Suicidality: Talking About Suicide and Support

Adapted from Australian Institute of Professional Counsellors, Institute Inbrief, Edition 359.

Good day readers! How are you? … Shit? Depressed? Anxious? Angry? First of all, if you’re someone who says “I feel shit”, I would encourage you to use a more accurate descriptor instead of shit. Tell your brain what emotion or feeling you are experiencing. Shit can mean a lot of things. When we’re able to identify an emotion, it’s more likely we’ll be able to regulate or manage it. When I was learning Dialectical Behavioural Therapy, they had a saying: Name it to claim it to tame it. They also encouraged us to distance our identity from our feelings e.g., “I’m having the feeling that I’m angry” rather than “I’m angry”. I know it sounds like simple fluff but there is a profound difference between observing the experience of anger, loneliness, fear, guilt etc. and believing we (the self) are the embodiment or a manifestation of an emotion.

Alright, moving along to the subject of the article. The Australian Institute of Professional Counsellors sent me their monthly (I think it’s monthly) Institute Inbrief. If you’re someone who has lived with a mental health disorder or emotional difficulties for a long time, being in nature is not really a new antidote from the field. And it’s not always as simple as just going out into nature. When I was deep in the abyss of my own depression, there wasn’t a lot that would change my mood or perception of life. But, we do these practices anyway – and that’s kind of the point. It’s a practice. It may have to be initiated using a bit of self-force. Oftentimes, motivation comes after we begin the motion.

So, here are some examples from the article that support ‘nature has a therapeutic effect for the mind and body’:

• One study found that women who looked at pictures of nature for two minutes had lower levels of the stress hormone cortisol (Gillespie, et al., 2019).
• Another study showed that people who walked in a forest preserve showed lower levels of hostility, aggression and anxiety than they did before the walk.
• Gregory Bratman, PhD, an assistant professor at the University of Washington, and colleagues shared evidence that contact with nature is associated with increases in happiness, subjective well-being, positive affect, positive social interactions and a sense of meaning and purpose in life, as well as decreases in mental distress (Science Advances, Vol. 5, No. 7, 2019).

How can we most effectively reap the mental health benefits that nature offers?

Why nature?

I’m aware we’re in Covid-19 lockdown and restrictions at the moment (27/09/2021) so you will need to determine for yourself if what proceeds to be written is practical and realistic for you right now.

We need to understand that the psyche of the human-being is linked to the natural world in many important ways. The human brain constantly processes and assimilates incoming information, and it relies on external stimuli for guidance regarding how to think and behave. Not only does incorporating nature into our daily lives help us understand the world better, but it can also contextualise ourselves in accordance with this understanding; humans – as an animal – have evolved in tandem with the natural world, and thus it is able to promote the development of beneficial skills including improved visual–spatial acuity, attentional abilities, and memory (Oddie, 2019). Our world is full of beautiful and intricate natural structures, and even just a simple walk through a park can provide us with moments of joy, awe, and wonder (Fiebert et al., 1980; Lefebvre & Brucker, 2018).

Additionally, the seemingly chaotic stimulus that nature provides us with promotes creativity and abstract thought (Berman, et al., 2012); these qualities have been the cornerstone of our species’ evolutionary development over the past few thousand years, thus illustrating the primacy of our relationship with nature.

Our neurobiology is extremely complex, and as such cannot be reduced to simple terms. However, we can say with some certainty that our brains’ sophisticated processing systems are enhanced by our interactions with nature. Our brain naturally integrates external stimuli into existing mental frameworks—this is referred to as “cognitive recursion” (Oddie, 2019). This means that if we spend our time in environments that were designed and created by the human mind, then we are putting ourselves in an echo chamber of stimulus and will not receive new information to broaden our mental capabilities. If we spend time in nature surrounded by structures and patterns that are born of unfathomably complex and foreign processes, then our minds can assimilate this new content into its existing understanding of reality.

Basically, if you spend your days in a white cube (i.e. a house) then your mental framework will be limited to the creative potential that a white cube suggests. If, however, you spend your days in an ever-changing fractal world of colours and shapes (i.e. natural environments) then your mind will reflect this, and adopt an expanded creative potential in order to perceive and understand its surroundings. This is a powerful reality; understanding how our connection with nature nourishes our minds is where spirituality meets both science and intuition.

What benefits does nature offer?

Perhaps the most important and relevant aspect of an active lifestyle in nature is its ability to reduce stress. Studies have shown that taking a walk in a park could decrease stressful thoughts, and even reduce blood pressure (Bush, et al., 2016; Robins, 2020). This finding demonstrates that simply being exposed to nature can decrease stress levels, and implies that returning to nature may be an effective way of keeping our mental health at its best. And here’s the kicker: any amount of time spent in nature is net-gain for your mental wellbeing (Robins, 2020). There is no threshold or minimum a dosage of nature that will have an effect on you – even just spending a short time sitting in your backyard enjoying nature will likely have a positive impact on your mental health.

Other studies have also shown that exposure to nature has an effect on our emotional outlook; particularly in regards to relieving us from pessimistic and fearful thinking (Lefebvre & Brucker, 2018). Life in the modern world is full of consequential decisions and options, the outcomes of which can dictate the quality of your entire life. Decision making is one of the more neurologically complex and taxing processes that our brains undertake, and research has shown that we make 35,000 choices per day (Huston, 2018).

This process involves assessing each option for its individual merit, sorting each option into a hierarchy in relation to every other option, making predictions about every possible positive and negative outcome of each option, and then weighing each outcome against that of every other option; golly, how exhausting! The fear and pessimism arises because each option invariably comes with the potential for myriad negative outcomes, and we are constantly coerced into assessing these. Thankfully, nature offers respite from all this noise. Spending time in nature relieves us from overthinking by presenting us with very few options, each with relatively inconsequential outcomes; ‘where will I sit while I drink from my water bottle?’ or ‘should I take the path leading towards the lookout, or the waterfall?’ are not taxing decisions to make, and will not prompt fearful or pessimistic thought patterns. There is an easiness to natural environments in which things seem to flow along their own course, and we are able to simply jump into the stream and flow along with it.

Aside from experiential benefits, time in nature can help us orient ourselves in the world in more grounded and productive ways. In today’s society, our attentional abilities are sapped by large corporations who profit from our distractibility, and it seems as though a way to remedy this mental breach is routine contact with nature. Attentional abilities are bolstered by spending time in nature (Ebata & Izenstark, 2017), making you less susceptible to the temptations of modernity (i.e. problematic social media scrolling, binging streaming services, etc).

Thus, making time in nature a priority in our lives – especially when we do not even feel stressed or anxious – can help us orient ourselves to the world around us and find a sense of personal empowerment. Taking time to be immersed in nature can help us regain confidence, ground us in a personal sense of meaning, and re-establish our wellbeing. Being in nature is correlated with increased positive emotions and feelings of control over one’s life (Chowdhurry, 2021), so even if we do not believe we need some sort of mental intervention, the benefits are there for everybody to experience.

How can I fit more nature-time into my life?

For the most part, we only need to reflect on our daily behaviours to see how we can incorporate time in nature into our lives. James Clear, in his wildly popular book Atomic Habits (2018), suggests incorporating a “budding habit” into an existing habit.

So for instance, if you have a lunch break during the work day, you could spend it outside on a park bench instead of in the staff room. If you come home at the end of the day and like to sit on the couch with a book, go outside and sit on the grass instead. These are simply ways to adopt more nature-time into your life, without having to add another separate activity to your schedule. In a 2017 study (Austin, et al., 2017), some participants were asked to take a brief walk in nature once per day, and other participants weren’t. The results showed that those who walked daily had higher levels of positive emotions and well-being than those who walked less. It doesn’t take a lot of time to nourish our minds in the deep ways that only nature offers us, and it seems to be a worthwhile habit to form.

Making the time to experience nature is easy to ignore in lieu of more ‘important’ tasks. That walk in the park you planned on taking this afternoon suddenly seems overshadowed by a looming deadline or a sink full of dirty dishes. For this reason, it can be beneficial to keep yourself accountable by planning nature-time with other people. Planning to go for a walk with friends means there is a lower likelihood of cancelling. Better yet, if you can join a weekly community group or class of some sort then you won’t even have to continually plan your time in nature.

There are volunteer groups who aid revegetation in nature reserves, there are community gardens who need people to tend to plants and crops, and there are clean up groups who dispose of discarded rubbish in bush-lands. If volunteering isn’t appealing to you, then you could change your routine by canceling your gym membership in lieu of outdoor exercise classes or yoga, or even new activities like cycling or rowing. Making scheduled appointments to spend time in nature can assist those who have trouble achieving this with sheer willpower, and your mental health will thank you for it.

Our acknowledgment of the value of time spent in nature is growing each day, which is why more urban living environments are incorporating ‘green spaces’ into their design. Using the latest neuroscience research, we are able to determine which types of natural environments compliments our mental states the most effectively. For example, it has been found that areas with high levels of biodiversity can alleviate symptoms of anxiety and depressions more-so than those with low levels of biodiversity (Wyles, et al., 2019). Similarly, people who watched videos featuring a diverse array of flora and fauna reported lower anxiety and higher vitality than those who watched videos of less biodiverse landscapes (Wolf, et al., 2017).

Findings like these offer valuable insight into how we can engineer our surroundings to best facilitate the highest levels of wellbeing possible. It is clear that spending time in nature is invaluable for our mental health, but a half-hour lunch break doesn’t give us time to go hiking through a biodiverse mountain landscape; what we can do, however, is have access to green spaces which replicate the stimulus that we would receive if we were in nature. This has proven to be an eloquent solution to the pressing issue of depression rates in urban CBD areas (Ebata & Izenstark, 2017).

Summary

In conclusion, the role of nature in our lives is of paramount importance to our health and should be a priority for us all. Although it may feel like adding a daily walk outside to our schedules would be in futility, the positive mental health benefits outweigh the costs significantly. Making time in nature a priority, no matter how little, can greatly increase our overall sense of wellbeing, and remind us that we are interconnected to the living world around us.

There is no minimum threshold required to reap the benefits of nature, so we can all find a way to capitalise on just a little bit of time in natural environments. As a species, it is our natural disposition to enjoy the outdoors, and the benefits are more abundant than you might expect. So pop on a pair of joggers, Google search ‘hikes near me’, phone a friend, and get out there amongst the fresh air; you can thank us later!

References:

1. Berman, M. G., Kross, E., Krpan, K. M., Askren, M. K., Burson, A., Deldin, P. J., . . . Jonides, J. (2012, November). Interacting with nature improves cognition and affect for individuals with depression. Retrieved from: Website.
2. Bush, R., Dean, J., Lin, B., & Fuller, R. (2016). Health Benefits from Nature Experiences Depend on Dose. Scientific Reports.
3. Chowdhury, M. (2021, February 19). The Positive Effects Of Nature On Your Mental Well-Being. Retrieved from: Website.
4. Clear, J. (2018). Atomic habits: An easy and proven way to build good habits and break bad ones. London: RH Business Books.
5. Hunter, M. R., Gillespie, B. W., & Chen, S. Y. (2019, March 15). Urban Nature Experiences Reduce Stress in the Context of Daily Life Based on Salivary Biomarkers. Retrieved from: Website.
6. Huston, M. (2018). How Many Decisions Do We Make Each Day? Retrieved from: Website.
7. Izenstark, D., & Ebata, A. (2017). The Effects of the Natural Environment on Attention and Family Cohesion: An Experimental Study. Children, Youth, and Environments.
8. Wyles, K. J., White, M. P., Hattam, C., Pahl, S., King, H., & Austen, M. (2017). Are Some Natural Environments More Psychologically Beneficial Than Others? The Importance of Type and Quality on Connectedness to Nature and Psychological Restoration. Environment and Behavior, 51(2), 111-143. doi:10.1177/0013916517738312

Psychological factors influencing drug use in Sydney’s gay community often stem from unique social and emotional challenges. Research highlights that stigma, discrimination, self-stigma, and internalised homophobia can lead to feelings of isolation, shame, and mental distress, which may increase vulnerability to substance use.

Additionally, the normalisation of partying in certain social settings, such as bars and clubs, has historically been a way for subcultural populations of LGBTQ+ individuals to connect and find community. However, this environment can also contribute to higher rates of drug use. Emotional coping mechanisms, such as using substances to manage stress or trauma, are also significant factors.

The biopsychosocial model provides a comprehensive framework for understanding alcohol and other drug dependency in the LGBTIA+ community. Here’s a breakdown of the factors:

1. Biological Factors:
   • Genetic predisposition plays a role, with some individuals being more vulnerable to chemical dependency due to inherited traits.
   • Neurobiological changes caused by substance use can alter brain function, making it very challenging to reduce or stop using substances despite the negative consequences occurring in the individual’s life.
2. Psychological Factors:
   • Trauma, such as adverse childhood experiences, peer bullying, neglect, authoritarian child rearing, seemingly innocuous societal messages, and/or discrimination, can lead to emotional distress and substance use as a coping mechanism.
   • Internalised stigma, homophobia, or transphobia can exacerbate mental health issues like anxiety and depression, increasing the risk of substance use and potential physical and psychological dependency.
3. Social Factors:
   • Experiences of ostracism, violence, or lack of acceptance and belonging can lead to isolation and substance use.
   • Social norms in certain LGBTQ+ spaces, such as bars or clubs, may normalise or encourage substance use.

This model underscores the importance of addressing all these interconnected factors in prevention and treatment efforts.

The Flux Study, also known as “Following Lives Undergoing Change,” is a longitudinal research project focusing on the lives of gay and bisexual men in Australia. Conducted by the Kirby Institute at UNSW Sydney, it examines various aspects of health, behaviour, and social factors, including drug use, sexual health, and the adoption of HIV prevention strategies like PrEP.

Key findings from the study include:

• Recreational drug use is common among gay and bisexual men, with substances like marijuana, amyl nitrite (“poppers”), and party drugs being frequently used. However, dependency rates are relatively low.
• Drug use is often linked to enhancing pleasurable experiences, including sexual enjoyment.
• The study has provided insights into how men mitigate risks, such as using biomedical HIV prevention methods alongside drug use.

The Flux Study is a collaborative effort involving organisations like the National Drug and Alcohol Research Centre, ACON, and the Victorian AIDS Council. It aims to inform health interventions and support services tailored to the needs of this community.

The Flux Study has provided valuable insights into the health and behaviours of gay and bisexual men in Australia. Here are some key findings:

• Drug Use: While recreational drug use is common, most participants reported infrequent use. Harm reduction strategies, such as not sharing injecting equipment, were widely practiced.
• HIV Prevention: There was a significant increase in the uptake of HIV pre-exposure prophylaxis (PrEP), with usage rising from less than 1% in 2014 to about one-third of participants by 2017.
• COVID-19 Impact: During the pandemic, participants reduced sexual contacts and adapted strategies to minimize risks in sexual contexts. Many also paused PrEP usage due to reduced sexual activity.
• Mental Health: A notable proportion of participants reported mental health challenges, highlighting the need for targeted support services.

There are several support services available for addressing mental health challenges, particularly for the LGBTIA+ community in Australia. Here are some key options:

1. QLife: A free, anonymous peer support and referral service for LGBTQ+ individuals. It operates via phone and webchat from 3 PM to midnight, 7 days a week. Phone: 1800 184 527. Their website provides a webchat service: QLife – Support and Referrals
2. Beyond Blue: Offers 24/7 mental health support, including phone and online counselling. They also provide resources tailored to the LGBTQ+ community. Phone: 1300 22 4636. Click the following link to Beyond Blue’s Wellbeing Action Tool: beyond-blue-wellbeing-action-tool_dec_2024_updated.pdf
3. Lifeline: A leading crisis support service available 24/7 for anyone in distress. They offer phone, text, and online counselling. Phone: 13 11 14
4. Head to Health: Connects individuals to mental health resources, including helplines, apps, and digital programs. Medicare Mental Health is a free service that connects you with the mental health support that is right for you. Phone: 1800 595 212 or visit their website: Home | Medicare Mental Health
5. WayAhead Directory: An online database to find local mental health services and resources. Phone: 1300 794 991
6. NSW Mental Health Line: A 24/7 telephone service providing advice and recommendations for appropriate care. Phone: 1800 011 511

These services are designed to provide immediate support and guide individuals toward long-term mental health care.

I want to preface this post by stating that the concepts and suggestions I’ve made below are my own thoughts, opinions, and suggestions based on my own experience working in the mental health sector and lived experience. There may also be numerous grammatical and logical errors. I know that you’re intuitive enough to understand what I’m attempting to describe and explain. Therefore, there will be no references section at the end. This is merely an expression of thoughts, a stream of consciousness (William James coined the term Stream of Consciousness).

Episodic, acute, and chronic anxiety can be miserable and debilitating. Individuals living with anxiety have generally experimented with many techniques to cope with anxiety symptoms, and they have often been practicing these techniques for months, years, or decades. Anxiety is life changing. Current treatment can be efficacious at reducing the intensity or frequency of symptoms for the vast majority of people living with anxiety, but only at best. I, myself, have tried the deep breathing technique commonly advised by mental health professionals, and it can be about as useful as taking a sugar pill. There is credible science that supports deep breathing exercises can improve symptoms and recovery rates for stress, anxiety and depression levels – but what about for an anxiety attack or a panic attack or intense chronic symptoms of anxiety?

Sometimes nothing is effective enough for immediate relief. It is my contention that building a relationship with a trained psychiatrist, specialised in this domain, is an essential first step. Your treating specialist(s) will need to have extensive experience and a comprehensive understanding of the debilitating impacts of anxiety, anxiety attacks, and/or panic attacks. I recommend psychiatry because you will need someone who can prescribe short-term medication, schedule 4 or greater, to alleviate the pain rapidly. All symptoms a person may experience from any condition in the anxiety family present a risk for searching for any immediate relief. This is true for you or me or anyone. Without prompt and effective medical care readily available, many people who do not have a plan for managing anxiety will potentially search for an unhealthy substitute to acquire relief.

These substitutes are often unhelpful long term but effective short term. We all know what they are: alcohol and other drugs, sexual promiscuity or sex addiction, love addiction, gambling, excessive or unhealthy eating habits, self-injury, addictive forms of gaming, impulse spending, co-dependent or dependent behaviours on people, people pleasing, running away (avoiding reality), raging, reckless driving and other criminal behaviour, and relying on pharmaceuticals (legally prescribes or otherwise) that will have long-term unhealthy side effects. People know how to “doctor shop”, and although this area of medicine is becoming much more regulated, it still occurs. Unfortunately, there are people who do require certain types of legal drugs, in a timely manner, to find relief as a means of not engaging in any of the previously mentioned behaviours.

Some people may not have much faith in the field of psychiatry or psychology – HOWEVER – you may find yourself in a situation one day where you will need a doctor who knows your history to increase the likelihood of prescribing medication to treat anxiety when you need it most. This medication usually has addictive properties. An ethical psychiatrist will usually be unwilling to prescribe more than a single repeat of potentially addictive medication to treat their patients. This is standard, regulated medical practice in Australia.

Anyone working in the drug and alcohol sector or has regular contact with a person living with anxiety, or any form of addiction, will know that patients – people – are not being seen in a timely manner top treat anxiety before the patient starts looking elsewhere. Even once the patient has accessed some type of medical care, the length of care is not long enough for the patient to be “well enough” after discharge or ending their hourly session, to be on their own in the community safely without becoming vulnerable to their condition in a short time and looking for more relief to ease their pain and improve their well-being.

If a person or a patient cannot depend on the medical system in the way they need to feel safe and well, they will almost certainly begin to lose faith and trust in health professionals, and ‘the system’. This perpetuates their internalised stigma being reinforced, yet again.

I am not saying the patient doesn’t have a significant responsibly of their own to make valuable choices outside of medical treatment. I quote what someone once said to me, “You may not have asked for this disease, but it becomes our responsibility to stay well”. That is our duty as the person living with a health issue of any kind. There are things we certainly must do (or not do) to stay as healthy as possible. The help make not be there in a timely manner the next time we need immediate help.

It can take weeks or more to enter a detox facility. It can take months to enter a rehabilitation facility. It can take months for an available appointment to open with a psychiatrist. It becomes our responsibility to know that even when we’re feeling well and back to “normal”, we must continue those relationships with medication professionals. It becomes our responsibility to try alternative medicines if that’s something you’re interested in. Let’s face it, psychiatrists cease their practice, our professional relationship has reached it’s potential for adequate, loving care, or we want to try something new.

Start the process of finding a reliable, qualified, and credible psychiatrist today. I would recommend finding a counselling psychologist or other mental health professional that you have a productive and friendly working relationship with – and if you want to practice Buddhism, or acupuncture, or hypnotherapy, or any other complementary and alternative medicine – do it. If you want to connect with God – do it. If you want to see a naturopath – do it. Whatever it is, this may very well be a lifelong journey for you. Based on my own experience, don’t stop because you think you’re “all better now”. The previously mentioned professions or treatment options or lifestyle choices can be extremely expensive, but I would encourage you to save for it, find less expensive options. Sitting in church is free, or listening to an online guru can be the price or maintaining your mobile service bill.

I once knew of a fellow peer in treatment alongside me who said he saved money for years to travel overseas to have a procedure not available in Australia at the time for this purpose. He wanted blood transfusions and heat therapy for chronic pain that didn’t doctors could not determine had physiological origins. The peer was sure it had to, and medical investigations in Australia come up negative. The peer explained the theory behind blood transfusions and heat therapy – he believed – were supposed to improve his blood circulation and blood flow to treat the chronic pain he’d been living with for years after a workplace accident. Even this procedure overseas proved ineffective in mitigating his chronic pain. So, next he tried the wim hof method. He changed is diet. He exercised differently. He tried hypnotherapy. Finally, he turned psychology to treat stress and process childhood trauma. He was being treated for this a private facility where I was a patient at that time. I lost contact with him after I ended my own treatment episode. I don’t know if he’s still living with chronic pain or not.

The following are some very basic and well-known strategies in the Western world of psychology that you can begin to practice today, and then practice every day after that too – even for 5-20 minutes:

– learning about anxiety – your specific “causes” and the conditions more generally

– mindfulness

– relaxation techniques

– correct breathing techniques

– dietary adjustments

– exercise

– learning to be assertive

– building self-esteem

– cognitive therapy

– exposure therapy

– structured problem solving

– support groups

My firm believe is this:

Strong, healthy, quality relationships are essential to treating anxiety and other psychological illnesses. This about your life today: are you lonely (romantically or otherwise), are you a stressed individual, do you regularly feel like you job is stressful or unfulfilling, do you feel sad a lot, are you feeling pointless a lot, or feeling helpless a lot, feeling shame a lot, getting angry a lot over considerably minor things? etc. etc. etc. I would strongly encourage talking to a professional and begin exploring what options you have available to you.

Try, explore, play with a few methods of treatment. However, this must take a priority in your life. It must balance will all the many other obligations and responsibilities people encounter daily.

Type alternative medications or approaches to psychology. There are so many. It can be fun to try out a few when your finances permit. Even planning a holiday every 3-6 months is taking care of your well-being.

Many blessings friends.