123 Mentally Ill People Killed By Police So Far This Year

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. c07_jd_02jul_shootinggraphic-640x230

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.

Andreas Lubitz; The Plane Crash And Mental Illness

Andreas Lubitz; The Plane Crash And Mental Illness

Andreas-Lubitz-Germanwings-PilotThere’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

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.
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.

Family Shares UPenn Student’s Suicide Note

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.

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

robin-williams7878It’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

Anti-Depressants May Increase Suicide Risk In Children, Teenagers and Young Adults

Sucide-depression-pillsIt’s been known for a long time that when people with depression are treated with antidepressants, their risks of committing suicide can actually increase, at least initially.

It’s thought that one of the causes of this is because highly suicidal people are often so depressed that they don’t have the energy to go through with attempting suicide. However, when they start taking antidepressants, sometimes they will start to feel more energy before they actually start to feel less depressed, therefore they now have both the thought to commit suicide and the energy to do it.

Recently, a study published in JAMA Internal Medicine explored the effects of antidepressants on children and young adults and found that they too have an increased risk of suicide when they first start on antidepressants, perhaps even more so than older people, especially when given selective serotonin reuptake inhibitors (SSRIs).

SSRI antidepressants can increase suicidal thinking and behavior in children, teenagers and young adults which is why the Food and Drug Administration issued a warning about the risk in 2004 after various independent studies showed a higher rate of suicides and suicide attempts among children and teenagers taking SSRI antidepressants .

The risk of suicide was most severe for those young people who started taking antidepressants at higher than average doses. They were twice as likely to attempt suicide when compared to those taking an average dose.

Than why are SSRI antidepressants being used? It’s because many think the benefits of them far outweigh the risk since the medication eventually lessens the risk of anxiety, depression and suicidal thoughts and behaviors. In most cases, SSRI antidepressants work really well and can be life savers, but there are risks that every parent should know about including the risk of increased suicidal thoughts.

People under 25 who were started on a higher than recommended dose of SSRI antidepressants were twice as likely to attempt suicide, especially in the first three months of starting them.

You may be asking, why then do doctors prescribe a higher dose than necessary?

In the study, almost 20 percent of the people had been given an initial prescription for higher than recommended doses. Part of the reason why is often times doctors including psychiatrist, play a guessing game when prescribing medication. They often don’t know what doses will be effective for a person and often don’t follow guidelines. They start people off with a dose that may be too much or too little and count on them to come back and let them know if it’s working or if they are having too many side effects. Then they will decide if they should increase the dose, decrease it or change the medication all together.

I’ve worked in the mental health field long enough to know that psychiatry is often a guessing game and anyone who has been on psych medications before can attest to this. Many patients often tell me they feel like the psychiatrist is using them as a Guinea pig because they keep trying different medications and doses of medications out on them. In all fairness, usually psychiatrist do this to see what works best for the patient, but often time the patient is left feeling an experiment and may even stop seeking help.

I’ve included a great Ted Talk video on psychiatry that talks about the importance of looking at individual brains instead of playing guessing games when it comes to treating people. Not everyone who has depression or anxiety or any other mental illness should be treated in the same way with the same drugs or with the same therapy, but in psychiatry and the mental health field in general, that is often the case.

If you or your child is depressed and thinking about getting on an anti-depressant, make sure you talk to your doctor, read the black box warnings and ask the important questions so that you will be informed and also know what warning signs to look for. antidepressants have worked wonders for many, but for some they have also been tragically bad.

 

Tragic Romeo And Juliet: Teens Kill Officer Then Themselves

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Officer Robert German

In an article I wrote previously Are You In Tune With Your Teenager,  I discussed the importance of parents engaging their teenagers in conversation and actually listening to what they have to say. So many parents simply do not listen to their teens and in this one incident in particular, it proved to be deathly.

Last week, in Windermere, Florida, a very small town just outside of Orlando, 18-year-old Brandon Goode and 17-year-old Alexandria Hollinghurst, two troubled teens in love from Davenport, Florida, decided to run away together. They were both suicidal.

Alexandria seemed to have been suffering from depression while Brandon may have suffered from any number of mental issues (in 2012 his mother called the police reporting that her son had painted his face black and was threatening her with an axe).

Their relationship seemed to be as unstable as the typical teenage relationship, but much more so due to both of their emotional and mental health states. Alexandria’s family didn’t seem to like Brandon too much, and three days before they ran away together, Brandon wrote Alexandria a letter apologizing for the trouble he had caused her with her parents and thought it would be better if they broke it off so he wouldn’t continue to cause her pain.

In that letter which was partially made public, and previous letters, it was obvious that the two were in love and had an intense emotional relationship, even declaring themselves to be engaged. They had thoughts of running away to the west coast of Florida together and sailing a boat to Panama where they would get married and live happily every after. A teenage fantasy that they were determined to either make happy, or die trying.

Brandon Goode and Alexandria Hollinghurst
Brandon Goode and Alexandria Hollinghurst

On the day they ran away together, Brandon left a suicide note that said: “Please don’t be sad, this is what I want now, I get to die peacefully with the woman I love, the woman of my dreams, my fiance (Yes we were engaged!).”

Alexandria had written a suicide note a day earlier, stating to her mother: “If I  had stayed another minute I would have painted the walls and stained the carpets with my blood, so you could clean it up,” she wrote in another letter to her mother “you turned a conversation about depression and suicide  into something all about you.”

Her mom called the police who were there when Alexandria showed back up at her home. She denied being suicidal and the deputy left. The next day she ran away with Brandon. The two were immediately listed as “missing and endangered” and local and surrounding police officers went looking for them, even spotting them once before they drove off recklessly, only to later encounter Windermere police Officer Robert German as they walked along the side of the road.

Officer German immediately called for assistance, but it was too late. The teens shot and killed the officer before killing themselves.

Could the murder of this officer and the suicide of these two teens have been prevented? I’m almost sure it could have, but it may have taken some type of intervention a long time ago. However, I can’t help, but to wonder what if Alexandria’s mother would have really listened to her when she tried to talk to her about depression and suicide? Would she have been able to save her daughter, get her some help and maybe both her daughter and Officer German and maybe even Brandon would be alive today?

We will never really know, but I definitely think this reinforces the fact that parents really need to listen to their teens, make sure they understand what their teen is trying to say and DO NOT turn their conversation into a lecture or something about the parent. That’s not what your teen needs in that moment. They need you to listen, to be in tune with them and definitely to help support and guide them.

There is a lesson to be learned from every tragedy and I hope this one helps us learn to listen, communicate and pay attention to warning signs before it’s too late.

The True Toll Of War

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I’ve written before about the affects of war on our veterans. About how on average 22 veterans kill themselves everyday, many suffering from post traumatic stress disorder, traumatic brain injuries, physical injuries, substance abuse, depression and other mental stressors. However, what is rarely talked about is wars toll on the families of veterans.

Many military spouses, children, even siblings and parents end up suffering when their loved ones are deployed and sadly, many of them end up killing themselves as well. Exactly how many is unknown as that record is not yet being kept the way the number of veterans who commit suicide is, yet it is an issue that needs to be tackled.

Deployment after deployment can take its toll on any veteran and his or her family. The fear, trauma, uncertainty, pressure and strain can be too much for some of them to bear. Many are left feeling exhausted, isolated and desperate.

Multiple deployments can leave a family feeling despondent. Many families end up emotionally and financially shattered as they take care of injured veterans with physical and or emotional wounds that can take their toll over time. Some are so grief stricken over the loss of a loved one at war, that they themselves can’t stand to live.

I am not saying that stress, plus deployment equals suicide. Suicide is much more complicated than that. The combination of reasons a person commits suicide is different for each individual. There are many military families who deal with war, injury and death fairly well and show great resilience.

However, when it comes to suicide there are usually many underlying factors such as a wife who was already depressed and gets extremely depressed when her husband is deployed. Alone and depressed, she may be more tempted to take her own life.

Many family members get severely depressed when their loved one is deployed, but fail to seek mental health help out of fear that it will jeopardize the career of their loved one. After all, they are supposed to be the strong ones, supporting their family members at war. However, they too suffer.

Many who sought help felt like they did not get adequate treatment. Some confided in their doctors only to receive medication with no counseling or follow up care.

Take Faye Vick for example, a 36-year-old Army wife of a newborn and 2-year-old who killed herself and both kids by asphyxiation in her car while her husband was deployed.

Cassey Walton, a wife of an Iraq vet who killed himself outside his home in 2007, shot and killed herself just days later wearing her husbands fatigue jacket and dog tags.

Monique Lingenfelter, the wife of a sergeant, barricaded herself in her home and killed herself and her baby despite police trying for hours to persuade her to come out.

Sheena Griffin told her husband while he was away at Fort Hood preparing to be deployed to Afghanistan, that she wanted to kill herself and their 8 and 9-year-old sons. By the time he called police and they arrived to her house, the home was already engulfed in flames and Sheena and her two sons were both dead.

And then there is Jessica Harp who wrote a nearly 4,000 page suicide letter that went viral, detailing how her marriage had deteriorated after her husband served in the war.

According to Harp, her husband came back changed, drinking, impulsive and most likely suffering from PTSD. She said that if her husband had died she would have been surrounded with support, but because he wasn’t dead physically, but wounded mentally, there was little to no support and the weight and emotional strain was too much for her to bear.

Harp didn’t kill herself. Her letter was preprogrammed to be sent out, but she ended up in a local hospital instead of killing herself.

Melinda Moore, a researcher at the University of Kentucky says, “The service member is like a pebble in a pool, the pain a person carries affects everyone around them. Trauma ripples outward.”

You can see these affects on their spouses, their children, other family members and even friends before, during and after deployment. War has a way of changing people. The person who left isn’t always the person that comes back and this has an affect on the entire family unit from parents, to spouses and kids.

The number of military family members who have killed themselves or attempted to kill themselves is unknown, because it isn’t being tracked, something I hope will change soon. In 2009 there were 9 confirmed suicides of service family members and “too many to count” attempted suicides in just the army alone according to Army officials.

The way we treat our veterans who come back from war has to be holistic, meaning that we treat not only the veterans, but those are are closes to them as well in order to keep families together, people mentally health and a live.

If you or anyone you know who is a family member, spouse or even friend of a service member and you need help, here’s a list of resources.

Veterans Crisis Line- A 24/7 hotline open to family members of all armed forces: 1-800-273-8255 and press 1

For nonemergency help try TAPS (Tragedy Assistance Program for Survivors): 1-800-959-TAPS (8277)

Military OneSource- provides counseling referrals and assistance with all needs of military life including mental health: 1-800-342-9647

Donald Glover’s Dark Instagram Musings: Celebrity Meldown Or A Cry For Help?

1089859-chidlishgambino-617-409I know Donald Glover more for his music. He’s a rapper and goes by the name Childish Gambino, but he’s not just any rapper. In my opinion he is a lyrical genius and generally writes lyrics that are controversial and thought-provoking at the same time. His music, for the most part has a sense of depth to it which separates real artists from those who think they are real artists.

Most people however know Donald Glover from his work as a writer on the NBC hit 30 Rock as well as his character Troy on the NBC show Community which he recently left, some say to pursue his rap career. He’s also a talented comedian and only 30 years old.

Recently, Glover set the social world ablaze when he went diary like on his Instagram account on October 14th, revealing some intimate and honest feelings about his inner most fears which include fears over disappointing his fans, his career and his love life.

On a piece of hotel stationery he wrote:

  • “I feel like I’m letting everyone down,”
  • “I’m afraid people hate who I really am.”Donald-Glover-467-1
  • “I’m afraid I hate who I really am.”
  • “I’m afraid this is all an accident.”
  • “I’m scared I won’t know anything ever again.”
  • “I’m scared I never knew anything.”
  • “I’m afraid I’ll regret this.”
  • “I’m afraid this doesn’t matter at all.”
  • “I don’t wanna rap,” he wrote. “I wanted to be on my own.” (clarifying that he didn’t leave Community to pursue his rap career)
  • “I’m afraid of the future,”
  • “I’m afraid my parents won’t live long enough to see my kids”
  • “I’m afraid people think I hate my race.”
  • “I’m afraid people think I hate women.”

On one hand, this freeing of emotions, this type of introspection is heroic.

Celebrities, especially Donald Glover, often times come off as shallow, narcissistic, and ego-maniacs. It’s refreshing to hear a celebrity express his fears. It humanizes them and reminds us that we have much more in common with each other than we may realize.

This sort of expression is good for the person too, it’s a catharsis and can help us not only think about what we are doing and where we are going, but also helps us bring balance back into our lives. The release of emotion is generally the mind and body trying to get back to a sense of balance when we feel out of balance.

However, there are times when this type of expression, especially when made as public as Donald Glover’s was, is a cry for help. A sign that someone is dealing with more mental angst, anxiety and/or depression than they may believe they can handle so they are putting it all out there in hopes that if the action alone doesn’t bring about a sense of relief, then hopefully it will gain the attention of people willing to help them get back into a state of balance and peace. Donald-Glover-467-2

Some of his fans even feared that this could be a type of suicide note for now or in the future, and while I don’t believe it is, I can see where they could get that from. We’ve lost enough young celebrities this year to know that many have no overt signs of suicidal tendencies and the ones they did have were often overlooked or ignored. I would hate for this to be another one.

If I were someone close to Donald Glover, his friend, his family, even his business partner, I would definitely use this as an opportunity to reach out to him to make sure that he is okay. Chances are he is fine. Artist, depression and anxiety often go hand in hand. There’s been many studies and books written on manic depression and creativity and how depression, anxiety and even mania can spark creativity and yet sabotage the artist by overwhelming them.

Look at how many artists, musicians, and actors have killed themselves either purposely or through drugs and alcohol.

While I definitely think it’s freeing and refreshing to see an artist be so open about their fears, I think it’s also a warning sign for those closest to him to make sure that he stays balanced and doesn’t go too far unto the side of negativity and ends up ruining his life or doing something that is irreversible.

I am all about creative expression and introspection, but I also know that celebrities most often do not ask for help directly, usually do to their pride and status, yet they are just like the rest of us when it comes to dealing with our intrapsychic suffering.

Mental Health Awareness Week: Borderline Personality Disorder

istock_000008463493xsmall-243x300Perhaps out of all of the different types of personality disorders, borderline personality disorder is the most studied and most known as it seems like more and more people today are being diagnosed with borderline personality disorder (BPD) and it was definitely one of the most common personality disorders I run into when working with teenage girls.

People with borderline personality disorder are said to stand on the threshold between neurosis and psychosis. They are characterized by their incredibly unstable affect, behavior, mood, self-image and object relations (how they relate to others).

Borderline personality disorder is thought to represent about 1 to 2 percent of the population and is twice as common in women compared to men.

People who have borderline personality disorder seem to be in a constant state of crisis. They experience almost every emotion to the extreme and typically have mood swings. They can go from being very angry and confrontational one moment, to crying the next moment to feeling nothing at all the very next. They may even have very brief periods of psychosis known as micropsychotic episodes that are generally not as bizarre as those who have full-blown psychotic breaks and may even go largely unnoticed or written off as “strange”.

The behavior of people with BPD is highly unpredictable and they generally do not achieve everything they can to their full potential. Their lives are usually marred by repetitive, self-destructive actions.

These individuals are very often associated with cutting and other self-injurious behaviors as they may harm themselves as a way of crying out for help, to express anger or to feel pain or numb themselves from intense and overwhelming emotions and affect. As a matter of fact, most of the young women I ended up counseling who had BPD were referred to me for their self-injurious behaviors and/or their intense mood swings.

They may feel both dependent and hostile which creates an environment for stormy interpersonal relationships. They can be dependent on the people they are closest to, yet lash out with intense anger at the smallest perceived slight or frustration. They basically pull and push people away all the time, yet they can not tolerate being alone and will prefer chasing and trying to have relationships with people who are not good for them, even if they themselves are not satisfied in the relationship. They tend to prefer that roller coaster over their own company.

They will complain about being treated like crap in their relationships, discuss leaving their partner, yet if their partner doesn’t respond to their text or phone call they will panic and do whatever it takes to track them down.

When they are forced to be alone, even briefly, they will take a stranger as a friend or become promiscuous to fill the loneliness they feel. They are often trying to fill the void of chronic feelings of emptiness, boredom and lack of a sense of identity. They may even complain about how depressed they feel despite all the other emotions that they usually display.

People with borderline personality disorder tend to distort their relationships by characterizing people to be all good or all bad. They will see people as either nurturing or as evil, hateful figures that threaten their security needs and are always threatening to abandon them whenever they feel dependent. The good person, even if they really are not a good person, then gets idealized while the bad person, even if they really are good, gets devalued. More often than not, the same person can be seen as good one moment and bad the next, meaning that a woman can see her husband as perfect and caring today and tomorrow he is the most evil man in the world and she hates his guts, even if nothing really changed between them over the last twenty-four hours.

This aspect of BPD I found extremely frustrating at times because one moment a client would see me as the only person in the world who could understand and help her and the next session she would treat me like she hated me and like I hadn’t ever helped her. One client in particular for instance was chatting with me like I was her best friend one week, the next week when I was redirecting a negative statement she made about herself she said “F*ck you” out of the blue and walked out of the room, only to come back the next week and apologize, but this cycle repeated itself over and  over again. It wasn’t uncommon for her to tell me in one session that she “couldn’t stand me” and the next session tell me that I was the only one who understood her.

Another reason people with BPD are trying even for therapists is that they are very good at subconsciously projecting a role unto someone and getting that person to unconsciously play that role. It can be very draining and even scary trying to deal with someone who has BPD as their impulsiveness and instability as well as their dependency needs can make them overwhelming for many people.

For the most part, this particular client and all other clients I’ve dealt with who had BPD were overall pleasant people with great personalities whenever they were in a good mood and I generally enjoyed our sessions, but there were times when they made therapy so difficult that although I enjoyed working with them, I was relieved when I was able to discharge them, not that I was happy to get rid of them so to say, but it was draining and by then I felt like I had given them everything they could have learned from me and now needed to practice the skills they built up with others.

 DSM-IV-TR Diagnostic Criteria for Borderline Personality Disorder

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is what we use in the mental health field to diagnose mental disorders and personality disorders and it list the criteria for BPD as:

A pervasive pattern of instability of interpersonal relationships, self-image and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1)   Frantic efforts to avoid real or imagined abandonment.

Note:  Do not include suicidal or self-mutilating behavior covered in Criterion 5.

2)   A pattern of unstable and intense interpersonal relationships characterized by alternating between  extremes of idealization and devaluation.

3)  Identity disturbance:  markedly and persistently unstable self-image or sense of self.

4)   Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating).

Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

5)   Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.

6)   Affective [mood] instability.

7)   Chronic feelings of emptiness.

8)   Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).

9)   Transient, stress-related paranoid ideation or severe dissociative symptoms.

 Treatment

Psychotherapy has had the best results for treating individuals with borderline personality disorder, especially when combined with pharmacotherapy. Reality-oriented and social skills training are ideal in order to help people with BPD see how their actions affect others. Intense psychotherapy on an individual and group level is often recommended to help clients work on their interpersonal skills and to deal with their self-destructive and self-injurious behaviors.

Dialectical behavior therapy (DBT) is a specific type of psychotherapy that works great with people who have borderline personality disorder, especially those who do self-harm behaviors like cutting. It has perhaps gotten the best recognition for being high effective with people who have BPD.

I mostly used psychotherapy in the form of cognitive behavioral therapy, but later started utilizing much of DBT and it proved to work faster if not better than traditional cognitive behavioral therapy.

More Information

There are some great books on borderline personality disorder, but I recommend the classic, I Hate You- Don’t Leave Me: Understanding Borderline Personality Disorder by Kreisman MD, Jerold J. and Hal Straus as a great place to start.

www.borderlinepersonalitydisorder.com  is another great resource and they even have a list of movies with characters who have BPD and they include:

Fatal Attraction (1987)

In “Fatal Attraction,” the infamous femme fatale character played by Glenn Close displays the emotional instability and fear of abandonment that are symptomatic of someone with Borderline Personality Disorder. Her character also exhibits the BPD symptoms of self-harm, intense anger, and manipulation as she stalks her former lover and his family.

Single White Female (1992)

Jennifer Jason Leigh’s character in “Single White Female” exhibits the Borderline Personality Disorder symptoms of fear of abandonment, impulsivity, and mirroring as she attempts to take over the persona and life of her roommate (Bridget Fonda).

Girl, Interrupted (1999)

“Girl, Interrupted” is based on the memoir of Susanna Kaysen, who struggled with mental illness and Borderline Personality Disorder as a teenager and young adult. The film, which stars Winona Ryder and Angelina Jolie, centers around Kaysen’s 18-month stay at a mental hospital.

Hours (2002)

The three main characters in “The Hours,” which include author Virginia Woolf, all struggle with Borderline Personality Disorder, depression, and suicide. The movie, which links women from different generations to Woolf’s book “Mrs. Dalloway,” stars Nicole Kidman, Meryl Streep, and Julianne Moore.

Monster (2003)

Charlize Theron transformed into the role of female serial killer Aileen Wuornos in “Monster.” Wuornos was diagnosed with Borderline Personality Disorder, which may have contributed to the unstable and angry behaviors that led to her killing at least six men.

My Super Ex-Girlfriend (2006)

One of the few comedy movies that features a character with Borderline Personality Disorder is “My Super Ex-Girlfriend.” In this movie, Uma Thurman portrays a woman with superpowers and a secret identity who also displays the BPD symptoms of impulsivity, unstable interpersonal relationships, and poor self-image.