PRN

I was visiting the Mood Disorders Association clinic. One of the psychiatrists asked me what I was using for a PRN. A PRN is a medication that you take in an emergency. The initials are from the Latin, “pro re nata.”

“Ativan, one or two milligrams,” I replied.

“Where is it?”

“At home.”

He smiled. “How is it going to help you from home? Carry a couple of tablets with you in your wallet, okay?”

Running was a major part of keeping me stable and functioning while my wife was in hospital. Shortly after my visit to the clinic, I saw my wife, and she wasn’t doing well. The kids were at school. I decided to go for a run.

Usually, a jog would cheer me up, but not this day. As I hit the last six kilometers of my route, I started to feel like everything around me was unreal and that my life was coming undone. I came to a large bridge.

Midway across it I felt a strong urge to jump off – like when you stand on the edge of a pool and are teetering because you know the water is cold, but you want to swim.

I reached toward the railing.

It took every ounce of my will and training to stop.

I took all of the Ativan I had in my wallet and put it under my tongue. I thought about my kids. I felt the cement under me. I thought about everything I could to ground myself and return to reality.

After about ten minutes I could feel the drug start to work. The impulse disappeared, my mind relaxed.

I was shaken, but finished my run home. Near the end, I saw a good friend out walking her dog. She waved and I stopped. She asked how I was doing and I burst into tears. I couldn’t believe what had almost happened.

I saw my doctor right away. My medications were adjusted to help make sure that I wouldn’t get that depressed again.

The PRN did what it is supposed to do. It is the last line of defence with mental illness.

It terrified me to reach the point where I needed it. Hopefully, with the treatment I’m receiving now, it will never happen again.

Media Blackout

The other day I heard a traffic reporter on the radio. She said, “Traffic on the bridge is stopped in both directions as police deal with an incident. I’m not allowed to say what the incident is, but you can all guess.”

It is taboo in the media to talk about death from mental illness. This is prompted by some research that shows a spike in deaths in the aftermath of prominent reporting of celebrities that have taken their own lives. Nobody wants blood on their hands, so police, psychiatrists and the fifth estate all choose to remain silent.

Unless, of course, it’s a celebrity.

 

I find it ironic that the media will talk in great detail about murders, assaults, arsons, and other violent acts. Surely these sometimes provoke copycat crimes? Especially when methods are described in extreme detail? Mass killers like Timothy McVey, the Unabomber and the Beltway Sniper all talk about what inspired them from the media. Why is there no feeling of culpability there?

Probably because a group of medical authorities has not issued guidelines on reporting that leave media outlets feeling vulnerable to lawsuits, like associations in the United States and Canada.

Here is what the Canadian Psychiatric Association has published for the benefit of the Canadian media:

 

The media is to avoid:

-        Details of the method
-        The word “suicide” in the headline
-        Photos of the deceased
-        Admiration of the deceased
-        The idea that suicide is unexplainable
-        Repetitive or excessive coverage
-        Front page coverage
-        Exciting reporting
-        Romanticized reasons for the suicide
-        Simplistic reasons for the suicide
-        Approval of the suicide

The media should convey:

-        Alternatives to suicide (i.e. treatment)
-        Community resource information for those with suicidal ideation
-        Examples of a positive outcome of a suicidal crisis (i.e. calling a suicide hotline)
-        Warning signs of suicidal behaviour
-        How to approach a suicidal person

Okay…here is where I start to have problems.

First off, what the media “should convey” reads both as a brochure for the Canadian Psychiatric Association (a noble thing, but not a news story); and second, it reads as a condemnation of the deceased (i.e. “these are the choices they and their loved ones should have made”).

I have problems, too, with some of the things “to avoid.”

“Admiration of the deceased.” Most people who have died from mental illness have done so after a long and difficult struggle. They should be admired like cancer patients.

What does “simplistic reasons for the suicide” mean? If a newspaper says, “They died from a mental illness” is that too simplistic?

If the death caused a major newsworthy event, or was part of such an event, why not place it on the front page? (They do when it’s a celebrity).

Here is what I would have liked to have heard from that traffic reporter:

“Traffic is stopped in both directions on the bridge as emergency crews are trying to save a man’s life. It appears he may have a mental illness – which can result in death if not treated properly. Please be patient while the authorities try to avert a tragedy. Unfortunately, incidents like this are all too common – learn how to detect mental illness in its earliest stages, before it becomes deadly – visit our website for more information.”

This taboo must be broken, so that people can learn how common these tragedies are.

For a fantastic article on this, please go here.

 

 

 

 

When Suicide Prevention Hung Up On Me

I firmly believe that very few people truly want to kill themselves. With mental illness, the urge to commit suicide builds through steps - first, there is a depression. The depression becomes significantly worse, and is followed by intrusive thoughts - images about death that come into your mind out of your control. Then for me it is like a switch goes off in my head, and I make a plan to end the pain. My plans are usually very dangerous - not like taking pills, where someone can find you and save you. The plans are usually for instantaneous death - like stepping in front of a bus. It's very scary, because inside I really, really want to live - but outside, I am determined to die (sort of like those jawbreakers with the sweet centre that take an hour to get to through the yucky, hard exterior).

Anyhow, I had been released from hospital and was at work when Darth Vader came back and started talking into my ear. I sat at my desk, trying to ignore him, but the Force was strong with him (damn you, Yoda, for not giving me better training! Lifting boxes with my mind? What the hell!) I told my boss that I wasn't feeling well, and left to walk to the bus.

It didn't take long for Darth to take me through the steps towards suicide. I recognized it early (it's part of what you learn in hospital), and took my new cell phone out to call the suicide prevention number I had been given.

"Suicide prevention, how can we help you today?"

(Now that I think about it, do they really need to ask that? Do they do something else, too, like deliver pizzas?)

"My name is D'Arcy. I think I'm going to kill myself."

"Um, this is actually a bad time for us. Are you feeling pretty bad, or just a little bit bad?"

"Pretty bad. I think I'm going to kill myself."

"Okay, I heard that. The thing is, we're all on lunch."

"Can I please talk to someone? To you? I really think I'm going to kill myself."

"Just hang in there. Call back in say, a half hour, and we'll be able to help you. Or go to your doctor, okay?"

"Click."

My first thought was "Suicide prevention probably DID put Rodney Dangerfield on hold!"

I couldn't think of any other  numbers to call. My brain was too overwhelmed to think of  911, and Darth Vader was laughing too loudly. As I walked toward a bus stop and certain death, I called my sister-in-law - the first contact saved on my cell.

I am so grateful to so many people for the many kindnesses they have shown me. My poor sister-in-law was first shocked when I told her what was happening, but then calmly talked to me for the next half hour until I got to safety.

Sometimes the best suicide prevention comes from someone who loves you. Thanks, Rhonda, for saving my life. :)

"Seriously? A lunch break? I gets no respect, I tells ya. No respect."

Mental note: Keep some suicide prevention numbers stored in your phone. You never know when you or someone else might need one.

If you live in Canada, here is a suicide prevention number that ALWAYS works: 1-800-SUICIDE (1-800-784-2433) Call it even if you don't feel suicidal but are depressed - catch it early!

If you live in British Columbia, there is the 24 hour Mental Health Distress Line: 310-6789 (no area code) Again, call it even if you only feel depressed - that's why it's called a "distress line."

If you live in Vancouver, here are two important numbers:

- The Vancouver Crisis Centre: 604-874-7307
- VPD Car 87 (A police car with specially trained officers and a psychiatric nurse): 604-874-7307