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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by icubaby on January 16, 2012, at 0:08:09
Hi All,
In June last year I had a serious suicide attempt and ended up on life support. I was discharged from the intensive care unit and in a matter of days I was on life support again. I was definitely in a deep bipolar depression on mixed state. I was very depressed and just wanted to die as I couldn't see the point of anything. Now I am doing much better on medication but the suicidal urges are still there. I don't understand why this is the case and just want them to go away. I am constantly having suicide thoughts but I doubt that I fit the criteria for depression. Why is this the case?
Posted by icubaby on January 16, 2012, at 0:12:37
In reply to Suicidal but not depressed - whats going on?, posted by icubaby on January 16, 2012, at 0:08:09
Is it possible that I could have post traumatic stress disorder?
Posted by pegasus on January 16, 2012, at 8:46:11
In reply to Re: Suicidal but not depressed - whats going on?, posted by icubaby on January 16, 2012, at 0:12:37
First off, I'm worried about your suicidal urges. Are you seeing someone to help you with those? Are the urges pretty serious? Do you have a suicide plan that you're considering? Please keep yourself safe.
Suicidal urges are not an official criteria for diagnosing PTSD according to the DSM IV (the diagnostic bible for mental disorders).
Suicidal urges are an official criteria for diagnosing depression, though.
Do you have other symptoms?
You know, diagnosing people for mental stuff is not like diagnosing people for medical stuff. No one has a firm understanding of the causes of mental diagnoses, so it's all just based on symptoms, which vary a lot from person to person. There is a ton of debate about the best way to even define different diagnoses. So, some people think it's not all that helpful to put a diagnosis on a mental condition. It might just be making something that we don't understand seem more understandable. Which has dubious value, you know?
So, when it sounds like you're trying to find a diagnosis for what you feel, I wonder what you're hoping that will do to help you? Are you trying to figure out what kind of help to seek?
- peg
Posted by Phillipa on January 16, 2012, at 10:09:34
In reply to Re: Suicidal but not depressed - whats going on? » icubaby, posted by pegasus on January 16, 2012, at 8:46:11
True practicing medicine. But I'd also be concerned with those thoughts. Phillipa
Posted by emmanuel98 on January 16, 2012, at 20:25:02
In reply to Re: Suicidal but not depressed - whats going on? » pegasus, posted by Phillipa on January 16, 2012, at 10:09:34
I know exactly what you mean. I fight off suicidal thoughts even when I don't feel particularly depressed. It's helped me a lot to work with a DBT therapist. I think suicide seems like kind of release valve for me. A way out if I need it. There is something almost reassuring about suicidal ideation though it also terrifies me because I have come very close to dying on three occasions now. But this is the kind of thing therapy is good for.
Posted by icubaby on January 16, 2012, at 23:18:24
In reply to Re: Suicidal but not depressed - whats going on?, posted by emmanuel98 on January 16, 2012, at 20:25:02
> I know exactly what you mean. I fight off suicidal thoughts even when I don't feel particularly depressed. It's helped me a lot to work with a DBT therapist. I think suicide seems like kind of release valve for me. A way out if I need it. There is something almost reassuring about suicidal ideation though it also terrifies me because I have come very close to dying on three occasions now. But this is the kind of thing therapy is good for.
Dear Emmanuel, I am sorry that you are struggling with suicidal feelings too. I have read about DBT and bought a workbook and worked through the exercises. I thought that it was helpful but the suicidal thoughts are constant. I just have to learn to ride them out like a wave. This sounds easy but it is hard because the waves are big and frequently come rolling in. I think that somehow my brain became conditioned to think of suicide long after the feelings of depression has subsided and I don't know why.
Posted by emmanuel98 on January 17, 2012, at 19:50:09
In reply to Re: Suicidal but not depressed - whats going on?, posted by icubaby on January 16, 2012, at 23:18:24
It's hard to do DBT on your own. But they do tell you in DBT to ride out emotions like a wave, to watch them come and go, to be curious about them but not overwhelmed by them. To learn to say, hey, I'm thinking about suicide. What is that about? How does that feel in my body? What are the thoughts that exacerbate this.
For me, I struggle endlessly with suicidality. I get very close to taking my life, then think about my daughter and the pain it would cause her. She is 23 now and has her own life and would recover, but the thought of her crying is so upsetting to me. All her life, I soothed her when she cried. People criticized my mothering when she was small because I was so averse to letting her cry. I hated the idea of her feeling pain. I felt such pain as a child and learned all these f***ked up defenses against it that have proved dysfunctional. The thought of my daughter crying is just more than I can bear. It has pulled me back from the brink a couple of times. God, I hate this sometimes. I try to let it go and see it as a wave that will ebb. But sometimes I just can't move past it. I work with my DBT therapist and my p-doc (who I still see for an hour every other week) but it's still a problem. It has gotten better though. DBT has helped me learn to suffer through it. When it gets to bad and I get agitated and start making plans, I take a heavy dose of an anti-psychotic and a benzo and let myself sleep for hours and hours on end.
Posted by Phillipa on January 17, 2012, at 20:56:26
In reply to Re: Suicidal but not depressed - whats going on?, posted by emmanuel98 on January 17, 2012, at 19:50:09
Seriously sleeping makes it go away? How do you feel after sleeping? Phillipa
Posted by icubaby on January 17, 2012, at 22:01:09
In reply to Re: Suicidal but not depressed - whats going on?, posted by emmanuel98 on January 17, 2012, at 19:50:09
I am just scared that if I inform someone I will be viewed as an attention seeker since I am not depressed but suicidal. That is my biggest worry.
Posted by emmanuel98 on January 18, 2012, at 1:32:39
In reply to Re: Suicidal but not depressed - whats going on? » emmanuel98, posted by Phillipa on January 17, 2012, at 20:56:26
I usually feel better after sleeping, but I will sleep for 14-16 hours two days in a row or somtimes for 24-36 hours at once. Before I did DBT, this would not help. Now, with the DBT, I get this relief from sleep that allows me to step back and think about what's going on with me.
Posted by emmanuel98 on January 18, 2012, at 1:36:28
In reply to Re: Suicidal but not depressed - whats going on?, posted by icubaby on January 17, 2012, at 22:01:09
> I am just scared that if I inform someone I will be viewed as an attention seeker since I am not depressed but suicidal. That is my biggest worry.
Yeah. I know that thought. Are you an attention seeker? Have you been in the past? If not, you are not seeking attention but just seeking help for a difficult problem. I once said to my p-doc, I feel like the boy who cried wolf. He said the boy who cried wolf was scared.
Posted by Dinah on January 18, 2012, at 13:14:19
In reply to Suicidal but not depressed - whats going on?, posted by icubaby on January 16, 2012, at 0:08:09
For me, suicidal ideation comes more from anxiety and agitation than depression.
Sometimes it's an intrusive thought that doesn't really match my state of mind at all.
With the first, I try to look at the underlying problem and treat the agitation and anxiety. It seems to be almost a byproduct of those feelings.
With the second I treat it like any other obsessive thought. I externalize it by telling myself "I'm having thoughts about wanting to kill myself." instead of "I want to kill myself." I try not to fight the actual thought, but to observe it. To find it "interesting". I try not to give it too much power. Obsessive thoughts feed on energy devoted to them, even energy to suppress them. Not that you should act on them, of course, or allow them to guide your actions.
The secrecy is likely strengthening the thoughts. A good therapist will understand and won't think you're asking for attention, other than the attention you need. You're asking for help in trying to reduce the thoughts. A therapist should appreciate that.
Posted by icubaby on January 18, 2012, at 16:22:07
In reply to Re: Suicidal but not depressed - whats going on? » icubaby, posted by Dinah on January 18, 2012, at 13:14:19
Dear Dinah,
Thank you so much for your detailed message. It seems that anxiety can cause suicidal thoughts. I thought that only depression can cause suicidal thoughts. I certainly feel anxious. I wake up every morning thinking someone in my family is going to die today. I have the most terrible anxiety.
I think your right, if you struggle with feelings and trying to push them away will only make them come back stronger. I have been reading a lot about acceptance and behaviour therapy and they seem to say that. Dialectical behaviour therapy also seems to say this too.
I am so sorry that you are having a tough time too.
Posted by emmanuel98 on January 18, 2012, at 19:11:31
In reply to Re: Suicidal but not depressed - whats going on? » icubaby, posted by Dinah on January 18, 2012, at 13:14:19
I also generally experience SI with a lot of agitation. That's why I take a strong AAP to try to control it. But the idea of observing it, treating it with curiosity rather than agitation is what my DBT therapist has been trying to teach me and I have been trying to learn.
> For me, suicidal ideation comes more from anxiety and agitation than depression.
>
feelings.
>
> With the second I treat it like any other obsessive thought. I externalize it by telling myself "I'm having thoughts about wanting to kill myself." instead of "I want to kill myself." I try not to fight the actual thought, but to observe it. To find it "interesting".
Posted by Dinah on January 18, 2012, at 22:34:34
In reply to Re: Suicidal but not depressed - whats going on?, posted by icubaby on January 18, 2012, at 16:22:07
I'm ok at the moment. But I've had those times in the past.
I've read a lot, and probably incorporated a lot of DBT into my thinking processes. My therapist isn't trained in DBT but sometimes you'd think he was. He also incorporates a lot of Eastern philosophy.
Posted by emmanuel98 on January 19, 2012, at 18:31:45
In reply to Re: Suicidal but not depressed - whats going on? » icubaby, posted by Dinah on January 18, 2012, at 22:34:34
Eastern philosphy is good. It really informs DBT with many of the same ideas -- acceptance, sitting with feelings, etc. My DBT therapist is also kind of a Buddhist and goes on meditation retreats. My sister, who is into Buddhism, tells me that Marsh Linehan was strongly impacted by Buddhist teaching and that that's where the whole DBT notion of radical acceptance comes from.
My p-doc is classically trained dynamic therapist, but he has great respect for DBT and told me he's often thought about taking courses to learn the techniques, but decided he was too old, too close to retirement.
This is the end of the thread.
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