Please note that this article is still a work in progress. I still need to do a lot more research on it, and the drug companies are just now making the data available. I didn’t have access to my computer or books for almost a month and I’m still catching up with unpacking, paying bills, selling my house and all that crap. But this is a huge issue that is on everyone’s mind right now, so I had better deal with what I do know and get it out there.
Once the decision has been made to take meds, there are some steps that can be taken to lessen the chances of suicide caused by the meds themselves.
In-patient hospitalization when starting a course of medication if there is a real risk of suicide to start with.
Hospitalization isn’t all that bad. No, really, it’s not. Read all about my recent experience. (Eventually that will be a complete article on its own. For now it’s just a recent blog entry and isn’t yet finished.)
Remember folks, One Flew Over The Cuckoo’s Nest was written over 40 years ago. Things have changed a lot. It ain’t perfect, but it’s not as scary as you might think. My stay in the lock ward was much more like being on a cruise ship than being in some kind of torture camp. And I was involuntarily committed under a 5150 order!
Here’s the deal – one of the main factors in drug-related suicide is that when someone is nearly catatonic in a well of infinite hurt waiting for the sweet release of death, they’re just too damned depressed to actually do anything about it! And when an antidepressant works just a little bit it gives them enough energy and clarity of thought to accomplish the one thing on their mind. In a psychiatric hospital killing yourself is a much more difficult thing to do.
Of course hospitalization isn’t always an option for one reason or another.
So that’s where you rely on your network of family / friends / whomever as well as a minimum of twice-weekly visits with your doctor and therapist. And if you’re talking to other counselors, then you’ll be doing more than twice-weekly sessions, because the semi-pros don’t count in this case, as extraordinarily helpful as they can be.
In other words, if you can’t be watched 24/7 in a hospital, then you have to be watched by as many competent, in-the-flesh humans as possible as often as possible. Pets, angels, stuffed animals, internet buddies and fellow nut jobs don’t count.
Med compliance. I cannot stress the importance of med compliance. Taking your pills as directed. Every day. The same time of day every day. Get a pill organizer.
One of the biggest problems, especially with kids, is med compliance. If a dose is skipped it’s possible to feel like shit the next day. This is really the case with many of the SSRIs, and notoriously Paxil (paroxetine). And Paxil is especially problematic in that skipping doses can cause it to become less effective. You can see where this is going, right?
Skip a dose – feel like shit – take the drug and don’t feel as well as before – skip a dose – feel like shit – take the drug and still don’t feel right…
This is one of the reasons why Prozac (fluoxetine) is the only modern antidepressant approved for use with kids. Its 9.3 day half-life makes med compliance less of an issue.
If you have any sort of suicidal thoughts, call your doctor and/or therapist immediately! If your doctor isn’t available, call 1-800-SUICIDE (1-800-784-2433) or any of the local suicide hotlines you can find at SuicideHotlines.com. Outside of the US find hotline numbers at Suicide Helplines.org If all else fails, there’s always 911 or whatever the emergency number is where you live.
Expectations are generally set way too high. This is part of the quick fix mentality that everyone has.
Doctors, patients, patients’ families and HMO / insurance company accountants want the meds, and only the meds, to fix the problems RIGHT NOW.
If the problem isn’t fixed RIGHT NOW who gets blamed? The crazy person, that’s who. That sort of guilt and stress contributes to suicidal ideation. And if they do kill themselves, the drug companies and the medications are suddenly at fault. Certainly not all the people who wanted everyone to get well right away. Oh no, they’re never to blame.
Everyone needs to take a deep breath and get some perspective. The numbers I’ve seen for bipolar disorder are that it takes an average of two years, from initial crisis and diagnosis to some form of reasonable stability. I’ll try to find some verification for that, but from what I’ve seen in support group land and in my own experiences that’s a pretty good number. It seems to map well to other severe disorders.
Two years people.
Two years before you can go back to doing whatever it was that you were doing before you flipped out. Or at least something close to what you were doing.
Two years of therapy, eating right, exercising, participating in a support group.
Two years of being on the right meds. OK, some of you need not be on the meds for that long, but there’s still going to be a period of being on meds that’s longer than a month, that’s for damned sure.
See, this is presuming you’re on the right meds in the first place. It’s a complex process of figuring out what you need, based on your symptoms, your history and various physical markers. at The Amen Clinic Mouse and I had three-hour long evaluations on top of the brain scans.
Now do you expect to get the right meds the first time after a 30-minute visit to an HMO doctor? Maybe you will, maybe you won’t. It won’t be entirely the doctor’s fault if you don’t. It’s hard to get accurate information from someone in the midst of a psychological or neurological crisis.
I’m amazed that doctors and nurse practitioners get it right as often as they do. Or close enough anyway. But that just goes to show you yet another way that they are vastly smarter than I am, or most other people with these websites, when it comes to making you better. Translating PI sheets into English and giving you tips on how to live your life when your nuts is a hell of a lot easier than actually trying to heal you.
So relax and have some patience, patient. As I wrote in the introduction to this site a severe crisis, regardless of the disorder, is the psychic equivalent of a broken leg. The injury is real, if invisible without the aid of a fancy brain scan. It’s not your fault that you’re not better tomorrow or next week.
Forget about work, school or similar commitments.
Your only priorities are:
Caring for yourself (get all the help you can with this).
Caring for any children, pets and other dependents (again, get all the help you can)
Apply for disability.
Take a leave of absence, a sabbatical, whatever.
Fuck anybody who tells you to “Get over it” or “Cowboy up” or similar nonsense. And not in the good way.
Two years may seem like forever, but compared to the rest of your life, it’s not that long.
Learn about how long it takes for a particular med to work, and what the side effects are like. As in point 5 some people lose all hope when taking an SSRI and nothing happens after a week. Yet most SSRIs take 2-4 weeks to kick in.
Other people fall into despair over the cognitive impairments (i.e. me feel stooopid) from anticonvulsants (a.k.a. mood stabilizers). OK, feeling stupid really sucks. I will be addressing what you can do to counter this side effect. But, really, it takes about a year for your brain to adjust to those powerful, but really wacky meds. Epileptic seizures and bipolar flip-outs do serious damage to your brain, but the anticonvulsants can actually reverse said damage. No, really, they can. While your brain is being fixed it’s going to act a little slower than before.
Then there’s always the question of finding the right med. That takes time, too. I’m working on articles to help speed up that process. Un then it’s often trial’n’error.
Use this site to learn all you can about the meds. Knowledge is power. If you feel empowered about your healing, if you feel more in control about it then things won’t seem so bleak and hopeless.