What if mental illness is preventable

Mental Health Day : "Mental illnesses are like tumors"

If you follow Dominique de Mané on Instagram, you'll see a happy young woman climbing mountains, running marathons and enjoying beer with a pretzel in the beer garden. What you can't tell: She has borderline syndrome, is a dry alcoholic and suffers from depression. She has lived with the diseases for 15 years and has only been under treatment for five years. Today she says: "I kept falling and at some point I knew: If I fall a few more times, I won't get up again."

Among those aged 15 to 19, suicide is the second leading cause of death worldwide. Last year there were 800,000 people worldwide, and on average one person kills himself every 40 seconds. The World Health Organization has therefore put this year's Mental Health Day under the topic of "Suicide Prevention". Because 90 percent of all suicide deaths had a mental illness, only ten percent acted out of an acute life crisis such as illness, separation or bankruptcy, estimates the German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN).

“The majority of suicides are preventable,” says de Mané. “Because people try to pull themselves together until they can't.” She compares mental illnesses with tumors: if they are not treated, they can be fatal.

In 2017, a total of 9,235 people committed suicide in Germany. Dominque de Mané almost became a part of this statistic several times. The last time it happened was in May 2017: she relapsed, drank, injured herself and was suicidal. In the end, the 33-year-old delivered herself to a psychiatric clinic. Since then she went into therapy-assisted withdrawal and changed her life. “It just helps me a lot to have a morning routine of planning my weeks in advance,” she says. "And if I feel worse, I talk to my boyfriend or friends about it." Yoga, running, cooking, trips to the mountains and a meaningful job - she is now building her life on these pillars.

As a teenager, de Mané developed borderline syndrome, "too many thoughts and feelings," as she describes it. This resulted in self-harm and alcoholism as a pressure reduction, which in turn led to depression. De Mané hid all of this from her family, her friends, and even her boyfriend. She limited her episodes of alcohol and self-harm to the periods when her partner was away on business.

"At some point I realized that in my dark phases I was slipping more and more towards suicide," says de Mané. She confided in a friend who helped her find a therapist. It lasted a year in total. Today she speaks with the psychotherapist Anke Glaßmeyer in the podcast “Die Psychotanten” about topics such as everyday life in a psychiatric clinic.

Anke Glaßmeyer has had an eating disorder herself and now runs a psychotherapeutic practice in Ibbenbüren as well as online psychological counseling. She criticizes the supply situation in Germany. “There should be more cash register seats for psychotherapists,” she says. She herself does not have a license that would cost between 50,000 and 100,000 euros. “I have to keep turning patients away,” she says.

Low-threshold offers are important

On her Instagram account “diepsychotherapeutin” she explains diagnoses, answers questions and reveals “therapy secrets”. It is a low-threshold offer, because if you are in an acute crisis, you often cannot pick up the phone. Followers often comment that they have the same diagnosis as described. The feeling of not being alone with one's problems and of having a name for them helps break out of isolation, says Glaßmeyer.

Information and education are crucial, says Iris Hauth, psychiatrist and medical director at the Alexianer Hospital in Weißensee. She is one of the initiators of the "Berlin Mental Health Week", which runs from October 10th to 20th. “The population should know as much as possible about mental illness,” says Hauth. “If you notice psychological changes in yourself or in someone around you, fear, guilt and shame should not prevent you from seeking help.” There are still many prejudices that stand in the way of openly dealing with suicidal thoughts - like the myth that people who talk about suicide don't commit suicide.

Do you have dark thoughts? If you are not doing well or are thinking of killing yourself, try talking about it to other people. They can be friends or relatives. But there are also a large number of offers of help that you can contact.

The Berlin Crisis Service is anonymous, free and available around the clock. The phone numbers vary by district, the correct extension for your district can be found here.

The telephone counseling service also offers a help chat. There is also the option of email counseling. Registration takes place - also anonymously and free of charge - on the website. You can find information at: www.telefonseelsorge.de

But what exactly causes a person to contravene his natural instinct for survival? That depends on the previous illness, says Hauth: "Severely depressed people often get into a downward spiral: They think they are worthless and that they are a burden to their environment. As a result, they often get negative feedback, and because of their lack of drive they lack positive self-affirmation. "

Depressed people cannot "pull themselves together"

She recommends two strategies for relatives, friends and neighbors who notice the withdrawal or the crisis of a fellow human being: Sensitive and active listening and building bridges, for example in the form of offers of help such as support in the search for a therapist or accompaniment to appointments. "It is absolutely counterproductive to suggest activities and tell those affected to just pull themselves together," says Hauth. This would make those affected feel even worse and inadequate.

Mentally ill people often do not want to be a burden - shocked reactions and visible sadness trigger these feelings of guilt again and should therefore be avoided in conversation. “One should be very careful when asking whether the person has thoughts of suicide and whether they would like to seek help,” says Hauth. She advises: Build trust, provide sensitive support and offer help.

That talking about mental illness is still a problem is also shown by the fact that mostly female activists are visible and more women are working in the helping professions. Because 76 percent of suicides in Germany in 2017 were committed by men.

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