What I have learned from my suicidal patients • Hacker News Board

Re: What I have learned from my suicidal patients

#11

Post by clarry » Sat, Nov 23, 2019, 9:54 PM UTC

whatshisface wrote: post #7

shrimp_emoji wrote: post #2

>The soldier who hiked out on to the moor, lay down in the heather and overdosed. Émile Durkheim, the great sociologist, theorised as to why suicide is so common among military personnel – not simply because of the devastating effects of war, or because of their easy access to weapons, but because of the depersonalising effect of army training: “Military esprit can only be strong if the individual is self-detached, a…

One one hand, we have a growing body of research saying that almost nothing anybody does is rational, and that most "rational explanations" that people deliver are post-hoc rationalizations of something they did on a whim. The popular interpretation is that this represents evidence against free will, but that may be a little overblown. On the other hand, there is a parallel cultural trend of people arguing that suici…

It's not like people become fat on a whim or have no regrets about it happening. Likewise, you can plan suicide for years.

Re: What I have learned from my suicidal patients

#12

Post by sonofhans » Sat, Nov 23, 2019, 9:54 PM UTC

snagglegaggle wrote: post #4

shrimp_emoji wrote: post #2

>The soldier who hiked out on to the moor, lay down in the heather and overdosed. Émile Durkheim, the great sociologist, theorised as to why suicide is so common among military personnel – not simply because of the devastating effects of war, or because of their easy access to weapons, but because of the depersonalising effect of army training: “Military esprit can only be strong if the individual is self-detached, a…

I think you are going in the right direction. Society needs to recognize that suicide must be some evolutionarily advantageous adaptation. Many people when pressed will say they think an individual has value, but that individual often sees no actions come from that sentiment. And if someone thinks they provide no value and are not wanted, it seems logical to unburden everyone else. It would be similar to how cats go…

I do not believe there's evidence or reason to say that suicidal tendencies convey evolutionary advantage to the species. Many things seem to be accidents. Does the https://en.wikipedia.org/wiki/Photic_sneeze_reflex convey advantage? Very likely no; it's an accidental mutation that doesn't cause enough damage to be selected against.

Evolution isn't directed, and there is no end state. Attributing positive effect to every mutation verges on https://en.wikipedia.org/wiki/Teleology.

Re: What I have learned from my suicidal patients

#13

Post by clarry » Sat, Nov 23, 2019, 9:58 PM UTC

marmadukester39 wrote: post #6

snagglegaggle wrote: post #4

Earlier quoted context omitted.

I think you are going in the right direction. Society needs to recognize that suicide must be some evolutionarily advantageous adaptation. Many people when pressed will say they think an individual has value, but that individual often sees no actions come from that sentiment. And if someone thinks they provide no value and are not wanted, it seems logical to unburden everyone else. It would be similar to how cats go…

Except that suicide burdens everyone around a person terribly.

And that is a major issue for many younger people who contemplate suicide.

I think it's more that they want to unburden themselves, but knowing that doing so will burden their close ones is what keeps them from doing it.

Quite nightmarish, if you think about it.

Re: What I have learned from my suicidal patients

#14

Post by sysbin » Sat, Nov 23, 2019, 9:59 PM UTC

I theorize society would be a better place if people could choose to end their life when they please by assistance in dying (commonly given to terminally ill). Although the idea is controversial I'm firmly attached to it from what I've witnessed in my life. Some people just have a terrible fate and nothing that comes in their life changes it because not everyone gets a good job, significant other, place to call home, and the healthy body. Some just don't want to settle with what fate gave them and others have had enough of life. edit: lol @ the person who downvoted every single comment of mine.

Re: What I have learned from my suicidal patients

#15

Post by sillysaurusx » Sat, Nov 23, 2019, 9:59 PM UTC

BuildTheRobots wrote: post #10

sillysaurusx wrote: post #9

I just wanted to say, if anyone is having a dark time, make an appointment with a doctor and ask them about Prozac. Unlike most antidepressants, the side effects don’t seem very noticeable. I think there’s a sort of stigma against talking about mental health (except in the third person), but it’s one of those things that should probably change. Taking Prozac doesn’t mean you’re somehow broken. It’s like a crutch: why…

This reads like advertising copy. Prozac has a number of potential side effects as well as needing commitment and a staged withdrawal. This is a dangerous comment and should be burried. edit: this isn't to say I don't think antidepressants are a fantastic tool; just that I don't think you should be going to your doctor and asking for a specific flavour of drugs because you heard about them on the internet. It's a rea…

I can tell you from firsthand experience for more than a year that the only effects I’ve noticed are slightly decreased libido. That’s generally considered TMI, which is why I didn’t mention it. But if I’m going to be honest and open, well...

Other than that, the side effects have included a renewed appreciation for life and and an ability not to have a sense of impending doom engulf my soul.

I was careful to say “my one datapoint.” Obviously, it’s not a miracle cure, and everyone is different. But it’s somewhat remarkable to diff my life vs what it was.

I’m a scientist at heart. I try to rule out placebo effect, and not attribute everything to one simple change. But a hearing aid is a simple change too.

The reason I’m speaking up is that it’s incredibly tempting to do nothing and to try to deal with your problems on your own. But it feels like that’s the real danger. Even if you succeed, why live life that way? It’s like succeeding in punching through a concrete wall for no reason. Much easier to use a sledgehammer.

You can always stop taking it. In fact, it wasn’t till I stopped for a month that I realized it had actually been working.

Re: What I have learned from my suicidal patients

#16

Post by cairo_x » Sat, Nov 23, 2019, 9:59 PM UTC

shrimp_emoji wrote: post #2

>The soldier who hiked out on to the moor, lay down in the heather and overdosed. Émile Durkheim, the great sociologist, theorised as to why suicide is so common among military personnel – not simply because of the devastating effects of war, or because of their easy access to weapons, but because of the depersonalising effect of army training: “Military esprit can only be strong if the individual is self-detached, a…

The number of people who have put off suicide and gone on to do great things is immeasurable. Curtailed suicide is such a common story, not just from people who have been exceptional, but normal people who go on to have families and spring forth entire trees of life, which themselves produce endless greatness.

Re: What I have learned from my suicidal patients

#17

Post by ThrowawayP » Sat, Nov 23, 2019, 10:00 PM UTC

syrrim wrote: post #5

shrimp_emoji wrote: post #2

>The soldier who hiked out on to the moor, lay down in the heather and overdosed. Émile Durkheim, the great sociologist, theorised as to why suicide is so common among military personnel – not simply because of the devastating effects of war, or because of their easy access to weapons, but because of the depersonalising effect of army training: “Military esprit can only be strong if the individual is self-detached, a…

I don't think rationality is a good way of looking at it. Rationality is defined over some goal, and there's no obvious goal here. The better way of looking at it is to say that the military teaches them to treat their own life as less valuable. Lives have no inherent value or disvalue, beyond what we apply to them, so this is neither rational or irrational. But the effect is that they are more willing to, as you say…

> Rationality is defined over some goal, and there's no obvious goal here.

Relieving themselves of (to them) unbearable misery is a goal, quite possibly the most rational of all goals.

Re: What I have learned from my suicidal patients

#18

Post by brazzy » Sat, Nov 23, 2019, 10:00 PM UTC

snagglegaggle wrote: post #4

shrimp_emoji wrote: post #2

>The soldier who hiked out on to the moor, lay down in the heather and overdosed. Émile Durkheim, the great sociologist, theorised as to why suicide is so common among military personnel – not simply because of the devastating effects of war, or because of their easy access to weapons, but because of the depersonalising effect of army training: “Military esprit can only be strong if the individual is self-detached, a…

I think you are going in the right direction. Society needs to recognize that suicide must be some evolutionarily advantageous adaptation. Many people when pressed will say they think an individual has value, but that individual often sees no actions come from that sentiment. And if someone thinks they provide no value and are not wanted, it seems logical to unburden everyone else. It would be similar to how cats go…

> Society needs to recognize that suicide must be some evolutionarily advantageous adaptation.

Bollocks. There is very close to zero evolutionary pressure against (and, of course, even less than that for) having a small percentage of individual of a species decide to off themselves. Especially when it's older males (the most likely age group to commit suicide).

Re: What I have learned from my suicidal patients

#19

Post by Fnoord » Sat, Nov 23, 2019, 10:03 PM UTC

sillysaurusx wrote: post #9

I just wanted to say, if anyone is having a dark time, make an appointment with a doctor and ask them about Prozac. Unlike most antidepressants, the side effects don’t seem very noticeable. I think there’s a sort of stigma against talking about mental health (except in the third person), but it’s one of those things that should probably change. Taking Prozac doesn’t mean you’re somehow broken. It’s like a crutch: why…

I'm on Prozac. Mild side effects? When I started with it, my muscles hurt for weeks. I had to quit coffee (temporarily). I had to stop exercising (temporarily), and I was also very tired for weeks. Slowly all of that became less severe, though it never truly went away. Add to that, when I started my partner was about to bare our first-born. It was a hell of a time in my life, in many ways. A rollercoaster for sure. I still need to be very careful with alcohol (about twice as strong effect). One glass of alcohol at a cocktail party at Friday afternoon on work can rub the wrong way, as it did the other day.

> It’s fuether compounded by the fact that most antidepressants have severe or annoying side effects.

As does Prozac.

Nearly all medicine have side effects. People should be informed about them (it is included with the medicine, at least here).

When depressed or suicidal, the advice of going to your doctor is good. The advice to be open about anti depressants as well (though you didn't give it, one could deduce it from your post). The advice to go for this specific brand because "no severe or annoying side effects? Bad advice.

Honestly, I had less side effects from Zyban/Bupropion and Citalopram.

Full disclosure: I don't use Prozac/Fluoxetine for depression (though one could argue I suffer from depression); I used it so I can better cope with autism.

Re: What I have learned from my suicidal patients

#20

Post by throwaway28282 » Sat, Nov 23, 2019, 10:03 PM UTC

shrimp_emoji wrote: post #2

>The soldier who hiked out on to the moor, lay down in the heather and overdosed. Émile Durkheim, the great sociologist, theorised as to why suicide is so common among military personnel – not simply because of the devastating effects of war, or because of their easy access to weapons, but because of the depersonalising effect of army training: “Military esprit can only be strong if the individual is self-detached, a…

It's important to note that rational clarity about the situation can also be what leads soldiers to insinuate that they are actually the bad actors in a given conflict, which can lead to depression and then suicidal thoughts.

I can't find the study now. But it was documented that Viet Cong soldiers had overall less PTSD years after the Vietnam War than Americans. And the extrapolation was that Viet Cong soldiers, defending their country and people from a foreign invader, were more easily able to justify their actions and thus didn't feel the remorse, guilt, and fear during fighting that their American counterparts did.

Perhaps that isn't the whole story, but I'd bet that part of the reason American vets struggle with PTSD so much is that not all of them can rationalize and defend the things the American army does in other countries around the world. It is almost always involved in offensive invasions, especially of lands where neither the natives nor the insurgents trust them or want them involved. And I think being so face to face with injustice and having to perpetrate it without any moral salve that you are doing the right thing is hard, especially in our digitally connected, personally disconnected world.