Strange Suicide Case

Postby kapitokrug » Fri Feb 22, 2013 5:25 pm

Say you had a patient who is anxious and depressed, but can't kill oneself because of a fear of pain.

To get over one's conditions, the patient has to get over pain, but in doing so, would become at risk at killing oneself. For example, if the patient were to go on meds, the patient might be confident enough to go through with it (before or after a painful experience).

How would you deal with the patient?
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#1

Postby gwen » Fri Feb 22, 2013 7:39 pm

Surely if the anxiety and depression is treated then that said patient wouldn't feel the need to do something so dramatic. A holistic approach is best, combining meds and therapy. It might be better if the person is admitted into a clinic for obs for a few weeks or stays with a family member for a bit of support.
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#2

Postby kapitokrug » Sat Feb 23, 2013 5:14 pm

gwen wrote:Surely if the anxiety and depression is treated then that said patient wouldn't feel the need to do something so dramatic.


Following is a graph which I think describes what I'm talking about a little better:

At first, there are two pain cycles where the patient recovers, but doesn't have suicidal urges. After that, the patient is treated, but there's potential for the pain to become so intense that the lack of anxiety fails to inhibit suicide.

Image

A holistic approach is best, combining meds and therapy.


This sounds very vague. Can you elaborate?

It might be better if the person is admitted into a clinic for obs for a few weeks or stays with a family member for a bit of support.


The patient doesn't have reliable family, and clinical observation wouldn't help the patient get along in society.
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#3

Postby gwen » Sat Feb 23, 2013 5:41 pm

What perspective are you asking this from? Are you a therapist? If so, what sort?
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#4

Postby kapitokrug » Mon Feb 25, 2013 7:28 pm

gwen wrote:What perspective are you asking this from? Are you a therapist? If so, what sort?


I'm asking for advice because I have a cousin who's seeing a therapist and a psychiatrist at the moment. They suggested that he goes on meds, but he's afraid of killing himself.

I'm just asking for a second opinion.
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#5

Postby gwen » Tue Feb 26, 2013 2:27 pm

It is a noble thing supporting your cousin during this difficult time and trying to get as much information as you can..

I have to be honest when I say that I have studied psychology with practical experience in psychotherapy. This is relevant because I would not have as much of a say on the matter as his own therapist or psychiatrist would have. They have recommended meds for a reason. I can also speak from a perspective of someone who was crippled with agoraphobia and is now at the other side. I took meds at the beginning to take the edge off and they really helped. I didn't stay on them for long.

Your cousin is going through a very difficult time and is finding it very difficult to cope for many reasons. There are no guarantees no matter what they do, but what are the options. He may not be able to pull out of this without relying on medication for a while. Taking pills will change his outlook on life. The trick is to ask how long he would have to stick with them. If one type doesn't agree he may need to try something else. There needs to be a stable family support network in place and a plan of action for the future.

If his therapist, family and friends can focus on future plans with him, that may help. He needs something to look forward to when he gets better. Always say when he gets better as opposed to if....
His therapy should also include proactivity. CBT or NLP can be productive. They can help introduce coping mechanisms to help when he feels down.

Bottom line.. First of all, trust the therapist and psychiatrist, but question everything they do, more for your own perspective. If the meds don't seem to be effective, get them changed. Remember, he is a lost soul and probably needs meds to get him over the hump. Be positive and productive with his future.

He is better off taking a chance to feel better. Taking mads may lead to a domino effect, helping with everything else. That cannot be ruled out.

I don't know if my perspective has helped but with the lack of information there is not much else I could recommend.

Good luck with this,

Gwen
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