News Deconstructing The Relationship Between Ptsd And Suicidal Thinking

[joeylittle]

I came upon this opinion (blog) piece, written by a PTSD sufferer. She really nails it, when it comes to why people suffering from PTSD should proactively combat their suicidal ideation. I strongly recommend it for anyone who finds themselves 'reasoning' their way into the idea that they cannot ever come back from this disorder.

I Could Have Been That Girl: Is PTSD Incurable? | The Huffington Post

She quotes a psychiatrist she has worked with - and this is at the heart of the point:

One of the clinical features of PTSD is a sense of a foreshortened future, a kind of pessimistic outlook that danger is inevitable and inescapable. In other words, people with PTSD often have the perception of impending doom, that disaster is unavoidably just around the corner. In my view, this impairs a person’s ability to make a fully rational decision about ending their own life.

It's simple - but to me, it's very hard to deny the truth of it.

Thoughts?

 

[digger]

Interesting. I haven't managed to read the whole article yet, but have bookmarked it to come back to.

I do know that at the core of my suicidal 'reasoning', and past attempts, is the feeling that I don't have a future that will be any better, or that it will ever be a life that ever feels like it's actually worth being alive for. It can/could be a bearable life, but is that actually enough?

I'm not sure that that comes down to a sense of a foreshortened future in the direct sense - I don't think it's that I expect something bad to happen, more that I don't expect anything good to happen.

It's tricky because it doesn't feel like I have any evidence in my life to date to prove that supposition wrong and looking for it (and not finding it) just adds to the depression.

 

[scout86]

Until my T said, "yes, you have PTSD", and I started seriously reading about it, I didn't know there was anything unusual about my view of the future. I still can't quit imagine how else you'd experience it. I hadn't thought about the idea that there's a new disaster around every corner as being unusual until I read what you wrote. Because, large or small, life IS about moving from one crisis to the next, isn't it? And most of it is beyond your control?

I guess I can see the connection to suicide. You get tired sometimes. (I'll have to go read the whole piece.)

 

[The Albatross]

Put on the watch list as I am not really in a position personally to comment at this time but am interested in this discussion.

 

[Jadie Rose]

I came upon this opinion (blog) piece, written by a PTSD sufferer. She really nails it, when it com...

Wow, I needed to read this right now, thanks for the share! I tried to commit suicide three times in November and have been working closely (after that) with a trauma team of P and two T's ever since. Things are moving fast because have been in therapy for over a year, otherwise, but not with a trauma specialist (but she was great, saw me two times a week before she ended up leaving on medical leave, which is before I tried to commit suicide multiple times, because she was only one who got me). Anyway, I am reading this before my T appt and it all makes sense - I actually researched Switzerland's facility for suicide assistance, and attended meetings in my city, with assisted suicide board members on the international board of assisted suicide organization (forgot name and have to go).

 

[joeylittle]

I don't think it's that I expect something bad to happen, more that I don't expect anything good to happen.

That technically (in psych-speak) is the same as foreshortened future, which often is coupled with phrases like 'doomsday thinking' (that it's all coming to an end from multiple angles), and 'negative outcome' (nothing can or will improve).

It's really a symptom. It can chicken-and-egg in one's head, a bit...because things do get worse before they get better, and things getting worse supports the symptom, and it becomes next-to-impossible to reason out whether it's a thought/feeling or a fact.

So the piece is clearly on the side of - it's not a fact, and the sufferer is incapable of intuitively knowing that they are seeing a symptom, when they believe that things cannot come to a positive end point.

It's interesting to me. One of the defining characteristics in a schizophrenia spectrum diagnosis used to be something like 'whether or not the person knows that what they are seeing/hearing is hallucinatory'. Either way, you have the visions. But one way, you know they aren't real - and the other, you absolutely positively cannot tell the difference.

I think grasping the same concept when it comes to our own thoughts is difficult. If I'm thinking it, and I can make sense of it, isn't it actual fact?

It's very valuable to challenge that - though also, so hard for the person who is inside of the perspective. One of the reasons why having an outside voice you can believe who can tell you (general you) when you aren't dealing in fact, but feeling - and that language circles back to having some buy-in on the basic concepts of CBT (and DBT, and any other model that has a cognitive focus I believe).

 

[scout86]

So the piece is clearly on the side of - it's not a fact, and the sufferer is incapable of intuitively knowing that they are seeing a symptom, when they believe that things cannot come to a positive end point.

If your experience primarily IS moving from one disaster to another, wouldn't it be a little crazy to expect anything else? This might be a little like the difference between being paranoid and the reality that there are people out to get you. I suppose that line of reasoning might be off, if you don't also think there might, possibly, be someone, somewhere, who doesn't care if they get you or not. (Ok, maybe someone, somewhere is on your side. That's at least possible.)

Don't we base our world view on our experiences? Isn't that reasonable? So, if your experiences run to 'death and destruction', isn't it totally reasonable to think you won't lead a long life? Besides that, if your brain is busy just trying to figure out how to survive, there isn't a lot of time and energy to spend thinking about some distant time that might arrive, if you successfully navigate all the chaos, known and imagined, that stands between now and the potential of then?

 

[joeylittle]

Don't we base our world view on our experiences? Isn't that reasonable?

Yes - but what if your experience has altered the way you are able to think...does that mean we should base our view of reality on an injured organ? I'm writing that badly....but that's the reasoning behind saying that certain mental illnesses make it impossible for the sufferer to perceive the world as a place that they can function in.

I think it might go hand in hand with needing to accept a basic premise - that the human brain/body/organism....the human animal, you could say, has the same drive towards self-preservation as any creature. Mental illness can obscure that drive, and allow the human to fixate on self-destruction instead of self-preservation.

If the diagnosis were more empirical - that would balance out the perception of the sufferer. When you have a broken bone, you can be given reasonably secure assurance that the bone will mend (or do whatever the docs say it will do). If they say that it's not a bone that can be repaired, then that is also a secure fact. But who can predict whether or not an individual can come back from certain mental illnesses?

I like that the doctor quoted in the article is clear about saying that some people don't get better - that the point is not, 'there's always an answer' - the point is, we as individuals who suffer from this stuff aren't capable of fully assessing our own situation, and are in fact most likely to assess it as being hopeless. So, we need to commit to finding the voice that is going to counter-balance that skewed perception.

 

[scout86]

Yes - but what if your experience has altered the way you are able to think...does that mean we should base our view of reality on an injured organ?

Good question.

My T likes to quote an author who's name escapes me right now. That we all have our own road map of reality. They are all different. None of them are reality, they are just road maps. He goes on to say that he thinks it's good to have the most up to date, accurate map you can.

I think there probably is a such thing as objective reality. I'm just not real sure how you decide who's version is "right". After 9/11, I was amazed at all the people going on about how shocking it was to see the world as a place that wasn't safe. I was amazed that they'd been under the illusion that it was safe. I think my world view was more accurate than theirs. But maybe not?

At the same time, all things considered, maybe we SHOULD take or reactions to some of this stuff with a grain of salt.

Up until I started therapy, it was pretty rare that there was anyone I thought I could go to for a reality check. Having that option seems like a pretty good thing these days.

 

[Sideways]

Hopelessness is one of the symptoms that I've totally nailed. And I definitely relate to the feeling that I'm never going to live a long life.

But when I'm sitting on the suicidal ideation chair, it's not so much that the future looks all doom and gloom, it's that the future is presumably something similar to, well, this. Life as I know it is better than when I was a kid, but it still doesn't hold anything in it that I want, never has really. It holds a whole lotta pain that I don't want, but is there really some golden goose worth persisting for?

I think that's "Hopelessness" in a nutshell. But in the same way as this argument about the foreshortened future symptom, trying to rationalise a reason to live when you're keen on the idea of not living, becomes near impossible. And in my mind, my pro-suicide reasons seem really rational.

I tend to come back to the idea that the suicidal thoughts, whatever the cause, are evidence that my brain/mind isn't workig right, because (in theory) humans are naturally into self-preservation. And I have to stop myself at that point: Quit trying to justify suicide with a brain that's evidently too sick to reason properly right now. If you know the calculator is faulty, quit trying to solve equations on it...?

 

[Deleted member 38644]

Actually she nailed it! Now that I read this it reminds me of being suicidal few years ago. When everything ends in disaster that's what use to come to my mind. When I was told I had PTSD it opened up a new form of explanation to my life. I use to cut myself and years later down the line you find out what's wrong with you and reading all these stories on this website gives you your answer to everything. I completely forgot about alot of things until I read other stories and see it was in my tracks. I don't even have the energy to cut myself anymore because im completely numb and I conquered alot. when so much bad was happening to me it felt like a cycle I couldn't get out of when I wasn't aware at the time that was a cycle so yes I love her post

 

[Jadie Rose]

I think there probably is a such thing as objective reality. I'm just not real sure how you decide who's version is "right".

There are social/cultural issues to take into consideration, too. The practice of assisted suicide, for individuals who have been citizens for (if I remember correctly) at least five years within the country providing the assistance, such a practice is normal to them (for anyone suffering, period). They have been living this norm for decades. I do not necessarily agree with it, myself, because I attended some meetings in order to meet people who assisted with suicide because I was all alone and had zero clue I had disassociated for 15 years into something else. My disassociation was leading me there, since the real me was coming out again and it was too much for me to even try and begin to understand on my own. The people in these organizations are SO NICE and so willing to offer information to help in any way they can to anyone who is suffering - such is the culture in these organizations.

Now, I could see some of them were afraid to die, themselves, as they have all the contacts and even have prepared methods (including items) ready to do it upon a moments notice. Of course, it is illegal here in the U.S. unless an MD does it at a hospital due to terminal disease, but that has not stopped some organizations from still assisting under the table here in the U.S. They follow the group belief suffering is not necessary in life, and it is a choice that single individual should have the opportunity to make. If one is suffering so badly and there is a group of professional MDs, lawyers, etc. whom all happily support your will to die, rather than suffer any longer because you just don't want to, that is all it takes for them to service to your needs.

Now, one has to submit their medical records in detail and has to be seen by a physician of the facilities choosing to determine if the individual is sane and can make this decision according to their own individual rules (each country's are different). When I went to these meetings, I was seeing ten of my physicians on a consistent basis at my medical offices, including a pain management psychologist. I told some of them I had gone to these meetings and planned to attend another, that I was not afraid of death because I had already died once before inside, and they did nothing (I had not been diagnosed with PTSD yet). I still find that kind of odd. In any case, consciously I was too afraid to do anything and stopped going. Subconsciously it was all I wanted to do, was to die, so when I drank vodka (normally drank beer and wine), my subconscious decided to do the attempts. After being hospitalized twice, only then did I finally start to see a tiny little bit of light with the right trauma P & T. My view is they make it way too easy for people, but on the other side, cultures are all different (even just within social settings).