I saw a lady who'd tried to kill herself, pretty seriously, with paracetamol and strong opiates and alcohol.
After being ventilated and coming out of intensive care, it was clear she wasn't clinically depressed. She'd had low mood through relationship changes, chronic pain, changes in health, her GP'd started an antidepressant last year but it hadn't helped. A sensible thought to try one, but not surprising it did nothing, given she was low in mood through reacting to grim life situations, not through endogenous clinical depression.
We talked for an hour and a half. She wasn't mentally ill. She was psychiatrically fit for discharge. She went home to her husband with numbers of our crisis team (which she'll never call) and an appointment with our psychologist, which hopefully will afford her changes in perspective, acceptance and alternative ways of coping that're useful, enabling her to feel she is equipped to manage.
I stopped her antidepressant. Sometimes suicide isn't about clinical depression. Sometimes it's not a mental illness, sometimes it's a choice. But I hope she'll choose a different way.
It's reading your blog over the years which has made me confident that when a patient is not sufferring from an impairing axis 1 disorder, or a cognitive deficiency, I not only can but should allow them to make their own (bad) decisions. Thank you for illustrating that time and time again, it is such an important skill to have.
This post really struck a chord with me and made me think. Sobering.
Having been treated for severe depression / affective disorder I have never quite been sure whether it (my consideration of suicide) is just depression or a rational decision based upon my assessment of my life and future.
Obviously suicide is ultimately a choice and is inextricably linked to mental illness in many cases but maybe it can just be a rational choice to end pain. And why not.
Sorry, you don't normally get these kind of posts, but it was a thought-provoking topic.
I wish there was more out there about suicide - in a non-provocative manner - people shy away from it too much, even MH practitioners.
There are lots of arguments for and against and a vast topic.
But a very thought provoking post.
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