Friday, September 21, 2012

Suicide and You

Clink and I are talking at at Maryland's 24th Annual Suicide Prevention Conference next week.  When we were asked, we told them that suicide was not an area of specialty for either of us, and that we usually speak about the Public Face of Psychiatry and ways that blogs, podcasts, twitter, Facebook, and good old fashion books like Shrink Rap can help people understand what it is that psychiatry is all about.  They told us that was fine.  Still, we'd like our workshop to be relevant to the overall topic at hand, so I thought I would ask you to share your experiences with us.  

If you've been suicidal, what helped get you through? 
Did a mental health care professional say or do anything that was helpful?
Did hospitalization help?  Did medicine help?
If you had a serious attempt, do you think there was anything someone could have said or done to have prevented your attempt?  
What keeps you from acting on suicidal impulses?  What has pushed you towards acting on them?

As always, thank you for your help.  We continue to learn a lot from our readers!


Anonymous said...

Having a reason to stay sucked in is how I barely hang on and keep going. For me, when I was so close to doing something, it has always been my kids that have kept me hanging on. I don't want someone else raising my kids, especially the jerk of an Ex. I have also learned that when I am feeling suicidal, I can't stay home alone because I get close to doing somethin. I have to get out, sometimes I will just do errands where I know I will not run into someone. I don't want to see people, but I know I have to do it. Other times I will just drive, listen to music and maybe get a soft serve.

I reach out to my Dr. and yes I am on quite the cocktail of meds. (bipolar)

I lost a close friend to suicide a few years ago. It was awful. She reached out with her first serious attempt. She didn't with her second and it was fatal.

Some of my reasons wouldn't work for someone else, I realize. But you do have to have a strong reason to continue to live, even when you don't feel like you can do it anymore.

Anonymous said...

1. If you've been suicidal, what helped get you through?

To be honest, not much did. I would sit down at the hospital, in the foyer, and keep myself there until the urge had passed. It was part of my safety plan, and it's the only part I've been able to follow through on. Recently I was caught by my family doctor there and put into the hospital.

I have troubles talking to my doctors and therapist about my suicidal urges. Honestly, I don't think they know just how bad I've been, I simply don't talk about it. Until my doctor recently caught me, nobody during that time except my mother had known I was doing poorly.

I can't admit to it, something in me won't *let* me admit to it. To admit to it actually feels like some sort of cardinal sin, like I'm doing bad by myself to admit it. Like I'll be punished.

2. Did a mental health care professional say or do anything that was helpful?

My therapist helped me create my safety plan. He kept in mind that the likelihood of me following through with the steps was slim, so as a final step he had me add to sit at the hospital. He knew I wouldn't check myself in, but sitting there was at least one step closer to keeping me safe.

3. Did hospitalization help? Did medicine help?

Hospitalisation hasn't helped. You're in and out so incredibly fast that it can't help. If you're up for lying you can be out of the hospital within two days, and you don't even have to do all that great a job of proving that you're doing better.

Likewise, I don't find that the medication helps with the suicidal thoughts. Sure, they take it away for a little while, sometimes only weeks, but with Bipolar Disorder they always come back.

4. If you had a serious attempt, do you think there was anything someone could have said or done to have prevented your attempt?

Had they known about it, they could have taken away all of my pills. The problem is, after my mum did this I started hiding and hoarding pills, so really it's a one-shot deal for somebody who's intent on going out on their own terms.

5. What keeps you from acting on suicidal impulses? What has pushed you towards acting on them?

What keeps me from acting on them is knowing that other people view it as "wrong". I have to at least put in some effort to prove to them that I'm trying not to do anything, even if I "fail".

As for what pushed me to act on my own attempt, I can't say. The pills were not three feet away, my mind wouldn't shut up, the thought popped in my head and I downed them all.

Sunny CA said...

When I have felt the worse, I called my psychiatrist. He takes calls "live" in his office between fifty minutes after the hour and on the hour. Also he takes calls at home. He less than five minutes, somehow manages to give to the heart of the problem, make me feel better about it, and communicate that he really, really cares. I never called excessively. Only when I absolutely needed him. When I was doing poorly, at sessions, he would strongly urge me to call a few times between sessions to check in with him. He assured me than not only does he not mind the calls, but he would rather hear from a patient that he is worried about because it relieves his worrying. Even when I did not call him, the connection to him, which at certain bad times was seemingly my only personal connection, was a major factor in getting through it. The fact that he openly and freely and regularly communicated that he really cares about me was enough to help me stay with the living. Having pets and nobody to take care of them in case I die helped, too. In some ways, I feel that I never felt suicidal, but I kept thinking about how I would do it and wondering if it was a good plan, so I felt at times that I could just go straight to taking the steps to kill myself without having it emerge as a suicidal though per se. Strange, except that I have buried my feelings so deeply that some things just emerge as actions.

I am "not a robot", but I can't read the darned letters. It is so frustrating to get rejected, only to have more illegible letters come up.

Sunny CA said...

Typos in the above:

When I have felt the worst.
In less than 5 minutes, he somehow manages to get to the heart of the problem.

SarahJayne said...

I am bipolar and usually fairly stable but towards the end of last year I was tapered off all my meds (under the supervision of my shrink) so that we could try for another baby. I did well for about 6 months before I crashed into the worst depression of my life. I was suicidal for the first time and that really scared me because I was mid-cycle trying to have a baby and couldn't get out of bed. What truly helped was my shrink. He is the most amazing person. He told me over and over again that if I died my kids statistically would be 3 times more likely to commit suicide in their lifetime. At my worse he was so close to putting me in the hospital but we negotiated an alternative which was a better option for me. He said I could stay at home if I promised to appear for an appointment with him every day (Mon-Thur) and call him on Fridays. It really helped to know that someone cared enough to do something unusual that they don't normally do and he continued to see me daily for 6 weeks until I finished that last cycle of trying to get pregnant and then titrated back up onto my meds. Knowing someone cares enough to be there when I need them and is reachable when I'm crying hysterically at 8pm on a Wednesday night because my 5 year old (whose kindergarten teacher is pregnant)told me I looked like I was pregnant (eating disorder issues) or when I'm in a panic, pacing my living room for 3 hours (he stayed on the phone with me that night for 40 minutes until some Seroquel started to kick in.

Really, what it comes down to is someone outside of your immediate family showing they are truly invested in your care and would be upset with you if you decided to take your own life. A strong therapeutic relationship with someone you can truly be honest with and not be judged for feeling bad.

Anonymous said...

I have suffered depression and anxiety all of my life (I am 55). When I was younger I thought I would go to Hell if I committed suicide. Although I analyze most things to death, I would not question the validity of this idea, because it was what kept me from following through. Once I had my son, 20 years ago-all bets were off. No matter how desperate I feel I no longer have that option, because it gives him an example of suicide as an option. I am new to this site and find it very informative.

Anonymous said...

I have made a very serious attempt and a few other more tentative ones. The hospitalizations do not help at all. They have brought me to the place of no longer viewing hospital as an option for getting well and that means that I no longer tell doctors about how poorly I may be doing. I will die before I go back so I don't believe that suicide is 100 per cent preventable.I knew someone who also had bipolar and committed suicide the day after being released from hospital.
The medications do not relieve the impulse to commit suicide.It is there every day. Some days I am able to fight it and no one would every know. Some days I have a much harder time and then I tend not to stay in and self medicate to the point of no longer feeling anything at all.If I can get to that point, I will probably stay safe. The problem is that there is that line between numb and dead so who knows?
I do not believe that any doctor actually cares if I live or do not live. I don't worry about them and I don't call them. Children are small for a short time. When mine were kids, I think being a parent was a bit of protection because I wanted to protect them. Now that they are older,it is much easier to consider suicide as a rational choice that I might make if I can no longer imagine living the way that I do.
Mental health professionals tend to be least likely to say something helpful because they all say the same things that they have been taught to say. The best thing I ever heard came from a lay person who told me that if I died, they would be sad for a bit but get over it. I believe that and I won't worry about someone being sad for a bit.
if I want to die, no one will be able to do anything about it. A doctor can ask a question and I can answer with a lie. I can find the means if I am serious. Only one thing holds me back and that is the fear of failing and putting myself into a situation of not being able to finish what I started.If they offered assisted suicide to people with a bipolar diagnosis, I would be there. I would love to have a peaceful death and know it would be completed properly.

Anonymous said...

1. If you've been suicidal, what helped get you through?

I always just tried to think of how much it would hurt my family and the people around me who cared for me. It's a little odd, it's been awhile since I was really suicidal and I'm not sure what else might have got me through.

2. Did a mental health care professional say or do anything that was helpful?

I was horrible at telling my health care professionals know how I felt. I think it was in part because I felt like even though I felt suicidal, it wasn't REALLY suicidal, and thus, I didn't need to tell anyone. I guess I just didn't want to worry anyone. Anyway, no, I didn't give my doctors etc. a chance to say useful things.

3. Did hospitalization help? Did medicine help?

I was never hospitalized. But I think medication helped. I am very happily now on an MAOI, and while the change wasn't instantaneous, I feel quite happy now!

4. If you had a serious attempt, do you think there was anything someone could have said or done to have prevented your attempt?

No serious attempts. I nearly swallowed a bunch of antidepressants once, but my sister walked up the stairs and I stopped with my hand next to my mouth. I'm sure my sister doesn't know how wonderful she is.

5. What keeps you from acting on suicidal impulses? What has pushed you towards acting on them?

Oh. I guess I'd just say the same thing as I did for the first question. I'd only add that the habit of thinking of suicide as an out stayed with me for awhile. Small things would go wrong and I'd think "Ah well, better to just kill myself" even though I wasn't really unhappy at all. I finally asked my therapist about this and she suggested I just make note of it when I did it. To my surprise, just doing that made a huge difference.

Anonymous said...

Bipolar here.

Medications don't seem to help directly. They do help me remain more aware of myself, so that I notice things going badly faster and can appreciate that the thoughts are just that, and don't have to be acted on. This is a tremendous help with my garden-variety suicidal thoughts.

I've been hospitalized...I went to the ER for suicidal ideations after cutting myself to test the sharpness of the blade...that's when I was diagnosed and I wound up staying 6 days. And yes, I think it saved my life. The night I made that test cut I was able to stop because it was so close to morning and I was afraid of one of my children coming in and finding me dying or dead. I do not think I would have survived the next night.

Before then, what kept me going was, oddly, knowing that suicide is always an option. I could always kill myself tomorrow if I wanted to, so why not see what happens today? That curiosity has served me well through many rounds of torment.

I haven't been actively suicidal since my hospitalization, but I do have a good treatment team and I trust them more than I thought I ever could, so I feel safe now because I know there's someone who understands what's going on who I can call if I need to.

It did surprise the hell out of me that I got suicidal right at the worst of my mania. I think that might have been what was so dangerous about that particular moment for self-control was shot to hell. Depressed me has plenty of suicidal thoughts but not that crazed intensity that nearly made me act on them. When I'm depressed they're almost more like a mantra, weirdly enough.

Long time reader, first time commenter. :) Hope this helps.

Anonymous said...

1. I'm a chemistry teacher and I'm hard to replace. My students need me and if I am out of the picture they would suffer. That's what gets me through most of the time during the school year. Summer vacation is another story- still haven't come up with a successful solution. The other thing that gets me through is my relationship with my psychiatrist and psychologist. They both know me very well by now and are very accessible. If I need to call every day, I can. I know they care and that means a lot because I am pretty isolated.

2. My psychologist reminds me that "I don't need the chaos". Being reminded of previous attempts and hospitalizations and the consequences helps a little bit (not a lot). He also says I need to be "wise". I think the most helpful thing is that I know he cares.

3. Hospitalization kept me safe because I was locked up. With the exception of the first time, it did not make things better. It kept everyone else involved happy. The first time I was hospitalized, it was involuntary, and the psychiatrist was pretty awesome. She forced me to admit there were some pretty big problems in my life and that I needed help. The fact that she hospitalized me felt like she was saying "you are going to get some help whether you want it or not". Other hospitalizations have just been holding cells and I have left the hospital just to make another attempt. Medications have not helped.

4. The times I have made an attempt could have been at least postponed if someone had been with me, had taken away my pills, or my keys, expressed their love/care for me, called my doctor, or basically seen through my b.s. and taken charge of the situation.

5. The fact that my students need me helps me keep from acting on my thoughts. The biggest force pushing me towards it is my OCD thoughts that I have to kill myself by overdosing on Tylenol, and the fact that I have convinced myself that I am evil.

Anonymous said...

If you've been suicidal, what helped get you through?
Did a mental health care professional say or do anything that was helpful?

I did really well with professionals who treated me with respect and dignity. I am intelligent, even in my worst of times, and like to be treated as one who is very well informed.

Did hospitalization help?
I found hospitalization helped a bit. I found it nice to be taken away from the lonely pain and suffering I had in my daily routine.
Even if it was for a short time.

Did medicine help?-- No not really. I guess I slept more with meds. I guess that is nice when my waking hours were not so awful. When you are asleep you aren't really bugged with your anxiety and depression as much.

A Girl said...

If you've been suicidal, what helped get you through?

As a teen, I believed, rightly or wrongly, that if I committed suicide, my mom would implode. I couldn't do that to her. Instead, I decided to kill myself at the age of 30, by which time I was certain she'd be dead.

This was in many ways a good decision. It freed me to live my life a little, and ultimately led me to meeting my now husband. So, when I turned 30, again I couldn't kill myself, this time because of him. That's when my 'healing' began.

Well, healing and healing. I think of it more like digging a ditch. It's hard work, with frequent mudslides and the rain and the wind gets in your face, but there are also sunny days, when I can rest and dream about decorating my little mudhole, and perhaps erecting some proper walls.
Who knows, one day, I may put a roof on the place :)

Did a mental health care professional say or do anything that was helpful?

My psychiatrist told me at our first meeting that I should not tell him about my suicidal thoughts, because he'd be forced to commit me. That was a great way to start a therapeutic relationship. But he probably didn't need to hear about how there was this giant blackhole in my chest that sucked everything but pain out of life, except for that time when Odin (yes, the god Odin) sat next to me on the bus and had me howling with laughter at his attempts to get all the pretty ladys to sit on his lap.

Did hospitalization help? Did medicine help?

Never was hospitalized, but yes, the medicin helped. It wrapped me in a blanket of "I don't care" which allowed me to deal with some of the stuff in my life, without the feeling that I was constantly being poked by a cattle prod.

What keeps you from acting on suicidal impulses?

Today, my children not only keep me from acting on them, but push me towards living. I consider myself their rolemodel, and I want them to know that they can succeed and be happy.

What has pushed you towards acting on them?

Every time my mum has been for a visit, every time something goes wrong in a friendship, every time there's too much stress and politics at work, I feel the "iron sky of oblivion" pushing down on me.

There have been rare times when I've felt that my kids would be better off without me, and that's when I really have to bite down on my tounge and just plod away in the hope of a better day.

Anonymous said...

What a girl said her pdoc told her not to tell him about suicidal thoughts because he would be forced to hospitalize her. That part is very familiar. I have met shrinks who did not want to hear about a lot of things that they might have to act on.
Many shrinks don't want to be called if you are feeling suicidal. They give a message that if it an emergency (you have the loaded gun in your hand already) go to the emergency room.If you don't have the gun , don't bother calling because it is not an emergency. That, or they rarely answer a phone they give out for emergencies. It sends the message that they don't want to deal with that kind of thing but would be happy to speak with you in the office in two weeks time.

Anonymous said...

If you've been suicidal, what helped get you through?

My friends actively engaging me and touching base with each other. While I was ashamed that they felt they had to do this, it is their effort that kept me here.

Did a mental health care professional say or do anything that was helpful?

Actually, it was often things that mental health professionals said/acted that increased my suicidality. In fact, I first became suicidal after 3 months of engaging with mental health care for mild depression. I got much worse through treatment.
The most helpful was giving up on getting help with suiciality from psychiatrists and engage my actual social supports. So perhaps it was the realization that psychiatrists wouldn't be helpful that forced me to take the more, for me, last ditch effort to engage my friends.

Did medicine help?

Medicine led to severe agitation and hostility that created the conditions for me to not cope with suicidal thoughts like I used to.

What keeps you from acting on suicidal impulses?

I have a big family history of suicide. Feeling suicidal was coupled with intense shame because I know how the suicide of others has affected me and people I care about. Though, with those feelings I knew suicide would cause a lot more pain beyond myself, and I didn't want my inability to cope with pain to cause any more pain that it already had.

What has pushed you towards acting
on them?

Feeling duped, fragmented, confusion, and sever agitation in mental health care. It forced me into a period of isolation where I didn't trust anyone or myself for help.

withallmyheart said...

Thank you, Shrink Rap, for opening up communication to those of us who are often all too intimate with suicidal thoughts. Bravo to each of you for asking us. I would imagine it is very hard for a psychiatrist to hear that his/her patient wants to die. So, thank you.

A psychiatrist told my parents that I was suicidal when I was in 6th grade. I am now 61. Thank you for listening to me, and the others....

I have a magnificent psychiatrist, and the therapeutic bond that I feel between us truly keeps me alive.

Also, I just cannot hurt the people I love. I often lament: "How can I do this to them?". It is precarious, almost as if I must choose 'them' over my suicide.

I am very clear in my mind when I need the hospital. And yes, being hospitalized has helped me when I feel there is no stopping me......

The safety of it, the being able to talk freely about how I feel as if I cannot go on, and also, "letting someone else take care of me, when I cannot take care of me" is crucial.

Medicines help. Especially prn's. I have prn Ativan and prn Trilafon that my doctor has given to me - respectively for anxiety and agitation. I use them, literally, to go to sleep. When I awake, I am often so relieved that the suicidal thoughts and urges have passed. (That is the crux: when I am suicidal I just have a diminished ability/capacity to see that the need to die will pass.......)

Finally, lately I am telling myself when I am suicidal that "It is my illness that is telling me that I must die" - "The depression is talking" doing this, I have been able to somehow create a wedge. So the suicidal thoughts are somehow separate from me; as if it is not *I* who needs and wants to die, but it is The Illness that is causing these thoughts. The Illness as interloper, the Illness as Murderer......

Thank you again for being open to hear and listen......


pdf doc said...

1. When suicidal, in the past it was always my children that kept me from completing the act, and the satisfaction that the ex would get from my death. Now as the children are getting older, I also think about my animals - cats, dogs, horses, cockatiel - who would take care of them?
2. My psychiatrist sees me more frequently when I'm suicidal. He has reminded me about the effect that my suicide would have on their chances of committing suicide. A few months ago, he told me that children's brains aren't done developing until they're 25 years old, so it was his job to keep me alive until then, and after that I could do what I liked. I reminded him of that a few weeks ago, and he just laughed.
3.I have not been hospitalized, but have been close several times. I think that my psychiatrist gives me a bit more leeway as I'm a physician and the turmoil created by my absence (my own as well as the hospital)could very well erase any benefits of admission. Medication definitely helps - there is always tweaking when manic, depressed,or suicidal, and most of the time it helps. Sometimes only by making me so stoned that I can't think a plan through.
4.The closest I have come was several years ago when the separation/divorce was still nasty and ex wouldn't let me have the kids on Christmas eve, which is very important to me, being of German descent. I was very upset, got very drunk, and took a large handful of assorted meds. I slept for 36 hours, and when I woke up very groggy, my first coherent thought was "didn't take enough". That was the same response I gave my psychiatrist when he asked me what I'd learned from this. I guess that's classic, as an impulsive act. Since, I haven't had any serious attempts, but think about the how and when frequently. I share custody of the kids and they are teenagers now, so there are times I'm alone so I have ample opportunity for a lethal attempt, made more certain as I am rural and don't have close friends or colleagues that would consider coming to look for me soon enough.
5. Kids, animals - typical risk factors. One of my worst experiences was before I saw my current psychiatrist. I was in an agitated depression, not eating, not sleeping, thinking about suicide all the time. I had a trajectory planned out to put my car into a highway overpass piling. Every time I passed that piling, I thought "now"? I saw a psychiatrist for the first (and only) time, poured out everything, and at the end he told me that I wasn't depressed, just had marital problems and needed to find someone to talk to (clearly not him). I was so upset that I ended up stopped on the side of the highway near my piling in tears for a good half hour. I think that day was very close, thanks to him. It was a few months (and pounds) before I saw my current psychiatrist, and was diagnosed first with major depression and then bipolar.

Anonymous said...

There are two times I was "suicidal".

The first time I was a battered wife. He was threatening to kill my family and friends as a way of controlling me. The only way I could see to protect them was to remove myself from the equation. I carefully explained the logic to a therapist at the school, as well as my plan for how to kill myself. He contacted both our families and had them sign paperwork to have my husband committed.

The second time, a physicians assistant had prescribed "The Pill" (mini-Pill version) to manage perimenopausal symptoms. It made me feel rather frantic within a month. Within two I was the victim of rampant suicidal ideation. I could tell it was not "me" thinking this, that the meds had changed me, changed who I was, changed my personality. It terrified me that someone could give me a pill to make me insane.

I phoned the clinic. She said to tough it out, it would go away. The third month the suicidal ideation was so strong, so dominating, so overwhelming, that I knew I could not survive another month. My family was scared. My relatives in other states were scared. They could tell something was very very wrong. I was shaking a lot. My eyes were jittery. I had trouble focusing attention. I was scared all the time. I did a lot of deep breathing. I prayed. I talked with people I trusted, begging them to keep an eye on me.

I made an appointment with the PA, who wanted to know why I was back again, and told me I HAD TO stay on them for six months, or the meds couldn't work. She was upset with me and frustrated that I was continuing to pester her instead of doing what I was told. I did not believe I could survive until the six month mark.

I had a friend who was an ob/gyn nurse, and talked this all through with her. She agreed that I should stop the meds. While she didn't say so, I think she was angry that the PA was not listening to me. I asked her if I needed to wait until the end of the cycle, or if I needed to taper off the meds. She said, no. So I went home, and threw them out, and never took another one.

Longterm, however, this has made me understand that the idea of our Self is far far far more fragile than we think it is.

Awake and Dreaming said...

If you've been suicidal, what helped get you through?

I haven't been all that suicidal since university ended, but thinking back, there were a few things. Cutting myself definitely helped me get through the suicidal urges, but definitely not the best coping skill ever. Rereading my favourite books over and over and over again. I remember being crazy suicidal and a broken mess and just throwing myself into Harry Potter six. Counselling helped A LOT. One of my practicum supervisors helped. Prayer, my church, my friends, some AWESOME mentors, disengaging with some horrible and abusive ones. And then, getting my cat, getting my first social work job, feeling like and adult. Oh, and my meds.

Did a mental health care professional say or do anything that was helpful?

The best thing a mental health professional has ever said to me, was at my very first counselling session. She asked if I was suicidal, and I said no, I just wanted to not feel horrible, or something like that. And she understood and described it as curling up in a little black hole and not coming out, and she was SO bang on in her reflection. It made me feel like there was hope, because someone finally understood.

Did hospitalization help?
never had to go that route.

Did medicine help?

YES. Effexor changed my life completely. It was amazing. Absolutely AMAZING! And when I say was, I mean is. That and when I got my prescription for clonazepam. I rarely take it, but I have it. And having it is what matters. Because I could take it, if I needed to.

If you had a serious attempt, do you think there was anything someone could have said or done to have prevented your attempt?

I have never attempted suicide.

What keeps you from acting on suicidal impulses?

Lots of things. My cat, in particular. I more than one, but this one is an incredibly one woman cat who would probably die without me. My friends, my house, my job, my church, my life, my daily decisions, self taught cbt skills. My yoga practice. Being mindful. Journaling, communicating, taking time for myself, not isolating, not letting myself be bored, not letting myself be overwhelmed, boundaries, intentional relationships, community, lack of means (I will not overdose, it rarely works), working with suicidal clients, my job, my boss, the sun, my naturopath, acupuncture, my garden, eating better, exercising more, I could go on and on.

What has pushed you towards acting on them?

I would say that the absolute biggest triggers are being bored and being overwhelmed by the clutter in my house. (Somehow, cleaning the clutter never seems to be an end to the boredom.... you would think those two could cancel each other out, but that would be too simple).

Liz said...

last summer, i wanted hospitalization to help me not feel suicidal. so i decided- an impulsive choice, that i would overdose and go to the hospital, and then, they could help me. and if i didn't feel better upon my discharge, i'd kill myself.

so after church, i overdosed in my car. and then, i went to the hospital. i didn't feel better when it was time for my discharge, so i convinced the doctor to let me go by myself so i could "take a cab" home. i walked to the bank but they wouldn't let me withdraw money without id, so i just took the medication i had with me upon my discharge-- two weeks of lithium and synthroid. and took a razor from the bank and cut forearm. and someone nearby called 911 and i was taken back to the hospital. this time, i was court ordered to stay... i barely escaped dialysis, btw. three times that amount of medication and god knows what would have happened.

i'm thankful, now, that the bank wouldn't give me any money. that may have saved my life, because with id, i would have gotten money, filled my prescriptions, and taken ALL of my lithium and synthroid.

i wasn't reasonable. but being with family that day might have kept me from attempting suicide again. i would never kill myself in front of anyone else. one piece of advice is never to release patients alone. make sure there is someone to get them if at ALL possible.

hospitalization didn't help me, except hospitalization is where i was referred to dbt, and dbt saved my life. and it potentially gave me a little time to be safe when i was at my lowest of lows... but that could have been accomplished in a much more humane way.

medication hasn't helped me. at all. to me, it's a fake way for families to feel like "something is being done" to help their loved one.

dialectical behavior therapy is what has helped me. learning skills. working towards building a life worth living. if anyone wants to help chronically suicidal people, they NEED to take the dbt training.

Anonymous said...

First off, thank you for opening up this topic for discussion. It's one that too often is danced around, and spoken of only in whispers. To have been able to read the replies has helped me understand I'm truly not alone. Thanks go to all the brave souls who have written before me as well.
Only one 'true' attempt, at age 16, interrupted by an unsuspecting Mom. She didn't recognize exactly what was going on, but she got me into therapy. That was strictly talk therapy, but it got me through that period. Much later, early 30's, another dark period when obsession with suicide tried to take over. Had already returned to talk therapy and admitted exactly how bad off I was; therapist helped me self-commit. Her guidance, patience, and plain caring made all the difference in the world. Meds started playing a role then, but the doc was simply the 'script writer, the psychologist was the one who got me on the path out of hell.
That was over 20 years ago, and still the desire creeps in now and again. Remain on meds, outwardly function at a level that appears to be well-rounded, and 'sane', but I do not share my darkest thoughts with the doc and therapist I now work with. No matter how well healed the trauma may appear, the scar is just that, a patch covering a deep wound. I don't act on the thoughts because to do so would allow the evil to 'win', and as one previous writer alluded to, that would be akin to once again allowing the power to belong outside of myself.

Shruti said...

If you've been suicidal, what helped get you through?

First time I was taking infertility treatments and so I just blamed it on that! Later I realized it had nothing to do with that! 

Did a mental health care professional say or do anything that was helpful?

No! I was admitted to hospital after having my twin girls for feeling suicidal! I did not find it useful even a little!

Did hospitalization help?  Did medicine help?

No! They were useless .

If you had a serious attempt, do you think there was anything someone could have said or done to have prevented your attempt?  

I just did not know! I did not realize how many people would love to see me unsuccessful and sad. The reality of it REMOVED me out of any depressed feelings I had!

What keeps you from acting on suicidal impulses?  What has pushed you towards acting on them?

Forget the impulses I am scared to even THINK negative thoughts. I am very aware of the struggles my family and even my ancestors had to merely live their lives. I feel responsible and committed to be a better parent and make sure when my daughters grow, they can see the value of my life, their great great grandparents and grandparents lives and just commit to be a great citizen!

In my case it has been a complete turn around in the way I think.
I understood the meaning of destructive criticism. I realized how rampant it is, ESP for people like us . ( my family were refugees from Pakistan to India.)How my parents shielded from it and perhaps made me weak in a way as I had so much belief in everything. Now that I do not, it makes me want to live and be a committed parent.

Most useless thing I encountered was Psychotherapy. The lady just want to validate any of my silly notion and weave her own brazen reality. It was waste of time and money.

Anonymous said...

1. If you've been suicidal, what helped get you through?

Thinking about the consequences that have happened in the past, such as paying for hospital bills, losing people's trust or feeling embarrassed. Also, I have learned to think about the people that would be affected by my death (I haven't always been able to make it matter).

Did a mental health care professional say or do anything that was helpful?

I don't think anyone has really ever said anything that was helpful. They always told me it would get better but I never believed them. However, my therapist's availability via phone did save my life on one occasion and prevented many other destructive decisions.

Did hospitalization help? Did medicine help?

Hospitalization was helpful the first time (5 total) because I really needed a break from my environment and I did actually learn some things. The other times I didn't benefit. Medication did help because the precipitant to my suicide attempts usually involves me not taking my meds.

If you had a serious attempt, do you think there was anything someone could have said or done to have prevented your attempt?

No. Once I have made up my mind to do it, nothing can change it (so far).

What keeps you from acting on suicidal impulses? What has pushed you towards acting on them?

Feeling like I have a future and realizing that people love and care about me keeps me from acting on my thoughts.
Feeling like things will never get better and that my moods will never stop cycling pushes me towards acting on them.

Anonymous said...

I am still surprised I made it through. Ultimately, geodon saved me. Other drugs tried in rapid succession prior to geodon caused rapid cycling, making matters worse. I told my shrink I was suicidal and he said it was normal for a depressed person to feel that way. That was not helpful.

Anonymous said...

I am alive because of my children. I am very afraid that, if I kill myself, they will try to do it too. I know there are studies to support this.

Honestly, I don't know if my doctor helped. He tried so hard -- more visits, more calls, more drugs -- but I had a very hard time. I agree with the poster who said that you need to be building other sources of support.

Hospitalization bought me time. Meds helped. I was at highest risk when frantic, not when paralytically depressed, and meds helped numb that.

I need to stay busy. I can forget about it for a while, but I don't know that it will ever go away entirely. While I think we that we as a society should keep trying, I have doubts about "100% preventable."

Jane said...

Not sure if I wanted to answer such sad questions :(, but I will give it a go at a couple.

If you've been suicidal, what helped get you through?

I think getting older has helped a lot. The dream of growing up and living a better life helped a lot when I was young. I realized that I would never do kill myself, and I could go on living my life, planning it, and setting goals for myself. I also stopped caring about people that don't matter. But really, I think a lot of it was growing up. I got out of my teen years, I made it through the early 20s, and you change a lot in that time. Getting away from my father and moving to another city was very helpful and helped me to be more grounded and see myself in a different light. I think my early 20s was a good learning experience for me, because I was able to meet so many different kinds of people in my travels. It taught me how to live in different ways and to be true to myself.

What keeps you from acting on suicidal impulses? What has pushed you towards acting on them?

Like I said, becoming an adult has kept me from suicidal impulses. I mellowed out as I got older. I don't have the same kind of intense emotional reactions that I had as a teenager.

I would say my father pushed me towards acting on them. Also, my school system, mental health workers, etc. My father was cruel but would act loving in front of other a martyr who was trying to help his poor crazy daughter. And anyone in any position of authority was too busy agreeing with him and over drugging me or bullying me to care....of saying that I wasn't learning because I was crazy and they don't believe in learning disabilities...I had a terrible childhood.

Though I would say the biggest factor was psychiatric medications. I generally become very moody on them and I am glad that I am not on any at the moment. I am always less depressed and more stable when not on meds.

Anonymous said...
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Jane said...

"I laugh at the person who said s/he is a chemistry teacher. Teachers are replacable. I am a special ed teacher and have deep relationships with each kid and their family -- and they would survive and be fine if I killed myself"

...Dude...that guy just wrote that he prevents himself from committing suicide by reminding himself of how important he is as a chemistry teacher...Why would you write that response? This belief is how he stays alive when he wants to die...

And I will say this, depending on the level of chem he teaches and the location of the school, he may very well be difficult to replace. He could be the only source of college level chem available for miles. There is a shortage of science and math majors in America.

And I can tell you right now, as someone who was in special ed, a good special ed teacher is irreplaceable. They are very difficult to come by and it's a hard job to do well. I only met a couple that I thought were actually good at their jobs, able to get the info to go through with their students, and appropriately advocated for the needs of the students. And I was in special ed from 2nd-12th grade. Most of the special ed. teachers were self-entitled, lazy, and giving a paycheck performance.

Gretch said...
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Anonymous said...

I'm the one that posted about being a chemistry teacher. I was only referring to the fact that there is a shortage of chemistry teachers and it would take the school some time to find a new one. That would mean lost time for the students which is unfair to them. Also, like it or not, and for better or worse, teenagers see teachers as role models. What if a student decided that suicide was okay because one of their teachers killed themselves?

Dinah said...

Dear Readers,
Thank you so much for your responses. This will be very helpful to us in linking how we use new media to communicate about our work to a relevant discussion on suicide prevention. I agree with the reader who called everyone Brave, and please know that I appreciate your responses.

If I can recap the patterns I think I see:
-- It helps to have meaningful interpersonal connections (and even animal person-connections in the case of pet owners).
-- It helps to have a sense of support, that there is someone who cares, wants you alive, and that you can call on.
-- It helps to have a sense of purpose, whether it be as a teacher, a parent, a pet owner, a friend.
-- Medicines help some people but not others.
-- Mental health professionals can be very helpful but only if there is good chemistry and if the patient feels personally cared about
-- Hospitalization is useful to some people but not others. It mostly seems to help as a 'time-out' or a place to remain safe only briefly, but for many people it does not prevent future thoughts of suicide.

Am I getting it right?

Anonymous said...

I think you left out one key thing -- good treatment. Being sedated with anti-psychotics is not treating depression. On the other hand, antidepressants are going to just manage (maybe) the symptoms of personality disorders - talk and behavioral therapy would be essential. Being diagnosed with bipolar because the treatment is rocky will not actually resolve issues of severe major depression. Medication only helps if it's right. Medication does not help if it's not prescribed when called for. Talk therapy, whether DBT or supportive IPT, does not help if the treater is incompetent. Etc.

Good, decent treatment is absolutely essential.

(2) I also think it's essential that you recognize that hospitalization is not just only helpful to some, but can cause tremendous harm to others. Good treatment clause, again.

jesse said...

These responses are among the very best I have ever read on Shrink Rap. I hope a lot of people read them. Thank you all for these thoughtful comments.

Anonymous said...

The one thing helpful things I have seen, experienced, witnessed, that is not included in your list is a sense of faith and spirituality. Prayer was huge for me. And knowing people were praying for me.

Anonymous said...

Another thing? We here believe that if you commit suicide, God sends you back to "do over" whatever you got wrong. Reincarnation. It is kind of like cheating on your homework, and the teacher gives you an extra set to make up for cheating.

Anonymous said...

i would agree with the anon who said hospitalization may help some and cause tremendous harm in others, for me hospitalization made a bad situation a lot worse. it was further traumatization i didnt need. i left feeling more suicidal and completely alone. i didn't see another psychiatrist for 10 years because of it.

What helped me was having someone i could be open and honest with about how dark things were without having to fear being dragged away and locked up. Having a therapist who genuinely cared about me and who cared about what was in my best interests was crucial.

Unknown said...

I definitely agree with the previous posts. The main thing that has helped me to overcome suicidality is having a caring professional who does not believe in "medicate first, listen later." Also, my therapist understands that self injury and suicide are related, but not in the way most people think. Self injury is used (for me) to express feelings I cannot feel or connect and thus it prevents suicide.

Hospitalization helped me but I was well aware that in order to get better i had to integrate into "normal" society. Often, I find professionals inhibit healing by playing up the "you can't function without help and medication" card. We (those suffering from suicidal tendencies) need to be taught how to live, not how to "survive our diagnosis." A humanist approach is necessary.

I'm thankful for all those therapists, doctors, social workers who take a client-centered approach and realize that a diagnosis isn't a set of rules for treating someone. It's a guideline.

How I stay focused and have been able to get through "speed bumps" is by having action plans in place (what can I do if I feel like self injuring or killing myself) and keeping busy.

tracy said...

i often think the only reason i haven't killed myself by now is that i am a coward. That and my son.

i am a cronic self mutilator.

tracy said...

PS i have lost both Psychiatrist's who truly helped me-they actually did therapy and have searched for years to find help.

Anonymous said...

Ultimately I found an outpatient program helped me the most -- there I could connect with other people in a reasonably positive way & that helped to counteract the insistent and relentless YOU ARE THE SOURCE OF EVIL IN THE WORLD AND MUST DIE thoughts I was having.

Finding professionals who were willing to hear about suicidal thoughts/feelings without freaking out and popping me into the hospital. (A dr not willing to hear this suggested I come into the hospital for "a little ECT".)

Recognizing suicidal thoughts as a recurring dangerous thing for me, not something I can ever afford to indulge in. Kind of like the alchoholic who can't ever have a drink. Previously I had enough CBT to think that thoughts weren't actions and I could keep myself from acting on suicidal thoughts, so didn't need to bother anyone if the contents of my head were getting messier and messier.

Woke up in the hospital after a suicide attempt I (still) have no recollection of! (Drugs caused a seizure.) So now I'm more aware that my thoughts can be too relentless to avoid acting upon, though it really does take a while to build up to that level.

Medications have helped, in so far as my worst experiences have been when I was completed unmedicated.
But I still made that particular attempt under a full cocktail.

Biggest factor keeping me from acting: knowing from my own family history what a mindfuck a suicide would be to people around me.

Biggest factor egging me on: the relentlessness of obsessive, instrusive thoughts, trying every angle, it feels like, to make me act on them.

jcat said...

I've had one attempt, and almost made it. A lot of the time I wish I had succeeded then, because by now, 20 years on, the hurt I caused would have been long buried. I'm Bipolar II, and am seriously depressed about half the time.

I own a handgun for self-defence (needed here in South Africa, with where I live and jobs I've done), but could never see myself using it for suicide. My choice has always been sucking exhaust fumes plus a good combo of meds to make sure.

I have a very close and loving family, and I have animals that I treasure, and I would regret the impact that it would have on them, but they don't stop me from thinking about it, and they wouldn't stop me from doing it. So what does?

First safety valve is cutting myself. Second is having my car, and a good collection of psych meds saved up - knowing that I have that out, and that it would be guaranteed to be successful and virtually pain-free helps a lot. Oh yeah, and I'd throw in a good bit of alcohol and the really unsexy but effective OTC meds just to be sure.

Hospitalisation has really helped a couple of times, even though I know that I could walk out of there and do it anyway. Some of the meds have helped for a while, but I've learned over the years that even the best of the meds only work for a while, and then you're back where you started from, but with a little bit less hope.

What works the most for me is the relationships I have with both psychologist and psychiatrist(s). They know me at my worst, they have been there and helped. And they trust me enough to reach out to them when it gets too bad, even though they know (and don't like it) that I have the means at hand. That trust, and that availability, is most of what has kept me from doing it again for the last twenty years. And knowing that if I tried and failed I would lose the most important relationships in my life.

Maybe that sucks as reasons for not committing suicide, but I figure that every day I want to but don't is another chance at finding something that might make me not want to at all.