Are you thinking about suicide?
Let’s start getting comfortable with suicide. What a scary proposal, as someone who has lost someone close to them you’d think this is the last sentence I would ever say. But, if you’ve ever met me, you’ll know that believing we should get comfortable with it is something I will go to the grave campaigning for. We have come so, so far – with discussing cancer, race, sexuality and while we have come a long, long way with some things;
Why are we STILL not talking about depression and anxiety properly?
We’re still so ashamed of experiencing these conditions for fear of judgment, fear of isolation (which is entirely dumb because there’s no other illness that is as isolating as these two) and fear of the loss of our identity ‘the strong one’ that we’re still hiding it or denying its presence. So, let’s get comfortable with it. Do you want to know how? Ask. But first, let’s start with the basics. We know our family and we know our friends and we should know the signs. And, for the purposes of education, I have expanded on some that I think are a little less known than the usual ones like being teary, anger or being unusually quiet:
1. They say they feel physically ill
Friends and family members who are experiencing anxiety and depression may talk a lot about being physically ill. This is because both can lead to experiencing physical symptoms such as headaches and stomach pains. With panic attacks, people may feel physical symptoms such as chest pains and shortness of breath. This is particularly difficult because it can be hard to tell if they are using their physical symptoms as a cover for anxiety and/or depression, or if they themselves don’t know. It’s entirely possible that they are as confused as you or their doctor about their constant nauseousness.
Solution? Ask. If they’ve been to a doctor than maybe suggest to them that there could be underlying issues causing their pain and there’s no harm in talking to a specialist about it. If they are using it as a cover, still ASK. You’ll know if they stop turning up to events or catch ups that maybe there’s something else going on. You know when you ask someone if they have a cold when you hear that their voice is a bit stuffy and you ask them? Same thing. Ask. Are you experiencing more stress than usual? Do you think that it could be contributing to the daily headaches that you’re having? Let’s look into that, let’s explore your options to try and help relieve some of the physical pain you’re in.
2. Their sleep is disturbed
People suffering with depression and/or anxiety can often feel extremely tired because their bodies over produce adrenaline and cortisol, which switches them into flight or fight mode. But on the flip side, they may oversleep at night because sleeping feels better than being awake and fighting the same battle hour after hour. Therefore, they can often wake up feeling more tired than when they went to bed. This one I truly believe is chemical, the brain and the adrenals are messed up because the adrenaline in someone who’s anxious flies around their body for so long and so hard that when it eventually dies down they are left feeling like they just ran two marathons in a row. Can you imagine feeling that tired? I don’t have to, I’ve been there. Ask. Ask them how they are sleeping. Find out if they would be open to a gentle walk or a swim. Tell them you understand that they are tired because fighting what they are fighting is like running away from a man with a gun, all the time. This will help them realise you may not be able to empathise but you can definitely sympathise.
2. They need excessive reassurance
Anxiety and/or depression have an effect on both the body and mind. Psychological symptoms include feeling nervous and tense, thinking about a worrying situation over and over again and feeling like other people are noticing your anxiety and/or depression. You might notice someone asking you repetitive questions about something that involves them. They may even be going to their doctor quite a lot. Or, one big warning sign is that they are less confident doing something that you have seen them do thousands of time. I know my boss knows when I’m unwell. I struggle to communicate and talk to clients and we have a ‘safe’ word when I have to leave a meeting. Ask. Ask them if a lot of their thoughts at the moment are repetitive? Are they thinking about one particular thing over and over and when they are finally done with worrying about that they find something else to obsessively think about? It’s part of the OCD family, repetitive thoughts that are really difficult to break out of. Just by asking them if their thought patterns feel unusual might make all of the difference.
3. Their eating habits have changed
This a big one for me and something I struggle to hide. Anxiety and depression can have a knock-on effect to eating habits, so someone may eat more or less than they previously did. Ask. Ask your friend or family member if they think they are eating too little or if perhaps they might be ‘stress eating’. Reassure them that this has nothing to do with weight or self-image, it’s entirely about a symptom. If someone notices a lump, they’re going to get it checked out. If someone asks if you’re eating habits are swinging one way or another, it’s time to ask them if they should get checked out. Time to get help, it’s there but they’ll need you. For someone under-eating, their a few things you can do that may help them out in the short run. Buy them a smoothie, have soups and yoghurts ready for them. Soft food that even with a few mouthfuls, you’ll know they are at least getting something. Someone stress-eating is different and an approach where you can get them into nature and get some fresh air can also make all the difference. Again a gentle walk, or even just sitting outside having tea, coffee or smoothie can be a good alternative. It’s not about the food; it’s about combating the isolation. Remember that.
4. They've developed perfectionist tendencies
Here’s one that’s pretty new to me too. I recently came across BDD disorder (from Anxiety Trust NZ a fantastic organisation right here in NZ) and how it can be a symptom of anxiety and can greatly increase depression. It is also of the OCD family (yay) and it can be devastating.
Some people with anxiety may be overly obsessed with their appearance. Especially younger kids who now have people like the glorious Kardashians to live up to. Aren’t we all so glad of that? *Pause for a sarcastic lift of the eyebrows.* You may notice that your friend or loved one spend a lot of time and money trying to look 'perfect.' At work, it may mean someone becomes overly perfectionistic, taking a long time to complete work. And be utterly devastated when something routine falls through (been there, done that).
This can be hard to notice in a lot of situations because, as well as being perfectionists – to some degree – those struggling with this symptom are often said to be people who are natural people pleasers, over-thinkers, compassionate, intelligent and responsible. What you are looking for is an increase in this behaviour, subtle (or not so subtle changes), over-washing hands, obsessed with small part of their hair on either side of their had being the same length, obsessing over muscles being equal on either side of their body, picking skin, pulling out hair, comparing themselves to others and the list goes on.
This is a difficult one but my advice would be to deflect away from the perceived flaw. Ask if when they are thinking about what is wrong if they find it hard to concentrate on anything else, Ask them that if they get reassurance do they feel better for a short period of time and then it comes back? Ask. Make them comfortable with the fact that they are not alone. This applies to everything I have said so far. By asking, we’re breaking down the walls of isolation. It’s so, so important.
5. They may not answer their phone
Yeah, this one is my particular favourite and I have already told all of my close friends and family that if they don’t hear from me for more than 2 days. Something is wrong, really wrong.
If a loved one starts avoiding activities they used to enjoy or is spending more time alone, it could be a sign something's not right. Less obvious signs of avoidance behaviour are getting taxis instead of using public transport, making excuses to avoid going out with family or friends, sitting at the end of the row in theatres or cinemas, always being accompanied when out and about, only shopping when it's quiet, using minor roads to avoid busier ones and crossing the street to avoid people. It’s difficult to be around other people when anxiety is high or your mood is so low you feel like a burden on people. Ask. This time don’t ask about the symptom, ask them what they need from you. And, if it is to be left alone, make sure to ask them if they are first safe (from self-harm) and put a time limit on it. Check in with them in an hour, a few hours even if you are just asking them to answer your texts with one letter. That’s what I often do. If you are physically with them, ask if they would like to take their phone and field phone calls for a few hours. And, if they say they’d like you around but don’t want to talk, do it. They’ll never forget that you did.
Finally, if you are seeing these symptoms and it has been on-going for a while.
Ask them if they are thinking about suicide. Here are a few ways of asking this question, because the WAY you ask is also extremely important:
Are you thinking about suicide?
Do you think a lot about falling asleep and never waking up?
Are you thinking of harming yourself?
Are you thinking about death a lot?
How can I help?
I can tell you know that I have had suicidal thoughts a few times in my life and while I can look at them objectively, many, many people can’t. Imagine if we asked more, imagine if people knew just how common it was to have these thoughts. Imagine if we started to not feel ashamed of them and people who have never experienced them started to not be as afraid of them.
Ask. Always ask. You could save a life.
P.S I have been running this blog for 3 years and I am so, so grateful for everything is has brought to me. I do everything voluntarily and I will keep it going for us long as I can. there are some small costs to maintain and if my content is valuable to you I would so appreciate a small donation to keep the website alive. Entirely up to you and even if it is a dollar you can be rest assured it will be greatly appreciated and pumped straight back into everything I do. At ease SC xx