Dear group,

Throughout all of my years of severe depression I have never seriously given suicide much thought. Initially because of moral and religious beliefs, beliefs that I still hold, and reinforced in 2002 when my hateful stepmother committed suicide, three years after laughing at me when I tried to explain to her that depression was disabling me.

But today, somewhat out of the blue, I began to think about suicide and just within eight hours or so began to consider it as an option.

For those who don't know: my current diagnoses are Major Depressive Disorder, severe, with Psychotic Features and Anxiety Disorder. I have a number of social phobias as well. I had the same diagnoses in 1999. I was mute and mostly uncommunicative for over a year, did not respond to any medication and was, finally, treated successfully with ECT. But I 'lost' myself over that three year period and was never able to recover. I was in Atlanta and I lost my personality, my family, my friends, any connection to my old job, everything. I was living in a facility run by the Atlanta Union Mission (a more open-hearted and helpful organization cannot be found) and I Googled my stepmother's name, found that she had died and ended up moving to Birmingham, Alabama. Here I remain.

I was in a nursing home from 2005-2012, had my right leg completely amputated in 2006 and later my left leg partially amputated (between ankle and knee). Today is my three year anniversary of getting out of the nursing home and into my own apartment.

In late November of 2014 I had the remainder of my left leg amputated. That was the catalyst for the reemergence of my severe depression and anxiety.

I have been on Effexor (venlafaxine) for three months and although I went through many, if not most, of the common, uncommon and even rare side effects, most of them subsided. I still have some nausea from time to time but the main side effect, still with me, is hypergraphia. Before I knew what was wrong I was frightened. Even after finding out that it was a condition that I shared with others, it took some time for me to get it under control. I'm not under the delusion that I am now destined to pen a great American novel and I'm grateful that what I write is lucid, although 90% of the content would bore the pants off others.

I'm on 225mg of Effexor daily. The majority of side effects that I was having quickly went away when someone on these boards (and I'm ashamed to say that I don't recall whom) advised me that I was taking the medication incorrectly. I was taking all three tablets in the morning. I was told by that mysterious someone that I should be taking one tablet three times a day. My pharmacist confirmed this.

Effexor is the only antidepressant that I have ever had any sort of response to. I was even on Pristiq, it's synthetic sibling, with no results. I'm not cured, I have okay days and I have bad days, but my mood is a bit elevated, I am able to THINK CLEARLY (a very big improvement), I am not confused any longer and I no longer fear that I am delusional or too close to the edge.

I don't have a single second in which I could call myself happy. On my okay days I am still very sad and still very depressed if I can't keep my mind focused only on the present. On my bad days I go beyond sad because a thought of my past will surface or a thought of what could be in the future will take hold.

The really horrible thing, the thing that makes days like today so very bad, is that I KNOW that in order to get 'better' (and I don't know what that means, really, I am 'better' now than I've been in over ten years) that I must stop repressing the losses and grief that I have never dealt with. When I write letters to my doctor and begin to write of the loss of my son and how I have never grieved over him, I am overcome with anxiety and I continue to write while roiling over one constant unrelenting panic attack.

Thinking of the past is bad. But the corner of my mind where I packed up and compressed and suppressed memories of the past is leaking and if they ever just burst through that would be it. At the very least I would shut down again. At the worst I would go over the edge. My final days and years would be spent in the mental ward of a nursing home. Until today, that was my greatest fear, the part of my depression that was complete hopelessness and insane despair.

Until today.

A little background. I have a Facebook account. I've had it for over five years. I can go a long time without looking at it. Four days ago I had a message, sent through FB to my email address, from an old high school girlfriend asking if I was planning to attend our reunion next year. I didn't know that she was on FB. I didn't intend on responding to her message but I was curious to see what she LOOKED LIKE now. She aged wonderfully. She had a photo of her and her four gorgeous daughters on the beach, all in bikinis. She didn't look out of place at all. She married the guy that she was dating when we were seniors. They've been married for 38 years. They have grandchildren. Her husband is bald and fat but when she writes of him she writes how deeply she's still in love with him.

I spent a total of about eight hours over a three day period looking up old high school and college friends. I did not stay in contact with most of them. The few that I did stay in contact with abandoned me either before my hospitalization in 1999 or shortly after I returned to the world in 2002. I started looking at old friend's Facebook pages. As expected, all had aged. Some had aged well, some had aged so grossly that there was no trace of their younger selves remaining.

As I flipped from page to page I began to be disturbed by a pattern that I was noticing for the MAJORITY of these old friends (not all, but the number of those who didn't fit the pattern was surprisingly small). The VAST MAJORITY had married shortly after graduation from college (some earlier, as early as their first year of college), are in loving and enduring marriages (32-38 years), and had 2-4 children (of various ages) and grandchildren (varied numbers and ages). They are middle to upper-middle class, have lovely homes and numerous friends. There are so many messages to these people expressing deep love that you would have to be abnormally cynical to doubt the emotion.

They lived and are living my dream. If I was back in 1996, I could almost, almost but not quite, be where they are today. It just took me longer to find a woman who I loved and trusted enough to be mother to my children and who I could imagine growing old with.

All I wanted from life was to have a middle class socioeconomic lifestyle, to be a great husband and father, to have a loving and enduring marriage and to have three or so children and live long enough to know my children's children.

And I came close. But I lost it. I lost it all and I could not only not recover one single thing, I was too damaged to even make an attempt at starting over.

During those hours spent looking at FB I was switching back and forth to my journal. I recognized the envy that I felt. For some of those unions, I felt jealousy – it could have been me. In the end, for almost the past 24 hours, I've just been depressed.

The past means nothing. Any effect that I may have had on others in my life was a blip, of no lasting significance. My father, who loved me unconditionally, has been dead for thirty years. Of those remaining who I still feel some love, or affection, it is completely unreciprocated. Even those who I hurt, who I might have effected negatively, weren't badly hurt. I never meant enough to anyone so that I could hurt them badly.

I went into this in a lot more detail in my journal but the essence of it is that my past is meaningless. Nothing at all like "It's a Wonderful Life." The opposite – had I never been born those that I would have failed to come in contact with would not have missed out on anything.

I don't have a past. To think that I did is what's crazy. To think that my grief is real is insane. I look at my birth certificate and the woman listed as having had given birth to me is a woman that I did not meet until I was eight years old.

So where does suicide come in?

When thinking of tomorrow and a week from today (my next doctor's appointment).

For five months I started drifting into what is now, and what has been for four months now, my daily routine. On the three days a week that my caregiver comes, I am out of bed for about an hour. Those are the days that I shower. On the days that she is not here, I am at of bed no longer than thirty minutes. I get up to take my meds, to get food to bring back to bed to eat, to return my dirty containers to the sink, to get more water and to travel to the bathroom as needed. I sleep well for eight hours each evening. Yesterday I didn't awake until nearly two in the afternoon. I slept for sixteen hours. The last four hours I was in and out of sleep. I couldn't think of a reason to get up.

In bed, I'm either doing something on my iPad or reading a physical book. During the first month of this habit, I was reading on the iPad. As the hypergraphia started to take hold, I began to read less and write more. For the past month there have been days when I haven't read a single page of any sort of book. When I do read, it's no more than four or five pages and then I'm writing again.

As long as I take the Effexor the hypergraphia will be a part of my life. There is no guarantee that it would cease if I stopped taking the drug.

I don't eat well. I have three blackened nubs for teeth so I cannot chew. My Meals on Tuesday consisted of two small bowls of applesauce, two Pop-Tarts, eight saltine crackers and one glass of milk. And around ten pints of water.

Because of my social phobias I don't leave my apartment except to visit my doctor and I don't allow anyone in my apartment except for my caregiver and the maintenance man. Even if I could be 'cured' of my agoraphobia, I cannot transfer from my wheelchair to a car after my last leg surgery and I cannot afford $110 for a round trip on one of the paratransit vans.

I have been pretty good about avoiding any questions about the future. I can envision and say 'tomorrow I will write about...' And I can even envision sitting in front of my doctor and thinking 'at our next session I must tell him...' But that's about it.

Last week, though, when we were discussing the effect of Effexor, I asked him, "What if this is as good as it gets?" He threw it back at me, "What if it is?" I thought for 3-4 minutes and answered, "I don't know."

And when confronted with my lack of a past where even the happiest memory becomes the most bitter and with the acknowledgment that I cannot tolerate, I cannot live with, what I foresee in the future, I thought of suicide.

I'm sticking to the rules here not so much because I want others to read my message but because I'm not making any plans, etc. I realize that, because of my handicaps, suicide would be very, very difficult. There are doctors around that will help those who are physically ill or in chronic physical pain, but they all stipulate that you must "be in your right mind." And here's where I want to ask my first moral/philosophical question:

Is it possible to be mentally ill, even to be entrenched in severe major depression, and be able to clearly and logically conclude that the mental health industry has done all that it can and that you simply do not wish to live in such great pain any longer?

Or does the stigma of having a psychiatric diagnosis disqualify you? Is psychological chronic and acute pain just not as important as physical pain? What's kinder and more humane: assisted suicide or a full frontal lobotomy? And if the latter, where do I sign up?

I am Roman Catholic. Early in my life I was taught that suicide is a sin. A grave sin. A sin that, without God's forgiveness, means that your soul will be damned. The StJPII catechism (to paraphrase) says that the sin can be mitigated by those psychologically damaged or suffering or in pain (as well as some physical sufferings). My take on the final two paragraphs can be summed up by saying that we can never know the extent of God's mercy.

Some of you here may, like me, have a religious belief that leads you to reject suicide. Some may have a moral, or a philosophical, reason. If you have any reason that you reject suicide, I would like to hear your reason.

I am praying. I no longer have, or feel that I have, the close relationship that I once felt that I had with God. But if I ask, He still answers. Nothing mysterious or mystical about it.

I have prayed to God to answer one question; will He forgive me if I commit suicide or if I am able to find someone to assist me in committing suicide.

I'm sorry that I can't write with brevity. I hope that no one will take the low road and suggest that my religious beliefs indicate that I'm not lucid or in my 'right mind.'

I'm looking for opinions. With no past and no future that holds a single hope of a single 'good' thing, nothing at all to 'look forward to,' is suicide an acceptable option?

I can't find the 'gun' icon? Let me look and see if there is another that might be suitable.

[spring2014]

hi ciderguy,
I made a promise to my therapist that if I had suicidal ideation thoughts or acted upon suicide I call the suicide prevention hotline. also that suicide is wrong according to God's plans .

Thanks for this thoughtful post, ciderguy. I have spent a lot of time during the 25+ years that I've been dealing with depression thinking about suicide.

I suppose the only reasons that I've come up with not to do it that make sense to me are that, first, because most of society hasn't spent years contemplating the moral implications of suicide, most of them are going to react by being shocked and sad-to-devastated if someone they know commits suicide.

I don't see any way to leave this world like that without causing a huge tear in the fabric of society. Even people who don't have extremely close personal connections are going to have this effect.

My second reason is that this is my only life, as far as I know, and I've decided, really only in the last year, that I want to be here for all of it. I used to read this poem, called "Wait" by Galway Kinnell, and I didn't want to wait, but right now I feel like I want to be around for everything.

(I don't know what the deal is with the references to hair in the poem - I think GK wrote the poem for a student of his, so maybe it was particular to that student.)

I was talking to a former therapist late last year about my constant (at that time) thoughts of suicide, and came to the conclusion that my brain was trying to reassure me that I had a way out if things got unbearable.

Since my mental states often fluctuate, I can't say that I won't go back to contemplating suicide regularly, but for now, I've decided to wait.

[Tauren]

I don't know if it's true that you haven't affected the people in your past, but even if it is, that doesn't mean you won't affect people in the future. Depression is telling you that you can't do any more than you already are, but clearly you're a good writer and you think a lot and you really can affect people that way.

I don't like to talk about suicide as being acceptable or unacceptable, but let's say reasonable or unreasonable. I don't think it's reasonable to kill yourself because you think there's no hope for the future. You can't see the future, no matter how obvious it seems now.

After I wrote my message last night, I continued to pray. I can't say that I received any epiphany since then, but as I was debating the issue with myself in my journal, contemplating the two most probable outcomes of this renewed crisis, I did have a sort of 'mini-epiphany.'

It can't hurt to, at the least, be prepared.

Believe me, there is no living being who would be saddened, much less devastated, by my suicide. I stepped out, and was partially pushed out, of the circle of human society over sixteen years ago and was so disgusted and distrustful of what I saw and experienced that I never made an attempt to 'fit' again.

Yesterday, hypergraphiac that I am – we love making lists, I started a list of the effect that my suicide would have on anyone. I believe that my caregiver might be sad for a couple of hours but that she would be more concerned about getting another client quickly. My death, my suicide, would cause a very, very slight, almost minuscule, economic blip for a handful of companies but my apartment would have a new tenant quickly, the utility companies would have new subscribers, etc. My disability check is slightly under $24K annually. Not much of a blip.

My pastor, who is also my confessor, would not be surprised. He is retiring and moving to another state in two weeks and were I to follow through he will have been long gone from here. I'm sure that he would continue to offer masses for the benefit of my soul as he's been doing over the past two years. But he knows my history, he knows more about me than any living soul, and he wouldn't be surprised or even saddened to any degree: he's seen death in such varied and tragic circumstances that I would be a blip for him, too.

I, too, believe that we only have one earthly life. But I also believe that we have an immortal soul. I believe in heaven, purgatory and complete separation from God (hell). Those beliefs are what have kept me, over these many years, from contemplating suicide.

But the 'okay' days, which I've only had while on the Effexor, are few. Most of my days are days of sadness, emptiness and a new type of hopelessness and despair. I am always asking forgiveness for those latter two feelings.

I cannot have any impact in the future. No one has any need for anything that I could provide. I am wholly unnecessary. I am unusable, damaged beyond the cost of repair. Were it not for the space that I occupy, the money that I spend and the things that I consume, I would be nothing.

I cannot change the past that led me to my first 'breakdown' or the events, resulting from that first breakdown, that led to this current breakdown.

You have much more insight on suicide than me. I have never considered it before. You have considered it, and I'm guessing even considered methods, etc,? I took a very quick glance on the web and saw that there are abundant resources. Gaining access to some of these resources are quite expensive, which surprised me. You would think that some of the people compiling this information might be acting on humanitarian grounds.

I'm going to copy your message and paste it in my journal. I need to think on and pray about some of the things that you've written. My intention, to be carried out over the next three or four days, is to visit some of these resourceful websites and, if one or two seem to be truly helpful and receive 'good reviews,' pay and join. To attempt to, at the least, secure the 'means' before even making a concrete decision or plan.

Obviously, I won't share any information that I might obtain. I genuinely do believe that MOST people, whether able to take solace in it or not, ARE a part of a larger society which may include family, friends, coworkers, acquaintances, etc., some of whom may be devastated by that person's suicide.

I don't believe that 'my case is so very special' that I'm excluded from societal norms but I do believe that it's rare enough that I need not favor those norms with much consideration. I can't even think of a way that any previous friends might become aware of my death. None of the residents of my apartment building are 'friends' with me on Facebook, nor any of my doctors or my caregiver. My cremation and columbarium niche are paid up. There will be no funeral, funeral mass or newspaper obituary. It would take a minor miracle for word to spread across town much less back to Atlanta.

I am so sorry for rambling on... I have had only minor success in controlling this disorder. I can't tell you how very much I appreciate you sharing your thoughts and experiences: your words are in my journal and I can ponder and review them in leisure as I continue to consider this most final action.

Thank you,

[Angelique67]

I have been reading your posts ciderguy, and I very much like your writing. I would be saddened if you ended your life. I would miss you.

Originally Posted by Tauren

I don't know if it's true that you haven't affected the people in your past, but even if it is, that doesn't mean you won't affect people in the future. Depression is telling you that you can't do any more than you already are, but clearly you're a good writer and you think a lot and you really can affect people that way.

I don't like to talk about suicide as being acceptable or unacceptable, but let's say reasonable or unreasonable. I don't think it's reasonable to kill yourself because you think there's no hope for the future. You can't see the future, no matter how obvious it seems now.

Tauren,

Thanks so much for replying. You cannot imagine how much it means to me to know that there are others actually listening. My experience for the past couple of decades has been that the state and federal governments pay, through my insurance company, for someone to listen to me.

I'm still in the process of trying to determine if there is, realistically, any 'hope for the future' AND trying to come to a lucid conclusion if any yes or no determination that I make is influenced overwhelmingly by my depression or overwhelmingly by sound and reasonable practicality.

I don't believe that severe major depression, even when combined with auditory hallucinations and severe anxiety precludes the ability to make sound and realistic decisions. When I started having the hallucinations again I knew that they weren't real. I went into my den, the 'source' of the sounds, and assured myself that they weren't real – even though they began again when I was comfortably back in bed.

When I reached the point where my depression was causing me to doubt my sanity, I made the completely rational and lucid decision to immediately seek help. And, despite the side effects that I first suffered, I have responded well to Effexor (venlafaxine) and do not presently feel as if I am nothing more than a tumorous mass of grief. I am 'pleased' to be sad and empty. But I have two avenues of hopelessness that can take hold on a 'bad' day – one, an old fear of how I might spend the remainder of my life; the second, a new and far more realistic fear of the same.

Both of my hopeless fears involve reasonable assumptions and realistic expectations of the future. I'm not under the delusion tha I can see or foretell the future but I do believe that I have gathered enough data and know myself well enough to be able to make accurate predictions.

My initial hopeless fear, before I sought help, was that there would be no recovery this time. Sixteen years ago I became mute and virtually non-communicative. I did not respond to medication or other types of treatment. Over a year passed and someone finally came up with the bright idea to use ECT. The first round, a total of 48 sessions, worked well. A few months later a 'booster' follow-up of 24 sessions did the trick. I slowly began to speak again – and you can't imagine the pain that I felt in my throat. That was one of the reasons that I had to use few words and speak slowly at first; it hurt.

Since that 'recovery' I never made a return to society. Also since that time, I have had numerous physical ailments, many involving my heart. I have a list of thirty different cardiac 'conditions' and eleven different cardiac 'procedures' (operations). I also have a pacemaker/defibrillator implant. When I saw my new psychiatrist for the first time we reviewed my history. He told me that with all of my cardiac problems I probably would not be a candidate for ECT again. He told me that he would consult with my cardiologist but that he was of the opinion that the mortality risk would be too great to warrant the procedure.

So this very realistic hopelessness set in. No medication had ever had any effect on me (except the antipsychotics which almost drove me insane and did nothing to stop the hallucinations) and the nursing home psychiatrist and, later, my GP, had been trying different medications on me (including Pristiq, the synthetic form of Effexor). I started Effexor at 150mg daily. For two weeks I believed that no medication would help, that ECT was not an option, that my depression was basically untreatable and that I would continue to slide down until I reached the point where I would need to be hospitalized for the remainder of my life or spend that time in a mental ward of a nursing home.

I considered that as a possibility. A probability if there was no other treatment.

I did not even think of suicide at this time.

Two weeks later and I had my second session. The Effexor was doing something – doing a lot of things – but those things were all over the place and changing several times a day. One thing that I was certain of, though, was that my mood was elevated. That my mind was no longer just a festering ball of grief. It would have been a lie to even imply any type of 'happy' feeling but the hopelessness that I was fearing was sated somewhat. There was now a chance that I could be treated. I didn't consider what that might mean for the future, only that it might not mean living in an institution until death.

I grew impatient with my shrink for not contacting my cardiologist so I did it myself. He is in a huge group of partners, over fifty of them, and it took me two days to finally talk to him. I had faxed him a letter on that first day (when I could still write with some brevity) and explained the situation. He told me that there was no problem with me having ECT sessions. He told me that my ICD would have to be turned off (there are two different ways to do this, but the simplest way is to place a strong magnet on top of the device) and that his preference would be that one of his junior cardiologists be present during the sessions. That was great news – I was on a medication that seemed to be helping but, if it failed, I had ECT to go back to. My shrink contacted my cardiologist for confirmation.

At that point, I still had not even thought of the word 'suicide.'

But the Effexor seems to have reached a plateau, it seems to have helped as much as it's going to help. My doctor keeps putting off the decision to increase my dosage to 300mg daily but told me that when I see him next week that he would have the staff psychopharmacologist meet with us and that we would reach a decision together.

As I wrote, I began to despair when I met with him last week and when I asked him, "What if this is as good as it's going to get?" and he answered by asking, "What if it is?" I came home and thought about that and realized that there is absolutely no 'quality of life' in my existence and that's when suicide became a consideration.

Again, you're right, I have no power to see into the future. An increase in the medication may enable me to accept this way of living as 'good enough.' My doctor may decide to augment the effects of the medication with a round of ECT sessions and that may lead me to believe that this life is 'good enough.'

I will wait and see.

I am, however, going to begin to make preparations. With my physical and financial limitations, and my uncertainty at this moment if this is even an option for me, I want to be prepared should I decide that it is an option and should I go further and decide that it is the best option for me.

I'm off to visit some websites. There are two that I know that I want to join – almost $200 to join both! I have right at $50,000 in credit card availability and about $5,000 in credit card debt. I don't own a single item worth more than $500 after depreciation and I have no savings or relatives that the credit card companies could come after to collect those debts when I die. So I suppose that my suicide would cause a blip on some credit card companies screens.

Thank you for your reply. I should keep a plain text file open that contains a single sentence apologizing for my hypergraphia disorder that I can copy and paste into the beginning of each message that I begin. I assure you that I appreciate your kind reminder that I must keep my limitations in mind when intent on making the most accurate forecasts possible before carrying out mortal actions.

Thank you, again,

[AstridLovelight]

Hi Ciderguy,

No need to apologize or feel self-conscious about the hypergraphia. You write very beautifully and lucidly. And what you've shared has touched and moved me greatly, so please don't think that you don't make a difference. I'm just a stranger on the Internet, and you've made a difference in my life tonight.

I'm Catholic too, so my thoughts on suicide are in alignment with the catechism, as you describe it: that suicide is a grave sin, but that the souls of suicides are entrusted to God's mercy. But at the times when I felt I did not have a future and wanted to take my own life, I didn't follow through with it because I did not feel prepared to presume upon, or demand, God's mercy. (I know we're not really supposed to have religious discussions, so I hope I won't get in trouble for writing that, but I felt like sharing it since it seemed germane to your overall question.)

Unfortunately I'm not wise or psychic enough to know the future, yours, mine or anyone else's, but I do believe in hope for us all. Groundless, irrational, sometimes seemingly impossible hope. And I hope that doesn't sound Pollyanna-ish, given the challenges and struggles you've described. Because sometimes that feeling of hope for me has been nothing more than, as Samuel Beckett wrote, "I can't go on. I'll go on."

Anyway, this is kind of rambling and not well thought out on my part. I just wanted to let you know I read what you wrote, more than anything else and say hello. You're always welcome to send me a pm with any thoughts or writings, hypergraphic or not--if you ever feel so inclined. I don't have any great insights, advice or answers to offer, just a pair of ears to listen with.

[Tiamat]

Ciderguy,

I love your writing. You have a real gift that should be shared with the world and it would be a great tragedy to see it go, and no, not just a 'blip on a screen'. I can only apologize that I have no real advice to give other than this.

Share your story with the world and let it move others like it has us. I think it would give you new purpose and drive and help you feel a real connection to life.

Thank you for sharing, and most of all thank you for your tenacity.

[Fuzzybear]

[francisR]

Hi Ciderguy

Strong religious beliefs are a great deterrent against suicide. It is never the answer , it does devastate the lives of loved ones and friends that never recover from the bad feelings.
I am sorry that you had to have your legs amputated. I'm glad that effexor is working for you. Keeping your mind busy especially doing things that you enjoy would be a great help when you are having sad thoughts

I am sorry you lost your son. Perhaps there would be some bereavement groups where you live or your therapist or Dr. would be able to recommend a grief counselor.

I was just wondering whether there are charitable organizations for the disabled in the US that would be able to help you? I really hope and pray that things will improve for you. Have a really great day. God bless and best wishes from your friend Francis

[waterknob1234]

Ciderguy, aside from the caretaker coming 3 days a week do you have any way to get out and do stuff? Where I live there is transportation for handicapped people, it is not the best and sometimes the wait time is too long, but people do have a way to travel. From what you write I can see that you also have physical disabilities with the depression. So I know going out places is not that easy, but would maybe be helpful?

You are a good writer, and a very thoughtful person.

Some of us here have thought of suicide. When I start thinking in that direction I start to think off all the reasons to stay here and who would be hurt if I left. You would probably be surprised whose lives you have touched in a positive way. Even and especially your caretaker. I used to work in the nursing field and there are wonderful patients I can remember who were a gift to care for. Some of them also suffered depression as well as physical ailments.

Religious beliefs have also stopped me from suicide. I don't know for sure if it would send me to hell but I don't want to find out.

But I know there has to be a way not to suffer all the mental torment.

Anyway, I don't have any great answers, I wish I did. But I am still very glad to talk to you.

Hello Ciderguy
Like the other posters, your words and this thread have touched me. I enjoy reading what you write, however difficult the content. My life is more fortunate than yours, but I have felt and thought the same. I am also a Catholic. I too have no family, other than my elderly mother, who I am sole carer for. I cannot cope with the grief of her death when that time comes and I do trust in God's mercy. You are doing a lot of thinking and praying, and I hope that you read this, and feel our love and concern for you. PM me if you like. It is a pleasure reading your posts. God watch over you.

[Blues47]

Originally Posted by ciderguy

I'm looking for opinions. With no past and no future that holds a single hope of a single 'good' thing, nothing at all to 'look forward to,' is suicide an acceptable option?

It's a very personal decision but I wouldn't consider it if you have to ask. I think people who are ready for that step are past caring what the world thinks as far as go/nogo.

Good essay btw, this is a great place to unload.

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.

Hi Cider, good to hear from you. One thing you wrote caught my eye.

I'm still in the process of trying to determine if there is, realistically, any 'hope for the future' AND trying to come to a lucid conclusion if any yes or no determination that I make is influenced overwhelmingly by my depression or overwhelmingly by sound and reasonable practicality.

You said later in your post that you feel like you can make rational decisions when you're very depressed. I generally can't, or at least not reliably. My brain lies to me if it's anything to do with mood or the probability of something good/bad happening.

Any chance of your reading/listening to "Night Falls Fast"? It's such an excellent book by someone who knows about suicide both from the personal perspective and the epidemiological perspective.

Hey Cider. I read all your post. These two comments aren't meant to address all of it.

About Effexor withdrawal:

I have read of the horror and pain that most go through upon withdrawal.

I decreased my Cymbalta dosage from 120 mg to 60 mg/day last year over a period of 5 months by dumping out "beads" from the extended-release capsules. It was tedious, but it limited my withdrawal symptoms mostly to some unpleasant, but tolerable anxiety. I used 25-50 mg Vistaril for that symptom.

It's if you try to stop an SNRI suddenly that the withdrawal is very bad. I would compare it to withdrawal from a benzo.

I can't say I'd call it "horror and pain". It's not as bad as an extremely bad depressive episode.

The other comment I have is about your auditory hallucinations. If you've already thought of this, please disregard. I once had an experience where a narcotic pain med interacted with my psych meds, and the result was auditory hallucinations very similar to what you described.

It took me about two weeks to make the connection. That was the first time I had ever experienced hallucinations and I didn't tell my doctor, or maybe the reason would have been discovered more quickly.

I mention this because, although I, like you, knew that the hallucinations weren't real, they made me anxious physically (tension, feeling unable to relax, jumpy). They were wearisome. I hope that you're able to find a way to get rid of yours without medications that have terrible side effects. If you want to ask people on Psych Central, the Bipolar forum might be a good place to try. Either that or the medications forum.

Originally Posted by jo_thorne

Hi Cider, good to hear from you. One thing you wrote caught my eye.

You said later in your post that you feel like you can make rational decisions when you're very depressed. I generally can't, or at least not reliably. My brain lies to me if it's anything to do with mood or the probability of something good/bad happening.

Any chance of your reading/listening to "Night Falls Fast"? It's such an excellent book by someone who knows about suicide both from the personal perspective and the epidemiological perspective.

Jo,

I will definitely jump over to Amazon shortly. Thanks for the recommendation.

Your question is great and is really at the heart of something that needs to be determined: can someone with a diagnosis of severe Major Depressive Disorder make rational decisions about his or her life?

My answer would be that it is possible but that, if the decision reached is one involving death, the rationality would need to be affirmed by one (or even three) competent people.

I don't know if I can explain why, in even some of my darkest hours, I believe that I can make rational decisions... sometimes; and also believe that If I am doubtful of my lucidity, my sanity, then I know that I am not capable of making "right-minded" decisions.

It goes back to the old conundrum – does the crazy man know that he's crazy? Some do and some don't. I have yet to meet, however, a person so deep into depression that they didn't know that they were depressed, even without knowing the reason. We're no flavor of bipolar. We don't enjoy schizophrenia. I am psychotic but not delusional (this time). Even when I was delusional I had doubts. I have severe anxiety but when I actually had a heart attack I didn't fear impending death so I know, now, that even my absolute worst full-blown panic attack isn't going to kill me.

Next year I 'celebrate' my thirtieth anniversary of being treated for depression and anxiety. During that time I had some good years – about three straight in a row – and four horrible years, 1999-2002 and this past year. 1997 to the present – 18 years – have all been cruel.

I've coped. I've had varying degrees of help during the past 18 years but even in the horrible years I've had to make, I have been forced to make, life changing and life threatening decisions on my own. I have never been as utterly alone in my life than for the past three years. During the past, oh, ten months there have been days when I have only been able to make it to the bathroom but not to the kitchen so I have not eaten. I have a grave fear of soiling the bed because I know that my caregiver would report it and if it occurred again I would have to return to a nursing home.

I am rambling, as I do.

The short answer to your question is that, even in a shroud of darkness and pain, I am aware of when I can and when I cannot make a rational, well reasoned decision. I am hearing a single voice at the moment, from my kitchen. I do not need to wheel into the kitchen to verify that it isn't real; I know that it isn't real. It has only been lately that I have found them bothersome. Wow. It's now the voice of Natalie Merchant singing but the only word that I caught was "brother" and, just now, "one day." Still able, currently, to make a logical decision.

I'm getting a bit tired and sleepy. I've been that way while writing but am rapidly losing the battle. I'm going to look at the book now.

Thanks.