Sorry, but I've not been checking my email. My past week has not been one of my better. We.re going to give the increased Effexor a shot and I'll find Wednesday if they decide to augment the Effoxor. I'm on 375mg daily now which, I've been told, is the highest suggested dosage. No one is suggesting that we can't try ECT but I believe that they just don't want to deal with, unless necessary, using ECT with my damaged heart. Of those 1 of 10,000 deaths that occur during ECT, the majority are caused by cardiovascular events.

I'm also some new meds, a few even OTC, to counteract the remaining side effects. I have read of the horror and pain that most go through upon withdrawal. I think that I must have had a taste of that when I started the drug.

Thanks to so many for your words, observations and advice. I should have come here this weekend.

Along with the plummet of my soul, I've not been writing often, or well, for a week. I as disappointed, no, I was hurt, to see it go. I know that hypergraphia is a disorder That I experience as a side effect of Effexor but I receive pleasure from it. When I realized that I was sane and that my content was lucid, I allowed myself to find pleasure in, if nothing else, having accomplished something on my own. It surprised me that the feeling felt so alien, as if I had never accomplished anything of personal value before. I thought of how I once felt essential at m job of twenty+ years. It was an "ego booster," it contributed to my feeling of "self worth" and empowered my "self esteem."

My auditory hallucinations are getting annoying. All through the day. Two different sources and each with different styles now. From the bathroom come the African/American Indian rhythmic tribal chants or prayers and, just now, a radio broadcast of some team sport from the den. I know, this time, that they are not real. I am unwilling to take antipsychotic medication. It is a bothersome hallucination but it lacks any malice.

I actually dropped back in because of an email message that I received from the UK non-profit "Death with Dignity" organization that I sent a small, solicited, donation about an hour ago. In last Friday's mail I sent a small check to a pro-life group that I support when I can. It has only been of late that I have decided that one may support both with no moral incongruence.

I've spent some time and some money with groups that, for a fee, give you leads on how to access the most peaceful ways to die. But, as I think that I wrote, the terminally mentally ill and suffering cannot only expect no welcome, we can expect nothing more than a locked door with a cruel slur marked upon it. A large NiMH gate with "Retards Keep Out!" writ large in red paint. What would they say if confronted with prejudice? What they must say. That they only endorse assistance for the suicide of the old, "seniors," and those "who are seriously ill." Most of the public advocacy organizations speak only of "terminally ill adults." And the helping groups, whose terms I have quoted, make it clear that they only mean intellectually challenged "seniors" and those "who are seriously (physically) ill." Every living thing is terminal. Many adults are "seniors."

Let me say clearly, if I have not written it previously and with the intent of NEVER going beyond the suicide posting policy, that I am not an advocate of suicide for the treatable mentally ill. I'm hoping (without being certain and I hope that if a moderator decides to delete this post that he/she will leave the others intact) that I can instigate a discussion in this forum as to those who suffer through unrelenting pain for decades with a diagnosed but untreatable mental illness should be considered both "seriously ill" and "terminally ill." And should their pain be recognized as "real"?

There is a fine, extraordinarily fine, so small that the eye cannot see, line that is meticulously maintained between the physically seriously, or terminally, ill and the seriously (and I will argue terminally) mentally ill. I have been both and even treated, initially, in the same hospital, but on different floors. When the extent of my worse physical illness was known I had surgery in that hospital. Even before the extent of my worse mental illness was guessed I was moved to another hospital. As a society we know better than to mix the genuinely sick with those "only sick in the head."

And psychiatrists, along with their fellow MD's, know that mental illness isn't fatal. Mental illness never killed anyone.

After all, it's only a wee bit more than 90% of all who commit suicide that have been diagnosed as mentally ill in the U.S.

Luckily, we live in a society where mental illness is treatable. Where neither your government, your insurance companies or your best buddies will ever give up on you.

And we're fortunate to live in a time when depression, "feeling blue," can be treated with three months with a prescription from your GP and you're cured for life.

Before I present my question, I want to share one more autobiographical tidbit. I wasn't placed on Social Security Disability because I lost my legs, because of my bad heart or because of my unmanageable diabetes. I had nothing to do with filing the claim. My guardian signed the necessary forms. I was awarded disability because I was crazy and no sane person around me for three years thought that I would ever be lucid enough to ever work again.

And then I lost one leg and then another so I never had to go through another re-approval process.

Under Federal law, it's illegal to sell me a firearm. In many states it's illegal for me to possess a firearm. Luckily, I live in a "state's right" state that has no restrictions on how many or what type of firearms that I can own. And no one takes that Federal law seriously.

I just thought that anyone reading this should be made aware of my instability. My irrationality. My lunacy. No one should expect anything reasonable from me. Nonetheless, my questions...

Is it possible to be able to say that someone has a "terminal mental illness"? Is is possible to say that someone may prove untreatable for a mental illness? Is it reasonable to expect an MD, any MD, to accept that mental pain is as real a pain as physical and can be gauged on a similar patient declaration of the 1 to 10 scale? Do you believe that mental pain is real?

Do you believe that someone suffering from a physically untreatable illness that is extraordinarily painful should be given a chance to die with dignity? Do you believe that person might be unduly influenced, not quite in their right mind, by pain if making that choice? Is a life filled with untreatable physical pain, or untreatable mental dementia with a chemical or physical cause, a life that can be enjoyed with quality? If you believe that those suffering from untreatable physical illnesses deserve 'death with dignity,' how long should they be made to wait to make certain that no viable treatment options or cure becomes available?

Do you believe that someone suffering from a mentally untreatable illness that is extraordinarily painful should be given a chance to die with dignity? Do you believe that person might be unduly influenced, not quite in their right mind, by pain if making that choice? Is a life filled with untreatable mental pain, or untreatable mental dementia with a chemical or physical cause, a life that can be enjoyed with quality? If you believe that those suffering from untreatable mental illnesses deserve 'death with dignity,' how long should they be made to wait to make certain that no viable treatment options or cure becomes available?

I'll just write a short (for me) opinion on what I have only lately considered and, even more recently, come to believe.

I believe that I have a terminal mental illness. It has been in treatment for this disorder for 29 years. I was hospitalized for it for almost 3 years. I was in 'remission' for just over 6 months. My mental pain has been far worse than any physical pain that I have experienced. I was treated with one method that provided those six months of relief. Even on medication that seemed to do something similar I am being treated with the maximum dosage in hopes that my response will be longer term.

I know that events triggered my initial breakdown. I know that events in the following 16 years, and my inability to rectify with those events or even to properly grieve what was lost has triggered this new breakdown. I have been in constant emotional pain, mental pain, for a total of 18+ years. Only the degree of pain, which can vary from day to day, differs. On a scale of 1-10 my 18+ year daily average would be around 8.5. Since November of 2014, most of my days have been 10's with the occasional good 9.

The 'reason' for my first breakdown was never treated. My symptoms were treated and deemed successful. But the cause of my disease has not, and can no longer be, treated.

I fear lunacy. I would hurt much less, I believe, if I were insane. I could live in the leper colony. I am angry to be so lucid and yet so afraid. I feel the pain when waking, sometimes in my dreams and it is my final memory when I take the massive mounds of medication for sleep.

I believe that I deserve the right to die with dignity. MD's make life and death decisions as a routine matter. Some openly support assisted suicide. In U.S. states, where legal, doctors assist in suicide. Psychiatrists should be able to make similar decisions. They should be able to speak aloud when they determine (as they do) that a patient is untreatable. The should be able to assess a patient's sanity (a court asks to know a prisoner's sanity, not whether he or she is depressed) and depend on the patient's self-assessment as to the degree of pain. Just as any doctor. They should be able to review the patient's history, response to treatment, degree of pain and, if the patient has come to ask for a comfortable, peaceful death, a psychiatrist should be able to gauge the patient's competence to make the decision.

It is the elephant in the room that those who are pro assisted suicide don't want to acknowledge. The elephant that psychiatrists have been ignoring because it to acknowledge it would make them responsible for those horribly painful and gruesome deaths that their patients endure each year. I believe that having assisted death available for the mentally ill would result in far fewer annual suicides.

Suicide is usually NOT a spur of the moment decision. It requires some planning. I won't discuss the most common methods of suicide in the U.S., but, as I wrote, they are painful and gruesome. When my stepmother went to lengths in planning her suicide she made certain that no one would walk in on the gruesome corpse she left behind. I believe, and it's just a personal belief with no facts to back it up, that if mentally ill people intent on death had the opportunity to choose the peaceful exit that they would choose that over the more painful. Most who commit suicide are already under some kind of mental health care. If they could ask with no further stigma and expect to receive an answer in, say, three days, I think that they would wait. They might change their mind during that period of time, even. If they're denied, which I expect most would be, they may or may not continue with the suicide.

I really don't know what patients might do. But I believe that the mentally should be a welcome guest at the table, and soon. Assisted suicide will, sooner than expected I think, be federally mandated instead of state regulated. We already consist of over ninety percent of the suicide deaths – don't we deserve a chance at a more peaceful death?

I haven't made any sort of decision on the question of even can I take my own life. There are still moral and religious obstacles for me. Although had I the 'peaceful' means at hand last week, there's a chance that I wouldn't be using my iPad right now.

What I do think is that I would like to have an option. And I am pursuing the 'option of an option.' It's a very expensive process. On my limited income, with my physical limitations, I expect that at least two years will pass before I have an option at hand.

I'm interested to know what others think, though, for anyone who may read this. I posted a lot is separate questions but the essence, I suppose, is in asking whether there are others who would support physician assisted suicide for the long term, untreatable, painful mentally ill?

I doubt that the is even a forum 'out there' that would allow discussion of such a giant elephant.