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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by peddidle on March 24, 2007, at 15:23:45
I told my T that I have had suicidal thoughts for about four years. She had asked me a few weeks ago if I was suicidal, and I said no. I expected her to ask again the following week, but she didn't. I got this really strong urge to run back into her office and tell her, but I didn't. I wrote her a really cryptic email telling her that she had asked me something that I probably should have given a different answer to, and that I knew I would never bring it up if I didn't do it right now, etc., so maybe she should try her "guessing thing" next time we meet.
She wrote back and said she liked the email, and that she would think about it before we meet again.
I saw her for first time since the email (this was the first week after spring break) this past Thursday. While she was guessing, she kept asking me just to give her a little clue, or hint, or SOMETHING, and I told her I just couldn't. She finally got it, though.
She asked how often (many times a day), if I had a plan (I don't), what I do to stop them (I don't, they just come and go), how I would do it, etc. For this last one, we had to go back to the guessing thing. She got a few of them, but one was still missing that she couldn't think of. I wouldn't say it, so she asked me to write it down. She seemed surprised that I wouldn't even do that. Why does it even matter? I have the thoughts, I don't have a plan, are the specific details really that important? I told her the thoughts aren't like, I want to die, or I don't want to be here; they're literally thoughts about killing myself. She asked if when I have them, if I recognize that they're not really me, and if I'm able to detach myself from them. I told her no, because I know it's still my mind.
She said that the thoughts are part of the constant low-level depression that I have. I tried to tell her that it's not, because I've had them for this many years. They've changed too, when they first started, they weren't so short and quick, they were more, "I really want to die, and this is how I'm gonna do it." So, no, I don't enjoy having these thoughts, but I'm used to them. When I have one, I know what it is, and I know it'll be brief (usually).
She said I was just reinforcing her argument that I should talk to my pdoc about adjusting my meds (I haven't made a change since fall 2004). I keep telling her they're fine the way they are, and I especially don't want to change them in the middle of the semester. I know how bad the thoughts, and dysthymia in general, used to be, and I know it's not nearly that bad now. She said that when you are depressed for long enough, you start to think that these things are "normal."
I know she isn't going to let up about the meds thing. She said it would take A LOT to convince her that this state of mind is normal for me. Translation: NOTHING will convince her. I didn't remember to tell her during the session, but I actually had suicidal thoughts when I was as young as 10 or 11. I didn't recognize them as suicidal thoughts at the time, though. Nothing traumatic happened to me as a child or anything like that, so there was no reason for these thoughts. Will telling her about this convince her that these thoughts are normal for me, or will it just make her argument even stronger?
I don't understand why this can't just be the way I am. Why am I not allowed to be this way? No, pessimism, negativity, etc. are not the best qualities to have, but neither are a lot of things. So I'm a pessimist, it's not good, but it's the way I am...why do I HAVE to be an optimist? If everything could be fixed by changing my meds, what am I even in therapy for? I used to hate going to therapy, I thought I could make everything better by changing my meds. Isn't it good that I don't want to just throw pills at everything, and that I actually want to go to therapy?
Despite how I may have written this, the session was not just one big fight. She listens to me, and tries to get me to see things in certain ways. When necessary, she may argue with me, but it's always in a friendly way, if that makes any sense.
I'm sure this is already too long, so I'll stop here. I would really appreciate any input on this.
Posted by gazo on March 24, 2007, at 15:38:02
In reply to Why isn't this me? (long) *suicide trigger*, posted by peddidle on March 24, 2007, at 15:23:45
I won't tell that it can't just be the way you are.. I don't know you. I will tell you though that as much help as therapy can be, it can't do certain things in light of biochemical imbalance. I don't know if you have one. The thing I am wondering is what do you have to lose by giving a med change a try? You said you are used to the thoughts.. you feel they are part of you... but do you wish you didn't have them? Aren't you curious whether life would feel different in a positive way?
again.. i may be full of it, so you can just ignore me if you wish, no offense taken.
Posted by Poet on March 24, 2007, at 16:46:26
In reply to Why isn't this me? (long) *suicide trigger*, posted by peddidle on March 24, 2007, at 15:23:45
Hi Pediddle,
I am not in the best emotional state right now, but I wanted to try to respond to your post because being dysthymic I understand being negative, pesimistic, and suicidal.
You wrote: I don't understand why this can't just be the way I am. Why am I not allowed to be this way? No, pessimism, negativity, etc. are not the best qualities to have, but neither are a lot of things. So I'm a pessimist, it's not good, but it's the way I am...why do I HAVE to be an optimist? If everything could be fixed by changing my meds, what am I even in therapy for?
My T suggested that I try an AD, so I think it's pretty standard for them to suggest meds might help. Dr. Clueless always asks if I'm still seeing my therapist, so that leads me to believe that both T and pdoc believe a combination of meds and therapy are right for me. Though at the moment I am not on an AD, I just tapered off Effexor XR. I'm sure T is going to ask me when my next pdoc appointment is, and I suspect she's going to call her before it.
I think your T asked you if you have a suicide plan because she needs to know if you are going to act on it.
It's good that your session wasn't one long fight, I've had enough of those.
Poet
Posted by cubic_me on March 24, 2007, at 16:58:50
In reply to Why isn't this me? (long) *suicide trigger*, posted by peddidle on March 24, 2007, at 15:23:45
Like Poet, I can relate to the dysthymia and negative feelings your having too. Infact the way you describe your suicidal thoughts sound so like mine it's scary. I've discussed it in the past with my T and my Pdoc and while both have asked about the thoughts, neither of them have really dwelled on it. or suggested I get any specific help for them. My pdoc thinks that once I'm feeling better in my mood the thoughts will disappear, although I have said that when I'm feeling OK I still get the thoughts.
I don't know about you, but in an ideal world I wouldn't have these thougths as often, they can be distracting sometimes, since they can come when I'm least expecting it or when I'm in a stressful situation (which isn't the best time to stop concentrating!) but I can understand how you don't want to change your medications in the middle of the semester; could you wait until a break? You can always say you'll discuss your meds with your pdoc, it doesn't mean you'll have to change them if they're suiting you, but a change might help if you feel they could do more for you.
Posted by Dinah on March 24, 2007, at 20:21:06
In reply to Why isn't this me? (long) *suicide trigger*, posted by peddidle on March 24, 2007, at 15:23:45
My therapist doesn't take my suicidal thoughts particularly seriously. He does ask if I think I'm in danger of acting on them, but if I'm not he just acknowledges that it's unpleasant.
But he freaks at even the mildest self injury.
I think therapists have their own personal hot buttons, and you may have run into hers.
I'm not minimizing suicidal thoughts, and if you think you might act on them it's important to tell people that and get help right away.
But persistent suicidal ideation isn't all that uncommon, and if you've been dealing with it for a long time and think you can keep dealing with it safely, I can see wanting to postpone med changes until it is less likely to disrupt your life.
That's just my thoughts, and my thoughts may be tainted by the fact that I too have frequent suicidal thoughts.
Posted by Iwillsurvive on March 25, 2007, at 14:19:13
In reply to Re: Why isn't this me? (long) *suicide trigger* » peddidle, posted by Dinah on March 24, 2007, at 20:21:06
Geeze. I never realized it, I woulda said I don't have suicidal ideation, but I guess I do. Cuz yes, there are times where it just comes upon me, and I just wish I didn't exist. I wished I was dead I guess. Other day I saw a bad pic of someone w/their head blown off (why I was searching that????) but anyways, I thot to myself, well, thats not *so* bad....
Damn, I had no idea.
But for me its not often, mebbe 2-3x/month?? I don't really know as I just realized it.
But the point of my post, is that it truly doesn't bother me (well its sorta bothering me now, that I do it, but not so much,more it bothers me that I know so little of myself). I have these thots, they not so nice, but they pass quickly, and like I say, I obvo wasn't even really noticing them. So mebbe its just the way some of us are made? Mebbe its no big deal? Cuz I truly won't act on it, even tho at the time it feels so real.
Thats my thots.
Posted by peddidle on March 25, 2007, at 18:33:53
In reply to Re: Why isn't this me? (long) *suicide trigger* » peddidle, posted by gazo on March 24, 2007, at 15:38:02
> I won't tell that it can't just be the way you are.. I don't know you. I will tell you though that as much help as therapy can be, it can't do certain things in light of biochemical imbalance. I don't know if you have one. The thing I am wondering is what do you have to lose by giving a med change a try? You said you are used to the thoughts.. you feel they are part of you... but do you wish you didn't have them? Aren't you curious whether life would feel different in a positive way?
**Last time I changed my meds, though, the withdrawawl symptoms were awful. Granted, I wasn't in the best state of mind anyway, but the dizziness, inability to concentrate (more so than usual), etc. made it impossible to study or do any other school work. Plus, my pdoc added a med while I was cutting the dose of my current one, and the side-effects from that med were unbareable. I stopped taking it after about six weeks.
I'm sure life would be better without the thoughts, but I'd rather live with them than deal with all the hassle that goes with changing psychiatric meds. Yes, I'm curious to know what life would be like without the thoughts, but not curious enough to try it right now.
>
> again.. i may be full of it, so you can just ignore me if you wish, no offense taken.**Not at all. I appreciate your thoughts. Thanks!
Posted by peddidle on March 25, 2007, at 18:46:17
In reply to Re: Why isn't this me? (long) *suicide trigger* » peddidle, posted by Poet on March 24, 2007, at 16:46:26
> Hi Pediddle,
>
> I am not in the best emotional state right now, but I wanted to try to respond to your post because being dysthymic I understand being negative, pesimistic, and suicidal.
>
> You wrote: I don't understand why this can't just be the way I am. Why am I not allowed to be this way? No, pessimism, negativity, etc. are not the best qualities to have, but neither are a lot of things. So I'm a pessimist, it's not good, but it's the way I am...why do I HAVE to be an optimist? If everything could be fixed by changing my meds, what am I even in therapy for?
>
> My T suggested that I try an AD, so I think it's pretty standard for them to suggest meds might help. Dr. Clueless always asks if I'm still seeing my therapist, so that leads me to believe that both T and pdoc believe a combination of meds and therapy are right for me. Though at the moment I am not on an AD, I just tapered off Effexor XR. I'm sure T is going to ask me when my next pdoc appointment is, and I suspect she's going to call her before it.**I agree. I actually prefer T's/pdocs who are open to the idea of combining meds with therapy. I haven't had any who weren't, but I can imagine there are some T's out there who are avidly opposed to meds, as well as pdocs who think all psychological problems are due to chemical imbalances. Come to think of it, my first pdoc/T was pretty big on the "oh, you're not in a good mood today? That means we need to increase your zoloft."
>
> I think your T asked you if you have a suicide plan because she needs to know if you are going to act on it.**No, I completely understand that. I was referring to how, even after I told her I didn't have a plan, she kept asking about the specific ways that I think about doing it; like, "would you eat a bunch of pills? Jump off a bridge?" etc. I just don't understand why that matters. I have suicidal thoughts that I'm not going to act on... do the details matter?
>
> It's good that your session wasn't one long fight, I've had enough of those.**I've never fought with my T *knocks on wood*. She would probably be thrilled if I did, though, to prove to her that I am capable of experiencing various emotions. I know, therapy isn't the place to suppress emotions, but I can't help it.
As always, thanks for your help, Poet. I hope you feel better soon.
Posted by peddidle on March 25, 2007, at 19:01:50
In reply to Re: Why isn't this me? (long) *suicide trigger* » peddidle, posted by cubic_me on March 24, 2007, at 16:58:50
> Like Poet, I can relate to the dysthymia and negative feelings your having too. Infact the way you describe your suicidal thoughts sound so like mine it's scary. I've discussed it in the past with my T and my Pdoc and while both have asked about the thoughts, neither of them have really dwelled on it. or suggested I get any specific help for them. My pdoc thinks that once I'm feeling better in my mood the thoughts will disappear, although I have said that when I'm feeling OK I still get the thoughts.
**This is the first time I've discussed them with my T. So I guess I'll have to wait to see if she dwells on them. I don't think she was suggesting I change meds specifically for that reason, I think it was more like they are just another symptom of the dysthymia that she insists is getting worse.
>
> I don't know about you, but in an ideal world I wouldn't have these thougths as often, they can be distracting sometimes, since they can come when I'm least expecting it or when I'm in a stressful situation (which isn't the best time to stop concentrating!)**Yeah, in an ideal world, I wouldn't have them [as often] either. They can be distracting and annoying. But, let's be honest, a lot of things would be different in an "ideal world."
>
>but I can understand how you don't want to change your medications in the middle of the semester; could you wait until a break? You can always say you'll discuss your meds with your pdoc, it doesn't mean you'll have to change them if they're suiting you, but a change might help if you feel they could do more for you.**I can't really wait for a break because I see my pdoc through my college. To go to a different pdoc, I would have to tell my parents. I don't know why it bothers me so much to tell my parents that I want to change my meds (I don't want to change them, but for arguments sake...), but it does. That's another popular topic in therapy recently. Maybe I just don't want them to think it's worse than it really is. I don't know. Plus, that would mean I'm seeing a different pdoc over the summer, and I wouldn't be seeing my T for that entire time. That's seems like a bad idea to me.
Maybe I could make a deal with my T-- I'll talk the pdoc, but I won't change my meds. It's a pretty stupid compromise (and not really a compromise at all), so I doubt she'll fall for it, but it's the only way I can think of to get her to stop harping on it. lol
Thanks for your help. It's good to know I'm not the only one with these weird, annoying thoughts.
Posted by Honore on March 25, 2007, at 21:11:37
In reply to Why isn't this me? (long) *suicide trigger*, posted by peddidle on March 24, 2007, at 15:23:45
Hi, peddidle.
You ask why "this" can't be you. But when you say "this" what do you mean? someone who is quite depressed but not as depressed as she once was? Even if you had somewhat suicidal seeming thoughts at 10 or 11, who's to say those thoughts were particularly germaine to who you "are."
There are lots of thoughts, and moods and hopes and fears that we have. Some of them seem more germaine to the core sense of who we are. Does having suicidal thoughts seem very constitutive of you, ie who you are to yourself? Would you be someone else without them? Not know yourself without them?
You say you don't enjoy them, and in my experience of suidical thoughts, even if they'll pass, that's an understatement.
Somehow isn't it strange that it was so important for you to tell your T that you had those thoughts-- that you wished you could run back and tell her-- and wrote her an email-- and yet, you resist her attempt to say that you don't have to have them-- that they aren't necessary, they aren't you?
Isn't that somehow contradictory?
And why make her guess? what's the secret? why is it so unspeakable, that she has to be the one ot speak it? and if she did want to know how you imagine dying-- if she thought it would give her some understanding-- why again the guessing? why the resentment at being asked to say?
If it's so unspeakable, or so precious and private a feeling-- yet you did want her to know. And she is a T. She is going to say that she doesn't want you to have those feelings, that you don't need to have them. That much is certain-- before you told her.
So I believe that you don't want those feelings; that you don't really believe that they "are" you, even if they represent some private source of relief, or some statement of how bad it is-- or whatever.
I think if changing meds would really help-- a short period of discomfort would be well worth it. Plus, I had a terrible time come off one med, and an easy time coming off another. It's not always the same. And there are better and worse ways to do it.
Maybe you're not ready. I think that may be it. Or even ready to admit that you hope for change. Hope is tough. It takes time to have hopes. But they're worth it, I think. To the extent that I have them, I feel that life is worth living, and worth risking.
So I think those thoughts "are" you-- although they don't have to be-- and you have the right to be that way, and to have those thoughts, and not to change and not to change meds. It's just that you also have the right, if you change your mind, to let the thoughts go, and to go for the best, most helpful meds that you and your pdoc can find. And to let your T in on things without feeling so on the spot and so protective of parts of you.
Honore
Posted by peddidle on March 27, 2007, at 20:39:00
In reply to Re: Why isn't this me? (long) *suicide trigger* » peddidle, posted by Dinah on March 24, 2007, at 20:21:06
> My therapist doesn't take my suicidal thoughts particularly seriously. He does ask if I think I'm in danger of acting on them, but if I'm not he just acknowledges that it's unpleasant.
>
> But he freaks at even the mildest self injury.
>
> I think therapists have their own personal hot buttons, and you may have run into hers.**I guess. Although, maybe it isn't actually a big deal. I mean, it took her a pretty long time to come up with it. She rattled off all the other things are usually the "big ones," but it took a while for her to think of suicidal thoughts. I know it's my fault for making it difficult, but I would have thought that would have been one of the first things she guessed.
>
> I'm not minimizing suicidal thoughts, and if you think you might act on them it's important to tell people that and get help right away.**I know, but they're the kinds of things that are there, but I'd never act on... I haven't considered acting on them for several years.
>
> But persistent suicidal ideation isn't all that uncommon, and if you've been dealing with it for a long time and think you can keep dealing with it safely, I can see wanting to postpone med changes until it is less likely to disrupt your life.**Good to know that it's not all that uncommon. I mean, I guess it's not "normal," but it's hard for me to believe that most people's minds don't go there at one time or another.
>
> That's just my thoughts, and my thoughts may be tainted by the fact that I too have frequent suicidal thoughts.
>**Well, your understanding is probably better because your thoughts are tainted. :)
Thanks!
Posted by peddidle on March 27, 2007, at 20:54:11
In reply to Re: Why isn't this me? (long) *suicide trigger*, posted by Iwillsurvive on March 25, 2007, at 14:19:13
> Geeze. I never realized it, I woulda said I don't have suicidal ideation, but I guess I do. Cuz yes, there are times where it just comes upon me, and I just wish I didn't exist. I wished I was dead I guess. Other day I saw a bad pic of someone w/their head blown off (why I was searching that????) but anyways, I thot to myself, well, thats not *so* bad....
**I know the feeling. Like I said, when I was younger, I didn't even realize that they were suicidal thoughts. Isn't it strange how we don't even fully understand our own mind?
> Damn, I had no idea.
> But for me its not often, mebbe 2-3x/month?? I don't really know as I just realized it.**Yeah, my T asked how often mine were. I told her they were multiple times a day. I guess that sounds bad, but I also told her they're really quick. I don't even need to do anything to stop them, because they're in and out. I got the feeling that she was looking at them more as obsessions than actual suicidal thoughts (but, of course, not fully discounting the fact that it is suicidal ideation). I could be wrong though.
> But the point of my post, is that it truly doesn't bother me (well its sorta bothering me now, that I do it, but not so much,more it bothers me that I know so little of myself). I have these thots, they not so nice, but they pass quickly, and like I say, I obvo wasn't even really noticing them. So mebbe its just the way some of us are made? Mebbe its no big deal? Cuz I truly won't act on it, even tho at the time it feels so real.**That's exactly my point. Don't I have the right to think this way? I'm not hurting myself (physically) or anyone else by having these thoughts. I mean, I'm saying I won't act on them now, but I guess the possibility that I will somewhere down the line is always there. I guess the risk is higher than if the thoughts weren't there to begin with. I'm playing devil's advocate now. The point is, yes they're annoying, and I would prefer that they weren't there, but I can deal with them.
> Thats my thots.
**Thanks for your thoughts, IWS!
P.S.
Maybe you should think about mentioning the thoughts to your T. You could even tell her that you learned more about yourself and wanted to share your findings with her.
Posted by peddidle on March 27, 2007, at 21:18:24
In reply to Re: Why isn't this me? (long) *suicide trigger* » peddidle, posted by Honore on March 25, 2007, at 21:11:37
> Hi, peddidle.
>
> You ask why "this" can't be you. But when you say "this" what do you mean? someone who is quite depressed but not as depressed as she once was? Even if you had somewhat suicidal seeming thoughts at 10 or 11, who's to say those thoughts were particularly germaine to who you "are."**But I don't feel depressed. Granted, I'm basing that opinion based on how depressed I was at one time, but I still don't think I'm depressed.
>
> There are lots of thoughts, and moods and hopes and fears that we have. Some of them seem more germaine to the core sense of who we are. Does having suicidal thoughts seem very constitutive of you, ie who you are to yourself? Would you be someone else without them? Not know yourself without them?**I guess I wouldn't be someone else without them. It's kind of scary to think that they are part of who I am to myself, but maybe they are...
>
> You say you don't enjoy them, and in my experience of suidical thoughts, even if they'll pass, that's an understatement.
>
> Somehow isn't it strange that it was so important for you to tell your T that you had those thoughts-- that you wished you could run back and tell her-- and wrote her an email-- and yet, you resist her attempt to say that you don't have to have them-- that they aren't necessary, they aren't you?
>
> Isn't that somehow contradictory?**Yeah, I guess you're right. Although, she was talking about the meds even before I told her about the suicidal thoughts. I think it was a combination of the fact that I wasn't going to see her the next week, and I felt bad that I lied to her about something potentially significant.
>
> And why make her guess? what's the secret? why is it so unspeakable, that she has to be the one ot speak it? and if she did want to know how you imagine dying-- if she thought it would give her some understanding-- why again the guessing? why the resentment at being asked to say?**This is something that I have a real problem with. It's not just about this particular subject. I have a hard time speaking at all during therapy, even though I want to so badly. The only difference is, I usually don't come right out and say, "no, I can't say it," (I'll usually try to say it before I finally give up and say, "I don't know) but this time I did. She was told me about a boy that she sees in her private practice who is a selective mute. She said she kind of thinks of me as her selective mute, but not quite that extreme. It's kind of funny...maybe she's not too far off with that idea...
>
> If it's so unspeakable, or so precious and private a feeling-- yet you did want her to know. And she is a T. She is going to say that she doesn't want you to have those feelings, that you don't need to have them. That much is certain-- before you told her.**I know that, and I want to let her in on everything. I really do.
>
> So I believe that you don't want those feelings; that you don't really believe that they "are" you, even if they represent some private source of relief, or some statement of how bad it is-- or whatever.**I don't want them. I don't know. Maybe I'm too afraid of what I'll be like without them...I don't know.
>
> I think if changing meds would really help-- a short period of discomfort would be well worth it. Plus, I had a terrible time come off one med, and an easy time coming off another. It's not always the same. And there are better and worse ways to do it.
>
> Maybe you're not ready. I think that may be it. Or even ready to admit that you hope for change. Hope is tough. It takes time to have hopes. But they're worth it, I think. To the extent that I have them, I feel that life is worth living, and worth risking.** It's interesting, a couple of weeks ago, my T said something along the lines of that I want to change, but I'm not ready...or something like that. I don't know what the difference is... how could I want to, and yet not be ready?
Hope is a tough one, I agree. I'm glad you've found it, though.
>
> So I think those thoughts "are" you-- although they don't have to be-- and you have the right to be that way, and to have those thoughts, and not to change and not to change meds. It's just that you also have the right, if you change your mind, to let the thoughts go, and to go for the best, most helpful meds that you and your pdoc can find. And to let your T in on things without feeling so on the spot and so protective of parts of you.**Maybe I just want to try doing it without changing the meds first. That might be it. I really do want to let my T in on things, and I know she wants me to let her in on things (I can see her frustration when I sit there in silence), it's just hard for me. I'm trying, though.
>
> HonoreThanks for your help. I really appreciate it.
This is the end of the thread.
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