Tag:

Suicidal Ideation

Difficulties with Emotions

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP March 6, 2021

written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I used to love everything about life. I was so happy and ready to show the world who I was. I started college and during my junior year everything changed in one night. I got home from work and started feeling terrible. I felt like nothing mattered and that life had no point. Since then I have had difficulty with suicidal thoughts, depersonalization and derealization. Sometimes I feel like part of me is watching over me, and that it wants me to join it in heaven. Other times I get scared when I’m around loved ones because I know they are going to die one day, and that I’ll be left without them. I also get scared that I’m going to die, that I could end my life without realizing I’m doing it. How I feel seems to vary by the day, but they are not mood swings from high to low, just low to lower. When I’m walking around sometimes I feel like I may be in heaven already, especially when I’m walking through scenic environments. If I see something especially pretty or out of place I feel like I may be imagining it. Even going to the lake is enough to make me wonder if I’m real. This feeling doesn’t ever go away. I get overwhelmed extremely easily, and sometimes feel like I’m in a fog. Situations as simple as having a conversation at work or going to the store can make me feel like there’s too much going on, and that I’m about to wake up from a coma or a dream. I always feel like I’m about to hear my alarm clock go off and I’ll wake up. I’ve seen several therapists, talk therapy hasn’t been very helpful. I’ve been on and off Lexapro a few times. I’m on it now and this has been the only successful time. My dad, his parents and my other grandpa are alcoholics and my sister and aunt are bipolar type 1. I feel like a freak and honestly don’t understand why this is happening to me. I have never had real issues in my entire life. (From the USA)

I appreciate the courage it takes to discuss this and try to change it. It sounds difficult and your resilience and persistence in managing it so far is extraordinary. I think it may be time to add group therapy to your recovery process. Group therapy — when done effectively — can give you a support forum for change, while challenging your perceptions. Spend some time looking for a good group therapist. Here is one organization that can help you find someone in your area or you can use our Find Help tab at the top of this page.

Wishing you patience and peace,
Dr. Dan

March 6, 2021 0 comment

ADHD Bipolar Family OCD Suicide Therapy

I Think I Have a Mania or Obsessive Disorder. Should I See a Therapist?

by Kristina Randle, Ph.D., LCSW February 26, 2021

written by Kristina Randle, Ph.D., LCSW

I have created a fantasy world in my head with characters and one of them talks to me in my head. Often when I’m alone I will reply to them out loud. When I was younger it was good because I was never alone. But now it is causing me to see and hear things or people that aren’t there. My parents believe I have ADHD and it’s simply an overactive imagination but I’m not so sure. It has caused me to have nightmares and get this weird feeling like someone is following me. On one hand I see the world in a way that I would never be able to, but on the other hand it’s starting to drive me crazy. What makes it worse is I used to be able to do this thing where I could tell what people were thinking, but now I can’t do it. Instead when I look at people I get this horrible feeling that they’re thinking the worst of me. I have thought about taking my life but I always talk myself out of it because I wouldn’t want to hurt my family’s feelings or make them believe I didn’t
care about them or they didn’t do a good job of being supportive for me.

Because you think you have a problem, you should seek help. As you have described, you are experiencing significant distress. It has led you to think about taking your own life. That is a serious matter. When someone is considering suicide, they are struggling and need help. To answer your question directly, yes, you should see a therapist.

It helps to talk about your problems with a trained professional. A therapist will assess your situation and give you feedback based on their knowledge. Therapists also provide much-needed support for people with emotional problems. Your symptoms are treatable. You will feel better with treatment.

If you have health insurance, call the 1-800 number on the back of your insurance card. The insurance company can refer you to the appropriate therapist. You can also ask your primary care physician for a referral for a mental health professional. If you feel as though you might harm yourself, contact emergency services or go to the hospital. They can protect you and keep you safe. Please take care.

Dr. Kristina Randle

February 26, 2021 0 comment

Anxiety Depression Family Phobia Suicide Therapy

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

by Kristina Randle, Ph.D., LCSW February 17, 2021

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

February 17, 2021 0 comment

Depression General Suicide Teen Issues Therapy

Will I Be Hospitalized for Telling my Therapist I Came Close to Committing Suicide?

by Dr. Marie Hartwell-Walker February 9, 2021

written by Dr. Marie Hartwell-Walker

From a teen in the U.S.: A few nights ago I was in my car near an overpass typing my letter to my family on my phone. I didn’t get out of my car, but i was coming close to it. I got it together and left and haven’t had any suicidal thoughts since then and have no intent of coming that close again.

I see my therapist this week but I’m scared to talk about it because i don’t want to be admitted. I have a lot of school work to focus on right now and feel that being inpatient for a few days would just set me back and dig myself deeper into a hole. If i discuss this with her will i be hospitalized?

Thank you for asking that question. I’m sure there are many other people who share your concern but didn’t write to us.

Therapists regularly talk with their clients about suicidal thinking. If someone reports a story like yours to me, it doesn’t automatically activate a referral to hospital. What it does activate is a series of questions to help us both determine if the person is safe. Often the incident was a serious way to show both of us how deeply troubled the person has been. Most of the time, the person didn’t want to die but wanted (and still wants) the emotional pain to stop. Then we talk about that. Such sessions often deepen the trust between us and take the therapy to another level.

If, on the other hand, we agree that the client isn’t safe, meaning that the client may make a more drastic attempt, then we will discuss whether and how a hospitalization would be helpful. (And, hard as it may be to believe, I’ve had more than one client write papers for school while hospitalized. They found that feeling safe in the hospital let them focus on doing the work.)

If you are worried about how your therapist will react, you could ask her something like, “What do you usually do when someone talks about suicidal thoughts or even maybe thinks about doing it?” the answer may reassure you. It is likely that you will open a new and useful path in your treatment.

I wish you well.
Dr. Marie

February 9, 2021 0 comment

General PTSD Suicide Teen Issues

I Don’t Know What Is Going on Anymore

by Kristina Randle, Ph.D., LCSW January 21, 2021

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

January 21, 2021 0 comment

Depression Medication related questions Sleep Suicide

Does Depression Worsen with Age?

by Kristina Randle, Ph.D., LCSW January 19, 2021

written by Kristina Randle, Ph.D., LCSW

Hello. I have suffered from depression for about 15 years, but right now I am experiencing symptoms I have never had before. I’ve always felt the emptiness, the numbness, fatigue and often the suicidal ideation (more often than I care to elaborate on).

But now my depression is either changing or worsening. These new symptoms include disliking the light; I’d rather sit in a dark room alone. I’m not enjoying anything, but it’s much worse than what it used to be. I can’t concentrate, I can’t get sleepy when I go to bed (even if it’s late) and then I wake up very early even though I’m not rested, then I’m tired during the day.

I’ve been on the same medications for five years and have successfully held down two full time jobs for four years. Why is this now just starting to happen?

Does depression worsen with age? I thought it got better with age.

I haven;’t had any traumatic life events happen, nothing has changed except for the nature and severity of my symptoms.

Thank you for your help.

Some people report having a similar experience. What used to work for them suddenly seems to no longer work.

It may be that over time certain medications lose their effectiveness or there could be biochemical changes that occur with age. It is important to report your symptoms to your prescribing physician so that he or she may make the necessary adjustments.

You have had depression for 15 years. That’s a long time. If your only source of treatment has been medication, it might not be enough. You should consider counseling. There is no better treatment to promote mental health. Everyone possesses a certain degree of mental health just as they possess a certain degree of physical health. Some are very healthy and some are not very healthy. Counseling will, with the choice of the correct therapist, increase your level of mental health from wherever it is now.

Comprehensive treatments for depression often involve both medication and counseling. You might be missing a key element of treatment, which might explain why you’ve had depression for a decade and a half. Counseling could help a great deal. Please take care.

Dr. Kristina Randle

January 19, 2021 0 comment

Suicide Therapy

I Told My Therapist I Wanted to See Someone Else

by Kristina Randle, Ph.D., LCSW December 22, 2020

written by Kristina Randle, Ph.D., LCSW

Yesterday I was in a really bad place. I have been struggling with suicidal ideation and self-harming for weeks. My therapist made the comment she was worried about me and that made me panic. I told her I wanted to see someone else because I didn’t want her to worry about me, in an email. I said it without thinking through. She said she respected my decision and she deleted all my upcoming appointments. Today I feel so much worse. I thought we would talk about it then have at least one more session for closure or something. Now I don’t know what to do.

Call or write her another email expressing your regret. Tell her that you would like another appointment with her. Once you explain yourself, she may understand and resume treatment with you. Hopefully, she will be open to seeing you again.

If she is unwilling, it would be advisable to find another therapist. The concern is your suicidal ideation and self-harm. When someone is considering suicide and/or engaging in purposefully harming themselves, it is evident that they are experiencing severe emotional distress. It’s always a sign that help is needed.

The more help you receive, the better, even if it’s not from your original therapist. There are many therapists who can help you. During times of deep distress, the key is not isolating and being open to treatment. One must do what is necessary to protect themselves. If you feel that you cannot keep yourself safe, please contact emergency services who can protect you and ensure that you receive the appropriate treatment. Please take care and stay safe.

Dr. Kristina Randle

December 22, 2020 0 comment

Anxiety Depression General Personality Phobia Psychology Self-esteem Teen Issues Therapy Violence

I Have the Desire for Something Horrible to Happen to Me

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP December 22, 2020

written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

At 14 my life is easy but sometimes I have fantasies of either getting into an accident (or just getting injured to the point of being hospitalized ) or losing everything I have, including the people I love. I have no suicidal thoughts nor have I ever self-harmed, I’m not very confident in myself but I don’t hate myself .

The problem is I imagine these scenarios so often and in so much detail that I bring myself tears.
I’m worried that these thoughts could become something destructive.

Thank you, I hope you respond. (From England)

It takes a great deal of courage to ask for help and I admire your resilience in dealing with these fantasies. There are many possible reasons why these thoughts are happening, and it would be a good idea for you to be talking about them with someone who can help. Let your parents know what is going on and that you are worried and want to speak to a therapist. Often just by talking about these things they get better.

You’ve taken a brave first step by writing us here. Now it is time to get someone you can talk to on a regular basis to help.

Wishing you patience and peace,
Dr. Dan

December 22, 2020 0 comment

Anxiety Depression Family Personality Psychology School Self-esteem Teen Issues Therapy

Worthlessness

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP December 22, 2020

written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

Agoraphobia, fear of public places and college. Neglected by own father and abundant feeling of worthlessness. Feels threatened by father sometimes and suicide being the only option available. Fear of future enrages my weaknesses and loss of interest in studies and all my previously admired hobbies. (From India)

While there wasn’t an actual question in your email it sounds like there are several issues that are impinging on you as you enter college. I appreciate you reaching out and explaining the struggles you are having.

Your university has a counseling center and I think as you transition into your studies talking to someone there would be very important. Each of the elements described—the fears, abandonment, suicidal ideation, and your lack of interests, are all concerns the counselors at the university can help with. I’d make an appointment with them and have them start helping you sort through them with you… and more importantly, find effective ways to deal with them.

Wishing you patience and peace,
Dr. Dan

December 22, 2020 0 comment

Anxiety Family General Grief & Loss Teen Issues Therapy

How Do I Stop Wanting to Hurt Myself?

by Dr. Marie Hartwell-Walker December 22, 2020

written by Dr. Marie Hartwell-Walker

From a teen in the U.S.: Not so sound edgy but I have episodes of hurting myself. I went even as far as to saying I wanted to rip my lip into thirds and peel off my skin. I never did any of these. I was hospitalized twice for suicidal ideation due to the death of my father and wanting to jump of the Golden Gate Bridge and lack of support from school and home. I’m currently not in therapy but I’ll get it soon in one week. I’m only fourteen and I have these. What do I do.

I’m so very glad you will be seeing a therapist soon. What you do is be as honest and upfront with your therapist as you can be. You already know your reaction to your father’s death was extreme. You know your impulses to self-harm are dangerous. So accept the help that can be helpful. With good support and helpful advice, you can take care of these issues now and have a happy and successful life.

I wish you well.
Dr. Marie

December 22, 2020 0 comment

Anger Management Anxiety Depression Personality Psychology Trauma Violence

Everything Is Cloudy and Weird

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP December 22, 2020

written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I feel like everything is cloudy and weird and get thoughts of stabbing my self with a knife. I sometimes hear stuff like phones ringing or people calling me while there is no one there. I also sometimes randomly see a thing that starts moving around slightly and warping. I also get depressed for short or long periods of time half a day to a week and other times I just can’t contain myself and feel like I’m so excited I would like to hurt others. I have cut myself but stopped and used recreational drugs thinking it can help but of course it didn’t. Help. (From Greece)

It sounds like these very disturbing experiences need some attention and I highly recommend talking about these feelings with a professional. I appreciate you trying to cope with them on your own, but as you’ve said, this doesn’t work.

Make an appointment with a psychiatrist or clinical psychologist who can do a proper evaluation and help put together a plan that can help.

Wishing you patience and peace,
Dr. Dan

December 22, 2020 0 comment

Depression General Suicide Therapy

Considering Suicide: Need Help Finding a “Detached” Therapist

by Kristina Randle, Ph.D., LCSW January 1, 2021

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

January 1, 2021 0 comment