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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by mair on June 21, 2004, at 21:12:33
I don't want to stir anything up, so please avoid this thread if it upsets you.
I have an on-going difference of opinion with my T about the relationship between suicide and depression. In my case, I associate depression with symptoms that are as much physical as mental - an inability to sleep, persistent anxiety, exhaustion etc. Suicidal ideation goes hand in hand with those symptoms for me, but at times, I have alot of suicidal ideation which seems totally unrelated to depression. I can feel devoid of most of the rest of the typical symptoms, feel very clear headed and contemplate suicide (albeit somewhat impulsively) as a totally rational and realistic solution to an external set of circumstances. Admittedly, there's usually a fair amount of self-hatred lurking not very far from the surface, but that, too, is not necessarily related to depression. Sometimes likes and dislikes are just subjective.
My T takes the position that I don't have to feel depressed to be depressed; that therapy and medication have been periodically successful in addressing a lot of symptoms, but not that particular symptom. I don't really buy this.
I'd be interested to hear some other takes on this.
Thanks
Mair
Posted by shadows721 on June 21, 2004, at 21:56:16
In reply to Another Suicide Question, posted by mair on June 21, 2004, at 21:12:33
Let me share something from a medical stand point. A person most at risk for suicide is the person that is starting to feel better from medication. This person now has the energy to act on those thoughts. Where as before, they couldn't because they depression caused them to be very slowed down (sleeping too much, not able to have any energy, etc.)
Posted by Dinah on June 21, 2004, at 22:15:50
In reply to Another Suicide Question, posted by mair on June 21, 2004, at 21:12:33
I would tend to agree with you. I think that suicidal ideation *can* be a part of depression, but it can also be a habitual way of responding to pressure. And that self hatred doesn't *always* have to be associated with depression either.
It's like a fever is part of an earache, but you can have a fever without having an earache.
My therapist tends to argue the point as well, although he strangely also admits that I'm not all that depressed. Go figure.
Posted by daisym on June 22, 2004, at 2:52:42
In reply to Re: Another Suicide Question » mair, posted by Dinah on June 21, 2004, at 22:15:50
I think sometimes the idea that suicide is better than living with constant pain (physical or mental) is a clear, thought out "solution" to a problem. It is one of the options. I don't think you have to be depressed to think about suicide. I also don't think you necessarily think about suicide when you are depressed.
I think the feelings can be old and overwhelming so you "lose it" momentarily. This happens to me. I think you can feel trapped or stuck and this presents itself as a way out.
I also think what shadow said makes perfect sense. Well enough to act -- a scary thought.
I hope the thoughts for you don't become overwhelming. Take good care.
Daisy
Posted by mair on June 23, 2004, at 8:14:38
In reply to Re: Another Suicide Question, posted by daisym on June 22, 2004, at 2:52:42
Daisy - you said alot that I can identify with. I probably do drift that way particularly when I feel in need of an escape. Most of the time when I dwell on suicide, I know my resistance to feeling depressed is low. (unfortunately very true right now) At such times I occasionally "wake up" enough to realize that I'm working pretty hard trying to convince myself that it's a good idea. However there are definitely other times when I really don't feel particularly depleted and I'm functioning well and yet am still capable of the harsh sorts of judgments that lead me to thinking about suicide. I guess my therapist would say that even though I don't feel depressed, what she would perceive to be distorted thinking is a byproduct of depression. Maybe it's just that I've lived with these thoughts for such a long time that it's easy to fall back on them.
I think shadow's statements make sense, although I don't think it's the way things would play out for me. Even when depressed, I certainly function well enough to put a suicide plan into action, and the impulse and tendency to trigger the impulse are stronger. However, I do have to say that when I'm more depressed, I'm also more willing to acknowledge that the way I feel is transitory and that the suicide aspect may be the product of distorted thinking. So maybe in that sense I'm somewhat safer.
All in all, whether depressed or not, I need to do everything I can to make it difficult to act on the impulses, and to avoid placing myself in situations where suicide becomes an easy option.
Mair
This is the end of the thread.
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