[Danaliz]

I told my psychiatrist that i'm constantly suicidal and i cant take it anymore. I've been having these thoughts every day for well over ten years, and they are intrusive. I'm tired of having them when I know I don't want to actually kill myself.

I asked if i could be put on a second anti depressant to help with that and my anxiety, and he basically freaked out on me.

He told me that I was being dishonest because in even the past few sessions I told him I felt somewhat better and don't want to/ have plans to harm myself

I do actually feel alot better taking the medication and I function now, but i'm just tired of feeling suicidal. I guess I should of said something but i almost started to think it was something that would never go away, so why mention it.

He said that it would be way too much medication because I already take Wellbutrin 450xl and ritilan 10mg twice a day.

and because of this wasn't even sure if he could continue to treat me any more...

Did I do something that wrong? I'm confused
Is being on two antidepressants a strange request?

[Fuzzybear]

[lonely-and-sad]

It is obvious to me you are not being adequately treated. Ritalin is not considered an antidepressant, it is a stimulant medication most commonly prescribed to sufferers of attention deficit disorder. But it is also prescribed to augment antidepressants and it is not unusual to be prescribed Ritalin if your response to anti depressant medications is partial. I take ritalin as well as nortriptyline. I think your combination is not ideal. I would like to know how you ended up on that combination. Wellbutrin is not a very powerful antidepressant. In my country it is only used as a stop smoking aid. I can't say much more if you don't provide me any information about past medications and exact diagnosis etc I can't see anything about you on tapatalk.

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Dana, I'm sorry to hear that this happened to you. I've been in that place, too, where I thought about suicide everyday, although with no plans to do it. The thoughts became an energy drain, but they also became so commonplace that they seemed like a part of me.

I told my therapist last winter about the thoughts, and we did some work specifically about the suicidal thoughts. My meds provider also added low-dose Remeron/mirtazapine to my Cymbalta. I got a lot better and rarely have thoughts of suicide now. It seemed like a miracle to me after thinking of it everyday for years.

Since you're dealing with an MD, I might say to them "Okay, let me start over. I have been having thoughts about suicide everyday/almost everyday for so long that I had decided they were there to stay. Since I didn't have any intention of acting on the thoughts and wasn't making a plan, they weren't at the top of my list.

I've realized lately how draining they are, though, and would like help to get rid of them. It wasn't until I started feeling somewhat better that they even neared the top of my list to ask about. I wasn't intending to be dishonest - they have just become such a familiar part of my life that they're not the first problem I thought to discuss with you.

A second antidepressant was just a suggestion. What I'd like is for you to re-evaluate my meds to see if you can make a change to help this symptom."

If you like your meds provider and want to keep him, I might try saying something like that. If you don't like him that much, I would just find another one. (The above is totally a suggestion - unfortunately I've had experiences where I had to "talk around" a psychiatrist's hurt feelings.)

It sounds like he's feeling a little threatened, either by you suggesting a meds change yourself or by your not telling him about the suicidal thoughts. Most of the therapists and psychiatrists that I have seen have been familiar with the fact that some people have thoughts of suicide every day, often for years. When I've told one that I had this problem, they would generally ask "do you have a plan?"

I don't know if you're run into someone who isn't familiar with this, or if he's just feeling threatened.

I agree with the other poster who said that they didn't think much of Wellbutrin as your primary antidepressant. I think of it as more for mild to moderate depression. You're taking a high dose of it, plus the Ritalin. Is the Ritalin also for depression? Just curious - that meds combo seems aimed at someone who has mild depression with energy/focus problems maybe.

Being on two antidepressants is not at all strange.

I'm glad you came here to Psych Central to get an idea of what other people take and what they think about this problem. Since we get treated by psychiatrists as individuals, until we've seen several of them or talked to other people about their experiences, it can be easy for a doctor to make us feel like we're in the wrong or to intimidate us.

[spring2014]

sounds very unusual to be put on two anti-depression meds at the same time
.what you need is an anti anxiety meds to help with your anxiety .





Diagnosis: Anxiety and depression
meds : Cymbalta 90 mgs at night
Vistaril 2 25 mgs daily for anxiety prn
50 mgs at night for insomnia

[eeyorestail]

Hi Danaliz--

Sorry you have been having an especially rough time lately. I definitely understand the constant suicidal thoughts, and also the urge to hide them from people for fear of them freaking out (like your doc did).

From my understanding, it really is not all that unusual to be on more than one antidepressant at once. I have been on more than one many times. The only thing to be careful about is to not be on two at once that are very similar (i.e. that work on the same receptor), as this can cause issues. For example, you wouldn't want to be on simultaneous full doses of Prozac and Paxil, as they both work exclusively on serotonin.

One possibility to consider is something to augment the antidepressant, such as Abilify or Latuda. These are both technically antipsychotics, but are often used in smaller doses to give the antidepressant a "boost," so to speak. Your doctor should be familiar with these drugs and hopefully will not be upset if you suggest the possibility (hell, the TV ads even say, "ask your doctor about...")

I think jo_thorne had some great advice about how to approach the subject with your doctor. Unfortunately some doctors are very sensitive about being told by the patient what they want and need to be managed delicately. If this "management" becomes too difficult, however, I would move on and see if you can find someone else.

Good luck and please let us know how things go!

[Purplesept2007]

I agree with many of the comments above. I do not feel it is unusual to be on two anti-depressants at once it works for me. When it comes to medication make sure you have someone with the credentials to prescribe psych medication. I actually have a psych nurse practitioner for my medication. And someone separate for my therapy. Welcome to PC please come back and continue to talk.

[Tauren]

If you have anxiety, Welbutrin alone can make it worse. Usually with anxiety you use Welbutrin with an SSRI.

I don't understand why you hadn't told your psychiatrist sooner that you were suicidal. He can't help you if he doesn't know.

[bluebaseball]

It doesn't matter when you tell your psych that you're suicidal. The important thing is that you told him and felt comfortable enough to do that. Their are some things that people would think they never tell anyone even if it could mean something good coming out of it in the end, they either don't see a chance of any good or don't want to go through with whatever they think may happen next. For me nothing really happened, it was just another symptom of depression and the same feeling others get. We just want it to stop.

Their isn't a medication just for suicidal thoughts, as far as i know. These thoughts would probably be linked to anxiety and depression symptoms which their are meds for .

I feel the same way you do though generally about everything. I told my doctor about suicidal thoughts years ago as well as being abused when I was younger. I thought telling that would bring me sort of magical relief. Well maybe not magical but sometimes I don't know why I told my doctor i'm suicidal or sexually abused because I'm still going through the same crap I did before telling anyone and I didn't really get better yet.

I don't understand why you hadn't told your psychiatrist sooner that you were suicidal.

I probably should wait for the OP to answer this, but since I've had the same experience, I want to point out that she didn't say that she was suicidal. She said that she was having constant thoughts of suicide.

I personally spent years thinking of suicide every day or almost every day but had no plans to do anything about it. It can become sort of an obsessive thought pattern.

In a strange way, it can be anxiety-relieving in the sense that worrying about thinking about suicide so much can distract you from whatever else you were worrying about. (If that sounds convoluted, it is, a bit.)

[eeyorestail]

Originally Posted by jo_thorne

I probably should wait for the OP to answer this, but since I've had the same experience, I want to point out that she didn't say that she was suicidal. She said that she was having constant thoughts of suicide.

I personally spent years thinking of suicide every day or almost every day but had no plans to do anything about it. It can become sort of an obsessive thought pattern.

In a strange way, it can be anxiety-relieving in the sense that worrying about thinking about suicide so much can distract you from whatever else you were worrying about. (If that sounds convoluted, it is, a bit.)

I've had the same exact experience.

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[francisR]

hi Danaliz

Don't worry about the suicidal thoughts. They are just thoughts and cannot make you do anything because we are always in charge of what we do. I have heard of people being on two antidepressants each working on separate sets of brain chemicals to give more help with depression.

The problem is that psychiatrists only do medication and not therapy. Are you in therapy? That can give you really good coping skills to manage symptoms. CBT has been adapted for all conditions. And there is acceptance and commitment therapy, which I use. It is based on research which indicates that, trying to get rid of thoughts or symptoms doesn't work because it only makes them worse, and the thing to do is to accept them. Saying to yourself I am having this thought and watching how it goes through your mind and disappears and keeping doing this till they stop. Which they always do, while at the same time getting on with the business of the day.. Keeping the mind busy doing things, especially enjoyable ones does take the focus away from depression. Setting small easily achievable goals gives the confidence that things are coming under control. I hope and pray things do work out with your psychiatrist. But if you become dissatisfied you can always get another one. Take care. Have a really great day. God bless and best wishes from your friend Francis