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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 21 to 45 of 128. Go back in thread:
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.
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
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
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
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.
>
> LinkadgeI 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."
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.
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.
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?
Posted by maya3 on September 15, 2010, at 7:52:02
In reply to suicidality exhaustion..., posted by linkadge on September 12, 2010, at 15:20:09
In my view, no one attempts suicide for attention, knowing that such behavior will most likely result in either severe brain damage or death. Conditions such as depression or psychosis can lead to suicide as they involve emotional flooding and cognitive changes that bring about faulty perception and judgement. The act is often commited impulsively as a result of the biochemical changes mentioned above.
Posted by Dr. Bob on September 15, 2010, at 10:30:29
In reply to Re: suicidality exhaustion... » Maxime, posted by linkadge on September 14, 2010, at 18:36:39
> 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 wouldn't be caught dead ... failing suicide. If I did, I would feel so much more utterly worthless.I'm sorry you're feeling worthless. At the same time, I need to ask you not to post anything that could lead others to feel put down or to jump to conclusions about them.
But please don't take this personally, either, this doesn't mean I don't like you or think you're a bad person, and I'm sorry if this hurts you.
More information about posting policies and tips on alternative ways to express yourself, including a link to a nice post by Dinah on I-statements, are in the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
http://www.dr-bob.org/babble/faq.html#enforceFollow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above post, should of course themselves be civil.
Thanks,
Bob
Posted by floatingbridge on September 15, 2010, at 12:42:16
In reply to Re: suicidality exhaustion... » linkadge, posted by Deneb on September 14, 2010, at 20:10:25
> It's not in all countries that more men than women kill themselves. I think in rural China a lot more women succeed.
>
>Deneb, I didn't realize this.
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