#855 Discussing Suicidal Ideation

February 23, 2023Scott Benner

Erika Forsyth is an LMFT who has type 1 diabetes.

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Scott Benner 0:00
Hello friends, and welcome to episode 855 of the Juicebox Podcast.

On today's episode of Juicebox Podcast I'm joined once again by Erica Forsythe. Erica is a licensed Marriage and Family Therapist out of California. She can also see patients right now, virtually, who live in Utah, Oregon and Florida. She's adding more states all the time, check her out at Erica forsyth.com Or by calling six to 63442263. Just a little heads up, you'll see by the title Eric and I are going to talk about suicidal ideation today, and everything that goes around that, how to spot it what to do, how you might be able to help someone. While you're listening, please remember that nothing you hear on the Juicebox Podcast should be considered advice, medical or otherwise, please Always consult a physician before making any changes to your health care plan, or becoming bold with insulin. If you're a type one who is a US resident or a person who is the caregiver of someone with type one, filling out the survey AT T one D exchange.org. Forward slash juicebox will go a long way towards helping type one diabetes research. complete that survey AT T one D exchange.org. Forward slash juicebox. If you are currently having suicidal thoughts or just want to speak with someone just pick up your phone and dial 988 That's the suicide and crisis lifeline 988. You can also look online Samaritans hope.org Or just go to Google and type in suicide help. All kinds of local returns will come up for you. This episode of The Juicebox Podcast doesn't have any ads. But if you're interested in supporting the podcast through one of the advertisers, there are links in the show notes of this episode. And at juicebox podcast.com to all of the sponsors. Okay. Hello. Hi, Erica. How are you? Hi,

Erika Forsyth, MFT, LMFT 2:09
great. Thank you.

Scott Benner 2:11
I appreciate you. Oh, I'm already I just hit record. And I'm already doubting that I should do this. But I know I'm no I know I shouldn't I know it's going to be valuable. But I'm gonna get upset at some point while I'm doing this. So let me let me lay out how we got here. A lot of people write to me, that's the thing you hear a lot of people say most of them are probably lying because they're trying to make their social influence seem more powerful. But I get a ton of emails, private messages, so many so that I mean, I read I read every one of them. But sometimes they'll sit in my inbox for a month before I can get to them. And I got a note from a girl a while back now. And it was pretty long and descriptive. And and they wanted to come on the show. They didn't mention any mental health issues. But I would say that the letter had some signs of it in there. Sometimes you can kind of tell by the length of the letter or details get over shared things like that, like I can I kind of have like maybe a half a sixth sense for it. And so I got right back to her. And I see you know, would love to have you on the show, let's set it up. And then I never ever heard back from Oregon. And I mean, like a year went by. And then she responded to the email, as if I had just sent it like the week before. And we were talking and here was the conversation again. And they were very excited to come on the show. And this time I got her booked onto the show. And it takes about six months after your book to get on the show. So about two months before, about two months before she was supposed to record with me. I got this very strange email from somebody I don't know. And it became obvious that the person was trying to tell me that their daughter had passed away without using the words. And then as I read a little farther, opened up and said yes, she had passed, but then I realized they weren't going to say how. So I was like, okay, and at the end of the note, it said that at at their daughter's funeral. They wanted to take donations for the podcast. And this was at his daughter's behest. And I was just like, I mean, if you could try to imagine my wife and I are sitting in our car outside of a restaurant, just waiting for our takeout. You're not I mean, and I'm like, Hey, look at this and I'm reading it we're both trying to make sense of it. it and the gentleman says, leaves his phone number and says you can call me. And I thought I said to my wife, I'm like, this is I don't know what to do about this. But I can't just email back. I don't know what the right thing to say like this has to happen conversationally. And so I just called him from the car. And he never said how, just that his daughter had passed away that morning. And, and then I started putting it together. And I realized, I think this girl took her own life. And I think I'm in her suicide note. Like, like, you don't I mean, because you don't like and I'm obviously making a couple of leaps. But you don't walk into a bedroom and say to your parents, like, Hey, I'm gonna go kill myself now. But at my funeral, could you please handle donation like, so I started thinking like, Oh, my God, I'm in somebody's like, like, last last will and testament, basically, you know, and it freaked me out a lot. And I held myself together. And I talked to him, and he was barely holding himself together. And I told him, I get back to him the next day. And so I'm sorry to say that in that moment, I didn't realize that his daughter was the person who I described as the person I was emailing with the beginning. And I put a lot of effort into it. I asked people online, Jenny and I talked privately, and I ended up giving him three places. I said, Look, I can't take donations from from this. I was like, but here's, I gave him touched by type one. I said, this is an organization that helps children, I gave him diabetes sisters, is an organization that helps women, and we are diabetes, for eating disorders, and things like that. And I was like, these are three places I think, would be very valuable. And, you know, I can't like I would never, I said, I'm not a I'm not a charity. I'm like, I don't even know what I would do with money if it came, like, you know, I'm not going to take but but he but he kept saying, but my daughter wants you to have it. And I was like, I can't take it. Like I just can't, you know, and so we set this up, everybody was okay with it. Like two days later, my cell phone, I'm sitting right here and my cell phone rings and I don't recognize the number and I pick it up. And there is a crying woman on the phone. Before she says hello, she's, she's crying. But she's also doing the dishes. So I can hear someone crying and doing dishes at the same time. And I just thought, Oh God, this is this girl's mom. Like it is she's got my number because I called her husband. And we just stayed on the phone for maybe 20 minutes. She described what the podcast meant to her daughter how much it had helped her through her life. And told me that never never used the word suicide never said took her own life. She didn't use those words. We all it was spoken around the entire time. And and she just thanked me and then asked me if I had any insight about her daughter. And I told her that I would be happy to share the emails that she sent me and I sent them back to her. And I've never I've never heard from them again. I did tell the woman like it was like if you ever want to come on the podcast and speak about your daughter, you know, eulogize her memorialized or anything at all? Like you could I took from the conversations that she had a lot of different problems. Some were physical and some were mental. And that she had really succeeded through her life she'd I think become a nurse and like, done a number of things going to school the way she meant to, I hope I'm not miss speaking about what she accomplished. But she had gone to school she was working towards she had a life you know, but the mom said something. And I'm not going to get it right word for word, but I'm never gonna forget the intent of what she said is, this was always how it was going to end she said, I've been waiting for this for a long time. And I thought and again, not her exact words, but I think I think it was I think what she said word for word as close as I can get to it is we always knew this was going to happen. So I'm assuming there were fits and starts and attempts and things along the way. And so I of course not to make this about me because it certainly is and I want to shine a light on this and help people understand how to identify suicidal thoughts, how you can help people with them, etc. But just telling you the story because that's why the episode exists. I I was I don't know anybody who's suicidal, I don't think and then it made me think or do I and I don't know, because this girl did not seem suicidal in these emails. She just seemed a little I don't know, all over the place a little bit but not but in a way that would have put up a red flag for me, you know? Certainly. Anyway, I, I just wanted to help people recognize it and others and know where to go next. So if you can help me with that, that'd be great.

Erika Forsyth, MFT, LMFT 10:15
Yes. Well, yeah, it's obviously a tragic story. And it's such a painful and sensitive topic. And I know that our community responded as well, there was an outpouring of love and support for this, this woman. So I think one of the main things is often you, as you were sharing, just through the email, we might not notice any significant red flags you hear a lot of family members talk about when their child dies by suicide, which I just want to note, it's, we really don't want to say committed suicide anymore is if it's like they committed a crime, and it's died by suicide. And so they reflect back and say, gosh, we really didn't even notice any signs, maybe they were sad, at some certain moments, there was you know, irregularity in their emotional regulation or their their functioning. And that might feel scary, but some things that we that you can do that one of the myths out there is that we don't want to ask if someone's suicidal, or if they have any thoughts about suicide that maybe in so doing that might plant a seed, but that's actually a really false myth. And so, by simply asking, Hey, I noticed you've been down or sad for a while, or you don't just seem yourself, have you been thinking about wanting to harm yourself? Have you been thinking about killing yourself? That that is disclosing and showing them that you care, you see them, it is not planting a seed? And, and if they say, No, that's also great, because then they know maybe if they do ever start to feel that way, they know that you're a safe person to come to. So simply just by asking, is not going to plant a seed, and it's showing that you care, you notice, and you're in your safe, right?

Scott Benner 12:20
Yeah, I I've wondered about that. Because even with a lot of parenting or, or issues or friend, you know, even like, personal relationships, it is difficult to say the thing out loud, is what's happening. Are you cheating on me? Are you like, you know what I mean? Like, like, that kind of stuff. And there are people who will live their entire lives, wondering about something, never saying it out loud. And maybe a it's not true. And you've made yourself worried about it for no reason, or B, it is true, and you could have maybe made your situation better. But the fact of the matter isn't going to change, whether you say it out loud or not. So you might as well, right?

Erika Forsyth, MFT, LMFT 13:01
Yes, and it, it can be so scary to say and obviously, as a clinician, I am trained, and I've practiced and it's I'm more comfortable doing it. And so as I coach parents to do this, I know there is that moment of it's fearful, it can be scary. But it is not. It is not what you think it's going to do. It's not going to plant the seed. And I know a lot of people might also not want to ask the question, because then they feel like well, am I responsible? What if they do say yes? And now am I responsible to make them feel better or to care for them? And you are, you are not you are then well, you're responsible at that point to get them, you know, to a trusted adult to call, you know, depending on the severity of the situation, 911988, which is the national suicide line. But you're not you yourself are not responsible to save them and make them feel better, right? You're that kind of first line of defense, so to speak.

Scott Benner 14:02
I would say that, um, I understand the fear. If you've never been in that situation, it's not something you'll get ready for. I've I've been in at one time. And I certainly won't share anybody's personal details. But as I was heading to the place where this person was, I called a friend of mine who's a police officer. And I said, I'm about to walk into this situation, and I don't know what to do. And, and he said, Okay, he goes well, just, he's like, you're gonna have to assess what's happening. He's like, is it something that's just being said out loud? Is it they're distraught about something because they, you know, something happened? Is this a real thing? Is it ongoing? And then you need He's like, he's like, then there's this important part. It's interesting. I never thought about it because you want to get this person to go seek help on their own. And I said, why? And he said, well, most of the time this works out And I said, okay, and he goes, but if you have to be taken in by force, it changes a lot about how the rest of your life goes. And I said, Really, and he said, he said from owning a firearm to like a number of different things, he said, He's like, he's like if you can get this person to go on their own. And when I got there, all I knew for sure is that I didn't understand how this person felt. And they did not seem to be the best arbiter of the next thing that happened to them. And so I made this description, I said, Look, I was told, if you go get help, you're probably going to be okay. And later, you're going to really be happy that you did this on your own. And they did that they were assessed by a professional, came home, we're okay made up an appointment with a therapist to therapist now we're doing very much better. But had that had that moment boiled over and somebody would have called a cop that would have changed their life forever. And I and even that's got to be in people's minds, right? Because like, am I going to do something? Is this a momentary thing? I'm going to this person up, you know, for the rest of their life. I can see why people would be concerned about what to do next afterwards.

Erika Forsyth, MFT, LMFT 16:13
Yes, yes. And I? For sure, yeah. The sense of responsibility, am I going to change the course of their whole entire life if I feel like I need to make this call because they aren't responding? I think it's really important for for you, as the person who's you know, attending to someone who is severely depressed or suicidal, is to give them that sense of control. Like, let them decide if they're, if you feel like they truly can. Hey, what do you need from me right now? Do you need me to stay here? And maybe elicit the help of other family and friends to take shifts? Do you need me to call you every day? What would be good for you at this moment? check ins, you all that type of stuff?

Scott Benner 16:54
Well, okay, so the thing that I was involved in was, was sprung on me, I didn't know it was happening, you know, an hour before I was there. I was, I was doing the dishes if I'm being honest. And so but if, if I'm, if I'm in a home with someone who I think feels this way, now I bet it because we've we've gone over, you can ask somebody, you know, how do you feel? So what are we what are we looking for exactly like the NIH says that warning signs of suicide are if someone is talking about wanting to die, talking about great guilt or shame, talking about being a burden to others, that those things can be indicators, you agree with that? Absolutely. If they talk about feeling empty, hopeless, trapped, or having no reason to live, if they talk about feel if they have feelings of extreme sadness, more anxiety, agitation, or a full range, or full rage, excuse me, and then an unbearable emotional or physical pain, if they feel that way. Now, they also say to look for change in behaviors, making a plan or researching ways to die, withdrawing from friends saying goodbye giving away important items, or making a will, taking dangerous risks such as driving extremely fast, displaying extreme mood swings, eating or sleeping more or less using drugs or alcohol more often than you would be expecting from them. You agree with all that? Yes. Is there anything to add to it?

Erika Forsyth, MFT, LMFT 18:24
Well, I think one thing that might get confusing for people, you know, the extreme sadness, or the even the suicidal ideation, I think can be confusing, and a lot of you know, websites and any if you Google, you know suicidal ideation. There's not a TED talks on this as well. Because a lot of people who are depressed, and I hear this in my office as well. It's kind of like a release valve for them to say, I don't want to kill myself. But sometimes it just feels easier to envision myself not being alive. Or just things might be easier if I didn't have to feel this pain, this weight. And so they're, they're thinking about it, but not they don't have means or a plan. Right? That's those are the questions you'd fall up with. If someone says yes, I have been thinking about not wanting to live, then you would say well, do you have means meaning? Have you do you have tools that were What are you? How are you going to do this and then then a plan. Now most of the time, people will say no, I don't have means or a plan. And they ideate and it's it's really not there's no it's not an active thought. It's more of a passive release.

Scott Benner 19:35
So, release is the word I was going to use. So if you are trapped in a situation, say I take a perfectly healthy, jovial person, and I locked them in a box, and that at some point, they're going to think I have to kill myself to get out of this because there's no way for me to get out of this. So that box could be an overbearing parent. It could be an abusive spouse. It could be a situation that they can't find another way out of and so they're not people Who in any normal situation is that what you're saying would consider ending their life it's just the only thing they can think of conceive.

Erika Forsyth, MFT, LMFT 20:08
The only thing they can think of or and, and the experience that that their lived experience for the day, the season, it feels so overwhelming that they feel like the only way to have any kind of relief from the physical and emotional pain is to envision them not being alive. And so it's more of a Yeah, it's a release is really the best word from that current lived experience. But they aren't saying well put in I'm gonna go do this and this and this to actually make that happen.

Scott Benner 20:40
Yeah, but just just imagining it puts their puts their brain in a place where they don't exist in the world anymore. And therefore all this anxiety and pressure and stress they feel doesn't exist either. Yes, a way to make it go away. Yes, yes, yes. Is that the if I'm wrong about this, you'll stop me. But I only know enough about this from talking to other people who have gone through these things. But is that sort of the intellectual exercise? That would be the physical equivalent of cutting? Like to like to interesting to see what I mean by that? Maybe I'm wrong.

Erika Forsyth, MFT, LMFT 21:13
Yes. I mean, I wouldn't make that like in total equal comparison. But yeah, I mean, I think if that helps kind of understand the concept,

Scott Benner 21:23
right? You're gonna say something so bombastic that it just everything, all the feelings go away, and you can just feel yourself being hurt at that moment. Right. Right. Right. Right. Which doesn't work, by the way, like it just it works. That's why cutters describe how often they have to do it, because the release and the relief is only momentary for them.

Erika Forsyth, MFT, LMFT 21:41
And then usually, what ensues is shame after that, whereas I'm not sure you know, that, that, that release of thinking about not being alive, if shame follows that. So there might be different patterns after that kind of experience. But yeah, I think that's, that's an interesting comparison.

Scott Benner 22:00
And again, I interviewed a few people, like, involve themselves in self harm somehow, and they all seem to when they're on the other side of it, they seem to talk about it that way, a little bit. So

Erika Forsyth, MFT, LMFT 22:10
I think, yes, I mean, the the list that you just described, is comprehensive. And I think what keeps a lot of that hidden, is shame. I think one of the things, I just heard this great example of thinking about yourself as a student in junior, and you know, elementary school, high school, even college, and the teacher has explained something over and over and over again, you still aren't understanding it. And you know, you want to raise your hand, you want to ask the question. But you're kind of embarrassed to raise your hand, maybe you feel like you're the only one who doesn't understand the concepts, you don't raise your hand. And this the same thing applies for someone who is who is suicidal? Is there so much shame? Am I the only one who feels this way? And so they aren't raising their hand for help. And so by you taking kind of the heavy lift and taking that initiative, of saying, Hey, I noticed you just don't, it can be very simple. You just don't seem yourself. Have you been thinking about hurting yourself, harming yourself? killing yourself, you are doing that you are raising the hand for them, because they might be trapped in a lot of shame and feelings of isolation.

Scott Benner 23:23
Okay. And it's important to be very clear, when you um, I see you using the same words over and over again, not, don't dance around it don't know, euphemisms like, Are you thinking of harming yourself killing yourself? Like be clear? Yes, yes. Is it reasonable to expect that if they do feel that way that they will tell you?

Erika Forsyth, MFT, LMFT 23:44
I mean, typically, in my experience people do and then they will clarify it? So if they do say, Well, yeah, actually, I kind of have then they'll then you can ask those further questions. Like we just said around double, do you have to have you thought about how you would do it, you'd have to say means and plan that's kind of clinical language, but have you thought about how you would kill yourself and you're using that specific language? Because they know that you are taking them seriously. And they in that process, they feel validated, heard, taken care of all of those things. And so then they will help kind of differentiate that for you by saying, Well, yeah, I have and I have these things, or no, it's just kind of this idea that I'm feeling so overwhelmed. I kind of don't want to be alive right now.

Scott Benner 24:29
And am I right to say that a person with suicidal ideation or thoughts, they don't have to be depressed, and like depressed people don't, that being depressed doesn't necessarily make you suicidal. And being suicidal doesn't necessarily make you depressed.

Erika Forsyth, MFT, LMFT 24:46
Right, because you can, I mean, obviously, they go hand in hand often, but there's, there's so many different levels of depression, and you might be a fully healthy be functioning adult, and have a really hard day, maybe multiple days in a row and feel like, Ah, I just don't want to be here right now. Yeah, I wish I could not be living at this moment and have that fleeting thought,

Scott Benner 25:13
when we were first married, my wife worked at a company who brought a very popular anti depression medication target. And so my wife would come home and say, Hey, we're seeing in the data, that sometimes there are suicidal people who are so deeply depressed, that they can't even work up the energy to hurt themselves. And then they took the medication and the medication lifted enough of the of the of the weight, that they could actually harm themselves. They were seeing people, like, does that make sense that they weren't they were so chained down by their depression, they, they they wanted to end their life and they couldn't, and then the medication would take away enough of it that they could go try to harm themselves. And that was obviously I think, unexpected in the beginning when these drugs were being like that.

Erika Forsyth, MFT, LMFT 26:04
Yes, that is, I have I have heard of that. And I also have heard of when you start medication, they why they say wait for three or four weeks for any kind of change to take effect. Because oftentimes people who are experiencing depression and start taking medication, they have so much hope in the medication. And then they don't feel any change quickly or quickly enough that are within their expectations. That then is when maybe the suicidal ideation becomes more severe. And there are more attempts. So that's why it's, we really want to emphasize it. Finding the right dose and medication takes time. And to be patient with that

Scott Benner 26:46
the idea of like, well, this is going to do it for me, and then it doesn't, and then

Erika Forsyth, MFT, LMFT 26:51
that all hope is lost that yeah, there was the straw

Scott Benner 26:55
that broke the camel's back, like, well, if this isn't gonna work, I'm out of here. Yes, that's so crazy. What are the numbers? Do you know them? Like how many people do this? A year? I

Erika Forsyth, MFT, LMFT 27:04
don't know. I know the I know that seven purse. This was a couple of years ago. I don't know actually the exact year but 7% of the population have identified as being depressed. I don't know. The numbers of suicidal attempts. I'm looking here or death by suicide. But I think that the depression is it's so common. But we you know, everyone has their their fear and shame to talk about it.

Scott Benner 27:39
A fsp.org is American Foundation for Suicide Prevention. on their front page, they said suicide is the 12th leading leading cause of death in the US in 2020 45,979. Americans were successful in their attempt 1.2 million tried. That's a wow, astonishing thing. The rate of service 2020 2020 additional facts about suicide in the US. The age adjusted suicide rate in 2020 was 13.4 per 100,000 the rate of suicide is highest and middle aged white men and 2020 men died by suicide 3.88 times more than women did. On average, their 130 a day. White males accounted for 69.68% of deaths in 2020. And it looks like in 2020 over 50% where a handgun was involved that firearm was that's really something and for my again from my perspective, I've never known anyone personally who's who's done this or tried it. I've known a person who's obviously spoken about it in a in a tense situation. And I have this experience with the listener and her family. I can tell you that I don't know what it's like to be her parents. But but I am pretty far outside of this girl's sphere. And I was really really impacted by it. It stuck with me for quite some time it made and I can see where the feelings come from because I the first thing I thought was and this is ridiculous right but had I got her on the podcast sooner like maybe we would have talked about something that I'm sure everyone feels like that when the bargaining yeah like maybe I could have helped me well that's ridiculous. How was I gonna do for you didn't mean like I don't know her I don't know her life. And I'm not I'm not trained in any way you don't I mean like but I still had that's that's silly. I can't imagine that our parents must feel that. You know every second like what did I not do? Or do And so what happens then, if you're, if you find yourself in this situation someone is able to help you you do get to help is that I hear people talk about being scared of the help too, though. And, and a little bit of the cost. I hear people worried about the cost the help, they say, there's no good facilities around them, then you hear people who have been in the system, and it's difficult to find good facilities, is there a way to help yourself in that to go in the right direction?

Erika Forsyth, MFT, LMFT 30:34
Yeah, I mean, those are all sinking significant and valid concerns, the costs, you know, if do you want to be an inpatient care, outpatient care, one of depending on, you know, your insurance and your ability to pay for treatment, one of the best things I know that helped people who are severely depressed and in this suicidal space, is giving giving them a purpose to get up every day, because perhaps at that point, they've lost the ability to, to function to get to go to work to get up and take a shower. And so there are, you know, treatment facilities that aren't necessarily fully inpatient, or fully outpatient, but you go just for the day, and part of the the intervention. And the kind of reward of that is you have to, you have to get up, you have to show up at 9am. And you're there, you're accountable. You're learning, you're also being exposed to community, and you come back. So that's a kind of a good middle space, if if going into a full inpatient treatment facility, doesn't feel appropriate for all of the reasons emotional financial. Because it's that finding that purpose. And if it's just to get up and get out of bed and report to a support group, every day, for a certain amount of weeks. Yeah, you, you, you receive so much out of that, right. I think one of the fears of a family member who has was trying to support someone who is severely depressed, is that they might not want it right, they there's resist, they're resisting, they're saying that they're not going to kill themselves, but they also don't want to go to any treatment facility, or they don't want to go to therapy, they don't want to take medication. And if you are feeling trapped in that place, I know it can be so overwhelming and isolating. But you get to the point where you know what I need to help my family member, and they're going to be mad at me, but they're going to be alive. And so getting to that place of I need to find the right support, whatever it is, if it means having a family intervention, friends coming over, and that and that fund member is going to be mad at you, because you've exposed them to get to a place of being okay with them being mad at you for that because they're still going to be alive. Yeah, it's

Scott Benner 33:03
the it's funny, it's the one instance when I can think it's okay to ignore their wishes, right? Because because the end result is is so finite, you know, if you anything else, I could see if they were like, I drink too much we're gonna or maybe we'll work it out. If you know that you can say alright, mate, because there's another day, there's another possibility of being hopeful and finding another answer. But when when the idea is this, there's there's nowhere to go from there. That's Do you think? I don't know what the question is, I guess, in your personal like, experience to people who identify these things and seek treatment? Did they end up with a different reality later? Do they often get through it?

Erika Forsyth, MFT, LMFT 33:52
Well, I would say, you know, the people who I see are either they aren't at that. I don't see people who are at the severe clinical stage of depression who need this, you know, more intense, either inpatient or daily treatment. So the people that I interact with more might be, you know, grieving from a newly diagnosed diagnosis, right of diabetes, and they're feeling so overwhelmed by all of the things. And that's when I hear pretty frequently those feelings of gosh, I just, it's so hard to juggle family and work and now having to figure out this diabetes for myself or my child. And there are days where I just feel like I don't want to be here. And life would just be easier if I didn't have to face all this. And so I associate that, you know, technically it is ideation, but that's connected with grief, and kind of the shock of all of it. And so working through all of the emotional, the grieving from the diagnosis, is really the ideation is relieved as we process the diagnosis and the grief If that makes sense,

Scott Benner 35:00
no, it doesn't. It's there is hope. Yes. But I just think that most people listening to this are going to if they if they intersect this, it's going to be more on that level. Like, I don't think that if you're if you have a loved one who's institutionalized and you know, like and is on, I don't think this is they you probably would have stopped listening to this a while ago. So I mean, it's it this is for people who find themselves with a new situation that people respond to sometimes in the way you described, are offhanded. Like, like, what about offhanded jokes? Like when you? I mean, I have my opinion, I want to hear what you think like if you if somebody says like, Oh, my teacher gave me a beat, I'm gonna kill myself. And you're being that's, that's not a that's not the same thing. Right. That's a colloquialism.

Erika Forsyth, MFT, LMFT 35:47
Yes, I Yes, I hear that, you know, and I, I'm sensitive to it in the in the fact that yes, it's a colloquialism. It's like, Ah, I'm so frustrated with myself. And so if I'll hear a client or a child, say that, say, hey, let's, let's just use a different word, you know, not not overly do it in terms of having a conversation or do it, you really want to kill yourself? I mean, obviously, I would do that if I saw some other signs and symptoms. Yeah, but let's just use another word like, Oh, I'm so frustrated with myself.

Scott Benner 36:23
Yeah. And it's, but it's a very, listen, it's an incredibly common thing. Like people say that, I mean, people who are not suicidal and not depressed, just they say it, like, it's like, it's a silly thing. And so but um, my point is, if your kids walked in through the room, and they're like, I gotta be on this, I'm gonna kill myself. Like, they do have to turn to them and say, Are you really having? Like, do you need me like, where's the line? And and I guess that's for everyone to decide. You know, like, where is like, when is somebody being flippant? And somebody's really having thoughts like that? And is is, is the flippancy happening over and over again? Is that is that an indicator? Like? Is that person trying to say something to you? Or are they really just a person with what you might consider a wide open sense of humor? And a dark sense of humor, but they don't have any thoughts like that?

Erika Forsyth, MFT, LMFT 37:12
I would look at if that was my child's saying that over and over again, I would look at, you know, the context, and how are they functioning? How were their friendships? How are they doing in school? Are they? Are they saying, Are they stopping doing things that used to find pleasure in or enjoyment and? Or are they still are they still, quote, normal functioning, I would just remind them, let's choose a different word. But I think it's also something just to be, you know, gut checking yourself and saying, Gosh, they are saying this a lot. And I also noticed that he's sleeping more or she's deciding not to play tennis anymore, or you

Scott Benner 37:48
know, to find that find the, is this just the thing, and there's no thread to something else? Where am I? Like, do I can I step back, see the big picture. And notice, wow, not only am I hearing this, but I do see some of these other things that we listed earlier.

Erika Forsyth, MFT, LMFT 38:01
And there's there's nothing wrong and asking, there's as we already said, In the beginning, like you by asking your child or family member, are you thinking about really killing yourself? Are you thinking about harming yourself? And they say no. Okay, now they know you're an open field member to talk about it. If they do ever feel like that.

Scott Benner 38:22
Yeah. And you might end up in another situation, helping them I'll tell you, the person that I had my interaction with. Thanks me, like every couple of months, just they'll just get like a random note to say, I appreciate what you did that day. And, you know, I'm doing well and that kind of stuff. So and it's just, and it was in a situation where I noticed that a lot of other people were like, well, let's just be done with this person. Like, it's enough already. And P and people got frustrated. And I just I was the opposite. I thought, well, we're not going to quit on this. Right, this would be a silly time to like, give up here. So, I don't know, there's just a lot of intricacies, especially within families. And, you know, like, there's, there's politics and families you don't even like probably think of it that way. You know, but

Erika Forsyth, MFT, LMFT 39:15
well, and I think yeah, that what you just said, you know, people kind of giving up on someone or maybe like, Oh, this is just you know, Bobby being Bobby, you know, he's just got to get over it. Well, I just heard I think Bill Bill Burnett, just saying the the lat the depression is the lack of ability to get over it. And so they have someone who is clinically depressed, has probably tried to get over it and isn't able to get over it. Yeah. And so it's it's a real true thing. And so, by by going there and you know, using you talking to them in a normal voice connecting, seeing them for who they are as human beings and not seeing them as this You know, sick, scary person, I think is also really important.

Scott Benner 40:03
I've had a number of meaningful, life altering relationships through this podcast, by taking on people to come on the show to talk about things that most people would not have talked about. And I've seen their lives change. I've seen, I understand better I get a note online from one from a from a person who's been on this podcast, they send me about one a year. And it just says, Why don't you know I'm doing well, this is my one, see, if I respond, they will not respond back to me. But this person just reaches out to me about once a year to let me know they're doing okay. And and I can see why people wouldn't, why you'd be afraid to get involved. Because I also have an experience where someone, there was a clear cry for help in the Facebook group. And everyone tried to help this person. So there's this kind of like, they run into the group, there's a cry for help post, then they don't respond. And you trying to decide like, is this? Are they? Is it just attention seeking, like, what is this exactly right. And so you don't want to make the decision. You don't want to just brush it off as attention seeking, because what if they really need the help, but a lot of people tried to help, they were actually able to contact people in this person's extended family, like, you know what I'm talking about, like, Yes, I'm dealing with that way. But there was a moment where I couldn't let these attention seeking posts happen anymore. So I stopped, I blocked the person from being able to post, but I didn't just block them and walk away. I sent them a private email. And I said, I don't know you, I don't know your situation. But I do understand diabetes, and I can help you if you want. We can sit and talk privately. I'll call you on the phone, whatever you need, ignored me, ignored me ignored me. And then an email comes back. Everyone always says they're going to help me and no one does. And blah, blah, blah. And I'm like, okay, so I responded back one more time. I said, Well, I am telling you, I will, I don't know that for sure if I can help but I'm happy to talk to you. And then it was vitriol back at me again. And I went okay, well, now we're done. Okay, so like, I've tried, I've tried, I don't know, you, you're you seem like you just want this dance to keep going. I can't fix that for you. That's a hard thing. So I stopped answering. And then that person went around on social media and tried to like hit me every place they thought they publicly could, then I put a stop to all of that. And so do I wish I didn't try to help that person? A little bit. I do wish I didn't do that. Right. But I think back on the others, where I took that chance, and it went really well. And I guess I thought, well, this is the this the price of doing business, right? If I'm gonna forget to help somebody, it's not always gonna work out. Right. So,

Erika Forsyth, MFT, LMFT 42:54
and they, you know, at that point, she wasn't ready to receive it. Ya

Scott Benner 43:00
know, there's compatibility. They all the reason, oh, my God, they might send it out six months from now and be like, Hey, I'm so sorry. I should have said, Yeah, let's chat. I wasn't in that right place. Or maybe it's a internet troll. Like, I have no way to know, you know, so. But in your real life, there's, you will not be let down. If you try to help somebody. That's from my perspective, it will, it will help them and it'll help you too.

Erika Forsyth, MFT, LMFT 43:26
So, yes,

Scott Benner 43:28
we're missing here. I'm sorry to cut you off?

Erika Forsyth, MFT, LMFT 43:30
No, I was gonna say I think it will. And that piece, I think I know, I already mentioned it, but I think it's so it's such a huge factor in why people might hesitate in asking the question, because of that fear of I don't know, what am I? What do I do? I'm just a person, I'm not a trained therapist or doctor, what do I do this sense of feeling of either inadequate, or, like, what do I have to be responsible? And just, I just encourage you, if you have those thoughts, don't let those you know, stop you from just reaching out because just that very, the act of asking if someone's Okay, is going to will be a lifeline for them. Yeah.

Scott Benner 44:11
You know, we didn't talk too much about though, like, what if we're on the other side of that? What if we're not the person trying to help? Like, what if we're the person in in trouble? Are they able to make that leap? Normally, or do they need someone to come get them?

Erika Forsyth, MFT, LMFT 44:26
I think, you know, if someone's already in therapy, I'm thinking of just my personal examples. That's part of my questioning if I am noticing some depressive symptoms. So it's, it's kind of an automatic conversation. I think if it's a family member, and you're sitting there and you're the one who is suffering and dealing with some of these thoughts and feelings. I think it's really hard to reach out because depression is so connected to feelings of shame, which then leads to feelings of isolation and no one else feels this way, no one's going to understand no one's going to get me. And no one knows what this feels like those types of thoughts are really common. So when you're when you're swimming in that pool of shame, it's really hard to say, hey, and somebody, I'm Richard Hambrick, and somebody helped me here, I'm really drowning. Because the shame really prevents of doing that. No, this is not all, you know, all the time. But I think often, people do need someone else to ask, how are you doing?

Scott Benner 45:35
Yeah, I was really interested by the breakdown of the male to female because I, I generally think of men, as people who are more willing to ignore those cues and just push forward. But obviously, the numbers kind of say opposite, like maybe that maybe pushing through is, is stuffing down, not not not lurching forward all the time. I mean, obviously, for some people, it's different. But that threw me off the breakdown of the numbers a little bit. I don't know why

Erika Forsyth, MFT, LMFT 46:05
exactly stuff stuffing down. And then I think what we were talking about, on the other episode about the shame that perhaps there's stereotypically in a male mindset, I gotta be much, Oh, I gotta keep it all together, I get all of my, I feel good about myself about what I do my work, my family, these are all stereotypes, obviously. And so when a male might be struggling with depression, the shame is just right there. I should I should not be feeling this way I should be providing for myself or my family. How can I be stuck here in bed all day? I'm a bad person. Yeah,

Scott Benner 46:46
I can tell you is that having kids, you just you're always looking at them, like assessing things. They're assessing their health and their happiness and the things they are saying and the things they aren't saying, and what are they doing? And who are they around. And it's just, I don't know, like, I understand how it could be overwhelming to a person from the outside. But if you're seeing these things, obviously, if you don't know what to do find somebody that doesn't know what to do. I'll put I'll book in this episode with like phone numbers and websites and stuff like that. But anyway, the last thing I'll tell you about the person from my story at the beginning, is that one of the last things her mom said on the phone, when I said, you know, you can you can come on the podcast, if you ever want to, like I don't know, like, it's a weird thing to say to somebody, but she felt like she wanted to talk about her daughter. And she said, I said, just reach out to me when the time feels appropriate. And she said, You're gonna have to reach out to me, because I don't think I'm gonna remember this day. She said, It made me sad. And and I don't have the nerve to reach out to her. I can and I can't decide if I'm letting her down by not doing that or not. Like, does she really want me to? I don't want to be totally mean. Like, I don't want her to do this if she doesn't want to. And I? And I don't know, I'm lost as to what to do about that at the moment.

Erika Forsyth, MFT, LMFT 48:08
But I think, you know, she can always say no, and you could always say, right. I was hesitating to reach out. Right.

Scott Benner 48:16
Yeah, I think I might, because I feel like I promised her that I was going to do it.

Erika Forsyth, MFT, LMFT 48:22
But it is it is hard and painful. And I think if you if you are listening to this and feeling those feelings, you know, reach out 988 is the is the easiest thing to remember. Or you can plug it into your phone and save it. Because those are there 24/7 365 Someone a mental health professional is there to talk you can also text.

Scott Benner 48:44
Yeah, I think two of you. If something like this has happened, and you're left behind, I think you probably should seek out, you know, help as well. Right? Because I don't see. I mean, we I think anybody who has kids is spoken about this back and forth. Right? Like, if something happened to my kids, it wouldn't have to be you know, a suicide event. Just anything like I don't like I'm I'm really impressed by people who go on after they lose their children. Yeah, you know. So, anyway, just anyway, find help. You know, that's pretty much what I want to do. I appreciate you doing this very much. Am I leaving anything out?

Erika Forsyth, MFT, LMFT 49:22
No, I think we've covered covered it. Thank you.

Scott Benner 49:25
No, thank you. Once again, if you're having any suicidal thoughts or considerations around hurting yourself, please dial 988 Or go to Samaritans hope that org I want to thank Erica again and remind you that if you live in California, Utah, Oregon or Florida, Erica can help you at Erica forsyth.com Or you can give her a call at 626-344-2266 Thank you So much for listening. I'll be back very soon with another episode of The Juicebox Podcast

if you'd like to learn more about diabetes sisters, they offer a range of education and supportive services to help women of all ages with all types of diabetes to live fuller, healthier lives. diabetes sisters.org. Of course, if you're a listener, you know touched by type one they are a podcast sponsor and a longtime favorite of mine, touched by type one.org. And we are diabetes. At we are diabetes.org We help people living with type one diabetes and disordered eating. We are diabetes.org