There are books on display by the front table here at the annual conference for survivors sponsored by the southeast Florida Chapter of the American Foundation for Suicide Prevention. There are books on grief, why people commit suicide, my new book on my experience with depression, bipolar and alcoholism, along with brochures and newsletters.

“Are there any books for children?” one woman asked during the Q&A.

Yes, a Michael T. Miles, a psychologist who works with children told the crowd: The Fall of Freddie the Leaf
by Leo Buscaglia.

Let me know if you know of other books.

I am spending today with several dozen survivors at a gathering sponsored by the southeast Florida chapter of the American Foundation for Suicide Prevention. On each table are programs for the event, LifeSavers candy and packets of Kleenex. I want to share with you what I experience here today. I have never been to this annual event before. I am told it will change my life. I believe them.

I found this in the folder on my table.

Survivors Bill of Rights
I have the right to be free of guilt.
I have the right not to feel reponsible for the suicide death.
I have the right to express my feelings and emotions, even if they do not seem acceptable, as long as they do not interfere with the rights of others.
I have the right to have my questions answered honestly by authorities and family members.
I have the right not to be deceived because others feel they can spare me further grief.
I have the right to maintain a sense of hopefulness.
I have the right to peace and dignity.
I have the right to positive feelings about the one I lost through suicide, regardless of events prior to or at the time of the untimely death.
I have the right to retain my individuality and not be judged because of the suicide death.
I have the right to seek counseling and support groups to enable me to explore my feelings honestly to further the acceptance process.
I have the right to reach acceptance.
I have the right to a new beginning.
I have the right to be.

From JoAnn Mecca’s Center for Inner Growth and Wholeness

Today is National Suicide Survivors Day. Survivors are the loved ones who live with anguished - and sometimes angry - hearts. Their lives are consumed with unimaginable sorrow and unanswered questions: What could I have done? How could I have missed this? Why? Why? Why? How do I live with this?

“You don’t,” said a mother whose son killed himself with a gunshot to the head. “You learn to live around it.”

My thoughts today turn to two coworkers - one drank himself to death, the other swallowed a bottle of pills and left behind two young sons. “He’s really cold,” one of the boys told me as we stood beside his father’s casket.

My thoughts today are with another friend who left left behind twin boys - just toddlers - when he closed the garage door and turned the ignition key on his truck. My prayers today are for the widow of German soccer star Robert Enke - whose husband stepped in front of a train two weeks ago. He had depression and was overwhelmed with fear that if his illness became public the baby girl the couple adopted earlier this year would be taken from them - just as their natural daughter was taken from them several years ago when her heart failed.

I will spent today at a local conference of suicide survivors. I doubt I will be able to listen to all of the speakers’ stories. But I will try. Suicide scares me. I have seen a glimpse of the unfathomable grief it leaves behind. Suicide scares me because I know I am capable of it. Twice before I have tried. I know the thoughts. I know the singleness of purpose. I know the pain. I know, I know, I know.

Today I will pray that God gives the survivors serenity, acceptance and absolution from their unnecessary guilt. Even if just for a moment, God, just let them have some peace.

It is naive to believe that people will respond to stressful events in exactly the same way. Actually, it is stupid. Which is why I am slightly ticked off this morning by an opinion piece written by the Washington Post’s Pulitzer Prize winning columnist Charles Krauthammer.

In it, Krauthammer, a psychiatrist who has not practiced for decades, slams those of us who believe what he skeptically calls “Secondary Post Traumatic Stress Disorder,” “Vicarious Traumatization” or “Compassion Fatigue”. The Army calls it “Provider Fatigue.”

Krauthammer scoffs at recent reports that Dr. Nidal Hasan’s job of listening to the terrible stories of combat-wounded soldiers returning from Iraq and Afghanistan may have contributed to his rampage at Fort Hood: “They suffered. He listened. He snapped.”

“Really? What about the doctors and nurses, the counselors and physical therapists at Walter Reed Army Medical Center who every day hear and live with the pain and the suffering of returning soldiers? How many of them then picked up a gun and shot 51 innocents?”

None, which is my point. We each have our own set of personal circumstances. Dr. Hasan is Muslim. He is against the war. He was afraid of being sent to the battlefields he had heard so much about. He was concerned about going into a combat zone where our soldiers were killing enemies who practiced the same religion - Islam. We do not know if Dr. Hasan is mentally ill. News reports do portray him as a zealot and we know that religiosity is a symptom of some mental illnesses.

To say that Dr. Hasan should have the same emotional strength and fortitude as other doctors, nurses, counselors and therapists at Walter Reed Amy Medical Center is to say that if you swim the same workouts as Michael Phelps you should be as fast as Michael Phelps.

Some of us are physically and mentally stronger than others - ergo - we react differently to the same stressor. I am NOT making excuses for Dr. Hasan. But I will defend Secondary PTSD - which Krauthammer snears at: “After all, secondary PTSD, for those …

I was a panelist last Friday on the BBC radio program called World Have Your Say. The title of the program was Should You Make Your Mental Illness Public? Debates like this are being held throughout Europe as the continent mourns the suicide of Robert Enke, the beloved German soccer player and young husband and father. Enke kept his illness from everyone but his wife. And now we are asking ourselves all kinds of questions about how mental illness should be handled in public. But our panel discussion strayed to whether employers should be allowed to ask and employees be required to tell employers about their mental illness.

I used the word “abhorrent” to describe the idea. Where would it stop? Would bosses be allowed to ask about other medical conditions, such as AIDS? In a way it is not really an issue. If an employer really wants to know whether a job candidate or employee is being treated for a mental illness, just do a drug test. Most workers believe they are being tested for marijuana and opiates. But there are employment drug tests that screen for a smorgasbord of drugs, including antidepressants and mood stabilizers.

The civil libertarian in me want to stamp her feet and claim invasion of privacy. But I understand why employers want to know. Depression is the number one workplace disability in the United States. Overall, mental illness costs employers an estimated $140 billion a year in disability, lost wages and productivity. There is also the “Ola Nolen” factor. I covered Ola Nolen’s murder trial back when I was a beat reporter. Ola - a sweet-looking grandmother - had thrown gasoline on a coworker and tossed a match on her because she believed the woman had stolen the $1 million check that John F. Kennedy had given Ola to solve the Cuban Missile Crisis. Ola had paranoid schizophrenia. Would Ola’s horribly burned coworker be alive today if Ola’s employer knew she was mentally ill? We don’t know.

Last week a gunman in Orlando walked into the engineering firm that laid him off …

Stigma kills.

Robert Enke, the beloved goalkeeper for the German national soccer team, stepped in front of a train on Tuesday.  Enke, 32, was at the height of his career – expected to be the German team’s goalkeeper  in the 2010 World Cup. He and his wife Teresa had adopted a daughter, Leila, earlier this year. Leila is 18 months old. Three years ago the couple’s 2-year-daughter, Lara, died of a heart condition.

Enke had battled battled depression for six years but feared that if his depression became public they would lose Leila, his widow said.

“We had Lara; we have Leila. I always wanted to help him to get through it,” she told reporters. “He didn’t want it to come out because of fear. He was scared of losing Leila.”

Sit down, close your eyes and imagine – if you can – what it would feel like if you suffered from a reviled illness and believed that your child would be taken from you if word of your illness got out. People with cancer or heart disease or diabetes do not have these worries. They can focus on getting well. But not people with mental illnesses. Those of us with mental illness have to worry about losing our friends, family and job – not to mention insurance – if our alcoholism, depression, bipolar or schizophrenia etc. becomes public.

Regardless of whether you are a soccer fan, we can honor Enke’s memory by speaking up and out. Loud. Anytime you hear anyone poke fun at the mentally ill, doubt their suffering or joke about their medication, chime in, interrupt and defend Enke’s despair. It was horribly real. Make a statement when you see an antidepressant ad on television, listen to Nirvana or read about Anna Nicole. The stigma is not going to go away on its own.

Unfortunately Enke believed that he had to choose between getting well and losing his daughter or staying sick and keeping his family together. Sadly, he got it …

Please tell me that Steven Tyler’s relapse last year was not the cause of his splitting from Aerosmith this week. Tyler got clean in 1986 - when the band was in a drug and alcohol induced free-fall. Eventually the rest of the band got clean and sober and reunited for rock-n-roll’s biggest comeback ever. The new and improved, clean and sober Aerosmith united generations - with kids listening to their parents’ music and proved that sobriety did not mean a lifetime of musty church basements and bingo games on Saturday nights. In sobriety you can party without a drink, go to concerts and - best of all - remember it all in the morning. In other words, I can still have fun. And if sobriety is not fun, you probably won’t stay sober.

So, why am I writing about Tyler in my depression blog? Because I am triple-diagnosed. I have depression, bipolar and alcoholism. Aerosmith was the music of my high school days back in the mid-70s and I met Tyler in my favorite bar in Grand Rapids, Michigan. Aerosmith’s music was so tied to my drinking days that I did not know if I could ever listen to their music without craving a drink.

When I learned that the entire band had gotten clean and sober, I listened without worry. If they could MAKE that kind of music while sober, I could certainly LISTEN to it sober. The band gave me hope. It was cool to be sober and getting sober was the best thing I could do for my depression. For many years I turned to alcohol - a depressant - to self-medicate my depression.

But as we addicts and alcoholics know, sobriety it is a one-day-at-a-time program. After 20 years of sobriety Tyler relapsed on pain pills he began using after surgery on his throat. He checked into rehab in May 2008. Little has been said about whether Tyler has remained clean and sober but Tyler has been keeping his distance from his band mates. The band cancelled several shows in August after Tyler fell off …

I will go to my therapist’s office this afternoon. I will sit in the waiting room and read an old magazine. Another client will walk from a hallway that leads to my therapist’s office, pass through the waiting room and leave. My therapist will poke her head out, smile and say: “I’ll be with you in a minute.” After a  few minutes she will come back and invite me into her office. I will walk in, notice Kleenex in the waste basket and sit on the couch beside the box of Kleenex.

After a few pleasantries I will start unloading the detritus of my soul. She always pays attention and looks interested. I am her last patient on Friday. I cap off her week of listening to the detritus of other peoples’ souls. I ask myself, who in their right freakin’ mind would do this for a living? Hour after hour, day after day, week after week, year after year, listening other peoples’ misery.

So I asked her. ”It does get to you,” she said and explained how she takes care of herself. Burnout is a big problem among mental health care providers, she said. Then I remembered Tony Soprano’s therapist who had her own therapist on The Sopranos. It never dawned on me that a therapist might have a therapist.

This morning I got to thinking about this after reading about the gunman and his horrible rampage at Fort Hood yesterday. His name is Maj. Nidal Malik Hasan and he is an Army psychiatrist. He also is Muslim. Before he opened fire and killed 12 and wounded 31 people yesterday he had been assigned to counsel soldiers returning from the battlefields with post traumatic stress disorder. Hour after hour, day after day, week after week he listened to the horrors and atrocities of war. The soldiers he counseled were emotionally raw - just off the battlefield.

Then Dr. Nidal Malik Hasan learned that the Army wanted to send him to the very place where those horrors and atrocities occur. There was the “Muslim issue”, too. The doctor is a practicing …

On Thursday former First Lady Rosalynn Carter, 82, will do what she has done for over 30 years - bring together doctors, policy makers and consumers to draft policies that will decrease stigma and discrimination against people with mental illnesses and promote positive policy change on mental health issues.

Mrs. Carter’s annual Symposium on Mental Health Policy is one of the best kept secrets in the ranks of mental health advocacy. Although the symposia are not open to the public, they can be viewed in realtime on the Carter Center’s website. The idea is to bring stakeholders together - not only to listen to each others’ problems but to create solutions that address the needs and goals of all.

I like to think that things happen when they happen for a reason. There are no coincidences in life, just synchronicity. How else can you explain Congress debating health care reform in Washington on the same day that Rosalynn Carter opens this year’s symposium, entitled Fixing the Nation’s Broken Behavioral Health Care System? It’s destiny - good karma.

So when you get to work on Wednesday check your calendar for Thursday and Friday. Make some time to listen in to the symposium - even for a few minutes, for a little inspiration. Sometimes, just listening to others care so deeply about what you care for and hearing how badly they want to help you is enough to get you through the day.

Someone wants to help you. Her name is Rosalynn.

A three-week court hearing about the roles of two doctors in the death of Anna Nicole Smith ended last week with a judge ordering the doctors and Smith’s long-time companion to stand trial on charges of illegally supplying her with prescription drugs, according to the Los Angeles Times.

Amen. Hallelujah. God bless America.

It’s about time.

Smith died 2-1/2 years ago. The medical examiner found a smorgasbord of benzodiazepines in her blood - but no antidepressants. According to reports, she had fallen into a deep depression after her son died in her hospital room, where she had given birth to her daughter just hours earlier. Anna Nicole Smith was 39-years-old. The cause of her death was “combined drug intoxication.” Simply put, she overdosed. But according to prosecutor, Smith did not overdose. Her doctors overdosed her. And now, two of them are looking at prison.

Why is this case so significant? Because finally, someone with some clout has finally realized that doctors who irresponsibly prescribe drugs such as Ativan, Klonopin and Valium - to patients they know are addicts and alcoholics must be held responsible. It was obvious that Smith was an addict/alcoholic. Anyone who watched her reality television show knew that.

Still, her doctors wrote prescriptions - sometimes under an alias - for drugs that are widely prescribed for anxiety and depression and widely abused by addicts/alcoholics. Drugs like Ativan, an anti-anxiety medication. My mother took it in hospice, and, boy, did it work. Klonopin is the drug to which Stevie Nicks was addicted. And Valium, well, let’s just say a lot of us know what Valium feels like. Then there was Soma and Methadone, both habit-forming. And finally Noctec, a very old sedative that is rarely used and must be used — especially by an addict and/or alcoholic — with extreme caution.

If that isn’t criminal malpractice I do not know what it. We saw the same thing with Michael Jackson, whose death was ruled a homicide by drug overdose. Jackson’s doctor has not been charged. However, the doctor prescribed drugs to Jackson - including the benzodiazepine lorazepam - …