Mental Health Podcast Episode two

Intro to AFSP: Podcast Season 1 – Episode 2

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Mental Health Podcast Episode 2: Transcript Below

Hello everybody and welcome back to the Allison and Wonderland Mental Health podcast. 

 Allison: I have Dr. Doreen Marshall from the American Foundation for Suicide Prevention. I will let her introduce herself in her own words in just a moment, but I do want to remind everyone I am not a doctor. This is meant to explain issues about mental health and give people a place to.

Listen and talk about mental health. So none of it is meant as mental health advice that you should take over the advice of a doctor. If you’re in a state of crisis, please call 9 1 1 or go to your nearest emergency room. And the National Suicide Hotline recently changed its number to 9 88, and you can text or call that number at any time.

So that’s 9 88 so Dr. Doreen Marshall, why don’t you know, tell us a little bit about. 

Dr Doreen Marshall: Thanks [00:01:00] Allison, and thanks for having me on your podcast. Um, I’m Doreen Marshall. I am the Vice President of Mission Engagement at the American Foundation for Suicide Prevention. Um, if you haven’t heard of A.F.S.P., we are a large organization of chapters in all 50 states, and our mission quite simply is, um, to provide hope and to prevent suicide.

We engage people ba basically that can approach this issue from any standpoint. Um, you can be someone with your own lived experience. Um, you may have lost someone, you may be someone supporting another person or you just wanna get involved to help. So, uh, we also do advocacy, so we advocate a lot for mental health parody, um, you know, improved access to mental health services as well.

Allison Frye: Yeah, that’s, that’s wonderful. And I know that. Most people that end up on this journey do not end up on it in, um, a happy way. And anyone that’s ever [00:02:00] followed my blog or talked to me for five minutes knows that in 2007, I lost my brother Kevin as a result of mental illness and suicide. And then three years later, I lost my mother also as a result of mental illness and suicide.

And what people may not realize is that the American Foundation for Suicide Prevention is the very first place I found any answers. I immediately after the funeral was like, okay, I need to know what just happened and I’ve been connected to the organization now for, um, 15 years.

I’ve done a lot with walks in different states. I did the Talk Save Lives program a little bit before covid happened. So, um, even before I had this medium to talk about mental health, I’ve been talking about it a lot. But that being said, um, do you wanna explain like how you ended up working for the American Foundation for Suicide?

Prevent. Yeah, so I’ve 

Dr Doreen Marshall: been, um, on the staff team [00:03:00] of the organization since 2014, but I too have a longer history with A F S P, um, having connected with A F S P, um, shortly after losing someone in my life, the suicides. So, I am also a mental health professional. I should mention that, that, I have a PhD in counseling psychology.

um, the loss I experienced, I was actually in graduate school. It was in the mid nineties, and I was getting a master’s degree and I was surprised then how little I knew about suicide and, and why this happens. In addition to just the personal impact, which I know Alison, you know, personally as well, that, you know, there’s this need to understand like, why does this happen?

How does this happen? . I think in that process it kind of guided me toward, or, you know, not only organizations but also people. There’s a lot of people that are in my life right now because of the work I do and you know, I just think [00:04:00] it’s a journey for all of us. But I learned a lot more after he died than I knew about suicide before.


Allison Frye: Yeah, absolutely. I did not even realize that I grew up in a home with mental illness. I was an adult before I even knew that was what was going on when I was a kid. It’s, it’s interesting, um, but definitely wanting more knowledge and that’s really always been the way that I have, um, Kind of talked about this.

I know that I’ve done the “Out of the Darkness Walk” and I’ll share it. And I never really try to solicit donations because I’m really terrible at that. But I’m like, you don’t have to donate. Just go read my story. Because I’m just trying to reduce stigma. I’m just trying to raise awareness.

And so, I mean, obviously some people would donate, but I, I’m just terrible at that. So, I think that what’s really interesting is kind of the way people talk about suicide and even myself. So I’ve, you know, read all of the information. I’ve gone through the training for the Talk Save Lives, [00:05:00] program, and then yesterday I was a guest on someone else’s podcast and they were like, , well, what signs were there that you missed with your brother?

And I just kind of went blank. I was just like, uh, . And I’m like, I’ve been talking about this for 15 years. So I think that’s a really good place to start. What would you say are the things that people should really look out for, pay attention to? Yeah. 

Dr Doreen Marshall: Well, I, before I say that, I, I do wanna kind of maybe put in the caveat that I think most of what we understand.

about signs is looking back. So, you know, there’s a, a way of kind of understanding, uh, suicide called psychological autopsy. And what that means is they interview family and friends after someone has died to understand kind of what was happening with the person before they died. And so I say that because that, in addition to some other research, um, has really led us to understand kind of what we think of as warning signs.

But I certainly don’t share them. , [00:06:00] any thought that anyone who has lost someone should have seen something, right? Because absolutely more complex than that. And I think it, it can be hard looking, you know, looking at someone and putting it in the context because no one wants to believe they’re gonna lose someone in their 

Allison Frye: life to suicide.

I also found when I was doing that, and I didn’t call it psychological autopsy, I, I basically interrogated everyone in my life that had had any contact with my brother. , I realized that I had to stop because there was too much blame I was putting on other people and on myself for very tiny pieces of a really big puzzle.

And we would’ve had to all sat down and had this conversation to know what was going on. Um, so I, I, those what ifs, I’ll just, they’ll drive you crazy. But yeah, psychological autopsy, that’s, I guess that’s what I did. , yeah. 

Dr Doreen Marshall: Common. You know, I think lost survivors do generally have a need to [00:07:00] understand why did this happen?

Because for, for many people, they may not have had all of the information of what was going on with the person. In fact, I don’t think any of us have all of the information what goes on with any other person. You know, when we think about kind of warning signs, um, you know, some of what we look for, we tend to categorize them as, you know, in uh, three categories, talk behavior, and mood

and in talk what we we’re listening for is an indicator of hopelessness or an indicator. Sometimes people talk directly about suicide or wanting to end their life, but often it, it, it’s more kind of veiled where they may say, you know, what’s the point in going on? Or there’s no point in any of this.

There may be kind of a statement of hopelessness or not planning to kind of be a future. and I say that knowing that some people make those statements and also go about their daily lives. And so it can be really hard to reconcile those two things. But we’re generally listening for statements about hopelessness, [00:08:00] not wanting to be alive, um, wanting to end one’s life.

Um, the behaviors, we tend to look at for change in behaviors. So something that is different than what would be typical for someone. So it could be, um, they’re starting to isolate more or things they would normally be doing that would bring them enjoyment they stopped doing. Um, it could be that they’re making arrangements or giving things away.

They’re using substances. Um, they’re making arrangements or, or looking for information about suicide, making arrangements to plan out a suicide but, but generally things that are uncharacteristic for the person or feel different than what we would typically see. Um, and then the last category is mood. And so we’re really looking for a change in mood that indicates things are worsening for the person.

So we tend to think about sadness, but we also think about agitation, [00:09:00] anger, shame, these mood states that we know. have been connected to suicide. So, you know, we’re looking for just kind of a, a mood change that’s different than what we have typically seen from the person. Um, you know, a couple things I tend to listen a little bit more for too is if someone’s talking about going through the worst period in their life, you know, if, if things are feeling worse than they’ve ever felt for the person, you know, that helps me know that, you know, this is something, at least in their mind

feels, you know, bigger than anything they’ve experienced up to that point. And if somebody has attempted suicide in the past or has gone through a suicidal crisis in the past, it can be helpful to know that because it does tell you something about how they see suicide or how they think about suicide if, if they have tempted.

Allison Frye: Yeah, absolutely. And that’s, those are some of the pieces of information that I didn’t have. And I also listen for [00:10:00] those things and , I don’t know what other people’s comfort level would be. I just jump right in and I’m just like, Hey, I’m here. So when I hear things like that, I, just flat out ask them.

I’m like, , do you feel like you might Want to hurt yourself? Or that, you would not want to be here and just kind of see where they are at you know, and just bring up the conversation. And it’s led me to some really rewarding conversations, I think. And then I’ve also had some people get really irritated and with me and be like, Allison, not everything’s about suicide.

And I’m like, well, you gotta know where my brain goes. It’s just, it’s, it’s hard been hardwired in me for like half my life now. 

Dr Doreen Marshall: Well, and I think the other thing too is that, you know, we want to help people and, and kind of connect people to help early. The hardest time, I think to prevent a suicide is when someone’s in a crisis.

Right? Right. So, you know, the fact that you’re listening proactively, that you’re asking directly, which is what we encourage people to do, to ask directly, you know, are you having thoughts of suicide? Are you feeling [00:11:00] so overwhelmed that you’re thinking about ending your life? Those kinds of statements. Um, recognizing that, you know, many people have a hard time articulating it.

And so they need us to ask right then, and they may not just bring it up. Um, but then the other thing I think that’s really important to acknowledge is that, you know, there, there have been some studies that looked at the window for people who have survived a suicide attempt looking at the window between when they were having thoughts and, and then when they decided to act and when they, they actually took action.

So when they decided to act and when they took action. And what we know is that sometimes people have thoughts for a long time and never. . But when someone decides to take their life, the interval from them making that decision and taking action tends to be very short. Um, we’re talking inside 30 minutes and less if substances are involved.

So, you know, it’s really hard to prevent suicide in that window, right? You’re talking about really a short, [00:12:00] so what we wanna do is get ahead of that, right? We want to talk to people about their suicidal thoughts long before they get into that place where they’re thinking about acting on them. 

Allison Frye: Yeah, absolutely.

And, and you said that, you know, it’s, it’s more difficult during that crisis state, but it is still preventable in that state, correct? 

Dr Doreen Marshall: Yeah. I mean, we, we want people to know suicide can be prevented. You know, I think, you know, what gets challenging is that it requires, um, knowing when you know, you can know that someone’s at.

and not know when they’re actually planning to take their life or when they’re going to take action on that. So, you know, even the best, minds in the field, the people who’ve studied this issue would say there’s no predicting a suicide. Um, but we prevent as many as we can, recognizing that, that some are really difficult.

It may be impossible to prevent because we don’t have the information to prevent them. , 

Allison Frye: you talked about the change in [00:13:00] people and you know, the way that they talk and their mood, so, , it’s really always been difficult for me. You know, I, I raised boys, so when they became teenagers, I thought I was just, everything that happened, I thought it was like, oh my gosh.

They’re, they’re, they’ve got bipolar disorder, it’s hereditary, they’ve got it now. Um, so when, when kids are going through like that, that teenage change, there are a lot of mood changes and agitation and things like that. , is there any kind of a way for someone to really know what is completely out of the normal for someone that’s going through puberty and they’re just absolutely changing anyways?

Dr Doreen Marshall: Well, you know, I, I, completely understand where I have a teenager at home, so I I get that this is a time of their lives where things are changing rapidly for them. Yeah. It could be hard to know what, what is typical of them. Cause I, cause they’re, you know, they’re trying on lots of different things at this [00:14:00] stage in their life.

You know, I would say that, I think one of the things you said that feels really important is, you know, knowing your family history around mental health and. , um, knowing what vulnerabilities you might have as individuals, but also as a family around mental health. And the way I see it is it’s just like you would, um, around things like diabetes and heart disease, right?

That the more information you know about those kind of risk factors that exist, you know, the more you can kind of proactively take action. So, you know, if I, I were, the teen years are hard to navigate. I just said to someone yesterday, you couldn’t pay me all the money in the world to go back to a teenager.

It’s a hard time. Your body’s changing. Your mind is growing, you’re in different peer groups. It’s really hard. And so I think proactively taking steps to have these conversations, to letting them know that there’s nothing you can’t figure out together, um, that there’s help out there. That even in the moment if you don’t know [00:15:00] how to get the help, you’re gonna help them find.

proactively having those conversations, whether they ever tell you they’re thinking of suicide or not, um, can be really important because we know, given surveys of high school students, we know that you know of any classroom, you are gonna have a group of students who have thought about suicide and even some who may have attempted suicide in the preceding year.

So I think just proactively having those conversations and also proactively having conversations about mental health, about emotional expression. about those things that, you know, we don’t always get, um, all the tools we need going into adolescents. So really making that kind of a mission to make sure.

they know where there’s resources, um, how to express, how to ask for help. That’s a big one too. Um, and I will say one other thing really quick. We have a campaign we worked on with the JED Foundation called Seize the Awkward, S E I Z E. Mm-hmm. , uh, t H e awkward right. Uh, dot org. [00:16:00] And it really is targeted at having those conversations during the teen and um, early adulthood.

Allison Frye: Yeah, I know that my experience parenting is probably very different than other people’s because I talked about it a lot and I mean, I have other people in my family that were like, we’re not gonna say what happened to Uncle Kevin because of the myth that talking about it. implants that into their mind.

Um, I went the other direction. I was like, we talk about it all the time. Um, there, there were times where my kids were worried about their friends and I, , I intervened and, you know, talked to their parents or if I didn’t know their parents, I’d go talk to the resource officer. And, and we had some really great outcomes with that.

So we were obviously very open about mental health, but there were a lot of people that disagree. with the fact that I would talk about that worry that I was putting the thoughts into their head. But that’s, that’s [00:17:00] one of like the common myths about talking about suicide. Absolutely. Yeah.

Dr Doreen Marshall: In fact, I’d say it’s one of the biggest myths that as a society, we have to find a way to overcome. You know, many people believe, you can’t even say the word, let alone ask the question without putting the thought in someone’s head. And that’s not. . Now we do know that, you know, there are safe ways to talk about suicide, but certainly asking someone if they’re having thoughts of suicide and asking them like what that experience is like for them, that is not going to increase someone’s risk for suicide.

In fact, you know what I hear people say is that it actually those, the fact that someone is asking can be met with relief because it means someone sees their. Pain that, that they probably have had a hard time showing anyone. So, you know, I, I think if we can overcome that myth as a society and know it’s okay to ask, um, it’s important to ask and that it’s important to take any expression of, uh, suicidal [00:18:00] thoughts, seriously.

You know, the other prevailing myth I hear is people talk about, well, don’t people just do this for attention? And the reality is they do it because they’re in pain and they’re hurting, and that needs attention. So it’s important that we take it seriously when people, um, express that they’re feeling suicidal or having thoughts of suicide.

Allison Frye: Uh, I’ve always felt like people do try to get attention in different ways, but if that is the way someone’s trying to get attention that is still very serious because it, it’s dangerous when, their minds going to that place definitely means that we need to pay attention, give them the attention.

It’s not like, oh, well, they’re just trying to get attention. I hate when people say that about anything. . Allison, your hair is pink. You’re just trying to get attention. Um, 

Dr Doreen Marshall: but you know, it’s interesting. We did this, um, we did a Harris school. We partnered with some organizations to ask the public about perceptions about mental health and suicide prevention.

And one of the really interesting outcomes of that poll was [00:19:00] that, um, people saw mental health as equivalent to physical health. So we are a society that’s really starting to understand the importance of mental health. Um, and most people said they would do something to try and prevent suicide if they knew someone was suicidal.

But the interesting piece was that the, the, the respondent said, but we don’t always know what to do. Right? Like, we wanna help, but we don’t always know what to do, or we don’t feel like we have the tools to help. . And so that’s why organizations like A F S P and many others are really trying to equip people to have these conversations and like tell them it’s okay.

You can ask someone directly and give them the tools to do it because you know people wanna help but they don’t know how to bring this up. How do you talk about it? And I love what you said about, um, I, you know, I tell parents this quite a bit, that if you wanna know what’s going on with your child, ask them what’s going on with their friends

ask them if they’re worried about any of their friends. You’ll really get a window into what they’re experiencing. And that can be a lead in to also [00:20:00] asking them if they have ever struggled or had thoughts of suicide. 

Allison Frye: It is interesting , I talk about my losses so people know, and I’ve had a lot of people come to me and say, oh, I’m worried about this person, or I’m worried about.

Person and, and, and I’m in that same position where I’m like, uh, I, I don’t know. But so I, I have had instances where, you know, someone from California that knew me and called, and they were really worried about their sister, and I called the suicide lifeline with them and we figured out what, what she needed to do from the other side of the country with her, her sister that she was worried about.

And then when Covid took everyone remote, I’m not if everyone realizes this, but Psychology has all kinds of mental health providers listed and it talks about their different, um, specialties and you get a little bio about them. And so I, I sat there with someone, [00:21:00] you know, that I worked with remotely, also lived a few states over, and we sat and found a doctor that would see him right away.

And, it’s those things where it’s like, okay, I know you need help. The way I can help you is by trying to help you find help . It’s like that’s the the way to do it. I will help you find whatever help you need. Hopefully, and you 

Dr Doreen Marshall: know, if we think about this, you know, when someone is struggling, when they’re in the midst of a crisis, it’s hard for them to think clearly and put the steps together.

So something that might seem, you know, not very difficult for someone who’s not in that kind of, , it’s often what they need help with, right? They need somebody to be willing to find, help them find a provider. You know, you may think, well, can’t they just go online? Look themselves? Just putting kind of that, those steps together can feel really hard and arduous for somebody who’s in a suicidal crisis or in that level of emotional pain.

So it’s really important that we reach in, right? And we want them to reach out, but we also need to [00:22:00] reach in and like you said, we’re not gonna. . You know, if we’re not mental health trained, we’re certainly not gonna be their therapist or, but we can help connect them to someone who’s trained to help them.

Um, the same with the 9 8 8 number. You know, a lot of people don’t realize we now have a three digit number, uh, that you can call anywhere in the country and you can get a trained listener 

Allison Frye: and text, which is 

Dr Doreen Marshall: great. Right, right. And making sure people know that because that’s not, um, common information.

We’ve done a lot to get the word out, but I, I’m sure there’s lots of people who don’t realize that’s the. that’s available and free 

Allison Frye: for them. And it, and it really is helpful. It’s, it’s still run by the same organization, I believe, as the, the suicide hotline? Yeah. 

Dr Doreen Marshall: So, um, the infrastructure is still the same.

That it, it’s run through the same. In fact, I think if you dial the old number, it’s the, it’ll get forwarded. 

Allison Frye: Yeah. I remember the little logos with the green phone number and I feel like it’s the same organization. Yeah. . And so I have called them. find people to help with [00:23:00] resources. So I think that it’s important for people to know that like it’s not just for people that are in crisis, it’s for people trying to help people in crisis.

Dr Doreen Marshall: Absolutely. And it’s a network of crisis centers across the country where, you know, the investment now was to change the numbers so that it’s easier to remember. , um, but also, um, to help train and expand, uh, what I think of as the crisis workforce, so the people who are going to respond. So I think what we’re gonna see in the upcoming years is just these resources getting better and better and being more accessible.

Um, because what happens now is if you dial that number, it, it gets routed to the closest, um, crisis center based on area code. But if that crisis center is overloaded, then it go, goes to somewhere else. And so we’re really trying to build that infrastructure and make it even more robust. But it’s a working system.

It’s worked for a number of years now. We just want people to know there’s an easier number to 

Allison Frye: dial. [00:24:00] Yeah, absolutely. And it’s actually on the website now, but I’ll make sure it’s also on the bottom of the video and it’s at the end. But I do, I, I was very happy when I started seeing the post that it was changing to that number because I was like, oh, great, because I still had the little business card and my wallet that I was given years ago that had the, the hotline number on it.

And so now I’m like, Hey, I know what it is. I know the number . . 

Dr Doreen Marshall: Yeah. And what you said is absolutely right. You can call if you’re concerned about someone, you know, you can call to get information. So it’s a number for people who are trying to support someone too. Um, I’ve even made the call with someone. I said, Hey, let, let’s call together and you can do that.

So, um, yeah, if you’re not familiar with that, it’s now 9 88 and it’s a resource really for all. . Um, and you know, as you know, Allison, once you’ve had this experience and been public with it, you hear from other people who either know someone who’s struggling, who’ve lost someone, or are struggling [00:25:00] themselves.

Allison Frye: I think that people, people don’t hear a lot of people talking about suicide. 15 years ago really, they didn’t. And I’d be wearing a suicide prevention shirt and people would come up to me in the store and be like, I lost my uncle and I’ve never talked to anybody about it, and that made me become more vocal.

And then it’s, and over the years as I’ve learned more about my own mental health, I am probably the most open person about my mental health than any you’ve ever met because it, it does seem to lead conversations to where other people feel comfortable with being able to have someone to talk to that they can relate to, they feel

like their information’s safe with, because you know, I’ve been through a lot of it too. 

Dr Doreen Marshall: Yeah. Just you being vulnerable and sharing that, you know, people, I think it empowers people to say if she can share it, I can share. I can share my struggle too. 

Allison Frye: Yeah. And it’s.[00:26:00] Actually is. It’s very helpful to, to share and I understand why, like even when my brother first passed away, I didn’t know what to tell people.

I told the people at work, like I was like my boss knew, but I told her not to tell anybody else. And it was a few weeks before I was like, okay, this is what happened. And it was also, I, I probably. Research, um, earlier than most people do in this journey, um, of their grief. But it was then when I started to learn, you know, there are certain ways to talk about it and there are words you don’t wanna use and phrases you don’t wanna use and you don’t wanna romanticize things.

But it was after I, I learned those things because that’s just my nature that I then was comfortable saying what happened because. . I just didn’t, I didn’t even understand what happened. There was no way for me to put in words what had happened. So, um, but I think that’s really interesting too. So like [00:27:00] A F S P is there to reduce stigma, to, to study, to get information into schools and things like that.

But there are also resources for people like us that have experienced the loss of someone and. Feel very isolated in that. 

Dr Doreen Marshall: Yeah. We have programs that are geared toward suicidal loss survivors, including a program called Healing Conversations, which is what I think of as like a peer, I think of as a peer-to-peer program.

But the idea is that, um, someone who, um, is more newly briefed or really, um, has not reached, you know, ever reached out for support. They can be connected with someone. , who’s a trained volunteer, who’s also had a loss. And we do try to pair people with losses that have been similar. So if you lost a sibling, someone who also lost a sibling, um, and the goal really is not that this person [00:28:00] is, you know, going to provide therapy, but it’s really more to share resources, to be a beacon of hope.

Right? I remember very clearly after my loss, the first person that I had a conversation, that had also had a loss by suicide. And that conversa, I mean, I’ve, I’ve never forgotten it’s been 25 years. And so to be able to connect with somebody who you think really understands what you’re going through, um, or has experienced it and can share, you know, how they were navigating, how they still navigate their grief, I think that, and sharing resources is really a big goal of that program.

We also have a, uh, support group listing, a national support group listing on our. , 

Allison Frye: I’ll make sure that that also gets, um, linked as well. Um, yeah, I think that that’s really important. It real, the first time you meet someone that has gone through it and that’s willing to talk about it. you, it really is like this sigh of relief.

It’s, I mean, yes, I, I am a big believer in therapy, so I’m not saying, you know, it’s [00:29:00] better than therapy, but it’s a different type of conversation than it is when you’re talking to your therapist about what happened because you’re talking to someone that. . I mean, no one truly understands what any of us are feeling because all of our experiences are different.

Even the experience of the loss from my brother and the loss of my mom were very different from me. Um, but they understand somewhat of what you’re going through, and I think that it makes it easier to be able to talk and, , we’ve got to talk things out sometimes. . 

Dr Doreen Marshall: Yeah, I couldn’t agree more. And I do think there’s something about seeing somebody who’s a little further ahead on the journey, who’s had the experience, um, before you and you see them navigating life.

It kind of gives you hope that it’s possible. Um, I know it certainly did for 

Allison Frye: me. , absolutely. So we’ve talked a little bit about the resources, um, for someone who’s struggling, if you have someone that’s struggling and [00:30:00] you’re concerned, do you think that. Overreacting to be like, okay, we’re gonna go to the hospital or just kind of keep them on watch and be there for them.

Remove anything that may be dangerous to them and stay with them. . Now, obviously this is not medical advice, just, you know, I know that there are different ways, you know, if something happened tomorrow, there are people in my family that I don’t think would let me haul to the emergency room

Dr Doreen Marshall: Yeah, well, and you know, I think it’s, there’s no one, one size fits all here. Um, but what I would say is some general guiding principles stay connected to the person. You know, some people, many people think about suicide and never make a suicide attempt. So really, you know, I think this is a, a collaborative discussion.

It’s like, I wanna help you, here’s what I think might help. What do you think might help? Right. Um, you know, certainly we wanna make their environment safe [00:31:00] and that is limiting, um, access, uh, to means when we can. . We don’t always have that control for folks, but we certainly wanna make sure that we’re taking steps if they’re possible.

Um, you know, the other thing I would say in terms of when in doubt, this is what the 9 8 8 number is really for, um, if you don’t know, like, should I cart this person to a hospital? Um, you might call and they, some, uh, crisis centers have mobile crisis, they’ll send someone to you. So, you know, I. kind of thinking about like, okay, what would I first thinking in advance, like what would I do if someone in my life shared this with me?

What, what do I know of in terms of resources? But I think also the, the main thing is that you reassure the person that help is out there, that you’re gonna help them get it. And if you’re really, really worried, there’s nothing wrong with going to a hospital and getting a, another set of eyes is the way I think of it.

Right, right. Getting an assessment, somebody trained. Just like we would if someone was, you know, holding their [00:32:00] chest in pain. Right, right. Exactly. Um, well, you know, I, I, you look like you’re in pain, but I think, you know, you’ll be fine. So we’re not gonna take you to hospital. I mean, if in doubt, you know, if there’s nothing wrong with that and the 9 8 8 number is a good kind of step toward that because they may have, um, mobile crisis, they may share a resource with you, you can get an appointment for the person.

I guess in, you know, if there’s no other path and you’re worried the hospital is never a bad to just go get an assessment, um, right. But there are other steps you can take and certainly calling 9 8 8 will help guide that. Um, but the, the main thing I think is to, to be able to listen, right? When someone says, yes, I’ve had those thought, you know, I said, get curious about it.

Ask them about it. Um, tell them you’re there to listen, that you wanna. , um, reassure them that, you know, help is out there for them. I, I think you can do those things, whether or not you end up going to a [00:33:00] hospital or not. Those are important things to do. 

Allison Frye: Yeah, I think so too. I think that if they realize that you’re with them, then that hopelessness may, not feel quite as hopeless because there is someone there, there someone.

Cares that they’re gonna be there tomorrow or not. And I think that that’s really important too. , And I’m not saying that, that my brother didn’t know we cared about him. You know, , he was dealing with the severe state of depression as a result of his bipolar disorder. And that is, you know, those underlying illnesses that I did not even understand he had at the time.

, it’s difficult, but I, I don’t think he felt like no one loved him. So I’m, I don’t wanna make it sound like I’m saying that the message is, is that, you know, no one loves you, but I also want to make sure people realize that I would grieve for them if they were gone tomorrow. There are people that I’ve never met that, you [00:34:00] know, when you hear about celebrities and things like that, people, I, I didn’t even know who they were before you hear the news.

and then I am grieving and, and for them, but for their families and for things that people say afterwards that are just so hurtful, which, , I lost friends over it because, , I don’t think my brother or my mom were selfish. I think they were sick, they had mental illness, they were hurting.

And when you lose someone, or when you know someone who’s lost someone, the way you react is less about the person that’s gone and more about the person that’s grieving. So those comments about being selfish and things like that, every time I see those come up in the media, it just makes me hurt for those people’s families because , that’s not helping that, you know, these people didn’t do this to be selfish.

They didn’t do it to hurt you. You know? And I think that that’s, that’s really important in my mind. . [00:35:00] 

Dr Doreen Marshall: Yeah. I mean, I, I agree and I would add that, you know, the person struggling, you know, they, we hear people say they don’t wanna be a burden to other people. In fact, that’s one of the things, if someone says that, that’s a kind of indicator to ask about that.

But part of the reason they, I think they feel that is because the depression or what they’re feeling feels so burdensome to them. Right. And so they think if I share. . Um, the other, I’m gonna just burden other people with what already feels so burdensome to me. And I think that’s another thing we can do is re just reassure someone when they do share with us that we don’t think differently of them.

That we understand the health issue, um, and we want to see them feel better. So we wanna help them get some help. I mean, you know, just like we would for other physical issues. But I think you’re right in that, you know, as a society, , we need to really understand more of this as a health issue. We’re getting there.

I mean, it’s certainly better [00:36:00] now than when I had my lost five years ago, I’m 

Allison Frye: sure you would say. And even mine 15 years ago. Yeah, absolutely. 

Dr Doreen Marshall: So it’s nice to see that things are trending in a good direction and that people understand this as a health issue. They understand they have a role to play in helping prevent it.

But I think the other piece of supporting other lost survivors, by recognizing that this was a person who was. loved, who had family, who was connected to family? You know, I think sometimes people have an idea of who and dies by suicide or ends their life and they imagine somebody who’s isolated, who’s, they don’t imagine somebody who had family that loved them or who had friends that cared for them.

You know, they don’t imagine that we should realize that. Suicide happens to all kinds of people across the age groups, across racial demographics, um, whether you’re a rich, um, middle class or e economically challenged, like you what? It happens to all groups of people. And so, you know, it’s important that we recognize that there’s not [00:37:00] this one image and that someone we know that we interact with every day could be struggling.

Allison Frye: Absolutely. I know one of the most common things that the memorial for my brother and my mother, were that people, they, you know, they, their manic episodes with their bipolar disorder, they were the life of every of every party people were just sucked into them, like magnets. And so that was the thing that people remembered.

They didn’t see the dark moments that now that I look back on it, I’m like, oh wow. That’s what bipolar disorder’s like, um, , that was the side that everyone knew of both them. And I remember people just like Kevin was the greatest guy. He was so much fun to be around all of these things. So they, they were very surprised.

It’s not what, you know, as you described, like people picturing like the loner over there. Um, well, there may be people that are in that state, but then there’s, there also may be people that are the life of the party and[00:38:00] . You don’t see what happens when they’re not in the middle of the party anymore.

Dr Doreen Marshall: You know, I think, I think a lot of people felt that when Robin Williams died, for example, or Anthony Bourdain, or folks that, you know, from, from our image of them, you know, in the media and, you know, we saw someone that did not fit our, our typical picture of what it might be like for someone who’s struggling.

And I think, I like to think that you. seeing that and also seeing people you know, who are influencers in entertainment talk about their own struggle. And people realize like you can have somebody who, who can function in the world and still be in a lot of pain, that those two things are not mutually exclusive.

Um, and sometimes people hide their pain and they. , you know, they do seem like they’re okay in some moments and they’re not. Um, so it can be really confusing. I mean, I imagine Allison, part of, I know part of my own experience is like [00:39:00] reconciling what happened with the person I knew and trying to kind of make those things fit.

Because I do think it’s really, um, even when, you know, someone has been struggling with their mental health, it can be really, um, shocking. , but not surprising, right? Like just kind of trying to reconcile you understand on some level how this might have happened, but it also, there’s times when I think about it and it doesn’t really fit with the person I knew either.


Allison Frye: , I think that my biggest thing is that we’re very feisty family and so I, the one thing that gets me. How did you get to a moment where there was no more fight left in you because that, you know what I mean? And that’s the, the, the thing that I struggle with sometimes and I honestly, I worried about my own mental health.

Well, I was like, oh, my mom’s bipolar, or my brother’s bipolar, you know, when I was, um, first seeing a psychiatrist after Kevin died, they, um, they gave me mood stabilizers instead of [00:40:00] antidepressants because they needed. Make sure I wasn’t bipolar and I wasn’t gonna take something that would, you know, be dangerous for me.

 So, yeah, the, it’s that fight, like I never had those highs, so my lows were never as low as theirs. . So I think that’s why I can’t quite get to the point of where the fight’s not in you anymore.

And I’m not blaming them for that. I’m just saying that’s the part that, because I’ve never been in that state, that’s the part that I, I can’t completely wrap my head around. 

Dr Doreen Marshall: Yeah. You know, I, I can understand that for sure. I. . You know, this is part of, I think the journey we go on with grief is really trying to kind of somehow understand this, even though we know we’ll never have all the information that we needed or what was actually happening in that moment inside their minds, but it’s trying to put the pieces together enough.

So that we can say, I, I think I understand what happened and [00:41:00] here’s how I can go forward in grief. And I always tell people when they’re, you know, they’re grieving. It’s important you grieve the whole person. So not just the part of them that was great, but the part of them that, you know, bugged you constantly, or the part of them that you really were annoyed by like to grieve the whole person.

Because that’s what human relationships are. They’re messy, they’re the good, they’re the challenging. . And sometimes I think it’s hard for people to see the full picture of their loved one. Um, but it’s important that we don’t, you know, it’s okay to wish that it had been different or wished they had, um, reached out.

You know, sometimes I think people are, um, afraid to feel those things, but it, it can be really important to just acknowledge. Um, and I would say that the one feeling, I think some loss survivors do feel really guilty when they have. is relief. And it’s not that that you ever wish this as an outcome. It’s relief that the person is not suffering.

Um, particularly when there’s been a [00:42:00] long trajectory of mental health where you’ve seen the person really, really struggle. There can be this relief that they’re no longer in pain. And, um, that’s a complicated feeling for a lot of lost survivors because they think if they. , you know, I, I’m glad this person’s pain is over that somehow, um, they don’t feel devastated by the loss when they do.

And so I did wanna mention that. Cause I do think that’s the feeling that even sometimes as lost survivors, we stigmatize ourselves around feeling some of these things. 

Allison Frye: Yeah. And, and it is interesting how the grief journey can be so different and really thinking about those things. I know when I, my brother passed away, , all of the bad moments we had were not in my mind.

And when my mother passed away, all of the bad moments that we had were the things that made it easier for me to go through the process and not make my siblings have to deal with organ donation and life support and cremation and the memorial. [00:43:00] And it was a couple of years after she passed away that the good times started coming up into my mind.

So I thought that. , I had just become a much stronger person after Kevin died because I, I completely broke into a million pieces. And then I did all of this work and I went to school for psychology. I, I wanted to learn as much as I could, and so what I thought when my mom passed away was that I’m stronger and that’s why I’m not falling apart.

And really it took me some time to get the distance. to see what issues we had were related to her mental illness. And then also remember the happy times. And I grieved really hard two years after she passed away. So I mean, , it’s interesting that you said that because I, I experienced it both ways.

Um, with only seeing the good in one and then with only seeing the bad in the other, and then it gradually changing. . 

Dr Doreen Marshall: Yeah. I mean [00:44:00] that’s probably maybe the biggest takeaway away, right? That no two people grieve the same, but no person grieves the same wa you know, you grieve Yeah. Differently, right? And you experience different losses and you know, I think the other piece is that grief has no timetable.

So you know, you, you know, you feel it when you’re ready to feel it and when it’s, you know, it’s your next task, right? Is so sometimes people, I think what you did is exactly right. They can. Kind of grieve certain pieces, right? Or grieve certain aspects of the person. And it takes some time for the good memories to come back, for example, or for the more challenging things to come back.

And so, . I just always encourage people, you know, to take your time. It’s okay. There’s no timetable for grief. 

Allison Frye: Yeah, I think that’s really important. And I think that people are like, well, there’s five stages of grief. When are you gonna be done with them? And I’m like, ah, . Because the thing is, is that I could have a very happy, wonderful moment and in that moment, [00:45:00] grieve the fact that my brother’s not there to share.

So there, there’s not like stages and then you’re done. And I think that that’s like, even in those super great moments where I’m like, Hey, I moved to this beautiful farm. I can’t imagine what my mom would think of this farm in the mountains of Kentucky. You know? So it’s, it’s one of those things that, you know, you definitely, and I’m not saying you don’t get better, those really terrible moments you do, you, you learn to have a new kind of, Life, I’m a different person than I was 15 years ago.

Um, time does that usually, but the loss of my brother was a, had a very profound impact on me. And, um, I did grieve very, very heavily for him. But then I do have moments where I just, small moments of grief of, wow, I wish that, you know, my mom had seen my kids graduate high school and things like that. And I think.

it’s important for people to understand [00:46:00] that, you know, they’re allowed to grieve for as long as they need to, even if that’s their whole, you know, the rest of their life. And also for other people to realize that it’s okay for people to grieve past whatever stages that they’ve heard you have. , 

Dr Doreen Marshall: there’s, there’s a thing, I’m probably gonna get it wrong, but they talk about how.

Your life expands around the grief, right? Mm-hmm. , or like the grief. So you find ways to go on living, incorporating this as part of your, your life story and as part of, you know, the thing that, that have happened to you. Um, and so it’s not a task to get done, right? That right steps and I’m done. It’s more that, you know, your, you grew your life and your, your experiences kind of.

it be, this becomes part of that whole story of, of life experiences that we all have. And this is a tough one. Um, but it doesn’t mean that it, it you grieve at [00:47:00] the same intensity forever either. That’s the thing I tell people, right. Um, changes in intensity. It also changes. You may feel differently about things, you know, may be really angry now, but at some point you may not feel angry.

So, you know, just kind of recognizing it changes it. The intensity doesn’t stay the. , but also that, that the task, if there is one, is to really, um, make this part of the things you’ve experienced in your life and to kind of, um, go forward in that way versus something you have to finish. Yeah, 

Allison Frye: , I mean, all of it’s really great.

It’s, it’s, it’s great to talk to someone. is like such an expert in this area and all and knows about all of the research that’s going on. I feel like I can only keep up with so like, so many pieces and then I’m like, oh, there’s this other thing. And it’s, it’s very exciting to know that things are progressing so much.

And I know that social media and podcast and this constant connection [00:48:00] has negative effects on us as a society. . I do think that it’s given a lot of us more of a voice about these issues. So, you know, I, I can definitely see bad things that have come out of way too much social media exposure, but I do think that it’s, this connection that everyone has has helped us to get to the point where people realize that mental illness

is physical illness, , , if you treat diabetes, you also treat, bipolar disorder. And I think that it’s really good that we’ve gotten to that point. With all of it. Is there anything else for the listeners or for me that you think would be really helpful to take away from this, you know, that we didn’t cover?

Dr Doreen Marshall: I think we covered so much. I, you know, I certainly wanna, uh, give a plug for A F S P if you don’t know af. , please check us out. We have chapters in all 50 states and um, our website is [00:49:00] There’s lots of good information both on suicide prevention, but also suicide loss. Um, and I think the last thing I would just say, maybe just in closing here, is that you know, you, you will have someone listen who might be struggling right now.

And you know what I would tell that person is that your life matters. , there’s help out there and there’s hope out there. And even if you can’t see it right now, there are people who can help guide you to it. Um, and resources like the 9 88 number and trained professionals, um, you know, the, this is how you start on that journey of, of healing, of getting support, um, because I think it, you.

I wouldn’t want anyone who’s struggling right now to hear two law survivors talking and feel shame about what they’re experiencing. So I just wanted to say that, that we see you, we see you’re struggle, and that your life matters. Um, and the help is out [00:50:00] there. And taking the first step, calling 9 88, reaching out to a mental health professional.

the most important thing you can do, just like a physical health issue. We want you to reach out for that kind of, uh, professional 

Allison Frye: support. Absolutely. And in the organizations I love tab on the Allison and website. There is a big logo for, um, I will also link it, for this episode.

And also, um, the out of the darkness walks if in, if no one knows about those in the areas, there is a, an annual walk where you can get together. I have a , minor heart condition, so I don’t walk. I just go and hang out or go. handout shirts, . So I, I always think it’s important to tell people, Hey, you don’t have to do a 5k.

You can just go and be a part of it and, you know, go look at the survivor’s wall and, you know, talk to other people that you know, maybe you don’t feel like [00:51:00] you have anyone in your life that you can talk to, but everyone there. is going to have a story of someone that they’re supporting or someone that they’re grieving or their, their own personal struggles, um, with suicidal ideation.

So I think that I’ll, I’ll also link that one in here because that’s, I think it is been a really great resource. I have felt, especially as I’ve moved from state to state. Then I find this new network of people in each. . Now Kentucky needs to get better because they’ve only got one in Louisville. It’s really far.

Dr Doreen Marshall: glad you brought up the walks because it is a community of support and just kind of showing up to one of those events, you, you recognize that you’re not alone. 

Allison Frye: Right? Absolutely. Well, thank you so much for, for being on. Um, I know that there are a lot of other areas that I would like to talk about in more detail on future episodes.

, I did wanna get this episode just to kind of talk about suicide in general out, and I [00:52:00] really appreciate you, , taking the time to hop on this brand new podcast, , , and chat with me.

Thanks for 

Dr Doreen Marshall: having me. You’re doing important work. 

Allison Frye: Well, thank you so much