depression – Page 3 – Licensed Mental Health Counselor

Embracing Your Inner Power

16 Feb 201615 Feb 2016by Torey C. Richards, LMHCLeave a Comment

istock dollar inner child Sometimes you just have one of those days where it seems like the sun isn’t shining on you. In that darkness it’s easy to beat yourself up over the past and become anxious and negative about the future.

I’ve been there. It used to happen to me a lot actually and sometimes it still does. In the past, I dealt with those days the only ways I knew how which were becoming cling, needy, depressed and anxious. All maladaptive coping mechanisms I had picked up sometime during my life.

In return, I found myself trying to control other people and situations. Wanting people to do what I wanted them to do, think what I wanted them to think and feel the way I wanted them to feel. This rarely worked out in my favor. Usually the people I was trying to control either pulled away or responded negatively which in the end only made me feel worse.

Even when I did get what I thought I wanted, I usually still felt empty and overtime I realize the reason I still felt empty was because the real issue was within me and I couldn’t fix that with people or things.

I realized overtime and from doing therapy clients who suffering from anxiety, depression, and anger issues, that people and things do not stop our pain or move us to a better place. Only we can do that for ourselves.

We are the only ones who have the inner-power to end our suffering and angst. Sure sometimes we need the help of our support systems and/or our spiritual beliefs, but all change truly begins within us. That is when we truly heal and move beyond that pain and darkness.

Once we dig into and heal ourselves, peace, love and trust will return to use easier and quicker than we thought. Trust me. I’ve been there time and time again and it never fails. Our past neurotic attempt to bring back balance and peace to our universe happens much more naturally when it comes from within.

We have to deal with our feelings and accept them as ours. We have to stop our need to control. Peace, love and happiness will return. Remember, a bad day is just a bad day and we don’t have to make it last any longer than absolutely necessary.

I’m not saying it’s easy to stop the pain and anxiety when it comes rushing in. Sometimes even for myself today it takes a moment for me to recognize it, stop from going to my default maladaptive coping mechanisms, and reach inside my own inner-power, but I am better at it today than I was yesterday and will be better at it tomorrow than I am today. That’s all I ask of myself and all I ask of you.

We are much more powerful than we believe we are! We can control not only our thoughts and feeling, but our destinies! We have to learn to harness and embrace our inner power.

It doesn’t matter if you have anger issues, depression, low-self-esteem, whatever it is. The faster you realize you have all the control and no need to try to control other people or situations, the faster you will have the strength to overcome any obstacle that’s in your way, even if that obstacle is yourself.

Popular Psychology

Micropsychosis: Temporarily Losing Your Mind

17 Jan 2016by Torey C. Richards, LMHC1 Comment

loses their minds

Have you ever heard someone say that they “lost their mind”? Perhaps you’ve even witnessed a seemingly normal person “lose it”, such as the JetBlue pilot in 2012 that had to be subdued by passengers because of sudden, erratic behavior during a flight, or when a flight attendant on an American Airlines flight began speaking erratically over the intercom.

There are multiple medical conditions that can trigger psychotic like episodes such as brain tumors, thyroid conditions, fever, infection and substance abuse. There are also multiple psychiatric conditions that can cause a person to have brief psychosis such as bipolar disorder and major depression.

However, there are times when relatively healthy people can for an incredibly short amount of time, lose touch with reality, becoming paranoid, hearing voices, having a sense of depersonalization (a state in which one’s thoughts and feelings seem unreal or not to belong to oneself, or in which one loses all sense of identity) or derealization (a feeling that one’s surroundings are not real).

This condition is called micropsychosis and generally last only a few minutes to a few hours and typically occurs during times of heightened anxiety and/or stress. Afterwards, the person goes back to him or her normal self and may never have an episode again. It’s not to be confused with a brief psychotic episode which by definition last longer, typically one day to a month and is not re-occurring.

Micropsychotic episodes are what I think often happens when someone goes into a rage and is seemingly out of control. Afterwards, many of them can’t remember what happened, or feel as if they were watching themselves do things as if it were a movie.

Whenever someone who has never had a psychotic episode suddenly has one, it usually takes them and everyone by surprise, but in retrospect, there is usually some early symptoms that may have gone unnoticed or ignored. Often times it’s the way someone is dealing (or not dealing) with stress.

While having a micropsychotic episode may actually be quite a normal psychological response under some extreme stressful conditions, there is probably some underlying condition that needs to be investigated, even if it’s just talk therapy to help deal with stress or a visit to a medical doctor to rule out a medical condition.

Below is a video of a character with Borderline Personality Disorder and her Micropsychotic hallucination. A funny title for this video would be, “How To Make Your Hallucinations Disappear”.

Popular Psychology

We All Need To Practice Emotional First Aid

14 Jul 201514 Jul 2015by Torey C. Richards, LMHCLeave a Comment

As a mental health professional, I have found myself spending a lot of time trying to convince people that they need to take care of themselves mentally and emotionally. Meaning, I run into people who are working two jobs, taking care of their family and everyone else around them, but are letting themselves go mentally and are getting sicker and sicker over time.

Or, I meet someone who is obviously not dealing with various issues in their lives, probably hoping that ignoring them will make them go away, but all the while they are growing emotionally unhealthy.

It reminds me of when a parent would bring a child in to see me for therapy and it would become apparent pretty quickly that it’s the parent that needs therapy, not the the child. Many times the parent would like at me as if I was crazy. They couldn’t see that their own neurotic behavior, substance abuse or even past childhood issues are creating the “problem” they are prescribing to their child.

It’s easy to tell when someone is physically not doing well, but it’s not always easy to tell when someone isn’t mentally doing well, especially when it comes to everyday things like anxiety, depression and self-esteem. Things we all deal with from time to time.

I have a sister who at one point was working a very demanding job, raising a challenging teenager on her own, volunteering her sparse free time to multiple organizations and if that wasn’t enough, she was trying to help every friend that called and needed something from her.

On the outside she looked ambitious, energetic, like a true type A-personality. On the inside she was feeling overwhelmed, flustered and fragile.

One night, while having dinner with our family which should have been relaxing, seemingly out of the blue she had what some would call a nervous breakdown. She started crying, hyperventilating and felt as though she was going to lose control of her mind. I could look at her and tell she was having a classic panic attack, but she was too far gone to hear me and was convinced she needed medical attention.

Soon afterwards she was diagnosed with an anxiety disorder and was told to cut back on the million and one things she did in her day to day life to take care of other people and to start taking care of her own mental health, something many of us don’t do enough of.

Sometimes I even catch myself too caught up in work, life and everything else and before I realize it I am dealing with some type of anxiety, insecurity or dysthmia. I have to slow down, stop myself and figure out a) where is it coming from and b) how do I take care of it. Often times for me the solution is simple awareness and acknowledgement that something is bothering me. Other times it takes journaling, reading something inspirational or processing my feelings with someone I trust. I’m usually that person for everyone, but sometimes I need someone to be that person for me.

It doesn’t always have to be something major and it doesn’t always take a therapist, but sometimes it does. Sometimes it’s simple mindfulness, meditation, or getting out and having some fun, but many of us have no real idea of what it means to administer emotional first aid to ourselves which is why I included this Ted Talk by Guy Winch: Why We All Need To Practice Emotional First Aid

Popular Psychology

123 Mentally Ill People Killed By Police So Far This Year

2 Jul 20152 Jul 2015by Torey C. Richards, LMHC3 Comments

In the first six months of the year, nationwide police have shot and killed 462 people. Out of those 462 people, 123 of them were in the midst of a mental or emotional crisis according to a Washington post analysis.

To be fair, most of these individuals were armed, but mostly with weapons less lethal than a firearm such as toy guns, knives or a machete. Only 3 officers have been killed by a knife or machete in the past decade according to the FBI.

Below I have included a video of a mentally ill man shot and killed by police only seconds after they arrive on the scene. The mans mother called because her mentally ill son was acting erratic. He was armed with a screw driver. You can watch the video with caution and judge for yourself.

The police who responded weren’t usually called to respond to a crime, but were called by concerned family members, bystanders and neighbors because a person was acting erratically. 50 of them were outright threatening suicide.

In more than half of those killings, the officers who responded did not have adequate training in dealing with persons with a mental illness. Most of them actually responded with tactics that escalated the already volatile situation.

Yelling and pointing guns at a person with a mental illness is like pouring gasoline on a fire. A person in the middle of a mental crisis is not going to respond like someone else would, they have too much going on in their heads.

Almost a dozen of these individuals killed by the police were military veterans, many who suffered from post-traumatic stress disorder (PTSD). One was even a former California Highway patrolman who was forced into retirement after a severe beating during a traffic stop lift him suffering from depression and PTSD.

Forty five of these cases involved someone who was seeking medical treatment or had been turned away from medical treatment.

John Guillory, a 32 year old father of two had worked as a contractor in Afghanistan. He was having what his wife called a mental health emergency. He went to the Veterans Affairs hospital in Arizona, but was turned away because they were too busy. He went home and called 911 twice, hanging up both times. When the police showed up to his house he pulled a gun out of his waistband saying, “I bet I can outdraw you”. The police shot him six times killing him.

Suicide by cop is real thing and accounts for a number of these killings.

One individual in San Francisco who pulled a BB gun out on a group of officers and was shot and killed, had left a message on his phone telling the officers “You did nothing wrong. You ended the life of a man who was too much of a coward to do it himself.”

On average, police have killed someone who was mentally ill every 36 hours so far this year. Police are starting to acknowledge the lack of effective tools and trainings they have in dealing with this population. Without large-scale retraining and a nationwide increase in mental health services, these deadly encounters will continue.

While officers on average spend 60 hours in firearm training, they only spend 8 hours on learning to de-escalate a tense situation and 8 hours on handling mentally ill individuals. Otherwise they use tactics that are counterproductive and increase the risk of violence when they encounter these individuals. Most of these individuals end up dead within minutes of encountering the police.

Some of these killings probably couldn’t have been avoided. In some of the situations the individuals had guns pointed at the police. However, a large number of these individuals could still be alive if the officers had proper crisis intervention training.

Popular Psychology

Drawing From Emotional Pain: One Artist’s Struggle With Mental Illness

1 Jun 20151 Jun 2015by Torey C. Richards, LMHC2 Comments

In psychology there has long thought to be a link between mental illness and creativity. While disorders like depression tend to affect many people, creative types such as writers, musicians, inventors and dancers seem to get hit twice as hard.

I will follow this post with a discussion on mental illness and creativity later, but today I would like to share something special.

One of my favorite artists, Destiny Blue recently shared with her fans her struggle with anxiety and depression. Her story was touching and powerful. The fact that she shared it on her birthday, May 22nd made it even more special as she was giving such a great gift to so many other people. She wanted her story shared and with her permission, I am thankful that she is allowing me to share it here in hopes that it will help others who think they are suffering alone or are ashamed of their illness. We both hope it will inspire others to reach out and seek help.

Destiny Blue

Hi I’m Blue, and I struggle with mental illness.

Some of you will dismiss me, some of you will be scared of me, some of you will blame me, but a surprising amount of you will understand me, because 1 in 4 people experience mental health issues. Considering so many people experience it, we hear so little about it; it’s the family secret you can’t tell anyone, the fake smile so know one knows, the calling in sick but blaming food poisoning. It’s hard for me to write about, but I write this hoping it makes it easier for the next person to speak about it.

I am going to tell you my story, of my path with mental illness. I don’t know if it has a happy ending yet…

It began with a tough situation at home, which triggered the anxiety. It’s hard to explain the exact feeling. It’s kind of like where you’re leaning back on your chair, and go that bit too far and you just about to fall back. That sudden jolt of panic inside your chest, that half second spike that makes you fling your hands forward and grab the desk infront of you to steady yourself. That ‘oh shit’ moment. It’s that. Only it didn’t last for half a second, for even a minute, it lasted years. I thought I’d just have to live with it until the situations improved, but even when it did anxiety still clung to me like a scarf of live electricity. That feeling could come when I was alone in a room, sitting comfortably, with nothing to do and a clear day ahead. The world would spin and tumble, and I’d want to put my hands out to grab the desk and steady myself, but there was nothing there. Nothing to grab onto. Over and over.

And so, through anxiety’s hot trickery depressions cold crept in, it sat at the back of my mind and laughed at me. “Why are you even trying? It’s useless anyway” and when you’re fighting a non-existent force from a chair you’re not even really sitting on it’s hard to argue with that. And this feeling spread.

It wasn’t that I couldn’t feel happy, and it wasn’t total sadness per-se, I did feel sad, but the harshness of depression is that it makes the process of living excruciating. It’s like walking through thick treacle, every movement pushed against and held back by sticky tar. Suffocating and exhausting. Even when there’s no energy left you still have to walk. This same tar is in your brain, slowing your thoughts, numbing your feelings, even when there’s no energy left, you can never stop thinking. Then everything feels overwhelming. Even the small things, one task in particular for me, washing my clothes, was a mountain, even to think about it required so much energy, I could wash my clothes, but then I’d have to pick up the dirty clothes, taken them to the washer, open the washer, put the clothes in the washer, close the door, open the detergent bottle, put the detergent in. It was just too much. So the clothes sat there. And you know it’s absurd, everyone else can do it no trouble, so, I thought, maybe I’m just lazy, I should push on, I’m a strong person, so I pushed. Now you can push yourself do enough to look like your functioning normally, but it doesn’t get rid of the tar, the sticky molasses in your veins, on the outside I was normal enough, inside I was decaying. My mind was ablaze trying to grab a desk and my soul was swallowed in the bitter treacle. The worst thing, was that I never felt at peace, however still I sat, however beautiful the morning, however hard it was searched for, no peace arrived. It was torture, and my own mind was the torturer.

I didn’t -want- to kill myself, that’s messy, and probably involved going out of the house, a body, sad friends. I just wanted to be dead. My brain fantasized about it. That sweet release of deep restful unexistence, it seemed so much better than existing like this. If only, I thought, there weren’t people who loved me. It’s a sick twisted logic you don’t have control over; to you it all makes sense. I didn’t even know I was depressed, I thought what I was feeling was justified, life -was- meaningless, I -would- be better off dead. It had been a slow decline into darkness, the light wasn’t just switched off, I had no ‘oh shit it’s dark’ moment, I didn’t even realise I couldn’t see properly, my eyes had adjusted to the dark as the light faded, my mind replacing reality with it’s own twisted night vision, of strange shadows and dark half logic.

Yeah, I won’t go out today, no I don’t need to do my essay yet, it can wait, they probably don’t want to hang around with me anyway, It’s not worth it, I’m not worth it, I’m worthless.

So I hurt myself. Mostly to feel better, or to feel something, I’m not sure, but it proved a point. When I saw what I had done to my own skin, I had a thought: “This is what sick people do” The thought turned over a few times in my head and twisted into a lump in my throat “Am -I- sick?” That was the first time I really realised. Despite crippling depression, despite feeling suicidal, being unable to properly care for myself, I had barely thought I was ill, I’d just thought I was lazy, or sad, or worthless. But I looked at the blood, and the damage I’d done, and knew I needed help.

So I went to the doctor, and yes, I was sick, and the slow process began. Full of relapse and recovery. It’s not over, and it may never be for me, it’s more complicated than I can say here. But now I can recognise the signs and know what to look out for and I have learned how to manage my condition. I took a break at the start of this year, and didn’t do any conventions, just focused on getting better and giving myself a steady foundation to stand on for the rest of this year. At the moment I am doing well, and I appreciate the peace in my head so much more now I’ve known such darkness. But life is worth living, and I try and do it with vitatily.

Depression is so disgusting because it erodes the you-ness of you, the qualities you like in yourself are taken over, even the things you enjoy doing you have to do in the tar. It is not your fault, though it can feel like it is, and others may think it is. I hate that some people think it shows weakness. It shows no more weakness than walking up a mountain with a broken leg shows weakness. Your brain’s broken and you must get on -despite- that, doing the washing can be a huge victory, higher than climbing a mountain with a broken leg, and a lot more sensible. People congratulate me for creating a piece of art, or running my own business. No one congratulated me when I did my washing. But really, in my darkest time, it was one of my greatest achievements. And, on some future day where I’m feeling bad, putting another load of washing on will be a big achievement again.

I juts wanted to let you guys know that you were a small light in the huge darkness. Thank you so much for all your comments and notes, I treasure each one of you. Thank you for always being there for me. It’s a wonderful feeling to know I can reach out and so many people would grab my hand to help. I know many of you are suffering with the same thing I did. Please reach out, and for those of you willing to, please offer a hand to someone when they reach out, they probably need it more than you know, they might even need it more than they know.

It’s my birthday, and if I have a birthday wish, it’s for this message to be shared.

Peace, love, and mental well-being,

Blue x

Popular Psychology

Andreas Lubitz; The Plane Crash And Mental Illness

31 Mar 201531 Mar 2015by Torey C. Richards, LMHCLeave a Comment

There’s been a lot of talk about the mental health of Andreas Lubitz, the co-pilot that crashed the Germanwings plane into the French Alps.

As more details come out, it appears obvious that he was suffering from some type of depression, psychosis and/or personality disorder. Without having examined him myself, I can only speculate by the information covered by the news outlets, but I do know that there are certain forms of mental illness that make a person more likely to not only kill themselves, but to take the lives of other people with them.

Sometimes severe depression can include psychotic features that come and go. This is often missed when the person sees a clinician because the psychosis may not be present during the examination, only the depression, therefore the person is treated only for depression.

If a person has psychotic depression combined with grandiosity, egocentricity and lack of morals/conscience, that can lead to a person who almost has a god like complex where they believe that not only is their lives in their own hands, but so are the lives of other people. Thank goodness that this type of condition coupled with violence is rare.

Usually people who are depressed and/or have suicidal tendencies are only focused on harming themselves. They would never take the lives of another person, much less that of a stranger. Depressed people and people who suffer from a mental illness in general are not dangerous, it’s only when these mental illnesses are combined with other conditions such as psychosis and/or a personality disorder that they can become disastrous.

For example, as we stated above, some forms of depression can have short episodes of psychosis . Conditions such as bipolar disorder sometimes may also include psychotic features, where the person may be depressed and hallucinating or manic, grandiose and delusional. The contents of the psychosis may or may not be aggressive.

Because people with bipolar disorder often only go see a doctor when they are deeply depressed, they are often misdiagnosed with depression and given antidepressants which can then send that person into a manic episode. I’m not saying that is what happened to this pilot, but his girlfriend reported that he made statements such as “One day I will do something that will change the whole system, and then all will know my name and remember it.” This is a very grandiose statement.

There’s even some reports that his vision problems he was so afraid would cost him his career may have been psychosomatic, meaning that they weren’t organic kn nature but psychological. His mental illness could have been causing him to believe he was losing his vision.

On top of that, perhaps the thoughts he shared with his girlfriend only alluded to even more grandiose and obsessive thoughts. Some people with mental disorders suffer from painful, oppressive, relentless, intrusive thoughts that may be scary and constant.

For example, a person with Obessive-Compulsive Disorder may know that they turned off the oven before they left the house because they checked 10 times, yet they can’t get the thought out of their head that they may have left it on and it will burn down their house so they recheck it again and again causing them to be late for work every day. Or the husband who has the obsessive thought that his wife is cheating, although he knows she’s not, yet he can’t get the thoughts out of his head so he is constantly accusing her, checking her phone, going through her things and driving her crazy.

Also, in some personality disorders and psychosis, there can be very grandiose ideas where the person thinks they are better than everyone else and that no ones life really matters. This could have played a role in the airplane crash and would help explain the selfishness and egocentricity of killing oneself with no regard for the lives of the other 150 people and their families.

For the most part, people with mental illnesses can maintain very successful lives and careers, such as being an airplane pilot, but only if they are diagnosed and treated properly. Often people with mental illness are misdiagnosed or don’t ever get treated because they don’t believe they need help or because of stigma.

People who suffer from bipolar disorder often like the high of the mania therefore they don’t get treated or take their medication accordingly. People suffering from psychosis often don’t realize that they are psychotic and therefore decline treatment.

I once spent several weeks trying to convince a successful business man suffering from bipolar disorder that he was not only bipolar, but needed medication to help control himself. At the time he was manic, had been arrested 3 times in 2 months for various reckless behaviors and was on the brink of losing everything. It was only after he had a long time to think in solitary confinement did he start to have some insight and agreed to treatment.

This pilot, suffering from real or psychosomatic vision problems he believed would end his career, seized the opportunity to not only end his suffering, but to live out his grandiose fantasy of going down in history, once he was alone in the cockpit. In his right mind this pilot wouldn’t have did what he did, but his mental illness made him impulsive and in that moment he did something that could never be undone.

Often times suicide is an impulsive act. A person may have the thought, but without adequate means they won’t harm themselves. However, if the impulse is strong enough and a weapon of destruction is within reach, the urge to kill themselves may win out over any desire to live.

Once again, at this point it is pure speculation as to what was actually going on inside of Andreas Lubitz mind at the time he made that fatal decision. However, this gives us a great opportunity to have an open discussion about mental illness no matter if it’s our own or others.

Being A Psychotherapist: Things School and Books Can’t Really Prepare You For Part Two: Suicidal Clients

3 Feb 2015by Torey C. Richards, LMHC2 Comments

Another thing school and books can’t really prepare you for are suicidal clients. Sure they cover the subject of suicide in graduate school, but the training of dealing with suicidal patients is usually very brief. There are many great books on working with suicidal clients and I have read a few, but I don’t think anything can really prepare you for sitting face to face with and working with a suicidal patient.

From my experiences, there are many types of suicidal clients and they all have to be taken seriously.

There’s the client who doesn’t really want to commit suicide, but they like to self-injure and that self-injurious behavior may lead to an accidental suicide. These are often the most common types of clients, often called “cutters” and they tend to be the most frustrating since a lot of them have cluster b type personality disorders such as borderline personality disorder.

When I worked in a high school I had a whole group full of students who self-injured and ended up involuntarily hospitalizing at least one every month because while they said they weren’t suicidal, they were definitely at times flirting with death.

This picture was taken of one of my former students who likes to cut. The next day she had twice as many cuts on her arm and I was forced to involuntarily hospitalize her.

There’s also the suicidal client who is extremely depressed or emotionally unstable and talks about death and suicide a lot. They typically don’t self-injure and have never tried to commit suicide and don’t think they ever would, but they talk about it so often and their emotional pain is so deep that when they leave your office you often wonder if this will be the last time you ever see them.

These type of clients can also be very stressful to deal with. Often when I have had clients like this I found myself worrying about them when I wasn’t even at work, when I was on vacation, when they didn’t show up for an appointment and sometimes I even dreamt about them.

One patient in particular was diagnosed with a terminal disease and she didn’t want to die a slow death. She didn’t think she would kill herself, but all she talked about was death and dying and her depression was so deep that it was hard to not be concerned about her when she missed an appointment. Eventually I had to hospitalize her after one particularly draining and emotional session when she couldn’t promise me she wasn’t going to go home and try to kill herself. Everything inside of me was screaming she would. She was angry that I hospitalized her against her will, but told me in later sessions that she had every intent of going home and killing herself that day and thanked me.

Another type of suicidal client is the one who never talks about suicide. Some are impulsive, but many just keep their thoughts and feelings buried deep inside. They may never even tell anyone that they are in pain. They just attempt or commit suicide without any real warning signs. These clients take not only you by surprise, but everyone else in their lives too.

I once worked with a student for two years dealing with the grief of a parent and then one day he gave me a card thanking me for helping him. It was our last session, he was doing great. Less than a week later I got a call from his family telling me he had attempted suicide and was in critical condition at a local hospital. I was stunned. I rushed to the hospital and nearly broke down in tears as I looked down at his lifeless body. I kept replaying our last sessions together, our last interactions, his last words to me, trying to figure out what did I miss. Thank goodness he came out of his comatose state after a few days and I was grateful that he not only lived, but that I had the opportunity to process his suicide attempt with him. I didn’t miss anything. He had suddenly decided he didn’t want to live any more and wanted to be with his deceased parent.

A couple of years before that I had been part of a crisis team that was sent to two different schools after two students had killed themselves apparently out of the blue. One was a popular jock that killed himself and stunned the whole community because no one, not even his closes friends knew that he was in so much emotional and psychological pain. His friends, family and even school staff members were blaming themselves for not seeing signs that weren’t even there.

The other student apparently killed himself on impulse in the midst of an angry dispute with his girlfriend. He told her he was going to hang himself. She didn’t believe him, but that’s exactly what he did. He had no history of being suicidal and no one saw it coming.

In my nearly 8 year career as a psychotherapist I’ve dealt with hundreds of suicidal clients. My main job right now is interacting with inmates who have been flagged as suicidal. Luckily I have not had one client commit suicide although I have had a few who have made serious suicide attempts landing them in the emergency room.

Studies suggest that:

1 in 4 interns/trainees will have a patient who attempts suicide at some point during their training and 1 in 9 will experience a completed patient’s suicide.
25% of psychologists and 50% of psychiatrists will experience a patient’s suicide.
1 in 6 psychiatric patients who die by suicide die in active treatment with a healthcare provider.
Approximately 50% of those who die by suicide in America will have seen a mental health provider at some time in their life.
Work with suicidal patients is considered the most stressful of all clinical endeavors. One third of psychotherapists who experienced a patient’s suicide subsequently suffer from severe emotional distress. Several factors may contribute to such severe distress including failure to hospitalize a suicidal patient who then died; a treatment decision that the therapist may feel contributed to the suicide; negative reactions from the therapist’s institution; and the fear of a lawsuit by the patient’s relatives.
25 % of family members of suicidal patients take legal actions against the patient’s mental health treatment team.

As a coincidence, just as I was finishing this post I was informed that an inmate just purposely swallowed 18 Ativan pills in an attempted suicide and is being rushed to the hospital.

Popular Psychology

Family Shares UPenn Student’s Suicide Note

23 Jan 2015by Torey C. Richards, LMHCLeave a Comment

Suicide affects thousands of families each year. Last year, many people were shocked to hear about Madison Holleran’s suicide. She was a beautiful, intelligent college freshman, but like many college students, she was having difficulty adjusting. Her suicide took her family by surprise and if you read her suicide note, it appeared to have taken her somewhat by surprise as well.

I’ve read a number of books on suicide and have unfortunately read a number of suicide notes during my career as a psychotherapist.

Reading suicide notes, especially from people who have completed suicides, can help us understand what that person was going through at that time and may be able to help us prevent other suicides.

Many times families and friends have no real ideal of the internal struggles and emotional pain that suicidal people are dealing with.

Madisons’ family recently released her suicide note to the public. If you’d like to read it, it gives a brief but heart wrenching account inside of Madisons’ mental and emotional state.

Family Shares UPenn Student’s Suicide Note – FOX 29 News Philadelphia | WTXF-TV.

The Perplexed Minds of Teenagers

Signs Your Teen May Need To See A Counselor

15 Sep 2014by Torey C. Richards, LMHC6 Comments

Very often I have parents ask me if I think their teen needs counseling. They will tell me about different behaviors they have observed and pretty much ask me if it is “normal”.

The advice I normally give is, if you think your teen needs counseling, they probably do. I have seen more instances of teens not receiving mental health help or receiving it once the issue has gotten out of hand, then I have of parents bringing their teens in for counseling when they are perfectly “normal”.

Don’t get me wrong, I have seen parents who have brought their teens in for counseling only for me to soon realize that it was the parent that actually needed help, and not their teen.

In any case, it never hurts to schedule a session for your teen if you think they may need help. A trained mental health professional will be able to tell you in a couple of sessions or so if your teen needs further help or if the issue extends further into the family system.

Some signs that your teenager may need counseling

Mood swings– Yes we all know that teenagers have mood swings. It is definitely part of that developmental age, but as a parent, you should have a general baseline of your teens mood swings. If their mood swings seem extreme or are way outside of your teens normal mood swings (too depressed, too elated, too labile, etc.) trust your gut, it may be worth looking into with a trained professional.
Self-medicating– Some teens will try to hide or control their issues, especially when they don’t understand why they think or feel a certain way. Many will turn to drugs, alcohol, sex, self-mutilation, or eating disorders just to name a few, in an effort to make themselves feel better. If you notice your teen involved in any of these things it’s almost a guarantee that they are trying to mask something else, that could be anything from low self-esteem to sexual abuse and it’s worth investigating.
Changes in friends– many times when a teen is suffering from a mental illness it will impact their ability to maintain healthy friendships. They may push friends away or become too clingy. You may see some of your teens friends start wanting to avoid them or your teens choices of friends may drastically change.
Changes in school performance– is another sign that your teen may be suffering from some form of mental illness. It’s generally hard to concentrate and focus when one is in a poor mental state and this can affect a teens grades and/or conduct.
Physical symptoms– if your teen suddenly starts to care less about their appearance, stops taking showers, gains or loses a lot of weight or starts complaining of psychosomatic symptoms like backaches, headaches or stomach aches, these are all possible signs that your teen is dealing with something they can’t handle alone.
Behavior changes– behavior like mood can change a lot during the teenage years, but for the most part, if you teens starts presenting as a totally different person to you then it may indicate either a mental illness or substance abuse issue.

Being a teenager is hard and most teens will try their best to hide their problems from their parents, which is why it is imperative that parents are attune with their teenagers. Today it’s even easier for teens to hide how they really feel through social media so parents have to be vigilant to monitor their social media pages as well in order to gain insight into what is really going on with their teen.

With the appropriate help, all mental and emotional issues can be treated and managed so if you have to ask the question, “Is this normal”, chances are you should contact a qualified mental health professional for a further evaluation.

Popular Psychology

Robin Williams: Depression, Bipolar Disorder, Substance abuse And Suicide

12 Aug 2014by Torey C. Richards, LMHCLeave a Comment

It’s hard for many people to understand how someone can be “successful”, and “wealthy” and still be miserable and end up committing suicide, but mental illness and substance abuse doesn’t care about socio-economic status.

There are countless examples of wealthy and famous celebrities who have taken their lives in the face of mental illness and/or addiction.

Still, many are shocked that someone so funny and loved as Robin Williams, age 63, who’s been battling bipolar disorder, severe depression, drug abuse and alcoholism for a large part of his life, would end up taking his own life.

For anyone who has ever felt the pain of severe depression knows that once it has a grip on them, it’s almost like being covered in darkness where they can’t see past their failures, no matter how successful they are.

The only thing that they see, hear and think about are their missed opportunities, mistakes and what seems like the bleakness of the future. It doesn’t matter if they are happily married, have accomplished many goals, all they see are their failures. They forget all of their successes and things they should be proud of and just become consumed with feelings of worthlessness, shame and guilt.

When in a deep depression, suicidal thoughts may creep in and become overwhelming to the point where the person feels like they are a burden to the world, especially those close to them. They feel like their spouses, children and friends would be better off without them. Their view of reality becomes severely distorted.

In Robin Williams case, he was married, had children, had a long successful career, was loved by millions, yet he battled addiction, bipolar disorder and depression. At some point in the midst of his depression, the thoughts of being worthless and a burden became overwhelming.

It also speaks to the point that depression and suicide doesn’t go away at a certain point of wealthiness or happiness. It’s a disease.

Robin Williams is no different than anyone else who suffers from a severe mental illness. About 90% of people who commit suicide have an undiagnosed, untreated or undertreated mental illness.

Robin Williams was also in the demographic of those highly at risk of suicide which are white, middle aged men with health problems. Robin Williams had been suffering from a heart condition and it’s possible that the thought of losing control of his life, his quality of life or losing his life in general to a physical illness, increased his risk of suicide.

More than 38,000 Americans commit suicide each year and while depression can last a life time, suicidal thoughts are usually temporary and the act of suicide itself is often impulsive. If we can deter someone from committing suicide they usually will move on from the desire to kill themselves even though the depression continues.

According to the American Association of Suicidology:

39,518 people died by suicide in the U.S. (2011)
108.3 per day
1 person every 13.3 minutes
3.6 male deaths for each female death by suicide

Comparison to other highly publicized causes of death per year:

Homicide 16,238
Prostate Cancer 32,050
Motor Vehicle Accidents 35,303
Suicide 39,518
Breast Cancer 39,520

By age:

Middle age (45-64 years): 18.6 per 100,000,
Elderly: 15.3 per 100,000

*Teens (15-24) is 11 per 100,000*

*The rate for middle aged has been increasing and surpassed the rate for elderly a few years ago*

If you are anyone you know is suffering from suicidal thoughts, the national suicide prevention lifeline can be reached at 1-800-273-8255 or http://www.suicidepreventionlifeline.org