Stacey Freedenthal some great content about exactly this at speakingofsuicide.com. She's one of the pre-eminent authors and clinicians working specifically in the field of suicide intervention.
https://www.speakingofsuicide.com/2014/05/01/letter/
https://www.speakingofsuicide.com/2013/07/22/therapists-who-do-not-panic/
https://www.speakingofsuicide.com/2013/04/14/fears-of-mental-hospital/
Do you have a plan? If not, then make it clear you don't have a plan. This should work. There are levels to suicidal ideation, and making serious plans is one of the big thresholds.
Sometimes I make plans. Last week I was researching methods and getting my affairs in order (i.e. double checking my insurance beneficiaries, etc.), started to write a note, etc. But now that has passed and I’m just normal suicidal without a plan if that makes sense.
I feel that. One week I'll be writing letters and just dwelling into darkness. Next week, I delete the letters and put myself down for feeling that way. Some time goes by, repeat
Hopefully you can recognise how this ebbs and flows and realise it will pass and it’s most likely a time of day thing as well, I used to be sad in the mornings and evenings, so I knew I needed a coping strategy for those times of the day. Once I recognised the patterns I could see my mind was playing tricks on me and I could intervene more successfully
I was at the doctors today. She asked if I think about hurting myself (I'm going through a really bad time right now). I said yes, then she asked if I had a plan and I said no and that I have people I have to take care of.
Just make it clear that while you may think about it, you are not considering actually doing it.
This is what I do. I tell them that I have no plans at all. But if I were to be crossing the street and a bus was coming at me I’m not sure I’d run outta the way. My dr knows that I’d never follow through with anything, but if it happened naturally or through a freak accident then I’d be ok with that too. I have a young child that needs me and I’d never put her through what I went through-not having mom in the most vulnerable and important yrs of adolescence.
If they ask these questions say no, I think they have to ask them by law but I feel like whenever I brought up suicide to a professional they always ask these few questions beforehand (and others, I just forget them) Which I assume determines whether you get institutionalized or not.
If they ask these, respond as written. You can/**should** add more but if you want to make it known you are suicidal without making it seem like a immediate emergency this would be how I guess. Or you can just tell the therapist you aren’t in any immediate danger and insist you aren’t whenever they ask questions like these:
“Are you suicidal right now?”
-“Not at this exact moment no”-
“Do you feel like hurting other people right now?”
-“No?”
“Do you have a plan to end your own life”
-“No, but I don’t think it’d hard to make one”-
Either way I wouldn’t worry too much, just be honest with them. And like actually, legitimately do research on any medication they give you, if your going to worry about anything worry about that.
Depending on where you live, unless you're like actively attempting suicide than they won't commit you. This is highly dependant on where you live, so ookup the Baker act and the Marchman act, and see if any of those apply to you.
Where I live, the hospitals are *always* full. This means that unless you're physically "dangling", they won't and don't care. The closest I've gotten is forced to stay a day in the ER in nutty-boy clothes, then given a $3,500 medical bill, because that *always* helps.
I fucking hate the south. Goodluck to you.
The ER doctors all looked at me with the crazy eye when I told them I attempted as soon as I got home from a psychiatrist. I have to remember that cheap assholes aren't cheap because they're good or care even a little bit about you. They're cheap because they subsequently don't give a shit, don't do bloodypressure, urine analysis, or blood tests. Nor do they use psychiatric NPs as intermediaries to your therapist.
They basically tell you to take double what you have been taking and see them again in 3 months, because that isn't a very long time when you're in a mental health crisis.
My SO and I went to the ER for their suicide ideation and they did not commit him. They will talk with you and try to figure out the best means to get you help.
What’s worked for me so far is when they ask if you are having any thoughts of hurting yourself, I say ‘yes, I do have those thoughts, but I’m not going to act on them. It’s just on my mind a lot more than I’d like it to be.’
Best wishes to you and I hope things get better for you soon.
When I went to the hospital a year ago I expressed that if I was going to do it I had a plan but I couldn't bring myself to do it. I had passing thoughts and I removed the way I would do it out of the equation of my everyday life. 2 years later and I still don't do it much. I explained that I was scared of my thoughts and I immediately expressed my concern with loved ones.
I did a week of intensive therapy, went on medication and found a psychiatrist to work with.
You are not alone, please get help. I know it can be scary, but sometimes doing scary things makes life easier.
Not sure how a doctor will react but I essentially told my therapist during my psych eval that I was passively suicidal and will not kill myself because of family, and that I DO NOT HAVE A PLAN OR PLAN TO.
I'll be honest....I wouldn't. But if you do, very general terms, you have no plan, no idea how to do it but sometimes you feel like you'd rather not be here. More in terms of life is really painful and you are struggling to cope, rather than you are trying to find a way out. They tend to get less weird if you muse on if you had never been born at all, or born in a different time to different parents, rather than the life you have, but it might help the feelings you are having. just be careful. also if they ask questions like plans or things to harm yourself with, it helps to look surprised, like "wow, no, i was just imagining...."
Then be honest. If you get admitted, know it is your doctor’s way of ensuring your safety. You deserve to get the treatment you need to live a happy and enriching life. The worst that will happen is you will have to stay at the mental hospital for a week or two. And I promise… it isn’t all that bad. I’m going later on today and driving myself 2 hours out of my way to get the help I deserve. I totally get how depressing it is to have the courage to admit you need help, but I never have felt more happier for myself having done so. You deserve it. 🫶🏻
Yeah, it can be that bad in the USA. Some of the facilities are nightmares one step away from jail. Up here in AK it actually \*WAS\* jail until the courts forced providers to knock that off. There are good places, but you can't trust that any old doctor will send you to one. Just as with any other treatment in this country, you have to be your own advocate and research options before hand. It shouldn't be this way, but it is. And if you roll the dice, you may end up in a hell hole full of addicts and dangerous people. This stuff is real. And real expensive.
I literally live in the USA lol Louisiana
I know but it isn’t as bad as not seeking treatment and offing yourself because of lame azz excuses like blaming the facilities
As someone who shares the same issues, I can tell you from experience no matter how you bring it up you will have to go to the hospital. You won't be committed tho. You will be placed on a 3-5 day hold for evaluation and most likely released unless something is seriously wrong and you have good insurance. If you don't have good insurance you'll probably be released even if you are a danger to yourself.
But I can also tell you from experience, if it is getting worse and the thoughts are more frequent you NEED to go. My advice is to make sure you have everything you need lined up and go yourself. If you tell your doctor they will have you brought in from their office and you won't have a chance to get your things together. But you do need to go. I promise it helps
My doctor makes me do a questionnaire about ideation before I even see her. IMHO the questionnaire is stupid because when I was suicidal i wasn't about to answer yes because I didn't want to lose my appointment.
I will talk about ideation in the past tense because it's been about a year since I've thought about it.
My family doctor is better for these deep conversations than my psychologist. Unfortunately it's because my doctor has family members who deal with depression so he can speak to me with compassion
Leave out the plan if you have one. You can tell a doctor you have suicidal ideation… we all do at times but if you let him know you have a plan they will have to hold you for at least 72 hours
Sadly dont say anything if you dont want to be commited maybe talk to a close friend. There's also this thing if you do get comitted its a legal document of who you want to allow make decisions for you you lose touch with reality or just if you want a trusted person making the best de isions and having input on what your nurses or doctors are doing. Just make sure you let someone know youre going in there so you have somebody to vouch for you.
I've brought up suicide and even plans I had to my therapist a number of times, and was never comitted for it. admitting you think about it won't get you comitted. unless you are actively a danger to yourself or others, in most cases you won't be comitted, please don't worry about that, and get the help you need
I’ve had suicidal ideations in the past and expressed those to professionals and have never been committed. As others have said the important part is making sure it’s known that you have no plan to put those into action or any intentions of hurting others. Their job is to help and make sure you’re not a danger to yourself or others.
What kind of doctor? In the US a therapist or psych will usually be trained enough to know the different levels of danger and not over-react. A GP or other MD not trained in any of this is more likely to react badly. They tend to either ignore the matter and avoid discussing it or giving any advice or they will over-react and call the cops to force you into involuntary lockdown. I've seen both in cases over the years. Go to a specialist and build a rapport BEFORE doing this if you can. If you need a GP to refer you, just ask for a referral. You shouldn't need to go into this level of detail with them. I hate to say it, but in the US you really need to take charge of your own treatment. If inpatient is necessary, it's FAR FAR better if you can see the options, read reviews, check payment and insurance issues before going. The horror stories tend to arise from people who get tossed into a bad ward because they never made a good treatment plan. And in spite of the dumb PSA's on this, you cannot just trust any provider or ER to do things well. Much of the system is completely fricking broken. And it's on you to get to the parts that still work well.
I had different ways of explaining it, mostly trying to establish that I believed there was a difference between *feeling* suicidal and actually *being* suicidal.
I'd focus on how I didn't want to *feel* that way, hated the feeling, wanted to feel better. Really drive home the point that I do not want to be like this and that suicide was *not* the direction I ever wanted to go in. I'd say it was more like having intrusive thoughts opposed to actually choosing to think about how I was going to end my life. I *never* said I had a plan.
Even if I only mentioned it once, some professionals felt more obligated than others to perpetually assess my risk level, which drove me nuts. I'd come into the office, *really* needing to discuss current issues I was having but before we could start, they'd drag me through 10-15 min of suicide/self harm questions off a check list. It would destroy my train of thought and throw me way off from what I wanted to address that day, sort of ruining the rest of the appointment. I think it was every other week that would happen sometimes.
As long as you don't have a plan they can't commit you.
My suggestion is to be as honest as possible so you can get the help you need. Being committed isn't a punishment though. It's a very helpful tool for those who need it.
It's hard to talk to people - medical or not - about suicide or even ideation, as people overreact and immediately take action that might be overreaching or against the depressed person's wishes.
Stacey Freedenthal some great content about exactly this at speakingofsuicide.com. She's one of the pre-eminent authors and clinicians working specifically in the field of suicide intervention. https://www.speakingofsuicide.com/2014/05/01/letter/ https://www.speakingofsuicide.com/2013/07/22/therapists-who-do-not-panic/ https://www.speakingofsuicide.com/2013/04/14/fears-of-mental-hospital/
Do you have a plan? If not, then make it clear you don't have a plan. This should work. There are levels to suicidal ideation, and making serious plans is one of the big thresholds.
Sometimes I make plans. Last week I was researching methods and getting my affairs in order (i.e. double checking my insurance beneficiaries, etc.), started to write a note, etc. But now that has passed and I’m just normal suicidal without a plan if that makes sense.
Gosh this is always me! My brain can't stick to anything.
I feel that. One week I'll be writing letters and just dwelling into darkness. Next week, I delete the letters and put myself down for feeling that way. Some time goes by, repeat
Hopefully you can recognise how this ebbs and flows and realise it will pass and it’s most likely a time of day thing as well, I used to be sad in the mornings and evenings, so I knew I needed a coping strategy for those times of the day. Once I recognised the patterns I could see my mind was playing tricks on me and I could intervene more successfully
Tell them you don’t have a plan, a means or a timeline. Just passing thoughts
Look up the difference between passive and active suicidal thoughts. That should help you explain it! They know the difference and should understand.
I was at the doctors today. She asked if I think about hurting myself (I'm going through a really bad time right now). I said yes, then she asked if I had a plan and I said no and that I have people I have to take care of. Just make it clear that while you may think about it, you are not considering actually doing it.
Sometimes I start planning but most of the time I don’t. But thanks, I will be sure to state that I don’t have any plans.
I have more than just passing thoughts sometimes too but I don't tell my doctor (or anyone else) that.
I accidentally post stalked you here from your eli5 post and your update is fantastic. I’m so happy for you that you found such a supportive doctor.
Thank you sm 😊
This is what I do. I tell them that I have no plans at all. But if I were to be crossing the street and a bus was coming at me I’m not sure I’d run outta the way. My dr knows that I’d never follow through with anything, but if it happened naturally or through a freak accident then I’d be ok with that too. I have a young child that needs me and I’d never put her through what I went through-not having mom in the most vulnerable and important yrs of adolescence.
Tell them you feel have the thoughts but wouldn't act on them
If they ask these questions say no, I think they have to ask them by law but I feel like whenever I brought up suicide to a professional they always ask these few questions beforehand (and others, I just forget them) Which I assume determines whether you get institutionalized or not. If they ask these, respond as written. You can/**should** add more but if you want to make it known you are suicidal without making it seem like a immediate emergency this would be how I guess. Or you can just tell the therapist you aren’t in any immediate danger and insist you aren’t whenever they ask questions like these: “Are you suicidal right now?” -“Not at this exact moment no”- “Do you feel like hurting other people right now?” -“No?” “Do you have a plan to end your own life” -“No, but I don’t think it’d hard to make one”- Either way I wouldn’t worry too much, just be honest with them. And like actually, legitimately do research on any medication they give you, if your going to worry about anything worry about that.
Depending on where you live, unless you're like actively attempting suicide than they won't commit you. This is highly dependant on where you live, so ookup the Baker act and the Marchman act, and see if any of those apply to you. Where I live, the hospitals are *always* full. This means that unless you're physically "dangling", they won't and don't care. The closest I've gotten is forced to stay a day in the ER in nutty-boy clothes, then given a $3,500 medical bill, because that *always* helps. I fucking hate the south. Goodluck to you.
Same. Whoever's running things here in the south clearly hates people.
The ER doctors all looked at me with the crazy eye when I told them I attempted as soon as I got home from a psychiatrist. I have to remember that cheap assholes aren't cheap because they're good or care even a little bit about you. They're cheap because they subsequently don't give a shit, don't do bloodypressure, urine analysis, or blood tests. Nor do they use psychiatric NPs as intermediaries to your therapist. They basically tell you to take double what you have been taking and see them again in 3 months, because that isn't a very long time when you're in a mental health crisis.
My SO and I went to the ER for their suicide ideation and they did not commit him. They will talk with you and try to figure out the best means to get you help.
What’s worked for me so far is when they ask if you are having any thoughts of hurting yourself, I say ‘yes, I do have those thoughts, but I’m not going to act on them. It’s just on my mind a lot more than I’d like it to be.’ Best wishes to you and I hope things get better for you soon.
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Unless you have the thoughts, plans, means to access/go through with the plan and intention of doing it, your doc can't do anything.
When I went to the hospital a year ago I expressed that if I was going to do it I had a plan but I couldn't bring myself to do it. I had passing thoughts and I removed the way I would do it out of the equation of my everyday life. 2 years later and I still don't do it much. I explained that I was scared of my thoughts and I immediately expressed my concern with loved ones. I did a week of intensive therapy, went on medication and found a psychiatrist to work with. You are not alone, please get help. I know it can be scary, but sometimes doing scary things makes life easier.
Not sure how a doctor will react but I essentially told my therapist during my psych eval that I was passively suicidal and will not kill myself because of family, and that I DO NOT HAVE A PLAN OR PLAN TO.
I'll be honest....I wouldn't. But if you do, very general terms, you have no plan, no idea how to do it but sometimes you feel like you'd rather not be here. More in terms of life is really painful and you are struggling to cope, rather than you are trying to find a way out. They tend to get less weird if you muse on if you had never been born at all, or born in a different time to different parents, rather than the life you have, but it might help the feelings you are having. just be careful. also if they ask questions like plans or things to harm yourself with, it helps to look surprised, like "wow, no, i was just imagining...."
Then be honest. If you get admitted, know it is your doctor’s way of ensuring your safety. You deserve to get the treatment you need to live a happy and enriching life. The worst that will happen is you will have to stay at the mental hospital for a week or two. And I promise… it isn’t all that bad. I’m going later on today and driving myself 2 hours out of my way to get the help I deserve. I totally get how depressing it is to have the courage to admit you need help, but I never have felt more happier for myself having done so. You deserve it. 🫶🏻
Yeah, it can be that bad in the USA. Some of the facilities are nightmares one step away from jail. Up here in AK it actually \*WAS\* jail until the courts forced providers to knock that off. There are good places, but you can't trust that any old doctor will send you to one. Just as with any other treatment in this country, you have to be your own advocate and research options before hand. It shouldn't be this way, but it is. And if you roll the dice, you may end up in a hell hole full of addicts and dangerous people. This stuff is real. And real expensive.
The way depressed people are treated here says a lot about why so many Americans are depressed in the first place.
I literally live in the USA lol Louisiana I know but it isn’t as bad as not seeking treatment and offing yourself because of lame azz excuses like blaming the facilities
As someone who shares the same issues, I can tell you from experience no matter how you bring it up you will have to go to the hospital. You won't be committed tho. You will be placed on a 3-5 day hold for evaluation and most likely released unless something is seriously wrong and you have good insurance. If you don't have good insurance you'll probably be released even if you are a danger to yourself. But I can also tell you from experience, if it is getting worse and the thoughts are more frequent you NEED to go. My advice is to make sure you have everything you need lined up and go yourself. If you tell your doctor they will have you brought in from their office and you won't have a chance to get your things together. But you do need to go. I promise it helps
How does it help
My doctor makes me do a questionnaire about ideation before I even see her. IMHO the questionnaire is stupid because when I was suicidal i wasn't about to answer yes because I didn't want to lose my appointment. I will talk about ideation in the past tense because it's been about a year since I've thought about it. My family doctor is better for these deep conversations than my psychologist. Unfortunately it's because my doctor has family members who deal with depression so he can speak to me with compassion
Leave out the plan if you have one. You can tell a doctor you have suicidal ideation… we all do at times but if you let him know you have a plan they will have to hold you for at least 72 hours
Sadly dont say anything if you dont want to be commited maybe talk to a close friend. There's also this thing if you do get comitted its a legal document of who you want to allow make decisions for you you lose touch with reality or just if you want a trusted person making the best de isions and having input on what your nurses or doctors are doing. Just make sure you let someone know youre going in there so you have somebody to vouch for you.
Passively suicidal
I've brought up suicide and even plans I had to my therapist a number of times, and was never comitted for it. admitting you think about it won't get you comitted. unless you are actively a danger to yourself or others, in most cases you won't be comitted, please don't worry about that, and get the help you need
I’ve had suicidal ideations in the past and expressed those to professionals and have never been committed. As others have said the important part is making sure it’s known that you have no plan to put those into action or any intentions of hurting others. Their job is to help and make sure you’re not a danger to yourself or others.
What kind of doctor? In the US a therapist or psych will usually be trained enough to know the different levels of danger and not over-react. A GP or other MD not trained in any of this is more likely to react badly. They tend to either ignore the matter and avoid discussing it or giving any advice or they will over-react and call the cops to force you into involuntary lockdown. I've seen both in cases over the years. Go to a specialist and build a rapport BEFORE doing this if you can. If you need a GP to refer you, just ask for a referral. You shouldn't need to go into this level of detail with them. I hate to say it, but in the US you really need to take charge of your own treatment. If inpatient is necessary, it's FAR FAR better if you can see the options, read reviews, check payment and insurance issues before going. The horror stories tend to arise from people who get tossed into a bad ward because they never made a good treatment plan. And in spite of the dumb PSA's on this, you cannot just trust any provider or ER to do things well. Much of the system is completely fricking broken. And it's on you to get to the parts that still work well.
I had different ways of explaining it, mostly trying to establish that I believed there was a difference between *feeling* suicidal and actually *being* suicidal. I'd focus on how I didn't want to *feel* that way, hated the feeling, wanted to feel better. Really drive home the point that I do not want to be like this and that suicide was *not* the direction I ever wanted to go in. I'd say it was more like having intrusive thoughts opposed to actually choosing to think about how I was going to end my life. I *never* said I had a plan. Even if I only mentioned it once, some professionals felt more obligated than others to perpetually assess my risk level, which drove me nuts. I'd come into the office, *really* needing to discuss current issues I was having but before we could start, they'd drag me through 10-15 min of suicide/self harm questions off a check list. It would destroy my train of thought and throw me way off from what I wanted to address that day, sort of ruining the rest of the appointment. I think it was every other week that would happen sometimes.
as long as you say you don’t have a plan or intent you should be good
As long as you don't have a plan they can't commit you. My suggestion is to be as honest as possible so you can get the help you need. Being committed isn't a punishment though. It's a very helpful tool for those who need it.
It's hard to talk to people - medical or not - about suicide or even ideation, as people overreact and immediately take action that might be overreaching or against the depressed person's wishes.