Anger can strike when we least expect it. A seemingly personal attack can release adrenaline in the brain and put one's body in overdrive. The mind instantly prepares for a potential threat. Strength increases as pain receptors diminish. Breathing becomes shallow, and the heart rate quickens. Since the dawn of man, survival has depended on instinct and adrenaline. Adrenaline prepares us to fight, to run, and sometimes freeze, guarding us against a range of predators.
Anger is just one emotion that arrives with a flood of adrenaline and cortisol. It is difficult to think clearly, as the brain is taken over by the emotional response center, the amygdala. The amygdala's mission is to react and to do it quickly. When this happens, we need a little help from our prefrontal cortex. This is the part of our brain that helps us reason and make logical decisions. The prefrontal cortex is the part of the brain that keeps us from hitting "send" on a snarky email that was written in haste. The cortex engages and slows us down when we really want to react to road rage, and helps us hold our tongue when we are in an extremely provocative situation. It buys us time to negotiate with the amygdala and make a reasonable choice based on our emotional needs, a perceived threat, and our overall best interests.
When someone is experiencing extreme depression or thoughts of suicide, the same brain chemistry occurs. The emotional control center takes over, robbing power from rational decision making. As the brain is flooded, sensible choices cease to exist. The question is, how can we buy time for the amygdala to calm down and for the prefrontal cortex to take over?
Time and space are paramount in times of personal crisis. Fortunately, there are many ways that we can intervene safely and even save lives. One of the best ways to help someone regain control is to listen. Being able to vent, especially in a non-judgmental setting, can provide an incredible release. When we get things off of our chest, especially intense emotional pain, we can restrain impulsivity and provide hope. This listening approach also works when someone is feeling suicidal. Asking someone directly, "are you thinking about suicide?" helps to clarify and reveal any hidden secrets.
Another technique in saving lives by suicide is to put some barriers in the way of impulsive acts. For instance, firearms should be removed from the home in a time of crisis, or safely secured under lock and key. Trigger locks can be utilized as well as gun cabinets or other safe storage. Ammunition should be kept separate and inaccessible. Medications that are no longer used can be safely disposed of at the Sheriff's department. All other medications can be kept in a lockbox with restricted access. Over the counter medications can be rationed with a minimal amount available as needed.
It is easy to think that a crisis like suicide doesn't apply to us. Just like we prepare for any other emergency in our lives, so should we be ready to help a friend or family member in a time of emotional distress. The amygdala, when called upon, is ready to react without reasoning. We need to be prepared to step in and "be the prefrontal cortex" for a friend until they can regain control. We need to be willing to listen, question, and to find them help. It is never too late to care and create time and space.
Kelly Brevig is Suicide Educational Services Coordinator with Evergreen Youth and Family Services.