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Suicide Prevention: What to Know

September 9, 2024

Part 1: Children/Adolescents

By Dr. Stacey Gagliano

Suicidal ideation is a serious concern that affects individuals across all ages and backgrounds. Suicide is the 11^th leading cause of death in the United States. In 2021, suicides nearly doubled the number of homicides in the U.S. and in 2022, it was the second leading cause of death for those aged 10-14 and 25-34, and the third for those aged 15-24. Unfortunately, suicide rates have seen a troubling increase over recent years. From 2000 to 2018, the rate of suicides in the U.S. rose by 37%.

Understanding who is at risk and recognizing the warning signs can be crucial in preventing tragedy and providing timely help. In this two-part blog, we’ll explore key factors that contribute to an increased risk for suicidal ideation, important warning signs to be aware of, as well as what you can do if someone you know is struggling with these thoughts and feelings.

Who is at Risk? – Youth

Identity questions: Struggles with sexual or gender identity can lead to increased risk.
Victims of bullying.
Access to lethal means: Availability of firearms or other means can heighten risk. Firearms were involved in over 50% of all suicide deaths in 2022.
History of self-harm or previous attempts.
Mental health diagnoses such as anxiety and depression, and/or struggles with chronic medical conditions.
Recent loss: Youth experiencing significant losses are at higher risk.
Witness to violence or family history of suicide.
Lack of social support: can increase feelings of isolation.
Lack of access to mental health resources or services.
Stigma: Cultural or societal stigma around seeking help can prevent individuals from reaching out.

Recognizing the Warning Signs

Verbal threats of death, seeking access to weapons, and/or talk of death/dying
Hopelessness and rage: Feelings of despair, rage, or seeking revenge
Changes: Neglecting personal appearance, changes in appetite, and/or withdrawing from friends/family
Engaging in reckless behavior
Feeling trapped: A sense of being trapped with no way out
Making arrangements: Preparing for end-of-life matters, like updating a will or saying goodbye
Increased substance use
Mood swings: Dramatic changes in mood or personality
Loss of purpose: Feeling that life has no meaning or purpose

What Can I Do to Help?

If you are the parent/guardian of a child who struggles with or is at risk for suicidal ideation,

Take steps to reduce access to lethal means in your home.
- Remove all firearms from the home, or at a minimum, ensure that they are all locked and inaccessible to your child. Store bullets separate from the guns.
- Secure all medications and sharp objects in your home as well.
Seek the support of a mental health provider. Ensure that an appropriate safety plan is created.
In the case of an emergency, call 911 or bring your child to your nearest emergency room for an evaluation. You may also wish to contact mobile crisis intervention services in your area.

Hotlines

Suicide Prevention Lifeline: Call or text 988
Crisis Text Line: Text TALK to 741-741
National de Prevencion del Suicidio: 1-888-628-9454
The Trevor Project (Crisis line for LGBTQ+ youth): 1-866-488-7386
National Teen Dating Abuse Helpline: 1-866-331-9474
The National Runaway Safeline: 800-RUNAWAY (800-786-2929)

Check our social media for more resources and useful information.

Sources

American Foundation for Suicide Prevention. (2024, May 11). Suicide statistics.

https://afsp.org/suicide-statistics

Centers for Disease Control and Prevention. ((2024, April 25). Suicide facts.

https://www.cdc.gov/suicide/facts/index.html

National Institute of Mental Health. (2024, February). Suicide statistics.

https://www.nimh.nih.gov/health/statistics/suicide

National Vital Statistics System. (2024). Mortality 2018-2022 on CDC WONDER Online

Database. Centers for Disease Control and Prevention. http://wonder.cdc.gov/mcd-icd10-expanded.html

Rejuvenate your Relationships:

August 6, 2024

Applying the Gottman Method, by Emily Israel, M.S.

Relationships can provide us with comfort, security, enjoyment, pleasure, love, companionship, support, safety, and care. However, we can feel very distressed when our relationships lack these positive experiences. Most of us have experienced challenges in relationships with a partner or loved one at some point. There are ways to support the development of healthy relationships, as well as ways to help a relationship that has become more conflictual become healthy once again.

John Gottman, Ph.D., and his wife Julie Gottman, Ph.D. spent many years researching aspects that support healthy couple relationships and found tools that can benefit both couples and other relationships.

Ways to support a healthy relationship according to Gottman Research:

Get to know the other person’s needs, values, past experiences, priorities, and stresses.
Experience and express love to those with whom you share a relationship (more specific to romantic partners but can apply to other loved ones).
Turn towards your loved one and respond when they engage you. Create opportunities to spend time together to support the building of connection.
Try to view the person from a positive perspective.
Management of Conflict
- Engage in active listening skills to develop empathy: listen intently to the person’s feelings and acknowledge them by validating and summarizing what you heard them say.
- Avoid defensiveness: Take accountability and create an improvement plan. Acknowledge your role in an argument and pick one way you might make it better.
- Avoid attacking the other person’s character or criticizing them: Start with “I feel” and describe what created the feeling without attacking without directing at them and share what you need to feel better.
- Resist Stonewalling: Stonewalling is when we become frustrated in a conflict and we walk away from our significant other or withdraw. When you are tempted to tune out a loved one, consider engaging in self-soothing techniques and taking a timed break to give yourself time to calm down instead. This break should be no more than 24 hours and is meant to bring down each person’s heart rate so that you can re-engage effectively.
Discuss future dreams and understand each other’s goals to create shared meaning.
When one person is stressed about something such as an incident at work, unrelated to the relationship, join in on how they feel and support their position on the issue.
Demonstrate trust and commitment to one another.

If you would like to develop these skills further and rejuvenate any of your relationships, please contact us at the Center.

Recognizing Different Presentations of Obsessive-Compulsive Disorder (OCD)

May 9, 2024

By Brittany Keim, MS, Therapist, The Center for Neuropsychology and Counseling

Obsessive compulsive disorder (OCD) is characterized by obsessions and compulsions. Obsessions are recurrent and persistent thoughts or images; whereas, compulsions are behavioral or mental actions that are performed to reduce the distress or discomfort that an individual experiences. In simpler terms, an obsession is something that you cannot stop thinking about regardless of how hard you try to stop and a compulsion is a behavior that gives you short-term relief from your obsession. For instance, an individual may experience obsessions about their safety when they leave the house. In an effort to decrease their feelings or distress, that individual may stay home and this action will act as a compulsion because it is directly related to a decrease in anxiety or discomfort.

When thinking about OCD, it is important to remember that obsessions and compulsions have to result in significant distress and impairment. This means that obsessions and/or compulsions are time consuming and take away from your ability to participate in everyday activities. Significant distress and impairment may look like being late to school, skipping work, not being able to participate in activities that you once found enjoyable, etc.

Obsessive compulsive disorder is often thought of as excessive hand washing and a fear of contamination or germs, but OCD has many other presentations that can be overlooked. Knowledge of these other presentations is helpful in obtaining a correct diagnosis and receiving effective treatment. Below, I will detail common OCD subtypes, but please note that this is not an exhaustive list of presentations.

Harm OCD – involves intrusive thoughts of harming others or committing a violent act. People fear they could lose control at any moment and engage in violent behaviors. Due to this fear, individuals with this subtype of OCD may engage in significant avoidance. They may avoid interacting with others or completing everyday tasks that pose a risk (e.g., chopping vegetables).

Postpartum OCD – characterized by unwanted thoughts of harming a newborn. Individuals who experience this presentation will often avoid interacting with their baby or they will refrain from engaging in actions that are essential in taking care of a newborn (e.g., changing a diaper).

“Just Right” OCD – obsessions are thoughts and/or feelings that something is not quite right or that something is incomplete. Those who struggle with this subtype of OCD, will often wait to complete a task until it feels “right” or they will excessively engage in a behavior until it feels “right.”

Scrupulosity OCD – strict adherence to religious principles or moral ideals. Individuals will hold themselves to high moral/religious standards and feel extreme guilt or anxiety when they fall short. Some examples of compulsions are: excessively reading scripture or not allowing oneself to enjoy interests in fear that this could be considered sinful.

Relationship OCD – described as repetitive thoughts that center on doubts or fears about the relationship. The person may experience uncertainty and obsess about whether their partner really loves them or whether the relationship will last. A common compulsion related to this subtype is seeking reassurance.

Pedophilia OCD – this subtype of OCD occurs in individuals who have no desire to harm children, but are plagued with worry that they may do so. Individuals may become concerned with their thoughts towards children and/or they may fear that they may interact with a child in a way that is deemed inappropriate.

If you are currently experiencing symptoms of OCD and relate to any of the above presentations, you are not alone. Exposure with response prevention (ERP) is an evidence-based approach to treatment that has been proven to be very effective in treating OCD. Through ERP, an individual will learn to navigate their obsessions and decrease unwanted compulsions that interfere with their everyday functioning. Reach out to The Center today to learn more about receiving treatment for OCD.

5 Ways to Accept and Overcome Your Anxiety

April 15, 2024

By Dr. Lorna Jansen

Most of us have felt anxious at one point or another. Maybe it was a school or work evaluation or a difficult relationship or fears about the state of the world that recently caused an increase in anxiety for you or a loved one. Regardless of the origin, it is important to understand how to recognize and respond appropriately to anxiety when it comes up. I attended a seminar by Lynn Lyons, LCSW, on the topic of Helping Anxious Families. What follows is a combination of information from her presentation and my own clinical experiences.

The first step is to be aware and acknowledge the anxiety you or your family member is feeling.
- This can manifest as physical symptoms, such as shortness of breath, shaky hands, an upset stomach or headache, and/or feeling like your heart is racing.
- Take notice if you are having trouble sleeping or concentrating.

The second step is to understand that we often can’t change the fact that anxiety will show up, but we can change how we respond when we feel anxious. In fact, it is more important that we should welcome anxiety and get used to the thing that is making us anxious. We can even be curious about our feelings of discomfort and realize that if we aren’t always feeling at ease, that means we’re headed in the right direction.
The next step is to look at how the anxiety is being reinforced in your own life or within the family. Often, a person who is anxious will require that certain things are done to help them reduce their anxiety. For example, a child who is worried about interacting with peers on the playground may avoid going out for recess. In the absence of any safety issues, it would be best if a teacher or guidance counselor helped that child get used to playing on the playground instead of allowing them to skip out on the experience all together.
Anxiety runs in families and it affects the people with whom you live. If you tend to be a person who is often worried, you have probably affected the anxiety level of those around you. If you are a parent, it is suggested that you
- Talk less about your anxieties and fears about the world to your child, and do not repeat others’ fears to yourself or to them
- Seek to find ways that you can encounter your fears while also supporting yourself appropriately
- Control your response to others’ fears – try to remain calm instead of expressing excess emotions
- Reduce your expectations that accommodations should be made in response to your fears or to someone else’s worries
Anxiety wants us to feel calm, comfortable, and certain. Instead, we can
- Expect that worries and fears will come up.
- Talk to your worry. You can even name your anxious voice and acknowledge it when it shows up: “Hi, George. There you are again. I hear that you’re anxious about getting in the car today.”
- Aim to be unsure and uncomfortable on purpose at times.
- Keep breathing. The 4-7-8 breathing technique involves breathing in for four counts, holding for seven counts, and breathing out for eight. When you notice you are breathing rapidly, try to slow it down using this method (or box or belly breathing, if preferred). Rapid breathing sends the message to your brain that you are anxious, relaxed breathing lets your body know you are OK.
- Keep your goals in mind and remember the success you have had in the past when you have encountered other feared environments.
- Continue showing up and remember that worry doesn’t have to get in the way of you achieving your goals, whether that be dealing with a difficult boss or taking a test at school.

In conclusion, if you or someone you know is living with anxiety, it can be draining and difficult to know how to combat it. Remember that anxiety will show up – expect it, but do not give it a foothold or give in to its demands for security. Also, consider how you are separate from your anxiety and realize that it is not you, but a separate thing outside of you that is calling for this flight or fight responses to situations that are not actually dangerous. You can do this!

Quick Tips for Regulating Your Emotions

September 1, 2023

By: Brittany Keim, Therapist at The Center

Oftentimes, before we even know what emotion we are feeling, we experience physical symptoms that tell us that something is “off”. These symptoms can include: an accelerated heart rate, a pit in our stomach, or an all-encompassing feeling of heaviness. We ponder, “Why am I feeling this way?” This can be a tricky question to answer, which is why it is important to employ specific skills to assist us in identifying and understanding our big emotions.

Simply put, emotion regulation skills help us to manage and respond to an emotional experience in a productive way. When we know what we feel and why we feel that way, we are in a much better place to navigate a challenging situation and prepare for what is next to come.

Here are some tips to help you better understand and regulate your emotions:

Recognize your early warning signs

As mentioned above, our emotions are usually accompanied by a physical reaction. It is helpful to catch these feelings in our body early on and before they overwhelm us. Take a moment now and ask yourself, “Where do I tend to feel my emotions?” Does your face become flushed? Does your stomach start to hurt? Does your chest get tight? These physical sensations can be thought of as hints that tell us that we are experiencing an emotion. The sooner we recognize these early warning signs, the sooner we can understand, regulate, and resolve our emotion. With practice, you may even be able to prevent big emotional reactions from happening in the first place!

Slow down and try to avoid jumping to conclusions

When we are experiencing a big emotion, it can feel impossible to think clearly. Take a few deep breaths and think of something else you can put your attention on for a brief moment. In order to properly work through an emotional experience, you have to calm yourself down so that you have the mental clarity to do some critical thinking.

Consider which emotion(s) you may be experiencing and then label your emotion(s)

It is important to identify what emotion or emotions you are feeling. Once you put a name to what you are feeling, you have valuable information. If you know what emotion you’re feeling, you’re one step closer to understanding what triggered you and why you are feeling that way.

Observe, observe, observe! Be a detective!

Observe what is happening around you and consider what happened right before you started feeling that given emotion. Usually, the thing or event that occurred right before your emotional experience is what triggered you in the first place. Pay close attention to thoughts that you may be experiencing as this will also give you insight into why you are feeling some type of way.

Ask yourself, “What do I want to get out of this situation?”

You’ve upgraded to problem solver! Now that you know what you’re feeling and why you are feeling that way, consider what actions will help you get what you want. Think through possible solutions and choose the option that you feel will benefit you the most. For instance, if you are feeling sad because you just found out that you didn’t perform well on a test, you likely want to improve your grade. You should accept your feelings of sadness, but it probably won’t help if you sit in your sadness for a long period of time or come to the conclusion that you’re done trying in school. Instead, start thinking of helpful solutions. You may conclude that it is best to ask a teacher for help or study more next time.

Keep these steps in mind next time you encounter a similar situation

You’ve proven that you can work through a challenging emotional experience. Use this thinking process to help you in future situations. You will likely find that recognizing your triggers can help you the next time you encounter them.

The Center for Neuropsychology and Counseling

Select a Category

Suicide Prevention: What to Know

Rejuvenate your Relationships:

Recognizing Different Presentations of Obsessive-Compulsive Disorder (OCD)

5 Ways to Accept and Overcome Your Anxiety

Quick Tips for Regulating Your Emotions

Here are some tips to help you better understand and regulate your emotions:

Recognize your early warning signs

Slow down and try to avoid jumping to conclusions

Consider which emotion(s) you may be experiencing and then label your emotion(s)

Observe, observe, observe! Be a detective!

Ask yourself, “What do I want to get out of this situation?”

Keep these steps in mind next time you encounter a similar situation

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