About the Hosts

Christy Wilkie provides therapy for children and adolescents, ages 5-25, who have complex behavioral health issues. She combines her extensive clinical expertise with a belief in kids, and has a unique ability to find and develop their strengths. She works hard to be an ideal therapist for her clients, doing what is best to fit their needs.

Lucas Mitzel provides therapy for children, adolescents, and adults, ages 5 - 30. He believes building relationships with clients is the most important piece of successful therapy. He loves what he does because it allows him to walk next to people he would never have met had he chosen a different profession, as they work to make amazing life changes. He has the honor of meeting people at their worst, all while watching them grow into the people they’ve always wanted to be.

Transcript
We Need to Talk About Suicide

Featuring Christy Wilkie, LCSW, and Lucas Mitzel, LCSW, Dakota Family Services

Announcer:

This episode of "Is It Just Me," is brought to you by Dakota Family Services, your trusted partner in mental and behavioral health. Whether you need in-person or virtual care, the team of professionals at Dakota Family Services is dedicated to supporting children, adolescents, and adults in their journey to better mental health.

Christy:

Disrupting life patterns and life routines that aren't serving you.

Lucas:

It's how we feel that keeps us going.

Christy:

You can be a masterpiece and a work of art all at the same time.

Lucas:

Hey, everyone, I'm Lucas.

Christy:

And I'm Christy.

Lucas:

And you're listening to the, Is It Just Me podcast where

Christy:

We aim to provide education, decrease the stigma, and expel some myths around mental health.

Lucas:

Christy, is it just me or do we need to talk about suicide?

Christy:

It is not just you. We do need to talk about suicide.

Lucas:

Well, I think before we do that, we need to probably have a little bit of a trigger warning. We're talking about suicide, and this is a very sensitive topic to a lot of people. And so if this is not something that you are ready to listen to or able to, it is totally okay for you to skip this week. Or if you just need to be done listening to it in the middle, that's totally fine.

Christy:

That would be just fine. Take care of yourselves. That's always the number one thing.

Lucas:

Absolutely. I think a good spot to start is, I mean, there's a lot of myths about suicide.

Christy:

There are.

Lucas:

Yes. Like a lot of really, in my opinion, gross ones.

Christy:

Yeah. And I think the tricky thing about myths too is that when you're in a depressed place, it is way more believable. Like the myths become more believable when you're already in a depressed space. So like, let's get 'em out there. Let's talk about them.

Lucas:

Absolutely. What's, what's one of the big ones that you always hear

Christy:

That suicide is selfish.

Lucas:

Ooh. Yeah.

Christy:

That is the biggest one. And I think people don't necessarily see depression in the way that a mental health provider sees depression, or somebody who's gone through depression even, where it's like, it's a symptom of being very depressed. I mean, that, that is a potential outcome of severe depression. And people who don't understand depression don't understand the mindset is of somebody who's contemplating suicide. Right. Because it's like, suicide isn't a rational thought. Wanting to end your life is an irrational thought. So think about how dark of a place you have to be in to realize everybody else doesn't want me here. 'Cause I think that's the trick, right? Where it's like people just think they, they just want it out. They just wanted to get out. They just, they didn't think about anybody else. They didn't care what anybody else would think about it. When it is, a lot of times the very, very opposite they do think about it, their perception is just different because they're thinking how much better they're gonna make it for everybody else, for them to not be around.

Lucas:

I like to talk about it in a way where like, the brain's primary function above all, is to keep you alive and, and feeling comfortable. Right? Right. And so, if your brain is overriding its primary function and saying that the better option is to be dead something is going vastly wrong And so there's a malfunction happening, and we need to look at fixing that malfunction. It has nothing to do with being selfish or coward or weak or anything like that. There's just something going on in the brain, and it's 100% preventable.

Christy:

Yes it is. And I think people think about this is, which is probably another myth, but they look at people and they're like, they have everything. What do they have to be sad about? Like, you have to be really depressed and look depressed in order for there to be suicidal thoughts present. And that's also not true. And that makes it even more difficult for depressed person when they can look at it too and be like, I have on paper everything that I could possibly want. I have a job. I have a spouse or a partner. I have hobbies, I have friends. I have all these things, and I still feel this way. It's like, just because you have those things doesn't mean that your brain computes that in a way of like, you're worthy to be here.

Lucas:

Yeah. I can't tell you how many times I've had people sitting in my office who are bawling their eyes out and are like, why am I sad? Mm-Hmm. Why do I want to die? I have everything I've ever wanted in life, and I'm the most miserable I've ever been. Right. And again, it goes back to that, that malfunction that's going on. There is a chemical issue in the brain, and we just gotta work through that. There could be some medications that we need to try, but, you know, and, and also like therapy and just working through some different stuff, but it's totally fixable. We can get through that.

Christy:

I always try to get, for people who haven't experienced depression or haven't known somebody who's depressed, to get them to understand the place that a brain has to be in order for that to even be contemplated as an option. And you said it just there, where it's like you have somebody who's crying saying, I have everything that I could possibly need. There's nothing more that I, I want, and I still feel like this. Think about how that just throws gas on an already hopeless fire. To be like, I have everything. Like, there's nothing more I could have in my life that would make it better. You know? And you're still feeling like that. It's like, it's not about the stuff. It's not about what you have. It's literally your brain lying to you in saying that you're not worthy to be here.

Lucas:

Right. I think another huge myth that we hear is talking about suicide increases the chance a person will act on it.

Christy:

Ooh. Yep. That's a good one. We hear that a lot.

Lucas:

There is a ton of research on this, and it is 100% the other way around. Talking about it with somebody actually decreases the risk of suicide. And it's really important, we'll get to this a little bit later on, like, how to talk to somebody who's experiencing a suicidal thought, but being very direct and upfront about it is more beneficial than just trying to like, give 'em a hug and not talking about it. Or ignoring it all together.

Christy:

Because it's such a taboo topic. Right? Yeah. People don't wanna talk about it. Or, and like, it, people are like, if if I say it, I'm gonna put that thought in their head. That was never there before. And we say this all the time, it's like, if you ask somebody who's suicidal and the person who is responding hasn't been, they'd be like, no, <laugh>. Yeah. Like, 'cause that's, that's not the thought that has ever crossed my mind. It's never like, ah, good idea. Like, that's not what happens. But for somebody who is suicidal, to have somebody ask them that question is in a weird way, really validating to be like, oh, we can talk. I can talk about it. You're, you're like opening up a pathway to be like, you're not gonna judge me if I tell you how I'm really feeling. Because that's what gets in the way most of the time of people talking are feelings of shame, guilt, embarrassment, feeling judged, having anybody say something to them that discredits how they're feeling. It's huge.

Lucas:

It goes back to that first myth that you said, where they're weak or cowards or whatever. They, they're thinking that already, and so that's why they're not talking about it. Right. So if we can break through that barrier and ask them those questions, then it shows them that we don't think that way about them. Right. And that we're wanting to help. Yeah. Which is huge.

Christy:

Extraordinarily huge. This is a good, Lucas is gonna get mad at me about this, but today you won't <laugh>. But he walked in today, and I, I work with Lucas every day. I know the guy pretty well, but he came in and he was just not acting his normal self. And I was like, dude, are you anxious today? And he's like, oh my gosh. Yes. Yes. I am anxious today. I have to fly today. I didn't have time to prep this week. Like I've been busy all week. And it was just a little bit of a flood kind of came out. But how validating for me to be like, Hey, you feeling anxious today? Yeah. And he's like, oh my God.

Lucas:

I felt seen.

Christy:

<Laugh>. And it's such, it doesn't even have to be depression or suicide, but it's like you put the word suicide in it and all of a sudden it becomes taboo. Or like it's gonna be hurtful. And it's like, it's not if me asking Lucas if he's anxious and he's not, he would just be like, no, <laugh>. I'm not, I'm not anxious today.

Lucas:

It's not gonna make me anxious.

Christy:

Are you projecting your feelings of anxiety onto me? It's it's not gonna make him anxious. Right. He's just gonna say, no, I'm not. And that it's, it's no different than that.

Lucas:

Yeah. What about people who talk about suicide are just seeking attention?

Christy:

Ah, that's a good one. And you know what? Maybe they are. And that's what the purpose is. If someone is any threat of suicide, we take super seriously all of the time. Because even if it is for attention, why are they wanting the attention? What's lacking that they, that they're looking for that attention. And if what happens if, if they don't get it? 'cause Everybody says this, so I'm, no, I don't wanna feed into the thoughts. I don't wanna feed into the behavior. So you're not feeding into it by asking what's going on with that. Like, I can tell that you're people who are doing really well are not going to say, "I'm going to kill myself for attention."

Christy:

Just, there's something there.

Lucas:

Healthy people don't say that.

Christy:

<Laugh>. Exactly. Right. Exactly. And so it's like, I've always hated that where people are like, they're just doing it for attention. It's like, maybe they are. What is the attention that they need? Let's figure out what the attention is so that it doesn't go to a place worse than where it is right now.

Lucas:

Right. And I, I like to think of it instead of attention seeking, it's connection seeking.

Christy:

Absolutely.

Lucas:

Yeah. And if that is, even if that is the purpose of it, why do they feel like there isn't a connection there? Right. And can we address that? And that is like, we keep talking about, it's very fixable. And we can get through those things and make it so that that's not happening. A lot of times I think, I work with a lot of kids who, who get really angry, and then when they're angry, they are just like, I'm just gonna, I'm gonna kill myself. Right? Mm-Hmm. <affirmative>. And sometimes it's those, those big feelings come out and they just, they just say it spontaneously. And when you sit down and you talk to them, they're not, they're saying something else. But something is wrong and they don't know how to say it. And so they say these things, but it's never for attention. They're trying to talk to you. They're trying to say something is wrong and they need help. It's always about help me, the end of the day. And so it doesn't, doesn't matter if it feels attention seeking. 'cAuse a lot of times it can feel that way. Mm-Hmm. <affirmative>, something's wrong. And that's what we need to go after.

Christy:

Right. And I think it's important to note too, I mean, we're obviously mental health professionals. We've both been doing this for a long time, but it's, it's not your job necessarily to assess if people are telling the truth or they're not telling the truth. Or if it's attention seeking or not attention seeking. That's not on anybody out in the world. That's not a licensed mental health professional to determine. If you have somebody who's making any of those comments, they need to be seen and assessed Absolutely. By somebody who knows what they're doing. I feel like sometimes that trying to believe that something is attention seeking, is almost trying to talk whoever is has the loved one who's having those thoughts, they're trying to be like, they're fine. It's like, it's, it's just attention seeking. It's not real. It's like, it's almost a, it's almost a state of a denial sometimes to be like I'm sure it's just for attention, but that's just not a chance that I'm ever willing to take with anything. And so when you have somebody who's making any of those comments, get them into a mental health professional to be assessed.

Lucas:

Absolutely. There's not a hospital in the world that is going to admit a person who's not suicidal. They're not just gonna be like, do you wanna have a fun weekend? Like, it's just, it doesn't, it doesn't happen that way. And so if you bring 'em in and they're not a danger to themselves, great. Yeah. But then it's not on you. And you made the right choice. You had a person who's trained in this to, to assess them, and they have told you that your child is safe.

Christy:

Or they'll help you make a safety plan. Even if it, it could be that, that they go in and, and they, and there is, I mean, I'm sure we'll talk about this too later, but there's a difference between having suicidal ideation and actually having a plan. To want to die. Those are two very different things. And it, and it does take somebody to kind of sit down with somebody and be like, because if, if you've got a loved one that's making any sort of gesture about or statement about wanting to die, it can be frightening. Terrifying, honestly.

Christy:

And so it's like going in and getting some sort of safety plan or plan moving forward, or even validation to be like, this is what's going on. Like, let's put a plan together and and make sure that you feel okay going forward.

Lucas:

Yeah. It's really important. And it, it, it's gonna make you feel better as a parent,or as just a family member. And I think another really important distinction to talk about is the myth that self-harm means suicide. 'Cause It doesn't. Self-Harm can have a connection in that there is a similar mood that can be there. And like they can occur at the same time. However, one does not equal the other. Oftentimes people who are self-harming don't actually want to die. In fact, more often than not that's what's happening. And self-harm is actually a coping skill that they've done a lot of studies on this. It's really interesting. And it, it actually, it does work. Like it does lower the distress levels and it lowers it very fast.

Lucas:

Which is why people will do it over and over and over 'cause it can be kind of addicting ss to how fast it relieves the emotional distress. The problem with self-harm is that number one, you're, you're harming yourself. But it relieves the pain temporarily. And then it comes back way worse because now you have this wave of shame. But it works. So then you do it again. Right. And this is where people can get caught in this cycle. But it doesn't necessarily mean that if, if my child, if I found out my child cut, it doesn't necessarily mean that they're wanting to die.

Christy:

The good thing about that, which it sounds really stupid to say, but we've found that there are other ways that you can kind of mimic that same sort of feeling of being relieved that don't have to do with self-harmlike cold water, ice packs. There's all sorts of things that, that people have come up with that, that you can try as a substitute to get people to stop self-harming. So there's a lot of hope, I guess, in having somebody who, who's doing some self-harm work, because there's a lot of therapeutic interventions that you can do with that behavior.

Lucas:

And I'm not saying, just to be clear here, I'm not saying that if you find your child self-harming to be like, oh, no big deal. It's a big deal. Absolutely. We need to talk about that. But I don't want people to panic and think, oh my goodness, my child wants to die. Because that may not be the case. We'll talk about in a little bit how to actually talk to somebody about that. I don't wanna get ahead of myself, but Right. Another interesting myth is that teenagers and college students are the most risk for suicide.

Christy:

Oh, yeah.

Lucas:

Which is a great segue into some statistics 'cause I'm a nerd.

Christy:

Oh, look, it, what would, what would our podcast be without some numbers from Lucas Mitzel.

Lucas:

I love it.

Christy:

Thank you.

Lucas:

Do you like how I did that segue?

Christy:

I did. Yeah. I liked it. You don't,

Lucas:

But it's fine. <Laugh> the eye roll. You guys was insane.

Christy:

Oh, it was? Well, I was wondering how you were gonna get to the nerdy portion of your, of the show. So here we are, <laugh> <laugh>. We, we have arrived.

Lucas:

We have arrived. So the most the highest risk population is actually 75 and up.

Christy:

Oh, yeah. Yeah. Sure.

Lucas:

And ages 10 to 14 is the lowest risk. Okay. But 25 to 34 is fairly high, but between 10 to 24 is actually the lowest risk of suicide qhich is interesting because I feel like it's the most, for lack of a better word, sensationalized.

Christy:

Yes. I would agree.

Lucas:

And that's my theory for that is because it is such a big deal when that happens. Like, everybody is so shocked when a young person dies at their hand. It's, it's just much I think it's a bigger shockwave to the community. But yeah, it's just interesting that that's the case.

Christy:

It is. The 75 and older does not, it's not a surprising statistic only because if, if you look at, we'll talk about some of the risk factors, but if you look at the risk factors of people who die by suicide, they have a lot of those. I mean, there's illness, there's the loss of a loved one, the loss of a significant other would be huge. Not knowing how to, how to live your life without somebody who's maybe been with you for a really long time or having chronic pain. Like there's all sorts of things that would impact that 75 and older category. I just don't know that you hear about them as much. They don't hit the media like the other ones do.

Lucas:

Men are at the highest risk of dying by suicide. They die at a rate of 3.9 times more than women. And they attempt suicide at a higher rate

Christy:

Now that you say that, 'cause I think that goes back to a myth because it used to be at one point where everybody believed that men had a higher rate of suicide, but that women had a higher rate of attempts. Because women, sometimes, typically women end up choosing less lethal means where men typically use more lethal means.

Lucas:

Right. I think I got that mixed up. You are right. Okay.

Christy:

About that. Okay. So I was

Lucas:

Like, thank you for correcting me.

Christy:

That is a, the one of the greatest joys of my life. I

Lucas:

Know you love that.

Christy:

That <laugh>. I do <laugh>. So women have the highest attempt rate.

Lucas:

Yes. Yep. And this is really sad, but 12.3 million adults seriously thought about suicide according to the CDC.

Christy:

That's a lot.

Lucas:

Yeah. In 2022 and 3.5 million adults made a plan. Really? And so the reason that I really wanna share that is because you are not alone. No. If you're listening to this and this is you, like this is big thing that's going on and you can get help for this, we're gonna say that over and over and over. There is hope. And it's not just you. Right.

Christy:

I think I read a statistic the other day, it's one in five, one in five people have had some sort of suicidal thought at some time in their lives. So that's, I mean, that's, that's significant.

Lucas:

It's huge. Yeah. Yeah. That's insane. Right.

Christy:

But most people, which goes back to, I mean, 'cause one of the biggest things is you have to talk to somebody. But knowing that statistic, I feel like, like think of one in five people around you. At least one of those people are going to be like, I know what that feels like. There's gonna be some sort of validation there, but you just, you talking about how you're feeling is gonna get somebody else talking about how they're feeling. I feel like it's very rare that someone's gonna be like, oh my gosh, what?

Lucas:

Yep. And the most, the most common cause of death by suicide is a firearm. And that is just because of how the

Christy:

The Lethality

Lucas:

Yeah. Thank you. That was the word. Yep. The lethality of it. And there's really no help after that happens. Mm-Hmm. So make sure that you are locking up your firearms. And that you are taking care of those things. Because it is a huge risk factor.

Christy:

The thing that a lot of people don't think of either, but we talk about it a lot. So if you're a person who's contemplating suicide, the number one thing that you should do is get rid of your guns. Immediately. You can bring them to a friend's house, you can bring 'em to a parent's house. You don't have to wait for someone to come in and take them from you. I've had several people who have been like, I need to get rid of these because I don't, I don't wanna die. I think that's the other myth is that people who die by suicide want to die. And that's not true. They want to live. They want the situation that's causing the distress to end. And it's a very important distinction, I feel like, between the two of them 'cause they want to live. They just don't want to be miserable. And so if you can figure out how to help them not be miserable, then they can get back to their goal of wanting to live. So it's, it's something that I think a lot of people don't think about. If they can get rid of their thing, get rid of their guns or whatever, whatever their plan is, remove the means.

Lucas:

Right. When we talk about how prevalent, this just popped in my head for, for myths that I hear a lot. And although it is very prevalent, like we have 12.3 million adults who have seriously considered this in one in five. It's not normal Right. To think that way at all. Mm-Hmm. And so even if you're having what I call passive suicidal thoughts, which is like you're driving down the road, you go over a bridge and a random thought pops into your head to drive off the bridge and you just push it away like, what the heck just happened? That's not normal. No. A normal brain, a healthy brain does not think that way. Right. It doesn't have those intrusive thoughts. So take them all seriously. It doesn't mean that you have an intrusive thought and like, I, you need to turn around and go to the hospital. But we need to take them seriously because a lot of people are just like, oh yeah, everybody has those. That's not true.

Christy:

Yeah. We say that all the time. Right. And it's like, there's an underlying something there. If you're having that thought. And so going to therapy and like maybe hashing it out and figuring out what, why that intrusive thought got there or, or what it's a symptom of, because that's a symptom of something, whether it's not depression or who knows? Trauma. It could be all sorts of things. All sorts of things. But it's a thought that deserves to be addressed because you deserve to live a life where you don't have those thoughts.

Lucas:

Yes. Absolutely. So what are some risk factors? What should we be considering when talking to people or just be aware of in our own selves?

Christy:

The biggest one for me is, is substance abuse. Because people are more likely to do something while under the influence than they would be if they're sober. And I think that's one thing too, to really keep in with your loved ones. If you see there's an increase of drinking or drugs or whatever the case may be, if it's out of what they had normally done, that to me is a red flag to be like, I'm gonna sit down and talk with you and be like, Hey, I've noticed that your alcohol consumption's gone up. What's up with that? Just because when you have a mental health issue and then you pour liquor on it, or you put drugs on it, your thoughts become even more out of control. And it spirals and you're just more likely to do something.

Lucas:

Yeah. I think there's a disproportionate amount of suicide attempts that have alcohol involved. Yeah. Like a significant portion. I don't have that statistic.

Christy:

Oh, you don't have that statistic. We could make one up.

Lucas:

No we can't <laugh>.

Christy:

I just completely shot our credibility.

Lucas:

Yep.

Lucas:

Really, like any sort of mental health condition is gonna increase your risk of suicide. Or just having thoughts of that, but specifically things like depression, bipolar disorder, both the manic episodes and the depressive episodes increase your risk just in different ways. The personality disorders specifically borderline personality disorder. There's a disproportionate amount of suicide attempts from that population. And anxiety disorders as well can increase your risk for that.

Christy:

I would guess trauma too. A PTSD diagnosis, especially if it's gone unresolved or you know, you haven't sought help for it to help resolve that trauma. There's a lot that goes on with that too.

Lucas:

Physical illness can also increase your risk for suicide or having those thoughts, having chronic illness or just even chronic pain. . That is a major factor for a lot of people that I talk to and I would guess is a huge part in why the elderly population has such a high risk of suicide.

Christy:

Yeah. Because anybody who's had pain that you've had to live with for any amount of time, it is draining. It's exhausting. It gets in the way of doing anything. I mean, to the point where it's like, if you have to get up and go to the bathroom, it's like, oh my gosh, this is like the undertaking of a century. And to have to live like that is really, really difficult.

Lucas:

Yeah. Brain injuries can cause a huge risk in suicide. I find with a lot of people who can present as functioning very well. And that doesn't seem like they have a brain injury. It's very frustrating. 'Cause Sometimes it just doesn't work. And it can cause a lot of,distress and you want that to end. And there's a lot of self deprecating statements about the brain injury. And it's, it's just really challenging for a lot of people who are going through that.

Christy:

I'm not a brain injury expert by any stretch of the imagination, but what I do know about, about brain injuries is that you can have a brain injury that completely changes who you are. And so it's like trying to figure out who you are and who you used to be and what you used to be able to do versus what you're able to do. And having that constant comparison about how I used to be able to do this in one way and not understanding that there's, how can we figure out how to help you do it in a different way with your brain injury? And that takes a lot of work. It's, I mean, that's, there's a lot of therapy that goes into any sort of brain injury, honestly.

Lucas:

Having a family history of suicide attempts. Yeah. or having your own history of suicide attempts increases your risk for future attempts as well.

Christy:

Because genetics play such a huge part in mental health stuff, that if you have, if you come from a line of people that, that have depression in, that runs in your genes, that depression is more likely to pass down from generation to generation. And I say that because and I've talked about this in other podcasts, but what we find right now is that we get adults that are bringing their kids in because they're concerned about their mental health. Because I think a lot of parents see in their children kind of what they felt like when they were growing up and they never got the help for it. And so if you know that there's depression in your genealogy and your lineage, that's even more of a reason to have open conversations about mental health with your kids.

Lucas:

Yeah. You had talked about trauma where like child abuse or having a traumatic event occur to you, but also prolonged stress, such as like bullying or relationship problems, unemployment, things like that can often lead to increased risk of suicidal thoughts. And really, anytime you are grieving too, you have an increased risk. So if you've lost something, going with the unemployment example, losing your job can be a huge stressor for a long time. But then just that initial loss of a job can have some initial intrusive thoughts of suicide. And then the longer you're in that and stressed out about that, it can just make it worse.

Christy:

I think people too don't realize a lot of times with jobs, people's identities are surrounded by that. I mean, you are, I think about myself 'cause I'm the only one that can, I can only speak for myself. A huge part of my identity is that I'm a therapist. It's not the only part of my identity, but it's super important to me. It's, it just is a part of who I am. If, if I had to wake up tomorrow and I'm all of a sudden not a therapist anymore, like oh my gosh. Like, that would be devastating. It's a loss on so many levels. It's not just the loss of a job. It's not just loss of income. It's a loss of who you are and a giant piece of you along with the guilt, shame, embarrassment that comes along with having to explain to people, oh you changed jobs? Why? You were so happy where you were. Yeah. You know? Like, there, it's just, it's, there's so much that goes along with that.

Lucas:

Remember during covid when all of those kids had to stop their sports and how many crises we were working through with kids. Their whole identity was wrapped up in these different sports and activities. And now they couldn't finish out their senior track year, which was gonna be the best year ever. Or whatever sport they were in Or whatever activity they were doing, they couldn't even graduate with their class. You know and so any sort of activity or or thing you're doing that is connected to your identity, if you can't have that anymore, you, it is huge. Right. And that is so harmful to the brain. It's a very difficult transition to work through.

Christy:

It rocks people. I think in the one before you were talking about social connections, and I, and I just needed to take a minute for a plug, which I will, every time I get an option, monitor your kids' social media usage.

Christy:

The things that I see in my office every week is like, and thank goodness that they're coming to therapy. Right. But there's a lot of stuff that happens on social media that is, especially if you're already in a dark place. Because I think what people don't understand too sometimes is like when you are depressed, you don't see things realistically and it, it doesn't matter. 'cause Your perception is your reality. And so when you're depressed and then you see somebody saying something, it could be a completely innocuous statement. It could be that it's, it's nobody's saying it to intend any sort of harm, but where you are in your head, you're like, that's about me. I know that they're talking about me. I know that this is what's happening. And it's like, maybe isn't true, but we've gotta help people walk through that.

Lucas:

Yeah. And there's so much slang and people are so mean on the internet. Because of just being able to be anonymous. And the stuff that gets told to people in just like these code phrases like KYS which is "kill yourself."

Christy:

That's where my brain went to.

Lucas:

And all these different things. Like, it's really important that you stay up-to-date on that and just start having these conversations with your kids and starting these conversations early. And when you do that and you make it non-threatening, they're gonna be willing to talk to you about it a little bit more. We don't want you to like confront your kids and like sit 'em down.

Christy:

No, but show me your contacts.

Lucas:

But just being open about that, talking about internet safety, because there is so much bullying that's going on When I was younger, even like, internet was a thing, but social media was just blowing up. Like, it wasn't as huge. Now it's everywhere. They have got multiple different accounts in multiple different areas. Right. So bullying used to be, you would get bullied at school, you'd go home and it's done. Now it's, you're bullied at school and then you're bullied online. And that continued stress day in and day out, night in, night out. It really impacts the brain and can make people really depressed and anxious and scared and traumatized. And the risk of suicide just keeps going up.

Christy:

Yeah. And there's no reprieve. And it's a tricky line to walk. And, it's not just kids. I mean, adults can be jerks on the internet too. And so, I mean, adults are very much, I mean, it's maybe a different sort of thing, but there can be things that are really hurtful on the internet for adults too.

Lucas:

Identifying as part of the lgbtq plus community and not being supported in it is a major risk factor for suicide. The transgender population specifically is at a higher risk of suicide than almost any other community we work with. Especially when it comes to not being supported. And so that's huge. And I just feel like we need to talk about that.

Christy:

Yeah. There's this common denominator, right. About identity. It's like when you don't know who you are and you don't know where you fit, and you don't know where to find the support for that, I think you just find yourself in a really lonely, hopeless place. Yeah.

Lucas:

Having your gender affirmed lowers suicide rates by 70%. It's wild.

Christy:

Wild.

Lucas:

So it's a big, big deal. It is. What is the contagion effect?

Christy:

The contagion effect is when, and it happens in small communities, it happens in small schools, but it's where there's one suicide and someone who's already in a bad spot, again, your perception when you're, when you're depressed is not reality, but your perception is reality. And so they see that and they're like, all those people care about that person. Look at how much that person's cared about. Look at all the stuff that's coming out. And you get the memorials on Facebook and then it that can cause somebody to be like, that's the kind of attention that, that I kind of wanna have. And it causes somebody else to, to commit suicide in the same small community. I can speak for my own community. Growing up, there was a time period where where we had four or five in a very, very small amount of time.

Lucas:

Yeah. So how is that different from when we said earlier that the myth of talking about suicide does not increase the risk. But yet seeing it on the news or seeing it like that, like, does that not contradict itself?

Christy:

I mean, it can, but I also think if you are a parent or just a person in that community to be talking to your kids and saying, are you thinking about that? That's what we're talking about. But these kids that don't have an outlet, they don't have a safe place to go. They don't know where to go to talk about something. They don't understand that there is help for them. I think that's very different. I would be talking to my kids about that no matter what, and be like, Hey, have you ever felt that way? I'm always a safe place to go to. How did I do?

Lucas:

You did really good. That was great. That was exactly what we needed to do. Thank you for that. So what are some, we should probably talk about some warning signs. Those, those are the risk factors that make you more likely to be at a risk for suicide. Now, what are the warning signs that we should look out for? We'll start with one of the obvious ones, which is they're talking about suicide. Right. But you'd be shocked at how many times that one gets missed. Yeah. Because people are just, sometimes kids are just throwing it out.

Christy:

It could even be inquiries about suicide. Like they're maybe not talking about it like even as themselves, but just asking random questions about, oh, what happened to this person? Or what did you think about this suicide? It just, anytime that that comes up, like, why, why is that on their brain? You know?

Lucas:

Who would show up at my funeral? You know, just talking about death in general, specifically their death is a huge red flag for me. It doesn't necessarily mean that they're thinking about killing themselves. It could just be an honest question, but we still need to ask those questions. Right. Having the feeling of being trapped, talking about being trapped. If they talk about being a burden to other people. Talking about having unbearable pain. Or like nothing is going to improve ever. That kind of hopelessness talk is a huge warning. A red flag.

Christy:

Right. Well, and it's those things too, it's like any one of these risk factors can be present. And it doesn't mean that somebody's thinking about suicide, but if somebody's having this thought of being a burden or feeling hopeless, it for sure is a sign that they need to get help. They need to talk to somebody. 'cause It's for sure a sign of depression one way or the other. And one of the, one of the more telling ones too, I think is like giving away their stuff. Giving away their possessions or things that mean something to them. Because then I feel like we're, we're, we're in a stage where they're, they're contemplating, they have a plan. Now we're getting into, into some, okay. What's going on?

Lucas:

Yeah. Now that's getting into like, some of the danger territory, like hospital time. You've already talked about like increased risk or increased usage in drugs and alcohol or starting to use 'em at all. But like looking for a way to end their lives online. So if you're monitoring your children's internet usage and you start seeing that stuff pop up, big red flag. It is very often that kids and even adults will google search the best ways to, to do it. To like, make it less messy or make it less painful. Or make it not cost as much on the family, you know, trying to lower that burden. Right. And so if you're seeing that come up, then we, that's when we need to talk and get them in. Yeah.

Christy:

I think another one that sometimes people, especially if you're, if you're not looking for it, having a change in mood from being really depressed to all of a sudden being not depressed and all of a sudden like, oh my gosh, thank goodness they're in a good mood again. So they go, they have this long period of being depressed, and then it's just kind of like this. Okay. No, there's okay, they're good. Like everything's good, everything's fine. Sometimes that's an indicator that they've made the decision that, that they're going to end their lives. And so that burden is lifted 'cause they know that the end is the, the end is there. They're not gonna feel like this for so long. And it's just like this sigh of relief that they can go and just feel light for a little while because they know that their suffering is, is going to end. And it, that gets missed a lot.

Lucas:

It does. 'cause It, it just looks like a huge improvement. Yeah. And we're just gonna celebrate that. Right. And as you should. But when we go from a, and we're talking like drastic change here. Like one day it's the whole world is ending to the next day. Everything's amazing. Almost this euphoric state that's, we're like, we're hitting the end there. Like it's gonna happen very soon. Yeah. So always be safe rather than, sorry. And just go bring them in. I don't care if they're getting mad at you. I don't care if they're like straight, up and down. I'm fine, I'm fine, I'm fine. Have them assessed. And to just let everybody know what's going on. Right. The professionals and they'll do all the work for you.

Christy:

And we preach this in, in every podcast, I feel like, but any change in behavior is significant. Any change in behavior and it doesn't have to relate to suicide, it doesn't have to relate to whatever. If you see a change in somebody, it's always good to be like, Hey, what's up with that? Good or bad. 'cause I think we're really quick to, to address things when they're going from good to not good, but it we're less likely to address it from going from not good to better. But they're both significant.

Lucas:

Yeah. They're huge. And another warning sign that I think gets missed a lot is withdrawing from activities and or isolating from people and not spending a lot of time with them right. Now that could just be that we're feeling depressed or anxious or something and it's not a suicidal warning sign. However, when people are wanting to die, they will do that. So because they're trying to, they're just distancing themselves from people. And it's, it's often just one that gets missed. But when looking back, it's one of those very clear, like, oh my goodness, I should have seen this.

Christy:

We keep talking about it relating to suicide, but it could just be that it's, it's a symptom of something that's happening somewhere. So let's just say somebody decides to leave a lacrosse team. I'm saying that 'cause I don't really know lacrosse.

Lucas:

Sure, Lacrosse, let's go there.

Christy:

Here we are and they wanna leave that team. But it used to be important to them. Is there something happening within the team that's not healthy? Is there something that's happening with coach that's not healthy? Is there something, are they honestly, 'cause this is true too. Are they honestly just setting a healthy boundary because it's not a healthy environment for them? All of those are potential things, but they all deserve to be talked about.

Lucas:

Yes. If you start hearing that he's having, he or she's having phone calls with people and like saying, thank you for everything. And like, it just sounds like a big goodbye. Right. People will start to do this often in letters or phone calls or text messages. I had this parent the other day who got one of those text messages from their kid and we have talked about these things and so they call us and immediately drive 'em in to get an appointment. Everything was fine. It was a total misunderstanding with the text and stuff. But that's what you're supposed to do.

Lucas:

You're just get him in. We'll, we will figure it out. Let me do the work. And it was just a big misunderstanding. He's like, I'm never texting that again. But, but now we know he's good. Rather than just guessing.

Christy:

I think, I mean, obviously I'm a mental health professional, so I'm like hypersensitive to all of these things. So I think any one of my friends would be like, they'd get so annoyed with me because I'll get a text that's just like, Hey, you have time to talk. And I'm like, I don't have time right now, but are you okay? Like, what's happening? I was like, are you alright? Just 'cause I always ask the question if it's, if it's a text that's out of character from what I would normally get from somebody, be like, I don't have time right now, like right now, right now, but I can make time if you need time. Like, what can I do? And they're like, oh my God, no. Like, I literally just wanted to know if you wanted to golf. And I was like, okay, well maybe lead with that next time. Like, do you wanna golf? That is, that's a way better way than to say, Hey, do you have time right now? 'cause I mean I will ask, I will go straight into interrogation mode.

Lucas:

Absolutely. Or if I get a random call from someone that doesn't normally call me I'll stop everything to call to answer that phone call. Because I'm, I'm thinking something horrible happened. We're not anxious though.

Christy:

No.It's part of my charm because it's incredible my friends put up with me, but I will, I do, I always ask the questions that I think anybody who knows me knows that.

Lucas:

So what are some protective factors, things that we can do or put in place to keep people more safe?

Christy:

I think because sense of belonging is so important. Finding a place to belong, a group, a sport, a church club, whatever it is that is important to you. Find a group that you feel like you belong in as long as it's healthy and it's promoting healthy values and whatever, whatever, whatever. Loneliness is such a risk factor that finding a place to belong in a place that you can talk is huge.

Lucas:

Yeah. One of the obvious ones. I mean, getting connected with a mental health provider, and having somebody to talk to that you feel safe with when you are looking for We should do a whole podcast on how to find a therapist. I think that'd be, we should, that'd be a good one.

Christy:

Oh wow. Yeah. Write it down.

Lucas:

But I will, oh my goodness. My thoughts just died. When you're looking for a therapist shop around Like, if you don't like the first one you go to, that's fine. Right. We're people too. We don't mesh with literally everybody. We do try, but if it's not working, that's fine. We're not offended. Never. We just want you to feel good.

Christy:

So we want you to find help. And if it's not with me, oh my gosh, I hope it's with somebody. I'll, I'll take your hand and walk you over to my neighbors and be like, how about this one? How about this one? I just want you to find somebody to talk to. Because if you're, if you're at a point where you're reaching out for a therapist, you need the help. So let, let's find someone that you connect with. Yeah.

Lucas:

Another thing we can do is limit the access to any sort of lethal means of ending your life. We've already talked about firearms. Some people, I've got some families that need to lock up the knives. And make sure that those are, those are safe.

Christy:

Medications.

Lucas:

Medications are another really popular one that gets taken care of. But it's, it's important to, one of the questions that we often ask is, if you were to end your life, if you were to kill yourself, how would you do it? And that question gets them to talk about how they've been thinking about it. And it gives us an idea of number one, what is their plan and what things do we need to put in place? Like the firearms, putting it away, but also how realistic is this? Because I've talked with people who are like, I'm gonna jump into a volcano. I'm like, oh, okay. Well, we don't have volcanoes around here so that's that's good. And so it's taking the time to follow a safety plan and visiting with a therapist about this, or your psychiatrist or psychologist and figuring out what you can do to make sure everybody's staying safe.

Christy:

I think another one of the huge protective factors is, again, I could make up a statistic, but I'm already outing myself. It's astounding. The impact that a child specifically having a connection with an adult, just one trusted adult can have on the life of a child. Whether it's a teacher, whether it's a coach, whether it's an aunt, an uncle, a parent, whoever. But finding that connection with somebody is huge because it goes back to loneliness. But if you have somebody that you can trust that can help you, that's huge.

Lucas:

Increasing your coping skills. And doing things that you enjoy, for example, or your ability to problem solve can increase your protective factors against suicide, but you may need to go to therapy to learn some of those things too. But I will tell you that people who have come to therapy and we've worked through depression and figured things out, you are much more likely to have another depressive episode once you've had one. And I would say 100% of the time, people who have been in therapy that I've worked with, when they have another episode, it is way easier to get through that. Suicidal thoughts, like they got nothing on those skills that these people are using. And so it is a really big deal to try and figure out A: what are the, what are the thoughts, what are the triggers of those, what are the warning signs in your own body?

Lucas:

And then how I deal with that. Specifically in my case. Right? Because just because something works for Christy doesn't mean it's gonna work for me. And working with a therapist, it's our job to help you figure out what works for you and how to implement those things for you. It's great that maybe your friend is telling you, Hey, this really works well for me. But if it's like journaling, for example, if Christy really likes journaling and getting her thoughts out. For me, that's a no go. I don't like journaling. It just stresses me out. It feels like an assignment. Right. So I'm gonna use a different skill, but we have to figure out what that looks like. And a therapist can do that for you.

Christy:

I'm gonna say it now 'cause I'll forget it. When we're talking about how to talk to somebody who's having suicidal thoughts, but randomly saying, Hey, I was suicidal once, this is what worked for me. This, this should work for you. When you're talking to somebody who's already not in a good space and they're like, okay, this is what's gonna, if it worked for them, it's gonna work for me. And if they're, if they try it and then it doesn't work for them, it increases the hopelessness. So it's not about offering people to be like, this is what, this is what you should do. This is gonna make you feel better. It's like, hey, let's talk about it. Like what are some things that you enjoy doing that that could possibly make you feel better instead of putting something on somebody who it just has the potential to fail.

Lucas:

Right. And I'll say when working with somebody who's, who's suicidal, it's interesting you brought that up because one of the things that we do not do is, is problem solve in those moments. We never do that. Because fixing the problem isn't the isn't the issue. It's getting through that problem. And just being there and validating that person and letting 'em know that what they're feeling isn't their fault and they're gonna get through this and I'm right here with you the entire time. That's what gets them through. It's not trying to fix it or put a bandaid on it. We will get there. E will figure it out. But sometimes a lot of these problems that are going through, they're not fixable. Right. And it's just a matter of getting through it. Right. So trying to problem solve with them or figure out how to prevent that thing from happening in the future is just gonna make things worse. It's incredibly invalidating.

Lucas:

Right. So you, you mentioned talking about it, one of the biggest things that you do when you talk about suicide and it's very uncomfortable when you're starting to do it, but with practice it gets much easier, is you have to be very blunt. And so for example, "Christy, are you thinking about killing yourself? And that's how you ask it, right? It's just a point blank, like super blunt.

Christy:

I've always said when, because we, we've been talking about this, but they're like, what if they get mad at me? Or what if I ask them if they're not doing well and they get mad at me? And, and I'm like, if you have a friend that's gonna get mad at you for asking them if they're okay, they're probably not okay. There's never anything wrong with asking your friend or your loved one, "Hey, I've noticed that you're just a little outta sorts. Is everything all right?" And if they get mad at you, that is your inclination that something isn't right. So they might get mad at you for sure. But that's just further validation that's like, okay, I maybe need to help this person figure out whatever they're going through.

Lucas:

Absolutely. Another thing is that you can ask is, "Do you wish you were dead?" Because thinking about killing yourself and wishing you were dead are two different questions, even though they sound very similar. Some people have thoughts of death where they just wish that they wouldn't wake up, but they're not gonna do it by their own hands. If they're saying no to wanting to kill yourself, that's great. But if they're still saying that they wish they were dead, we still help because that's not normal. But there's a big distinction there. And so I always ask those two questions. I will always ask what your plan is, like I said earlier, or if you were to do this, what is your plan? If they say that they don't have one? And when do you plan on doing this? If they do have a plan, right. Um,'s a timeline. What is the timeline of that? Sometimes they don't have one. And that's fine. But it's just getting those questions out. Having the conversation in a non-threatening, uh-judgmental way. 'Cause This is very, it's a very shameful conversation to have for people. And we gotta make sure that they feel comfortable and loved during that.

Christy:

When you say blunt, it's not in your approach. It's more in your words. Like, you come at it from a very loving, you know, Hey, what's going on? Are you thinking about suicide? It's not like, Hey, you, I'm sitting down and we're asking these questions. Good distinction. Bang, bang, bang. 'cause It's, you don't want it to feel like an interrogation. I joked about it before with my own friends 'cause I feel like that's probably what they think sometimes. But when you're talking with people that are feeling like that, like to be very gentle and you, and you have to watch your, your whole body language because your face tells a story. Your body language tells a story. And try to not be shocked when they're talking to you and be like, oh my gosh.

Christy:

And never say there's, you have so many reasons to live. And then try to convince them that what they're, it's not, it's, you're not trying to convince them that what they have is good, because that's not gonna work. I promise you it's not gonna work. It's more or less coming at it from, wow, that's really tough. Like, what do you need? How can I help you? Where are we gonna go? Like how can we, how can we, we figure this out? It's very much they lead the conversation. You're just kind of, you're there as a co-regulation support person rather than a, someone's like, okay, this is what we're doing and now we're doing this, and now we're doing this. Because it's, that's just, that's gonna make it a more tense situation than it already is. Yeah.

Lucas:

And don't say things like, well, what about your kids? Like you just made them feel so much shame Right. For, for explaining this to you. And now they're gonna stop talking, which is the opposite of what we need.

Christy:

Right. I I always tell people, it's like you can't, you can't have a rational conversation with somebody who's in an irrational state of mind. You can't do it. And so, like, your thinking might be rational and put together, but the person that you're talking to, if you're contemplating suicide, it's not a rational thought. So you're not having a rational conversation. Like those sort of intricacies of, of life and meaning and philosophical existence is like, not where you need to go with somebody who's it's like, okay, I hear you. I'm with you. How can we keep you safe? What are we gonna do? Like it's, it's very much managing just this situation. Let's get it, let's get it figured out. Mm-Hmm.

Lucas:

So when do we call for help?

Christy:

The second you have a thought about suicide or that I don't wanna be here anymore. Yeah.

Lucas:

What about a is there a difference between when we call for like to make a therapy appointment versus a hospital? Also there's, I mean, we talk about this a lot, right? Like, there's depression where, I mean, you maybe have some suicidal ideations where you just kinda have the thought. I think we've talked about, we didn't really identify what a suicide ideation is, but it's kind of like, just the thought that you don't wanna be here anymore. Just like, my life would be easier if I just wasn't here. Like, but there's no, there's no plan. They're not gonna do anything tomorrow. That's very different than someone who is giving away their possessions, who's saying, I have a plan. I'm gonna kill myself. I don't wanna be here anymore. Then you go to the hospital, there's a very clear distinction between the two.

Lucas:

Yep. And if you don't know for sure, just bring them in. Just go get assessed. When you've been, if you have a, especially if you have a child or have been just working with a mental health provider for a while, you will learn. We teach parents how to like, kind of look at this stuff and like pick out different things and know when their kids are in like a danger zone or when it's still okay to just be home and we're just gonna, you know, follow the safety plan, those sorts of things. But if you just don't know those things, do bring them in. Right. And maybe they, you know, hopefully they can help you develop a safety plan if they don't need to be hospitalized. But don't assess. Right. You're not trained.

Christy:

No. And having the person who's struggling be a part of that safety plan is huge. Like, because we talk about, you know, you tell someone to journal who's not into journaling, that's stupid <laugh>. Yeah. Or you tell somebody to listen to music, the kind of music that you think they need...you need to listen to calming music. Well, calming music isn't gonna make everybody calm down. For some people, they wanna listen to some screamo stuff and they're like, oh, that makes me feel better. You don't get to dictate what they're telling you is gonna make them feel better. You just walk with them and be a part of the process. But don't put things on them that you think should make them feel better, because that's just what you think should make it feel better. They need to start telling you, you know, what, what do you need from us?

Lucas:

Yeah. And so if, if you yourself are having suicidal thoughts, there's a few things that we always tell people as just as some advice and some protective things that you can do. Number one is call somebody. Immediately. You oftentimes, when this is going on, I, I don't know why it does this, but our brains pick nighttime for these thoughts to pop up the most and like when we're alone. It's like, it knows you're vulnerable now, so it's gonna really act up in there. Don't be alone then. So call somebody, have them come over if you need to. If you need to just, even if it's just to sit in silence. It doesn't matter. Just be on the phone with somebody so you're not alone. That's a huge thing for people.

Christy:

Right. And if you can't get somebody to answer the phone, there's the 988 number.

Lucas:

Yeah. So if you, if you need to talk to somebodyand you can't get ahold of anybody or you just, you just wanna go straight to this, I would highly recommend it. You can call 9 8 8 for the suicide and Crisis lifeline. You can also chat online at 9 8 8 lifeline.org and you can call 9 8 8 and press one to reach the Veterans crisis line. Oh, there you go. Which is really cool.

Christy:

That's actually really cool. I bring that up because you say like, at nighttime is when a lot of those thoughts kind of sneak in and a lot of people have their ringers off or they're, they're not night owls or whatever the case may be. So even if it's not someone who's close to you, there's always somebody who's willing to listen. And honestly, if you're really feeling that suicidal, call 9 1 1. That's always an option too.

Lucas:

Another thing that is really helpful is focusing on right now. Because oftentimes when people are feeling suicidal, they're thinking about way too many things all at once. It feels overwhelming. They don't know how to move forward. I like to use a running analogy for this weird, I know it's so strange, but in running,specially long distances, there's these things called walls that you hit. And that's where things get really, really hard. And in those walls, it's really important to really focus on right here and now. And so what I'll ask myself when I'm hitting those walls is, can I run 10 more seconds? And the answer is always yes. I can, I always got 10 more seconds in me. So the same thing when I'm running. You can do this with having, when having those dark times. Yeah. And can I do this for 10 more seconds? Can I do this for 10 more seconds?

Christy:

Run the mile you're in.

Lucas:

Just we are gonna focus on right here and now grab some distractions. I don't care what it is. I just don't care. Right. Whatever's going to keep you here with us is what I want you to do.

Christy:

Crush some candy. Scroll your TikTok. Binge watch a show. Go golf. I don't care what you do.

Lucas:

Go grab a Starbucks. I don't, I don't care if, I mean, if it's nighttime, they're not open, but if it's daytime, go do that.

Christy:

Make yourself a cup of coffee. There you go. Smell it. Do the, the five senses be in the here and now. It's all mindfulness stuff.

Lucas:

And just remember above anything else that emotions cannot stay with us forever. So this will end.

Christy:

Everything changes and ends.

Lucas:

I promise you it will end. We always want to encourage you to ask the question, is it just me? You're likely not alone. And there is always a way to help. If anything we've talked about today resonates with you, please reach out.

Christy:

Do you have a topic you'd like us to talk about or feedback? Message us. We'd love to hear from you at, is it just me@dakotaranch.org.

Lucas:

And don't forget to share us with your friends and family.

Announcer:

Thanks for listening to today's episode of Is It Just Me? To learn more or make an appointment for psychiatric or mental health services at Dakota Family Services, go to dakota family services.org or call 1 802 0 1 64 95.

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