Why Do Doctors Ask (Dumb) Questions About Suicide?

May 13, 2011 Natasha Tracy

If you’re in treatment for depression and have ever mentioned a desire to die, you’ve probably heard these questions:

  1. How would you commit suicide?
  2. Have you make a plan to commit suicide?

And others.

So a commenter recently mentioned that this is just a way of “covering their backs,” and “. . . if I were serious about killing myself and had made a plan, why on earth would I tell them?”

This is a logical question, but an uninformed one. In studies, we know that people who attempt suicide do reach out for help and do not really want to die.

mp9002016851Suicide is a Serious Problem

Suicide is the 11th leading cause of death in the US and is the 3rd leading cause of death among adolescents and young adults. Suicide is not to be taken lightly and doctors are trained (rightfully) not to take it lightly.

95% of people who commit suicide have a mental illness. (Depression is the leading mental illness indicator of suicide, but depression combined with other conditions like anxiety or an eating disorder is more dangerous than depression alone. Anorexia has the greatest rate of suicide with more than 1-in-5 anorexics dying of suicide.)

Lifestyle Suicide Predictors

Suicide has been studied extensively by the mental health community and in addition to mental illness predictors we know many other predictors of suicide:

  • Demographics (such as age, sex, ethnic background and religion)
  • Substance abuse
  • Occupation
  • Gun availability
  • Media / internet content
  • Life experiences (recent and past)
  • Prior attempts

And many others.

Mindset Suicide Predictors

Most people who commit suicide are under the care of a doctor or see a doctor within three weeks of committing suicide. These people want help but they commonly don’t ask for it directly. Many people come to doctors for complaints not related to suicide so the doctor must ask questions to determine if suicide is actually the underlying concern.

So, understanding that we know many of the predictors of suicide and understanding that most people do, in fact, want help, the questions doctors ask try to determine if that is what the patient is really saying. While it is logical to think people who want to commit suicide would lie, this isn’t actually the case.

ExamWe know the mindsets to investigate are:

  • Do you have thoughts of hurting yourself or others? (For some, suicidal feelings can become homicidal.)
  • Do you have a plan to commit suicide? (The more specific the plan, the more likely suicide is.)
  • What do you think your suicide would achieve? (People who feel other would be better off without them are more likely to attempt suicide.)
  • Do you have hope for the future? (Hopelessness is a major factor in suicide attempts.)

Suicide Questions Do Prevent Suicide

Suicide likelihood is a hard thing to assess and in many cases the doctors seeing the patients do not have a well-developed relationship with them and so it is hard to gauge the patient’s true crisis. These questions are a way of doctors trying to assess clear indicators to prevent a person’s death.

While, absolutely, a patient can lie to a doctor about their intentions, the fact of the matter is, the patient is in front of a doctor proving that, on some level, they do want help. People do not really want to die. People want to escape their pain. People need help to do that.


If you’re considering suicide, call a helpline right now. There are caring people sitting on the other end of the line and they want to help you. Reach out to them.

Read fellow HealthyPlace blogger Amy Kiel's recent accounting of her suicide attempt: Never Going Back: Memories of A Suicide Attempt

Information in this article was mostly found here. Only a tiny portion of suicide predictors are mentioned above so I recommend looking at the article for all the details.

You can find Natasha Tracy on Facebook or @Natasha_Tracy on Twitter.

APA Reference
Tracy, N. (2011, May 13). Why Do Doctors Ask (Dumb) Questions About Suicide?, HealthyPlace. Retrieved on 2024, June 15 from

Author: Natasha Tracy

Natasha Tracy is a renowned speaker, award-winning advocate, and author of Lost Marbles: Insights into My Life with Depression & Bipolar. She's also the host of the podcast Snap Out of It! The Mental Illness in the Workplace Podcast.

Natasha is also unveiling a new book, Bipolar Rules! Hacks to Live Successfully with Bipolar Disorder, mid-2024.

Find Natasha Tracy on her blog, Bipolar BurbleX, InstagramFacebook, and YouTube.

September, 5 2018 at 9:13 am

I have read quite a few pages like this and every single one of you is the same. "Look at me, I'm the best because I survived and now I am going to sit here and tell you all how wrong you are, because I know better". You all think suicidal people fit into your little category boxes, feels a burden, check... thinks family would be better off without them... check. Blah, blah, some other tick-box... check. Well here's the wake-up call, we're not all like that.
I am an artist and life is nothing more than a painting. You start with an empty canvas and as you live, you fill in the details. But here's the thing, like an artist, you don't just keep adding paint because there's a white space on the canvas, you add paint until the canvas represents your vision. Life is just the same, you don't just keep living another day, just because you can. If you keep wringing another day out of life, just so you can be alive, then *you* are the burden. If you cannot objectively look at your life and say "You know what, I am happy with that painting, it's finished", then you are a more needy person than anyone considering suicide.
If anyone tells you "I understand what you're going through", they're liars. All they understand is what *they* went through and are arrogant enough to think thier experiences is the mirror of yours. The whole motivation of so called *experts* or *advisors* is "Get you onto my level, so I can use my life experiences to show you the error in your thinking". Do people tell their doctor their plans? Yes. Is it because they really don't want to die? NO! In my case it was out of anger, because I was going to die and nobody knew. I was angry that I couldn't just walk up to someone and say "Hey, I'm planning on dying soon", without them giving out the "Don't do it, there's hope" BS that everyone pours out. My family lives 4 doors away and I never see them, so if you think I care how they will react, you're way of base. Friends... fake people who just want something you have and that's why people don't want you to die, because you just might have something they need one day and if you're dead, they can't have it... and they say suicide is a selfish act.
We're not all hopeless, we don't need hope, we just want to be acknowledged for what we did in our lives and allowed to go on our merry way out of life. I should have the choice but I don't. I don't wander the house going "Woe is me, my life is so hopeless, I am such a burden on this world etc, etc...". I pack up boxes, so I don't inconvenience people when they have to clear the house out. I'm practical, I'm logical and I have simply finished my painting and want to put my paint and brushes away.
But you always get the moral-high-grounders who have to tell you otherwise... because they attempted and survived, so now they're better than you.
Do doctors ask dumb questions? Yes, because when it comes to this subject, they're dumb, so what else do you expect? When my doctor isn't asking dumb questions, she's treating me like someone with a cut on their knee... "Here, take this advice three times a day and come back in 4 weeks". It's laughable, it really is. What I do know, is telling a doctor is the most stupid thing you can do.
The fact that you people think all potential suicides *do* fit into your nice little categories, is proof of how ignorant you are, to anything other than the miniscule piece of life-experience you have yourself. Your solution isn't everyone else's solution, so stop trying to tell people that it is. If you can't respect a person's individuality, say nothing. I have seen things you will never see (if you're lucky), so how can you know what it is like to see them? Or to suffer the consequences and after-effects of it?
You also should not allow any bible bashers to push their brainwashing onto people either. Life and death have nothing to do with mythology, don't insult people by allowing fairy-tales into the mix. It's like that Kevin Caruso, thinks he can call everyone *his friend* because he has a donate button on his site. Thinks he has a right to "Love everyone" because you read his parasite page... makes me want to vomit... such pretentious BS.
Final thoughts: Every page I read like this, convinces me that little bit more, that I have chosen the right path.... the exit path.

January, 7 2023 at 10:56 am

There are several valid points in here besides the fact that you painfully overplayed the “I’m an artist and the way I look at life is more unique than you could ever even comprehend and you’re stupid” trope. I got secondhand embarrassment while reading this.

January, 30 2017 at 7:23 pm

I seriously want to die. I have had depression for 20 years. My kids are grown and stable and i want to leave this world.

In reply to by Anonymous (not verified)

Natasha Tracy
February, 1 2017 at 10:21 am

Hi Mary,
I'm so sorry you are feeling that way right now. I have had that feeling many, many times. In fact, I have attempted.
What I can tell you, though, is that things can improve with help. There are new treatments every day. RTMS, ECT, ketamine and so on. While I can definitely understand why you might feel the way you do, you don't have to feel that way forever.
Please call a hotline to start getting help:…
There is more out there. Don't give up.
- Natasha Tracy

In reply to by Anonymous (not verified)

Candy Smith
May, 24 2017 at 1:40 pm

I would like to encourage you to read the Bible. Surprisingly the Bible Verses that have to do with several different types of emotions. There are a lot of called books "God's Promises" but you can also just look up "Bible Verses about Depression and Suicide" and a list will come up. I do not know whether you are a believer or not, but, regardless, I encourage you to consider doing this.

In reply to by Anonymous (not verified)

January, 7 2023 at 10:58 am

Do you really think that anyone who hasn’t already read the Bible is going to do this? Trumpers and right wing homophobic white people have killed off Christianity. It will be nothing but a joke in just the next few generations. Nobody is going to read your fake book.

Katelyn Eaton
December, 13 2016 at 1:16 am

I was just diagnosed with Major Depressive Disorder, Manic Episodes, Bipolar Disorder, Post-Traumatic Stress Disorder, Generalized Anxiety Disorder, Panic Disorder and Panic Attacks. I was 16 when my mom left me with my step dad to go to a party. My step dad molested me that night. I went a week with no sleep and no food. I was living on water and fat and muscle that was left In my body. That was the first time I ever cut myself. I also put a rope around my throat, got on a chair and was about to jump when my dog walked in. He looked up at me with his puppy dog eyes. I untied the rope and I got down and just broke down he cuddled with me and loved on me. The cops came and my mom blamed him touching me on me. I told the cops it was an accident and they left. A week later my mom was in the other room and I felt like I had been drugged. I opened my eyes and I saw him move my shorts. Than he saw I was awake and he left. He threatened me multiple times to punch me in the face, he even called me a B****. My mom accused me of stealing her narcotics, even though I knew who did it and I'm pretty sure she did too. I'm 19 now and I went a whole year without cutting. I relapsed 2 days ago. Last night i went as much as shoving pills in my mouth to get the memories to go away and get the voices to stop talking to me. I only ended up making myself have an anxiety attack. I had heat flashes, my head became fuzzy, I was dizzy, my arms and legs were shaking uncontrollably, I couldn't move, and I could hard breath, when I could finally move again I almost vomitted everywhere, I need serious help. I did this all because of voices and also because my dad told me that I'm doing all this for attention. He didn't see the cuts or scars on my arms

In reply to by Anonymous (not verified)

Natasha Tracy
December, 13 2016 at 4:17 am

Hi Katelyn,
I'm so sorry to hear what you have shared in this comment. I want you to know that it does get better.
I don't just say this as a person with bipolar or an advocate, I say this as a person who has been sexually assaulted as well. I know what it's like to have images and voices haunt you. Please understand, that while this can be torture, it _can_ get better.
I also say this as a person who has attempted suicide. Even though I felt nothing could help my pain at that time, I was wrong. I have been helped since then.
Please reach out and get help. Please find a therapist who specializes in what you need. Please find a support group. Please see a doctor. Please be open about how you feel and what you have experienced.
We have a hotlines and resources page here where you can start:…
I am with you in this. You are not alone.
- Natasha Tracy

February, 12 2016 at 11:09 am

After ending up locked in the hospital against my will on one more than occasion for the crime of trusting doctors I will never again tell them anything. The last two times it happened I told the doctor that I did not want to die but to be "safe" he violated my trust and my rights and locked me up. That is not ok.
In less than 2 years I have been raped and nearly killed twice. I am falling apart. I have lost everyone. I can't sleep. I can't eat. I have panic attacks every time I have to leave my home. I have panic attacks when the phone rings or someone knocks on my door. Some days I am ok. Some days I do nothing but cry myself sick. Some days I am full of rage. And some days I am nothing at all. I hate my body. I hate being female. I hate myself. I hate this life. I am scared by my own thoughts. I am scared that if I tell anyone what i'm truly feeling they will harm me by locking me up against my will.
Before any appointments I practice my smile. By smiling I can keep myself from telling. By not telling I keep myself safe. It's ridiculous that I have to do this. I don't even see the point anymore. If doctors and therapist actually want to help people then they need stop hurting them. If they want people to trust them then they need to remove the threat of imprisonment.

July, 25 2015 at 11:47 am

"People do not really want to die. People want to escape their pain. People need help to do that."
Avoid that kind of generalisation please.
Some people do want to die or rather "not live" and not for the reason you mentioned, without any medical problem, for philosophical reasons for example.
It is uncommon but it exists.
I am a living proof.

July, 23 2015 at 4:51 pm

Pdocs need to work harder to see things from their patients perspective and build more of a collaborative style relationship that is if they are truly interested in 'helping" them at all. They need to listen to and understand why patients lie and then work with them to overcome these roadblocks
I've never ever told a pdoc that I felt suicidal before even when I was, not because I didn't want help but because I was fearful of the type of help that might be offered. I don't want to be held against my will, or over medicated again like I have been in the past nor would I want to take a chance that I might have my memories erased with ECT performed on me against my will. I've been involuntarily committed before (apparently I lacked insight) and it was extremely stressful. Some of the medication side effects were worse than the illness. I felt like a wild animal trapped in a cage that would do anything to get out. If I had a very good relationship with a down to earth pdoc who I'd gotten to know well and trusted (I'm working on that) I might consider being more open but I would still have to test the waters first before I'd completely come clean with that type of revelation. In the past pdocs were too agressive and jumped to conclusions because unfortunately I have many of the risk factors working against me before I even open my mouth

March, 25 2015 at 1:56 pm

I have to be with Julie here.Didn't die in Jan. although I tried.My estranged adult daughter has been so cruel to me (the one person I thought it might matter to).My meds are maxxed out.My plans I tell my pdoc are more of the long term variety,get my affairs in order first etc.Who knows maybe something will change,or maybe I will get sick with something else.

Mary Kate
March, 23 2015 at 11:54 am

I have recently had a few ect treatments because the meds don't seem to be helping. But at my last outpatient treatment, I was asked several questions regarding how likely it would be that I would attempt suicide in the following week. I answered "not sure", but knowing I will be asked the same question after my next treatment, I will refuse to answer, or not answer honestly. I am currently looking forward to the end of a lifetime of pain and suffering.

Lucy Howard
May, 16 2013 at 2:37 am

Please can I ask with the questions asked, that can a true assessment be really done in some cases, would it be logical to say that someone could be really serious and they just need to get it off their mind with someone that's not in their circle , but if they were to say I want to say goodbye and they can't when asked is this viewed as a person is not serious or they are scared of being admitted and therefore unable to act.

April, 17 2013 at 6:04 am

I have on 3 seperate times attempted suicide, 2 overdoses and one cutting incident. I am so happy that I was not sucessful as I have a 14 year old son who would have been devistated. I often think some of the same things as mentioned above however would never act on it.I have a fabulos Doc and he has me on the right "cocktail" so life is good!
Thanks for listening and I hope everyone can find their cockyail too!

April, 15 2013 at 10:08 am

Why is it that ppl think telling someone in mental pain that they are not alone...or millions suffer the same depression...think that will make the person feel better? I am sorry but at the point of feeling hopeless why would i care who or how many feel the same? If i got cancer would it make me feel better to know million of ppl have cancer? Not so much.
When i am tormented by inner pain, suicidal or just having a bad day, it gives me no comfort in knowing others are feeling the only angers me that the world is so very hurtful. I am sure i sound very selfish but the reality is when i am so hopeless and helpless, so totally consumed by inner turmoil, i need someone to acknowledge my pain....not by telling me how many ppl suffer the same. Sorry if this doesnt make sense....but in an irrational mind it it hard to sound rational.

Tanya J. Peterson
April, 15 2013 at 9:12 am

Thank you for addressing the issue of suicide/discussing suicidal ideation. Contrary to a common belief, talking about suicide does not make someone more likely to commit suicide; it actually makes them less likely. But you already know this.
The standard questions that are asked have two functions: they are designed to assess the degree of risk (and if someone's thinking of suicide, the risk is always there, of course, so this assessment isn't judgmental or dismissive -- it just looks at how close a person is to following through on a plan in the moment), and the questions are also designed to, hopefully, open up further conversation. Therapists and patients ideally can discuss protective factors and develop a safety plan tailored especially for the patient based on the questions. I know from experience that sometimes it's really hard to answer these questions honestly, but even opening up a little bit will start the process of healing so that eventually someone will want to live rather than want to die.

stevie B
April, 14 2013 at 12:49 pm

I answered this truthfully today and told my Doctor about my exit plan. I dont think she really knew what to say accept the standard you really should continue seeing the Therapist when we all know that does not help. The medications only fog my head so I am weened off them. The exit plan seems to be the only real solution. So I may as well go ahead with the solution cause there sure as hell dont seem to be any other way.

March, 28 2013 at 6:56 pm

Tens of thousands of people will never address the root causes of their depression because they refuse to tell their therapists/psychiatrists/doctors about their suicidal thoughts. Why? Because they're (rightly) afraid of being committed against their will.
It's time for the "medical community" to put the interests of patients ahead of malpractice liability. And yes, sometimes those interests are helping the suicidal person understand her thoughts, not preventing her from committing suicide.
Why is assisted suicide all right but suicide among 'healthy' people (as if depression isn't a horribly painful disease) is discouraged? It seems to me you should either be against all suicide or be willing to give people the benefit of the doubt.

January, 6 2013 at 4:20 am

In my experience - when you answer this question truthfully as in yes I want to die - absolutely nothing happens. I answered yes to this question asked by a psychiatrist - he referred me to a therapist with a 6 month long waiting list. I said yes to the therapist assessor when she asked me 6 weeks later- I asked her to call me the next day as I was afraid I would act on these thoughts - she never rang. I left five messages for her - she never contacted me. I took an overdose. I answered yes to the therapist when she asked this question, when I finally got to see her after 6 months ( with no support in the mean time and trying to keep myself alive all that time with these thoughts) She said - OK I see, well bye for now, see you in 2 weeks. Realising she was not going to help me I took another overdose. Basically when they ask you if you feel suicidal and you say yes - they don't do anything. so I don't know why they bother asking you in the first place. When I get asked this question again im just gonna say no because there is no point telling the truth.

October, 11 2012 at 4:33 pm

The last person i would talk to is the doctor.

Missy Richmond
September, 12 2012 at 2:20 pm

I'm so sorry for all you've been through. I feel somewhat like you. I have no qualms about talking about my suicidal Ideations, as they're pretty much always with me. However, I STRONGLY agree about needing help from the dr/therapist with the PRESENT first. Every therapy I've had that started in my past, I ended up leaving after a few months. Even if it was every week. I feel like you: what good will it do me today to talk about many years ago? How will that help me today? I understand the past is important and know it will indeed play an integral part in my therapy, just as it does in my life. However, I want help to cope with today and tomorrow, next weekend, next week. I think we are of the same mind: start with today and work backwards. My most successful therapy did just that: helped me to deal with the here and now, then started taking parts of my past and helping me to see how it all integrates, and teaching me very desperately needed coping skills. Regression therapy was an absolute nightmare for me. It left me worse than I walked in. It ignored everything in my life at present.
I'm not saying that everyone needs the type of therapy I would like to have. It's very individualistic; however, every person should know that they may need to see a few (or several) different therapists or doctors before they find the right one. Don't give up. I don't think that's talked about enough, either. After all, it's one of THE most personal relationships you're going to have. It has to be the right fit.

September, 12 2012 at 7:53 am

I honestly feel "put on the spot" every time a healthcare professional asks me, "Have you ever tried to commit suicide?" or "Do you ever think about killing yourself?" Especially when it's the first few sessions, making me extremely uncomfortable, and more likely to either lie about my past, or make it "not a big deal." When they start out with questions like this, especially if we are not comfortable with each other, I feel like it cuts off a communication line.
Yes, when you make such a global statement... Yes. I have wanted to kill myself before. I have wished I were dead, or that there were an easy way to disappear. But haven't we all? Sure, I have tried to kill myself.
But I am here to talk to you about the present, how I should be dealing with what I am right now, and not the suicidal urges I had 10 years ago, or 2 years ago, or maybe a few months ago, when situations were completely different. My medical conditions and mentalities change so rapidly that I really want to discuss what is going on NOW- not what was going on before in my head (one of those quirks of having "bipolar tendencies," I suppose...).
What I want support for is how I'm trying to live my life through now; not how I was trying to end it a decade ago.
Of course, when we become close, and it comes up in one of the sessions after a year, two, or whenever we can forge a nice trustful relationship, I wouldn't mind going back to it and talking about it- as long as the doctor knows who I am now, and what we are talking about is the past, and that I've changed, and whatever problems I was having then are not the problems I'm having now (if I am suicidal at the moment).
For example, when I was in middle school, I was suicidal. I was extremely depressed, very confused about life (I am a first generation immigrant, so everything about "growing up in America" was new to my whole family, and my parents were unable to support me). I was bullied, couldn't make friends, and though I made great grades, felt like nothing. I wanted to die- disappear.
Last year, I wanted to die and disappear. But it was because I was diagnosed with Arteriovenous Malformations, was having multiple seizures, and living daily in fatigue, dizziness, exhaustion, stress, anxiety, and depression that today may be the day that I have a stroke, causing me to have brain damage or die.
Both are "wish I were dead" mentalities, but for completely different reasons. Digging up my past pre-teen woeful years and trying to talk to me about it would not have helped my last year's situation. Or this year's, where I am dealing with different kinds of problems, but I'm trying to keep my life in a forward trajectory (though expecting to not get there- a lot of therapist don't understand that, either... That I go through my day as though I will live until old, but expecting to be dead in a few years- which, I personally think, allows me to appreciate life a lot more).
I honestly think, at least for me, this is a question that requires a LOT of trust. I am not going to admit to a random doctor that "I wanted to kill myself" so that they can make instant judgement above me and "how to deal with me" based on that statement. Once they know me better, I would feel much more comfortable talking about it.

Missy Richmond
September, 12 2012 at 5:32 am

I, too, have a few failed suicide attempts. I was very lucky that a friend randomly stopped by or I'd not be here. I have bipolar 2 with treatment resistant depression. I have many things going on...things I've battled for 24 years, since age 14. Anorexia, rape, chronic pain, autoimmune diseases, rapid cycling, anxiety, agoraphobia, mental abuse, financial ruin and I'm now blind from a rare genetic disease, Stargardt Disease, that I was diagnosed with late 2008..when I had perfect corrected vision. I'm now past legal blindness. I lost my career, Dental Hygiene, because of that. It took me 3 years to win my Disability case. In that court room, very unexpectedly, the Federal Judge asked me how often I think of suicide. This was last December. I was sworn to truth, so I truthfully, tearfully answered: every day of my life. I go to sleep praying I won't wake up. I cry when I do, sometimes. I lost my best friend to suicide last November. I loved him, had discussed all my knowledge of depression, urged him to see a therapist...everything. I am lucky in that he happened to answer his phone for me to tell me he loved me, and I, him..2 days prior. I had no idea of his plan. I now know the intense grief those left behind experience, which keeps me from acting on my own feelings. I've had every therapy in the world, taken a novel of medications, spent multiple visits willingly in private psychiatric hospitals. I wonder if there will EVER come a day that I DO NOT think of suicide. The scariness of going blind surely isn't helping. And my depression has made me put off getting my Medicaid, so I have no health insurance and no money. Actually, I'm filing bankruptcy, much to my dismay.
I don't have answers. Every day I hope it gets better. I am religious about taking my medications. I know I'd be dead without them. I do my best to avoid my triggers. I have the Suicide Hotline number saved in my phone. I am a constant worry to everyone that loves me, ironically making it impossible to go to them just to talk to. Truthfully, I feel dead already...just physically alive, like it's a punishment. I desperately WANT to get better. I've tried all the alternatives as well. The only thing I haven't done is shocks. I'm preparing that I'm going to have to try.
I plan to see a psychiatrist, therapist, pain clinic, neurologist and urologist as soon as I get my insurance. I can barely afford my monthly medications. I have goals. I think those help give me hope. Hope keeps us alive. If we can just come up with even 1 goal...there's hope. I'm not suicidal, but as someone mentioned above, were I to find myself in a life or death situation, I wouldn't fight it. I think there's a LOT of people who feel this way, but the stigma prevents them from coming forward. Thank you for freely writing about it. If you help just one person...that's a great accomplishment.

Des Kehoe
September, 11 2012 at 3:11 pm

Here in the UK it just seems that you are yet another piece of paperwork to fill in.
Don't get me wrong they do their jobs but there seems to be no "why do you feel this way?"There is a lot of covering of backs in the system and it just dosen't work.
I am seeing a new shrink in a couple of weeks and i will give them my ears but we will just have to wait and see
Sorry to moan but having a bad day

Natasha Tracy
September, 11 2012 at 2:54 pm

Hi Julie,
Let me be honest with you - your comment is making me cry. Not because I feel bad for you (although I do) but because I know exactly what you're feeling. I know that pain. I know that longing. I know those plans. I know the helplessness. I know where you are in treatment. I have been there, right beside you, in the pain, and I really, really get it.
If I had the words to help, even a little, I would gladly give them to you, but all I can tell you is that you're not alone. I can't fix your treatment and I can't make the thoughts go away but I can say I stand beside you.
And I can tell you this - you are absolutely right that sane people have no idea what pain management is for those with a mental illness. But I believe the fight of that pain is monumental and worthwhile. Your leaving this comment here has been very worthwhile. There is a valiancy in your fight that you might not be able to see, but I can. I don't know if that means anything to you but I know it means something to those around you. You are strong and you are powerful and you prove that every day by continuing forward.
Thank-you for taking the time to comment here. I know you have put the words out that express what so many people feel, but just can't say.
- Natasha Tracy

Julie Cochrane
September, 11 2012 at 10:16 am

Yeah, unfortunately, having been early onset (5 years old) with bipolar 2, and having been terrified of an unsuccessful suicide attempt, I researched high lethality methods. So "do you have a plan"--the answer I always have to give is, "After 40 years of mental illness and having an engineering and researching kind of mind, I have multiple, redundant, specific, high-lethality plans that are independent of the availability or inavailability of various resources that may or may not be available to me at any given time. Um...sorry? It was one of those oddly comforting hobbies for awhile. It's a little like having the car keys in your pocket if you get dragooned into attending a really lousy party."
I would like the party to quit sucking. It's not really that I want to be talked into staying at the party--although when I'm not depressed, I have fun here. It's not that when I'm really depressed that I truly don't want to get the heck out of the party--I truly do. I don't "want to be helped" for my own sake.
I mean, I "want to be helped" in the sense that I want someone to make the pain stop. But if they can't make the pain stop and all they're going to do is yell at me and blame me because I can't work and get a job and other people are having to support me, then for crying out loud, just shoot me already. Or at least get out of the way and let me--or substitute any one of any number of equal lethality, relatively quick and relatively pain-lite methods.
Mostly, I stick around because there are a very, very few immediate family who are specifically, personally attached to me and would be unduly hurt if I checked out early. However, if I was sick or injured or freezing to death or otherwise had a situation where I had a convenient, tactful, "natural causes" exit from the bad party, I'd say hasta and split.
It's not that I don't love my people, it's just that my pdoc hasn't been able to get my depression lifted up to euthymia again for the past year despite getting my current meds maxed out, so the "next thing to try" is going to be, well, something different.
It's painful, it sucks. It's a really obnoxious party right now. And of course I'm not going to get proactive about the suicide thing. But if I had a nice, convenient "natural causes" excuse and all I had to do was not act? Yeah, I'd take that tactful out.
Do I "want to be helped" in the sense that I want my pdoc to try something different and get the pain stopped? Sure, absolutely. Do I "want to be helped" in the sense of, "Oh my god, life at all costs, stay at the damn party through all kinds of pain no matter how much it hurts, pain is such a small price to pay because life is sooooo precious"? Puh-lease. Spare me. Hell no.
I think "sane people" (for want of a better term) drastically undervalue pain management as applied to depressed people.

Dr Musli Ferati
May, 26 2011 at 9:45 am

Even suicidology has made great invention on etiopathogenesis of suicide, it is remain more unacquainted facts about this fatal humane vice. Indeed this acute auto-destructive behave has stir up the interest of many scientist to every humane sciences such are: medicine, sociology, psychology, philosophy, anthropology, theology etc. Although all above mentioned sciences give important information of this social disastrous phenomenon, medicine, exactly psychiatry is to confront directly with person who commit suicide. Therefore, they bears the responsibility on these unfortunate persons. The challenge is enormous. However, till now there are many knowledge in psychiatry on suicide and suicide predictors as preventable measures against this exterminate act. The same are gained by taking the history of illness, that imply to ask the patient a lot of unbecoming questions. Thus, it may to rescue from death many depressive patient who are mostly susceptible from suicide. Furthermore, when it is known that depressive disorders in 90% of cases are curable.

Natasha Tracy
May, 13 2011 at 2:34 pm

Hi Dan, so far so good indeed.
One of the things the article I linked to mentions is the "intangibles." Basically the feeling the doctor has about whether you are acutely suicidal or not. And sometimes this involves asking the questions and assessing the lies.
And yes, I agree, we do know ourselves. And hopefully between you and the relationship you have with your doctor, you'll be able to know when you need a greater level of care.
- Natasha

May, 13 2011 at 12:53 pm

I agree that doctors asking these questions are neccessary and helpfull. However, sometimes I don't answer them truthfully due to how persistant my suicidal thoughts are and I don't want the doctor overeacting to the situation. Maybe that means that they arent serious enough. I don't know... What I do know is that my suicidal thoughts are very regular. It's been just over a year since my last attempt and I'm still working on keeping those thoughts from taking over again. So far, so good.

Natasha Tracy
May, 13 2011 at 9:42 am

Hi Amy,
And thank-you for sharing your experience. It's chilling to think of someone taking one pill after another with their child in the next room but it's important for people to understand that happens and people come back from it.
"I am glad that doctors ask the “dumb” questions because I personally have answered them honestly in the past and it has helped me and my doctors."
And thanks for sharing that too. It's good for people to hear.
- Natasha

Amy Kiel
May, 13 2011 at 9:40 am

Thanks for mentioning my post Natasha and especially for writing an excellent post on this issue!
This is great information and full of truths. People do want help and need help to find relief for their suffering. I am glad that doctors ask the "dumb" questions because I personally have answered them honestly in the past and it has helped me and my doctors.

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