For more than a decade, I have been working with suicide prevention and I know from experience that it is in times like these that we need to be extra careful with those at risk. But this article is not for them only, it is for all of us who are in the privileged position to help others, for those of us who woke up today not worried about where we will get the money to feed our kids, for those who can sit in front of the TV to binge-watch, and for those of us who are wondering how they can support others but don’t know how. There are many ways in which we can do that, so keep reading and find the ones that fit you.


When it comes to the Coronavirus and suicide, three visible impacts immediately raise a red flag: society’s increased isolation to contain the spread, the financial strain it has been provoking in families, and the limited access to mental health treatment many patients are experiencing.

Isolation is a central drive to suicide. Most people who contemplate it believe that what they should not share their pain. They feel ashamed, scared, and uncertain of how they will be perceived by others. Every time I am contacted by someone who is going through this, and I respond, they react with surprise. Every single time. You know why? Because they did not expect it. Suicidal people are certain no one cares, and even when they are not, they don’t know how to express what is going on with them.

The stigma surrounding suicide silences society, including those who are contemplating it.

Mental illness is also a key risk factor for suicide and right now, the quarantine is forcing clinics to shut down services and offer remote sessions only. This helps only partially because not all patients have access to it, particularly those who are served within community and agency settings. They will also have a hard time buying their medication because these are the individuals who are paid by the hour in jobs that are in a halt right now, so they might not have the financial means to afford their pills. Add this to having less social contact and limited medical assistance in hospitals who are rightly prioritizing the Coronavirus, and we have a concerning picture ahead of us.


We have been bombarded by an overload of information about what we can’t and shouldn’t be doing right now, so I decided to flatten this curve. I will focus on positive actions that will make a difference and will strengthen our human connection.




Here are some ideas:


1. Keep physical distance, but don’t disconnect — Use your time to check in with friends and loved ones. There is no reason not to phone (yes, the old-fashioned way), message, video chat, whatever works with you. If you know someone who struggles with mental illness, particularly anxiety and depression, believe me, chances are that they might be feeling worse right now. These conditions thrive during uncertainties and fear. Let them know you care. Create online communities. Again, we have to keep our physical contact at a minimum but this does not have to apply to emotional connection.


2. Maintain an exercise routine — This is key to maintaining mental health. Gyms are closed? Search for online classes, there is an infinite number of options out there. Invite friends to do it together. Offer practical help to those in need: Are they of age? Many elderly rely on their friends and family member to bring them food and medication, but this may not be possible right now. Offer to do their groceries for them. If you prefer to minimize risk, use online shopping, most supermarkets are still delivering. Older people have a hard time using technology, so do it for them.


3. Be compassionate, share your privilege — Many workers who are paid by the hour are in dire need of financial support. If this is possible for you, be there for them. For example, if you have a cleaner, keep the payment even if they are not able to provide the service. Establish a time frame that is comfortable and affordable to you and let them know what you can do. Maybe pay them in advance for future service? Give them this peace of mind. Buy gift cards from local small services, such as salons, pet shops, etc. Many offer this option online.


4. Track medication intake and needs — The drugs used for mental illness have unique characteristics. They have to be taken regularly because if not, it takes the patient weeks to regain mental, emotional, and behavioral stability. Ask those you know about their supply, whether or not they could use financial assistance and if they are older, offer to pick them up for them.


5. Parents need support — Parents have been hit hard by this. They suddenly have to home schools their kids and keep a balance between keeping their kids safe while offering them a distraction, meals, and emotional support. Check in with them regularly, maybe take turns in homeschooling, for example by doing it online. Exchange your experiences, foster community building.


6. Attend to spiritual needs — During a crisis, those who have faith and spiritual beliefs meet their communities in search of comfort but this is not possible right now. Again, use online tools to pray together, create forums and chat groups, for example. Invite your religious leaders to do the same, maybe they just don’t know how. If you don’t either, ask your 10-year-old child, they will. :)


7. Talk about emotions — Keep a line of communication open about fear, anxiety, and sadness. We are all experiencing these in much higher intensity than normal, so let’s share not only what we are feeling, but what has been working for us.


8. Last, but not least, foster joy - Send memes, watch a comedy together, play a game with your family, anything that will generate smiles and laughter. Create positive memories so that in the future, fear and anxiety will not be the only things to remember this moment by.

  • Paula Fontenelle


“So this is Christmas…”


At this time of year, it is practically impossible to go one day without listening to John Lennon’s song. I love it, but every time I hear the second line “and what have you done?” - I cringe because the answer to this question is one of the reasons behind the holiday blues. Many people struggle emotionally because they look back and see very little accomplished. Either that or they envision a bleak future ahead. As an advocate for suicide prevention, I naturally worry about this fragile population.



A common trigger to sadness and anxiety is the ubiquitous pressure to be jolly and happy during the holidays; to have the perfect family, numerous friends, and of course, to be surrounded by carefully chosen presents. All this comes with a heavy toll, which can make us feel like a failure and pressured to put on a show because reality hardly ever meets these requirements.


Full disclosure, I am one of those annoying people who listen loudly to Christmas songs, sing along, and dance to them around the house. I decorate my home, make plans to visit friends, bug my sister to have a huge tree for when we come over, and convince my boyfriend to drive around the city to check the lights. Still, on the back of my mind is the concern about those who feel the opposite, so if you are one of these individuals, here are some ideas and reflections that may help you mitigate or even avoid the blues.


Before I dive into the suggestions, you should know that you are not alone. A survey conducted by the American Psychological Association found that although the holidays generate mainly positive emotions, such as happiness (96%), love (90 %), and high spirits (89%), a large number of Americans are on the other side of the spectrum. Sixty-eight percent mentioned experiencing fatigue, 61% stress, 52% said they felt irritable, and 36% cited sadness. So be graceful with yourself. It is not just you.


I cannot miss the opportunity to debunk a long perpetuated myth about suicide: contrary to common belief, suicide rates decrease in the winter months. In the US, it peaks between March and August, therefore, during Spring and Summer.


December has the lowest suicide rates of the year.

How to fight the holiday blues:


1. Make time for yourself - No matter how busy and crazy the final days of 2019 may seem, find a few moments to be by yourself. Use the time to reflect on what is important to you. Have you lived in congruence with your values? Which plans did you leave behind and why? Any mistakes you made that can be avoided next year? What were the highlights of 2019? The answer to these questions may help clarify your priorities and can be a compass to guide you through the new year.


2. Say “no” - When planning your social engagements, remember that this is actually the perfect time to say “no” to undesired invitations. Take advantage of the seasonal excuse that everyone else throws around: “Sorry, but there is so much going on right now…” Who will doubt that? Surround yourself with people who genuinely care for you. The main goal here is to give yourself space to breathe and be selective about who you will spend your time with. In case you’re wondering, this includes family, which takes me to number three.


3. Say “no” to family or at least, limit your time with them - If part of your stress comes from having to be around family members, restrict your stay with them. We have an idealized image of what family means but the reality is that they can be toxic and a major source of anxiety. Sometimes, it takes months to get over the holidays with them, so if saying “no” is out of the question, cut back on time together as much as it’s comfortable for you.



4. Pace yourself - Hoping from party to party is usually not the best way to enjoy the festivities. Try to prioritize and balance between work and personal engagements. Who do you really want to spend time with? If it helps, get your calendar, write their names on a piece of paper and choose how to fit them into your schedule. A useful tip is to avoid condensing all your energy on two or three days. When you space it out over a couple of weeks, you have the opportunity to spend quality time with those who matter most.


5. Don’t let nostalgia take over - Remembering good times from the past can be quite joyful but only to a degree. Avoid falling into the trap of believing that your past was better. Even if you are having a hard time, fixating on the earlier years will only add dark, pessimistic strokes to the image you have of the present. How about reflecting on what needs to change so that next year you can be in a better place?


6. Short on money? Find free events - How about checking out the Christmas decorations around your city? Many stores and businesses offer cultural options this time of year. It is also common for cities to have outside events, such as choirs, tree lighting ceremonies, and festivals. These are also good options for those who prefer to be alone. And if that’s your case, make the best of it. Going for a walk is not in the picture? Then prepare the staying home days in advance so that they can be filled with activities you enjoy: binge TV shows, stock up on good food, get a comfortable pair of pajamas. Do your thing.


7. Take advantage of technology - If you can’t be with those you love, ask them to connect with you by video and just leave it on, so you can see what’s happening during their gatherings. You may not be physically there but you can still participate. When my sisters and I lived in separate countries, we used to Skype for hours, many times a week. We even watched TV together. This may seem odd at first, but it will decrease your sense of isolation.


8. Boost your self-esteem by volunteering - Helping others can not only add a new perspective to your life, but it can also make you feel good about yourself. Try it.


9. Put some time aside to reconnect - Call a couple of friends or family members you have not heard from for a while. Note that I wrote “call.” Texting is great but nothing beats hearing the caring voice of a loved one.


Making a phone or a video call says “I made an effort.”

10. Set realistic expectations for 2020 - This is the perfect time to look at what you have accomplished and what needs to change or improve in your life, but don’t go overboard. You did no exercise in 2019? Please don’t go from there to the goal of running five days a week. Be honest and kind to yourself because when you raise the bar to an unattainable level, you are just paving the way for more disappointment.


Most importantly, whatever you do, be truly present. If at a party, look people in the eyes, listen to what they say, pay attention to the music, taste the food you eat. If possible, put your phone on silent mode so that you are not tempted to look at the screen instead of living the moment.


Finally, enjoy and value what you have.


Listen to my podcast on your app or click:

https://anchor.fm/paula-fontenelle


My book Understanding Suicide: living with loss, paths to prevention can be found on Amazon.


Death is the only certainty all of us have, but when it happens, finding the rights words to say or the right things to do can be a challenge. Don’t let your fear stop you from reaching out. Grief is hard for everyone but if you keep these two things in mind, chances are your efforts will be remembered:


It’s not about you.
Just show up.

For more than a decade, I have been interviewing families who lost loved ones. The sad irony about grief is that most of the time, these individuals are surrounded by friends and who want to help but don’t know how. They think about calling but don’t because they believe that giving breathing space is more helpful; they want to come over but the thought ‘what if it’s a hard day?’ stops them halfway. This creates frustration and pain on both sides.


If you are in this position or just want to be ready when it happens - yes, it will happen - here are some ideas of how to show you care:


Instead of saying ‘call me if you need anything,’ take the initiative. Grief hits you like a tornado, leaving a messy, broken world behind. Don’t expect the griever to have the energy to call or let you know about their needs. This is precisely the moment when you should take the initiative.



The thing about showing up is to stick to what you do best. This is something I have learned recently. I don’t know about you, but every time I have a friend in need, the first thing that comes to mind is to bring them a meal. Nothing wrong with that, it’s a great gesture, but I don’t enjoy cooking, never did, never will. Moreover, this is what most people do. There is a chance that your friend will have tons of food at home already, so find a service you can provide.


One way to decide on how to help is to think of all the things that can become overwhelming in their daily lives. Most of the time, these are simple chores that need to be done. Here are some examples:


- Laundry: clothes will certainly be piling up, especially if they have kids. Offer to do it. You can even text them to leave the bag by the door so that they don’t have to say hello. Believe me, this can make a huge difference.


- Mail: sort it out for them. Write down bills that need to be paid, the due dates and value; separate the sympathy cards they might be receiving. Help make a list of those that need to be replied, get the cards yourself, and just have your friend sign them. Mail the cards.


- Food: if you are not like me and that’s your thing, by all means, bring them food. It doesn’t even have to be cooked by you, just make sure you know what they like and be aware of any restrictions or allergies.


- Clean their home.

- Mow their lawn.


- Take care of their pets, particularly dogs because they need to be taken out for walks.


- Be the one to update your friends: having to call people so that they know how you are doing or to inform them about the wake, etc. can be daunting. Make a list of people you can contact and do it yourself so that some of the burdens can be relieved.

- If you are close enough, come to their home, take calls and receive guests during the first few days.

- Drive them where they need to go.


- Organize your community to help together: if you are good at getting things organized, go for it! When my friend Pepe told me about his cancer surgery, I realized that the following day I would be traveling abroad, so I contacted our closest friends and asked what each of them could do to be present for him. We created a spreadsheet online and each person added the days they would visit, which food they would bring, who would walk his dog, etc. I couldn’t be there for him, but I made sure everybody else would.


- If faith and religion are relevant to them, create a prayer group. Having them participate is their choice. A middle term would be to have them be present by a video or voice call.


If none of these hit a cord, find an area in which you can support them. Are you a lawyer? Then help them with legal matters; A teacher? Assist the kids with homework; Gardener? How about adding some beautiful flowers to their yard? Just do your thing, no matter what it is. The point is to be there.



Kids


Parents get particularly overwhelmed after a loss, but life goes on, and so do the endless chores that need to get done for the kids. Showing up for them is meaningful for both the parents and the children, who will learn the value of friendship and community in tough times.


- Take them to activities: Although it is important for the family to go through bereavement together, parents can benefit from having time to be alone, organize the home, and rest. Let them know which days you are available so they can plan accordingly.


- Entertain them: Take the kids for a day out or establish a day of the week to have them over.


- Assist with homework.


- Give them rides to parties, to school events, and friends’ homes. Wherever they need to go.Be ready to talk to them, bring up the subject: it’s common for kids to feel that they shouldn’t talk about their loss because it causes pain to their parents. Sometimes, they even feel guilty about the death but don’t know how to express it, so let them know that they can come to you.


The Don’ts


Being a source of comfort is not always about what you do. Knowing what to avoid can be equally important. Here is a list to keep in mind:


- Avoid talking about it on social media: grief is a private matter, so if you feel the need to discuss it with someone, call a friend. Let the family be in charge of online posts, particularly photos of them and the deceased.


- Don’t feel that you have to be the one to be positive about their pain: if they are having a hard day, just listen.


- No, you don’t know how they are feeling: sometimes we believe that because we have lost loved ones, the experiences can be compared. They can’t and when you switch the story to yours by saying “when I lost…” you make it about you. Unless they ask specific questions regarding how you dealt with your loss, just listen to what they have to say.


- Avoid imposing your faith: unless you know that religion and spirituality are important to them, don’t push your own beliefs on the bereaved.


- Don’t minimize it: even with the best intentions at heart, saying things like “it could be worse,” “at least you have your family,” or “you have a lot to be thankful for” can upset and make them feel that they are alone or that you are not ready to listen to them.


If the person mentions the deceased, don’t change the subject: silence is grief’s most constant companion. No matter how uncomfortable it may be for you, remember that it is much worse for them, so if there is a need to talk about the one who left, please listen. Few people do. The flip side of this is equally important. Be able to sit in with them in silence. Let them lead the way.


- Don’t say “you should”: instead, use less judgmental statements like “have you thought about…?” “maybe it would be helpful” and “you could try this…”


Finally, understand that grief follows no set path. It will look different on each of us, and that is totally fine. Respect their pace, their reactions, their pain.


Again, it is not about you.
Just show up.
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© 2019 by Paula Fontenelle