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What I have learned from my suicidal patients

theguardian.com

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Re: What I have learned from my suicidal patients

#91

Post by snagglegaggle »

Ixiaus wrote: post #23
BuildTheRobots wrote: post #10

Earlier quoted context omitted.

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've known many people who've been helped in a non-trivial way by antidepressants. Furthermore I had a colleague commit suicide recently due to depression. His comment is not dangerous, it's encouraging. Pharmaceuticals all have side effects and must be taken with care, I've known literally no one that went into antidepressants ignorant of those things.

I don't think so. Buproprion is supposed to be the most side-effect free antidepressant yet it seems to have permanently messed up my sex drive. If I had the choice of the two I'd probably have kept my sex drive and tried something else.

Re: What I have learned from my suicidal patients

#92

Post by brookside »

cassowary37 wrote: post #89
brookside wrote: post #80

Earlier quoted context omitted.

The term "treatment resistant depression" bothers me because, I think, a more accurate name would be "placebo resistant depression". Sorry to come off as frustrated; I'm like others in this thread with 10+ years of trying various therapies and antidepressants to end up feeling more, not less, hopeless. David Burns does a good job explaining why antidepressants and psychotherapy don't typically work in his most recent…

and HN refusal to pay attention to data when it relates to depression in 3..2..1... https://www.ncbi.nlm.nih.gov/pubmed/29477251 for moderate to severe depression, the kind most posters are talking about, they're consistently better than placebo. It is true that placebo is often effective too. But most people I talk to would rather have that extra chance of getting better.

"We excluded trials that included 20% or more of participants with bipolar disorder, psychotic depression, or treatment-resistant depression"

This is an honest question - is it fair to exclude people for whom antidepressants don't work in an analysis of if antidepressants work?

Re: What I have learned from my suicidal patients

#93

Post by downerending »

cassowary37 wrote: post #88
dkersten wrote: post #87

Earlier quoted context omitted.

I've always disliked it too. It seems very presumptuous. The people repeating it typically don't know what the person in question is dealing with.

actually that statement is itself rather presumptuous. How would you know that those of us who repeat it don't know? I can state with authority that may of us do.

It's a truism in life that most people offering simplistic advice don't have long and deep personal experience of the malady they're advising on. None of us can guess about your experience personally, but that's the broad trend across large groups.

A lot of anti-suicide advice can seem like a sick joke, little more than empty virtue signaling. Want to really help? Offer a friendly ear and a sense that you really care about the person in question, and stand behind that over a period of time.

Being depressed is generally not a temporary problem. Many of us have suffered it for decades. It may wax and wane, but it's often not something that just goes away. In my opinion, it's something that many of us simply have to learn to live with, as with so many other chronic diseases.

Re: What I have learned from my suicidal patients

#94

Post by downerending »

hestipod wrote: post #84

I won't make it through the end of the year and it's all preventable. Nearly everything I see posted about suicidal people from non-suicidal people, and ESPECIALLY doctors get it wrong and avoids root causes in some self serving attempt to justify their failures or live with that existential fear. Most people I have known professionally when I was a provider, and personally since I became a victim, who were suicidal…

The situation with your family sucks, no doubt.

What would improve things for you right now?

Re: What I have learned from my suicidal patients

#95

Post by viburnum »

0xcde4c3db wrote: post #38

> To feel depressed about the state of your life is to demonstrate capacity to imagine something different, and that spark of imagination can prove a motive to change. This was arguably true for me, but not in a good way. I'm pretty sure that I started having intrusive suicidal thoughts because my depression had motivated me to try to change. Said changes utterly failed to even make a dent in my depression, finally c…

This has been my experience as well.

Re: What I have learned from my suicidal patients

#96

Post by RandomTisk »

hestipod wrote: post #84

I won't make it through the end of the year and it's all preventable. Nearly everything I see posted about suicidal people from non-suicidal people, and ESPECIALLY doctors get it wrong and avoids root causes in some self serving attempt to justify their failures or live with that existential fear. Most people I have known professionally when I was a provider, and personally since I became a victim, who were suicidal…

Have you applied for disability? Really hope you find a way through.

Re: What I have learned from my suicidal patients

#97

Post by viburnum »

sjg007 wrote: post #63
0xcde4c3db wrote: post #38

> To feel depressed about the state of your life is to demonstrate capacity to imagine something different, and that spark of imagination can prove a motive to change. This was arguably true for me, but not in a good way. I'm pretty sure that I started having intrusive suicidal thoughts because my depression had motivated me to try to change. Said changes utterly failed to even make a dent in my depression, finally c…

Are you still depressed? I try to have 5 good days out of 7 in a week. I found that CBT helps especially the book Feeling Good by David Burns. He has a podcast out now about a new team base cbt approach. The podcast is great and the workbooks in his books are really helpful. He has an associated clinic in Mountain View as well. The approach is practical and specific. CBT has roots in Buddhism and stoicism as well for…

Another vote for Burns. I think he’s way ahead the rest of the field. He’s kind of like the old extreme programming methodology: lots of automatic testing, consistent use of best practices, short iterations, and pragmatically focused. I took me a while to get into his podcast but it’s helped me a ton. Having listened to nearly every episode now I get it. He’s usually too nice to say it but he also gets to why most therapies (and therapists) fail. Knowing this especially helped me.

Re: What I have learned from my suicidal patients

#98

Post by jpindar »

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…

People may say "everyone is valuable" but will they support UBI?

Oh, so not THAT valuable.

Re: What I have learned from my suicidal patients

#99

Post by hestipod »

RandomTisk wrote: post #96
hestipod wrote: post #84

I won't make it through the end of the year and it's all preventable. Nearly everything I see posted about suicidal people from non-suicidal people, and ESPECIALLY doctors get it wrong and avoids root causes in some self serving attempt to justify their failures or live with that existential fear. Most people I have known professionally when I was a provider, and personally since I became a victim, who were suicidal…

Have you applied for disability? Really hope you find a way through.

Yes of course. Fought for it with lawyers for years. Denied despite evidence by a very biased judge. Appealed. Same judge denied again. The system is broken. I am out of credits to apply now. I have done everything you are supposed to and that people think works. It doesn't. It's just the same advice recycled and disbelief it didn't work...then on to blaming me for it...and me getting more upset and hopeless. Over and over. I know who I am and what I have done...but it doesn't matter.

Re: What I have learned from my suicidal patients

#100

Post by hestipod »

downerending wrote: post #94
hestipod wrote: post #84

I won't make it through the end of the year and it's all preventable. Nearly everything I see posted about suicidal people from non-suicidal people, and ESPECIALLY doctors get it wrong and avoids root causes in some self serving attempt to justify their failures or live with that existential fear. Most people I have known professionally when I was a provider, and personally since I became a victim, who were suicidal…

The situation with your family sucks, no doubt. What would improve things for you right now?

I am so stressed, distressed, angry, in pain that I don't even know at this point. I need stability so I can assess things. See what the baseline is without all this bullshit here. I need to get back to Warsaw where I lived before and my only friends and reliable doctors are,or at a minimum some European city with dense services, affordable healthcare, and transport so I can live within a small area. This country is too costly and lacking in services in this rural hell, and I don't trust the healthcare anymore in general. But anything will require money. I cannot earn well or at all because my health requires all my energy to endure most days except for basic household stuff and even some days I don't move much at all. I simply cannot dig down like one can when they were a 20yo and scrap and build a new foundation. I don't know if I would EVER be able to work reliably...but for sure never full time.The money I have access to isn't enough for anywhere and there is no safety net. I have no insurance. When they ruined my health they took away my means to guarantee that financial security...and then denied assistance. Nothing went right.

People always think you should be able to do more than you say but my body is the boss and will fall out from under me and that takes my mental state with it...as you can see now. Nearly two years ago someone here offered me a very bespoke job part time with the ability to immigrate, but my health problems and personal tragedies (family betrayals and death of the person I loved most...one I may have been able to prevent had I been back there instead of across the world) all came at the right time to confound even THAT chance. Now things are even worse physically, financially, and mentally and my capabilities less. In a modern country I'd be on social aid so I could have stability and time to assess and long term help if I couldn't improve...not feel I would be cast out at any moment with no survivable path. Maybe I'd be like this for the rest of my days...maybe I can improve a little and do more. I can't know until I have that security and access to trustworthy doctors and systems...and those are not here in America.

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