Tuesday Sober Thread: Right to Die

The best and sometimes worst thing about being human is that we have freewill, we can do what ever we want, we can choose to live any way we want or for the matter of this discussion cease to live any more.
My opinion on this is that even if we have the right to do something it does not make it right to do it. Like any other selfish act we as humans can do, suicide will and does affect other people. I do not think suicide is the answer to anyones problems.
In the case of the elderly and terminal illness I do not have an opinion, there is to much suffering that I have not experienced to even have be able to intelligently argue for either side and my opinion would be jaded by my upbringing.

Mental illness is treatable it takes time but treatment works, my wife suffers from depression but has made huge strides in the last 5 years with a number of different therapies, so much so she is no longer on any medication.

 

If you look at it in terms of basics, isn't it a form of emotional blackmail? "Don't commit suicide, you'll hurt me"?

While I realise one is a conscious choice and one is not, I see parallels between contemplating suicide and coming out (insofar as how the people around them may react). I'm not suggesting they're the same. Rather, if a parent reacts badly to a son or daughter professing their sexuality and claims that it "hurts them" or that they're "dead to me", isn't that seen as a selfish act on the part of the parent? Why then is a suicide any different?

Society will make judgments in either case; it's what society does. When you look at from a more encompassing viewpoint, society often uses emotional blackmail to curtail what it considers to be undesirable behaviour. The past few decades has shown that to be crumbling at the edges. I would guess, though, that something like suicide is a core concept and therefore a long way from any form of acceptance.

I mentioned in an earlier post about suicide when you're leaving children behind, and how that's wrong. That's because there's a distinct responsibility that's been undertaken. However, no such responsibility (to my mind) is owed to other members of the family. This includes spouses. However, I'm being very distinct and narrow in my definition of responsibility. Explaining it properly can't be reduced to a few words here without creating too many tangents and exceptions. Suffice to say, I think you either get it or you don't.

 

Did anyone else get a Dexter vibe from that letter? He talks about the darkness inside him, and how he was afraid he was going to hurt or kill people. That is all.

 

I'm reading Ballsack's stupidity and really wondering what the fuck it takes to be considered an asshole at this point. I mean I know the douche doesn't have another mode of interaction - but for fuck sake. I can't bring myself to wish for anyone to go through the kind of experiences that might let him actually empathize with sufferers, but I certainly won't be able to feel sorry for him if he ever does.

I spent the better part of two years on Antidepressants. I was suicidal and utterly broken for a big chunk of that. My guilt at the people I'd hurt and the lack of energy that came as a result of the depression meant that I never actually managed to knuckle up and do the fucking job. I'm also fortunately not a gun owner, and the only thing that seemed worse at the time than not existing, was continuing to exist with even more pain if I'd fucked it up. Had I had access to a shotgun? I doubt I'd be writing this.

I saw a dozen different doctors. I had doctors cancel emergency sessions when I was suicidal. I had doctors forget my name mid therapy session. I had a doctor fall fucking asleep in the middle of a therapy session while I was sobbing about how much trouble I was having not driving into on coming traffic and how not being able to manage this shit was destroying my life. I had doctors do everything possible to get me to shut up about my problems and give me a prescription. I had about 30 minutes in total of advice on cognitive behavioural therapy that included some completely ineffective management strategies (I should look at 5 things, name them in my head, and then remove one thing from the list and repeat until I'm calm? Knife, RatPoison, Tail Pipe, Sharp Drop, Oncoming Vehicle. Rat Poison, Tail Pipe, Sharp Drop, Oncoming Veh... Yanno what Doc? I think I'm doing it wrong. Can we get a follow up app... Yeah, I told your receptionist, but my name's Sean. Yeah Sean. I'm a patient. Yeah I'm sure. I saw you a couple of days ago about depression and suicidal impu... yeah the drugs are fine I guess. No appointments free for 2 months? That's great. Thanks a bunch).

The side effects from the drugs cost me the best paying job I've ever had, made me a danger to the health of others, cost me another job. The changes from one drug to another were up there with the worst experiences of my life. Worse then coming off a recreational amphetamine addiction orders of magnitude. They worked - in that I didn't kill myself. But the damage done to my life, financially and in terms of my relationships and health will take years, if not decades to recover from. I went from about 185lbs to about 340lbs while on the drugs. That's not a typo. I gained more than 150lbs over 18 months of using that shit. I have friends who don't weigh that fucking much.

Had I not been struggling with the futility of the process and my own ability to function, or had I witnessed a doctor treating one of my friends or family the way they treated me? I think I probably would have physically harmed that Doctor. If I didn't feel that the drugs I was on had saved my life - I'd sue for malpractice for prescribing shit that harmful. If I could bring myself to seriously relive that whole period in enough detail to make a case? I probably still would chase some of my doctors for malpractice for lack of fucking human decency they showed.

If I'd known at the start what I know now - I really doubt I would have had the strength to try treatment. I'm glad I did in retrospect. I'm glad I didn't suck on a tail pipe or play chicken with a truck. It was without question the hardest, most painful experience of my life just trying to survive through that shit. Coming off the drugs when I felt like they were no longer beneficial was fucking brutal. If you really don't understand - I envy your health. I envy your experience with doctors. I envy your biochemistry's mild reaction to the drugs. I envy any life where you haven't felt that suicide was the vastly, vastly more reasonable option.

I generally think Suicide is a bad idea. I think it's better to tough it out and worth through the treatment path if there is one. If there's not a treatment path - if you're going to spend the rest of your foreseeable life suffering intolerably from an incurable and untreatable condition - I think the right to check out with dignity and control should be assured and it disgusts me that it's not available to more people. But for cases like the initially linked story - Fuck, I understand the decision to do it instead of to go through the treatment process

 

The thing that stood out most to me was the fact that his earliest memory is of being raped. Repeatedly.

Think about that for a second. When you're having a shitty day, or when you're sobbing in your shower because you just want to end it all, or when you're thinking about just jerking the wheel into oncoming traffic...you can probably still remember a time when you didn't feel like that. Sure, you may feel as though you can never feel happy like that again, or that it was soooo long ago when you last felt happiness that you're running on memories and fumes. That's pretty typical for clinical depression, and that feeling alone can be powerful enough to cause suicidal impulses.

This poor, poor man never had that frame of reference. He quite literally had no memory of a better time, of a carefree youth, of a time before his life was irreversably marred by some bastard. His earliest memory is of pain and violation, and every subsequent memory was tinged with sadness and anger.

I simply cannot imagine how a human being can live like that. My heart broke for this man while reading about how he would try and immerse himself in some task just to achieve a state of full concentration, because those few moments of absorption were the only relief from his suffering that he'd ever get. FUCK. I can totally see why therapy wasn't an option for him...other than the rightfully-earned mistrust he had in other human beings, why would he want to dwell on the thoughts he tried so desperately hard to run away from? For an hour or so every week? If your thoughts are legitimately so painful that you turn to complicated tasks in order to give your brain something else to do, it seems almost masochistic to let those thoughts run wild and rampant on a regular basis with someone who may or may not break your trust.

I wish he had tried therapy, and I wish his therapist was someone who knew what the fuck he/she was doing, and I wish he had gotten some measure of relief from his excruciatingly painful thought patterns. I wish that there was some super-awesome combination of medication that would've stopped him from being disgusted by himself. I wish that doctor-patient confidentiality was something that potential patients can rely on always. But that's an awful lot of wishing and hoping for a process that has a LOT of variables. And I can see why he would be tired of living with chronic suffering and was ready for a 100% effective cure. I can see why he thought that he was stained and dirty and without hope of ever becoming as clean as he perceived others to be. I can see why he stopped trying to hope for a better future, and I can see several instances where others failed him and why he developed crippling trust issues that further isolated him.

So while I wish that he'd sought help (probably because I am a wellspring of optimism and I desperately want to believe that it would've helped him), I see how he believed that suicide was the only viable option for him. And I don't blame him a bit. He obviously considered it carefully, and with much more rational thought than most people are capable of when they're in acute pain such as he was.

I'm glad that he's at peace now.

 

Just on a side note - I'm not even vaguely arguing against seeking professional help if you have a mental health issue. My experience sucked and I had shitty doctors - but most people don't have that kind of experience, most doctors are good people who do an incredibly valuable job - I just got really fucking unlucky. I'm also not arguing against anti-depressants - I had a really fucking rough time on them, but I think without them - I probably wouldn't have survived that period. I'm just saying I understand the decision to not choose that route.

 

The really fucked up part is I understand how this happens. Since I've started doing therapy at the counseling center on campus, it's been an eye opening experience to say the least. It's emotionally draining. My tolerance and patience is lower for people in my personal life. I'm short and curt with people that I used to have more patience with, because my therapy clients use up those resources that I used to have available for people in my personal life.

The more clients I see, the more I hear the same shit, over and over. Everybody's problems are the same problems. The first time I did therapy with a client that had been raped at a young age by someone in their family was shocking. The 5th or 6th time? Not so much. I think therapy has made me more numb as a person, and honestly, I feel some sort of way about it, but I'm not exactly sure how it makes me feel.

Last semester, during my finals, I still had to do therapy. I had stayed up all Sunday night to finish a paper, then I had class, after class I had to do intakes at the counseling center for two hours. Then I had two therapy sessions scheduled. One client didn't show up and I was grateful. My other client did show up. I have no idea how I made it through that hour long session. To be present, aware, and serve as an emotional container for another person is an extremely exhausting process, particularly since I'm still learning.

The mental health field is woefully underfunded and there are glaring needs that must be addressed, particularly in the South. The Counseling Center on campus serves somewhere between 100-150 people a month, and there are only 6 licensed psychologists and 3 licensed psychiatrists on site? The rest of the slack is picked up by the interns, externs, and practicum students.

 

If you are feeling this way while still in graduate school, you need to talk to someone about burnout. You sound like you've been in practice for 40 years seeing 50+ clients each week. That is not a good spot to be in so early in your career.

 

It's just too broad a statement. It's not too far a stretch from saying "physical illnesses are treatable." Some are, some are not. It's the same with mental illness, assuming you are not restricting the definition to the very severe and persistently disturbed. I've had patients with complex Panic Disorder and phobias who are cured in under 5 sessions. Symptom-free. I've also had singular depressive episodes that have responded poorly to any and all treatments. And there's everything in between.

Mental illness is sometimes treatable, sometimes not. It can often be only managed, while other times it can be eradicated permanently. And sometimes there's little to nothing that can be done. When making statements about treatment efficacy, you really have to be clear about what specific illness we are talking about.

 

My Grandparents were married for 60+ years. When my Grandad died, Grandma was on her 2nd stroke and couldn't take care of herself. She didn't want to live in a world without my Grandad, a world where she would have to live in 'assisted living' care, a world where she could barely speak, hear, see, or interact with the world around her. She asked my Dad to find her something that would take her out. He is pro-choice in this matter, but he refused. I can't speak to his decision making process, although if I had to guess I'd say that he hoped my Grandmother would find a reason to live once the initial shock of my Grandad's death had passed. That was 4 years ago.

To this day, she hates her life. She regularly wishes to die. Her mind is unmercifully sharp while her body rots around her. Her companion of 6 decades is gone, and she spends her life surrounded by senile, unmoving husks, who can't wipe themselves after going to the toilet, much less hold a conversation.

For fuck's sake, introduce assisted suicide. Make it legal, and available. It's the only human thing to do.

 

I am actually investigating affordable therapy, as I feel my program and supervision are somewhat inadequate in transitioning students into therapy, and the only provisions that my program provides is therapy at the counseling center...which is my site.

 

If I'm wrong in any of the below, please correct me - especially Dr Rob. I think this is right, but I'm only calling it from my armchair.

First, medicine is considered an art - not a science. There are no absolutes when dealing with the treatment of a person as a whole being.

The next is that we still don't know enough about the brain. Hell, we don't know how a lot of the medications we take for the brain exactly work. It's a lot of educated guesswork, to almost oversimplify it. I've had several GPs and three specialists tell me they're stumped so far; and that's for a physical problem in my brain. One can give an educated guess of where the problem is, but they don't know how that part of the brain works and don't have the technology to check it out to the degree needed without killing me or turning me into a vegetable. The mind is even more problematic.

Then we need to realise that there's a huge difference between something being treated and something being cured. Think of it like diabetes. We can treat diabetes, but we can't cure it. In pretty much every mental disorder I can think of, we can apply treatment but for a cure to happen it comes from within the person who is suffering (if it happens).

If the disease is incurable, then the treatment masks the symptoms to a degree. It doesn't mean that the disease is gone. If the disease is curable, then the treatment alleviates the symptoms enough to give the mind an opportunity to rectify itself. To use another analogy: we take cold medicine when we have a cold. The medicine does not directly affect the cold virus, but it settles the symptoms and gives the body a better chance at using its own defences against the virus.

When we're dealing the mind, it's akin to searching a warehouse with a torch and looking for one specific item... while blindfolded. Patients want answers and help. Practitioners want to cure. It's easy to see the frustration that can come from both sides.

 

This.

I have dealt with many mental health professionals in a professional capacity. These folks were paid very well to evaluate and give some analysis to my clients. Money not well spent for the most part. In part, this was because I thought these folks should be the gold standard for good mental health themselves. As I worked with more and more of them, I found this not to be true. Frequent cancelling of apointments, making large bombshell assessments based on a small amount of time with the client, not paying attention, and many of the other things mentioned by previous posters. Who knows what the hell is going on in their own personal life. Anecdotal, of course, but it was my general observation.

That said, at two points in my life I have needed to personally use a mental health professional. Luckily, I knew enough about the local talent to pick two that were good. One helped me work through personal issues, while the other helped my wife and I work through a small but difficult marital problem (i.e. bullshit with the inlaws). I have a profound appreciation for what they did for us. BUT, if we had used one of the many "lesser effective professionals", I suspect we would have been in a worse possession than when we started.

The point of it is that taking the time to ask around, check with licensing boards about complaints and doing the research to find someone good can make all the difference.

 

To go back and pick at the point about the social perception of mental health versus physical health, I think the key thing here is that none of us who aren't Mr. Zeller can ever know how bad the storm really was inside his head.

Take, for example, chronic illnesses that involve a lot of physical pain. It's safe to say that nearly everyone has experienced intense physical pain at some point, even if for a short period. Therefore, we can all, at least at a conceptual level, understand someone suffering from kidney disease, cancer, etc. But a huge part of our ability to feel empathy and compassion for other people depends on things like their character, their values, and the personal connections we have forged with them over time. The bête noir of mental illness is that in serious cases it interferes a lot with this process. It's hard for us to feel kinship with someone who behaves erratically, in ways we perceive as irrational, especially if we don't know the person very well in the first place. The natural reaction toward such a person is fear.

It's also safe to say that many of us, including those who study mental illness, have experienced things like depression, anxiety, etc. temporarily, and in mild form. Thus, from hindsight, we know that these things were surmountable, once we realized that it depended largely on our own effort. Then we can reflect the ”come on, you can get over it too” fanfare toward our peers. But with people like Mr. Zeller, we can't put ourselves inside his head to see the film reel playing in there. We can only listen to his words, and try to make a vague estimate of the intensity of his suffering using our own perspective. This, I think, will continue to be a significant barrier until we can one day experience another person's brain workings ”directly.” But for now, pronouncing judgment on his actions or his decision making process seems to me nonviable, as we aren't even communicating on the same frequency

Back to the focus: I think it should be legal, and that there should be a system to have it done. However, a significant waiting period should be required. Personally, I have a tendency to dip into dark places every now and then, but usually, when I least expect it, things turn right around. Maybe its the push-pull effect of being unhappy making you work harder toward your goals and solving your problems. The hindsight is always realizing how foolish I was to get into the dark state of mind in the first place. Whatever, folks, life's a roller coaster ride.