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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by LibbyH on February 27, 2003, at 2:12:16
For the last few weeks I've been half-plotting my own suicide. I know this is something I should tell my doc, but I have suicidal thoughts many times before & am seldom tempted to act on them. I've been battling major depression for about 25 years now, so this is not new. Lately, the thoughts are so persistent & I'm thinking aobut details like how to make it work so I actually die instead of just getting hurt, so it's more like planning than just thinking about it, but I still haven't taken any real action toward it.
My pdoc knows I'm seriously depressed. My last AD's just pooped out a short while ago & I just started new ones a few days ago. The new meds seem to be helping, but they will take time & meanwhile, a lot of personal stuff is going on around my family, friends, & job that feels too overwhelming to live with.
The other day, I mentioned I was thinkinga bout "checking out" to a friend & she called the police. Two officers came to my house & I had been crying but I was able to speak with them calmly & coherently so they said they couldn't take me to the hospital. They said I seemed a little upset but basically calm & lucid. They did ask for my pdoc's number & called, but they let me speak with him first & I easily convinced him I wasn't danger to myself. I told him my friend had just overreacted when I told her I had suicdal thoughts but then said I would never follow through on them. He asked me to promise I wouldn't harm myself & I promised without hesitation, but I was lying. As soon as the cops left, I started trying to scrape together enough of my leftover drugs to OD, but I didn't really have anything I knew for sure would do the trick. Tried to find a site on the internet that would list fatal doses of drugs, but of course it's not there.
I had an old Ativan prescription, so I took what was left of them & drank a couple beers. I was going to go to the garage to sit in the car with the engine running, but I passed out before I made it that far & woke up 16 hrs. later, pretty groggy but basically fine. I missed work, but no one even noticed. They thought I was in meetings all day.
In my life, I function just fine. I'm well-groomed & appear outgoing. My work gets done well & on time. My house is clean & my family is well cared for. But I pray at least once every single day for God to kill me. Of course, that hasn't happened so far, but I really wish it worked that way!
Please don't try to talk me out of suicide. I already know that's a bad solution & I don't want to do that to my family. So I know I am probably going to have to tell my pdoc about this. And if I do, will he put me in the hospital immediately?
I've never been to the hospital for my depression before. I actually made a suicide attempt once & was taken to the ER for carbon monoxide poisioning, but I managed to convince them it was an accident. A neighbor "resuced" me that time. I really intended to die. Wanted to. But I told the docs I was just stupid, not suicidal & they bought it.
I'm starting to scare myself with my planning & plotting because I know I don't really want to die. It's "just" my depression. But the depression is so bad that sometimes it feels like I HAVE TO die just for a little relief. Do you guys understand that feeling?Anyway, I'm willing to go into the hospital if that's what it takes, but I need to know some things about it first. Like if I check myself in, what can I expect? What will they do to me? How long do they keep me? When I get out is anything better or is it worse for awhile?
What kinds of problems does it cause with family, friends, work, etc.?Please, I need experience on this...
L.
Posted by mair on February 27, 2003, at 7:54:50
In reply to Half-Baked Suicide Plans Hospitalization, posted by LibbyH on February 27, 2003, at 2:12:16
Libby, I can't tell you anything about the hospital because I've managed to keep myself out although it's sure been the subject of a couple of serious discussions I've had with my therapist.
What I can relate to is the obsessive quality of suicidal thinking. Thoughts of suicide are pretty much there a good deal of the time. Mostly I now can just treat them as a temporary annoyance and give them little credence, but from time to time I realize that my thinking gets pretty obsessive - I start doing more planning; I start visualize myself going through each step I need to; I start trying to convince myself that I should make preparations, even if I have no intention of following through - just so if I change my mind, the means and methodology are easily at hand. It can get pretty frightening. I haven't had the thought that I have to kill myself, but I do sort of overwelm myself with the thought that I should kill myself. What frequently stops me is that I have never been able to convince myself that my husband and children would be better off if I did this, although when I'm most depressed I try hard to puzzle this out. The family piece of this is one of several safety nets, I've either consciously or unconsciously devised for myself.
I've had a lot of discussions with my therapist about suicide, but the first time I talked to her about how obsessive my thinking had become, we had several sessions where we discussed hospital alternatives and more practical things like when I should call her, what I should say etc. This was useful because it made me feel, over time, that I could turn to her without the fear that she'd want to hospitalize me. It's been helpful to me to know that I can turn to her as an outlet for my worst thoughts and that she'll listen and try to help without overreacting. I have no doubt that she'd intervene if she really thought I was about to act, but after having worked through this with her, hospitalization doesn't seem as awful as it used to; I used to feel that I'd rather die than go to the hospital, but talking about this so much with her has demysitfied that whole process for me - I don't feel, as I used to, that it's not a viable alternative. By the way, it also helped that when things were at their worst, I posted a message here not dissimilar to what you've written, and I got a lot of feedback from people about the positives to being hospitalized.
I think you're doing the right thing seeking out the stories of others here, but I also think you need to work this through with your pdoc or therapist - I don't think you should just assume that he will force you into a hospital if you come clean about what you've been feeling, but talking about it may provide you with some relief and also might help you to recognize when you need more agressive intervention and how you can ask for it.
Please keep posting here to let us know how you're doing.
Mair
Posted by fayeroe on February 27, 2003, at 15:22:22
In reply to Re: Half-Baked Suicide Plans Hospitalization » LibbyH, posted by mair on February 27, 2003, at 7:54:50
I know a little about hospitalization for depression as I have worked in one. You would have a room just like any patient would. If it were a psychiatric hospital, you could expect group therapy and individual therapy with counselors. And probably medications added to what you are taking. Or perhaps a med change. Have you asked your doctor about what would go on. Seems to me that would be the place to start.
You could be in for 30 to 45 days. I worked as a therapist for three years in a psychiatric hospital and saw alot of positive change in the patients. If they were willing to do the work. That is the key to getting well. The work. I pray for you and hope you make the decision to seek the hospitalization soon.
Posted by judy1 on February 27, 2003, at 17:41:40
In reply to Half-Baked Suicide Plans Hospitalization, posted by LibbyH on February 27, 2003, at 2:12:16
I've been in several times Lilly- 3 times for suicide attempts, others for mania. The suicide attempts: a 72 hour involuntary hold which depending on how good you are at convincing your pdoc you're ok (plus how good your insurance is) can easily drag into a week or more. I loathe hospitals (but manic people probably have more negative experiences than depressed patients), but I will strongly encourage you to go because you are no longer in the ideation phase and you recognize that. So think about a normal hospital room that you will probably share with a bathroom, no leaving the ward for 72 hours, 30 minute bed checks and you spend most of your time in the lounge with other patients usually talking or watching TV. You definitely need a safe place and I'm sorry but it sounds like that's your only recourse. Hopefully you'll feel less suicidal after the 72 hours (and actually it IS better to go in voluntarily) and you'll be able to leave and do day hospital. If you have more questions I'll be hapy to write, but please, please go in- judy
Posted by judy1 on February 27, 2003, at 18:12:42
In reply to Re: Half-Baked Suicide Plans Hospitalization » LibbyH, posted by judy1 on February 27, 2003, at 17:41:40
Posted by noa on February 27, 2003, at 19:07:56
In reply to Re: Half-Baked Suicide Plans Hospitalization » LibbyH, posted by judy1 on February 27, 2003, at 17:41:40
I was once hospitalized but that was so long ago that I can't say if hospitalization today would be similar or not.
It is my impression that for most people nowadays, unfortunately, insurance plans limit hospitalization to extremely minimal numbers of days. The 35-45 day model seems to me to be quite rare these days. More likely is what Judy described-- the 2 to 3 days or until they were more confident that you were not going to be in imminent danger.
Unfortunately, it seems to me that the pendulum has swung from the days when hospitalizations could be rather endless (like about 25 to 30 years ago, when my friend was hospitalized for 18 months from the outset, lenght of hospitalization being based on her diagnosis) to the opposite end, where we typically are now,I think, with insurance companies trying to keep people out of hospitals as much as possible (I think if my friend presented with exactly the same problems and symptoms now, she would maybe be in hospital for 2 days, if they even admitted her at all).
A couple of years ago, when I was very depressed and sometimes feeling quite suicidal, I thought about whther to go into hospital. But I wasn't at the point of being unable to resist the urge to act on my plans. I did come very close during one episode, where my planned was more detailed and included not telling anyone including my therapist, with whom I have a very honest relationship. I withheld it from him but then blurted it out because I couldn't be dishonest with him for long. He then basically read me the riot act and told me if I couldn't discuss it openly and withheld my suicidal intentions from him again, I would need more intense level of treatment, like hospitalisation. I ended up being to contract for safety after that, and somehow got through it. But I had at points considered hospitalization. However, even though my therapist was supportive of the idea (if I was unable to agree to safety he would have insisted), my pdoc, who does a lot of hospital work, actually said that he didn't think my insurance would even approve it, and if they did they would only approve of a couple of days max.
However, my therapist at that point said that there were day treatment programs I could consider, if I couldn't feel confident about my ability to keep myself safe, the thinking being that while day programs are not exactly like being hospitalized, a day program could provide a lot more structure and "holding" than just outpatient therapy, to see me through the crisis. I ended up not needing it, but I think that is partly due to knowing it was there if I couldn't hold it together and be safe.Hopefully, you have better insurance coverage of hospitalization, and access to hospitalization for more than just 1 or 2 days, ie, enough to work through a med change if needed, and to "hold" you until your current suicide risk level subsides and you are safer.
Even though my own hospitalization was 20 years ago, it was rather brief (about 6 days) because my med insurance was one of the early HMOs. And it served its purpose for me--to hold me until I felt safer--but was at a rather mediocre hospital, where not much real therapy happened. The first unit I had been in was the locked unit, and most of the staff was fairly young and incompetent--I think they were sketchily trained "techs". Very little therapy happened while I was on that unit, except one session of art therapy with a fairly good therapist. No "aha" experiences or anything, but some sympathy and a chance to do some art work and connect with the two other patients who chose to participate (out of about 30 on the unit!). Mostly, people just sat around the day room complaining and being bored and depressed.
Then, they moved me to an open unit (open meaning there were incresing levels of grounds privileges you could gain depending on how you were doing). That allowed me to participate in some therapy groups, some of which were real jokes, led by very young and inexperienced and not very sophisticated, (even at my young and unsophisticated age myself this was so obvious to me) activities therapists, including one who basically flirted through entire sessions with a very ill (and rather perseverative and annoying) young man who only left his bed to attend this particular activities leader's groups.
But there was that one art therapist who was decent and I was able to go to two group sessions she led, one which was just kind of fun and distracting for me--music therapy--and one that was actually constructive, and where I think I learned a little bit about how to gauge mood and what kinds of activities could help improve mood. But it was VERY basic. Very basic. At the time, I was rather young and not possessed of much in the way of knowledge about depression, and not possessed of much in the way of coping skills, so even though it was so basic, I did learn something in that session. And there was one nurse on the unit who I liked talking to, who seemed to have some actual counseling skills. The other somewhat helpful resource was that the HMO sent a visitng case manager for a couple of meetings and she happened to be kind of helpful in thinking about how to increase supports in my life for after the hospitalization.
I rarely saw my assigned pdoc, especially since my hospitalization was mostly during an extended US holiday, and I did not find my meetings with him to be of much value, because he neither recommended any med changes, nor did he offer any support or counseling (I think I saw him a total of 3 times for literally 5 minutes each time).
So, lousy hospital program though it was, I did get some benefit out of it--it got me through the worst part of my crisis, and I did gain a little from those three women--Art therapist, nurse, clinical case manager, in the brief encounters with them.
So much has developed over the years in terms of short term treatment and I know nothing about what happens nowadays in hospital programs, except the part of the rationing of services by insurance companies.
Hopefully, programs are much more developed than the one I experienced 20 years ago. But I'm sure there are some that are very good and some not.
I did read here on Babble once that it is possible to call a hospital and request a meeting with someone (a social worker maybe?) to find out more about their particular program and what it would be like, and thus do some comparison shopping, as it were, before admitting yourself. This would only work if you are safe in the immediate term and don't need to go in this minute, and of course, if you even have more than one program to choose from (geography and health insurance limitations being what they might). Also, it might be important for you to go where your doctor and/or therapist has priveleges so you can continue the treatment you are already in (that was definitely lacking in my own hospital experience). Also, your pdoc/therapist might be able to tell you about the plusses and minuses of hospitals in your area.You do sound like you are at a higher risk at the moment than you have been at other times, and I'm glad you are considering hospitalization as an option. I have had some really scary suicidal episodes myself when I wasn't sure I would be able to get past the horrible pain and obsession with ending it, but I am sure glad I was open with my therapist about it because I am glad to be alive now (there was one time when it was really bad that I came close to not telling him. I knew that was a sign it was getting serious, because I knew the reason I was witholding it from him was to try to ensure being able to carry it out. I ended up telling him, but it was a struggle for me to get past the conflict of not wanting to tell him vs. otherwise being totally honest with him and unable to withold anything important).
Take care. I don't know if my rambling babbling is helpful. I hope so, anyway. I hope you get the exra support you need now.
Posted by Miller on February 27, 2003, at 20:05:02
In reply to Half-Baked Suicide Plans Hospitalization, posted by LibbyH on February 27, 2003, at 2:12:16
Funny that you should mention this, as I just got out of a hospital for my second suicide attempt in less than 6 weeks. SO, I have my story to share.
The day I overdosed (the second attempt is the real story inwhich it will help you). Since my husband had to call the emergency number to get an ambulance, after I had my stomache pumped in the hospital, I was in police custody.
The police took my to the local Mental Health Complex. I was "evaluated" by an psychiatrist. I put that in quotes because since it was my second attempt in such a short period of time, no matter what I said or did, they weren't letting me out. I was sent to an obsevation unit for the night. I had a room to myself, but the door was to remain open. The next day I had a session with another psychiatrist. I tried EVERYTHING to convince him I was no linger a danger to myself. It suisn;t work. I was sent to the "ward". This was a county hospital which is required to take anyone regardless of income. The ward was a scarey place.
The functional people were with the non-functional people. It was a Sunday, so there was no psychiatrist to see me until Monday. On Monday I was told by that shrink that if she has her way, I would be in for quite a while because of the amount of stress (and distress) I caused myself. However, luckily for me, my insurance insisted on moving me to a private hospital. In order to be released to the private hospital, I had to sign a court stipulation that stated that if I try to harm myself or others, if I fail to take my meds, or if I fail to attend any doctor recommended appointments for 60 days, I would be immediately taken back into custody for a minimum of 14 days or until the doctors/courts agreed.
I was transferred to a hospital with a wonderful program. The staff was warm and considerate to the emotional needs of the patients. They were concerned and helpful. All day we had "classes". They taught us coping skills, daily planning, goals, we had classes on the meds we were taking, art therapy, and communication classes. I can say it was the most productive 6 days I spent.
Bottom line: If you are feeling as bad as you are telling me, go seek help. If nothing else, you will be safe. I know it doesn't seem as if you want to be safe right now, but there are other alternatives. Even if you don't go to the hospital, talk to your shrink aboutit. He can only help you as far as the information you are giving him.
May you find peace.
-Miller
Posted by judy1 on February 28, 2003, at 12:12:44
In reply to Re: Half-Baked Suicide Plans Hospitalization » LibbyH, posted by Miller on February 27, 2003, at 20:05:02
just wanted to add to Miller's post- if you wait until you actually make an attempt, you are indeed in police custody and not treated very well. I also was moved to a private facility, but until after the 72 hours could not do anything constructive. It wasn't until day hospital- out-patient 8-5, that group therapy, etc. was offered. I did meet someone who went in voluntarily through her shrink who didn't go through the loops I did and was offered therapy right away. Plus getting your stomach pumped is pretty damn unpleasant. Like Miller said, communicate with your pdoc and best of luck- judy
Posted by Eilidh on March 8, 2003, at 13:50:42
In reply to Half-Baked Suicide Plans Hospitalization, posted by LibbyH on February 27, 2003, at 2:12:16
Like you I presented a polished exterior to the world, but was hospitalised eventually by agreement because, also like you, all I could think was that I had to die.
While in hospital I eventually felt overwhelmed by the realisation that no matter how long I was in hospital, If I wanted to die I could eventually arrange it, and the only person who could keep me alive was myself. What a massive responsibility this felt, and it made me angry that even this was to be down to me.
CBT helped me to identify reasons as to why I should remain alive at the time. Since then, despite medication, I still have times when I return to the thought of taking my life.
You mentioned nobody missing you at work etc. I find this type of thinking very harmful for us and try to challenge the unhelpful thoughts. If I cannot do it myself, and it is not a convenient time to talk to a therapist, I try to find someone to chat to in an effort to divert my thinking for a while.I do anything but stay on my own so that I cannot take any action. I maybe lucky, as I know some people cannot leave their home at such a time, but for me it is a must.
Hospitalisation may well be the right action for you at this time to help reduce your stress due to your need to "put on a face to the world" but the assistance of a good CBT therapist is also essential. They help us to choose to stay alive for reasons we identify. CBT does not have all the answers, but can be very useful when the only thoughts we can create for ourselves are those of self destruction.
Please hold on until you receive assistance, whether it is in the form of hospitalisation, change of meds, CBT or all three.
I know you may find it difficult to keep in touch with the board, but please stay safe.
Eilidh
Posted by Rachel2 on March 24, 2003, at 14:39:39
In reply to Re: Half-Baked Suicide Plans Hospitalization » LibbyH, posted by Eilidh on March 8, 2003, at 13:50:42
Libby,
I haven't seen any posts from you here in a month and am wondering how you are doing.
Posted by noa on March 26, 2003, at 4:57:50
In reply to Re: Half-Baked Suicide Plans Hospitalization, posted by Rachel2 on March 24, 2003, at 14:39:39
see thread below, Rach.
This is the end of the thread.
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