77- Teen Suicide Prevention with Dr. Mark Goulston

Bryan: 00:16 Hello. Hello and welcome to episode 77 of the summit for wellness podcast. I'm your host, Bryan Carroll. And today we have a little bit different of a podcast episode than normal because we are going to be talking about teen suicide prevention and at different ways that we can stay connected with the kids in our lives so that they feel like they have a place in this world. And um, the reason for this is because where I live in the county that I live in Washington, there have been a lot of teen suicides lately and in a one week period they had about as many teen suicides as they normally get in one year. So for some reason teen suicide rates are skyrocketing. And I think we need to learn how we can better connect with the teens and the kids that, , are in our lives.

Bryan: 01:10 So this whole episode is with Doctor Mark Goulston who specializes in suicides, not just teen suicides, but suicides in a population as a whole. And um, he actually has a whole docu series on youtube that talks about a lot of these different stories that he's worked with. So in this episode we'll talk about different ways to connect with kids and with other people, , to make them understand that they are seen and that they do belong in this world. And we just talk about a lot of different important topics. And we also talk about a Dr. Marks own personal journey through suicide or suicide attempts or suicide thoughts. So, , just some statistics on suicide in, um, Washington and the United States. Suicide is the second leading cause of death in Washington state for people between the ages of 10 to 24. And it is the third leading cause nationally for people in the same age range.

Bryan: 02:17 Females attempt suicide more often, but males succeed at a ratio of four to one. And a report from Washington in 2010 showed that 18% of 10th graders and minute to seriously contemplating suicide with seven 7% actually attempting to do it, and that same report showed 14% of sixth graders thought of attempting suicide with 5% actually trying and that was back in 2010 so the rates have definitely increased. So this episode is brought to us by doctor Mark Goulston wins a Docu series that you can find for free on youtube. If you go to youtube.com/stay alive video, you can see the eight part series there and it's a very, very well done series. All right, let's dive right into my conversation with doctor Mark Goulston. Doctor Mark Goulston is one of the world's foremost experts on empathic listening with his book. Just listen, becoming the top book on listening in the World and translated into 22 languages.

Bryan: 03:22 His personal mission is to teach the world to listen to each other and he speaks globally on that. His current focus is preventing suicide, and he has a cocreator and moderation of the award winning documentary stay alive and intimate conversation about suicide prevention, which can be found for free on youtube. And he is also the host of the my wake up call podcast where he talks about with influencers like Larry King, Norman Lear, Ivan Misner and many others about what is most important to them and their lives and the journey and wake up calls that brought them to that. Thanks for coming onto the show, mark.

Dr. Mark: 03:58 Well, I'm so glad to be here with you. Thank you for having me.

Bryan: 04:02 Of course. And we are going to be talking about a pretty tough topic, , which is suicide, , but it's definitely one of those topics that we need to be talking about because it's becoming more and more prevalent. So can you talk a little, a little bit about your background and what got you into, , the whole suicide? Yep.

Dr. Mark: 04:22 Well, you know, there's usually a backstory and so I may as well just share that and hopefully I won't be long winded. , one of my greatest personal accomplishments. And you know, I'm kind of, I've accomplished a fair amount, but I think my greatest personal accomplishment as I dropped out of medical school twice and finished, and when I dropped out, I think it was for untreated depression. And so I dropped out because I just, I, I would highlight my book and I just couldn't hold on to it. Took a leave of absence, came back, was good for about two or three months and then it happened again. So I applied for another leave of absence and I met with the dean of the school who's curious about funding and clearly, , you know, when he met with me, he, , I think to his credit he felt, well this guy was probably depressed when he dropped that one.

Dr. Mark: 05:16 She wants to drop out again. We probably need to cut our losses because we lose matching funds when someone drops up. But I don't want them killing himself. So he referred me to the dean of students and the dean of students contact me and said, you better come in here. We have a letter from the, the main dean. And I went in there and I think I was at a low point. He was I suicidal. , I'm not sure, but I was at a low point and, and I came from a background not unlike a lot of your lists there is from parents who had depression age and you're basically only worth what you can do in the world. And when you feel you can't do anything in the world, you really don't feel worthwhile and you sometimes don't feel that you deserve to be in the world.

Dr. Mark: 06:00 So he read me the letter, the dean of students that, um, that they were going to be asking me to withdraw for medical school because I was still passing things. And when I asked the dean of students as well, what does this mean? He said you'd been kicked out. And I'm not really, I might be spiritual, I'm not religious. But I think a miracle happened because when he said that, it's like a, it's like I got shot in my abdomen and I know what that feels like cause I had a perforated colon about 10 years ago and I almost died. It felt exactly like that. And so I kind of looked down and I went, whoa. And then I felt something wet on my cheeks and I thought it was blood. So this gets almost like resurrectional. And I keep looking at my fingers, I'm touching my cheeks and I'm looking at my hands and it's not blood, it's tears.

Dr. Mark: 06:51 And I think I'm going down. , and I think if he had said to me, you know, if we can, if I can help you give me a call, I think I would've gone back to my apartment. And I'm not sure I would be here today. But he didn't do that. But I think he sensed that would happen. And he said, he said, mark, you didn't screw up, but you are screwed up. But if you get unscrewed up, I think the school would be glad they gave you a second chance. So I now start to cry with, I mean, he's pummeling me with compassion and kindness and I didn't know what to make of that. And, and I'm almost getting embarrassed talking about it now. And he said, you didn't screw up. , but you are screwed up. But if you got unscrewed up, if you, , , I think the school would be glad they gave you another chance.

Dr. Mark: 07:50 And then he said, and even if you don't get unscrewed up, even if you don't become a doctor, even if you don't do anything the rest of your life, which is what I felt capable of, he said, I'd be proud to know you because you have a streak of goodness in you that we don't grade in medical school and the world needs that goodness in. You won't know how much the world needs it till you're 35, but you have to make it till you're 35. And I'm just crying. I mean, you know, he's, he sees value in me. He's, he's a future for me. He sees something positive. And he said, , and so you won't know until you're 35, but you have to make it till you're 35 and you deserve to be on this planet. And then he said to me, look at me, cause I couldn't look at them.

Dr. Mark: 08:36 I can hardly look at you. And he said, you're going to let me help you. And so he arranged an appeal and he, and he stood up for me at his own risk. I mean, he stood up, he was a phd in anatomy and he stood up against the school, against the most powerful person in the school. And I think what happened is when someone sees a future for you, sees value in you, and you don't have to do anything, which is all you feel you're capable of, and then they go to bat for you, it flips a switch. And that's what happened to me. And, , interestingly, about 10 years ago, I was talking about this incident to Reverend Jim Kowalski. He was the main reverend at Saint John, the divine Gothic Cathedral in Manhattan. And as I was sharing the story, I just felt this warm rush through me.

Dr. Mark: 09:29 And I said, , Reverend Jim, the Dean was an angel. I mean, I'm not talking figuratively. He was an angel. And Reverend Jim said, yes, he was. So here's the good and bad news and then we'll get back to this. And thank you for hearing me out. Um, the good news is when an angel comes into your life and touches you, you're never the same. You just don't walk the same. Here's the bad news. It's not really bad news. You have to pay it forward. You don't have a choice. You have to pay it forward. And so I was a suicide specializing psychiatrist, sort of boots on the ground, kind of a street interventionists for over 25 years. And none of my patients killed themselves. And I think basically what I did is I just replicated what the dean of students did for me. And now in our documentary stay alive.

Dr. Mark: 10:28 , you'll get a taste of that as I speak with Kevin Hines, the fellow who jumped off the golden gate bridge. And so I'm now speaking widely on, , one of the ways to get through to people who are feeling very depressed or suicidal is something I call interventional empathy. And what interventional empathy is. If you can imagine that way, way down deep and people who are suicidal is an abscess, a deep abscess that's in their psyche, spirit and soul. And you have to drain an abscess. You can't just put lipstick on a pain, you have to drain it. And so I think what I did, which is what, , the dean of students did, is they found a way to listen into people's eyes and go into their dark night of the soul, just as the dean of students went into mine. And when you're able to do that, um, can I share another anecdote? Is this okay? What we're talking about?

Dr. Mark: 11:36 Hey, you haven't fallen asleep yet. That's good. So in my book, just listen, which did very well around the world. It's about how do you cause people to feel, felt and feeling felt is not the same as feeling. Understood. Feeling felt is what you need when you feel totally alone. So one of the central turning points for this whole idea of, , causing people to feel, felt happened with a patient of mine that I'll call Nancy and Nancy had made three or four suicide attempts and had been in the hospital two to three months every year for four years before I saw her. And I had a mentor named Doctor Ed Shneidman and if you look him up, he is really the father of the pioneer of suicides study. And he founded the suicide prevention centers in Washington and La and went on to found the American Association of Suicidology, which is still there.

Dr. Mark: 12:39 And he would go up and see still suicidal patients who needed to be discharged. , and they weren't acutely suicidal. So you can't keep someone in a hospital forever. , just because they're suicidal, you keep them in there when you think they're about to do it. And so some of the residents, well residents didn't want to see these people because they felt, well if they're discharged, they're going to do it. So Ed would go up and he would meet with these people and he would call me, put me on the phone, and he would always say the same thing. You would say, mark, this is ed. I'm with this handsome young man. I'm with this, a lovely young woman. They're in pain. Mark, you could help them see them. So always the same phone call. So Nancy was one of those patients. And way back when I used to moonlight, , at one of the state hospitals, psychiatric hospitals.

Dr. Mark: 13:35 And Moonlighting means I'd go in and I'd spend the weekend and I would cover for the other psychiatrists who are off on the weekend. And I would do admissions right up medications, you know, if there was an incident on one of the units, they call me over. I try and calm it down. And sometimes you didn't sleep for 36 hours in a one weekend. I hadn't slept for 36 hours. And if you've ever pulled an all nighter or an all nighter and a half, you get a little bit wigged out. So Monday morning there I come into my office and there Nancy and Nancy never made eye contact. She wasn't catatonic, but you never made eye contact. And, and I'm seated there with her sleep deprived and all the color in the room that I'm looking at turns to black and white. So I'm looking at a room and it's all black and white.

Dr. Mark: 14:25 And then I felt this cold chill through me and I thought I'm having a stroke or a seizure. And she's not looking at me and I'm a medical doctor. I'm a psychiatrist. So I do a neurologic exam on myself. I'm tapping my knees, I'm looking at my finger, um, , trying to see if I have double vision, if, if I'm numb. And, and I said to myself, I'm all here. I'm not having a stroke or seizure. And then I thought, I think I'm seeing the world to her eyes and feeling it. And because I was sleep deprived, I'm blurted this out, which if I wasn't sleep deprived and I probably wouldn't have said, and I'll, and I'll slow the tone down just so you can get a taste of it. So imagine you're just this shutoff person who has all but given up. And I said, and who feels like a burden to the world?

Dr. Mark: 15:16 And I said, , , and remember the dean said to me he'd be proud to know me. So this is almost a carry over. I said, Nancy, I didn't know it was so bad and I can't help you kill yourself. But if you do, I will still think, well of you. I'll miss you. And maybe I'll understand why you had to, to get out of the pain. And I thought to myself, did I say that or that? I think that, and I realized I said it and I went, oops, don't put that in the medical record.

Dr. Mark: 15:56 So she looks at me. It was actually the first time she really looked at me and she looked at me. I mean she lives, she looked into my eyes. I looked into her eyes and I said, what are you thinking? And I thought she was going to say thanks for understanding, I'm overdue. And she looked at me and she said, if you can really understand why I might have to kill myself to get out of the pain, maybe I won't need to. And then she smiled. And while I had her eyes locked on mine, no, she had my eyes locked on hers. I said, here's what we're going to do. I'm not going to give you any treatment, solution or advice unless you ask for it. Because if I give you things that have been tried before, you probably won't do them. You'll come in and have to make excuses. Would that be okay? And again, imagine our eyes are locked and she looked at me and her eyes, her eyes said, keep talking. I'm intrigued.

Dr. Mark: 16:59 And so I am looking into her eyes and I said, what I'm going to do is I'm gonna find you wherever you are and keep you company there as long as it takes, because you've been alone too many times at two 30 in the morning, I'm really pissed off that you are still alive. That's seven and I don't want you to be there alone. Would that be okay? And her eyes got a little watery and, but that was sort of a turning point. And so, so I've learned how to listen into people's eyes. And it's interesting, I go around the world teaching it and it's really quite simple.

Dr. Mark: 17:50 In fact, if people are listening, if you're with someone and you think they're in a bad place, there's something we talk about in the stay alive documentary and it's called interventional empathy. I mentioned that before and it's actually in chapter seven. So if you go to youtube.com forward slash stay alive video, and look at Chapter Seven, I think it says it's a, it's a targeted interventional empathy. It's going into the dark night of the soul. And one of the tools we have is called seven words. So if you're trying to reach someone, a teenager, and they're upset, you say you want to talk about, and they say, leave me alone, will you seem upset? You might feel, get off my back. Just leave me alone. And what you'll do normally as a parent, you just, Oh, okay, okay. You know, you'll think, oh, I don't want to make it worse.

Dr. Mark: 18:46 Okay, cool. If you want to talk, you know, it might make you feel better, leave me alone. So that's not an unusual dynamic between parents and teens. So the way the seven words work is, wait, let, let them say that wait for two seconds. Because that will communicate that what they said you heard doesn't mean you don't back off and say, okay, okay, you wait for two seconds and you say, I know you don't want to talk about it, but seven words and they're gonna look at you like what? And you say yes. Seven words. And then they're going to look at you and maybe say what the F but you've engaged them. And then I'm going to say the words to you and I want you to imagine, , that when you say it to other people that you are a syringe going into the abscess inside the core of where they are, which has caused them to give up. And you say it in this way. It's not checking boxes. You say to them, yes, seven words hurt, afraid, angry, ashamed, alone, lonely, tired. Pick one. And when I did that with Kevin Hines in the documentary, he responded the way a lot of depressed and suicidal people do. He smiled with relief and he said all of them.

Dr. Mark: 20:24 And then I say, and I said, pick one. I'm not sure what he said, but with teens they might say angry. Good, good. Take me to when you were your angriest in the last week. And here's an interesting thing that happens is when you can get someone to IX describe an incident that they felt alone, which made them feel worse when you can get them to. So describe it so clearly that you can see it. They re-experience the event, but they don't re-experience it along the, re-experience it with this lifeline connection to you. And when you don't jump in with advice or solutions, in fact, you go deeper when they talk about it and you say at its worst, how bad does it get? And they might say things really bad. , I remember one of my patients said, you don't want to know. And I said, you're probably right, but if someone other than you doesn't know and doesn't know how bad it feels, you're going to go crazy.

Dr. Mark: 21:42 And the patient looked at me and smiled and said, I'm already there, but can you follow this? It's a, it's a, it's, it's an empowered click approach, , to suicide. And I, and I wrote a blog after Anthony Bordain killed himself. It's on medium and it's entitled why people kill themselves. It's not depression. Got 500,000 views and 70,000 reads in about a week because of the title. And I said, you know, there's hundreds of millions, probably billions of people in the world that are depressed, maybe a billion people have lost jobs, lost the marriage, and it contributes to suicide. But there's many more people who go through that who wants suicidal. And I said, from my experience of many years, one of the things that nearly all suicidal people feel at the end is despair. And if you break the word despair into d s dash p a I are, they feel unpaired with reasons to live hope less help, less power, less use, less worth, less meaningless. And when they all line up, they feel it's all pointless and they pair with death to take the pain away.

Dr. Mark: 23:18 But if you can pair with them in the dark night of the soul, if you can go deep into the heart of that abscessing keep him company, what happens is they start to cry with relief. Kind of what happened exactly with the dean of students. For me. And, and it's important if you do this and I start to cry that you don't get freaked out because what you're doing is you're starting drain that pus that's inside them all alone. And as it drains, they start to feel relief and they start to cry. So you don't want to get freaked out into, oh, it'll be all kill. I'll go, oh, we'll do something. We'll do such and such. Because now there's different kinds of crimes. Some people cry out or frustration, some people cry when they're angry. , and some crying is not all that helpful. Although I think most crying is helpful, certainly more helpful than getting angry and , violent.

Dr. Mark: 24:16 And so that's what you want to do. And, , and just like a physical abscess and the way you go into physical apps as you go in and you clean it out and you leave a drain and you know, you leave the body open and you leave the drain in and the body heals from the inside out. So when you're dealing with someone who's deeply depressed or suicidal, and you go in and you keep them company and the pain, instead of trying to rush to make it better, you put an empathic drain in there, keeping them company from their inside out and they heal with hope. So are you following any of this?

Bryan: 25:00 Yeah. And there's so much to unpack in the last 20 minutes here. Um, but since we're talking about, , listening deeper to your children, um, if you go back to the seven words, can you continue to use that same method or at some point does it just start glossing over for the kids and you have to move on to a different method?

Dr. Mark: 25:24 Um, I think what they hear is your intention. So there's something in business called the assumptive close. And I hate to trivialize what we're talking about. But the assumptive close in business means you don't ask someone, do you want to buy a, don't you want to buy what you assume is they're going to buy? And you say, how would you like to take? How would you like to take delivery of that? Would you like to pick it up at the store or would you like us to mail it to it? So that's the assumptive close. When you give your team the seven words, you assume they're feeling one of them. And so, so your intention is to go in there and relieve it. And see that's different than asking them questions, which can actually aggravate them. If you say to them, , do you feel angry?

Dr. Mark: 26:16 , , do you feel alone? Do you feel depressed? You know, inside they may respond, but inside they're gonna be thinking, no, I'm a happy camper. I mean, what the heck do you think I'm feeling? And so there's something about asking questions, even though they're well intentioned, it puts a barrier between you and your kid. , I'll give parents an interesting tip that I, from the headmaster when my children elementary school, and I think that this is a lovely story in a break from the dark stuff we're talking about. And I remember he said to the parents, he said, when your kids come back from school, what do you ask them in the parents say, how's school? What'd you do at school? What'd you learn at school? And, and he said, how your kids react. Well, you know, it's like they don't want to answer.

Dr. Mark: 27:11 And he said, well, the reason they don't want to answer is because they've been asked a hundred questions already in school. And why do you ask them the questions? Are you there to interrogate them? No, I love my child and I want to connect with them and I want to relate to them. And he said, well, when you ask them another question like that, they begin to think there's a right and wrong answer. And it turns them off. And I'll never forget it. He said, if you want to connect with them, when you see your kid, when they come home from school, smile at them and say, boy, am I glad to see you? And I said, that is brilliant. That is brilliant. But do you follow what I'm saying? It's, it's, so in answer your question, if your intention is, I know you're feeling one of those things, I don't want you to feel it alone because when you feel it alone, things can get worse.

Dr. Mark: 28:03 So I want you to be able to feel it right here, right now with me and maybe feel less alone with it. I think. I think it'll work. And if it gets a little bit repetitive, you can say to them, , if they're feisty and you've already done it before, you sort of smile at them because you don't want to aggravate them. You could say, okay, um, I know you don't want to talk to me, but can we do the drill again? And they're going to smile at you. Oh, you mean those sevenF and words? Yeah, the sevenF and words. Unless you can add some, that'd be cool if you could add some and yeah. Yeah. And so you're playful with them and then you say them.

Bryan: 28:45 Yeah. I love that approach because I think, um, you know, teens are pretty feisty and so, um, if you continue to ask them the same questions over and over, how was your day? How are you all that stuff? It starts to gloss over, like you said, by giving them emotions that they can say, this is what I feel. Um, I think that just allows them to connect with you a little bit better, but also to go with that and to unpack a little bit more that you said. Um, it seems like kids nowadays have access to so much. They have, you know, technology wise, they have access to way more than either you or I ever did growing up. , they just, they're able to do so much more. There's more activities they can do, all this type of stuff. However, for some reason these children are still feeling alone and it requires someone else to see that potential inside of them. And you mentioned that with, um, the dean of students who was able to see through you and see the potential that you had if you just had to reach the age of 35. So why, why do people, and especially kids need other people to be able to see the potential that's available within them? Why can't they see it themselves?

Dr. Mark: 30:06 Well, here's my unsolicited, the old fart commentary. So you know, you're going to out me for that. Um, way before you were born. I'm speaking about you. , tenderness, compassion, love making, which are all driven by Oxytocin, which is the bonding hormone used to produce pleasure, which is driven by dopamine. Well, what happened is that at the same time as that was happening, there were some, some nerds in school who didn't really connect with people, but they loved radio shack. Oh, you know, they forget sports. They couldn't wait to go to radio shack. And they love technology and what you can do with it. And they got excited by technology and they use that to make up for the fact that they really couldn't connect emotionally with people. , and what happened is those people, Bill Gates and Steve Jobs, , and now, , Elon Musk, Bezos and Zuckerberg.

Dr. Mark: 31:17 What happened is they addicted the world to adrenaline. So now adrenaline is what produces pleasure and dopamine. Oxytocin is becoming a, I mean, young mothers feel it for their babies when they're born, but oxytocin is going away. So as a result, listening to someone caring about their feelings instead of rushing them. So what are you going to do about it? It's going away. And here's the problem for kids is the only thing more powerful than an adrenaline rush is an adrenaline crash and [inaudible] and the quickness with which you then go from all excited and amazed and everything is terrific to the slightest bit of, , upset and you fall. I mean, you fall so quickly that you do anything to stop the fall. And so that's one of the problems. I'll share another anecdote because, , you're allowing me to, but I think people remember stories.

Dr. Mark: 32:26 I agree. And, , two weeks ago I was on a panel at Hollywood high school with high school students and it was an afterschool program. And there was a panel of two therapist, a life coach in me, and I asked the facilitator, I said, let me go last. Because often what I look for is I look for an engagement between audiences and people upfront because I, especially with teens, when they get disengaged, they tune out. And the other panelists were great and they were giving such great information about what stresses and anxiety and depression and about half of the kids were sort of listing the other half. It's kind of another lecture. And so, , and I'm pretty spontaneous when I give talks. So my, , , I gave a talk in Russia for six hours to the managers of the Russian Federation, just me for one and a half hour modules.

Dr. Mark: 33:24 And my slides broke down in module one. So for four and a half hours I was just improv and none of them looked at their iPhones, you know, because I just spoke to engage them and I was speaking in English and it was translated into Russian and they actually made a highlight reel. If you look up Moscow Goulston Youtube, you'll see it. They made this three minute highlight reel. So what I did, , I said to the audience, I said, you know, I'm part of a film having to do with depression, suicide, and to seven words, and I'm going to say those seven words to all of you. And then we're gonna go around and each of you is going to pick a word and just say it. So I gave out the seven words, but again, I gave it out in that wanting to pull their pain.

Dr. Mark: 34:13 And each of them mentioned the word. And what happened is one of the, , one of the afterschool program facilitators came up to me afterwards and said it was fascinating because I saw their backs, but each time one of them spoke, I could see them tense up a little bit and then relax. And then when I asked the students, I said, what was that like? They said, that was better. I feel calmer. And I said, okay, I want you to try to hold on to it so you know that it's possible. Because here's your dilemma and here's the dilemma for teens. I said, there's four emotions you live with and only for excitement, boredom, fear, anger, excitement, boredom, fear, anger, and what we just did, which you said was better, was it any of those? And they said, no, no, it wasn't any of those. And I, and I said, so I want you to know you said it was better. It wasn't any of those gave you a break from that. And you now have the seven words. So when you're talking to your friends and your peers and you know, if one of your parents is down, you want to cheer them up, use the seven words, see what happens. So can you picture that in your mind's eye how that would work? I'm just trying to spread that as far and wide as I can.

Bryan: 35:40 Briefly, I told you that there has been in the county, I live in a pair in Washington. There's been a big increase in teen suicides lately, which people are trying to figure out why that would be. And, and a lot of the cases that friends and family, they've come out and said they had no idea that these people were feeling this way at all. Or even thinking about suicide. So with the seven words, that's a great method. But what, what do we do to better be able to check in with people and be able to use the seven words and not have a stuff like that fly over the radar?

Dr. Mark: 36:18 Well, a good friend of mine, a fellow named Marshall Goldsmith, he is the top executive coach in the world. And one of the things that he talks about is he says, focus on the future before bad things happen. And so what you can say to your kids, you can say to them, um, , going forward, if you are really going into a bad place, what's the best way for me to be with you to help you get through that? What should I always do? What should I never do? And C, you can say it like that because the bad thing hasn't happened yet. And then after routine, , and at that point, hopefully they won't be ticked off and hopefully they want to just leave me alone hopefully. Because see down deep in the inside team to a feeling all along with this, they need someone to get inside.

Dr. Mark: 37:17 They need someone to get in there and help them feel less alone, but they don't want it. And the reason they don't want it is because the parents are so anxious and scared that that anxiety feels like pressure on the teenager. It feels like they're saying, oh, my parents were really nervous. They want me to tell me. I'm telling them I'm fine because they're nervous. And of course you're nervous because the parents are scared and their imagination is running away with them. But I think if you say, and what parents can say is, you know, I'm a little bit freaked out by all the news. I'm a little freaked out. [inaudible] I read a story about some parent whose kid, you know, really got depressed and, and she, the dad had no clue. And, , it's kind of freaking me out. So going out, she'll going forward, if you're getting into a bad place and it really does help, even if it's awkward to somehow connect.

Dr. Mark: 38:13 What's the best way for me to be with you? , and by the way, , unless it would really tick you off, but I think I'm still gonna do it. You know what I might, what I'd like to do every week, maybe Sunday night, is to say what was the best and worst thing that happened you last week. And I'm not going to give you advice and I'm not going to freak out. You're just going to tell me what the best and worst thing is. And I'll try and understand so you feel less alone. And then I'm going to say in the next week, what is the thing you're most excited and most nervous about? And I just want you to tell me whatever it is and then, you know, I'll check in with you maybe at the end of the week or I'll say, you know, if, if that thing you're nervous about is on Wednesday, , I'd appreciate it if you'd let me know how it went. But do you see by focusing on the future like that it's not after something's happened and they shut down and they get angry and you get scared.

Bryan: 39:18 Yeah. And I think that could be really good for friends to do with each other as well. A friends, they see each other probably more often than the parents do once you're in this school. So some, so if kids can start learning these different tactics and be able to check in with each other, I think that'd be a fantastic thing to do. So one thing that I recognize with you is you've gone through depression or n you said possibly suicidal thoughts. You weren't totally sure if you ever had that or not. , but you've known the feeling of, um, that pit where people can't quite see what it is that you see. So when people go and talk with a psychiatrist or, um, even like the suicide hotline or something like that, do the people that they talk to, should they also have some sort of experience like that so that they're able to connect on a deeper level? Or do you think anyone is able to connect with these people even if they haven't gone through situations like that?

Dr. Mark: 40:22 I think the more you've gone through something, the more you can connect. Now that's a, that said, , you're off to be suicidal, to help someone who's suicidal. Um, it's interesting. I have a podcast called my wakeup call and I hope people will check it out. And I speak to people about what really matters to the most in life and what are the wakeup calls that led to it. And, , some podcasts ago, I interviewed a rabbi Steve Leader, who's the rabbi at the biggest temple in Los Angeles, and he has a book out, something about the power of suffering. And what was interesting, , and I think it was a terrific podcast because of him. He said, you know, I wrote this book as an apology to my synagogue because for 30 years I've been saying all the right things. Someone had a death. So, you know, whatever.

Dr. Mark: 41:20 I could comfort them and in the usual way. And he said, six years ago I had this big back issue and I got addicted to opiates and I mean addicted and I couldn't get off of them. I'm not sure. He said he got suicidal. He said, I got incredibly depressed. I saw a psychiatrist and this is a guy who before six or seven years ago, let me, he just stroke struck you as the most confident, decent guy. And he said, I wrote this book because I had no idea what it felt like. All these people that I was trying to comfort and saying the right things. It's a whole different story than when you've gone through it yourself. Now I'm not trying to have people listening saying, Oh, I've never been depressed. Maybe I shouldn't be on a teen hotline. I think, you know, you can still have deep compassion, , for people's pain, helplessness.

Dr. Mark: 42:14 I mean, if you're capable of feeling deep compassion for your dog or cat when it's really hurting, you know, then you can, you can have compassion for people who are really in pain. The real challenge. And one of also, one of the things that's enabled me to do what I've done is after I finished training, I didn't work for an institution. I was a clinical professor. I supervise, but I didn't, which means I didn't have to check all the boxes. I mean, I would do that, you know, because they're important. But what I recognized early with suicidal patients is when I was asking questions to check the boxes and fill out a form, I could see in their eyes they were disconnecting. And what I learned afterwards is the way the reason they were disconnecting is because they were thinking, you're checking boxes and I'm running out of time.

Dr. Mark: 43:11 And so that's when I abandoned the checking boxes and I got all the information, you know, it just wasn't done in a check the box manner. Um, and that's what I learned to listen into their eyes, especially after Nancy. And I think that's what helped them. Here's another insight I want to share with people. That's really important. If you're listening, if you're a parent. So years ago when I was seeing suicidal patients and now I'm, I don't see anyone one on one. , I'll, I'll speak to teachers, counselors and parents. I've actually retired because I wasn't keeping up with all the computerized HIPAA stuff, but I'm going out there teaching and training to any place that wants help with this. But years ago I would ask some of the suicidal, , people I saw what helped and they said, you're the only person in my life who enjoyed me.

Dr. Mark: 44:02 And I said, what do you mean? They said, I scare my parents. My brothers and sisters think I'm manipulative. And they're partially right. And when I saw all the doctors and clinicians, you know, they were very professional, but they, they were very serious. Did you take your medicine? What are the side effects? Um, are you doing social activities? And I always felt there was a distance between them and me and it kind of felt like they wouldn't touch me with a 10 foot pole. But when you would see me die to Golston, you had this huge smile on your face. Like you were glad to see me. And had nothing to do with whether I was following the treatment. You know, sometimes I thought you were looking over my shoulder at someone else and, and I started to think sometimes I don't think he's lying to me.

Dr. Mark: 44:51 I just think doctor Goulston is crazy. And, but a number of them said, when I felt enjoyed by you, you were like this oasis where I was, it was clear that I was not a burden. And there was something about having a place where I was not a burden. You know, that it grew from there. It was kind of like the Hollywood high school thing where we did the exercise and they weren't a excited, bored, fearful or angry, but there was something else. So, um, so I just want to share that because you're depressed. Suicidal team is still a person. They don't want to feel burdensome. They want to feel enjoyed. And I know it's tough if you're a parent to enjoy them if they scare the heck out of you, but they need that.

Bryan: 45:45 Awesome. Mark, thank you so much. Um, people can find [email protected] you also have youtube.com/stay alive video, which is they can watch the full documentary or there's an eight part video series that they can watch it they want to watch a little bit at at time. Is there any final things you would like to touch on before we fully wrap up?

Dr. Mark: 46:08 Well, there's also a place that they can go up. I have about 560,000 Twitter followers and if you go to at Mark Goulston, m a R, k, g, O, u, l, s t, O, n, I have permanently pinned at the top a tweet that says, have you ever known of or known someone who died by suicide? I said committed suicide, but you know you're not supposed to say that. And it has 2.4 million impressions, over 1500 comments and people just lift the people they've known who have killed themselves. It is heart wrenching. It is chilling. But if you're feeling alone in this particular fraternity or sorority that you never wanted to be part of just going there. And what I do is I encourage people to reach across to each other and just be compassionate. You know, someone's thinking of doing it, reach out to them and see if they're okay. I'm not really able to monitor it myself. Um, but I, I would, , you know, even though I'm reasonably well known, I would like to expand that to her. Potentially millions of people can just go, it's a community because I'll tell you if you read, if you just weed the listings, it'll, it'll help you value your life. It'll help you feel compassion for these people. It'll help you want to reach out to them. So I hope people will check that out.

Bryan: 47:36 Awesome. Thanks mark so much. We appreciate you. This is such an important topic that people need to talk about and I think the, the seven word frame, our work is so important for everybody to utilize, so thank you so much.

Dr. Mark: 47:49 Well, thanks for having me on again. Thank you Bryan.

Bryan: 47:52 Teen suicides and suicide in general is just a tragic epidemic that's happening right now. And there are ways that we can help to try and support the people are around us. And one of those ways is to go to youtube.com/stay alive video and watch that Docu series. Um, part of it talks with Kevin Hines, who's won a few people that has survived jumping off the golden gate bridge and he talks about how the second his hands and his legs cleared the railing. He instantly regretted his decision, but it was too late at that moment. And I'm lucky enough for him, he was able to survive. But there have been hundreds of people that have probably had that same regret as they're falling off of that bridge. So, , it's, it's an epidemic that too, we need to talk about. It's an epidemic that we need to communicate more with our kids, that there are better options out there and we need to just give them love and support.

Bryan: 48:59 , so you can learn more about doctor Mark [email protected] and that's g o u l s t, O, n and you can get all the links in the show [email protected] slash 77 this episode is brought to us by our friends over at Athletic Greens, which is a greens powder that has 75 whole food ingredients that support all of our micro nutrient needs. Um, it just gives an really nice boost to your day. It has adapted Jen's immune support and a bunch of other good stuff in there that's really good for your body and you can check that out at summit for [inaudible] dot com slash grains now listen in to at a quick clip from our next episode. I am joined with Stephanie [inaudible] who is a nutritional therapy practitioner. And Stephanie, what is one unique thing about you that most people don't know?

Speaker 4: 49:54 I was in a Janet Jackson video in the early nineties. Wow. For which song? For black cat. It was alive. , a live concert shoot she did here in Minneapolis. And I got my three seconds of fame right after the guitar Solo.

Bryan: 50:12 Okay. We'll have to go back to them a music video and take a look at that. So what is, what will we be learning in our interview together?

Speaker 4: 50:22 , we're going to talk about what the thyroid is, um, what it looks like when you have, , what your symptoms might look like, um, what your lab values should be. Um, and why I pretty much liked to use food as medicine.

Bryan: 50:40 Awesome. And what are your favorite foods or nutrients that you think everyone should get more of it in their diet?

Speaker 4: 50:46 I think, um, fish oil is one. Um, especially if you don't like fish like me, you should supplement with some fish oil. A bone broth is super healing and very tasty and healthy fats.

Bryan: 51:01 And when you say fish oil, do you care about where the fish oil is coming from or just fish oil in general?

Speaker 4: 51:08 Um, I really do like to get it from a practitioner like, um, source. So like biotics research, apex energetics, someplace like that. Highest quality you can afford.

Bryan: 51:20 And then what are your top three health tips for anyone who wants to improve their overall wellness?

Speaker 4: 51:26 You must make sleep a priority. Um, you need to manage your stress through meditation, gentle exercise, um, social, personal connections, and don't get stressed out about what foods you can and can't have because sometimes that's worse than eating the food that you might be sensitive to. So just chill.

Bryan: 51:49 Yeah. That can cause more stress and the stress that you had before you had stress about eating food.

Speaker 4: 51:54 Yeah, for sure.

Bryan: 51:56 And as you can see, we will be diving into the thyroid and learning a lot more about Hashimoto's. Keep on climbing to the peak of your health and we will see you next time.