Welcome to the podcast. Thanks for joining me. I’m your host, Christopher Gajewski.
Let’s get naked about mental health!
In my last episode, The Space Between Breaths, I mentioned tWitch, but I stayed away from the topic. What can I add to the conversation? As I say in my podcast, I am not a mental health care professional with letters at the end of my name. I am just a guy who has been there. What the hell do I know?
An article/post got me typing. It featured a smiling picture of tWitch and was, “I Still Don’t Think We Understand Depression” by Dr. Jen Welter.
I read the questions and advice the post posed and realized that I do have something to add, that I may even be able to make an impact. No, I am not a mental health professional, but I am a guy who has been there. I understand what I do know about depression, and I understand what I don’t know about depression. Most importantly, I am learning what I need to learn about depression.
Who am I? I’m Chris, nice to meet you. Have you checked out my podcast? A lot of the answers are here if you care to check it out. I suffer from depression, among other things, and have almost taken my life twice. I was a leader and educator in my industry for 35 years. I am a storyteller/journalist, and I have answered many questions in the first 23 episodes of my podcast from a personal point of view, with what others are saying is insightful.
Now, let’s get into the episode.
First, let’s break down Dr. Welter’s article.
[Side note: Dr. Welter, I am not trying to attack you. I am merely answering questions you pose and adding my thoughts.]
Dr. Welter wrote, “Mental Health: just because someone seems funny or healthy or strong (or all of the above) does not mean he/she does not struggle with depression/ mental health.”
True, but what does that mean? She gives general examples about comedians and being the life of the party, how we use that to divert people from our center, our core.
One of my earliest podcast episodes was about my secret world. Nobody ever knew about it. I am a master of disguise, putting a façade on to face the world, the other world. Whether I was a high-school student, infantryman, chef, college student, business owner, husband, brother, son, educator or what have you, these were the identities I allowed others to see. The depressive, my secret world, was what I did not allow anybody to see until it became apparent in crisis.
I talk about how there is a part of me that wishes I was like my mother, who was bipolar with schizophrenic tendencies. When she was not doing well, it was like a neon sign, the size of a stadium, lighting up with an arrow pointing to her saying, “there is something really, really wrong here.” There were even massive fireworks displays.
Me? My bad times can be interpreted as me being a piece of shit, lazy, having a bad day, when the internal secret world would slop over beyond the facade.
“Strong people,” she writes, “those who claim strong shoulders, often feel like they are burdening others by sharing with others.”
“Read that again,” she wrote.
Yes and no is my response. There is a lot of truth to it. I often felt that way, that I was burdening others. I was the strongest of the strong, trying to help everybody–which was a sign of my depression. So yes, I talk about how not being a burden to others was one of the reasons why I hid it.
There was another reason though. I hid it because the lessons I learned inspired utter terror to keep it hidden.
Back to my mom. I was taught to hide it by people’s reactions to her, and the system’s reaction to her. She came from a huge family, the youngest of nine. When I was born, I was grandchild number #35 or so on her side alone. I was one of three children. There were so many times throughout her life where I was –and this is the reality and not a perception– the only child of an only child.
On her deathbed, one of her surviving brothers came to see her who she had not seen in 35 years. It made her happy, so I just kept my mouth shut, but it made me angry as he gushed about how much he loved her.
My brother was there, the first time he had seen her in 25 years.
During my first time that I almost committed suicide, I lost close, close friends. They did not see “crisis.” They saw me burdening them and living off of them because I could not do anything else. It was much like when I broke my ankle, but there was no physical cast for people to see and associate with me not being able to do anything.
I also believe that this is a problem with the system in general, a failure to move beyond “crisis intervention” and to “illness management.” I don’t blame my mother’s family or my brother. I finally dealt with the anger.
Imagine, I talk about, living in Miami. I was there for Hurricane Andrew. But imagine that a Class 5 hurricane will hit every year, maybe twice a year, guaranteed, destroying everything. What do you do? You move. Stay away.
I don’t blame them. It was hard, though, being the only child of an only child of a very sick parent. I never wanted to put somebody in that position. It would end up costing me everything during my next suicide plan.
“With that being said,” she writes, “the next question is often, how do I know if someone is actually ok? Well, honestly, it’s hard… but also, honestly no one is good all the time, no one laughs at their own jokes all the time, sometimes sunglasses are to cover tears & give the illusion of a sunny day….
Realize that one-word answers actually tell you nothing. So, ask questions that encourage sentences, thoughts, activities, actual updates.
– if at first you don’t succeed, try again… and again… in another way on another day.”
Again, yes and no. That’s another episode.
The answer is: first, you will never know. You can ask, check in, even stop by, and you will never know. If you had stopped by with pizza and beer while I was suicidal, you would never have known. I would have laughed with you, telling stories, and everything with me was fine, A-okay.
Second, and this is an interesting thing I came across in my self-reflection, checking in on me can do more harm than good. My question in an episode is “should you check in?” The path to hell is paved with good intentions. The path deeper into my personal hell is paved with the wrong people checking in on me.
A great example is my brother. He loves me. I have no doubt about that. He is a good big brother and has always been. He also shared with me one time that he has the emotional intelligence of a shrub. He a guy’s guy, characterized by Deborah Tannen’s book, “You Just Don’t Understand: Women and Men in Conversation.” He wants to fix everything.
If you are not ready to invest the time and emotional energy necessary in communicating with me, please don’t check in. Please don’t try to help. Really. You do more harm than good.
“Close the distance,” she writes, “a text is better than nothing, a call is better than a text, a FaceTime is better than a call, and in person is best… it’s easy to hide behind an emoji, words, a voice, much harder to look into the eyes of someone you care about and lie.
Don’t be so afraid of saying or doing the wrong thing that you do nothing… what you don’t want to live with is the wish that you had made the call, given the hug, asked the question, or held the hand… the past is past, can’t change it, so instead, let’s be a little better, kinder, more proactive in the future… especially during the holidays (which some people really struggle with).”
Eh. The first thing that jumps out at me here is, “the past is past, can’t be changed.” I disagree. The past can be changed. There’s an episode about that as well.
I’m learning a lot about changing the past these days as I do my podcast and educate myself on depression, PTSD, trauma and other mental health issues. Simply, we cannot change events of the past, but we can change our perception of those events. By changing our perception, we change the past.
I am a child of trauma. I need to nurture and allow that inner child to grow where that growth was stunted. How do I do that? First, by recognizing the signs. I read an article recently, a meme really, about the signs of unresolved childhood trauma in an adult. Each point was something I was not expecting, and each point was like a hammer blow between the eyes. Yes, there is a podcast about it.
Then, what are the more subtle signs of depression? I read this in an Instagram post from the Real Depression Project. The one that jumped out at me the most was, “rewatching old reruns of tv shows to feel comfortable and safe.” When I read that, everything clicked. I won’t get into the clicks here, but it had a profound effect on the way that I view my past, the way I perceive it, and the perception is helping me to change it.
The second thing that jumped out at me about what Dr. Welter wrote was, “…much harder to look into the eyes of someone you care about [and] lie.”
No, it’s pretty easy. Eh, I’ve been doing it for the better part of 51 years now. It may have been hard at first, but now? I am the master of disguise. I’ve worn the facade for so long, it is second nature to me.
Another thing she wrote that jumps out at me goes back to my brother and communication styles and what has helped me. If you have the emotional intelligence of a shrub, please don’t speak. Please, for the love of all that is holy, don’t offer advice and try to fix things. Just hug me. That could be all that I need. It could be enough.
But also understand that that is me. That’s my communication style, as revealed by multiple tests. I love, and am loved, through touch. It is what grounds me and centers me. It is what keeps me connected.
Communication, like therapy, is a two-way street. Just as there has to be a healthy therapeutic relationship established, understanding the communication style of the person you are reaching out to is of utmost importance.
The final thing that jumps out at me about that section is, “…what you don’t want to live with is the wish that you had made the call…”
Something about that bothers me and I do not know what. An interview I did with Leo Flowers, host of the podcast, “Before You Kill Yourself,” comes to mind (found on my website). We spoke about how it can be selfish of a person to say something like, “don’t kill yourself because I love you.” They miss the opportunity really understand you by placing themselves first.
Second, it’s not about you. That’s another podcast. No, I didn’t want anybody to live with the wish, and possibly the trauma and mental issues, of not calling. Have a ceremony, spread my ashes at South Point in Hawai’i, talk about the tragedy of a life cut short by an illness, and then get on with your friggin’ life. My will allows for that. Have a party. Celebrate my life.
And know, whether you made the call, didn’t make the call, stopped by and hugged me or didn’t stop by to hug me, at a point, there is absolutely nothing you could do. There is a point of no return. I passed that point now twice. I can tell you with absolute certainty that there was nothing that could have stopped me except myself.
How I stopped myself is another episode, but both times had to do with me reaching out. Once to a friend and a second time to the Universe.
“And… get professional help,” Dr. Welter writes. Remember, if you fear someone is a danger to themselves or others, get help.”
I agree, but how? I’ll be getting into that next. Most people who need it can’t afford it. When they are at that point of needing intervention, when it is seen and known, they are typically in crisis. We need to do a better job of being proactive and helping people before they are in crisis.
Just as an example, I’m there now. Not suicidal, not in crisis, but the depression is kicking my ass. I’ve learned enough that I have not crossed into crisis mode, and won’t, but I could really use help, therapy. I can’t afford it. I’ve been out of work for months, broke my ankle, and am stranded in a foreign country. What can I do?
And what happens if I cross the border (I’m in Tijuana) and check myself into a hospital? At my nonexistent income level, that thought terrifies me far more than the depression. I know what those places are like. I knew what they were like in the 70’s and 80’s visiting my mother and I know they have gotten worse.
I did visit a very nice one once, but the person was paying out of pocket.
One of my mother’s suicide attempts in 1999 was because she would rather die than go into the hospital again. I really can’t blame her. It was during her previous hospitalization that an event occurred that brought on the madness that made the choice between hospitalization and suicide a reality.
“Getting help,” she finishes up with, “is a sign of true bravery.”
I completely agree. But that is not the perception. It’s getting there, but it needs a lot of work. More so for men, I think.
I saw this video and wish I could remember where I saw it, but it was about being a man in America, particularly a black man. We are taught at the youngest of ages to be strong, shake it off. That is our job and our identity. That is who we are. Add in “black man” on top of it, and you add an entire level of complexity to the situation.
Then, how do we reach people? How do we explain this to them? How do we change perception and culture?
I’m seeing a lot of great stuff online. The Real Depression Project is doing fantastic things on educating people about depression and trauma. Do you follow or support them? Have you checked them out? Did you even know about them before reading or hearing it here. It really is an incredible resource.
There is a project to reduce suicide by 20% by 2025 by The America Foundation for Suicide Prevention. I think we can do 50%, if we do it right.
How do we do it right?
Well, first, let me in!
Aye, I need a job. Don’t make me go back into orthodontics. Yes, I can make a lot of money there but I’d really rather not. I’d rather continue my journey as a mental health advocate. I might not be a mental health professional, but I have a hell of a resume and a background (though rusty) in communications.
Second, watch movies. I have a list of “must watch” movies for, well, everybody. Some of them are even entertaining.
1) Mindwalk. Free on YouTube. It was a movie that I was forced to watch in a science writing class in college a long time ago and it changed how I look at everything. It is an introduction into systems theory, which must be applied to everything we do. It basically says, but not in so many words, that the mental health care system really got screwed up with the invention of the first clock.
With the invention of the clock, society moved from a “prevent” mentality to a “fix what is broken” mentality. Watch it. Please.
2) The Legend of Bagger Vance. A more entertaining version of Mindwalk, watered down a bit, but just as powerful in some of the scenes.
3) No Cure for Cancer. Denis Leary’s very non-PC comedy routine from 1993. It has some amazing pearls in it to take away and addresses the comedian aspect Dr. Welter spoke about.
Other notables are Good Will Hunting, Bill and Ted’s Excellent Adventure, Scent of a Woman, and Patch Adams. They look at mental from a first person perspective, real and uncensored.
Next, check out this response I received from Antony Malmo on LinkedIn when we were discussing the mental health care crisis and what to do about it, what’s wrong with it. It resonated with me and should resonate with everybody. It might seem like common sense to many, but I have found that things we think of as common sense may not be as common as we think.
“Here’s a back of a napkin summary of what I know,” he wrote to me.
1. Human threat perception is very sensitive to fast moving, physical emergencies. (AKA predators). We did not evolve to perceive intangible, creeping calamity. (AKA climate change, societal mental health trends)
2. Science (and business) demand measurability of impact preferably delivered ASAP. The catch, measuring the effectiveness of Upstream preventative interventions in complex systems require massive data sets, serious statisticians, money and time. Downstream reactive measures are cheaper, easier and faster (albeit less effective).
3. When it comes to budget time, critical care gets priority over prevention [because] we have an emotional response to helping someone in critical need, whereas “non-urgent/non-critical” issues don’t trip our amygdala. That’s fine if it’s a 1:1 ratio. However, in practice, [population] level prevention saves far more lives. E.g. Modern plumbing (clean drinking water + hand washing) has saved more lives than all the doctors of history. And to take it to a more cynical level, disasters make better photo ops for politicians.
Solution: Change minds. Story telling is crucial.”
My initial response is he’s right. I see all of the pictures of tWitch, just as I remember seeing all of the pictures of Robin Williams and other smiling celebrities who lost their lives to depression, and I see all of the calls for action.
The cynical side of me, and the infantryman, sees it all like the flag waving and praise for veterans on certain holidays and during election time: lip service while the veteran population has continued to have a suicide rate 6x more than the non-vet population. They also have a 7% jump on the non-vet population on homelessness.
Next, it reminds me of an episode of The West Wing. A very wealthy man went to the press secretary and asked how he could really, really help. What could he do? Her answer surprised him. “Build roads in Africa.”
It’s not sexy, she explained, but necessary. The foundation of roads makes everything else possible. I think we need to get away from the poster children of suicide prevention (no disrespect intended to tWitch or others) and start building roads. It’s not sexy. It costs a lot of money. But it makes everything else easier.
Next, Antony Molin asked for a storyteller. Well, here is a storyteller, just waiting for an audience. Trying to reach one. Let me in? Follow my podcast? Support my podcast? Share my podcast. I’ll keep talking.
This next thing may make people choke so make sure you are not drinking or eating anything while reading or listening to it. I’ll give you a second to finish swallowing.
…
Okay, here goes: Give me a lot of money and leave me alone to get it done.
I’m serious! I did it before, but with no money. That’s how I burned out and was part of what almost brought me to kill myself. I did help save an entire industry though. Long story.
Then, when the industry people were asking me what to do next, I told them to give me a lot of money and leave me alone. Nobody took me seriously. Not that I can blame them, but I was serious. I’m a pretty smart guy, already accomplished a lot, saved many in my industry, but I saw many still struggling, wading through new technology and new concepts. Over and over, I said they were trying to jam square pegs into round holes. They were adapting, but not well.
Many finally figured it out, after 5-6 years, but it would have been a hell of a lot quicker and more efficient if they had just all chipped in, given me a lot of money, and left me alone. –and the association that turned its back on me still owes me $1,000. That’s what you get for electing a board instead of keeping a dictator.
A very simple thing to do, that doesn’t require any money, is break down my book.
Oh, I have a book coming out. Next Tuesday, December 27th. Let’s Get Naked About Mental Health! It is the transcripts from episodes 1-22. I already saw it on Amazon, but I clicked the wrong button in IngramSpark, so it is not available until the 27th. I struggle with technology at times.
As I said, I am a storyteller, not a mental health professional. I would love to have a second version of the book where, essentially, a mental health professional breaks down my stories into counseling sessions. Just tears them apart with the precision of a surgeon–or like the editor who is currently making me cry editing my first book. She is making me a better writer. You can make me a better advocate. Any takers?
This is some difficult stuff. I have many instances in the book and podcast where I say, “I don’t know.” Places where I am trying to figure things out. I’m stumbling a lot. Lend me your arm. I’ll be Dante, you be Virgil. [Just in case, that is a reference to the first part of Dante’s Divine Comedy, Inferno. Which is an apt metaphor if you think about it.] Let’s share my struggles and screw ups with everybody. I’m game. Lead me through my personal levels of hell and show me how I got there.
Which leads me to my next point: share my book. Aye, I’d love to make my $2 per copy on it, but I am making it available to anybody who wants it. The eBook and print version will be available. Anybody who signs up for my website, or requests it, though, gets the eBook free. –I should be able to figure out the “how” by the 27th. IngramSpark is not like Lulu.
Giving my book away is probably not the best business decision I have ever made but that is not the point. I want to get my story out there, help people to get help. Start talking and keep talking so we don’t suffer anymore tragedies like with tWitch.
Look, I’m not saying I have all of the answers. I’m not that arrogant. But I do have some. And I have directions to other answers. We cannot possibly understand tWitch unless we walk in his shoes. Or if he had a podcast about that journey.
I talk and write about my journey to break it down and dissect it. My two times almost committing suicide were very different but shared many similarities. The more I understand about depression, the more I understand that the doorway to suicide was somewhere I was going to end up eventually, and somewhere I am trying like hell not to return to.
Was tWitch like my first time, where time compressed into a single moment filled with unbearable pain? When the depression altered time and reality so the question “how can I do this to my loved ones” is manipulated to become “how can I NOT do this FOR my loved ones”?
I have a podcast about that.
An extreme example is what happened to my mother during a psychotic state. Her reality was that she was an instrument of Satan sent to spread disease on the earth and had infected me and her grandson. What would you do in that situation to protect the people you love? If that was your reality?
Or was it like my second time for tWitch? Was the exhaustion, over such a long period of time, so that every breath was a burden, made me feel like what I saw in friends and family who finally passed from cancer? Where I was angry at the people who loved me and wanted me to continue?
I compared that depression, that experience, to a cancer of the soul. I justified suicide by saying it was just like my loved ones who died. Time compressed and distorted reality again, so that the 5% of my life that had been depression became 100%.
I had sat with others. For a month, I sat with my best friend, my dear, sweet girl, while she battled cancer, and the end finally came after 14 years. That final month was excruciating to watch. She was in so much pain. Just let go, I wished. And she finally did, finding peace. To me, my cancer of the soul and spirit was no different. Just let me go so I can find peace.
Or was it completely different for tWitch? Is there another reason, another altered reality that allows us to override that basic instinct to survive.
I think that that is a way in, something to be talking about, something to research to better battle suicide. What are the stories? What are the stories of non-depressed people who choose doctor assisted suicide? The stories where that basic instinct for survival for any organism is overridden by something more powerful? What is that “more powerful” and how do we address it?
For me, the answer is in Mindwalk and systems theory. We have to move upstream from the “crisis” period and prevent the crisis from occurring. Some of the answers are simple, yet difficult to implement, like minimum basic mental health care and preventative care as I discuss in my Mental Health Triangle–another episode. Building the roads.
There are many stories and examples from outside of the mental health space that directly correspond to mental health care. I knew a woman who died from a cavity. Seriously. She got a cavity in her tooth and was terrified of going to the dentist. There were other issues involved, but it abscessed, the abscess spread throughout her body, and she died.
Then there is the story of a person I know closely, the biggest pain in the ass who ever lived, who is still alive and living well. He taught me everything I know about being a pain in the ass.
He was diagnosed with Hepatitis C and almost died when he finally received his liver transplant. He was down to under 5% liver function. When the treatment came out that cured Hepatitis C, he started writing his insurance company about it because the treatment was $100,000 and not covered.
The illness was still at work on his liver, he was coming to the end of the new liver’s life, and he started to write to the insurance company with a very simple question. “You will pay the 2 million dollars plus for another transplant. Why not pay for the treatment that has a 95% effective rate and save all that money?”
Denied.
He kept writing. On a fixed income, he laughed off the offers of 20% off, 50% off, etc. and kept writing. When the price came down to $10,000, I jumped in. I said I would pay for it. He replied, “No, I got this.” And he kept writing.
They eventually paid for the treatment and cured him. His liver regenerated as it is meant to do when not being attacked by the illness.
That story, though so common in health care, boggles my mind. It makes no logical sense. A company is more than willing to pay over two million dollars in reactionary care but not $100,000 in preventative care.
This absurdity must change. How do you fix it though? –the first thing I wrote was “how do you fix stupid” but that was a bit harsh. But it is stupid!
My final point brings me back to Mindwalk and terminology. Yes, we use mental health care and have different rules for mental health insurance. It is just like dental insurance. That’s absurd.
We are not pieces. We are not a clock that needs to be fixed. We are more than the sum of our parts. The mouth, and dental care–though my example is an extreme one–is a doorway to our general health, so proper dental care is essential for proper health care.
Mental health care is the same. There are studies, tons of them, that show a direct correlation between mental health and physical health.
We need to redefine things. We need to change attitudes and perceptions. We need to stop the crisis before it becomes a crisis. We need to add our collective knowledge and attack these issues and educate others.
We need to do more.
We need to not only start talking and keep talking, but we also need to change the landscape to make the conversations more accessible and relatable.
Y’all need to watch Mindwalk.
Aloha.
A special PS. I brought her up. My dear, sweet girl, Maureen, diagnosed with stage four metastatic breast cancer at 29. Who still makes me smile. Who is a poster child for early intervention. I learned that early detection of breast cancer leads to a 99% survival rate.
But as I sat in that hospital room, night after night, a poem began to reverberate in my mind. It did not make sense. Until it did. It seems to fit here, though I do not know why, so I am adding it.
For Maureen Kalix Smith
Rage, rage against the dying of the light.
I grasp at the hope that her rage inspired in others. 14 years ago, in the noon of her life, the light threatened to be eclipsed with the diagnosis of stage IV cancer. But she raged against the eclipse, fought and battled, endured through pain that most of us cannot comprehend, and saw her young son grown into a man, cousins and a Goddaughter born, and celebrated life with her family, friends and parish.
I grasp at the hope, but it slips through my fingers as the refrain from the poem reverberates in my mind. Rage, rage against the dying of the light. So apt for my friend, and yet so terribly, cruelly wrong.
My dear, sweet girl: the poem was never meant for you. “Do not go gentle into that good night” was written for an old man, at the end of his days. The only rage you were supposed to experience, at 29, when you were first diagnosed, was at catching your son smoking. You were supposed to rage against higher gas prices and skyrocketing tuition costs. As the world moved onward, and our bodies followed, you were supposed to rage against the passing of that first blush of youth, at a cheating boyfriend, or at yet another stupid ass thing that your friend did. The dying of the light was never something that you were supposed to have to rage against.
Rage, rage against the dying of the light. And as your rage falters, slowly dims with the light of your life, the rage builds within me. You set yourself against the evil that is cancer, at the dying of the light. I can only set myself against my own impotent anger, at the coming of darkness.
I push at the darkness, with thoughts of you, mingling my own selfish memories with those others who gather around your bed. Yes, I was Batman, beating that flying rodent senseless with a pizza box. There were the notes we passed back and forth in geometry class to entertain each other. A friendship that spanned 29 years as I tumbled through one mess after another, and being so happy that your mother never changed her phone number because, to this day, I still cannot find your house, only wander through your neighborhood until I stumble across it.
I continued to show up, even after you’d rather I not, because you continued to show up, when I was not sure if you could. I embrace the fact that you saw me finally get my head out of my ass. You were there when I got married—betcha’ you didn’t see that one coming? You were there for the jewelry parties and the surprise party. You were with me for a long time now, and that is why I am here with you.
Oh my dear, sweet girl. Rage, rage against the dying of the light. Maybe that is why the refrain has become a mantra in my mind. It is not for you anymore to rage, rage against the dying of the light. It is time for you to put your burden down, and let go. The pain has been terrible. The sickness unbearable. The endurance required incalculable. It is time, honey, though I selfishly resist the truth. It is time for you to go gentle into that good night.
Gently, my dear one, ever so gently. Just open your hand and let go. Slip from the pain, knowing that our memories will catch you and hold you tight.
Rage, rage against the dying of the light.
The refrain is not for you anymore, but for us. And it is such an easy thing to do, for you have made it easy for us. The light of your life fades, but the light of your existence burns as bright as the sun. Your smile is engraved on our minds, your laughter rings in our hearts, and your warmth and kindness have become pieces of our souls. The laughter you have inspired will ease the tears of your passing. You will live as long as we do.
Rage, rage against the dying of the light.
How can the light die when it is a part of who we are?