Helping those with chronic stress, mental health takes careful consideration

During tough times, stress becomes something many people have to deal with daily. If left unchecked, stress can lead to other much worse things.

Susan Harris, Nebraska Extension educator, rural health, wellness and safety, spoke during a recent webinar hosted by Nebraska AgrAbility and the Nebraska Extension Service.

Chronic stress signs can come in many forms. Harris said a big one is isolation from public and no socialization.

“Unfortunately, that’s our new normal right now,” she said. “So this could cause more stress.”

Another sign is loss of interest in things a person used to enjoy. This is a big red flag. Also, trouble making decisions, forgetfulness, tunnel vision—could all be signs of chronic stress.

“I know personally, tunnel vision is a big one when I’m stressed,” Harris said. “You just have a really hard time seeing anything other than what they’re stressing about.”

Things like negative thinking and talking, loss of sense of humor could also be included, along with increased drinking and drug use.

“You might want to just pay attention to that,” she said. “No desire to exercise especially in the winter. Sometimes you just get to having poor hygiene because you just don’t care anymore.”

Health issues become relevant as stress starts to manifest itself physically.

Empathy

So what does a person need to be aware of when dealing with stress in family or a loved one? Empathy is very different than sympathy, Harris said.

“Empathy fuels connection, sympathy drives disconnection,” she said. “It’s very interesting.”

There are four qualities of empathy—perspective; staying out of judgment; recognizing emotion; and communicating empathy.

“To me, I always think of empathy as this kind of sacred space,” Harris said.

When someone is in a “deep hole” and they shout from the bottom they’re stuck and overwhelmed, a person with empathy will say, “I knew what it was like down there, and you’re not alone.” Sympathy on the other hand, is when someone says something like, “Oh it’s bad. Uh huh. Now you won’t see much.”

If the person has a choice, and it’s a vulnerable choice in order to connect with someone—Harris said, don’t begin the response with “at least.”

“We do it all the time,” she said. “Because you know what? Someone just shared something with us. That’s incredibly painful. And we’re trying to find a silver lining it.”

Humans try to make things better when faced with difficult conversations.

“If I share something with you that’s very difficult, whether you say, I don’t even know what to say right now. I’m just so glad you told me,” she said. “Because the truth is rarely a response, make something better. What makes something better is connection.”

Harris said to consider what you’re saying in response to someone who’s told you something difficult. First, it’s your job to listen; but be very aware of what kind of listener you really are.

“Maybe you are an attentive listener at work, but around family you become more selective or even worse one of those pretending kind,” Harris said. “Most people do not listen with the intent to understand they listen with the intent to reply.”

If a person can get past that level three, and on to level four—where you’re paying attention and focusing energy on what the person is saying.

“Of course, the ultimate goal is to hit that empathic listening level where instead of projecting your own feelings and assumptions, you’re dealing with the reality that’s actually in that other person’s head,” she said. “And you’re listening to understand.”

But that doesn’t come very easy, so Harris suggests practice, practice, practice. Other tips include:

• Help that person see the facts because they are emotionally charged and not thinking clearly.

• Use a pleasant tone of voice.

• Ask open-ended questions.

• Don’t tell the person what the solution is.

• Restate and summarize techniques.

• Follow up.

“You know how much it means when you’re going through something and someone else just checks up on you to see how you’re doing,” Harris said. “So it’s highly recommended. Even if it’s a text or two after your conversation, at least it shows that you care.”

Suicide

In Nebraska, like many other High Plains states, suicide is more common than one might think, according to Harris.

“When someone is seriously distressed, they might show signs and they might not,” Harris said. “We can’t feel guilty if they don’t and we didn’t catch it.”

Some who are contemplating suicide might start writing or talking about it—in a coded way, she said. Mentioning things like, “what would you do with my life insurance if I die,” for example.

“They could be misusing alcohol and drugs more. They could be giving away prized possessions, isolating themselves from others,” Harris said. “They could be feeling like a burden or hopeless and trapped. It could be making a plan and maybe buying a pistol and they’ve never owned a pistol in their lives. They could be saying goodbyes.”

Some might even write letters apologizing for things they’ve done in the past. They could have a loss of interest in life. Even a posture change, you know someone who used to walk very straight up and down and walk in like they own the place. They’re suddenly slouched and just moody.

“In general, the mood change is pretty obvious,” she said.

When interacting with a person going through these emotions, Harris said to choose your words very wisely. If someone is thinking about suicide, don’t use the words commit suicide or successful suicide.

“For instance, if someone is exhibiting some of those symptoms that we talked about, you shouldn’t be saying, ‘You’re not thinking of killing yourself are you?’” Harris said. “Because would you open up to a person if you were considering suicide and they acted like that toward you? No, absolutely not.”

Tone of voice becomes very important, and making them feel guilty, or trying to convince them that what they’re thinking about is crazy, is not helpful either. Your job is to not be a counselor, but rather offer hope, focus on assisting and find them help.

“Practice those words—are you having thoughts of suicide?” Harris said. “And don’t ask things like, are you thinking about hurting yourself? Because if they’re very truthful, a logical answer will be no. They’re not thinking of hurting themselves. They’re thinking of killing themselves.”

Harris said to practice those words. She’s used them twice since learning them a little over a year ago.

“I was very glad both times that I did,” she said. “It opened up a great conversation. Asking them does not plant the idea.”

She gets asked that question often, about planting the idea, and believes it does not. She suggested Googling the Kevin Hines story. He’s one of thousands of people who jumped off the Golden Gate Bridge and survived.

“The point of his story is that had someone just asked, this wouldn’t have happened,” Harris said. “He gave plenty of opportunity for people to ask, and he made a pact with himself instead, that if someone will just ask they don’t follow through.”

The scary part is when the person answers yes.

“First, never promise to keep a suicide plan a secret and never leave that person alone,” Harris said. “That’s super important.”

If the person already has a plan in mind when asked, make sure they’re in a safe environment, find someone—a counselor, a hospital social worker or even offer to call the national suicide hotline with them.

“And of course, if it escalates out of control, then it would be important to bring in police,” she said.

The suicide prevention hotline at 800-273-8255 is available 24 hours a day, 7 days a week. It’s confidential, free and those answering know how to talk to other people.

“So if you’re in a conversation and you don’t know what to say or you don’t know what to do, this is a great number to call,” Harris said.

Other sources to look for help include attorneys, financial counselors, clergy, farm mediation services and others. Nebraska, Iowa and Kansas have similar farm mediation resources to help farmers and ranchers needing services. Harris said Nebraska Extension has resources for help at www.ruralwellness.unl.edu.

Remember, in the end, talking about mental health is a good place to start.

“Those aren’t bad words. Those are good words. They’re not scary words,” Harris said. “We all have mental health, just like we have physical health.”

Kylene Scott can be reached at 620-227-1804 or [email protected].