Monday, December 3, 2012

How I Stayed Alive When My Brain Was Trying to Kill Me — Book Review

Here's a first-rate book review from the Finance for a Freelance Life Blog that I have shamelessly swiped for my own blog.

In my group therapy sessions for my OCD/anxiety issues, I have been in groups with clinically depressed and BiPolar folks and this is such a dire, recurring situation for them, I thought I'd share it here on the Smirk blog. I bought this heavy-topic book  -- for the usual $3 (in the clearance section) -- in the hopes of helping my friends with a few suggestions culled from Susan Rose Blauner's book. The holiday season can be especially trying for the depressed.

Here then is the book review written by mrsmicah, taken from

When I saw How I Stayed Alive When My Brain Was Trying to Kill Me sitting on a shelf in my library, I couldn’t help grabbing it. The title is a work of pure genius. In an instant, I was identifying with the author (Susan Rose Blauner) and wanting to know what worked for her.
She subtitles it “One Person’s Guide to Suicide Prevention.” Her hope, expressed in the introduction, is that when depressed people or those with suicidal thoughts read her book, they’ll find something useful to keep them going. The book, therefore, is specially focused on NOT committing suicide. But I think it’s helpful for those dealing with depression even if they’re not suicidal.

If you’re not depressed and are thinking about not finishing this, skip to the “Helping a Suicidal Thinker” section.

So You Think You Want to Die?

She explains up front that she’s basing this book on a set of beliefs about suicide and suicidal thinking:
  1. Most suicidal thinkers don’t want to die; they just want their feelings to change or go away [emphasis mine. and when you think they won't go another way, you figure the death should end it, right?]
  2. Every single feeling we experience eventually does change — with or without any help from us. They never stay the same or at the same intensity.
  3. Feelings and thoughts come from electrochemical impulses in the brain. [this is important for understanding that something might be physiologically wrong but fixable.]
  4. It is possible to outthink the brain, actively change feelings and eventually eliminate suicidal thoughts.
  5. The reality of suicide is far different from the fantasy. Most suicidal thinkers romanticize their death by suicide, failing to realize that any suicidal gesture or attempt can result in permanent brain, kidney, or liver damage, loss of limbs, blindness…or even death.
Blauner believes that when talking about suicide and our thoughts and feelings we should be very careful to use our words to shape our reality. She dislikes the word “suicidal” when applied to a person, because she believes the idea of a suicidal state is harder to break out of than her alternative. She suggests using the phrases “having suicidal thoughts” or “thoughts of suicide” instead. That reminds us that these are thoughts…they’re something we can work to overcome.

As someone who made three suicidal gestures, she also explains that when she came to the point she really didn’t want to die. She wanted things to be different, she wanted these things to go away, but after she’d taken the pills always ended up calling for help…even if she thought this time she’d go through with it.

Despite having made…I guess “gestures” is the proper word for them…I’ve found that the two times in my life I thought I was really going to die (one involving real choking…the kind where you don’t make a sound…and one involving a head-on car crash that I narrowly avoided) I fought like hell/drove like hell. I was angry and I wasn’t going to let this happen.

Tricks of the Depression-Defeating Trade

Blauner scatters these throughout How I Stayed Alive as tricks she’s learned through her time in therapy. Many are related to cognitive behavioral therapy, which I’ve found quite helpful. Others involve getting help…which is surprisingly hard to do when you’re depressed.
For example, Trick #5 is Feelings vs. Facts. The short version is that when you’re starting to feel things, you ask whether they’re in line with the facts of the situation.
To use a real-life example, sometimes I feel like my life isn’t worth living. If I remember to do it, this method helps me come up with some answers to that feeling. I might point out that while I can’t tell if my life is worth living it’s too early to know. Or that even if I can’t come up with a reason to live it overall, there’s nothing to say it’s not worth living today. Or that if I believe human life is valuable that extends to me as well. Or just that I have something exciting coming up in a few days or weeks.

That particular trick works best if the answers come from within you, not from other people. They can help you come up with answers, but if someone tells me my life is worth living it doesn’t mean nearly as much as coming to that conclusion myself.

Other “tricks” include Healthy Diversions, Service — Helping Others, Movement and Exercise, and practical things like Asking for Help, Therapy, and Crisis Planning.

Suicidal Crisis Plans

Blauner strongly encourages those with frequent suicidal thoughts to come up with a just-in-case crisis plan. The idea is that when you’re getting to the point of killing yourself, you can call or visit the people on this plan (there are a lot of backup people in case your top picks aren’t home) to help you defuse the situation and possibly get yourself help.

After the top people you’ve chosen (and talked with about this beforehand so they’re more prepared), you add your therapist (if you’re seeing one), suicide hotlines, local hospitals.

During a particularly rough year, the author’s plan included getting herself hospitalized if it came to that. Yours may not need to, but she explained to all the people on the plan that this was what she wanted and collected local hospital numbers.

Then, there’s the smaller crisis plan. When you’re having some mildly suicidal feelings which you’re afraid might snowflake and snowball out of control, you can turn to your smaller crisis plan. It includes simple things like stopping and breathing, using the tricks of the trade (above) that you find most helpful, trying some of your favorite activities, etc.

At the bottom of the smaller crisis, include a few numbers for the people on your suicide plan. If your plan doesn’t work, they’re still there for you to talk to them. Even suicide hotlines are willing to work with you if you’re “only” having thoughts. Don’t be afraid to bother them.

Helping the Suicidal Thinker

Almost another book in itself, this section of How I Stayed Alive is meant for those who are, well, helping people with suicidal thoughts.

It covers which responses are helpful and which aren’t, why people can’t “just get over” their suicidal thoughts, and what you can offer the depressed people in your life. She includes the warning signs and risk factors which might lead you to encourage someone to get help.

She encourages families to talk, to listen well, to respect boundaries and privacy (without being sworn to a secrecy that might keep you from helping the suicidal person). She explains what is an isn’t helpful when talking to someone depressed.

This section is something which I’d like to see more people read. I’m fortunate enough to have a psychologist for a MIL and a husband who was raised by one. But a number of my friends have been told by their families “Don’t feel this way” or “You should try harder.” Not helpful.

To Buy or Not to Buy?

I think that How I Stayed Alive When My Brain Was Trying to Kill Me is a must-read. Whether you’re mildly depressed, very depressed, or not depressed at all, depression will play a role somewhere in your life. It may be a family member, a friend, a coworker, a spouse, a child.
This book shows you how (some) depression works, the impact it has on a person’s life, the nature of their thoughts.

As someone dealing with lighter and heavier depression, I found it enormously helpful. I’ve never seen someone take on suicide that well before. It wasn’t just her story but it engaged her story. It helps to know that the author has been there. And that she doesn’t think suicidal thoughts are wrong, they’re just something we have to learn to overcome.

While I’d heard many of the “tricks of the trade” before, she presented them inspirationally. She made me want to do them. I also knew I wouldn’t be alone in doing them because she does them too.

As for whether it’s a must-buy, I always suggest hitting up the library first. Then you can decide if it’s good for a one-time read or something you should have around. I’m still deliberating (I do own one really helpful book, so I’m not sure if I need How I Stayed Alive around at all times, even though it takes on suicide more than the other).

If You’re Having a Crisis Right Now

Like all books about depression and working through depression, this is no substitute for actual therapy and possibly medication.

If you’re having a crisis right now and don’t have a therapist (calling them when you’re in crisis shouldn’t bother them, that’s what they’re there for) or friend/family member you can talk to, here are some numbers for getting help:

By phone in the US: 1-800-784-2433 (1-800-SUICIDE) & 1-800-273-8255 (1-800-273-TALK).

By phone in the UK: 08457 90 90 90 (Samaritans)

By phone in the Republic of Ireland: 1850 60 90 90 (Samaritans)

By phone in Canada: 1-877-822-0140 (some sites suggest this is for adults 18 and over) 1-888-821-3760 (some sites suggest this is for youth 17 and under)

Getting help by e-mail: (There will be some delay time because each e-mail is answered by a person. The e-mails are anonymous/confidential, their system will remove your details.)

Honestly, the only way I’ve been able to reach out to one of these groups is via e-mail. When I need help, I tend to feel as though I’m going to become an unwelcome burden. Hence talking to someone on the phone is burdening them. With e-mail, I can tell myself that they’re choosing to reply.

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