Sunday, May 07, 2017

If they died from suicide

I've suffered from depression for most of my life and have had a couple of major episodes. There have been times when I decided dying would be better than living and while I'm not proud of that, I'm also not ashamed of it. My illness has caused lots of irrational thinking, but so far, I'm still here.

Chronic depression is a mental illness - emphasis on the word illness. You can't snap out of it or overcome it with activity, will power or positive thinking. Depression is an emotional disorder caused by the brain's inability to maintain the chemical balance required for normal functioning. It's a physical disease just as much as hypertension and diabetes are physical diseases. And that's why, when someone dies from suicide, no one should beat themselves up for failing to stop it. Suicidal depression can be extremely hard to identify and, like high blood pressure and diabetes, when it ends in death, no one is to blame.

When they hear that someone took their life, people who don't understand suicidal depression invariably react with things like,
How could she do that?
Why did he do that when he had everything to live for?
She took the coward's way out.
How selfish of him.

They act as if suicide was a lucid action taken by someone who clearly looked at all the options, added up the numbers and made a reasoned decision. Bizarrely, people who react that way are often the first to judge someone's actions with she must be crazy. For some reason, when someone really does act out of insanity, these judgmental people switch to seeing the person as selfish or cowardly instead of ill. 

What was really going on was that someone whose suicidal depression reached the point of death was in a state of serious illness. When someone reaches that point, there's nothing that can help them except for professional help such as hospitalization, medication and therapy. 

But sometimes even the best professional treatment isn't enough and that's why people who find out that someone they know killed herself/himself should not feel responsible. I say this to anyone suffering the emotional aftermath of a suicide. Because suicidal depression is an illness, it's not influenced by things that would cheer someone up if they were just going through "the blues." When someone's having a bad day, you might be able to pull them out of it through conversation, humor or activity. But suicidal depression is not an emotion. It's a set of symptoms caused by a malfunctioning brain. It's a physical disease with behavioral symptoms. Your actions and words will rarely have any effect at all on a disease like this when it's at its worst.

Because people misunderstand suicidal depression as being in a bad mood, they think their actions could have made a difference, but they couldn't have. If, instead of suicide, the person had passed away after years of managing high blood pressure or Alzheimer's or a lower respiratory disease, would you believe they would have lived if only you had done more? Would you be plagued by the guilt of "If only I'd made more time for her, she'd still be here today?" No, you wouldn't. If someone died from Alzheimer's or a lower respiratory disease or a heart attack, you might feel guilty for not having given her more attention while she was alive, but you wouldn't feel responsible for her death. Likewise, with someone who has killed herself, more visits, texts or I-love-you's would not have made the difference. Once someone begins planning her death, her brain has tipped so far out of chemical balance that it's producing little else but irrational thinking. She needs professional help.

Maybe you think that because it's the person's own hand that caused his death, there must have been a way to stop it. Well, I suppose if you lock up such a person on suicide watch permanently you might physically keep him alive, but you can only do that once you've realized how dangerous he is to himself. Unfortunately, suicidal depression is often too tricky for even family members to identify. People in the worst of a major depression might give hints about wanting to kill themselves, but those who are most determined to do it usually give the fewest clues. This makes sense to me. If someone is absolutely convinced that ending his life will be best for all concerned, why would he give anyone a chance to stop him? He won't. He'll just do it. Because suicidal depression can be that hidden and wily, no one should feel bad that they didn't see it.

People who kill themselves sometimes leave notes apologizing for the pain their death will cause (many kill themselves in the symptomatic delusion that no one will care, so they don't leave notes). As someone who's been on the inside of suicidal depression, I know that remorse is real: they know there will be pain, but they've weighed the pain of their death against the pain of their life and have decided that dying is the better option. But as much as their disease has twisted their thinking, the lucid part of them makes this final attempt to connect. With such a note, the person about to take her life tries to relieve her family and friends of feelings of responsibility and guilt, as someone dying of cancer would try to alleviate her family's pain.

Both the person who dies of suicide and the one who dies of cancer knows there's no one to blame and no one who could have done anything more for them. Please take that to heart. While you grieve your loss, feel your sadness and wonder why this happened to your family member or friend, please don't add to your pain by thinking there was anything you could have done to change this outcome. There really wasn't.

Monday, April 17, 2017

Obesity crisis is mental health crisis

At the age of 50, I'm now on my fifth year of being fat. When I went from size 10 to size 18 in the last months of my marriage in 2013, I thought, "I'm not worried about gaining weight. I've been thin and active my whole life. I'll take this weight off as soon as my life gets back to normal." Obviously that didn't happen, and since 2015 I've been very focused on at least dropping about 20 of the 50 extra pounds I'm carrying (I'm only 5'2" so those pounds really count).

But I'm trying to take it easy on myself these days. Here's a theory I recently came up with: many of us are fat because we need mental health services. Many people struggle with chronic depression or other mood disorders and the easiest and cheapest way to self-medicate is with food. We're trying to get through the days without the psychiatric treatment we need, or our medication has stopped working, or we just got on medication but it hasn't kicked in yet and we feel like hell all the time. We're tired or angry or discouraged or self-loathing or hopeless or numb or despondent or can't get out of bed or we're any combination of those. So what's quick and easy and cheap and has an immediate effect on mood and energy? Food. Whether it's sweets or alcohol or fried stuff, the key is carbohydrates. Carbohydrates turn into sugar and that gives our brains the serotonin they desperately need, so we can get through the workday or the party or the conversation with our spouse. But while our brains need the chemical reaction those carbs cause, our bodies don't need the energy, so we pack on the extra calories as fat. And the fat just builds and stays and builds and stays and no amount of dieting or exercise can counteract that process.

It's a horrible problem. I believe a large part of the obese Americans we all scorn are managing our moods and energy with food. And while mood management is the reason we eat and drink the way we do, there's no way we can lose an ounce by trying to eat less and move more. I believe our obesity crisis might actually be a mental health crisis.

We have such disgust for fat people, but what's more important: being thin or not committing suicide after the depression takes over and tells you it's time to die? On good days I have a clear answer to that. So I'll be fat because for now being fat seems like it's probably better than being dead. Probably.

Saturday, April 15, 2017

Dating while depressed


When you're in a major depressive episode, get off your dating apps. I'm not talking about having a blue day. I'm talking about the chronic emotional disorder: clinical major depression that warps your view of the world. If you suffer from this and you're single and you've been trying to meet someone, but you find yourself at the bottom of that hole once again, get off OK Cupid and Tinder and Plenty of Fish or you might have exchanges like this.

Him: Hi. You're beautiful.
You: Hi.
Him: I'd like to get to know you.
You: How are you with moody depressives?
Him: Good as long as they're at least half nude.
You: Never mind.

Or like this.

Him: Hello. How are you?
You: Not good.
Him: Why not?
You: Life sucks.
Him: How so?
You: Haven't you noticed?
Him: No.

And then you can't be bothered to respond because he's obviously delusional.

Being in a major depressive episode can make you not care about anything and see others as in another world that has nothing to do with you. Of course most people have no idea what chronic depression really is and if you have a conversation with them, they might try to make you feel better. I made the mistake of having an initial phone call with a very nice man, telling him about my mental condition and then having to listen to story after story of how he had dealt with adversity. He seemed to hope his optimism would inspire me and that after hearing how his grandmother told him to pull himself together, I'd say, "Hey, I feel better now! Thanks." Instead, he talked and talked and I became increasingly bored and sleepy until he muttered that I didn't "get it" and we ended the call.

It might seem like those quick-contact apps and websites can alleviate your feeling of isolation, but they really won't. If you're a woman with good photos on your profile, you can get someone's attention pretty easily, but interacting with him will just lead you back to the conclusion that you're incapable of normal human behavior and ever being loved. So just don't do it.

What do you do instead? I don't know. If you've already called your psychiatrist and had your medication adjusted and talked to your therapist and spent time with friends and gotten some exercise and meditated and had a good night's sleep, then maybe try another box of donuts.

Tuesday, March 28, 2017

Stop asking: where are you from?

We Americans, especially those of us in urban places like the Chicagoland area, often welcome the chance to meet international people and hope to expand our knowledge of the world. When we notice that someone seems like they're from another place, we ask, "Where are you from?" We think it will sound engaging and lead to an interesting exchange. Maybe we'll learn something new. Unfortunately, it's not always the best question to start with. It can cause discomfort, and I'd even say it's best not to ask it at all.

Maybe you wonder How can that be? We mean "Where are you from" in the nicest of ways! Yes, we do mean it in the nicest of ways, but I'll now talk about the feedback I've received from many of my international clients and friends who moved the U.S. as adults. They tell me that being asked "Where are you from" rarely feels like a friendly question. It usually feels like the American has just noticed that the immigrant doesn't belong here and the American wants to figure out what's out of place. Often, an ex-pat just wants to blend into the party or the networking event or the office, and they don't want to draw attention. They're looking to make friends or professional connections and they want to be accepted the same as everyone else. In this context, the question "Where are you from?" can feel jarring. I've heard this consistently from people from across the globe, even white, European professionals.

The exception is when it's part of the natural flow of the conversation. If everyone's chatting about where everyone is from, then it feels right for an international person to also answer. Or if an ex-pat has just said something like, "I just moved to Chicago last month," then asking where they came from can be perfectly acceptable.

It's not that Americans should never ask "Where are you from?" The problem is the context in which we ask it. If the conversation takes an abrupt shift to ask it or if the question is used as an opening line or ice-breaker, it can feel awkward. When it comes out of nowhere like that, it's often followed by the American asking questions about the person's home country or saying things like "I love that food" or "I've been meaning go there. Where would you suggest I visit?" At that point, the exchange often turns into a lesson on the person's home country, with the international being nudged into the teaching role. Sometimes they're fine with that, but often they're not. Although they'll be too polite to ever let on, they often don't want to be an instructor. They'll hide it, but they'd rather talk about something that doesn't make them the center of attention.

When you meet someone from another country and you want to make them feel comfortable, save the "Where are you from?" question until it feels like it naturally fits into the flow of the conversation. Much better is to not ask it at all, but wait until the immigrant offers that information on their own. If you talk long enough, or become their friend, it will probably come up later. If you can keep your curiosity to yourself, you can find out more about the individual as a person, not as a representative from another country. There are plenty of other things to talk about with anyone you've just met. If an international professional mentions that they're from Thailand and you've always had a million questions about Thailand, make a note to do your own research and focus getting to know the human being in front of you. That will feel more welcoming to the person than a bunch of questions that you can find the answers to on the internet.

These aren't some new politically correct rules I made up just to be annoying. I say all of this as an American culture coach who interacts with and works with international professionals every week. This is based on feedback from immigrants trying to build their lives in the U.S. And a friend who has lived abroad confirms my advice. He's a white American and when he's abroad and gets asked "Where are you from?" it feels like the person wants to figure out what set of stereotypical behaviors they can expect from him.

Please keep in mind that American people of color don't like getting that question either. It feels like the questioner has identified us as looking like we aren't from the U.S. and they want to know what box or label to use for us. In general, the question simply feels rude, so please just don't ask it unless the conversation truly makes it appropriate to the discussion you're having at that moment.

On a recent podcast NPR's Code Switch panel discussed how bad "Where are you from?" feels. Listen here (the relevant part starts at 9 minutes and 45 seconds). 

Friday, February 17, 2017

El Idiota's positive thinking

Americans like to believe we're bending towards justice, but we can no longer tell ourselves that now that we've elected Donald (or as my dad calls him, El Payaso) as our president. And those of us who didn't directly cast a vote for him, still allowed him to be elected. We did this. I've heard this many times: "It doesn't really matter if we have a Republican or Democratic president. American politics never really change." Does anyone still say that? Does anyone say it who doesn't use it to hide that they voted for that man and they don't want to talk about it? Does anyone truly believe that if Clinton had been elected, millions of us would still be terrified of being deported, of losing our health insurance, of losing access to birth control and abortion services, of having a former Breitbart editor as a White House advisor? I think we can finally stop pretending that it doesn't materially matter if a Democrat or a Republican takes the White House. It matters.

I've managed chronic depression for decades and I was going through a bad episode in the weeks before the election on November 8, 2016. Incredibly, my depression broke the day after Trump (or as I call him, El Idiota) was elected and it hasn't come back. I think I'm currently experiencing what people without mental illness have: a painfully clear-eyed view of just how fucked we all are, without the dulling fog of depression to insulate me from the sharp edges. It's a different kind of pain, a broader fear, a bigger feeling of hopelessness. In depression, I feel certain that I can't do anything to improve my life, but now I feel certain I can't do anything to improve our national situation. Before, it felt like I was trapped inside my mind. Now I feel like I'm trapped inside of life in general, along with everyone else on the planet.

How exquisite to emerge from my lifelong purgatory of mental illness just in time to face the disempowerment and persecution of so much of the population in general. As many times as I've longed to be rid of my emotional disorder, I never imagined it feeling like this. Or maybe the world was always like this. Maybe life is just moving through one nightmare after another.

Of the people who voted for El Idiota because he wasn't a politician, I wonder, "How do you feel about salespeople?" Because, while he's not a politician, he is a salesperson, using marketing techniques every time he uses words. He repeats things until we believe them, just like companies such as McDonald's, Coke, General Electric and countless other sellers of things. El Idiota incants phrases like "the failing New York Times" and "fake news" and if we let him, he'll hypnotize us into believing that we really can't trust any news except that which comes from his Twitter feed.

Nineteen days ago I had major surgery, so February has been a haze of painkillers, long naps and staggering around my apartment with a walker and then a cane. (If you live far from family, like me, build strong friendships and get to know your neighbors! Without those relationships, I wouldn't have been able to recuperate as I have been.) Through this haze I've begun ingesting some news for the first time since the election. It goes down easier when you're already on pain-dulling medication. Worse than El Idiota's executive orders, struggling appointments and information-blocking strategies is his insistence that his White House is running like a fine-tuned machine. I say that's the worst because those words aren't El Idiota spinning the facts or trying to pull the wool over our eyes. He truly believes everything is fine in his White House (aside from leaks). He's secure in his knowledge that he's doing everything perfectly and there's nothing to change or improve. He believes this and he'll repeat it until we believe it, too.

He's got Congress behind him, focused on those illegal leaks like a driver disabling that annoying oil light. He's creating the reality he wants. Growing up, El Idiota's family followed the teachings of people like Norman Vincent Peale who pioneered the phrase "the power of positive thinking." Peale taught that with the power of thinking, you can change the future, but the current American president has taken this further and believes that with the power of thinking, you can change the past. This president believes that with the power of his thinking, he can make reality whatever he wants it to be. Honestly, I don't see any reason to think he won't succeed. Over decades, Madison Avenue has trained Americans to respond to the marketing techniques El Idiota is using. He might very well cause the New York Times to fail. He might very well convince us that we can't trust any media but what he has personally produced.

I guess the good news is that more people than ever are ready to agitate, resist and take risks to secure our civil rights (if that's true). But we were already battling to improve American education, immigration policy, voting access, health care and equal rights for all. Now we're realizing that these battles are going to be twice or ten times as hard as they already have been. Do we have the stamina for that? The optimism? The posterboard?

I believe it's entirely possible that this will become his America and his world, and I think I prefer my mental illness to his.

Wednesday, January 04, 2017

I was on NPR!

Jerome McDonnell is the nicest person!
Hey, everyone: I was on NPR yesterday! National Public Radio (NPR) is a non-profit American news organization that provides news without advertising or government money. It's supported 100% by listerners and private grants. The Chicago station is WBEZ 91.5 FM and they have a program called Worldview.

Listen to Jerome McDonnell interview me on Worldview, a show that focuses on issues of interest to the Chicago international community. I was on the January 3, 2017 show!

Jerome and talked about the challenges that international professionals face. That is, white-collar immigrants who speak fluent English and came to Chicago with a job lined up or to go to school. Some people (especially Americans) might think such ex-pats don't face challenges compared to impoverished refugees or unemployed immigrants, but they do. As I told Jerome, my business is Welcome Dialogue LLC and it helps fluently English-speaking immigrants master American culture. The interview is only 15 minutes long, so please listen. And I'd love it if you let me know what you think! My favorite part of the interview is when I say the American accent isn't pretty.