[peppermint1]

Has anyone had a similar situation? What would or what has your Psychologist do/did or required to do in this situation:

A few months ago I may have been considering an accidental overdose on something Im allergic to. I didn't actually do it and felt stupid for even thinking of it. I didn't try anything else and tried to push it out of my mind. I was afraid to tell him do to a recent suicide in the family, I didn't want him to think I was going to because of that. Im not going to do anything and im embarrassed by the whole thing. Im not normally like that.
I don't want to make more out of it than needs to be and I have hear stories of people getting put in hospitals and stuff for things like this and I don't think that is necessary but I am afraid of the risk since I don't know what they would do for something like this.
Has anyone ben in a similar situation? what was the result, I didn't act on it if that clarifies.
Thanks

[Leah123]

I've told my therapist about my suicidal ideations, including vague plans. I discussed such things perhaps... three times during the ugliest phase of my trauma work. The reaction varied depending on the situation.

Once she didn't really comment much that I recall as I think I did not sound serious.
Once she asked me if I had an intention to kill myself. I answered, honestly, no, I didn't.
Once she actually told me "I need you to stop talking like that" - that was her way of warning me that she would need to escalate the situation if I could not rein myself in and I think trying to get me to be more productive/connected to her, not get lost down that path. I gathered myself back up and became 5% more reasonable.

I found the suicidal ideations comforting, but more as a fantasy, though sometimes a tempting one, than something I could carry out.

I went to therapy in the first place for pretty intense suicidal ideation. As long as I was clear I had no intent of acting on it, my T said that he would not take any action and would not try to hospitalize me nor would he try break confidentiality to try to get my husband involved.

Since this is a few months ago, bringing it up now would probably result in nothing more than thoughtful discussion.

Had you brought it up at the time you were thinking about this "accidental" (it would have been deliberate) overdose, your therapist would probably have taken it quite seriously.

The potential harm, since this would have not been just any overdose but an overdose on something already known to be harmful to you, would have been very worrisome to most therapists. Mine would have asked, minimally, to speak to my husband to let him know of the potential danger. If having my husband take control of the meds or dangerous item in the house would be enough to keep me safe, that would be his first step.

Impulsivity is a really scary factor that my pdoc and therapist deal with concerning me, so honestly, they would probably rather I be in the hospital for safety and stabilization. As my T and pdoc both remind me from time to time, they've seen me one hour telling them I am fine and won't hurt myself, then discover a few hours later that I had impulsively taken something and needed to be hospitalized, so they err on the side of caution with me.

Good therapists and pdocs know their clients and make those decisions individually based on their experience with them.

[Parley]

I have never considered hurting myself in any way so if I sound insensitive ~ please forgive me. It isn't accident if you plan to have an "accidental over dose."

I know it's a crazy concept but when I start stressing on something I feel, I expose it. Generally like a coward, through email, but it makes me feel better. It's a release and if you tell him, maybe you will help you before you plan another "accident."

[precaryous]

My T would say something like, "Then we need to take steps to help you protect yourself." She never seemed mad or annoyed. She was concerned.

[freefallin]

I have never told a therapist about my suicidal thoughts. They're pretty mild as far as suicidal ideation goes; they're mostly thoughts about how I wish I could make myself magically stop existing. I know I would never actually do it--too chicken. But even though therapists aren't "supposed to" hospitalize patients for thoughts like these, I'll never say a word about them to a therapist because I know therapists don't always do what they're "supposed" to do. I had a therapist urge me to hospitalize myself for run of the mill panic attacks, and that scared the hell out of me because I thought she was going to force me into a psych ward over anxiety, so I'm just really careful about what I do and do not reveal now. Not worth risking having what little control I have over my life taken away from me.

[peppermint1]

Thank you all for the insight, I feel really bad that I even considered the idea, I don't want to hurt anyone with anything like that, I just don't understand why I thought of that particular thing, almost cowardly thinking that if I did actually do it would look as if I mistakenly took it and just had an allergic reaction, I just don't want more to be made of it that has to be.

I have actual sui attempts in my history, plus sui idolation was a constant, not now, but I use to tell T. Often.
I think I wanted her to carry my anxiety around sui for me.
She responded to these conversations, not reacted. She took the anxiety out of it, without becoming it.

[HazelGirl]

I started therapy because I nearly killed myself. I came about two steps away from attempting suicide. And unless something went really wrong, I probably would have been successful. I spent months thinking about it and planning how it would go, and was just waiting for that moment. Once that moment hit, I did what I promised myself I would do, and reached out to someone. I didn't tell them I was suicidal, but they reacted like they needed to and it saved my life that night.

Two weeks later, I found myself at my first appointment with my T because friends forced me to go. I was severely depressed, very anxious, and overwhelmed by life. I didn't tell her about the near suicide attempt until two years later (and despite knowing how depressed I was, she never asked at the time whether I was suicidal...maybe she knew I wouldn't tell the truth?). Her response was that if it ever got to that point again, we could talk about it and figure out why, and we could find our way through it together. I don't think she would hospitalize me unless she had a lot of evidence that I wouldn't be able to make it to my next appointment, and would only use that as an absolute last resort.

[HazelGirl]

Oh, and I do have a lot of suicidal ideation, fleeting thoughts of harming or killing myself. I am allowed to talk about those whenever I have them without my T freaking out. She knows that I won't act on any of the suicidal thoughts.

[peppermint1]

Whts the difference between suicidal ideation and just a 1st time thought but not really thinking it as a plan

Suicidal thoughts are those thoughts about wanting life to be over, etc. that most of us get who deal with depression from time to time. They tending to be fairly fleeting.

Ideation is more of a preoccupation with that kind of thinking. The thoughts become more of a fixation, but still, a plan really isn't there. This can become concerning for therapists if they have patients who are prone to impulsivity, but generally still not a huge risk factor for most patients.

When a patient seems to have a plan, that is when pdocs and therapists may make more direct intervention. They may contact a loved one or each other. They may request you admit yourself voluntarily to a hospital for safety.

[tinyrabbit]

My T has listened without freaking out and as a result has helped me identify that I feel sui in response to any overwhelming emotion - if i connect to my sadness or anger I freak out and feel sui.

I have attempted in the past. My T told me once that he does sometimes worry that I'm serious when I say I feel like that. It means a lot to me that he is willing to sit with that worry. Everyone else always told me I had no reason to feel like that or otherwise invalidated me.

Had a therapist in the hospital explain it in this hierarchy from most benign to most deadly:

Issue ----- Depressed

Thought ----- Suicidal thought
Suicidal ideation
Suicidal plan

Feeling ----- Suicidal intent (when the patient has a plan
with intent, that is when most
pdocs and T's will insist on
hospitalization)

Behavior ----- Suicidal Act

Therapists and pdocs have to figure out that fine line between thought and behavior, and sometimes they err on the side of caution, but having just buried a dear friend who did not express any of the above to anyone in his life at all, I wish he had told someone his thoughts before they moved into deep feelings and he acted upon them.

Originally Posted by 1914sierra

Had a therapist in the hospital explain it in this hierarchy from most benign to most deadly:

Issue ----- Depressed

Thought ----- Suicidal thought
Suicidal ideation
Suicidal plan

Feeling ----- Suicidal intent (when the patient has a plan
with intent, that is when most
pdocs and T's will insist on
hospitalization)

Behavior ----- Suicidal Act

Therapists and pdocs have to figure out that fine line between thought and behavior, and sometimes they err on the side of caution, but having just buried a dear friend who did not express any of the above to anyone in his life at all, I wish he had told someone his thoughts before they moved into deep feelings and he acted upon them.

So if I had a plan, it was no longer just suicidal ideation?

It's a continuum and a compounding kind of phenomena. (Couldn't really draw it right on the computer). Does that make sense? Least to most severity top to bottom. But one level doesn't necessarily go away when a patient reaches the next level.

That's why the level of questioning changes as doctors evaluate the danger. They go from asking about thoughts, to asking about how much time you are thinking about it, to have you come up with a way to do this, to do you have the means to do this, to do you know when you plan to do this, etc.

[HazelGirl]

Originally Posted by My kids are cool

So if I had a plan, it was no longer just suicidal ideation?

Probably not. It's moved to more of a planning stage, which is much more dangerous.

Getting back to the OP . . . so in her case, she had the thoughts, plan, and means to hurt herself if she had chosen to act. What may have been lacking is intent, but that's a very fine line. That's why I responded that in her case, I suspect her therapist would have felt the need to make some sort of intervention at the time, perhaps something as mild as asking her to give him that particular med she was allergic to so it was out of her hands.

But talking about it months later will just result in conversation, perhaps a plan to get rid of the means since obviously having possession of it is of no benefit to her, etc. Getting rid of the means slows us down. It give the patient time to think before acting. It puts a safety net below us that gives or pdocs and T's a little bit of reassurance that they can get to us before we act.

[peppermint1]

Thank you, I think you may have clarified some things up for me, I find it strange that I am in my 20s, a working professional and seem to know very little on the subject as a whole, I wasn't even sure if I was technically suicidal or if it was just a convenient way to think at the moment. I think I was confusing myself on if I was suicidal or just had an ide in my head of how to do it. I created more confusion and anxiety about it by not understanding it.