How To Stay Alive (When You Really Don’t Want To)
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How To Stay Alive (When You Really Don’t Want To)
A subscriber recently requested:
❝Request: more people need to be aware of suicidal tendencies and what they can do to ward them off❞
…and we said we’d do that one of these Psychology Sundays, so here we are, doing it!
First of all, we’ll mention that we did previously do a main feature on managing depression (in oneself or a loved one); here it is:
The Mental Health First Aid That You’ll Hopefully Never Need
Now, not all depression leads to suicidality, and not all suicide is pre-empted by depression, but there’s a large enough crossover that it seems sensible to put that article here, for anyone who might find it of use, or even just of interest.
Now, onwards, to the specific, and very important, topic of suicide.
This should go without saying, but some of today’s content may be a little heavy.
We invite you to read it anyway if you’re able, because it’s important stuff that we all should know, and not talking about it is part of what allows it to kill people.
So, let’s take a deep breath, and read on…
The risk factors
Top risk factors for suicide include:
- Not talking about it
- Having access to a firearm
- Having a plan of specifically how to commit suicide
- A lack of social support
- Being male
- Being over 40
Now, some of these are interesting sociologically, but aren’t very useful practically; what a convenient world it’d be if we could all simply choose to be under 40, for instance.
Some serve as alarm bells, such as “having a plan of specifically how to commit suicide”.
If someone has a plan, that plan’s never going to disappear entirely, even if it’s set aside!
(this writer is deeply aware of the specifics of how she has wanted to end things before, and has used the advice she gives in this article herself numerous times. So far so good, still alive to write about it!)
Specific advices, therefore, include:
Talk about it / Listen
Depending on whether it’s you or someone else at risk:
- Talk about it, if it’s you
- Listen attentively, if it’s someone else
There are two main objections that you might have at this point, so let’s look at those:
“I have nobody to talk to”—it can certainly feel that way, sometimes, but you may be surprised who would listen if you gave them the chance. If you really can’t trust anyone around you, there are of course suicide hotlines (usually per area, so we’ll not try to list them here; a quick Internet search will get you what you need).
If you’re worried it’ll result in bad legal/social consequences, check their confidentiality policy first:
- Some hotlines can and will call the police, for instance.
- Others deliberately have a set-up whereby they couldn’t even trace the call if they wanted to.
- On the one hand, that means they can’t intervene
- On the other hand, that means they’re a resource for anyone who will only trust a listener who can’t intervene.
“But it is just a cry for help”—then that person deserves help. What some may call “attention-seeking” is, in effect, care-seeking. Listen, without judgement.
Remove access to firearms, if applicable and possible
Ideally, get rid of them (safely and responsibly, please).
If you can’t bring yourself to do that, make them as inconvenient to get at as possible. Stored securely at your local gun club is better than at home, for example.
If your/their plan isn’t firearm-related, but the thing in question can be similarly removed, remove it. You/they do not need that stockpile of pills, for instance.
And of course you/they could get more, but the point is to make it less frictionless. The more necessary stopping points between thinking “I should just kill myself” and being able to actually do it, the better.
Have/give social support
What do the following people have in common?
- A bullied teenager
- A divorced 40-something who just lost a job
- A lonely 70-something with no surviving family, and friends that are hard to visit
Often, at least, the answer is: the absence of a good social support network
So, it’s good to get one, and be part of some sort of community that’s meaningful to us. That could look different to a lot of people, for example:
- A church, or other religious community, if we be religious
- The LGBT+ community, or even just a part of it, if that fits for us
- Any mutual-support oriented, we-have-this-shared-experience community, could be anything from AA to the VA.
Some bonus ideas…
If you can’t live for love, living for spite might suffice. Outlive your enemies; don’t give them the satisfaction.
If you’re going to do it anyway, you might as well take the time to do some “bucket list” items first. After all, what do you have to lose? Feel free to add further bucket list items as they occur to you, of course. Because, why not? Before you know it, you’ve postponed your way into a rich and fulfilling life.
Finally, some gems from Matt Haig’s “The Comfort Book”:
- “The hardest question I have been asked is: “How do I stay alive for other people if I have no one?” The answer is that you stay alive for other versions of you. For the people you will meet, yes, but also the people you will be.”
- “Stay for the person you will become”
- “You are more than a bad day, or week, or month, or year, or even decade”
- “It is better to let people down than to blow yourself up”
- “Nothing is stronger than a small hope that doesn’t give up”
- “You are here. And that is enough.”
You can find Matt Haig’s excellent “The Comfort Book” on Amazon, as well as his more well-known book more specifically on the topic we’ve covered today, “Reasons To Stay Alive“.
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Keeping Your Kidneys Healthy (Especially After 60)
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Keeping your kidneys happy: it’s more than just hydration!
Your kidneys are very busy organs. They filter waste products, balance hydration, pH, salt, and potassium. They also make some of our hormones, and are responsible for regulating red blood cell production too. They also handle vitamin D in a way our bodies would not work without, making them essential for calcium absorption and the health of our bones, and even muscular function.
So, how to keep them in good working order?
Yes, hydrate
This is obvious and may go without saying, but we try to not leave important things without saying. So yes, get plenty of water, spread out over the day (you can only usefully absorb so much at once!). If you feel thirsty, you’re probably already dehydrated, so have a little (hydrating!) drink.
Don’t smoke
It’s bad for everything, including your kidneys.
Look after your blood
Not just “try to keep it inside your body”, but also:
- Keep your blood sugar levels healthy (hyperglycemia can cause kidney damage)
- Keep your blood pressure healthy (hypertension can cause kidney damage)
Basically, your kidneys’ primary job of filtering blood will go much more smoothly if that blood is less problematic on the way in.
Watch your over-the-counter pill intake
A lot of PRN OTC NSAIDs (PRN = pro re nata, i.e. you take them as and when symptoms arise) (NSAIDs = Non-Steroidal Anti-Inflammatory Drugs, such as ibuprofen for example) can cause kidney damage if taken regularly.
Many people take ibuprofen (for example) constantly for chronic pain, especially the kind cause by chronic inflammation, including many autoimmune diseases.
It is recommended to not take them for more than 10 days, nor more than 8 per day. Taking more than that, or taking them for longer, could damage your kidneys temporarily or permanently.
Read more: National Kidney Foundation: Advice About Pain Medicines
See also: Which Drugs Are Harmful To Your Kidneys?
Get a regular kidney function checkup if you’re in a high risk group
Who’s in a high risk group?
- If you’re over 60
- If you have diabetes
- If you have cardiovascular disease
- If you have high blood pressure
- If you believe, or know, you have existing kidney damage
The tests are very noninvasive, and will be a urine and/or blood test.
For more information, see:
Kidney Testing: Everything You Need to Know
Take care!
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You Are Not Broken – by Dr. Kelly Casperson
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Many women express “I think I’m broken down there”, and it turns out simply that neither they nor their partners had the right knowledge, that’s all. The good news is: bedroom competence is an entirely learnable skill!
Dr. Casperson is a urologist, and over the years has expanded her work into all things pelvic, including the relevant use of both systemic and topical hormones (as in, hormones to increase overall blood serum levels of that hormone, like most HRT, and also, creams and lotions to increase levels of a given hormone in one particular place).
However, this is not 200 pages to say “take hormones”. Rather, she covers many areas of female sexual health and wellbeing, including yes, simply pleasure. From the physiological to the psychological, Dr. Casperson talks the reader through avoiding blame games and “getting out of your head and into your body”.
Bottom line: if you (or a loved one) are one of the many women who have doubts about being entirely correctly set up down there, then this book is definitely for you.
Click here to check out You Are Not Broken, and indeed stop “should-ing” all over your sex life!
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How To Get More Nutrition From The Same Food
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How To Get More Out Of What’s On Your Plate
Where does digestion begin? It’s not the stomach. It’s not even the mouth.
It’s when we see and smell our food; maybe even hear it! “Sell the sizzle, not the steak” has a biological underpinning.
At that point, when we begin to salivate, that’s just one of many ways that our body is preparing itself for what we’re about to receive.
When we grab some ready-meal and wolf it down, we undercut that process. In the case of ready-meals, they often didn’t have much nutritional value, but even the most nutritious food isn’t going to do us nearly as much good if it barely touches the sides on the way down.
We’re not kidding about the importance of that initial stage of our external senses, by the way:
- Food perception primes hepatic endoplasmic reticulum homeostasis via melanocortin-dependent control of mTOR activation
- Olfaction regulates organismal proteostasis and longevity via microRNA-dependent signalling
So, mindful eating is not just something for Instagrammable “what I eat in a day” aesthetic photos, nor is just for monks atop cold mountains. There is actual science here, and a lot of it.
It starts with ingredients
“Eating the rainbow” (no, Skittles do not count) is great health advice for getting a wide variety of micronutrients, but it’s also simply beneficial for our senses, too. Which, as above-linked, makes a difference to digestion and nutrient absorption.
Enough is enough
That phrase always sounds like an expression of frustration, “Enough is enough!”. But, really:
Don’t overcomplicate your cooking, especially if you’re new to this approach. You can add in more complexities later, but for now, figure out what will be “enough”, and let it be enough.
The kitchen flow
Here we’re talking about flow in the Csikszentmihalyi sense of the word. Get “into the swing of things” and enjoy your time in the kitchen. Schedule more time than you need, and take it casually. Listen to your favourite music. Dance while you cook. Taste things as you go.
There are benefits, by the way, not just to our digestion (in being thusly primed and prepared for eating), but also to our cognition:
In The Zone: Flow State and Cognition in Older Adults
Serve
No, not just “put the food on the table”, but serve.
Have a pleasant environment; with sensory pleasures but without too many sensory distractions. Think less “the news on in the background” and more smooth jazz or Mozart or whatever works for you. Use your favourite (small!) plates/bowls, silverware, glasses. Have a candle if you like (unscented!).
Pay attention to presentation on the plate / in the bowl / in any “serve yourself” serving-things. Use a garnish (parsley is great if you want to add a touch of greenery without changing the flavor much). Crack that black pepper at the table. Make any condiments count (less “ketchup bottle” and more “elegant dip”).
Take your time
Say grace if that fits with your religious traditions, and/or take a moment to reflect on gratitude.
In many languages there’s a pre-dinner blessing that most often translates to “good appetite”. This writer is fond of the Norwegian “Velbekommen”, and it means more like “May good come of it for you”, or “May it do you good”.
Then, enjoy the food.
For the most even of blood sugar levels, consider eating fiber, protein/fat, carbs, in that order.
Why? See: 10 Ways To Balance Blood Sugars
Chew adequately and mindfully. Put your fork (or spoon, or chopsticks, or whatever) down between bites. Drink water alongside your meal.
Try to take at least 20 minutes to enjoy your meal, and/but any time you go to reach for another helping, take a moment to check in with yourself with regard to whether you are actually still hungry. If you’re not, and are just eating for pleasure, consider deferring that pleasure by saving the food for later.
At this point, people with partners/family may be thinking “But it won’t be there later! Someone else will eat it!”, and… That’s fine! Be happy for them. You can cook again tomorrow. You prepared delicious wholesome food that your partner/family enjoyed, and that’s always a good thing.
Want to know more about the science of mindful eating?
Check out Harvard’s Dr. Lilian Cheung on Mindful Eating here!
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Menopause, & When Not To Let Your Guard Down
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This is Dr. Jessica Shepherd, a physician Fellow of the American College of Obstetricians & Gynecologists, CEO at Sanctum Medical & Wellness, and CMO at Hers.
She’s most well-known for her expertise in the field of the menopause. So, what does she want us to know?
Untreated menopause is more serious than most people think
Beyond the famous hot flashes, there’s also the increased osteoporosis risk, which is more well-known at least amongst the health-conscious, but oft-neglected is the increased cardiovascular disease risk:
What Menopause Does To The Heart
…and, which a lot of Dr. Shepherd’s work focuses on, it also increases dementia risk; she cites that 60–80% of dementia cases are women, and it’s also established that it progresses more quickly in women than men too, and this is associated with lower estrogen levels (not a problem for men, because testosterone does it for them) which had previously been a protective factor, but in untreated menopause, was no longer there to help:
Alzheimer’s Sex Differences May Not Be What They Appear
Treated menopause is safer than many people think
The Women’s Health Initiative (WHI) study, conducted in the 90s and published in 2002, linked HRT to breast cancer, causing fear, but it turned out that this was quite bad science in several ways and the reporting was even worse (even the flawed data did not really support the conclusion, much less the headlines); it was since broadly refuted (and in fact, it can be a protective factor, depending on the HRT regimen), but fearmongering headlines made it to mainstream news, whereas “oopsies, never mind, we take that back” didn’t.
The short version of the current state of the science is: breast cancer risk varies depending on age, HRT type, and dosage; some kinds of HRT can increase the risk marginally in those older than 60, but absolute risk is low compared to placebo, and taking estrogen alone can reduce risk at any age in the event of not having a uterus (almost always because of having had a hysterectomy; as a quirk, it is possible to be born without, though).
It’s worth noting that even in the cases where HRT marginally increased the risk of breast cancer, it significantly decreased the risk of cancers in total, as well fractures and all-cause-mortality compared to the placebo group.
In other words, it might be worth having a 0.12% risk of breast cancer, to avoid the >30% risk of osteoporosis, which can ultimately be just as fatal (without even looking at the other things the HRT is protective against).
However! In the case of those who already have (or have had) breast cancer, increasing estrogen levels can indeed make that worse/return, and it becomes more complicated in cases where you haven’t had it, but there is a family history of it, or you otherwise know you have the gene for it.
You can read more about HRT and breast cancer risk (increases and decreases) here:
…and about the same with regard to HMT, here:
The Hormone Therapy That Reduces Breast Cancer Risk & More
Lifestyle matters, and continues to matter
Menopause often receives the following attention from people:
- Perimenopause: “Is this menopause?”
- Menopause: “Ok, choices to make about HRT or not, plus I should watch out for osteoporosis”
- Postmenopause: “Yay, that’s behind me now, back to the new normal”
The reality, Dr. Shepherd advises, is that “postmenopause” is a misnomer because if it’s not being treated, then the changes are continuing to occur in your body.
This is a simple factor of physiology; your body is always rebuilding itself, will never stop until you die, and in untreated menopause+postmenopause, it’s now doing it without much estrogen.
So, you can’t let your guard down!
Thus, she recommends: focus on maintaining muscle mass, bone health, and cardiovascular health. If you focus on those things, the rest (including your brain, which is highly dependent on cardiovascular health) will mostly take care of itself.
Because falls and fractures, particularly hip fractures, drastically reduce quality and length of life in older adults, it is vital to avoid those, and try to be sufficiently robust so that if you do go A over T, you won’t injure yourself too badly, because your bones are strong. As a bonus, the same things (especially that muscle mass we talked about) will help you avoid falling in the first place, by improving stability.
See also: Resistance Is Useful! (Especially As We Get Older)
And about falls specifically: Fall Special: Be Robust, Mobile, & Balanced!
Want to know more from Dr. Shepherd?
You might like this book of hers that we reviewed not long back:
Generation M – by Dr. Jessica Shepherd
Take care!
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When You “Can’t Complain”
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A Bone To Pick… Up And Then Put Back Where We Found It
In today’s Psychology Sunday feature, we’re going to be flipping the narrative on gratitude, by tackling it from the other end.
We have, by the way, written previously about gratitude, and what mistakes to avoid, in one of our pieces on positive psychology:
How To Get Your Brain On A More Positive Track (Without Toxic Positivity)
“Can’t complain”
Your mission, should you choose to accept it (and come on, who doesn’t like a challenge?) is to go 21 days without complaining (to anyone, including yourself, about anything). If you break your streak, that’s ok, just start again!
Why?
Complaining is (unsurprisingly) inversely correlated with happiness, in a self-perpetuating cycle:
Pet Peeves and Happiness: How Do Happy People Complain?
And if a stronger motivation is required, there’s a considerable inverse correlation between all-cause happiness and all-cause mortality, even when potential confounding factors (e.g., chronic health conditions, socioeconomic status, etc) are controlled for, and especially as we get older:
Investing in Happiness: The Gerontological Perspective
How?
You may have already formulated some objections by this point, for example:
- Am I supposed to tell my doctor/therapist “I’m fine thanks; how are you?”
- Some things are worthy of complaint; should I be silent?
But both of these issues (communication, and righteousness) have answers:
On communication:
There is a difference between complaining, and giving the necessary information in answer to a question—or even volunteering such information.
For example, when our site went down yesterday, some of you wrote to us to let us know the links weren’t working. There is a substantive difference (semantic, ontological, and teleological) between:
- ❝The content was great but the links in “you may have missed” did not work.❞ ← a genuine piece of feedback we received (thank you!)
- ❝Wasted my time, couldn’t read your articles! Unsubscribing, and I hope your socks get wet tomorrow!❞ ← nobody said this; our subscribers are lovely (thank you)
- Note that the former wasn’t a complaint, it was genuinely helpful feedback, without which we might not have noticed the problem and fixed it.
- The latter was a complaint, and also (like many complaints) didn’t even address the actual problem usefully.
What makes it a complaint or not is not the information conveyed, but the tone and intention. So for example:
“You’ve only done half the job I asked you to!” → “Thank you for doing the first half of this job, could you please do the other half now?”
Writer’s anecdote: my washing machine needs a part replaced; the part was ordered two weeks ago and I was told it would take a week to arrive. It’s been two weeks, so tomorrow I will not complain, but I will politely ask whether they have any information about the delay, and a new estimated time of arrival. Because you know what? Whatever the delay is, complaining won’t make it arrive last week!
On righteousness:
Indeed, some things are very worthy of complaint. But are you able to effect a solution by complaining? If not, then it’s just hot air. And venting isn’t without its own merits (we touched on the benefits of emotional catharsis recently), but that should be a mindful choice when you choose to do that, not a matter of reactivity.
Complaining is a subset of criticizing, and criticizing can be done without the feeling and intent of complaining. However, it too should definitely be measured and considered, responsive, not reactive. This itself could be the topic for another main feature, but for now, here’s a Psychology Today article that at least explains the distinction in more words than we have room for here:
React vs Respond: What’s the difference?
This, by the way, also goes the same for engaging in social and political discourse. It’s easy to get angry and reactive, but it’s good to take a moment to pick your battles, and by all means fight for what you believe in, and/but also do so responsively rather than reactively.
Not only will your health thank you, but you’re also more likely to “win friends and influence people” and all that!
What gets measured, gets done
Find a way of tracking your streak. There are apps for that, like this one, or you could find a low-tech method you prefer.
Bonus tip: if you do mess up and complain, and you realize as you’re doing it, take a moment to take a breath and correct yourself in the moment.
Take care!
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13 Things Mentally Strong Couples Don’t Do – by Dr. Amy Morin
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The saying “happy wife; happy life” indeed goes regardless of gender. One can have every other happiness, but if there’s relational trouble, it brings everything else down.
This book is not intended, however, only for people whose relationships are one couple’s therapy session away from divorce. Rather, it’s intended as a preventative. Because, in this as in every other aspect of health, prevention is better than cure!
It is the sign of a strong couple to be proactive about the health of the relationship, and work together to build and reinforce things along the way.
The style of this book is very accessible pop-science, but the author speaks from a strong professional background in social work, psychology, and psychotherapy, and it shows.
Bottom line: if you’d like to strengthen your relationship skills, this book gives 13 great ways to do that.
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