Welcome to she persisted I'm your host Sadie Saxton a 19 year
old from the Bay Area studying psychology at the University of
Pennsylvania. She persisted is the Teen Mental
Health podcast made for teenagers by a team in each
episode. I'll bring you authentic
accessible and relatable conversations about every aspect
of mental Wellness. You can expect evidence-based,
Tina, proof resources, coping skills, including lots of DBT,
insights and education. In each piece of content, you
consume, she persisted Offers you a safe space to feel
validated and understood in your struggle.
While encouraging you to take ownership of your journey and
build your life worth living. So let's Dive In.
Before we get onto this episode, as I'm sure you could tell from
the title, I would like to give a trigger warning for topics
like suicidal, ideation and suicide attempts.
I encourage you to take care of your mental health first.
And so, if that means not listening to this episode, to
avoid being triggered, then do that set that boundary do.
What is best for you. A caveat, if you're still on the
fence, this is a very skills heavy and education focused
episode, I tried to really stay away from Graphics, so nothing
crazy in here, but just if that Epic is triggering to you.
Here's your little trigger warning.
Hello, hello. And welcome back to.
She persisted. I'm a little bit nervous for
this week's episode. It's a vulnerable topic.
It's an important topic, which is why I wanted to do a solo
episode on. It, it hits very close to home.
So definitely a little bit nervous to talk about this, but
I am hoping that this episode will be helpful for you guys,
and that it will provide some tips and support that will help
you in your journey. So, with that, today's episode
is about About suicide, prevention and suicidal
ideation. If you didn't know, September is
suicide prevention month. And so I wanted to do a little
mini series of sorts talking about how you can navigate to a
satellite Aviation, how to support someone struggling with
suicidal, ideation and speak from not only what worked for me
but about what the evidence shows is helpful.
As far as resources next week's episode is a really exciting
interview with the fellow teen in the mental health space.
Her name is Aditya. She worked very closely with
Didi Hirsch. She is actually one of the
people that picks up the phones if you call. 988.
We talk about what happens if you call 988, what to expect, if
you ever call a hotline or a helpline, what questions?
They asked some common tips that she gives that you can help
Implement, it's just an amazing conversation.
We talked a lot about the the evidence in the research and the
suicide prevention space, the do's and don'ts all of that kind
of stuff. Stuff.
And it's a very helpful amazing episode that I've never seen
anyone do and the podcast space before.
So I'm very excited about that. But today's episode is going to
be a solo episode and I'm going to touch on my journey and give
you a whole bunch of tips and tricks and resources and skills
that worked for me when I struggled with suicidal
ideation. So it's going to be a lot.
I also wanted to give a trigger warning at this point.
I am going to touch on my journey.
I'm not Go into any graphics or any details is going to be very
skills. Heavy.
Very resource Focus because I think that will be what will be
most helpful without triggering anyone or adding fuel to the
fire if you will. So to begin to give you a little
bit of background. When I started struggling with
depression, I was not struggling with suicidal ideation.
I noticed I began to get suicidal after my first or
second hospitalization when that kind of hopelessness set in and
I would say it was kind of tied to having an understanding
Understanding of what I was experiencing, I was struggling
with depression. I had a lot of emotions that
were very overwhelming and big and difficult to navigate.
And on top of that, I wasn't really feeling a difference in
these emotions. Feelings, diagnosis, Etc.
I was trying a lot of different things I was doing outpatient
and inpatient, and DBT, and all these different things.
But I wasn't seeing a shift in my mood or my ability to cope.
And so with that lack of improvement, I started Feel a
sense of hopelessness and if you've heard me talk about my
story before, you know that, I talk about those two years of
treatment and home with and now increased sense of nuance which
is that I didn't believe that I was going to not be depressed.
Which again, the hopelessness was there.
I didn't think that I deserve to be happy.
My self-esteem was so shot and I was going to all these resources
whether is inpatient treatment or outpatient therapy or group
therapy but I I didn't believe it was going to work.
I didn't think I was deserving of getting better and so just
like manifesting I feel is the best way to explain this if you
don't believe something is going to happen, it's not going to
happen and that's true. If you're training for a
marathon or pursuing a degree or getting better at a scale if you
are so sure and certain that it's not going to work it
probably won't and that was true of my recovery especially in the
early days. So was really hopeless.
I felt really overwhelmed and I started to It's suicidal
ideation and that went on for probably a year or two years it
culminated in a suicide attempt before I went to three East and
when I noticed a shift in this symptom presentation being
suicidal ideation, it was when I decided that I was no longer
going to have suicide as an option on the quote-unquote back
burner in my life. I realized when therapy session
at McClain that the way I operated through any challenge,
whether it's It was a difficult emotion or therapy appointment
or a tough conversation with my parents.
Anything and everything in my life, there was always this
voice in the back of my mind, saying, well, you know what?
If it gets really bad, there's always this option or if things
are just really terrible, it's okay.
I don't have to experience that and keeping that on the back
burner came at a huge deficit to me because I wasn't invested in
my progress. It was always like this like one
foot out the door one foot in the door.
Like if this works great but also whatever because there's
this other And in, so I was in this therapy.
Appointment, I realized. Okay, this is how I'm operating
through life and this is why I can't stop feeling this suicidal
ideation at this point. At this therapy appointment
during my time at three East, I forgot to mention.
If you are not familiar with my story halfway through my
freshman year of high school, I went to a residential treatment
program called three East at McLean Hospital.
It was a dialectical behavioral therapy program is there for 14
weeks and that's where I really saw a shift and my depression
and anxiety and suicidal. Asian.
So during my time there, I was in this therapy appointment and
I started to see improvements in my mood, I had started to see
some behavioral changes, so my sleep was improving.
I was starting to be vulnerable with my parents.
My ability to use my coping skills was improving, so I was
seeing shifts but I still was really struggling with the
suicidal ideation and so, I was in this therapy session.
We're talking through this and my therapist asked me something
that allowed me to get to the realization.
That this is how I think about life.
I have Thing on the back burner. She's like, that's, that's the
problem here. This is why you're still feeling
suicidal. This is why you're still having
this ideation, is because you always see that as an option.
And because I had seen these small shifts, I was starting to
gain a little bit of hope. I was starting to feel what my
life worth living, really could be.
I was able to say, okay, I can make this jump, I can decide
this is no longer going to be my back burner.
This is no longer going to be in the cards.
I trust myself to cope with any emotions that arise.
I trust myself to navigate any challenges that come my way and
I trust myself to persist through that without having this
back, burner option. If suicide, and that making that
decision would not have been possible, six months prior
because there was no, hope I hadn't made any progress.
So I didn't see the light at the end of the tunnel where it was
like, I know what it feels like to be happy and okay.
And I can keep working towards that goal, no matter what comes,
Way because I just, I didn't know what that was.
Like, I was blindly stumbling towards this idea of getting
better. I didn't trust that.
That would happen for me. I didn't trust that I was
capable of feeling that, so it took some small shifts.
It took some progress for me to be able to make that commitment.
But once I made that commitment, the way that I approach
everything shifted, so instead of when I had a tough urge, or a
tough emotion, or a rough day, or an uncomfortable conversation
instead of kind of toying and playing around with that idea,
Idea of like, well, if things are really that bad, there's
always this option. I would like nip that thought
that urge that idea in the but immediately and I would say no,
my life worth living does not include having suicide as a
plan, B, as a back burner as a second option.
That's not the life I want to live.
That's not the life, I'm living. So no, even in the worst case
scenario, even if this is incredibly challenging and
embarrassing, and overwhelming, and difficult and stressful, I'm
going to cope with that, and it's going to be okay, and I
will get to the other side and there.
No plan, B, worst case scenario, second option that I will engage
in and it took a long time. It took months for those
thoughts to start going away, but every single time I would
have them, I would, in my mind re convince myself that I've
made this commitment, I made this decision and that actually
wasn't an option and we're going to get into like how suicidal
ideation. I like to think of it as a habit
rather than just an urge or an intrusive thought and why it
takes so long to rewire. but, With time, with continuing to
stick to my decision. My commitment, I made to myself,
those thoughts, slowly started to go away.
And I want to remind you that this wasn't an overnight thing.
I can pinpoint this moment. This therapy session as a shift,
but it took many months after that to get to the point where I
wouldn't have a suicidal thought, passive or active for
months years at a time. And if there is anything in my
treatment Journey, that was like a progressive.
Trajectory it was that it was that commitment to no longer
feeling suicidal because I just kept reaffirming that
commitment. I just kept reminding myself
that this is what my life worth living is.
And this suicidal ideation doesn't fit in with that.
And so, I'm going to let that go and just continuing with time to
rewire that habit Behavior, thought urge, I really did see a
difference so that is kind of my story, very boiled down.
Again, we're staying away from Graphics, that's not going to be
helpful to you. Ooh, you?
Because of our stories are all different, but that commitment,
I think is helpful to share because I think that is
something that a lot of people can relate to, and that I think
is common on a lot of people's Journeys, and it was such a
light bulb moment in my therapy journey through East.
Another thing that I want to touch on, when I mentioned,
seeing those small shifts to give a little bit more clarity
there. The small shifts, that allowed
me to feel hope towards the light at the end of the tunnel,
the life worth living, the feeling happy feeling.
Okay, not, Depressed, some of those examples in the early days
was not waking up immediately. Depressed like baby five minutes
after I got up. I was like, oh don't feel great
today but there was this amazing shift from having 24 hours a day
feeling like numb and hopeless and overwhelmed to waking up in
the morning and not immediately feeling terrible.
So that was one thing. I remember being something that
brought me a lot of Hope using skills effectively, you guys
know, I love coping skills, but getting better at being able to
navigate emotions getting Better at being able to advocate for
myself or be vulnerable or tolerate distress was something
that also brought a lot of Hope because it meant that down the
line. No matter what challenges.
I encountered, I could cope with them and I would be okay.
And then the last thing that I'll mention and I'll go into
more depth on this later during our skills.
Education was putting off engaging in an urge for a given
period of time. This is one of the key skills,
not only in exposure therapy, which I've done an episode on
before. But Advocating suicidal ideation
and just urges in general, no matter what urges you're
struggling with is making a commitment.
That's really small at the beginning.
It's like, okay, I am not going to engage in this suicidal
ideation for 30 seconds. I'm going to put off engaging in
this for a minute or 5 minutes or 10 minutes or an hour and
slowly but surely you make it through the night, you make it
through the day, you make it through the week.
So being able to sit with the discomfort being able to ride
the wave of the Earth. Urge for a day a week, a month
brought me a lot of Hope because it was like okay I can navigate
this level of Challenge and it won't derail me.
It won't cause me immense stress and overwhelm and things won't.
Implode I am capable of handling life and these urges and not
allowing it to completely collapse.
Everything around me, nothing's going to implode the world will
continue to spin Etc. So those are three things that
brought me a lot of hope, they'll probably Different for
you. But getting clearer and what
those things are, whether you write them down on a list, maybe
they're always front of mind is really helpful, and giving you a
destination that you're working towards and being able to stay
true to that commitment. And all of those things, I feel
like are pretty reasonable using a scale, putting off an urge
having a moment throughout the day.
When you feel a little bit more, okay, than you normally do.
None of those are insane. Like, oh, I'm gonna run.
Run a marathon and that'll give me hope because I can do
anything like know your, it's baby steps, baby goals and those
brought me a lot of hope. So the next thing that I want to
touch on is some little things that I've learned during my
time, at Penn, in my psychology classes that I think are helpful
to keep in mind, if you're struggling with suicidal,
ideation, they put things in perspective.
They remind you that the thoughts going through your
head, aren't always true. It's the first, is that as human
beings. So we are really flawed in our
ability to predict how things pan out and you're probably like
a course we are, we can't predict the future, but when you
ask people in 10 years, how important will this test?
Be? How important will this
relationship? Be to me?
How much will I love this band that I'm obsessed with right
now? People predict that it will be
like a 100% correlation and 10 years, this will still be my
favorite band, this test directly impacted the job that
I'm at now. This relationship was so
pivotal. We're now married with kids Etc.
That is so not the case. When you follow people, ten
years down the line, and ask them.
Oh, how was that test? What about that band?
What happened to that relationship?
People like what are you talking about?
That is so irrelevant to my current place of functioning in
the life that I live. Whatever it is.
The point is that we are really, really bad at impacting how
things will turn out. So, whatever stressors are
currently consuming, you Whatever relationships are
feeling difficult, whatever emotions are becoming
overwhelming. It's important to remind
yourself that when your brain tells you, this is going to be
so important in the future. This is night or day, it's life
and death. Everything is dependent on this.
I promise you, it's not and the science backs that up.
The next thing is a piece of wisdom that came to light on the
podcast. I talk about this all the time,
I'll link the episode in the show notes.
It is an interview with dr. Blais a giri, who is one of my
doctors at 3:00 Least things really come full circle.
But the idea is that life is impermanent and that
impermanence will be on your side.
Nothing lasts forever. At least, at the same level of
consistency. They, that's an emotion of
thought and urge relationship. A behavior things are constantly
fluctuating and changing and that is true for suicidal,
ideation. That is true for the emotions
that can lead to that the things in your life.
And so, when you are having a really rough day, Really rough
thought a really rough urge notice how the intensity of it
increases and decreases and I still to this day.
When I'm having a tough emotion, a tough day, a tough moment, I
remind myself this will pass because by the laws of the
universe nothing is permanent and this emotion thought urge
relationship, Dynamic will pass too because that can last
forever. And so that's something like a
little Mantra that gives me a lot of Hope.
And then the last thing that I want to touch on That I've kind
of been toying around with this idea recently is that suicidal
ideation can be so difficult to quit, if we can use that term
because I feel like the way that I've always thought about
suicidal ideation is through the OCD model, you have an intrusive
thought, it then, causes all these emotions, it's like a
spiral effect that leads to these behaviors and maybe
impacts your relationships. But I found it a lot more
accurate and effective to think about it as a bit of a habit,
but also a self-soothing mechanism.
Because for me, when I had a difficult day month, emotion,
urge thought, all of these things, that would trigger these
thoughts. Having this back burner idea was
really calming to me, it was really soothing to me.
It was well, all goes to hell, there's always this Escape
patch, there's always this plan, B, there's always this way to
not have to feel this terrible. So every single time I would
engage in a suicidal ideation, I would be decreasing, my
emotional intensity. It was like calming, it was
self-soothing, it was making me feel better, so what makes it so
difficult to recover? Quit these thoughts and urges is
that they're not only intrusively entering your mind.
But you have trained yourself to utilize these thoughts as a way
to soothe your emotions and it's become a coping skill.
And so when you are trying to quit these thoughts or urges,
you not only have to learn to say no that's that's actually
not true. I don't like that but you have
to replace the coping mechanism. You have to find a new way to
deal with the emotions. That arise that you would
previously soothe with thought, if that makes sense.
So there's a lot of different ways you could go about that.
I really like the book Atomic habits, which is just about
habit, making and breaking, and it talks a lot about the science
behind it. When it's easier to make a
habit. When it's easier to break a
habit, it talks about like habit stacking, you could apply this
to anything. Whether it's your morning
routine or trying to work out more anything and everything.
But I think this has a really interesting Testing application
to suicidal ideation because you can think about every time you
engage in a suicidal thought as reinforcing that habit and
making it stronger increasing, that neural pathway.
Whereas when you do that, rewiring that I just touched on
for like, no, you know, actually this isn't in my life worth
living and I don't agree with that.
And this is not something that I want to entertain.
You are not only breaking that initial habit, but you're
building a new habit and so that's another way.
Way, that kind of helped me was to, like, add some tallies to
the side of making the new habit, and take some way from
this side. And it felt like I was making
progress in the right direction if that makes sense.
Today's episode is brought to you by teen counseling.
If you are struggling with suicidal ideation and not
already utilizing a mental health, professional as a
resource. I highly recommend, checking out
therapy and one way to do that, is teen counseling teen
counseling is better. Branch of their company
specifically for teens, they have over 14,000 licensed
therapist in your network that can help you with a whole host
of topics. Whether it's anxiety or
depression or suicidal, ideation or stress relationships.
You name it. They can help support you.
What you're going to do is go to teen counseling.com, says she
persisted, you fill out a survey about what you're hoping to work
on your match with the therapist that specializes in that area?
And then you can start working with them.
Via talk text or video counseling depending On what
level of support you are looking for super fast turnaround, you
don't have to deal with long wait lists or trying to get
referred by your pediatrician or a local provider.
It is a great solution and hugely effective.
I mean, therapy changed my life. It saved my life as we talked
about in this episode. And so I highly recommend giving
that a shot, if you haven't already.
And one way to do that, is teen counseling.
So again, teen counseling.com says, she persisted to try to
check it out today. So That is the things to keep in
mind section. We're now going to talk about
crisis management. And then, after this, we're
going to talk about long-term, decreasing suicidal ideation and
building your life worth living. So, a lot of dealing with
suicidal ideation and suicidal urges is the crisis management.
It's the moment when you're having the surge, when you're
having this thought and it's tolerating the distress.
In that moment, an important caveat to add.
Before I give you these skills is that distress tolerance.
Gil's. Only stay effective.
If we only use them in moments of extreme distress.
The more, we use these skills, the less effective they are.
And a good example of this is like your comfort TV show.
Mine is the office. When I'm having a rough day or a
rough night or stressed from school, I'll put on the office,
and it's so soothing and calming and I love it and I laugh, but
if I watched the office 24 hours a day, every single day week, it
wouldn't be calming be like background noise.
It be white noise. Maybe it would get even a
Waiting to be reserved these scales, her when our emotions
are really bad so that they can maintain their effectiveness and
help us when we really need it. So the first skill that I want
to give you is the stop scale. This is from the distress
tolerance module DBT, or dialectical behavioral therapy
and it is an acronym that stands for stop.
Take a step back, observe and proceed mindfully.
Most of the time I think of the stop scale through the lens of
anger or an argument, or maybe Sadness or anxiety, where?
If you're super anxious about, something you would stop, you
would leave the situation, you would work through that anxiety,
and then re-enter it. But I want you to think about it
from the perspective of an urge. So if you have a thought in your
mind, it's like an intrusive thought.
You're like, wow, this is a suicidal ideation, that has just
popped into my brain, and I'm feeling some distressed about
that stop and take a step back from the urge, rather than
entertaining it and listening to those.
It's and starting to feel the distress and going down that
thought Rabbit Hole instead take a step back from the urge and
back. Okay, I just had this thought
pass into my mind and I noticed that when I have this suicidal
ideation, I then feel stressed, I feel anxious, maybe I feel
hopeless, maybe I feel overwhelmed, maybe I feel angry,
whatever emotions, observe, those and then decide how you
want to proceed. And if it was me, Me the way
that I would proceed as doing that thought rewiring which we
just touched on. So I would say, you know, at one
point it was really effective for me to cope with what I was
experiencing by entertaining these suicidal ideations.
But now I know that being suicidal and entertaining
suicidal ideations isn't within my life worth living.
That's not the life that I want to live and I have so much hope
for my future and I want to be around for that.
And I know that, no matter what I challenge is, are Own at me, I
can navigate them effectively. And for that reason, I am
choosing not to engage in the suicidal ideation.
And I actually want to be here, and I want to continue to live
life and see this challenge through to the other side.
Whatever that looks like for you, and you proceed mindfully,
you continue on with your life. So kind of rethinking about the
way thoughts happen. There are not happening to you,
you kind of have the decision to engage in them to go down that.
That rabbit hole spiral or you can kind of like nip them in the
butt and rewire them the next skill that I want to mention is
the ride, the wave skill. This was probably the most
relevant skill for me when I was struggling with suicidal
ideation, and this skill is really simple.
The idea is that everything is impermanent, it comes in waves,
with that's an emotion, I use the skill and I get headaches
because the intensity of the headache will give and take like
it'll it'll be Tense and it will gradually decrease.
And I kind of like wait for those moments of decreased pain
because I'm like, okay headache is going to go away.
It's going to be fine, but the idea is that you experience your
emotion or your urge or your thought as a wave.
So it's coming and it's going, you're not trying to get rid of
it. You're not trying to push it
away but you're just experiencing as it comes and
goes. You're not blocking it, you're
not suppressing, it, you're not necessarily trying to keep it
around or entertain the idea. You're not holding on to it,
you're not amplifying, it, you're simply just letting it
happen and the great thing about this is that you can really hold
on to those moments where it's less intense, when these urges
feel so scary, and overwhelming, and a lot to deal with and
handle, you can hold onto those moments that they, they go away
and that they're less present, and they're less intense.
And you can remind yourself that that lower intensity will
return. The next skill is a Each one and
that is distraction, when you're having this really intense.
Urges distraction is one of the greatest things that you can do
to get yourself out of your head.
Just stopped engaging with these thoughts.
Emotions and urges. So distraction is pretty
straightforward. There are two acronyms in DBT
that are used to kind of break down the distraction skill.
And I'm not going to go into a crazy amount of detail here
because I'm sure you guys know how to distract yourself, but in
DBT the way that they break it down the except skills
activities. He's contributing comparisons,
emotions, pushing away, thoughts and Sensations.
So, engage in an activity, help someone else compare.
What you're currently feeling with what you've previously felt
like, we just talked about with those urges generate a different
emotion. Maybe you watch a funny TV show.
Maybe you watch scary horror movie, you invoke a different
emotion than what you're currently feeling you push away.
This doesn't mean that we're avoiding all of our emotions and
thoughts together. But you're like, you know what,
I'm not going to think about this.
Now we're, I'm not going to entertain the thought right now,
going to put it on a shelf and we're going to come back to it
later when I have more emotional capacity to cope with it.
Thoughts, you are again. Rewiring those thought patterns
like we talked about and then sensation, so self-soothing.
Using the five senses to calm yourself.
So listening to music, drinking a smoothie, smelling a nice
candle watching, a funny TV show heading a dog, using those five
senses to calm yourself and then the improve skill.
Is using imagery. Meaning, prayer, relaxation, one
thing at a time, vacation and encouragement.
So, with the improve skill, you are using imagery to calm
yourself. So, maybe you imagine yourself
in your happy place, maybe you. Imagine yourself getting to the
other side of this urgent feeling, okay?
With meaning, you are finding meaning on what you're
experiencing for me, this came after a while.
Like when I was in crisis mode, meaning wasn't a skill, I would
use. But once I had started to Ricci
suicidal ideations and was like, a couple months into this
process. And once I actually started the
podcast, I was able to think about the suicidal ideations.
I'd struggled with and these urges and realize this has given
me an really interesting and unique skill set to help other
people and speak from experience and share, what worked for me
and finding a purpose in that pain prayer.
This kid either be, if you are religious you can either use a
prayer. Or even just the repetition of
having something to Think Through can be really effective
relaxation, do things that relax you again, you can use the self,
soothing five senses. One thing in the moment you are
doing one thing, you are being mindful.
So if you are, I don't know. Going to go back to drinking a
smoothie. You are just focusing on the
sensations, The Taste rather than also having your mind be
somewhere else with an urge, and being overwhelmed and watching
TV show and having a conversation, you are just
breaking it down to one thing. In the moment.
And getting through that, one moment vacation, you are either
physically or mentally taking a vacation from the emotional
distress. So you imagine, you're somewhere
else, maybe you take a walk, you take a break from what you're
experiencing and then revisit it again.
Similar to the top, stop scale. And then encouragement, this is
like a little pep talk for yourself.
You're like I will get through this, it will be okay this too
shall pass. This moment won't last forever
Etc. We talked about self-soothing.
The next thing is the pros and cons scale.
This was another really big scale that I use when I was
struggling with really big suicidal ideation.
I remember doing a pros and cons when I was in the hospital
hospitalized for suicidal ideation.
And the idea is that you pros and cons living, which, if
you've never been depressed or never struggle for suicidal
ideation, you're probably like, what on Earth are you talking
about? But if you are really struggling
and that is actually a decision that you are making it.
Really effective to have a list and get really clear on all the
reasons to stay here. All the reasons that you love
your life, all the things that you look forward to all the
reasons to stick around. And I would take this a step
further and any time that you feel something that brings you
Joy. Anytime you're like, wow, this
is pretty cool or I love this, write it down, whether it's in
your notes app, whether it's in a journal, whether it's on your
hand, anything and everything, have a running list.
So what you have an intense urge, you can go back to the
List and say, these are all the reasons I want to be here.
These are all the reasons I want to stick around.
And these are all the reasons that I love life.
And even though right now, it doesn't feel that way.
There's a lot of reasons why this life is really beautiful
and amazing and why I want to continue to be here and you can
also pull from that list as ways to build your life worth living,
which we'll get to the next skill that I want to touch on,
is your coat box. So, this is an idea that I
learned in DBT group where you make a box.
Or like a little bag. If you go to school and you want
to put it in your backpack, but it's all coping skills that you
use in crisis. So, some things that I had in
mind was a printed out list of the hundred coping skills and
those are things like gonna walk pet a dog like all these tiny
coping skills that you can use, that might not immediately come
to mind a book that you like maybe headphones to remind you
to listen to music. Another one is those little ice
packs where you pop them and they get cold.
So do you Using the tip scale by putting ice under your eyes, to
decrease your physical emotional intensity, maybe a piece of gum
or a lollipop like a piece of candy, I would put notes in
there from family members, or friends, maybe a movie, like a
DVD, just reminders of how you can cope and be effective
without having to think of all those things on top of trying to
cope with an emotion. And you can make a travel
version for your backpack and addition to like a bigger
version in your room, but the idea here, And with the next
skill I'm going to mention is to make things easy for yourself.
When you're in crisis mode, you don't want to have to be trying
to figure out, how do I cope with a crisis and then
implementing your skills. You just want to implement and
you want to make things really easy for yourself when you're
struggling and you're more emotional, and you're not able
to pull from that rational side of your brain.
So the next thing is a crisis survival plan, and I will link
this in the show notes. But what you do is you write
down your warning signs. So what are the thoughts,
feelings? Behaviors that come up, Up, when
you are triggered, when you're at in crisis mode, and this
could be different for anxiety versus depression versus
suicidal ideation. But if we're doing this one for
suicidal ideation, what urges come up, what thoughts come up,
what? Emotions come up?
What behaviors are you engaging in?
You're going to list out some people that you can reach out
to. So that is going to be, maybe a
friend, a family member, a parent, you are going to put
their phone numbers there because you're making this
really easy for yourself. You're going to also list some
Crisis Professional Resources, maybe that's your therapist
phone number. Maybe that is your local
hotline? Maybe it's the crisis text line
which is text 741 741 and I think the word is home.
There's a lot of them, I'll put it in the show notes but what
are the Professional Resources? You can utilize your also going
to include the coping skills you can use.
So how can you distract yourself list?
Your top three and maybe those are in your coat box.
Then you're going to list from past It's what helps you.
When you feel this way is it taking a shower as it talking to
a friend? Is it watching a movie?
You making this super, super easy for yourself.
And then the last thing to include here is ways to keep
yourself and your space safe. So maybe it's asking a parent to
remove things from your room. Maybe it is doing a sleepover
with the friends, you're not alone.
I slept on my parents bedroom floor for six months because
that was what was necessary to keep myself and my space safe.
Maybe it is Chloe. Teacher and/or, friends, we can
just keep an eye on you and check in.
So all of those things are meant to make your life easier when
you're in crisis mode. So you don't have to plan and
Implement we're just going to implement and we're going to do
the work beforehand so that were not double stressed.
Okay. The last tip for crisis
management that we are going to give is to take things really
slow I touched on this but I want you to not think about how
I'm going to get through tonight when I'm I'm so deeply suicidal
and having so many or just every three seconds, but how I'm going
to get through, how am I going to get through the next 30
seconds? And I'm going to do some deep
breathing. Am I going to get in the shower?
And I'm going to take a walk. Am I going to watch a TV show?
Like literally just 30 seconds? Then you're going to say, how am
I going to get through the next minute?
I'm going to get through the next five minutes and break it
down incrementally and just take it minute-by-minute day-by-day.
Don't think about this long term life worth living when you're in
crisis mode? And then I know that I said that
was the last Staying. But I've touched on this in the
crisis plan, but ask for help. What I the worst thing I think
that people could come away from this episode with this thinking
that you need to do all these things by yourself.
No, my hope is that you have so many people in your corner to
give you ideas on how to cope to be there to support you when
you're at your lowest to check in on you to remind you that
they want you and love you in this world.
So ask for help when you're in crisis that was probably my
number one skill was to call a therapist or a friend or a
parent and just have someone Around me ask for help.
Is that phone coaching? Is that a helpline?
Is a texting? Is it just spending time with
someone? Is it doing a movie night?
Have people in your corner? I don't think anyone should be
expected to navigate to Saddle, ideation by themselves.
And if anything, I think being by yourself ads to those
feelings, so if there's one skill, I know, I said that stop
skill was important and distraction and self-soothing,
but number one is ask for help again, no one should have to
deal with this alone. And so I think if there's
anything that you take away that you implement And ask for help.
Please. And my DMs are always open.
I also forgot to mention that you ever are like, I literally
have no one to talk to and I just don't know what skill to
use right now and I need support.
Send me TM, I will do my very best to get back to you and be
there for you because anyone that has struggled with this
before I think would want to support someone on the other
side of it and that's true for me.
So always here always here to support in any way that I can
Okay. Now we're going to talk about
long-term building, your life, worth living and decreasing
these skills. Because crisis management skills
are really helpful in the moment.
But like we talked about if you implement those all the time,
they lose their effectiveness. So what do we do to decrease
suicidal, ideation over the next week.
Month. Three months.
Six months Etc. The first thing that I want to
mention is getting really clear on your life worth living your
life worth living. I've said that a lot of times
during this episode It is an idea that is a key pillar of
DBT. You're working towards this life
worth living because the idea is that if you are in your life
worth living, you are no longer struggling with suicidal
ideation because your life is worth living.
So one of the first things that you do when you start DBT, as
you get really clear on what that is and you get really clear
on what you're working towards, what is your goal?
And what does that life look like?
How do you cope with your emotions?
What is your support system look like What is your daily routine
look? Like, do you can you actually
engage in school and feel passionate about what you're
learning? Do you have healthy
relationships? What are your hobbies?
How do you spend your free time, Etc?
Write that out. Maybe you draw a picture.
Maybe you put it in your notes app and you remind yourself
again. And again, and again, this is
what I'm working towards because when you're abstractly kind of
pursuing this goal of getting better, it can be really
discouraging. It can be It can cause you to
feel really hopeless, especially if you don't identify
emotionally with that concept if you're like, I don't remember
what it feels like to be happy. So how can I possibly work
towards that goal? That was something I struggled
with so much. So we get really clear on what
this life would look like if it was worth living and and start
making incremental steps towards that point and when you do get
into that, that crisis mode, remind yourself.
This is the end goal. I'm I've already made so many
Oops, towards getting to that point and this is why I'm going
to keep going. The next thing that I want to
mention here is routine. So routine is something that is
really common across the board when it comes to mental health.
If you've ever been in a treatment program, they are
really big on routine. It's like you get up at this
time, then you take your meds and then it's breakfast.
And then we do this group therapy and don't forget, we
have this one, our room time and that's the same, whether it's
like an outpatient and inpatient a residential, therapeutic
boarding Got their really big on schedule and I'm sure there's
logistical reasons for that with Staffing.
But routine is also shown to be really important for mental
health and have really positive impacts on mental health.
And I felt this firsthand, but the research also backs this up.
So there's three reasons that I want to give you to implement a
routine. The first is that decisions can
increase stress and when I, when I wrote this out of my bullet
points, I immediately thought of Steve Jobs and his like black
turtleneck and he didn't want the stress of like or the mental
Expenditure of like, choosing an outfit in the morning, so he's
just going to wear the same thing every day.
Like, that's not really what we're going for here, but trying
to decide in the morning, like, okay.
Am I going to make eggs and bacon or cereal and get my
nutrients and when you're consumed with like stress and
suicidal ideation and depression?
That's a lot to add to your plate and end goal.
There is just to get nutrients in your body so you're not more
emotionally vulnerable. So we can just decrease that
stress and take that out of the equation and have a routine that
you stick. No, you're not, adding more fuel
to the fire and you're not adding more emotions when you're
probably already very emotionally, sensitive and
reactive, and overwhelmed. The next reason I want to give
you that routine. Is helpful is that many, many,
many things in life, can't be controlled, whether that's other
people's actions. Their beliefs of us a lot.
Sometimes our schedules are commitments, our relationships
so many things can't be controlled, but in many ways,
your routine can and so because of this, if you can have it,
Consistent routine that you stick to, you can Garner a sense
of calm, a sense of reliability stability.
And this is a game changer when your emotions and your mental
health. Don't provide that.
So, for me, I have a really consistent routine that I stick
to, I get up. I wash my face, I brush my
teeth. I do my skincare, I do my
makeup. If I'm wearing makeup that day,
I do my hair. I get dressed.
I make my bed. I make my coffee which we look
forward to every day and then from there it's kind of up in
the air. Maybe I've class maybe I'm
working out, maybe Meeting a friend, maybe I was studying,
not really sure what happens. But then at the end of the day,
I come home, I shower I put on my skincare, do my hair put on
my lotion? I put on my pajamas, I watch TV
show. I read before bed and that
morning. And and those bookends at the
day or really consistent, all of those things within the routine
are really calming, they're really reinforcing.
We bring me a lot of joy and I can count on them, they're very
grounding for me. So if you can have these little
things in your life, They bring you that reliability, that
stability and that calm throughout your day.
It can be a huge game changer with regards to your mental
health. The last thing to add about
routine is that it helps you stay on top of behaviors and
habits that are really important for your mental health, which
will gradually improve your Baseline.
So DBT there's an acronym called please which helps you decrease,
your emotional vulnerability by staying on top of your physical
health. So you are treating physical
illness your Eating balanced, you're avoiding mood-altering
drugs, you're getting enough sleep and you are exercising in
a balanced way. So you are decreasing potential
stress and dysregulation that could come from, not eating
enough from drinking too much coffee from skipping.
Taking your meds from not exercising, so you don't have
any endorphins from being sick and being.
So, physically depleted, all of these little things that could
make navigating emotional situations worse, you're trying
to avoid that from happening. Inning.
So for your routine, you're not only giving your senses yourself
the sense of calm and stability. But if you have a morning and
night routine with what you're eating, so like in the morning,
you have your cup of coffee and you have these three nutrient
filled breakfast that you choose from and after school, you come
home, then it's dinner time. And these are your four favorite
dinners that you choose from. Throughout the week, you are
solving for being angry or emotionally overwhelmed from not
getting enough food or nutrients same thing.
If you This consistent morning and night routine where you wake
up at the same time every day you go to bed at the same time
every day, you're solving for getting enough sleep and not
being emotionally overwhelmed from that.
Again, another example would be meds, maybe you're for me, my
Med time is at night and it's built into my routine so I never
miss it. And if I do miss it, I noticed
some like, something's missing something feels off.
What did I forget to do? You are avoiding potential
emotional dysregulation, that could come from, not taking your
meds. So if you stay on top of your
routine, You are also staying on top of behaviors and habits that
are important for your mental health and over time, that
improves your Baseline. If you want to get better about
building habits Tomic habits, it's such a good book with, so
many applications to mental health, I highly recommend, and
it's like a normal book. You've probably seen it all over
Tick Tock. It's not like, very heavy and
dark, and all these crazy things, it's just about building
habits and improving your routine, and it's a great
resource. The next thing that I want to
want to talk about is emotion regulation.
While the Stress tolerance. Skills are helpful in crisis.
Emotion regulation is what will help?
Decrease these suicidal ideations long-term.
And so one skill that is really important.
Here is accumulating positives. We just touched on this in your
morning routine but having things, that improve your mood
and make you happy and make you joyful allows you to add to that
Pros column that we talked about.
So if you are having a really bad urge and you are having a
thought we were Like I have nothing going for me, everything
sucks. You go back to that Pros.
Column you go back to these positives that you've
accumulated. And you say, you know what, I
have, all of these things that make my life worth living and
all of these things that make me really happy.
So it's not true that I have nothing going for me, and
nothing to look forward to. Because I have all of these
things that bring me joy and long-term accumulating positives
in planning moments of joy, in decreases the distance between
your highs and your lows and increases your Regulation, some
other things that are important to implement but our heart
boiled down and tell you how to do on a podcast.
It's healthy relationships, having good communication with
your loved ones and having people that care about you and
support you and want you to be okay therapy or treatment is
really, really effective and helpful, especially dialectical
behavioral therapy when it comes to suicidal ideation.
It's proven to decrease it and there's a lot of studies that
back that up and so if you have Noticed, you're having these
thoughts. Try and find a DBT, therapist
near you try and see if they can help you decrease these emotions
and feelings. In addition to trying these
coping skills, when you're in crisis mode, then the last thing
is having structure and commitments.
I think a really big thing that can be tied with suicidal
ideation. It's not having a sense of
purpose or somewhere to show up and get to, or I have to be at
class. I have to be at this meeting.
Or I have worked to show up to so trying to build your route.
In your scheduler, you have places to be and people to
interact with the things to look forward.
To can be really helpful and increasing that sense of hope.
Today's episode is brought to you by Prime student.
You guys know. I am a huge Amazon Prime Fant
going along with last week's Trend, this week, I ordered
myself some chip clips and they are cute colors.
I love them, I am obsessed. My grandmother also sent me a
little contraption that makes a very loud noise.
In case, there is a safety issue.
So, those were my Amazon orders. As we love Amazon Prime and you
are a college student, you can get Amazon Prime is student,
which is at no cost for the first six months.
After the first six months, it is 50% off the normal price of
Prime with Amazon. Prime, you get free shipping,
it's super fast shipping, like a couple of days, turn around.
And with prime student, you also get access to LinkedIn, premium
GrubHub, plus course, hero student.
Universe discounts, a free calm premium.
Option. And so many other Partnerships
that have been created with students.
In mind, it's an amazing deal. I'm obsessed.
Again, use it on a weekly basis as you just heard.
So if you would like to check out Prime student, you can go to
Prime student dotco. So join student again, that is
prime student dot Cosa joint student, and you can order
Atomic habits, is what I recommended in this episode.
The last section of this episode is listener questions.
And there's a lot but I'm going to try and go through these
really quickly to try and touch on some topics that I didn't
already mention. The first one is tips for
feeling passively suicidal and how to deal with recurring
thought that you want to die. But you know that you're not
actually going to hurt yourself because you can't hurt the
people around you, so feeling suicidal without intent.
So, this is called passive suicidal ideation.
Passive suicidal ideation is when you have thoughts of not
wanting to, You live but you don't necessarily have intent or
a plan. And so the tips that I would
give here is to start building your life worth living.
It sounds like that life, that you're operating in and working
through isn't one that feels worth living.
If you like you have a need to show up for other people, or you
feel like you should, you don't want to add that burden to other
people. So I would get curious on.
How can you adjust your life to make it feel more worth living?
And more enjoyable. And more hopeful is that
relationships, is that a routine?
Is that a behavior? How do you feel navigating, the
challenges that come up? Is it, your coping skills?
Is it the people in your corner, Etc?
So, kind of rethinking that and working towards that goal and
seeing, if those urges shift as well.
I would also say to anyone that are struggling with passive
suicidal ideation to start really working on your support
system. I'm not saying that you're
suicidal, ideation will shift and develop and get Potentially,
but if that's something you already know you're struggling
with, you really want to make sure you have a good support
system so that if you ever need it which it sounds like you
probably do right now. Anyways you have that in place
and you have those people to lean on and you have those
people in your corner. The next question is advice on
specific language to use when talking to your parents to tell
them that you're depressed and need help.
This depends on whether your parents maybe there's a lot of
stigma on the way to think about mental health.
Is it that they They think you should just be capable of
navigating this independently. Have they never felt that way
before I would go to your school, counselor or a or a
local councillor potentially your pediatrician and have them
looped in on the conversation. Having an adult that's in like a
kind of professional position to also provide resources and say,
hey, I think this could be helpful can be really powerful
to convince a parent and I would also another tip here is to make
an appointment, prepare your parents, okay?
I want to talk to you about something really important.
And one would work for you and also go into that conversation.
Not expecting to get a response immediately and maybe you go in.
You make your ask, use it to your man.
You can Google that like a dear man DPT and it'll tell you
exactly how to make a request to get your objective met.
I've mentioned in episodes before but go in make your
request and give them time to think about it.
Next question, what are the steps?
I should take if I'm concerned about a friend who might be
suicidal so as you will hear in next week's episode with Diaz
There's a lot of tips there. You could call 988, if you have
a friend or loved one that suicidal and you don't know how
to support them. So that is one thing I would
definitely mention, I would say first, make sure that your own
mental health is okay, supporting someone that suicidal
is a really challenging and emotionally exhausting thing it
puts a lot of pressure on you. It's very overwhelming and it
can be very stressful. So I would make sure that you
are in a good spot and you have the Capacity to support them.
And if not set boundaries and I'm not saying you leave them on
their own to navigate this independently but maybe you're
there is a safe space as someone that they can spend time with
and laugh with and you're always there to spend quality time with
them, but you're not the person that they like give such super
graphic details of the thoughts they're having like that's for
their therapist. You're there to just have
quality time with and be a safe space.
So depending on what level of emotional support you Can
provide set those boundaries. Yeah.
And, and try not to be judgmental.
Try not to problem-solve just be there as a listener.
As we talked about, in the episode, with Michael slept Yen,
being vulnerable and sharing the quote unquote secret, or just
being vulnerable about anything that you don't talk about
broadly, a lot of the times it goes a lot better than you think
it will. Even if it's like a subpar
response from the other person. You see that as a positive
experience, that's what the research shows.
So even if you're just neutral and you're like, wow, that's
really Difficult. I'm sorry you're feeling that
way. The other person will see that
likely as supportive and helpful and an overall positive
experience. Next question, when does
suicidal ideation become serious?
So, like I mentioned, there's a difference between active and
passive, suicidal ideation, passive is thoughts without
intent. May be something like, I don't
really want to be alive or I hate life.
I mean, that's not really sucks because I do ideation.
But, like, I just would rather not be here or things like that,
whereas activist with intent, where's active is with a plan,
it's kind of more fleshed out And then the second thing there
is with, or without a plan. So is there a date as their time
is their intent? And when you get into the with
the plan with intent with, that's when you would want to
call 911 call 988 when someone is really at risk of being a
harm to themselves and and they need more professional support
than you can likely offer when they're in that passive Camp.
It's difficult because you don't want to see anyone suffering to
the degree that they're feeling suicidal, or they don't want to
be here. And There's also kind of that
acceptance of okay, even though this is so incredibly painful,
they're not necessarily a danger to themselves right now.
So this might be a long term something that shifts with lots
of time and effort in conversations and skills usage.
But there's not that that quick fix, which is a difficult thing
to to Grapple with the next question is, how can family
members of someone with suicidality support them?
So, again, you can call 988. If you're worried about the
person, especially if they're getting into that spectrum of
being, I'm more active and with a plan the the key things here
are to be non-judgmental just to kind of be there as a listening
ear, create a safe space for them, make them feel okay and
comfortable coming to you and talking to you if they need
support avoid problem-solving. I think.
Most people, I mean like can you even solve suicidal ideation?
Like, that's something that is really difficult to solve.
I suppose you could be like, well, like What does your life
look like? Now, what do you want your life
to look like? Let's make a 12-step plan to get
you there. Like, if I was suicidal, that
would be hugely on helpful to me because you're probably so
emotionally exhausted and overwhelmed.
You just want someone to validate and support you and to
feel seen and feel loved and supported.
So don't problem-solve, just be there for them, love them,
support them. Tell them that you would miss
him if they weren't here and you really value them as a person.
And again if you feel out of your wheelhouse, if you feel
like you need help ask a professional.
So call 988, talk to your Pediatrician, talk to a
therapist, talk to a school, counselor.
All of these people can give more information on how to
navigate this. The next question is, why was
Thirteen Reasons Why? So problematic so, Thirteen
Reasons. Why is a show?
I have a lot of beef with. I've never watched it, but a
study done in April 2017 by the National Institute of Mental
Health showed that there was a 28 point nine percent increase
in suicide rates among youth aged 10 to 17 in the month,
following the show's release. I don't even know how to follow
that. Like any show that leads to a
30% increase in adolescent suicides.
There's a huge red flag there and there's something's not,
right? And the way that we are
portraying suicide on the media. If there's a 30% increase that
just feel so, not right. And so not, okay to me, and it's
so saddening and the National Institute of Mental Health.
Again, they say that it, it highlights a necessity of using
best practices. When / trying suicide and
popular entertainment and again, Cross-media.
It's just so so saddening and and so concerning and yeah, I
don't even know what to say. I'm at a loss for words because
it's just everything that causes that much of an increase in teen
suicide is hugely problematic. Personally, like I said, I never
watched a show, that's a boundary I've set for myself
because around the time that came out in 2017, I was
suicidal, I was going through treatment and then I was just
newly, not suicidal. So engaging with content that
was wrapped that graphic and potentially triggering with
something that I've had a feeling would not be good for my
mental health. So if you are someone listening,
and you haven't watched it or you're like, oh, like I don't
know if that would be good for me to watch it.
Maybe that maybe set that boundary.
Think about it. But, yeah, that's, that's the
data there. If you're not familiar with
that, it's heartbreaking, it's terrible.
And it's again shows why it's so important to be intentional with
how we talk about suicide. And I hope that I've done that
well or somewhat effectively in this episode, two questions,
left one is what was the number one skill that helped?
You overcome suicidality, I touched on a couple riding the
wave of urges with huge distraction really gets you
through those moments. But asking for help and having
it people in my corner that were continuously, helping me move in
the right direction in therapy and treatment, and building my
skills, usage, and continuing to use that muscle of coping and
and working towards my life worth living was huge.
But I mean, consistency with those things was really what
made a difference. The last question is how can
universities who have a suicide in their Community best respond?
What programs should they fund? What support should they Etc to
do their best to prevent future repeat incidents.
This is a difficult because the data does show that when there
is a teen suicide there can be repeat suicides or can be
triggering two other teens and talking about it and bring a lot
of attention to it and glamorizing.
It can have negative impacts. I think, at a minimum having
extensive skills, education, and resources, be very transparent.
So emails, going out saying, if you are struggling With grief or
you are struggling with suicidal ideation or if you are
struggling with my stress this week because are the skills you
can use use the people. You can call these are the
resources currently available. I think getting really curious
following such a tragedy on what causes person to feel so
overwhelmed and alone. And like this was the only
option was it relationships? Was it?
The amount of stress they were experiencing, was it unrelated
to school, and like, whatever it is getting curious and then
trying to solve in the future is Does that mean changing the way
that teachers schedule exams and tests to decrease a workload to
not cause that much overwhelmed does it mean providing more
resources? So people feel that there is an
option or something that they can go to when they feel that
way. Yeah, I it's hard and there's
not an easy answer and I had a conversation about this.
In one of the mental health clubs that pain last week and
the students that had gone to the events, Put on by pain
following student, suicides weren't seen as very effective
and very helpful and so it's hard, even if the best of
intentions are there, it's not always received.
Well, it's not always doesn't always land and so it's very
difficult but I think skills education and resources and
transparency of how you can get help if you need it is huge.
And then looking at how you can change the culture of the
University, if there were specific factors that led to
that are some good To take and getting curious talking to
students talking to friends of that student.
Talking to peers family members, and trying to not have any other
students. And that position, the future is
a good place to start. So that was a lot, a very heavy
episode, but I hope it was helpful.
And I hope that you can come away with this with some really
tangible ways. You can support someone or you
yourself cope with these emotions and urges if they arise
Hopefully they never do again. The best-case scenario is that
you never have to apply anything in this episode that you just
listen to or that you are never familiar with any of this.
That would be amazing. And we live in a world where
many people, struggle and many people in our lives, struggle.
And I would rather us be prepared and feel capable to
support them. Then to be at a loss of like, I
don't even know how to help this person and I'm just so
overwhelmed. So I hope this was helpful.
As always, if you found this episode to be supportive and
informational and helpful share with a friend or a family
member. If you have any questions or any
thoughts after this episode. Be sure to DM me.
I would love to hear how it resonated or if there's
something you wish was set differently.
Or if there was something that wasn't effective, that it's
really helpful feedback for me. And yeah, April include a ton of
resources in the show notes about hotlines and suicide.
Prevention, educational resources and awareness and
companies that are doing amazing, things to help
individuals that are struggling with suicidal ideation.
And so, yeah, that that's it. Thank you for listening.
I'll see you next week for an amazing part, two of the series,
with the DIA where we talk about what happens when you call a
hotline. What, to expect some resources
that she recommends, what she tells people, when they call a
hotline system skills that you can implement That they would
recommend and just generally within the suicide prevention
industry. What is happening where she
hopes that? Where she sees that going?
How we as a society can improve the suicide prevention work.
Thank you for listening or watching.
I really appreciate all you guys and yeah I'll see you next week.
Thank you so much for listening to this week's episode of she
persisted. If you enjoyed make sure to
share with a friend or family member it Helps out the podcast
and if you haven't already leave a review on Apple podcasts or
Spotify, you can also make sure to follow along at at she
persisted podcast on both Instagram and Tick-Tock and
check out all the bonus resources content and
information on my website. She persisted podcast.com,
thanks for supporting, keep persisting and I'll see you next
week.