Judging 'seriousness'

[gooblax]

So. The suicidal ideation that I've been experiencing has been increasing in frequency and possibly in intensity. I find it extremely difficult to judge how seriously I'm considering any of these thoughts.

I decided to mention the topic to my current therapist today, thinking that it might be an idea to just let him know where I'm at. The discussion itself was essentially as I'd imagined, which was okay, but now I'm feeling particularly stupid for having mentioned it. Exceptionally, particularly stupid. Especially since I?m probably not thinking about it with any seriousness, and it?s probably another of those ridiculous exaggerations that I often believe I?m making.

Anyway, how does one gauge how ?serious? one?s thoughts about suicide are? Since I don?t know how ?seriously? I?m considering it, does that make it (or, alternatively, could it be) a minor concern or completely bogus?

I feel like such a daft phoney.

 

[Into The Light]

i don't think it matters how serious the thoughts are. you noticed an increase in frequency and intensity and you did the right thing to bring this up.

you're not a phoney nor a fraud. those feelings are there, they are real, they are a symptom of what's going on with you, and your therapist needs to know about this. you did the right thing :goodjob:

 

[Retired]

Suicidal thoughts are the result of distorted thinking where logic is hampered. Obviously this cannot usually be evaluated by the person experiencing the thoughts, which is why it should be mentioned to whomever will listen.

Many people are uncomfortable with hearing someone is thinking about suicide, and will often try to minimize its importance. Speaking to a therapist or a crisis line where the person is trained to recognize and to deal with a person thinking about suicide is one's best assurance of staying safe.

Gooblax, you did the right thing, and if the thoughts recur, don't hesitate to speak to your therapist immediately, call a local crisis line, speak to us here on Psychlinks or if you feel in immedeiate danger call 911 or whatever is the local emergency service number in your area.

 

[Daniel E.]

...but now I'm feeling particularly stupid for having mentioned it. Exceptionally, particularly stupid.

I would think that's partly related to an internalized stigma against mental conditions. I only remember feeling better by talking to my therapist about my suicidal thoughts. As the others have said, it's dealing with the suicidal thoughts alone that is a bad idea, so you are doing the right thing by talking about it.

The more painful and potentially fatal alternative would be waiting for the thoughts to get more intense before speaking up. So the preventive approach of being very open with one's therapist is, as always, the best approach because it makes it much easier to treat and monitor issues like hopelessness that are related to the depression and suicidal thoughts.

 

[ladylore]

Hey Gooblax

I am also glad you spoke up. It is the only way to get help.

I know when I have felt suicidal or had thought of that sort of nature it was because I didn't see options and felt backed into a corner.

If those thoughts do start to creep in I ask myself what specifically has been going on around me? Specific situations. Once I know that then I start listing options on how to change the situation - If I can't come up with any I ask people I trust - like my therapist.

Hope some of this helps.

 

[gooblax]

Thanks for the replies and for highlighting the advantages of telling my therapist about it. I spent quite some time convincing myself to tell him, and knew I’d be disappointed in myself if I didn’t. I just forgot how much I’d start doubting that decision afterwards.

Still, I wish it could be described quantitatively.

 

[Daniel E.]

I find it extremely difficult to judge how seriously I'm considering any of these thoughts.

This may give a clue, but everyone is different:

SUICIDE LETHALITY SCALE

 

[gooblax]

Thanks Daniel, that gives me a bit of a guide.

 

[Halo]

I really like the link to the Suicide Lethality Scale that you posted Daniel...thanks

 

[David Baxter PhD]

This may give a clue, but everyone is different:

SUICIDE LETHALITY SCALE

What's missing from that table is personality or character traits and behavioral controls.

I used to emphasize to my students that you also need to look at the individual's general impulse controls - sometimes, people who are not "truly suicidal" will still do something impulsive and (inadvertently) lethal.

The other side of that coin is the balance of reasons for dying versus reasons for living. At the moment, I'm having difficulty remembering the name of the author but there was an excellent scale called "The Reasons for Living Inventory" or something similar that makes that point. Someone with a lot of reasons for dying may still resist suicide if there are also a lot of reasons for staying alive - even if those reasons are external (e.g., other people or pets).

 

[Daniel E.]

At the moment, I'm having difficulty remembering the name of the author but there was an excellent scale called "The Reasons for Living Inventory" or something similar that makes that point.

BTW, the inventory is here: Behavioral Research Therapy Clinics - About the BRTC
The author is Marsha M. Linehan along with some others.

A suicide researcher at FSU, Thomas Joiner, gives two contrasting examples regarding suicide risk in an excerpt of his book Why People Die by Suicide:

A main thesis of this book is that those who die by suicide work up to the act.They do this in various ways—for instance, previous suicide attempts—and all of these various ways have the effect of insulating people from danger signals. They get used to the pain and fear associated with self-harm, and thus gradually lose natural inhibitions against it.

The cases of Gayle and Sharon, especially when viewed through the lens of his book’s theory on suicide, are informative regarding suicide risk assessment. Generally speaking, someone like Gayle is at chronically elevated risk, at least to some degree, because the capacity for serious self-injury already is in place. All that is needed for Gayle to engage in serious suicidal behavior if she chooses is a quick change in her feelings of connection and effectiveness. Accordingly, routine assessment of risk status is required with someone like Gayle. By contrast, someone like Sharon is unlikely to engage in serious self harm because she has not beaten down the instinct to live. Even if Sharon feels disconnected from others and ineffective, she lacks the capacity to translate the desire for death into action. (pg. 24-25)

http://www.hup.harvard.edu/pdf/JOIWHY_excerpt.pdf

Also:

In settings where serious mood disorders are common, people understand that suicidality is just part of the disorder; the majority of people who experience mood disorders will have ideas about suicide, and the vast majority will neither attempt suicide nor die by suicide. (pg. 18)

http://www.hup.harvard.edu/pdf/JOIWHY_excerpt.pdf

 

[stargazer]

Suicidal thoughts are the result of distorted thinking where logic is hampered. Obviously this cannot usually be evaluated by the person experiencing the thoughts, which is why it should be mentioned to whomever will listen.

I think this is very much the case. I never used to have suicidal thoughts at all, but I have had these thoughts intermittently since early in 2006, at varying degrees of intensity.

In my case, I never believed for a minute that I would actually go so far as to kill myself, but the mere fact that the thoughts are being entertained ought to raise a red flag.

I did find that it wasn't too helpful to bring them up to friends, especially at the moments of their arising. But it was helpful to bring them up in therapy, and on a forum like this.

Even well-meaning friends are more likely to be tainted by their past and present experiences with you than a trained counselor or a person in a support group whose objective it is to provide you with help and a positive sense of direction.

I have also wondered if the corollary thought: "But I would never go so far as to do it," coupled with "I sure am thinking about it a lot," is itself an example of a distorted thought pattern.

 

[suewatters1]

Gooblax Great topic to bring up I had a hard time to talk to my therapist Friday but before we finish our session I brought it up.

Sue

 

[stargazer]

Just saw my above post, and read through the other posts in the thread. I'm old enough that my memory doesn't serve me very well, so I have to read what I wrote. That was last February. Suicidal thoughts (or they called them "parasuicidal" when I went for treatment) increased as my life-circumstances became worse and worse. I did find it very helpful at this time to call Suicide Prevention. Although it was very difficult for my friends and family members to hear about it, the people involved in suicide counseling did not judge me.

Also, the distorted thinking pccasionally resulted in my making untruthful or exaggerated statement. These seriously damaged one family relationship and another professional relationship. However, treatment here in California, in particular dialectical behavior therapy, was very effective. I actually went three times for short stays (3-5 days) at two different hospitals. So, I think it's very important to discuss these thoughts and feelings, but with the right people.

 

[suewatters1]

Thanks for sharing your story stargazer.

Sue

 

[stargazer]

Thanks for sharing your story stargazer.

Sue

You're welcome, Sue.