Treating treatment-resistant depression.
September 22, 2014 6:51 PM Subscribe
My boyfriend attempted suicide recently. He is resistant to help. How do I deal with this?
Yesterday afternoon, my boyfriend attempted suicide. He has been depressed for a long time, I don't know for sure how long, but at least as long as I have known him. Over the last six months it has become much worse, with him saying that he is feeling low or sad almost all of the time, not being able to sleep, feeling restless, having anxiety attacks etc. I have been advocating for him to get help for about that long, but didn't realise quite how serious it was until yesterday, when he called me crying and saying that he had done something "very stupid" (he tried to asphyxiate himself and it failed).
I was understandably completely devastated, but did my best to do the right thing and support him. I got him to call a local mental health crisis team, but they never called back.
My boyfriend is absolutely 100% convinced that medical help won't do any good. He refuses to be put on medication because he says it will make him a zombie and just serves to let doctors off the hook because it makes you "technically better" (he has been on medication before, which I believe wasn't his choice -- he has a history of childhood abuse). He has been through therapy and is likewise convinced that it won't help. His problem, as he sees it, is that he is stupid and miserable and that will never change. He knows he is depressed but refuses to believe he is ill. He hates his job and his living situation and desperately wants to change it, but again can't see it ever changing. Trying to talk to him about this stuff is like hitting a brick wall. He gets angry and defensive and won't listen.
Right now, we're in crisis mode. He is staying with me and I have spoken to a few mutual friends and they have also spoken to him, with similar results. He is making promises that he will call his GP and crisis teams (mostly because he sees how upset this is making me) but I'm not convinced that it will go much further, as he will give up as soon as he hits the first hurdle. He simply doesn't have the resources to fight this. I have numbers saved in my phone for local mental health services (we're in London so it differs borough by borough, unfortunately he lives in one and I live in another) and the out of hours numbers for his GP and a national helpline. I have a plan for what to do if he attempts again (which depends on me knowing about it, but I'm trying not to think about that). I have friends and support.
My questions:
- Am I doing the right thing? My best scenario right now is for him to make contact with a medical professional who will sit him down and tell him he is seriously unwell and he needs to get his shit together. Do I keep pushing him? Do I keep fighting?
- Is there any other option, aside from therapy and medication, which can help us, or is that pretty much the be-all-end-all right now?
Any and all personal experiences of this kind of depression would be really helpful, if you feel up to telling me. Thank you.
Yesterday afternoon, my boyfriend attempted suicide. He has been depressed for a long time, I don't know for sure how long, but at least as long as I have known him. Over the last six months it has become much worse, with him saying that he is feeling low or sad almost all of the time, not being able to sleep, feeling restless, having anxiety attacks etc. I have been advocating for him to get help for about that long, but didn't realise quite how serious it was until yesterday, when he called me crying and saying that he had done something "very stupid" (he tried to asphyxiate himself and it failed).
I was understandably completely devastated, but did my best to do the right thing and support him. I got him to call a local mental health crisis team, but they never called back.
My boyfriend is absolutely 100% convinced that medical help won't do any good. He refuses to be put on medication because he says it will make him a zombie and just serves to let doctors off the hook because it makes you "technically better" (he has been on medication before, which I believe wasn't his choice -- he has a history of childhood abuse). He has been through therapy and is likewise convinced that it won't help. His problem, as he sees it, is that he is stupid and miserable and that will never change. He knows he is depressed but refuses to believe he is ill. He hates his job and his living situation and desperately wants to change it, but again can't see it ever changing. Trying to talk to him about this stuff is like hitting a brick wall. He gets angry and defensive and won't listen.
Right now, we're in crisis mode. He is staying with me and I have spoken to a few mutual friends and they have also spoken to him, with similar results. He is making promises that he will call his GP and crisis teams (mostly because he sees how upset this is making me) but I'm not convinced that it will go much further, as he will give up as soon as he hits the first hurdle. He simply doesn't have the resources to fight this. I have numbers saved in my phone for local mental health services (we're in London so it differs borough by borough, unfortunately he lives in one and I live in another) and the out of hours numbers for his GP and a national helpline. I have a plan for what to do if he attempts again (which depends on me knowing about it, but I'm trying not to think about that). I have friends and support.
My questions:
- Am I doing the right thing? My best scenario right now is for him to make contact with a medical professional who will sit him down and tell him he is seriously unwell and he needs to get his shit together. Do I keep pushing him? Do I keep fighting?
- Is there any other option, aside from therapy and medication, which can help us, or is that pretty much the be-all-end-all right now?
Any and all personal experiences of this kind of depression would be really helpful, if you feel up to telling me. Thank you.
When my husband tried to commit suicide I drove him to a psych hospital and he stayed there for at least a week. Your boyfriend needs serious professional help that you cannot provide.
posted by something something at 7:05 PM on September 22, 2014 [50 favorites]
posted by something something at 7:05 PM on September 22, 2014 [50 favorites]
He needs in-patient treatment. He needs to be in a hospital setting where he can be on suicide watch until the crisis is over and he's stable enough to begin treatment. This is like a heart attack - your job is not to perform surgery but to get him into a hospital so he can have surgery.
If the underlying problem is depression, then therapy and meds and helpful life changes (like getting meaningful work, exercise etc) are the only solutions we have for now. It could be that this is a different condition or a response to a crisis of other sorts.
I've been in your position, and I have to say the hospitalization feels scary and official but is a big relief for family and friends. You will probably have to argue to get them in because beds are often limited, but it's the most helpful thing you can do, be his advocate for treatment, not trying to provide the treatment yourself.
posted by viggorlijah at 7:11 PM on September 22, 2014 [19 favorites]
If the underlying problem is depression, then therapy and meds and helpful life changes (like getting meaningful work, exercise etc) are the only solutions we have for now. It could be that this is a different condition or a response to a crisis of other sorts.
I've been in your position, and I have to say the hospitalization feels scary and official but is a big relief for family and friends. You will probably have to argue to get them in because beds are often limited, but it's the most helpful thing you can do, be his advocate for treatment, not trying to provide the treatment yourself.
posted by viggorlijah at 7:11 PM on September 22, 2014 [19 favorites]
Much like your boyfriend needs external intervention and professional help to get through this, so do you, in navigating the waters and getting him to the help he needs. I do not know anything about resources or laws in the UK. I would recommend calling a local suicide helpline - not encouraging your boyfriend to do it, but calling yourself for guidance. They are trained to listen to what you have to say and helping you to figure out your next steps. This is indeed a crisis! Please remember that it is something that you need professional help with - you can't solve this or fix it. He may not believe he is ill, but you wouldn't try to talk someone who was having a heart attack into considering seeing a doctor, you would just get them to the hospital! Good luck to you, warm healing thoughts to you both. I wish I knew of a good resource in the UK - perhaps this site may have some good guidelines to point you in the right direction?
posted by pazazygeek at 7:12 PM on September 22, 2014 [1 favorite]
posted by pazazygeek at 7:12 PM on September 22, 2014 [1 favorite]
(speaking from a point of moderate personal ignorance, comparatively)
From what you described, hospitalization or similar sounds like it may be good decision. I have previously worked with a girl who exhibited similar behaviors (although she was bipolar), and short period hospitalization was necessary (this was in the US). She would go in to "re-balance" her medications, needing the care and consistency to begin to build herself up. She hated going in, but always felt better after.
In the UK, the Mental Health Act is the relevant legislation under which your bf could be admitted even if he doesn't want to. A quick glance at waiting times can be longer than desirable, , for what I believe is voluntary admittance. I would urge you to start by calling the NHS and get yourself an appointment to talk to someone for yourself, and ask lots of questions.
Also: self care for yourself. Don't forget about yourself in this situation.
posted by troytroy at 7:15 PM on September 22, 2014
From what you described, hospitalization or similar sounds like it may be good decision. I have previously worked with a girl who exhibited similar behaviors (although she was bipolar), and short period hospitalization was necessary (this was in the US). She would go in to "re-balance" her medications, needing the care and consistency to begin to build herself up. She hated going in, but always felt better after.
In the UK, the Mental Health Act is the relevant legislation under which your bf could be admitted even if he doesn't want to. A quick glance at waiting times can be longer than desirable, , for what I believe is voluntary admittance. I would urge you to start by calling the NHS and get yourself an appointment to talk to someone for yourself, and ask lots of questions.
Also: self care for yourself. Don't forget about yourself in this situation.
posted by troytroy at 7:15 PM on September 22, 2014
I am so sorry that you are both going through this.
Call a suicide hotline yourself, agreeing with pazazygeek.
Please remember to take care of yourself during this time as well.
Even though it might feel surreal and otherworldly right now, try to build a little routine and structure into this (crisis) time -- make meals and sit down for meals. Get sleep. I know when I've spiraled to points similar to your boyfriend, some semblence of order was a really, really important anchor. Give that to yourself, be kind to yourself, and try to share that with him now as well.
Go on walks -- try to break up the intense indoor and mind-racing time with simple things that take you into the world. Walks are great.
Remember, you can't fix all of somebody's problems overnight, but you can give your best when you act with kindness and calm, so try to give those things to yourself first and then, to the extent you can, give those to him. Sending you my support and warmth -- this crisis too shall pass!
posted by elephantsvanish at 7:15 PM on September 22, 2014 [3 favorites]
Call a suicide hotline yourself, agreeing with pazazygeek.
Please remember to take care of yourself during this time as well.
Even though it might feel surreal and otherworldly right now, try to build a little routine and structure into this (crisis) time -- make meals and sit down for meals. Get sleep. I know when I've spiraled to points similar to your boyfriend, some semblence of order was a really, really important anchor. Give that to yourself, be kind to yourself, and try to share that with him now as well.
Go on walks -- try to break up the intense indoor and mind-racing time with simple things that take you into the world. Walks are great.
Remember, you can't fix all of somebody's problems overnight, but you can give your best when you act with kindness and calm, so try to give those things to yourself first and then, to the extent you can, give those to him. Sending you my support and warmth -- this crisis too shall pass!
posted by elephantsvanish at 7:15 PM on September 22, 2014 [3 favorites]
Oh, and the NHS advertises this for carers:
Call Carers Direct on 0300 123 1053
Confidential information and advice for carers.
Lines are open 9am to 8pm Monday to Friday (except bank holidays), 11am to 4pm at weekends. Request a free call back or an interpreted call back in one of more than 170 languages including ربي, বাংলা, 中文, Français, ગુજરાતી, Polski, Português, ਪੰਜਾਬੀ, Soomaali, Español, Türkçe and .اردو.
You can talk to an adviser live online or send a query by email.
posted by troytroy at 7:16 PM on September 22, 2014 [3 favorites]
Call Carers Direct on 0300 123 1053
Confidential information and advice for carers.
Lines are open 9am to 8pm Monday to Friday (except bank holidays), 11am to 4pm at weekends. Request a free call back or an interpreted call back in one of more than 170 languages including ربي, বাংলা, 中文, Français, ગુજરાતી, Polski, Português, ਪੰਜਾਬੀ, Soomaali, Español, Türkçe and .اردو.
You can talk to an adviser live online or send a query by email.
posted by troytroy at 7:16 PM on September 22, 2014 [3 favorites]
With all love and respect, this isn't what treatment-resistant means. Depression almost always lies about how it's never, ever going to get better and that there's nothing one can possibly do to make it go away so one might as well not even bother. While there's no doubt in my mind that he believes what he's saying, you should go ahead and hold tight to the idea that it can get better, because he's hardly even begun to explore his resources.
posted by teremala at 7:17 PM on September 22, 2014 [30 favorites]
posted by teremala at 7:17 PM on September 22, 2014 [30 favorites]
(Also, so my comment above isn't misconstrued, I absolutely believe this is an acute crisis and inpatient hospitalization is an appropriate step to take. Just in case there is some kind of wait time or other logistical barrier, you can employ the steps of calm and routine as well.)
posted by elephantsvanish at 7:21 PM on September 22, 2014
posted by elephantsvanish at 7:21 PM on September 22, 2014
Yes, jumping on the bandwagon of "get him hospitalized at all costs, right now."
Also - hopefully once he's in a slightly better place you can help him understand that not all medications work the same for everyone. Some people can get rid of a headache with tylenol, others need ibuprofen. Some people treat allergies with claritin, others with allegra, and still others with zyrtec. Once he can internalize that his past experience with medication "making him a zombie" isn't indicative of all drug treatments, maybe he'll be willing to try something new. Same with therapy.
posted by trivia genius at 8:41 PM on September 22, 2014 [4 favorites]
Also - hopefully once he's in a slightly better place you can help him understand that not all medications work the same for everyone. Some people can get rid of a headache with tylenol, others need ibuprofen. Some people treat allergies with claritin, others with allegra, and still others with zyrtec. Once he can internalize that his past experience with medication "making him a zombie" isn't indicative of all drug treatments, maybe he'll be willing to try something new. Same with therapy.
posted by trivia genius at 8:41 PM on September 22, 2014 [4 favorites]
Google "suicidal gesture" which is what this sounds like it was. You will find advice about how to proceed.
posted by mlis at 8:58 PM on September 22, 2014
posted by mlis at 8:58 PM on September 22, 2014
I agree with everyone saying he needs to go to the hospital, because this is exactly the kind of thing in-patient treatment is for. It's not a punishment or prison, it's a *help* to stabilize him. I know it's frightening, but him dying of depression instead of going to the hospital for help is much more frightening.
He's right about the worst case scenario -- that it won't help. But he's wrong about the probability of the worst case scenario happening -- it's much, much lower than 100%. It sounds like he actually doesn't have treatment-resistant depression, either, which is depression that doesn't respond to (multiple) anti-depressants. He just has *severe* depression, that he needs help with.
He refuses to be put on medication because he says it will make him a zombie
I had an ex who would say this whenever I brought up medication. He'd also been on medication when he was much younger. Most psychotropic medications, and definitely most anti-depressants, work differently on kids and teens (or, the label says anyway, people under 25) than they do on adults. What your bf experienced when he went on medication when he was younger isn't necessarily what he would experience now. He also might need to give a few different medications a shot before finding one that works for him. I had to go through a couple that gave me nothing but side effects before finding one that actually worked. Taking a pill in the morning is honestly the easiest treatment there is for depression, though -- there are others that he could/should do in conjunction, but taking a pill (instead of just suffering the pain he's suffering now!) is really not that onerous, as far as treatments go.
Also, if he's suffering from severe depression and is suicidal, he might not even remember what having emotions is *like.* Depression isn't an emotion. It's more like a black hole that your emotions vanish into. Depression is *much* more likely to make someone into a "zombie" than anti-depressants are, imo.
Personally, I was shocked when I finally got onto an antidepressant that worked (which was not the first or second antidepressant I tried) and I could actually *feel* things again. First just anger, than sadness, too, and eventually lots of good things! Like love, delight, curiosity...even *anger* was delicious at first, though. The world just felt so much brighter and more alive. Even a low-grade depression can suck the feelings out of you. He should try flipping his thinking -- it's not necessarily medication keeping him from feeling positive emotions (or honestly, emotions at all), it's likely depression that's keeping him from that.
And if anti-depressants do make him feel like a "zombie," he can always go off of them again. Trying them out isn't a contract written in blood.
Anyway, this isn't to say that medication will definitely work and it's probably not going to work all by itself in any case, but imo it's bullheaded not to at least give it a try. They're not sugarpills, but anti-depressants aren't *that* dangerous, and they're not addictive.
and just serves to let doctors off the hook because it makes you "technically better"
I feel belittled and honestly frightened when doctors jump to explain all of a person's problems as stemming from a mental illness or mood disorder, because mental and physical health are so intricately intertwined, and because I don't want doctors to miss something physiological and serious just because they refuse to take me seriously, and because it just feels like such a brush-off to be told "it's all in your head." So I kind of know what your bf is talking about when he says he feels that medication "serves to let doctors off the hook."
Does your bf think anything *else* is wrong? He definitely needs treatment ASAP for his suicide attempt and related depression *in any case.* But what else is worrying him, does he think that some other problem is getting blown off? You can help him get help for those things, too -- eventually. The depression is the #1 priority right now, because it's threatening to be lethal. But once it's been dealt with, then you guys can move on to the #2 priority, whatever that might be -- if he even wants to make a list of things he wants to change or that are bothering him, that's OK. But try not to make any big decisions (either of you) right now, because the mental state each of you is in right now is likely to change and is likely not your "normal" state anyway.
Also, when he says "serves to let doctors off the hook," is he scared of not being taken care of, and does he feel like he needs more care than he's getting? If so, then he's right to be scared, because he *does* need more help than he's getting -- as shown by the suicide attempt. That's not *your* fault, you're doing the best you possibly can, it sounds like. But you're not a medical professional and this is beyond your pay grade as his gf. He needs to be taken care of by professionals who know how to treat this and are set up to treat this. You can't cure illnesses on your own, much as you might want to -- but luckily, that's why people created Health Care Systems and why there's an NHS.
If he does feel alone and like he's being left to twist in the wind and nobody is able to help him, then he should know that the place he'll get the *most* help and the *most* care and care specially suited to people in his situation, is in an in-patient facility. And again, I know it's frightening, but it really is his best shot at getting better.
In the meantime, or if something happens that means he can't go into in-patient treatment, I second elephantsvanish that routine and physical health is of the *utmost* importance. The bare minimum, imo, is: 1. bedtime and wakeup at regular times. 2. nutritious food and at regular mealtimes -- three squares a day 3. bathe and do at least basic cleaning up every day 4. leave the house at least once every day. 5. If at all possible, exercise (even walking is great. Outside is better than in a gym in any case). Even if he does go into in-patient treatment, once he's out, he'll need the support of a routine, still. It's a good thing to keep to until he's really "all better" (and just in general). Routine and structure is a way of making life easier and less stressful, by making it less chaotic -- so while he's such a mess inside, and under so much stress, it's important than the world outside be as orderly as possible.
It's very good that he's staying with you right now. Try to get him to follow your lead. If he's just going through the motions *that's OK.* He can feel however he feels, but he *has* to get through every day and he has to be as minimally self-destructive as possible, which is where the routine can help, too.
He also needs to figure out how to take time off of work. He obviously can't go in, but he may be able to get signed off for health reasons instead of having to quit. I'll let others speak to that, though, because I don't know the system for that in the UK (or really anywhere, frankly!).
posted by rue72 at 10:00 PM on September 22, 2014 [12 favorites]
He's right about the worst case scenario -- that it won't help. But he's wrong about the probability of the worst case scenario happening -- it's much, much lower than 100%. It sounds like he actually doesn't have treatment-resistant depression, either, which is depression that doesn't respond to (multiple) anti-depressants. He just has *severe* depression, that he needs help with.
He refuses to be put on medication because he says it will make him a zombie
I had an ex who would say this whenever I brought up medication. He'd also been on medication when he was much younger. Most psychotropic medications, and definitely most anti-depressants, work differently on kids and teens (or, the label says anyway, people under 25) than they do on adults. What your bf experienced when he went on medication when he was younger isn't necessarily what he would experience now. He also might need to give a few different medications a shot before finding one that works for him. I had to go through a couple that gave me nothing but side effects before finding one that actually worked. Taking a pill in the morning is honestly the easiest treatment there is for depression, though -- there are others that he could/should do in conjunction, but taking a pill (instead of just suffering the pain he's suffering now!) is really not that onerous, as far as treatments go.
Also, if he's suffering from severe depression and is suicidal, he might not even remember what having emotions is *like.* Depression isn't an emotion. It's more like a black hole that your emotions vanish into. Depression is *much* more likely to make someone into a "zombie" than anti-depressants are, imo.
Personally, I was shocked when I finally got onto an antidepressant that worked (which was not the first or second antidepressant I tried) and I could actually *feel* things again. First just anger, than sadness, too, and eventually lots of good things! Like love, delight, curiosity...even *anger* was delicious at first, though. The world just felt so much brighter and more alive. Even a low-grade depression can suck the feelings out of you. He should try flipping his thinking -- it's not necessarily medication keeping him from feeling positive emotions (or honestly, emotions at all), it's likely depression that's keeping him from that.
And if anti-depressants do make him feel like a "zombie," he can always go off of them again. Trying them out isn't a contract written in blood.
Anyway, this isn't to say that medication will definitely work and it's probably not going to work all by itself in any case, but imo it's bullheaded not to at least give it a try. They're not sugarpills, but anti-depressants aren't *that* dangerous, and they're not addictive.
and just serves to let doctors off the hook because it makes you "technically better"
I feel belittled and honestly frightened when doctors jump to explain all of a person's problems as stemming from a mental illness or mood disorder, because mental and physical health are so intricately intertwined, and because I don't want doctors to miss something physiological and serious just because they refuse to take me seriously, and because it just feels like such a brush-off to be told "it's all in your head." So I kind of know what your bf is talking about when he says he feels that medication "serves to let doctors off the hook."
Does your bf think anything *else* is wrong? He definitely needs treatment ASAP for his suicide attempt and related depression *in any case.* But what else is worrying him, does he think that some other problem is getting blown off? You can help him get help for those things, too -- eventually. The depression is the #1 priority right now, because it's threatening to be lethal. But once it's been dealt with, then you guys can move on to the #2 priority, whatever that might be -- if he even wants to make a list of things he wants to change or that are bothering him, that's OK. But try not to make any big decisions (either of you) right now, because the mental state each of you is in right now is likely to change and is likely not your "normal" state anyway.
Also, when he says "serves to let doctors off the hook," is he scared of not being taken care of, and does he feel like he needs more care than he's getting? If so, then he's right to be scared, because he *does* need more help than he's getting -- as shown by the suicide attempt. That's not *your* fault, you're doing the best you possibly can, it sounds like. But you're not a medical professional and this is beyond your pay grade as his gf. He needs to be taken care of by professionals who know how to treat this and are set up to treat this. You can't cure illnesses on your own, much as you might want to -- but luckily, that's why people created Health Care Systems and why there's an NHS.
If he does feel alone and like he's being left to twist in the wind and nobody is able to help him, then he should know that the place he'll get the *most* help and the *most* care and care specially suited to people in his situation, is in an in-patient facility. And again, I know it's frightening, but it really is his best shot at getting better.
In the meantime, or if something happens that means he can't go into in-patient treatment, I second elephantsvanish that routine and physical health is of the *utmost* importance. The bare minimum, imo, is: 1. bedtime and wakeup at regular times. 2. nutritious food and at regular mealtimes -- three squares a day 3. bathe and do at least basic cleaning up every day 4. leave the house at least once every day. 5. If at all possible, exercise (even walking is great. Outside is better than in a gym in any case). Even if he does go into in-patient treatment, once he's out, he'll need the support of a routine, still. It's a good thing to keep to until he's really "all better" (and just in general). Routine and structure is a way of making life easier and less stressful, by making it less chaotic -- so while he's such a mess inside, and under so much stress, it's important than the world outside be as orderly as possible.
It's very good that he's staying with you right now. Try to get him to follow your lead. If he's just going through the motions *that's OK.* He can feel however he feels, but he *has* to get through every day and he has to be as minimally self-destructive as possible, which is where the routine can help, too.
He also needs to figure out how to take time off of work. He obviously can't go in, but he may be able to get signed off for health reasons instead of having to quit. I'll let others speak to that, though, because I don't know the system for that in the UK (or really anywhere, frankly!).
posted by rue72 at 10:00 PM on September 22, 2014 [12 favorites]
I know next to nothing about UK health care or mental health care. I know all kinds of lots about depression. YMMV.
I am currently taking 2 antidepressants, an anxiolytic, and a mood stabilizer. Today, I had a major panic attack because somebody knocked on my door. Last weekend, I was on suicide watch at my local ED because in the middle of a complex migraine that included aphasia, the thought of stabbing myself in the thigh with scissors sounded like a really good idea, because it was pain that I would know the cause of and be able to fix. That scared the hell out of me. Ever go to a foreign country where you mostly know enough of the language to get by, but you're missing vocabulary? That's how I felt trying to communicate what was going on to the ED staff. I was almost screaming at the Dr., with wild, frantic gestures, that the pain was real, that I didn't want to die, I just wanted the pain to stop. They treated the migraine, while keeping me on suicide watch, and when I was more coherent, I was able to explain my frustrations.
My point is that ED staff can help. If there is a hospital near you, get him in the car and go. Or call them and ask for help yourself. I did not want to go to the ED. It was the last thing on earth I wanted to do. But a friend convinced me to call a local friend to get a ride. (Well, ok, he threatened to call her himself if I didn't.) They snapped right into action to help me, and I was only having thoughts of self-harm. Your boyfriend attempted to kill himself. They will snap into action to help him, too.
One last thing: You know how on airplanes, the flight attendants tell you to put your oxygen mask on first, then assist others? That applies tenfold to people who love people with mental illnesses. You have to make sure you're taking care of yourself, physically, emotionally, and mentally, so that you are able to take care of your boyfriend. Best of luck.
posted by The Almighty Mommy Goddess at 10:23 PM on September 22, 2014 [1 favorite]
I am currently taking 2 antidepressants, an anxiolytic, and a mood stabilizer. Today, I had a major panic attack because somebody knocked on my door. Last weekend, I was on suicide watch at my local ED because in the middle of a complex migraine that included aphasia, the thought of stabbing myself in the thigh with scissors sounded like a really good idea, because it was pain that I would know the cause of and be able to fix. That scared the hell out of me. Ever go to a foreign country where you mostly know enough of the language to get by, but you're missing vocabulary? That's how I felt trying to communicate what was going on to the ED staff. I was almost screaming at the Dr., with wild, frantic gestures, that the pain was real, that I didn't want to die, I just wanted the pain to stop. They treated the migraine, while keeping me on suicide watch, and when I was more coherent, I was able to explain my frustrations.
My point is that ED staff can help. If there is a hospital near you, get him in the car and go. Or call them and ask for help yourself. I did not want to go to the ED. It was the last thing on earth I wanted to do. But a friend convinced me to call a local friend to get a ride. (Well, ok, he threatened to call her himself if I didn't.) They snapped right into action to help me, and I was only having thoughts of self-harm. Your boyfriend attempted to kill himself. They will snap into action to help him, too.
One last thing: You know how on airplanes, the flight attendants tell you to put your oxygen mask on first, then assist others? That applies tenfold to people who love people with mental illnesses. You have to make sure you're taking care of yourself, physically, emotionally, and mentally, so that you are able to take care of your boyfriend. Best of luck.
posted by The Almighty Mommy Goddess at 10:23 PM on September 22, 2014 [1 favorite]
Agreed with the answerers above. Calling a crisis line is appropriate for depression or passive suicidal ideation (i.e. "I wish I were dead" with no actual plan to hurt oneself, or having transient thoughts of hurting oneself but being assured that one would never carry out these plans because of whatever reasons).
Calling a crisis line is not meant for people who have actually attempted suicide or have active suicidal thoughts/a plan to hurt themselves - such people will be referred directly to the emergency department as they need to be immediately evaluated by a mental health professional and likely to be hospitalized.
DO NOT WAIT FOR HIM TO ATTEMPT SUICIDE AGAIN. He could be successful this time, and then how will you be able to help him? Get him to an emergency mental health evaluation immediately.
posted by treehorn+bunny at 10:54 PM on September 22, 2014 [5 favorites]
Calling a crisis line is not meant for people who have actually attempted suicide or have active suicidal thoughts/a plan to hurt themselves - such people will be referred directly to the emergency department as they need to be immediately evaluated by a mental health professional and likely to be hospitalized.
DO NOT WAIT FOR HIM TO ATTEMPT SUICIDE AGAIN. He could be successful this time, and then how will you be able to help him? Get him to an emergency mental health evaluation immediately.
posted by treehorn+bunny at 10:54 PM on September 22, 2014 [5 favorites]
My boyfriend is absolutely 100% convinced that medical help won't do any good.
He is, of course, dead wrong. He knows this, but doesn't want to face it, almost certainly knowing the amount of work that he is facing down should he become as concerned about all this as you are.
He refuses to be put on medication
Then he's screwed.
because he says it will make him a zombie
It is -- sometimes; some people get really lucky, and find the right medication(s) right off the bat, but for many (most?) it is a trial and error thing -- it is very frustrating to find the right medication or "meds stew" that will address your particular flavor of depression, anxiety, and despair yet not affect you negatively, either physiologically or psychologically. But the right medication is absolutely out there. Repeat, for effect: The right medication is absolutely out there.
It is imperative that he accept, gut level, that there absolutely is medical help for him. Once he accepts that, it is up to him to gen the willingness to be at least 50% of the partnership with a competent shrink, to find that medication.
Oh, wait -- how does he know his shrink is competent? That's part of the learning process, and damn sure part of the frustration in it all. Though, again, some people get real lucky, get a great doc right off.
and just serves to let doctors off the hook because it makes you "technically better"
If he was "technically better" when he was on this medication or that one at some time in the past, that means that he was "better" and that medication got him there, and he knows it. He's resentful, and he's got some self pity going on here also; both are hallmarks of untreated depression.
(he has been on medication before,
Was that when it "technically" helped him?
which I believe wasn't his choice --
Here in the states, it's DTS/DTO -- Danger To Self / Danger To Others. If you fall in either (or both) of those two categories, you can be held for 72 hours, while things get sorted out. And then there is a hearing, to determine if you need to be held for more extended medical care, until you are no longer DTS/DTO, as determined by the treatment facility.
Don't be surprised if your beau isn't completely and totally joyous about these prospects; it's generally not a festive time for the person being committed.
He has been through therapy
As far as I know, any person who has ever been suicidal is never really "through" therapy. Anyone who attempted suicide yesterday needs to be in therapy last week, and/or last year, also. Your boyfriend is damn sure is not through with therapy, and he may never be. He's got work to do.
His problem, as he sees it, is that he is stupid and miserable and that will never change.
Here's that self-hatred and self-pity thing again. Truly, hallmarks of depression. I get it; it totally blows being depressed. And it absolutely is an uphill slog, especially since you don't really believe -- at least not totally -- esp since you don't really believe you can find your way. It's uphill and it's a slippery slope and the depressed person is in a bad place for slippery uphills. But there it is.
He knows he is depressed but refuses to believe he is ill.
Totally illogical and he knows that as well as you and I do.
He hates his job and his living situation and desperately wants to change it, but again can't see it ever changing.
He can't see it ever changing without him busting his ass to do the work that might change it, not at all sure while he's doing that work that he's ever going to get to a place of peace.
Trying to talk to him about this stuff is like hitting a brick wall. He gets angry and defensive and won't listen.
He's running a game. I'm not saying that he's conscious of that. But it's what he's doing.
~~~~~
My questions:
- Am I doing the right thing? My best scenario right now is for him to make contact with a medical professional who will sit him down and tell him he is seriously unwell and he needs to get his shit together.
Unless/until you are ready, willing, and able to go DTS/DTO and get him committed, it is up to him to get help. You can love him -- he is extraordinarily fortunate to have you in his corner. But this is his work.
Do I keep pushing him?
No. Love him, don't push him. This is his show.
Do I keep fighting?
No. Love him, don't fight with him -- this is *way* bigger than you are.
- Is there any other option, aside from therapy and medication, which can help us, or is that pretty much the be-all-end-all right now?
Therapy and medication are where it is at. Yoga, running in the park, meditation, petting the cat, walking with you -- these are all Good Things, and are Very Nice. But he tried to take himself out yesterday. Meds and therapy are what it is for most all of your basic ham-and-egger depressed people, damn sure what it is for me.
~~~~~
, if you feel up to telling me.
I have not ever attempted suicide. I have put loaded, cocked guns in my mouth, my finger on the trigger, but I never have pulled the trigger. So it wasn't an attempt, really, more a stab in that direction than an attempt, as I see it. I know despair, and I know it very, very well. I know savage, unrelenting depression, I know childhood scars plenty goddamn well enough for me and the next five persons, I know of how mental illness in a parent (or parents, as in my case, not to mention in my sibs) can have major impacts upon the children, regardless there being deep love in said family. I have been impacted severely both from others in my family suffering alcoholism and from myself suffering it, and drug addiction also.
I have not had a gun in my mouth in 27 years. I'm not saying I've not had horrific depression in those years -- I damn sure have. I just sortof finally hit some bottom or other, and/or realized that I don't have the jam to go out with a bang. And I do think that I somehow thought that I could get out, get past, get relief, find peace. I've found peace a moving target, to be sure, but through medication -- Better living through chemistry! -- costing thousands upon thousands and thousands of dollars*, and through dedicated, determined self-care (prayer, meditation, medication, yoga, owning the prettiest pickup in Texas, etc) and through the love of many, many professionals and family members and friends, that target is smaller now. Peace lives in a smaller frame. It's still work of course, but the path to there is well worn now.
*My dollars and taxpayer dollars. It is very, very difficult to get help from county/city/state/whatever -- you've got to be broken enough to need the help, yet determined enough to jump through the mazes inside of mazes of loops to get the help.1 It's a fucker.
1In the end, I had to flippin' die before they agreed to help me. But that's another story.
Your man is remarkably lucky that you are there, and hanging in with him. I do wish you'd had an older sister, on this side of the pond, who would have been able to have hung in with me, lo those long years gone by. And I hope she had a really cool accent, like I'd bet you do, and spelled it "colour" instead of color. But I never was too terribly easy to hang in with, so I guess it's best for your pretend older sister that she never was here, though I bet she'd like Texas, at least to visit; I sure did like London.
~~~~~
This is his show. He is profoundly depressed, and needs help, and needs to get it himself. You can love him, and it's clear that you are loving him, and the best kind of love, too -- love as a verb. But hows about loving yourself? As a verb. In your writing about this situation, there was very little mention of self-care; you are in a highly charged, very strained situation. If you asked me -- and you did -- I'd say that you need a step back, or two steps back, give yourself a chance to recharge, regroup, relax. Take a break, take a breath, take another. Buy yourself some flowers, and a nice hat -- I'd bet two hundred bucks he hasn't bought you either of those things this week.
Unless you are really ready, willing, and able to do the hard work of DTS/DTO -- and it really is a bitch, in my experience, which is considerable -- this is his show. He may have to lose you as he learns, on a deeper level, how much this is costing him.
Good luck.
posted by dancestoblue at 11:55 PM on September 22, 2014 [2 favorites]
He is, of course, dead wrong. He knows this, but doesn't want to face it, almost certainly knowing the amount of work that he is facing down should he become as concerned about all this as you are.
He refuses to be put on medication
Then he's screwed.
because he says it will make him a zombie
It is -- sometimes; some people get really lucky, and find the right medication(s) right off the bat, but for many (most?) it is a trial and error thing -- it is very frustrating to find the right medication or "meds stew" that will address your particular flavor of depression, anxiety, and despair yet not affect you negatively, either physiologically or psychologically. But the right medication is absolutely out there. Repeat, for effect: The right medication is absolutely out there.
It is imperative that he accept, gut level, that there absolutely is medical help for him. Once he accepts that, it is up to him to gen the willingness to be at least 50% of the partnership with a competent shrink, to find that medication.
Oh, wait -- how does he know his shrink is competent? That's part of the learning process, and damn sure part of the frustration in it all. Though, again, some people get real lucky, get a great doc right off.
and just serves to let doctors off the hook because it makes you "technically better"
If he was "technically better" when he was on this medication or that one at some time in the past, that means that he was "better" and that medication got him there, and he knows it. He's resentful, and he's got some self pity going on here also; both are hallmarks of untreated depression.
(he has been on medication before,
Was that when it "technically" helped him?
which I believe wasn't his choice --
Here in the states, it's DTS/DTO -- Danger To Self / Danger To Others. If you fall in either (or both) of those two categories, you can be held for 72 hours, while things get sorted out. And then there is a hearing, to determine if you need to be held for more extended medical care, until you are no longer DTS/DTO, as determined by the treatment facility.
Don't be surprised if your beau isn't completely and totally joyous about these prospects; it's generally not a festive time for the person being committed.
He has been through therapy
As far as I know, any person who has ever been suicidal is never really "through" therapy. Anyone who attempted suicide yesterday needs to be in therapy last week, and/or last year, also. Your boyfriend is damn sure is not through with therapy, and he may never be. He's got work to do.
His problem, as he sees it, is that he is stupid and miserable and that will never change.
Here's that self-hatred and self-pity thing again. Truly, hallmarks of depression. I get it; it totally blows being depressed. And it absolutely is an uphill slog, especially since you don't really believe -- at least not totally -- esp since you don't really believe you can find your way. It's uphill and it's a slippery slope and the depressed person is in a bad place for slippery uphills. But there it is.
He knows he is depressed but refuses to believe he is ill.
Totally illogical and he knows that as well as you and I do.
He hates his job and his living situation and desperately wants to change it, but again can't see it ever changing.
He can't see it ever changing without him busting his ass to do the work that might change it, not at all sure while he's doing that work that he's ever going to get to a place of peace.
Trying to talk to him about this stuff is like hitting a brick wall. He gets angry and defensive and won't listen.
He's running a game. I'm not saying that he's conscious of that. But it's what he's doing.
~~~~~
My questions:
- Am I doing the right thing? My best scenario right now is for him to make contact with a medical professional who will sit him down and tell him he is seriously unwell and he needs to get his shit together.
Unless/until you are ready, willing, and able to go DTS/DTO and get him committed, it is up to him to get help. You can love him -- he is extraordinarily fortunate to have you in his corner. But this is his work.
Do I keep pushing him?
No. Love him, don't push him. This is his show.
Do I keep fighting?
No. Love him, don't fight with him -- this is *way* bigger than you are.
- Is there any other option, aside from therapy and medication, which can help us, or is that pretty much the be-all-end-all right now?
Therapy and medication are where it is at. Yoga, running in the park, meditation, petting the cat, walking with you -- these are all Good Things, and are Very Nice. But he tried to take himself out yesterday. Meds and therapy are what it is for most all of your basic ham-and-egger depressed people, damn sure what it is for me.
~~~~~
, if you feel up to telling me.
I have not ever attempted suicide. I have put loaded, cocked guns in my mouth, my finger on the trigger, but I never have pulled the trigger. So it wasn't an attempt, really, more a stab in that direction than an attempt, as I see it. I know despair, and I know it very, very well. I know savage, unrelenting depression, I know childhood scars plenty goddamn well enough for me and the next five persons, I know of how mental illness in a parent (or parents, as in my case, not to mention in my sibs) can have major impacts upon the children, regardless there being deep love in said family. I have been impacted severely both from others in my family suffering alcoholism and from myself suffering it, and drug addiction also.
I have not had a gun in my mouth in 27 years. I'm not saying I've not had horrific depression in those years -- I damn sure have. I just sortof finally hit some bottom or other, and/or realized that I don't have the jam to go out with a bang. And I do think that I somehow thought that I could get out, get past, get relief, find peace. I've found peace a moving target, to be sure, but through medication -- Better living through chemistry! -- costing thousands upon thousands and thousands of dollars*, and through dedicated, determined self-care (prayer, meditation, medication, yoga, owning the prettiest pickup in Texas, etc) and through the love of many, many professionals and family members and friends, that target is smaller now. Peace lives in a smaller frame. It's still work of course, but the path to there is well worn now.
*My dollars and taxpayer dollars. It is very, very difficult to get help from county/city/state/whatever -- you've got to be broken enough to need the help, yet determined enough to jump through the mazes inside of mazes of loops to get the help.1 It's a fucker.
1In the end, I had to flippin' die before they agreed to help me. But that's another story.
Your man is remarkably lucky that you are there, and hanging in with him. I do wish you'd had an older sister, on this side of the pond, who would have been able to have hung in with me, lo those long years gone by. And I hope she had a really cool accent, like I'd bet you do, and spelled it "colour" instead of color. But I never was too terribly easy to hang in with, so I guess it's best for your pretend older sister that she never was here, though I bet she'd like Texas, at least to visit; I sure did like London.
~~~~~
This is his show. He is profoundly depressed, and needs help, and needs to get it himself. You can love him, and it's clear that you are loving him, and the best kind of love, too -- love as a verb. But hows about loving yourself? As a verb. In your writing about this situation, there was very little mention of self-care; you are in a highly charged, very strained situation. If you asked me -- and you did -- I'd say that you need a step back, or two steps back, give yourself a chance to recharge, regroup, relax. Take a break, take a breath, take another. Buy yourself some flowers, and a nice hat -- I'd bet two hundred bucks he hasn't bought you either of those things this week.
Unless you are really ready, willing, and able to do the hard work of DTS/DTO -- and it really is a bitch, in my experience, which is considerable -- this is his show. He may have to lose you as he learns, on a deeper level, how much this is costing him.
Good luck.
posted by dancestoblue at 11:55 PM on September 22, 2014 [2 favorites]
Please get your boyfriend to an ER as soon as possible. Very sorry that you're both going through this, but you could literally save his life by doing so. Best wishes to you both!
posted by InsertNiftyNameHere at 11:57 PM on September 22, 2014 [1 favorite]
posted by InsertNiftyNameHere at 11:57 PM on September 22, 2014 [1 favorite]
teremala really has it, above. And meds do work. We have enough of them to where we can find relief for the suffering of many people who suffer from depression. And that's a big, big deal. I say this as someone who knows this terrain from the inside too well.
posted by persona au gratin at 12:18 AM on September 23, 2014
posted by persona au gratin at 12:18 AM on September 23, 2014
Mental health services are generally accessed via the GP, so he needs an emergency appointment. Alternatively present at A and E and he will be seen by psychiatric liaison. That said, you can take a horse to water but you can't make it drink.
Check out the Maytree retreat but it's a gamble - if they knock him back it will hit hard.
posted by tanktop at 12:44 AM on September 23, 2014
Check out the Maytree retreat but it's a gamble - if they knock him back it will hit hard.
posted by tanktop at 12:44 AM on September 23, 2014
UK hospital doctor here (not a psych).
Take him to A&E, tell them what you told us. He will be seen and assessed by psychiatry there and then. He might be admitted, he might be managed as an outpatient (my money would be on admission if he is sti suicidal and is refusing medication) but either way he will have been seen and assessed.
A&Es are generally not that busy in the mornings, so go in now. You'll probably wait an hour or two, and a full paych assessment takes about an hour to complete. Go to the hospital in his borough, it will be easier for them to plug him back into a community team on discharge.
posted by tinkletown at 12:54 AM on September 23, 2014 [9 favorites]
Take him to A&E, tell them what you told us. He will be seen and assessed by psychiatry there and then. He might be admitted, he might be managed as an outpatient (my money would be on admission if he is sti suicidal and is refusing medication) but either way he will have been seen and assessed.
A&Es are generally not that busy in the mornings, so go in now. You'll probably wait an hour or two, and a full paych assessment takes about an hour to complete. Go to the hospital in his borough, it will be easier for them to plug him back into a community team on discharge.
posted by tinkletown at 12:54 AM on September 23, 2014 [9 favorites]
I have been told by someone involved in UK mental health treatment that if I was even considering suicide seriously, let alone if I had attempted it, that the thing to do was call an ambulance and get to the hospital however silly or attention-seeking or useless that would feel.
Get him to A+E.
posted by mymbleth at 1:14 AM on September 23, 2014 [1 favorite]
Get him to A+E.
posted by mymbleth at 1:14 AM on September 23, 2014 [1 favorite]
You can't fix him. You can't even really help him. And he is, after all, only a boyfriend, not a husband, not family. It is okay to hand him over to someone else and walk away. You are not a terrible person for doing so. This problem that he has, is not in your control, not your fault, and not your responsibility.
He needs to be in a hospital. There is a good chance that he will never get better. There is a good chance that he will succeed next time. It is up to him to change and, if he is resistant to medical intervention, that won't happen. You can't fix that.
And don't think for a minute that he isn't using this to manipulate you. No one can go through something like this and not be manipulated. In a healthy relationship, you could get mad at him for something and storm off. You don't have that option in this relationship because he may kill himself. What he is doing to himself is wrong. What you are allowing him to do to you is worse.
Drop him off at the nearest hospital, wish him the best, and drive away. In America, if someone even threatens to hurt themselves, we call the police and let them handle it. Use your resources and don't try to manage this burden alone.
posted by myselfasme at 4:16 AM on September 23, 2014 [2 favorites]
He needs to be in a hospital. There is a good chance that he will never get better. There is a good chance that he will succeed next time. It is up to him to change and, if he is resistant to medical intervention, that won't happen. You can't fix that.
And don't think for a minute that he isn't using this to manipulate you. No one can go through something like this and not be manipulated. In a healthy relationship, you could get mad at him for something and storm off. You don't have that option in this relationship because he may kill himself. What he is doing to himself is wrong. What you are allowing him to do to you is worse.
Drop him off at the nearest hospital, wish him the best, and drive away. In America, if someone even threatens to hurt themselves, we call the police and let them handle it. Use your resources and don't try to manage this burden alone.
posted by myselfasme at 4:16 AM on September 23, 2014 [2 favorites]
Hi all, I am the OP of this question (and blockquoting myself to make this easier for later readers to find).posted by fight or flight at 6:54 AM on September 23, 2014 [8 favorites]
Thank you for all of your responses. I really appreciate your words and thoughts for us.
I woke up this morning at 4AM after some weird-ass dreams and couldn't get back to sleep, so I called the NHS 111 helpline and spoke to a lovely nurse who walked me through how I was feeling and what the situation was like. He gave me some language to use and helped to steady my resolve a little. He couldn't provide specific help or crisis management because apparently that would require actually talking to my boyfriend, who was upstairs asleep.
This morning my boyfriend and I talked a bit and I got him to agree to see his GP with me tomorrow (we couldn't see them today because he has an important work thing he needs to be at -- I know, I know, but everything is so fragile right now I didn't want to push it). So I'm going to call tomorrow morning and see if they can give us an emergency appointment. If not, I am going to take him to the nearest A&E (thankfully there are two within 15 minutes of our respective homes) and see if he can be assessed that way.
Right now his instinct is to rail against my advice because he's been so poorly treated in the past, but he has acknowledged that this is unreasonable and that I am making sense. His mood is generally OK, but swinging a lot between normal "up"ness and laughing at dumb jokes on Twitter and then talking about how the universe doesn't want him in it and that things will never get better. He hasn't spoken about specifically ending his life again. He does seem to think that he's only "a little bit sad" and therefore it's nothing to worry about. I have talked to some other friends who know him and have also dealt with mental health issues, and they are also providing support.
So yeah, I'm tired but hopeful. Wish us luck.
I've been there and I feel for you. The process here in the UK with mental health services is that you would need persuade your partner to visit his GP with you in tow, and explain the situation to his GP with the hope of getting an urgent referral to mental health services.
If he becomes a danger to himself at any point then call his GP and state that you need to speak to a Dr urgently, in my experience you will get straight through by doing this and explain the situation to them. Obviously they are limited in their ability to talk to you due to confidentiality but this shouldn't stop you speaking to them about him. They should make arrangements for an psych team to visit him urgently.
If he is at risk of harming himself overnight or on a weekend you call NHS direct (which functions as the out of hours service too) and again they should be able to refer you.
In all cases you should not downplay the seriousness of his position as you will find that mental health services in this country are seriously poorly run as well as overstretched. We found that basically being suicidal is the only thing that triggers a response. Psych meds are dealt with by your GP, counselling is non existent and only group CBT sessions during working hours are offered.
I am afraid I can't speak to the resistance to treatment element as my family member had been on meds before and knew how well they worked. Seriously, if he is this bad then being on meds can only help him, and is nothing like the days of lithium and valium he may be fearing.
And yeah, please, put on your own oxygen mask first, I have been through this and if you'd like to talk, please memail me.
posted by RandomInconsistencies at 8:34 AM on September 23, 2014 [1 favorite]
If he becomes a danger to himself at any point then call his GP and state that you need to speak to a Dr urgently, in my experience you will get straight through by doing this and explain the situation to them. Obviously they are limited in their ability to talk to you due to confidentiality but this shouldn't stop you speaking to them about him. They should make arrangements for an psych team to visit him urgently.
If he is at risk of harming himself overnight or on a weekend you call NHS direct (which functions as the out of hours service too) and again they should be able to refer you.
In all cases you should not downplay the seriousness of his position as you will find that mental health services in this country are seriously poorly run as well as overstretched. We found that basically being suicidal is the only thing that triggers a response. Psych meds are dealt with by your GP, counselling is non existent and only group CBT sessions during working hours are offered.
I am afraid I can't speak to the resistance to treatment element as my family member had been on meds before and knew how well they worked. Seriously, if he is this bad then being on meds can only help him, and is nothing like the days of lithium and valium he may be fearing.
And yeah, please, put on your own oxygen mask first, I have been through this and if you'd like to talk, please memail me.
posted by RandomInconsistencies at 8:34 AM on September 23, 2014 [1 favorite]
I am not familiar with involuntary commitment laws in the UK, but generally in the US if someone has made an actual suicide attempt, then that is at least grounds enough for a psychiatric hold (commonly ~1 week at an in-patient facility).
One thing to consider that I haven't seen mentioned here is electro-convulsive therapy. I know this sounds extreme, but it is often a treatment of last resort in highly resistant depressions. It is not guaranteed to fix him for good, but may knock him out of his death-spiral for long enough to have him adhere to and benefit from a behavioral/pharmaceutical regimen. If you consider this then it is definitely something to discuss with a staff psychiatrist or psychologist at an in-patient facility, which your boyfriend desperately needs to be in.
posted by obliterati at 8:36 AM on September 23, 2014
One thing to consider that I haven't seen mentioned here is electro-convulsive therapy. I know this sounds extreme, but it is often a treatment of last resort in highly resistant depressions. It is not guaranteed to fix him for good, but may knock him out of his death-spiral for long enough to have him adhere to and benefit from a behavioral/pharmaceutical regimen. If you consider this then it is definitely something to discuss with a staff psychiatrist or psychologist at an in-patient facility, which your boyfriend desperately needs to be in.
posted by obliterati at 8:36 AM on September 23, 2014
Also, once the crisis period is over, consider seeing a therapist/counselor for yourself if financials/time are not constraints. Being in a relationship with someone so seriously mentally unwell is going to take the stuffing out of anybody. Best of luck to you indeed.
posted by obliterati at 8:41 AM on September 23, 2014 [1 favorite]
posted by obliterati at 8:41 AM on September 23, 2014 [1 favorite]
I wish both you and your boyfriend the best. I may be way across the pond, but I want you both to know that you're both in my thoughts. You seem like a wonderful partner for your boyfriend. I can only wish that some of my family members were half as concerned for me as you seem to be for your boyfriend. No matter what else, please remember that you two are not alone. There are many of us thinking of you both and wishing you well. Now I'm crying. Best of luck to you both!!
posted by InsertNiftyNameHere at 2:25 PM on September 23, 2014 [1 favorite]
posted by InsertNiftyNameHere at 2:25 PM on September 23, 2014 [1 favorite]
Update: we managed to get an emergency appointment to see my boyfriend's GP yesterday (otherwise we would have had to wait over a week). She seemed concerned and referred him to the borough's mental health crisis team. For those of you in the US, MH crisis teams are set up by the local NHS service as a front-line alternative to hospitalisation. They liaise directly with the person in crisis and recommend them to various services including therapists, social workers and psychologists, but they can't themselves prescribe medication. They are also critically overworked, underfunded and understaffed and it is a fucking travesty at every level, but that particular political rant can wait for another time.posted by fight or flight at 3:11 AM on September 25, 2014 [3 favorites]
Luckily the crisis team are situated not far from my boyfriend's place, so we could spend the few hours between appointments chilling out and watching a couple episodes of The Wire to distract ourselves. So that was good.
The nurse from the crisis team was lovely, albeit a little tactless and clearly stressed. She got my boyfriend to describe his level of risk and did an assessment of his mental state and previous experiences with healthcare. He is no longer actively suicidal but did admit that he has been having suicidal thoughts (though not ideation) for a while. His biggest problem is that he has no hope for his future and doesn't see anything working out. He said that he is willing to experiment with medication, but the nurse advised that it would be difficult for him if he is starting from a place of not wanting to be medicated, given how long it would take to find the right drug, the side-effects etc. She said that she doesn't think a hospital stay would benefit him and is instead trying to speed up his existing referral to a counselor (which usually takes 6 weeks at least, see above comment re: the shitty state of the NHS mental health services). His GP is also going to call him today to check up on him, which I hope means she is taking a dedicated interest in his well-being.
So yeah, right now we are in a holding pattern. My boyfriend is mostly up-and-down in mood, positive and happy during the day and then crashing hard at night. He's staying with me right now and I'm doing my best to trust him when he's on his own, but it's tough. I will be looking at finding therapy for myself but I can't afford the expense at the moment.
Thanks for being here for me, Mefites. Knowing I have this space to burble out my feelings is really reassuring.
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posted by alphanerd at 7:00 PM on September 22, 2014 [5 favorites]