Mental Health, Suicide Prevention
 

A separate thread?

Metaschima, I respect that you treat the issue with respect. :)

What you stated above is what I've been told by doctors before.

However... When I first sought treatment, I had an initial consultation with a psychotherapist, and was given a 566 question test, and then in the first session with a psychiatrist was put on three different medications.

According the drug makers and doctors, it can take up to six weeks for medication to get the full effect.

I had no prior history of suicide attempts.

Now, during this time, I was working. I owned a car. I drove. I was rational enough to do these things.

I've used myself for an example because it's relevant for other people. We can agree that some people who are struggling are still taking care of themselves, even to the extent of having their own apartment and working at a full-time job?

In situations like this, I think considering medication is fine, keeping that option on the table. But because of the unknowns of the brain, and psych meds, more emphasis should be put on non-pharmacological treatment.

Another key point to consider, meds can take up to six weeks to work, so even prescribing them to a patient who is far closer to the point of suicide can do little to actually prevent a suicide. That's when the close monitoring should be done.

Speaking of close monitoring, once a week appointments is the standard. Any problems, call the doctors office. After hours, a message usually instructs someone to dial 911 in the case of an emergency. And usually there's no help available unless one actually has a plan. It's not enough to simply feel hopeless and desparate, if they determine you're not an immediate threat to yourself or others... nothing 911 can do, except give you the number for a suicide hotline.

So then you talk to an operator who's never met you before and you have no rapport with. Their job is apparently to help you feel better so you can... cope until your next appointment with your doctor or therapist?

Going directly back to close monitoring... family and friends? I believe it's commonly known that many people with mental illness are more likely to voluntarily isolate themselves, or simply not have a good connection to family and friends. So... the reality is, close monitoring is not realistic. One could argue it's irrational to expect it of a patient, or treat someone with psychoactive drugs unless there is a method to closely monitor them. ;)

Or irrational to expect someone to feel happy and content when they know every week they have to pay someone to talk to them ;)

It seems almost irrational that in some cases it's cheaper to see a prostitute rather than a therapist. But prostitutes don't take insurance, so, no, I'm not advocating that if one has to pick one or the other to feel better in the short-term.

Once in a session I was feeling particularly down, and spoke more of thinking about suicide. He usually just let me vent, but this time he said, "Well, if you're going to commit suicide, there's really nothing I can do about it."

See, if there's no immediate plan, then legally they really can't.

In fact, if someone is put on a 72-hour hold because of a suicide attempt or because he was deemed to be in immediate danger, he is released if deemed no longer an immediate danger. Where to then? Back in the same situation he was in before the attempt. For me, it was like a little vacation, I met some nice people who I could relate to, so yes, I did feel better afterward and able to cope.

I learned about Depressive Realism when I read Lincoln's Melancholy a few years ago.

Some research shows that depressed people are more realistic than non-depressed people. The problem is the balance isn't there, which leads to depression caused by negative thoughts and feelings. Too much focus on the negative, not enough on the positive. But it's a big topic and I won't attempt to summarize further. And I'm not suggesting depressive realism applies to all cases of depression.

Well, as I sometimes do, I addressed more than one topic in a post. I do apologize for being long-winded. I did my best to stay on topic and be relevant.

I realize my personal experience will be different from that of other people.

But when I keep seeing messages about getting help, call this number... I get a bit frustrated because I have been asking for help, off and on for thirty years. For the last 6 I haven't been on medication. I've been meditating and practicing CBT. I feel more stable generally, and I feel more like myself off the meds, but I still struggle with depression. But not more than when I was receiving treatment. The things that help me the most? Socializing with family and friends. Escaping into discussions on message boards... playing piano, which I started for the first time almost three years ago. It's the first instrument I ever learned. I've had more personal growth in the last six years than in the entire time of treatment.

Oh, by the way, the only suicide attempts I've had were when I was getting treatment, when I was getting treatment. None before, none since. Coincidence? I honestly don't know. I'm just glad to be myself. Meds can cause anxiety, depression, suicidal thoughts, insomnia... well, I'm grateful that now I can narrow down the list of things that might be affecting me, and not wondering how a drug is interacting with me.

As for the medication cocktail, well, I have tried many combinations at different doses for different lengths of time. I don't think it's rational for treatment to consist of casually prescribing drugs that can cause a multitude of side effects. If they take six weeks to build up, how long does it take to leave your system? If a person has a severe adverse reaction... is it the med? Is it the patient? Up the dose, decrease the dose...

I'm not anti-med, but their efficacy is hyped up, and the dangers are... minimized.

I know some people have been helped, at least that's what I've heard. I think there's people who feel just as strongly about the opposite point of view I have. So, no, I'm not anti-med. I would simply like the information about the various aspects of mental illness and treatment to be honest and complete by all involved.

I'd be remiss if I didn't mention this info I recently found. A genetic test that can determine how a med will metabolize.
Medication Sensitivity: It’s In Your Genes
I do appreciate the kind and supportive messages that people posted in the RIP Robin Williams thread. It is helpful to know that there are understanding, non-judgmental people that are willing to talk about the issue. Thank you. Many people, I believe, will appreciate it.

I didn't vote because I never had treatment for my depressions nor taken medications.

Don't get me wrong, I had my share of depressions in life but they weren't in the severe situations. I did had a health related depression but I never consider suicide as a means to resolve the depression. Many of my depressions got resolved through time.

A peculiarity about anti-depressants that isn't mentioned too often (to patients) is that they give you energy (2 weeks) BEFORE they improve your mood (6 weeks). This means that when starting anti-depressants you must be very closely monitored, because if you didn't have the energy to act on your suicide plan, now you do. Once your mood is improved (6 weeks), things should get better. However, not everyone responds to the medication, so treatments can be changed to try and obtain an effect (I guess in the future they may be able to know using genetic tests which meds are best beforehand).

Monitoring is a real problem, and many solutions aren't realistic like you said. However, the more support you have from everyone in your life, the better.

depression really sucks
 

Hello...I'm back after a sudden freakout.....


After a few months hiatus...I'm not dead even though months ago I did have ideations....thanks to xanax

After lurking these months and recent freak out at the beginning of this year, I guess I will post my :twocents: For me it started with a severe panic attack due to the sudden onset of tinnitus, which turned into a vicious cycle of depression and anxiety.. Im taking benzos and z-drugs just to sleep and stay asleep, which cycled into chronic fatigue, depression, , wash - rinse - repeat. Went to a psych, prescribed some weird sublingual med "zephryss" or whatever it was, and I ended up at the ER because of it. I can't sleep normally now because of the tinnitus causing anxiety , turning to insomnia, which leads to depression.... btw xanax(alprolazam) is a benzo ... I am currently on lorazepam though, unlike xanax, it stays with you longer so you don't crash like xanax does. And to add a Z-drug into the mix as well, zolpidem for sleep. Its the only way I can sleep now, it sucks but what else can I do?

Also I have lost considerable amount of weight... 215lbs to 165lbs within a month

Oh and its not just having tinnitus , what makes it worse is that I have hperacusis. Been to many audiologists which confounds them even more, because my audiograms are within range no loss. MRI confirmed a cyst in the occipital lobe, but shouldn't have anything to do with my tinnitus due to that portion is visual. Nothing else, no acoustic neuroma or anything. No TMJ...Which also added to my depression... "sorry just deal with it.' :(


Oh, benzos and z-drugs are 'short term' and doc isn't going to keep giving me these presc. So I will have to figure out how to sleep without them but at this point in time I still need them. Which is probably also bad because I've been on these meds for months already :eek: , but when I don't sleep I feel I want to :banghead:

I'm glad to see discussion on this. This is a place where a lot of people will see it.

(Sigh ... Rest in Peace, Robin, and know that you raised great public awareness of the demon that assaulted you.)

To quote part from another thread comment I just made, to increase the chance that someone ... you, yes, I am talking to you, whoever you are ... will encounter it.

Sometimes mental-illness treatment requires kick-ass drugs with serious side effects, and-d-d-d sometimes it doesn't. The brain is a profoundly delicate thing that is also, of course, tapped-in to the lion's share of the body's blood supply. It's impossible to "characterize" what strategies will work with any individual, and which will not. Therefore ( ... Gentle Reader who may be reading this now ...) don't let this thing persuade you not to treat it. If you're in the middle of this morass, to any degree at all, you need to talk to someone.

And as I have said before: a suicide-prevention hotline is manned 24 hours a day; there are also internet equivalents, but in this case I think it's really, really important to talk. (Yeah, you can skype some of 'em.) You don't have to actually be contemplating suicide. All that you need is the realization that you need help ... of some kind and with some urgency that is "yet to be determined." Mental illness is a physiological syndrome. Regrard it as soberly as you would any other disease process that has no right to be attacking you, and that can be driven away.

Welcome back, glad to see you're still with us. Sorry to see that you can't find a good solution to your problems. I've found that eventually a solution is found to virtually every problem, so don't give up.

I'm glad you and others are posting.

It's a drag not being able to sleep or not being able to predict when one will be tired enough to fall asleep.

I'm curious—have you (or anyone else) ever heard of melatonin supplement use to help regulate sleep and circadian rhythm?

Unrelated to the quote above:

sundialsvcs mentioned working at a hotline (Thanks for that). Correct me if I'm wrong, but does it seem like hotlines are far more well-known than warm lines? I was given a number to a local warmline several years ago; I'd never heard of it before.

I just looked up to see about national warmlines. Here's one link:
www.warmline.org/
I wonder how updated their site is or if there's other directories that people should be aware of. Anyone know?

I wasn't familiar with "warmlines."

For a person who is locked in a crisis disease-syndrome and is basically coming to grips for the first time that something is "happening to him or her" that s/he can't deal with directly (despite earnest attempts to do so ...), I think that a hotline would be the first call. You need that trained, interventive point-of-view, and you need those resources. Going forward, I can see that a warmline would be helpful in showing you that "you are not alone."

I have taken melatonin too on this seemingly un-ending hell of a ride that I'm still on. 5mg tabs of melatonin, but I would be taking 2x of it, along with the benzo and zolpidem, AND valerian root (400mg) along with all that at one point. Sometimes I would still wake in the middle of the night and thats the worst, because I wouldn't be able to go back to sleep. Then I found myself taking yet another zolpidem to knock me out. Oh yea, and thats a class iv drug! great....

Bedtime for me has turned into a nightmare, thats where the benzos come in to keep me calm. I have to go back to the doc soon, for an alternatives. I've tried trazodone but didn't make me sleep... I know I can't stay on z-drugs and benzos, problem is now I've been with them long enough that I probably can't just quit without withdrawls -- This from researching. Another possible alternative is amitriptyline for sleep. I dunno.... Sorry for hijacking the thread if I did.

@Jeebizz:

No, I don't think you hijacked the thread. The topic is mental health and suicide prevention, and I don't see any reason this thread should be about any one individual.

I hope I'm not out of line if I suggest: try not to worry about the withdrawal. Not everyone experiences it, and those who do seem to be affected to different degrees. If you get to the point of talking to your doctor about weaning off, withdrawal may be a problem, but there are ways to manage that if it is (hint, doctor suggested ways to manager, and if you also prefer, various web sites and blogs by people who have gone through it). In the meantime, I just wanted to remind people that discontinuation syndrome doesn't affect everyone. What I don't know is how common or rare it is, or even if it's documented when it happens to a... consumer such as you or I ;).

To tell you the truth, I don't have much first-hand experience with it. I've had problems getting off SNRI meds, but nothing severe. I can't recall right now if I've ever been on any benzos. If I was, it wasn't for very long.

Here's a list of the meds I've been prescribed over the last twenty years (may not be complete):

Prozac
Stelazine
Cogentin
Wellbutrin
Paxil/Seroxat
Effexor
Celexa
Buspar
Trazadone
Amytriptylene
Nortryptiline
Alprazalam

I have been prescribed paroxetine aka 'paxil' , tried it for a week and quit - it is an SSRI , problem sideffects are insomnia which I already have. amitriptyline/trazodone are also antidepressents but can be used for sleep - so thats what I am looking for now as alternatives.

Alprazalam (xanax) also a benzo. Usually 1mg tab, but thats where I had problems. It WILL calm you down, but it acts too quickly and leaves too quickly, so its like a hand that catches you, but then lets you go too quickly. Lorazepam aka 'ativan' is slower to act, which is better, because it leaves your sys. a lot slower, so there is no 'shock', at least not to me, which is why xanax caused me to feel the way I did when this shit started..

Fsck, its no secret that I am still pretty much depressed, not on the lines of where Robin Williams was , but still I am pretty low right now :(.

SSRI/SNRI/etc all sounds good 'in theory' , but also the unfortunate side effect is that it can amplify suicidal ideations as well...ironic. :(


Oh yea, I have also tried triptophan 500mg too. So I have been combining natural supplements and prescriptions at one point... *sigh*

As someone who have suffered from depression, anxiety and OCD, I have also had my fair share of bad times and have been medicated for about 16 years as well. I'm not depressed anymore, but a subtle anxiety remains (it's bearable to be honest). Currently taking a very low dose of an antipsychotic to help control my anxiety, but my doctor said I can stop taking it in a few months (which is completely fine by me).

Anyway, hope things get better for you guys.

Cheers!

....just want to sleep normally again for once......
 

I don't think you need to complete the list :eek:.... I'm aghast that you have been on all that... Its great that you are off , meanwhile I still don't know where I stand. Its near bedtime again, and this time I don't have the help of zolpidem (ran out, pharmacy won't prescribe anymore)... I figured it was THAT or temazepam which I never touched... I also forgot I was prescribed 'quetiapine' or whatever the hell it is, but reading side effects of that also made me not touch it. FSCK it, I'll go and say it I was always averse to taking any kind of meds, even when I was little, especially cough syrup (then again what kid LIKED cough syrup...)...still probably bad example sorry.

I'm forced to weigh options of sleep vs. other side effects... Kinda makes me look that one song now from Huey Lewis & The News 'New Drug'. in a different way now(not intending to make light of any of this - I just feel it is an apt comparison)

I'm glad that you've overcome it. Months have nothing against YEARS.....

@odiseo77, thanks for sharing. Every story is important, especially success stories.

@Jeebizz: Oh, yeah, I forgot about Paxil. The wonders of "zapping." That was my first experience with discontinuation syndrome from an SSRI.

Anyone else think manufacturers should have a comprehensive, official guide to tapering off psych meds (for the times it's applicable to patients)? Last I heard—and my info on this may very well be outdated—doctors have to guess at it, or experiment, whatever term one prefers. But doesn't it seem that in a rational world such as ours, when drug manufacturers include warnings not to stop medications suddenly, they should provide information to doctors about what to do when a patient needs to taper off?

Good luck with sleep. I know it can be a real nightmare sometimes. :) I remember when the Huey Lewis song came out. It's great.

I couldn't tell you how many long nights I heard this song come on: "I'm so Tired" by the Beatles (primarily written and sung by John Lennon. It's great.

Yer Blues (White Album), another of his songs. "Yes, I'm lonely.... wanna die." How's that for a cry for help? He told the whole world. Glad he conquered his depression. From what I know about his life and what I've heard in interviews, he seemed to find genuine happiness, contentment, and inner peace near the end.

@Andy Alkaline thank you for your encouraging words, trying not to dwell also.

Yes I do think manufacturers need to have a comprehensive guide to tapering off....But I look at them as the problem...Remember the show Scrubs? I don't recall what episode/season it was, but I distinctly remember an episode where a drug manufacturer was visiting the hospital essentially 'hocking' their new product......The younger doctors I think obviously tried to do everything they could to deny the manufacturer, but if I recall the senior doc was convinced otherwise...Why? $$$$$$$$$$$

A medical issue caused my nutrition to be poor.
After a while from this condition I noticed weird feelings. Sort of a sad, hopeless, moody almost like a hormone imbalance issue. After taking common multivitamins, (which helped my sleep, and going back to exercise) my mood improved back to normal.
Sometimes the most simple solution may need to be tried.

Do most people need vitamins? I doubt it. Can it be a good starting step? Yes, along with good nutrition, exercise, regular sleep, avoiding too much caffeine, alcohol and stress. Learning your own mind and how others think is also a good start. Consider an old book, "I'm OK, You're OK." If you don't believe you are OK, you can't be OK.

I'm afraid I won't be helping, but you do know that it can be risky to combine tryptophan with SSRIs, don't you? (And, yes, I do know that you could be in a situation in which it might be dangerous not to combine tryptophan with an SSRI, which would change the significance of that comment).

Please check the full 'warnings and contra-indications' on your current medications to check that there isn't anything warning you off taking tryptophan in combination. I know Sertraline, for example, does have such a warning.

Well when I'm depressed, I talk to my mom. That works every time.

Regards.

Its 4am, and I'm still awake
 

When I had my supply of triptophan, I wasn't prescribed SSRI. I was combining triptophan with zolpidem. Hell, here is the combos I been trying with better luck than now, because it is almost 4 am and I have yet to sleep.

Zolpidem
Zolpidem + valerian root
Zolpidem + valerian root + triptophan
Zolpidem + valerian root + lorazepam
Zolpidem + lorazepam
Those resulted in sleep at least.

Then...

Zolpidem + 5-10mg of melatonin... sleep.

As stated before, now I'm out of zolpidem .... fine, I figured I gotta get off that crap sometime right?

Now I tried just 15mg of temazepam ONLY (without lorazepam, because really why would I take two types of benzos, even I'm not that daft, even though I just listed a combo of zolpidem (nonbenzo hypnotic) a friggin z-drug). that I also been purposely avoiding...and here I am posting .... I took it when... 9:30pm last night? been in and out of bed , no sleep whatsoever :banghead:


Oh yea and when all this started, I purposefully tried to just break zolpidem in half , but I would wake up in the middle of night..


And I recall the triptophan was 500mg..

I guess now I have no choice but to just stay up until I crash.

--edit

In case questions arise, I did run out of melatonin as well and no more valerian root. Also as for the SSRI, I only took that for a week, and in the morning only with nothing else, which just made me feel worse thats even though 'SSRI's don't take effect until a few weeks, but I just remember it making me sick to my stomach outright)

Just a comment since I haven't noticed anyone making the direct distinction between at least 2 kinds of depression

1) Depression aka Situational Depression - This is absolutely normal and correct. We are supposed to experience negative emotions when things don't go well. Learning how to let that pass, correct that situation, or rise above is the path to emotional maturity. Some just grow hard or numb and that's not particularly healthy.

is not at all the same as -

2) Clinical Depression - This is an internal chemistry problem, most of which is hereditary but also whose severity can be triggered and escalated by some external events such as various kinds of drugs both legal and not.

Repeat - if you're depressed because you lost your job/wife/house/etc, that is to be expected but if you're depressed despite getting a new job/wife/house/etc, you might want to check into the root causes of that.

Note that many doctors these days are so lock-stepped with pharmaceutical companies that even they will not make this distinction largely because they want to prescribe SSRIs. I assume they make themselves believe this fits "First, do no harm" because they rarely have the inclination, let alone the time to screen out those who are adversely affected by so-called "anti-depressants". It seems that many doctors assume we would all be better off (or at least stop bugging them) if we were all numbed out on some sort of anti-depressant and unfortunately this has contributed greatly to blurring the line between these two very different states of health and mind.

The "when I'm depressed, I talk to my Mom" is situational, not clinical. (Probably, but could be mildly clinical. Causes such as nutrition and so-on are possible, although "talking to your Mom" is working.

Jeebiz's story is very frightening to me because it describes "self-dosing," perhaps through the night(?), in hopes that "something will work and I'll get to sleep." Uh huh ... maybe sleep forever. :eek: Careful, careful.

Yup, we all get depressed occasionally in this stressful life, talking to somebody who actually cares for you and can give a bit of advice works, doesn't matter how far they are.

And yeah, clinical depression should be treated clinically. I've almost reached the edge of it last year for some unmentionable reasons, I just quit my job, went back to my native for 2 months, spent time with family, took care of health and came back as a new man. That's just my case.

Regards.

It's nice to hear that. When I talk to my mom I end up depressed or furious. It's legitimately nice to hear that not everyone has fractious relationships with their parents. :)

Mental Health and Suicide Prevention
 

I wholeheartedly agree that making a distinction is important, extremely difficult for both doctor and patient, and often it's labelled a disease far too quickly.

Accepting it as a disease can create both positive and negative consequences.

I do believe that whether or not it's clinical or situational, it's not the person's fault. Even if it's situational, a person can't be expected simply to "snap out of it", or "pull himself up by his bootstraps", and I don't think it can be dismissed as self-pity.

When a person suffers from prolonged/long-term situational depression, they often don't have to tools necessary to cope with stress or have a handle on how to address their problems efficiently and in a healthy manner. Of course in some cases, a situation (maybe more than one) has arisen that would make it difficult for anyone, even the most well-adjusted person, to cope.

There are different methods to learning coping skills, and other forms of therapy designed to help a person who's distorted thoughts contribute to depression (CBT, DBT, etc). These often take a long time to make a dramatic difference, and require routine practice. Changing one's way of thinking is no easy task. If someone gets frustrated or takes a break from trying, or doesn't believe it will ever help... I can hardly judge them.

I'll give a little personal background to help illustrate:

I'm aware that I have distorted thoughts that contribute to my depression, also that I can alleviate some depression by modifying some of my routine behaviors, such as brushing my teeth, or taking a shower, or eating better. When I'm aware that something is bothering me, when it's something I have the power to do something about, I try to address it, so it's just one less thing I have on my mind weighing me down. Sometimes it's a major effort, a chore, and I procrastinate anyway.

I wasn't around positive people growing up. After my father died, we moved almost every year or two. I was always an outsider, criticized by many people. I never learned how important self-love or self-acceptance is, as a child I had to figure out how to deal with most of my problems. There was little stability and security. There was really no reason for me to believe I had a bright future. There was no reason to believe in myself. Let me tell you that the effects of low self-esteem and lack of self-confidence can sure FEEL like a disease.

I'm working on that stuff by the way. I haven't accepted that just because some negative ideas are ingrained from childhood, that I can't have a more balanced view of myself and the rational world we live in.

One a more positive note: I don't mean to imply it was all bad. Things could have been a lot worse. My mother tried very hard after my dad was gone. My grandparents helped out immensely. There were kind people here and there, I did have a few good friends and good times. My Aunt and Uncle have made a huge difference in my life.

So now I'm forty-one. I was introduced to CBT circa 1992. I would be a lot worse now if not for that.

I do also believe there are some biological issues working against me as well. My body doesn't seem to regulate my moods or energy levels very well. My "highs" never get too high, and it seems that if I do have a high, when I have more energy and motivation than usual, am less likely to get overpowered by depression, it is inevitably followed by a low.

When I go out and socialize, afterward I feel wound up and my thoughts race and it delays me going to sleep by an avg of three hours. No matter what, I can't stop it. I can get my mind off it sometimes by doing other things, but when I have to step away from the hobby or the "escape," the thoughts go back to racing. "Self-talk" (CBT) and meditaTion almost never have a calming effect during those times, or very little.

Well, there are other clues too, but I'd best tie up my thoughts and make a point.

I mentioned above negative and positive consequences about make general statements about it being a disease...

I get the impression from reading patient blogs that once it's accepted as a disease, it takes incentive away for people to make changes that might help. To change the things that they do have power over. In fact, once it's accepted as a disease, it can add to the feeling of being helpless and powerless.

There really needs to be more emphasis on making distinctions. Some people are more self-aware than others so I know this is a tough issue. Doctors and therapists really need to be more pro-active in their approach to identifying as many factors as possible.

Does saying it's a disease and convincing the public it's a disease make it easier to accept prescription drugs as a treatment option, and cause over-prescribing to be common? Does classifying it as a disease help to ensure that medication is covered by insurance? Anyone have opinions or knowledge about these questions?

I won't cover the "positive" consequences of calling it a disease; I think those are more obvious.

I failed to emphasize that I most certainly believe that working with a good therapist—rather than by yourself—can be TREMENDOUSLY beneficial for those who are focusing on treatment without drugs, using methods such as Cognitive Behavioral Therapy and the many other forms of non-pharmacological methods I haven't mentioned. Remember that doctors and therapists can only recommend, they can not force you to take prescriptions. If you feel that your doctor is pushing it or not acknowledging your feelings about it, or thinks you're being uncooperative, or seems not very not pro-active—get a second opinion, or a third opinion. There are many good therapists and doctors so try not to let the bad ones discourage you from getting effective treatment.

—
Forums at Psych Central
National Suicide Prevention Lifeline Call 24/7 1-800-273-TALK (8255)
Absent: The Movie | Documentary on the social pandemic of fatherlessness afflicting today's societies.

For sure do NOT take triptophan and MAOIs, that would lead to serotonin syndrome.

I think that might be true of any chronic condition including things like diabetes and heart disease. It's awful easy to turn over personal responsibility for managing a chronic condition to the medical community. That doesn't fix the situation of course, but actively taking steps to address any chronic condition is so much harder than just taking a pill, whether the self managed steps are diet and exercise or self-talk.

Also I think there are a lot of duds out there in the therapy world. There are some gifted individuals, but there are some duds. Therapists are like hair stylists. You just have to try them out and see if the style works for you. I mean no offense to either therapists or hair stylists (though the bill for a cut and color is the same as a therapy session).

Mental Health and Suicide Prevention
 

Well put. I'm glad you filled in some gaps I left.

—
Forums at Psych Central
National Suicide Prevention Lifeline Call 24/7 1-800-273-TALK (8255)
Absent: The Movie | Documentary on the social pandemic of fatherlessness afflicting today's societies.

When I get depressed I say to myself: get off it or stop feeling sorry for yourself.

And sometimes it works.

Although I was depressed at one point for a few weeks, I recovered without intervention. I was on a trip at the time, I don't remember where, but maybe something was affecting me there. Most other times I can readily turn sadness into anger, so I rarely get depressed. Not very productive you may say, but it has kept me alive so far. Sometimes I am able to simply preoccupy myself with something else, often I try to improve everything I can in the hope that my mood will change, and it usually does.

When I feel I have too many things that it all seems impossible to deal with, I try to tackle one thing at a time. Even it's really small, that's one less thing that weighs me down. I try to determine what I have control over and what I don't.

And yeah, sometimes I also will call my mother. :)

Sometimes "getting outside myself" helps and I watch the news (which can be depressing so I can only take so much), or read a book, a biography, some history, or sci-fi. I go for a walk, chill at the library, see if my nephews can pull themselves away from the video games to do something together, or just ask them how they're doing. Playing the piano usually elevates my mood but like some other things I can't always do that when the depression hits really hard, and sometimes my hands get sore from just holding a book when reading. But the point is there's a lot of little, realistic things I can do.

Oh, and I try to get the proper nutrition, even when I'm not hungry if I know I'm behind on eating. I drink water and have breakfast right away in the morning, so I can rule out that I've not been affected by skipping a meal.

When I started learning meditation it was pointed out to avoid things that can create negativity—and a "side effect" of the meditation is that I'm more aware of how dark or violent movies affect me, and now rarely watch them. Usually I go with comedies.

Unfortunately it can get so severe for some people, myself included, that sometimes I can't focus well enough even to read a book, watch tv, or play piano. Then I remind myself that it will pass and not feel guilty about it. That it probably means that I have to face it for it to pass and not hide from it. But even then, something simple like having the opportunity to hang out with friends and relatives can help make that dissipate. Seems like everybody's got computers or devices these days they don't want to leave.

Unrelated, but I want to mention that everyone gets sad or depressed sometimes. There's varying degrees and beyond the scope of what I could say here, but for me, sadness is a very small part of depression. Depression is separate from sadness. Actually I read once that depression is anger turned inward. I don't know how often that's true. But yeah, sometimes I get sad, but sometimes it's more like... hold down a button, that button is "depressed". Now keep holding that button. That's depression. Feeling weighed down, energy and motivation sapped for no obvious reason, and not even being able to predict how one's going to feel and think from one hour to the next. Getting irritated with oneself because something that's interesting one day may hold no appeal the next. Though some of what I described might fall more in line with bi-polar disorder or some other mood disorder than depression alone.

Once I was also diagnosed with Dysthymia so my symptoms may not be "typical" of "standard" bi-polar, depression, etc.

Yeah, I notice that movies, but especially series nowadays are just truly despicable, depraved, abhorrent ... it's hard to find an appropriate word for them. They do affect me, especially if watched for several days in a row. I don't watch TV almost at all now, and not at my place.

Watch Lone Ranger. Always a good show.

Better Options for Mental Health Treatment are Needed
 

I tried to write a piece that summed up my opinions and was solution-oriented (and edited for clarity). Feedback is welcome. Thanks.

People struggling with mental health issues—especially those who feel they're unable to manage and cope on their own—are encouraged to seek professional help. Talking with family and friends about their struggles can be beneficial, but if that proves insufficient then other steps need to be taken. But what if a person (I'll use the term consumer for the remainder of this letter) is unable or unwilling to seek professional help? What options remain after consumers have obtained professional help in the past and it's yielded few, zero, or negative results? Professional help is no guarantee. Doctors are not gods, and doctors do not claim to be gods. When we tell consumers that help and treatment is available, that they simply have to ask, it implies that they are likely to receive effective treatment from professionals. This is sometimes not the case, and their feelings of disillusionment may prevent them from seeking help in the future.

I am a consumer. In the last twenty years, I have seen seven psychiatrists and seven trained therapists (seven, to the best of my recollection). The opinions in this letter and the following suggestions are based on that experience. I will also draw on what I've learned from talking to other consumers, and reading Internet blogs and message forums where they've written about their treatment experiences.

In order to improve the mental health system, encouraging consumers to share their experience is necessary. Furthermore, we should help those who believe they have received ineffective treatment to feel comfortable enough to share their thoughts about it—they are a demographic who are less likely to publicly provide feedback than the many consumers who have had positive outcomes.

What we learn from listening to consumers is always beneficial to improving current "merchandise." Without analyzing differing points of view and by omitting factors from the discussion we are doing a disservice to those we'd like to help, people who have placed their trust in us (non-consumers) and believe we have their best interests at heart. I understand that no one wants to speak of things that may potentially discourage a consumer from getting help—I'm aware that talking about the "S" word often creates controversy; however, little progress can be obtained by silence, and ignoring relevant and crucial information isn't conducive to opening doors or forming solutions.

In the short term, a list of resources should be compiled and made widely accessible and easy to find, e.g., a web site, a blog, and a "flyer" published periodically by a local paper. Consumers should be presented with many options from which to choose. Options provide hope, and hope—in many cases—is the only force that has the ability to sustain someone struggling with mental health issues. Presently, most resource directories and lists are incomplete, and some resources exist of which consumers aren't aware. We need to create a list/directory that includes any and all resources available.

Remember, the National Suicide Prevention Lifeline number is 1-800-273-TALK (8255). (I'm not affiliated with that nor any other mental health organization, and I'm not professionally trained to give mental health advice.)

You know, after I wrote my comment about some therapists being duds, I realized that I was speaking from the relaxed position of having found one who works well with me. I stayed with my oh-so-sweet-yet-completely-dimwitted therapist for far too long. Starting up with a new therapist is so hard. One has to go through so much garbage yet again just to get to the point where you can start working. And, of course, one wonders if one just wasn't trying hard enough with the last one. Repeating that process again and again is disheartening. If I hadn't found a few real gems along the way I probably would have given up.

Your comments about the mental health system as a commodity that consumers have difficulty evaluating can be expanded to health care systems in general. It's very hard to get information about outcomes. There are metrics about how nice the office staff are and how long one waits in the exam room, but it's really hard to get information about outcomes except through informal communication with people.

Yeah, starting from scratch with a new therapist can be difficult. Getting used to a new therapeutic relation, repating the same all over again, etc.

And talking about bad therapists, I went to a Lacanian therapist for some years... I wouldn't recomend this type of "therapy" to anyone. I could sit there, speak about how bad I felt and this guy wouldn't say anything useful; sometimes said some obvious stuff or repeated what I had just said. I know they can't make people feel good magically, but they could do their best to help. Fortunately, I found other therapist who helped me to get in the proper state to solve the problems I was having by that time.

My favorite was the one with her "Tips and Tricks for Living". Seriously, she never said anything that was more profound than what one might find in Woman's Day magazine or Reader's Digest.

Forgot movie where doctor asks patient to jump out of window after spending too much nerves trying to make him not commit suicide, surprisingly it worked and helped not do it at all. :D

Holistic Recovery from Schizophrenia
 

This seems interesting: Holistic Recovery from Schizophrenia
Good point, thanks.

does phycology exist?
 

Some research shows that depressed people are more realistic than non-depressed people. The problem is the balance isn't there, which leads to depression caused by negative thoughts and feelings.
i know someone who has an interesting sorta psycosis he was told that awarenes of phycology is unhealthy
this after i told him not to resist making a face at what disturbs him if he really feels that emotion he shoul take the time by himself to consider what he wants when he feels it and try to go get it
and what about that famous argument that phycology isint real "its al brain chemestry and motor nerons fireing" but i can never seem to see what all these putzy agresive scientists see in the gathering that disqualifies the existance of a phy cology
fireing brain activity in conjunction to a sorta "bio batery/resistor" system results in a co dependant balance of logic given purpose/funtion by a set of chemical portions that fuel/drain/impeed/accelorate a raidio signal more or less
then we intro duce a nice tal cold glass of koke cola on the table and a heat raidiater on the other and watch the subject for a minute or two as they discover the sensation of heat and ascociate it with thirst and discomfort and we move away then the cold side of the room where the coke is and we move toward it because it is more comfortable
we move closer to the radiator when the window near the coke lets in a draft and makes the room cold ...
this is called ascociative behaivior and if you are consious of ascociative behavior you can remember things and in the recurring phenominon as more ascociations are established we begin to pre concieve with varrying degrees of acuracy what we may experience
inacurate conception or accurate conception
inacurate conceptions or phycosis are a malody to the health of this niche that is our phycology and anyone with a substantial psycology may feel compelled alter your experiences due to acociative experiences that result in a phyco relationship known as a friend these sensations are verry desireable and being one who likes to feel friendship i afirmly reccomend it to evryone
so with the understandings of primal ascociative behaivior and accurate conception we can begin to gather information a scientific mind may call this gatherings with them we can pre assert situations decide what we want and how we want to recover from something resulting in a gathering from with in the omega to the apha
and so exists psycology
if you can read this you have a niche that depends on phycology
so for a nutrtious meditation and a healthy phycology i recomend we get back to the basics and practice ascociateing our feelings with our experience so we can gather gather and hypothisize with greater accuracy so we can render inert any deleterium cause whenever or wherever and in whomsoever it may occur with exeeding efficiency so we can get back to sipping cokeacola and making friends
i look forward to a reply to this one
note it isint good to be unconcious of your phycology because people like me who have tendancy disacociative behavior
(sociopaths) could hurt you really badly

I had trouble understanding most of what you wrote. There were a lot of misspelled words and poorly constructed sentences. No offense is intended; I realize not everyone has "perfect" grammar. I sure as heck don't :)

But I'll respond to a couple things.

Your first two sentences were from something I wrote in previous post regarding Depressive Realism.

When you wrote:
That's a very general statement, but I do believe there some validity to it. Who told him that "awareness of psychology is unhealthy"? A friend, doctor, something he read, etc? But it is a general statement and may apply to some people, but not others.


Could you state this another way, to help make it more clear what you meant by this:

It's that time of year again:
World Suicide Prevention Day

In my experience mental health treatment over the last 15 years seems almost experimental. It seems about every 8 weeks or so I find out another guy I served with has committed suicide. (I'm aware that is probably not that frequent but it just feels that way) I would be nice if people stopped perceiving mental illness as a weakness or problem that needs to be hidden and started doing pushing for some actual research on the issue. Maybe things are changing it's been a good long while since I've been to the states and the military community overseas is well insulated so I could be talking about the past but it is my thoughts on the matter.

Military personnel can be (and often are) exposed to situations that can induce mental illness. I know I've spoken to a number of psychologists and they are very concerned about the huge number of cases of PTSD in soldiers coming back from active war zones. War experience is definitely not good for the mind. Certainly you've heard of the high rate of suicide among soldiers coming back from war zones. I'm not sure if there are enough psychologists and psychiatrists to handle the situation ... and the future doesn't look like war is going away, quite the opposite.

Yes..

I've either been in or worked for the Army since 22 June 2000

Chris, my father died of suicide when I was eight. I've had two attempts myself (last was 13 years ago) But I don't claim to know what it's like for members of the military to lose colleague after colleague to suicide. It's gotta be tough, to say the least.

Even among civilians, many still view depression or suicide as acts of cowardice, or a weakness. But I think they are in the minority now.

But I suspect for those in the military, when they have been trained to ignore pain and show no weakness, it must be five times harder to change the thinking, to realize it's not a weakness, it's a sign that some healing needs to be done, that humans are not machines and sometimes need to be vulnerable in expressing how they feel and asking for help. As I said, to do that for many "civilians" is difficult, but it must be so much harder for a soldier trained for combat. We do hear about it in the news from time to time (the "soldier mentality that prevents them from getting help), but of course the reality is always much darker than a statistic.

My Uncle served in the Army during Vietnam (Rangers '68,69), my grandfather served in World War II (Navy). I can't speak about their personal experience, but I can say that I do have respect for what Veterans do and I believe they should be entitled to top-notch health care.

As for what treatment is like these day,s that's up for debate. Some was covered in this thread. From what I can tell from all the mental health-related blogs that have sprung up in recent years, getting quality mental health care can be quite a challenge and far too much emphasis is still placed on the psych drugs. They can be effective, but without proper non-drug treatment they fall far short of helping people recover.

And there is still quite a bit of controversy over their efficacy versus risks. I remember in 2008 in TIME an article by Mark Thompson that said antidepressants were going to be used to help treat deployed veterans (It was the cover story actually: America's Medicated Army). Meaning the vets would stay in-theater, but be given SSRI medication to help deal with combat-related stress. This struck me as a very bad idea. Particularly at the time, just a few years after black box warnings were added to SSRI and SNRI medications.

Some say it "only" raises suicide risk by 1% but I believe that's only in clinical trials. The sad truth, as I know it, is that in the real world the amount of data collected by doctors treating patients after drug approval is pitiful. To the best of my knowledge, doctors aren't required to submit data to an central body so post-clinical trial data can be analyzed properly. so what happens in the meantime? Anecdotal evidence is dismissed as being non-scientific and people who speak against medication are labelled as Scientologists and nutjobs. 1% maybe, but if a patient being treated for depression and suicidal thoughts commits suicide after starting treatment... does anyone raise an eyebrow? Is there any way to determine if the med played a role? No, in most case it's chalked up as a suicide and added to suicide statistics.

I don't mean to repeat myself, some of this I've already mentioned earlier in this thread, but wanted to summarize a bit.

As for drugging the military, I haven't read any follow-up info on how well that "treatment" method worked. But I don't always follow the news either.

This forum might be helpful to you or your colleagues:

Hadit.com Veteran to Veteran LLC
Veteran’s Crisis Line

This guy is stationed in Germany, too. You and Lance might have something to talk about.
http://mordfilm.wordpress.com/

This guy's a doctor who appears to focus on treatment without meds, and he's got resources on his site for clinicians and the general public/patients:

The website of David D. Burns, MD
http://feelinggood.com/

Let me know if you'd like any other reading material, Chris. I wish the best to you and yours.

I decided to try another therapist. So far, so good, after five weekly sessions. He specializes in DBT (Dialectical Behavior Therapy). It seems like a pretty good approach. He hasn't recommended I get on medication yet. He suggested I join his DBT group, which I did. I've attended two group sessions so far, a "skills-based" group, that so far seems like it'll work well for me.

That's good to hear. There are many different types of therapies, and how well they work is on an individual basis.

I am sincerely happy for you too. Good luck.

Keep on keepin' on..and congrats