09 Jun

PSA: Mental Health Crises

TRIGGER WARNING: SUICIDE

This post is directed toward folks not themselves experiencing a mental health crisis, in hopes of increasing understanding of those who are. I’m putting all of it under the fold. If you’re fragile, don’t click it.

Following the news about Kate Spade and Anthony Bourdain, the internet is full of disbelief that the suicide of someone you don’t even know could possibly send anyone into a spiral.

A lot of these “you’re overreacting, get over it” hot takes come from known festering hemorrhoids devoid of empathy who wouldn’t experience a feeling if the person nearest and dearest to them dropped dead right in front of them. But more people, I think, are well-meaning and simply don’t have a frame of reference for a disordered mental state. Since someone in the midst of a crisis needs all their energy to stay alive and has none to spare to educate others, these things often go unsaid. I, currently in a place of safety, have the energy to spare to say something.

I’m fine, or at least no worse than I was before the latest round of high-profile suicides. But other people are not fine, and I’m infuriated by the widespread dismissal of the danger by people who don’t understand it’s not about who died.

It’s about yet another reminder that no matter how good the life surrounding you gets, the defective brain inside your skull can still tell you there’s nothing to live for and you don’t belong here.

Having a mental illness is a never-ending mind game. You get through each day by assuring yourself that someday you’ll get a better job with insurance that covers a medication that might work so it won’t cost you $400 a month out of pocket, which you can’t afford currently and also eat. You assure yourself that someday you’ll get 2% “better,” people will like you more, and having a tribe will make you happier. You cling to the lifeline of “it can get better and then everything will be okay” and let it tow you from one miserable minute to the next in search of a better one.

When someone who has the resources to get the best treatment money can buy and someone who is admired and respected by millions says “nope, nothing to live for,” all those hopes for a brighter tomorrow vanish. Somebody living your hope of salvation wasn’t saved by it, and it won’t save you, either. The lifeline that got you through the day is smoke in your hands, and you remember you’re drowning.

Everybody wasn’t fine a couple of days ago and didn’t lapse into hysterics at a minor provocation. They’ve been treading water in the middle of the ocean, and they watched one of their fellow survivors—the one everybody thought would last long enough to be rescued—go under. They’re cold and tired and it’s hard to rationalize treading water for another day, week, year, decade because if nobody could save the rich, famous person, nobody’s ever coming to save nobodies like them.

I wish I had some brilliant advice for how to help someone who’s struggling, but in my experience (both personal and clinical), you can’t help, not in the sense that there’s anything that will make them able to say “oh, that’s sad,” snuggle a puppy, and be back to normal in the morning. They’re not wired the way you are, no matter how much they wish otherwise, and they’re most likely going to spend some time in a hard, ugly place. All I can suggest is not making it worse than it has to be.

Don’t be judgmental and dismissive.

If you can be present or available even during times when that person isn’t fun to be around, constancy may have long-term benefits. (With the understanding your mental health also needs safeguarding and people in crisis can tolerate different degrees of human contact.)

Understand that the person in crisis is desperately trying to find a path forward and doesn’t have any resources to spare to reassure you that everything will be fine, and accept that the relationship may be one-sided as long as the other person is in survival mode.

Stability can go a long way toward convincing someone life will go on, so unless you’re asked to change something, call, stop by, issue invitations, etc. as you normally would. Don’t hover if you normally wouldn’t, but don’t abandon someone and expect them to come back around when they’re “better.” That just reinforces deeply held beliefs that no one wants us around and we don’t deserve relationships until we’re 100%, which we’ll never be.

When the crisis passes, everybody is relieved and wants to pretend it never happened and will never happen again, but it did and it will. When that person is no longer fighting just to stay alive, you need to have what may be a very awkward conversation (or several) about what they need from you in the future. THEY MAY NOT KNOW. We have the best grasp on what doesn’t help and sometimes have no experience with effective support, or we may not be able to articulate what’s churning inside. But if that communication is ever going to take place, it has to be during the calm time.

You are not obligated to provide what anyone needs or wants from you, and you should communicate your limits and boundaries, ideally also during that quiet time so there’s no confusion in an emergency.

Remember someone’s mental health crisis is no more about you than about a celebrity, so try not to take it personally. If your feelings are hurt, you are entitled to those feelings. You should never tolerate abuse. (Mental illness is not an excuse for abusive behavior.) But if you’re just feeling neglected, please don’t penalize someone who’s been trying not to die for not giving you enough attention during that struggle.

If someone is acutely suicidal, all the good intentions in the world won’t save them. Call 911 and let professionals stabilize the situation. Any negative effects of making that call pale in comparison to the trauma to you, the person you’re worried about, and everyone else in that person’s life if intervention is necessary but never sought.

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