What Happens When You Tell Your Doctor That You're Suicidal

Rothko

I've been treated for depression for the past couple of months but last week I almost killed myself. I had made serious plans to do it and intended to go through with it but I had second thoughts. I don't think I'm a serious risk at the moment though. I have an upcoming appointment with my doctor but I'm extremely worried about telling him that I've been suicidal. I'm just terrified that I'll end up in a psychiatric unit or something.

Can anyone please tell me what exactly is most likely to happen if I tell him about this?

Wednesday Addams

If you have serious plans to act on the thoughts and you state this to your doctor, they have duty of care to you to follow up on this. However, many people who suffer from depression have suicidal thoughts daily and it does not necessarily mean you are an immediate risk to yourself - your doctor will be aware of this.

When you say you're being 'treated', I'm assuming you mean medication and not therapy? What you need to do right now, is find a good counselling psychologist or get referred to one by your doctor when you meet. You also may need to adjust your meds if you feel they are not working so please say this to your doctor. Is there any chance you can see your doc sooner?

If you feel you are in immediate danger in the meantime, please don't think twice about bringing yourself to A&E as this is just as valid as any other emergency.

Hang in there OP. You can get through this and you will.

Valmont

Generally speaking, if someone tells their doctor they want to kill themselves the doctor can have them imprisoned. I don't think this would happen in every instance but it is a very real risk.

Rothko

Wednesday Addams wrote: »

If you have serious plans to act on the thoughts and you state this to your doctor, they have duty of care to you to follow up on this. However, many people who suffer from depression have suicidal thoughts daily and it does not necessarily mean you are an immediate risk to yourself - your doctor will be aware of this.

When you say you're being 'treated', I'm assuming you mean medication and not therapy? What you need to do right now, is find a good counselling psychologist or get referred to one by your doctor when you meet. You also may need to adjust your meds if you feel they are not working so please say this to your doctor. Is there any chance you can see your doc sooner?

If you feel you are in immediate danger in the meantime, please don't think twice about bringing yourself to A&E as this is just as valid as any other emergency.

Hang in there OP. You can get through this and you will.

Yeah, I've been taking medication for the past three weeks. It's Lexapro which I know is sometimes known to cause suicidal thoughts to intensify. I'm thinking of getting my medication changed as I've just started to feel worse and worse.

The next appointment is this day week. I have thought of trying to see the doctor sooner but the worry of what might happen when I tell him how I've been feeling has been putting me off.

RGDATA!

Suas11 wrote: »

Yeah, I've been taking medication for the past three weeks. It's Lexapro which I know is sometimes known to cause suicidal thoughts to intensify. I'm thinking of getting my medication changed as I've just started to feel worse and worse.

The next appointment is this day week. I have thought of trying to see the doctor sooner but the worry of what might happen when I tell him how I've been feeling has been putting me off.

Seriously, please talk to your doctor about this urgently. Not giving medical advice but as you already know this is an occasional but serious side effect from lexapro and some other SSRIs. I used it myself without these symptoms, but knew of this risk. Please see your doctor asap, and if you have a good friend or family member you can talk to please do. Take care.

edit:
Do see him sooner, and you should definitely not be worried about being institutionalised against your will or anything like that, that's not going to happen.

Wednesday Addams

Suas11 wrote: »

Yeah, I've been taking medication for the past three weeks. It's Lexapro which I know is sometimes known to cause suicidal thoughts to intensify. I'm thinking of getting my medication changed as I've just started to feel worse and worse.

The next appointment is this day week. I have thought of trying to see the doctor sooner but the worry of what might happen when I tell him how I've been feeling has been putting me off.

Firstly, please don't stop taking it without seeing the doctor first as it could make things worse rather than better. It may be simply a case of increasing or decreasing the dose, I'm familiar with Lexapro it can be very good. but it can take a while to get these things right. Also 3 weeks is a very short time to have been on it - normally it takes 6-8 weeks before you start feeling any real changes and it can take a few weeks to adjust to. So just bear that in mind.

I think you should try to bring your apt forward. But I also think you really need to see a counsellor/psychologist. Lexapro helps, but it won't fix the underlying issues that are making you feel the way you feel. Your doctor is there to help, please be honest with them and I bet you'll feel nothing but relief afterwards.

Rothko

Wednesday Addams wrote: »

Firstly, please don't stop taking it without seeing the doctor first as it could make things worse rather than better. It may be simply a case of increasing or decreasing the dose, I'm familiar with Lexapro it can be very good. but it can take a while to get these things right. Also 3 weeks is a very short time to have been on it - normally it takes 6-8 weeks before you start feeling any real changes and it can take a few weeks to adjust to. So just bear that in mind.

I think you should try to bring your apt forward. But I also think you really need to see a counsellor/psychologist. Lexapro helps, but it won't fix the underlying issues that are making you feel the way you feel. Your doctor is there to help, please be honest with them and I bet you'll feel nothing but relief afterwards.

I was on 10mg but for the past two days I've halved it.

My doctor has previously brought up the idea of going for CBT to treat my social anxiety/phobia, which I think is one of the main causes of my depression. I would like to go through with it as I don't see myself getting any better if my social anxiety doesn't change.

Wednesday Addams

Suas11 wrote: »

I was on 10mg but for the past two days I've halved it.

My doctor has previously brought up the idea of going for CBT to treat my social anxiety/phobia, which I think is one of the main causes of my depression. I would like to go through with it as I don't see myself getting any better if my social anxiety doesn't change.

Please go back to your normal dose at least until you see your doc, you really shouldn't taper off these things unless under medical supervision. I understand your frustration, but it might not be the Lexapro at all that's behind that issue. Your doc prescribed the 10mg for a reason and I really would stick with it til you see them again.

CBT is an excellent idea for your anxiety issues.

Rothko

Wednesday Addams wrote: »

Please go back to your normal dose at least until you see your doc, you really shouldn't taper off these things unless under medical supervision. I understand your frustration, but it might not be the Lexapro at all that's behind that issue. Your doc prescribed the 10mg for a reason and I really would stick with it til you see them again.

CBT is an excellent idea for your anxiety issues.

Ok, I'll go back to taking the prescribed dose. Thanks.

JuliusCaesar

Valmont wrote: »

Generally speaking, if someone tells their doctor they want to kill themselves the doctor can have them imprisoned.

WHAT??? :eek:

This is entirely untrue. Yes, people can be admitted to psychiatric units involuntarily - but this isn't imprisonment! People are admitted for treatment, not to be punished. There are a lot of legal rules about this including regular reviews.

In any case, involuntary admission is not treated lightly, and people are only admitted even on a voluntary basis if absolutely necessary.

OP - I don't know what you have against inpatient treatment or what you imagine it to be, or what you have experienced, but inpatient wards are generally in ordinary general hospitals alongside the cardiac ward, the surgical ward etc. Many people have home visits, go home for the day/weekend, and even go to work from the ward. The ward ideally have a therapeutic atmosphere and every encounter with staff should be therapeutic, whether formal or informal. There's access to psychiatrists, psychologists, mental health nurses, occupational therapy, social workers etc etc etc.

Talk with your doctor, tell her/him how you feel, and look into getting onto the CBT list as soon as possible.

dar100

Valmont wrote: »

Generally speaking, if someone tells their doctor they want to kill themselves the doctor can have them imprisoned. I don't think this would happen in every instance but it is a very real risk.

WTF.... like seriously, why would you say such a thing??????

singsong321

Suas11 wrote: »

I've been treated for depression for the past couple of months but last week I almost killed myself. I had made serious plans to do it and intended to go through with it but I had second thoughts. I don't think I'm a serious risk at the moment though. I have an upcoming appointment with my doctor but I'm extremely worried about telling him that I've been suicidal. I'm just terrified that I'll end up in a psychiatric unit or something.

Can anyone please tell me what exactly is most likely to happen if I tell him about this?

Sorry to hear your struggling at the moment, it can be really difficult to deal with negative emotions. It would be best if you went back to your doctor and explain how you've been feeling. At the end of the day they will be a better judge of what treatment is best, however I doubht they can admit you for treatment without your consent. I think the only incidence where inpatient care without consent is permissible is if your under 18. When I was prescribed lexapro I was taking anti-anxiety tablets aswell for the first three weeks. This is because my main issues were anxiety related and lexapro can intially increase anxiety. Have you been feeling more anxious? If so, then i would recommend this treatment, and also book to see a cbt. It has been proven that recovery rates from mental illness are high if both medication and therapy are employed. Stay strong!

Valmont

JuliusCaesar wrote: »

This is entirely untrue. Yes, people can be admitted to psychiatric units involuntarily - but this isn't imprisonment!

Dress it up all you like but detaining an individual against their will behind a locked door is imprisonment. This does not mean it is the same as imprisonment through the penal system as these individuals have more rights and protections in the form of being innocent until proven guilty and being able to post bail.

JuliusCaesar wrote:

People are admitted for treatment, not to be punished.

I could imprisonment somebody because I like them, it still doesn't change the nature of the action. Whether it's for 'treatment' or punishment, locking somebody up, detaining them, making them captive, or 'civilly committing' them are all forms of imprisonment.

And treatment isn't necessarily nice and fluffy and helpful. For the 2000 people in the UK between 2011 and 2012 who received Electro-convulsive therapy against their will after being sectioned would be more likely to call it torture given the chronic global cognitive deficits they will now have to live with for the rest of their lives.

Dar100 wrote:

WTF.... like seriously, why would you say such a thing??????

Such is the typical reaction of the faithful when mental health orthodoxy is stripped of its medicalised jargon. I would like to hear you explain how detaining somebody in a room against their will and possibly even administering them with drugs is not a form of imprisonment.

Nonoperational

Very very unhelpful, agenda driven "drivel" that's unhelpful to the OP who is going through a tough time.

dar100

Such is the typical reaction of the faithful when mental health orthodoxy is stripped of its medicalised jargon. I would like to hear you explain how detaining somebody in a room against their will and possibly even administering them with drugs is not a form of imprisonment.[/QUOTE]

I am far from faithful Valmont, I also am very cynical of psychiatry. In the context of the post by the OP, given the fear of even attending the doctor, I feel your post was very unhelpful, not the actual content of the post as such.

Maybe it is a form of imprisonment, but it does only occur as a last line intervention, is this not a better outcome than the person actually following through with their suicide ideation?? I'm sure the OP family would much prefare s/he to be in a hospital as opposed to a ......

dar100

Valmont wrote: »

Dress it up all you like but detaining an individual against their will behind a locked door is imprisonment. This does not mean it is the same as imprisonment through the penal system as these individuals have more rights and protections in the form of being innocent until proven guilty and being able to post bail.

I could imprisonment somebody because I like them, it still doesn't change the nature of the action. Whether it's for 'treatment' or punishment, locking somebody up, detaining them, making them captive, or 'civilly committing' them are all forms of imprisonment.

And treatment isn't necessarily nice and fluffy and helpful. For the 2000 people in the UK between 2011 and 2012 who received Electro-convulsive therapy against their will after being sectioned would be more likely to call it torture given the chronic global cognitive deficits they will now have to live with for the rest of their lives.

Such is the typical reaction of the faithful when mental health orthodoxy is stripped of its medicalised jargon. I would like to hear you explain how detaining somebody in a room against their will and possibly even administering them with drugs is not a form of imprisonment.

You might enjoy this Valmont, diagnosis used to stop someone been imprisoned:):):D

http://www.buzzfeed.com/ryanhatesthis/massive-uproar-over-the-teenager-who-won-a-drunk-driving-cas

neemish

OP, I have unfortunately had to tell my doc many times that I was suicidal, and I've never been met with anything but compassion.
Saying that you want to die/kill yourself doesn't automatically mean that the guards are going to called to cart you off. Often, it's a sign that you are finding life too difficult to cope with and need more support, that's all. And you can have an input into what that support is. For example, do you have a family member you could tell? Or maybe get an appointment quicker with the psych doc. Or see a counsellor a few times a week. There are LOADS of options.

What I remember of being suicidal is that there never seemed to be any options. I couldn't tell my sister because she was busy at work. I couldn't take time off work because there was a deadline. And somehow in my head, ending my life was the perfect solution. That's why my doctor would always put several options on the table, to open doors for me, to try to get me to see that there were answers.

Several times, my doctor and I decided TOGETHER that hospital would be the best place for me. This was always done with my consent, and in a very gentle way. And it was always such a relief when I got there. Mind you, I was always in a private hospital. Somehow, my mind couldn't cope with the thought of the local unit.

Don't be scared - reach out to some one. ring Pieta House for advice, find a low cost counsellor, talk to a friend first. But reach out and get the support you deserve.


One tip - if you are going to see your doctor, tell the receptionist when you make the appointment that you might need a longer time. The last thing you need is the doctor feeling pressured after 6 minutes!

Valmont

Nonoperational wrote: »

Very very unhelpful, agenda driven "drivel" that's unhelpful to the OP who is going through a tough time.

Unhelpful to whom? The OP thanked my post pointing out the very real risk that one may be detained in a psych ward for discussing suicide with a doctor or mental health worker.

But considering this is a discussion forum, it would be helpful if you could explain why you think my argument is "drivel" or why you believe it is unhelpful (despite the obvious evidence to the contrary of course)? The difference between us at this point is that my agenda is open to scrutiny and debate whereas you seem to prefer throwing mud.

dar100 wrote: »

In the context of the post by the OP, given the fear of even attending the doctor, I feel your post was very unhelpful, not the actual content of the post as such.

I work with a charitable organisation who have many people discuss suicide with us simply because they don't want to be sectioned by their GPs. I think it is both relevant and helpful to point out that discussing suicide with your doctor may have you carted off to a psych ward for a potentially lengthy stay. However don't take this to mean I would encourage somebody to refrain from seeking help! There are many people who could help in such a situation.

dar100 wrote:

Maybe it is a form of imprisonment, but it does only occur as a last line intervention, is this not a better outcome than the person actually following through with their suicide ideation?? I'm sure the OP family would much prefare s/he to be in a hospital as opposed to a ......

I'm sure a suicidal person's family would prefer to see them restrained from taking their own life (understandably) but ultimately we have to ask whether we respect an individual's right to self-determination. If it is their life, shouldn't they be the sole judge of how to live or how to die?

dar100

Valmont wrote: »

Unhelpful to whom? The OP thanked my post pointing out the very real risk that one may be detained in a psych ward for discussing suicide with a doctor or mental health worker.

But considering this is a discussion forum, it would be helpful if you could explain why you think my argument is "drivel" or why you believe it is unhelpful (despite the obvious evidence to the contrary of course)? The difference between us at this point is that my agenda is open to scrutiny and debate whereas you seem to prefer throwing mud.

I work with a charitable organisation who have many people discuss suicide with us simply because they don't want to be sectioned by their GPs. I think it is both relevant and helpful to point out that discussing suicide with your doctor may have you carted off to a psych ward for a potentially lengthy stay. However don't take this to mean I would encourage somebody to refrain from seeking help! There are many people who could help in such a situation.

I'm sure a suicidal person's family would prefer to see them restrained from taking their own life (understandably) but ultimately we have to ask whether we respect an individual's right to self-determination. If it is their life, shouldn't they be the sole judge of how to live or how to die?

Self-determination is something I believe in when working with clients, but I think there are times and situations when this can and should be taking away (short term) from the individual.

The idea of self-determination is a great philosophy to live/work by, but what happens when an individuals self-determination impacts upon others around them??

Lets say a person wants to commit suicide, they see no other option but to carry this out because they are overwhelmed with emotional pain. Now in order to make assessments, treatment plan etc it may be the only option to hospitalise the person to keep them alive while conducting treatment.

Lets say this person also has young children (I'm not talking about the OP), is there not a duty of care towards them??

When the issues are worked through and medication/therapy does it's job, what person will not be thankful that they are still alive??

When the bigger picture is explored, things don't seem so black and white

Semele

Just another line of encouragement to stay on the medication until speaking to your doctor- both from professional and personal experience I know that antidepressant take 6-8 weeks to stabilise and if you're not used to any sort of mind-altering substances then the feelings you get in that initial phase can feel very scary and out of control. That does pass though, and tinkering with your dose at such an early stage is only likely to make that stage last longer as your system isn't getting a chance to settle down.

Also, to the other posters, although I do think the medical model and its power structures do need to be questioned and challenged, I have severe reservations about how responsible it is for MH professionals to be having such melodramatic and scaremongering debates on a thread where someone has asked for advice and support. Some of us are familiar with the issues involved and have had the opportunity to make an informed decision on our stance towards them, however I can only imagine how off putting and anxiety-provoking witnessing that is for a 'layperson' experiencing difficulties. We should know better than to cause harm or distress in the furthering of our own agendas.

Valmont

Semele wrote: »

Also, to the other posters, although I do think the medical model and its power structures do need to be questioned and challenged, I have severe reservations about how responsible it is for MH professionals to be having such melodramatic and scaremongering debates on a thread where someone has asked for advice and support. Some of us are familiar with the issues involved and have had the opportunity to make an informed decision on our stance towards them, however I can only imagine how off putting and anxiety-provoking witnessing that is for a 'layperson' experiencing difficulties. We should know better than to cause harm or distress in the furthering of our own agendas.

The latest figures I can find suggest that 1,633 people were involuntarily admitted for mental health treatment in 2009. This doesn't even include those who were bullied into a voluntary admission under the threat of an actual commitment. I think you need to provide some evidence or even an argument to support why you feel pointing out the risk of imprisonment when talking about suicide somehow amounts to melodramatic scare-mongering.

You are also suggesting that speaking frankly about civil commitment harms the mental health of mentally ill people who may become 'anxious' as a result. How you can bring this point up without comparing it to the very real harm and distress involved the civil commitment procedure is beyond me. Genuine clinical medical practice prides itself on the principles of honesty, forthrightness, and informed consent but here you are suggesting that we shouldn't actually call civil commitment by its proper name: imprisonment by mental health workers in a mental health facility.

Given that the critic of involuntary commitment has an agenda in seeing the practice stopped, the psychologist has an agenda in seeing the practice continue and to lend it justification. There is no reason to dismiss one camp solely for 'having an agenda' -- we all do. You seem to have taken an ultimately hypocritical (and unsupportable) stance in ignoring the physical harm and distress which is a necessary part of involuntary commitment under the guise of preventing alleged mental harm resulting from a frank discussion of the facts. Those deemed mentally ill should have every right to openly discuss any details of 'treatments' which may effect them -- any other suggestion is simply dehumanising and reinforces stigma.

Jesus Wept

I was climbing the walls when I started out on lex, I felt I got worse for a number of weeks (and I felt every minute of it). Push though it imo (with the lex), it gets better. It isn't an uncommon side effect, and more common for under 25's like yourself.

I can recommend an excellent highly qualified cbt specialist (but in Dublin) if you like.

JuliusCaesar

Can I point out yet again that this is a psychology forum, NOT a psychiatry forum? If you want to complain about psychiatry (which is a medical speciality) please do so in the appropriate forum. Psychologists do not prescribe. Psychologists do not administer ECT. JC

Valmont, what do you suggest when the person is incapable of giving informed consent? I take it you have not dealt with people suffering acute psychosis.

Chrisita

According to the William J Walsh research institute, it is not good practice to medicate people randomly

Please - did you even read the Mod comment above?? (and if you want to quote a study, please link to that study) JC