, yet safe, social situations and give them time to learn how to exist with others.