Posted by simon levane on February 4, 2006, at 12:23:10
In reply to Re: Suicide on Effexor, posted by Devastated Mother on February 4, 2006, at 6:31:58
Dear D.M.
thanks for your post. I struggle to write about the unbelievable impact of loss. I know you understand this. Whereas your son was on a positive path in his life from what you wrote, and I feel your loss of the possibilities for him that he would have achieved, my daughter had been on a tragic path for many years due to her illness. We both feel the same horror of loss and the same feeling that we should have been able to save our children. For me, there is an agony that I did not truly understand her illness and that I could and should have, had I focused on this and researched it. I read a bit about it, but her diagnosis was vague with differing opinions by different doctors. I took a doctor who said she did not have BPD and was relieved at his diagnosis, but he was wrong. On top of this, she was so full of life and of her own energy, and so stubborn that I had truly withdrawn from exhaustion and an inability to know how to discipine her or keep her on a good track. I didn't know how to get her to stop her truancy from school as early as grade 7. We had truant officers coming to our house to get her to go to school, but even at that stage, the help was flawed. For all the support I tried to get, I just didn't have the right focus to help her. Close friends have told me that I was a good father, but I just don't believe that now. I was not a "good enough" father for her needs. Still, when I look at the confusion surrounding her care, and the utter failure to give her the real support and care she needed, and then the ultimate horror of a drug that very likely pushed her over the edge, I feel as if she was "stolen" from us due to this completely flippant and care-me-not attitude of the doctors. My close friends tell me that she and I would have found one another again. We had shared a lot of joy and laughter together, but her behaviours and my own ways of somehow trying to survive psychologically, conspired against us. It is hard to fathom all of this now and I see so much I could have done differently and better, but it is too late, so I live the pain of these thoughts of what I should have done against the harsh reality that I can do nothing anymore, and of the loss.. Missing her.. Missing who should was and who she could have been.
I wanted to die in a bed with her and her family as it could have been, there to see me go to the next life, not to be without her now and to suffer the agony for the rest of my life. It is just too heavy a punishment for my not being "a good enough" father.
And I know that there are others who suffer the same agony at the loss of their children, when it should not have happened, had the medical care been better.
SL> Dear Simon,
>
> "Had this expert just said to us both.. "if she feels suicidal, call your doctor and take her to the hospital, here are some things to be watchful about." This would have saved her life. And in DM's case, had she known something about effexor, she would have been in a position to have her son admitted due to the effects of that drug, and may have saved his life."
>
> You are absolutely correct in this. As a matter of fact, Simon, since I know you will understand let me tell you that his father and I were out of the country when he died, which we would never have done had we had a clue of what he was facing. Or we would at the very least have contacted someone in our families, any one of whom would have contacted him and talked with him and watched for this. As it was, none of us knew, and so no one made the special life-saving efforts that meant that he is gone.
>
> Simon, you are right, no one else can really understand, unless they have been there, how totally violated and abused by the medical profession one can feel. When we called to tell the doctor, all she wanted to know was what the "precipitating factor" was. No sympathy, no clues, no indication that she even recognized that she had played any role in this. It was not until much later that I investigated the drug and realized what had happened. We were all in such a state of shock, because my son had never exhibited any suicidal tendencies, and had no reason to do so. It hit us like a ton of bricks, and my life, my husband's life, his, brother and sister's lives, and all his cousins, aunts and uncles, grandmothers...everyone whose life he touched will never be the same. I have such a horrible lump in my throat writing this. I wish people would just stop saying how sorry they are. It is so irrelevant.
>
> > Dear DM and Racer,
> > sometimes the law really is an *ss.
> > the age of majority at which a patient has privacy rights is quite young in some jurisdictions. It is really hard to imagine sometimes that a child as young as 16 has the right of patient-doctor privilege. I found out after my daughter's death in her medical records that she had confided much of her clinical at-risk behaviours to a consulting expert psychiatrist who had diagnosed her with borderline personality disorder. He did not sit down with me and her mother and explain the full scale of her illness. Instead he told us the name of what it was, but neither of us really understood the implications. Some of the risk factors in her situation were as high as 50% chance of successful suicide within 5 years - for example, drug abuse. I had no idea that this risk factor existed. I only discovered this after her death.
> > The most horrific part of this for both myself and I believe for DM from what she has written, is that neither of us were advised of the actual potential risk of Effexor. I still remember that state of naiveness not imagining that a doctor could approve a drug for my daughter that "might" cause her to kill herself. Who could imagine anyone prescribing a drug like that without giving a clear caution. I sat in front of an expert telling me how this drug would help my daughter deal with obsessive compulsive disorder and general anxiety disorder. She did not even know about my daughter's drug abuse in past, nor have a clue that she was actually abusing ritalin and that this was a potential risk factor. She just asked my daughter if she was suicidal and of course my daughter said no,, and in that was telling the truth, but she didn't tell the doctor that she was abusing the ritalin. Had this expert just said to us both.. "if she feels suicidal, call your doctor and take her to the hospital, here are some things to be watchful about." This would have saved her life. And in DM's case, had she known something about effexor, she would have been in a position to have her son admitted due to the effects of that drug, and may have saved his life.
> > Now when one reads about good clinical practice in the case of patients at risk for suicidal behaviour, one of the key elements is "INVOLVING FAMILY".. There is a guide put out by the American Psychiatric Association on this, but you can imagine that most doctors don't even know it exists. The doctor patient confidentiality is superceded if a patient gives indication of harming others, or of harming self. But so many doctors won't risk breeching the confidentiality because of potential law suits, or as in the case of the doctors who gave "care" to my daughter, they just were either disinterested or plain simple ignorant. Not so dissimilar to DM's son's doctors.
> > Oh dear... there is a level at which one starts to not care about others because the worst thing that could happen has happened to self. It is a kind of reflection back of the fact that the very doctors who could have saved the life of one's own child, are just so insensitive to our loss, it hardly touches them. Tsk tsk .. too bad...
> > I have found more understanding from others who have suffered similar losses, and from some very decent caring people, than from most professionals whose greatest interest is themselves. Not one of my daughter's doctors sent even a note of sympathy or regret.
> > Now it is has become so clear that the evidence of risk was there, and one of these doctors could have saved our daughter's life by letting us be aware of the risk of this drug.
> > I rail at myself every day for not researching the drug as I should have done, but I was lulled into a false sense of security because I could not imagine anyone putting my child at such risk. For all the difficulties she presented and many years of upset at her behaviours, I never could imagine her taking her own life. I was actually thinking about the years ahead that I faced in trying to be a good father to her in spite of the difficulties. I felt worn out by her behaviours, but I was hopeful for the future. Sadly, a lot of people let us down. But at end, the parents are the ones who are left with the agony of loss, and it is terrible beyond any imagination or comprehension. If I tell someone who is urging me to "move forward" to imagine their own child's death - I can just see in their faces, that like myself before my daughter's death, they cannot bear to even think of this as a reality. Doctors should hear the pain of parents and keep that somewhere in the forefront of their thoughts in patient care to prevent this agony of a torture that is simply beyond comprehension.
> > SL
> >
> >
> > > "Or even just that doctors be required to give parents information about the risks of the drugs their children are taking."
> > >
> > > The new HIPA law does exactly the opposite. In the interest of maintaining privacy, unless children sign a release, doctors cannot talk with parents or anyone else. Depressed people are not likely to make the best decisions for themselves. My son, on the other hand, was not even asked, but even when asked, I am sure some would refuse having anyone in their family know.
> > >
> > > Frankly, while I admit that your idea is not a bad one, I am fairly jaded at this point about anyone or anything doing anything for anyone but themselves. I think politicians (responsible for HIPA) only care about the money and the power their position can give them; I think the same is true of doctors. So who would we get to make these changes? I am just not very hopeful for this world. How exactly would anyone get this to happen? No one really cares. It is very easy to say, but doing something about it....something else entirely.
> > >
> > > It doesn't matter, in my opinion, how old someone is--my son was 20, but he was still very much growing and developing. He was a college junior; college students are still in flux, no matter how old they are...
> > >
> > > Good idea. Implementation? How?
> > >
> > > DM
> > >
> > > > > Dear Racer...
> > > > > I really didn't answer your question better.
> > > > > I did find a very good guide that I wish I had had long ago...
> > > > > it is an excellent guide for parents with a child who may be suicidal.. or anyone for that matter..
> > > > >
> > > > > http://www.bcmentalhealthworks.ca/files/living_suicidal.html
> > > > >
> > > > > When I read this, I so wished that someone had given this to me before.. as it has so much excellent information. Hope it helps someone if you pass this on.
> > > > > SL
> > > > >
> > > >
> > > > And I think I wasn't all that clear in asking the question, either, so we're even on this. Let me try again, see if I get any clearer.
> > > >
> > > > I was wondering if you had come across any advocacy groups that were set up to that parents would be OFFERED that sort of resource as soon as a child was diagnosed or put on medication. Maybe a group trying to pass legislation that would require doctors' offices to give parents a list of local, national, and online resources that provided information about mental illness in children, and the benefits and risks of psychotropic medication for children. Or even just that doctors be required to give parents information about the risks of the drugs their children are taking.
> > > >
> > > > I'm not sure how old your daughter was, but if she was under 18, I am absolutely stunned that the doctor wouldn't communicate with you at all. That's terrible, since minor children are under a parent's guardianship. That just seems wrong -- her pediatrician would have told you about the risks of an antibiotic, right? Psychotropic medication should be held to the same standards as other drugs, except in very rare instances. (I'm thinking things like cases where the parent belongs to a religion that doesn't allow western doctors, or where a parent refuses to believe in depression, so creates roadblocks to that child getting help. That sort of thing, where the child's life is either in danger, or the child's quality of life is impaired, but the parent refuses to get help. And only if the child makes the move to do it -- I would NOT want to see the schools able to send kids to doctors without authorization from the parents. Basically the same sorts of things that apply to minor girls getting gynecological care without parental notification in some states.)
> > > >
> > > > After reading your story, as well as DM's, I just think that there should be some sort of requirement that doctors communicate risks of these drugs to parents, even if the DOCTOR him/herself does not believe that there is a risk in this case. Sort of like a black box saying "If prescribed for children under 18, risk information must be provided for parent or guardian." You know? And, frankly, since there's no way to undo the damage that has already occurred, it seemed as though you and DM might be very compelling for getting something changed, and working towards that might help a bit?
> > > >
> > > > Again, you have my deepest sympathy for your devasting loss, as does DM.
> > >
> > >
> >
> >
>
>
poster:simon levane
thread:601406
URL: http://www.dr-bob.org/babble/20060129/msgs/606276.html