WORLD SUICIDE PREVENTION DAY: CHANGING THE CONVERSATION AMONG MEN OF WORKING AGE

Colorado has the 6th highest suicide rate in the nation.  Men between the ages of 25 and 54 account for 44% of the suicide deaths in the state, and in 2010 had the highest suicide rate among all age and gender groups. The high number of suicide deaths in this group, coupled with the limited prevention and intervention efforts, targeting this difficult to reach demographic, confirmed the urgent need to develop suicide prevention strategies to better serve this population. In 2006 the partnership between Cactus, The Office of Suicide Prevention (OSP) and the Carson J Spencer Foundation began and we made a commitment to address this growing public health crisis.  In 2011 the partnership received funding from the Anschutz Foundation to further these efforts and on July 9th 2012 launched the Man Therapy™ campaign with an article in the New York Times.

Dozens of Denver Metro Billboards with Man Therapy messages

 

The purpose of the Man Therapy™ campaign is to provide men with a place to learn more about men’s mental health, examine their own situation and consider a wide array of actions that will put them on the path to treatment and recovery. The universal message is that all men should be aware of their mental health status and treat it like they would any other ailment and strive to get better.

 

 

From the outset, Man Therapy was created to be shared with other states and mental health organizations around the U.S. that are working to prevent suicides in their communities.  It has been created so it can very easily be implemented in communities throughout the country.

 

Man Therapy reshapes the conversation, using humor to cut through stigma and tackle issues like depression, divorce and suicidal thoughts head on, the way a man would do it. The campaign features a mental health hero, the good Dr. Rich Mahogany. He’s a man’s man who is dedicated to cutting through the denial with a fresh approach using his rapier wit, odd sense of humor, no BS approach and practical advice for men. Dr. Rich Mahogany is dedicated to helping men take charge of their own mental health.

Posters and Bus Station Displays

 The centerpiece of the campaign is the mantherapy.org website, where men and their loved ones will find they have a virtual appointment with Dr. Mahogany.  Visitors can navigate through Dr. Mahogany’s office where they can find useful information about men’s mental health with Gentlemental Health™. Men can also take an 18-question quiz to evaluate their own mental health status.  Within the site you are able to access resources and explore a wide range of choices from do-it-yourself tips to professional therapist referrals. Additional resources include links to local support groups as well as a national suicide crisis line that is ever present on the site.

 

In addition to the engaging experience viewers can find at mantherapy.org, the integrated communications campaign includes a 30-second TV PSA, three viral videos, social media promotions, outdoor boards and outreach materials including posters, coasters and Dr. Mahogany’s business card. 

Results and Evaluation

Impressive results in just the first six weeks. After generating 5,000 hits in the first day, the mantherapy.org Web site has seen an average of 1,000 unique visitors per day and has had 40,000 total visitors averaging 7 minutes on the site.  A total of 8,000 people have taken the quiz and been given advice and recommendations to consider.  A thorough evaluation is being conducted currently to obtain more detailed feedback and analysis of the effectiveness of the campaign and Web site experience. The evaluation includes a one and three-month follow-up component designed to measure whether the website contributed to positive behavior change among men who have visited the site.  A survey on the website also captures users’ immediate impressions.

• 73% were satisfied with the quality of the Gentlemental Health™, video testimonials, and Man Therapies
• 86% said the Web site was useful to them
• 89% would recommend the Web site to a friend

The survey also revealed that the 34% of those who came to the website were looking for resources for themselves, and 14% were looking to help a friend or family member. The model user is a man aged 25-34. Some of the qualitative responses include:

• I have never regarded myself as a stereotypical macho male, but was struck by (i) how many of the macho-male myths I subscribed to and (ii) how fast they crumble when they are examined.
• I am a mental health clinician and I love the idea and the concept of using humor to get men the help they need. This is such an important area.
• Awesome way to reduce "stigma" for men seeking mental health assistance! This is what we need instead of the same old SAMHSA, DCOE, NIMH, etc. sites. This makes men want to use it as it delivers info in an easy to understand format! Love it!
• Extremely engaging use of humor, not only via the actor and faux therapist, but throughout. As a therapist and a man, I was pleased to see such a resource. Well done! Hopefully this will become the model for preventative campaigns within public health using modern media.
• Brilliantly uses a classic manly character to say that it's ok to be depressed and offer advice. The small jokes in the information booklets like Gentlemental Health 101, such as Ben Leizman ‎"The effects of substance abuse on your brain are as ugly as an 80-year old fat man in spandex," really make the argument more effective and appealing. A very well done website and an idea that will save hundreds of lives.
• Dr. Mahogany is hilarious, with just the right level of warmth to keep me feeling engaged. That's not easy!

 

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About Cactus Marketing

Cactus is a full-service brand communications agency providing business solutions for companies and causes through brand strategy, advertising, design, interactive and media services. Cactus has been nationally recognized for its breakthrough creative executions by The One Show, Communication Arts, The Webby Awards, South by Southwest, Favourite Website Awards, Advertising Age, Creativity and Print’s Regional Design Annual. To learn more about Cactus, visit http://www.sharpideas.com.

About the Carson J Spencer Foundation - Sustaining a Passion for Life

The Carson J Spencer Foundation (www.CarsonJSpencer.org) is a Colorado nonprofit, established in 2005.  We envision a world where leaders and communities are committed to sustaining a passion for life. We sustain a passion for life by:

• Delivering innovative and effective suicide prevention programs for working-aged people
• Coaching young leaders to develop social enterprises for mental health promotion and suicide prevention
• Supporting people bereaved by suicide

About Colorado’s Office of Suicide Prevention

The Office of Suicide Prevention, a legislatively mandated entity of the Colorado Department of Public Health and Environment, serves as the lead entity for statewide suicide prevention and intervention efforts, collaborating with Colorado communities to reduce the number of suicide deaths and attempts in the state. To learn more about the Office, visit www.coosp.org.

 

Guest Blog: Unemployed, Depressed and Searching for Hope Part II

Moving On After Professional Disaster Hits
Editor’s note:  This is the first of a two part series.

By Dr. Christina McCale, author, “Waiting for Change”

In the subsequent months after the publication of my book, “Waiting for Change” I have had innumerable people contact me: some thanking me for the book. Others commenting how they could relate to my situation. Others describing their own stories of job loss and the terror that ensues after that catastrophe has been set upon them.

But invariably, as I talk with, thank and continue to share with these incredible human beings, the question comes up: So how do you move on?

I wish I had a good answer. But in this posting, I’ll provide a bit of “framework” for thinking about the grieving process after your loved one has lost their professional identity.

Most times, when I’m asked this question, I compare the experience of the last two years to the grieving process Kubler-Ross describes: you’re going to go through different phases. There really isn’t a logical “pattern” for getting from point A (the day you lose your job) to point B (the day you realize you’ve gotten past the pain).  Not everyone is going to go through all the same phases in the same way or in the same order – because grief is a personal thing.

As I was told by a kind soul, so long ago, upon the death of my own family members:  “I promise you there will come a day – a whole 24 hour time period – when you will forget that they’re gone; that the pain has slipped away. But it may take a whole year of birthdays and holidays and missed vacations to get through all the ‘what might have beens’ before you can move on.”

While I know intellectually that there has been some comment and criticism of the Kubler-Ross model (denial, anger, bargaining, depression and acceptance), and I am hardly an expert therapist or knowledgeable about psychology, to me, it does at least seem to provide somewhat of a framework to begin to make some sense of what has just occurred – and perhaps a perspective that can help the loved ones who will now be called on to buoy the unemployed person through the next phase of their life.

A Complicating Factor

What might complicate matters, though, is that as a society we don’t see job loss as a “death” per se – although many have described work as an innate part of our identities and in many cases a cornerstone of one’s social life.  The notion of unemployment – or rather the inability to move on and find a new job – carries a stigma with it that dates back to our colonial America.

The Puritan work ethic, a belief that our dedication to doing a job well is a way of honoring God, is a part of our very social fabric. Our very language is peppered with the language that reinforces the importance of getting the job done and doing it well:

“Make hay while the sun shines.”

“Go the extra mile.”

“Your work should speak for itself.”

“Actions speak louder than words.”

“Don’t waste time.”

“Idleness is the devil’s handmaiden.”

“Don’t put off to tomorrow what you can do today.”

“Don’t just stand there … DO something.”

Some of our most fundamental attitudes come from that colonial society which emphasized the importance of work: where the community had to prioritize and safeguard its resources. Therefore, the poor then fell into two categories: the deserving poor and the non-deserving poor – those who through some character flaw or lacking in their effort to contribute their work. Later these attitudes morphed – that the poor were acculturated to be poor – that they didn’t know how to behave any differently and that their own actions perpetuated their lot in life.

So not only are we as a society taught to believe that work is an important part of our lives, to the degree that we identify ourselves through our work, but we are also then lead to the fallacy that if we are not working there must be something wrong with us.

Or if we were fired, laid off, etc., then we must have done something wrong…  been inadequate in some way.

We failed.

And let’s face it – failure is not something our society talks about willingly, let alone accept and forgive readily.

So understanding that there is a whole host of acculturation, societal expectations and psychological identity elements – not to mention the greater issues of macro-economics, social justice, and equity that I won’t even begin to touch here – how do you get through those stages of grief and attempt to get your life back in some fashion?

Not easily.

When my own identity had been ripped from me, destroying a decade’s worth of effort and dedication to complete my doctorate – something that had cost me dearly in so many other ways –to say that I had been laid low would be too cliché, too much of an understatement for the reality that would ensue. I could barely get off the couch for weeks.  I didn’t sleep more than a few hours a night. I could barely eat. The most mundane tasks of getting kids to school and dinner on the table (which turned into a lot of nights with Domino’s) became insurmountable peaks to climb.

Much like what some may feel when they lose the one they love – a spouse, a parent, a child.  You are now experiencing the unthinkable. The unimaginable is now real. After all,  our profession is a part of our identity. So it follows that we grieve at the loss of a job because we are not only losing a part of ourselves, but experiencing a social death as well.

Editor’s note: Next week Dr. McCale will discuss suggestions for navigating the emotional landscape after layoff, termination or downsizing.

About Waiting for Change:

Part memoir and part social commentary, the book Waiting for Change profiles the very personal realities of job loss during the Great Recession and the domino effect to one’s housing, sustenance, employment, children, and social support systems.  The book takes the reader on a guided tour “behind the story” of all the statistics on the evening news to explore the new and evolving landscape of poverty in the richest country on Earth.  Waiting for Change provides a mental “travelogue” that illuminates not just the immediate impacts of poverty, but the downstream repercussions, all in very personal, relatable and easy to read ways.

About the Author:

Prior to getting her doctorate in Marketing, Christina McCale worked for 17+ years in some of corporate America's biggest companies. For the last 10 years she has taught marketing and management instructional duties at the university level for the last 10 years, she has also been one of the key and has conducted research on how to best prepare our undergraduates for career entry. Today, she lives in Olympia, Washington with her son, daughter, and their two beloved greyhounds.

Guest Blog: Unemployed, Depressed and Searching for Hope

By Dr. Christina McCale

           “I can’t live like this,” I said to the person at the other end of the phone. I’d seen several flyers for free and sliding scale health services, to include mental health while making my very first visit to the Food Bank, and had picked one up. “I just know I can’t go on living this way.”

            It wasn’t the first time I’d come to this conclusion or had this conversation with a medical professional. But it was the first time I was having such a conversation with so few options due to the lack of insurance. I’d lost my health insurance when I had lost my full time job teaching at the university level: a career choice I had loved with every fiber of my being.

            Being a classic over-achiever who had worked three jobs while completing my doctorate; the stress of that coupled with two young children and a deteriorating marriage; and a family history full of stories of women who were plagued with “melancholy” or “the blues” had probably made me a prime candidate for depression, which, perhaps today, might have been diagnosed even earlier.

            So then throughout the remaining years of my doctoral program (and then, later, dissertation), the doctor continued monitoring me, adjusting my medication as need be. And things were relatively fine. Sure, there were bad days, even stressful, horrible days. After all, I passed my comprehensive exams, wrote my dissertation and ended my marriage all during these subsequent years.

            But all of that was manageable by comparison to what was to come.

            When my professional career as an academic, and the entire identity I had built for myself was suddenly yanked out from under me, I was left gasping for air and struggling to find any sense of self outside of what I had loved to do for the previous 10 years. Medication became the only way I could manage through the waves of sadness, the raging anger, and the sense of complete and utter ambiguity.

            I hadn’t even taken time off for maternity leave after the births of both of my children – in part because I had no such time to take as maternity leave did not apply to me as an adjunct faculty – but also because I couldn’t imagine not being in the classroom with my other “kids.” My students were children who were on loan to me from their real parents: kiddos I had an obligation to give my best self to each and every day.

            As I used to explain to my classes of undergraduates: “I’d better be doing what I love because each and every day I choose to leave the three people I love most in the world, and come to be with you.”

            Some people describe the day they were laid off as being the worst day of their lives. That day – and the days to follow – became the worst “life” of my life.

            Some don’t really understand the debilitating blow job loss, and the subsequent emotional turmoil that follows. Maybe that’s because some have been lucky, and have been spared that particular experience during the Great Recession. For others, the notions of unemployment come from deep seated feelings that date all the way back to Puritan America: if you are unemployed, and not infirmed, it must be because there is something deficient about you: you’re not trying hard enough, you deserved to be laid off, or you’re just too lazy to go out there and get another one.

            While I suppose there are exceptions to every situation, I tend to believe that everyone , at some level, wants to feel productive: like they are contributing. Work, as Freud once noted, is a part of who we are.  And to deny that work is a part of our identities is to deny a part of our cultural ethos: Do what you love. That your talents are a part of who you are. That we choose to make our 40-80 working hours a week not just a way to earn a living but to make it a personal expression of self.

            But work is a part of our identity.

            Work is where we find meaning.

            It’s often how we define ourselves.

            So when what we’ve been doing is abruptly taken away, it’s no wonder there can be significant repercussions. So the job loss, at least for me, became a spiral of depression and grieving. It’s nothing so simple as being linear – a straight or even sloped line from bad to worse. No, depression becomes a progression of stages when you’re trying to job hunt. Because each new step forward, puts yourself at risk. The perpetual changes take you through a perpetual cycle:

            You have jobs to apply to, so you’re up.

            When the job doesn’t come through, and you were so sure you did so well on the interview, you become morose.

            A friend doesn’t understand your disappointment, and you feel like it must be something “you’re doing” – so you’re pushed three steps back.

            You find a new job listing you’d be perfect for – so you’re optimistic.

            Weeks go by and you don’t get a call back, so you worry.

            A friend lets you know about a possibility he might be able to get you in to, and you are elated.

             People ask about the job hunt, so you get more down because you have nothing new, and no good news to share.

            You get an email from a potential employer that says you weren’t qualified enough, and so you’re back in the gutter of despair until the cycle starts all over again. The part of your bleeding soul that had started to scab up is now pulled off with the new wound of loss.

            I have a new found respect for actors and other performers who live through this cycle by choice, in pursuit of their craft. I have no idea how they do it and remain sane. Is there an inner sense of balance they draw on? Accepting themselves and knowing their value with or without the gig?

            The lesson so many long term unemployed have had to learn is that it’s not that we all haven’t dealt with sadness. And it’s not like we all haven’t wrestled with disappointment. We all have. We’re human beings. We live in the world. We know there are disappointments, set-backs, and frustrations in career management.

            But this is a new kind of “emotion management” because a person who’s been laid off may not be managing a 3, 6 or 9 month time span… but potentially years where you have to find the strength and the resources to navigate the self-doubt and rejection you experience when one is laid off.  A set of skills to navigate the ambiguity and the rollercoaster of emotions for more than just a few months … but potentially for 12-24 months?

            So what is helpful? That may depend on the person involved, just as the grieving process can look different from person to person. But undoubtedly one of the most important things is to find the resources you need to survive during this time: find the people who are supportive. Find the organizations who can help you.

            Additionally, for the people surrounding the one who has been laid off, this next period of time might seem a bit like being a caregiver. Learning as much as you can about depression and long term unemployment may certainly be helpful.  But just as caregivers of those with Alzheimer’s or Cancer need to take care of themselves and find their own support networks, so do those who are providing care and support to the long term unemployed.

            Because we certainly couldn’t get through those hard times without you.

About the Author:

Dr. Christina McCale, author of Waiting for Change 
www.waitingforchange.us
Prior to getting her doctorate in Marketing, Christina McCale worked for 17+ years in some of corporate America's biggest companies. For the last 10 years she has taught marketing and management instructional duties at the university level for the last 10 years, she has also been one of the key and has conducted research on how to best prepare our undergraduates for career entry. Today, she lives in Olympia, Washington with her son, daughter, and their two beloved greyhounds.

About Waiting for Change:

Part memoir and part social commentary, the book Waiting for Change profiles the very personal realities of job loss during the Great Recession and the domino effect to one’s housing, sustenance, employment, children, and social support systems.  The book takes the reader on a guided tour “behind the story” of all the statistics on the evening news to explore the new and evolving landscape of poverty in the richest country on Earth.  Waiting for Change provides a mental “travelogue” that illuminates not just the immediate impacts of poverty, but the downstream repercussions, all in very personal, relatable and easy to read ways.

Lifting their Voices: Suicide Attempt Survivors Speak Out

[Reprinted from American Association of Suicidology's NEWSlink June 2011]

The roadmap of suicide prevention is filled with challenging terrain and blind spots around the curves. Just when we feel we have advanced to a new frontier, another uncharted land lies ahead. Last year at the annual conference for the American Association of Suicidology we heard the voices of the clinician survivors come to the forefront: clinician survivors built solidarity around unaddressed needs and created a forum to advance the work to address these needs. At this year’s conference another group got organized and found momentum for organized empowerment: survivors of suicide attempts.

AAS Panel about helping attempt-survivors and their families (photo by David Covington)

Most notably, the conference featured a plenary panel about suicide attempt survivors called “Silent Journey: Helping Suicide Attempters and their Families.” Stephanie Weber, the Executive Director of Suicide Prevention Services in Batavia, Illinois shared her experiences running a support group for suicide attempt survivors.

“At last year’s conference,” Stephanie said, “a woman asked me ‘This is for survivors, but I am a survivor of my own attempt, not of someone else’s death. What is here for me?’ I told her ‘Next year we will have a panel of attempt survivors who are no longer alone or ashamed.’” Stephanie continued, “This is the last stigma. Why is it when we lose a loved one to suicide, we grieve, but when we have a loved one who attempts suicide and survives we are angry and don’t know how to talk about it?”

CW Tillman, a suicide attempt survivor, talked about his experiences with first responders and family members. He said, “There are several ways to help suicide attempters. The first way is just to be honest. At first, after my suicide attempt they told me, ‘That was a stupid thing to do,’ and I know they meant ‘I love you’ and ‘I want you around.’” CW recommends not using the term “failed attempt.” He explains how he sees his suicide attempt as a success by virtue of its not resulting in his death.

Jason Padgett, Project Coordinator for Tennessee Lives Count, talked about his experiences with family members who had gone through suicidal crises. He said, “For all those out there who support those who struggle with suicide, you need support too.”

Finally, Dr. Kate Comtois, Associate Professor at University of Washington, shared findings from her research. After evaluating the similarities of effective psychotherapies for suicidal individuals, she concluded they have at least three qualities:

1) Suicide is treated directly, not just by treating the diagnosed mental illness or by observing or constraining the individual. She said these therapies focus tightly on what is making people suicidal and what can be done about it.

2) These therapies employ an overt, determined, and persistent collaborative stance. The therapist connects with the individual, not using the perspective “We, the experts will fix you, the patient,” but rather “Together, let’s see what we can figure out.”

3) Clinicians work as part of a staff team – they meet regularly to discuss cases and burnout.

Dr. Comtois also summarized what participants in her research said about their journeys after attempting suicide:

1) The pressures on individuals who have attempted suicide are tremendous. The response of our mental health system is to diagnose mental illness and prescribe medication, yet this will not solve their problems.

2) Individuals who had attempted suicide reflected that the researchers asked many more questions about their suicide attempt and their history of suicidal coping than the referring clinicians or team had.

3) Study participants engage in and appreciate the suicide-specific treatment that the researchers developed. This was not consistently the case for the treatment as usual group.

4) Study participants followed most of the recommendations from emergency departments, inpatient units, and the researchers.

Some of the conference attendees found the panel moving. Eduardo Vega, himself a survivor of a suicide attempt, said, “Suicide is not a problem that is fixed in a hospital. Bringing the voices here really touched me.” David Covington, Executive Committee member of the National Action Alliance for Suicide Prevention said, “The leaders of suicide attempt survivors are changing the way we think.”

I too am moved by their lived experience and believe their inner wisdom holds the keys to our ability to better understand suicide prevention.

Guest Blog: Why I Donated My Psyche to Science

I am delighted to introduce my guest blogger Amy (Cooper) Rodriguez. Her husband Dave was a good friend of my brother Carson's; they all attended Bowdoin College (class of '93). Last month she reached out to me to tell me they thought of Carson a lot and remembered his vitality. She also told me that she suffered from depression on a number of occasions (including while at Bowdoin) and did her best to hide it at all cost. Recently, she met with a group of medical students to let them interview her about her experiences with depression and anxiety and to let them know how good people can be at hiding it. Thank you, Amy for sharing your story. In her words...

Amy Cooper Rodriquez, Guest Blogger


As Robert Frost said, “I experience everything twice. Once when I experience it and once when I write about it.” Therein lies the reason I don’t like to talk-much less write- about depression.

But after successful treatment for post-partum depression, I was intrigued to get an email from my psychiatrist saying, “How would you feel about being interviewed by some second-year med students? You can tell them what you’ve gone through and help them understand a bit about depression and anxiety. You’d be great!”

Hmmm. What did this mean? I couldn’t figure out whether to be flattered or alarmed. Did this mean I was the epitome of anxiety…the most extreme case he’d ever seen? Or did it mean I was just high-functioning enough to put some answers together?

I had my first bout with depression when I was a sophomore at Bowdoin College. My boyfriend and I had broken up, and he was dating someone new. I watched them stroll hand in hand as I plodded across the quad to class. I felt as if I were wearing a lead vest from an x-ray. The campus still looked idyllic, like the brochure. The pine trees still reached into the brilliant blue sky while the sun shone on the students playing Frisbee, yet I could only observe: “The sky is very blue.” I had a hard time understanding people. When I think back, I picture cocking my head to the side while I listened to them, as if I were a dog, or squinting my eyes while I watched their mouths, as if I were hard of hearing. Worst of all, I didn’t tell anyone how I was feeling. Not only did I feel depressed, I felt ashamed.

When I recovered, I swore I’d never feel that shame again. But the next time, the shame was worse because this time my depression came with the birth of my first baby, my daughter. I remember how guilty I’d felt lying next to her thinking, what gives me the right to be sad when I have a beautiful, healthy baby? I wondered how many moms were out there now, lying next to their babies, crying. And I knew I had to contact my doctor and see what I could do.

I emailed my psychiatrist asking him what the meeting would involve. He left me an enthusiastic voicemail, “Oh, they need to learn how to listen to their patients. They’ll be more nervous than you! You’ll be wonderful!”

So, a week later I drove into Boston. Like everyone in hospital waiting rooms, I was nervous and fidgety. I sat up straight, slouched back into the chair, stood up, looked out the windows, and rummaged through my pocketbook.

At last, my doctor appeared, smiling warmly. He gestured behind him to a flock of eager young people in white coats. Beautiful people right out of Grey’s Anatomy.

“Amy,” my doctor said, “you’ll be coming with us. “Mike, here,” he pointed to the cutest one, “has agreed to do the interview.” Mike, with his dark hair and olive skin, smiled at me with piercing blue eyes. I found myself wishing he were less handsome.

My doctor led us to the hospital cafeteria where I scanned the room to see if I knew anybody. This seemed like a strange place for a confidential interview, but my doctor found a table tucked toward the back of the room. The students and I jockeyed awkwardly for seats. I didn’t want to be at the head of the table, like I was leading a boardroom meeting, nor did I want to be alone on one side of the table like an inmate at a parole board hearing. I was hoping for a we’re-all-in- this-together feeling.

I finally sat in the middle of one side, and hospitably waved for the students to sit. They looked nervous and, because of my habit of talking when I am nervous, I began to babble. “It’s so great that you guys are doing this. Wow. Med school. I went to PT school.” Smile. Smile. Babble. Babble. I was playing emcee for this group of medical students. I looked at my doctor as if to say please stop me.

He intervened. “Mike will ask you some questions, and you answer with whatever you are comfortable sharing.”

Mike smiled. He made excellent eye contact.

“So Amy, how’ve you been feeling?”

I reverted to the role of the happy patient. “Good. Good,” I answered, nodding my head and smiling.

Mike raised his eyebrows.

“Oh well, I used to be depressed,” I said, laughing nervously. “You know, back in college, when my boyfriend and I broke up. And then after I had my daughter. Sometimes I don’t feel so great, but then I see Dr. Sharp, and he helps me.”

Mike nodded and leaned toward me.

I leaned in, too, ready to be impressive and articulate. But then I thought, What am I doing? I am not here for a job interview. I am not trying to convince people of how capable I am. I took a deep breath and sat back. I remembered why I came. Why I paid a sitter to watch my kids. Why I drove through crazy Boston traffic. Not to chat with a handsome guy but to help doctors learn how to figure out their patients. To take time. To dig deeper. To really know them. Because they would all have patients like me who try to appear peppy and bright when they are dying inside.

I let my shoulders fall. “It’s been really, really hard,” I said. “I’ve been depressed a few times. I have to be careful to make sure my life is balanced. I take medicine, but I also have to talk about it and make time for myself.”

I scanned the table. They were all listening intently. So I held nothing back. “I’ve given birth twice, had surgeries, been hospitalized with infections, had migraines, and I would gladly take all of those experiences over being depressed. That’s how bad it feels.”

Suddenly I was acutely aware of my surroundings--not in anxious way--but in an empowered way. I had wanted to be honest, to try to help others, to reduce the stigma of mental illness. I had never been sure of how, but maybe this was it.

The students looked at me and nodded. I didn’t babble or fidget and neither did they. We sat in silence for a moment, and I knew they had heard me. After a pause, they began asking questions, and I answered them. It became less of an interview and more of a conversation. They asked me what made me tell the truth to Dr. Sharp and asked what they could do to get patients to talk. I told them, “I saw a lot of doctors who were fine but they never knew how much I struggled. Dr. Sharp took the time to chip away until I told him how bad things were. I think the doctor has to be open and caring, and I think the patient has to be ready.”

They thanked me graciously as we stood and shook hands. Then my doctor patted me on the back as he walked me to the door. “See?” he said. “I told you you’d do great. Thanks for helping us.”

Maybe it was the idealist in me, the romantic--the Grey’s Anatomy viewer, but I drove home feeling like those young people would understand more about their patients someday. Maybe someday a college girl like me would come in to their office- or a new mom ashamed to admit just how desperate she feels. Maybe it would be a middle-aged man-a CEO- or a new dad, and maybe these doctors-to-be would help. At least I hope so. And hope, so they say, is the best antidote to depression.