Doing Life Together

cannabis-2186917_1920Recently, I attended a conference on chronic pain and treatments. A woman in the audience made a passionate case for the use of marijuana for pain relief. Her source was friends who used it and reported that it helped. The conference leader, associated with a major university, responded to her question about the effectiveness of marijuana for pain by saying, there is currently no evidence to support this.

If you listen to a people talk about the help they have received taking medical marijuana, you might be convinced that it works great for chronic pain. But, in the medical world, we judge the effectiveness of a treatment based on the evidence, not personal stories. Right now, we lack that evidence. There just are not enough studies to say whether or not cannabis is effective for pain relief.

Medical marijuana is legal is 30 states and Washington D.C., but is still illegal on the federal level. It is rated as a drug (Schedule 1) that has high potential for abuse with “no currently accepted medical use (Medscape, April 24, 2018). After reviewing seven  studies, the National Academies report found that cannabis worked best for nerve pain (neuropathy),  cancer-related pain and improved muscle spasms in patients with multiple sclerosis. However, a European Academy report noted downsides to use–more car accidents, unintentional overdose injuries among children, increase in bronchitis when smoked, increase in schizophrenia and depression, low birth rates and more.  Use can also  affect heart rate, blood pressure and balance.

At the conference we were also told that overall, there is little research with chronic pain as noted above, showing little benefit, with it possibly helping sleep and reducing anxiety. However, 10% of users become addicted, and those who use it because they have opioid use disorder, don’t reduce the use of opioids–39% of people who are long time opioid users also use pot. And where use is legal, teen ER visits related to use have increased by 170%. The conclusion of this section of the conference was that exposing people to marihuana without evidence of its effectiveness for pain may increase the problem of abuse.

Clearly, this is an area where more studies are needed. The jury is still out on the effectiveness and the cost-benefits in terms of the science. Yet, I know this is an area that people feel passionate about one way or another. Usually, this is based on stories from friends or personal use. For me, it is important to follow the data and look at the science. And that will take more time.

IMG_4220 2This Father’s Day, I am visiting my 97-year-old dad. He is hard of hearing, in a wheelchair but still clear in his mind. We are blessed! Despite the setbacks of aging, his mood is remarkably upbeat. He rarely complains and knows that when he dies he will be with the Lord and joining all those who have gone before him. Knowing my father is closer to heaven than earth seems harder on me than on him. The thought of losing him brings tears. Even with the hope of seeing him again, physical loss of parents is palpable.

Every year, I think, “Could this be my last Father’s Day with my dad? My mom has already left us and he is next.” When moments of that reality hit, sadness wells inside of me. I know he has lived a long life and that I am fortunate to still have him around, but parent loss is still loss. The sound of their voice is no more when they leave us.

So this year, like every year, appreciate your dad. We really don’t know how long we have them in our lives. Don’t get caught up in what he did or did not do for you. Rather find a way to honor him. This is our biblical mandate. One of the best ways to do this is simply to listen to his life story. What made him the man he is today? What life lessons can you learn from him? Knowing your dad’s story brings empathy and understanding.

Acknowledge your dad in your own achievements. How did he contribute? In my case, college was not optional. He didn’t have the chance to go to college and truly believed his children all needed to go. We all did and are grateful for his push to education.

Your dad may not have done everything right. Some of you may even feel failed by your dad. But this one day a year, be merciful and full of grace. Give him honor and model this for your children. Find a positive memory and focus on it. Choose the path of grace.

And perhaps the biggest gift you can offer is the gift of forgiveness. Don’t wait for him to acknowledge wrong, instead choose to forgive. It will give you freedom. Then engage him in something pleasant or fun in order to create a good memory. Get him to laugh, relax or enjoy his grandkids. I’ve never had a patient tell me that they were sorry they chose the road of forgiveness. On the contrary, they report  a lifting of a weight after doing the forgiveness.

Maybe your dad is elderly like mine and can’t give back much at this stage in his life. This means we step up and give back to them. So this weekend, love on your dad, tell him you appreciate him, pray for him, forgive and extend grace. The promise is that as we honor our father and mother as God commands us to do, it will go well with us. This Father’s Day, be a model of grace. Live in the blessing of honoring your dad.

emotions-2764936_1280Another week and another report of a celebrity suicide. In case you didn’t hear about it, celebrity chef and TV star, Anthony Bourdain, joined the growing numbers of people who take their lives by suicide. According to the CDC, suicide rates have been rising in almost every state. Suicide is the 10th leading cause of death and one that is preventable.

The question is why? Why do so many people feel hopeless and despairing?  We know mental illness accounts for less than half of the cases, so what is going on with people not suffering from mental health issues? When researchers study causes of suicide, they find relationship loss or problems, substance misuse, physical health problems and stress related to work, money, legal issues or housing to be significant factors. And while it is important to learn the warning signs, pay attention to those who are depressed, and reduce lethal means, this isn’t the entire story. Something prompts the flash flood of negative emotions that creates a tipping point.

Roy Baumeister, a Florida State University psychologist, once described suicide as an escape from the self. There is something intolerable going on inside a person to make this choice. According to Baumeister, a person can live a better than average life which can create unreasonable standards for happiness. When the going gets tough, they have a harder time coping with failures whether that be financial difficulties, going from married to single or adjusting to a new state in life. This “fall from grace” is humiliating when you don’t have a spiritual foundation to understand grace.

When grace is missing, the suicidal person often becomes self-loathing or self-blaming. Other people may be good the suicidal person sees himself as bad. From this low opinion of the self comes feelings of worthlessness, shame, guilt, inadequacy and rejection. Something is rotten to the core. And while we are all sinners, the inability to receive God’s grace and be a person of worth just because we belong to God, is difficult or missing from the mind of someone so self-loathing.

For some, comparisons are frequent and the person is highly aware of his or her shortcomings. This awareness of falling short leads to loneliness and distance. And when you are alone, the mind can easily go negative.

Anxiety from all the self-blame and guilt is on-going. It is as if suicide is the end of psychological pain, a sort of loss of consciousness from the pain of living. Present moments seem interminable. The future is hard to picture and looks hopeless. There is an emotional deadness that develops over time and ends with the act.

One theory regarding people who actually go through with the act is that they have been exposed to pain–physical, emotional or relational. This tolerance of pain lowers the fear of death and enables the person to do what physically hurts. The exposure to pain coupled with heritable traits of impulsivity, fearlessness and pain tolerance, in part, explains why suicide runs in families.

Now place those people in a culture of superficial connections, constant comparisons and expectations to succeed, with no meaning or purpose in their lives and no  spiritual solution to rise out of  desperation. They have not found the place of  rest, peace, and contentment. Perhaps we should not be so afraid to talk about the spiritual life that can bring hope and healing. People need t a place to trade their pain and sorrows for hope and healing. They need the Great Physician-the One who gives value, grace and unconditional love.


depression-1250870_1280I was stunned this week when I saw the headline. Kate Spade dead at age 55. This designer of the purse I carry to work every day, ended her what appeared to be successful life. And the age old question is WHY? What causes a person to decide they cannot go on and prefer to die?

At present, there is much speculation about Kate Spade’s death. TMZ reports that she fell into deep depression and had marital problems. She was separated. A suicide note was left for her 13-year-old daughter which reportedly said it had nothing to do with the daughter, but that the daughter could ask her dad about the why. If true, this is a lot for a 13-year-old to handle. Pray for her!

Even when a note is left, it doesn’t really explain the decision to end it all. Questions linger among those left behind.  For loved ones, questions center on why did the person see no other solution than to die? Yes, they might have been depressed, felt despair, overwhelmed and more, but why did they feel they had die? According to CBS news, Kate’s dad talked to her the night before her death and found her happy, planning a trip, and doting on her daughter. Her sister and husband, however, reported that Kate suffered from depression and anxiety.

I don’t pretend to know the answer to the question as to why some people decide suicide is the answer, but those that have made unsuccessful attempts often say they didn’t so much want to die, they wanted to stop living. In many cases, they want the pain to stop, the problem to end or to find a way out.

One of the leading causes of suicide is depression. In fact, when we assess for depression, we always ask about suicidal thoughts, plans or attempts. A previous attempt places a person more at risk. Depression is characterized by negative thinking, sad and depressed mood which can lead to suicide. And when depression is hidden, a person is more at risk. So asking about suicidal thoughts or plans actually decreases the risk of attempt.

In some cases, suicide comes at the hand of someone who is suffering from psychosis. There are voices in their head telling them to end their life when psychosis is in play. This type of mental illness can torment a person to take their own life.

Another contributor to suicide is impulsivity often brought on through the use of drugs and alcohol. Once out of an altered state, a person is usually remorseful for thinking of suicide. Yet, when altered, that inhibition can be lifted. People do things in an altered state they would not do when sober.

Some people make suicide attempts as a cry for help. Something is wrong and they don’t know what to do. A suicide attempt signals the pain and hopefully brings help. Yet, in some cases, the cry for help is lethal and ends in death.

Those suffering from a terminal illness and who have lost all hope may consider suicide. They want to control the end of life and decide to do it at their own hand.

Whatever the reason behind the action, most people do not let on that they are going to kill themselves. The decision can be made in advance or minutes before the behavior occurs. And this is one of the toughest parts of losing someone to suicide. You just don’t know that they will do it. We do know that people are at higher risk when they have depression, psychosis or anxiety, when there is a significant loss, personal crisis, or significant stress.

If you hear someone talking about death, take them seriously. If you notice they have means, take that seriously. If someone feels helpless, hopeless, or trapped with no way of escape, take that seriously. And if you hear statements about self-worth related to self-loathing, pay attention. Distress is at play and the person needs help.

The National Suicide Prevention Lifeline is  800-273-TALK. Counselors are available 24 hours a day, 7 days a week. The service is available to anyone. All calls are confidential.

Ultimately, suicide is based on a lie that there is no hope, no way of escape, no solution to life’s problems. Yet, we know that while we suffer and have emotional and physical pain, God promises His peace and presence. Hope in Him is the strongest prevention.