Platitudes and Attitudes

The news of Kate Spade dying by suicide and the news of Anthony Bourdain suffering the same fate only a couple of days later was saddening.

My response to the news was not unlike that of a lot of other people, or so my social media feeds suggest.  There were a litany of posts from tons of people: some shared their own struggles with depression and suicidal ideation, some encouraged others to check on their friends, others reminding us that we don’t always know what people are going through, and even others providing links and phone numbers to help those who may be in need but not know how to access it.  

I joined the fray by I encouraging people who may not see themselves as suffering from depression to still seek the professional help of a therapist.  I firmly believe that if more of us who are fiscally able to and also do not suffer from major depression, suicidal ideation or other serious mental disorders would get in therapy we would see positive changes in our lives and in the perception of mental health.  

But even with all of these encouraging posts, there was something that bothered me.

This “check on your friends” thing.

What does that mean?  Send them a text and ask them if they’re ok?  Then what? What if they say no? Then what do you do?  What’s the plan?

I hate blaming social media for things.  Social media is only what social media can be based on how we use it and allow it to use us.  But one thing too many of us allow is the use of social media to share platitudes and attitudes that are superficial.  They are the placebos of the internet. They sound and look good but don’t actually do anything. I think we all mean well when we say “check on your friends” but I think we also don’t give any real thought to why we say it or what our purpose is.

I want to encourage us to be better than that, especially when we’re discussing the mental well being of our friends.  I want us to care that our intent and our actions align. I want us to quit saying things that are catchy and seem timely; I want us to start DOING things that support the people we care about in real tangible ways.

First, let’s be clear about a few things:

1. Your “strong” friend probably won’t tell you they’re struggling, EVEN IF YOU ASK.  Your “strong” friend is the “strong” friend for a reason.  Because they never admit when they are struggling.
2. Even if your friends admit to you that they don’t feel ok, that they are feeling hopeless, that they do contemplate suicide, unless you are a trained professional, odds are great that you don’t actually know what to do if someone lays that on you.  If a person is at the point where they are actively considering suicide, telling you their problems isn’t going to fix it. They need the help of a mental health professional and the best thing you can do is help them figure out how to access that help and perhaps even make sure they follow through (e.g. go to the appointment, make the phone call, etc…)
3. The truth of the matter is that studies show us that people who have firmly decided to die by suicide will seem happy.  Maybe even happier than they have in a very long while. This is because they know it will all be over soon.  Kate Spade’s husband said, “we were in touch with her the night before and she sounded happy. There was no indication and no warning that she would do this. It was a complete shock.”  I say this to emphasize that our role in these situations is not to fix it. It is to have a plan. It is to be a support. It is to be aware.

When we say check on our friends, I want us to understand how important that statement is and that checking on your friends isn’t something you do for a few days via a quick text only after two celebrities die by suicide.  Checking on your friends is multi-faceted and it sometimes means being uncomfortable, it means taking risks, it means being honest with yourself about your own issues, it means being real, it means caring, it’s inconvenient sometimes, it’s frustrating other times, it’s… hard.  

When I was a junior in high school, a friend died by suicide.  It came as a shock to all of us. Most of us knew he struggled with depression but we thought it was under control.  15 years later, I still vividly remember talking to him just the day before and how happy he seemed. Hearing that he had then hung himself in a closet was cognitive dissonance that I couldn’t begin to get on top of.  For years after, I would wonder if there was anything I could’ve done. I beat myself up for a long time for not making it a point to talk to him that day even though he had been on my mind because I could tell something was different.  It wasn’t big, it wasn’t obvious, but I noticed it and I didn’t do anything.

Was I responsible for his death?  No. Definitely not. But trust me when I say that as mucha s I know that to be true, that doesn’t change the guilt that I still occasionally feel.  We cannot operate from a place of guilt; neither guilt we already feel or guilt we anticipate. Check on your friends because you want to have a relationship with them where they trust you.  Check on your friends because you want them to check on you. Check on your friends to be a friend - not to mitigate guilt. The real bottom line is that sometimes, even in the best case scenarios, people who are dealing with their own demons, make their own choices even when they are surrounded by love.  That’s why you can’t check on a friend because you think you might prevent their suicide. If you do, that’s a cherry. The sundae, however, is the relationship. It’s the effort. And when your actions and your intentions truly align, you will find a lot more peace in whatever outcome there is.

I have never suffered from suicidal ideation, but I have suffered from depression and anxiety that people around me read as “anger” or “disinterest” or “disengagement”.  This emotional expression has scared people - not because it is explosive or dangerous, but because it is quiet and hard to read. And in being hard to read, I get read as the “strong” friend.  Whatever the hell that means. If I’m really honest right here, I revel in that identity because it makes it easier to hide from well-meaning inquiries that I don’t trust are rooted in intentionality.  Does that mean my friends aren’t being honest when they ask me how I feel? No. It doesn’t. But if you know that your “strong” friend doesn’t believe that you really want to know how they feel, how does that change the way you approach them?

It’s not easy to check on me, because I will say what I think needs to be said so that a person will stop worrying about me.  Thinking that someone is worrying about me increases my anxiety. I hide my issues very well. I know how to disappear when I know my aesthetic will not be pleasing to others.  I know how to hide when I don’t feel “ok”. I know how to do all of these things and I do not suffer from suicidal ideation or major depression. Imagine someone who does suffer from these things.  What is asking them if they’re “ok” whenever social media reminds you to, going to do?

There are things you can do, though:

Be a constant.  Show up for them.  It’s a lot easier to ask someone for help that you talk to regularly because you don’t have to start all over with explaining everything that happened.  Check yourself, too. The last time you had an extended conversation with them, what was the topic? Was any significant amount of time spent on their life?  If not, trust me when I tell you, they’re not going to open up to you. Why would they?

Be understanding.  Be patient. Realize that asking for help with something that is as intangible as mental health is almost impossible for most people.  If I break my leg, someone can see that I need help. If my mind breaks, that can’t be seen by most and I probably cannot describe it well.  Be willing to be with someone (whether that’s in person, digitally, over the phone or otherwise) even if neither of you understands what’s going on.  Just commit to being someone that they can be vulnerable with. Understand that if someone is struggling, usually they don’t need advice or “everything will be ok” they want someone to truly listen and then echo what they probably already feel: “this really sucks.”    

Be knowledgeable.  Do you suspect your friend has suffered from issues of depression or anxiety before?  What did it look like and so what might it look like in the future? Could you be of assistance without them asking?  I read a twitter thread recently where a user described how her friends rallied around her to help her unpack her apartment after her father died and she was severely depressed.  Her friend did ask if she was ok and she said that she was. He knew she wasn’t, he figured out what could be done to help and he took a risk and tried it. As she points out, it could’ve backfired, but the point is that he tried and often that’s all we can do.

Ultimately, be realistic.  You’re not the mental health professional in this relationship - and that’s even if you are an actual mental health professional.  And that’s ok! Be a friend. That’s all you have to be, no matter what happens. I tell my friends, all the time (though many don’t like to hear it) that I’m their friend, not their therapist.  I may listen well, and I may seem to know the right things to say but at the end of the day I am not objective. A true therapist is objective and that’s what provides true personal growth. A true friend, however, is on your side and all about you.  That’s what provides growth in a friendship.

We’re all out here trying to do this life thing the best way we know how.  I get that. Doing life is harder for some of us than others, which is ok. Being a real friend isn’t easy, especially to someone who suffers from mental health issues.  It just isn’t. But if you’re going to commit to doing it and doing it well, it’s going to take some intentionality. Check on your friends. Your strong friends, your struggling friends, your happy friends.  Do it regularly. Keep up with what’s happening in their world. Expect your friends to do the same for you. Share the load. If you suspect a friend is having a hard time, loop in another trusted friend. Make a plan.  Execute it. We get through this life with a little help from our friends. That’s from a song, so it’s true. Friendship is a thing you do from love, not to be a hero.

RESOURCES

Get Immediate Help

If you are in crisis, and need immediate support or intervention, call, or go the website of the National Suicide Prevention Lifeline (1-800-273-8255). Trained crisis workers are available to talk 24 hours a day, 7 days a week. Your confidential and toll-free call goes to the nearest crisis center in the Lifeline national network. These centers provide crisis counseling and mental health referrals. If the situation is potentially life-threatening, call 911 or go to a hospital emergency room.

Find a Health Care Provider or Treatment

For general information on mental health and to locate treatment services in your area, call the Substance Abuse and Mental Health Services Administration (SAMHSA) Treatment Referral Helpline at 1-800-662-HELP (4357). SAMHSA also has a Behavioral Health Treatment Locator on its website that can be searched by location.

National agencies and advocacy and professional organizations have information on finding a mental health professional and sometimes practitioner locators on their websites. Examples include but are not limited to:

• Anxiety and Depression Association of America
• Depression and Bipolar Support Alliance
• Mental Health America
• National Alliance on Mental Illness

University or medical school-affiliated programs may offer treatment options. Search on the website of local university health centers for their psychiatry or psychology departments.

You can also go to the website of your state or county government and search for the health services department.

Some federal agencies offer resources for identifying practitioners and assistance in finding low cost health services. These include:

• Health Resources and Services Administration (HRSA): HRSA works to improve access to health care. The website has information on finding affordable healthcare, including health centers that offer care on a sliding fee scale.
• Centers for Medicare & Medicaid Services (CMS): CMS has information on the website about benefits and eligibility for these programs and how to enroll.
• The National Library of Medicine’s MedlinePlus website also has lists of directories and organizations that can help in identifying a health practitioner.
• Practitioner lists in health care plans can provide mental health professionals that participate with your plan.
• Mental Health and Addiction Insurance Help: This website from the U.S. Department of Health and Human Services offers resources to help answer questions about insurance coverage for mental health care.

Participate in a Clinical Trial

Clinical trials are part of clinical research and at the heart of all medical advances.. People volunteer to participate in carefully conducted investigations that ultimately uncover better ways to treat, prevent, diagnose, and understand human disease. Clinical trials can also look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Learn more about clinical trials on the Clinical Trials — Participants page.

• Find a Clinical Trial at NIMH. Doctors at the NIMH in Bethesda, Maryland are trying to learn more about the causes of, treatments for, and genetic factors in mental disorders. To learn more, visit the NIMH Join a Study page.
• Find a Clinical Trial Near You. For information on clinical studies across the country, visit  www.clinicaltrials.gov. You can search by topic and location.

Help for Service Members and Their Families

Current and former service members may face different mental health issues than the general public. For resources for both service members and veterans, please visit http://www.mentalhealth.gov/get-help/veterans/index.html.

Learn More about Mental Disorders

NIMH offers health information and free easy-to-read publications on various mental disorders on its website in the Health & Education section. The website is mobile and print-friendly. Printed publications can be ordered for free and free eBooks are available for select publications. Many publications are also available in Spanish. To order free publications, order online (haga su pedido por el Internet en español) or call 1-866-615-6464 (TTY: 1-866-415-8051).