Psycho-Babble Medication Thread 962166

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Re: suicidality exhaustion... » floatingbridge

Posted by linkadge on September 13, 2010, at 7:59:45

In reply to Re: suicidality exhaustion... » linkadge, posted by floatingbridge on September 13, 2010, at 4:25:55

I have suicidal urges all the time, but I'm not going to sit here and subject everybody to a constant commentary about how many times I've attempted suicide and try to wear it like some badge that tells everybody how bad I feel.

I don't fail at a lot of things. If I really wanted to commit suicide, I wouldn't fail.

Sure, I've though about half *ss killing myself, you know to try and show the doctor how bad I feel, but then I realize how pathetic that is, and how nobody likes the boy who cried wolf.

Linkadge

 

Re: suicidality exhaustion... » europerep

Posted by linkadge on September 13, 2010, at 8:34:14

In reply to Re: suicidality exhaustion..., posted by europerep on September 13, 2010, at 4:53:11

>I guess what Link wanted to say that he is >frustrated by people who only talk about it, or >who try it in a way that is destined to fail. on >that point, I am sort of torn.

The point I'm trying to make is:

a) with a failed suicide attempt you just end up damaging your body and brain more and making yourself more treatment resistant and sick.

b) you exhaust the support and compassion of family and friends, who eventually become desensitized to your threats. Eventually, people have a hard time caring about another "attempt".

I can think of a kazillion ways to succesfully kill oneself. I just don't really "buy" the notion that its such a hard thing to do if you really want to do it.


Linkadge

 

Re: suicidality exhaustion...

Posted by violette on September 13, 2010, at 11:17:16

In reply to Re: suicidality exhaustion... » floatingbridge, posted by linkadge on September 13, 2010, at 7:59:45

This might help with awareness of why some talk about suicide and some don't:

http://www.psychsystems.net/Publications/2006/13.%20psychodynamics%20of%20bpd_Bradley_dev%20and%20psychopathology%202006.pdf

I posted some stuff about this on the psychology board. People with long-standing MI have commanalities-usually low self-worth-that are expressed in different ways.

Somone with borderline might osciliate between states of feeling ok with themself and positive to extreme self-loathing and feelings of not wanting to 'exist'. Someone who is narcissistic would live in a state of false self-and be seperated, so out of touch with the inner pain, compensating with grandiousity...but when that defense breaks down, usually after loss, the inner pain is exposed--which is so shameful, they may not tell anyone about their suicical thoughts and commit suicide. Someone with OCPD traits is likely to have 2 self states-the inner world and the outer world everyone sees..they would be less likely to expose their inner world to anyone-because their self state is to do right, abide by morals, society standards...

There are different expressions of the same concepts, low self-worth, shame, ..core issues. I think it's difficult to imagine unless you are in another's shoes. It's really sad hearing of anyone's suicidal feelings, whether they internalize it or externalize it.

 

Re: BTW » morgan miller

Posted by johnj1 on September 13, 2010, at 12:32:24

In reply to Re: BTW, posted by morgan miller on September 12, 2010, at 23:09:41

Why do you care what I write? Don't YOU have better posts to make to? LOL

 

Re: suicidality exhaustion... » linkadge

Posted by floatingbridge on September 13, 2010, at 13:36:08

In reply to Re: suicidality exhaustion... » floatingbridge, posted by linkadge on September 13, 2010, at 7:59:45

I hear you Link. Thanks for explaining further.

I had a grandmother who would 'let' her children find her mid-act. They then were responsible for her rescue. As a child I didn't know this. I did dislike her intensely, and my mother, her daughter was a troubled, sad woman who never behaved that way with her children. My
grandmother burnt everyone around her. To this day I have yet to feel any true compassion for her, though I imagine her pain was enormous.

Then, on my husband's side, are the men with guns who disappear into a room or basement while alone and that's that.

Determination and/or drama
surrounding suicide aren't gender-specific, though stereotyped, I suppose.

I don't know who was burned worse. I suppose, well yes, my mother for living
with someone who dramatized her suicidal feelings and relied on others so
heavily in her scripting.

Then again, for the spouses and children
left dealing with blood and not a word of understanding from which to go
forward....

Being human is quite a task. I don't know how we do it.

 

Re: suicidality exhaustion...

Posted by linkadge on September 14, 2010, at 6:54:46

In reply to Re: suicidality exhaustion... » linkadge, posted by floatingbridge on September 13, 2010, at 13:36:08

>I had a grandmother who would 'let' her children >find her mid-act. They then were responsible for >her rescue. As a child I didn't know this.

Thats the kind of thing I don't understand. While some people say suicide is selfish, I don't think the act of suicide is intrinsically selfish. When people act in a way like this however, (making others feel bad so that you can feel better) to get attention, its pretty selfish.

Its putting your needs above everybody else. Sure, I know, the squeaky wheel gets the grease, but there are plenty of severely depressed patients that suffer. Doctors are going to give you the best treatment they can (hopefully) anyway. I don't know of any additional extra special measures they can implement for those have established themselves as "really sick".

Its not as if the doctor is going to pull out some magic, top secret treatment, that only the "really sick" patients get. "Now that you've attempted suicide, I can see that you are sick enough to warrant proclonifaxoft. I was just giving you placebos before, this one works every time.

Is it extra attention from family and friends; is it needed time off work? I don't get it. These things are available anyway. I think its necessary to build the kind of relationships that will last beyond the emergency efforts.

Its like the "balloon boy" incident. Sure, he got his 15 days of fame, now what?

Linkadge

 

Re: suicidality exhaustion... » linkadge

Posted by Dinah on September 14, 2010, at 8:20:54

In reply to Re: suicidality exhaustion..., posted by linkadge on September 14, 2010, at 6:54:46

I can understand and appreciate your feelings of frustration. Especially if you have been frightened repeatedly by suicidal behaviors.

But in my experience, it's difficult to determine another person's feelings or motivations from their actions or your feelings about their actions. For example, it's possible to feel manipulated even when the other person is not trying to manipulate you. Or it's possible that behaviors can look the same on the outside but have different feelings and motivations behind them.

While some people might consciously use threats of suicide as a way of seeking help, I don't think it can be generalized that all people who exhibit suicidal or parasuicidal behaviors are attempting to do so.

In some disorders, mood lability is an issue. A person might genuinely feel despair and have suicidal impulses that are difficult to resist. At the moment the person is experiencing the feelings, they feel absolutely real and are absolutely real. I would hope that over time a good therapist could help a client learn to recognize the warning signs, realize the impulses and obsessions as something that will pass, and learn skills to delay acting and hold on without suicidal gestures. It would be nice if medications could help control the lability. I *still* get those feelings and urges sometimes, and it's very difficult to hold onto the knowledge that I've felt that way before, and it will pass. I think a large part of my therapy was learning to think "I'm having suicidal thoughts and impulses" instead of "I want to kill myself." Externalizing it a bit. I'm not sure it's even a good thing to be quite so certain as I am. It's probably wiser to seek help. Well, I suppose I do tell my therapist...

Other people might indeed feel suicidal when they feel really really bad and want to be helped. However, that still doesn't make their behavior deliberate or conscious. DBT is a therapy that helps make those things conscious through a combination of validation of the client's feelings, while bringing awareness to their actions. But I'm pretty sure I read in the books on DBT that it isn't helpful to insist that the client is behaving manipulatively when they may not have any awareness of their motivations. I know I wouldn't be inclined to change if others insisted that I was feeling things and doing things that were not true to my experience. I'd likely feel resistant and defensive. On the other hand, if a therapist could bring me to see that my behaviors were not in my best interests in a *nonjudgmental* way, I might grow to an understanding of how my actions might be having a negative impact on my life and my relationships, what might be motivating my behaviors, and healthier ways to get help.

I'm sure there are other possibilities I haven't even considered for repeated suicidal behaviors. Just trying to recall some of my long ago readings on DBT. My apologies to Marsha Linehan for any errors in my recollections.

If you have an interest in the subject, I really recommend her book. DBT was developed for patients with suicidal and parasuicidal behaviors, though it has since been used for many other disorders. She's done a good deal of research on the topic.

"Cognitive-Behavioral Treatment of Borderline Personality Disorder"

 

Re: suicidality exhaustion...

Posted by Dinah on September 14, 2010, at 8:30:49

In reply to Re: suicidality exhaustion... » linkadge, posted by Dinah on September 14, 2010, at 8:20:54

I remember the worst period of my suicidal impulses. I'd been a wreck for a week or two, and acting out I suppose. I came closer to acting on my impulses than I ever want to come again, when I had a sudden moment of insight. I recognized that I hadn't felt so horrible before I'd started Wellbutrin. I suddenly realized it would be pretty awful if I did something very final because of a drug. The idea actually made me angry. Sure enough, the Wellbutrin had caused a hypomania of the very bad sort. I quit taking that, my new pdoc added a mood stabilizer to my SSRI, and my impulses decreased markedly.

 

Re: suicidality exhaustion...

Posted by SLS on September 14, 2010, at 8:39:36

In reply to Re: suicidality exhaustion... » linkadge, posted by Dinah on September 14, 2010, at 8:20:54

> In some disorders, mood lability is an issue. A person might genuinely feel despair and have suicidal impulses that are difficult to resist.

For some Axis II disorders that involve impaired impulse control and mood lability, Tegretol and Trileptal can be helpful. Zyprexa, too. These seem to work better when combined with psychotherapy such as CBT or DBT. If facilitated properly, even group CBT therapy can be effective.


- Scott

 

Re: suicidality exhaustion... » Dinah

Posted by SLS on September 14, 2010, at 8:41:19

In reply to Re: suicidality exhaustion..., posted by Dinah on September 14, 2010, at 8:30:49

> ...my new pdoc added a mood stabilizer to my SSRI, and my impulses decreased markedly.

Which mood stabilizer?


- Scott

 

Re: suicidality exhaustion... (Dinah?)

Posted by floatingbridge on September 14, 2010, at 10:51:23

In reply to Re: suicidality exhaustion... » Dinah, posted by SLS on September 14, 2010, at 8:41:19

> > ...my new pdoc added a mood stabilizer to my SSRI, and my impulses decreased markedly.
>
> Which mood stabilizer?
>
>
> - Scott

Yes, would you mind? Which stabilizer?

Thanks.

 

Re: suicidality exhaustion... » Dinah

Posted by floatingbridge on September 14, 2010, at 10:58:15

In reply to Re: suicidality exhaustion... » linkadge, posted by Dinah on September 14, 2010, at 8:20:54

Dinah, that was very helpful. Within that framework, how might one come to terms w/ behavior like my grandmother (mentioned in thread above). Sometimes, I was told, her attempts coincided with the time my uncle would be expected home after school.

Is this a zebra of a different stripe?

She's a real puzzle. I cannot find a way in.

 

Re: suicidality exhaustion... » linkadge

Posted by ed_uk2010 on September 14, 2010, at 13:50:41

In reply to Re: suicidality exhaustion..., posted by linkadge on September 14, 2010, at 6:54:46

>you are sick enough to warrant proclonifaxoft.

I like it!

 

Re: suicidality exhaustion... » SLS

Posted by Dinah on September 14, 2010, at 17:00:02

In reply to Re: suicidality exhaustion... » Dinah, posted by SLS on September 14, 2010, at 8:41:19

At the time it was Depakote. Eventually I went off the SSRI completely. While I appreciate what it did do, it also had some bad effects for me. I self injured on Luvox, which I never had done before and have rarely done since. I think I read somewhere in the tips section that SSRI's can be disinhibiting for self injury for some people. Or maybe there was some low level agitation that I wasn't aware of.

When I went off Luvox, I stayed on Depakote for migraine prophylaxis, then changed it to Lamictal, which has been good enough with less side effects (weight).

I guess different people respond differently to medication. SSRI's are supposed to reduce self injury and suicidal urges.

 

Re: suicidality exhaustion... » floatingbridge

Posted by Dinah on September 14, 2010, at 17:07:00

In reply to Re: suicidality exhaustion... » Dinah, posted by floatingbridge on September 14, 2010, at 10:58:15

From how you describe the timing, it sounds manipulative or angry. I'm sure that does happen at times. I just don't think it's necessarily true all the time.

I suppose it's possible that your uncle's return home from school triggered something in her. But, having a son myself, I find it very hard to understand.

I wish for your family's sake that medications and effective therapy had been available to her. That's an awful way to grow up.

 

Re: suicidality exhaustion... » SLS

Posted by Dinah on September 14, 2010, at 17:17:16

In reply to Re: suicidality exhaustion..., posted by SLS on September 14, 2010, at 8:39:36

> > In some disorders, mood lability is an issue. A person might genuinely feel despair and have suicidal impulses that are difficult to resist.
>
> For some Axis II disorders that involve impaired impulse control and mood lability, Tegretol and Trileptal can be helpful. Zyprexa, too. These seem to work better when combined with psychotherapy such as CBT or DBT. If facilitated properly, even group CBT therapy can be effective.
>
>
> - Scott

I'm not familiar with Tegretol or Trileptal, but I can definitely see why antipsychotics would help. I use Risperdal on occasion as needed to keep steadier than I might otherwise be. Bone deep calm without grogginess. For me anyway.

Therapy also definitely helps.

(I'm very lucky to have a pdoc who supports my as needed tweaking of meds to keep even.)

 

Re: suicidality exhaustion... » Dinah

Posted by SLS on September 14, 2010, at 17:18:15

In reply to Re: suicidality exhaustion... » floatingbridge, posted by Dinah on September 14, 2010, at 17:07:00

Thanks for replying, Dinah.


- Scott

 

Re: suicidality exhaustion... » Dinah

Posted by Maxime on September 14, 2010, at 17:50:48

In reply to Re: suicidality exhaustion... » SLS, posted by Dinah on September 14, 2010, at 17:17:16

I can't remember the stats, but more women attempt suicide than men. But men are more succesful at carrying it out because they usually use a more violent means (gun, hanging). Women take to take pills with alhohol.

 

Re: suicidality exhaustion...

Posted by linkadge on September 14, 2010, at 18:20:52

In reply to Re: suicidality exhaustion... » SLS, posted by Dinah on September 14, 2010, at 17:00:02

>SSRI's are supposed to reduce self injury and >suicidal urges.

Oh yeah, they're "supposed" to do a lot of things.

Linkadge

 

Re: suicidality exhaustion... » Maxime

Posted by linkadge on September 14, 2010, at 18:36:39

In reply to Re: suicidality exhaustion... » Dinah, posted by Maxime on September 14, 2010, at 17:50:48

I have read that statistic too. I tend to think it is because of sex differences in brain wiring.

Ever notice when women have a problem, men want to simply "fix" the problem, wheras women really want consolation? They want to talk about the problem, or to know that their husband loves them yadi yada (a stereotype I appologise).

When I think about my problems (I am male), I don't really care about the conscolation of family and friends. I don't want it. I think of my problems in terms of something that needs to be fixed. If I come to the conclusion that I cannot "fix" the problem, or that it cannot be fixed by medications, then I really don't really want to talk about it much at all.

Thats why CBT probably doesn't work for me. I don't want to talk about my problems unless you have something that will "fix" the situation. Suicide (but certainly not failed suicide) becomes the solution to the problem.

There are two possiblities as to why women fail more. Either a) they are not as good at men at devising lethal methods b) they don't really want to die. I am leaning towards the latter, simply because of the way women may derive more positive mood benefit from the attention of family and friends, whereas men don't want consolation, they want a solution.

I wouldn't be caught dead (an oxymoron I appologise :)), failing suicide. If I did, I would feel so much more utterly worthless.

Linkadge

 

Sorry, above post was not for Dinah - just general (nm)

Posted by Maxime on September 14, 2010, at 18:57:05

In reply to Re: suicidality exhaustion... » Dinah, posted by Maxime on September 14, 2010, at 17:50:48

 

Re: suicidality exhaustion...

Posted by Maxime on September 14, 2010, at 19:12:27

In reply to Re: suicidality exhaustion... » Maxime, posted by linkadge on September 14, 2010, at 18:36:39


> I wouldn't be caught dead (an oxymoron I appologise :)), failing suicide. If I did, I would feel so much more utterly worthless.
>
> Linkadge

I hear you! When I attempted in 2008 and I woke up from a coma and on a breathing machine my first thought was "oh f*ck, failed at something else."

 

Re: suicidality exhaustion... » linkadge

Posted by Deneb on September 14, 2010, at 20:10:25

In reply to Re: suicidality exhaustion... » Maxime, posted by linkadge on September 14, 2010, at 18:36:39

It's not in all countries that more men than women kill themselves. I think in rural China a lot more women succeed.

 

Re: suicidality exhaustion... » Deneb

Posted by Maxime on September 14, 2010, at 21:56:03

In reply to Re: suicidality exhaustion... » linkadge, posted by Deneb on September 14, 2010, at 20:10:25

You are right Deneb. And the method is not pretty. They often drink pesticide. China has one of the highest suicide rates in the WORLD.

 

Re: suicidality exhaustion... » Maxime

Posted by Deneb on September 15, 2010, at 0:25:22

In reply to Re: suicidality exhaustion... » Deneb, posted by Maxime on September 14, 2010, at 21:56:03

I watch a lot of period Chinese dramas now that my Mom watches Chinese TV all day and one thing I've noticed is that suicide is involved in most of them. It almost seems like suicide is a noble and courageous thing to do in that culture. Most suicide impulsively in those dramas. I wonder if people really were like that back during that time?


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