I can’t really tell my story without telling my parents’ story.

I was born to a single mom who was diagnosed with schizophrenia. At age nineteen, she became a mental patient. We had a really hard life in inner city Milwaukee. It was chaotic. She really struggled. She went on and off her meds, didn’t want to take them. She was locked up in institutions, and I was kind of in the middle of all of that. By the time I was five, child protective services said, “You need to leave the household.” I had also been in and out of foster care, and a lot of really unsavory things went down.

My dad also had been diagnosed as schizoaffective or something when he was eighteen. He just couldn’t be in the picture at that point, so I went to live with my maternal grandmother and her second husband in a whole other state, completely away from my mom—who had not been abusive. We had a good relationship; it was just chaos. It was really difficult to be yanked into another situation.

I was asking these like existential philosopher questions like, “Why am I here?”

I remember having my first suicidal thoughts when I was probably seven. I remember it very clearly. I guess the way I voiced that was, “I should have never been born.” My family obviously freaked out. I was asking these like existential philosopher questions like, “Why am I here?” Which, if you’re an old white, it’s considered a philosophy, but for me, it was a sign of pathology.

I was shipped off to a child psychiatrist, this eighty year old woman who really did not know anything about how to interact with children. She would peer at me from across a desk and show me ink blots. This was in the 80s—really old school. They put me on medication for the first time. Because I was dealing with the effects of early childhood trauma, which medication doesn’t really fix, it didn’t help me at all with anything, other than making me into a zombie. I kind of pushed the issue, and my family let me go off the medication.

Things were sort of okay for a while, I was just really introverted. We moved a lot, so I sort of never really connected with other kids. It was kind of a mess. By the time I went into puberty, we had settled down in San Diego. I was extremely distressed. Now I know that, when you have these kind of early childhood trauma issues, they might come out when you’re really young, but puberty is often when they come out. Big time.

I was actively depressed and suicidal. I wouldn’t leave the house. There was also this bullying scenario that happened, where I had been friends with these three girls and they, all of a sudden, turned on me. They weren’t just being mean girls, they were also physically violent towards me. I wouldn’t go to school and I wouldn’t leave the house, so they took me to a psychiatrist again.

That was right at the dawn of the Prozac era—late 80s, like ‘89. He was like, “Oh, there’s this amazing new drug for depression,” so they put me on Prozac, which kicked me into high gear mania. I had never had that experience before. I was super depressed and down, and all of a sudden, I was having racing thoughts. It was like the RPMs on a record speeding up. I couldn’t sleep. I was completely a wreck. They’re like, “Oh, that’s her underlying illness. That’s her latent bipolar coming out.”

Then they put me on drugs to take me down, so I was on uppers and downers. Around then is when I started getting urges to cut myself, so I started doing that. That had never happened before. I kind of got the strength, and I had the fortitude to follow through on an attempt. That was really my first interface with what happens when you attempt to take your life. I had never really been in the system, other than seeing counselors.

My first inpatient hospitalization was when I was fourteen. My first roommate in the hospital was this cheerleader. To look at her, she was one of those perfect popular people. She said, “If you wanna get out of here, just tell them what they want to hear. Don’t be too happy, don’t cry a lot. Just tell them exactly what they want to hear, and you’ll get out of here.”

I took her advice. I didn’t make too much trouble and got out, but I was just starting up this cycle of self-injuring, which they would react to as if it was a suicide attempt. I was in and out of different facilities. We were privileged in the sense that [we] had insurance, but [they only kept me in the hospital] until the insurance ran out. You always knew that’s when you would get out—when the insurance ran out.

It was the most disparaging time. I did love learning; I loved school. I didn’t love the social aspects of school, but I liked the academic aspects of school. I was in line to be the editor of the high school paper. They were kind of grooming me for that, because I loved to write. I had to drop all my classes, and all of that went down the tubes. Anything I was hopeful about was completely taken away from me. Everyone at school found out. I was already not a super popular person, so there was all of that shame on top of it. That was really devastating.

When I was sixteen, after the most serious attempt, I really almost died. I remember coming to in the emergency room, and people treating me like shit. I understand they were trying to save my life, and I’m thankful that they did, but there was no bedside manner. That was almost more traumatizing than having survived an attempt. There were all these blinding lights, they were pumping my stomach, and talking about me as if I wasn’t there, even though I think they knew I was conscious at the time. They seemed annoyed that they had to save my life.

Nobody ever addressed the childhood trauma I had gone through. Neuroscience shows now that it changes your brain. It has an effect on you that can be really enduring, but they never really addressed it. They were like, “Oh, your symptoms are getting worse. We’re going to have to put you on a new medication. You’re bipolar. No, you have borderline personality disorder. No, you have obsessive-compulsive disorder, and we think you may have major depression with schizoaffective features.” Just one thing after another.

I didn’t get very good counseling. There was group counseling, but a lot of it was really focused on my symptoms, my medication, and how it was helping or not helping my symptoms… and the rest was just warehousing. Babysitting.

After that serious attempt, I was put into a long-term facility for a year. It was an interesting place. It didn’t have actual walls. It wasn’t locked, per se, but it was in the middle of nowhere, and the minute I got there, they took my picture. They said, “We’re giving this picture to all of the local police, so if you try to run, they’ll be able to catch up with you in about five to ten minutes.” I don’t even know if that was true, but that’s what they told us.

Everybody in that place was all children who had traumatic backgrounds. Every single one had experienced different forms of abuse. It was so clear that young people were just reeling from the effects of that. Some of them used drugs. I mean, I definitely dabbled quite a bit in that. It was just sort of like, “Oh, you’re an addict.”

Everything was punitive or judgmental. They would force us to go to twelve-step meetings, which we really liked because we got to smoke at those. Oh, and they would take us to the Circle K to buy candy. We really enjoyed that, too. We didn’t usually get to do that. All the addict kids got to go to Circle K. All the other kids were trying to play off that they were drug addicts so that they could go, because it was an outing.

That was my longest institutionalization. I got out of there, and it was increasingly hopeless.

I tried to go back to my old school, but it was a really oppressive environment. I was so filled with shame about what I had done that I think I couldn’t handle it. Knowing that everybody knew [what was happening] wasn’t cool back then. There were very few kids who would’ve thought that was cool where I lived. I felt like a pariah.

Kind of stopped going [to school] again. Started doing a lot of drugs again. By then, I was probably on the fifth or sixth psychiatric medication that they had tried me on. They just kept cycling through new ones. I was on legal and illegal drugs, and it was a complete disaster.

My family didn’t want me anymore. They placed me in a group home for adults when I was seventeen. They said, “Yeah, you’re going to have to be here the rest of your life. You’re severely disabled.” I got on disability. It was the most horrible, awful place. It was filthy, there were all kinds of bizarre things going on in there. There were people vomiting out the window. Things of that nature were happening at that place.

I attempted again in that place. I was in a lot of despair, but the other motivation was that I needed to get the hell out of there. I didn’t want to live either, but it was like, “I can’t be here.” Of course, seventy-two hours later, they sent me back to the place with a new prescription for something else.

I had this weird moment. Maybe it was motivated because I had seen the hell my parents went through being permanent patients. Neither of them were really suicidal, but they were in and out of the system, and it was horrific watching what was going on with them from afar. After they kicked me back to the group home, I was like, “This cannot be my life. It will not be my life.” I was almost eighteen. I sucked it up, and begged my family to let me come home. I was like, “It’s gonna be different.”

I’m lucky that I had them, even though we had gone through a lot of struggles. They finally agreed to let me come home, on the condition that I finish high school. At that point, I had not finished high school. I had no job. I was on disability. I was living in a group home. That was going to be my future.

I was really, really lucky—they sent me back to one of those alternative schools for the bad kids. It was a situation where I had a really good educator. He knew that I was academically motivated. I was allowed to finish high school at my own pace. I didn’t really have to go in, except once a week. That was because I had this sort of internal motivation. I really wanted to do this. He worked with me. He was this great mentor, and was really supportive. I got my high school diploma.

Things kind of started to shift for me then—I started to have the smallest amount of hope that maybe everything that they told me about myself wasn’t true. I couldn’t get into a four-year college because I missed so much education, so I went to community college. I had a great guidance counselor there. I feel like the people who really helped me were not the mental health professionals who were supposed to be helping, but educators. I loved learning, so I kind of ingratiated myself with them.

This amazing guidance counselor who knew all about my history said, “I’d like you to sign up to do this mentoring program with returning vets who are coming back to schools.”

I was like, “I don’t know, that’s kind of weird. I’m this nineteen year old girl. What can I possibly offer these men?”

I was able to see what peer support is. Even though they weren’t technically my peers, we could support one another.

It ended up being the coolest experience. They were navigating being back in school after years and years. We would meet every morning over coffee and read the paper. I became friends with all these men who were in their fifties. We just started helping each other. I know it’s weird to describe, but I was able to see what peer support is. Even though they weren’t technically my peers, we could support one another. Obviously I hadn’t been to Vietnam or through any kind of war, but I felt like I had been through a war in my own way. We connected around different kinds of battle scars, I guess you would say.

It was the positive cycle where my self-esteem was rising. I felt like I was contributing. I was helping other people. I was doing some good things in the world. That cycle just started to kind of feed on itself.

I was lucky because I had a lot of support, and a lot of privilege. I’m completely understanding of that. Not everyone is so lucky. Not everyone’s family would let them come home. Not everybody has a family to come home to. I’m aware that luck plays a lot and privilege plays a lot in my story.

At the same time, my parents came from that, as well. They were never able to escape it. They had family support, but they were so broken down by the system… Still, I was able to emerge from that cycle.

One of the most healing things for me was when I ended up getting into a four-year college. I got into UC Santa Cruz and left the country. I went to the Middle East, right after my mother died at age forty-six due, in a large part, to all of the meds she was on, which we now know can really shorten peoples’ lives by twenty-five years. I wasn’t gonna go, but I decided to go.

I went to Cairo, Egypt, and it was a trip—a completely chaotic place. It was so healing for me to be in a different culture where they had different values, a place where people were so welcoming of the foreigner, or the stranger. People would take me in. They were curious about me.

I felt loved and accepted, even in this other culture. It gave me a lot of insight into my own culture as well—things that I hadn’t really seen or understood about America, like our consumerist and individualistic way of being. We don’t take in random people. These people didn’t know me. They didn’t know me from anyone. Yeah, I was a twenty-one year old girl, so I’m not necessarily threatening. It’s just that sense of the culture, where we welcome people in, where we value community. Some people can kind of view that as suffocating. But [in America], we have the exact opposite of that, where it’s everyone out for themselves in a lot of ways. Generally, people don’t think that way in that culture, because it’s a desert culture. They had to be hospitable. People’s survival depended on the kindness of strangers, and that kind of endured. It’s a bit of an oversimplification, but generally speaking.

I would say that got me on my path to recovery. I was in such a bad situation, being in the group home, not having a diploma, not having a job. Completely on the track of poverty and disability. I was able to get out of that. While living in the Middle East, I got excited about going into diplomacy, or doing something internationally—I didn’t know what. I went to graduate school for that.

In my second year of graduate school, that sense of hopelessness came back. I thought I was over it. I became extremely depressed. I couldn’t get out of bed. I was really isolated. I didn’t know anybody. I had moved to Washington, D.C. from California for graduate school. I hated the culture of D.C. It was just a huge slap in the face to see all of the racism and classism. It’s right up there, in your face.

Now, I understand that recovery is not, “Oh, you have no more symptoms. You’re fine forever. You’re normal again.”

I ended up going to the university counseling service. That was the first time in seven years I had sought treatment, but I knew I was going downhill, and it was not looking good. I told the counselor my life story, the story I am telling you right now, and she burst into tears. I had never seen anything like that. I mean, I understand we’re all humans. We all have reactions, but it affected her, and I don’t know why. Who knows if it touched on something from her own life. She burst into tears, and that was kind of shocking to me. Then the session was over. That was the intake.

The next time I came back, she said, “Given your family history, it’s a real problem that you are unmedicated. I need you to go see the psychiatrist right now,” so she walked me over to the psychiatrist.

He was this completely bug-eyed, creepy guy with wild hair. He’s like, “We need to get you back on medication.Your family history, and you have OCD, bipolar disorder, major depression with schizoaffective… We need to get you back on the meds.”

I said, “You know, they really hadn’t ever worked for me. Even when I wasn’t using illicit substances. I was in a hospital and under a controlled situation. They never helped me. It’s not an anti-meds thing. It’s just different things help different people. I have friends who are hugely helped by meds.” I was just really resistant to going back on the meds.

He said, “Well, here is a new drug. It’s called Celexa. It works because it’s selective.” He took out a chart, showed me brain synapses [to show me how it worked]. He gave me a starter pack. I didn’t even have to go to a pharmacy. He’s like, “Next week I’ll see you, and I’ll see how it’s working.”

I said, “You know, Dr. Whatever-Your-Name-Is, I’m really not comfortable. I’m struggling with a lot of things due to my environment and the stresses of this program, and not knowing anyone.” I wanted to talk about what was going on!

He said, “Well, read this book called Listening to Prozac by Peter Kramer. Get this book, and it’ll completely change your mind about the meds. Completely change your mind.”

I was resistant, but I was like, “You know, whatever… I’ll go look for the book.” I went to the university bookstore, looking for this book. Instead of Listening to Prozac, I found this book Talking Back to Prozac by this guy named Peter Breggin.

I literally read this book from cover to cover. It talked about a lot of side effects that people get on Prozac or other SSRIs. Some people get these really horrible side effects, including increased suicidal feelings and ideation. My mind was blown. This was literally the first time that I had ever heard anything besides the positive narrative that Prozac was “The Wonder Drug.”

Something just went off in my head, and I wrote to the author. Back, like, ten to twelve years ago when you could write to people and they were accessible. I wrote to him, and [told him my story.]

He said, “Well, you need to get in touch with the movement.”

I was like, “What movement? Nobody’s ever heard of this movement!”

I got in touch with them. At the time, there was a whole group of people whose children had killed themselves on different SSRIs, like within a week of starting them. They had been distressed and troubled before, but then became suicidal, which is now well-documented. It doesn’t affect everybody, just a subset of people who have this reaction.

I started advocating with them. The FDA psychopharmacologic drugs committee was having hearings on this issue with SSRI antidepressants and youth. There were all these families who testified that their children had killed themselves on the drugs, and I was one of the few people who had actually survived. There were maybe only one or two survivors who testified. It was absolutely empowering to connect up with other people who were trying to get the word out about these dangerous side effects.

They ended up putting a black box warning on those drugs in 2004. It had a sense of victory and accomplishment that, at least, people would know. When I became suicidal on those drugs… I definitely had a lot going on, it’s not like life was great, but I went on the drugs and became suicidal. They activated something in me, but nobody ever said, “Oh, maybe these are not good drugs for Leah.” They just kept putting me on more. They increased my dosage, or they would switch to a different kind. They were like, “This is her underlying illness getting worse,” which is complete bullshit.

That was kind of my first taste of activism, and then I dedicated myself to this work. I haven’t always focused on antidepressants or drugs. I’ve really been focusing more on systems change. I’ve kind of taken on this suicide prevention industrial complex a little bit by trying to bring the voices of people who have used these services and gone through these experiences, to say, “Yes, we are experts, too. I really respect you. I respect that you have an MD, you have a PhD, you have an LCSW, and whatever you might have in terms of letters behind your name, but we are experts by experience.”

I’m lucky that, when I’m having those feelings, I can reach out to people.

I haven’t attempted suicide in over twenty years. I’m not going to say that I’ve never been suicidal since then, because I have been. I’ve learned to work with those thoughts. I can apply things like mindfulness. I’ve learned a lot of strategies. I have a lot of friends now who understand. I have friends in every time zone—from this activist work—who understand and who know how to respond appropriately. I’m lucky that, when I’m having those feelings, I can reach out to people. They’re not gonna call the cops on me. They’re gonna listen; they’re gonna support me.

A part of what I’ve been trying to do, and what I’d like to do more of, is educating people how to respond if they have a friend who’s in crisis or who’s feeling suicidal. People just don’t know. I feel really strongly about that work, that this is actually all of our responsibility. Part of the problem is that we farm out care to professionals who, most of the time, aren’t themselves trained to deal with it.

It is a situation where everyone who gives a shit needs to be educated or empowered to learn about how to be a support person if they’re ever in that situation. Not everybody learns CPR, but a lot of people learn CPR. If somebody’s choking or if someone’s having a cardiac arrest or something, they know what to do to save that person’s life. I’ve been involved in something called Emotional CPR, which kind of has that same approach. We don’t have to be afraid. It’s scary, but we don’t have to let our reactions be driven by fear. When reactions are driven by fear, they can often cause more harm, which I’ve experienced in my life over and over and over.

Des: Talk about this idea that, if we put a bunch of attempt survivors in a room, they’re just gonna teach each other better knots for their nooses.

Leah: Right. That’s what the internet is for. If somebody wants to learn this stuff, it’s all over the internet. There’s no way to take that stuff down. I mean, you could try.

But I think there was always this understanding that there must always be a professional present. That’s fine if there is—I’m not saying that it has to be without a professional—but what I’ve known is that bringing people together who’ve had these experiences is the number one way to humanize the experience. It’s a very serious topic, but when you bring a bunch of people together to talk about suicide, you’ll be surprised at how much laughter there’ll be in the room.

I guess it’s not unlike going to a twelve-step meeting or something like that. I think we actually have more potential to support each other than to bring one another down. There’s certainly plenty of that out there. We’ve heard lots of horror stories. I wish there was almost something like AA for people who are suicidal. Not twelve-step necessarily, but something, just to know that there are people who gather to talk about these taboo things—and if you live in, like, Wyoming, you can find a support network like that in your area or wherever you live. We don’t have anything like that when it comes to suicide.

There are some groups that are starting up now, like Alternatives to Suicide in Massachusetts, but there’s still this idea that we are not equipped to support one another. Certainly, these groups always have people who’ve been through some kind of facilitator training. I’m not saying that it should just be whoever, whenever, because there are some skills that are helpful.

That’s how I’ve found so much of my healing. I’ve had some good counselors, but when I’m in distress, I don’t call a counselor. That’s just me. I get in touch with my friends. I’ll text my friend in South Dakota, and she texts me. That’s what helps me.

I wish there was more of that, in whatever medium. Some people don’t show up to meetings. I think text has a lot of potential, and we need more of that. I don’t really know too many people who are gonna call a suicide hotline, at least who are younger. Young people don’t make phone calls. I think we need to really meet people where they’re at, with the technology that they’re comfortable using. There should be a variety of options for people in distress in our society, and there aren’t. That’s the kind of thing that I’m gonna keep fighting to raise awareness around, and try to advocate where I can.

Des: Talk about experiences you’ve had with suicidal people in need of help.

Leah: I’m someone who’s had a fair amount of experience. I’ve supported friends through suicidal crises. Literally, sometimes, someone who’s on their way to a bridge. I’ve been there. I’m happy that I saw the text, that I was able to respond. It doesn’t ever stop being scary. I think if you can maintain your authenticity, that is what’s healing for people. [People in crisis] have a very sensitive radar for bullshit, or for people having a knee-jerk reaction.

I think it’s just all about educating each other. How do you respond? What’s helpful? What’s not helpful? Just because you’ve been suicidal yourself doesn’t necessarily mean you know the right thing to do automatically—or what is helpful and what isn’t—and that, I guess, gets back to what I was talking about, just that need for all of us to be educating one another and educating society at large.

When that person [online] posted that they were feeling like they were going to take their life, somebody else contacted me and said, “Oh, this is happening.” There was such an outpouring of support. I’m not going to claim it was easy for anyone involved but, to me, it seemed like it had a really positive outcome.

I think that it went as well as it possibly could have. I don’t want to go too much into the detail, but it helped that person deal with some of the circumstances that were driving some of her suicidal feelings. It was kind of amazing to me. It went even beyond the outcome of her not killing herself, because people weren’t afraid, and they didn’t just call the police. Sometimes that’s unfortunately the only thing someone can do.

Des: I mean, we did have the police sent to her house.

Leah: Yeah. It was the only option. There are no other options, generally. Unfortunately.

That’s another thing I really want to change. I’d really like to see a different model, where there are more mobile crisis situations for people who actually know how to respond to someone who’s suicidal, including a peer, and the police just kind of hang back. If the police have to be involved, they’re not front and center, being the first responders. I know there’s some good cops out there who’ve been very sensitive… but it’s not a great feeling. When you’re in that crisis, you don’t want to have cops knocking on your door. It’s not a fun, good thing. At least have people who are just kind of regular, caring people—not in a uniform, not with a gun. It’s not great to have anyone show up, but if somebody’s gotta show up… I think that’s the struggle. I don’t think people should be left to their devices. I know I’m really glad that I wasn’t left up to my devices.

I have a kickass life now. I love my life. I’m eternally grateful that I was forcibly stopped from taking it. It’s challenging, because I’m also a strong believer in human dignity and civil liberties. Those are really challenging things to negotiate. How do you maintain autonomy? How do you maintain civil liberties and human dignity when, sometimes, you’re trying to force someone to do something they don’t want to do? Or trying to save someone who doesn’t necessarily want to be saved in that moment? These are hugely challenging ethical issues that I don’t have an answer to, but I do know that I’m not a, “Oh, let anyone do whatever they want,” kind of person.

That is where the tension continues to lie. I feel like, as long as we can make our response as compassionate and humane as possible, then we’re on the right track.

Des: Talk about Facebook’s suicide prevention tools.

Leah: There’s a billion people on Facebook. I think they do have some kind of ethical responsibility. I would argue that, at large, the whole world has an ethical responsibility, in a way. I think they’re trying to do the best they can. I really like a lot of aspects of it. I like that they give people actual tips on how to support a friend who might be in crisis. They have videos and things like that, that give you a sense of how to be helpful. That’s exactly the kind of information that people don’t have and need.

What I’m afraid of is a chilling effect. People think that, now, if you post something that you’re distressed on Facebook, that it’s going to be reported, somehow, or the cops are going to show up at your door. I’ve already had several Facebook friends say, “Now I’m scared to vent about whatever is going on with me.” For some people, that is their way of venting. That’s how they get support. They’ll post something that’s really stressful, all these people respond, and they feel better doing that.

Des: Now talk about clinicians. Specifically, clinicians who are afraid to take us on because of liability.

Leah: More often than not, people have this experience: they reveal to a clinician that they are suicidal, and a cloud comes over the person’s eyes where the cognition starts to happen. [They start to think], “Okay, what is my boss gonna say? I wonder what the protocol is,” and so on. That’s a problem because that shuts down the therapeutic connection…

I think the issue is that people are so afraid of being sued. They’re so afraid. To be honest, it’s more likely that someone will be sued for not responding appropriately than they would be sued for… It’s rare that clinicians or hospitals are sued when someone attempts their life. That’s really rare. What happens is people get sued when someone attempts their life in the hospital. The hospital will get sued for not protecting that person. There’s a lot of that that goes on.

There was like a huge expose in the UK about people actually dying by suicide in an inpatient setting. The hospitals are so understaffed and don’t really pay attention to people. This is a huge problem. I think we need to rethink liability. We need to move away from being obsessed with risk management. It’s really problematic.

People have different, conflicting definitions of safety. Our view of what’s safe, as someone who’s going through distress, who’s in a crisis—versus what the theoretically “liable people” are concerned about—are two very different things. They’re often at odds. They often cause more harm to the individual in distress. Things like, someone acts suicidal while they’re in care, and then they get put into seclusion and restraint. That happens all the time in 2015, where we are tying people down who are in pain, and we are shooting them up with drugs, or locking them in rooms. These are people who are in pain. They just tried to kill themselves, and that’s how we respond. I don’t know why there’s not an outcry that that’s the most fucked up thing imaginable. That’s all because they’re covering their ass.

I happens all the time, anyway, so it’s obviously not an effective tactic. You know what I mean? I think really just teaching people how to respond in a way that does not do further harm—I think that is kind of what I’m all about.

Des: Talk about this idea that—not this idea, this truth—that suicide doesn’t always affect people who are mentally ill, and the idea of mental illness as a construct, and trauma-informed care—all the things you love to talk about. Talk about ‘em.

Leah: There’s this, I think, totally bullshit statistic that 90% of people who die by suicide had a mental illness. That is done on the basis of something called psychological autopsy, which is where they go around and ask people’s family and friends what they thought about it. Which is like, “Wow. That’s really scientific. Thank you for arriving at that highly subjective conclusion through highly subjective means, and then throwing out this statistic ad infinitum.”

Suicide is something we don’t understand.

Suicide is something we don’t understand. Every time someone hurts themselves, we say, “Oh, they were mentally ill.” Anytime anyone hurts someone else, we say, “Oh, they were mentally ill.” It’s like, “Oh, that explains everything about self and others. They were mentally ill!” It’s this constant feedback loop: they did it because they were mentally ill, and they were mentally ill because… It gets us nowhere in terms of addressing the root causes of these things.

There’s this psychiatrist that’s come out with a new book called Shrinks, where he tries to defend the profession of psychiatry. It’s sort of like, “Well, the fact that you have to defend your profession might show that there are maybe some valid critiques of it. I know great psychiatrists. It’s not an anti-psychiatry thing. It’s just this idea that everything human distress-wise can be reduced to biological mechanisms in the brain. It’s this extremely reductionist way of understanding the human experience, which is way more complicated than mechanics of the brain.

We are affected by our environment, and that also affects the brain. I’m not trying to say there’s nothing going on with the brain. Sure there is, but to reduce everything to, “These are the symptoms located in an individual. That is illness and pathology,” denies the role of the environment; of society; of our schools; of our workplaces; of everywhere where human beings live and exist.

That, to me, is the huge, huge failing of the mental illness lens. If you identify with your diagnosis, awesome. Whatever works for you. I believe in people waving whatever flag makes them feel good. But I think there’s a whole other aspect to this which is not talked about as much, but is starting to be more understood—the effect of traumatic stress on people. I’m not just talking your classic PTSD, where someone’s in the military, or an abusive relationship, but the effects of childhood trauma on people.

There’s this thing called the Adverse Childhood Experiences Study, where they asked 17,000 Kaiser Permanente members about things that had happened to them, whether it was abuse or neglect, having an incarcerated parent, any number of categories of traumatic experience. It’s basically ten yes-or-no questions. If you have an ACE score higher than four out of ten, you are much more at risk to die by suicide. The higher your ACE score, the higher the risk. It’s a graded relationship. They call it “dose-response relationship.”

Des: Dose of trauma?

Leah: Yeah! Basically, the higher your trauma level, the more likely you are not only be suicidal, but to have physical health problems, to have mental health problems, to have various social problems. This is hard science. This is not some foofoo stuff. It’s been replicated over and over. The CDC is involved in this. This study has been replicated in almost every state. It started in California with these 17,000 people. It’s not some sort of minor piece of vague science. I think we need to have more of an understanding about that. Most of the people I know who really struggle with suicide on an ongoing basis didn’t have it so good in their lives.

We don’t look at that. That did not come up in my treatment. It was just sort of, “Oh. Duly noted. Patient has schizophrenic mother and was in fifty-nine foster care facilities.” It wasn’t ever part of my treatment. It was just like, “Oh, here’s your fifth diagnosis,” which isn’t resolved trauma.

I wasn’t able to do any of that stuff until I was in my thirties. That’s when I realized I was suffering from the effects of traumatic stress and got some actual treatment that helped with that—but I had to be a grown-ass person to figure that out, and that’s just not right.

I just wish that the whole suicide prevention field was aware of this, and that it was understanding that 90% of people, particularly in the public mental health system, have a serious trauma history. 100% of incarcerated women have a trauma history. Probably men, too. It’s almost a tie.

None of our human services reflect this understanding. That’s why we continue to hurt people, even though we have awesome intentions. Nobody goes into this field for the money. They obviously go into it because they care. But we do harm when we don’t take into account that trauma is in people’s background. If, for some reason, it wasn’t in their background when they got into various service systems, they will be traumatized in some way—even witnessing the violence that goes on in institutions [is trauma].

I am lucky that I didn’t experience seclusion and restraint, because I just played along like that cheerleader told me to. I was pretty compliant in the institution, or I didn’t get caught doing things. But I saw takedowns. I saw young people getting hurt by adults in the institution. That was the most abuse I’d ever seen in my life. I had a lot of my own negative experiences as a very young child. But that’s where I saw abuse, and that stuff stays with me.

You don’t even have to experience the trauma yourself. You can witness it. Whether you witness it on the streets in your neighborhood, or you witness it in juvenile detention, or wherever you witness it. We’re learning more and more about the science of this. We’re learning more about how to actually treat trauma. The earlier you can support someone to heal their trauma, the better the outcome is.

Although there’s always hope. There’s always hope. I think that this is sort of like the lens through which we should actually be looking at things. It still involves biology. It doesn’t deny the role of biology, but it understands a person in a context of their environment. I think a lot of the traditional way of looking at mental illness just misses that. It’s like, “You’re a broken brain, and that’s the end of the story. Take a drug.”

Again, I know people are helped by medication. Medication is a tool. It’s not going to usher in total healing for a person, especially if they’re continuing to be in a traumatizing environment. It’s just going to make them dull to their environment. It’s going to dampen down the response.

Des: Is suicide still an option for you?

Leah: This is my own personal decision and I don’t judge anybody else for whatever decisions they make. Suicide is not an option for me because I have a young son, and I’m a single mom. When I became a mother, I took it off the table for me as an option. I’m lucky that when those feelings do come up–and they still come up–I have the resources to deal with them without acting on them becoming an attractive option.

That’s basically been the approach I’ve taken. When I have suicidal feelings, I don’t really freak out anymore. I just sort of see them as, “Oh, some stuff is just really off, and you need to address the stuff that’s off.” For me, it’s almost just a warning sign. It actually can be kind of good, because it forces me to take care of myself. It often happens when I haven’t been sleeping, I’ve been working too hard, I’ve just been stretching myself way too thin, and I’m just at the breaking point. Then, that stuff all sounds attractive. When that happens, I now know what to do, and it goes away.

I don’t know that I’ll ever be cured of having suicidal feelings, and I don’t know that I need to be. I do know that I want to be there to see my son grow up. That’s really important to me.

It’s not easy, but I think we all struggle with it to different degrees. It’s just gotten to the point in my life where it’s not overwhelming anymore. It’s just this thing that comes up. I don’t know that I’ll ever be cured of having suicidal feelings, and I don’t know that I need to be. I do know that I want to be there to see my son grow up. That’s really important to me.

Recovery is real. You can recover from this, even if you have symptoms. Those don’t mean you aren’t in a process of recovery. [Recovery] is really just a process of achieving the kind of life you want—not just an absence of symptoms, or feeling okay all the time, but that struggle where you have support to get on the path you want to get on.

I just want to emphasize that recovery is a hope and possibility, no matter what your diagnosis, no matter what your history is, no matter what your trauma history is. There is healing. But we need to create the conditions where people can heal. I think that’s why so many people aren’t healing, because we don’t have those conditions for everyone.