Jump to content
CrazyBoards.org

What to do when you can't go to the Hospital?


Recommended Posts

What are some of your coping mechanisms when you really are a danger to yourself, but can't go - or won't go - to the hospital?

I've been really suicidal for awhile now & my only option is to just try and wait it out and hope that the Cymbalta will work this time. It takes 3 weeks to work for me and I still have till Tues (the 10th) until I'll know if it will kick in. If it doesn't; I've already decided to double the dose to 120mg so that when my next pdoc appt comes on the 24th, I'll know if the med will work - ever.

The problem is, I lost hope back in January & have been going downhill ever since.

A part of me really would like to go to a hospital (especially since I know I am very much a danger to myself), but I just can't justify it because:

- I can't afford it - and would be so much more depressed once I left with yet another thing hanging over my head.

- It would interfere with my jobs & if I actually stayed as long as I was a danger to myself, I'd lose them.

- All they can really do is give me drugs & I can get the same thing from my pdoc

- I hate being controlled and distrust authority. I really want a break, but if I'm not in control of myself I'd freak out and get scared.

And, ultimately..

- Going to the hospital would not keep me from killing myself if that's what I decided to do. I'm smart enough to just fake my way out and do it anyway.

I've been very honest with my tdoc and old pdoc about this, so they know. Luckily, they understand me enough to realize that it really wouldn't do me much good considering the above. I even told my tdoc that I was scared of myself. She went to talk to my pdoc.. and he just took a "wait and see if the meds work stance."

I don't have much support in general & even if I did have someone to watch me.. I wouldn't do that. I like being in control of my own destiny.

So what do you say or do for yourself when you're mentally getting really close to doing something you don't, in your heart, want to?

Link to comment
Share on other sites

Hi,

I have a book called How I Stayed Alive When My Brain Was Trying To Kill Me.

I would be more than happy to PM you with some of the suggestions from the book. I would list them in the post to share with other people, but copyrights and all that.

Im Selene, BTW.

Just let me know if you want the suggestions. Some of them are, um, Childish? Cant think of a word to describe it. But its better than killing yourself.

Of couse if you really are determined, Well, you covered that in your post.

PM or Reply and Ill share some of this book with you, K?

Selene

Link to comment
Share on other sites

- All they can really do is give me drugs & I can get the same thing from my pdoc

Not true. A major advantage of going to the hospital is the intensive oversight from multiple pro's. Yes the meds may be the same, but they are able to quickly adjust them on a daily basis, vice the weeks required thru normal pdoc office visits. Next is the shelter from the stress of your normal environment. Finally, individual therapy, group therapies and other activities on a full time basis help defuse your acute situation.

Going to the hospital would not keep me from killing myself if that's what I decided to do. I'm smart enough to just fake my way out and do it anyway.

*I'm going to be brusque* True. But if you are not going to be honest with your docs and yourself, then don't bother wasting other people's time, including our own. This is a maturity issue for you.

Other alternatives for you are to attend an Outpatient or Day Hospital Program. The advantage is that you get almost all the same treatment, but don't have the additional cost of taking up a bed, and get to go home every evening.

- Get intensive support from your pdoc and therapist. See the pdoc every week, and the therapist twice a week.

- Take vacation or medical leave from your jobs, if your pdoc/therapist think this would be helpful.

- Be sure you are spending time with people you enjoy and doing things that make you happy.

- Do all the good supporting things: lay off the booze and any non-rx drugs, get some light exercise each day for 30 minutes, get some sun each day, eat square meals, take a multivitamin, keep regular sleep hours.

Keep stroking,

a.m.

Link to comment
Share on other sites

One thing I notice with myself is the more depressed I get, the more important commitments and jobs and money issues seem, when the truth is actually that my mental health is the most important issue. Do whatever you can to implement the suggestions AM gave you in regards to inpatient or outpatient treatment. You know that there is still a little part of you that wants to stay alive, but you need intensive help. Not the pdoc once a month and the therapist once a week. If you seriously think you might kill yourself it is worth going into debt for.

Also very important--ask your pdoc and tdoc what the best course of action would be, minus all of your caveats. If nothing was standing in your way. Then do the best you can to implement it.

Link to comment
Share on other sites

oh, cetkat, i wish you an easy time with this.

i know that sometimes it gets to a point, at least for me, where i don't even know where to turn anymore. i get tired of the run around and just want the answer. but who the hell has it and how do i find them?

i wish it were easier. i do think am has some really good ideas. it can be really hard to implement them when you are in a certain state. i guess just try to get more intensive therapy from you pdoc and tdoc?

i hope the cymbalta kicks in really, really soon!

have a peaceful day!

kathryn

will pm in next couple of days. what an adventure!

Link to comment
Share on other sites

Not true. A major advantage of going to the hospital is the intensive oversight from multiple pro's. Yes the meds may be the same, but they are able to quickly adjust them on a daily basis, vice the weeks required thru normal pdoc office visits. Next is the shelter from the stress of your normal environment. Finally, individual therapy, group therapies and other activities on a full time basis help defuse your acute situation.

But if they're being adjusted on a daily basis, how can they know if they're going to be effective? It takes just as long for them to work there as on your own. And if you're talking about titrating up.. I do that just as quickly too. I typically make many (approved) adjustments in-between visits as well.

With the stress; you're right. It would be great for a time.. and it really appeals to me.. but then it would just lead to more stress once I left.

I don't really know if the therapy would be helpful or not. I have huge trust issues & can't see myself really opening up to a group of strangers... plus I really want the choice to go or not - I wouldn't get that.

The problem is, the situation really isn't acute. Sometimes I am more broken by it, but it's always there. It's not something I can protect myself from by hiding.

*I'm going to be brusque* True. But if you are not going to be honest with your docs and yourself, then don't bother wasting other people's time, including our own. This is a maturity issue for you.

I appreciate your honesty; but, I disagree. I have been completely honest with those trying to help me, and with myself. It was an true statement that I have shared with all parties. I was only trying to make the point, that if the meds didn't somehow make me feel better (the same meds I could get elsewhere) my going to a hospital wouldn't serve to save me.

If I'm seriously going to kill myself, going to the hospital won't save me unless the meds work. If it doesn't help and my mind stays the same, I would just carry it out anyway. That's why I fight myself here and now.. because if I lose this battle, no amount of protection will save me. That's just me being realistic.

I think it is mature to realize that if I go to the hospital as a last resort, and their meds don't work, that I will give up. It's not that I wouldn't give the hospital a chance.. it's just that I don't see it giving me any real benefit that I don't already have access to besides a break - that would financially destroy me & cause a resurgence of suicidal depression.

Other alternatives for you are to attend an Outpatient or Day Hospital Program. The advantage is that you get almost all the same treatment, but don't have the additional cost of taking up a bed, and get to go home every evening.

- Get intensive support from your pdoc and therapist. See the pdoc every week, and the therapist twice a week.

I can already do that if I choose to, and I wouldn't want anyone other than who I already have. Right now I'm going as often as my pocketbook allows.

- Take vacation or medical leave from your jobs, if your pdoc/therapist think this would be helpful.

It would be unpaid.. and I'm already doing a form of this at one job.

- Be sure you are spending time with people you enjoy and doing things that make you happy.

I do try.. Unfortunately, once of the things I'm dealing with is not being able to enjoy or want to do anything. I see everything as a coping mechanism and find no real joy in life.

- Do all the good supporting things: lay off the booze and any non-rx drugs, get some light exercise each day for 30 minutes, get some sun each day, eat square meals, take a multivitamin, keep regular sleep hours.

Well, I don't do drugs and don't drink very much (if I saw it interfere with my meds I wouldn't do it at all) but in the interim I need all the coping mechanisms I can get. I do try to do the rest.. but I'll admit to not doing very well with it. That's my fault.. and if it was just depression, following that might help. As it stands, I'm too far down for that to really make a difference (mine and tdoc's opinion).

Link to comment
Share on other sites

One thing I notice with myself is the more depressed I get, the more important commitments and jobs and money issues seem, when the truth is actually that my mental health is the most important issue. Do whatever you can to implement the suggestions AM gave you in regards to inpatient or outpatient treatment. You know that there is still a little part of you that wants to stay alive, but you need intensive help. Not the pdoc once a month and the therapist once a week. If you seriously think you might kill yourself it is worth going into debt for.

Also very important--ask your pdoc and tdoc what the best course of action would be, minus all of your caveats. If nothing was standing in your way. Then do the best you can to implement it.

Yeah, I do need help. I always have. But I really do feel alone with it, and the fact is, going away wouldn't just put me in debt (I'm already there), it'd put me on the street. I wouldn't be in there for just a weekend.

I've come to realize that the only one who can help me is myself... and no matter how much the docs may care; I am just a patient. I'm not their responsibility. I'm nobody's responsibility except my own.

The fact of the matter is; when I first started going there, I told my pdoc & tdoc that I was suicidal and my plan. The plan was to try meds and therapy, then try the hospital, and if that didn't work..kill myself. They told me that, in my case, hospital wouldn't help. Ultimately, they're right.

A hospital is supposed to keep you physically safe; but, I need to know how to keep myself mentally safe.

Link to comment
Share on other sites

The reason why your plan is unworkable is that you have suicide as an intentional end step.

As long as you see that as an acceptable action, then you aren't committed to resisting it.

Now, I know how low low can be. I've been there. I know how the idea of morting seems like relief.

Are you docs really aware of just how close to the end of the rope you are? If not, then you need to see your pdoc immediately and in calm but absolutely serious manner lay out just how poorly you are feeling, what your mind is thinking and make him understand that you are desperate and need maximum action and support.

nite. a.m.

Link to comment
Share on other sites

"So what do you say or do for yourself when you're mentally getting really close to doing something you don't, in your heart, want to?"

cetkat, there is/was nothing for me but to trust that my depression could be treated chemically. push for treatment. plan and center your thoughts around the certainty that medicine can put a bottom on your emotional hurting.

"So what do you say or do for yourself when you're mentally getting really close to doing something you don't, in your heart, want to?"

cetkat, there is/was nothing for me but to trust that my depression could be treated chemically. push for treatment. plan and center your thoughts around the certainty that medicine can put a bottom on your emotional hurting.

i do hope that you swing upward tomorrow.

Link to comment
Share on other sites

Not true. A major advantage of going to the hospital is the intensive oversight from multiple pro's. Yes the meds may be the same, but they are able to quickly adjust them on a daily basis, vice the weeks required thru normal pdoc office visits. Next is the shelter from the stress of your normal environment. Finally, individual therapy, group therapies and other activities on a full time basis help defuse your acute situation.

But if they're being adjusted on a daily basis, how can they know if they're going to be effective? It takes just as long for them to work there as on your own. And if you're talking about titrating up.. I do that just as quickly too. I typically make many (approved) adjustments in-between visits as well.

The point is that in a well-staffed hospital, a doctor can try faster medication ramp-ups or stronger initial doses without the likelihood of the patient driving home and collapsing behind the wheel in rush-hour in traffic or having the med crash/react with the patient home, alone and either not able to call 911 or too able to find a gun before that.

Obviously I'm talking about a psych ward; ER triage can involve an hours' long wait for a patient who's breathing and not bleeding out. They also have set protocols for standard symptom clusters and a tendency to ignore the patient's reported problems. When we're talking about outpatient psych med care, that can be a deadly combination at times - another reason for a doctor who is pushing hard to stabilize a patient NOT to want that patient to leave specialized care.

*I'm going to be brusque* True. But if you are not going to be honest with your docs and yourself, then don't bother wasting other people's time, including our own. This is a maturity issue for you.

I appreciate your honesty; but, I disagree. I have been completely honest with those trying to help me, and with myself. It was an true statement that I have shared with all parties. I was only trying to make the point, that if the meds didn't somehow make me feel better (the same meds I could get elsewhere) my going to a hospital wouldn't serve to save me.

A.M.'s just not reading what you wrote. Living in Florida, all you have to do is get to the right (common, btw) landscaping plant and they'll play hell trying to revive you.

An intelligent person, able to craft a convincing act, can get nearly any desired result from the medical system. If you know that you are capable of doing this if things get bad enough, the best a psych ward can offer is emergency stabilization. But they can do that, and they can bring to bear the resources to put together a med regimen to hold you together long enough to see your own doctors.

I do try.. Unfortunately, once of the things I'm dealing with is not being able to enjoy or want to do anything. I see everything as a coping mechanism and find no real joy in life.

Treatment-resistant atypical depression, isn't it? The standard suggestions for bipolar depression usually don't do crap for that, especially any of the ones that rely on motivation or enthusiasm - which are probably alien concepts by this point.

To exercise, you'll have to schedule it in as a "do it anyway" task or in place of something *more* unpleasant. When I was on no medications, it helped me unwind from another f'd-up day at work. Later, going to the gym sure beat the hell out of commuter traffic. At the moment I've no excuse, so it don't get done.

Another coping mechanism is just putting in a little extra time at the office (if you're in a position) or working on skills acquisition. It won't make you feel a damned bit better, but it beats staring at four walls alone and wondering whether now's the time to kill yourself or should you put it off another week.

Obviously, get your affairs in complete order. It's bullshit to go through all the trouble of killing yourself when you weren't in a hurry to do so, and leaving all sorts of crap undone. After all, you're depressed, not a stupid jerk.

I've seen a few flowcharts for depression treatment that suggest stimulant augmentation before ECT is finally considered. Honestly, you just want a dose that can help you feel less like a lifeless slug praying for salt and more like a person with stuff to do today. ("Shiny happy people" dosing is way too much, and you probably don't want to chemically feel like the sort of person you may secretly think should be shot to put them out of everyone else's misery)

So, does any of that make sense?

Link to comment
Share on other sites

Hi, Cetkat,

I hope you're doing a little better today and sorry you're having to fight so hard. Feeling suicidal when you know you don't want to die is a crappy way to live. But, it IS living. Even when you feel you can't make it another hour, remind yourself that if you made it through the last hour, you can make it through the next one. Mentally, if you're really serious about getting through these rough times, I've found that I have to separate my rational self from my emotional self and set some rules. I know it sounds stupid, like trying to trick yourself into being on time by setting your watch ahead, but sometimes it works.

Ask yourself if you have to do it right this minute. If not, then you have to live another 24 hours.

Set some small goals. Even if it's as stupid as thinking I can't die with dishes in the sink, it's still something that will get you past a bad moment.

Force yourself to do something productive for only 15 minutes and then you can quit. But what I've found is that once I start, I realize it's not such a big thing and I can finish it.

Keep reminding yourself that suicidality is a feeling. It comes and goes. Life may never be perfect, but you know it will not stay this bad.

I know it's hard to be optimistic when your mind is telling you that you're too worthless to live, but try to give the new med regimen time to work. Who knows, it might!

Talk to your pdoc about the ETC. Ask if you can get it set up and scheduled now so that in case these new meds don't work you have something else immediately available. I know what it feels like to be told, let's try this other new thing, and have to slog through another three to four weeks of grinding psychic pain.

Don't brood around the house alone on your days off. They can be the worst. Make plans ahead of time and stick to them. Be with people even though it sucks and they have no idea what you're going through. After all, suicide is generally carried out alone, not while you're out to lunch with a friend or having your nails done. So take yourself out of the situations where suicide would likely work.

Have you asked your pdoc to restrict your meds to one week at a time?

And remember, just like objects in the mirror being closer than they appear, life is not as bad as it seems when seen through the lens of depression.

Give yourself a chance, hon. You've made it this far, you can keep going a little longer.

Greeny

Link to comment
Share on other sites

The reason why your plan is unworkable is that you have suicide as an intentional end step.

As long as you see that as an acceptable action, then you aren't committed to resisting it.

Now, I know how low low can be. I've been there. I know how the idea of morting seems like relief.

The plan of trying to keep myself alive you mean? Or the progression of treatment part?

The fact is.. you're right, I'm not "committed" to keeping myself alive - I just want to. When I was younger, I was committed to getting through my situational depression. I did everything possible for myself, including running myself mentally and physically into the ground just to survive. Suicide was not an option, because mentally.. I knew I had a way out (other than killing myself). I waited it out - and I won... at a price.

But living just to live isn't worth it to me - the price is just too high. There has to be a damn good reason.. or a way out from the pain. I forced myself to live like that before & I know better than to do it again without an end to it somewhere. There has to be a reason more than pure stubbornness.

I don't have a reason for living in my life. All I have is the struggle inside.

I don't see a way out other than to not be depressed anymore. I'm trying everything medically I can to do that, but if that doesn't work.. I do give myself the option of ending it.

If I knew for a fact that I would be better in 10 years; I would live in misery and wait. That's not how things work now, though.

Instead, I'm struggling with the fact that half the drugs haven't worked.. and there's a very good chance the other half won't either. Before, I had hope and optimism that I could find the right things to get over it. But now, the one and only drug that really worked - stopped. How likely is it that I'll find another one that works in the other half?

Faced with those odds; I don't have hope. I just have the want to survive and try all the rest of them (and wait to see if the Cymbalta magically kicks back in).

The fact that I'm still here is nothing but resistance.

Are you docs really aware of just how close to the end of the rope you are? If not, then you need to see your pdoc immediately and in calm but absolutely serious manner lay out just how poorly you are feeling, what your mind is thinking and make him understand that you are desperate and need maximum action and support.

nite. a.m.

Well, my new pdoc is still too well.. new..for me to really talk to him like that. But my tdoc & pdoc share the same office and file & I've been very serious and upfront about my current situation with the tdoc - who then went directly next door and discussed it with him. So, I can't imagine that he doesn't know.

He's trying the med that worked before, and I'm going to up it to the very max if it doesn't work. I'll know by my next appointment with him whether it's going to do anything.

The fact is.. other than putting me in the hospital, there's nothing more to do. I just have to try and force myself to wait, at least until I know about the Cymbalta.. and hopefully until I've tried every medication.

I wish I had more support in my life. I wish I had someone who could save me. But they're just people getting paid to try and help me help myself. In the end, it's all on me.

cetkat, there is/was nothing for me but to trust that my depression could be treated chemically. push for treatment. plan and center your thoughts around the certainty that medicine can put a bottom on your emotional hurting.

i do hope that you swing upward tomorrow.

I'm hoping that it can.. but it's very disheartening when the talk goes to .."well, who knows, something may be invented"..

Link to comment
Share on other sites

But if they're being adjusted on a daily basis, how can they know if they're going to be effective? It takes just as long for them to work there as on your own. And if you're talking about titrating up.. I do that just as quickly too. I typically make many (approved) adjustments in-between visits as well.

The point is that in a well-staffed hospital, a doctor can try faster medication ramp-ups or stronger initial doses without the likelihood of the patient driving

home and collapsing behind the wheel in rush-hour in traffic or having the med crash/react with the patient home, alone and either not able to call 911 or too able to find a gun before that.

Obviously I'm talking about a psych ward; ER triage can involve an hours' long wait for a patient who's breathing and not bleeding out. They also have set protocols for standard symptom clusters and a tendency to ignore the patient's reported problems. When we're talking about outpatient psych med care, that can be a deadly combination at times - another reason for a doctor who is pushing hard to stabilize a patient NOT to want that patient to leave specialized care.

So would they still keep to the therapeutic dose, or completely max it out? My goal is always to get to the 'right' dose as quickly as possible since my body usually handles meds pretty well. I'm usually at where I'm supposed to be by the third day - and with stuff I've already taken.. I can pretty much just go back to the same dose right off the bat. Would the ward really be that different other than not giving any work-up?

A.M.'s just not reading what you wrote. Living in Florida, all you have to do is get to the right (common, btw) landscaping plant and they'll play hell trying to revive you.

Ahh..ok. {a.m.: so what are your thoughts?} Yeah, it's not too difficult at all. There's always a way.

An intelligent person, able to craft a convincing act, can get nearly any desired result from the medical system. If you know that you are capable of doing this if things get bad enough, the best a psych ward can offer is emergency stabilization. But they can do that, and they can bring to bear the resources to put together a med regimen to hold you together long enough to see your own doctors.

Exactly. Even at my worst, I can control how I present myself to people. I grew up needing to.

If they could find a stabilizing med course that would be great. But I don't see them being able to do any better than my pdoc - medicine is one thing he knows real well.

I do try.. Unfortunately, once of the things I'm dealing with is not being able to enjoy or want to do anything. I see everything as a coping mechanism and find no real joy in life.

Treatment-resistant atypical depression, isn't it? The standard suggestions for bipolar depression usually don't do crap for that, especially any of the ones that rely on motivation or enthusiasm - which are probably alien concepts by this point.

Yes, and yes. If there was an end to it, I could just push myself though.. But I don't have the knowledge that it will pass to sustain me. There's a good chance that it will never go away, and that's difficult to bear. Any motivation I get is empty and forced.. and just causes me to feel worse when I eventually crash from it, because it took so much energy to sustain.

To exercise, you'll have to schedule it in as a "do it anyway" task or in place of something *more* unpleasant. When I was on no medications, it helped me unwind from another f'd-up day at work. Later, going to the gym sure beat the hell out of commuter traffic. At the moment I've no excuse, so it don't get done.

Another coping mechanism is just putting in a little extra time at the office (if you're in a position) or working on skills acquisition. It won't make you feel a damned bit better, but it beats staring at four walls alone and wondering whether now's the time to kill yourself or should you put it off another week.

Obviously, get your affairs in complete order. It's bullshit to go through all the trouble of killing yourself when you weren't in a hurry to do so, and leaving all sorts of crap undone. After all, you're depressed, not a stupid jerk.

I've seen a few flowcharts for depression treatment that suggest stimulant augmentation before ECT is finally considered. Honestly, you just want a dose that can help you feel less like a lifeless slug praying for salt and more like a person with stuff to do today. ("Shiny happy people" dosing is way too much, and you probably don't want to chemically feel like the sort of person you may secretly think should be shot to put them out of everyone else's misery)

So, does any of that make sense?

Yeah.. I know I should exercise. I keep wanting to for health reasons, but I rarely have the energy.. so I don't, unfortunately.

I actually need a combination of distraction and dwelling to handle things. Too much of either will make the depression worse. If I spend too much time thinking about it, I sink deeper; but, if I don't think about it at all.. it forces it's way up and feels worse than if I had spent all my time thinking about it. -- My tdoc thought that fact was interesting.. what does everyone else think?

Thank you for the affairs comment! You're completely right. It's a logical mental reason why I can't act rashly. That could help better than the, "no..you're not doing it, just go to bed" thinking. That way I'll have at least some extra planning to cushion the decision/act relationship... even if it's only a little.

Yeah.. I've seen charts like that too. It's something I'd suggest if he runs out of ideas & hasn't tried it yet. The only problem is, I have to find something to "augment." I know that if the meds do work, it will take a combination.. but I need a functional base for that.

So I basically have drugs of the same classes I haven't tried, MAOI's, ECT, and other augmenters..

What you say does make sense, btw. ;)

-------------------------

Thanks for your thoughts Manny & Kathryn. Anything you two can or can't say is fine.

It would be nice to volunteer for a cause.. it could help give some meaning. Unfortunately I'm not stable enough living on my own to put time into something like that.

Link to comment
Share on other sites

Hi, Cetkat,

I hope you're doing a little better today and sorry you're having to fight so hard. Feeling suicidal when you know you don't want to die is a crappy way to live. But, it IS living. Even when you feel you can't make it another hour, remind yourself that if you made it through the last hour, you can make it through the next one. Mentally, if you're really serious about getting through these rough times, I've found that I have to separate my rational self from my emotional self and set some rules. I know it sounds stupid, like trying to trick yourself into being on time by setting your watch ahead, but sometimes it works.

Ask yourself if you have to do it right this minute. If not, then you have to live another 24 hours.

Set some small goals. Even if it's as stupid as thinking I can't die with dishes in the sink, it's still something that will get you past a bad moment.

Force yourself to do something productive for only 15 minutes and then you can quit. But what I've found is that once I start, I realize it's not such a big thing and I can finish it.

Not really any better. The level of functioning changes, but not the underlying feelings. Well, I suppose technically I'm living...but really living to me means more than this. This is just surviving. I know I could force my way through, moment by moment, if that's what I wanted to do mentally. (I've gone that course before) But it's not really the individual moments that I'm afraid of. It's the fact that I've become so much worse than before, with less options open to me. It's harder to struggle against it and find reasons not to do what I want. It's like, I'm not fighting the depression.. but myself.

It scares me that I'm finding it so much harder to tell myself no - especially to rash actions that go against who I am.

My mind sees all this as a futile effort; but emotionally, I'm a fighter and worry about regretting my action later.

I've always made decisions based upon what I think instead of what I feel & I can separate myself from my emotions (even though the depression is always there underneath the surface). So my problem is that I'm trying to do the opposite.. even though I'm in so much pain & therefore, emotionally conflicted.

I've made my mental assessment (and would love to be logically proven wrong).. but my survival feelings just make me want to try everything else first.

The more emotionally worse I feel, the more that balance shifts.. and the weaker the position.

Does this make sense?

I assume that your rational self is the part telling you not to do it, right? Do you have any thoughts on how I could make my balance work?

Keep reminding yourself that suicidality is a feeling. It comes and goes. Life may never be perfect, but you know it will not stay this bad.

For me, suicidality is a thought and solution brought on by the feelings of despair and hopelessness (and wanting to fix them). The more I think about my life and situation, the more suicidal I become because I can't find another solution. The only ways out of feeling what I do are to find medication or some greater meaning in my life to make any pain or stress worthwhile.

I'm conflicted and too tired to really want to do much of anything. I need a break that I can't have, and a life that I don't know how to find. Without that life, that meaning and happiness, bearing all the responsibilities and hardships just doesn't seem worth it & it's killing me.

It is possible that my life could improve to the point I need it to, but it's far from a certainty. Right now my only hope is to find meds that allow me to go out and find it.

I know it's hard to be optimistic when your mind is telling you that you're too worthless to live, but try to give the new med regimen time to work. Who knows, it might!

Talk to your pdoc about the ETC. Ask if you can get it set up and scheduled now so that in case these new meds don't work you have something else immediately available. I know what it feels like to be told, let's try this other new thing, and have to slog through another three to four weeks of grinding psychic pain.

My goal is to give it time. Hence the fact that I just made myself go to bed when I had made a rash, yet complete, plan of suicide.. every step but writing letters and finishing it. I don't want to do something rashly. I want to carry out my plan of trying meds... The fact that I came so close worries me & I need another resource besides the hospital and sleep.

ECT is on the menu. I don't think my pdoc would want to try it before MAOI's though. Perhaps if the Cymbalta doesn't work, I will insist that the next treatment have a quick reaction time.

Don't brood around the house alone on your days off. They can be the worst. Make plans ahead of time and stick to them. Be with people even though it sucks and they have no idea what you're going through. After all, suicide is generally carried out alone, not while you're out to lunch with a friend or having your nails done. So take yourself out of the situations where suicide would likely work.

I get what you're saying. Unfortunately I can't be in a (good) restrictive situation 24/7. My near-attempt ironically came after a very good day of work and friends. I was having a great time, but suddenly came to the conclusion that I was going to do it once I got home. I mentally disassociated but stayed there enjoying their company until it was time to leave. I even made a last meal once I was home.

I never changed my mind about wanting to do it, but I came to the conclusion that since I had had a beer, my sense of survival was dulled & doing it then would be a cop-out. I'd rather face my doubts head-on and come to terms with them than just make them go away. So I forced myself to go to bed & when I woke up, that feeling of survival was back.

If it was just the beer, I'd either just not drink or continue to force myself not to do what I want based upon a logical point.. but it's the fact that I almost went though with it - that shows just how close I am to doing it in my complete right mind. I don't really believe that the meds will work, so making myself try them has alot less of a sway than it used to. I want to finish them.. but that's become more of a feeling of completion and having tried than a reason to continue.

Have you asked your pdoc to restrict your meds to one week at a time?

No. It's not my way.

;) {Feel free to edit/remove if this is too graphic:}

I've decided on Helium or Nitrogen; and the rash act would have been hanging (not at all one of the methods I chose from). I can get a gun from multiple places, and there are high enough buildings..

Unless you have the right shit, meds aren't really that great of an option & you can just end up really sick with organ damage. You'd be better off taking sleeping pills, downing a bottle of vodka, and duck-taping your mouth shut to choke on your own vomit. :)

And remember, just like objects in the mirror being closer than they appear, life is not as bad as it seems when seen through the lens of depression.

Give yourself a chance, hon. You've made it this far, you can keep going a little longer.

Greeny

That's probably true. Unfortunately, when you've lived your life depressed.. you can't really see it any other way.

I really am trying.. Thank you for the words of encouragement Greeny.

Link to comment
Share on other sites

The point is that in a well-staffed hospital, a doctor can try faster medication ramp-ups or stronger initial doses without the likelihood of the patient driving home and collapsing behind the wheel in rush-hour in traffic or having the med crash/react with the patient home, alone and either not able to call 911 or too able to find a gun before that.

So would they still keep to the therapeutic dose, or completely max it out? My goal is always to get to the 'right' dose as quickly as possible since my body usually handles meds pretty well. I'm usually at where I'm supposed to be by the third day - and with stuff I've already taken.. I can pretty much just go back to the same dose right off the bat. Would the ward really be that different other than not giving any work-up?

From what some people have said, it appears that they'll go straight for a max dose - the kind where the nurse asks if you're feeling better the next day once you wake up. A doctor can't try that out-patient.

I actually need a combination of distraction and dwelling to handle things. Too much of either will make the depression worse. If I spend too much time thinking about it, I sink deeper; but, if I don't think about it at all.. it forces it's way up and feels worse than if I had spent all my time thinking about it. -- My tdoc thought that fact was interesting.. what does everyone else think?

It's reasonable. Dwelling on anything makes it worse to deal with. Then, when you do have a respite when it's not bringing you down, it hits twice as hard because you weren't feeling so bad before.

So I basically have drugs of the same classes I haven't tried, MAOI's, ECT, and other augmenters..

That still leaves a lot of room to work with.

Link to comment
Share on other sites

So would they still keep to the therapeutic dose, or completely max it out? My goal is always to get to the 'right' dose as quickly as possible since my body usually handles meds pretty well. I'm usually at where I'm supposed to be by the third day - and with stuff I've already taken.. I can pretty much just go back to the same dose right off the bat. Would the ward really be that different other than not giving any work-up?

From what some people have said, it appears that they'll go straight for a max dose - the kind where the nurse asks if you're feeling better the next day once you wake up. A doctor can't try that out-patient.

So overdoing it is supposed to make it work faster?

So I basically have drugs of the same classes I haven't tried, MAOI's, ECT, and other augmenters..

That still leaves a lot of room to work with.

With different medicines in the same classes.. not really with different types of combination.

Link to comment
Share on other sites

I've been thinking about you all afternoon. The problem is, when I get right down to it, I don't have a strong logical defense against suicide. Life is hard enough when you're not depressed, but the added burden of depression and anxiety can make things pretty unbearable, especially if you see it as unending. At some point, contemplation becomes planning and all of the traditional anti-suicide arguments lose their potency. Staying alive because of the pain you'd cause your loved ones so much heartache, that sense of moral duty to live in despair to prevent pain in others becomes moot. If you can't stand it, then you can't, regardless of the moral and social implications.

Having a commitment to try several other treatment possibilities is a good thing. It keeps you alive and sets a reasonable goal.

But, based on last night, I think staying away from alcohol is a must. Impulsivity is not your friend right now.

I think that what makes suicide seem like the right solution sometimes is that it feels like the only thing that solves the problem of being stuck in unbearable pain for the foreseeable future and believing that your life situation is beyond repair.

You say that the more you think about your life the more suicidal you become because you can't think of any other solution. I don't know what your situation is, only that you are very young and have fought depression for a long time. Despair constricts your ability to see beyond your hopelessness.

It's a false sense of security that sometimes keeps us tied to bad lives, that it's better to suffer with what you're familiar with than to walk away from it all and start again. It's deeply frightening to think of casting yourself adrift and starting anew, but even that must be less scary than ending all possibility of betterment with your death.

If your current life is so unbearable that suicide seems like a reasonable response, then you have nothing to lose from jettisoning the life you think you're stuck in and forging a new path.

Maybe the hopelessness and despair is more than a medical condition. Maybe it's also a new "you" screaming that you need to find another way to create meaning and worth in your life. If you consider suicide a rational choice, then can't you try making a radical change in your life first?

It's your survival at stake here. Whatever you think is forcing you to stay where you are and exist in agony is not all there is. Just the fact that you are talking about this shows strength and will. Besides, you can always kill yourself later.

Love, Greeny

Link to comment
Share on other sites

Archived

This topic is now archived and is closed to further replies.

×
×
  • Create New...