The tickle of curiosity. The gasp of discovery. Fingers running across the keyboard.

The tickle of curiosity. The gasp of discovery. Fingers running across the keyboard.

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Showing posts with label depression. Show all posts
Showing posts with label depression. Show all posts

Sunday, July 10, 2016

Is Your Character Considering Suicide? Info for Writers

Detail of The Death of Socrates. A disciple is...
Detail of The Death of Socrates. A disciple is handing Socrates a goblet of hemlock (Photo credit: Wikipedia)
TRIGGER ALERT - While this article is a combination interview and basic review of psychology, if you have had any contact with someone who has attempted suicide or suicided, or you have contemplated suicide, this might engage you in thoughts along those lines. Please read safely and with my best wishes.







Fiona - 
I would like to introduce you to The Bergh (how cool is that for a pen name?), a fellow Kindle Scout winner and writer friend. He writes horror - the kind that submerges crazy voices in your head that a year later, when you're lying in your bed listening to the house creak, bouys thoughts of terror to the surface.

The Bergh recently wrote a short story that struck me in a new way - one that is equally frightening but in a different way. Apparently on Twitter there was a discussion about books with "The Girl" in the title - the one on the train, the one that was gone, the  . . . Well, it seems popular books have to have a girl in the title. And thus a challenge was born.

The Bergh - 
I’ve never penned a story or novel based off of an idea for a title before. Usually it’s the story’s idea that captures me and holds me hostage, demanding to be written; so this was a first for me. Yet as much as I thought the title was wickedly clever, I didn’t want this to be just a cheesy satire or an attempt to milk the very teet I was poking fun of. I wanted this to be a story that could stand on its own.

The only idea I started with was that the Girl would be searching for a title to something she had written. But, and I can say this in all honesty, what came out as I continued writing frightened me. It wasn’t the light-hearted story I was attempting to write. Instead, this story dove deep, sinking into a dark place that I have shared with very few people in my life. It’s not an autobiography; it’d have to be called “The Boy Who …” and, quite frankly, books with “Boy” in the title don’t sell as well as those with “Girl.”
AMAZON LINK


(KIDDING!)

There are times when I feel creative ideas, especially exceptional ones, aren’t so much created by their auteurs, but discovered. Like finding treasure buried in sand -- you can’t claim to have created what you find, you just swept away the dirt and grime in order to reveal what was always there but just kept hidden. This story, for me, fell into that category. I don’t think I could have come up with it if I had tried to. Instead, I opened up a vein and let the story bleed onto the page, almost literally.

Depression. Suicide. These are subjects that are difficult to approach. I had no intention of including even the thought of these themes in the story, and yet it’s where the narrative demanded to go. And so, rather than the Girl searching for a title to her story, we discover she’s searching for the title to her suicide note.



Fiona - 
If you are writing suicide or suicidal ideations into your plot, here is some information you might find helpful:

The following information was presented at a suicide intervention talk for the Medical Reserve Corps and is incormporated with the permission of the instructor.

SUICIDE WARNING SIGNS
  • Talking about wanting to die or kill oneself
  • Looking for ways to kill oneself such as searching on line or buying a gun
  • Talking about feeling hopeless or having no reason to live
  • Talking about feeling trapped or unbearable pain
  • Talking about being a burden to others
  • Increased use of alcohol or drugs
  • Acting anxious or agitated, unusually confused
  • Reckless behavior
  • Sleeping too little or too much 
  • Withdrawing from society
  • Showing rage or seeking revenge
  • Extreme mood swings
  • Low or no energy, unable to perform daily tasks like taking care of self or kids
  • Feeling numb or nothingness
  • Fighting with family and friends
  • Thinking of hurting self or someone else
  • Unable to get rid of troubling thoughts or memories
NOW, be careful to only pick a few of these characteristics for your character - your character would not exhibit them all. And perhaps would exhibit them only to certain people and put up a front for others.

You'll see that many of the above signs are also part of mental health conditions. Not everyone with a mental health disorder knows they have a mental health disorder. Most go undiagnosed. Many people who are undiagnosed self medicate with alcohol and/or drugs. You'll see drugs and alcohol on the list below - but frequently it is the overt/obvious-to-others expression of an underlying mental health issue  -- what others might notice. Conditions that are health factors in suicide:
  • Depression (full article)
    • Please note that while this is the diagnosis that most people associate with suicidal ideation, it's important to understand that Most people with depression do NOT attempt suicide BUT most people who attempt suicide are depressed.
    • Depression affects (according to the CDC) 20-25% of Americans over the age of 18 in any year.
  • Substance use disorder
  • Bipolar disorder (full article)
  • Schizophrenia and psychosis (full article)
  • Personality traits of aggression, mood changes, and poor relationships
  • Conduct disorder
  • Anxiety disorder
  • PTSD (full article)
  • TBI (traumatic brain injury)
  • Smoking
  • Serious cronic helath issue and/or pain
Environmental Factors:
  • Access to a lethal means (example guns in the house)
  • Prolonged stress
    • harassment
    • bullying
    • unemployment
    • relationship problems
  • Life events
    • divorce
    • death
    • job loss
  • Exposure to someone else's suicide
Historical Factors:
  • Previous suicide attempts
  • Family history
  • Child abuse

Is your character going to be helpful?
  • Acknowledge
    • Take suicidal talk seriously. 
    • Be willing to listen
  • Care
    • Talk to the person about what's troubling them and how they feel. It will probably take some effort to overcome reluctance to having this conversation on the part of the helper. It's a hard thing to hear/talk about for both parties.
  • Treatment
    • Get professional help immediately
      • Call a hot line. You can make one up but the real one to find help in your area is 1800-273-TALK
      • Go to the local emergency department or community health center
      • Contact their primary health provider or mental health provider 
      • If all else fails 911
Is your character going to do the wrong thing?
  • Cheer the person up or tell them to snap out of it.
  • Assume the situation will take care of itself
  • Let them swear you to secrecy
  • Argue or debate moral issues
  • Risk their personal safety. (if they're doing it right they'd leave and call the police) - this might be a planned murder suicide in your plot, and you can get your character out and possibly save multiple lives - or not, how do you want your plot to play out?

Some stats to inform your writing from the CDC&P:
  • Approximately 38k people suicide each year (suicide is the end result so differentiate attempted suicide and suicided) Compare that to the 14,196 in 2013 according to the FBI who were murdered
  • 70% of people who commit suicide  give some kind of warning to their friends or family. 
  • 50% have a positive blood alcohol level (for an alcohol level article go HERE)
  • Suicide is the 2nd leading cause of death for adolescents aged 12-18
  • Females are 3x more likely to attempt suicide, but males are much more likely to suicide.
  • Between 20 - 40% of people who suicide have attempted suicide in the past.
Perhaps your plot line indicates that someone in your character's life has committed suicide. All characters will follow a bereavement journey in their own way. In some this might have them recall a death (especially of a beloved pet which is an immensely traumatic event that isn't recognized enough in mental health and in general) or might uncover a characters own underlying issues. But there are some commonly experienced feelings:
  • Alone
  • Sad
  • Deveasted
  • Angry 
  • Afraid
  • Ashamed
  • Guilty
  • Abandoned
Struggles after a suicide that you can lace into your plot line might include:
  • Disbelief that it was indeed a suicide.
  • Ambivalnece - glad that they are now at peace though they wish the other character had worked out a way to be happy and alive,
  • Coping - coming to terms moving on
  • Review - going over the event sifting through events and conversations
  • Searching - making sense of the loss
  • Renewal - seeing a path to carry on. Reprioritizing  and reviewing values
The Behrg - 
About three or four years ago I was diagnosed with MDD (Major Depressive Disorder). I won’t go into the details of what triggered my disease, but it has been – and continues to be – the most difficult thing I’ve ever experienced.

If you’re one of those who have never experienced depression or suicidal thoughts, count your blessings, but know that someone within your sphere of influence is most likely suffering right now. We can all do better at reaching out to those who are down, lifting instead of kicking. 

And to those of you who find every day is a battle, know that you’re not alone. There is help. Seek a professional – believe me, it can be life changing. As difficult as it can be, reach out to a friend, a prevention hotline, ANYONE who can help you in those moments when the darkness seems to surround you from all sides. And know that without the darkness, we’d never appreciate the light.”




Fiona - 
Suicidal ideation (thinking about) is not uncommon. If you read this article, and it has triggered you please talk with someone. A number to call is:
1-800-273-TALK
1-888-628-9454 (Spanish)
Crisischat.org

A big thank you to The Behrgh for sharing. 

As always, a big thank you ThrillWriters and readers for stopping by. Thank you, too, for your support. When you buy my books, you make it possible for me to continue to bring you 

helpful articles and keep ThrillWriting free and accessible to all.

Monday, October 28, 2013

Do You Think Your Character Might Be Depressed? Psych 101 for Writers

__________________________________________________________________________________


Excerpt from WEAKEST LYNX

     “So how many Zoloft are you popping each day?” Dave gingerly set his coffee on the table.
    “That would be a fair indicator of how badly this guy’s getting to me. Right now? None.”
     “Nerves of steel?” He was in professional mode, eyes scanning me, assessing. It felt intrusive; I lowered my lashes for privacy.
     “Hardly. I’m trying to stay busy so when I fall into bed, I’m too exhausted to let the tap dancing in my stomach keep me awake.”
     “So Zantac, not Zoloft, keeps you together?”
     I focused on the mug I slid back and forth in front of me. “I guess.






What causes depression and how can you tell if your character might be depressed?



Depression
Depression (Photo credit: Wikipedia)
There are many reasons for feeling depressed. Some people are affected by the amount of light available in the winter (SAD - Seasonal Affective Disorder), some people have an inherited propensity towards depressive episodes, while others experience depression following a traumatic experience. Medical issues such as thyroid disorders and diabetes can produce depressive symptoms. Also, brain trauma such as concussions or tumors can produce depressive symptoms. Researchers believe that depression is a physiological response to a hormonal disturbance (fewer neuro-transmitters such as serotonin.)

Depression is diagnosed when sadness is accompanied by helplessness, hopelessness, and worthlessness.


No Me Mireis!
 (Photo credit: El Hermano Pila)
According to the DSM V, a manual used to diagnose mental disorders, depression occurs when you have at least five of the following symptoms at the same time over a two week period of time:

* A depressed mood during most of the day, particularly
   in the morning
* Fatigue or loss of energy almost every day
* Feelings of worthlessness or guilt almost every day
* Impaired concentration, indecisiveness
* Insomnia (an inability to sleep) or hypersomnia
   (excessive sleeping) almost every day
* Markedly diminished interest or pleasure in almost all
   activities nearly every day
* Recurring thoughts of death or suicide (not just fearing
   death)
* A sense of restlessness or being slowed down
* Significant weight loss or weight gain




NOTE: Your character probably won't demonstrate ALL of the signs. Pick five to work with.

Types of depression include:
* Major
* Dysthimia (chronic low level)
* Bipolar
* Seasonal (SAD or seasonal affective disorder)
* Psychotic
* Postpartum (many mental health workers include episodic depression related to the menstrual cycle, etc)



How might your character look?

Of course, your character will have her own way of expressing her depressed state. 
A depressed man sitting on a bench
 (Photo credit: Wikipedia)

* Flat affect - which means that the face is slack and
  does not register a normal range of emotion
* Weight changes which make clothing too tight or hang
    from their frames.
* Dark circles under the eye if the character is
   experiencing insomnia
* An unkept appearance which might include
  uncharacteristically:
  `Wearing the same clothes day after day without
    washing them
  ` Unwashed hair
  ` Unshaven
  ` Body odor
  ` Mismatched clothing
* The unkept appearance will extend to their home and environments
* Gray pallor
* Stooped posture
* Dragging gait
* Vacantly staring
* Frowning

VIDEO QUICK STUDY, TED Talk: We Need to Talk About Depression (9:30) Excellent description of what a character would feel/experience.
  
 How might your character act?

* Difficulty concentrating, remembering details, and making decisions
* Fatigued with decreased energy
* Not reactive to sound or interaction
* Feelings of guilt, worthlessness, helplessness, and/or hopeless/pessimism
* Insomnia or excessive sleeping
* Irritable
* Restlessness
* Loss of interest in activities or hobbies
* Loss of pleasure in life
* Loss of sex drive
* Change in appetite
* Persistent aches or pains such as headaches, cramps,
* Digestive issues that do not respond to conventional treatment.
* Feeling sad, anxious, and/or emptiness
* Lathargic gestures and movements
English: Human Experiences, depression/loss of...
English: Human Experiences, depression/loss of loved one (Photo credit: Wikipedia)
* Their eyes may be red or wet and blink infrequently
* Little to no social interaction
  ` ignoring computer or phone messages
  ` No visitors/isolation
* Suicidal thoughts or suicide
     attempts

Your character may try to hide their depression by:
* Self-medicating (drugs/alcohol)
* Forced positive emotions like being on
   the stage and performing.
* Overly bright fake smiles
* Telling people that they have been ill - flu etc.

During this period your depressed heroine might be a target to nefarious characters because she may have diminished:
* Observational skills
* Ability to concentrate
* Time sequencing skills
* Concern for self-harm


Things that might help your character:
* A physical exam to rule out various medical issues
* Exercise
* Refraining from unprescribed drug use and alcohol consumption
* Nutritious food
* Caring friends, family, coworkers
* Meditation/yoga
* Therapy
* Medications

Zoloft (photograph)
Zoloft (photograph) (Photo credit: Wikipedia)

Common medications include (top 10):  
* Cymbalta
* Lexapro
* Effexor
* Zoloft
* Celexa
* Trazadone
* Prozac
* Welbutrin (anxiety) 
* Citalopram
* Pristiq
According to WebMD Link



Why Should My Character Have Follow Up Appointments With Her Diagnosing Physician

1. If a character is suicidal, but is too depressed to act on their ideations, 
    * They don't have the strength to carry through with the suicidal
        act. 
    * Once the medications have started to act in the character's
       system, and they start up the hill towards
       recovery, the character might reach a point where suicidal 
       ideations and physical ability intersect and
       that can be disastrous. 
    * A monitoring physician might be able to intercede if this is
       disclosed in therapy. 
2.  Many people do not like the side-effects of the medications.
     * As soon as they start to feel better they stop taking their pills. 
     * The pills have an effect on the body system. 
     * If the character was taking pills to increase serotonin, for
        example, her body might stop producing
        serotonin on its own. 
     * When the patient suddenly stops taking the medication, they
        are often in a worse place than when they
        started. This could be a very interesting plot twist. ( Patients
        are weaned slowly and with careful
        monitoring from psychotropic meds.)

Should you recognize yourself in any of this information. Please seek help from your physician. Depression is a physiological disorder.

If you find yourself thinking about suicide please contact One of these National Suicide Prevention Hotlines
If you are a veteran, there is help specifically for you at this link to The Veterans Crisis Hotline 







Thank you so much for stopping by. And thank you for your support. When you buy my books, you make it possible for me to continue to bring you helpful articles and keep ThrillWriting free and accessible to all.