Category: Behavioral

Sasha Lloyd

Adolescents, Teenagers, and Non-Suicidal Self-Injury

In recent years the mental health community has become more aware of self-harm practices in the adolescent and young adult populations. Non-suicidal self-injury (NSSI) has been difficult for therapists and parents to fully understand due to its sensitive nature and the fear of suicidal ideation. Teenagers and young adults turn to this behavior to release emotional pain that they aren’t sure how to process and manage.

Although unhealthy and at times extremely dangerous, adolescents that practice NSSI are generally not suicidal and are using this practice to cope with painful experiences. As a result, therapist and parents are unsure how to act. Do we create a safety plan? Make sure the teenager is never left alone? Take them to the hospital?

In this article we’ll discuss the ins and outs of NSSI and how you can help your teenager navigate these rocky waters.

What is Non-Suicidal Self-Injury (NSSI)?

Non-suicidal self-injury, aka self-harm, is performed through avenues such as cutting, burning, hitting hard objects or self, pinching, scratching, and even interfering with healing wounds (Peterson et al., 2008). It is commonly assumed that NSSI is an attention seeking behavior and it certainly can be, but typically not as a means of hurting others or gaining sympathy. Rather, it tends to be used as a cry for help because of depression and/or anxiety.

Some people choose to engage in NSSI as a means of self-punishment, but most often the action is carried out simple to create a physical outlet to emotional pain. Oftentimes, parents of teens that engage in self-harm behavior don’t understand this explanation and tend to respond with statements of confusion trying to figure out why someone would cause intentional pain when they are already hurting.

Why Do People Engage in Non-Suicidal Self-Injury?

Studies have shown several possible reasons for this phenomenon, the most promising of which is the observation that the removal of physical pain brings emotional release. Therefore, it isn’t the pain that causes the relief but the way the person feels once the pain has stopped (Association for Psychological Science, 2017).

Other theories include the idea that the pain provides a distraction for the emotional pain and the release of hormones provides a sense of relief from negative thoughts causing the emotional distress. Whatever the reason someone chooses to engage in NSSI the fact remains that it is a potentially dangerous practice that can lead to long-term, negative effects on health.

Many treatment options are available to help individuals cope with painful emotional distress. If you or someone you know is engaging in self-harm behaviors seek support from a local therapist or contact your local crisis line.

How to Help Your Teenager Overcome NSSI

While discovering that your teenager is engaging in self-harm practices is disturbing for you as parents, it’s important to remain calm. Whether your child has disclosed this information to you of their own accord, you were told by their therapist or friend, or you discover it on your own, it’s important to remember that regardless of the reasons behind the behavior your child is in severe emotional pain and they need your support more than ever.

Show Your Teenager Support

Be sure to let your child know that you aren’t angry with them but you are concerned about the self-harm behaviors. While you understand that this how they have been able to cope it’s important that they remain safe. Be sure to let them know that if they are having the urge to self-harm or have engaged in the behavior, they can come to you for help without fear of punishment.

Create a Safety Plan

Engage your child in the discussion and be sure to take their input as to what coping skills to use at each stage of distress.

My favorite safety plan is a simple 1-10 list describing thoughts, feelings and behaviors at each level (1 is the lowest distress and 10 is the highest) and what they can do to cope. For example, at a level 1 I feel relaxed and content with life and I may be looking forward to something. I would also be engaging with people around me and laughing and smiling. At this level I would cope by continuing my self-care routine and spending time with friends and family. At a level 5, I might feel irritated, stressed or overwhelmed. I might have racing thoughts that some effort to control and I may want to isolate and stay away from others. At this level I would probably cope by journaling to get my thoughts out, talking to a close friend or family member and maybe a warm bath.

Once this safety plan is completed you have easy way to communicate with your teenager about their level of distress and a clear plan of action.

Regulate Their Access to Self-Harm Tools

Talk to your teens about the objects used for self-harm and ask them to give you the items for safe keeping. Oftentimes it’s a razor or lighter that is used and while you don’t want to restrict their use of these items you do want them to let you know when they are using them so you can help keep them safe.

Your teens may not be ready to hand over their tools or may give them to you but keep some hidden or obtain more of them after giving them to you. Therefore, keeping the lines of communication open and not punishing your kids is so important.

Don’t always keep your eyes on them, don’t take their door off their wall, and don’t search their room. This will only enforce their fears of talking to you in the future and coming to you when they need support. With that said, be sure to let them know that your primary goal is keeping them safe because you love them so you’re going to be checking in on them often.

Seek Professional Help Immediately

Be sure to seek professional help immediately. Right now, therapists have a huge waiting list all over the country, but there are many support groups and resources available to help you get started in the meantime. Call as many clinics as possible and get on their waiting list being sure to mention that your child is engaging in self-harm. This can sometimes get you bumped to the top of the waiting list and many clinics can offer other resources while you wait for a therapist to become available. If your child is already seeing a therapist check in with them often to see how therapy is going and if there is anything else, you can do to support your teens.

Take Care of Yourself

As a bonus tip, I want to remind you as the parent to take care of yourself. Your child will need a lot of support during this time, but you can’t pour from an empty cup. Be sure that you are getting enough sleep, eating well, and taking time to laugh and enjoy your hobbies. Model appropriate self-care for your children so they can learn how to take care of themselves.

References

  •  Peterson, J., Freedenthal, S., Sheldon, C., Andersen, R. (2008). Nonsuicidal Self Injury in Adolescents. Psychiatry (Edgmont), 5(11) 20-26.
  • Association For Psychological Science. (March 10,2017) Why Does Nonsuicidal Self-Injury Improve Mood? Psychologicalscience.org
Steps to Reduce the Challenges of Depression, by Kyle Bradford Jones
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Steps to Reduce the Challenges of Depression

Steps to Reduce the Challenges of Depression
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When it comes to reducing depression, focus on the small things you can control. One of my favorite anecdotes comes from the legendary UCLA basketball coach John Wooden. He is considered possibly the greatest collegiate coach of any sport in history. At the beginning of each year, the first thing he taught his players wasn’t something flashy or mysterious, but it was simple and profound. His first lesson? How to put on your shoes and socks to avoid blisters. They are the most important equipment associated with basketball, he said, and a simple blister can hobble and derail your season very quickly. It’s crucial to smooth out the socks over the little toe, the most likely spot to get a blister. Smooth it over the heel as well, and make sure that it remains smooth when you put on your shoes. This seemed like silly advice to some of the biggest basketball recruits in the world, but it was likely a small secret to Wooden’s ten national championships at UCLA.

It’s All About the Small Things

The small things are critical for addressing depression as well. I have a major depressive disorder, generalized anxiety disorder, and am a physician who addresses these issues every day in my medical practice. I understand how everything that needs to be done appears so much bigger than usual when you are in the throes of these terrible illnesses. That’s why my best advice is to address life one small thing at a time and relish those small victories. While I am not suggesting that these are the only things that are needed to address the challenges of depression, they will absolutely compound into better overall functioning.

A woman jogs outdoors

Physical Ways to Reduce Depression

  • Drink more water. This may sound ridiculous, but poor hydration can worsen your mood, thinking, and a whole host of other physical issues. Drinking water specifically is crucial to mental and physical health. I recommend a minimum of 2 liters per day (~64 oz), but some people need more.
  • Get more sunshine. We all know that some people struggle more in the winter when the sun shines less, but this helps at any time of year. It’s more than vitamin D, but helps awaken many of the positive mood centers in our brain. If you live in a cold-weather climate, I would suggest investing in a special lamp to provide that needed light during the winter months.
  • Diet and exercise. The irony is that when you are depressed or anxious, you have no motivation. I didn’t exercise for years for this specific reason. But every little bit counts. Even if you can only go on a walk for 5 minutes, or do some jumping jacks at home, that can still be helpful to reduce depression. Same with your diet; it doesn’t have to be perfect to be helpful. Just do what you can and give yourself some positive reinforcement for what you did.
A couple snuggles while watching a sunset

Emotional Ways to Reduce Depression

  • Secure close relationships. As you probably know, mental illness can be just as hard on your loved ones and friends as it is on you. Make sure to communicate with them. Let them know what they should or should not do to help you, but don’t isolate from them. During periods where I am struggling, my wife will often ask me “Where are you today?” It’s important for everyone to stay on the same page.
  • Allow yourself some grace. This has become my mantra. It’s certainly easier said than done, but it has helped me. It’s okay that you’re not perfect. You are allowed to forgive yourself for an illness that isn’t your fault, but for which you feel extremely guilty.

When it comes to reducing depression, these are just a few small things to focus on that you can control. Above all, just remember that you are worth all of the efforts to get better.

Kyle Bradford Jones, MD, FAAFP

The Doctor Jones Dialogue – The Doctor Jones Dialogue (kylebradfordjones.com)

Kyle is an Associate (Clinical) Professor in Family and Preventive Medicine at the University of Utah School of Medicine. He has worked at the Neurobehavior HOME Program, a clinical program for individuals with a developmental disability. Kyle is also the author of the best-selling and award-winning book Fallible: A Memoir of a Young Physician’s Struggle with Mental Illness.

If you or anyone you know is facing mental health challenges and needs support, we can help you.

You can share how you’re feeling or about your experience, or apply to our subsidized therapy program.

How to Get Enough Sleep: Proper Sleep Management, by Curtis Duty
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How to Get Enough Sleep: Proper Sleep Management

How to Get Enough Sleep: Proper Sleep Management, by Curtis Duty
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We frequently observe that humans spend roughly a third of their lives sleeping. In my twenties, I found that idea repulsive, as if sleep was absorbing my maximum capacity for living. A bi-product of this sentiment is an entire industry constructed to help keep us awake and limit the hours we sleep.

My Experience

I was in 7th grade the first time I took a caffeine pill (it had been marketed to truck drivers). I remember being tired before a baseball game and thought the pill would help me focus. Instead, I began to visibly shake and I missed several ground balls for which I in part blamed the caffeine and not my lack of athletic skill.

It was almost 10 years later when the “energy drink” gained popularity and I quickly formed a habit of consuming them if I felt sleepy before I was prepared to turn in for the evening. I knew this was a bad habit, but considered myself lucky I didn’t head down a worse rabbit hole. I was in college when the drug Adderall began to be commonly used on campus, and it seemed very normal (almost praiseworthy) to be burning the candle at both ends.

This approach to living is all wrong. An older and wiser me has discovered that proper sleep management is one of many levers we can use to maximize our capacity to live well.

It is true that the importance of sleep has been largely misunderstood throughout human history, and until recently scientists could not even answer the question of why it is required for mammals to sleep. In modern times, SCIENTIFIC AMERICAN has published research out of the Sunnybrook Health Sciences Center that provides these conclusions as to what happens to the brain during sleep:

Tired man lying on bed rubbing his eyes

The brain puts the body to sleep in a series of 5 stages

  • Stage 1: Your heart rate and body temperature drop. Your eyes transition from naturally open to naturally closed
  • Stage 2: Two groups of cells in your brain switch on (the hypothalamus and parafacial zone) causing unconsciousness and paralyzing the muscles
  • Stages 3 and 4: You are asleep. Your blood pressure drops, your muscles relax, and your breathing is slow. This is the most restorative phase of sleep
  • Stage 5 (AKA REM sleep): You experience rapid eye movement (REM) and brain cells become very active. This is the dream phase
  • This pattern repeats every 90-110 minutes.
  • During sleep the brain sends out growth hormones, consolidates memories, and forms connections

How to Get Enough Sleep

The arguments for getting enough sleep are not met with much criticism, as it is easy to feel the negative effects of too little sleep on the brain. How then can we maximize the usefulness of our sleep, and awake feeling well-rested and prepared for the tasks of the day?

It is a difficult question to answer, as brain chemistry varies widely from person to person, but here are some general guidelines that will lead the way to a good nights’ rest, and an easy path out of bed in the morning:

Be thoughtful about the use of sleep aids:

Though sleep aids are an option if you struggle to get to sleep, The Mayo Clinic warns that such remedies are not a magic cure. The choices consist of the following drugs under various brand names: Diphenhydramine, doxylamine succinate, melatonin, and valerian. The first two are sedating antihistamines and have similar negative side effects. Melatonin is a hormone that regulates the sleep-wake cycle and though it shortens the time to fall asleep, it can also cause daytime drowsiness. Valerian is a plant that is manufactured into supplements and studies find little to no evidence of the substance being useful in any regard.

The best advice around the use of these substances is that their use should be temporary. Long-term use results in the body developing a tolerance to these drugs, removing them as an effective option. As well, they become dangerous when mixed with other substances, particularly alcohol. Consult a doctor before considering any of these options and use them as a last resort if lifestyle changes and holistic approaches fail, and even then, only temporarily.

Sleepy woman resting on couch using her phone

Avoid screen time after dark:

Light and sound are both stimulants that affect the hormones produced in your brain; particularly melatonin production. Light and sound inhibit melatonin products because they confuse your body into believing you should still be awake. You will sleep better if you ban screen time in your bedroom.

Consider your sleeping situation:

Making some investment in your sleeping situation is worth the cost. Increased relaxation results in better sleep and more productive waking hours. Consider purchasing blackout curtains to eliminate light, a white noise option to drown out noise pollution, and a decent mattress and bedding. If you happen to share sleeping space with a partner, consider using separate bedding to avoid waking when your partner stirs in the night.

Consider different means of waking:

Despite the quality or duration of your sleep, the act of getting out of bed in the morning can still be difficult, particularly if you use an alarm clock that goes “ANCK! ANCK! ANCK!” in the wee hours of the morning. If this describes you, consider purchasing an alarm clock that simulates the rising sun. Any number of models are available that will allow you to awake gradually with slowly increasing levels of light and sound. If you have a particularly difficult struggle with this aspect of sleep management, I recommend positioning your alarm clock across your bedroom, requiring you to get out of bed in order to hit the snooze button.

Is your physical health a barrier to sleep?

Among common sleep disorders include sleep apnea, restless leg syndrome (RLS), insomnia, and narcolepsy. Each of these is a diagnosable illness and treatment is available from medical professionals. It is worthwhile to seek treatment if you feel your difficulty sleeping may be clinical.

Caffeine consumption is a physical factor affecting sleep as well. Not only is caffeine an addictive substance that robs your body of bone density and calcium economy, but it also greatly increases sleep onset (the amount of time it takes to fall asleep). If you are battling sleeplessness, avoid caffeine.

Woman sleeping in her bed with a cat

Is your mental health a barrier to sleep?

Stress and sleep exist in what can become a terrible cycle. It is no wonder that sleep deprivation has been used as a means of both psychological warfare and outright torture throughout history. Stress lowers the quality of sleep, and lack of sleep impairs brain function that often causes stress. There is no silver bullet to end stress, and a combination of lifestyle changes, therapy, and sometimes medication under the care of a professional can alleviate this hindrance to a good night’s rest.

Like most disciplines within health and wellness, a focused, multi-faceted approach using common sense and good judgment can help increase your quality of sleep, and as a result, your quality of life.

Curtis Duty

Curtis grew up in Texas and graduated from Southern Utah University with a master’s degree in Public Administration. He has spent the majority of his career working in field operations and currently works as a talent acquisition manager. His passion for mental health comes from personally witnessing the struggles of individuals experiencing mental health challenges and their suffering from the social stigma with which such illnesses are often met. 

If you or anyone you know is facing mental health challenges and needs support, we can help you.

You can share how you’re feeling or about your experience, or apply to our subsidized therapy program.

Addiction: Coping in Healthy Ways During the Isolation, by Steven Eastmond
Steve Eastmond

Addiction: Coping in Healthy Ways During the Isolation

Addiction: Coping in Healthy Ways During the Isolation, by Steven Eastmond
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Addictive behaviors are unfortunately common across our nation for a variety of reasons. Anywhere from entertainment all the way to heavily stuck in substance use and unable to escape, these behaviors have been prevalent for a number of years across the United States and throughout the globe. According to American Addiction Centers, in 2017 over one-third of adult Americans (38%) struggled with addiction. Even more people struggle with addiction as a way of coping during this recent period of social isolation.

People tend to expend exorbitant amounts of energy fighting off anything that is painful, be that emotional or physical. We avoid, hide, run, medicate, or numb whatever might cause us to hurt. And doing so makes sense. Not many people enjoy pain.

How Isolation Leads to Coping Through Addiction

When the entire nation is in isolation due to the coronavirus pandemic, mental health concerns are mounting. The inability to communicate or connect face to face with friends, coworkers, or family; lost employment and/or income; and especially the contraction of this illness by oneself or a close family member are just a few of the increased painful stressors that Americans are grappling with currently. And as a result, many will resort to substance abuse as a way to cope.

A man passed out on a desk while holding a glass of alcohol

It is not uncommon for therapists to hear that this isolation has influenced an increase in drinking or drug use in a client. One client told me that the coping mechanisms they found most effective were talking to people and socializing and drinking. So naturally, during this period of prolonged isolation, he has turned to drinking to cope with painful things in his life.

Coping Alternatives to Addiction

May I suggest a couple of alternatives to drinking or drug abuse that can be used as you or a loved one struggles to cope with isolation? First of all (don’t quit reading after this), physical exercise. Physical exercise has been shown in repeated studies to be just as effective in combatting feelings of depression as a combination of medication and psychotherapy. Granted, exercise won’t teach the tools that therapy would teach, but the outcomes in terms of what one feels from both are very similar. Many during this time have found it difficult to exercise because they were accustomed to going to a public gym, but several things can be done quite effectively in the privacy of one’s own home, or through outdoor exercise. All you need to do is a small bit of research and effort and an effective home exercise plan can be mapped out.

Spending Time with Family

Secondly, although social distancing regulations have kept most of us at bay from typical social gatherings and communications that normally would fill our buckets, many have reported to me in therapy sessions how much they have grown to appreciate and cherish the additional time with their family members. They have learned to adapt to not being able to do other things, be distracted by outside activities, or engage in a myriad of other “important,” albeit not family-centered engagements. Throw yourself into your family relationships, assuming you have some reasonably emotionally healthy relatives, and work to discover some bonds that could provide you with extensive support for you in the future for many years to come.

Journaling

Third, many of my clients have found that journaling is a very healthy outlet for many of their painful and persistent emotional concerns. Many ask, “How is it helpful to talk about or write about what’s bothering me? It isn’t a solution.” The example I give them is that our issues in life, when allowed to build up and fester without an outlet, feel much like taking ten superballs into a racquetball court and throwing them all at once against the wall. It will feel like several dozen superballs are bouncing around in various directions when in reality it is only ten.

Talking about problems or writing them in a journal is similar in effect to taking all of those superballs and setting them quietly down on the floor where they can be accounted for much more easily. Writing and talking help a person to organize thoughts and feelings and assists in alleviating stress and the buildup of emotions.

A woman sitting alone on the corner of a dock

Virtual Therapy

Finally, consider arranging an appointment via telehealth with a licensed therapist or life coach. These individuals are trained to listen and provide appropriate ideas, tools, and/or advice and counsel on ways to improve your life and plan an effective future for yourself and your family. Given the fact that therapists can provide these services online securely, it is safe and easy to and is a good opportunity to work through some private concerns and painful issues that might otherwise provoke an individual into substance use. Counsel from a trained professional can be tailored to your individual needs and can set you on a straight and helpful path of recovery, healthy coping skills, and healing.

Use These Coping Suggestions to Build a Healthier Life During Isolation

During this time of isolation, consider alternatives to the unhealthy coping of addiction or addictive substances. Try some other means for coping with pain and, again, consider contacting a professional to help you in getting things more organized in your life. While the restrictions persist, perhaps it is the perfect opportunity to work on oneself and one’s ineffective coping mechanisms. We wish you the best of luck in facing these difficulties and accessing the help you need.

Steven Eastmond, LCSW

Family Transitions Counseling (familytcc.com)

Steve is a Utah native and earned a master’s in social work from Washington University in St. Louis, the top school of social work in the country. He owns and runs Family Transitions Counseling in Pleasant Grove, Utah, and has other therapists working in this clinic as well. Steve is also an adjunct professor of social work at Utah Valley University.

If you or anyone you know is facing mental health challenges and needs support, we can help you.

You can share how you’re feeling or about your experience, or apply to our subsidized therapy program.

6 Ways to Handle Your Mental Health Crisis, by Zachary Duty
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6 Ways to Handle Your Mental Health Crisis

6 Ways to Handle Your Mental Health Crisis, by Zachary Duty
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Taking care of yourself during a mental health crisis is just as important as taking care of your physical health.

When I was 7 my brothers and I built a rope swing. We took a couple of test runs and our childhood handiwork seemed to be functional. I was a little nervous to try it out so my older brother decided to give me a tutorial. He showed me where to put my hands so I could hang on, and then he took a swing to show me how safe it was. Well… the swing broke and my brother fell off, breaking his arm.

We sounded the parental alarm and adults were soon at his side. They whisked him away to the hospital where his arm was set by an experienced physician. A week later he went back and the doctors put on a hard cast, which he wore for 6 weeks until his arm was healed. Even after the removal of his hard cast, he was advised to “take it easy,” working back towards normal full use. He fully recovered from the injury and has had no lasting effects of a broken arm.

The system we, as a society, have in place for physical health is fully operational. Anyone who suffers a physical injury knows they can go to a doctor and get the help they need. There is no shaming or stigma attached to visiting a doctor when you are experiencing some form of ailment. So why then are we so hesitant to visit a mental health professional?

Start by Acknowledging Your Mental Health Crisis

I have personally experienced trauma, addiction, and chemical imbalances that have caused real emotional suffering. Yet, for years I was hesitant to visit a therapist. My justification was that I was strong enough to handle my struggles on my own. After finally meeting with a therapist I came to the conclusion that it took more strength to ask for help.

Sad woman with person's arms on her shoulders

Like physical health, your mental health can be attacked from many different angles. You may get sick with a virus, appearing pale, sweaty, and vomiting. You may break your arm, walking around in a bright-colored cast. You may suffer a concussion, dilated pupils, blurred vision, vomiting, etc. Mental health is similar in variety, but the attacks are less apparent, at least on the surface. Most people won’t know you are struggling with depression, anxiety, trauma, etc. You may not even realize the extent of your own ailment. You may simply feel alone and afraid because everyone else seems to be enjoying life with ease while you are fighting for every moment. Without any knowledge of how to handle the pain, you may be looking for a way out.

Get Help with Your Mental Health Crisis

So how do you handle an imbalance of your mental health? When the path isn’t clear and you are suffering, options can seem very limited. Perhaps you feel like you can’t share your struggle because of what others may think about you. Just like you would go see a doctor if you broke your arm, you can visit a therapist for your mental health needs. A good therapist will listen judgment-free and provide you with some guidance on how to proceed.

There are people out there right now who are suffering silently. You may be one of them. You may be in need of something you can do right now to get through this mental health crisis. You may be looking for a way out. First off, if you or a loved one is considering suicide, please call the National Suicide Prevention Lifeline number (1-800-273-8255). They are well trained and can provide you with local resources. They may even discuss some of these steps with you.

These are some things you can do right now and moving forward to work through this difficult moment:

Grounding

Stay present in this moment. Is anything hurting you at this moment? Look around you. Notice your feet on the ground, feel your toes in your shoes, notice the wind on your face or the humming of an appliance in the background. These are things constantly going on around us that we may not notice if we aren’t being present. An exercise like this can ground you to the moment. You may experience intrusive thoughts, those are not part of the moment, watch them go by like leaves floating down a stream. Only focus on what is right here and right now. The past is over and the future hasn’t arrived. All there is, is right now.

A man meditates in a field

Take some deep breaths, grounding has a calming effect that will help you think more clearly.

Anchor Points

There are people who care about you and/or people who need you. Your work isn’t finished and the effect you will have on the world is extraordinary. What do you love? What would you say is your passion? If you can’t answer that, take some time to ponder and try to land on something you absolutely love to do. Who are the people in your life that love you? Don’t say no one. Instead, dig deep and be truthful. When was a time that you didn’t feel like this? Focus on that time and ask yourself what was different. If you are trying to support a loved one, ask lots of open-ended questions. The goal here is to open awareness that there is more in your life than this mental health crisis or pain and things can be different.

Building the Future

Look forward. The future has the potential to be a blank slate. What do you want to do with it? The painful thoughts you are experiencing can go away if you let them, and the future can be completely different. You may feel like nothing is in your control, but that isn’t true. You always have choices. And, depending on how you decide to make those choices, your world could open up to a wonderful variety of choices.

What do you want?

Are you reaching out? Is this a cry for help and support? Do you want/need to make some major life changes because your current life is not manageable? Is your mental health crisis plaguing you and keeping you from seeing the light in the world? What is it you truly want, and is your current course of action getting you what you want? So often our desires don’t match our actions. We may want someone to love, yet we constantly argue and fight against the people around us, who are likely trying to love us. So ask yourself what your deepest desire is and check to make sure your actions are building towards that desire.

Safety Plan

Make a list of things that work and help towards a more balanced and healthy future. Then make a list of things that are not helpful. You could come up with a specific plan, like calling someone specific when you are feeling down. Safety plans are as good as you make them and only work if you’re willing to follow them.

Access to Lethal Means

I always say that avoidance is the lowest level of overcoming a problem, but in many ways, it can also be a good first step. If you don’t want to drink alcohol, it’s probably a good idea to empty the liquor cabinet down the sink and skip the after-work trip to the bar. If you don’t want to end your life in an unstable moment, it is a good idea to get rid of lethal means from your house. Also, if you or a loved one have thought about a specific plan and has the means to carry it out please reach out immediately.

A man sitting on a bed with alcohol bottles on the floor

What to Do Post-Mental Health Crisis

Once you’re out of the crisis, you can work towards getting the help you need to stabilize and balance your mental health. This can be done through therapy and medication management. It is difficult, if not impossible to find that balance when you are in crisis. This can be done on your own but works even better with the support of a loved one and mental health professional.

We are working towards shining a more positive light on the very serious need for regular mental health care. Hopefully, it will become a familiar process like setting a broken arm. Unfortunately, a broken arm can’t be set if you never go to the hospital. So, please reach out

By the way, I never ended up taking my turn on that rope swing.

Zachary Duty, CSW

Zach Duty is a native Texan and a graduate of Southern Utah University with a bachelor’s degree in Outdoor Recreation. He went on to complete a master’s in social work at the University of Utah with an emphasis in child welfare. As a therapist, Zach has worked in residential treatment and for the state of Utah through the Division of Juvenile Justice. 

If you or anyone you know is facing mental health challenges and needs support, we can help you.

You can share how you’re feeling or about your experience, or apply to our subsidized therapy program.