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Suicidal Ideation

MDD Is Worsening. What Else Can I Try?

by Dr. Marie Hartwell-Walker
written by Dr. Marie Hartwell-Walker

From the U.S.: I’ve been in therapy and taken many different medications for close to 30 years. In the last 8-9 months my MDD has become medication resistant and is worse than I ever thought possible. I’ve tried ECT (3 treatments) and it did not help at all. I’m doing a litany of self-help wellness things that have taken over my entire life and I’m just getting worse. I take Effexor, Adderal & Clonapin. I do yoga, meditate daily, swim 2-3 times a week, see a therapist weekly, eat very nutritionally, get plenty of sleep but not too much,

I don’t work, and my life situation outside of this debilitating depression is very good. Happy marriage, great kids, generally financially stable, few good friends, mostly good relationships with family although there are a few estrangements that haunt me. My therapist did the Minnesota assessment on me and the high levels included major depression, anxiety and PTSD. I had a very unhappy and unstable childhood.

I am at the point now where I feel like I am a tremendous burden on my family and have completely isolated myself within my own home. I feel like a completely different person than I was before and I miss myself and my old life. What else can I do?

I cannot live like this any longer. Nothing is working and I feel very alone even though my family is very supportive. Right now i’m just pushing them away for their own good. I’m so sick of myself and of being me. I attempted suicide via OD in 2014 but it was a compulsive act at the time based on a situation. I have the means to do it again, successfully this time, but I genuinely don’t want to do it.

I simply don’t know what to do and cannot plan anything more than 5 minutes in advance because I’m completely unmotivated. I spend most of my day reading. I don’t cook or clean and I have a very enviable life all things considered. But if this is what I have to look forward to for 20 more years, I’m just ready to go right now. I’m exhausted and I’m just done.

I do sympathize. This is what an intractable depression looks like. You are doing everything you’ve been asked to do and nothing seems to help. You say you are sick of being you. But it sounds like your family isn’t. They love and support you. To me, that means that there is much more to you than your depression. I’m very glad for their sake and yours that you are resisting the thoughts of suicide.

If your therapist is truly out of ideas, it may be time for the two of you to call in another therapist as a “consultant”. Sometimes new eyes on a situation can make a huge difference.

This is not to be understood as a negative comment on your therapist. He or she may be excellent. But each of us therapists has our own training and has our own unique history of experience with many different people and situations. A new therapist just might have had experience with a former client that would be helpful to you. Ask your therapist to consider inviting a colleague or two to some of your sessions.

I also suggest that you join a forum here at LifeHelper. People from all over the world offer help and support to each other. Click on the “find help” tab on the homepage. Then click on “forums and support groups”.

I wish you well.
Dr. Marie

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How Do I Help My Daughter?

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

About 6 months ago I found out my husband had been having suicidal ideation for about a year. I thought he was having a lot of work related stress and had no idea how bad he was because he managed to be highly functional despite his depression. Depression and suicide runs in his family. Shortly after that I found my 16 yr old weeping and stressed a few times. A year ago one of her acquaintances committed suicide and two of her friends have been depressed and are now being treated for it. She was in constant fear that someone else was going to die. Fearing she was also in trouble I got her into therapy. As her father and friends have improved with medication and therapy, it seemed like my daughter had improved, but neither her and I have felt like her therapy sessions have had much impact. She is very shy still with her therapist. Tonight she broke down and was crying again. She is very imaginative and says that she wishes she lived in the fantasies she imagines and is disappointed that she can’t. But sometimes it feels like they are real. Real life is boring. She can’t stand being around most people and large groups of people make her feel very anxious. She feels irritable around her family and feels like being mean to her siblings and harps on them. She hates feeling like she is a mean person, but can’t help it. She is often disrespectful to my husband and I and doesn’t care and feels guilty that she doesn’t. A couple weeks ago she was mad at us because we wanted her to do her chores and she stormed out of the house and was gone for a couple hours before returning. It scared me, but we just treated it like she retreated to her room for a bit, because we didn’t want her to using running away as an attention getting thing. She was interested in writing but no longer wants to because she is discouraged that she can’t write out what she can imagine much better. She knows she is being too perfectionistic about it but can’t get past it. I also think she feels low self esteem because although she is very bright, imaginative and enjoyable to be around she compares herself to others, including her siblings, who have talents that are more easily seen such as being in the gifted program, music or athletics. She was a very outgoing, fun child but is much more reserved and insecure as a teen, at least outside of the family. She says she thinks something is wrong with her. She sleeps fine, no weight or diet changes and had straight A’s. She doesn’t want to go to her therapist anymore or start over with anyone else. I don’t know if she is just going through normal growing pains or if she really needs more intervention. And my recent failure to see my husband’s needs makes me not trust my own judgment on the matter. I just want all my family to all be happy again. What can/should I do to help her?

Between your husband’s recent suicidal ideation and the suicide of one of your daughter’s acquaintances, the fact that she is reacting to these circumstances is normal, but professional intervention is required. Some research suggests that suicide can be contagious, especially among teenagers. One person’s suicide or suicidal ideation can trigger another person’s thoughts or behaviors. Though she has never directly expressed suicidal thoughts, her risk of suicide is elevated.

You felt that her therapy was not helping but was it given a fair chance? Your daughter improved but you allowed her to quit because she was “very shy with her therapist.” Shyness is not uncommon in the beginning of therapy. It takes time to build a trusting relationship. She should return to therapy. Try another therapist. We are not all the same.

If resuming therapy is not an option, then you should contact the therapist, report that your daughter refuses treatment but clearly needs it and ask for help. The therapist is familiar with her case and can advise you about how to proceed.

Given your daughter’s exposure to suicide, she may be more susceptible to suicidal thoughts or behaviors than someone without exposure. Your daughter should be in treatment.

If you continue to struggle to help your daughter, then you should consider entering individual therapy. Family therapy is also a wise option, especially given your husband’s suicidal ideation. If you attended therapy, you would serve as a great role model for your daughter. If she sees that you are willing to engage in treatment, then she might follow in your footsteps. Do whatever is necessary to ensure that she receives help. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

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Hallucinations & Social Withdraw

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I have been experiencing hallucinations for a little more that a year. I am 20 now, and have been experiencing a lot of stress due to school-what I had thought to be a potential cause. I had considered talking to someone about it but it seems to be too much of a risk. Another symptom that has struck me recently is my inability to handle social situations, I find myself wanting to be alone more than I used to. I cant seem to act appropriately in specific social contexts. My friends can tell the difference, I’m more distant, and apathetic. in less then a half hour, Iv gone from depression to moments of extreme euphoria — which has also prompted unusual behavior. When something goes wrong, almost immediately, my mind assumes tampering of some kind of sort. after which i can reason as to be irrational.

I am going to school for electrical engineering. The majority of which is math based. If I lose my ability to do math I am going to assume I have lost my mind. I have taken up chess as a hobby, as it is the perfect test for a rational mind. My question to you then is not whether or not my mind is leaving me, for I am convinced of this, it’s whether or not I should spare my family from the burden that I would become. If I am not a weight on their shoulders surely I would be onto someone else.

I am not sad about my current condition, I’ve learned to cope. I only regret not being able to do the good that I had so hoped to fulfill. My values had held the virtue of economy, my goals were forged with everyone in mind. I had hoped to be a force for good, and yet I have been struck with ailment that would hinder my mind. please help me figure out what to do!

You’re making a mistake by not seeking professional help. You are not a mental health professional. Leave issues of mental health to the professionals. Few mental health professionals could design a tuned inductive circuit. They would wisely leave it up to an electrical engineer. Chess is based on logic and as a logical person you should come to the logical conclusion that you are not qualified to diagnose yourself and most certainly not qualified to treat yourself. Get help. You have your life ahead of you and it can easily be the rich life that you have desired. The key is to simply to make up your mind that seeking help is the right thing to do.

If you were having physical health symptoms, would you judge it as “too much of a risk” to consult a medical professional? I highly doubt it.

Mental health symptoms are every bit as serious as physical health symptoms in the sense that they require professional treatment. You are no more equipped to treat your own mental health symptoms than you would be to treat your own physical health symptoms. That is true not just for you but for all laypersons.

You’re worried that seeking help is “too much of a risk” but not seeking help is a much greater risk. Based on your letter, your symptoms have not improved and have made your life more difficult. Seeking help to prevent your symptoms from worsening is much less of a risk than allowing the symptoms to grow out of control to the point where you have lost your ability to think rationally. Without intervention, your symptoms could progress to the point where you are unable to complete your electrical engineering degree. Thus, the longer you wait to seek help, the bigger the risk you are taking.

You insightfully recognize that a problem exists. I hope that you can also recognize the importance of seeking professional help before this problem further disrupts your life.

Virtually all colleges have counseling centers where students can receive free mental health counseling. In cases where longer-term care is needed, the counseling center staff can refer you to specialists in the community. I urge you to utilize those services so you can prevent the development of future problems. Please take care.

Dr. Kristina Randle

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Needing Help

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I’m a 15-year-old female. The past 6 months of my school life and sleep schedule have been deteriorating to me physically, but recently it seems like my emotions have been going haywire too. I used to get 8-9 hours of sleep nightly, but have now gotten 4-5 hours of sleep for the past 5 months and have been holed up in my room doing homework more than ever.

I get irritated with everyone much more easily, and find myself sighing and glaring at everyone and everything. I didn’t tell my friends because I don’t want them to be worried about me either. I think of death almost constantly, and it happens out of nowhere. I’m afraid of death, but have had increasing thoughts of killing myself and how I could do it. I don’t believe I’d act on it, but I still get scared. I haven’t self harmed since I’m too afraid to hurt myself either.

My (12 yrs divorced) parents believe I’m overreacting, and refuse to take me to a therapist or mental health professional. (one of them has bipolar disorder and extreme anger management issues too) I have no money to take myself or get a proper evaluation.

Am I overreacting about this?

Much thanks.

You’re not overreacting. Whenever you think something may be wrong, you should take action. Not everyone does, but they should and your instinct to ask for help is a very good one.

Part of why you may be feeling more irritable is a lack of sleep. People are more irritable and emotional when they do not receive the proper amount of sleep. As a teenager, ideally, you should be receiving a minimum of nine hours of sleep. If you’re not getting the amount of sleep you need, you will be less sharp, and more emotional and irritable.

What’s most concerning are your thoughts of suicide. Suicidal ideation is not necessarily a side effect of lack of sleep. It may be exacerbated by a lack of sleep, but it is not generally caused by it. It might suggest that something else is wrong such as depression.

Because your parents are reluctant to take you to a therapist, one way around this may be to consult your school guidance counselor or another trusted faculty member. The more direct you are with them, the more they will be able to assist you. They may also be able to speak to your parents on your behalf and convince them that mental health treatment is the solution to this problem.

It’s good that you are proactive and are attempting to seek treatment. The school guidance counselor will likely be able to assist you with this problem. If not, and you are still thinking about suicide, do not hesitate to contact emergency services. The phone number for the National Suicide Prevention Hotline is 1-800-273-8255. The crisis text line information is the following: text HOME to 741741 in the United States. They will know how to keep you safe. Please take care.

Dr. Kristina Randle

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Are Casual Suicidal Thoughts Normal?

by Dr. Marie Hartwell-Walker
written by Dr. Marie Hartwell-Walker

From a teen in Venezuela: So, the thing is… I have occasional suicidal thoughts that kinda have been going on and off since I a child, but since I’ve been more stressed lately they’d become more frequent.

I wasn’t a depressed child (quite the contrary tbh), but I blamed myself for my parents’ constant arguing (I did till the end of middle school) and every time they fought I would wonder/believe if I hadn’t been born they would have been happy without me and I tried to smother myself a couple of time with a pillow and even more rarely would (softly) bang my head against the wall. I was scared to die and pain tbh. But this is as far as “self-harm” (if you even can call it that, that’s as far I ever went).

Since then the suicidal thoughts have been going on and off. I don’t even know when exactly I decided that that one still in-construction building would be the ideal (high enough to low chance of survival with a permanent injury which is what truly terrifies me, far enough to give a chance to regret it on your way there, and deserted enough to be left alone) (though chocking have taking more prevalence recently). At that point, I worried more about the economic consequences of having to pay for a funeral for my family if I died or the case of failing and having to ling with a chronic injury (+ having to pay hospital bill).

The thing is that despite all that It ever felt like an off-handed idea and not something I would ever actually do, but recently the suicidal thought have become more frequent.

And I know(/think?) it has something to do with the fact I’ve been stressed with the University. I feel like my life lack of direction: I not sure of what to do with it. I don’t really know if I like what I’m studying, or what I like at all for that matter. I sometimes feel like a complete failure. I was that “golden child”: good notes, good behavior, promising, but In ever feel comfortable being recognized that way because I was always low-key terrified that someday the would see what is coming to afloat today: That I’m nothing of that. That I never was. I feel like I’m regretting all my life decisions and the what-ifs are becoming more common (yohooo, mid-life crisis at 19. yey).

And I don’t feel depressed in my day-to-day life or hopeless, I’m quite the out-going, cheerful type, but I feel like the days go by in a blur. I don’t know how to express it exactly but is like there nothing noteworthy in them. I can’t even remember 90% of what I cheerfully discuss with people. Everything is just small chit-chat, but if amenable and not bad enough to justify suicidal thoughts. I don’t think I wanna kill myself, but since my life is not getting any direction and things just will be more stress in the future I’m worrying that these “casual” suicidal thoughts will become more frequent, and stop being “casual” but a thing I would rather start considering.

Sorry for the rant: I really don’t know where I’m going with this tbh. I suppose that I just wanted to let it out, at least a little of it. There’s still so much in my head, like for example the feeling that I sometimes don’t know if I genuinely sometimes feel like this or like I’m not quite right; or if I’m just being an edgy attention-craving bitch pushing these feeling onto myself because I want to make something about me noteworthy (Which is funny because this is the first time I put this in to words).

There is also sometimes the feeling that sabotaging myself. Or the feeling that I rarely can get way too hyped/excited and become loud and only loosely in control of my actions/words, that everything goes outta my mouth before it even has the chance of make a stop by the brain station.

Anyway, maybe if just that. That I’m pushing things onto myself and overthinking everything to justify the fact that I sometimes things there is something wrong with me.

Gosh, this “ask” is a mess.

Actually, it’s not a mess. It’s a good reflection of how you are feeling, which is kind of “messy”. A couple of things: First, your feelings as a child during your parents’ fights is very usual. Kids often blame themselves. It is thought that children do this in order to feel like they have some control of the situation. If they are at fault, they think, then all they have to do is be better kids and the parents will stop fighting. That isn’t the case, of course. But lots of kids think that way, at least for a while.

Casual thoughts of suicide are not uncommon at your stage of life. You are confronting lots of big, big questions and what feel like big, big decisions. It is especially common in kids who have been repeatedly told they have “great potential”. At some point, being young with potential runs out and the potential has to be realized. For many young people, that is frightening indeed. For them, thoughts of suicide are not really about wanting to die. But since they can’t find immediate answers or relief from the stress, they think about it as a way out of the situation.

I once knew a group of teens who would say “I want to kill myself” as casually as others talk about the weather. They didn’t want to die. They were expressing how overwhelming or difficult a situation might be, whether it was a major homework paper that was due, trouble with a boyfriend or a car that needed repair. The phrase shocked the adults around them but, for that group, it had become better than 4-letter words to express their frustrations and upsets.

Of course, a much better solution than threatening to jump off a building is to get some therapy if you can or to talk to someone older and wiser. A therapist can help you bring those problems and decisions down to a manageable size and can provide you with needed support while you work on them. If you can’t see a therapist, consider talking with a teacher, coach another adult you know to be a supportive helper for teens.

In the meantime, consider joining one of the forums here at LifeHelper. If you can’t find one you think is appropriate to your situation, form one. The forums are not run by professionals. People like you contribute advice and support for each other as they deal with a common problem.

I wish you well,

Dr. Marie

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Why Do I Want Bad Things to Happen to Me?

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

Since I can remember I have wanted bad things to happen to me . . . and I mean bad. For as long as I can remember (but becoming more serious and more prevalent now) I have wanted terrible things so happen to me.

Background: I was in a violent relationship when I was 12-14. It was emotional, physical a sexual. I have recently been being treated for what my psychiatrist says is Bipolar Mani Depression with some Schizo in the mix. I have been depressed and hearing voices since I was a little kid. The voices talk to me and talk down to me (I DO know they DO NOT EXIST, so how I have schizo I don’t know). I have been on medicine for about 2 years now.

Problem: Lately I have been noticing how much I want something bad to happen to me. I read books and read about people getting brutally abused or raped and I FULLY wish it would happen to me. I put myself in situations were I believe I have the chance of getting hurt. I mean the things I want to happen are everything. Let your mind run crazy. However, I want to point out that I have never wanted to die, at least not lately. I mean I dream about getting shot and actually enjoy it. Its crazy and it is so confusing because why would I want something horrible to happen to me? I can’t control the feelings though. I dont think this would tie into my past but you never know. Its just everytime I read or hear about something bad happening to someone else I want it to happen to me (Not to be rude but I have no intentions of wanting it to happen to me and not them! It is not that at all I know that for certain).

I hope this question helps other people out there! Thank you so much for your help. It is driving me insane!

What you have described may be passive suicidal ideation. Basically this means that an individual would not mind if they died but they would not actively attempt to end their own life.

It may be passive suicidal ideation but I cannot say for certain because your letter is contradictory. You wrote that you wish bad things would happen to you and you purposefully put yourself in dangerous situations. You also wrote that you have no intention of ending your life and don’t want to die. It is unclear exactly how you feel.

My sense of the situation is that you are sincerely suffering. Much of your focus seems to be wishing yourself harm. This is an unnatural desire. It is psychologically unhealthy to wish yourself harm. All types of suicidal ideation or thoughts of self-harm should be taken very seriously. Individuals having such thoughts should be in treatment.

Another important element of this issue is that you perceive your thoughts of self-harm as being out of your control. What you may be describing are intrusive thoughts. Individuals with anxiety disorders such as obsessive-compulsive disorder (OCD) often describe having these types of thoughts. Intrusive thoughts are unwanted, often disturbing thoughts that are difficult to stop. Individuals who have intrusive thoughts describe them as being out of their control and frightening. Medication can be an effective treatment for decreasing or eliminating these types of thoughts.

People with schizophrenia also describe having intrusive thoughts. The voices they hear are sometimes similar to what you have described, intrusive and focused on self-harm.

I would recommend seeing both a therapist and psychiatrist. A therapist could help you examine why you are having thoughts of self-harm. He or she could also teach you strategies to stop the negative thoughts. A psychiatrist could prescribe a medicine to help eliminate or decrease your unwanted thoughts. Here’s a link to a directory where you could search for a local therapist in your community. Generally, a therapist can refer you to a psychiatrist.

I’m not certain if I answered your question because I am unclear about exactly what it is. Please do not hesitate to write back if you have more specific questions. Thank you for writing.

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I Do Not Understand Myself & It Is Slowly Killing Me

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

Lately I have been extremely unhappy for no apparent reason. I feel empty almost all the time. It is like nothing can give me genuine joy anymore. I also feel alone a lot, even though I do have friends and close friends. Whenever I try to imagine my future all I see is one full of obstacles. I have become so consumed in sadness and I do not know how to deal anymore. I feel so confused and I do not understand myself anymore.

I am a naturally quiet person and have always struggled in making new friendships for as long as I can remember. I am currently in my third semester of university and I have not been able to make any friends, just acquaintances. The only friends I have are the ones from high school and even those friendships are not going well. I guess this all has to do with my deep sense of sadness but the thing is as much as I wish to meet new people I have no drive in me to do so. I am missing this lack of drive to do anything with my life. There is so much I want to do but at the same time I don’t want to.

It has been getting worse. Lately I find myself practically begging God that something bad would happen to me. I imagine myself in horrible situations and at times feel bummed out when I evade them. I sometimes find myself imagining all the possibly terrible things that could happen to me. It is not like I want to die, I would never attempt suicide, but like I said, I just want something bad to happen to me. I used to be the kind of person who could never comprehend people who self-harm but today I get strong urges to do it. I have not been through any traumatic experiences, nothing that could possibly justify my thoughts and feelings, but I still feel and think them.

I do not understand myself. I do not understand what is going on. What is wrong with me? Is this depression?

You might have depression. The best way to know with certainty is to be evaluated by a mental health professional. An evaluation can determine a diagnosis and the best course of treatment.

Many people with depression feel the way you do. They don’t have the energy or the happiness they once had. They don’t want to die, but they don’t want to live either. Life can feel like a chore, each day more of a struggle than the last. And just like you, the cause of their increasing unhappiness is not evident to them. Nor is the solution.

That’s why consulting a therapist is of paramount importance. Therapy can correct whatever is wrong so that it is no longer disrupting your life. With the assistance of a competent therapist and a dedication to treatment, you should expect a positive outcome.

Therapy is an effective treatment for most mental health problems, but many people also benefit from medication. You can discuss these options with a mental health professional, should you decide to consult one. I hope that you will. Please take care.

Dr. Kristina Randle

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Suffering From Depression?

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I feel like i have always suffered from depression but i’m not 100% sure. To start off with the issue/issues:

1)I have always been bullied for most of my life from elementary school onward not so much anymore. I was either mainly bullied by my siblings(brother and sister)when i was the middle child growing up. They picked on me for whatever reason they could think of. One main reason they picked on me was my weight. I was also bullied by peers in my grade, and or friends.

2)I have always been extremely shy, and i struggle with low self-esteem. As i got older, the low self-esteem was still there, but i have now noticed that i am extremely self-conscious of the way i look, i have always struggled with my weight, and i usually hate looking in any mirror because i can see all of my flaws with how gross and ugly i look from being overweight. I do believe this is a form of body dysmorphic disorder? i’m convinced i have it.

3)I was diagnosed with a learning disability so whenever it came to school, i struggled with that and grades sometimes. It was especially hard during the spring semester of the new college i was going to because of the harder classes. Even though i did well for the fall semester. I didn’t realize that i get anxiety a lot, with school but i do.

4)continued from number 3: I was seeing a counselor at the school that i was going to for the fall semester of 2012, because i was super stressed and anxiety driven. I continued seeing a counselor at school for the spring semester 2013, both of them said i had depression. The last one i was seeing said that counseling would not help, but medication with the counseling helped. I learned the hard way when i was at college during the spring semester that college can be extremely lonely at times. I was even hospitalized for suicidal ideation. At that time i was put on 3 medications, i guess all for depression. I have yet to see my doctor about it though even though its been 6 months from that specific incident.

However now that i’m home i’m still convinced that i have depression like the counselor and hospital said. Could the issues that i have struggled with all lead to major depression. any advice would be greatly appreciated.

Yes, the issues that you are struggling with can lead to depression. It’s good that you are seeking professional help but it seems that you require more help than you are currently receiving. As you mentioned, it’s been six months since you have seen your doctor. That’s too long to go without professional help, especially after being hospitalized for suicidal ideation.

The counseling that you have been receiving at school is a great first step but it’s not enough. Typically, college counseling centers are geared toward assessment, emergencies and short-term problems. Given the chronic nature of your depression, you would benefit from professional help that is more intensive and long-term.

I would recommend seeking mental health treatment, outside of the college counseling setting, that involves both counseling and medication. You can ask the school counselors for a referral to a therapist in your community. You can also check with your primary care physician for referrals. They can assist you in receiving the proper help.

The issues that you have been struggling with are correctable. Your depression has been chronic perhaps in part because you have only just begun to receive mental health treatment. Once you’re established with a long-term therapist, and have found a medication that provides symptom relief, your quality of life should improve greatly. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

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I’m Very Happy But I Really Don’t Care if I Die

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

hi i think i have nice life*great parents,great grades,loving boyfrind,a lot of friends who really love me,in fact everyone likes me,i go to gym almmot everyday,i eat very healthy,im etichal vegan,never had any problems in life,everything almmost always worked great for me,couldt aks for anything more)but i could not care less if someone told me that i would die tomorrow,its like 50/50 for me,i love my life but still ready to die..also i cant really conect to anyone,i mean i love my boyfred and friends,but he breaks up with me ill be okey(but i really love him,and he means a lot to me)..and i am going to high schoole of nursing(planning to go to med school when i finish) so when we are in hospital i am always giving my best to help every patient and do whatever i can but yet i dont care about them at all,its same with everyone else,im always happy to help but never care..i often thinks that this is normal and i dont need to tell anyone about this,and im being overdramatic and i have that conversation in my haed a lot,not for just for that,for everything else,im just like no one would care about that anyway so i go through everything alone,i thing i dont care about what they have to say why would them care about what i have to say..and i think i had sort of dissorderd eathing in the past,even today i am not sure that i have 100% healthy relationship with food but ist about 97%

If you don’t care about whether you live or die, then maybe you are not as happy as you say you are. Happy people want to live. They value life.

You state that you are not planning to end your life, but if it ended you would not care. You might be describing passive suicidal ideation. Passive suicidal ideation is indicative of depression. Depression is a symptom of unhappiness. It suggests that something might be wrong and needs to be changed.

An alternative view is that you are taking your good fortunes in life for granted. If everything has gone well for you and you’ve never experienced loss or suffering, then perhaps you don’t realize your fortune.

I’m reminded of an Abraham Maslow quote about taking life for granted. Abraham Maslow studied psychologically healthy people and wrote about their characteristics. He thought that people would be more satisfied with their lives if they had gratitude for their everyday blessings such as freedom, physical health and economic well-being. He was “…convinced that getting used to our blessings is one of the most important nonevil generators of human evil, tragedy, and suffering. What we take for granted we undervalue…” Sometimes people only appreciate the true value of what they had after it’s gone, when it is too late.

It would be good to explore this problem with a mental health professional. Counseling could help you understand why you feel the way that you do. You also mentioned disordered eating but did not elaborate. Eating disorders are dangerous. Disordered eating is also a sign of discontentment. If something is wrong, then it’s important to correct it so you can have a joyful life. Counseling could help you achieve that goal. Please take care.

Dr. Kristina Randle

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Tried Everything & Feel There Is Nothing Else that Can Be Done

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I have agoraphobia, social anxiety and depression. Had loads of help to work through these problems, different therapies, different medications but still struggle a lot with all of them and the agoraphobia I have never really got on top of it.

I am an adult living with my parents for many years due to my mental illness. I work a lot, have no friends (mainly by choice as it is very hard for me to enjoy spending time with people due to the social phobia) and stay home over the weekend mainly. I feel I am at the end of the line, that nothing can help me. I have got to the point I am over trying to get better, I am tired and feel defeated. I want to die, but I am an only child and I am worried for my parents, but I cannot cope with them dying, and one has COPD and the other a bowel cancer.

Most normal people, would just deal with the illness of their parents and their death as inevitable, but I have always had this terrible fear of them dying, as my life is really nothing without them and I feel that when they start to get really sick , I will simply lose it and not be able to cope anymore and would end up committing suicide. I saw a movie when I was a young girl called Night Mother and felt a profound connection with the main character, I was only 17 at the time I did not know about mental illness or how my life would turn out, but to this day, over 20 years later, I feel that this is how my life is, like that character, you get to a point where you have had enough.I would like to possibly die before my parents, but I am so scared of getting it wrong and ending up worse off. I would like to talk to my parents about my wishes, but it would crush them, but I dont know how long I can keep pretending that I will be okay when they become ill. I feel I should have the right to choose to die if my life is so unhappy or that I am going to suffer considerably mentally by the deaths of my parents.This is not something that would happen in the very near future.

You may not be doing everything you can to help yourself. You seem to have essentially given up. The evidence? You choose not to have friends because of your anxiety. You could have friends, but you’d rather not because you consider your anxiety to be insurmountable. You are thus making a choice, the wrong choice in my opinion.

Anxiety is unpleasant, but it’s not insurmountable. No one likes unpleasant emotions, but avoidance only makes them worse. Avoidance reinforces and increases your anxiety and the stranglehold it has upon your life. Instead of choosing to avoid unpleasant emotions, choose to endure them and learn to work through them. In concrete terms, that means having friends even if the thought of interacting with them frightens you. If you face the problems that frighten you, rather than run from them, those problems will eventually not frighten you. With the assistance of a competent therapist to guide you through the process, you can prevail.

Anxiety and depression are highly treatable disorders. You should never stop searching for help until you find a treatment that works. It is especially important to find help because of your suicidal ideation. When someone is suicidal, it’s evidence of their suffering.

Regarding your parents, it is true that they will eventually die. Everyone who walks the earth will eventually die, but while we are here we must make the best of our time. You mustn’t allow it to be a torture. With therapy it needn’t be that way. There are many support groups and counselors that can assist you.

Call 5 to 10 therapists and speak to them over the phone. Choose the one with whom you feel the strongest connection. You might also try connecting with friends and family, members of clergy or anyone else who you think could help. Don’t stop trying until you find relief.

Finally, you might also try reading the book The Road Less Traveled: A New Psychology of Love, Traditional Values and Spiritual Growth by M. Scott Peck. He discusses many of these issues in his book and provides suggestions for solutions. You might find it beneficial. Please take care.

Dr. Kristina Randle

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I Don’t Know What Is Going on Anymore

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

Honestly, i don’t know how and where even to start… and i dont know how to say all of this in only 400 words…recently ive started to suspect i might have schizophrenia. i believe that everyone is watching me, and i cant trust anyone (that includes you), that there are cameras everywhere, that i am dead and that this is just someone trying to see how id be after my death. ever since i was little too (about 5) i believed i was being watched by people on a secret island and made a film of. i try to convince myself that it’s not real;that there’s no way it’s real..but i cant. i have a psychotherapist, but i just can’t tell her anything i want to. i can’t force myself to tell her anything, but i really want to. and when i tried to explain my anxiety and attacks to her, i couldnt explain it properly.(diagnosed me with DID but i dont feel it at all) at school, when someone asks me something, i can never explain my feelings AT ALL. i always get something wrong,even though i know the answer.i’ve noticed that sometimes my sentences dont make sense to my friends, because i cant even say a sentence properly and i see things they don’t. i also have severe ptsd where at times i go completely deaf and nightmares, but the memories came back only recently (after 3 yrs) and i am sure im just making it up so i can pity myself and have a reason to be depressed. during the past 1yr i also ended up diagnosing myself with different disorders to explain my head-but always changing my mind..(pathological lying,ADD,PTSD,schizo,cotard delusion,SAD..)i know it’s wrong to diagnose myself;but since i cant tell anyone,and just keep lying all the time,im curious&desperate i only have this.i discovered something about myself though-im comfortable anonymous.there’s also always someone watching me from my bedroom window and scared.im suicidal(but im dead anyway so).i have crazy voices in my head that i cant control.i can barely tell whats real and whats not.i hate lying to my friends and family all the time about the smallest things.no one knows though.i cant really put all my emotions and things going on in 400 words.but this is without many details…

It is important to tell your therapist about how you feel. If you can’t say it face-to-face, then write it in a letter. You wrote us a letter here at Psych Central. You can just as easily write your therapist a letter or give her this one. Your treatment might improve if she knew what was wrong. She may be treating the wrong symptoms because she doesn’t have all of the facts.

You might fear that she’s going to judge you but therapists would not do that. Their job is to help people with whatever is wrong. Therapists want to help and are used to hearing about many types of problems. What you reveal will not be shocking. It will help her to know how to help you. It’s the first and fundamental step in getting better.

You mentioned feeling suicidal. Thoughts of suicide are indicative of immense suffering. This cannot be ignored. I’ve seen many people overcome these types of problems and you can too. But it begins with you revealing the scope of the problem to your therapist. Utilize the help that is available to you. Call the authorities if you are in danger of harming yourself. Please take care.

Dr. Kristina Randle

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Considering Suicide: Need Help Finding a “Detached” Therapist

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I’m having existential issues. I have very good affect regulation and impulse control. I am on medication and have been in about 2 years of psychotherapy. I’ve struggled with suicidal ideation, not as a function of seeking attention or because I don’t feel loved or valued (I very much am) – I am also accomplished and motivated and have a life full of things to do – I’m physically healthy. My primary psychological issues are PTSD from extreme childhood abuse and neglect and I have almost no ability to attach to people. I’ve found suicide to be a rational expression of what I feel is a pointless life that I don’t care for anymore. I need to talk to someone about this in a philosophical sense and my therapist is on the side of life and it is dangerous to her professionally to help me with this issue. I also cannot get the personal (though still detached) reflections due to boundary issues. I really REALLY want to explore what I feel about death the way I may explore the issue of abortion (I’m pro-choice but anti-abortion for myself). With suicide I feel I am pro-choice there too but I’m wondering if it’s the right option for me. I need someone to consult with who isn’t professionally obligated to “save me” and can be impartial? Like a spiritual advisor? Or are there therapists you can sign a pre-release to make sure they do not get bothered for malpractice if I choose to die?

You are essentially asking for assisted suicide. Assisted suicide is almost universally illegal. I am aware of no cases in which a mental health professional has or would knowingly agree to assist a client in ending their life.

In virtually all cases of assisted suicide, the individual who is considering suicide is experiencing agonizing physical circumstances. Their distress and pain are typically the result of an incurable medical illness, the prolonging of which could be characterized by some as tortuous or inhumane.

With regard to psychological problems, under no circumstance is suicide an appropriate choice or action. Research supports this assertion. Case after case, study after study, has shown that suicide ideation is temporary and fleeting. The feelings eventually dissipate. Studies of individuals who have survived their suicide attempts report that survivors strongly regret their actions and were grateful to have lived. Many of those individuals feel so strongly about their mistakes that they have dedicated their lives to suicide prevention.

You stated that you are loved but that you believe you’re not. That is evidence of an inability to see reality as it is. Nothing is more important than one’s ability to see reality clearly. Simply believing in the truth could prevent you making the biggest mistake of your life.

The inability to see reality clearly might also be a sign of depression. Individuals who are depressed are more likely to consider suicide than individuals who are not depressed. Those around you do love you but you do not believe them. It could be that you do not feel worthy of their love so you deny that it exists. Feeling unworthy of love is a signature characteristic of depression.

I would highly recommend that you strongly reconsider your plans. Take suicide “off the table.” Do not allow it to be an option. Realize that psychological pain can be eliminated from your life. It is often a matter of finding the right therapist or the right medication, or a combination of both. Explore your existential questions through meeting with a variety of mental health professionals. Become familiar with the work of Abraham Maslow, Viktor Frankl, and M. Scott Peck, all of whom wrote extensively about existential and psychological problems.

Finally, consider how suicide would forever alter the lives of those who love you. You may not believe that they love you but the reality is, as you have stated, they do. That is reality. In all probability, your loss would be devastating and their suffering would be immense.

I sincerely hope that you get the help that you desire. Please take care.

Dr. Kristina Randle
@DrKRandle

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