Suicide touches all ages and incomes; all racial, ethnic, and religious groups; and in all parts of the country. It is a leading cause of death in the US.
As self-inflicted injuries increase so does the need to prepare for encountering someone who has attempted suicide. As a first-aid provider, you have a vital role in addressing immediate medical needs. You can also provide clarity and support to the victim and other people at the scene.
In 2017, guns were the most common method of death by suicide, accounting for a little more than half of all suicide deaths. The next most common methods were suffocation at 27.72 percent, and poisoning at 13.89 percent.
The following first-aid recommendations are for each of the most common methods of attempted suicide. Each case is unique, and it is essential to tailor your care and support to that person’s needs.
Above all ensure the safety of everyone present and address any serious medical needs first.
A self-inflicted gunshot wound (SIGW)—or any gunshot wound—to the head is correlated with severe disability and a high mortality rate. There is a greater chance of death caused by SIGWs compared to victims injured by gunshot wounds that are delivered in an assault or by accident.
Head trauma from a gunshot wound is fatal in about 90 percent of cases, with many victims dying prior to arriving at the hospital.
About 50 percent of the victims that survive the initial trauma die in the emergency department.
Head trauma from a gunshot wound is the cause of approximately 35 percent of deaths attributed to traumatic brain injury.
Although the head is the most commonly injured body region during a suicide attempt, the following is a general guideline for how to approach a gunshot wound on any area of the body.
Ensure your safety. Ensure the scene is safe and immediately call or have someone else call 9-1-1 or emergency medical services.
Locate the source of the bleeding. Attempt to open or remove the clothing over the wound so you can see it—this will allow you to see injuries that may have been covered or hidden.
Stop the bleeding. Pressure to stop the bleeding is the most critical intervention. If the victim has blood that is coming out of a hole, put steady pressure on it with both hands by pushing down as hard as you can.
Use a dressing (towels, shirts, gauze, etc.). Dressings will help seal the wound and aid in clotting.
Elevate the extremity. If the gunshot wound is above the waist do not elevate the legs to treat for shock (unless the injury is in the arm). Gunshot wounds to the chest and abdomen will bleed more rapidly if the legs are elevated, thus making it more difficult for the individual to breathe.
If you can, use a tourniquet.Tourniquets will only work on arm and leg injuries. Using them correctly takes practice, and they should only be used if the bleeding cannot be stopped when direct pressure and elevation are applied immediately and simultaneously or if there is a reason why direct pressure cannot be maintained.
Gunshot wounds to the chest may be sealed with a type of plastic to keep air from being sucked into the wound—this can help prevent a collapsed lung. Remove the seal if shortness of breath worsens after sealing the wound.
Chest compressions in a cardiac arrest caused by hemorrhagic shock from severe blood loss may worsen the situation.
First Aid for Hanging or Suffocation
Self-administered and assisted suicides by asphyxiation—the process of being deprived of oxygen resulting in unconsciousness or death—can be done by several methods. The use of a plastic bag, or suicide bag, is often in conjunction with a flow of an inert gas like nitrogen or helium.
Suicides using a plastic bag with helium were first recorded in the 90s. Since the 2000s, guides on how to use this method have spread on the internet, in print, and on video; and the frequency of suicides by this technique has increased.
Asphyxiation is also present in hanging and strangling. Both hanging and strangling can obstruct blood flow to and from the brain as well as block air flow to and from the lungs.
How to Recognize Suffocation
A constricting article is around the neck
Marks around the victim’s neck where a constriction was removed
Impaired consciousness or unconscious
Grey-blue skin (cyanosis)
Uneven breathing
Prominent veins and congestion of the face
Petechiae – tiny red spots on the face or the whites of the eyes
What to Do in the Case of Suffocation
Make sure the scene is safe, and immediately remove any constriction from around the victim’s neck; support the body if it is still hanging.
Call or have someone else call 9-1-1 or emergency services.
Lay the victim on the floor. In the case of spinal injury, don’t move the victim unnecessarily.
Check for breathing and pulse; If not breathing begin CPR.
If breathing, place in the recovery position and monitor until emergency responders arrive.
Don’t interfere with or destroy any material, such as a knotted rope, that police may need as evidence.
First Aid for Overdose or Poisoning
Poisoning is due to swallowing, inhaling, touching, or injecting various chemicals, drugs, gases, or venoms. Both suicide and unintentional drug overdoses kill adults at twice the rate today as they did two decades ago, and opioids are a key contributor to this rise. The following focuses on the use of drugs as a means of attempting suicide.
When a drug overdose is suspected, you may not know what drug the person was taking. Often, an overdose victim will either be unconscious or not fully conscious of their surroundings. Because of this, it is imperative to recognize the general signs of a drug overdose and what to do for first aid in the majority of situations.
How to Recognize an Overdose
Unusual sleepiness or unresponsiveness
Confusion, disorientation, or hallucination
Slow, shallow, irregular, or absent breathing
Bradycardia (slow heartbeat) or hypotension (low blood pressure)
Cold and clammy skin
Constricted pupils (small or pinpoint pupils)
Cyanotic (nails and lips are blue)
Mood changes, including aggression, agitation, anxiety, or depression
Abdominal pain or vomiting
Loss of coordination or motor control
Do’s for Drug Overdoses
Make sure the scene is safe, and check alertness. Comfort them if they are awake. If they are unconscious, turn them on their side to prevent aspiration (choking on their vomit).
Call 9-1-1 or emergency medical services. Call, or have someone else call, even if the person seems not to be experiencing overdose symptoms; never wait to see if the overdose will wear off. Some effects of an overdose don’t present themselves right away.
Check for breathing and pulse; If not breathing begin CPR.
Remove unnecessary clothing if the situation allows. Some drugs cause the patient to quickly overheat.
Find details to aid with treatment. Knowing what drug was taken, how much, when, and by what method is important. If the victim is not awake, look for containers, needles, syringes, and other items.
Don’ts for Drug Overdoses
Don’t put the person in the shower. Even if the victim seems okay, a large temperature change could put them in shock.
Don’t let the person sleep. Someone who overdosed may pass out, and you will not be able to stop them; however, trying to keep them awake makes it easier to monitor their condition.
Don’t attempt to make them throw up if they took the drugs orally. This can increase the chance of aspiration.
Don’t wait for the drug to wear off. Call for emergency medical services immediately.
Don’t try to feed the victim. Some foods can have adverse effects.
Don’t leave the victim alone. Stay with them, monitor their condition, and provide help as needed.
Don’t try to reason with or restrain a violent person or put yourself in an unsafe position.
First Aid for Known Opioid Overdose
Examples of opioids include morphine, codeine, oxycodone, oxycodone with acetaminophen, and hydrocodone with acetaminophen. Because opioids affect the part of the brain that controls breathing, too high of opioid levels in the blood can slow breathing down to dangerous levels, which could cause death.
For victims with a suspected or known opioid overdose who have a definite pulse but no normal breathing or only gasping (respiratory arrest) in addition to providing standard care, it is reasonable for trained rescuers—this includes first aid providers, non-healthcare providers, or BLS providers—to administer Narcan® (naloxone) intramuscularly or intranasally to victims with an opioid-associated respiratory emergency.
Victims with no definite pulse may be in cardiac arrest or they may have an undetected slow or weak pulse. These cases should be managed as a cardiac arrest victim.
Standard resuscitation should take priority over the administration of naloxone, with a focus on high-quality CPR. It may be reasonable to administer naloxone—especially when an opioid overdose is suspected—based on the possibility that the victim is in respiratory arrest, not cardiac.
Assess and activate. Check for unresponsiveness and call for nearby help. Send someone to call 9-1-1 and get AED and naloxone. Observe for breathing versus no breathing or only gasping.
Begin CPR. If the victim is unresponsive with no breathing or only gasping, begin CPR (CPR technique based on the rescuer’s level of training). If alone, perform CPR for about 2 minutes before leaving to phone 9-1-1 and get naloxone and an AED.
Administer naloxone. Give naloxone as soon as it is available. 2 mg intranasal or 0.4 mg intramuscular. May repeat after 4 minutes.
Does the person respond? If yes, stimulate and reassess. Continue to check responsiveness and breathing until advanced help arrives. If the person stops responding, begin CPR and repeat naloxone. If no response, continue CPR and use an AED as soon as it is available. Continue until the person responds or until advanced help arrives.
First Aid for Self-Harm or Self-Cutting
Because self-harm, also known as self-injury or self-cutting, involves physical injury, it can seem like self-harm and suicide are directly related. For example, it is common to think that cutting one’s wrist may be a suicidal gesture indicating that the person wishes to slit their wrists to die.
Self-injury can indicate a number of different things. Many people who practice self-injury may not intend to kill themselves and may even see self-harm as a way of avoiding suicide. It is crucial to note that with the pattern of self-injury occurring over weeks, months, or years, the person may be at risk for suicide.
Here’s what you should do if you a self-harm situation presents to you:
Make sure the scene is safe, and assess and activate. Assess the victim’s responsiveness. Call or have someone else call 9-1-1 or emergency services.
Locate and control the bleed. Arterial blood is bright red and spurts or sprays from the wound. If the blood is darker in color and easier to control, it means that the veins have been cut, and the artery was missed.
Apply direct, firm pressure. Apply a towel or dressing directly to the wound.
Elevate. Position the wounded limb in a position where it’s above the victim’s heart.
Occlude or pinch an artery above the injury. If possible apply pressure to an artery to halt the blood supply to that limb. If the bleeding does not stop after direct pressure, a tourniquet may be needed.
Assuming the bleeding has stopped, continue to assess the victim—circulation, airway, and breathing. Follow the Basic Life Support (BLS) Algorithm.
If You Know Someone in Crisis:
Call the toll-free National Suicide Prevention Lifeline (NSPL) at 1–800–273–TALK (8255), 24 hours a day, 7 days a week. The service is available to everyone. The deaf and hard of hearing can contact the Lifeline via TTY at 1–800–799–4889. All calls are confidential.
Washington State Crime Victim Service Center Hotline: 888.288.9221
Contact social media outlets directly if you are concerned about a friend’s social media updates or dial 911 in an emergency.
Learn more on the NSPL’s website. The Crisis Text Line is another resource available 24 hours a day, 7 days a week. Text “HOME” to 741741.
I have always considered myself a success story. A poster child for treatment and medication. And I’ve been able to achieve a lot in the past 20 years since diagnosis.
A friend who suffers from anxiety and depression told me, “I figured you had all of the same problems as me, only worse.”
No, not really. I don’t have a personality disorder. I never really had any serious issues with trauma until a year and a half ago.
One in 23 Americans experience bipolar at some point in their lives. Many bipolar people experience no symptoms at all with medication. They are able to go back to normal life. Most people with bipolar disorder are closeted, and that is because the stigma is so bad. We are always at risk for gaslighting. Many people will not willingly associate with us. Yet I have close friends, clients, and professional colleagues that knew me for years before I ever told them my diagnosis. They said they said they never would have guessed.
I happen to believe that stigma, even more than the disease, is why our death rate is so high. How high? About 15% over a lifetime. To put that in perspective, annualized over the first 50 years after diagnosis, the risk of suicide if you are bipolar is about one third as high as the risk of dying from COVID-19. They are comparable.
The bipolar death rate is probably quite a bit higher in actuality, as many suicides are not reported as such and because the disease strikes people most commonly in their teens and twenties. I am told that if you can make it past middle age, symptoms decrease, particularly for women. This has proved true for my mother, who is also bipolar.
For me a lot seems to do with having access to the right formulation of Lithium (brand name vs. generic). Switching to brand name Lithium (Lithane) worked wonders for me, probably because the quality control and dosage standards are much higher. The catch is that this formulation is at present only available in Canada. I am working with a Vancouver local to get my prescription picked up and shipped to the U.S.A. Wish me luck.
What is it like to have a manic episode? It’s hard to describe. A mild manic episode is disorienting and disabling — you can’t really work except for simple tasks like housework or cleaning. Inhibitions are lowered. You might do things you would do if you were drunk, like have a fling with someone or buy stuff you don’t need on Amazon.
A full-blown psychotic manic episode is very different. It’s more like a hallucinogenic drug trip — and we’re not talking microdoses. It puts you in a different reality. For example, I might wander outside my house and onto the bridge nearby, not really knowing what I am doing or where I am. I might get on a bus and just ride for half an hour.
There is a mystical component. You feel like you are at one with the universe. Music sounds amazing. Colors and tastes are more more intense. Some bipolar people enjoy the “high.” I have never sought it out. For that matter, I’ve never tried any drug stronger than pot. It’s not that I’m not curious. Just too risky with my brain chemistry.
For me, mania has always been highly correlated with insomnia and sleep disruption. Psychotic mania can be treated successfully at home, if you have the right drugs. The safest option is probably to go inpatient.
Not much happens in a mental hospital. There are no miracle drugs or aggressive treatments. You just take your Perphenazine and mill about in a safe place where you can’t do (much) damage to yourself or others, eat bad food, try to focus your concentration enough to play a card game or read a few pages out of a book, and wait until someone decides you’re well enough to go home.
To be honest, it feels a lot like… now.
Like the Coronavirus Lockdown.
The same boredom. The same impatience. For those who have never been through something like this before, the only advice I can give is to try to keep yourself occupied, and try to be courteous and respectful to the people around you. This too shall pass.
For more resources, articles, and advice on living with bipolar and being present for the bipolar people in your life, visit my Quora page or my coaching website.
Please note: I am not currently accepting new long-term clients.
In the time of COVID-19, we need access to quality therapists, coaches, and specialists now more than ever. PDX Local has assembled a guide of Portland area service providers for mental health and holistic/physical health offering consultations by video and phone. If you have additional practitioners you would like to suggest, please contact us.
Abri Radically Open DBT. Abri, based in Portland, Oregon, is one of the first psychotherapy clinics worldwide to specialize solely in Radically Open DBT for disorders of over-control. Both LiLin and Kirsten are on the RO DBT Senior Clinician team and are approved RO DBT trainers. They are enthusiastic practitioners of RO DBT, stay current with the research and have an active consultation team with other senior clinicians in the Northwest. Their mission is to provide excellent full-fidelity treatment in a lovely and inviting setting. (503) 386-1515
Connective Therapy Collective. Committed to intersectional, trauma-informed,
pleasure-centered clinical work in sex and gender. (971) 361-8303
The Counseling Umbrella. We are a mental health counseling private practice, committed to helping clients & our community engage around mental health issues. Masters in Professional Mental Health Counseling, Social Work. (503) 473-1600
Emerging Path Counseling, LLC. Mental Health counseling, general practice as well as specializing in trauma and anxiety. Stephanie Garneaux is a Licensed Professional Counselor, Certified Alcohol and Drug Counselor III, and a Certified Clinical Trauma Professional. She has worked in behavioral health for over 10 years, and as a Qualified Mental Health Professional since 2014. Stephanie has a Masters Degree in Community Mental Health Counseling. (971) 291-0579
Family Roots Therapy. Family Roots Therapy is a counseling practice in Portland, Oregon focused specifically on the unique mental health needs of new parents and young children. (503) 746-3373
Kirgin Consulting. I am a Jungian psychologist and business/leadership consultant. I am working virtually with individuals, couples, leaders at this time. Contact Online
Marchick Counseling and Consulting. My philosophy is that in every stage in life there is an opportunity for personal growth and acceptance of self. Together we will evaluate the options available to you, discuss how to navigate family dynamics, create appropriate plans and strategies, and learn about self-care. Exploring and establishing healthy habits can help one find balance and feel success. (503) 683-3179
MindTree. I am a licensed child and family therapist primarily working with children ( 4 plus) and women. Currently offer virtual sessions! (503) 766-4895
Rachael A Ringwood. Specializes in mood disorders such as depression, anxiety and bipolar conditions. (385) 203-7622
Root and Bloom Counseling. Specializing in Holistic, Inclusive Pregnancy and Postpartum Counseling, Including Depression, Anxiety, Traumatic Births, Grief, and Loss. (503) 905-9839
Sarah Hart, Psychotherapy. My approach is dynamic & collaborative. I work from a culturally-informed, inclusive model & incorporate all aspects of an individual’s identity/experiences into treatment. My specialties include anxiety, depression, identity, Autism & relationships. (503) 967-9767
Urban Counseling Collective. We are open to new telehealth intakes for anyone that is wanting to begin psychological services or anyone needing additional support during this time of social distancing. 503-610-2044
Coaches
Alignment and Alchemy. Hi, I’m Sarah, and I help women reconnect with their authentic selves and achieve greater health and happiness through movement, mindfulness, and mindset. Contact online
Apothic Energy. Working from a place of love and genuine desire for all to have well being, Apothic Energy utilizes old and new energy medicine techniques to bring people into a true sense of health. Contact online
Alyssa Rose Healing Arts. My focus and passion rests with end of life care and working with grief. I find Craniosacral Therapy and unwinding to be extremely beneficial for people at this stage of life, and love this work. I also practice massage (relaxation, wellness, MVA’s, myofascial, and deep tissue). (503) 345-0530
Beatriz Reyna. Inner child work/shadow work/journeys into your inner world.
Beloved Coaching. I am a Sex and Intimacy Coach who has completed Advanced Training in the Somatica® Method. My heart’s work is to help people explore, deshamify, and celebrate their unique sexual selves. (971) 238-8131
Coach Woida. Certified life coach specializing in mental health, building confidence and emotional intelligence. (802) 498-5062
The Courage Practice. The Courage Practice is offering FREE intuitive 1:1 coaching sessions via Zoom throughout April. Please share the love with someone you love. We are here for you and your community, friends. Contact online
Grief Warrior. I hope to soften the armor of grief by validating the pain and witnessing the emotion. Together, let’s make sure that the grieving know they are not alone. (800) 901-4617
Grounded Alignment. The Grounded Alignment work incorporates tools and practices from several disciplines, including guided breathing/visualization exercises, writing and daily practices. Contact online
Enhance Your Life. I work with heart-centered healers & women in business to create their ideal life. With over 30 years experience, Jan is a Transformational Coach, whose background includes: Tapping Into Wealth coach program, Naturopathic Physician (ret) instructor/speaker, hypnotherapist, and behavior therapy. (503) 593-3360
Inner Skye Counseling. Our inner world is multi-faceted, like the terrain of the Sky(e). I am honored and inspired to join you in navigating your inner landscapes. Now offering telehealth therapy sessions. (971) 361-8861
MCHealth Life Coach. I have a private Health & Life Coach practice where I specialize in transformational habit change, being an advocate for living healthy, and an accountability partner to keep you striving to reach your ultimate goals. Contact online
The Nature In You. Katrina Nilsson-Gorman, is a certified Nature and Forest Therapy Guide and Intuitive Healer. She holds certifications with The Association of Nature and Forest Therapy, the Tree of Totems Spiritual Wilderness School as an Ayu-Shamanic Practitioner, and a Bachelor of Arts from The University of Puget Sound in Music and English. (970) 556-4562
Nurture Life Coaching. Certified Life Coach & Licensed Massage Therapist, Focusing on Women and LGTBQ Individuals. Cultivating your inner clarity for positive change. (503) 473-4754
Rachel Li Coach. Rachel works with leaders to offer soulful solutions to the disquiet spoiling the workplace. If you are tired from too much screen staring and from having partially present dialogues come recharge with some deep healing. Contact online
Soul Talk Coaching. Phone support for LGBTQIA + Individuals, couples, and families, help with anxiety, depression, dating, relationships, family, career, financial worries, spiritual growth, and much more. Contact online
Stella Harris. I’m a certified intimacy educator and professional coach. In addition to my direct work with clients and students, I work with professionals such as therapists and educators in the hopes of putting myself out of a job. (503) 568-1275
The Vital Spirit. I am an empath, spiritual teacher, and intuitive healer living in Portland, Oregon. I created The Vital Spirit to be an instrument in the ongoing shift in human consciousness. I serve empaths and lightworkers through intuitive energy alignment and strategic business consulting. I align my clients with their true nature and their spirit-led businesses. (503) 784-3119
Sophia Treyger. Sophia is a Relationship & Intimacy Coach, and owner of Radical Pleasurist, teaching the global community how to have meaningful and deeply connected relationships through embodiment, courageous communication, and the creation of genuine agreements without needing to be a people-pleaser. Radical Pleasurist shifts people from pleaser to pleasure. Contact Online
Other Providers
Arbor Vitae. Massage & Somatic Therapies for every body, mind and spirit. Tap into the root of health at ARBOR VITAE. (503) 367-7659
Aurora Remember. My mission is to help Highly Excitable people use their fire without getting burned by connecting with their powers, balance their energy and feel a sense of accomplishment in their life. Contact Online
The Brain Breakthrough. Unlocking Your Brain’s Potential! Breakthrough anxiety, trauma, reading struggles, and concussions! (971) 231-5214
The Bodhi Tree. Dr. Sage Dillon The Bodhi Tree offering exercise, rehab, nutritional counseling, exams for new or old musculoskeletal injuries and referrals to imaging. I am also able to answer questions if somenone is unclear if they need to go to ED. Insurance is accepted for telehealth if you are in OR. (503) 331-1800
Dovetail College Counseling. Amy Romm Lockard is a dedicated college admissions expert and founder of Dovetail College Consulting. M.S.Ed. (609) 706-6492
Flying Squirrel Consulting Partners, LLC. I am offering discounted virtual business coaching: survival and recovery strategy. Flying Squirrel provides flexible support services for motivated business owners who are seeking mentoring, coaching, & experienced perspective. (503) 926-3601
Ikigai Wellness. Walking along in your journey of life, you’ve come across physical trauma, difficulties and stressors that have affected you in many ways. Your health is the foundation you walk on, a wholistic environment comprised of your physical, mental-emotional and spiritual well-being. My purpose is to assist you with reducing your pain naturally, finding your balance and returning to the activities you love. (503) 308-8676
Kirin Bhatti. Earth-Based Healing+Strategy Guided By The Rhythms Of The Seasons And Our Bodies. For The Change-Makers, Leaders And Healers Who Are Hungry To Resurrect Ancient Blueprints On How To Lead And Live Naturally. Email
New // Narratives. Robin Carlisle is a Multidisciplinary Healing Arts Practitioner, working with a wide range of therapeutic modalities from Cognitive Behavioral Therapy to Mindfulness, as well as variety of Somatic practices. (503) 457-2749
Tara Jade Nichols. Star Alchemy ~ a seemingly magical process of turning one’s life into gold. Astrology readings allow for discovery of your Soul’s contract, blessings, and challenges. This insight can lead to significant personal growth. Contact online
Disclaimer: This article is not intended to give health or fitness advice. Exercise at your own risk. Consult your doctor or another health professional if you are unsure whether a service or form of therapy is safe for you to use. All opinions expressed are those solely of the PDX Local blog, and do not represent its sponsors, affiliates, or guest contributors. No paid advertising or paid endorsements have been provided for the products featured above. The reviewer makes no claims regarding the efficacy, workmanship, utility, or safety of any of the products listed above.
We’ve put together a list of helpful national and local Portland, OR and Seattle, WA resources for mental health and suicide prevention, updated for COVID-19. Please let us know if any of these links are broken, or if you have new ones to suggest. Thank you, and be well.
Helplines
https://suicidepreventionlifeline.org The National Suicide Prevention Lifeline at 1-800-273-8255 provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals. Telephone and online chat available.
https://oregonyouthline.org For teens, they can call, text, chat and during certain hours can talk to peer support.
https://www.nami.orgNAMI, the National Alliance on Mental Illness, is the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness. Oregon NAMI Chapter:https://namior.org/
http://gettrainedtohelp.com – Suicide First Aid. Free trainings in suicide prevention for the general public, youth workers, and more. Includes the ASIST curriculum. Trainings temporarily suspended.
https://www.mentalhealthfirstaid.org – Nationwide organization providing training to help someone who is developing a mental health problem or experiencing a crisis.
https://bipolarlifecoach.com – A Portland-based practice offering one-on-one coaching to individuals with mood disorders, and their family and loved ones. Sliding scale spots available.
http://www.juliefast.com/ – A Portland-based site offering books and resources to individuals living with bipolar. The author also offers coaching services.
I’ve put together a list of helpful national and local Portland, OR and Seattle, WA resources for mental health and suicide prevention. This list reflects that there is no one-size fits all solution — text or online chat may be a better option for somebody who doesn’t have privacy to talk, and with “warmlines,” people may wish to seek help even if their life is not imminently in danger. Please let me know if any of these links are broken, or if you have new ones to suggest. Thank you, and be well.
Founding Members of the St. John’s Suicide Prevention Team: Elizabeth Gadwa, Laura Bee, and Kristen Gray
Helplines
https://suicidepreventionlifeline.org The National Suicide Prevention Lifeline at 1-800-273-8255 provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals. Telephone and online chat available.
https://oregonyouthline.org For teens, they can call, text, chat and during certain hours can talk to peer support.
https://www.nami.orgNAMI, the National Alliance on Mental Illness, is the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness. Oregon NAMI Chapter:https://namior.org/
http://gettrainedtohelp.com – Suicide First Aid. Free trainings in suicide prevention for the general public, youth workers, and more. Includes the ASIST curriculum.
https://www.mentalhealthfirstaid.org – Nationwide organization providing training to help someone who is developing a mental health problem or experiencing a crisis.
https://bipolarlifecoach.com – A Portland-based practice offering one-on-one coaching to individuals with mood disorders, and their family and loved ones. Sliding scale spots available.
http://www.juliefast.com/ – A Portland-based site offering books and resources to individuals living with bipolar. The author also offers coaching services.
The PDX Local Wellness Gift Guide celebrates independent, local, and woman-owned businesses while making it really, really easy to beat traffic and do your shopping online. But what exactly qualifies as a “wellness gift?”
Well…
That’s a tricky concept. Maybe you’re thinking it’s anything that doesn’t involve mindless consumption, booze, strippers, or chocolate. Except… we have beer yoga. And pole dancing workout classes. And chocolate, like that made locally right here in Portland by Moonstruck, has been shown to reduce heart disease and promote emotional well-being.
For me, wellness means taking care of yourself—and giving others the tools and resources to do the same. I put this list together by asking friends, allies, and colleagues on social media, as well as going with a few old favorites and items from my personal “wish list.” I hope it inspires you to think past the obvious and create wonderful experiences and memories for the year to come.
Here’s to a healthy and productive 2020. Have fun! Shop local.
Stand and Deliver
Maybe someone on your list works from home, but their office is a cubbyhole in the corner of the kitchen? Support their goals and dreams with a healthy, ergonomic home office.
Swopper Air Motion Chair With Wheels – by Aeris. There are plenty of adjustable ergonomic chairs out there that can be configured to work with standing desks. I’ll be honest. The Swopper is here because it looks the coolest.
Anker Wireless Vertical Ergonomic Mouse I have one of these, and in all honesty it is probably the reason I am still able to type and write today. For those who struggle with repetitive stress injuries (and for those who wish to prevent them!) this inexpensive and elegant wireless mouse is a game changer.
Olander Earthworks makes quirky desktop zen gardens that many therapists and wellness advocates use as a fun anxiety relief tool. So many ways to customize. Portland, Oregon Local Business.
Fitness
Seriously. Who doesn’t need a little Lululemon and prAna in their life? But did you know that we have fabulous, fashionable brands of active wear being produced right here in Portland? Check out SXY Athletics. This local, woman-owned line of fitness clothing will keep you motivated to go to the gym. Check out their #BlackFriday Sale. SXY Athletics is aPortland, Oregon Local Business.
Go “Ruck Yourself.” Seriously! Rucking (walking with a weighted backpack) is one of the easiest and safest ways to lose weight over time. If you don’t have a sturdy backpack, you can pick up the weighted kind at goruck.com. For the 80% to 90% who have our own (or our kid’s) Jansport sitting in a closet somewhere, adding weight to a day pack is a great way to try out rucking. I recommend custom rucking weightsover hand weights because they are less likely to shift and potentially damage the pack.
Comfort and Joy
You know how we always say “practice self care?” Well, sometimes that’s easier to do when somebody else helps out with the little things. The people on your list will know they are cared for with these thoughtful and practical gift ideas.
Full Belly Fare – Do you have a loved one who’s had a new baby, surgery, or other stressor? Although you may not be able to deliver a meal yourself, Full Belly Fare is the perfect gift solution for family and friends who want to provide meaningful support to someone experiencing a life transition or challenge! Personal chef Lyla prepares hand-crafted meals, including vegan gluten free, dairy free, vegetarian, soy free, and paleo meal options. Use discount code PDXLocal15for $15 off all first orders (new customers). Portland, Oregon Local Business
Cassarole – Handmade and vintage items. Only shop features tinctures, body butter, and this extraordinary geode soap. Portland, Oregon Local Business
Seagrape bath + body is a queer owned natural brand with a focus on artisan crafted goods for self-care. Portland, Oregon Local Business
Mama Tea-a Inspirational hand-blended organic herbal teas. Portland, Oregon Local Business.
Cherryriver.net. CBD products for Bath, Beauty, and Wellness. They offer gift sets, along with a line of topicals, a sports line, bath bombs, and have just released a high potency tincture. Portland, Oregon Local Business
Back to Broth. Organic, local, pasture-raised medicinal bone broth. Portland, Oregon Local Business
Briar Patch Herbs. Culinary and medicinal herbs. Receive compassionate guidance from an experienced Herbalist. Portland, Oregon Local Business
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Molly Muriel. The best lip balm I have ever found. Even better, it’s vegan! Read our interview with founder and apothecary Branda Tiffany here. Portland, Oregon Local Business
Optimistic Soap. Optimistic Soap makes unique, handcrafted soap with all-natural ingredients! 20% of all profits are donated to charity. Portland, Oregon Local Business
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Whole Tree CBD. Hand-crafted hemp CBD products that aid in healing of the mind and body. Portland, Oregon Local Business
Yo Soy Candles Handcrafted eco-conscious candles. Each beautiful scent is paired with its very own “I AM” statement to inspire a positive mindset + empower transformation by practicing the self loving ritual of I AM. Portland, Oregon Local Business
Gift Certificates
So many people will tell you that they don’t need more “stuff” in their life. So what is the perfect gift? Consider health and wellness services from a local practitioner. From massage to coaching to astrology, a gift certificate gives someone the opportunity to explore a path that they might never have discovered otherwise.
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The Bodhi Tree Clinic. Gift Certificates for Massage and Chiropractic. Portland, Oregon Local Business
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Jenee Woodlief. Massage gift certificates. Located in NE Portland. Portland, Oregon Local Business
Love Your Skin Day Spa. Lacey offers organic facials, massage, organic airbrush tans, facial waxing, Microderm, LED and oxygen treatments. Portland, Oregon Local Business
Marchick Counseling. If you’re a GenXer like me, eldercare is already on your mind, and probably on the minds of other family members as well. Daniella is a licensed therapist and consultant who makes it a little less scary to address this daunting topic. She specializes in caregiving and aging concerns, and offers give gift certificates to interested individuals who want to consult about caregiving. Portland, Oregon Local Business
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Pathfinder Wellness Clinic Black Friday offers through Monday 12/2. They have holiday gift certificates available for these packages and for gift packages of any size. Portland, Oregon Local Business
Pink Moon PDX. Facials, lashes & waxing & dermalogica products. Portland, Oregon Local Business
PDX Local Coaching. Yes, I offer gift certificates! My coaching practice focuses on entrepreneurial coaching and wellness coaching for individual with depressive and bipolar disorders. Contact me to find out more. Portland, Oregon Local Business
Portland Cuddle Shop. Connection and Cuddle Therapy. Gift a Connection Session to someone this winter. Hold or be held, think out loud, take a nap, play a game, color, cry, laugh, reminisce. Relax in a judgement free zone with you-centered attention. Portland, Oregon Local Business
Beatriz Reyna. Inner child work/shadow work/journeys into your inner world.
From Beatriz: “YOU WILL BE SEEN. YOU WILL BE HEARD. YOU WILL BE UNDERSTOOD. YOU WILL BE FELT INTO AND EXPERIENCE ATTUNEMENT. YOU WILL EXPERIENCE THE LOVE AND PRESENCE YOU’VE ALWAYS WANTED.YOU WILL HAVE MAJOR SHIFTS.”
Portland, Oregon Local Business
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Royal Treatment Skin. As a dual licensed Acupuncturist and Aesthetician, Melissa offers a ton of awesome services to help you look and feel your best. Portland, Oregon Local Business
Sabrina Wright. Massage therapist with gift certificates and massage packages available. Portland, Oregon Local Business
SkinSense Spa. Debbie offers holistic facials using Naturopathica and ISUN skin care lines that is organic, vegan and gluten free and wildcraft. Holistic facials for tweens, teens and adults specifically with acne, also pregnant mamas and clients recovering from skin cancer. She also offers Intraceuticals Oxygen facials to target aging and preventing fine lines and wrinkles and Cryoskin treatments to slim and tone for facials. Black Friday Special: use promo code BF20%
Sofia Angelina Photography. Sofia offers healing portrait sessions, in which she combines energy healing and portrait photography for folks who are looking to celebrate themselves and embrace their bodies with empathy. Portland, Oregon Local Business
Whole Being Massage. We have massage gift certificates and also sell some very nice aromatherapy oils and self-care tools that make great gifts! We can do couples/friend massages, prenatal, new mama massages, and more We are in inner SE PDX. Portland, Oregon Local Business
Therapia Wellness Clinic. Massage, chiropractic and acupuncture gift certificates available. Portland, Oregon Local Business
Disclaimer: This article is not intended to give health or fitness advice. Exercise at your own risk. Consult your doctor or another health professional if you are unsure whether a product or form of exercise is safe for you to use. All opinions expressed are those solely of the PDX Local blog, and do not represent its sponsors, affiliates, or guest contributors. No paid advertising or paid endorsements have been provided for the products featured above. The reviewer makes no claims regarding the efficacy, workmanship, utility, or safety of any of the products listed above. As an Amazon Associate I earn from qualifying purchases. Use and purchase at your own risk.
Me, standing under the St. John’s Bridge in my neighborhood in Portland, Oregon. The bridge is the site of weddings, festivals, film shoots, and deaths.
How to Save a Million Lives
It starts with being visible.
November 2, 2019
In anyone’s memory, certain dates stand out forever.
I remember standing in my aunt and uncle’s sunny family room in San Mateo, California on April 18, 2018. That was when the customer service rep on the phone told me I did not qualify for life insurance. This was a problem. In fact, it was a huge problem. It meant I would not be able to obtain what is called “Key Man” Insurance, which shields professional investors in case of the accidental or untimely death of the CEO or other essential team members. Key Man Insurance is a must for any startup seeking serious investor funding (seed round or VC). Unknowingly, I had raised funds from friends and family for a venture that could not succeed with me at the helm.
I checked it out. I got a second quote. It didn’t matter that I was healthy and had managed the condition successfully for 19 years.
This wasn’t a case of bias, or stigma. It was a numbers game. The diagnosis is bipolar disorder. The reason I couldn’t get life insurance was that my diagnosis carries a 15 – 20% lifetime fatality rate. That means that as many as one in five people with bipolar disorder may die by suicide. (National Institute of Mental Health, as cited by DBSA.)
If present trends continue, over 855,000 of the 5.7 million individuals living today with bipolar disorder in the U.S will die by suicide. That’s almost a million people.
We are living in the middle of an epidemic. And one ever seems to notice.
Our company’s investor woes seemed pretty trivial in comparison.
Which brings me to the other date. Just over a year ago.
October 17, 2018
On that single day, in my home city of Portland, Oregon, we lost three people to suicide. One of the deaths happened a few hundred feet from my apartment, when a woman jumped off the St. John’s Bridge. I found out when I heard the sirens and saw the flashing red lights. I took some roses out of a vase, went outside, walked down the hill, and put the roses by the police line.
For me, that death brought home the reality of the suicide epidemic in America. I don’t know whether any of the three people who died had a diagnosis, but given the high risk factor and the fact that 1 in 23 Americans are bipolar, it is likely. Suicide fatality rates are actually higher for people with bipolar disorder than for those with unipolar depression(NCBI). Because suicide is a social epidemic, the death of one individual can result in the deaths of other individuals, who may not even share the same diagnosis. There a lot of reasons why this post has been hard for me to write. One of them is that this year, in the time since I started writing this blog post, about three weeks ago, I learned of two other likely suicides in my home communities: one here in Oregon and one in Massachusetts. The taboo around speaking about suicide is strong, just like the taboo against discussing bipolar disorder. I went to a walk this month by the American Society for Suicide Prevention. It’s a worthy event, and it does a lot of good for survivors. But nowhere — nowhere — was bipolar disorder mentioned as a cause or a killer. Talking about America’s suicide epidemic without talking about bipolar is like trying to talk about heart disease and never mentioning high blood pressure.
Last fall it felt like the bodies were literally dropping from overhead. Those deaths, in particular the one so close to home, jolted me out of complacency. I kept thinking to myself, “If fifteen percent of bipolar people are dying by suicide, why don’t we hear about it? Why aren’t we doing more to stop it?”
I had been marked as a plague victim and I didn’t even know it.
I found a replacement CEO for my startup. After stepping down, my plan had been to take a course or two in data science and rejoin the corporate world. Instead, I found myself on an entirely different path. I earned a certification in Life Coaching, another as a Peer Support Specialist, and completed the excellent QPR suicide prevention training which is offered for free to lay people in the Portland area. The goal: work part time coaching bipolar and entrepreneurial clients from around the world. Spend the rest of my time building something cool.
The crazy thing is, one year later it actually seems to have worked.
The people I have coached confound my expectations. They are C-level executives, computer programmers, bankers, and accountants. Leave every expectation you have surrounding bipolar people and their temperament or personality type at the door. Just know, above all, we are here. And there are a lot of us. The recovery rate for bipolar disorder is 80%. (Health Central) Mostly you can’t tell us apart from anybody else. Because when the medication works well for us, like most other Americans, we’d much rather concentrate on our lives and families and hobbies than on getting riled up with anything that resembles activism.
Coaching is intense. I have had more than one occasion where the client burst into tears during the first session. Unlike therapy, the emphasis is on achieving short term goals. Most of my service offerings are designed to last 3-6 sessions, although some clients stay on much longer. I think my favorite sessions are the outdoor fitness sessions, where we do the coaching during an hourlong walk or hike. I never agree to work with a client unless they are also seeing a licensed doctor or clinician. Confidentiality is key. In the event of a situation where someone’s safety is at risk or where someone expresses suicidal thoughts, I will of course contact emergency services, as well as other members of a client’s care team.
Whatever assorted coaching gurus may promise, my type of coaching won’t make you rich. That’s not why I do it. I just know that it’s important for bipolar people to be visible.
This is where the saving lives come in. It’s about much more than the coaching, although I believe that’s important and meaningful work. It’s about being visible, and letting people know that bipolar gets better. Coming out is risky, and it has a cost. You may not get asked on that second date. As a programmer the last thing you want is your supervisor wondering what medications you were taking when you pushed that last commit! But I’ve come to believe that the cost of silence is greater. Silence equals death. Stigma equals death.
Here’s how we can save one million lives over the next generation:
1.) Make stigma against bipolar people unacceptable. End the jokes. Stop using bipolar as shorthand for a personality disorder. Educate yourselves. This shouldn’t be my job, as the person with the disability, but I need to take responsibility first and foremost for my own actions. I am not “out” in every professional or social social situation, but I try to live my life in a way that I can communicate to others, who may be more closeted, that there is hope.
2.) Improve quality and access to mental health care. Bipolar people face special challenges. We encounter more stigma than people with depression or anxiety disorders, and if we are misdiagnosed, the consequences can be serious. But all mental health conditions deserve treatment on a par with physical health. The quality of generic medications has taken an alarming dive. I have experienced these issues myself, and heard alarming reports from others. Legal or regulatory action must be taken to ensure that vulnerable populations do not suffer.
3.) Work for a cure. Amazingly, for a disease that affects millions of Americans and people the world over, we still do not understand the causes of bipolar disorder. It receives only a fraction of the federal funding for diseases with a similar mortality rate. Meanwhile, the pharmaceutical industry shows off its latest advances: a pill with a tracking device to make sure the patient complies and takes their medication. We are solving for the wrong goal here.
You may have noticed that the beginning of this piece promised to tell you how to save one million lives. And you may have noticed that based on the figures above, we’re still 145,000 lives short. There’s a reason for that. The reason is that bipolar people, when we are well and healthy, save lives.
The reason is that bipolar people are our best and our brightest. We are leaders. We are artists. We are entrepreneurs and innovators. We are mystics. We are heroes. We feel deeply, and we act on the courage of our convictions. From Winston Churchill to Kanye West, the names of famous bipolar people read like a roll call. Bipolar people who are able to live out their lives to their fullest potential will design lifesaving vaccines, help mitigate climate change, and create songs and stories that sustain and offer hope for an imperiled planet. We give back every day. We are mothers and fathers, aunts and uncles, teachers and mentors, some of the best and most loyal friends you will ever find. We are generous. We go the extra mile. Maybe we are still trying to prove we are “good enough.” Maybe deep down we know that we different, and also blessed. There is a reason we are in this genome.
We have so much to give, and we are irreplaceable.
Illustrator and puppeteer Geahk Burchill is homeless. That hasn’t stopped him from telling his story. A Portland resident for 18 years, and local to the St. John’s neighborhood since 2005, he spoke with us about his experiences and shared his newest project, a webcomic called Trucked Up.
How long have you been in Portland, Oregon?
I first moved to Portland, from Oakland, California, in May 2001 because of a sun allergy. I made the decision after getting a bad sunburn that February and felt like I could choose a place less difficult for me. I loved Portland instantly but didn’t have much savings. A minor fender-bender drained what saving I had and I spent a few months living in my VW van. Fortunately, I got work as a carpenter, and an apartment, relatively quickly. I had no idea it wouldn’t be the last time I was homeless.
Dr. Hadrian in his Library. (Photo: David Emmite)
I moved to St. Johns in 2005 after starting a marionette company. I worked days for Michael Curry Design, and nights on my own puppets, building up a small theater company. In 2010 I left Curry to start my own design/build business and did reasonably well until about 2013 when I received less and less work. By 2014 I had a personal unraveling after working very long hours and losing money on multiple jobs. I let go of my house, first, and lived in my studio; in late 2017 I lost the studio as well. I converted the old puppet-truck into a live/work space and put everything in storage.
Describe your current living situation.
Oakland, where Burchill grew up.
I live in a decommissioned bread truck in which I built a bed, a kitchen, and work space. I took all the tools which used to make up my studio and made a condensed wood shop to try and continue getting work. For a long time I was parking on the street, moving the truck constantly, from spot to spot, to avoid cops. It made jobs difficult and I delivered projects late. That made it harder to get further work. It was also deeply demoralizing.The body of the truck is aluminum. In the summer it’s an oven inside, and a freezer now that it’s winter. In October the truck broke down and I had to have it towed. It’s now parked in the side yard of a friend, whom I pay to use utilities. Even at the amount he’s charging, I’m often late paying. It’s still a very unstable situation. I’m looking forward to repairing the truck, if I can, and having a bit more control over my life again.
Would you describe yourself as homeless?
I’m not sleeping rough. I’ve made my space as comfortable as I can. I have my cat, who sleeps on a heating pad, and my art desk, which I built to perfectly suit me. I have a microwave, and toaster oven, to make hot meals; an electric kettle for coffee. It’s about as cozy as homelessness can get but there’s a lot of room for improvement. It leaks in places. It was unsafe at times. Someone cut my gas line and stole fuel in the middle of one night while I was inside. It’s old and unreliable. At the same time, it represents a certain amount of freedom. I like the space despite its problems. I can see myself driving to jobs in the future and working out of the back.
Your artistic style for the panels of “Trucked Up” is amazing. What is your process, and what tools do you use?
I started with traditional materials. I grew up poor and my medium was usually pen on copy paper. Five simple supplies. Paper, a good pen, a blue pencil, an eraser and a ruler. Later I began drawing with nib-pen on translucent vellum with India ink. That allowed me to sketch on cheap paper and then trace onto the expensive vellum with the nice dip pen for really crisp results.
I currently can’t do anything very messy in the truck, but I did an ad project a few months ago which earned me enough money to buy an iPad with Apple Pencil. I then recreated the way the vellum and dip-pen work in an app called Procreate. It allows me to be very portable and draw in cafes, where I can get wifi access.
Unfortunately, I bought the iPad just before the truck broke down. For a while I was kicking myself. It was a lot of money, but as I’ve kept drawing, I feel it was the only choice to keep me motivated and focused on the future. It’s become the tool I use for everything, including this comic I’ve started. I’m learning to animate and make videos for YouTube. It’s my connection to future work. A little bit of a security blanket too.
How has living in a truck impacted your artistic journey (thematically, pragmatically, etc.)?
Though I started drawing comics when I was fairly young, most of my career has been spent with sculpture and engineering. I’ve made puppets for nearly twenty years, including sewing the costumes, and painting the sets. In the truck I’ve been forced to narrow my focus to what I could accomplish in the space. Drawing and writing, mostly.
Even traditional drawing is hard to do in the truck. Ink gets too thick to use in the cold. My career has been built upon getting new work out often. It has to be in the internet age. Returning to comics is something I can accomplish with limited space, wifi, and access to power. It’s also a way to process the frustration and panic I frequently feel about my situation.
I’ve always talked about poverty, to one extent or another, in my work, but now it’s in sharp focus. I find so many situations that are darkly funny about the basic things I struggle with.
I have far more comic ideas than I’ll ever have time to draw. I’ve also wanted to do a video game which utilizes real scenarios I’ve found myself in as puzzle elements. So much of this is MacGuyvering my way through problems that come up. The comics are accomplishable though. Each one takes about five hours, which I can find time for. It’s a resource I have.
What’s next for “Trucked Up?”
I’ll keep drawing and posting to Instagram and Webtoons. I see there are some people who make decent money, once they get noticed, and build a following. I’m currently working on a mural for a client and that’s my main source of income, but it would be great if I could have something more stable and reliable. My income has been feast-or-famine for ten years, with almost constant stress. It would be nice to have some consistent money that I could plan for the future with.
I feel like I have a lot of ideas which extend beyond the scope of just living in the truck. I have a lot of life stories. Just the autobiographical content is enough for hundreds, or thousands of future comics, not to mention all the fictional stories I’d like to tell. Plus there are educational and instructional ideas I have. I’ve been teaching puppets over the years, and I can fold that into didactic drawings, maybe into a book.
Lennie & George from Of Mice and Men (Performed in 2012)
Laura and I are humbled and thrilled with all the media coverage received for our small effort to put up notes of encouragement on the St. John’s Bridge. Read or watch the story by Portland’s Fox 12 here.
But this is really only the beginning. Would you like to take two hours out of your busy schedule and learn how to save a life? We are please to announce a free training available in our community. The two-hour “Suicide First Aid” class, offered through http://gettrainedtohelp.com, a tri-county initiative, is for lay people. No special background is required. It teaches essential skills for responding if somebody you know or love has reached out and appears to be at risk. The one-time session will be held in the evening, from 6-8 PM on Tuesday, January 15. 2019, at Vision 8 Studios at Cathedral Park Place. Training is open to all residents of Portland, OR and the surrounding area; however St. John’s residents have priority. The training is for everyone aged 18 and over.
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