Q: Hello. I have been suffering from depression for most of my life. I started getting treatment for my depression in ’97 (I had at that time attempted suicide). What I want to ask is – how can I talk with my psychiatrist without her wanting to throw me in the hospital??? I, over the last 1 1/2 yrs, have been getting increasing worse. My depression has changed in ways even I don’t understand. I have been on several medications, have had ECT, been hospitalized just in this past year at least 6 times, and the last time I went one of the inpatient drs. said to me “we are usually trying to get you to go home, now we have to insist you stay”. God how that hurt me. All this time I thought there focus was on curing me, helping me get free of this suffering. Anyway, my psychiatrist is new to me of about six months. She is very kind and everyone says she is a great dr. I feel every time I say the least thing to her she wants me to be hospitalized. I admitted to her that I always have the thoughts of suicide in my mind. When I’m driving, when I’m just sitting, lying, it doesn’t matter. My second thoughts are constantly looking at ways how I can kill myself. I am increasingly getting worse. My therapist (of 2 yrs) is now gone as well on maternity leave; she was the best therapist I had ever had. She never wanted to always throw me in hospital. She knew me well. So now I really have no one to express the thoughts of my suffering to. It is continually building inside, where I think is becoming anger at the world just for living. I don’t want to die all the time, just need someone to say it to and describe how its killing me, to see if maybe I need hospitalization or just someone to cry to, to release whatever this agony is. Did I confuse you? Do you understand what I’m asking? If you do, please help me??? Please???

A: It sounds like you are in a very painful place and I am sorry you are suffering like this. There are some new innovative approaches to treatment resistant depression that you may want to talk to your psychiatrist about. And until your therapist comes back from maternity leave, you need to work on forging the trust with your psychiatrist. She will not have to hospitalize you every time you talk about suicide if she knows you better and knows what your limitations are. Just feeling suicidal is not enough. It takes having a plan and an “intent” to act on the plan that calls for hospitalization. There are many things, including safety planning, that you can do to talk through the feelings without having to go to the hospital. It is up to you to be honest with your practitioners so that they can help you best. If you are unable to work with the therapist you have been working with, you will need to find another one who you feel comfortable with. I know this is hard and no one likes to start over, but many times a fresh approach can be very helpful. It is also up to you to start finding ways to want to live, rather than die. This takes an enormous amount of energy and determination but I have seen many clients make this transition and it has become a permanent change of focus. I personally believe that there are other very helpful methods out there in addition to the “western approach” to healing. These are sometimes called alternative or complementary medicine. These could include acupuncture, energy work, Chinese herbs, energy psychology, etc. If you feel stuck, you may want to consider adding some of these healing techniques to what you have tried in the past. Lastly, if you have not been a part of a support group, I also recommend this addition. Many times you can find one in your area that is specific to what your needs are, such as depression and suicidal thoughts. It can be very helpful to talk to others who truly understand you and it can also be good to hear from others what works for them and what doesn’t. I hope this information helps and I hope you keep trying to get better. I wouldn’t do what I do for a living if I didn’t believe in our innate ability to heal. Peace.