A Slower, Sustainable Pace: My Road Less Traveled

Storyblocks image. By permission.

I was in my mid-30s when I was offered the side hustle of my dreams: teaching English writing skills in a college program for immigrant pastors. The students were highly motivated adults who wanted to earn the kind of credentials required for success in a new land. The program was on the campus of a Christian liberal arts college not terribly far from my home.

And yet … I had a full-time job that demanded, on average, 46 hours per week. The evening classes would not take huge amounts of time, but preparation would be significant. More significant to me, I would arrive home after classes at about 10 pm two nights a week. That’s the hour when I was usually falling asleep. By the time I wound down after teaching and the night-lit commute, I could expect to be asleep by 11:30 or so. And being awake that late two nights a week would throw my sleep cycle off dramatically.

For some people, sleeping and waking at odd hours makes no difference. But I had already learned by experience that I need to go to bed and wake up at the same hours every day of the week all year round. Until I learned that rule, I created “mood cycles” of high energy and desperate crashes every week: Monday and Tuesday, I was energetic and active until 11:30 at night; Wednesday I was in bed at 10; Thursday and Friday, I dragged through the day’s responsibilities; on the weekend I crashed to start the cycle all over on Monday.

I’d already changed careers once to gain a consistent schedule, leaving daily newspaper reporting for the much less prestigious copy desk. Now I was working in marketing for a technology consultant. The job was not quite as regular as the copy desk, but still I started at maybe 8 or 8:30 in the morning and left at 5 or 6 or sometimes 7. I got home for bedtime. And that worked.

But here stood Chris, a young denominational leader, inviting me to take on this exciting opportunity. After a few days consideration, I met him to say no.

Why? he wanted to know.

I had too many other things on my plate, I told him.

And this 30-something rising star, who pastored a church and was father of four and coordinating services to immigrant leadership, looked me in the eye and said:

“You know, you can do more than you think you can, Carlene.”

And I just reiterated my regrets.

How would I tell him that I knew precisely how much I could do? Or, rather, precisely the hours within which I could do it? We were still in the years when Americans were challenging the “dogma” of required hours of sleep. The person who slept only four hours a night was envied, even idolized. We hadn’t quite yet hit the time when young professionals were snagging prescriptions for “ADD” stimulants so they could “retain focus” on attaining billable hours through most of the day and night. But we refused to believe that our bodies were designed with built-in limits, and that to push beyond these was at the risk of our own lives.

It’s quite probable that I can do more than I think I can. At age 61, I’m still learning new skills, so it’s entirely likely that next year I will be able to do things that this year I didn’t imagine possible.

But I’m also quite certain that I can’t fit more hours of production into my day than my body allows. God has given me this body, which places its own specific boundaries on my activities.

So even if I wish I’d taken the chance to teach those classes, I’m glad I went to bed instead. God says that God supplies all my needs. Who would I be to refuse God’s supply of rest?

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US Mental Health by the Numbers: Unexpected News!

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You may have better mental health than you imagine! In fact, it’s possible “mental health” doesn’t actually describe what we’ve been measuring. Check out this totally macro level summary of recent statistics on mental health and mental health treatment and see what you think. Source links below.

Yes, that’s how it looks to me. Half of us are happier than the other half. Which sounds like math to me, not a mental health assessment. What do you think?

Sources

20% current, 50% lifetime mental illness rate: https://www.cdc.gov/mentalhealth/data_publications/index.htm  retrieved 7/27/19

26% current mental illness, 46% lifetime: https://www.healthypeople.gov/2020/leading-health-indicators/2020-lhi-topics/Mental-Health/determinants  retrieved 7/27/19 cites 2011 CDC report

17% optimal mental health: https://www.healthypeople.gov/2020/leading-health-indicators/2020-lhi-topics/Mental-Health/determinants  retrieved 7/27/19 cites 2011 CDC report

16.6% (1 in 6) takes psych med https://www.scientificamerican.com/article/1-in-6-americans-takes-a-psychiatric-drug/  retrieved 7/27/19

‘Mental health’ isn’t the norm — So there’s hope for me!

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During the eight years I taught NAMI’s Family to Family course, the session that most powerfully impacted participants was the one near the program’s end where they got to meet a person who relies on mental health services.

They’d look around the room expectantly and I’d announce:

“I know you’re expecting a special guest tonight, someone who lives with mental illness as your relatives do.” I’d pause a few beats, then say: “Hi. My name is Carlene and I live with bipolar disorder.”

Eyes would widen. Jaws would drop. Sometimes I could hear a sharp intake of breath. No one expected their teacher to have a diagnosis.

Over the two previous months of classes, the students had come to see me as trustworthy, reliable, capable. They knew my husband and I provided support to his brother, who was diagnosed with schizophrenia. They were aware I held a professional job in a well-regarded national firm.

And neither the content of the course, nor their challenging experiences with their own relatives, had led them to imagine that an ordinary shaped life was possible for a person with a mental health diagnosis.

Until they met me.

Statistically, ‘mental health’ isn’t the norm

The reality is that I’m much more the norm than most people imagine. Let’s do a little math:

  • If mental illnesses affect nearly 1 in 5 adults in a given year, but only 3.7% of the adult population is unemployed, then a lot of people with mental health conditions have jobs. People with mental illnesses are essential to our workforce. Most people with mental health conditions lead productive, valuable lives.
  • If only about 17% of Americans enjoy “optimal mental health,” then more than 8 in 10 of us are getting on in spite of having received a less than perfect bill of emotional health. Most of those 83% have never even received a diagnosis. Most people with less than “optimal mental health” are not teetering on the edge of a breakdown.
  • If 83% of the population falls short of “optimal mental health,” then “optimal” mental health is an outlier, not a condition toward which people can reasonably aspire.

But that’s just math. We’re people, not just numbers. We’re kind-hearted. We want the best for everyone. We see people who are not happy and ask: What’s to be done?

If 83% of the population falls short of ‘optimal mental health,’ then ‘optimal’ mental health is an outlier, not an aspiration.

The most common prescription today is mental health treatment. More counselors. More support groups. More psychiatrists. More medicines.

What I learned from 4 decades of mental health treatment

I would make a different recommendation. I come to my perspective not as a person with professional expertise but as a person who has been in some form of mental health treatment almost constantly since age 17. What I’ve learned from more than four decades in mental health care is that mental health treatments are less clearly helpful than many like to believe:

  • Many psychiatric medications have damaging physical health effects on some number of patients. For me, one of the most obvious was a trip to the emergency with a small kidney stone — a “side” effect of two medicines I was taking at the time. No one on either side of the family has any history of kidney issues.
  • Many psychiatric medications do damage to the patient’s competence. If we had practiced “early intervention” when I was a teen, I’d have been put on lithium, which was then the front-line treatment for bipolar disorder. A doctor did eventually try lithium on me when I was in my 40s. On lithium, I was so forgetful that I couldn’t remember my boss’s instructions for as long as it took to walk from his desk to his office door. If I’d started lithium as a teen, I’d never have been my high school’s valedictorian, a National Merit Scholar, a US Presidential Scholar.

‘Side’ effects of psych meds can cost a career — sometimes a life

Of course, new medications are regularly developed. They help some people and harm others. Over the decades of my treatment, psychiatrists have tested my response to 22 different medicines. Here are a few other “side” effects I had to weigh against hoped for mental health benefits:

  • My hair fell out as if I were on chemotherapy.
  • I gained weight faster than I could replace my business wardrobe..
  • My fingers ceased to be adequately under my control. I had to give up piano lessons and lost more than 30 words per minute of keyboard speed.
  • I became so disoriented that I got lost four times in one day on the four-mile trip home from my usual shopping center.
  • The “word finding” part of my brain became compromised. I started using Google Search to retrieve words I needed for writing. (“What is the cotton fabric with an all-over pattern of flowers?” Chintz, Google reminds me.)
  • I developed my first and only full-blown mania, physically attacking my husband then hiding out for three days under an assumed name in a hotel.
  • I was hospitalized with five active and viable suicide plans that I could not shut out of my brain. (At the time, I had just been started on one of those “black box” meds that “may” create suicidal ideation.) Two days after I returned to the office, my boss began suggesting other jobs I could apply for in other companies … four months later I was let go.
  • I spent weeks convinced that God is evil and the Bible a pack of lies — the kind of lies a dysfunctional Daddy would tell to make himself look good.

The medicines that were supposed to improve my mental health damaged my appearance, my daily living competence, my work, my marriage and my faith. These are not “side” effects to be balanced against better emotional equilibrium. These are the kinds of additional life stresses that send people who are already teetering over the edge

The medicines that were supposed to improve my mental health damaged my appearance, my competence, my work, my marriage and my faith.

Global research: More ‘mental health’ care means more suicides

I don’t find it surprising that three international studies, covering as many as 191 nations, find that the more mental health services a nation provides, the more people die by suicide. Our track record in the US supports this. Since the 1990s, we have tripled the percent of people using mental health services, increased to 1 in 6 the share taking psychiatric medicines, and watched our US suicide rate rise by a third. All this has happened in the US at the same time that the global suicide rate has dropped by a third.

It’s time to look to the rest of the world for a better set of solutions. People with mental health diagnoses — people like me — can and do live useful and productive lives. Let’s learn from other nations how they are helping people like me to avoid death by suicide.

God calls us to each other, not just to ‘treatment’

Church, it’s time for us to look to God for wisdom, which God promises to everyone who asks (James 1:5). It’s time to love the good that God has given to each of us instead of cultivating envy for the blessedly “optimal” mental health of the 17 percent. It’s only “together with all the saints” that we are able to comprehend “how wide and long and high and deep is the love of Christ, and to know this love that surpasses knowledge …” (Eph. 3: 17-19).

It’s time to love the good that God has given to each of us instead of cultivating envy for the blessedly “optimal” mental health of the 17 percent.

Only when we attempt to embrace the immensity of God’s love for all the people God loves — God’s sad saints and God’s exuberant saints and God’s despairing and desperate saints, God’s psychotic and visionary saints, God’s servant saints, God’s needy saints, and all the others God has called to God’s family — only then do we begin to understand how great is our God’s love for each of us as individuals and for all of us together as the people of God.

Learning to see and share a love that immense is the work of a lifetime. It is the greatest purpose a life can have. There is no greater reason for me to “choose life” for myself, each and every day.

Although the Lord gives you the bread of adversity and the water of affliction, your teachers will be hidden no more; with your own eyes you will see them. Whether you turn to the right or to the left, your ears will hear a voice behind you, saying, ‘This is the way; walk in it.’

Isaiah 30: 20-21

And so I continue to take my medicines — although in ever smaller amounts. I continue to seek God, to work in God’s world, and to serve among God’s people. Because as a person with a bipolar diagnosis, it’s only together with all God’s saints that I can find the place of meaning, purpose, and belonging that God has prepared for me.

Hearing Voices in the Normal Christian Life

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The Right Question: Who’s Talking and Will I Listen?

Trigger alert: Those with suicidal thinking may find parts of this post triggering. Support is available 24/7 by texting 741741 (Crisis Textline) or calling 800-273-8255 (Suicide Prevention Lifeline).

My brain is full of voices. Right now, I can hear a faint echo of Jim Bleikamp’s voice reading the 5:30 news on WCME, the radio station I was listening to during my commute home. The voice of this essay is running faster than I can type, and I type really fast. The voice that whispers “no one really cares what you have to say” is quiet for the moment. So is the musical soundtrack that accompanies all the hours of my day when I’m swinging high into a hypomania. In this quiet house, the hissing voice of my tinnitus is buzzing nearly as loud as the humming refrigerator. Even so, I can hear the out-of-sync ticking of two clocks, plus the rattle in the kerosene heater’s blower. If I stroke the lush black cat who’s just settled in beside me, his rumbly purr will add to the quiet cacophony.

Lots of voices. And that’s still a slow night in my brain.

I remember once when my husband and I were on a road trip together. “What are you thinking?” I asked him.

“Nothing,” he said.

He had to be evading, I was sure. It was not possible to simply think “nothing.” I pressed him.

“No, really,” I said, “what are you thinking?”

“Nothing,” he said. “I’m just driving.”

I couldn’t believe him, because I had never experienced what he was describing. My head was pretty much always full of voices, ideas, urges. People with bipolar disorder can hear a lot of voices. So, too, may people with other diagnoses.

Bipolar mania hears, “This is the best idea anyone has ever had! Everyone needs to listen now! Hey, you! All of you! Wake up! Get on the bus or get run over!”

Bipolar depression hears, “That oncoming bus is really convenient … you can step in front of it now.”

Social anxiety hears, “Just stay home. No one will talk with you. You’ll look like an idiot if you go.”

Chronic depression hears, “It’s too much work to get dressed. And people will be happier if you don’t show up.”

Anxiety hears: “Don’t even try going. You’ll mess up. Like you always do.”

The popular psychology of my young adult years held that the voices in our head were just looping recordings of voices we’d known … childhood memories that we can turn off if we chose to. On the one hand, I wanted to believe that idea. It seemed so simple. On the other hand, I couldn’t figure out what childhood voice I would have recorded shouting Yiddish vulgarities at me and telling me that I was a f— up who f—s everything up. I mean, sure, I probably had heard the f-word at school. But “schmuck”? In 1960s Maine? Not very likely.

So where did that hectoring voice come from? And the voice that urged me to die? And the voice that said everything is worthless because eventually the universe ends and it all vanishes? And was there a difference between the voices that caused me so much discomfort – the ones that harangued and insulted me – and the voices that gave me useful direction?

Because there was at least one useful voice. At a particularly rough moment, that voice told me that if I didn’t have a reason to live until spring, I should plant bulbs. I did, and still do, almost every fall.

And while I could recognize one of the helpful voices as God, I wondered why was there more than one voice that knew what’s what and could accurately predict circumstances.

I had learned to recognize God’s voice during a year or so when I attended a traditional silent Quaker meeting. In a “silent” Quaker meeting, there is no preacher and no musicians. But if anyone among the congregation feels moved by God to speak or sing, they stand up and do it. After the meeting, the people who spoke, if their words have resonated with others – that is, if their words are believed to have been inspired by the Holy Spirit – receive affirmation from others.

In the meeting I attended, which held to some very old Quaker traditions, people would come up to me quietly after the meeting and tell me, “Thou speakest to my concerns, sister.” Sometimes one person. Sometimes three or four. Over time, I learned to recognize in myself what were the signs of God’s presence in the room to speak through someone, God’s presence to speak through me, and God’s presence to speak through me right now.

But there were still those other voices. The nasty ones, which I did my best to push away. And one day, an unfamiliar voice came to me offering seemingly harmless advice.

I was preparing to sell my 1978 Volkswagen Beetle, the well used and gratefully owned first car that carried me to my first job after college. I’d bought it privateparty from a classified ad, so taking a classified ad to sell it made sense.

Then a voice told me: “Take it to Al Guregian’s. Someone there will pay more for it.”

Well, Al Guregian owned the junkyard where I’d bought most of the parts I replaced over the years, so I knew the guy and the place. I drove up and walked into his office. We started talking.

An employee kept sticking his head in and interrupting our negotiation. Al kept waving him out. We finally settled on a price. He handed me the cash; I signed over the title; and it was done.

As I walked out the office door, the employee sidled up to me.

“How much did he give you for it?” he asked in an undertone.

I told him.

He gasped with frustration. “He won’t sell it to me for twice that!”

Hmmm, I thought. The voice was right. There was someone at Al Guregian’s who was going to pay more for my Bug. But the voice wasn’t God’s voice. How could a voice that was not God give me information that was true?

I let that conundrum drop into a back corner of my brain for processing. A couple of days later, the answer emerged.

God knows everything. God doesn’t just know truth, God is truth. He is the way, the truth and the life. (John 14.6). When we know God, we know the Truth that sets us free (John 8:32).

But a spirit who is not God can know our material world as readily as I can – more so, because without the constraints of a physical body, a spirit potentially has access to much more information. So a spirit who is not God can be in the room when one of Al Guregian’s employees is talking with a buddy about wanting to buy an old VW to fix up. A spirit who is not God can observe Al Guregian’s sharp business dealings and anticipate accurately how he will behave when a car comes onto his lot for which he knows he has a ready buyer. And most of all, a spirit of greed – who is most definitely not God – knows in what direction greed can push an ordinary series of business transactions.

So the spirit who knew someone at Al’s garage would pay more for the car … that was the greedy spirit that set the employee up to pay Al more than double what Al paid me.

And a spirit of greed had told me what greed was doing. Just because a voice speaks truly doesn’t mean the voice is God.

That recognition, in turn, pushed me to a startling insight about my mother’s remarkable ability to see future or remote events – bad events, exclusively.

I remembered in particular one day when she’d come home from shopping. She hadn’t gotten all the way through the door before she demanded, “What happened to my blue cup?”

She couldn’t see, from where she stood in the entryway, the fragments of her blue porcelain mug in the dining room. I can’t remember who knocked it over or how it was broken. I just remember that Mom knew something had happened to her blue mug before she even made it into the house.

Mom was, I came to believe, “wired” for hearing from the spirit world. And not having committed herself yet to Jesus, she heard readily from spirits who were not God. They spoke truth, but not on behalf of the truth that sets us free. Mom was like the fortune teller who truthfully told all the world that Paul and Silas were “servants of the Most High God”, but lost her special knowledge after Paul ordered the spirit who gave her information to depart from her (Acts 16:16-19).

My own ability to hear voices represents the same kind of spiritual atunement. When a Christian listens to God, we call it prophecy. But in my experience, this special ability to listen in on the spirit world, a gift intended for good, is usable in some measure by any spirit who might pass by. The responsibility I hold, as a Christian who has that gift, is to discern among the voices I hear and choose which voices I will attend.

This is what Jesus talks about when he tells us that his sheep know his voice and they will not follow any other (John 10: 2-5). He doesn’t say that we won’t hear any other voice. Just that we’ll refuse to follow it.

(Please note: I only acknowledge that Christians may hear from passing spirits. I am not suggesting that any unholy spirit has access to enter and hold the temple of God which is the believer’s life.)

The voice I have to ignore most frequently is the one that tells me that on any given day, I can choose to end my life. This voice dogs me. It pretends to be comforting me. “Today was hard … you don’t need to do tomorrow,” is its seductive message. “You can stop right now. Forever.” Although it has never spoken as gently as that. Nor has it made its separate existence evident by addressing me from the second person.

This unholy voice speaks in an urgent, first-person shorthand that sounds like my own voice. “I can suicide,” it says to me on my pillow as I try to fall asleep. Night after night, year after year.

And night after night, day after day, year after year, I choose instead to listen to God: “I set before you this day life and death, blessings and curses. Now choose life …” (Dt. 30:19).

It’s like Martin Luther said: “You cannot keep birds from flying over your head, but you can keep them from building a nest in your hair.” The thoughts come. It took decades before they finally (seem to have) stopped. But even when they came nearly every night, when they pretended to be my own thoughts in my own voice, I refused to give them a home.

In the 21st century, people like me who hear voices are labeled as suffering from psychosis. It’s considered to be a symptom of a very serious mental illness that creates dangerous life situations.

After hearing many different voices for more than 40 years, I would say – with Jesus – that hearing voices is as ordinary as seeing sheep follow their shepherd. The only danger is if the sheep pay attention to voices other than God.

As long as you choose to follow God, you will learn to know God’s voice. And, as Jesus promises (John 10:8-10), you will follow God, and God alone, into the fold and out into the pasture and you will be kept safe.

Prevent Suicide by Finding Alternatives

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Terry tulips blooming in the park. Selective focus.

One way I stay alive: When I don’t know a reason to live till spring, I plant bulbs.

This weekend we mark Suicide Loss Survivor Day, which makes it a great time to learn from all three kinds of people who live beyond suicide.

Most of the people we call “suicide survivors” are people who lost loved ones to suicide deaths. These are the people who will be gathering this weekend. A suicide death often leaves relatives and friends not just grief-stricken but guilt-plagued. They fear they should have recognized signs and prevented the death. After my friend “Katie” hung herself, my other roommate and I weren’t even able to talk about her for maybe a decade. It was just too hard.

A second kind of “suicide survivor” is the person who manages to live beyond a suicide attempt. Kevin Hines, who survived his jump off the Golden Gate Bridge in the year 2000, is one of the better known of these. He’s focused his life since then on encouraging others to #BeHereTomorrow.

Add a Third Kind of Suicide Survivor to the Rally

A third kind of “suicide survivor” doesn’t quite fit the mix, yet has reason to be counted in this difficult company. The third kind of survivor are people who survive chronic suicidal thinking. We are the people who survive our suicidal thoughts many times a year, many times a week … some of us many times a day. And still we choose to keep moving forward.

At last count, I’ve wanted to die on more than 7,300 days of my life. I remember one bright autumn day when I was crossing my college campus, under the kind of impossibly brilliant blue sky that seems to have been created just to highlight the brilliant yellows and oranges of the changing leaves. My friend Loren, heading out of his fraternity house, hailed me.

“You are the happiest person I’ve ever known,” he said. “I never see you without a smile.”

And I kept smiling, even though I was actively considering — at that very moment — how best to die.

I didn’t die that day or that week, nor on any of the other 7,300 days when the prospect of death seemed a promise and a consolation in the face of crushing sadness, overwhelming challenges, or unsurmountable loneliness. Instead, I finished college. I got a job. I maintained a career over nearly four decades. I rebounded from job losses during two economic downturns. I even managed to get back up after the emotionally crushing revelation that my husband of almost 20 years was no longer romantically inclined toward women. I own a home, belong to a church, have friends, have retirement savings.

And the way that I survive chronic impulses toward suicide offers valuable lessons both to others like me, to those who worry about us, and to those who want to avoid yet another suicide death in their circle.

Wanting to Die is ‘Normal’ for Some

Wanting to die is, it turns out, not terribly unusual. People want to die because they’ve committed what they consider to be an unpardonable social sin, because they’ve failed in some way at work, because their spouse has ended the marriage, or they’ve experienced too many bereavements.

Wanting to die is a pretty reasonable reaction to lots of terrible life circumstances. I’ve been there, done it all, and I’m still alive. As are lots of people.

So the real question is why and how do some of us keep going when we frequently want to die. The answer lies in a mix of motivations and solutions that we practice. Over decades, I’ve amassed my own list of streategies. Others will have their own.

Some Things I Do Instead of Dying

Here are a few of the “alternatives to suicide” that I have used over the 40-plus years since I first wanted to die:

Escape: Binge watch television, binge read fiction, write revenge-themed novels, stare at the ocean, stare out the window.

Exhaust myself: Log intense time at the gym, on a trail, up a mountain, on the bike, in a kayak.

Become engaged in something: Use some creative skill; pet the cat or dog; arrange wildflowers into a bouquet; shop an hour for $5 worth of giftwrap and ribbon. Anything that’s not about the feelings inside of me.

Encourage myself: Mark every little step forward. Create a to-do list so detailed that I count it progress when I finish my shower … my breakfast … my commute. Remind myself during times when I feel without hope that the God in whom I believe has promised me “a hope and a future” (Jer. 29:11) … even if that comes far in the future, when I finally arrive in the country where God wipes away every tear (Rev. 21:4).

Extend myself: Extend myself for others, even when I feel like I have nothing to extend. Facebook COO Sheryl Sandberg, in “Option B,” her book about surviving the grief she suffered after her husband’s death, says one tool she learned was to log daily three ways she had influenced others for the good. For me, this works. I offer kindness. Volunteer. Show a colleague a new skill.

Remember: At one point, my best suicide preventive was recalling that I would have killed myself if I’d tried the particular overdose I’d considered at age 19, during that autumn when Loren thought I was so happy. Some years later, I held to the memory of a voice (that I know as God) telling me “If you don’t have a reason to live till spring, plant bulbs.” I still plant bulbs, lots of them, almost every year.

Walk through my rituals: Daily routines that never change can keep you going. For me, these include alarm at 6. Coffee. Oat cereal with milk and berries. The print newspaper. The chair where the Bible and journal and planner wait. They resume in the late evening, when 9 p.m. brings on hot tea, the buzzing electric toothbrush, jammies and a book by the bed.

Protect myself: At the worst, I just keep myself safe. I call the friend who is willing to come over, so I’m not alone. I text the person who will remind me that I don’t always feel this terrible. I check in with a suicide hotline or the crisis text service when I need to say things that even the best friend shouldn’t hear.

(And by the way, the hotline care strategy is to listen first, then help the caller identify any circle of belonging and choose even one thing the caller will do in the next 24 hours other than kill herself. That is to say: name notwithstanding, “suicide prevention” hotlines are designed not to prevent suicide, but to help us find alternatives to suicide that will allow us to choose life for another day. And the evidence is that they work.)

Suicide Alternatives vs. Suicide Prevention

None of these is a suicide “prevention” strategy. Suicide “prevention,” as we practice it today in the US, trains thousands of “gatekeepers” to peer into the lives around them for “signs” of suicidality. It urges them to push people like me toward professionals who hold the keys to locked wards, where we can be almost perfectly protected against self-harm.

Ironically, we have trained so many people to be on guard against “symptoms” that ordinary human supports have become much less available to people experiencing challenges. Today, I have to consider carefully any potential confidant. Is this a person who will (with or without professional qualifications) assess me to be a danger to myself, call police for a midnight “welfare check,” insist that I need to take a medication that time has proven doesn’t work for me? Will they shuttle me toward another locked ward?

Me, I’d rather hold my tongue than risk the professional suicide that an inpatient event provides. I’ve only just rebuilt a new career after my one-and-only psych hospital stay more than a decade ago.

People who have lost loved ones to suicide, professionals who have lost patients to suicide – even those who have temporarily protected family, friends, and patients from one episode of suicidality – don’t know even a percent as much about eluding suicide as those of us who have stood this battle for years. My friends and I don’t “prevent” suicide. But we each maintain our personal lists of “alternatives to suicide” that we put into practice when the urge hits. Even when it hits really often.

Why We Need to Focus on ‘Alternatives’ Instead

This year’s Suicide Prevention Awareness Month and Suicide Loss Survivors Day come at a time in our nation’s history when the suicide rate remains staggeringly high. We also have access to a number of multi-nation studies published across more than a decade demonstrating that as nations improve access to psych meds and hospitalizations, their suicide rates increase. Which is exactly what we’ve seen in the US over the last 30 years.

For more than 7,300 days of my life, waking up the next morning required me to make a conscious choice to diligently pursue something – anything – other than my impulse to die. Perhaps it’s time to reconsider our “suicide prevention” approach. Maybe the best teachers of how to avoid suicide will be, not the people who are afraid someone else will die, but those of us who can explain how and why we regularly choose to live.

Carlene Hill Byron is a nonprofit fundraiser who has worked as a writer, marketing communications specialist, or public relations officer for nearly four decades. Her paper, “Suicide Learning from Global Perspectives,” was presented at the 2015 NAMI-North Carolina state conference.

Finding Silence in a Run-On Brain

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Even when there’s no noise, there’s no silence for me.

I’m not one of those people whose brain is always running down the list of what’s next, what needs to be done, whose post needs to be liked, how to fit in all the many people and tasks that a day requires.

I have a brain that multitasks. All the time.

I’m typing this post while I’m listening (inside my head) to one of the songs from this morning’s worship set and (outside my house) to the cars passing by. My mother used to wonder how I could watch afterschool TV while doing my homework while (intermittently) crocheting granny squares. “I guess I just have an eight-track brain,” I told her.

My brain becomes more quiet when I have a task outside myself that engages more of its channels. The best is physical activity with a purpose. Gardening, for example. When I garden, one brain channel is deciding what needs to be pruned or raked or cut down or weeded, one channel is directing my hands and feet and maybe my huffing lungs (if the job requires heavy hauling, as the best jobs do). Another brain channel is measuring the project’s current status against some anticipated outcome: beds clear for winter, rose bushes free of strangling vines, lilac shrubs in beautiful bloom because I’ve taken down with a handsaw the five 20-foot maples that overshadowed them.

Work — hard, physical work — is where I find silence. With all my channels fully occupied in the task, there’s no place for my brain to run. It can focus on what it is doing and nothing more. Silence.

I suspect that others with a bipolar diagnosis have discovered the same thing. Silence doesn’t come with a meditation discipline. Thoughts that seem to run in four or five separate channels simultaneously can’t be quieted by trying to become quiet — or even by trying to follow the standard instruction and simply letting the thoughts pass. A brain built for radical multitasking keeps running on all five or eight cyclinders until it’s exhausted. That exhaustion can begin a serious downward slide. Other choices are essential.

Gardening works. Dancing works. Trying to play the piano — even just practicing scales — works. Playing music requires me to read the lesson book, to move my hands ways that are not easy for me, to keep track of each finger’s correct position in relation to the scale, to hear what is right and what is misplayed.

I don’t find silence in quiet. I find silence in big occupations — occupations big enough to require all the channels I can play at once and far enough outside me to make any of the yammering internal channels become irrelevant.

I am happy with the silence I find. I hope you find the kind of silence that suits you.

This post is part of the Five Minute Friday linkup: this week’s prompt is Silence.