Ep. 3: How an embedded therapist helps prevent suicide

If you are struggling with suicidal thoughts, Sanford providers say you're not alone

Episode Transcript

Courtney Collen (Host): Hello and welcome. You are listening to the Health and Wellness Podcast brought to you by Sanford Health. I’m your host, Courtney Collen, with Sanford Health News. This series begins new conversations and continues the important ones, all designed to keep you well, physically and mentally featuring our Sanford Health experts. Kathryn Gordon, PhD, LP, is a Sanford Health Psychologist in women’s health. In fact, she’s uniquely located in the Sanford Women’s Clinic in Fargo, North Dakota, and she’s here to join me now for this very important conversation.

Dr. Gordon, thank you for being with us.

Dr. Kathryn Gordon (Guest): Thank you so much. I’m happy to be here and have this opportunity to talk to you.

Host: First, let’s get to know you and talk about your role as a provider in Fargo.

Dr. Gordon: Sure. Well, I started working at the Southpointe Clinic with the idea that some there was a need for women who are at different stages in their life and having mental health concerns. So for example, a lot of patients that I see it might be during their pregnancy, if they’ve had a past history of anxiety or depression and they want some support during their pregnancy. I also see individuals for postpartum depression or postpartum anxiety. And then I see people just across the lifespan range, if they’ve gone in for like an annual visit and perhaps they told their provider, or they took one of the screening measures and it showed that they had some anxiety, depression, or maybe a history of trauma or grief and their provider then can refer them to meet within the same department to meet with them for therapy.

Host: How unique is it to be able to provide this type of care to women at Sanford?

Dr. Gordon: I think it’s a really unique position. I’m very grateful for it. The women who I meet with are already familiar with the clinic because it’s where they go to receive other services and for other health care appointments. And so it’s nice because they don’t have to go to a separate clinic. It’s also easy for me to communicate with their other providers so that we can have a team approach to their health as a whole.

Host: What do you most enjoy about this role and being a part of Sanford Health and Sanford Women’s up in Fargo?

Dr. Gordon: It’s just incredibly meaningful work. I get to work with some really great people and I enjoy working with patients learning about their lives and finding ways that fit within their lives to make changes that help them to feel better and to help them to live the lives that are consistent with their values and filled with joy and meaning. And so it’s just a really interesting way to get, to hear and learn from people from a lot of different and build a kind of collaboration together to find ways to improve their life and that that work is incredibly meaningful to me.

Host: How important is awareness around this topic of suicide and mental health, specifically among women?

Dr. Gordon: It’s incredibly important. The suicide rates over recent years have not declined like other types of death in the United States. Part of that is due to historically less research going to things like suicide as compared to other things like heart disease, cancer, and stroke. It’s very important to address all of these causes of death. Women are twice as likely to attempt suicide as compared to men so it’s important to ask women about suicide, be aware that they can struggle with it as well and find ways to navigate their lives so that they feel like they can cope and have a joyful life.

Host: So why are we seeing those numbers rise?

Dr. Gordon: It’s unclear exactly what suicide rates, one of the things that makes it hard to study is that it is relatively rare in the population as compared to, for example, even though it’s all too common, it is hard to understand. Sometimes it’s not clear if someone has died by suicide or died by an overdose, which is another issue that faces people. And so when you step back, I think of it more as the fact that the suicide rates have not gone down is of concern to us as compared to other types of death. In terms of why it might be rising in recent years, I think it takes a while for scientists to uncover that. Certainly we tend to see more things like that when there are issues with the economy. Having a pandemic has certainly added stress to a lot of people’s lives. And so those factors can all contribute.

Host: Yeah. Let’s talk about the care you provide now. What are you hearing from your patients?

Dr. Gordon: I think there’s a lot of concern about balancing school with working parents. There are some people who are out of work because they worked in an industry, which is not, you know, either in the restaurants or in a bar or something where we’re seeing fewer people utilizing those services. And so there are financial struggles and then in addition to that, it’s kind of balancing being there for your children and providing them with what they need while also adapting to virtual school. So even though some children are in hybrid school, there are usually at least some full days at home, and that’s really changed the structure of how families need to approach their lives to make room for all of that. And so I think there are stressors in there, and unfortunately, I think sometimes women tend to blame themselves or set kind of standards that are based on how things were pre-pandemic. And sometimes in therapy, we can talk about adjusting those to the way the situation is currently and reducing some of that excessive self-criticism.

Host: Give us a few examples perhaps of some of those coping strategies or therapies.

Dr. Gordon: Absolutely. There are some excellent scientifically-guided research based types of therapy that are available for anxiety, depression, and related concerns. Cognitive behavioral therapy is a major type of therapy that I use. And the basic gist of that is that when people are feeling anxious or depressed or feeling stressed, as many people are at the time of the pandemic, sometimes anxiety or depression can make people’s thoughts become more all or nothing than they usually would. And so what I mean by that is that if someone is adapting to helping their children with school in a way that is really different than it was before, they might feel really hard on themselves if their child is struggling with school or if they are feeling impatient or frustrated with the situation. And so what cognitive behavioral therapy does is try to identify those thinking patterns. How are you looking at the situation? How are you relating to yourself and looks at the evidence for and against it and tries to find a more compassionate way for people to relate to themselves that’s more accurate. Sometimes when people are feeling depressed, the thoughts have them thinking that they’re a horrible person or nothing’s ever going to go right and all of these types of things. So what we do in therapy is work with cognitive behavioral therapy to learn how to see things more realistically, and with compassion and acceptance.

Host: I can’t even imagine how busy you have probably been through this pandemic. Talk about what that has looked like, the impact of COVID-19 on women.

Dr. Gordon: A big portion of the patients that I see are it’s during their pregnancy or during the postpartum period. And something that the pandemic has changed for people is that they don’t all have as much support. So if their relatives live far apart, it may not be as safe for them to travel. And so they don’t have the support. They would normally have many people have had to cope with some grief about the fact that their baby showers were virtual rather than in person, or they’ve tried to have to balance the stressors of dropping their child off to daycare, which is usually a big transition anyway, but now on top of it, they’re also concerned about COVID. And so I think it’s really magnified a lot of the anxiety and reduce some of the typical strategies that people have, which is seeking social support and connecting with others. The pandemic has required people to get flexible and think about other ways to do things. And so that’s what I’m seeing a lot of is, is feeling overwhelmed and then feeling bad for feeling overwhelmed. And so we talk a lot about how that’s completely understandable and how to kind of be kind to yourself as you cope with these difficulties.

Host: That feeling of being overwhelmed… that’s human, that’s all of us. It’s not just those who might struggle with a mental health issue or a diagnosis, right?

Dr. Gordon: Yes, absolutely. I think that right now, a lot of people, their lives have gone through upheaval and I think people are adaptable, but at the same time, most of us benefit from certain routines. Like there’s fewer people that are comfortable going to the gym that are comfortable socializing with friends, understandably. And so it’s required coming up with new ways to deal with things and cope with things during a very stressful time. But yes, what you said is important to know that a lot of people are overwhelmed by the situation. It’s an overwhelming situation. That doesn’t mean you don’t have to have a mental health issue to feel overwhelmed right now. And a lot of people are struggling right now out there. That’s what a lot of the survey data show. And it makes sense. A lot of, a lot of things have changed and in times of change are stressful.

Host: Yeah. So on that note, what are the signs that we should watch for, if a friend or a loved one might be struggling?

Dr. Gordon: Some of the main ones, particularly with suicide, if someone is talking about hurting themselves or talking about death. That is something to take seriously. I think sometimes there is an idea that people, if they’re talking about it, they’re not really thinking about it but that that’s not true. If someone’s talking about it, it’s worth asking them, just, you know, I’m concerned about you. How are you feeling right now? What’s that like for you? That’s a big one. Significant sleep disturbance … insomnia or an increase in nightmares is another thing to notice. If you’re noticing that someone you care about is withdrawing from others. Maybe they’re not returning texts, or they’re not as engaged as they used to be in certain group activities. It’s worth asking, Hey, you know, what’s, what’s going on? I’m a little worried about you or I miss you. How are things going? If you notice significant change, like a sudden weight loss or other factors like that, where the person seems to just not be themselves, it doesn’t hurt to ask in a caring, non-judgmental tone, how things are going for them. And when it comes to suicide, it’s important to ask directly and say, ‘I’m worried about your afternoon, are you having thoughts about killing yourself?’ I think that some people are afraid to be that direct about it, but the research shows that it’s important to be direct when we’re talking about suicide. So the person understands what you’re saying, and there is no danger of planting the idea in someone’s head is what the research suggests, but it can help people if they’re already thinking about it.

Host: What if I’m the one struggling? Where would I begin to get the help that I need? What resources might be available through either Sanford Women’s your clinic or beyond? Where do I start?

Dr. Gordon: A good place to start off can be your general practitioner. If you regularly see someone, they can often refer you. There are also usually local resources. So for example, in Fargo, there is first link, which is 211. And if you call them, they are a crisis line, but they can also provide community referrals. So there are often, if you look things up or call one 800-273-TALK, which is a national suicide prevention lifeline, they can sometimes point you to where to find those local resources.

Host: We talk a lot about physical health and staying active and eating a healthy, balanced diet. But what can we do today, right now to make sure that we are staying on top of our mental health?

Dr. Gordon: The best that you can do for your mental health involves staying connected with people. We all need relationships and we need that kind of social support. Sleep is important. I understand, especially with the added demands that many people are dealing with right now, as well as stressors, it’s, it can be harder to sleep. There can be some disruptions for that, but as best as you can try to get some rest, if you can. And also another important thing is to make sure that you’re finding moments of joy and value in your daily life. Sometimes when you’re running around and you’re really busy and trying to balance different things are worried, you can feel like you’re not getting anywhere. So if you can find some moment in your day to find some joy or meaning that can really be sustaining and help with mental health.

Host: Now, what else would you want our listeners to know when it comes to raising awareness about mental health, behavioral health, and suicide prevention?

Dr. Gordon: The important thing to know is that if you are struggling with suicidal thoughts, you’re not alone. Many people struggle with the thoughts and that there are effective treatments available that you can connect with and it’s worth doing that. You’re very valuable. And I think sometimes people feel like they shouldn’t seek out help until something’s a bigger problem, or because other people are struggling more. But with therapy, we welcome anyone at any point, who’s looking to make some changes or struggling. And so you are worthy of getting help, no matter what point of your struggle you’re at.

Host: Dr. Gordon, we thank you for your time and for being a part of our continued conversation on this very important topic, we appreciate all that you do for women and for all of your insight today.

Dr. Gordon: Thank you. You’re very welcome. And thanks so much for talking about these important topics.

Host: This was another episode of the Health and Wellness Podcast series by Sanford Health. I’m Courtney Collen. Thanks for being here.

Posted In Behavioral Health, Children's, Family Medicine

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