As part of September Suicide Prevention Awareness Month, we are continuing our conversation about suicide. Today's guest is a board-certified psychiatrist and Family & Children’s Services, Medical Director, Dr. Stephan Lahr. Dr. Lahr is a graduate of Oklahoma State University College of Osteopathic Medicine. He's a psychotherapy supervisor from the University of Oklahoma Psychiatry and a regular on News on 6's Doctor on Call segment. He is a member of the American Psychiatry Association and the American Association of Physician Leadership. We asked Dr. Lahr to join us to share more about the biology behind a mental health crisis with the goal of discussing the stigmas and myths and learning more about prevention strategies that might help you save a life.
Support and stay connected to us. First, be sure to hit that subscribe button wherever you're listening to us. Subscribing ensures you never miss an episode, and it's absolutely free. It also helps us continue bringing you quality content.
Consider leaving us a review. Your reviews not only make our day, but they also help others discover the podcast and join our community.
Share this episode with your friends, family, and anyone who might find it interesting. Word of mouth is a powerful way to grow our podcast family, and we truly appreciate your support.
We're always eager to hear your thoughts, ideas, and suggestions for future episodes. Visit www.okstateofmind.com for all of our episodes. You can also email us at communications@fcsok.org with any episode ideas or questions. We'd love to connect with you.
Thank you once again for accompanying us on the journey. Until next time!
As part of September Suicide Prevention Awareness Month, we are continuing our conversation about suicide. Today's guest is a board-certified psychiatrist and Family & Children’s Services, Medical Director, Dr. Stephan Lahr. Dr. Lahr is a graduate of Oklahoma State University College of Osteopathic Medicine. He's a psychotherapy supervisor from the University of Oklahoma Psychiatry and a regular on News on 6's Doctor on Call segment. He is a member of the American Psychiatry Association and the American Association of Physician Leadership. We asked Dr. Lahr to join us to share more about the biology behind a mental health crisis with the goal of discussing the stigmas and myths and learning more about prevention strategies that might help you save a life.
Support and stay connected to us. First, be sure to hit that subscribe button wherever you're listening to us. Subscribing ensures you never miss an episode, and it's absolutely free. It also helps us continue bringing you quality content.
Consider leaving us a review. Your reviews not only make our day, but they also help others discover the podcast and join our community.
Share this episode with your friends, family, and anyone who might find it interesting. Word of mouth is a powerful way to grow our podcast family, and we truly appreciate your support.
We're always eager to hear your thoughts, ideas, and suggestions for future episodes. Visit www.okstateofmind.com for all of our episodes. You can also email us at communications@fcsok.org with any episode ideas or questions. We'd love to connect with you.
Thank you once again for accompanying us on the journey. Until next time!
Chris:
Hello, and welcome to OK State of Mind, a podcast by Family Children's Services based in Tulsa, Oklahoma. I'm Chris Posey.
Dee:
And I'm Dee Harris, your host today.
Chris:
This podcast seeks to satisfy inquisitive minds eager to delve into the realm of mental health and overall well being. Join us on a journey to gain insights into the intricacies of the human psyche, drawing inspiration from stories of resilience and hope. Moreover, we'll unravel the fascinating science, the invisibilia, that underpins our behaviors, shedding light on the whys behind our behavior and overall mental health.
Dee:
And through it all, our goal is to cut through the buzzwords and psych speak and bring you stories from people who have walked the walk and experts in the mental health field. Our goal is to empower, educate, and inspire you with actionable insights that you can immediately use in pursuing your own mental well being.
Chris:
Today, as part of September Suicide Prevention Awareness Month, we are continuing our conversation about suicide. But before we do, we want to take a moment to thank Family Children's Services' suicidologist, Emily Farmer, who was our guest on the show's last episode. Emily dispelled some myths about suicide, and she provided a couple of valuable resources for those struggling or who have loved ones who may be contemplating suicide. Emily noted that research shows us that for many, the brain functions differently during times of suicidal ideation. Today, we're going to discuss this topic from a different perspective through the lens of brain science.
Dee:
Now before we continue, suicide may be a sensitive and potentially distressing topic for some. And while we aim to provide an open and empathetic conversation about the subject, please be aware that this content may be triggering for some listeners. If you or someone you know is struggling with suicidal thoughts, we encourage you to reach out to a mental health provider. If you're in Tulsa, Oklahoma, you can call COPES 24/7 at 918-744-4800. Or in Oklahoma, you can call 988 or the helpline in your country. So listener discretion is advised for this episode.
Chris:
Today's guest is Board-certified psychiatrist and Family Children’s Services, Medical Director, Dr. Stephan Lahr. Dr. Lahr is a graduate of Oklahoma State University College of Osteopathic Medicine. He's a psychotherapy supervisor from the University of Oklahoma Psychiatry and a regular on News on 6's Doctor on Call segment. He is a member of the American Psychiatry Association and the American Association of Physician Leadership. We asked Dr. Lahr to join us to share more about the biology behind a mental health crisis with the goal of discussing the stigmas and myths and learning more about prevention strategies that might help you save a life. And with that, Welcome, Dr. Steven Lahr to the OK State of Mind podcast. We're happy to have you here.
Dr. Lahr:
Thank you. I'm happy to be here.
Chris:
Dr. Lahr. In our last episode with Emily Farmer, we talked about some of the social and cultural influences surrounding the stigma about seeking assistance and support with mental health issues and suicide. This can prevent those most in need from seeking help. Do you think stigma surrounding a mental health crisis is one of the reasons that people don't seek help?
Dr. Lahr:
That's definitely one of the top reasons that people do not seek help. There's something really scary going on and they don't know how they're going to be received. And sometimes it's really hard to take that first step and even to really know where to go.
Dee:
So Emily also talked about how the brain changes if you're in crisis, and I'd love for you to explain that more deeply for our listeners.
Dr. Lahr:
Sure. I like to start off by stating two things. One is that the brain is an organ. And I think we forget about that a lot of the time. We want to believe that somehow it operates different than the rest of the body and then the economy of the brain, our chemical pathways, that is chemical reactions, that is what makes the brain go, and so everything that you say, do, feel, believe is a chemical reaction. That is, that is just how the brain works. OK. So having that kind of, as a basic understanding, whenever there is any type of stress either internal stress or external stress, it's a chemical reaction and enough of those reactions can happen to where your brain becomes unhealthy. And so whenever you're in a crisis, it's easy for the brain to shift into this unhealthy chemical state that makes it very difficult to problem solve or even to experience help even whenever it's being offered to you.
Dee:
We live in such a stressed world. Stress is everywhere and, I know there's good stress and bad stress. Sure. But I feel like in, in today's world, especially post COVID, we're almost in this fight or flight situation. Is that contributing to the things that you are seeing and what does that look like and how can we get over that hump?
Dr. Lahr:
Anytime there's a large amount of pressure on a system it's going to identify those weaknesses, right? And so I think that's really what we've been seeing over the last three years is that people who, let's say, thought they were doing OK and weren't really taking care of themselves very well, are now kind of falling apart because we did not have probably as healthy as mental health as we thought we had at the time. And then our patients who do have mental health illness had an extra pressure applied to them. That was very difficult to handle. I have several patients who, you know, they've been stable for a very long time, and then because of the pandemic and financial pressures, they had a, a relapse of their symptoms. So 100% the environment can help contribute to pretty much every mental health symptom that you can imagine.
Dee:
So how can you tell, as a person who thinks you're coping, not realizing that the stressors are actually physiologically affecting you, at what point do you go, man, I really probably should get some help here before you get into a crisis.
Dr. Lahr:
So, Whenever you know, at the beginning we kind of talked about that the brain is an organ. So if we kind of think of other physiological responses or symptoms that are not as maybe as scary or stigmatizing as thoughts of suicide or depression. So I like to compare suicide ideation to a cough or a symptom. It's just there. And then we need to investigate what's going on. OK. And so the brain, because it's an organ, it's a very complicated organ, if something's going wrong, there's going to be symptoms of it. So some of the earlier signs that the anxiety management part of my brain is not working the way that I need it to. Oftentimes the first sign is sleep disturbance. Everything you read about anxiety management, mood regulation, it's going to talk about sleep. OK? And so you may notice that you're sleeping too much or just not enough, right? Then changes in appetite, really common initially, and then just a general kind of malaise of just not wanting to engage, right? It's not that you're stuck in bed or unable to function. It's just like, I just, it's almost like that Monday workday feeling just over and over, like you make it through, but you're really kind of pushing yourself just a little bit too hard is, those are probably some telltale signs that, eh, something's not quite right, and I probably need to make an adjustment, before it gets worse.
Dee:
So Dr. Lahr, can you talk about when somebody is starting to not sleep as well or eating differently, is that a time to call for help? Is that a, a period of time that they should call and say, Hey, I really would need to talk to somebody. I think it's just hard to know what to do.
Dr. Lahr:
It's going to be different for each person, because if you think about suicide ideation as a symptom kind of like a cough. There's so many different things that can cause you to have a cough, right? There's some things they'll just go away quickly. Sometimes you have to take medication for it. Sometimes you end up in the hospital. So suicide ideation is kind of in that same spectrum. But let's just say you're just not sure. What we're really looking at is a couple things. One how long is this lasting? OK? And so if it's a day and the next day you're fine, then it's just like if you had, the tickle in your throat the next day you're going to go on with your life, right? If you're seeing multiple days in a row where you're just like, I, I'm just not feeling or acting the same, these thoughts just keep creeping in, it's probably time to start talking to someone. It might not be the time that you need to talk to a professional but family, friends, a member of your faith community kind of like, Hey, this is happening. Has this ever happened to you? And kind of get some context for that. It's really important to one, realize that there's help out there, and that there's, today there's a lot more options for mental health treatment than there were even 10 years ago. So really, there's a lot of people that are waiting to help you if you need it. Excellent. Yeah.
Chris:
So would we be correct in assuming that just because intervention occurred successfully in one instance, the victim could experience a similar imbalance again in the future?
Dr. Lahr:
I wish that recovery was on a linear path where if you did everything you were supposed to do and you took your medication and whatever it was that you always would have symptom recovery. But that's just not how the body works. And doesn't matter which disease that we're treating there's always the opportunity for a relapse of symptoms. Sometimes I will compare depression and suicide ideation to the management of diabetes. You have the blood sugar. It's easy to measure and kind of see if you have improvement or not. So if you have diabetes your body cannot regulate blood sugar. It could be too high, it can be too low. Especially with let's say type two diabetes, you might have to take medication. You might have to do lifestyle modifications to kind of keep that blood sugar in a normal range. But we know that your body can't do it, and so you can do everything you're supposed to, and then there could be some type of stressor. You could get the flu that can cause your blood sugar go up. Or, you could have a, a, a weekend where you're eating too much, that makes your blood sugar go up and no one goes, oh, the treatment didn't work right. Don't take your diabetes medicine because your blood sugars went up. Well, no, you have diabetes. Your body cannot regulate blood sugar. So with mental health symptoms, it works the same way. So with suicide ideation, most of the time that is associated with some type of mood disorder, which means that your body does not have the ability to regulate mood in that normal range. And so you're going to have to make lifestyle modifications. You're going to have to possibly take medication, but we know that your brain does not naturally keep your mood into a normal state. And so a stressor can happen and then you're going to have a symptom again. So you may have a recurrence of that suicide ideation. It doesn't mean that your treatment doesn't work, it doesn't mean that you're not doing everything that you're supposed to do. It's just a sign of the fact that something we already know, that you have depression or some other mood disorder, anxiety disorder or sometimes it's just a response to extreme stress. You might not even suffer from depression or anxiety, but when you're under stress, your brain goes to suicide ideation. And unfortunately a lot of the times if you have thoughts of harming yourself it's almost like a default setting for the brain. And so when your stress gets high, it's easy for your brain to go there. So it's real important that you're doing all those healthy things that everyone should be doing. And if you do have a mental health condition that you're getting treatment for that to decrease that risk of those relapses.
Chris:
And to your point, you know, a big focus of this podcast is to overcome myth with, with fact. The more facts we know about a particular situation, the less room there is for imagination to create untruths about the situation. So it would seem that perpetuating the brain science around suicidal ideation may be beneficial in this regard.
Dr. Lahr:
I agree. There's just so many misconceptions about mental illness, mental health, and suicide ideation. One myth out there is that if you talk about it, you're going to force a person to think about it. And that's just not true at all. Just imagine if that's really how the brain worked where you could just tell somebody something and that's exactly what they did. Like parenting would be so easy. Go clean your room, do your homework, and then you would just do it, right? Mm-hmm. So talking about suicide ideation, depression does not cause those symptoms to occur. OK. In fact, it decreases that pressure and it really allows you to kind of partner with them. This is not normal, but it's not something that is atypical for whatever situation the person's in. Mm-hmm. Right? And so I'm also focusing in on that that organ function of the brain. OK? Anytime an organ is sick, it is going to give out symptoms. And that's really what that suicide thought is. It's just showing us that the part of our brain that's supposed to manage anxiety is not working the way that it's supposed to. We have evidence through chemistry studies that can show that the chemistry of your brain is different post suicide attempt or post completed suicide. We have at least three medications that either decrease thoughts of suicide all on their own, and we have one kind of newer medication out there that rapidly decreases thoughts of suicide. And so if you can change thoughts of suicide with a medication and really gives, you know, kind of clarifies this is a chemical process. Mm-hmm. You know, earlier I said, everything you say, think, do, feel, experience is a chemical reaction. That's very empowering also, because that means that you can control somewhat your brain chemistry. So by changing what you are saying, doing, feeling, experiencing changes your, your brain chemistry.
Dee:
Yeah. I find that so fascinating because I mean, there's a lot of talk these days about experiencing happiness or Right how gratitude helps you feel better or, you know joy or gardening so that's all related to this chemical component of the organ of the brain is what you're saying?
Dr. Lahr:
Exactly right. It's not about being oblivious. There's sometimes that belief like, oh, you're just trying to think positive thoughts. Forcing yourself to think positive doesn't change your situation, and it doesn't really help improve a whole lot. It is really looking at that full picture and making sure that you're doing things that are balanced and healthy and not ignoring. Sometimes that think positive, there could be something really wrong that you need to take action on, that's going to help you more than just ignoring the situation and trying to reframe it.
Dee:
Yeah, I'm hoping that today a lot of parents or even teens are listening and are realizing kind of the components that are behind this. You know I recently wrote an article for Tulsa World about the effects of social media and mental health and, right, how you know, the CDC came out with a report on how suicidal ideation, especially among young women, where it was on the rise. And I think this may tie in, I mean, correct me if I'm wrong, to the idea of kind of the stimuli that you're putting into your system, whether it's happiness, depression, sadness, a programming is affecting that. So do you have some advice for parents teens, for balancing, for prevention, for Talk Saves Life, which is a curriculum that we use. Yeah.
Dr. Lahr:
So it's all tied together for sure. So I guess the one little caveat is that the brain is very complicated and therefore behavior is very complicated. So don't think if I do this one thing, then all these other actions, behaviors are automatically going to change. Right. But specifically with social media, one of the issues would be is that it activates the part of the brain that's run off of dopamine. Dopamine is a pleasure neurotransmitter. It's also a stress neurotransmitter and it really helps with focus. And so we get overly focused and also it's addicting, right? So dopamine's in the addiction pathway. And so with social media it's really hard to get off of it, and then it's also decreases your brain's ability to have that critical thought process because you're stuck in that dopamine pathway. Let's say there's a negative comment or something, you know, pre-social media. You're at school, Johnny calls you a name, you go home, you don't have any access to that information anymore. But now with social media, it can be constant and people can start agreeing with Johnny and there's no way for you to get out of that cycle. So specifically social media, a good thermometer there is, if you feel worse once you sign off, that's a sign that it's not being mentally healthy for you. If you feel drained or if you just feel, in that negative spectrum and you just were on social media, you can correlate those together. And now if you are scrolling and you're able to stop after a few minutes and you feel good to go, then that's probably not what's affecting you. Right? And so if you are kind of in that negative head space, after the social media limiting it, number one thing that you can do especially if you're talking about the teens and, and young children that are on there, they may not need it, right? Really limit it. If they don't need access to all of it, limit to a certain amount of time or maybe a certain app not having so many options. Yeah. And then something for some of my, my patients who just have to be on social media, really force yourself to interact and interact in a positive way, that constant scrolling it does not give that engagement, right? So just by taking yourself out for the moment, sending a nice comment, sometimes you even get a great conversation going with somebody that in itself breaks out of that social media cycle that you can have.
Dee:
Great advice. And, and I know the brain development also is part of that problem, right so I think parents, it's important for them not to necessarily say, you can't have this because we're living in a digital world right now. Right. And, and we can't say you can't drive a car because it's dangerous. Like you can't be on social media, right? Because it's dangerous. It's about learning how to use that tool.
Dr. Lahr:
Right? You're going to teach your kid how to drive a car, right? Yeah. You're going to spend time with them in the car. You're going to go over the rules, the parameters you have to follow, obviously the state, city ordinances and laws, but then also every family probably will have some family rules. Social media is really the same way, right? It takes more from the parents, but really kind of setting those parameters, what's your family rules going to be about it? Making sure you kind of know what's on social media with your kid. I mean, a rule we had was you can't follow anyone that we're not following so that we're all on the same page and we know what's going on. So just spending that time, setting those parameters and learning how to do it in a healthy way. Awesome.
Chris:
Well, this is, great information, great insights, Dr. Lahr, we really just have one more question for you before we close today. We know that suicide rates in Oklahoma have increased over the last decade. So on this topic, what gives you hope?
Dr. Lahr:
Yeah, you know it's a really depressing statistic whenever you look at it. It's so hard. It's just very heartbreaking. But what gives me hope several things. One is the the awareness for mental health and mental illness I think is at an all time high. So we've talked a lot kind of bad on social media, but there's a lot of information out there. It's easier to access now. And there's more conversations around it. So that's very encouraging. And then another thing that gives me hope is with the understanding of how the brain works and knowing that everything I do, has the potential of changing the future me, right?
Dee:
Oh, love that. Love that.
Dr. Lahr:
So sometimes I tell myself, or I tell my patients, when they come to me and they're like, I just don't understand why this is happening. Part of it is your brain is going to do what you tell it to do. And so if you are not sleeping well, if you are not exercising, if you're in unstable relationships. If you have lots of financial stress and we're not taking any action on that, then how else would your brain work? Right? Everything is a chemical reaction. So we have a lot of negative input and there's no relief from that. And so some people might think it's almost simplistic, but some of the best treatments are the easy and free. And so the impact that you can not just have on yourself, but others you mentioned earlier, was kindness. I mean, treating people with a respect, making eye contact being kind. It's a chemical reaction. You're going to increase the likelihood of more positive things happening from there. And what I ask almost all my patients almost every time is, what are you doing for fun? Mm-hmm. That is a really powerful question. It tells me how they structure their day and what they put focus on, but fun I. It's it's just tons of great brain chemicals going on there. OK. And if you can do fun and be outside Oh, wow. There's a lot of good articles out there about improve mental health just with access to sunlight and being out in nature. So not only are there better awareness of mental illness, we have better treatments for mental illness now, but there's also just so many positive things that you can do yourself that will help improve your mental health.
Dee:
Well, you've encouraged me to go pour a glass of fun today and Yes. Change my future self. Thank you so much for being here today.
Dr. Lahr:
Thank you.
Dee:
This has been enlightening, informational. I've learned a ton already. And for our listeners, if you or someone you know is struggling with suicidal thoughts, we encourage you to reach out to a mental health professional. If you're in Tulsa, you can call Family Children's Services COPES at 918-744-4800, or you can text or call 988 in the US and or a helpline in the country where you are. So we wish you well. We hope that you spread kindness and pour a glass of fun today.
Dr. Lahr:
Perfect. Love it.
Chris:
Support Family Children's Services by purchasing a Care Card and you'll save 10 to 20 percent at Tulsa area shops, eateries, and service providers from Friday, October 27th through Sunday, November 5th, 2023. Use your Care Card to shop for clothing, shoes, and jewelry at some of Tulsa's finest boutiques. Or, use your Care Card to shop for art, antiques, and home furnishings. Or maybe you want to spend it on a spa day. However you decide to use it, the Care Card provides benefits at more than 200 merchants in the Tulsa Metro area. You'll have a full 10 days to enjoy these discounts so you'll have plenty of time to ponder and shop just in time for the holidays. You can learn more about the Family Children's Services Care Card by visiting carecardok. com. There you can find every participating merchant and you can even purchase your Care Card online. And you can feel confident in knowing that 100 percent of the Care Card purchase price goes directly to support the more than 70 services and programs provided by Family Children's Services. Join Family Children's Services in its mission to heal hurting and abused children, strengthen families in crisis, and provide a path to recovery for those battling mental illness and addiction, and support local businesses at the same time. Get your Care Card today at carecardok. com. Save money, support local, save lives. Thanks to our presenting sponsor, Airco Services, as well as other sponsors found online. Some restrictions apply.