Posted by med_empowered on August 29, 2005, at 19:34:34
In reply to Telling T about Suicidal thoughts, posted by felixbabble on August 29, 2005, at 17:57:09
I had one shrink who asked me if I'd ever considered suicide, and if so, why I hadn't done it yet (sounds weird, but this method was put forth by Frankel back in the 50s to help patients identify reasons to *live*--you answer why you didnt kill yourself, and this helps the T understand what's *really* important to you) Anyway, I may have been a little too honest--and I was really depressed and pissy, too--so I answered that one reason was that the whole suicide thing seems so messy--bloody, painful, and lots of attempts don't even work. I said that I had X reasons in general to live, but one reason I hadn't "taken the plunge" was that I hadn't zeroed in on *the* method to kill myself. Well...I didn't get hospitalized. Basically, all my meds were limited to, at most, 1 refill (Klonopin and other controlled substances usually didn't have a refill, and I always took sleeping pills in 2-week increments, which sucked b/c I had to do 2 fills per month when I first started taking Ambien and Sonata). As you might imagine, my T also made sure not to RX tricyclic antidepressants *at all*, and didn't really up my Klonopin to an effective dose until after my depression had abated somewhat. So...nothing terrible happened, but it was kind of a pain in the a$$ for a while. On the other hand...some shrinks are really hot-to-trot when it comes to "intensive" treatment for potentially "at-risk" patients, so you may want take this into account. If you're like me, and you tend to think about suicide--sometimes in detail, and at length--but you don't have a history of suicide attempts and you are sure to present your thoughts as just that: thoughts borne of desperation, your T should take that into account. Since I have bipolar disorder, and suicide is a big friggn' deal in bipolar, my T used a scale for suicidality: the spectrum went from passing thoughts of suicide to the extreme, which would be making a plan, buying necessary equipment, that kind of thing. Since I never hit the extreme end of the spectrum, I didnt have to worry about hospitalization (which, BTW, has *no* statistically proven effects on suicidal or violent behavior). Plus, it depends on your state...some states are *way* too lenient in allowing docs to toss people into hospitals, while others (rightly) restrict this sort of thing to very extreme cicrumstances. I believe that in my own state one still has the right to request a *jury* trial before being committed in most circumstances...from what I understand, when the patient opts for the jury trial, the shrink usually has a sudden change of heart and decides that the patient isn't so risky, after all (the costs and potential loss of ego from that kind of proceeding can be enormous). Good luck!
poster:med_empowered
thread:548311
URL: http://www.dr-bob.org/babble/20050827/msgs/548435.html