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Dr. Bob is Robert Hsiung, MD,
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Posted by violette on September 17, 2010, at 11:01:45
In reply to Re: suicidality exhaustion... » floatingbridge, posted by linkadge on September 17, 2010, at 8:11:29
> But as mentioned, I realize that when people are in such a state, they're not thinking logically. They're not thinking through all the potential consequences.
That's what i was trying to explain in my last post, but didn't see your post here.
some people are overcome by emotions...where the 'rational' part of the brain sort of shuts down. Emotional dysregulation. Others are sort of trapped in the logic/rational part of the brain.
Just adding for general discussion, not to anyone here in particular...
Posted by floatingbridge on September 17, 2010, at 11:19:50
In reply to Re: suicidality exhaustion... » Maxime, posted by SLS on September 17, 2010, at 5:53:00
> Some researchers like J. J. Mann believe that there is actually a neurobiological substrate for feelings of suicidality that are not tied to thoughts. It is comprised of both genetic and epigenetic factors.What is epigenetic?
And if so, are therapies proposed?
Posted by floatingbridge on September 17, 2010, at 14:31:34
In reply to Re: suicidality exhaustion... » SLS, posted by Maxime on September 17, 2010, at 10:40:55
> That's interesting. I know that I have been suicidal and not depressed which is weird.
>
> I think about suicide a lot.Wherever I go I try to spot possible suicide options (tall building, construction, metro). I tired of seeing Montreal through my eyesThat is interesting Maxime. I cannot say I have felt suicidal in the absence of depression. (I cannot say I recall the absence of depression.) Very interesting.
Googling epigentics led to all sorts of things, notably a wiki entry on foster care and it's aftermath. Thought Violette would be interested.
Posted by SLS on September 17, 2010, at 14:54:46
In reply to Re: suicidality exhaustion..., posted by floatingbridge on September 17, 2010, at 11:19:50
>
> > Some researchers like J. J. Mann believe that there is actually a neurobiological substrate for feelings of suicidality that are not tied to thoughts. It is comprised of both genetic and epigenetic factors.
>
> What is epigenetic?Simply stated, it is anything arising from non-genetic factors. However, such things can interact with the organism to change gene activity.
> And if so, are therapies proposed?
Certainly. However, it depends on what you are treating. To help prevent the repetition of acts of suicide, cognitive therapies have been suggested. I guess pychotherapies must be as varied as the people needing help. I have seen interpersonal therapy, CBT, and DBT mentioned. It has been suggested that almost any kind of psychotherapy is helpful in reducing suicide attempts as many patients find hope in the expectation that what they are doing will bring them relief. In fact, a reduction in the rate of suicide attempts has been demonstrated to be similar with both antidepressant treatment and psychotherapies. At the NIMH, NIH, they noticed that people coming in for treatment often reported feeling better for the first two weeks regardless of treatment status.
- Scott
Posted by Maxime on September 17, 2010, at 21:25:45
In reply to Re: suicidality exhaustion... » emmanuel98, posted by linkadge on September 17, 2010, at 7:51:48
> >And so what is wrong with this? That you want to >die 90% but not 100%. Are you saying that >anything less than 100% is being a wimpy >pathetic loser? I don't know what your point is.
>
> No, I'm just saying that when you attempt suicide, generally either a) you die, or b) you end up hurting yourself really badly.
>
> So, then wouldn't it make more logical sense, to either do, or do not?
>
> Now of course, as I said, failing is better than succeeding, but I guess the point I'm trying to make is,
>
> If you're not 100% sure you want to die...DON'T ATTEMPT IT!!!
>
> Anything else, just doesn't make logical sense to me, since you open up the door to the possiblitiy of making your situation much much worse.
>
> Linkadge
>
>Nothing is fool proof. People shoot themselves in the head and they just end up blowing half their face off. They stand in front of a train and just end up losing their legs. They try to drown themselves and they end of brain dead. Just because a person doesn't succeed it doesn't mean that they didn't want to die
Posted by SLS on September 18, 2010, at 6:59:38
In reply to Re: suicidality exhaustion... TRIGGER, posted by Maxime on September 17, 2010, at 21:25:45
Maxime, I was thinking...
Is it possible that you are cognitively obsessed with the idea of suicide (either OCD or OCPD) rather than just feeling suicidal? Wouldn't there be an obsessive counterpart to your psyche, given your other conditions? Perhaps there is a cognitive aspect to your thoughts of suicide that is independent of depression.
- Scott
Posted by Maxime on September 18, 2010, at 10:08:10
In reply to Re: suicidality exhaustion... TRIGGER » Maxime, posted by SLS on September 18, 2010, at 6:59:38
> Maxime, I was thinking...
>
> Is it possible that you are cognitively obsessed with the idea of suicide (either OCD or OCPD) rather than just feeling suicidal? Wouldn't there be an obsessive counterpart to your psyche, given your other conditions? Perhaps there is a cognitive aspect to your thoughts of suicide that is independent of depression.
>
>
> - ScottOh yes, for sure. I told my psychiatrist that I think that my suicidal thinking is OCD. He looked at me blankly and said "no". Even though he said "no" I still believe that there is an OCD component. Although my suicidal ideas get much, much worse when I am depressed, or feelings hopelessness. I feel hopeless a lot of the time. Me against the world and the world is winning. Maybe I wouldn`t feel this way if I were more social and around people (just a small group) and not so alone. But I am not very fun to be around when I feel this way (hopeless, depressed). I have few friends and the ones I have are scattered around Canada, mainly in Alberta.
How would I get rid of the OCD component? Would that be through therapy?
Posted by SLS on September 18, 2010, at 10:38:29
In reply to Re: suicidality exhaustion... TRIGGER » SLS, posted by Maxime on September 18, 2010, at 10:08:10
> How would I get rid of the OCD component? Would that be through therapy?
Well, seeing that you have probably run the gamut of SSRIs without effect, I would move in the direction of psychotherapy. Perhaps OCPD?
- Scott
Posted by linkadge on September 18, 2010, at 11:23:24
In reply to Re: suicidality exhaustion... TRIGGER, posted by Maxime on September 17, 2010, at 21:25:45
>Nothing is fool proof. People shoot themselves >in the head and they just end up blowing half >their face off. They stand in front of a train >and just end up losing their legs. They try to >drown themselves and they end of brain dead.
I would never say any of these methods are fool proof.
Linkadge
Posted by Maxime on September 18, 2010, at 13:00:27
In reply to Re: suicidality exhaustion... TRIGGER » Maxime, posted by SLS on September 18, 2010, at 10:38:29
> > How would I get rid of the OCD component? Would that be through therapy?
>
> Well, seeing that you have probably run the gamut of SSRIs without effect, I would move in the direction of psychotherapy. Perhaps OCPD?
>
>
> - ScottYeah, I am tired of adding pills and more pills.
What's OCPD? I do need therapy so badly but I can't afford it. I am trying to find a place that works on a slidding fee scales and has dealt with people who have EDs.
Posted by floatingbridge on September 18, 2010, at 15:02:11
In reply to Re: suicidality exhaustion... TRIGGER » SLS, posted by Maxime on September 18, 2010, at 13:00:27
What is ocpd?
Maxie, I had thought similar to Scott's about ocd. Not just for you--for myself as well. My thoughts are often so repetitive that if I described them accurately, but in just the right way, someone would say ocd component. Perhaps why I receive relief from addition of an opoid as it is approved (I
believe ) as pharmaceutical therapy.When you wrote about Montreal, I had that flash.
Posted by Maxime on September 18, 2010, at 16:32:30
In reply to Re: suicidality exhaustion.... » Maxime, posted by floatingbridge on September 18, 2010, at 15:02:11
It's weird that I would tell my pdoc that I think my suicidal thoughts are OCD and that he didn't agree (although I don't think that all my thoughts are OCD.). Humph! I am going to talk to him about it the next time I see him. It's not that I want to take another med (i won't) but I like to get an idea of how to stop these thoughts. They are ever present and it's hard to make it through the day. It's exhausting. Every night I look through my stash of pills and it calms me knowing that they are there. There are enough to kill me if taken with some alcohol.
It's very interesting to think of suicidal thoughts as OCD. I hope other people post their thought on the matter.
Maxie
Posted by twinleaf on September 18, 2010, at 21:07:12
In reply to Suicidal thoughts a form of OCD » floatingbridge, posted by Maxime on September 18, 2010, at 16:32:30
I think that idea is very interesting. I think many people experience suicidal thoughts as somehow alien ideas that have taken up residence in their brains. I don't have them now, but when I did, I kept wondering why I had them. At first I had depressive symptoms without suicidal ideation, and then when I took Prozac I began having suicidal thoughts even though the depression was better. I've always thought that the Prozac did something to my brain to cause the suicidal thoughts. This is a little different from what you are saying, except that we are both saying that these thoughts are brain-based. They are not caused by a desire for attention, revenge, etc
Posted by Maxime on September 18, 2010, at 22:14:46
In reply to Re: Suicidal thoughts a form of OCD » Maxime, posted by twinleaf on September 18, 2010, at 21:07:12
Prozac and the other SSRIs can cause people do to be suicidal. Do you think that is what caused it?
Posted by Maxime on September 18, 2010, at 23:06:04
In reply to Re: suicidality exhaustion..., posted by linkadge on September 16, 2010, at 7:09:16
I don't think anyone is faking suicide or suicidal thoughts. I think when people get to a certain level of crisis that suicide seems like a good option. But they aren't faking anything.
Posted by twinleaf on September 18, 2010, at 23:25:40
In reply to Re: Suicidal thoughts a form of OCD » twinleaf, posted by Maxime on September 18, 2010, at 22:14:46
I do think Prozac caused them. I think Prozac has a warning about it for children, but I'm convinced it causes it in adults too. I guess the last thing the drug company wants is a warning in heavy black letters about suicidal thoughts in adults.
Posted by linkadge on September 19, 2010, at 7:22:39
In reply to Re: Suicidal thoughts and Prozac, posted by twinleaf on September 18, 2010, at 23:25:40
Theres probably some serotonin receptor which activates suicidality.
The brain has all sorts of *opposite* emotions. For me, suicidality is the opposite to being in love with life.
You know, that obsessive feeling where life is so magical and meaningful. Then the SSRI comes in and puts all that love to an abrupt halt. This might be part of the anti-OCD effect. The ability of the drugs to shut off the obsession with living.
Granted, that "obsession with life" can be very confusing and complex at times.
Kind of like being passionately in love with somebody. SSRIs are known to make people abruptly fall out of love with eachother; to cause that love obsession to quickly cease.
To truely not be obsessed with something, you have to hate it to a certain degree. This is what the SSRI does; comes in and makes you hate life to a certain degree. Granted, this can be a good thing, sometimes.
When I took SSRIs, it was like life had no depth, no deep value. All of a sudden, much of the magic was gone. I think the suicidality came in about the same time I could no longer feel that, just like I could no longer feel beauty in Beethoven.
It was a feeling of discust, I guess. Sure the drugs ultimately made me less sappy and emotional, but all of a sudden I was numb to being alive. It was that discusted, numb feeling that made me suicidal.
Like somebody coming in and tearing some beautiful artwork that you've spent a long time creating. It just makes you angry and bitter and callous.
The suicidality is almost like a protective coping mechanism kicking in. Its like "I can't feel anything, I don't care about life and I can take my life any time I please".
Same thing like with SSRIs and relationships "I don't feel love for you, I don't care about love and I can leave any time I please".
Boosting serotonin makes you feel that you are "in control". In control of your emotions, in control of your life.
I also think, that the suicidality comes in when control clashes with lack of control. Perhaps you feel trapped in a job (or other aspect of life), the SSRI tries to force your brain to reframe the situaion wherein you are in control. If that means using suicidality to feel in control, then so be it.
my 2 cents.
Linkadge
Posted by ed_uk2010 on September 19, 2010, at 7:59:47
In reply to Re: Suicidal thoughts and Prozac, posted by linkadge on September 19, 2010, at 7:22:39
Life never feels magical to me anymore. It feels quite flat and dull most of the time, but OK. I do feel like I must be missing out on something, probably a lot. No idea what to do.
> Theres probably some serotonin receptor which activates suicidality.
>
> The brain has all sorts of *opposite* emotions. For me, suicidality is the opposite to being in love with life.
>
> You know, that obsessive feeling where life is so magical and meaningful. Then the SSRI comes in and puts all that love to an abrupt halt. This might be part of the anti-OCD effect. The ability of the drugs to shut off the obsession with living.
>
> Granted, that "obsession with life" can be very confusing and complex at times.
>
> Kind of like being passionately in love with somebody. SSRIs are known to make people abruptly fall out of love with eachother; to cause that love obsession to quickly cease.
>
> To truely not be obsessed with something, you have to hate it to a certain degree. This is what the SSRI does; comes in and makes you hate life to a certain degree. Granted, this can be a good thing, sometimes.
>
> When I took SSRIs, it was like life had no depth, no deep value. All of a sudden, much of the magic was gone. I think the suicidality came in about the same time I could no longer feel that, just like I could no longer feel beauty in Beethoven.
>
> It was a feeling of discust, I guess. Sure the drugs ultimately made me less sappy and emotional, but all of a sudden I was numb to being alive. It was that discusted, numb feeling that made me suicidal.
>
> Like somebody coming in and tearing some beautiful artwork that you've spent a long time creating. It just makes you angry and bitter and callous.
>
> The suicidality is almost like a protective coping mechanism kicking in. Its like "I can't feel anything, I don't care about life and I can take my life any time I please".
>
> Same thing like with SSRIs and relationships "I don't feel love for you, I don't care about love and I can leave any time I please".
>
> Boosting serotonin makes you feel that you are "in control". In control of your emotions, in control of your life.
>
> I also think, that the suicidality comes in when control clashes with lack of control. Perhaps you feel trapped in a job (or other aspect of life), the SSRI tries to force your brain to reframe the situaion wherein you are in control. If that means using suicidality to feel in control, then so be it.
>
> my 2 cents.
>
> Linkadge
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Posted by twinleaf on September 19, 2010, at 9:50:11
In reply to Re: Suicidal thoughts and Prozac, posted by linkadge on September 19, 2010, at 7:22:39
You describe it so well. It's a terrible thing to have happen to anyone, especially someone in the prime of life who should be experiencing all of life's joys.
The things that happened to me within a few months of starting Prozac were (in addition to suicidal thoughts), an end to dreaming, loss of sexual desire and the loss of joy in life which you describe. I experienced less emotional pain, and both I and my doctor thought that meant the Prozac was working. I took various SSRIs for about eight years before I realized what a terrible effect they were having on me. It's been six years since I have taken them, and I am slowly returning to my pre-SSRI self. I think I'm about 90% of the way.
Posted by violette on September 19, 2010, at 11:10:45
In reply to Re: Suicidal thoughts and Prozac, posted by linkadge on September 19, 2010, at 7:22:39
Linkadge,
You just described the concepts of the psychodynamic view of an OCD personality; obsessions-compulsions are the means by which the mind prevents unacceptable emotions from entering consciousness....
The emotions disavowed are a source of inner conflict because they contrast with what the sense of self one created and strives to maintain....there is no outlet for the emotion because it conflicts with your conscious sense of self-so it becomes that loop of ocd behavior to prevent the disavowed emotion(s) from emerging into conscious....some people are highly ocd because for whatever reason, that's the coping mechanism they developed; others use a mix of defenses to include ocd.
There are 2 poles involved that represent 2 seperate 'sense of self'. The conscious, like all things, tries to maintain an equilibrium-but cannot do so because those disavowed emotions defy the ego/self one tries to maintain, or even the idealized self...
I have ocd personality traits too; in psychoanalytic therapy, when the unconscious conflict came to consciousness, the ocd behavior diminished..because unacceptable emotion(s) gets 'discharged'. When this happened to me, when the emotions that were the primary source of conflict emerged in my awareness, it was the scariest affect state I ever had so far...
Of course this brought about emotional pain-and new symptoms to contend with! And there probably are some other conflicts i still hold inside by using ocd behavior-but the primary one was discovered, and the ocd behavior reduced dramatically. The unacceptable emotions need slowly integrated into the conscious...and the other ones blocked out by other defenses-which eventually leads to mental equilibrium...
Just imo i think the emotions are already there before the seratonin in whatever way alters how the mind has habitually kept those emotions out of consciousness.
Seratonin has been associated with aggression-nothing conclusive as far as i know-but any type of aggression/extroverted expression of anger is usually an unacceptable emotion-often a source of conflict with those with ocd traits.
Posted by violette on September 19, 2010, at 12:07:46
In reply to Re: suicidality exhaustion... TRIGGER » SLS, posted by Maxime on September 18, 2010, at 10:08:10
Maxime,
My therapist said OCPD traits are among the highest he sees in patients...i don't know how common it is for a person to be pure ocpd, but this site has a good description of the inner world:
http://www.health.am/psy/more/ocpd_history_and_theoretical_perspective/
There's really not alot of material on this outside of books/private articles. Anyway, i think the defense mechanisms, as opposed to symptoms, are more useful in assessing personality traits. Chronic intellectualizing is usually the most obvious sign of ocpd traits, but most people have a mix of defenses, rather than pure ocpd; and often those with ocpd are unaware of all the defenses they use or much of the stuff described in the article anyway. Maybe your doctor has you pinned down as having other traits? Anyway, you can learn more about it and see what resonates. Hope it helps.
Posted by SLS on September 19, 2010, at 12:54:36
In reply to Re: suicidality exhaustion... TRIGGER, posted by violette on September 19, 2010, at 12:07:46
It might be helpful to approach the doctor using a term other than OCD, which probably does not apply and may confuse communication. OCPD might be more accurate and and allow the doctor to think of things outside of Axis I disorders.
- Scott
Posted by Dinah on September 19, 2010, at 12:57:47
In reply to Re: suicidality exhaustion... TRIGGER » SLS, posted by Maxime on September 18, 2010, at 13:00:27
OCPD is totally different from OCD. People with OCPD are rigid and perfectionistic, and have very high standards that they impose on themselves and others. They have high need for control. It is related to anxiety. OCPD is ego syntonic, while OCD is ego dystonic.
My husband was reading one of the books on OCD I had left around. He came to me all excited, saying "that's me!". It was the section on OCPD, not OCD. :)
http://en.wikipedia.org/wiki/Obsessive%E2%80%93compulsive_personality_disorder
Posted by violette on September 19, 2010, at 14:01:17
In reply to Re: suicidality exhaustion... TRIGGER » Maxime, posted by Dinah on September 19, 2010, at 12:57:47
> People with OCPD are rigid and perfectionistic, and have very high standards that they impose on themselves and others. They have high need for control. It is related to anxiety. OCPD is ego syntonic, while OCD is ego dystonic.
That's true, but the thing is-there is a continuum involved. Lots of people have OCPD traits, but don't meet that description, or maybe only in times of extreme stress involving lack of control (like when people get "adjustment disorder"). The link i posted has some detail about the inner object relations & self state of OCPD. Also, other traits can compensate or even hide OCPD traits which come out later in life-such as in a time of physical illness when there is little control. Most people do have an element of control over lots of situations in life-employment, marriage...sometimes OCPD only gets symptomatic when their is less control...but before it gets symptomatic, it can cause dysthmia and other symptoms.
I don't even know the proporation of psychiatrists who are psychodynamically trained. Just because the DSM 'list of criteria' for OCPD is not met, for example, doesn't mean someone doesn't have strong OCPD traits. In my case, psychiatrists did not look into psychological traits because i don't technicially 'meet the dsm criteria' for a PD....
And people are often not pure OCPD, pure avoidant, pure whatever...people often have a mix of psychological issues. Anyway, just saying, it's important to look beyond those lists/brief descriptions...but rather, material that describes the inner world....but not alot is available online. Most is in psychodynamic books.
Posted by floatingbridge on September 19, 2010, at 14:31:27
In reply to Re: suicidality exhaustion... TRIGGER » Maxime, posted by Dinah on September 19, 2010, at 12:57:47
>OCPD is ego syntonic, while OCD is ego dystonic.
Dinah, so ocpd activity (behaviors) maintains ego sense? Are they experienced as self-directed or willed?
Ocd disturbs ego sense? Does one feel acted upon?
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