If it's long term, is it still suicide?

[SylG]

I'm just waiting for my parents to pass before getting serious about it. Is that weird?

I don't feel like this is a "cry for help", I just don't want to cause my parents extra pain. So I'm waiting. Then once they're gone, I'll figure how to go and get it done. I've tried CBT, self-help, antidepressants and nothing works. But since I've decided to just wait at least I feel more Zen about my future.

I just wanted to share with someone.

 

[Daniel E.]

I can relate to what you are saying, but I mostly relate to a more optimistic perspective, e.g. You wouldn't tell a friend to kill themselves.

I've tried CBT, self-help, antidepressants and nothing works.

Of course, there are other therapies besides CBT. And some therapists are way better at CBT than others. David Burns' new book addresses the resistance that makes CBT difficult, as does solution-focused therapy, etc.

With the SSRIs, etc., it may be worth trying again. I am on Prozac now and it seems to be helping me way more than it did 20+ years ago when I first took it. Also, back then I was expecting a miracle. Now, I am satisfied with more subtle effects like getting less frustrated.

 

[Daniel E.]

BTW, from a now-classic study:

Toward a clinical model of suicidal behavior in psychiatric patients - PubMed

Objective severity of current depression or psychosis did not distinguish the 184 patients who had attempted suicide from those who had never attempted suicide. However, higher scores on subjective depression, higher scores on suicidal ideation, and fewer reasons for living were reported by suicide attempters...

The authors propose a stress-diathesis model in which the risk for suicidal acts is determined not merely by a psychiatric illness (the stressor) but also by a diathesis. This diathesis may be reflected in tendencies to experience more suicidal ideation and to be more impulsive and, therefore, more likely to act on suicidal feelings.

"Subjective depression" reminds me of Albert Ellis' point about "secondary disturbance" -- one can become depressed/anxious about having depression/anxiety.

And even getting a personal trainer can help (as can new-but-still-expensive drugs like ketamine and Rexulti):

'People are desperate,' says Saskatoon psychiatrist offering ketamine treatment for depression

The hormone cortisol is released when people are stressed, but also during periods of depression, and cortisol can damage neural connections in key areas of the brain.

Ketamine works on the brain's glutamate neurotransmitter, which is involved in communicating between nerve cells. Researchers think this is what provides the immediate effects of relief, which then becomes reinforced with the formation of new synapses.

Ketamine works its magic on depression by 'stabilizing the brain in a well state'

even a behavioural intervention as simple as exercise could help maintain those connections.

Psychopharmacology Institute

Two new second-generation antipsychotics were approved in 2015: brexpiprazole (Rexulti) and cariprazine (Vraylar). Like aripiprazole (Abilify), they are both D2 partial agonists and are associated with risk of akathisia. Aripiprazole, brexpiprazole and cariprazine are FDA-approved for the treatment of schizophrenia. Aripiprazole and cariprazine are approved for the treatment of manic episodes in bipolar disorder, while aripiprazole and brexpiprazole are approved as adjunct treatment to antidepressants for major depressive disorder.

Abilify (aripiprazole) is now cheap, at least in the US. It used to be very expensive before it was available as a generic.

 

[SylG]

Thanks.