![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 40 to 64 of 143. Go back in thread:
Posted by simon levane on January 31, 2006, at 15:41:27
In reply to Re: Suicide on Effexor, posted by Devastated Mother on January 31, 2006, at 13:07:00
> Simon,
>
> Your comments helped more than anything else could. Did you know of the notice on the insert (I don't know how long the note has been there, but from my perspective, it requires the doctor to at least ask the person if they can inform the patient's relatives, or friends, or someone with whom they have regular contact of the dangers of Effexor. My son had no real suicidal tendencies. He was just reasonably sad because of some difficulties he had had in months leading up to his death. I believe that, in addition to being given really dangerous medication, he was mis-diagnosed. But proving that .... yeah, well, I have so little respect left for doctors, especially hearing how they treated you and your daughter.
>
> --DMDear DM...
if I tell you the madness of it, you would hardly believe this is possible. When I took the prescription for Effexor to the pharmacist two days before my daughter's suicide, he asked me to delay till the next day so he could speak to the doctor about the high dosage. I went back the next day to get the drug not realizing it had ANY risk. The pharmacist told me that the doctor said it was OK.. so I left there feeling very very re-assured and glad that he had taken the trouble. I found out later that there was an existing caution for Effexor and that on that very day there had been an alert issued by Health Canada for the drug. When I asked my family doctor about this after my daughter's death, he simply told me that he did not read the monograph for every drug he prescribes. He was relying on the psychiatrist's recommendation as the validation, and the psychiatrist never told us anything EITHER!!!!
In all the years of my daugher's troubles, no one sat us down and gave us a clear understanding of the risks of her illness. I later learned that for comorbid factors such as drug abuse, the risk of suicide for patients like my daughter was 50%, and the risk for suicide without those factors was 10%..
I never knew that.. no one told me.. and I had this belief that she would never do such a thing. I still don't believe she intended this end, but that the drugs simply enabled her to act out her impulse not truly realizing it was a finality.
I still feel more guilty than anyone..SL
Posted by Devastated Mother on January 31, 2006, at 16:08:31
In reply to Re: Suicide on Effexor, posted by simon levane on January 31, 2006, at 15:41:27
> > Simon,
> >
> > Your comments helped more than anything else could. Did you know of the notice on the insert (I don't know how long the note has been there, but from my perspective, it requires the doctor to at least ask the person if they can inform the patient's relatives, or friends, or someone with whom they have regular contact of the dangers of Effexor. My son had no real suicidal tendencies. He was just reasonably sad because of some difficulties he had had in months leading up to his death. I believe that, in addition to being given really dangerous medication, he was mis-diagnosed. But proving that .... yeah, well, I have so little respect left for doctors, especially hearing how they treated you and your daughter.
> >
> > --DM
>
> Dear DM...
> if I tell you the madness of it, you would hardly believe this is possible. When I took the prescription for Effexor to the pharmacist two days before my daughter's suicide, he asked me to delay till the next day so he could speak to the doctor about the high dosage. I went back the next day to get the drug not realizing it had ANY risk. The pharmacist told me that the doctor said it was OK.. so I left there feeling very very re-assured and glad that he had taken the trouble. I found out later that there was an existing caution for Effexor and that on that very day there had been an alert issued by Health Canada for the drug. When I asked my family doctor about this after my daughter's death, he simply told me that he did not read the monograph for every drug he prescribes. He was relying on the psychiatrist's recommendation as the validation, and the psychiatrist never told us anything EITHER!!!!
> In all the years of my daugher's troubles, no one sat us down and gave us a clear understanding of the risks of her illness. I later learned that for comorbid factors such as drug abuse, the risk of suicide for patients like my daughter was 50%, and the risk for suicide without those factors was 10%..
> I never knew that.. no one told me.. and I had this belief that she would never do such a thing. I still don't believe she intended this end, but that the drugs simply enabled her to act out her impulse not truly realizing it was a finality.
> I still feel more guilty than anyone..
>
> SL
>Medical Boards should be told when doctors do not live up to the "do no harm" that they are sworn to uphold. Talking to a doctor is impossible for a lay person, since doctors always think they know more than we do. Medical Boards are their peers, and should at least investigate this. Even at this point, I do not think it is too late to make that report. I urge you to do so. Doctors should have to be answerable to someone when they do something that takes a life.
--dm
Posted by simon levane on January 31, 2006, at 16:43:07
In reply to Re: Suicide on Effexor, posted by Devastated Mother on January 31, 2006, at 16:08:31
> > > Simon,
> > >
> > > Your comments helped more than anything else could. Did you know of the notice on the insert (I don't know how long the note has been there, but from my perspective, it requires the doctor to at least ask the person if they can inform the patient's relatives, or friends, or someone with whom they have regular contact of the dangers of Effexor. My son had no real suicidal tendencies. He was just reasonably sad because of some difficulties he had had in months leading up to his death. I believe that, in addition to being given really dangerous medication, he was mis-diagnosed. But proving that .... yeah, well, I have so little respect left for doctors, especially hearing how they treated you and your daughter.
> > >
> > > --DM
> >
> > Dear DM...
> > if I tell you the madness of it, you would hardly believe this is possible. When I took the prescription for Effexor to the pharmacist two days before my daughter's suicide, he asked me to delay till the next day so he could speak to the doctor about the high dosage. I went back the next day to get the drug not realizing it had ANY risk. The pharmacist told me that the doctor said it was OK.. so I left there feeling very very re-assured and glad that he had taken the trouble. I found out later that there was an existing caution for Effexor and that on that very day there had been an alert issued by Health Canada for the drug. When I asked my family doctor about this after my daughter's death, he simply told me that he did not read the monograph for every drug he prescribes. He was relying on the psychiatrist's recommendation as the validation, and the psychiatrist never told us anything EITHER!!!!
> > In all the years of my daugher's troubles, no one sat us down and gave us a clear understanding of the risks of her illness. I later learned that for comorbid factors such as drug abuse, the risk of suicide for patients like my daughter was 50%, and the risk for suicide without those factors was 10%..
> > I never knew that.. no one told me.. and I had this belief that she would never do such a thing. I still don't believe she intended this end, but that the drugs simply enabled her to act out her impulse not truly realizing it was a finality.
> > I still feel more guilty than anyone..
> >
> > SL
> >
>
> Medical Boards should be told when doctors do not live up to the "do no harm" that they are sworn to uphold. Talking to a doctor is impossible for a lay person, since doctors always think they know more than we do. Medical Boards are their peers, and should at least investigate this. Even at this point, I do not think it is too late to make that report. I urge you to do so. Doctors should have to be answerable to someone when they do something that takes a life.
> --dmDear DM
the fact is that when there are a multiplicity of factors such as diagnosis of Borderline Personality Disorder, previous suicide attempts in history, known drug abuse, then the doctor is basically off the hook in a flash. The best we could do was have our complaint on his record. And in fairness, he was not the only doctor who failed, but his selfish attitude and his personal space of not wanting to deal with parents were not best for our daughter, but only suited his needs. I know from reading about best practices for patients with this disorder that working with parents is CRUCIAL to helping them. I was struggling with the manifestations of my daughter's illness frustrated that my bright and beautiful daughter could not somehow get her act together. I just did not see the depth of her pain because she was so "up" and could be demanding, and self-serving and somehow disregarded the feelings of others in how she acted to get what she wanted. What I didn't see was that she had actually become an addict. The behaviour was driven by her illness. It is not as if I was not seeing doctors for help, but the scale of her illness was not explained to me in a way that I really understood... and I am not uneducated, but this was so close to the skin and I was in the middle of it for many years. I needed help to help her.
If this last doctor or another doctor had just looked at the situation clinically, they should have been blowing whistles and alarms at the risk. Instead they either had limited information or were simply ignorant of the situation - in the way a doctor forgets about the patient when they put that file back on the shelf.. Out of sight, out of mind... but prescribing is a quick.. sure go ahead it's ok..
There have been cases of medical disasters causing the death of children -- two cases in Toronto about 15 or so years apart, and in both cases the lawyers for the institution and for the doctors or others who had clearly failed in their medical roles resisted admitting to this. One woman who lost her son because he was complaining of stomach aches and one of the residents was "sure" that it was psychosomatic because she couldn't diagnose what was wrong with him and even forced him to clean up his own vomit.. he died on the operating table when they finally realized he had a twisted bowel and had been telling the truth from day one. The mother fought for about 10 years till they finally admitted that the doctor was clearly at fault. She got an apology and her costs I believe as well as a settlement, but it was not the money... She fought for her son after his deat h so that this would not happen to other children. This happened in the most famous Children's Hospital in Canada, and the best hospital in spite of this.. Imagine.. ten years of fighting in the courts without the resources of a huge institution.
It is very difficult in cases of psychotrophic drugs to have a direct cause and effect. After all, "she was depressed, and depressed people kill themselves."..
There is a survivor advocacy group on Yahoo, (Canadian) that strives to educate both the public and professionals to help prevent suicides. OH, so tragically, suicide is the second cause of death of young people from 16 - 24, the first one being auto accidents.
I wish I had known so much when my daughter was alive, but the thought of her suicide was so horrific that I could not bear to think it was possible. If only I had dared to face this as a reality. I think for many parents taking that leap to facing the real possibility of it happening must be excruciatingly difficult. I could not face it when my daughter was alive. Now I face it every day, and I know from talking to other parents, that they could not imagine it happening. Not my child. How could they do this to us (as we are still alive and they are gone). When we ask "how could they do it to themselves?" the answer is that we should have been able to protect them.. but we failed.
that is how I feel.
SL
Posted by Devastated Mother on January 31, 2006, at 16:56:13
In reply to Re: Suicide on Effexor, posted by simon levane on January 31, 2006, at 16:43:07
> > > > Simon,
> > > >
> > > > Your comments helped more than anything else could. Did you know of the notice on the insert (I don't know how long the note has been there, but from my perspective, it requires the doctor to at least ask the person if they can inform the patient's relatives, or friends, or someone with whom they have regular contact of the dangers of Effexor. My son had no real suicidal tendencies. He was just reasonably sad because of some difficulties he had had in months leading up to his death. I believe that, in addition to being given really dangerous medication, he was mis-diagnosed. But proving that .... yeah, well, I have so little respect left for doctors, especially hearing how they treated you and your daughter.
> > > >
> > > > --DM
> > >
> > > Dear DM...
> > > if I tell you the madness of it, you would hardly believe this is possible. When I took the prescription for Effexor to the pharmacist two days before my daughter's suicide, he asked me to delay till the next day so he could speak to the doctor about the high dosage. I went back the next day to get the drug not realizing it had ANY risk. The pharmacist told me that the doctor said it was OK.. so I left there feeling very very re-assured and glad that he had taken the trouble. I found out later that there was an existing caution for Effexor and that on that very day there had been an alert issued by Health Canada for the drug. When I asked my family doctor about this after my daughter's death, he simply told me that he did not read the monograph for every drug he prescribes. He was relying on the psychiatrist's recommendation as the validation, and the psychiatrist never told us anything EITHER!!!!
> > > In all the years of my daugher's troubles, no one sat us down and gave us a clear understanding of the risks of her illness. I later learned that for comorbid factors such as drug abuse, the risk of suicide for patients like my daughter was 50%, and the risk for suicide without those factors was 10%..
> > > I never knew that.. no one told me.. and I had this belief that she would never do such a thing. I still don't believe she intended this end, but that the drugs simply enabled her to act out her impulse not truly realizing it was a finality.
> > > I still feel more guilty than anyone..
> > >
> > > SL
> > >
> >
> > Medical Boards should be told when doctors do not live up to the "do no harm" that they are sworn to uphold. Talking to a doctor is impossible for a lay person, since doctors always think they know more than we do. Medical Boards are their peers, and should at least investigate this. Even at this point, I do not think it is too late to make that report. I urge you to do so. Doctors should have to be answerable to someone when they do something that takes a life.
> > --dm
>
> Dear DM
> the fact is that when there are a multiplicity of factors such as diagnosis of Borderline Personality Disorder, previous suicide attempts in history, known drug abuse, then the doctor is basically off the hook in a flash. The best we could do was have our complaint on his record. And in fairness, he was not the only doctor who failed, but his selfish attitude and his personal space of not wanting to deal with parents were not best for our daughter, but only suited his needs. I know from reading about best practices for patients with this disorder that working with parents is CRUCIAL to helping them. I was struggling with the manifestations of my daughter's illness frustrated that my bright and beautiful daughter could not somehow get her act together. I just did not see the depth of her pain because she was so "up" and could be demanding, and self-serving and somehow disregarded the feelings of others in how she acted to get what she wanted. What I didn't see was that she had actually become an addict. The behaviour was driven by her illness. It is not as if I was not seeing doctors for help, but the scale of her illness was not explained to me in a way that I really understood... and I am not uneducated, but this was so close to the skin and I was in the middle of it for many years. I needed help to help her.
> If this last doctor or another doctor had just looked at the situation clinically, they should have been blowing whistles and alarms at the risk. Instead they either had limited information or were simply ignorant of the situation - in the way a doctor forgets about the patient when they put that file back on the shelf.. Out of sight, out of mind... but prescribing is a quick.. sure go ahead it's ok..
> There have been cases of medical disasters causing the death of children -- two cases in Toronto about 15 or so years apart, and in both cases the lawyers for the institution and for the doctors or others who had clearly failed in their medical roles resisted admitting to this. One woman who lost her son because he was complaining of stomach aches and one of the residents was "sure" that it was psychosomatic because she couldn't diagnose what was wrong with him and even forced him to clean up his own vomit.. he died on the operating table when they finally realized he had a twisted bowel and had been telling the truth from day one. The mother fought for about 10 years till they finally admitted that the doctor was clearly at fault. She got an apology and her costs I believe as well as a settlement, but it was not the money... She fought for her son after his deat h so that this would not happen to other children. This happened in the most famous Children's Hospital in Canada, and the best hospital in spite of this.. Imagine.. ten years of fighting in the courts without the resources of a huge institution.
> It is very difficult in cases of psychotrophic drugs to have a direct cause and effect. After all, "she was depressed, and depressed people kill themselves."..
> There is a survivor advocacy group on Yahoo, (Canadian) that strives to educate both the public and professionals to help prevent suicides. OH, so tragically, suicide is the second cause of death of young people from 16 - 24, the first one being auto accidents.
> I wish I had known so much when my daughter was alive, but the thought of her suicide was so horrific that I could not bear to think it was possible. If only I had dared to face this as a reality. I think for many parents taking that leap to facing the real possibility of it happening must be excruciatingly difficult. I could not face it when my daughter was alive. Now I face it every day, and I know from talking to other parents, that they could not imagine it happening. Not my child. How could they do this to us (as we are still alive and they are gone). When we ask "how could they do it to themselves?" the answer is that we should have been able to protect them.. but we failed.
> that is how I feel.
> SLAnd I, dear friend in pain. My son had had no prior attempts, and had no real reason in his life for this. He had no underlying anything that would have led us to expect this. I suppose no one ever does. It is indeed very hard to know that we were not able to protect them, especially from these ignorant physicians who took them from us.
Posted by fenix on February 2, 2006, at 7:09:22
In reply to Re: Suicide on Effexor » Devastated Mother, posted by simon levane on January 31, 2006, at 8:52:20
Dear god, I am so sorry for what has happened to you. I have read so many stories of these things happening and that is why I dislike those drugs so much.
It has been shown numerous times in studies that these drugs can cause akathisia, which can drive someone to do very horrible things, like suicide. Many drug companies purposely kept secret these findings of akathisia for a very long time.
There is something you can do, you can fight back at those *ssholes and sue them for wrongful death because akathisia was probably the reason of the suicide.
Again, I am so sorry of that tradegy, I am actually suffering from a form of akathisia known as Tardive Akathisia, it lasts for a very very very long time, and the pain is so agonizing.
Damnit, another life destroyed by these medicines.
These drugs sometimes save people, but at what cost? Something is very wrong here with this world.
Posted by simon levane on February 2, 2006, at 13:21:30
In reply to Re: Suicide on Effexor, posted by fenix on February 2, 2006, at 7:09:22
The bigger problem, I think, is how poorly doctors inform family members.
It seems so easy to prescribe with ignorance of risk, or to minimize risk - as if the parents of a child with a peanut butter allergy or who had severe asthma were not informed of the risk.
This would be malpractice. But in the case of mental illness it is so much easier to blame the patient.. after all, they were depressed, and depressed people kill themselves.
after all, they were sick and sick people die...
doctors not being smarter about a very difficult illness...
at end, parents and family members are punished for not understanding illness, or being helpless to help their loved ones.
DM's son was a bright star with so many accomplishments, and yet he was lost because somehow the help he needed was not adequate in spite of his loving family, and in my case, a troubled child, but doctors not smart enough to enable us to help her better.
at end, the loss is on the heads of parents and family members. it is unimaginably painful..
S.L.
> Dear god, I am so sorry for what has happened to you. I have read so many stories of these things happening and that is why I dislike those drugs so much.
>
> It has been shown numerous times in studies that these drugs can cause akathisia, which can drive someone to do very horrible things, like suicide. Many drug companies purposely kept secret these findings of akathisia for a very long time.
>
> There is something you can do, you can fight back at those *ssholes and sue them for wrongful death because akathisia was probably the reason of the suicide.
>
> Again, I am so sorry of that tradegy, I am actually suffering from a form of akathisia known as Tardive Akathisia, it lasts for a very very very long time, and the pain is so agonizing.
>
> Damnit, another life destroyed by these medicines.
> These drugs sometimes save people, but at what cost? Something is very wrong here with this world.
>
>
Posted by Devastated Mother on February 2, 2006, at 14:00:14
In reply to Re: Suicide on Effexor, posted by simon levane on February 2, 2006, at 13:21:30
Retrospect is so frustrating. If I could turn back time...I would change this by demanding of the doctor that she tell me what the potential side effects were...oh, no, because I couldn't because of that stupid HIBA law. (not sure how to spell it) they always quote, that prevents sharing with family--who then is to blame, if the drug company says people should be informed and the doctor doesn't bother, and uses this HBIA privacy law to excuse it?
Legitimate and miserable depression ensues...
Posted by simon levane on February 2, 2006, at 16:05:16
In reply to Re: Suicide on Effexor, posted by Devastated Mother on February 2, 2006, at 14:00:14
Dear D.M.
I know where you are at.. I really do.
I feel empty and lost without my daughter - troubled as she was, she was a joy but not believing this could happen, I felt that I could be upset at her, not understanding the true scale of her illness, I reacted. Friends have told me that she and I would have come through the troubles because I loved her and she loved me, but I could not have imagined this terrible outcome. I know your son loved being in your family and from what you have written, my goodness, he sounded like such an accomplished young man with so much potential. I also know he would not want you to suffer, and he would not want you to be in any pain. I know that is also true of my daughter, though I know how hard it is to find that truth of our children's care for us against the reality of their deaths.
I sometimes write this, though it is hard to really experience it beyond the pain, but our children just would not want us to suffer. I do feel angry at the truly incompetent medical care and I do understand how you feel about those forms. My daughter would have been happy to have us see her doctor, but the fool just did not like dealing with parents. What a jerk!!
All we can do now is try to get across the importance of sharing information with family members. There are exceptions to confidentiality and one of them is risk. Risk to patient and risk to others. And what could be more horrible than the pain we now suffer?
Take care,
SL
> Retrospect is so frustrating. If I could turn back time...I would change this by demanding of the doctor that she tell me what the potential side effects were...oh, no, because I couldn't because of that stupid HIBA law. (not sure how to spell it) they always quote, that prevents sharing with family--who then is to blame, if the drug company says people should be informed and the doctor doesn't bother, and uses this HBIA privacy law to excuse it?
>
> Legitimate and miserable depression ensues...
Posted by Racer on February 2, 2006, at 20:14:23
In reply to Re: Suicide on Effexor, posted by simon levane on February 2, 2006, at 16:05:16
I am so sorry about your daughter. Reading this thread was heartwrenching, and you both have my deepest sympathy.
In the course of your searching for support, have either of you found any organizations that try to tell parents and other loved ones about this sort of thing BEFORE it happens? Or that try to find ways of reaching out to parents as soon as they start getting help for a child? I know that there are organizations that exist if someone looks for them, but I'm not aware of any that try to encourage parents to seek that information?
Again, I'm sorry -- and I'm also sorry to break in asking for information. Thank you.
Posted by simon levane on February 3, 2006, at 8:45:57
In reply to Re: Suicide on Effexor » simon levane, posted by Racer on February 2, 2006, at 20:14:23
Racer..
Both DM and myself did try to get help for our children. DM's postings tell how hard they tried to get help for their son. I also tried, this was extensive.. psychiatric ward of major children's hospital, centre for troubled youth with family counselling, parent support groups, consulting psychiatrists. My ex-wife and I had our daughter in a secure youth facility for two weeks when she was totally out of control. There were periods when she was going to school regularly, but the trouble is that neither her mother nor I really understood her illness and it was not very well explained to us. We also had contradictory diagnoses by different doctors and not very good advise on how to help her. She lived with me, so I was at the very "front lines" of coping with her behaviour and after so many years, I had fallen into a state of frustration and upset. I have read of other parents coming to this kind of situation.
Her care in terms of a concerted committed effort by professionals to help and to intervene was not very good. Her family doctor who should have been monitoring her overall health situation, was simply IGNORANT of the drugs he was prescribing her and did not recognize the warning signs that I was telling him about, and I was looking to him to advise and guide, but he simply was ignorant of her condition. The psychiatrists she saw were uniformly useless.
I now live in the anguish of regret that I did not research her illness as I should have done, but seeing these professionals in high places, I just took their advice and their lack of concern of risk as being reality. The actual reality is that she was at a very very high risk, and the drug she was on had a risk factor, but no one told us.
It really comes down to education and to some reasonable standards of medical practice.
My view of the psychiatric profession as I now see it is very low. There are smart doctors out there who understand the urgency of care for troubled youth and understand specific risks and how to keep kids safe, but unfortunately there are so many professionals out there who are really ignorant and who take prescribing drugs - psychiatric drugs, very very lightly..
It is a well known fact that Ritalin is over-prescribed, and in the tragic case of my daughter, I actually refused to let her have this drug at first, but felt over-ridden by all these qualified doctors. In hindsight, I was right to have expressed concern and she should never have been allowed to have that drug. It was a major contributor to destroying her.
The bottom line is that more education is needed for professionals and for parents in awareness of suicide risk and of better patient care. My daughter would be alive now if her doctors had not be so lackadaisical in her care.> I am so sorry about your daughter. Reading this thread was heartwrenching, and you both have my deepest sympathy.
>
> In the course of your searching for support, have either of you found any organizations that try to tell parents and other loved ones about this sort of thing BEFORE it happens? Or that try to find ways of reaching out to parents as soon as they start getting help for a child? I know that there are organizations that exist if someone looks for them, but I'm not aware of any that try to encourage parents to seek that information?
>
> Again, I'm sorry -- and I'm also sorry to break in asking for information. Thank you.
Posted by Devastated Mother on February 3, 2006, at 14:35:08
In reply to Re: Suicide on Effexor, posted by simon levane on February 3, 2006, at 8:45:57
Racer,
I must agree with Simon. While we did not have the extensive issues with our son he did with his daughter, we both experienced absolutely incompetent psychiatric care for our children. The helpless feeling of knowing that you did not do all that could have been done (regardless of the fact that you did not know what to do at the time) is an unbearable burden. A parent's job is to protect his/her child. To have a child who should have lived die due to reckless endangerment of medical ineptitude is so painful, I assure you, you have absolutely no idea. And to think of some group helping at this point...education needs to happen first in Medical School, and it obviously is not.
Still Devastated Mother
Racer..
> Both DM and myself did try to get help for our children. DM's postings tell how hard they tried to get help for their son. I also tried, this was extensive.. psychiatric ward of major children's hospital, centre for troubled youth with family counselling, parent support groups, consulting psychiatrists. My ex-wife and I had our daughter in a secure youth facility for two weeks when she was totally out of control. There were periods when she was going to school regularly, but the trouble is that neither her mother nor I really understood her illness and it was not very well explained to us. We also had contradictory diagnoses by different doctors and not very good advise on how to help her. She lived with me, so I was at the very "front lines" of coping with her behaviour and after so many years, I had fallen into a state of frustration and upset. I have read of other parents coming to this kind of situation.
> Her care in terms of a concerted committed effort by professionals to help and to intervene was not very good. Her family doctor who should have been monitoring her overall health situation, was simply IGNORANT of the drugs he was prescribing her and did not recognize the warning signs that I was telling him about, and I was looking to him to advise and guide, but he simply was ignorant of her condition. The psychiatrists she saw were uniformly useless.
> I now live in the anguish of regret that I did not research her illness as I should have done, but seeing these professionals in high places, I just took their advice and their lack of concern of risk as being reality. The actual reality is that she was at a very very high risk, and the drug she was on had a risk factor, but no one told us.
> It really comes down to education and to some reasonable standards of medical practice.
> My view of the psychiatric profession as I now see it is very low. There are smart doctors out there who understand the urgency of care for troubled youth and understand specific risks and how to keep kids safe, but unfortunately there are so many professionals out there who are really ignorant and who take prescribing drugs - psychiatric drugs, very very lightly..
> It is a well known fact that Ritalin is over-prescribed, and in the tragic case of my daughter, I actually refused to let her have this drug at first, but felt over-ridden by all these qualified doctors. In hindsight, I was right to have expressed concern and she should never have been allowed to have that drug. It was a major contributor to destroying her.
> The bottom line is that more education is needed for professionals and for parents in awareness of suicide risk and of better patient care. My daughter would be alive now if her doctors had not be so lackadaisical in her care.
>
> > I am so sorry about your daughter. Reading this thread was heartwrenching, and you both have my deepest sympathy.
> >
> > In the course of your searching for support, have either of you found any organizations that try to tell parents and other loved ones about this sort of thing BEFORE it happens? Or that try to find ways of reaching out to parents as soon as they start getting help for a child? I know that there are organizations that exist if someone looks for them, but I'm not aware of any that try to encourage parents to seek that information?
> >
> > Again, I'm sorry -- and I'm also sorry to break in asking for information. Thank you.
>
>
Posted by simon levane on February 3, 2006, at 16:14:39
In reply to Re: Suicide on Effexor » simon levane, posted by Racer on February 2, 2006, at 20:14:23
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> I am so sorry about your daughter. Reading this thread was heartwrenching, and you both have my deepest sympathy.
>
> In the course of your searching for support, have either of you found any organizations that try to tell parents and other loved ones about this sort of thing BEFORE it happens? Or that try to find ways of reaching out to parents as soon as they start getting help for a child? I know that there are organizations that exist if someone looks for them, but I'm not aware of any that try to encourage parents to seek that information?
>
> Again, I'm sorry -- and I'm also sorry to break in asking for information. Thank you.
Posted by Racer on February 3, 2006, at 19:45:39
In reply to Re: Suicide on Effexor, posted by simon levane on February 3, 2006, at 16:14:39
> 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.
Posted by Devastated Mother on February 3, 2006, at 21:40:52
In reply to Re: Suicide on Effexor » simon levane, posted by Racer on February 3, 2006, at 19:45:39
"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.
Posted by Dr. Bob on February 3, 2006, at 22:24:09
In reply to Re: Suicide on Effexor, posted by Devastated Mother on February 3, 2006, at 21:40:52
> The new HIPA law does exactly the opposite...
Sorry to interrupt, but I'd like to redirect follow-ups regarding the new HIPA law to Psycho-Babble Social. Here's a link:
http://www.dr-bob.org/babble/social/20060203/msgs/606122.html
Thanks,
Bob
Posted by simon levane on February 3, 2006, at 22:40:46
In reply to Re: Suicide on Effexor, posted by Devastated Mother on February 3, 2006, at 21:40:52
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.
>
>
Posted by Devastated Mother on February 4, 2006, at 6:31:58
In reply to Re: Suicide on Effexor, posted by simon levane on February 3, 2006, at 22:40:46
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.
> >
> >
>
>
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.
> > >
> > >
> >
> >
>
>
Posted by Devastated Mother on February 5, 2006, at 9:46:01
In reply to Re: Suicide on Effexor, posted by simon levane on February 4, 2006, at 12:23:10
"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"
This part of the comment you made was particularly meaningful to me, as it absolutely states exactly how I feel. I am sure your daughter would have grown into a wonderful young woman, as much as I am sure my son would have been a terrific adult, father, uncle, brother...
On the other hand, every time I say the Lord's Prayer, I think of Al, a friend of ours who on his deathbed in his dying gift to his young children (I think they were 6 and 11), shared the meaning of this prayer. We are none of us promised long life, and the knowledge that our children shared unspeakable pain gives me hope that they were welcomed into His house with rejoicing. This alone sustains me and allows me to continue living, else I would have to die, taking the good doc with me. I am also blessed to be a teacher and I minister to His other children every day of my life, and will continue to do so for as long as He sees fit to leave me on this good earth. The teens of all sorts that I watch every year grow and change into adults are the reason I know that yours and mine could have become comfortable adults, given the chance.
My daughter, at his funeral, asked during the service if she could sing for her brother (we had not planned this as part of the service). She said she didn't mean in church, but by the grave. I told her to just bring a song book and it would be fine, and asked what she wanted to sing. Together she and I sang "You are Mine". Nothing in my life has touched me more, and it gives me peace today knowing that for that brief time, she and I together recognized God's power over us all.
So, does this help? At times...at times all of it does. And at times nothing does. At times screaming and tearing my hair out would help.
Still devastated mother....
Posted by simon levane on February 6, 2006, at 9:35:28
In reply to Re: Suicide on Effexor, posted by Devastated Mother on February 5, 2006, at 9:46:01
Dear Still Devastated Mother,
Thank you for your kind thoughts and sharing of your own experience. You are so lucky to have other children, though I know this does not ease the pain, but at least it gives you reason to go on and your teaching of other children gives you that opportunity to make a difference in their lives. Unfortunately, my daughter did not have enough teachers who cared enough about her to help her. One mentor teacher could have made so much difference.. In elementary school she did have a wonderful librarian teacher who was able to motivate her, but at that time we did not see the long range risks.
Each of us can make so big a difference in the lives of others, but sometimes, so many just do not take that opportunity or do injury by their limitations.
They say "it takes a village to raise a child" and sadly in our case, we were just too isolated and alone.
again.. thanks for your comments...
I just received a request on the survivor advocate group in Canada from some health care specialists working on how to improve the whole issue of patient-doctor confidentiality in the case of patients at risk from suicide, involvement of families and proper sharing of relevant information. Perhaps there will be changes, but oh dear, in this modern age .. too late for my daughter.. too late for me..
Simon> "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"
>
> This part of the comment you made was particularly meaningful to me, as it absolutely states exactly how I feel. I am sure your daughter would have grown into a wonderful young woman, as much as I am sure my son would have been a terrific adult, father, uncle, brother...
>
> On the other hand, every time I say the Lord's Prayer, I think of Al, a friend of ours who on his deathbed in his dying gift to his young children (I think they were 6 and 11), shared the meaning of this prayer. We are none of us promised long life, and the knowledge that our children shared unspeakable pain gives me hope that they were welcomed into His house with rejoicing. This alone sustains me and allows me to continue living, else I would have to die, taking the good doc with me. I am also blessed to be a teacher and I minister to His other children every day of my life, and will continue to do so for as long as He sees fit to leave me on this good earth. The teens of all sorts that I watch every year grow and change into adults are the reason I know that yours and mine could have become comfortable adults, given the chance.
>
> My daughter, at his funeral, asked during the service if she could sing for her brother (we had not planned this as part of the service). She said she didn't mean in church, but by the grave. I told her to just bring a song book and it would be fine, and asked what she wanted to sing. Together she and I sang "You are Mine". Nothing in my life has touched me more, and it gives me peace today knowing that for that brief time, she and I together recognized God's power over us all.
>
> So, does this help? At times...at times all of it does. And at times nothing does. At times screaming and tearing my hair out would help.
>
> Still devastated mother....
Posted by Devastated Mother on February 6, 2006, at 9:44:43
In reply to Re: Suicide on Effexor, posted by simon levane on February 6, 2006, at 9:35:28
Simon,
And too late for my son, but in their memories, we must fight this fight to help others not go through this gut-wrenching pain.
I have good and bad days, like you. I agree that having other children has helped, but I feel a hole in my life that nothing can ever fill. It feels like I have lost an arm, or leg, or my heart. Children are all different, and he was not his brother or his sister. I miss him desperately, most minutes of every day, actually. I function because life demands it of me. But I wonder if I will ever truly be joyful again.
I hope you find some solace in this organization. If there is anything I can do to help, please let me know.
DM
Posted by simon levane on February 8, 2006, at 21:32:45
In reply to Re: Suicide on Effexor, posted by Devastated Mother on February 6, 2006, at 9:44:43
> Speaking to you here has helped D.M.
they say that time helps to ease the day to day pain, though it never ever goes away.. Someone told me that it scars over for a time, but never truly heals. It is a horror to realize that.
I wish I had had other children. Thinking in the way we think of things that perhaps it could have prevented the tragedy that a sibling might have helped and realizing that it might have made no difference at all, knowing that it often makes no difference when children are unwell and the help is incompetent.
Our link is at this post it seems. Perhaps we might find way to keep touch by e-mail.. though I certainly understand the need for privacy and confidentiality and appreciate this. It enables me to write openly.
take care, be well..
SimonSimon,
>
> And too late for my son, but in their memories, we must fight this fight to help others not go through this gut-wrenching pain.
>
> I have good and bad days, like you. I agree that having other children has helped, but I feel a hole in my life that nothing can ever fill. It feels like I have lost an arm, or leg, or my heart. Children are all different, and he was not his brother or his sister. I miss him desperately, most minutes of every day, actually. I function because life demands it of me. But I wonder if I will ever truly be joyful again.
>
> I hope you find some solace in this organization. If there is anything I can do to help, please let me know.
>
> DM
Posted by Phillipa on February 8, 2006, at 22:00:16
In reply to Re: Suicide on Effexor, posted by simon levane on February 8, 2006, at 21:32:45
Babblemail each other and exchange E-mail addresses. Fondly, Phillipa
Posted by Devastated Mother on February 9, 2006, at 16:48:57
In reply to Re: Suicide on Effexor, posted by simon levane on February 8, 2006, at 21:32:45
Simon,
Working on update of e-mail capabilities. Not having much luck. Hang on, please. Don't assume I don't want to e-mail.
--Devastated Mom
Posted by Devastated Mother on February 12, 2006, at 9:01:24
In reply to Re: Suicide on Effexor, posted by simon levane on February 8, 2006, at 21:32:45
My ultimate goal is to forgive the doctor. I'm so far from there right now that I don't know how ridiculous that hope is. I blame her at least 85%. He had some depression, but she exponentially increased it with effexor. This is as honest as I can be; I know this sounds a little counter-intuitive and maybe even impossible. I don't think I will ever stop missing my son, who he was, who he was becoming and who he would have been.
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