Trigger Warning: this article deals with suicide. Please read at your own discretion. 

Having spent much of my recent work time dedicated to suicide awareness and suicide prevention in Sheffield, England I was privileged to be offered the opportunity to travel to Africa to share the skills I have learned and to learn more from our mental health care partners in Kampala and Gulu, Uganda. Sheffield Health & Social Care NHS Foundation Trust, through the Gulu Sheffield Mental Health Partnership (GSMHP) which has been working in Uganda since 2012. As well as working on the development of this newly funded suicide prevention project members of the visiting team were also focused on helping to re-certify hospital staff in RESPECT techniques as a part of a longer running Tropical Health and Education Trust (THET) funded project.

RESPECT is a non-confrontational, de-escalation based way of managing potential violence and aggression that minimizes the need for physical restraint and restrictive practice by positively harnessing an individual’s unique personal strengths in managing difficult situations. RESPECT training techniques have been shared with key staff at the Gulu Regional Referral Hospital since 2012 and the results of this partnership work have been a phenomenal success in both Sheffield and Gulu. As a junior nurse, I remember attending 5-day courses on Preventing and Managing Violence and Aggression (PMVA) where they were essentially teaching me how to restrain people with holds akin to those used by the police to restrain violent criminals. Thankfully in Sheffield and in Gulu, the use of those techniques is well and truly a thing of the past and the experiences of the service users now play a key part in understanding how to manage potentially difficult and confrontational situations.

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We all hear that our childhood experiences impact our lives as adults — to varying degrees based on who you speak to and what you believe. But wherever you fall on the “nature vs. nurture” spectrum, one thing is undeniable: we all have childhood experiences that creep into our memories as adults, whether good or bad.

If you grew up with a physically abusive or emotionally abusive parent, for example, that tends to stick with you into your adult years and affect your mental health. That’s not to say that people who were abused as children can’t or don’t grow up to be perfectly functioning human beings — they do. It just means that they may have different baggage than other people. Let’s face it, we all carry around baggage of some sort. What it looks like and how heavy it is will change, that’s all. Regardless, no matter what the circumstances of your upbringing were, you were affected.

So what do you do about it?

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The worst things are the best things. I believe that with every fiber of my being. When my mom had a mental health crisis, I had to make the difficult decision to force her to get help.  I felt so guilty. I cried when we left her at the hospital. But she’s better now. It was the right move to make. Later on, she encouraged me to get help when I struggled with anxiety, depression, and suicidal thoughts. Again, it was the right move to make. This all came about after open-heart surgery, at the age of 24, that I never thought I would need to have. The surprise surgery was terrifying, but it wasn’t the hardest part. The emotional recovery was.

No surgeon, nurse, or other medical professional warned me of the post-surgery emotional impact that is so common for so many after invasive surgery. These experiences—the mental health crises—among the accumulation of many, many smaller ones, led me down a path to become a lifelong mental health advocate.  I feel it’s my calling. I know it is.

It’s why I went back to graduate school to become a social worker. And it’s why I launched an ambitious mental health project three weeks ago. I just launched a daily email newsletter called The Mental Health Update. It’s a concise update sent in the morning and packed with timeless wisdom from a mental health perspective. It’s all about helping people start their day in a thoughtful way.

Why did I do it? Because I wanted to. But, really, there were reasons.

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“Awesome,” the social worker for Clermont Mercy’s Behavioral Health Institute said after sitting in on my National Alliance on Mental Illness (NAMI) talk at the Clermont Mercy Hospital in Batavia, Ohio. Internally, I sighed with relief. I had just completed my first Friday NAMI talk at the Behavioral Health Unit at Clermont Mercy in months.

My name is Danei Edelen. I am the founder and president of the NAMI Brown County Ohio affiliate established in Brown County Ohio in June of 2018. We have been offering NAMI’s support groups in Brown County for over a year. Since July of 2018, I have routinely given a “talk” every other Friday about who NAMI is, what are the NAMI programs that can help, and shared my personal struggle at Clermont Mercy Hospital’s Behavioral Health Institute.

Where I’ve been

You probably haven’t heard from me in a while. For the last seven months, I’ve been out of commission, dealing with my own struggles. As can happen to anyone that lives with a mental illness, my mental illness unexpectedly struck in the form of a sodium deficiency that landed me in the Intensive Care Unit (ICU) for five days because my blood sodium level mysteriously dropped to 114. A normal blood sodium level is between 135 and 145 milliequivalents per liter (mEq/L). Hyponatremia occurs when the sodium in your blood falls below 135 mEq/L. 

First, I landed in ICU due to sodium deficiency, then I missed my son’s high school graduation due to a visit to the University of Cincinnati Psychiatry because of psychosis. With mental illness, there are no guarantees. You can be “on top of the world” and then your body will betray you.

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In a way, when I reflect back over my career as a nurse, I feel I have been inexorably drawn toward suicide awareness and prevention.  As a shiny new registered nurse working on my first ward, I completed the admission process and risk documentation for a young man who had been experiencing feelings of hopelessness and isolation. He was traveling around the country working and his family was not in the city.  My initial assessment identified that one tangible trigger for the onset of his feeling suicidal was excessive alcohol consumption, and he told me that when he finished work, he would drink a litre of brandy and then start to feel like there was no point in going on with his life.  I went through all of the correct processes for admission and offered, what I thought at the time, was hope that there was a future where he would not feel like he currently did. I assured him that over the coming days we would get to know each other and together get to the bottom of why he felt like he did.  I showed him around the ward environment and took him to his bed bay, which was unoccupied as we had had three discharges that day. He seemed really settled and thankful that he was in a ‘safe place’. I went back to the nursing office to finish my risk assessment and I clearly identified that alcohol was a precipitating factor in the onset of his low mood and suicidal thoughts.

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You don’t always have to be awesome, steller, or even happy all the time. We all need a break from the reckless and unrealistic expectations that we can always be happy. The truth is, sometimes we’re just doing okay. And that’s perfectly fine. There is nothing to be ashamed of when feeling “just okay”. 

As I went through the month of May, I felt good at times, bad at times, and just alright at times. Now, it’s well known that given our social media exposure, we think that everyone else is happy, gleeful, and always doing awesome things. And because of this, we feel that there is something wrong with us if we don’t feel the same way: that feeling “just okay” equates to being the opposite of happy. We have to change this paradigm. 

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