Your Brain Health Episode 8

Introduction: This is Your Brain Health was noted Neuroscientist, Dr. Kristen Willeumier. Your Brain Health explores strategies to maximize your cognitive functions through life. Here’s Dr. Kristen Willeumier.

Dr. Kristen Willeumier: Welcome to Your Brain Health. I’m Dr. Kristen Willeumier. With the Centers for Disease Control reporting that suicides are up 25% over the last two decades and with the recent deaths of iconic fashion designer Kate Spade and celebrated chef and Peabody award winning travel journalist Anthony Bordain. The time is now to have an honest dialogue about mental health disorders and the growing public health crisis of suicide. Today I’m honored to have my friend and colleague, Dr. Stephen Odom, share his insights on this very important topic. Dr. Odom is a distinguished Behavioral Healthcare and Addiction Treatment Professional with over 28 years of expertise. He serves as CEO and Chief Clinical Officer of New Vista Behavioral Health, the parent company of the Center for Professional Recovery, Avalon Malibu, Avalon Integrative Wellness, and Simple Recovery.

 

Stephen has a comprehensive educational background in healthcare, holding a bachelor’s degree in organizational behavior, master’s degrees in experimental and clinical psychology, a doctoral candidate in clinical psychology, a doctorate with a focus in healthcare administration. Moreover, he’s a licensed marriage and family therapist in the State of California. Some of his professional experience includes numerous administrative and clinical leadership positions at behavioral health and chemical dependency treatment centers and hospitals in California such as Hoag Hospital in Newport Beach and El Camino Hospital in the San Francisco Bay area. Additionally, Stephen conducts individual couples and family therapy and private practice setting and served as an University adjunct faculty member in child development and psychology. Stephen is a behavioral health expert having published peer reviewed articles on mental health and substance abuse parody, increasing utilization of the electronic medical record in behavioral health, and he’s appeared in the 2016 documentary film, California High. He’s also been featured on the Today Show and his executive leadership role, his therapeutic and compassionate approach allows him to lead his clinical teams with a client centered focus in mind. So good morning, Stephen. It truly is an honor to have you join me today. So may I call you Stephen?

Dr. Odam: Please do. May I call you Kristen?

Host: You may. So I have so many questions I wish to ask about this very important topic. So I’m going to dive right in. I’d like to begin by sharing with our audience that the data from the National Comorbidity Survey Replication, which is a nationally representative household survey on 9,282 US adults, revealed that 80% of suicide attempters in the US have a prior mental health disorder, anxiety, mood, impulse control, and substance abuse disorders significantly predict suicide attempts. Furthermore, they found that disorders characterized by severe anxiety and agitation such as PTSD and poor impulse control, including substance abuse disorders, predict which suicide ideators go on to make a plan or attempt Kate spades husband gave a statement to the press that she struggled with anxiety and depression. While, Anthony Bordain struggled with substance abuse issues, having tried everything from psychedelics, prescription meds, amphetamines, cocaine and heroin. Given that you have 28 years of experience in the field of addiction medicine and behavioral healthcare. I’m going to ask you a few questions about suicide to help educate our audience on the topic and what to look for. So I’d like to begin by asking what are the warning signs of suicide?

Dr. Odam: Sure, that’s really a good place to start. So when we think about what makes someone seem like they’re going to be thinking about suicide there’s, there’s cues that we can look for. Some of them are direct verbal cues. Some of them are indirect verbal cues, and then there’s a lot of nonverbal as well. So I’ll start with the direct verbal cues, which sound obvious, but when someone says, I wish I were dead, that’s not a good sign. If they say, I’m going to end it all, I believe in suicide. I like Dr. Kevorkian. If such and such doesn’t happen, I think I’ll kill myself. I’m thinking about moving to Oregon. Those are the kinds of things that should prompt some questions and some support. Other ways that people say suicidal type intent. They might say something like, I’m so tired of it all. I just can’t go on. Or here, take this, I won’t need it anymore.

 

Or how do you become an organ donor? Or my family would be much better off without me. So those are kind of roundabout ways that someone may be thinking about not wanting to be on the planet any longer. When it comes to the nonverbal we have a set of behaviors that we call terminal, terminal behaviors. And those are typically things about like I just mentioned, giving things away putting one’s affairs in order, making a will, seeming more anxious and agitated, behaving more recklessly, sleeping way too much or way too little, withdrawing more than usual, or expressing feelings of isolation. Having rage, extreme anger, anything around revenge. And then lots of mood swings. And what’s most interesting about those signs is that many of those, if you, if you narrowed those down or distilled them, they are the signs of other psychiatric problems too. You know, for example, major depression is exactly what most of these things could lead to or can be a part of. So many times people who are suicidal are obviously experiencing another psychiatric issue and they get to a place where they’re beginning to think that there’s no other options.

Host: I really appreciate you sharing these things that we need to look for. And part of the reason why I wanted to have you come on and speak about this is, you know, even with people getting treatment for their mental health issues you know, when you’re with a loved one who might say some of those things, like they’re thinking about harming themselves, it can be very difficult for somebody to know what to do, especially if they are currently working with a treatment provider. So do you have any insights that you can give to people who’ve lived with the loved one, who do see these behaviors and they know they’re being treated, but those behaviors are persisting?

Dr. Odam: Well, sure. I think one of the challenges in having someone in your life who thinks about suicide and potentially talks about it, and is also seeking mental health treatment, is just how seriously to take it. And that may sound a little callous, but there seems to be some differences between someone who is really crying for help. Or sometimes it’s part of an attempt at attention, even if it’s negative because they don’t know how to ask for what they need in other ways versus, wow, is this person really serious? So that’s really, it’s really tough to be a family member sometimes. I don’t pretend to have invented you know, any of these interventions there’s really great resources around, one of them is called a Lifeline, which is a national suicide hotline. They’ve come up with what they call the five action steps. When working with someone or having someone in your life who may be suicidal.

 

You know, the very first thing you’re supposed to do is ask, you know it’s okay to ask, are you thinking about suicide? I think there’s a lot of mythology around suicide because it’s such a taboo subject that if we ask someone if they’re suicidal, that that may make them more likely to want to do that. But in fact, research shows that the opposite is true. The more we talk about suicide, the less likely people are to actually attempt the act. So that’s important to remember. You need to listen, also. I mean, it’s not just asking, but it’s listening. And ask them how they hurt, what’s going on that’s making it seem so bad? One of the traps I’ve seen a lot of family members get into though, and friends too, is if someone’s feeling suicidal, they may tell you about it, but only with the promise that you’ll never tell anybody. And so you need to be careful not to get trapped into keeping their thoughts of suicide a secret. That’s risky, risky ground for everybody.

 

The second thing you do is you have to keep them safe. You know you have to decide how serious this is. And the way to know if it’s something is serious is do they have a plan? Do they know exactly what they would do and do they have the means to do it? And we look for things that are more lethal than others. You know, firearms are the most lethal and medication is extremely lethal. And when those are the issues that we’re confronted with, then it may be time to get serious help, you know, call 911, take them to a hospital. Because that sounds much more imminent than someone who’s having thoughts of, I just wish I wasn’t alive. Knowing why matters too. I think another thing that people forget is if you’re talking to someone and they are feeling suicidal you can think of all the reasons why they should live and all the reasons why they matter to you. But that’s not what’s important. What’s important is what are the reasons they have to live and what’s important to them, because you know, what you think and what you feel may in some ways make their situation seem more desperate or hopeless.

 

And looking for, you know, what are the things that can keep you going today? What’s something that can keep you going for the next hour? And then let’s get you back to your therapist, your psychiatrist, or get you to the hospital, whatever that needs to be. We also have to be there. You know, part of the, one of the biggest issues around suicide is a lack of connection. It’s not feeling like there’s anybody in your life who cares. And so that’s a real critical factor. And then ultimately it’s making sure they connect, you know, it’s not saying, it’s not having the conversation and then hanging up the phone or ending the text. It’s making sure that you’ve done a handoff to the treatment professional, whether again, it’s a suicide hotline or it’s a therapist or a psychiatrist or it’s a hospital. And then finally you have to follow up. You have to make sure that, you know, the things that you guys talked about are actually happening.

Host: Right, right. I think you gave a lot of wonderful insights. I love the communication aspect, not being afraid to talk to about it and openly communicate and not be afraid to take them to their mental health care provider. I mean, even going with them can be helpful because coming from a background of working in psychiatry, when we worked with people with mental health issues, a lot of times we’d have a spouse friend or loved one come in because they could help, not only to give support, give another perspective. And what do you think about that? Would you encourage that as well?

Dr. Odam: Oh, always. I think, you know, the less alone we are, the better. I think the other piece is that collecting information about the entire situation needs other collaborators because sometimes the person in distress isn’t telling the whole story or isn’t communicating very well at all. And so it might be very valuable to have the missing pieces of information. So the treatment professionals can help form the treatment plan. That’s going to really address what’s going on and hopefully the underlying causes too.

Host: We will return for part two of our conversation with Dr. Stephen Odom. Please join us. I’m Dr. Kristen Willeumier. Thank you for listening.

Conclusion: You’ve been listening to Your Brain Health with Dr. Kristen Willeumier. For more information or to contact Dr. Willeumier, visit DrWilleumier.com. That’s D, R W, I, L, L, E, U, M, I E, R.com.