Posted by g_g_g_unit on December 27, 2012, at 8:41:23
In reply to Re: thanks » g_g_g_unit, posted by SLS on December 27, 2012, at 7:15:29
> This is absolutely true. I am a believer that people have a right to choose their own destiny, even if that means choosing death. I have reached the point on two or three occasions when I contemplated a "rational suicide", or what I like to call autoeuthanasia. They shoot horses, don't they? However, I would council you against making a decision to move in that direction while you are experiencing such a severe episode of depression and anxiety. I am sure you actually "feel" doomed. This usually passes in cases like yours. I don't think it would be rational for you to commit suicide while you are in this state. You can choose to leave life anytime. Why do it today? I lived many years believing that suicide was to be an inevitable conclusion to my life. However, on a daily basis I was able to rationalize living for just one more day. I have never made plans nor investigated methods. One would think that I would have researched the thing. Nope. I wanted to distance myself away from suicide as much as possible. I don't want to have the tools ready to act on impulse. As long as I chose to live that one more day, it made no sense to add to my morbidity by investigating suicide. I seem to always work to gain positive energy.
Thank you, Scott. I was hesitant to mention the "S" word, but I suppose it was implied in my post. I have no plans to leave this world today, tomorrow or in the foreseeable future, but it is certainly something that I have begun contemplate with greater openmindedness. I do not subscribe to the theory that all suicide, enacted in the context of mental illness, is by default irrational. You are right -- I feel doomed and imprisoned, both internally and externally. This has been a slow process of degradation that I have been undergoing for 5 years, with almost no signs of reprieve. It is the continual process of reality clashing with fantasy which produces the greatest despondency.
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> I know that I have said this before, but I find hope in uncertainty. If you can conceive of a treatment that you have not yet tried, there is hope that you might find therapeutic success. If you cannot conceive of such a treatment, then let other people do it for you. Hopefully, this will be your doctor who offers you untried alternatives. Perhaps you will find hope in treatments that are not pharmacological. Certainty can be a killer. I reached my only state of certainty a little over a year ago. I could not conceive of any treatment that I had not yet tried. In my mind, I had run out of alternatives. I was certain I was doomed to live in a chronic state of severe depression and the pain and ruination that accompanies it. Thus began my existential crisis. My thoughts were deep, intense, and destructive. It is not that the thoughts were without fact to justify them. It is that they were exaggerated by the depressive state. The depressed brain sees life through unrealistic filters. There are no positive thoughts. The brain simply does not generate them. What's worse, it seems that the brain generates and exaggerates negative thoughts. So, in the nomenclature of behaviorists, the result of these filters is a lack of reward and/or a preponderance of punishment. Before making any decisions, you may want to wait for the negativistic brain state to subside so that any choice you make will be the result of a more objective deliberation. If you wait, I am hoping that the world will seem different enough for you such that you don't choose death today nor tomorrow.I hope so too. My personal psychiatrist has run out of treatment ideas -- our last appointment was a medication review, where he established that the priority should be to reign in the severity of my anxiety. He prescribed Xanax, which produced a paradoxical reaction, and is now on vacation, so I don't have access to him until the second week of January. As far as depression, the only thing that produced any significant gains, looking back, was Parnate (at 60mg) -- I became far more active, engaged, and motivated, though at the expense of insomnia, increased anxiety and agitation. Dexamphetamine also helps my amotivational and concentration issues (perhaps partly tied to ADD), though at the expense of anxiety and agitation as well.
I notice the bind I am in. I am suffering from such severe anxiety that I am effectively crippled, yet am so desperate to maintain some idealized quality-of-life. Maybe this is just a normal reaction to the whole process of medicating. But I fear that anything that produces a meaningful dent in my anxiety will come at the expense of apathy, anhedonia, etc. The last time I was referred to a Professor of Pharmacology for a consultation he had me on a high-dose of Lexapro and Zyprexa and I barely had the willpower to get out of bed.
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> > It isn't so much the depression -- if it was depression alone, I could make some changes (maybe work, move out of home) which would help a lot; it's the relentless anxiety and OCD and agoraphobia which rule my life, and which I feel no reprieve from.
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> Depressed people commit suicide more often when anxiety or anger are present. Anxiety is an intergral part of OCD. It is often considered a type of anxiety disorder. You must be in a hellish state right now. You must be ruminating to the point of exhaustion. Do you feel the intense anxiety viscerally? Do you feel it in the pit of your stomach and experience heart palpitations? I experience these things when I am overwhelmed and are plagued by thoughts of inevitable doom. There seems to be a neurobiological substrate for the suicidal brain. Mine was created by a depressive rebound from discontinuing Viibryd (vilazodone) abruptly. It sure didn't feel biological, though. However, my doctor knew better. The beast will beguile you. I do not believe that your suicidal brain state will last for very long. However, you might need help to process your existential crisis - the thought content of which reflect real issues - until your suicidal state subsides.To be honest, I live in such a constant state of fear that I don't even ruminate anymore. It's like my mind is frozen and barely able to think due to having to remain in such a constant state of hypervigilance. Perhaps my unconscious goal is to suppress thought since it seems so threatening; I spend my days in a constant state of meaningless distraction .. sleeping, playing video games, watching TV. I worry for my cognitive function. I don't see how it is possible to construct a meaningful future -- based on intellectual pursuit -- when I have basically fallen off the face of the planet. The circumstances that triggered my suicidal state (a relationship ending, Memantine failing me, diminishing med options) don't leave me in a state of 'chemical withdrawal' which somehow feels temporary -- I genuinely believe that it is no longer possible to etch out a meaningful future with my current malfunctioning brain, and sometimes it feels very tempting to just admit valiant defeat and put an end to things rather than face further humiliation.
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> Try not to feed the beast.
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> Anyway, let today not be the day that you act irrevocably. You will get through this. You will be okay.It won't be today. I will at least attempt inpatient treatment, though unfortunately have to wait until the end of February to be admitted.
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> Are there any crisis services available to you? Please keep reaching out.
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Well, there are things like lifeline etc. but I find them a little condescending. My last psychologist just left his practice to enter research but has said I am free to call him in cases of emergency.Anyway, I really appreciate your support and guidance.
poster:g_g_g_unit
thread:1033817
URL: http://www.dr-bob.org/babble/20121217/msgs/1033965.html