Talking with Alexis Wortley

Alexis Wortley is coming out, here and now. In the eight years since her attempt, she has been embarrassed about giving up on herself and has been seeking atonement for what she did. Seeing another attempt survivor speak openly helped her decide to do the same. As she started sharing with family, friends and colleagues over the past week, a weight began to lift. And she was surprised to find that her parents had long forgiven her.

Now Alexis, an elementary school teacher in Washington state, is working on finding ways to be happy and realizing that maybe people do care, if you let them. “Maybe the human spirit is also being strong enough to say, ‘I’m not as strong as I thought,'” she says.

Who are you? Please introduce yourself.

So, who am I? Um, well, and it’s interesting, I read previous interviews and wrote stuff down, and now I’m looking at it thinking, “No, I don’t want to say that anymore.” I’m just another person in the world, a teacher, I wanted to be one since I was 5, and I used to come home from school and want to play school and had this dream of standing up in front of a classroom of kids and giving them knowledge and learning and facts and stuff. I’m a military brat, both of my parents were Marines, and it’s kind of funny that both are from the same state and met in Hawaii, and here we go. And I’m a daughter, a sister, a stepsister, everything that most people tend to be, and I’m someone who really cares a lot about people, I wear my heart on my sleeve, which sometimes gets me in trouble and is a factor in why I get depressed.

And I’m not good at describing myself because I don’t usually like to draw attention to myself, but I would like to think I’m funny, pretty smart. I like to read. I’m an animal lover. I do everything for other people but rarely for myself. And I’m gonna have to start learning for myself, make myself a priority, because I don’t know how to do that. I’m an introvert, I can spend so much time alone, I could go into my room when I was younger and spend hours by myself, reading or whatever. I never needed somebody around. I’m still like that. I’ve been living on my own for about 10 years now. At the same time, when I need to be around people, I need it right then. Sometimes they’re not always available, and sometimes that gets me down, too.

I guess I’ll go with how other people describe me. Those people say I’m beautiful and smart and caring and care about kids and empathetic and sympathetic and would give anybody the shirt off my back if I needed to. And I just don’t like to draw attention to myself, which is hard because at 5-10, it’s hard to hide. So I learned to start crouching, hiding myself, I didn’t want people to notice me, not realizing that 5-10 is a gift. That’s kind of where it all started. I like to think I’m someone people can come to. I didn’t realize I needed to go to people.

How old are you?

I will be 34 in April.

How has the past week gone, and how did it get started?

Well, very emotional. A lot of crying, but also a lot of happiness, which is a word I have a hard time using. I discovered I wasn’t happy. I think three things made this happen. One of them, I will be vague, but it was a man I dated in January. I could tell he had issues, too. I decided to ignore those issues. Maybe being with me would help him. It turns out that he decided he couldn’t do it anymore. He unfortunately had had marriages end because of infidelity. He’s been overseas with the military, so probably there are some issues there. I don’t talk to him anymore, so I’m not sure it’s ethical to speak of that. He ended it with me, so I started wallowing: “I don’t want to get out of bed, why me, why am I being rejected again?” It’s something that’s been going on my whole dating life. I’ve been rejected a lot. I discovered I’ve been finding the wrong guys, I’ve been dating those wounded guys and trying to make them happy, but I’m not happy myself.

My sister, I love her to death, she’s 26, one of those people who can just let things go. If it bothers her, she doesn’t show it. I have no idea how she does it. She came over last weekend, and I was in my pajamas, wallowing and upset. At first she was like, “OK, I’ll accept it,” then she was like, “Look, you’ve got to stop being unhappy. You’re never going to be happy with someone if you’re not happy with yourself.” I remember thinking, “Do you think I like being like this? I wake up and think, ‘OK, I’ll be depressed today?'” She laughed, and I started thinking, “What makes me happy?” I couldn’t think of one thing. I’m 33, I’ve got a great life, but I couldn’t think of one thing that makes me happy. I started sobbing, then I realized that I don’t allow myself to be happy because I feel I don’t deserve it because of what I did to myself and my family eight years ago. And I said, “I can’t do this anymore. I need to be open about what I did.”

The third one was really how I found your website, Attemptsurvivors.com. I liked the TED Talk on Facebook, the one JD Schramm posted. I was watching and, oh my gosh, this guy had all these successes in life and admitted he tried to kill himself. And I was like, “Thank you!” I was like, “Maybe that’s what I need to do, admit that I’m ashamed and embarrassed of what I did and look for ways to make it better.” At the same time, I’m tired of hiding behind it. And it’s been, like, a weight has been lifted off my shoulders, honestly.

I went to my dad and my stepmom. I talked to them: “This is how I’m feeling.” They listened and were very supportive and said whatever has to be done so I find happiness. They knew I was upset a lot, was still depressed, but they didn’t now how to bring it up. And I went to my principal and said, “Look, this is what I plan on doing, there’s a possibility of it getting out publicly, and if so, I have to do something about it, because I teach kids.” Also I told him, “I’m going to start doing this, I want to be an advocate, speak out in the mental health community. I want people to know it’s a problem.” And everybody I talked to so far said, “I’ve got your back,” and then they said, “Yeah, my friend is bipolar” or “Yeah, I know somebody.” People just don’t talk about it because they’re uncomfortable.

How will you do this?

That’s the good question. That’s what I’ll have to find out. This is my first interview. A good way to get started. I looked into getting training with ASIST in Seattle. I’ve been looking at NAMI websites on how to get involved. I’ve been on the AFSP website, they have the Out of the Darkness walks, they have one in Seattle, maybe I could sign up for that and get people for that. I could advocate in my state, get public policy going for people with mental health issues. I’ve been on the Waking Up Alive website and talked with Sabrina. She emailed me back saying, “That’s so great, here’s how you go about it, just take classes and be knowledgeable, and if you want to help people, you have to have that training.” She also said, “You have to be into your recovery process because this will trigger emotions.” She was really helpful. And I’m talking to spiritual leaders. I have a weird relationship with God. There’s times I’m totally religious, yeah, and there’s times I want nothing to do with religion and God and spirituality, and maybe it’s time to start fixing that. I want to look into a new relationship with God. I’m seeking grace and atonement, and maybe I need that from God, too. I’m looking into all these possibilities. I’m trying to find some way to get my voice heard.

What has been your experience with recovery?

Well, it’s been eight years, actually this week, and I thought I was fine. I thought, “OK, I’m out of the hospital now, I’m going to start some heavy therapy, meds, life is good, I’m alive.” I spent the rest of my 20s thinking life is good, but I kept trying to fill a void. I was filling this void, I was trying to be happy, but I was doing things that actually were not making me happy. I thought, “OK, if I can get into a great relationship and get married, I’ll be happy.” Well, that’s not true. I got in the habit of dating guys with issues like me, wounded. I was going through this cycle of constantly finding these guys. I went through a process of buying stuff. I went through bankruptcy because of it. I was buying material items. I got that under control. I’m doing well financially. I’ve decided to take myself out of the dating pool and strictly focus on me because I don’t think maybe I am completely recovered. This last week, I discovered I don’t like who I am. I’ve been telling people I’m ashamed and embarrassed. I haven’t asked for forgiveness from anybody, hiding behind what I did in hopes it would go away, maybe it didn’t actually happen. What I really need to do is address this act.

So to answer, no. I don’t think I’m fully recovered. I never did it again, I won’t do it again. I continue to see counselors, take meds, but every couple of months I get into some times when I get really down, and I know it won’t last, but at that moment in time, my brain is telling me, “I don’t think it will get better and I don’t know how to be fine,” and I think, “What if I decide to do it again? I don’t know what I’ll do.” My parents and sister said their first thought when I get down is, “Oh no, will we get a phone call again?”  I decided I need to start addressing it and talking about my experience. Luckily, I now recognize the triggers that get me down.

Did they know when it happened?

Yes, the only people that knew were my mom, my stepmom, my sister, my dad, just very immediate family members. And I had two friends that knew. I work at a really wonderful school, it’s like a second family there, I’ve been there seven years, very supportive, caring. They know I have anxiety issues, I can get depressed, but they don’t know my past. I’m ready to start telling them, I guess.

My parents knew. They were there. I have some fuzzy memories of that week: ” You guys didn’t visit me at the hospital,” and my dad’s like, “No that’s not true. I distinctly remember talking to a doctor who was saying, ‘Should we put her on a liver transplant list? How do we know she won’t do it again?'” Instead, I was put on an experimental liver program to clean out my liver and kidneys. The only person I remember being there was my mom. I never asked her how she felt. The other night, she came over, and I was explaining what I’m doing. She looked at me and said, “Alexis, I forgave you a long time ago. You’re my daughter. I was upset and angry, but you’re my daughter.” I was like, “Wow, she forgave me.” I was kind of stunned.

Since then, you’ve talked to other family?

Yeah, my dad and stepmom said they had never forgotten about it but forgave me. The reason they swept it under the rug is because they thought I had. So they never brought it up. My uncle and aunt were very supportive. I went to them and said, “I have issues,” and they said, “Yeah, we’re praying for you.” I honestly can’t remember who knew aside from my immediate family and a couple of friends. Other than that, I’m gonna have to feel it out and see.

You mentioned feeling embarrassed and that you have to atone for what you did. Why? If it’s a health issue …

Well, I don’t like upsetting people, and I do understand that it is a health issue, but I feel that I should’ve been able to make a better choice and instead, I gave up. I very rarely give up on anything or anyone, and I gave up on myself, which is not the human spirit. I allowed my disease to take over, and I succumbed. I lost my pride. That’s where the embarrassment comes from. My cousin died of cancer two years ago, and he never stopped fighting, and he never gave up his will to live. How come I couldn’t do that? Waking up and being alive and continuing to live and make improvements should’ve made up for the embarrassment and shame, but it didn’t. Now, I’m admitting I’m not always strong, I am human, I make mistakes, and now I want to come out from that and let others know that hiding only makes the inner pain worse. Maybe the human spirit is also being strong enough to say, “I’m not as strong as I thought.”  I’m not sure if any of that makes sense.

Do you still live in the same community, the same location?

Yes.

What kind of response do you expect to get in the community?

I would hope it would be positive. One thing that really bothers me is that the media portrays people with mental health issues like we’re crazy and unstable and violent, we snap and go shoot up schools and all this stuff, and every time I read the comments and see what the media does, it makes me so upset. They’re lumping us into a category that’s completely not true. Unfortunately, with social media our lives are everywhere, and there are going to be some negative responses … But the majority, I think, will be supportive, will say, “Hey, that’s brave of you” and start telling their own stories, “Hey, sometimes I get really down” or “Hey, I have a mom or grandpa,” and the stories will come out because finally someone says something. I guess time will just tell. It’s not like I’m going to go on Facebook and say, “Hey, everybody, guess what I did eight years ago?” Some parents of my kids are on my friends list. I’m starting very slow, with my inner circle, and I hope to branch out from there.

What steps are needed to really open this door?

I liken it to the fact that the civil rights movement, how long that took for Martin Luther King and Rosa Parks and all of those great people that finally got the discussion going about civil rights. And I think about how in the ’80s with AIDS and how long it took to get the word out and prevention and those living with HIV or AIDS are not bad people. And you think how long it’s taken all these issues. Honestly, something like this is not gonna happen tomorrow. Like with the media, they badmouth it so much and portray it in a light that’s not fair. The stigma and taboo that go along with it: “I don’t want to say anything until someone else comes out and has the courage to say it.” Maybe that was the issue for the past eight years. I didn’t want to be called crazy and have people think I was violent or something. And I’ve been called crazy, for real, and it hurts. Even when people are joking and don’t know my past, I kind of laugh but think, “No, I’m really not. I have a disease. You can’t see it, but it’s still there, and I deserve to get as much help as someone with cancer or other horrible disease.”

I don’t know. That’s why the only thing I can do is reach out and get myself out there. I hope people will say, “Wow, I can’t believe you’ve been suffering for that long and didn’t say anything.”

What been useful in your treatment, and what hasn’t been useful and should be changed?

I was diagnosed when I was 19. I had my first panic attack. I thought I was having a heart attack. I went to my regular primary care doctor, and she was like, “OK, we’ll put you on pills” or whatever it was. Then it was like, “OK, see you later.” She didn’t say counseling or anything. I went on this medicine, things were fine, but as I was getting into my 20s, the pressures of life honed in on me. I graduated college, tried to find a job, my parents divorced, and I decided, “OK, maybe I need to seek out counseling, too.” I’ve been through many different counselors, I’ve been through many psychiatrists who say, “OK, maybe we up your dosage or reduce it or put you on another one.” And I say, “OK, you guys are the experts” and I go with it.

I think it’s good to have that there, to have someone to talk to, but I think they need to be on the same page. Some just let me talk but give no suggestions. The one I have, she’s very good, she lets me talk but gives me suggestions. Journaling, exercise. She wants me to get better. Apparently, she didn’t know what I tried to do, and I told her the other day. I started telling her what I want to do and she said, “That’s great, we need more people like you to start talking, and helping,”

But to answer your question, yes, the drugs have helped. I don’t get the horrible panic attacks. I don’t get into as deep, dark holes I don’t think I can climb out, like eight years ago. I know there’s a light at the end of the tunnel. The one thing that doesn’t help is the friends who say, “You know, happiness is a choice. You just have to choose happy.” I would give anything, I’d give everything I have if I could just choose to be happy and let it all go, but I can’t.

There’s just no money out there for those programs. To get appointments even with my counselor, it’s just weeks out. That’s how busy they are. I couldn’t find support groups in my area for after suicide attempts. I would have absolutely no idea how to start a group. One thing my principal suggested, I guess there’s a program called Celebrate Recovery, like a church-based 12-step program, basically like AA but for anybody who feels they need to recover from something, just anything. I said, “That’s great, how come they don’t put it out there more? It’s free, with churches. There’s just nothing out there to advertise it. Plus, you have politicians who say, “Cut funding for health care, cut veterans benefits.” They think if you get rid of it, it just goes away, but it’s just making it worse.

Oh, I just thought of something. Other things that help is just knowing people care. When I do finally start talking to people, say, “Hey, I’m having issues,” I have people who say, “Hey, if you ever have to talk” … I put on Facebook that I was having issues, and a colleague messaged me out of the blue and said, “Hey, I’m here.” And I said, “Yes, I’d like to talk. You’re taking time out of your life to help me?” It just felt really good to see people care. I’m really hard at accepting help: “No, I don’t want to bother you, I can take care of myself,” but maybe they’re offering because they really do care. I’m starting to realize that now. My dad, my principal, say, “If you need to talk, come talk to us, please!” And that is very comforting.

I’ve always been that person: “I you ever need to talk, please call on me.” We live in a world where people just want to think they can take of things by themselves. That’s how I am. They don’t want to look helpless, I guess. They want to look like, “Hey, I’m strong.” But when it comes right down to it, everybody, some of us are just dying inside and putting on a happy face. If we knew people cared, maybe people would start talking.

I think about bullying, being an elementary school teacher, bullying is such a huge deal. They’re projecting what they don’t like about themselves in an effort to make themselves feel better, not realizing they’re hurting the person they’re bullying, like a vicious cycle.

Do you ever see anything in your students, issues that concern you?

Yes. I can’t go into too much detail, but I have students who don’t get any support at home, don’t get nurturing, and they get attention anywhere they can get it, any attention is good. I think about those kids as they get older, what will they do, will it be good or bad? I have kids who already suffer from anxiety, and wow, they’re already suffering from anxiety from the pressures of life, to perform, and I feel for them because I know exactly where they’re coming from. I just let them know I’m here. Being the child of divorced parents, I say, “Hey, I’m here for you.” Most probably won’t take me up on it, but just being able to tell them they know somebody who really cares about it …

With your other issues, is 5th grade the place to connect?

Unfortunately not. Even though I am their teacher, I still … And I know it’s out there, I was doing some statistics-searching and it’s the third leading cause of death from 10- to 24-year olds, and I was stunned by that. That a fifth grader would think about that. But I don’t think it’s my place to talk about that unless I got permission from my parents. I think it’s more likely in junior high and high school. But as a teacher in 5th grade, I would feel uncomfortable because I don’t know what I could say, liability issues involved. That’s why we have counselors, school psychologists and, to be honest, why we have parents. We live in a society where everything’s out there. Parents really need to have that dialogue with their kids. I can honestly tell you I know of students at my school who unfortunately suffered the loss of parents because of suicide. And I could never say anything to them because I don’t know how they’d react. I mean, divorce is fine because everybody knows about it. But there are still some things these days we can’t touch upon. Maybe in 5,10 years that will change. Eventually the dialogue maybe needs to be there. Just not right now.

What will you do for yourself? To change?

Actually … Gosh. I don’t know how to go about that. I spent most of my life taking care of others, helping others. I have to figure out what makes me happy. Teaching makes me feel good, being around kids, laughing. Feeling successful makes me happy, but those are all fleeting moments. I’m not sure how to do “happy.” I think if maybe I get my story out, someone will say, “Hey, I heard your story and I decided not to go along with my plan. I’m going to try and get help.” In a way, I guess, that could make me happy.

I like being there for other people. But for myself, I just need to learn to be selfish. To me, selfish is a bad thing. I need to start taking care of myself, exercising … Gosh, I don’t know. I just need to stop being afraid. There are times I don’t like going out in public because I’m afraid if they’re looking at me, judging me. I have to say, “Hey, they look at you and then they’re gone.” That’s what I think this journey is. I need to find that inner peace and go to bed and say I’m happy. And I can wake up and say, “I’m good, this is who I am, and I’m dealing with it the best I can and helping others in the process.” I need to be able to be content with that. I have my support group. I’m not sure how to get there. Maybe a better relationship with God. Maybe recognize the warning signs that get me depressed and get away from that situation. That’s a loaded question. But I do know just in the past week I’ve felt better than I’ve probably felt in a really, really long time, and that’s the first step.

Where I was eight years ago and where I am now, it’s a complete improvement. Back then, I was in a dark hole. I really felt just there was no way out. If I took myself out of the equation, the world would be a better place. I had all these issues going on in my head. It just mushroomed. I didn’t plan it. I know a lot of people do. I didn’t. I snapped. I remember driving home sobbing, thinking, “Please, a car just take me out, something.” I remember swallowing Tylenol by the handful and thinking, “OK, it’ll be done.” But now I can say, “Yeah, I’m much more content than I was.” But I know I still have a long road, and I know I will never, ever do that again because I know I can pick up my phone and talk to somebody, and I know now in the past week that people will say, “Great, let’s talk.” And I thought eight years ago nobody gave a darn. And I know now it’s wrong. I just wasn’t willing to ask for help. And now I’m willing to ask.

I’m sitting here looking at my apartment. I have pets now. After my attempt, I got a cat and thought, “OK, that’ll help.” And that was the greatest thing I’d ever done. Then I got more. They are therapy, too. They need me like I need them. I started improving my job, getting better as a teacher, and now I’m an awesome teacher. Everything is good, and now there’s this one thing I have to do. I have to say, “I’m Alexis, I suffer from depression, I tried to take my own life and, you know what, it’s going to be OK because now I’m willing to admit it. And if you need to talk, I’m here for you.”

Who else are you?

I feel that I am somebody whose journey is just beginning. I’m gonna be 34 in April, and I thought my life started when I graduated from college and got my first teaching job. It turns out that’s a great part of my life. I can look in the mirror and say “Wow, you’ve made it,” but maybe my life is starting right now. I’ve questioned that a lot, asked, “What is my purpose in this world?” I thought it was to be a teacher, and it is, or half of it is, and maybe the other half is I need to help other people like me, and maybe this sounds like a cliche, but changing the world in some small way. Everybody changes the world in some way, either they do it quietly or with a lot of show. Maybe I’m just finally realizing what I’m going to do with the rest of my life. And maybe it’s not what i thought it would be, but that’s OK.

Maybe in another year I can give another answer to this question, a better answer, but now it’s completely new and scary, and there will be times I will ask, “Why did I decide to do this?” but at the end of the day, I’ll say, “OK, this is me and I’m doing the right thing.” But you know what, I don’t want to be that person who gets down by that and retreat into myself. I know now there are places and people I can talk to and be more open. So yeah, it’s a hard question to answer. I think I’m gonna be … I’m gonna be different. I’m gonna be a new Alexis, and now I have renewed hope and faith for the future.  Yeah.”

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Talking with Sandra Kiume Dawson

The Canadian activist who tweets at @unsuicide has built a peerless guide to the online world of crisis response, and she’s done it on her own time with zero budget. Here, Sandra Kiume Dawson discusses suicide hoaxes, what Twitter does wrong, the need for transparency, why hotlines are outdated, and how to walk the oh-so-careful law enforcement line between tracking people down for help and scaring them away.

Sandra also makes a special note about why trained peers like herself are crucial online. “We’ve seen the darkness, and it can’t get any darker,” she says. “I’m not afraid of it. I can hold someone’s hand and guide them out of it. And I think there should be more safe spaces like that.”

Who are you?

My name is Sandra Kiume Dawson. I’m a suicide attempt survivor, living with bipolar and other conditions since I was 7. I’ve had multiple attempts. Through treatment and self-education, I’ve learned a lot about suicide prevention, both from the standpoint of suicidology but also from more grassroots efforts. I have a part-time job as a mental health blogger at PsychCentral that helps ensure I keep current with mental health news.

Suicide is not the only topic, but I often write about it. I also have a wiki, Online Suicide Help, which is a directory specializing in e-mental health services, crisis IM chat services, social media supports, peer support forums and more. There’s quite a lot out there and more all the time. I’ve collected these resources into one place so people can find them easily. Another thing I do, I’ve been on Twitter since 2009 as @unsuicide, a peer support suicide prevention account. I’m not a trained counselor, but since I have lived experience and a lot of knowledge of the mental health systems, I can help people navigate both online and off to find supports.

A typical conversation with someone on Twitter is something like, “I have a plan to kill myself.” I’ll say, “Do you want to go to the hospital?” “No.” “Do you want to call a hotline?” “No, I don’t want that. I’m afraid the police will come knocking at my door.”

Or, “I have anxiety; I don’t want to talk on the phone.” That’s where online services are helpful: texting or IM chat services. It’s great to see more and more available. But I also refer people to peer support, because often people are more interested in peer support than professional help, or they want both. People want to know others really understand them; they can talk to someone who’s been where they are and have recovered. That provides a lot of hope, makes people less alone. Feeling suicidal is a very isolating experience, and so anything that makes you feel less alone is helpful.

Where did you come up with the term “unsuicide”?

I thought it was catchy and reflected my goal of people proactively preventing their own deaths. Unsuicide as the opposite of suicide.

When did you start pulling all these resources together?

I started on Twitter in 2009, and created the Online Suicide Help directory in 2011. I had already been bookmarking resources for over a decade.

Do you have everything?

No. I don’t pretend to be completely comprehensive. I’m continually searching for more, and asking people to share links. And there are always more services coming on board, especially with crisis chats.

Do you have measurements of users, traffic, etc.?

I do keep track. I get about 6,000 hits a month and have 15,000 Twitter followers.

Who comes to you?

With the wiki, it’s really worldwide. I’ve had visitors from 158 countries. The tragic thing about that is that while I’m aware of the worldwide need for online services, they’re not always able to access services because of geoblocking – restricting services to one country or even a single town. There’s a huge need to create an international network so people in, say, Mongolia or Malaysia or Ecuador or, you know, any country that doesn’t have the money to start their own services, can access help. People are desperately searching, and it’s devastating when they find there is a service but it intentionally won’t serve them.

Do you get paid at all, and how much time does this take?

No. I don’t get paid for this at all. How much time is really variable. I will check usually every day to answer tweets, share links. I would guess an average of maybe an hour a day, two. If someone contacts me to talk, it can take more time.

What has been the response from organizations you reach out to?

The IASP at least wrote me back. A lot of organizations don’t. I’ve tried writing to organizations that completely ignored me, like the Samaritans in the UK. It’s been frustrating because I don’t have a Ph.D, I’m not a suicidologist, am not employed by an organization and I don’t have credentials. And because of that, I think they’re not willing to engage with me.

You mention that you’ve had the experience?

Yes. It doesn’t make a difference. There have only been a handful of organizations that have taken me seriously. Crisis Chat is one, in the US.

A big exception happened recently with a petition I started to ask the American Foundation for Suicide Prevention to change the language of “survivors of suicide” to “survivors of suicide loss” or “the bereaved” in their events and literature. Once it reached 100 signatures, I contacted the CEO, Robert Gebbia, and he was very responsive and respectful and agreed that the language needed to change. I look forward to that happening soon.

What more would you like to see?

An organization that involves and includes users, by which I mean Internet users and app users who are also mental health service users. I see sometimes that organizations will engage stakeholders and say, “Oh, we’ll bring in a couple of people with lived experience and see what they think, or do a focus group,” but those consultants are not always on social media and seeing what triggers people in that realm. It’s people who don’t necessarily know the online landscape. Without mentioning an organization, I saw this just recently and it was really discouraging. I think people with lived experience who are brought on board need to have certain qualifications. Not academic, but the right experience.

In terms of diagnosis? Or what they lived through?

What they lived through, and what type of services they’ve engaged with in the past.

Have they used online services, do they know what they’re like, the barriers involved?

Just pulling someone out of the hospital randomly doesn’t mean they know how a crisis chat operates, or what kind of supports are on Twitter or Reddit, or the pros and cons of texting vs. IM chat.

Do you have a roll call of favorite resources?

Yes. There’s a service called Youthspace.ca for Canadian youth under age 30, which is actually problematic as a lot of online and texting services are just for youth and adults are often left out. They’re a great site, with texting, chat, a forum and trained counselors. IM Alive is now available 24/7, which is fantastic, and I’m also fond of Crisis Chat. But both those services are for Americans only. I wish I could recommend a peer support service, but I only know a few services that aren’t specifically for suicide. Real-time, peer-led suicide prevention intervention online almost does not exist! There’s one tiny service in the UK, but that’s all I’ve found beyond social media, and those people are lacking organization, training and support. There’s such a need for this. The professional peer support specialist community has not seemed to recognize this need yet, or has not acted on it. Professionalized peer support is only available offline.

How much do you think traditional nervousness around suicidal thinking affects not innovating?

I think it causes a rift because traditional services are hesitant to bring lived experience on board. I think in America it tends to be even more split: peer-led groups tend to be doing their own thing, as often they have a history of antipsychiatry activism. And possibly for that reason, the peer-led organizations – I don’t know, I’m just guessing here – but they’re maybe not privy to the same research that other suicide prevention organizations have access to. So maybe they’re not as up with changes in technology and demographic trends. I’ve noticed, too, that not only have I had trouble engaging with the traditional organizations, I’ve had even more trouble getting cooperation from peer-led organizations. There’s a schism that they’re suspicious of anything to do with psychiatry, and they want to do things their own way, and if you’re working within or advocating the medical model at all, you’re suspect. At least, I’ve been shunned before for that reason.

So that’s why I’m kind of doing things on my own here, you know? It’s frustrating. But if suicidologists don’t want to work with me and peer support activists don’t want to work with me, it hasn’t stopped me from doing a lot on my own.

But you’re on a national consumer group in Canada, right?

I’m a member of the Mental Health Commission of Canada Advisory Council. It’s not a consumer group, but I’m one of three members with lived experience on the council. It’s really exciting because I’m now included in high-level strategic discussions for national mental health policy. People with lived experience are not often involved at that level.

How did you come across each other?

I was already on their e-list. They put out a call, and I was one of almost 200 applicants.

Again, are you being paid?

For the advisory council, I receive a per diem plus travel expenses, yes. For the work I do on my own, no. I can’t expect to be paid for something that’s my own initiative. But I don’t mind, I can do a lot on my own. I went to an e-mental health conference last winter and showed a researcher my wiki, and she was just amazed I had a budget of zero. They spend millions to create a website, and to me, that’s such a waste of money. I can make a
site for nothing. So I did.

Where else would you like to take this?

I’d like to see what I’m doing expand into an international network with the cooperation of Twitter, as well as law enforcement. That’s beginning to happen now, but I’d like to see more peer involvement in the design and operation. When people have already announced they’ve ODed, they need immediate medical attention, and there’s no way to get them care if you can’t track their IP, which only law enforcement can. It’s really frustrating when people leave suicide notes and you can’t do anything else. Twitter is not helpful, all they do is send an automated DM telling the user to call a hotline. A new approach involves cooperation with social media companies, law enforcement and professionals who do counseling online. But it’s also critical to have peer support and lived experience advocacy in that equation. I see a lot of people afraid to talk to nurses and doctors, and even more afraid to talk to police. Peers have empathy, they’re not as scary, they understand and they can have intervention skills training. The right person with the right training and experience can be even more effective as a crisis counselor than someone who doesn’t have that lived experience.

What’s the ideal way to involve cops?

I think there needs to be rational discussions between people with lived experience and the police to see what those boundaries are. For example, many people don’t know the difference between self-harm and a suicidal act. They see a tweet “I just cut myself” and see that as a suicidal act, and if they brought in police to knock on the person’s door, it would be inappropriate. To have that knowledge, to know when intervention is warranted, is vital. Otherwise, you just scare people off, and they don’t trust you anymore. Phone hotlines have this problem, they have a reputation as being untrustworthy because they call police, and it’s a big part of the reason people I talk to refuse to call a hotline. It’s hard to know when to make that call.

Are online crisis services more transparent about their policies about contacting police?

Some are, but generally not that I’ve seen, no.

How do you work with law enforcement?

I’ve only called police a few times since 2009. I don’t involve police unless an attempt has already taken place and the person is unresponsive. One was an example of someone who left a suicide note and left enough clues on their timeline that I was able to figure out where the person lived. I called police, they checked it out, and it turned out to be a hoax. It’s surprisingly common. Another time, a girl, a teenager I had been talking to for over a month, was really depressed. She was saying how she was going to kill herself on her birthday. It was coming in three weeks, two weeks, one. I kept trying to get her to go to a school counselor, any kind of option, but she was not willing to do anything. She just kept coming back at me with, “I’m going to kill myself on my birthday.” When the day arrived, she left a suicide note on her timeline. That was it. I called police. They tracked her down at her school, and she was super mad at me. She deleted her Twitter account, and I never heard from her again.

She was OK?

She was alive.

Did law enforcement get back to you?

No. But she had made so many threats repeatedly, and she was so unresponsive that I felt involving police to get her to help was warranted. There was a similar incident with another girl but not enough clues about location, and when I phoned police, they said no, because it’s on the internet they can’t do anything. They brushed it off. That’s been a barrier to working with police. Unless they know an exact street address, they don’t respond. They don’t have access to Twitter’s user data. Fortunately, that’s changing now with the new Real Time Crisis service.

Why are suicide hoaxes surprisingly common? Why would someone do it?

I can only guess, as I’ve not read any research on the topic. But basically, it’s for attention, it’s to gain more followers or specific followers and get sympathetic messages encouraging them to live.

“Celebrity blackmail” is one very common reason behind a suicide hoax, especially among youth, but I’ve seen it happen with fans and stalkers of any age. The person will send a tweet to a celeb saying, “If you don’t talk to me/follow back/RT me, I’ll kill myself,” and it’s purely to gain the attention of their idol.

Another category of hoaxes comes from people who are genuinely disturbed, trying to gain attention for a personal issue in which they’ve felt silenced. They may tweet repeatedly to mass media accounts as well as anyone who will listen about being victimized by something, and sometimes make suicide threats.

I think someone who creates a hoax does have issues to look at, it’s not something a healthy person does just for fun.

You say Twitter isn’t responsive. Is that the same for other social media companies?

They all have different policies.

How hard would it be for them to make the changes you’d like to see?

It’s a technical issue, isn’t it? On one hand, you don’t want just anyone to say, “Oh my friend says she doesn’t like her life,” and send the police. That would not be a good approach. But if it’s a matter of, there’s a safety team already online and doing outreach and identifying when there’s a real, bona fide crisis and there’s a life in danger, an attempt has happened and a person needs immediate medical care, that’s where I would like to see Twitter and other services working with police and peers. And it’s coming, slowly.

What are the risks involved?

Of service users becoming less trusting of people like me. Right now, people trust me because I’m one of them, I have empathy and I’m not a police officer or a doctor. I don’t want people being afraid to contact me. Transparency is really important. One problem with hotlines is people being afraid of police being dispatched. Some hotlines have different policies. Some will send police and some have confidentiality policies. It would be better to know up front, because people have been quite traumatized by police showing up at their door unexpectedly.

Have you reached out to crisis lines on that issue?

No.

Here’s a question I’ve had a lot: What is a good suicide forum online?

It depends on the kind of support you want. I have close to 100 mental health forums linked in my wiki. Specifically for suicide, there are a couple I don’t recommend, but Suicide Forum is a good one. I also like PsychCentral’s forum, it’s a major one, but it’s not for suicide talk. It’s good for issues of depression or anxiety. You can dance around it, but you can’t mention suicide.

Why tiptoe around the subject in forums like that?

I wish they didn’t! It’s because of the fear of triggering, but where do you go if you can’t talk to peers, right? That’s why projects sometimes turn up on their own with their own rules. And that’s where my Twitter service comes in. People can say anything they want to me. I don’t get triggered. I think those who’ve had attempts are less afraid of talking about it. We’ve seen the darkness, and it can’t get any darker. I’m not afraid of it. I can hold someone’s hand and guide them out of it. And I think there should be more safe spaces like that. I guess that’s what hotlines are for, but they’re so outmoded, and they’re not peer services.

One thing I’d like to see, if we’re talking about alternatives: safe places to go and talk about suicidal feelings without the risk of being forcibly taken to the hospital. 24/7 crisis respite services with peer support and clinicians where people are free to talk about their feelings and not afraid of being institutionalized, even though that fear is often based on stigmatizing old stereotypes and not the reality of modern hospitals. It would be good to see that concept online as well. If you’re going to build a peer crisis service, with warmlines, etc., why not make them online services as well? Demand is there.

I’m not afraid of hospitals myself, and am not anti-psychiatry. Medication works very well for me, and I’ve been in hospital many times without any abuse. It kept me safe and saved my life. But I recognize that there are a significant number of service users who are afraid of hospitals or who had bad experiences and don’t want to go back. They should have an alternative.

How do you protect and take care of yourself when working with people in crisis?

For one thing, when I hear some of the negative things commonly expressed, I can recognize them as symptoms of depression, bipolar, whatever the person is dealing with.

A lot of people I talk to have borderline personality disorder, for example, which I used to have but recovered from. So I know the symptoms. When someone says a statement I recognize, I encourage perspective and insight.

I’m also very good at self-care and managing my moods and reactions to triggers, and when I feel fragile I simply don’t log into @unsuicide. I take a break from it for as long as I need to. I have the flexibility and knowledge to do that.

How did you get better?

It wasn’t simple. It was a multi-stage process. Finding the right medication combination and adjusting when needed, with the help of my doctor, was essential, but that’s not the whole answer. Lifestyle changes were critical: regulating my sleep cycle, getting fresh air and sun, lots of nature. Parks and trees are good for me. Moving to a quiet community that was a less stressful environment was helpful. Whatever I can do to lower stress is good. I also went through both CBT and DBT therapy, which were very helpful. I practice gratitude, and really like mindfulness meditation. I have a lot of apps as well. My mental health toolkit is a formidable arsenal. And last but definitely not least, love and support from my wife has been amazing and so helpful to my stability.

Where are you today?

In a pretty stable place. I still have occasional episodes. I can still get triggered, but I’m careful about self-care and pulling back from things when I’m feeling vulnerable. I’m not on @unsuicide every day if I’m in a low mood. If I’m just feeling kind of jaded about things, not feeling very supportive, I’ll just say, “I need some self-care, I’ll be offline today.” People understand. I leave the link to the wiki: “Here are others who can help you.”

Who else are you?

I do jewelry design as a hobby, and I don’t know, I’ve been many things in my life. I’m an Air Force brat, I grew up all over the place. Then I lost and gained a lot of different jobs, so I can’t say, “I’m a (blank)” because I didn’t have one career. There was so much chaos. In the last 10 years or so, since going on disability, things have calmed down.

I’m a mental health advocate, though I don’t like that phrase so much because it’s so vague. I’ve been on the board of a mental health housing nonprofit society, I’ve worked for a homelessness and mental health research project and I have a part time job at PsychCentral. Never just one thing.

Anything else to add?

I see so much peer support available online in forums and chat rooms, but I see damaging advice being given, flame wars sometimes. And I think there’s a real need for people giving peer support to have some skills training, and I don’t know how that could happen in an unmoderated internet. On one hand, you have certified peer support specialists working one-on-one with people offline. On another hand, you have millions of informal peer supporters online, but those people have no training at all, and sometimes they’re giving really bad advice. They don’t have an ethics background, or trauma-informed care skills, and they often can be triggering to people. I just wish those certified peer specialists would merge with the informal peer support. Set up a free mass training system for mental health literacy and intervention skills, a free webinar, or a site where you can get a mini-certificate. If peer specialist trainers set it up, that would be the most logical thing to do. But right now, I basically see them ignoring the internet and not integrating it into their work. They’ve got to get over that. Mental health professionals are now routinely offering e-mental health services, and it’s time professional peer support specialists were doing it as well.

Talking with Ameera Ladak

Ameera Ladak most likely just set a record for the shortest time between coming out on social media and appearing here. The Canadian college student emailed last week with a link to her new blog, and we were off.

“I was too stuck on getting help being a sign of weakness, that I tried to get through my depression alone, without therapeutic or pharmacologic support,” her first post says. “Have you ever tried to cure a cold without tea and Tylenol? It sucks ass, and what I was doing was no different. On top of that, I had the nerve to blame myself when I couldn’t cure my ‘cold’ without ‘tea and Tylenol.'”

She took a break from writing, including a breakdown of the kinds of people who mean well but don’t quite get there _ The Quick Fix, The Analyzer, The Disappearing Act _ for a phone call.

First, an easy question. Who are you? Please introduce yourself.

Who said that’s an easy question? Yeah, I’m a university student, second year, I take business, and what else can I tell you about me? There’s a lot of words people use to describe me, but I use different ones. They say I’m intelligent, smart, funny, outgoing, and I strive to be those things for sure, but I definitely have a lot more that goes on. It’s almost like two sides of me, and I select which side I show. I’m very aware of how people view me.

How would you describe your other side?

I think very sensitive, in a way. I take things very seriously. I like to think about things, be very careful and guarded with what I do and say, not too adventurous. I like to be comfortable, in my comfort zone. I like having a home base where I feel comfortable, safe. It’s really important to me.

You said you’re very guarded with what you say. How did you come to be talking to me?

When I was first depressed, I hid it from everyone. My parents. My friends, who I spoke to every day, all the time. And I just got really good at hiding who I was. I was in the hospital for a week and nobody knew, except my roommates and friends and family. Really, no one knew about it. As I started my recovery, I realized that if I have a hard time recovering, it’s because I have no one to go to because I don’t let people in. Maybe it was time to let people in, maybe they’d accept this part of me, that it’s not always sunshine and rainbows, but honest. It’s me. They may love it or hate it, but that’s how it is. I didn’t know quite how to say, “Hey, guess what, I have depression.” So I said, “I’m gonna write. For me. If they choose to read it, take interest in who I am, that’s their choice.” And I reached 1,000 hits in 48 hours. People were receptive. I like talking about my journey and what I go through. Just because it’s more serious doesn’t mean it’s boring, that I’m not that funny and outgoing person I usually show.

1,000 hits in 48 hours. How were the responses?

Amazing. I wrote maybe one or two posts. I just made a Facebook status: “I feel great because I started a blog.” No link. I just mentioned it. A typical Facebook status. People started messaging, “Hey, send me the link.” I chose to share it with one of my friends. I was sort of getting cold feet, but I just went for it. I sent it to a couple of people. And they loved it. “This is amazing, brilliant, keep going.” One of my friends said,” This is exactly what I feel.” Then it was seen on Facebook by others. Two people would share, then seven, then each one would get, like, 40 likes. I would hear from people I haven’t talked to in years. As I wrote more posts, I really started to address the things I never knew I could, and the reception just got better and better. Everyone was just like, “You know, I can’t believe I never knew.” What I tell them is, I’m a really good actor. When you do it for so long, you don’t actually know how to show what’s going on. When someone asks, “How are you?” the automatic response is, “Good.”  It’s not really a question. What I do with the blog is take that step back: “This is what’s really going on.” I just write and publish without reading it, thinking about it.

When did this start?

The blog? I started it Wednesday night. So about 48 hours. A little less, actually.

What started it?

I don’t know if you know what #BellLetsTalk day is. A few days ago, you know, tons of people were tweeting, and that’s when I first started to dip into letting people know. I talked with my sister about how great it was that people were talking, but what were they talking about? Talking about talking about mental illness. But are they really talking about it? That’s when I was like, “There are so many people who think they know about mental illness but don’t know at all. It’s not their fault, it’s just that no one talks about it in an open way. You find blogs, memes, about things like cancer, but not a whole lot about depression and suicide.” I was going on and on and my sister was like, “You should start a blog or something.” I was like, “No, who would read it?”

I had a really long day, and I was really frustrated because every time I tried to talk about my mental illness, nobody could get it. No one had explained it to them. My experience would have been easier if someone had known what’s going on. I started to write. Randomly, I set up a blog and started to write. One post turned to two, and I started feeling better. I was waiting to watch a movie with my roommate, and I just got started. I got suggestions from people on what to write about, and it really just snowballed from there.

How is this going to work, going forward? Are you going to pour it all out at once and be done, or keep it up?

No, it’s not where I pour out all my emotions. Yeah, I might not filter what I say, I may not have a concrete idea of what I’ll say, but usually I have a plan of what I’m writing and why. Some messages I got say, “I have a friend going through this, and what you wrote opened my eyes.” It started out as something for me, and now it’s for people who know people who have mental illness and people who have mental illness but don’t know how to express what they’re going through. It’s hard to say “I feel this” and “I need this.” This is how you get through it. It’s so hard to talk when you’re in that space. Now I have my voice. This is what I was thinking that whole time and never said. People are receptive to it. It will help people who can’t express what they need. And the way I see it is, I may not be able to change the world as a whole, but I can help be a part of changing someone else’s world, and that’s enough for me.

How would you tell your story?

I first started getting depressed when probably I was in junior high, probably grade 7, on and off throughout junior high. I wasn’t quite suicidal. I was very upset a lot, a lot of that anger and angst. Part of it was being a teen, and part was something a little more to it that I couldn’t really identify. I struggled through it, graduated, transferred to high school and put all of my energy into school. I did all I could to get good grades. I got into university and had a great first year. That’s when I started to have … my conversion disorder started to show up. I had a lot of seizures, because my brain was not processing emotion right. There were unprocessed psychological issues in my brain that were not being processed properly, and that emotion was released through something physical. So I’d have pain or a sort of seizure. After my first year, the summer after that, the past summer, I started to feel really, really sad. I had never felt that sad before. It was so raw and almost like it made it difficult to believe sometimes, because it was so much at one time. I didn’t know how to process it. But you know, I like to say, “You know, I can deal with this on my own.”

I tried to do it. When I couldn’t, I talked to my doctor and was put on anti-depressants, and I started seeing a counselor. I didn’t tell anybody. It was completely me. Nobody knew. A total secret. And then my anti-depressants weren’t working, obviously, because I was getting worse. So I made plans to kill myself one night. I had it all planned out. What I was going to do was, I would go out with my friends and have a good night, a couple beers, then get really intoxicated. Then, when I was so intoxicated, I was gonna take a bunch of sleeping pills and every prescription I could find. Whatever I could find. My biggest fear was not being successful. I knew that if my life was that bad before, it would get worse after.

It’s funny to use the word “success,” because the idea of dying is not succeeding in that sense. But at the time, it was. My goal. What ended up happening was, when I got drunk, my parents picked me up. I told them that I wanted to die. They were shocked, they didn’t really know what to do. My mom had never seen me drunk before. There was a weird feeling in the air. My memory is so vague, I can’t fill in all the details, but I did say I needed to go to the hospital. I was put into one of those rooms from the movies where all was white, just a stretcher, absolutely nothing. I had two security guards outside my door, a big metal door with a teeny metal window. I spent the entire night there until 10 the next morning, when the doctors came. They looked at me and said, “Let’s switch your meds.” At that point I was like, “I don’t know if it’s just the meds, but OK.” I was out of the hospital that day, maybe 5 p.m., with a new prescription for anti-depressants. I started taking them, and again, things got worse. My parents were really concerned all the time, they wouldn’t let me leave the room alone, I was not allowed to take pills on my own: “Hey Mom, Dad, can I have one of my pills?” It drove me insane. I was so used to my independence. I didn’t leave the house, I didn’t do anything until the end of summer, and I went back to Vancouver. I wanted to go back to school and say, “I’m good, I can do this, let’s go.” I came back.

I can’t describe how good it was to be here. Then school started, great, classes were good, then every night I would still get that way. And I’d be so depressed and so down and hating my life and feeling so alone. I wasn’t good enough, smart enough, not trying hard enough, in every way possible, not enough. One night I went to a friend’s house, explaining to her how I felt bad because I was putting so much on my roommates. I could see I was really bothering one of them. So I started to feel really bad. And it sort of triggered a spiral of “Die, don’t be here, you don’t deserve to exist, everyone would be better without you.” Once that started, it wouldn’t stop. I just crawled in a ball on the couch. All I said was, “Call an ambulance.” And I hate ambulances. If I hear one, I freeze up. I’m terrified of them and hospitals. But I was taken to the hospital, and I was kept in a hallway overnight. My roommate stayed with me. To prove how good an actor I was, we took a Snapchat, and I still have it today, and we both look so happy, smiling so wide. We were sitting on the hospital bed waiting for me to be admitted to the psych ward.

Anyway, they started doing their usual psychiatrist-analyzing me and decided to put me in a unit, West 1. I went to West 1, and I had three other roommates and felt, “I don’t belong here.” People would ask me my life story. I was comfortable, I went to university, I didn’t have drug problems, I had a loving family, a nice home. And people just couldn’t understand. The other people, they had been to hell and back, lived on the streets, abandoned, abused. I was like, “This isn’t me.” But I said, “OK, I’m gonna go with this, completely commit myself to this process.” So I really tried to make the most of the experience. I used the workout facilities every day, tried to get privileges like wearing my own clothes. I had gone from going to university, spending evenings with friends and going to class to going to the hospital with a 10 o’clock bedtime, 8 o’clock wake-up to line up and get pills and take showers without locks on the doors. Very surreal.

I was horrified because I was talking to others and they’d say, “Oh I’ve been here three weeks, a month.” Every time I talked to the doctors, I said, “The longer I’m in here, the more worried I am about school. If I don’t want to live, why do I care so much about school? Maybe I do want to live, but not in the state I’m in. So, OK, I want to live. Let’s make the living part work. The surviving part work.” That’s what I did. I was out of there in six days. It was one of the shortest stays they’d ever had there. I went to every workshop they offered. I wasn’t one of those people in bed all day. They provided a safe, caring environment to do those things. It was a very interesting experience, and I don’t want to go through it again, but I wouldn’t trade it for anything. It was one of the  best and worst experiences of my life.

Since then, it’s been a very slow recovery. People expect that when you get out of the hospital you’ve completely bounced back. That’s not really the case when it comes to depression and suicide. You’re not at the point where you want to take your life all the time, but you have a ton of work to do. I’d have good days, bad days. The bad days frustrated me because I would frustrate the people around me: “What happened?” “You know, I had a bad day.” It was learning to tell myself it was OK to have a bad day. I was lucky to have gone through that and be here today. If I get to that place again, I know what to do. I can do it if I need to.

As much as I hate having depression, it’s what allowed me to get close to a lot of people and connect me to people, and that’s what I want. I want to write about it, speak about it, tell people, “Your story is not completely different. It’s your story, but you’re not the only one who feels this way.” It’s just a matter of finding them and making it OK to talk about it, that raw, honest stuff. I had filtered myself around my friends so they wouldn’t think I was someone they didn’t want to hang out with. Filtered what I said to my family, my doctors, so they wouldn’t think I belong in the hospital again. When I did that, I couldn’t connect to people. It was filtered, too pretty. And when I don’t do that, just let it all out, just say it, it hits people way more. It strikes that nerve.

I think even right now, when I’m trying to be as candid as possible, I’m still filtering a bit. You have to be proper in what you say, how you act. But when it comes to mental illness, that honesty has to come out more. By only showing a small part of the truth, it’s defeating. It’s just a tiny part of truth. To me, it’s important to show the whole truth. I went so long saying what others wanted to hear that I never said what I wanted to say. It distanced me from people. This kind of raw truth, I think, is important. People with depression can feel so bad about what they want to say. People say, “What are you so depressed about, you have all this going for you!” It makes me feel more ashamed about it. It’s like saying, “Why are you diabetic?” I wanted to make people know it wasn’t my fault.

I’m at a point now where I can take it and say, “That’s not the truth at all.” But there are people who, hearing that, would be absolutely devastated. That’s why I want to get that out there. It’s really important that this kind of conversation start. Let’s talk about the real, raw truth about it. Take it apart, show its ugliness. When I was in the hospital, I was asked to do a really weird exercise. I did it because I wanted to get privileges to check my phone. I made a list of 10 reasons why I’m lucky I have depression. When the psychologist told me, I laughed: “You’re kidding. I’m not glad I’m depressed, it sucks.” She said, “I know, but it doesn’t have to all suck.” OK, well …  I connect to people more. I don’t have a perfect life, I have those battle wounds. Whatever, it makes me more real and human. It makes me more approachable, I would think. I was not at a point where I could enjoy or reap the benefits of my depression, but you have to make the most of the hand you’re dealt. The cliche, “make lemonade out of lemons.” That’s what I’m trying to do. I’m at the place where I can do that now. Educate people. That’s the hardest part, educate. They just didn’t know. It’s so hard when it’s such an isolating illness. It’s not their fault, it’s just part of society.

What do you think of the anti-stigma and other such efforts out there?

I think some these groups are absolutely brilliant. To Write Love on Her Arms or the Trevor Project or Love is Louder are so good and so meaningful. But I think sometimes they kind of become almost like a fashion statement. You look cool if you have a TWLOHA T-shirt, and people can sometimes lose the actual meaning. And part of it is, you’re trying to use that slogan. Good, you’re getting people talking and that’s something, right? I think it’s one thing to say, “I’m gonna do this because I support people who struggle with mental illness.” One thing I discussed with people on my blog is people who say, “I’m here for you, text me anytime.” They’re not, because the second you do, they get scared. They don’t get exposed to that raw honestly. Those projects say, “I want to help,” but they’re not always exposing the dark stuff no one wants to hear. It’s like you try put a Band-Aid on an open wound because it looks ugly. But you can’t know how deep the wound goes until you take the Band-Aid off and see for yourself.

It’s amazing that I can go and ask, “Hey, you know TWLOHA?” or you see tons of texts for #BellLetsTalk. It makes me happy because people aren’t afraid to admit mental illness is something to be addressed. OK, now what do we do about it? Not just on a national, global basis, but personal. Educate kids: “Hey, this is what to do when your friend is depressed.” There’s tons of websites, numbers to call. It’s something like, if you think your friend is going through something, try to talk to them. Actually trying how to … How do I, give me a second here. Getting people who say they support it, getting them to actually support it and not just say it.

How do you make that happen?

I don’t know that yet. If I did, I’d be out there doing that right now. The most I can do right now is tell people what I’m going through. If you want to be there for someone, be there for them. This is not like saying, “I’ll meet you for a coffee” and not showing up. What someone says or does can save a life. The smallest things can make the biggest differences. If someone says, “That’s a really great shirt” or the smallest compliment, that can make me feel not worthless for a split second. And there will be times where someone says something not very nice and not mean it but brings me down for hours. I’m for honesty, but I think sometimes people don’t realize the full impact of their words.

I think the hardest part, for my friends, is they don’t know how to support me because they can’t fix it. Well, if I could fix it, I’d be fixed by now.  You don’t have to run away because you feel incompetent to fix it. You can’t fix it. It’s your job to support and be there for them. Depression’s a funny illness. It’s not just the person who has it, but the responsibility of people who love and care about the person. People say, “It’s all in your head, it’s all on your own, only you can make you happy again.” And that’s true. I believe that at the end of the day, you can’t rely on other people for all your happiness. But telling me to be happy is not going to make me happy. It’s something that takes time, and more than one person.

If someone has a difficult illness, a broken foot, you know, they need their doctor, the person who does the X-ray, the person who opens the door for them. It takes all kinds of people to make it work. But with mental illness, you can’t see it, so it’s hard to know all the pieces of the puzzle required to help it. That’s why I think if we open the dialogue more, if we really get out there and not be afraid to be so raw and open … One thing I heard is, people don’t understand what someone with mental illness goes through. To hear that feedback: “OK, I have a better idea of what it is,” is really important to me.

There’s still a lot of professional nervousness about being raw and open. And because of that, how do you start a real national conversation?

It’s gonna take a lot. It’s gonna take professionals, people with mental illness, people who don’t. I think what drives me is that censorship: “You don’t want to really let anybody know, it’s really not anybody’s business.” I get that. This is the first time I’ve ever opened up and said, “Hey, I’m an open book.” When I first had my depression, after my parents, nobody else knew. They didn’t want the community to know. That’s understandable. It’s not something we talk about. A cultural thing, a societal thing. That’s just how it was. Part of the reason people want you to censor it is, you can sound very blunt or almost weird, not socially acceptable, when you talk about it. But I don’t care. I don’t. That sounds kind of obnoxious and pretentious. But if someone takes the heat for it, I’d rather it be me than someone struggling to open up. I have that close support group.

So, back to your question: How do we get that national conversation going? I haven’t really thought about this until today, with my latest post. I think it starts at school. I think we need to have teachers, students be able to open up about it. Kids get bullied for having mental illness. To me, that’s disgusting. To be bullied for something entirely out of your control disgusts me. If people were taught from a young age to be more tolerant … You always hear little kids talking about how a family member passed away: “My uncle had a heart attack. My aunt had cancer.” Where’s the kid who says, “My uncle killed himself because he had depression?”

It’s not talked about because it’s taboo, and it’s exhausting trying to break it down. And it’s an illness that affects one in five Canadians. So in a standard family, one of you has mental illness. It’s astounding, the occurrence of it. And people need to see it more, on TV more, and they need to see … And when I say on TV, I don’t mean that dramatized, soap opera way, I mean a real way, a raw way, honest. The only way to get the idea going is to base it on truth. You can’t sugar-coat it. It just has to be real. We’re getting better at it with new laws against bullying. If you think 10 years ago, we didn’t have half of these initiatives. We’re doing a good job as a society starting it out. But we’re still kind of new at this. Let’s make mental illness something we don’t ignore anymore.

I’m just happy there are people out there asking those questions.

When you talk about the need for openness, do you mean going as far as the S-word?

Let’s say it, because why not? We use words with any other illness. It’s not the S-word, it’s suicide. People are taking their own lives. It’s what happens. It’s very, very blunt to put it that way, and some might say vulgar, but it’s not. That feeling that I couldn’t tell people that I missed school because I wanted to commit suicide was way harder than saying I had mono or strep throat. If you think about it, suicidal thinking occurs quite often as well. But why be embarrassed about something that had nothing to do with us? It’s not something we deserve to be ashamed about it. It’s real. When it’s someone sitting by you in class, it becomes real. And it needs to become real for people who don’t actively see it on a daily basis. Yeah. Suicide is not a taboo.

What was least helpful as you recovered, and most helpful?

I hated the way people looked at me as though anything that came out of my mouth was a lie. If I admitted that I felt depressed and wanted to commit suicide, they would look at me like I wasn’t being honest. They would ask if I wanted attention or something. That one stung quite a lot. I never wanted to get attention. If I did, I would not have kept it quiet for so long. And if I said, “OK, I’m not feeling that way anymore,” it was, “Are they just saying that because they have to?” Nothing I said was right.

And then there’s the fear of liability. They were keeping me in that room not because they were keeping me alive but because someone had tried to kill themself on their watch. Also, you don’t always know what pill is gonna work the best, but I think therapy has to be very tailored to the person. CBT doesn’t work for some people. If personal therapy works, great, but it might not work for others. Recognize that all types of therapy have their place. Also, I didn’t like being told to breathe. I was told, “OK, just take a deep breath, in and out, everything’s gonna be OK.” Another one was being told, “Exercise, you’ll feel amazing.” I work out four times a week now, but back then I was like, “I can’t get myself out of bed in the morning, you really want me to tell you I’ll go for a run now? That’s not gonna happen.” Like people weren’t using common sense. Some of those suggestions aren’t really viable.

Was there anything that surprised you as being really helpful?

I think the physical presence of other people just worked wonders. Someone to come and just give me a hug and hold me and make it OK for a minute. The other thing I really enjoyed was the really little things. My roommates and I used to write messages on the mirror: “You look beautiful today,” or “You don’t need this mirror, you look fine without it.” It kind of starts your day off right. Stuff like that worked wonders. Also, one fun thing. Every day, I do one fun thing to be excited about.

For example?

Well, I love Legos, so I buy a lot of Legos. Maybe I’ll come home and build a Lego car or something like that. I also find it calming if I had a horrible day and feel like crap, I take one of the sets apart and put it together. I can feel I accomplished something, taking a million pieces _ well, not a million _ apart and putting it back together. It’s kind of metaphorical to what I’m doing with my own life.

You mentioned how nervous your parents had been. How is it going with them now?

Good. They’re amazing. They’re so supportive now. They understand I have good days, bad days. They know I don’t like to have long conversations about it. We have an agreement, if I don’t like something, I’ll make it known. They don’t expect me to text them all the time because I’m 19 years old, and they shouldn’t expect that. Even though we’re in different cities, the flight’s only an hour. The option is available to me.

One thing I meant to ask earlier: How did your school handle it, if it knew? I know stories of other people being kicked out of school.

They didn’t. I had to go out there and say, “This is what happened to me.” I got one of my roommates to write emails to my professors saying, “Ameera’s in the hospital for mental health issues.” I think the nicest response she got back was, “I’m sorry, we can’t discuss other students with you.” When I got back to school and emailed my professors, they said to talk to the undergraduate office to make accommodations. So I set up a  meeting. This was probably two weeks after I got out of the hospital. That’s a long time, I was already so behind, no idea what was going on. I went to my meeting and explained that I was in the hospital. Their first question was, “Do you have proof?” Yes. I pulled out my doctors’ notes. They said couldn’t do anything until they verified it. I asked them to email when they verified it, but I never heard from them. A week later, I contacted them. They said, “Well, it’s been weeks since you got out, why come in now? What do you suggest we do about this now? What kind of accommodations were you looking for?” I was like, “Maybe notes?” They said, “Well, you probably got notes from friends, and your professors probably put slides online.” So yeah, that was kind of that. So I was like, “OK. They’re not gonna kick me out.” I was told, one of my doctors said, “Don’t tell the school. They don’t need to know. Don’t tell them.” It wasn’t horrible. I didn’t get kicked out, ostracized. It was just a very cold response.

You mentioned being 19. What do you want to do with your life, and do you ever worry whether this will trail you somehow?

I just read an article that said 50 percent of Canadians didn’t feel comfortable having a doctor or lawyer or financial adviser who had mental illness. They felt they couldn’t do the job properly. They asked the same question about diabetes or asthma, and only a fraction weren’t comfortable. It was kind of alarming for me. I don’t want it to hinder me in the future. It’s already hindered me enough. I’m majoring in business. I want to go into supply chain management, hopefully in consumer packaged goods or the auto industry. And either I’ll work in a company or start my own firm. I’m quite specific where I want to go, what I want to do. I kind of have it all planned out, but probably it will change completely. I’ve always been very business-savvy, money-driven, type A. People say, “You’ll be successful, with a nice car, a nice house.” Yeah, that’s really important to me, but I also want to do public speaking, help people, kind of softening up a bit in that sense. I’m changing my thinking about that a lot. I see myself transitioning to be more balanced in that sense.

You mentioned softening up a bit. Did you once have a very different outlook on mental illness or on the people who have it?

Not at all. I always felt people with mental illness are incredibly strong and intelligent people. Before I was depressed, a person brought up suicide and said that people who commit suicide or attempt suicide are incredibly selfish. That bothered me a lot, because I didn’t think they were selfish at all. In fact, in my case, it was a selfless choice. I truly believed people would be better off with me gone. My suicide attempt was as much for other people as it was to end my own pain.

Who else are you?

I’m gonna start with my cop-out answer, which is the most honest answer, and then I’ll give you a more detailed answer. I’m 19, so I don’t know who I am. I have a long ways to go before I actually know. But to give a more concrete answer, since that was a bit fluffy, I’m just a person who loves to engage with other people. I like to do nice things for people, surprise them, be that person who’s like, “Oh my god, why are you so nice?” I like being the jokester, making fun, laughing and smiling. In my friends’ view, I’m kind of the little kid, always wants to play around, do something silly, but at the same time I’m one of the most mature ones as well. They come to me for advice, they know I’m there at the end of the day. Without trying to toot my own horn, I want to be responsible and loyal and a person people call reliable. I’m just trying to be not the best at something but the best version of me. I want to be the best at being me. So I hope that kind of answers your question.