According to a study from the Cleveland Clinic, one person dies by suicide in the US every 11 minutes. Tragically, it’s the second leading cause of death for those in the 10 to 34 age bracket.
The LGBTQ+ community faces a greater risk of suicide. And expats are also one of the most vulnerable groups for mental health struggles, with suicide rates 6-7 times higher than in local societies.
So how do we create more awareness? What are the red flags to watch out for, in ourselves and in others? And where can we turn for support?
This week’s episode comes with a warning. The following conversation about mental health and suicide may trigger pain for survivors.
To honor Men’s Mental Health Month (hence, all the Movember mustaches), Cross-Cultural Psychologist and Adaptation Strategist Elena Darmenko joins me for a gut-wrenching yet vital discussion. We’re talking about mental health and suicide, with a red thread to men and expats.
Elena’s a trained practitioner who holds a postgraduate degree from the Diplomatic Academy of Russia. She helps expats manage stress in their new cultural conditions. Elena’s specialization includes supporting introverts so they can feel more self-confident in their communication.
Beyond her head-spinning credentials, Elena also “gets it” from a personal level. Currently based in Moscow, she’s a seasoned expat, having lived throughout the Scandinavian countries and the Middle East.
What You’ll Learn in this Episode:
- The emotional burden of uncertainty
- Dealing with childhood trauma through escape
- Seeing the narrow vs. complex version of yourself
- Mental struggles of the male trailing spouse
- Straw that broke the camel’s back
Listen to the Full Episode
There’s no need to suffer in silence. I’ve included a few trusted mental health organizations in this week’s show notes. Please reach out and let others help.
Featured on the Show:
- Global Life in the Hard Resource Roundup
- Suicide Loss Support Series
- Movember Conversations
- American Society of Suicidology
- No Time to Say Goodbye: Surviving the Suicide of a Loved One by Carla Fine
- Why Suicide? by Eustace Chesser
- After Suicide: A Ray Of Hope For Those Left Behind by E. Betsy Ross
- Healing After the Suicide of a Loved One by Ann Smolin, John Guinan
- Cleveland Clinic: Recognizing Suicidal Behavior
- Suicide Trends During The Covid-19 Pandemic In Japan
- Sundae’s Facebook Business Page – Sundae Schneider-Bean LLC
Catch These Podcasts / Articles:
- EP224: Mental Health Check-Up With Patricia Jenkins
- Esther Perel: We Can Do Hard Things with Glennon Doyle
We’re delighted by our nomination to the global Top 25 Expat Podcasts!
Full Episode Transcript:
Before we dive into today’s episode, I want to offer a trigger warning related to mental health. This episode is being recorded during Movember, Men’s Mental Health Awareness Month, and on International Survivors of Suicide Loss Day.
During this episode we will be talking about mental health awareness, red flags to watch out for and suicide awareness. I recognize that this is a topic that may trigger pain from survivors of suicide loss so it was important to me to offer advance notice. Despite the challenging nature of the topic, I hope it is a small contribution to help break down the taboos of talking about mental health risks.
Hello. It is 10:00 am in New York, 4:00 pm in Johannesburg, and 9:00 pm in Bangkok. Welcome to the Expat Happy Hour. This is Sundae Schneider-Bean from www.sundaebean.com. I am a solution-orientated coach and intercultural strategist for individuals and organizations. I am on a mission to help you adapt and succeed when living abroad and get you through any life transition.
It is Movember. For those of you who have never heard of it, Movember is an annual event that is growing globally – and it involves growing a moustache during the month of November to raise awareness of men’s physical and mental health issues, such as prostate cancer, testicular cancer, and men’s suicide.
My husband has participated in Movember for years. This moustache transforms his whole look. How shall I say this? He goes from looking like a regular good-looking guy, to what almost everyone comments by saying he resembles, “A 1970s porn star”. He shakes this off this predictable comment, every time. And discussing this in a round of friends one day he said, “Well, I don’t know. That says more about the person commenting than me, doesn’t it?”
I notice that I feel awkward when we are with people who are meeting him for the first time thinking, “What if they think he just always looks like this?” And I catch myself in this selfishly protective thought and break my discomfort to actually accomplish what Movember sets out to do. I say something like, “My husband doesn’t always look like a 70’s star – it’s for Movember.” And that gives him a segue to say more or for us to start a conversation. You know what, it’s really awesome to watch that happen and I give them a lot of credit for doing that every single Movember.
In one instance, we had a good long conversation with a young South African man who admitted that mental health topics were an absolute taboo in his family. And I’m thinking, “Hey mission accomplished,” right?
And I really admire when he brings it up in an organizational meeting with humor, because it’s breaking the scripts, just briefly, to raise awareness about what matters so much, but goes far too often undiscussed: Mental health. (And in this case, especially men’s mental health – especially when it comes to suicide risk.)
Now, I have to be honest. This topic isn’t comfortable for me. In fact, it is tied to a lot of pain, like it is for a lot of people. For me, much of that pain is actually connected to the losses of people I have called dear friends, trusted advisors, and family friends. And I know that my pain is nothing compared to the nearest survivors of suicide loss. And that’s why I want to talk about it today is to help battle the taboo on these conversations and to break open awareness within ourselves and our inner circle about mental health and including suicide risk.
It’s astounding when you think about the numbers and I wonder why is it such a shock to learn the statistics behind it? That says everything that this is still a taboo. According to the Cleveland Clinic in the USA, “Suicide is the tenth leading cause of death in the U.S. One person dies by suicide about every 11 minutes. It is the second leading cause of death among people ages 10 to 34, and the fourth leading cause of death among people ages 34 to 54. Let alone the fifth leading cause of death among people ages 45 to 54.
Groups of people who have higher rates of suicide include: Young people who are lesbian, gay, bisexual, transgender.”
Since the COVID pandemic, we are also seeing a rise of suicide risk. The International Association of Suicide Prevention shares research from a reported by the Ministry of Health, Labor and Welfare (MHLW) and National Police Agency in Japan – those reports show that the total suicide rate among the Japanese general population increased in 2020 for the first time in the past 11 years.
Folks, I know the name of my podcast is Expat Happy Hour, and there is nothing happy about mental health struggles or suicide risk. But, we have to talk about it. And I know I can’t talk about this alone. So to do that, I have brought in a psychologist to help us understand what to look out for. Elena Darmenko is a cross-cultural psychologist from Moscow (Russia) and was raised in a multicultural family. She’s an expert in cross-cultural communication with over 15 years of experience in psychology and foreign relations. Her personal expat story includes several years in Scandinavian countries and the Middle East.
In 2020 Elena completed her postgraduate degree at Diplomatic Academy of Russia in the field of professional adaptation of foreign staff of international organizations. She focuses on the adaptation of introverted expats to help them feel more self-confident both in professional and personal communication by creating their own comfort zone. And because of what she does, generally, as a psychological practitioner, she helps expats to manage their stress in new cultural conditions, and she is by their side in their toughest moments. As a trained psychologist she has seen a lot. Elena’s core values and principle is to be on her clients’ side whatever happens in their lives, assisting them to make the most of their experience abroad.
Sundae: The reason I invited Elena to join us was we were actually having a conversation after the Global Life in the Hard series. For those of you who didn’t catch the Global Life in the Hard series, make sure you’re inside Expats on Purpose because Elena is a member of Expat Coach Coalition and she did a wonderful series session with Renata Andrade about Mental Health in the Hard, what are the red flags to look out for. So we were talking after that session and the topic came up about suicide and how she had just attended a conference recently and some of the shocking statistics. So Elena, you’ve been so kind to come and continue to share your expertise with us about this important topic. So, thank you Elena for joining us on Expat Happy Hour.
Elena: Thank you so much, Sundae for inviting me. It’s really very important. topic particularly today after the 18 months of pandemic. And unfortunately, I have found the very shocking statistics about the suicide rates which became higher during the pandemic and particularly in the expatriate society. Believe me, I was really shocked to find out that because according to this data to do those numbers, the suicide rates among the expats are six to seven times higher than in the local societies. So when I say that the expats are one of the most vulnerable groups when we’re speaking about mental health, well, I’m not joking. This is true. And even when we see those nice pictures on Instagram, the people are so happy to be the digital nomads and to live their expat lives. However, we do not see what’s behind that.
Sundae: Right? And that’s shocking, let’s just pause on that.
Elena: Yes, the vulnerability. And last week, I participated in the conference about suicidology and where we discussed all those really shocking rates. And well, I’ve made my short message, my short speech about the expatriate society and it’s really important not even to prevent it because we can’t. We can’t control the future. So when we are speaking about the prevention of the suicide, this is very difficult and also the vulnerable topic.
Sundae: Yeah, and to be really, really transparent here. I get really triggered when I hear about suicide prevention because I have loved ones in my life that have lost dear dear, dear family members to suicide and there was nothing that they could do to prevent it. So I think you and I are on the same page. This is about suicide awareness.
Elena: Absolutely. Absolutely.
Sundae: So tell us, do we understand why those who are living globally mobile lives are six or seven times at a higher likelihood of suicide than the local populations.
Elena: Well, I think that one of the main reasons, I mean the mental health reasons for the suicide is, of course, the depression. And starting from the light forms of depression, and became higher, and higher, and more and more difficult. People, unfortunately, came to the idea to end their lives.
Sometimes they feel alone. They have no one to share their bad feelings. And well, a lot of my clients say that they feel locked. They feel locked in their new country. They have lost the connections with their loved ones because we all understand that the Zoom is not enough.
And there’s also the problem of inability of controlling the future. Yeah, for instance, I have a client who is living in New Zealand and she was planning to visit her family for the Christmas holidays, but the country is locked and they are divided. So those are one of the main reasons and of course we speak about, we can speak about the different groups of people which are inside the society are the most vulnerable. We are speaking about the teenagers, the people around 40 years old and the crisis of 40s.
And of course, the senior people of 65, 70 years old, who feel useless, who feel even more alone. Particularly when they are divided with the children with their family, and they do not have any kind of idea about the future.
Sundae: Right? Especially the elderly. When you have so much time behind you and an unknown time ahead. I’m also thinking about the LGBTQ+ community, teens who are questioning their gender identity, their sexual identity.
Elena: Yeah, absolutely.
Sundae: It just exacerbates all of the pressure that society puts on people.
Elena: Yeah, absolutely. And it depends on the society they live.
Elena: Now, we know that there are societies with those patriarchy, patriarchal societies, where those topics are even hidden or even forbidden to discuss.
Elena: So people, particularly young people, have even more pressure on their shoulders.
Sundae: Absolutely. I even did a podcast, I have to make sure I share it in the show notes, but Patricia who came on that podcast talked about how coming from a Sub Saharan or a Southern African country, there’s a stigma around looking for support for mental health. There’s not a lot of space even today to publicly share with your friends or family that you want to seek out support for mental health. So we’re isolated, people are struggling. One thing that I’ve watched over the last ten years, and I’ve also seen in my own life, when you’re isolated and people don’t know you. It’s gonna be easy to get away with stuff like, “I just had one glass of wine,” or, “No. I’m not that bad.” Your best friends know you and they’re like, “No, come on. This is not okay,” right. I was just listening to a Podcast with Esther Perel and Glennon Doyle, they talked about how when you’re isolated you can have a narrow version of yourself. But when you are around the people that love you, they know who you are and then they invite you to be that complex version of yourself. But if you’re alone, if you’re isolated, then people around will just accept that narrow version.
Sundae: I’m curious from you, what are some shifts that you’ve seen with your clients “thanks” to COVID or as a result of COVID, Elena.
Elena: For the past two years. I have more and more cases with the suffering from social isolation. Particularly, well, I can speak about pressure because we didn’t have those huge restrictions as comparing with Europe for instance. However, for the past couple of months, we really have the bigger and bigger tension from the side of our state authorities and there are lots of reasons about that and I see more, and more people suffering from this tension and suffering from their obligation to, let’s say to — they don’t know. Their lives are not predictable. They don’t know what’s next. So okay. They say we live here in Russia. We feel very safe. But however, we don’t know what will happen tomorrow. Whether we are obliged to stay at home and to work from home or we are obliged to get vaccinated in the coming two days or what will happen and how we can manage this situation. Because really, this is the huge emotional burden.
Sundae: Right? And it’s, we can’t see it, right?
Elena: Absolutely, absolutely. And second if we speak about the virus and that’s what I was talking about, I think more than a year ago. We have this enemy, they call it, but it’s invisible. So even if we don’t have those restrictions, if we are not obliged to stay at home, we’re going out but we don’t know what to expect from each person we meet on the street. And this is also the second biggest problem we have here, I think this year brought us.
Sundae: Well, and one way that it’s evident, I have started to have dreams where I’m mad at people that they’re not wearing their masks.
Elena: Yeah. believe, you’re not alone.
Sundae: I want to get really concrete. Red flags, when is it a sign that you or someone you care about should probably get support? Whether it’s from a coach or whether it’s from a therapist? Again, there’s a lot of signs, but let’s just throw out a few of them that we should be looking for?
Elena: So I would like to name two most vulnerable groups of potential clients for a psychologist and probably something about the red flags in your emotional conditions. First of all, I would like to start with the most important thing from my side. Those are the people with the childhood trauma, the victim of the abusive behavior of as I said, the trauma of the gas lighting and all that kind of situation. Why? Just because the first thing they’re trying to do, they are trying to leave their abuser and with this purpose they leave the country they lived and they have an idea and I think that hundred percent of my clients with the childhood trauma suffered from the same. They had an idea that if they leave their abuser, their life would be better naturally and immediately and they are losing the time.
I have several clients has been living in Russia for five, six, seven years and they didn’t seek the help, the assistance of a psychologist. However, the more they live with this problem, the more, unfortunately, they start to feel guilty that probably there was something wrong with them in the past. And so they have this, this unhealthy circle on their minds. So if by coincidence, you are one of those people, use your time wisely, be smart and try to seek the support of the psychologist because it’s possible to change your life. It’s possible to help. It’s possible to find the support and this is really, very important.
So the second biggest group I started to work with, is the male trailing spouses. There are just a few number of them, but the number increases year by year. And we understand as psychologists that males have very different type of socialization, comparing with women and they really need the very specific type of treatment particularly if they used to be the breadwinners in the past.
Sundae: Huge identity shift.
Elena: Yes, absolutely.
And yeah. And a couple of words just about the red flags, the social loneliness and social isolation. The more you feel alone, the more reasons to look for a therapist or a coach.
Sundae: Right? Well, and if we talk about trauma, I was on a Facebook forum and they talked about how traumas passed around, like a soccer ball that there’s so much going around, and there’s so much from your family of origin, or whatever community experience you had that it’s happening everywhere. And before COVID, people were working with either conscious trauma or unconscious trauma with the best of their ability. And sometimes struggling and sometimes leading really healthy, functional lives. But then you add that one other layer on it and it’s like that straw that breaks the camel’s back. It’s too much.
Elena: Yeah, absolutely.
Sundae: Yeah, so what do you suggest? Should people just try to leave their posts and lock up and go home or what do you think people should do when they’re finding it’s too much or they’re feeling on the brink of it being too much?
Elena: Well, as a mental health professional, I would suggest to seek the professional help or at least support groups. Because, of course, and I’ve heard this from a lot of my clients, they would prefer to speak in person to, to be inside of a community, to be inside of a group. But when they feel that this pressure is too huge, it’s too much again, they’re trying to find at least someone who can speak with them online. Someone with whom they can share, all their problems, let’s say. So at least the support group.
Sundae: So what are some other warning signs? If you’re noticing yourself, do a, b, or c, you need to take it seriously, what were some of those things that we need to pay attention to?
Elena: Well, everything begins from the light forms of depression, as I said. So while you feel I can’t say said yeah, but it’s okay to feel sad for sometimes but when you’ve lost too much, when you feel probably useless, when you feel disconnected. And what is also even more important, when you don’t know — when you don’t have any idea how to reconnect with yourself first, and with your loved ones also. When you feel isolated in the local community, ask yourself, why? And what can you do to improve this situation? Or probably, you can seek professional help. Probably there is something you don’t know, but there should be someone who can explain to you what to do, who can give you some ideas, some insights. This will probably be helpful. The biggest advice I can give is, don’t stay alone because the longer you stay alone, the longer you stay locked, the worse is the situation.
Sundae: Right? Right. One of the things that I have, some people that I love, who have confided in me that they’ve had suicide ideation. And have said, “It’s nothing, don’t worry about it. But let me just tell you, it’s crossed my mind,” type of thing. And I’ve had some very transparent conversations to say, “Hey. If that’s what’s happening again. Would you mind letting me know?” Like, “Can you let me know if those thoughts come up,” to have someone who– who it’s already like, to break this taboo, but, “Hey, it’s popping up again,” or, “I’m in a dark place right now” What do you think about that as a professional health provider? What about that idea?
Elena: Well, as you said before, there’s a stigma not only about the suicide itself, but also about the mental health conditions. “Is it something wrong with me? No, I’m fine. I have my job. I have a good family. Even if they are away, I don’t have any logical reasons to feel bad. I’m probably just complaining. No, I shouldn’t. I shouldn’t be weak. I should keep strong. I should be endurant.” Because in some societies, in some cultures like Russian for instance, endurance is somewhere on the top of priorities, “Do not complain. Do it yourself.”
Elena: “Do you really think you need to call it a psychologist?”
Sundae: Right? Do you know if there’s higher rates among men versus women because in my experience just working in the personal development field is that women are more inclined to ask for help than their male counterparts.
Elena: Absolutely. Yeah. That’s the same.
Sundae: Are men at higher risk? That’s what Movember is all about.
Elena: I would say that the males are on high risk of the committing suicide. The high rates are, I remember, are among the white males of 60 plus years old. However, women tend to seek the help first of their friends, of their families, in their neighborhood, at the mental health professional. I think the reason for that is that the men and women have different ways of socialization.
Sundae: Right? Right. So we’re looking like traditional gender constructs.
Elena: Yeah. Yeah, absolutely.
Sundae: And that is why Movember, which I talked about at the top of the episode, is so important. It consciously aims to support men as they struggle, because gender expectations can be crushing for those who are socialized as men, and there is so much stigma associated with struggling.
I will add a resource from Movember in the show notes, on how to start these hard conversations. But one thing I took away is what to watch out for the strong ones. We are always told to, “Check on your strong friends.” In terms of checking on the men in your lives and their mental health, one place to start could be checking on the one’s juggling work and family. ANd it got me thinking, it is also important to be checking in on a colleague or a friend who seems to be withdrawing, or maybe even obsessing on something. And perhaps obvious, but needs to be said, those who are living with under employment or unemployment and managing a level of uncertainty that isn’t going away and that includes a lot of people.
I know this is just the tip of the iceberg, and Elena we are running out of time, but we had to start somewhere, right?
It’s a big topic. I want to just pull back for a second and look at where we’ve been. What we started talking about is that there is a heightened risk for suicide that we’ve seen statistically, and that expats are at a greater risk than the local population. So with that in mind, I’m just processing that It’s an important topic to not put off of our radar, mental health on any level, so that those statistics don’t rise even higher.
Elena: Yeah, unfortunately.
Sundae: And that’s part of the reason why I know I wanted to talk about suicide is to break that taboo and talk about mental health awareness, the red flags and what we can do about it. Anything that’s important around this topic that we haven’t yet talked about, that needs some attention?
Elena: Well, it was a really small conversation for the huge topic. This topic is really huge and I will also give you some resources, which would be helpful for our fellow expats. And I think the last thing and the most important thing I should say is that: You’re not alone. There’s always someone who can help you. And this is very important to start breaking this taboo around this topic. Because this is the small, very small, the very first baby step of the healing process, which may last for years. And I should say that the suicide survivors, it’s not possible to be prepared for this. But however, it is okay that this process lasts for years and years and years. But however, don’t give up, you’re not alone. That’s what I wanted to say.
Sundae: Thank you. Thank you. I have a dear friend who just celebrated her 10th birthday, she calls it. She had attempted to take her own life, 10 years ago and is now celebrating that she’s been alive for 10 years since that date. And she has shared about that publicly on social media so that the stigma is broken and she’s invited people on her own healing journey, and it’s inspiring to watch her courageously share that and Inspire others who are struggling and really remove that stigma and share what her joys as well, that have happened since she hit one of her lowest moments. So I’m thankful for that.
Elena: That’s really a great reason to celebrate.
Sundae: Yeah. Absolutely. Thank you for being courageous enough to talk about this tough topic with me today. I know it’s a really big one, and thank you for the work that you do to support other people when they’re experiencing loss or in their own mental health crisis. I really appreciate it.
Elena: Thank you so much for inviting me. And I really know that it’s so important to start breaking up this taboo.
Sundae: Absolutely. Elena is so kind to give us a list of resources that we will include in the show notes. If you are struggling or if you know someone who’s struggling, we’ve got some resources at your fingertips so that you can be in community with people who will love and support you through this.
You have been listening to a very special episode of Expat Happy Hour. Taking a different tone for my normal episodes, but definitely worth the time to talk about it and to pause and ask ourselves, how we’re doing and how our loved ones are doing. So thank you for joining me on Expat Happy Hour. This is Sundae Schneider-Bean. I’ll leave you with the words of Eckhart Tolle: “Awareness is the greatest agent for change.”
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