I have schizoaffective bipolar disorder, and aspergers. I was making $130,000 a year as a network engineer at Cisco in 1999 before I became too sick to work anymore. Right now I am homeless living in my van with a transmission about to go. I have attempted suicide three times already. I keep thinking about doing it again. No one wants to provide me the best medicine, stable housing. I make $1700 on disability but I can never save enough for a deposit. So what is the point. The fact that I cannot get housing just proves no one cares.
And through all this I keep up my research on my familial disease, pressuring doctors to at least do some tests. I am pretty sure, looking at my genetics, I actually have a mitochondrial disorder. This is an easy test, but they will never do it. They just keep focusing on the same old pathways and that is why there is no progress.
The medications? They do nothing but make me worse. They usually give me drug induced lupus or just make me more suicidal the next day. The only one I can rely on is Klonopin, it works great but I do not take it everyday adn I only take a very low dose, the lowest that works. And every time I get a new doctor I face the stigma of being a drug seeker. Luckily, that is not so much of a problem anymore.
Now iwth COVID, everyone thinks they haev a mood disoder but in reality it is just situational, but they take up all the appointments so now mine are getting pushed further apart.
My nephew hung himself at 14 years old after a doctor thought he had ADHD and gave him ritalin. It was a misdiagnosis.
If you do not have a serious mental illness you have no idea how bad the treatments are and how they ignore any other issues you have in your body. We are the garbage people in this age but we probably used to be the shaman.
So all I can do now is drink a bit to escape, its a great drugs, an awesome calcium channel blocker.
Oh well, that's enough of that. Just wanted to share.
Thanks for sharing this. I'm sorry that you've been so poorly treated. You deserve better. Very many people do.
I recently read Van Der Kolk's "The Body Keeps The Score", a book about trauma and its effects. It's a masterwork, and I'll be thinking about it for the next year. But one of the big themes for me is the extent to which he, a well-placed psychiatrist with a strong mix of clinical and research work, had trouble getting the medical establishment to go beyond outdated categories and marginally effective treatments. It's heartbreaking to think of all the patients so poorly supported by the existing system.
It made me realize that as far as mental health goes, we're living in an age that people will later look at with horror. It makes me think of Semmelweis [1], who had the then-radical idea that surgeons should wash their hands before cutting people open. Many in the establishment mocked him. How dare he call them dirty! He ended up being committed to an asylum where he was beaten; he died 2 weeks later from a gangrenous wound. Eventually people realized he was right, but too late for him. And for who knows how many deaths.
> My nephew hung himself at 14 years old after a doctor thought he had ADHD and gave him ritalin. It was a misdiagnosis.
I have ADHD and the first to get diagnosed in my family, and now that I'm dealing reasonably well with that, strongly suspect other ASD-related traits: obsessionality, sensory issues, social problems, but these lightly enough that I've been able to make it through life just being a bit "weird" and that's okay because I'm a successful software developer. (Crazy rich guys are just "eccentric", right?)
My father definitely does have many of these too, and if you look back at the family history it's everywhere... from cousins with autism who can't live independently, to back generations with erratic behaviour for which this sort of neural difference is the best explanation.
Now speaking to the quote... my 13 year old has terrible levels of anxiety and depression, and has an ADHD diagnosis. We very briefly tried a stimulant and just as quickly took him off it, whereas they have worked well for me (now, I was also suicidal as a teen.)
Why? He struggles with focus and concentration, which the stimulants should help with, as they do for me. My best guess is that he has a deeper problem in finding life meaningless, a lot of "no point to anything" and "I don't want to live anymore". When he took the stimulants, he was able to focus... but on those thoughts since he had little else he was thinking about and that made the depression and anxiety so much worse. So I can absolutely see how Ritalin could result in suicide. :(
The difference for me was that I knew what I loved, and I knew what I wanted to do with my life, yet I was constantly beset with intrusive thoughts that were telling me I should be doing something "better" with my time. And a fundamentalist religious upbringing had me thinking that was my conscience or God and therefore I should be paying attention to it. But then that almost shrank to nothing as soon as I started the amphetamines.
So I view this as a similar situation to giving antidepressants to sufferers of bipolar and mania; you end up exacerbating the problem.
They are finding there is so much genetic overlap for these disorders which is why you see so much similarity in your child, yet there will be differences that might be influenced by his mothers genetics.
My father was no doubt an Aspie, he was a poor Italian boy in NYC but somehow attained a full ride to NYU when he was 16. My mother, a poor Polish girl who ran away from the coal country to NYC where she met my father. She has the bipolar phenotype running through her side of family and she was in and out of hospitals and attempted suicide a few times as well.
So you end up with me, a mix of my mother mitochondrial DNA and my fathers Nuclear DNA. Bipolar, OCD, Aspergers...
Your experience with amphetamines is like mine with Benzodiazapines. When I took them for the first time I finally understood how other people were able to exist in the world. Klonipin stops my suicidal impulses in a half hour.
Regarding my nephew, I was frustrated with my brother, he did not listen to me. I was given Ritalin when I first saw a psychiatrist in 1996 and it threw me into an insane manic episode (I am still apologizing to my ex-girlfriend). That is how that "diagnosed" my bipolar disorder. So being he was realted, and showing some of the same behavior of my other brother who was also bipolar, I felt it was a wrong diagnosis.
I can tell you the most important thing you can do is get your child's full genome run if you can afford it. To me it is the only thing that will help you find what he needs. I have collected about 15 other people's genetics and I often compare them to mine. By a white European standard, I am a genetic "freak". But through intensive self study of nurtigenomics, I have found a lot about what works for me.
And I am sure you know this, but the less stress on your child the better, we need to live a life that looks nothing like the mainstream, and the more you can let him live how he needs to live the better. But I wish my parents could have helped me as much as you have already with your son. My mother told me that since I was pretty intelligent they felt I could be left to my own devices.
But I think mitochondrial genetics is huge in all of this. I have a family's genetics who have two sons with severe Autism and their mitochondrial genetics are different to say the least.
If you want to email about anything feel free: podgaj@fastmail.org
How is your 13 year old with the social stuff? As someone who seems to be similar to your son (although I'm much older - and a software developer like you), I would comment that it is having strong social connections that brings purpose to my life, and the degree to which I've been integrated in a social community has correlated strongly with times of my life where I've been happy versus times in my life where I've felt like everything is meaningless.
It is actually a 2001 Dodge Grand Caravan Sport with 175K miles on it. Trying to figure out the trigger but it's like when I come down from a gear doing around 45-55 the van jolts short and there is a loud cluck and then it slips into neutral and then catches back in gear.
And yes, like shit is the right way to put the treatment. But I understand, it is so hard for people to not see my disorder as something I willfully express on the world. I know a better understanding is around the corner, but I am afraid treatments will take longer to appear. It is a slow process.
mentions no prescription-restricted treatments, just vitamins, diet, exercise, and rest. It mentions therapy, but general skills therapy, nothing specific to mitochondrial disease.
Thanks for sharing. Getting the right treatment is such a gamble. I wish we were better at talking about mental illness openly instead of stigmatizing it. Perhaps then we would realize the need for better treatments and funding. I have a close relative that's been all the way down the hole with life-threatening mental illness, but recovered due to doctors finding the right cocktail of medication and safe environment. Getting to know this person I'm humbled by how ignorant I've always been on issues of mental health. I shudder when I read comment sections like this one, or talk to friends and family, as I'm reminded how pervasive this ignorance still is in the general public, and even in professional healthcare. I have the deepest respect for people like you, that are hanging on in spite of the terrible circumstances you've been given. I hope you find some shivers of light in between all the darkness.
I hope my question won’t wake up anything, and please accept my apologies if they do.
- What hopes did you have when you were younger?
- What did it look like when you started failing?
- Do you think a different turn of events would have avoided that?
I feel like I was on the high path up to 25 years old, I’m earning now, but I’m getting inexorably rid of my friends, one after another. I’d like to know where I’m at…
A difficult situation. I am impressed by your success at Cisco. If you had that capability, you still have that capability.You have significant hurdles to overcome, but you do have the opportunity to make it. I won't offer you platitudes, but I encourage you to keep trying.
Housing shortage? Probably, but why? In a town I lived in for a bit 50% of the houses were second houses, i would drive around and see them all dark, sitting there empty. Her where I am now, the housing has been moved over to AirBNB. It is all greed.
And go to a poor town? And not have healthcare, be away from my friends and support? But yes, I have tried it. They ask me what I do and when I say I am on disability they deny me the rental. And many of these towns will not let you live in your van while you are looking.
It is inequality, not a shortage.
I am telling you, you have no idea what it is like.
This is the part where every one piles in posting suicide hotline numbers. I would argue most of those people do not have any experience with, or understanding of those hotlines and it's just a trite thing to throw out to show support like "fuck cancer".
You should seriously understand what you are signing yourself up for if you call one of those numbers on yourself or someone else.
For one you are volunteering that person for involuntary incarceration in a mental health facility for an unspecified and potentially unlimited amount of time.
Need to show up to work tomorrow to avoid losing your job? That probably isn't happening.
Need to pay your bills to avoid losing your house? That might not be within your capabilities for the next several months or longer.
Kids need to get to school? CPS is likely going to be handling that for the indefinite future if they don't have another guardian because you aren't going to be around to do it and you are no longer fit to be a legal guardian anyway.
I'd probably rather end up in Jail than in that system.
Simply put, in our society indicating you are suicidal is a defacto crime and you should never do it(including and maybe especially to a psychiatrist/psychologist who maybe taking on legal risk if they don't institutionalize you after the admission) unless you are ready to suffer the consequences.
This article is from the UK, so we should be clear about consequences for the UK audience.
The Samaritans hotline (a general distress helpline) is there to listen. Nothing else. They do not provide treatment, judgement or the like. Sometimes that is enough. More importantly its anonymous. You will not be sectioned by phoning them
To be sectioned (ie detained against your will), you _have_ to be assessed by a doctor within 24 hours. You need to be deemed a risk to yourself or others(by at least two doctors) before you can be held any longer.
You cannot be fired for being sectioned in the UK.
So whilst the UK is very far from being perfect in terms of mental health (lord knows we have a multitude of problems, some alluded to in the article) it is not as bad as described in the parent thread.
Three years ago I made a plan to take my own life. Instead of pushing through I contacted a local suicide hotline, it was completely anonymous. I just talked for a bit, but that little moment helped me to find the courage to talk to a family member and that led me to go into therapy which I completed a few months ago.
Initially I was very scared telling my therapist about being suicidal, exactly sketching those horror scenarios. But when I finally talked about it, nothing happened. I remained into complete control of my own therapy the whole period. It helped me turn my life around and I'm incredibly happy I took the leap of faith to start talking about it.
Unfortunately, judging by the prevalence of the opposing situation happening in articles (in reputable newspapers too) online, you have essentially been lucky (or never got into a conflict with your therapist).
The odds of someone dying through suicide after a suicide attempt is very small (only 2%), but those odds greatly increase if inpatient treatment is provided, instead of reducing. There is a reason for that, and clearly your experience doesn't provide that reason. The stated reason psychiatrists give for this is that only the very serious cases get committed, but research doesn't back that, and for specific institutions (and you have no control over where you end up) it is definitely not true.
Suicide after inpatient treatment in a psychiatric facility is actually getting close to enter the top-10 causes of death. Whilst that doesn't directly contradict what you're saying, it comes pretty close.
In the Netherlands, it is now actually true that more than 50% of suicides happen with psychiatric help, which mostly means getting locked up. Given that less than 1.5% of the population ever gets committed (but rising fast, especially for kids), that's pretty incredible.
And in a bunch of published cases it isn't even the case that people were committed for a suicide attempt, but for an outburst that was then diagnosed, for example as autism. Suicide came, years later, after years of treatment, a progressively worsening situation, and months in isolation in such a facility, in one case with the person locked up without his glasses.
I agree with your general sentiment, but speaking as someone who has been in jail and also involuntarily committed on multiple occasions, jail is much much worse.
All the downsides you listed apply to jail time also, but the food is more terrible, the environment more restrictive, and the opportunities for extricating yourself (if you are reasonably cogent) are greatly reduced.
Also, ironically, being in jail on suicide watch is preferable to being in general population.
Thanks for the perspective. I have never experienced either directly so at best I'm speculating although I've been around many people who have been through both.
My basis for making that comment is that at least ostensibly you get due process in the legal system.
Man, what. Psychiatrists have to commit you if they think you're an immediate danger to yourself. I'm sure shitty ones do it in situations where they shouldn't, but speaking as someone who has actually experienced being suicidal, my psychiatrist was the only person I actually fully trusted to help me get what I needed.
Maybe I'm just lucky to have ended up with psychs who will take on more risk to avoid having to commit people, but it's at least a little more complicated than you imply.
The fundamental problem there is that plenty of people have won lawsuits against hospitals/doctors when their loved one mentioned suicide in some way, was not involuntarily committed and then proceeded to kill themself. The amounts involved in those lawsuits tend to be high. In contrast, very few people have won lawsuits against hospitals/doctors who involuntarily committed them when they probably shouldn't have been, and even if they do, the monetary harm that they can recoup is probably pretty small.
This results in very perverse incentives for the institution. In your case either the people involved in your care had a very high personal risk tolerance, or it happened in a state where there is less precedent on handing over megabucks to the families of people who commit suicide.
Perhaps this is a regional difference, but you might be confusing the suicide hotline with a petition for involuntary admission. The suicide hotline provides someone to talk to. The person might not even know your name or address. What you’ve described is involuntary admission. Any adult can petition for another person to be brought to a hospital and evaluated, but the hospital decides if the person is admitted and/or placed on a 72 hour hold.
I think the person you are replying to is claiming that the hotline operator will initiate the process for involuntary admission, or at least start a chain of events (e.g. calling local PD for a welfare check) that leads to that outcome.
One of the many things needing overhauling in our mental health system. I avoided seeking help for a long time because I was interested in jobs that would likely require government security clearances, and (I don't know how true this is) I had heard from multiple sources that a history of seeking help for mental health issues may disqualify you. Which is a little backwards in practice. If there's an issue I want to address it and manage it. Because of my desire for those jobs, I let the problem fester for longer.
I also found when I finally broke down and sought help (not for suicide, granted) the process of trying to take advantage of my company's resources like paying for short-term counseling, etc. was incredibly frustrating. You couldn't get a hold of the people at the company we paid for the plan, everything on their site was outdated and badly maintained, they only covered certain therapists, and they happened to be therapists who make a point of specializing in treating pretty much anything with drugs, etc. Had I been on the edge of suicide or unable to eventually just pay for the care I needed directly, I can only imagine trying to navigate this process could've finished me off, emotionally.
Company resources are next to useless. They are meant to be short term and are encouraged to turn you around in a few sessions. If you can, go private, since it's more open ended and the process of over over the basics of your life story are tedious.
> I was interested in jobs that would likely require government security clearances, and (I don't know how true this is) I had heard from multiple sources that a history of seeking help for mental health issues may disqualify you
FWIW, you heard correct. This is true. (I don’t have any clearances myself, but I did work for a major defense contractor in the past, and a family member has some sort of above-top-secret clearance for his work.)
This is precisely what they do. Fun fact: whilst Lifeline in Australia says that they will treat all calls as anonymous, they in fact do not. If you speak about killing yourself to a counsellor, then they will call the police and trace your number, despite whether or not you turned off caller ID.
Consider this: if the providers of these suicide hotline numbers actually cared about this stuff, they would provide an as pseudonymous as possible way to contact them that makes it as impossible as possible (in a mathematical/cryptographical sense) to identify the caller (think about Tor).
Additionally, the hotline operators would advocate very strongly for a right to encrypt and right of privacy.
But this is not the case, which should convince any rationally-thinking person that all of these claims of anonymity are fraud.
So speaking as someone who has worked in psychiatry and mental health care, I can say it's basically true. It's not the intent of those working in it, but I think like a lot of things it's sort of what has emerged through the system.
I had a colleague, now retired, who was the president of state mental health associations, etc. who made the argument that most suicide treatment programs are really designed to protect practitioners and healthcare providers, not the patients. At the time I understood what he was saying, but didn't really understand it until later.
The way it came up with him was more about prediction and risk. He was talking about it because there's basically no way to know if someone is actually imminently suicidal. Most people who talk about it never even make an attempt, and there are lots of people who commit suicide suddenly without saying a word to anyone else ahead of time.
My colleague's point was this: if saying X is totally unpredictive of Y in reality, why react so strongly to saying X? The reason is because it's not really about preventing Y -- you can't -- it's because it legally and morally absolves you of responsibility.
I feel weird writing this because it sounds so cynical, but its a sad truth about the poor state of care of our fellow human beings in contemporary society.
I don't know if he's considered to be a controversial figure or not generally but he is a real psychiatrist so I'd argue he knows what he is talking about
Have you experienced this process? There is a very good point why everyone has learned the "get help" mantra. There is only one suicide you need to do, and game is over. If that can be averted with quick intervention (as often is the case) then all the better.
Interventions cannot help all suicidal persons, but being acutely suicidal means one should get help _now_. It's exactly the same thing as a with a stroke or other imminent medical emergency.
… and … on the other hand, actually going through with it, is about the biggest “f**k you” that can be given to a family.
This is something that I have had personal experience with, in family, friends, acquaintances, and even enemies, that I wished dead, then was not so thrilled, when my wish came true.
I hang out in circles that experience a lot of … “out of band” … issues. It’s a long story, and not one I feel like sharing on HN. Suffice it to say that I have seen this kind of stuff many, many times.
Getting treatment for mental health issues —and there are very many types of issues, and types of treatments— is important. One way to support people going through this stuff, is to avoid feeding the “shame machine,” and try to realize that we may not have the answers, so we can help people connect with those who do.
I think the best part is the dance you do when looking for a therapist where you try to say you really need help, but you have to temper that severity by saying that you aren't in such bad shape that you are suicidal for fear that they commit you to protocol or something.
In reality mental healthcare feels like only a slight step up from antiquated methods from days long gone. Trying the medication roulette is like spending months at a time throwing darts blindfolded to see if anything helps, hurts or does nothing at all. Waiting months to see professionals who are burned out or just trying their best to not be completely overwhelmed by the demand but are unable to give meaningful care because of how overwhelmed they are. Or not even being able to see a therapist at all because it is cost prohibitive. And then consider basically having to do that on the side while you have your other obligations that you have to tend to. I wouldn't be surprised if only a fraction of people who need help get it, and of that fraction, only a fraction of them see a benefit. It basically boils down to society not caring, or barely caring at most.
In the end I suspect that the efficacy of mental healthcare has its limits, after all it is like trying to fix people after they have been broken, which is way harder than supporting people before they break, but that depends on social structures and support groups that are increasingly weak and strained.
The only way, still, to determine which of a mess of conditions you have, all called depression, is to see which, if any, medication seems to help. It is as if you present with a broken bone, but they have to try splinting one after another until they hit on the broken one. And, you might actually have more than one. And, some doctors have a favorite bone, and won't try the others.
Try to imagine a Random Controlled Trial protocol for a new depression medication. It is miraculous that any have been approved. It is why you are always seeing articles insisting, idiotically, that RCTs prove depression medications are no better than placebo. Splinting the left shinbone helps only a small fraction of patients who have a fracture.
For validity, RCTs depend utterly on reliable sortative diagnoses. RCT fetishists (which exist, and are common) are mentally unable to process that fact.
And the medicine dart board assumes your psychiatrist doesn't make mistakes. Ie you will have to look up the information on the medicine roulette and the combinations yourself.
Sheesh, that's fucking terrible. I had naively assumed that suicide hotlines would ring to someone who would really listen to you and try to give you some perspective in a non-intrusive manner, which is what I imagine myself needing if I was in that position. Although I guess it's not terribly surprising to hear it's the bog standard pattern of friendly-faced leadgen that passes off execution to a misincentivized backend.
I came here to post what you say not to, and was informed by your comment. Serious question though: what _should_ one say or do to help those who may be suicidal, both in the public and personal? I’ve known several people who committed suicide, and I wish I’d been able to do or say more for them. I know some now who struggle with suicidal thoughts and mental illness. What is the best, right thing to do and say both to friends/family and in a forum like this?
>This is the part where every one piles in posting suicide hotline numbers. I would argue most of those people do not have any experience with, or understanding of those hotlines and it's just a trite thing to throw out to show support like "fuck cancer".
As long as we keep rewarding it by pressing the "rightthink" button when we see it it will keep happening, just like every other cheap gesture that appeals to the lowest common denominator.
I agree with your first sentence, I find those annoying and assume that they're pointless and unhelpful, just posturing; but the rest of your comment... what?
People need to know what could happen when they call that hotline. I'm guessing people think it goes something like this:
"I'm feeling suicidal, let me call the hotline."
"I called the hotline and now I feel better, everything's great."
In reality, at least in the US, it could be like this and this is codified in law (Duty to Warn):
"I'm feeling suicidal, let me call the hotline."
"We've notified law enforcement. The police are on their way."
I'm guessing the reason it isn't always done the 2nd way is because actual therapists know how bad this can be to the patient. Realize therapists are taking a legal risk in not reporting. In the US, the only tool government has for most problems is, "call law enforcement." The only tool law enforcement has it, "take them to jail." If you do some research, you come to realize what a bad tool that can be.
Genuinely curious about this - if you call one of these numbers and say you are thinking of self harm but you are not actually going to hurt yourself and you do not want them to call whomever to your home are they likely to do it anyways?
A friend's husband called one of the suicide lines and he wasn't committed or visited by the police, so it's not a 100% chance. I don't know the details of what the husband talked about, but it may have been because it wasn't a recurring problem. He'd just had an especially awful time at work for a few weeks, and eventually had a breakdown and called a hotline.
He quit his job a couple of days later and has been fine since, so maybe the person on the phone can make a judgement call on whether it's a recurring issue that needs professional help, or something that is an extreme response to an isolated incident and the person will be fine after they're "talked down from the ledge".
Great, that sounds like a perfect pitch talk discourage anyone from calling such a number or talking to someone about a difficult time in their life.
I really hope you are very wrong about what you wrote, otherwise you live in a really cold and frightening place. There sure is a hotline where you can just talk to someone, without losing your job, right? right...?
> Great, that sounds like a perfect pitch talk discourage anyone from calling such a number or talking to someone about a difficult time in their life.
But it's mostly true. Do you just want people not to talk about the flaws in the system?
As long as involuntary detention for suicidal people is law, I would never ever ever tell anyone about any suicidal tendencies.
Not being honest about what happens when you call a hotline is also horrible. "Haha! Got you! Police are on the way!"
I can't imagine the dread if that happened to me, knowing my life is about to get way worse even though I'm already at my bottom.
Anyone saying "well suicide is worse!" is completely missing the point.
I have what is essentially a terminal illness and the fuck cancer resonates
You just want to turn to those people and say "I'm dying". While they are trying to be supportive but they completely miss the mark because they don't get it
Similar things can be said about people regarding addiction
Serious question. I’m signed up for cryonics myself, and in these instances I try to ask, as gently as possible, if they’ve heard of or considered cryonics as an option. I see it as potentially saving lives, although I don’t know anyone else who has actually followed through on the suggestion. But would you view this genuine suggestion to be as asinine and tasteless as I worry it sounds?
Being dead is still a better choice than being trapped in that system and carrying the stigma your whole life IMO. It becomes a permanent problem that you cannot escape.
As someone that was on medication that made me think about comitting suicide regularly, and I've learned to cope and overcome it somewhat...I thought I could read this...but this was like stepping into another reality where I was gone and this was about me. :S :S. and now I'm sitting at my desk bawling my eyes out...just wanting to hold my son and never let him go.
I watched the movie Real Steel starring Hugh Jackman and started to cry at the end. That's when I realized I was depressed, in a real low place. Because that movie is... not good and shouldn't have touched me in any way.
That's also when I found out that crying to shitty movies is so liberating and cathartic and good for me. Crying is good for you. It only takes a minute. Afterwards, I always felt more alive than I did before.
Just as the sibling post did, I hope this message is not out of line and that it reaches you in a good way.
There is no reason what so ever to think that tomorrow will be just like today. Here's to hoping that you also see that.
Thank you, and I like the idea of watching a dumb but harmless movie to kinda forget about things for a couple hours. It’s been a while since I’ve been able to do that. Thank you.
I had my son right before the pandemic. Caring for my new son during Toronto lockdowns in a tiny apartment was pure hell. He is the one thing keeping me going (and my wonderful wife, of course). My one hope is that we can put COVID-19 behind us soon enough so that he has no real memories of it and can live somewhat of a normal life. I want him to be able to meet people in public and see faces without masks. I want him to play with children his age and make friends in the neighbourhood and have sleepovers and playdates. I want to bring him to the toy store and urban playground without ridiculous rules about distancing. What is "normal" going to be post-COVID-19 even? Questions about the future and overall uncertainty keeps me up at night.
I ended up buying a house in my hometown. I work permanently remote now. It's a healthcare company, so it's very busy, stressful, often chaotic - but it is rewarding work and I feel like I am making my own small difference in the world.
My wife wrote a letter to my son about out life during the pandemic yesterday. We will give it to him one day when he is old enough. It made me think that I should create an email address on my server that is specifically for him and write him letters like this so that he can know what life was like and everything he went through. I just want to do everything I can to do right by him. I pray that he will forgive me for any mistakes I may have made while trying to keep him safe during this pandemic.
It means a lot that HN has been so kind to me. It's hard to find kindness these days. People are afraid, angry, in completed despair...but kindness is what we need. Thank you.
My healthcare provider wanted to switch me from stimulants for my ADHD to an off-label use of an antidepressant which listed suicidal thoughts as it’s most frequent side effect. As a father of two young kids I NOPED out of that real quick. I had to stop reading the TFA because I kept thinking “this could have been me” and spiking my anxiety.
It's a difficult read; more of a personal/lived experience but with some stats and thoughts sprinkled through.
I have two young'uns (3 years and 6 months), so it was the title and its expansion that got to me the most; telling your kids that their parent is not coming back? I struggle to tell them when mommy is out for a grocery run!
I told the children early on Saturday morning. “Daddy isn’t coming back,” I said as we lay curled into each other in bed. “He didn’t want to live any more and he made himself die.”
I suspect it’s easier knowing that they aren’t coming back than having to explain that you don’t know when they will come back and what mood they will be in when they do get back. This was my ex wife for several years until I kicked her ass on the street. I’ve got three kids and they’re doing fine now she’s gone but the emotional damage of uncertainty is possibly worse than absolutes.
Good on her for wording it like that. Too often I bet children are met with answers that don’t clearly describe the situation. Sadness is real and it isn’t wrong to feel deep sadness even as a child.
A friend's acquintance has been mentally ill for the last 10 years. They lost their spouse, their job, their car ... everything! They've been gradually increasingly incoherent in their speech over time. They've been resisting treatments.
We are not doctors and won't armchair diagnose them, but we figured out something was wrong. We called a hotline for mental health services trying to see how non-family could help. The counsellor from the hotline said that the best we could do was to convince them that they had to seek help. Since they're an adult, we should not put them in a mental health facility forcefully.
The family had put them in a mental health facility but they escaped. They still thought that they did nothing wrong.
We ran out of ideas on how to help them. They've been living on the streets. We feel helpless.
A relative of mine was clearly mentally ill, although was never diagnosed (he would never seek treatment). He hoarded garbage in his house until it was uninhabitable. Finally he ended up begging on the streets, until about a year ago when he passed away partly due to pneumonia.
It was a struggle to watch, and to repeat the same tired conversations with him about seeking help. In this case too, there was nothing that social services could, or would, undertake to help if he didn't ask for it personally.
While calling mental health facilities to get advice on a similarly mentally ill individual (homeless for probably decades, delusional speech, probably paranoid schizophrenic, afraid of authorities and equally resistant to treatment...no drugs or alcohol though, so that was nice) two of the people I spoke to said the only way they could reasonably see the person getting help was if I called 911 or the police and told them I was worried they were a threat to themselves. That was the only way to get them forcibly treated. One of them said this based on her own experience in trying to get help for a family member. So I did.
Depending on your city/state, they may send out a mental health specialist. Mine didn't have any available so the police called me and gathered the required information. It was the middle of winter and this individual steadfastly refused to go to a homeless shelter and had a respiratory illness, so it was easy to make the case he was endangering his life. The officer was friendly and explained that if they did find the person to indeed be a threat to themselves, they would be taken to a mental health facility if beds were available. In this person's case, turned out he had a warrant out for his arrest. Part of me felt bad that he went to jail, but the other part was relieved that he was out of the cold. Unfortunately, he fell through the cracks and doesn't seem to have been given mental health treatment during his time there.
Fast forward a few months and I got a call from him. He had made his way to some city in Arizona. He went to a hospital there for some unrelated illness; they quickly realized he was mentally ill and after an evaluation committed him against his will. I hope he gets better.
One of my friends actually paid upfront for a short-term semi-private accommodation. They did not stay for the whole time, asked for a refund of the remaining balance and left.
My friend has been mad because they took the money.
Wait list for private psychiatric care here can be six months long now. As for public assistance clinics, good luck...
Clinical-level psychiatric cases have increased since onset of the covid-19 pandemic. A number of doctors I have spoken to have said they are seeing twice as many patients, and cannot sustain this case load much longer.
Things like this made me quit the high-tech job developing self-driving. It's such a bullshit problem to work on if you think about it. Same with most menial SaaS startups creating CRUD websites.
Diarrhea kills 10M+ people globally a year, but it's not lucrative enough for companies to work on 'solving it'.
Same with mental health issues. Kills 3x as much people yearly, but not 'cool' to work on that problem.
Yeah, there's plenty of jobs in the world that pay well enough for someone to live well. But it's so much more satisfying to work 40 hours/week making a change in people's lives.
Readit News
https://archive.md/DvlP6
And through all this I keep up my research on my familial disease, pressuring doctors to at least do some tests. I am pretty sure, looking at my genetics, I actually have a mitochondrial disorder. This is an easy test, but they will never do it. They just keep focusing on the same old pathways and that is why there is no progress.
The medications? They do nothing but make me worse. They usually give me drug induced lupus or just make me more suicidal the next day. The only one I can rely on is Klonopin, it works great but I do not take it everyday adn I only take a very low dose, the lowest that works. And every time I get a new doctor I face the stigma of being a drug seeker. Luckily, that is not so much of a problem anymore.
Now iwth COVID, everyone thinks they haev a mood disoder but in reality it is just situational, but they take up all the appointments so now mine are getting pushed further apart.
My nephew hung himself at 14 years old after a doctor thought he had ADHD and gave him ritalin. It was a misdiagnosis.
If you do not have a serious mental illness you have no idea how bad the treatments are and how they ignore any other issues you have in your body. We are the garbage people in this age but we probably used to be the shaman.
So all I can do now is drink a bit to escape, its a great drugs, an awesome calcium channel blocker.
Oh well, that's enough of that. Just wanted to share.
I recently read Van Der Kolk's "The Body Keeps The Score", a book about trauma and its effects. It's a masterwork, and I'll be thinking about it for the next year. But one of the big themes for me is the extent to which he, a well-placed psychiatrist with a strong mix of clinical and research work, had trouble getting the medical establishment to go beyond outdated categories and marginally effective treatments. It's heartbreaking to think of all the patients so poorly supported by the existing system.
It made me realize that as far as mental health goes, we're living in an age that people will later look at with horror. It makes me think of Semmelweis [1], who had the then-radical idea that surgeons should wash their hands before cutting people open. Many in the establishment mocked him. How dare he call them dirty! He ended up being committed to an asylum where he was beaten; he died 2 weeks later from a gangrenous wound. Eventually people realized he was right, but too late for him. And for who knows how many deaths.
[1] https://en.wikipedia.org/wiki/Ignaz_Semmelweis
> My nephew hung himself at 14 years old after a doctor thought he had ADHD and gave him ritalin. It was a misdiagnosis.
I have ADHD and the first to get diagnosed in my family, and now that I'm dealing reasonably well with that, strongly suspect other ASD-related traits: obsessionality, sensory issues, social problems, but these lightly enough that I've been able to make it through life just being a bit "weird" and that's okay because I'm a successful software developer. (Crazy rich guys are just "eccentric", right?)
My father definitely does have many of these too, and if you look back at the family history it's everywhere... from cousins with autism who can't live independently, to back generations with erratic behaviour for which this sort of neural difference is the best explanation.
Now speaking to the quote... my 13 year old has terrible levels of anxiety and depression, and has an ADHD diagnosis. We very briefly tried a stimulant and just as quickly took him off it, whereas they have worked well for me (now, I was also suicidal as a teen.)
Why? He struggles with focus and concentration, which the stimulants should help with, as they do for me. My best guess is that he has a deeper problem in finding life meaningless, a lot of "no point to anything" and "I don't want to live anymore". When he took the stimulants, he was able to focus... but on those thoughts since he had little else he was thinking about and that made the depression and anxiety so much worse. So I can absolutely see how Ritalin could result in suicide. :(
The difference for me was that I knew what I loved, and I knew what I wanted to do with my life, yet I was constantly beset with intrusive thoughts that were telling me I should be doing something "better" with my time. And a fundamentalist religious upbringing had me thinking that was my conscience or God and therefore I should be paying attention to it. But then that almost shrank to nothing as soon as I started the amphetamines.
So I view this as a similar situation to giving antidepressants to sufferers of bipolar and mania; you end up exacerbating the problem.
They are finding there is so much genetic overlap for these disorders which is why you see so much similarity in your child, yet there will be differences that might be influenced by his mothers genetics.
My father was no doubt an Aspie, he was a poor Italian boy in NYC but somehow attained a full ride to NYU when he was 16. My mother, a poor Polish girl who ran away from the coal country to NYC where she met my father. She has the bipolar phenotype running through her side of family and she was in and out of hospitals and attempted suicide a few times as well.
So you end up with me, a mix of my mother mitochondrial DNA and my fathers Nuclear DNA. Bipolar, OCD, Aspergers...
Your experience with amphetamines is like mine with Benzodiazapines. When I took them for the first time I finally understood how other people were able to exist in the world. Klonipin stops my suicidal impulses in a half hour.
Regarding my nephew, I was frustrated with my brother, he did not listen to me. I was given Ritalin when I first saw a psychiatrist in 1996 and it threw me into an insane manic episode (I am still apologizing to my ex-girlfriend). That is how that "diagnosed" my bipolar disorder. So being he was realted, and showing some of the same behavior of my other brother who was also bipolar, I felt it was a wrong diagnosis.
I can tell you the most important thing you can do is get your child's full genome run if you can afford it. To me it is the only thing that will help you find what he needs. I have collected about 15 other people's genetics and I often compare them to mine. By a white European standard, I am a genetic "freak". But through intensive self study of nurtigenomics, I have found a lot about what works for me.
And I am sure you know this, but the less stress on your child the better, we need to live a life that looks nothing like the mainstream, and the more you can let him live how he needs to live the better. But I wish my parents could have helped me as much as you have already with your son. My mother told me that since I was pretty intelligent they felt I could be left to my own devices.
But I think mitochondrial genetics is huge in all of this. I have a family's genetics who have two sons with severe Autism and their mitochondrial genetics are different to say the least.
If you want to email about anything feel free: podgaj@fastmail.org
I hope you can get help. I have a few family members with schizophrenia / bipolar disorder and the way society treats them is like shit.
And yes, like shit is the right way to put the treatment. But I understand, it is so hard for people to not see my disorder as something I willfully express on the world. I know a better understanding is around the corner, but I am afraid treatments will take longer to appear. It is a slow process.
And thanks.
If you do, what treatment options does that offer? Can you pursue that treatment without an official diagnosis?
https://my.clevelandclinic.org/health/diseases/15612-mitocho...
mentions no prescription-restricted treatments, just vitamins, diet, exercise, and rest. It mentions therapy, but general skills therapy, nothing specific to mitochondrial disease.
- What hopes did you have when you were younger?
- What did it look like when you started failing?
- Do you think a different turn of events would have avoided that?
I feel like I was on the high path up to 25 years old, I’m earning now, but I’m getting inexorably rid of my friends, one after another. I’d like to know where I’m at…
All it proves is that there is a big housing shortage.
Have you tried taking your van somewhere where housing is dirt cheap?
I hear small poor towns are better at taking care of the downtrodden too. Walk into the church poor people go to, and see what happens.
And go to a poor town? And not have healthcare, be away from my friends and support? But yes, I have tried it. They ask me what I do and when I say I am on disability they deny me the rental. And many of these towns will not let you live in your van while you are looking.
It is inequality, not a shortage.
I am telling you, you have no idea what it is like.
Which is a symptom of people not caring.
Dead Comment
You should seriously understand what you are signing yourself up for if you call one of those numbers on yourself or someone else.
For one you are volunteering that person for involuntary incarceration in a mental health facility for an unspecified and potentially unlimited amount of time.
Need to show up to work tomorrow to avoid losing your job? That probably isn't happening.
Need to pay your bills to avoid losing your house? That might not be within your capabilities for the next several months or longer.
Kids need to get to school? CPS is likely going to be handling that for the indefinite future if they don't have another guardian because you aren't going to be around to do it and you are no longer fit to be a legal guardian anyway.
I'd probably rather end up in Jail than in that system.
Simply put, in our society indicating you are suicidal is a defacto crime and you should never do it(including and maybe especially to a psychiatrist/psychologist who maybe taking on legal risk if they don't institutionalize you after the admission) unless you are ready to suffer the consequences.
The Samaritans hotline (a general distress helpline) is there to listen. Nothing else. They do not provide treatment, judgement or the like. Sometimes that is enough. More importantly its anonymous. You will not be sectioned by phoning them
To be sectioned (ie detained against your will), you _have_ to be assessed by a doctor within 24 hours. You need to be deemed a risk to yourself or others(by at least two doctors) before you can be held any longer.
You cannot be fired for being sectioned in the UK.
So whilst the UK is very far from being perfect in terms of mental health (lord knows we have a multitude of problems, some alluded to in the article) it is not as bad as described in the parent thread.
Three years ago I made a plan to take my own life. Instead of pushing through I contacted a local suicide hotline, it was completely anonymous. I just talked for a bit, but that little moment helped me to find the courage to talk to a family member and that led me to go into therapy which I completed a few months ago.
Initially I was very scared telling my therapist about being suicidal, exactly sketching those horror scenarios. But when I finally talked about it, nothing happened. I remained into complete control of my own therapy the whole period. It helped me turn my life around and I'm incredibly happy I took the leap of faith to start talking about it.
The odds of someone dying through suicide after a suicide attempt is very small (only 2%), but those odds greatly increase if inpatient treatment is provided, instead of reducing. There is a reason for that, and clearly your experience doesn't provide that reason. The stated reason psychiatrists give for this is that only the very serious cases get committed, but research doesn't back that, and for specific institutions (and you have no control over where you end up) it is definitely not true.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5710249/
Suicide after inpatient treatment in a psychiatric facility is actually getting close to enter the top-10 causes of death. Whilst that doesn't directly contradict what you're saying, it comes pretty close.
In the Netherlands, it is now actually true that more than 50% of suicides happen with psychiatric help, which mostly means getting locked up. Given that less than 1.5% of the population ever gets committed (but rising fast, especially for kids), that's pretty incredible.
And in a bunch of published cases it isn't even the case that people were committed for a suicide attempt, but for an outburst that was then diagnosed, for example as autism. Suicide came, years later, after years of treatment, a progressively worsening situation, and months in isolation in such a facility, in one case with the person locked up without his glasses.
All the downsides you listed apply to jail time also, but the food is more terrible, the environment more restrictive, and the opportunities for extricating yourself (if you are reasonably cogent) are greatly reduced.
Also, ironically, being in jail on suicide watch is preferable to being in general population.
My basis for making that comment is that at least ostensibly you get due process in the legal system.
Hope you came out the other side in a good place.
Maybe I'm just lucky to have ended up with psychs who will take on more risk to avoid having to commit people, but it's at least a little more complicated than you imply.
The fundamental problem there is that plenty of people have won lawsuits against hospitals/doctors when their loved one mentioned suicide in some way, was not involuntarily committed and then proceeded to kill themself. The amounts involved in those lawsuits tend to be high. In contrast, very few people have won lawsuits against hospitals/doctors who involuntarily committed them when they probably shouldn't have been, and even if they do, the monetary harm that they can recoup is probably pretty small.
This results in very perverse incentives for the institution. In your case either the people involved in your care had a very high personal risk tolerance, or it happened in a state where there is less precedent on handing over megabucks to the families of people who commit suicide.
(No idea if that is true, but it is the claim.)
Deleted Comment
I also found when I finally broke down and sought help (not for suicide, granted) the process of trying to take advantage of my company's resources like paying for short-term counseling, etc. was incredibly frustrating. You couldn't get a hold of the people at the company we paid for the plan, everything on their site was outdated and badly maintained, they only covered certain therapists, and they happened to be therapists who make a point of specializing in treating pretty much anything with drugs, etc. Had I been on the edge of suicide or unable to eventually just pay for the care I needed directly, I can only imagine trying to navigate this process could've finished me off, emotionally.
If you can afford it at all, it can make a lot of sense to do this privately, to avoid a lot of this.
FWIW, you heard correct. This is true. (I don’t have any clearances myself, but I did work for a major defense contractor in the past, and a family member has some sort of above-top-secret clearance for his work.)
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Don't trust phone counselling services. Ever.
Consider this: if the providers of these suicide hotline numbers actually cared about this stuff, they would provide an as pseudonymous as possible way to contact them that makes it as impossible as possible (in a mathematical/cryptographical sense) to identify the caller (think about Tor).
Additionally, the hotline operators would advocate very strongly for a right to encrypt and right of privacy.
But this is not the case, which should convince any rationally-thinking person that all of these claims of anonymity are fraud.
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This comment seems really extreme and it's a perspective I haven't really seen anywhere else.
I had a colleague, now retired, who was the president of state mental health associations, etc. who made the argument that most suicide treatment programs are really designed to protect practitioners and healthcare providers, not the patients. At the time I understood what he was saying, but didn't really understand it until later.
The way it came up with him was more about prediction and risk. He was talking about it because there's basically no way to know if someone is actually imminently suicidal. Most people who talk about it never even make an attempt, and there are lots of people who commit suicide suddenly without saying a word to anyone else ahead of time.
My colleague's point was this: if saying X is totally unpredictive of Y in reality, why react so strongly to saying X? The reason is because it's not really about preventing Y -- you can't -- it's because it legally and morally absolves you of responsibility.
I feel weird writing this because it sounds so cynical, but its a sad truth about the poor state of care of our fellow human beings in contemporary society.
https://slatestarcodex.com/2018/03/22/navigating-and-or-avoi...
I don't know if he's considered to be a controversial figure or not generally but he is a real psychiatrist so I'd argue he knows what he is talking about
Interventions cannot help all suicidal persons, but being acutely suicidal means one should get help _now_. It's exactly the same thing as a with a stroke or other imminent medical emergency.
This is something that I have had personal experience with, in family, friends, acquaintances, and even enemies, that I wished dead, then was not so thrilled, when my wish came true.
I hang out in circles that experience a lot of … “out of band” … issues. It’s a long story, and not one I feel like sharing on HN. Suffice it to say that I have seen this kind of stuff many, many times.
Getting treatment for mental health issues —and there are very many types of issues, and types of treatments— is important. One way to support people going through this stuff, is to avoid feeding the “shame machine,” and try to realize that we may not have the answers, so we can help people connect with those who do.
In reality mental healthcare feels like only a slight step up from antiquated methods from days long gone. Trying the medication roulette is like spending months at a time throwing darts blindfolded to see if anything helps, hurts or does nothing at all. Waiting months to see professionals who are burned out or just trying their best to not be completely overwhelmed by the demand but are unable to give meaningful care because of how overwhelmed they are. Or not even being able to see a therapist at all because it is cost prohibitive. And then consider basically having to do that on the side while you have your other obligations that you have to tend to. I wouldn't be surprised if only a fraction of people who need help get it, and of that fraction, only a fraction of them see a benefit. It basically boils down to society not caring, or barely caring at most.
In the end I suspect that the efficacy of mental healthcare has its limits, after all it is like trying to fix people after they have been broken, which is way harder than supporting people before they break, but that depends on social structures and support groups that are increasingly weak and strained.
Try to imagine a Random Controlled Trial protocol for a new depression medication. It is miraculous that any have been approved. It is why you are always seeing articles insisting, idiotically, that RCTs prove depression medications are no better than placebo. Splinting the left shinbone helps only a small fraction of patients who have a fracture.
For validity, RCTs depend utterly on reliable sortative diagnoses. RCT fetishists (which exist, and are common) are mentally unable to process that fact.
But, they are required by law to escalate the issue if they believe self-harm is imminent.
Encourage others to do the same.
Most importantly, Resist the temptation to give advice (unless it’s solicited).
Don’t ask “have you tried X?”… instead ask “what can I do to help you get through this”.
As long as we keep rewarding it by pressing the "rightthink" button when we see it it will keep happening, just like every other cheap gesture that appeals to the lowest common denominator.
https://en.wikipedia.org/wiki/Suicide_legislation#United_Sta...
If it were me, I would call a professional therapist before calling a government hotline in the US. This is not medical or legal advice.
Deleted Comment
He quit his job a couple of days later and has been fine since, so maybe the person on the phone can make a judgement call on whether it's a recurring issue that needs professional help, or something that is an extreme response to an isolated incident and the person will be fine after they're "talked down from the ledge".
So the question is do you want to play roulette with your physical freedom.
I really hope you are very wrong about what you wrote, otherwise you live in a really cold and frightening place. There sure is a hotline where you can just talk to someone, without losing your job, right? right...?
But it's mostly true. Do you just want people not to talk about the flaws in the system?
As long as involuntary detention for suicidal people is law, I would never ever ever tell anyone about any suicidal tendencies.
Not being honest about what happens when you call a hotline is also horrible. "Haha! Got you! Police are on the way!"
I can't imagine the dread if that happened to me, knowing my life is about to get way worse even though I'm already at my bottom.
Anyone saying "well suicide is worse!" is completely missing the point.
I have what is essentially a terminal illness and the fuck cancer resonates
You just want to turn to those people and say "I'm dying". While they are trying to be supportive but they completely miss the mark because they don't get it
Similar things can be said about people regarding addiction
That's also when I found out that crying to shitty movies is so liberating and cathartic and good for me. Crying is good for you. It only takes a minute. Afterwards, I always felt more alive than I did before.
Just as the sibling post did, I hope this message is not out of line and that it reaches you in a good way.
There is no reason what so ever to think that tomorrow will be just like today. Here's to hoping that you also see that.
Just wanted to say I’m glad you’re there, for him and for yourself. I’m glad you’ve got something to latch onto.
Keep being there, sometimes it’s hard but it always pays off in the long run.
Again, hope it helps
I hope you feel better my friend. You’re not alone here.
I ended up buying a house in my hometown. I work permanently remote now. It's a healthcare company, so it's very busy, stressful, often chaotic - but it is rewarding work and I feel like I am making my own small difference in the world.
My wife wrote a letter to my son about out life during the pandemic yesterday. We will give it to him one day when he is old enough. It made me think that I should create an email address on my server that is specifically for him and write him letters like this so that he can know what life was like and everything he went through. I just want to do everything I can to do right by him. I pray that he will forgive me for any mistakes I may have made while trying to keep him safe during this pandemic.
It means a lot that HN has been so kind to me. It's hard to find kindness these days. People are afraid, angry, in completed despair...but kindness is what we need. Thank you.
I have two young'uns (3 years and 6 months), so it was the title and its expansion that got to me the most; telling your kids that their parent is not coming back? I struggle to tell them when mommy is out for a grocery run!
We are not doctors and won't armchair diagnose them, but we figured out something was wrong. We called a hotline for mental health services trying to see how non-family could help. The counsellor from the hotline said that the best we could do was to convince them that they had to seek help. Since they're an adult, we should not put them in a mental health facility forcefully.
The family had put them in a mental health facility but they escaped. They still thought that they did nothing wrong.
We ran out of ideas on how to help them. They've been living on the streets. We feel helpless.
It was a struggle to watch, and to repeat the same tired conversations with him about seeking help. In this case too, there was nothing that social services could, or would, undertake to help if he didn't ask for it personally.
Depending on your city/state, they may send out a mental health specialist. Mine didn't have any available so the police called me and gathered the required information. It was the middle of winter and this individual steadfastly refused to go to a homeless shelter and had a respiratory illness, so it was easy to make the case he was endangering his life. The officer was friendly and explained that if they did find the person to indeed be a threat to themselves, they would be taken to a mental health facility if beds were available. In this person's case, turned out he had a warrant out for his arrest. Part of me felt bad that he went to jail, but the other part was relieved that he was out of the cold. Unfortunately, he fell through the cracks and doesn't seem to have been given mental health treatment during his time there.
Fast forward a few months and I got a call from him. He had made his way to some city in Arizona. He went to a hospital there for some unrelated illness; they quickly realized he was mentally ill and after an evaluation committed him against his will. I hope he gets better.
My friend has been mad because they took the money.
Clinical-level psychiatric cases have increased since onset of the covid-19 pandemic. A number of doctors I have spoken to have said they are seeing twice as many patients, and cannot sustain this case load much longer.
I told them not to bother.