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Depression. Despair. Suicide.

Why can't we talk about mental illness?

Nurses Stress 101 Article   posted

Specializes in Peds, PICU, Peds Onc, Nursing Leadership. Has 31 years experience.

We have all felt sad and alone at one time or another, and many of us are feeling even more isolated because of the ongoing global pandemic and need for social distancing.

Depression. Despair. Suicide.
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Dark Secrets

Two years ago, there were several incidents of "jumpers" from a nearby parking garage that had occurred within a short time frame, and I couldn't get past the sadness and horror as I walked past it every day on my way to work. It touched me deeply, and I didn't even know them... but I knew of them, and seemed connected to them in some way. Each time it happened, it seemed like a dark secret no one would talk about. There was minimal information in the newspaper, and I had so many unanswered questions. There is a stigma that comes with mental illness that many do not feel comfortable talking about. So we don't.

When Suicide Hits Home

Something happened recently that shook me to my core; my daughter attempted suicide. She became so overwhelmed with her work in the news industry, with this relentless cycle of negativity and civil injustice, that she quite literally "broke". Her compassionate heart could not continue to write (and re-write, and re-re-write) about the horrific acts of violence and sadness in the world... that, and the tragic loss of life with the global pandemic, and the isolation of being in quarantine, was too much for her to bear, and she lost something that keeps most of us moving forward... hope. My own beautiful daughter became so depressed that she didn't want to live another day. That shocking realization is something that I was not prepared for... not my sassy, funny, bright, strong, successful daughter.... that can't be... under my own eyes, in my own house. How did I miss this? I felt like I had failed her.

Subtle Changes

In hindsight, I did see some subtle changes, but she was good at pretending she was OK... she stopped working-out with her virtual trainer because it was so hot outside. She stayed in her pajamas all day because didn't everyone who worked from home do that? She wasn't sleeping because she was working so hard writing for the news show that she produced. And me.... I am a Nurse, so I went to work like I always did, even under the stress of Covid. I came home late, sore, and tired... and I missed it. But thank God, I was able to stop her in time, and get her help. Yes, we have guardian angels among us.

Inner Demons

We have all felt sad, disappointed, and alone at one time or another in our lives. Those of us who have struggled with depression, or other high-risk factors such as loss, low self-esteem, rejection, or stress, have experienced varying degrees of darkness and despair; it’s not a fun place to be, and not everyone makes it out alive. Some have been in such a low place that they feel their only solution to overcome this immense pain and suffering is through one final extreme act of choosing death over an unbearable life. We all have our own inner demons that come out when we are at our most vulnerable.

Depression is an illness that often can be mistakenly viewed as a sign of weakness, or an inability to cope with everyday life. This is just not true. The American Psychiatric Association (2018) defines depression as a medical illness that affects how one feels, thinks, and acts; it can lead to thoughts of suicide if left untreated with the right mix of therapy and medication.

Death From Despair

Suicide has been described as death from despair. According to the Center for Disease Control (2018), suicide rates in the U.S. have increased 25% in the past two decades and are increasing among adults aged 45-64. Among those aged 15-34, suicide is the second-leading cause of death. These are scary statistics...especially when they hit so close to home.

Those of us in healthcare have seen the outcomes of an attempted suicide. My first experience as a young PICU nurse caring for a teenage girl who attempted suicide by hanging was extremely difficult; there was no happy ending or miraculous recovery for this young girl. This story was tragic, and yet it happens every day. She had gone through a bad break-up with her boyfriend, and the pain and rejection led her to self-mutilation, which didn’t dull the pain deep inside of her, so she hung herself. Her sister found her, and called 911. She was brought back to a life of vegetation. She wore a haunted look of pure rage, which seemed to be her only facial expression when “awake”. She had just enough brain activity to continue medical interventions. I still think about her from time-to-time and I wonder if she ever found the peace that she was looking for so long ago. I truly hope so.

What Can We Do?

What can we do to prevent our loved ones from choosing this ultimate act of despair? First, we need to be able to recognize the signs and symptoms of depression and not be afraid to ask if they need help or want to talk… or even if they have ever thought about hurting/killing themselves. We need to support better medical coverage for mental health and pre-existing conditions; we need to prevent those who have mental health conditions from being able to legally purchase a firearm; and last, and most important, we need to support them and not judge them. “There, but for the grace of God, go I”. Timing is everything, and if the pain and despair are recognized early enough, perhaps a life can be saved.

Linkin Park wrote a beautiful song about suicide called One More Light (2017). The irony that one of the writers, Chester Bennington, committed suicide a year later, speaks to his state of mind and intimate understanding of the effects of suicide for the ones who are left behind to try to heal from this great loss.

If you, or someone that you know, are having thoughts of suicide, please seek professional help; call a friend or family member, or call the

Suicide Hotline: 1-800-273-8255

depression despair suicide. Aston.docx

References

American Psychiatric Association (2018). What is depression?

CDC. (2018). Suicide rates rise sharply across the US, new report showswashingtonpost.com

Linkin Park. (2017). One more light

Strong nurse advocate; would have liked to meet Florence Nightingale... I think we would get along famously!

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dougjiro, CNA, LPN, RN

Specializes in Hyperbaric. Has 6 years experience.

Michael Phelps is my hero for speaking about his challenges and becoming a spokesperson for mental health. Twenty three gold medals and while battling mental health. His documentary “The Weight of Gold” gives perspective to nursing.

Trampledunderfoot, LPN

Specializes in Corrections, Dementia/Alzheimer's. Has 2 years experience.

I heard someone say it is hard for nurses to get mental health help because it shows on their back ground checks and will cause them to not get hired. Anyone know if this is true? If so, this is really sad, and seems like it would put patients more at risk because nurses would not seek care they need.

LindaGracie, ADN, BSN

Specializes in geriatric, psychiatric/mental illness. Has 5 years experience.

59 minutes ago, Trampledunderfoot said:

I heard someone say it is hard for nurses to get mental health help because it shows on their back ground checks and will cause them to not get hired. Anyone know if this is true? If so, this is really sad, and seems like it would put patients more at risk because nurses would not seek care they need. 

That would be a HIPAA violation. A major law suit!!

Yeah suicide has a way of making everything suddenly becoming 20/20 for anyone that was close, like how didn't I see this or, in the aftermath of trying to piece it together, you discover so much about their lives you had no clue about. Then it makes you question, why didn't they feel like they could tell me this? I don't know, it's haunting.

I think we've come to expect a state of hypomania as a norm. The black and white thinking, hysterics, lack of manners, the fake perfection. It's OK to feel like things are not cool and that somehow labels you as depressed, which leads people to 'worry' about you, which makes you feel even more weird and like there is something wrong with you.

I don't really know what the answer it because I haven't really found it. Having legitimate fun really helped me, even if it was temporary, not hobbies that everyone tells you youre supposed to enjoy and you fake enjoying because otherwise you aren't well-rounded. Counseling and therapy really didn't help either.

I think my depression cure would be to live close to that US national whitewater center in North Carolina and getting a Vespa to ride on rural back roads. Until then...

VivaLasViejas, ASN, RN

Specializes in LTC, assisted living, med-surg, psych. Has 20 years experience.

Another excellent resource for people who are thinking about suicide, or just want to talk to someone, is the Crisis Text Line. They have trained volunteer crisis counselors who can be reached by texting START to 741-741. This is ideal for those of us who don’t like to talk on the phone. I’ve used their services a couple of times and they are wonderful.

I am a medically retired RN who left nursing in 2014 due mainly to mental health concerns. Since then I have not been suicidal or even more than a little depressed. However, both my psychiatrist and I are certain I would decompensate rapidly if I were to try going back, not that it’s an issue since my license is in Retired status. I’m on Social Security Disability and don’t see that changing anytime soon. I’m also 61 and have several underlying conditions that are not compatible with nursing either. I miss my career, and I’m glad I had it for as long as I did. But my life works only because it’s relatively low-stress.

herring_RN, ASN, BSN

Specializes in Critical care, tele, Medical-Surgical. Has 48 years experience.

24 minutes ago, VivaLasViejas said:

Another excellent resource for people who are thinking about suicide, or just want to talk to someone, is the Crisis Text Line. They have trained volunteer crisis counselors who can be reached by texting START to 741-741. This is ideal for those of us who don’t like to talk on the phone. I’ve used their services a couple of times and they are wonderful.

I am a medically retired RN who left nursing in 2014 due mainly to mental health concerns. Since then I have not been suicidal or even more than a little depressed. However, both my psychiatrist and I are certain I would decompensate rapidly if I were to try going back, not that it’s an issue since my license is in Retired status. I’m on Social Security Disability and don’t see that changing anytime soon. I’m also 61 and have several underlying conditions that are not compatible with nursing either. I miss my career, and I’m glad I had it for as long as I did. But my life works only because it’s relatively low-stress.

You were a fine caring nurse whether staff or management, acute or long term care. Now I know you help your fellow allnurses.com members. I believe you help many we here don't know about.

Thank you.

emtpbruse, ASN, EMT-P

Specializes in Paramedic.

DEPRESSION...BLAHAHA. Let's talk about depression. You work yourself to death just so you can go to college to better yourself and your education. You forfeit commitments to family, vacations and reduce your work schedule just to study, do clinical's and meet deadlines. You eventually graduate from a nursing program after thousands of dollars in debt and then find yourself struggling to pass the NCLEX exam...which costs another $200 for each attempt followed by additional application fees to your individual state's BON. Oh, and the criminal Hx check each time you need to re-register also. I have failed the NCLEX 2-times and my level of depression is beyond what ANYONE can fathom. I've actually come to hate my decision to become a nurse. Trying to get into the club of nursing is like a "HAZING" an UNORTHODOX HAZING and I'm sick and tired of jumping through hoops. I work as a Paramedic and I can do more than a nurse can do...yet, by failing the NCLEX somebody wants to stand up and shout its all about "safety...safety...safety...". Do you want me to start a laundry list of RN's I've seen in practice who have demonstrated HORRIBLE safety and even based on negligence have KILLED someone???? DO YOU? I can provide a list! I'm in and out of these nursing home daily, I could write a book if you want? So DON'T preach to me about SAFETY and NCLEX style questions of SATA. It's time the NCSBN is sued in a class action lawsuit to stop the madness!

Edited by emtpbruse

On 8/9/2020 at 1:12 PM, emtpbruse said:

DEPRESSION...BLAHAHA. Let's talk about depression. You work yourself to death just so you can go to college to better yourself and your education. You forfeit commitments to family, vacations and reduce your work schedule just to study, do clinical's and meet deadlines. You eventually graduate from a nursing program after thousands of dollars in debt and then find yourself struggling to pass the NCLEX exam...which costs another $200 for each attempt followed by additional application fees to your individual state's BON. Oh, and the criminal Hx check each time you need to re-register also. I have failed the NCLEX 2-times and my level of depression is beyond what ANYONE can fathom. I've actually come to hate my decision to become a nurse. Trying to get into the club of nursing is like a "HAZING" an UNORTHODOX HAZING and I'm sick and tired of jumping through hoops. I work as a Paramedic and I can do more than a nurse can do...yet, by failing the NCLEX somebody wants to stand up and shout its all about "safety...safety...safety...". Do you want me to start a laundry list of RN's I've seen in practice who have demonstrated HORRIBLE safety and even based on negligence have KILLED someone???? DO YOU? I can provide a list! I'm in and out of these nursing home daily, I could write a book if you want? So DON'T preach to me about SAFETY and NCLEX style questions of SATA. It's time the NCSBN is sued in a class action lawsuit to stop the madness!

Have you sought help? I'm not trying to be facetious, I really think you would benefit from talking to someone about your depression. Maybe the depression and NCLEX issues have increased your anxiety as well.

On 8/7/2020 at 1:44 PM, pinkdoves said:

nursing is the whole reason im suicidal...I probably will have to leave the field

This is like the second or third thread you've said this. I don't think it's an afterthought at this point. If you keep repeating it then it must be addressed, sooner than later. Please contact a suicide hotline or seek counseling from a local agency. I'm honestly concerned for you.

Deb_Aston, MSN, RN

Specializes in Peds, PICU, Peds Onc, Nursing Leadership. Has 31 years experience.

@emtpbruse I am sorry that you feel this way and have had those experiences... I can see how it can make you feel bitter about Nursing. Sometimes the best thing you can do to help yourself move forward is to release the negativity and pain from the past and try to focus on what you can control moving forward... at least that has helped me. We have all had major disappointments in our lives in one way or another; we can only control our own actions and thoughts. I hope you find your peace.

Thank you for reading my post.

Deb

On 8/9/2020 at 1:12 PM, emtpbruse said:

DEPRESSION...BLAHAHA. Let's talk about depression. You work yourself to death just so you can go to college to better yourself and your education. You forfeit commitments to family, vacations and reduce your work schedule just to study, do clinical's and meet deadlines. You eventually graduate from a nursing program after thousands of dollars in debt and then find yourself struggling to pass the NCLEX exam...which costs another $200 for each attempt followed by additional application fees to your individual state's BON. Oh, and the criminal Hx check each time you need to re-register also. I have failed the NCLEX 2-times and my level of depression is beyond what ANYONE can fathom. I've actually come to hate my decision to become a nurse. Trying to get into the club of nursing is like a "HAZING" an UNORTHODOX HAZING and I'm sick and tired of jumping through hoops. I work as a Paramedic and I can do more than a nurse can do...yet, by failing the NCLEX somebody wants to stand up and shout its all about "safety...safety...safety...". Do you want me to start a laundry list of RN's I've seen in practice who have demonstrated HORRIBLE safety and even based on negligence have KILLED someone???? DO YOU? I can provide a list! I'm in and out of these nursing home daily, I could write a book if you want? So DON'T preach to me about SAFETY and NCLEX style questions of SATA. It's time the NCSBN is sued in a class action lawsuit to stop the madness!

Oh yeah it's frustrating trying to get into the nursing club, but you made it through school and THAT is a huge barrier.

I was actually thinking about going to school in California because they have a process where you can do challenge exams to get out of nursing classes, I guess it's a California BON mandate for schools to allow that option. Getting into a nursing program in California, whew, not going to happen for me LOL.

Anyways before finding out CA is impossible to get into, I wanted to see if actually going to a nursing program was necessary to pass the NCLEX or if I could just try to test out of as many theory classes as I could, graduate and then have the school give me approval to sit for the exam. So I just ordered one of those mometrix NCLEX-RN review books (a whole $25) and got a membership to Petersons.com to do the NCLEX sample questions. I'm almost positive no nursing program is actually needed to pass the NCLEX because apparently I'm more than passing. 3 weeks in my living room with no distractions, a $25 book and a $40 month subscription to a website and I too can be a nurse. Now if I could just find a program that would give me the green light to sit for the exam LOL 😫 Looks like 2 years of drudgery for me, which you've already done!

This is a learned exam. You're mistaking knowing what you're doing hands on vs. passing a theory exam. Not fair IMO, but with the emphasis on the 'BS'N now and hospital diploma RN programs disappearing, it's about passing the computerized exam. Take some time off work for a couple weeks and do a ton of sample questions. You know how expensive a "remediation" program is going to be if you fail for the 3rd time? On top of frustration!

Tweety, BSN, RN

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac. Has 28 years experience.

On 8/8/2020 at 3:20 PM, Trampledunderfoot said:

I heard someone say it is hard for nurses to get mental health help because it shows on their back ground checks and will cause them to not get hired. Anyone know if this is true? If so, this is really sad, and seems like it would put patients more at risk because nurses would not seek care they need.

Definitely not true.

Tweety, BSN, RN

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac. Has 28 years experience.

Great article. So sorry about your daughter.

Depression, alcoholism/drug abuse and suicide attempts run in my family and I sadly followed suit decades ago prior to becoming a nurse.

Nursing has since grounded me and provided me the stability to learn and grow as a person. I might be the odd duck that nursing doesn't make me anxious, depressed or suicidal. The stress does many things to me but not that because perhaps I've been there and done that already. Graduation from nursing school was a great accomplishment and one of the high points in my life.

I still find myself depressed and anxious at times and four years ago had to seek counseling to deal with some issues that popped up oddly when I was on leave from nursing for 12 weeks for a shoulder surgery. We think as nurses we're supposed to be the strong ones and be there for others and we don't take care of ourselves. I don't think I'll ever stop learning and growing and striving to find some peace.

Deb_Aston, MSN, RN

Specializes in Peds, PICU, Peds Onc, Nursing Leadership. Has 31 years experience.

Thank you @Tweety I appreciate your kind words and I definitely agree with you... self care is the only way we are physically and mentally able to do what we do to help others.

I have found that my career has been able to provide me with the unique perspective of minimizing my own "problems" compared with those of my patients... especially because I work with children who have been through so much and never give up.

Thank you for reading my post and I wish you well!

Deb

Unfortunately I’ve dealt with both depression and anxiety most of my life as well as being on the autism spectrum. The average neurotypical person doesn’t understand the struggles people like myself go through every day and usually can’t be bothered to.

Deb_Aston, MSN, RN

Specializes in Peds, PICU, Peds Onc, Nursing Leadership. Has 31 years experience.

I'm very sorry to hear that. Hope you stay well.

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