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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 11 to 35 of 128. Go back in thread:
Posted by Maxime on September 12, 2010, at 21:59:12
In reply to suicidality exhaustion..., posted by linkadge on September 12, 2010, at 15:20:09
I was wondering if something happened over the past couple of days for you to make the original post. Did a friend attempt suicide? Did a friend talk about commiting suicide? Were you thinking about suicide?
It's just that you thread sort of came out of no where. But maybe there is something that is going on in your life that made you post. Also, you said that you would probably be banned for making the post. Are you trying to get banned? If you are there are better ways. You can ask to be banned for a couple of weeks in admin so that you can't post for a while. I've done that on other sites.
Anyhow, if you need to talk you can send me a Babble Mail.
Posted by morgan miller on September 12, 2010, at 23:09:41
In reply to Re: BTW, posted by johnj1 on September 12, 2010, at 19:56:36
> Do you know Link personally or just from the board?
Why do you care? Don't you have better posts to make than this? GAL bro.
Posted by floatingbridge on September 13, 2010, at 4:09:03
In reply to Re: BTW, posted by morgan miller on September 12, 2010, at 23:09:41
> > Do you know Link personally or just from the board?
>
> Why do you care? Don't you have better posts to make than this? GAL bro.Morgan, I don't understand this post. And what does GAL bro mean?
Posted by floatingbridge on September 13, 2010, at 4:25:55
In reply to suicidality exhaustion..., posted by linkadge on September 12, 2010, at 15:20:09
Link, the way I see it, you are fortunate to have MI but not suicidal urges, impulses, suicidal intrusive thoughts, and the sure belief that life has gone so wrong and irreparable that the only solution (the decision is by now a no brainer) is to destroy one of the world's creation. And why not? If one is deeply broken, wouldn't it best we remove ourselves from sight, created as differently as we were.
The suicides apologize for lifting their veils through speech. They meant no harm or to frightene you. Merely their pain had grown unbearable, which is quite great indeed considering they cannot put it down.
If you made the offer, my pain for your ignorance, who would consider themself winner?
Posted by europerep on September 13, 2010, at 4:53:11
In reply to Re: suicidality exhaustion... » linkadge, posted by floatingbridge on September 13, 2010, at 4:25:55
well, as it appears, there are three distinct groups:
- people who commit suicide
- people who attempt suicide
- people who talk about commiting suicidethis is not my personal impression, it's kind of a status quo in terms of suicide research.
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.
on the one hand, I do kind of understand that. there are so many ways to get help, talk to a psychologist, friends, etc., that might help to steer one in the right direction. it does sometimes make me mad, because these individuals -and I will be flamed for this- DO not know the degree of despair one feels when seriously, honestly considering suicide.
but, on the other hand, it is always an expression of personal despair, and I guess that is what it has to be taken for. even "moderate" suffering can make one want to express it in the strongest imaginable way.also, I think none of the posters who were hurt by his post here were people link was actually refering to, but they have the right to be offended nonetheless, of course.
Posted by floatingbridge on September 13, 2010, at 5:25:42
In reply to Re: suicidality exhaustion..., posted by europerep on September 13, 2010, at 4:53:11
Would it be possible to avoid some suspected posts? Then he had regained control and can again conserve energy.
With energy gained, check if PB places any language limits on suicide. This would be a moderator's job. Some very good groups do this
Posted by linkadge on September 13, 2010, at 7:49:38
In reply to Re: suicidality exhaustion..., posted by emmanuel98 on September 12, 2010, at 19:48:37
>It's not easy to commit suicide.
Its extremely simple if you really want to do it.
Linkadge
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
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
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:
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.
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
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.
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
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"
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.
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
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
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?
>
>
> - ScottYes, would you mind? Which stabilizer?
Thanks.
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.
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!
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.
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.
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.
>
>
> - ScottI'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.)
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
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.
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