Suicide / Question
Published: July 8, 2009
Dear TeenHealthFX,
I know that you've answered similar questions, but I really need your help. I've been depressed & suicidal for years & I can't take it anymore. I see a psychiatrist (who is also my therapist) & I like her. The problem is that no matter how comfortable I am with her, the one thing I can't seem to be able to say is that I am serious about being suicidal. I have been hinting it & I even told her at one point that I want to die, but I think she just thought I was in a temporary crisis & wrote it off. Every time I get close to telling her, she seems like she's going to criticize me, so I stop. I can't talk to my family because they hate me & I hate them. As it is, I try to be home as little as possible. I called a hotline twice before, & they didn't help me. My question is, how can I talk to my psychiatrist about how suicidal I am? How can I bring up the subject & not sound like an idiot? I'm really upset about this. I'm tired of keeping secrets.
Signed: How Do I Tell My Psychiatrist That I am Feeling Suicidal?
Dear How Do I Tell My Psychiatrist That I am Feeling Suicidal?,
TeenHealthFX understands how difficult it can be to discuss such powerful and private emotions with other people, including therapists. It sounds like in many ways you feel comfortable with your therapist, but this is one topic where something is getting in the way. In terms of how to proceed with this, it would be helpful for you to think about what is worrying you. Imagine telling her and then imagine how you would be feeling and what exactly you would be fearful of. Do you worry you would be hospitalized? Are you afraid of her telling your parents and what their reaction would be because of the strained relationship you described? Are you worried about what your therapist would think of you if she knew how seriously you have been contemplating this – that she wouldn’t like you as much, be critical of you, or think less of you?
Once you figure out what is getting in the way of your telling your therapist, start there. So if you are worried about what she would think of you, you could start by saying, “There is something really important that I need to let you know about. But I’m finding that I’m really scared of what you will think of me or that you’ll be critical of me if I did tell you.” You might need to spend some of the session discussing your fear before you tell her about feeling suicidal.
If you are not sure what you are afraid of in telling her, you could start the session by saying something like, “There is something that I really should tell you, but I’m finding I’m having a really hard time getting it out. But I can’t figure out why.” Again, you may need to spend some of the session processing this before you can discuss your suicidal thoughts.
The other option, if it feels too tough to say, is to write down how you are feeling. You could write your therapist a note and give it to her at the beginning of the session, or you could even bring in this question/answer to show her to get the conversation started.
You mention worrying about sounding like an “idiot,” so FX does want to stress to you that there is nothing idiotic about letting your therapist know when you are in pain and when you feel you might hurt yourself. Your therapist is there to be helpful to you, not to judge you. Since you have such a contentious relationship with your parents, it may be very difficult to imagine that any adult would truly love you, care about you, and genuinely want to be there for you in a helpful way. But remember that your therapist is not a clone of your parents. She has her own thoughts and feelings and may have the capacity to be caring towards you in a way your parents cannot, for whatever reason.
It may feel like a risk to tell her, but this is your life in question here, so please let her know how you are feeling as soon as possible so she can give you the support and guidance you need to get through this. And know that there are people out there who do have the capacity to be loving and helpful to you.
If you get to the point that you are seriously considering suicide or are afraid of your impulses then you need to seek help immediately. You can call 911 or go to your nearest hospital emergency room. In northern
Signed: TeenHealthFX
The risk of motor vehicle crashes is higher among 16- to 19-year-olds than among any other age group.
