Ask MetaFilter questions tagged with suicide and therapy

Therapy without doctors

Anonymous — Sat, 11 Jul 2009 09:28:36 -0800

I can't do therapy. There must be other people who can't do therapy. What do these people do, when they get together, to fix their problems? What DIY, collaborative options are on the table, and how do I find them? I've had a really bad month to year -- graduate school has gone from bad to worse, and I can't get out of it. Suffice it to say, I am very, very sad. I've spent a lot of the last year alone, and am now am estranged from a lot of my friends. I've tried relocating temporarily to a new city, but I find myself getting increasingly desperate and related ramifications of total isolation. I have one friend who I talk to, and I feel like there's a limited tolerance for this kind of thing (there would be if I were the friend -- and he's been incredibly patient -- but it's got to be exhausting to listen to).

When I'm really sad, I get really paranoid, and I just fail totally to be able to communicate. This is obviously a problem. I do have this friend -- but again, I feel like I lean on him a lot -- and it's all I can do, when I'm really upset, to even make that contact.

Obvious solution -- therapy! Right? Therapy fixes everything! Except that I really, really object to this, and can't imagine attempting to fix what's wrong with my life -- itself the product of a highly professionalized, goal-and-career-oriented trajectory -- by going in for an hour a day of treatment I can't afford, talking to a "qualified medical professional" for forty five minute, once a week. I don't think that these are a substitute for basic, warm, HUMAN contact (not professionalized contact), which is what I feel like I need right now --- leaving aside the entirely disingenuous "fee-for-service" structure of mental health care (and especially private psychiatric care) that is a given in engaging with the medical establishment in any capacity.

I know there are groups that do low-cost community therapy. The ones I've seen in New York (where I am) are all part of the state hospital system -- which again, I don't want to go anywhere near or touch. I've seen a few that look like they make sense to me, but they're mostly in San Francisco. The one thing that has worked for me is low-cost yoga and meditation type stuff -- I've been doing a little bit of this in Philadelphia (where I am right now) and it's been a tremendous (if transient) relief. If anyone has suggestions for places they know and trust, in this line (or in the group therapy line) in New York, I would really appreciate any guidance.

Thanks in advance for all your help...and I'm sorry, in advance, for so aggressively bashing CBT, which I know a lot of people use, and which probably works. All I mean to say is, it doesn't work for me, and I'd REALLY like advice on where else to go...

I am crazy. Help.

Anonymous — Mon, 08 Dec 2008 07:53:52 -0800

Help me design a multi-pronged approach to dealing with longstanding depression/grief/craziness. Anonymous so I can be more explicit about my psychiatric history.

I've had depression since I was about 12. I am now 30, female, good marriage. I have had periods of remission, but things have generally gotten worse. I don't want to end up dead.

I have a family history of suicide. There are a few different possibilities for my diagnosis: dysthymia, double depression, major depression, anxiety, borderline personality disorder, or any combination of these. My most common symptoms are periods of extreme procrastination and paralysis, suicidal thoughts, crying, utter hopelessness. I am at college and having a complete bitch of a time getting anything done. I also work a "real job" and I often feel that I am not all there, mentally. I am spacey, have poor memory and concentration, and am often paralyzed with anxiety. My performance seems to be okay (people often have trouble understanding how I can have such serious problems when my performance seems to be acceptable) but I know that I am working far, far, far below my potential. And I feel like utter shit most of the time. I use the internet compulsively and excessively when feeling anxious. I have very low energy (I know how to eat well, and exercise makes me more sleepy, but I do it.)

I have tried the following medications: Effexor, Wellbutrin, Risperdal, Celexa. Also zopiclone for insomnia. I was on the first four in various combinations for six years, and I felt like they did nothing for my mood, merely gave me side-effects (sleepiness, no sex drive.) I gradually weened off (a hellish process) and I have little faith that drugs can help me. But I am, of course, willing to try anything. I've read books (Feeling Good, Learned Optimism, a lot of others about depression, procrastination, etc.)

I have a history of grief. I've had many family members and friends die, starting from a very young age. Thankfully, no first-degree relatives (mom dad or sib), but most have been close second-degree relatives. The suicides have especially wrecked me. The latest one was pretty recent. I also have experienced some emotionally abusive relationships, and have trauma from sexual harassment. I have very little money and may soon be laid off.

I have a couple close friends, but I do not go to them much for support with this. I am embarrassed by my troubles. I don't talk much about it with my family, though they are also aware of my history. I had several not-very-serious suicide attempts in my teens/early 20s, but none recently. I really don't want to end up like my other family members who have suicided, but I feel in my gut that is where I'm headed.

I see a therapist pretty regularly. We do CBT and work on practical stuff. I have a Dr. appointment this morning, and had one a few weeks ago as well for the depression, because I need sick notes for missed obligations at school. The doctor says I need to be back on meds. I have been given a list of other therapeutic resources to access that include Dr.s who specialize in anxiety, and gestalt therapists.

This is a very complex problem that has not been adequately addressed...ever. I was in therapy for a long time, starting when I was 16. I did interpersonal and CBT. The last psychiatrist who assessed me said I may benefit from psychodynamic approaches, but I am not sure which ones.

Really, I feel like I need to take the reins here. Despite all the professionals I have seen, I feel like none of them have good answers to give me, even the nice and helpful ones. I am sick of struggling to function day-to-day and never knowing when an episode of major depression will hit and totally fuck everything in my life up. I am angry, hopeless, and full of grief. I don't understand how people keep living when life is so consistently horrific. I look at my friends who are able to have a career + friends + hobbies + family, and I am totally dumbfounded. Is that how normal people live? Can I do that too?

I need to do something. I have to design some kind of therapy regimen. Please help me with this.

Things I think I need: grief counselling, esp for suicide survivors, perhaps some kind of schema therapy, or gestalt, or maybe DBT. I've done a bit of research on these methods, but am really confused. I've also researched medications a bit (in the past) and am at a loss for what to do now. Which therapies and medications are best for what? I feel like I cannot get a straight answer from my docs.

If you can give me some ideas for a more intense, multi-pronged regimen I can try, and give me specific names/resources I can contact in Toronto, I would really really appreciate it.

How honest should I be with my therapist?

Wroksie — Mon, 11 Aug 2008 02:53:22 -0800

As a way to comfort myself when I am worried, nervous, anxious, or sleepless, I plan my own suicide. I've done this for as long as I can remember - from early childhood. Sometimes I try to plan it as painlessly as possible, sometimes as dramatically as possible. Sometimes I try to think of ways to make it look like an accident. There have been times (thankfully not for years and years) that I have planned ways to make it look like murder and pin it on whomever I was most upset by at the time. Nowadays, I usually think of ways to make sure my friends and family are troubled as little as possible.

In spite of all this, I am NOT actually suicidal. At all. I am a happy person, and I am way too eager to see what's going to happen next to ever end my own life (unless I was terminally ill and in lots of pain, or on my way to being completely incapacitated, but that's a whole 'nother thing entirely, I think). My suicide game has always seemed to me to be a kind of escape hatch - a way of convincing myself that I can put up with anything, and make it through intact, as long as I know I can escape anytime I want to.

Now, for the actual question. I am soon to see a therapist to help me deal with my food issues (binge eating with a little body dysmorphia thrown in for fun). I want to be completely honest and open, which was difficult for me when I saw a therapist as a teenager for other issues. I think this strange little coping mechanism is probably something that my psychologist needs to know. What I DON'T want is to be labelled a suicide risk, be declared a danger to myself, have my belt and my shoelaces taken away, and have the word 'suicidal' written in big red letters on the medical records that will follow me around for the rest of my life. So how should I approach this?

Any stories of successfully breaking a depressive cycle?

nímwunnan — Wed, 29 Nov 2006 17:55:23 -0800

Any advice -- from experience please -- for breaking a friend's cycle of depression, hospitalization, and attempted suicide? A friend of mine has struggled with serious mental health issues as long as I've known her, but until the last few years was mostly keeping her head above water. She's gotten much worse lately, having been in and out of the hospital for most of the last year, and she's been treated with nearly every option available in the conventional mental health system. I'm worried that she's going to continue to spiral down, and the dioramas and cartoons I make for her don't really qualify as clinical treatment. Given the nature of my question, I'm certainly not hoping someone will suggest some concrete solution I hadn't thought of that is bound to work. I'm just interested to hear if anyone else has dealt with a similar situation, and if you encountered any methods of breaking the classic depressive cycle in such a way that gives the sufferer at least a little more power over his/her own situation. Not interested in hearing about new drugs or anything involving ECT -- that's been covered.

Now what?

Anonymous — Thu, 30 Mar 2006 10:55:19 -0800

Maybe I have a couple problems. The first one probably stems from the second. Insurance won't cover therapy or medication. Is there any place in Baltimore, MD that offers free or very low-cost assistance? Thank you.

C'mon, doesn't everybody do it?

Anonymous — Mon, 13 Mar 2006 04:23:10 -0800

How often do you contemplate suicide? What's your score on the Beck Depression Inventory? I contemplate suicide on a fairly regular basis, my score on the Beck Depression Inventory is about a 36, some days it is hard to get out of bed, blah blah blah. Supposedly this means I am severely depressed. However, it's hard for me to believe what I feel is all that different from what everybody else in the world deals with.

So is it? MeFites, what do you feel in your day-to-day life? Do you see the "classic signs of depression"? What's your Depression Inventory score, if you don't mind me asking? And are you diagnosed with depression or do you consider yourself depressed? Are my results really that abnormal?

It's hard for me to justify talking to a therapist or doctor about this if it's something everyone has to deal with. I don't want to go through the trouble and the medications if it's something that simply requires a bit more willpower.