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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Fi on January 10, 2004, at 12:23:16
Does anyone else get tired of this when its the only question about how you are coping? I do understand why its an important question, of course.
But its when its the only question and then the doctor visibly relaxes and doesnt bother asking any more that it makes me feel as if their perspective is it doesnt matter how grim life is, as long as I'm not suicidal. They wouldnt do that if it was someone with arthritis or cancer or something, would they? They should care about how it is for us living as well.
(end of rant, made me feel better writing it down!)
Fi
Posted by Penny on January 12, 2004, at 8:09:51
In reply to re being asked if suicidal, posted by Fi on January 10, 2004, at 12:23:16
Glad you could let it out!!!
It would be frustrating if that's all you were asked! Depression is such a 'shades of gray' disease - it's not just about either feeling suicidal or not.
I had the opposite problem with my former pdoc, however - he NEVER ONCE asked if I was suicidal. He wanted me to undergo ECT, but he had NEVER ONCE asked if I wanted to either hurt myself or end it all. He never even alluded to it. Hmmm....
'Course, I think he was sleeping through most of our sessions, though, so...
P
Posted by jane d on January 13, 2004, at 12:36:45
In reply to re being asked if suicidal, posted by Fi on January 10, 2004, at 12:23:16
Yes!
And saying no when I was asked was enough to keep me out of the mental health system for years. Slowly rotting away didn't count. Of course I've also been on the other side in recent years - where doctors I've known for years do not ask, even when I'm clearly much worse.
Posted by 8 Miles on January 15, 2004, at 16:41:39
In reply to re being asked if suicidal, posted by Fi on January 10, 2004, at 12:23:16
Fi, I hear what you are saying, but is it JUST the one Pdoc who does that to you, or counselors as well? Do you have a pretty good talking relation with the doc? I would really have to know a whole lot of your personal situation (NOT that I'm suggesting that you provide that!)to really understand the dynamics between you and your doc, and provide relevant comments. In general, however, IF one is or HAS been having suicidal ideations, it would be appropriate during each followup for the doc or couselor to ask that person how they were feeling (regarding suicide or feelings of hopelessness). It is something not only responsible of a doc to ask, but in many states, a legal requirement. I'm facing that right now with someone close to me. I cannot confront her about it directly, because I know she will deny it. However, if I tell her doc or counselor too much, they will have to throw the red-flag and contact local officials. This is a terrible place to be, as I am dam*** if I do and dam*** if I don't. So, I chose TO do so. I'd rather lose the trust or the relationship than to lose her because I DIDN'T speak out when I saw all the warning signs. So, bottom line. Yes, they should ask, but NO they should not just relax after getting the reply they want and then not ask other relevant questions. Maybe it's just the doc?
Hope you find the right answer.
8
Posted by mair on January 15, 2004, at 22:17:51
In reply to re being asked if suicidal, posted by Fi on January 10, 2004, at 12:23:16
Fi - what I used to hate being asked was if I was at "risk." I always thought that was not for me to say (how the hell would I know?) but for the doc to determine based on more tangible info. I had one pdoc who would ask this if i raised the issue of my suicidal feelings but that's as far as it got. I'd say no; he might extract some worthless promise from me to call him if things got worse, but that would be the end of the discussion. I wasn't a great one for volunteering information. It almost seemed to me that he didn't want me to talk about suicide. I even thought maybe he was concerned that talking about it would make it more of an issue.
It took some doing, but I'm on much better footing with my current therapist. She did let me talk about it enough for us both to determine that even if I wasn't "at risk" it was sometimes healthy for me to air it out. So now she rarely raises it unless I do first - and I'm more willing to raise it myself because I'm not threatened by how i think she'll respond.
Mair
Posted by Emme on January 16, 2004, at 10:01:10
In reply to Re: re being asked if suicidal » Fi, posted by mair on January 15, 2004, at 22:17:51
Hmmm...mine has an interesting way to question me. When she's asked "*how* suidical are you?" I never knew how to answer. Moods and thoughts can change so much and so quickly. If I seem a lot better, she may not ask.
Now she often she asks how much time can go by where I'm not thinking about it. A few hours? A day? And I try to tell her how intense or compelling it is, whether it's been relegated to the back burner. She knows the thoughts have pretty much taken up permanent residence in my mind - at least for a while now. And she knows I won't volunteer info, she generally needs to ask directly.
Posted by Camille Dumont on January 16, 2004, at 10:54:41
In reply to re being asked if suicidal, posted by Fi on January 10, 2004, at 12:23:16
Thats a really tricky question ... my GP always asks it but its very hard to be honest with him because the communication between us is super bad ... he doesn't seem to understand nuances in what I say.
Thus, he asks if I'm suicidal. I reply yes. Then he always asks how as in what method / plan. Then I always say that i don't have one because I'm afraid thad admitting it will land me in the hospital against my will.
I also find it sort of silly the whole "plan" question because yes I DO know how I would do it ... I've given some thoughts a long time ago and YES I've opted for a method but knowing how doesn't mean that I WILL do it now or whenever. I just can't "remove" that knowledge from my head ... unfortunately.
Its hard to be honest with someone who can take actions againts your will ... even if you want the help.
Posted by Penny on January 16, 2004, at 11:16:38
In reply to Re: re being asked if suicidal, posted by Camille Dumont on January 16, 2004, at 10:54:41
> Thus, he asks if I'm suicidal. I reply yes. Then he always asks how as in what method / plan. Then I always say that i don't have one because I'm afraid thad admitting it will land me in the hospital against my will.
>
> I also find it sort of silly the whole "plan" question because yes I DO know how I would do it ... I've given some thoughts a long time ago and YES I've opted for a method but knowing how doesn't mean that I WILL do it now or whenever. I just can't "remove" that knowledge from my head ... unfortunately.
>
> Its hard to be honest with someone who can take actions againts your will ... even if you want the help.You are right - admitting you have a plan will probably mean a trip to the hospital - but a couple of things:
First of all, that's not necessarily a bad thing. It depends on the hospital, but some of them are quite helpful. And you could opt (if you're in the US, tho' I don't know about elsewhere) to go in voluntarily and not be an involuntary admit. Which is less stressful. I went for my first hospital stay last summer, and my pdoc set it up before I went so I didn't have to go to the ER or anything, I just went in as a direct admit, and it was voluntary, etc. So...
Second, when my pdoc asks me if I have a *plan* he doesn't usually mean do I have a method of choice. Yes, of course I do - I have thought long and hard about that for long enough, and he knows it. What he means is am I planning to do it at a specific time. The day I was admitted to the hospital, I had already written my note, in my journal, and I had a definite time. But I trust my pdoc, and I didn't really want to die, I just didn't want to hurt anymore, and I was honest with him, and he took care of me. Now I'm feeling much much better, since my meds have finally started working properly (after much trial and error!!!), and I'm thankful I was honest with him.
Perhaps, Camille, you could talk to your doc about options - is there a day treatment program you could go into? I had success with one of those in the past, though I'm sure others here could give you differing opinions.
My hospital stay was only a week. And I talked to my pdoc and my T almost everyday by phone, telling them everything that was going on. I wasn't too happy with my pdoc in the hospital, but I was able to assert myself enough that my med changes while there were minor and things I agreed with. And I guess, to be honest, if I had to go again, as much as I would hate it, I would probably go. I guess...
P
Posted by Fi on January 19, 2004, at 6:18:52
In reply to Re: re being asked if suicidal » Fi, posted by 8 Miles on January 15, 2004, at 16:41:39
Thank you so much for the replies. I dont get near the boards often- ironically, I have today as I am off sick again and the cybercafe is pretty empty, so no-one to see what I am doing.
I wish doctors could read what you have all written! I live in the UK and dont have a pdoc at the moment (I had a private therapist for a while), so I'm talking about a succession of GPS (family doctors?) who have never seen me before and have 6 minutes for the consultation that I am talking about. I am making an appointment with a more experienced doctor (tho still only get my 6 minutes...)
I agree its crucial that they do ask, and seems downright uncaring/unethical if they dont if they know you are, or have been, feeling really bad.
They could do with all asking say at least 3 questions, including the more subtle suicide ones but also how are you getting on, isnt it grim, does anything help etc type. Wouldnt need to take long.
In the UK there is also voluntary as well as compulsory hospital admission, by the way, and it is much more common than compulsory. The problem we have hear in many areas is a lack of beds, so there is the risk you have to be incredibly sick to be admitted, then are likely to be surrounded by other really ill (including very psychotic) patients without enough staff. And may be discharged a bit too soon as they have more really sick people needing your bed... Which is a bit scarey. Though hopefully there are more civilised wards which just dont hit the news.
How interesting that most of us (who replied) have plans.I feel pleased with myself today as I came across some old meds when visiting my mother at Christmas that needed throwing away (she's confused), but brought them home instead. They included some I know are a quick and painless way out, but I threw them away yesterday. I think its a good idea not to have too easy an option around, even if its never been a really serious plan.
But I find that its also crucial to feel that staying around is still a choice, even if its never one I choose to exercise (and I very much hope I never do, if only for the huge amount of distress I know it causes those left behind).
The 'coping with crisis' links at the top of the pages are something I put together as I also think its absolutely vital that when things get really bad, people do at least try talking to someone and getting over that particular awful time.
I'm now on episode 7 of depression in less than a year (fortunately they dont last longer than a week or two), so tho I feel pretty bad, I know I will feel better someday.
I also have an instruction to myself- WoW. Stands for 'waste of worry'. Some of the time, I am aware that my thinking is distorted by the depression/anxiety. Times like when I am seriously planning what I need to pack when I have to be admitted, or how I should give up my job as I cant possibly cope with it. When I catch myself doing that, its a WOW moment and I try to remind myself I am not thinking clearly, and to leave that particular worry aside.
Sorry- this turned into rather a long ramble. Thanks again everyone- its so good you are there, even if I cant chat often.
Fi
Posted by Penny on January 20, 2004, at 8:38:34
In reply to Re: re being asked if suicidal- thank you (long), posted by Fi on January 19, 2004, at 6:18:52
Fi,
I am so proud of you for getting rid of those meds. I know how hard that can be when part of you just wants to hang onto them 'just in case.' I used to tell my therapist that I didn't want my pdoc to hold my meds for me (which he was doing for a while) because I wanted to 'keep my options open.' Though that wasn't good. It's much much easier, IMO, to deal with suicidal urges when the means aren't that readily available, ya' know?
Anyway, I'm glad that we could be of at least a little help. I'm so thankful that I have the ability to choose my pdoc - I have had such bad experiences with several docs that I don't know what I would do - but the one I have now is so good and I wish everyone could find someone like him. So very frustrating that mental illness lacks proper treatment due to government, insurance, and ignorance. Sigh...
Take care and check in occasionally to let us know how you're doing.
P
Posted by Fi on January 21, 2004, at 11:18:04
In reply to Re: re being asked if suicidal- thank you (long) » Fi, posted by Penny on January 20, 2004, at 8:38:34
Thank you- that really means a lot to me. I do value more than I can say the chance to 'speak' to others who understand this way.
I am now getting a little help (tho my 2 really desperate days are over, and hopefully things are improving,thank god). Twice daily phone calls, some counselling tomorrow, and possibly admission on Friday (tho hopefully I will be well enough not to need it by then).
Thanks again
Fi
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