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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 5122
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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Hi. Im moderately suicidal-contemplating it in the 3-9 month timeframe. Is there a w

Resolved Question:

Hi. I'm moderately suicidal-contemplating it in the 3-9 month timeframe. Is there a way to get psychiatric treatment that can help me come to terms with this and minimize the damage to others? I don't want to be talked out of it and I obviously can't discuss it with my therapist or I'll be hospitalized.

As background, I diagnosed with narcissistic personality disorder. I am also a lifetime clinical depressive. My father is also diagnosed with NPD. My mother is borderline. I've been unemployed for six months and am running out of savings. I have a progressive peripheral neuropathy that is slowly going to cripple me. I'm fully estranged from my family and have been for years. I have never been able to maintain a healthy long-term romantic relationship and I have almost no friends.

I really don't want to be talked out of it (ill do it if I run out of options, but not until then), I just want to come to terms with it so I can die peacefully, and minimize the harm to others.
Submitted: 10 months ago.
Category: Mental Health
Expert:  Dr. Z replied 10 months ago.

Dr. Z :

Hello I believe I can help you with your concern

Customer: Shoot
Dr. Z :

I am so sorry to hear about these issues you are currently undergoing and I understand that you want to end you life in a respectable manner for this.

Customer: May want-nothing's imminent I'm just planning ahead.
Dr. Z :

I would recommend going to the four states that allow for assisted suicide (Washington, Maine, Oregon, and Montana) and seek counseling there. Many of these places will allow for psychiatric treatment to help you come to terms with ending your life and planning ahead for it.

Dr. Z :

But other than that there are no states that can support this measure and if you do talk about it to a licensed therapist then yes you are correct they will hospitalize you

Customer: Not sure that helps-I live in Florida and obviously this would be an ongoing process. I'm also sure I wouldn't qualify for assisted suicide in those states.
Customer: What about anonymous or online resources?
Dr. Z :

Most patients for assisted suicide actually suffer from depression. But if you want an online resource, that can be a way to go as well, let me pull them up for you

Customer: Thanks you.
Customer: Those states allow assisted suicide for depression?
Customer: Still there? (I'm on iPad at Starbucks so if there are delays I can't tell if the connection was lost.
Dr. Z :

Many patients in these states do not just suffer from depression, but they suffer from physical ailments as well like your peripheral neuropathy and the patients are not concerned so much with the progressive physical pain, but the psychological impact. So that is why they are allowed to seek out physician assisted suicide or euthanasia in those states, but the process is long to help prepare the patient and see if that is truly the best course of action

Dr. Z :

Yes I am still here, I was just typing a lot

Customer: Yeah I don't think I'd qualify in those states. Plus the long-term process... Online and anonymous is probably better.
Dr. Z :

Well the online resources are not by professionals, these are by certain members of the community that feel these resources are appropriate and for information, but they will not give you an objective opinion

Customer: Anything with professionals? Maybe based abroad?
Customer: Or something like this but more regular-anonymized and online but with a professional?
Dr. Z :

Well the issue is that it is against ethics and in some cases the law to promote suicide in this country, unless you are doing it face to face in those 4 states under certain restricted circumstances, but I am looking in the Netherlands currently that has the broadest physician assisted suicide laws in the world currently

Customer: Yeah agreed-that's the issue. That's why I thought online and anonymized might work which is how I found this place. Doesn't solve the ethics issue but there's probably a solution to that.
Dr. Z :

So what exactly are you looking for, to talk to a professional about suicide and the process of it?

Customer: Yes. I don't want to hurt anyone else more than necessary. Like would it be better to just disappear? Does body condition matter? Is there a way to plan for disposal of the body according to my preferences? Should I Leave a note? What's good in a note and what looks silly? Can I make sure some particularly sensitive people won't be contacted by authorities etc.? Plus I want to come to some acceptance about it. Rationally I know I may choose that, but I really don't want to, and I'd like to be at peace about it?
Dr. Z :

Well this is a good international website on suicide that shows the pros and cons of suicide, it does not take a position, and it does not give you access to a professional at this time. But it can give you information

Customer: Yeah no one to really talk to there, and that's the issue. That site just wants to talk visitors out of it.
Dr. Z :

There is one place that I know of where you can try to speak to a professional about this, but it is in German, although I believe they have some English speakers there.

Customer: That works.
Dr. Z :

This will take you through a process of suicide, but as I hear it is very lengthy

Customer: Oh isn't that just the "peaceful pill" people? What I really need is a way to talk about this with a therapist without being hospitalized.
Dr. Z :

Have you tried online therapy?

Customer: That was one of the this I'd consider if its anonymous-haven't found it except here.
Dr. Z :

That can be a way to do it with someone from an international place who most likely does not have the power to hospitalize you

Dr. Z :

Let me give you some website referalls

Customer: Right, that's what I suggested a few minutes ago... (The NPD diagnosis was pretty spot on don't you think?)
Dr. Z :

Well typically individuals with NPD do not seek to commit suicide though

Dr. Z :

So that may be anonymous for you

Customer: I looked it up. There's no com orbiting but the rates are the same as with other behavioral disorders. The difference is that NPD attempts are far more likely to succeed. But what I meant was that of people tend to give their therapists a lot of shit.
Customer: Comorbiting was comorbidity
Customer: Anyway-thank you very much, I will try those.
Customer: Oh-and the NPD attempts, unlike other disorders, don't correlate with impulsivity.
Dr. Z :

I understand you may be able to be more forceful with your therapists because of the NPD.

Dr. Z :

That is true NPD typically commit self-harm more than a suicide attempt, this called Narcissistic Injury

Dr. Z :

It usually occurs when someone with NPD's fragile self-esteem takes a hit and they feel too vulnerable

Customer: Thought about that seemed counter-productive. I never harmed myself physically just with jobs and relationships. Hence my current situation. But that's all beside the point. I think you've very helpfully answered my question.
Dr. Z :

Anytime, and obviously I do hope that you change your mind about this, but I hope these therapists can help you

Customer: Thanks!
Dr. Z :

You are most welcome. 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, Psychologist
Category: Mental Health
Satisfied Customers: 5122
Experience: Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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