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Ask Dr. Z Your Own Question
Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10643
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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is one still actively suicidal if they cannot suppress the

This answer was rated:

is one still actively suicidal if they cannot suppress the survival instinct?

Dr. Z :

Hello

Dr. Z :

I believe I can help you with your question

Customer:

ok

Dr. Z :

May I ask specifically what you are describing when you say survival instinct? Can you give me an example?

Customer:

i had one suicide attempt a few months ago where i took all the pills i had and drank half a bottle of spirits. i dont remember making the decision, i just did it. i woke up two days later. since then i have gone to a nearby suicide bridge three times, but cannot make myself jump. i have tried using a plastic bag at home as well as a ligature for asphyxiation but remove it before i pass out of fear. i know that i cannot do it, i am wondering if this still makes me actively suicidal.

Dr. Z :

Yes, these are considered suicidal ideations where you have active thoughts of suicide and even a plan. Even though you have not gone through with it, you would be considered actively suicidal by most mental health experts. I would recommend seeing a mental health professional immediately, calling 911, or possibly going to your nearest E.R. for treatment

Customer:

i went to the er once and they asked me if i had any plans to hurt myself. since i know i cannot go through with it, i said no.

Dr. Z :

I think you misunderstood because you did have a plan, you just did not execute it.

Dr. Z :

May I ask are you currently in therapy or on any medications?

Customer:

I see a psychiatrist and take 30 mg of lexapro. it has been 10 years and the depression has never been this bad. have tried a dozen other drugs and nothing seems to work. he wants me to try ect but i dont know because of the qualitfications ie-schizophrenic, psychotic or actively suicidal

Dr. Z :

Well ECT has been approved to treat resistant depression, but before you do that I would recommend Transcranial Magnetic Stimulation (TMS). This is very similar to the Electroconvulsive Therapy, except this used magnetic stimulation instead of electrical and is considered safer with less side effects. Also this modality is relatively new (FDA approved since 2008) and has been considered a last resort for patients when other conventional treatments of depression have been unsuccessful. This novel method for treatment of depression has been very successful for resistant depression and I think it is something that you should consider based on your symptoms and the other unsuccessful treatment approaches. Here is one links describing it in more detail for you and another link of a study in praising its effectiveness and minimal side effects.

Dr. Z :

This is safer than ECT and has had great results for resistant depression

Customer:

my insurance does not cover tms

Dr. Z :

Also the use of Ketamine has been used for resistant depression and is very successful too.

Customer:

ketamine is also only in trials right now i believe

Dr. Z :

It is, but some psychiatrists have been using it and it has been successful in early studies. I just want to give you all your options. The ECT can be used and it has been perfected with minimal side effects, so that is an option that you can try with your psychiatrist.

Customer:

it seems ver0y

Customer:

exterme

Customer:

extreme

Dr. Z :

It is an extreme and last resort treatment, but if you are resistant to traditional treatment, usually the ECT or TMS are the next step in helping you

Customer:

do you know if they help motivate and help a person stop seeing everything as hopeless and overwhelming. or is that something one has to do on their own. i used to be able to do things. now ever since i got the thought of suicide i have given up on life and dont try anymore. like i dont believe i will be here tomorrow anywya so why bother

Dr. Z :

These are symptoms of Severe Major Depressive Disorder, and the ECT can help lessen these symptoms and can cause you to be more motivated and less hopeless, so the answer to your question is yes. In addition tot he ECT, I would recommend Cognitive Behavioral Therapy (CBT) as well since it the most evidence based therapy to effectively treat depression. CBT has a premise that your symptoms are caused by negative thoughts, so if we change your thought process to be more positive and objective as well, then your symptoms will lessen.

Customer:

i have done cbt and dbt. the problem is that i am unemployed and won't take work because of s.a.d. so that leaves me with nothing to do but ideate on suicide all day

Dr. Z :

I am so sorry to hear that. I imagine that CBT and DBT have not worked for you currently, but if you decide to do ECT, I recommend trying the CBT and DBT again (and I can recommend self-help books and a website too) as the ECT may make CBT and DBT more responsive for you because your symptoms of depression will be lessened.

Customer:

what are the reccomendations?

Dr. Z :

Here are the books

Dr. Z :

And here are the websites

Customer:

thank you

Customer:

will ect help me do you think?

Dr. Z :

I think it can help you and since you have tried other traditional therapies that have not worked, then this is the next step for you

Dr. Z :

I personally have seen great success with ECT for resistant depression as well, and with a good psychiatrist the side effects will be minimal

Customer:

ok. thank you.

Dr. Z :

You are most welcome. Is there anything else I can assist you with today?

Customer:

no. thank you for your help

Dr. Z :

Anytime, I am always happy to help. I wish you the best with your treatment and I hope that your symptoms of depression resolve soon for you. My goal is to provide you with excellent service, so if you ever have any further questions or concerns please do not hesitate to contact me at anytime.

Dr. Z and other Mental Health Specialists are ready to help you

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