Wednesday, September 7, 2011

Migraine and Suicide: What Are You Doing for Prevention?

I have heard the phrase “suicide prevention” in the past, but never really stopped to consider what it meant.   Dr. Paul Brand, who wrote the book The Gift of Pain said,
You do not want to start weaving the parachute when you're about to (need it). You want to have been weaving the parachute morning, noon, and night, day in, day out. And then when you need it, it might actually hold you.
Suicide prevention is something that we must do every day as we all know too well the ups and downs that Chronic Migraine and chronic pain bring us. For me, prevention means having a routine in place that will support me over the course of time especially when things get tougher. Some prevention ideas discussed will be familiar as they were also mentioned as coping mechanisms as they are effective tools for both. However  we will be flushing them our as a prevention measure as opposed to just a rescue measure.

-In the post, What to Do When You're Close to the End of Your Rope, we discussed coping mechanisms. It might be a good idea to write down a list of coping mechanisms you find helpful so you can easily turn to it when things get tougher.

-Over the years, I have kept a ragged pocket notebook that I call my "Chronic Migraine/Pain Toolbox." Having a personalized booklet put together ahead of time is quite handy when I am having a close to the end of my rope moment. Inside its pages are the following:
  • inspirational quotes from books
  • encouraging things others have told me 
  • Bible verses 
  • lists of non-medication ideas to use when medication is not available (i.e. diaphragmatic breathing or taking a bath by candlelight) 
  • a letter to my husband on how to handle me when I'm freaking out from pain
  • a letter I wrote to myself.
    • This letter was from the self who had seen some improvement to the self who is scared and despairing because she is so ill. You can read the letter in my post,  Letters to Myself

-One of the coping skills we talked about was getting professional help. In my opinion, seeing a therapist on a regular basis, not just when you are in crisis, is a vital way to work through the emotional side of chronic Migraine and chronic pain. Sarah Gomez, PsyD from the Jefferson Headache Clinic in Philadelphia who contributed to the article A Third Space for Migraine Patients said:
The pain and isolation that migraines produce commonly rob migraine sufferers of the things they enjoy most.  This is tremendously taxing; managing both the symptoms that migraines bring with them, as well as what they take away is exhausting. In psychotherapy we spend a lot of time processing this complex experience, as well as exploring ways to counteract the clutches of the disease. 
I have been seeing a therapist since my Migraines/pain became chronic.  She has become part of my support system as I navigate the ups and downs of my chronic Migraines and chronic pain. Going to therapy has helped me work through self-worth issues that many chronically ill people face. I have discovered I am worthy and loved just as I am even if I do burden those around me and am not able to contribute to society in the way I wish. Chronic Migraine and chronic pain often affect every aspect of our lives and having someone to talk with about this is invaluable.  My therapist also makes makes home visits when I cannot drive to her office and I am aware there are therapists that do phone visits as well if that is what you need.

-Stay involved and active in the Migraine/Chronic Pain community.
  •  Finding out how you can be involved/become an advocate will help you to feel better knowing that you are doing something positive for the future of your disease or pain condition. If you have Migraine disease or other headache disorder, check out the Alliance for Headache Disorders Advocacy (AHDA) to see how you can get involved. Join the mailing list and participate in action alerts. The Migraine Research Foundation is another great place to get involved.
  •  Follow the current research, read articles or simply read blogs that summarize the research for you. If you are informed, you will feel empowered about your disease.
  • Reading blogs of those who struggle with similar chronic illnesses will help you to commiserate, collaborate and may lead to personal connections. Through my connections on forums, and blogs, I have found friends who I email and talk on the phone with regularly. They are like family to me and because they know me in the better times, I trust them to support me in the worse times.
- Dr. Bill Young a headache specialist of the Jefferson Headache Clinic wrote an article I highly recommend called A Third Space For Migraine Patients. His article was not scientifically based, and was great food for thought. He discussed how how chronic Migraine/pain can become all consuming and he suggests that it might be helpful for patients to diversify their interests. More specifically he suggests chronic Migraine patients find what he calls a "third space" or an activity/space outside of Migraine that one finds to be meaningful.  Dr. Young said,
Migraine disease is so consuming, and has such an impact on family and work relations, that finding this third-space sanctuary becomes an ever more critical inoculation against becoming overwhelmed. 
Photography is my third space sactuary. When I am composing a photograph, I am completely drawn in and all thoughts of how I am feeling drift away. There is a joy and enjoyment I cannot describe and I can feel my spirit take a refreshing breath. This seems to be the purpose of a third space. Dr. Young recommends to "keep trying until you find something meaningful." The Migraine patient he referred to in the article had a third space of singing once a week at synagogue even though it made her pain worse temporarily, it was beneficial for her emotionally in the long run. Perhaps your third space is poetry or writing letters or drawing or dancing or knitting or volunteering. Whatever it is, finding a third space seems to be a good way to help prevent becoming overwhelmed.

The following prevention ideas were put together by a community member. They are incredibly insightful. Items discussed include making a commitment to yourself when you are not hurting, providing yourself external ways to remind yourself why you chose to live and have hope,  making a covenant with a safe person, and normalizing your desperation.

"First, as one who desires to escape pain through “whatever means,” it is important to establish boundaries -  that you make an unerring commitment to yourself when you are not hurting.  I have found that in the midst of pain and loneliness, there is no room for clear thinking.  For this reason, I sat down and wrote a list of promises to myself when I was “in my right mind.”  When I am going through a difficult time and my thinking is driven by pain, I pull these promises out and read them to myself in order to remind myself of what is truly important to me.

Second, provide yourself with an external means of reminding yourself why you choose to live and have hope.  In my case, I personalized a number of Scriptures and laminated them so I could read them during difficult times. One of the ones I wrote was “My Romans 8: 37, 38”  “In all things I are more than a conqueror through Him who loves me.  For I am convinced that neither pain nor depression, loneliness or insecurity, self-doubt or condemnation, rejection or ridicule, people’s opinions, finances or personal productivity, the ability to be involved in the church or the community, anxiety or an inability to meet earthly standards can separate me from the love of God in Christ Jesus my Lord.”  However, for those for whom Scripture is not a source of hope, you may ask a good friend or close family member to write a letter to you outlining why you are important to them and what you contribute to the world around you for you to read when you need to.  (A note to those who are writing such a letter: your job is not to talk them out of suicide but to state for them the “truths” of who they are as you see them.”)

Third, make a covenant with a safe person.  I personally have several people who when I am going through a particularly difficult time, I text the word “pray” to them.  They don’t text me back asking me what is going on, they simply text back that they are praying for me and that they love me.  It keeps me grounded - connected to others - so that I don’t feel so isolated in my pain and desperation.

Fourth, normalize your desperation.  It is normal to feel desperate when you are in so much pain.  It is normal to want to do almost anything to get out of pain.  It is normal to fear what the future holds when today is so bleak.  BUT remind yourself that you have been in this place before and that you made it through it.  It wasn’t easy - it may have been the hardest thing you ever did, but you know that your pain isn’t a sign of weakness.  In fact, it is a sign of your strength.  Not many people can live day in and day out like you do and emerge victorious.  The victory isn’t in overcoming the pain, but in learning to live with it - to make it through the next flare-up - to continue on when many would give up.  I frequently say to myself “of course, I’m feeling desperate - who wouldn’t in this kind of pain or when they feel so alone.  This is a normal feeling, and I’ve made it through it in the past and I will again in the future."

Do you have any prevention ideas you'd like to share? Please post in the comment section!

If you, or someone you know, is in suicidal crisis or emotional distress please call the National Suicide Prevention Lifeline 1-800-273-TALK (8255).

Please check out today's personal story from a community member: When Living Seems Too Hard.


  1. one of my new things in the tool box is self hypnosis and listening to contemporary christian music, Aaron Shust, and Steven Curtis Chapman, it is very up lifting and a good way to calm down.

  2. my new thing is self hypnosis and listening to contemporary chritian music. The songs are very uplifting and I feel as if it really brings you closer to God. The self hypnosis is really easy to do. And sometimes make me feel better without medication.

  3. Im late to the party but... When things get really bad I remind myself that I have made a promise to my boyfriend and mother to not hurt myself. I am an introvert and feel empathy very strong, so at that moment I can focus on the fact that I could NEVER hurt them, and hurting myself would be hurting them. This wouldn't work for everyone but I have always but others feelings first and in this case it works for me