Skip to main content

Posts

Trading Symptom Relief for Side Effect Relief

Recent posts

Physician-Assisted Suicide for Mental Illness - It's Complicated, or Not

Two years ago, Mark Komrad attended and presented at a symposium in Belgium on physician-assisted suicide for people with mental illness. Komrad is a clinical psychiatrist, ethicist, and faculty member at Johns Hopkins. He just finished a 6-year tenure on the APA Ethics Committee and helped craft the current APA position on Medical Euthanasia for non-terminally ill patients. [That position joins the AMA to say, in a word, Don't.]

Komrad reported back on his experiences to PsychiatricTimes.com. You can read or listen to the his entire report here. This post quotes the parts that particularly struck me from a suicide prevention perspective.

In 2002 Belgium legalized euthanasia by physician (typically by injection) at the request of patients, and removed any distinctions between terminal vs. nonterminal illness, and physical vs. psychological suffering. As long as the condition is deemed "untreatable" and "insufferable," a psychiatric patient can be potentially elig…

Got Bipolar 2? Chris Aiken Can Help

If you want to know best practices for treating bipolar, "bipolar not so much," recurrent depression, "more than depression," "something-about-this-depression-treatment-just-isn't-working," read  Chris Aiken.

When I needed a subtitle for my book, I tried really hard to sell my publisher on What if it's more than depression? - a subtle reference to Bipolar Not So Much by Aiken and Jim Phelps, who is another of my mental health go-to resources. I flatter myself that Prozac Monologues is the companion piece, written from the other side of the prescription pad. The publisher had something else in mind, but if you find one book useful, you will like the other.

When my new nurse practitioner talked me into a chart review by the cookie cutter psychiatrist employed by the practice, the recommendation came back, Abilify and Zoloft. I said, No thanks, and sent her an article by Aiken. I hope it helps my NP get over her Free-Range Bipolar on Aisle 2(i.e., no…

Preventing Suicide Among Gun Owners

Can we reconcile a most basic suicide prevention strategy, means restriction with the 2nd Amendment? Gun owners and public health people have to find a way to talk about this. In Oregon, the conversation has begun.
Gun owners in rural have a sense of responsibility and honor. It's a thing. Part of that responsibility is to protect one's family, one's livestock, and oneself. So let us begin by acknowledging that some gun owners, the ones who live in rural areas where suicide rates are growing the fastest, need guns for protection. But they have to do the protecting themselves. The government, on account of distance and distrust, cannot do the job. And then let us acknowledge that one of the things they need to protect their families (and maybe themselves) from is suicide.

Compare states to states.  Compare regions to regions.  Compare states within regions to other states within the same region.  Compare people of the same age group, in any age group, men to men and women t…

Warning Signs and Suicide Hot Lines Won't Fix This

A psychiatrist remembered his first days on his ER rotation. He dealt with a woman who had tried to kill herself. She was homeless, had been taking meth so she wouldn't sleep ever since she had been raped on the street. The supervisor asked what the young doc intended to do. "Prescribe antidepressants?"

They both knew how stupid that sounded.

In the 80s and 90s, they thought they had this suicide thing figured out. As the number of prescriptions for Prozac rose, the suicide rate was falling. It was widely claimed by people who flunked logic that this was epidemiological evidence that Prozac prevented suicide. Just get more people into treatment. This kind of error is common enough to have its own name: post hoc ergo propter hoc. Or maybe there was some economic incentive behind that sloppy thinking...

For a hundred years, suicide rates and unemployment rates rose and fell in tandem. The top chart is the unemployment rate 1927-2006. The bottom is the suicide rate in the …

Passive Suicidal Ideation and Suicide Prevention Awareness Month

Anna Borges speaks truth about suicidal ideation. In the midst of Suicide Prevention Awareness Month, with its lists of warning signs and gearing us up for the crisis, Anna brings to light the sometimes everyday-ness of suicidal ideation.

I am not always very attached to being alive, she wrote in at article for The Outline, an online magazine. It's not about being in crisis, not about having a "plan," not about needing an intervention. It's more like an indifference to life that sometimes surges into something more serious and then falls back. Like the waves of an ocean.



At 27, I’ve settled into a comfortable coexistence with my suicidality. We’ve made peace, or at least a temporary accord negotiated by therapy and medication. It’s still hard sometimes, but not as hard as you might think. What makes it harder is being unable to talk about it freely: the weightiness of the confession, the impossibility of explaining that it both is and isn’t as serious as it sounds. I d…

The Blues Aren’t Blue For Me - For Suicide Prevention Awareness Month

For Suicide Prevention Awareness Month, guest Margalea Warner tells a story of healing after an attempt and what happened #AfterIDidntKillMyself.
************************
When I emerged from the gray cloud of near death, the color I woke to was blue. It was an artificial blue, kin to a chlorinated pool water or blue Jell-o or Smurfs. It was a long tube with ridges that seemed to be coming from my face. I couldn't use my mind well enough to know it was a respirator tube. I stared at this blue with bewildered wonder. 

I did not remember what caused the gray. I did not remember walking away from my job at ten in the morning without asking for time off. I did not remember going through my closet and throwing all my clothing in the dumpster until I had very little left to wear.

From deep inside my mind I did remember a room of flickering shadows where I was on trial for witchcraft or for being a bad daughter. I rememberedthe voices saying that I must be executed. I had to be my own executi…