The following article is offered in an effort to prevent someone's suicide:

If someone you know is talking about helplessness or suicide, you would do well to write them a letter.  And if it's you, write yourself a letter, and ask someone else to write you one too, saying something along these lines:

"Please keep this letter in your (wallet or purse), so that you can read it if you ever think you've thought of everything, you've tried everything and it still seems to you there's no hope.  Stop here a minute and read first the article I've enclosed" [last week's column, see last line below].

"If you think you're all alone in your misery and no one cares, I beg you to stop running from your pain, shame and loneliness.  Listen to them instead, and let them teach you that you can't make it alone, that we're all as sick as our secrets, that continuing to live a lie is killing you, and that your life isn't working the way you're living it, so why not start it over?

Suicide would be a permanent response to a temporary situation.  Better to kill something else instead, such as your strong will/pride/ego, your sick relationships, or your bogus reasons for living (so you can choose some better ones).

Instead of killing your body and hope, why not kill those unrealistic little rules you live by, such as:  I must never let anybody know what I've done, what I'm thinking, how I feel.  I couldn't stand to be a burden, or to be pitied, helped or found to be a fraud.  I can't live with _______, and I can't live without ________ either.  I can't go on any longer by myself.  I'm sure my heartache will never end.

So how do you kill those parts of your life that are killing your desire to live?

1.  Tell somebody about it.

2.  Do everything they tell you to do, as much as your conscience will allow.

3.  If you can't or won't do all that, tell another person, and try your best to do what they say.

4.  Repeat step 3 as often as necessary until you can live with yourself again.

If you're wondering, who cares?  and why bother?, apparently you haven't yet realized that you are a huge blessing in my life.  Here are some things if I were you I would want to live for:  . . . .

I love the way you . . . .

I have benefited from the times you have . . . .

I will need you to be here for me in the future when . . . .

I'm not alone.  Others have told me (ask them!) you have been a blessing to them and they need you too:  . . . .  For each time we need you, your suicide would guarantee us a feeling of rejection and abandonment, but your getting help will make us happy right now and later.

Our society wouldn't excuse a murder just because the killer claimed that he didn't know how to stop wanting to do it, or that she didn't know anyone she could turn to for help, and yet that is just what suicide is, murder, so there is no excuse.  Even a suicide attempt is a crime that gets the police involved.

We all have people who can get us the help we need to turn our attitude and our lives around, but we won't know who they are until we ask them to give us time, hear us out, and then help us all they can.

When you've chosen someone to call, say something like this:  I don't know how to solve my problems.  If you will help me, and hook me up with others to help me, I will tell all my secrets to somebody, confess who I can't forgive (including myself) and tell why, seek to receive and believe the forgiveness of others, and ask what I can do to mend the good relationships I've broken.  I trust you to tell this only to people who will actively help me out, and who will keep what you've told them in private.  As an experiment to see if my life can be turned around, I will now do whatever I am told to do for a month.

If you read this letter and the attached article, do all you can, but you still believe suicide is the best for all concerned, don't believe your feeling—that's like trusting this decision to a child.  And don't believe your thoughts either—that's like trusting your life to a parent.  Trust your beliefs, in the most loving God you have ever experienced.  Just make sure your God has some skin on (helpers like me), or else you're tying God's hands behind him.

You owe it to yourself, your friends and your family to get some professional help first.  Go to,,, or mayoclinic/health/suicide.

If you've tried all this, and you're still there, you write me a letter, or leave me a recording.  Answer my reasoning point by point, or at least paragraph by paragraph.

And if that too hasn't changed your mind, just know that I'm not going to carry around anger for your suicide, so I forgive you.  Before you go, why don't you join me in that forgiveness?  It will make a big difference for lots of people."

The following article is offered in an effort to prevent someone's suicide:

There's a man I have admired and wanted to meet for some time.  He has helped lots of my clients, he's written a book, and he has had widespread exposure in the media.  He's in my field, and takes a very similar approach to his work and (I thought) his personal life.  Last week he killed himself.

Also last week, I read with alarm an article on "the rising tide of suicide", with Louisville hotline calls up 22% last year, suicides up 14% a year for the last four, and with hotline calls up nationwide 38% last year.  I hope and pray the words I offer here will prevent a suicide or two, and guide a few souls to turn their lives around.

My late colleague had problems of course like all who suicide.  His were medical, emotional, financial, and family, but he had apparently pretty much stopped working on them.  His 12-step home group hadn't seen him for many months, and all his other problems were made worse by chemical and behavioral addiction.

Too many folks with diseases don't work very hard at getting healthy again.  Too many with addictions don't keep working their program, and too many with problems don't do what they know it would take to solve them.  To recover from any of these situations we need to humble ourselves to do what we're told, and discipline ourselves to live within prescribed limits.  Those who kill themselves most always had plenty of chances to get the guidance and support to straighten out their lives, but they were too proud to admit their need for help, and too lazy to do the work.

Everybody needs to know a few things about suicide.  It is a crime, and not a victim-less crime by any means.  The victims of suicide are the survivors, not the perpetrators, who after all are murderers.

Suicide works just like other forms of abuse and neglect.  It deeply wounds other people, and makes its victims more likely to become perpetrators themselves, thereby extending the cycle and legacy to another generation.

Self-killers often anesthetize their pre-game guilt by reasoning that their loved ones will be better off without them.  After suicide, THAT NEVER HAPPENS.

Your victim-survivors would be haunted by your ghosts.  One ghost is nagging doubt about what they could or should have done to help or save you.  Another ghost is undermining doubt about their strength and self-worth.  Yet another haunts survivors with the temptation to check out of their own lives through the coward's exit, the one you had used, the suicide trap door in the floor

Our bodies don't know any more about what they need than a child does.  Better to kill the ego than to kill the body.  Taking your resentments out on your body is like punishing a child who just doesn't know better.

If you know someone who might be struggling now or later with thoughts of suicide, their own or somebody else's, invite them to read the words above out loud in your presence, and tell you what they think and feel about them.  Then you will at least know they have an inoculation against the suicide virus.

And for extra protection for both of you, in my next column, I will give a detailed outline of a personal letter you can write to anyone who struggles with depression and suicide.  It will provide them with insights beyond these today, personalized words of affirmation and appreciation, and specific reasons for living that apply directly to their situation.

A recent study found that about  one woman in three who went to a doctor’s office walked out with a prescription for an antidepressant, most without even a follow-up appointment to see how it would work. Today some 11% of American women and 5% of men are taking antidepressant medication.

The main reason these meds are so popular is that they work really well.  They resolve one of the causes of depression (chemical imbalance, most often serotonin), and relieve many of its symptoms: thinking, feeling and acting DOWN.

People with depression feel down on energy, sex drive, self-confidence and the desire to enjoy life.  They think negative thoughts about themselves, others, the world and their future.  They act down because they can’t work, sleep, eat or make love the way they’re supposed to.

Antidepressants would be much more effective if more people took them strictly as prescribed.  Since most of the bothersome side effects occur during the first 2-3 weeks, and as most of the symptom relief comes after those first 2-3 weeks, too many folks don’t give them a fair trial, and give up on them too soon.

A fair trial would be regular dosage for three or four weeks.  If the benefits are still being outweighed by the side effects, a second antidepressant should be tried for another 3-4 weeks.  But how do you know when you should take this medicine?

You should consult your primary care physician about antidepressants if you know what you need to be doing to make yourself feel better but you can’t make yourself do it.  Whe n making needed changes seems too difficult, you can level the playing field for yourself by trying medication.

Another way to tell if you need antidepressants is to give yourself the Beck Depression Inventory (Google it for a free copy of this quick 21-item test).  If your score is 14 to 19, you’d probably benefit from antidepressants.  But if your score is 20 or over, you might well be so depressed that efforts to cheer yourself up through counseling or willpower changes just won’t work without medication.

When you’re depressed, it’s a good idea to take that test (the BDI) once a week at the same time.  This not only measures your ups and downs, but the items that are elevated will also show you where you need to adjust your thinking and behavior.  Here are some signs that you are ready to cut back on your medication:

  1. When your BDI scores are consistently below 14 for 2-3 months
  2. When you are making the needed changes in your relationships, habits, and lifestyle
  3. When your losses (loved ones, health, job) have been resolved to the point you are now opening yourself to new experiences that seem likely to become fulfilling.

One final mistake people make with antidepressants is to take themselves off of them cold turkey.  Cutting antidepressants down and out should be done this way:

  1. Seek confirmation of your significant others and any professional counselor you are seeing.  These folks will make sure that the help you’ve been getting from your medication is going to be replaced by such mood lifters as lowered levels of alcohol, junk food, stress and conflict, and higher levels of appreciation, affection, inspiration, exercise, and fulfilling work to do.
  2. Consult your physician, tell him or her about the changes being made in your life from the previous paragraph, and follow doctor’s orders about exactly how fast to cut back on the medication.

Medicine can help you make significant changes in your relationships, habits, and lifestyle.  But don’t be foolish and lazy enough to think that medication alone will change your life. Antidepressants are only as helpful as the life changes they enable you to make.

You can feed your depression these body-building nutrients, or you can starve it to death.  Can you see how self-defeating and avoidable these behaviors and attitudes are? 

1.  Shame:  Hurt somebody, and don’t ask them or God for forgiveness.  Don’t make amends either, or learn from it--just forget about it.  That way you can’t forgive yourself either.

2.  Resentment:  Expressing anger is the normal human response to injustice.  Hold it inside so it can turn its energy against you.  Don’t forgive people until they repent and deserve it.

3.  Chronic Frustration:  We get depressed when life doesn’t meet our basic needs for friendship, affection, health, and the necessities money can buy (food, shelter, transportation, etc.), so take care of everybody else and just hope somebody takes care of you.  Don’t take care of yourself—that would be selfish.

4.  Unresolved Loss:  When you lose a job or people dear to you, don’t replace them--just live in the past, the hole left behind.

5.  Drifting:  Avoid a life that has purpose and meaning.  Avoid joining a group or reaching out for better relationships to get a sense of identity or belonging, as this all gets too confining.

6.  Buried Hurts:  If you were shamed or mistreated in your youth, don’t tell anybody about it.  If you do tell, stay in the victim role.  Don’t let God come into the memory for healing.

7.  Unrealistic Expectations:  Set your personal goals so high you can’t succeed, or so low you don’t feel any challenge.

8.  Avoid Cure:  Be too proud or scared to get medication. The same for counseling—be your own person.  And avoid the support of groups—the people and principles of recovery are only for the sick, not you.  Stay with your false pride, or your false humility, whatever preserves your privacy.

How can a person tell if she is clinically depressed or just down?

Depression is the most common mental/emotional disorder, costing American business untold billions of dollars in productivity each year.  That’s because most depressed people go to work anyway, and only 1/3 seek treatment, and because most folks believe they can and should bring themselves out of a blue funk without any outside help.  But that’s wrong, oh so wrong.

The primary symptoms of depression are well known:  loss of hope, energy, confidence, self-esteem, mental focus, sex drive, stress tolerance, and gains or losses of appetite, sleep, or weight.  It’s like the way you feel all unfocused and unmotivated when you can’t get out of bed some mornings, only it’s a low-to-medium-grade fever of that all day, every day.

The cures have been well researched too.  Take four groups of depressed people.  Give one medicine only, one counseling only, another receives neither, and the last gets both.  The first two work about the same, each works way better than the third, but nowhere near as well as the fourth.  Most people try to pull themselves up by the bootstraps, but that only pulls you down, wears you out, and leaves you with more depression.

Once medicated and counseled, try to believe and do what you’re told.  Get a forgiveness transfusion:  put some grace in your veins, and then become a donor.  Revise your expectations of yourself and others in light of what others tell you.  Depression is like an emotional stoplight stuck on red.  It works better to believe and act your way into feeling better than to sit and wait for that stoplight to change.

Moodiness, Mood Swings, & Bipolar Disorder

Most of us get called moody once in awhile, and the term bipolar gets thrown around an awful lot these days.  When we discuss someone’s moods, we need to define our terms very carefully.

Bipolar Disorder is a major psychological disorder, requiring medicine, counseling, and in the lifetimes of most bipolars, even hospitalization to treat.  “Bipolar” literally means subject to two extremes, in this case mania and depression.  To be diagnosed bipolar, you have to have a history of at least one manic episode, but because most get somewhat depressed afterward, they’re called bipolar.

manic episode is a period lasting roughly one week or longer marked by excessive amounts of roughly half the following:  self-esteem, talking, activity, energy, racing thoughts, distractibility, losing one’s temper, or pleasurable but risky/dangerous behaviors like gambling, spending sprees, and love affairs.  Manic episodes can wreak havoc on relationships and bank accounts if not brought under control through treatment.

major depressive episode is a period of two or more weeks with the exact opposite:  excessive lack of energy, self-esteem, activity, and the preoccupation of with thoughts and feelings of worthless, hopeless, useless, doomed, longing for sleep and death, etc., all of which is usually disabling vocationally.

One thing all the disorders above have in common is that folks at these extremes are generally the last ones to realize they have a problem, because they trust their feelings way too much.  Another common trait:  they get much better with counseling and medication than with either or neither.

An intermediate level of disturbance is a personality disorder (PD), a pervasive and stable pattern of emotional and relationship problems that has existed most of one’s adult life.  Of the 12 kinds of PD, three are most likely to be called moody (correct) or bipolar (incorrect):  histrionic (drama kings, crisis queens, exaggerators who need lots of attention), cyclothymic (moods go slowly from up to down without quite hitting the extremes of previous paragraphs), and borderline (relationships and moods are unstable and intense, and though they always know basic reality like who they are, they vacillate suddenly and without much apparent reason between extremes of idealizing and villainizing key people in their lives).  Don’t throw these terms around at home:  diagnosis and treatment of these conditions requires a licensed professional.

The mildest form of emotional disorders is adjustment disorders.  These do not have manic periods, but discouragement will alternate with anxiety and/or misbehavior (poor judgment) milder than a manic episode.  Adjustment disorders are basically triggered by life events, but involve prolonged reactions, longer than three months (or if losing a loved one, 6 to 12 months, depending on how close was the deceased, and how suddenly or violently they died).

Finally, all of us have moods, emotional reactions which seem excessive to others.  Others of us are just moody, inclined to be emotionally sensitive and over-reactive.  Neither medication nor counseling is going to change moody people that are born that way, or moody moments that life just deals us from time to time.  It’s best for us to give the comfort and help we can afford to give hurting people, and then just accept them, backing off to give them time and space they need to heal.  Otherwise we’ll just put ourselves in a bad mood.


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Dr. Paul F. Schmidt