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How do you help someone that is determined to die?

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where you really and truly have no reason to live, where death is the right choice.
Absolutely agree with this. Have been there. Things are looking up for me now, but man, there were some incredibly dark days. WtheF is there not support for people like us? Honest to god, what turned the corner for me was when I found a bunch of people who 'got it'. Got how hard it was. Weren't getting frustrated at my situation. Understood that I was doing the very best I could. And people who weren't constantly telling me (and expecting me to be) 'back to my old self'.

A ton of the problem for me IS about the hospitals. They are horrible -- my experiences anyway. Retraumatizing. Critical. No understanding. Abusive. When even seeking help is dangerous - well yeah. I don't just want out. I need out.

So grateful those days seem to be fading into the background for me.
 
I believe it's her schizophrenia and her situation that bothers her the most. She does speak with doctors for both physical and mental health.
Speaks with doctors - but it sounds like her schizophrenia isn’t being managed with medication. Is that right?

If it’s not being managed - and generally, some kind of medication is unavoidable - she can’t see reality clearly enough to make a cogent decision about her own death.

If she’s young, even more so.
 
If her schizophrenia & mde are not currently managed, she’s not in a headspace where she can make a decision like this responsibly for herself.

With a major depressive episode, it’s a typical symptom for a person to honestly believe that they have always felt as rotten as they do right now, and to honestly believe (and persuasively argue) that things can’t and won’t improve. They are symptoms of her depression. Depression is treatable. If she’s a ‘semi-new’ friend, you may not have been there for the times when things weren’t this bad. But chances are? There have been ups and downs. The very bottom of a down period is not the time to make decisions about suicide.

DID that is well managed “except she needs someone with her if she goes out” (in case she gets violent???) is not well managed. she has reason to be optimistic for massive improvement with treatment.

Does she have ptsd? If not? She also has reason to be optimistic that her depression could improve with proper treatment (and yes, even after 20 years).

If you think you want to support her decision to kill herself? She doesn’t need that right now. She needs people around her who will support her recovery, not her suicide.

Thing is, she can kill herself. As long as she’s living independently, there’s dozens of methods she could use. The fact that she’s talking to people about it? Suggests she’s looking for hope and some kind of human connection. You don’t need to fix her. You can’t. But she has the opportunity to substantially improve the quality and meaning of her life if she chooses to get the right support and treatment.
 
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With a major depressive episode, it’s a typical symptom for a person to honestly believe that they have always felt as rotten as they do right now, and to honestly believe (and persuasively argue) that things can’t and won’t improve.
Exactly! This is the reason I said, "if there really and truly is no hope." Such a place actually exists, I think, but you have to try a of stuff and actually get competent help before you know you're there.
 
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