Posted by SLS on October 10, 2000, at 11:38:45
In reply to Re: It's my party and I'll die if I want to. , posted by coral on October 9, 2000, at 17:16:33
Hi Coral.
> > "....Suicidality is often an impulse to escape an intensification of pain and feelings of doom.
The pain and feelings of doom are either transient or treatable. Often, the same person gets suicidal episodically. Their "rational" decision-making processes seem to change with the changes in the severity of their illness. Do you feel it is rational to allow or encourage such an individual to successfully end their own life during such an episode?"> I think you're confusing "suicidality" with "suicide ideation."
I'm not sure I have. Without having used a dictionary, I have taken from context that there are semantic differences. In my mind, I consider suicidal ideation to be the formation of ideas about committing suicide and perhaps composing plans to do so. On the other hand, suicidality reflects a state of mind/brain within which there may be an impulse or drive to commit suicide, with or without previous ideation or forethought.
I believe that for many people, there is actually a neurophysiological substrate that actually produces suicidality. Some rather strong evidence for this involves an increased density of 5-HT2 receptors found in suicidal depressed patients as opposed to non-suicidal depressed patients. In addition, there are people for whom suicidality only appears in association with adverse psychiatric reactions to medication. The evolution of anxiety seems to be important here. People who have not had suicidal ideations prior to drug exposure can become suicidal within days.
This has happened to me more than once.
With or without a biological etiology, some depressed individuals become suicidal when feelings of hopelessness appear. This does not mean that their situation is hopeless. They just perceive or believe it to be. It may not be. If they can be shown otherwise, they may change their mind about committing suicide. The perception of hopelessness can be both a cause and result of depression. When it is the result of depression, this represents a skewing of perception by the depression. Their judgment becomes biased towards negativity, and is often not commensurate with the situation. Upon remission from depression, this same person may not regard the same situation as being negative at all. If this sort of thing does happen, how are we to judge when a person's desire to commit suicidal is reflective of the temporary changes in thinking produced by depression? After they are dead, they have very little chance of changing their mind should their depression remits.
This stuff is meant to be a caveat in those cases in which the sufferer of depression is acting out of impulse or unrealistic negative thinking that can be produced by the depression itself.
> Much of what we "thought" we knew about suicide has been debunked, such as those who talk about it, don't do it. We now know that's a myth. Also, it's not easy to commit suicide. Suicide normally requires a great deal of planning for successful execution (sorry.... no pun intended.)
> I, too, have been told by therapists, through researching, formal education and by my own personal therapist, that a depressed person's perceptions are more accurate than a non-depressed persons, in many instances.
I guess I have some homework to do. Any chance I can find this on the Internet? I guess my first question is, are there things in particular about which a depressed person's perceptions can be more accurate? The notion still seems bazarre to me. I really would like to learn something here.
> That's part of the difficulty in the role of the therapist, to ascertain which perceptions are accurate and which are distorted, due to the depression. Not surprising, the causes of the depression are almost always linked to accurate perceptions of the depressed person.
I'm not sure I feel comfortable with the term "almost always". Perhaps it is the chicken and egg thing. The perceptions we have of the world as adults are very much the product of our development as children. When children grow up in a dysfunctional or abusive environment, I don't think their perceptions as adults are the same as they would be had they been raised in a healthier environment. Perhaps it is the distorted constucts of the world formed in childhood that lead to adult depression as the individual tries to navigate the real world with the unhealthy perceptions that they formed when accurately perceiving their unhealthy childhood environment. However, as adults, their perceptions remain inaccurate.
Just some thoughts. No backup.
> Rather than being able to handle the situation, for whatever reason, the psyche/brain malfunction, resulting in depression.
> As far as "allow or encourage", I have interrupted someone's attempted suicide and would unhesitatingly do so again. No, I would not encourage someone to commit suicide.
> I think the point of this discussion is whether someone has the right to commit suicide, and whether it should be considered as a viable option. I also clearly recognize that it's a slippery slope once a society says "okay" to suicide. The worst case scenario being forced euthanasia.
> But, ultimately, the choice to live or die must rest with the individual.
I do not disagree. This is tough stuff.
Depression sucks. Pain sucks. I want both to stop for me right now. I want life to begin for me right now.
- Scott
poster:SLS
thread:42903
URL: http://www.dr-bob.org/babble/20000926/msgs/46064.html