Psychopharmacology for Suicide Prevention
Baldessarini and Tondo, in Suicide in Psychiatric Disorders, Tartarelli, Pompili, and Giardi, Eds 2007
I read this chapter in this book because I thought it would be interesting. Once you read that clozapine and lithium were valuable in the reduction of suicide, the rest of the article fell flat on its face. It talked about SRI’s (serotonin reuptake inhibitors) and how only fluoxetine was approved for adolescent use. The rest were “black boxed”. Maybe I was tired when I read this as I have been up most of the day and despite having two cups of caffeinated drinks, I am still tired. But the article, I felt was ridiculous. It listed more references than sentences. I hate articles like that. And the graphs made absolutely no sense. So unless you suffer from schizophrenia or Bipolar I disorder, you are fucked. I got more depressed reading this article.
I really wanted to kill myself after reading this. I don’t know why. Maybe because it said that I was in the age range that suicides happen and I am “untreated”. It did talk about how studies excludes those with suicidal thinking, which is a shame. But what was unclear was if the RCT (Random clinical trials) did anything if the subject became suicidal during the study. And what really pissed me off was they quoted “suicidality” like it wasn’t a word or something. It was really a bizarre article.
I also read today that 6 transgendered people killed themselves so far this year. I feel like I should be #7. I also read that Bruce Jenner, the athlete, is now a she. That totally blew my mind. It kind of gave me hope but I am feeling so shitty that all I can think about is killing myself because I hate myself so damn much. And that stupid article just gave me enough reasons to go ahead with it. I am going to write a will, so that my family knows what to do with my stuff. I want my books donated to my therapist in the hope it might help her. My journal articles might as well be recycled. They were of no value to anyone except me. My Suicide and Life threatening journal can be donated to the MGH library or a library that doesn’t have these important articles.
I am just so tired of living this way. My foot is throbbing big time and I didn’t even do anything to it the last few hours. It just exploded about an hour or two ago and the pain meds hasn’t even touched it. I think I am becoming psychotic again. I keep hearing my father’s voice and he isn’t here. And my regular voices have been really quiet, which is unusual. I know once I go to sleep, I probably will feel better when I wake up. I just feel so wired yet tired. Damn, it’s 0200. I don’t know how the hell time keeps escaping me. Maybe that is why I feel so disoriented. I know I have been playing on my laptop for the last few hours. I know because I have had to log out of one account and then log onto another back and forth to get the items I need for the one account I am working on. All for this stupid game I am playing. Maybe I should take my antipsychotic tonight. I usually take it every other night because otherwise I get nasty side effects. I hate them because they are so uncomfortable and I can’t do anything but SPAZ out. My arms and legs become very spastic. I hate it. But the drug keeps the bad voices away. I don’t know why I am hearing my father’s voice. He isn’t commanding. It’s just like remnants of a conversation more than talking to him like he is there. I don’t know if that explains it very well. Maybe I will take a trilafon and see if that helps.
Seriously want to know why I take meds when it doesn’t seem to make a difference. I really believe suicidal thinking is more of a psychological think more than a biological thing, because shouldn’t I be better with meds than without? I have been on meds since I was sixteen. I have had many suicide attempts while on meds and while off meds, my most serious attempts being while ON. I am not saying that the medication that I take for my mood disorder made me suicidal. If that were the case, I think I would be dead by now. But seeing as I have been doing what the books tell you, to be in therapy and to have a medication regimen, shouldn’t I be LESS suicidal or at least a little bit more content with my life that I am not thinking of taking my life every day?
I have been on all the different psychotropic medications out there, from lithium to valproic acid, from Prozac to Zoloft, from remeron to cymbalta, all of the anti psychotics to deal with the nagging voices in my head that criticize me and tell me to kill myself. These voices sound like real voices to me and sometimes I have to be careful when others are around because they do think I am crazy when I have a conversation with myself. And I mean a full-fledged conversation with questions and answers. I don’t see my voices, just hear them. And a tiny pink pill called Abilify helps me to control them when they get too loud. Nothing else works with less side effects. And side effects is what kept me going from med to med to what I take today which is a handful of pills a day. Not only do I take meds for my mental illness, I take it for my blood pressure, menstrual cycle, GERD, pain, spasms, anxiety/worry, and allergies. I long for the day when I was only taking one or two pills a day.
Life has become more complicated and so my has my suicidality. I thought that if I stayed in talk therapy, I would be better. I thought that if I took medication, my moods would be better and I would be able to function. But none of that is true for me. I have struggled with this illness for the past twenty years and no break has happened. I am constantly depressed, constantly suicidal. I just cannot be happy or if I am it is short lived. My one highlight of the day is my Starbucks trips. I get my latte or mocha and all is right with the world for a little while. I might write in my journal or just watch the traffic go by on the street or just take my coffee and head home, which is what I do most days. I just cannot be out for more than an hour. I become fatigued too quickly and then need to lie down. Plus if I stand long while waiting for the bus, my leg gets inflamed and then starts hurting me. I hate being in chronic physical pain almost as much as I hate being in chronic psychological pain.
Why do I still continue to take my meds despite not feeling 100% better? I know what my life is like while taking the meds versus when I don’t. it’s not pretty. I can barely get out of bed and do things on most days when I don’t take my meds. Taking my meds give me the hope I need to try and see the silver lining in some shape or form. If I didn’t believe that a tomorrow will be better than today, then I think I would have killed myself a long time ago and succeeded. I know I don’t have much to live for. I am hopeless most days. But I do the routine as frustrating as it can be some days. I know my psychiatrist has helped me more than anyone. She is my rock of hope when I no longer have one. When I went on a med hiatus, she is the one that got me back on the meds because my heart was so heavy I didn’t think I was going to make it.
There are some people in my life that I am still here for and I guess that is why I take my meds. I have to be here for my nieces and nephew. I don’t want to. I rather be six feet under pushing up daisies for an eternity. But not today. Today is a dreary day in Boston and I am just going to sit in bed and write this story about why I take my meds and maybe sleep some. I have nothing else to do today. It is my day to relax and put my feet up. I ran out of spoons on Tuesday and today is the day that I am trying to collect them back.