Mental Health Question

Updated on August 21, 2013
C.C. asks from Brooklyn, NY
13 answers

I am reaching out with this because I think it's a good bet that some of you will have great advice. I have never faced a situation like this before.

I have a close friend I'll call BB. For reasons I won't go into, I'm basically like family to BB, so it is acceptable for me to "stick my nose in" about BB's problems. BB's relatives are not nearby.

BB is smart and successful. Has a PhD and a high-paying job.

BB suffers from depression. BB thinks so, BB's therapist thinks so, and I think so.

I had always wondered why BB was not taking anti-depressants. BB told me that therapist had suggested them in past. And I have friends who have really benefitted from them. I had always thought BB should try them.

Well this past weekend BB told me that the reason BB was not taking anti-depressants is because BB has had suicidal thoughts. BB has heard that people with suicidal tendencies should not take anti-depressants. I asked BB if this was discussed with therapist. BB said that BB has not told therapist about having suicidal thoughts because BB doesn't want to be "taken away in a straight jacket" (BB said that jokingly, BB's point was that BB doesn't want to send red flags that could harm career etc).

I am in shock. And I am scared for BB. So my questions - How should I help/advise BB? Is it true that suicidal people should not take anti-depressants? How should I handle the knowledge that BB is having suicidal thoughts? What do therapists usually do if a patient admits having suicidal thoughts?

ETA: I have heard comments from BB along the lines of "if I live til next weekend", said while BB was in a depressed mood (not just the "god willing"-type stuff that my grandparents used to say). But I have not heard BB make any direct statements about planning to do something harmful.

What can I do next?

  • Add yourAnswer own comment
  • Ask your own question Add Question
  • Join the Mamapedia community Mamapedia
  • as inappropriate
  • this with your friends

Featured Answers


answers from Austin on

BB is misinformed about the antidepressants. They can cause thoughts, but as long as BB stays under a doctors care and is honest with the therapist, there should not be a problem. BB is letting HS/her imagination run away.

The secret s for BB to get all the help they need. They deserve to be healthy, physically as well as mentally.

2 moms found this helpful

More Answers


answers from Columbia on

As a healthcare professional, I've attended classes on how to help a person who is thinking of or planning to commit suicide.

1. How should you help? Please follow this link for some information on how you can help. There is number that YOU can call to get advice from someone trained on helping people who are thinking about suicide. You can also share this number with BB. Please don't wait. The fact that your friend is telling you means that he (I'm just going with "he" for simplicity's sake) is feeling helpless and is seeking help from someone he trusts.

You mention that he hasn't actually made any direct statements about suicide, but many people who suicide DON'T. They're searching for someone who cares enough to ask them directly. Ask him: "Are you thinking about killing yourself?" or "Are you thinking about suicide?" Don't be vague. Use the words suicide/killing yourself. Some people think "are you thinking of 'hurting' yourself" is enough...but it's not. Because people who really want to die are trying to END the pain, and don't consider suicide to be 'hurting' themselves.

Unfortunately, most people don't know HOW to talk with someone who is considering suicide. It's important that you have the right tools available so you can help. Please, ask him soon. But before you do, look over the DOs and DON'Ts. Don't argue with him or debate. Listen. Do your best to validate his feelings and pain, help to find reasons to live, and help him to seek help.

2. Yes, it's true. One of the side effects of most antidepressants is that they can exacerbate or increase suicidal thoughts. For someone who is already having suicidal thoughts, this can send them right over the edge from "thinking" to "planning." Thinking of suicide is NOT the same as planning a suicide.

3. A trained healthcare professional will listen to a person who is thinking of suicide, and ask them why they want to die; then they'll ask if they have a plan. They'll do so in a way that helps the person in crisis recognize what they have to live for, and that even though they are currently in pain, it's not hopeless.

As I said, a person who has an actual plan for how they will suicide is IN CRISIS and should not be left alone.

4. Your friend needs to know that there ARE resources available to him. Nobody is going to show up and put him in a straightjacket and haul him away. Please call the number on the site above and seek guidance on how to help your friend.

C. Lee

10 moms found this helpful


answers from San Antonio on

I caught my best friend not only having suicidal thoughts but actually cutting herself to see if she could get up the nerve to do it. We were co-workers at the time and I knew how this could affect her job.

After work the day I found out abut the cutting. I put her in my car and drove her to her doctor. I walked her in and then went and told the receptionist it was an emergency, and we needed to see the doctor it was life and death. we waited and I them went in with her and made her tell the doctor what she was doing. He wanted to admit her for a three day observation. She cried and begged to say it would affect her job. (And it would have). The doctor took her off of her current medication (she was on an anti-depressant) and made me promise not to leave her alone for the next three days and bring her back. I stayed with her for three days, driving her to and from work, and took her back to the doctor.

For my friend turns out she was bi-polar and not just depressed (the anti-depressants did make her suicidal), but as soon as she got on medication for bi-polar she leveled out and was fine.

We have been friends for over 20 years, so I took the liberties to make her get help. Sometimes you just have to step in!! I even took everything sharp out of her apartment when she was finally allowed to be alone again because she wanted me to, "just in case".

When I was at my darkest dealing with depression myself, I finally was able to tell my husband I needed him to take me to the doctor and get me help. He did...he took me and held my hand...the doctor was able to get me some medication to help and with in six weeks I was a new person.

Go with her to her therapist and you can tell the therapist what you have heard her talking about...better to step in and try than to be sorry later!!

Big HUGS!!

6 moms found this helpful


answers from St. Louis on

Anti depressants, some, can cause suicidal thoughts. I think they listen too closely to the disclaimers on the commercials, bad, and not to their doctor, good.

So far as the god willing, or if I live that long, that isn't an indicator of suicidal thoughts, if it was half my office would be dead by their own hand. It is just pessimistic, and annoying. Makes you want to never say see you later to these types of people.

You do not know when they had suicidal thoughts, only that they admit they did. Could have been 16 and the epic breakup, you don't know. If they are so dang pessimistic that they answer if I live that long I wouldn't doubt they also believe they will be the one who kills them self on anti depressants. That they won't take them for that reason also shows they are not suicidal. A suicidal person would be, I am going to do it eventually, may as well blame it on the drugs.

You may want to encourage them to speak to her doctor. The ONLY way they would commit them is if they said they are going to go home and blow their head off. You must be in eminent danger to yourself or others to be committed they are not, they are just being paranoid and really stupid not getting help. Be honest with your doctor and they can show you which meds are safest.

4 moms found this helpful


answers from Washington DC on

The turnip is correct, but there is also a a reisk of suddenly having the "energy" to do it.

When I started, my doc asked about suicidal thoughts and told me to keep a close eye on it for the first week or two of taking the meds. The reason isn't that the meds cause suicidal thoughts, it was that the meds get your depressed but off the couch and sometimes give a deeply depressed/suicidal person the "energy" to carry it out.

Taking anti-depressants has changed my life. It's worth a try.

3 moms found this helpful


answers from Boston on

Suicidal thoughts for depressed patients are very common. Suicidal plans, or talk of imminently harming oneself, could lead to involuntary hospitalization, but there is a big difference between saying "sometimes when things get really dark I think about ending it all" and "I'm going to hang myself today." HIPAA rules prevent a therapist from disclosing this kind of thing to anyone, so he or she needn't be worried about career unless his or her therapy is being mandated by an employer for the purpose of evaluating fitness for duty (e.g. law enforcement officers or military personnel working through a trauma). The therapist should be able to clearly spell out for BB who exactly can see what and reassure him or her. Even for health insurance, the provider needs to report a diagnosis (such as depression) to the insurer to justify the need for services but the session notes are kept in separate files that are locked away and that info is shared only with the patient's permission.

It is not true that people with suicidal thoughts shouldn't take anti-depressants. In fact, someone with suicidal thoughts is exactly who needs medication. There is a "black box" warning on SSRIs (which are a certain class of anti-depressant) because there was a correlation between suicidal thoughts and SSRIs in adolescents. For most adults, these medications help elevate the mood and reduce thoughts but anyone trying them for the first time needs to be carefully monitored. I did have a friend in whom SSRIs triggered behavior that lead to repeated intentional drug and alcohol overdoses - which one could argue were suicide attempts - and she cannot take SSRIs ever again. My husband cannot take SSRIs either because he has some bi-polar characteristics to his mood disorder and those trigger manic episodes. However, there are plenty of other anti-depressants that are not SSRIs that can be used effectively by people who can't take SSRIs.

Bottom line is that there are lots of options out there for your friend, but he or she really needs to be 100% transparent with his or her therapist. Usually therapists (they are usually psychologists or social workers, not psychiatrists) can't prescribe medications, so she or he may need to go to a psychiatrist or psychopharmacologist for medication. What I would highly recommend is that she or he go to one of those experts, vs. just taking the recommendation of the therapist to his or her primary care doc for a prescription, which is very common. These drugs are powerful and their use should be carefully monitored by someone who does nothing but deal with mental health issues. One thing that is helpful is for the patient to have someone else give feedback to the prescribing doctor as well because it can be hard for someone who has a mood disorder to accurately self-report changes in mood - for better or worse - while on medication. Usually that person is a spouse, parent or other close relative who lives with the patient but perhaps you could offer to be that person for BB if she or he is open to it.

Please urge your friend to be completely open with his or her therapist, and perhaps offer to go to a session if she or he would like so that you can help BB ask the right questions about privacy and broach the topic of suicidal thoughts if it's just too much for him or her to say. I know that with my husband, I have had to bring up things that he wanted to just sweep under the rug and ignore that were really big red flags that he needed more help. It's hard for a patient to do this alone - BB will probably not take you up on the offer, but you would be a good friend for bringing it up.

3 moms found this helpful


answers from Philadelphia on

Someone close to me was having constant suicidal thoughts. My friend went to the psychiatric hospital and within a week and a half was feeling so much better because the docs adjusted their meds. My friend no longer has suicidal thoughts. The meds probably saved their life.
Your friend needs to be honest with their doctor. I would also point out your friend does not actually want to die because then they would take the medicine that they believed would lead to their suicide.
Admitting you have thoughts is also not the same as saying you have a suicide plan and are going to carry it out. Therefore, your friend need not worry about being carried out in a straight jacket. Best of luck. I hope you can convince your friend that they do not need to live this way and that there is help for this kind of thing.

3 moms found this helpful


answers from Dallas on

People who are depressed have impaired judgement. I have seen it many times. In children and young people, some antidepressants can increase suicidal thoughts. If he has a PhD, he is no longer that young.

There is help out there that will not make things worse. In fact, the right antidepressant can significantly make him feel and think better, which will only increase his proformance on his job and the pleasure he has in life.
It's his depression that doesnt allow him to see that. You are his lifeline to sanity. If you can convience him to see a psychiatrist to properly monitor his medicines and IF he is honest, he could be significantly better within a month. Please encourage him to trust your judgement. Maybe take you along on the visit to the doctor. Good luck.

2 moms found this helpful


answers from Boston on

Boy, there's a lot here. Many good responses so far. Many anti-depressants are not withheld from those with suicidal thoughts - if that were true, frankly, there'd be about 20% of the sales of these meds. That's not to say there aren't side effects in SOME people from SOME drugs, but with careful monitoring it's usually mitigated. BB is not a psychopharmacologist, psychiatrist or therapist, and is probably reading the warning panels in the magazine ads or, more likely, listening to the rapid-speak disclaimer at the end of every drug commercial on TV.

There are also phenomenal non-pharmaceutical approaches to depression - maybe not an overnight fix, but certainly harmless. I've done that and have weaned off my anti-depressants after years and years of being medicated. I worked with my doctor and am medication-free. However, I am not opposed to using medications, at least in the short term, or in conjunction with natural approaches.

It's hard to know whether to panic or not with BB's comments. Sometimes people share that because they trust you; sometimes they are reaching out for help and want someone to guide them. A lot of us who have or had depression can attest to the common symptom of not being able to complete tasks - so sometimes carrying out an attempt is just impossible, just as going to work or getting out of bed or vacuuming the living room seem like overwhelming tasks.

BB's therapist and doctor cannot talk to you. But you can talk to them. You can leave a phone message or drop a note to either of them, indicate your fears and concerns, and say you felt you needed to alert someone. Do not take it upon yourself to judge whether BB's comments are going to lead to an attempt or whether they are "just talk." "Talk" is important, and there's a reason BB is telling you this.

Good luck.

2 moms found this helpful


answers from Tampa on

I don't know about the anti-depressant thing, but I did want to comment on this affecting his career. It definitely depends on what he does for a living. For instance, if he does have a job that requires a security clearance, then his medical record is in fact subject to scrutiny...HIPPA does not apply for individuals holding a government security clearance.

2 moms found this helpful


answers from New York on

Anti-depressants are tricky. So many different drugs all with side effects and none work for everyone. You have to try 1 and adjust the dosage to see if it'll work and then move onto something else when it doesn't.

There's still a huge stigma in a lot of fields with mental health. BB may know that this information wouldn't be well received and is placing that as a huge negative in treatment.

1 mom found this helpful


answers from Norfolk on

He's talking to a therapist, but not yet about all his issues.
You don't need to advise him except to tell him to discuss it with his therapist - that's what he's paying him for - he might as well get his money's worth.
If he's worried that seeing a therapist (or what he discusses with his therapist) will somehow interfere with his work, he should look up what is spelled out in HIPPA.
No one at work will know unless he tells them and he doesn't have to tell them anything.
Just be a friend, listen to him and do some fun things with him - see a movie, have a meal out, take a class together, etc.
In some people some anti-depressants can increase suicidal thoughts.

1 mom found this helpful


answers from Albany on

A therapist will not take them away in a straight jacket. Lots of depressed people have suicidal thoughts. Your friend will just get help if he/she is forthcoming. It's all confidential. Nobody in there career will know. This is VERY common. Good luck.

1 mom found this helpful
For Updates and Special Promotions
Follow Us

Related Questions