**This post is rooted in recent current events, and has foundations in my experience as a mental health chaplain. The content may be upsetting or triggering to some**

"Regrets collect like old friends
Here to relive your darkest moments
I can see no way, I can see no way
And all of the ghouls come out to play

And every demon wants his pound of flesh
But I like to keep some things to myself
I like to keep my issues strong
It's always darkest before the dawn

And I've been a fool and I've been blind
I can never leave the past behind
I can see no way, I can see no way
I'm always dragging that horse around..."

I was asked by a friend today how we can support those individuals who are suffering from mental illness, but who may seem perfectly normal to the outside world. To our friends, family members, coworkers, colleagues, and even loved ones who may know us inside and out--but may never know we are suffering. My answer to this is grounded in my own personal struggles with mental illness and what I have had to do to normalize my life, and in the stories of many people I encounter day after day as a chaplain. 

Depression, anxiety, and similar cases of mental illness burdens the bearer with the additional feelings of fear, shame, guilt, feeling like a burden to self and others, sometimes intense apathy, fatigue and exhaustion, and the list continues. If it goes on long enough, the individual's battle against these symptoms can lead to suicidal ideation or worse. We know this. The root of this problem is hopelessness. An intense overwhelming feeling that circumstances will not or cannot change for the better at any foreseeable time. A person drowning in hopelessness is not going to reach out to others because they are literally just trying to garner enough energy to exist every day. This is why a constant stream of "Call or message me if you need anything..." or "You know I'm always here for you..." is good in theory, but poorly done in execution when the person suffering already feels like they are a burden on the ones they love. What can help, and what I have seen work are small networks of people dedicated to having real and genuine conversations about their emotional states on a continuous basis. Actual human connection, when enacted consistently lets people know they are supported and loved. The hard conversations about feelings (as uncomfortable as that sounds) are desperately needed in order to ensure people feel heard and accepted.

What does that look like? Calling each other regularly. Being more intentional about seeing each other face to face instead of relying on social media. Putting our phones down and spending time actually talking about heartfelt ideas and dreams and the things that make our souls tick instead of the weather. Talking about our fears. Talking about death. Talking about life. Being physical with one another in platonic contexts as well as saying I Love You and not being afraid to mean it. Isolation is what breeds hopelessness.

Suicide

Another topic that seems to only gain traction in retrospect is suicide. Many people feel uncomfortable talking about suicide, or feel they are poorly equipped to handle cases where suicide may be an option for someone. It is essential that if you feel someone is contemplating suicide, or even if you aren't sure, that you ASK the question. It is better to ask and receive an answer to move forward than to never have asked at all. 

Myth: Confronting a person about suicide will only make them angry or increase the risk of suicide.

Fact: Asking someone directly about suicide lowers anxiety, opens up communication, and lowers the risk of an impulsive act. 

What am I looking for?

Direct verbal cues and indirect verbal cues should never be taken lightly. Statements like "I've decided to end it all" or "I'm tired of life, I just can't go on" deserve the direct question "Are you thinking of harming yourself or killing yourself?" or "Are you thinking about suicide?"

Observing behavioral changes that suddenly seem odd (stockpiling guns, putting personal affairs in order, giving away possessions, stockpiling medications, co-occurring depression, moodiness, hopelessness, etc) are all flags that also deserve to be addressed. Situational cues such as a loss of loved one, major relationships, diagnosis of terminal illness, loss of financial security, fear of becoming a burden to others, etc deserve to be addressed. 

In cases of mental illness and suicide, the person desires to be seen, heard, and acknowledged. In many cases if any kind of hope can be restored it can be enough to change the course of thought that has a person feeling trapped. For suicide cases, offering to stay with them and put them in touch with resources is the best course of action (the warm hand off to counselors, therapists, and other professionals is preferred if possible) but at a minimum, helping them to remember that they are not alone and that people do care about them, or that they have a reason to live and thrive can be enough to give them hope. In the battle against hopelessness, we are the best source of hope for each other. 

National Suicide Prevention Lifeline: 1-800-273-8255 

Veteran's Crisis Line: 1-800-273-8255

I will put a final note on this piece by saying, in some cases we can never know why someone will choose suicide. It is a difficult thing to address in the forefront, and completely devastating to address in retrospect. It is still important to talk about it, because that is the only way we can bring these things to light.