Sonia Patel's Blog, page 3
December 1, 2023
...
The 2024 TAYSHAS Reading List is awarded by the Texas Library Association/Young Adult Round Table committee. So excited that the YA anthology AB(SOLUTELY) NORMAL—that includes my short story NOTHING FEELS NO PAIN—was choosen for the list!
May 25, 2023
May 15, 2023
Gujju From Hawaii Reppin' at VCBF!
July 18, 2022
April 12, 2022
CHECK OUT THIS LIT PODCAST EPISODE!
Full Episode #149 It’s Lit with PHDJ featuring Sonia Patel
This @itslitwithphdj podcast episode #149 just dropped! https://itslitwithphdj.wordpress.com/2022/04/02/sonia-patel/
Check it out for some nonviolent-hip-hop-YA resistance that be like 16-year-old Rani spittin,’ “My daddy’s gone. And I’m so done looking for another one.”
(Caveat: I hope readers/listeners will feel how difficult it is for Rani to liberate herself from her brain’s hardwiring to be groomed by older narcissistic/predator men like her father. Unlike Rani, most survivors of chronic childhood abuse DON’T gain insight/awareness into the abuse, or even disclose it, until the 3rd or 4th decade of life because the abuse has physically damaged and scarred their brains. But then RANI PATEL IN FULL EFFECT would’ve been a very different novel.)
My love & gratitude to hosts @pbanjoli & @jocelynkng for this opportunity. If you missed any episodes, catch up at https://itslitwithphdj.wordpress.com/
Shout out to @joannagordy for connecting me with these awesome podcasting humans!
Also, check out the podcast’s origin story: https://anjoliroy.com/bibliography/lit-on-radio-waves-holding-space-in-hawaii/
December 24, 2021
IN LIGHT OF THE SURGEON GENERAL’S RECENT WARNING ABOUT YOUTH MENTAL HEALTH, LET’S UNDERSTAND SUICIDAL BEHAVIOR
On December 7, 2021, U.S. Surgeon General Vivek Murthy issued a warning about the mental health of young people, stating that rates of anxiety and depression have increased during the pandemic (https://www.npr.org/2021/12/07/1062112212/the-u-s-surgeon-general-issues-a-stark-warning-about-the-state-of-youth-mental-h). Prior to the start of the pandemic, the statistics were already grim. In 2019, more than 1 in 3 high school students had experienced persistent feelings of sadness or hopelessness—a 40% increase since 2009—and approximately 1 in 6 youth reported making a suicide plan—a 44% increase since 2009 (https://www.cdc.gov/healthyyouth/mental-health/index.htm). Between 2007 and 2018, the national suicide rate among persons aged 10–24 increased 57.4% (https://www.cdc.gov/nchs/data/nvsr/nvsr69/nvsr-69-11-508.pdf). Sadly, I’ve seen some of these terrifying numbers reflected in the young patients who are referred to me.
In medical school and psychiatry residency, I was taught how to evaluate patients with suicidal behavior, how to keep them safe, and how to diagnose and treat accompanying symptoms and disorders. I learned that suicidal behavior is defined as thoughts and/or attempts to end one’s own life, and that it’s listed as an official symptom of some disorders, but can also accompany others.
In this essay, I’m referring to the most common form of youth suicidal behavior—those linked to depressive symptoms, anxious symptoms, or a combination of the two. I’m not referring to non-suicidal self-injury, like cutting. I’m also not referring to suicidal behavior that results from other specific disorders such as chronic traumatic encephalopathy (CTE), schizophrenia, or alcohol/drug-induced disorders.
Most people can agree that suicidal behavior in young people are cries for help. Suicidal youth want their pain to stop but don’t know how to make it stop. They feel overwhelmed, helpless, or hopeless.
But underneath the suicidal thoughts, do those youth really want to die?
Not usually.
In young people, suicidal behavior isn’t a literal edict. What people may not recognize is that suicidal behavior is often a counterinuitive way to find control in and survive what feels like neverending, unbearable pain. I’ve reflected deeply on this in terms of the experiences of the suicidal youth I’ve treated for over twenty years. The thing I’ve come to recognize is what suicidal behavior actually means in young people and that how I explain it them makes all the difference. This is the stuff I wasn’t taught in medical school or psychiatry residency, and it’s what I’d like to share with you.
Suicidal behavior in young people is the brain’s red engine warning light that something serious and specific that hasn’t been said and fixed needs to be said and fixed. In other words, youth suicidal behavior is a standard code for something very unique. If we help young people decode their suicidal behavior, then the intense suicidal drive eases up and the hard work of healing—with the assistance of a mental health professional—can begin.
Young people do attempt suicide, and do succeed. Yet, many of them don’t reveal their suicidal behaviors.
That’s why it’s urgent that if any change in mood or behavior is noticed in a kid or teen, consider asking them straight up if they’re having suicidal thoughts or plans. Chances are, even if they’ve kept their suicidal behavior hidden, they’ll tell you the truth if they’re directly asked.
Then, after their safety is ensured, hear their suicidal behavior as this—help me figure out what I need to say and fix so I can save myself. The sooner we can help young people understand what their suicidal behavior mean, the more likely they won’t make impulsive or meticulously planned suicide attempts.
Like with the ten-year-old who’s parents brought him to see me after he’d tried to hang himself. Together, he and I decoded his suicidal behavior as, “I need to tell my parents that I’m scared when they have big fights, and I need them to tell me it’s not my fault.”
Or, the eighth grader who was referred to me after she’d survived a serious overdose. Her suicidal behavior meant, “I need help dealing with the bully and I need to tell my parents that it hurts when they don’t notice what’s happening even when I’m falling apart.”
If youth suicidal behavior is decoded with care, it becomes possible for young people to rise up out of the smoldering ashes of counterintuitive survival like mighty, empowered phoenixes.
December 13, 2021
November 8, 2021
October 8, 2021
Let’s Rethink Suicidal Thoughts in Youth: Not Literal Edicts, Suicidal Thoughts Can Be The Brain’s Invitation to Solve a Personal Mystery
September was National Suicide Prevention Month. In the mental health trenches, however, every month, week, day, and hour is about suicide prevention. I’d like to offer a different perspective on suicidal thoughts in young people. Afterall, according to the World Health Organization, more than 700 000 people die due to suicide every year and suicide is the fourth leading cause of death in 15-19-year-olds (https://www.who.int/news-room/fact-sheets/detail/suicide).
Suicidal behavior—thoughts and attempts to end your own life—in youth terrify parents, caregivers, and sometimes the youth themselves. Suicidal behavior is listed as an official symptom of Major Depressive Disorder, the depressive episode of Bipolar Disorder, and Borderline Personality Disorder (though I’m hesitant to diagnose children and teens with a personality disorder as their brains are still developing). Children and teens with some type of anxiety disorder (Generalized Anxiety, Obsessive Compulsive Disorder, Panic Disorder, and/or Post-Traumatic Stress Disorder) often present with accompanying suicidal behavior. In addition, suicidal behavior can also accompany substance abuse disorders or, occasionally, other mental disorders.
Suicidal thoughts in the context of youth depression and anxiety are misunderstood. After safety is ensured, it’s essential to help patients and their parents discern what the suicidal thoughts actually mean. I go over the basics with them first.
Depression and anxiety are typically hardwired into brains.
Suicidal thoughts are therefore hardwired biologic symptoms, the same way wheezing is a biologic symptom of asthma. This is crucial for empathy building as suicidal thoughts aren’t character flaws or cop-outs. And just as weather changes or exercise can trigger wheezing in people with asthma—even well-treated asthma—being overwhelmed or feeling out-of-control can trigger suicidal thoughts in young people with depression and/or anxiety—even well-treated depression and/or anxiety.
Expect suicidal thoughts to recur when the brain is overwhelmed or feeling out-of-control.
Suicidal thoughts can be managed.
Then we dive into management of suicidal thoughts.
Suicidal thoughts are not literal edicts to kill yourself, so as intense and real as they seem, don’t act on them. Talk about them instead.
Suicidal thoughts are your brain’s tricky, secret code that something that needs to be said isn’t being said, or something that needs to change isn’t changing. For example, a ten-year-old I recently treated, his suicidal thoughts and attempts reflected a counterintuitive way to find control when everything in his life felt out of control (his parents were having scary fights in front of him and his brother, and there was talk of affairs and divorce). For an eighteen-year-old who was bullied since elementary school, her suicidal thoughts were years of bottled-up rage turned inward. A fifteen-year-old’s suicidal thoughts were internalized shame after years of being shamed or mocked by her parents.
What needs to be said? What needs to change? For the ten-year-old, it was learning to express his thoughts and feelings to his parents about their marital conflict. For the eighteen-year-old, it was learning to tell the internalized bully in her head to shut-up and learning how to speak up for herself against real-life bullies. For the fifteen-year-old, it was understanding that even though telling her parents what she thought and felt about their cruel words to her hadn’t made them stop, she could still learn to validate and find worth in herself.
Learning to manage suicidal thoughts can take time, but I tell my patients, it’s like learning to swim—the more they practice, the better they get. Once they comprehend that suicidal thoughts are their brains’ tricky, secret code that needs decoding, they find empowerment in the decoding, and managing future suicidal thoughts becomes possible.
Outside of the psychiatrist’s office, here are some of the basics of suicide prevention:
Know the sign and symptoms of someone thinking about suicide, such as: talking about wanting to die or kill themselves, talking about feeling hopeless or having nothing to live for, making plans or researching ways to kill themselves, talking about feeling shame, unbearable pain, or being a burden to others, using drugs or alcohol more often, acting different (more anxious, agitated, or withdrawn), more intense mood swings, giving away possessions, or saying goodbye.
Know the risk factors, such as: depression, other mental disorders or substance abuse disorders, some medical conditions, chronic pain, a prior suicide attempt, family history of a mental disorder, substance abuse, or suicide, family violence and/or abuse, having guns in the home, or being exposed to others’ suicidal behavior (like a family member, friend, or celebrity).
Have an action plan.
Listen and talk with the person. Ask them if they’re thinking about killing themselves. Asking directly “Are you thinking about killing yourself?” doesn’t make them do it.
If the suicidal person has a plan, try to get them away from lethal items or places.
Connect them.
National Suicide Prevention Lifeline 1-800-273-TALK (8255)
Family member or friend
Mental health professional
Keep in touch with them if possible.
