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Dr. Hive: Advice needed for help for someone with serious depression


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Someone wishes to remain anonymous and I am posting for her. I'll just post what she said:

 

Ask about voluntarily getting yourself admitted for some serious depression/anxiety attacks/suicidal thoughts?

 

Ask about some really cheap, still reasonably healthy, easy crockpot type of stuff that a stressed out bunch of kids and husband can handle with little experience in cooking? ***

 

Medicinal recommendations?

 

 

She'll be reading your answers. My PM box is nearly full (again) so I'll be working on cleaning out it if your reply needs to be private.

 

 

*** Edited to add: Post your meal ideas here and then this thread can be for the depression answers.

 

9/13 Edit: Latest update in post 51.

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The symptoms of major depression can be overwhelming as your friend describes, but they don't necessarily mean hospitalization is in order. Suicidal thoughts, for instance, aren't all the same. For many people, suicidal thoughts are a metaphor for how badly they feel and they are pretty certain they wouldn't actually carry it out. For others, there is a clear plan in place. The clearer and more specific the plan, the riskier the suicidal thoughts. Even with a clear plan, hospitalization can often be averted with other safeguards puts in place. This kind of distinction needs to be evaluated by a therapist, but I am putting it out there because it could relieve the mind a bit for someone new to depression.

 

If the depression is new, things that can be tried short of hospitalization are : exercise, working on eating a lot of produce, sunshine and outdoor time, time with friends;  talk therapy; medication. Effects of meds can sometimes be perceived in 3-5 days as a bit of lightening of the "load" but take a few weeks for full effect. Very few people need hospitalization, but they may need a break away with a friend, spouse, etc. Hospitalization is very expensive and a patient will often be kept only a few days.

 

I am guessing that there is not a therapist in the picture, since a therapist would be able to answer the questions on voluntary hospitalization. I would advise a therapist as the first step, and if there is a wait for a therapist, a trip to the primary care doctor to discuss the situation. Medicinal recommendations will be evaluated by the doctor involved. What works or doesn't  or what is suitable or not depends on the individual.

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Good for you for asking for help.  In my opinion that is a hard step to take!  It is my natural tendency to go deeper into myself and NOT ask for help when things get bad.   I hope someone with real life experience will be able to give you practical advice.

 

 

The only crockpot recipe I've ever liked...

 

Whole chicken (rinsed, etc.) place in crock pot

one lemon pierced and placed in body cavity

1/2 cup honey mixed with 1/2 cup of orange juice, pour over chicken

 

cook on high (?) five hours  

 

serve over egg noodles (or your choice)

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When she says "admitted," does she mean to a hospital?  If you go in to the ER saying you're suicidal, they'll generally observe you for a day and have you talk to a psychiatrist, then decide on a plan from there based on the doctor's recommendation.    

 

When I had my worst period of depression after dd was born, I was given Ativan to take as needed for the anxiety, and Celexa for long-term daily use.  The Ativan kept me from going crazy while I waited for the Celexa to kick in.  They often have to fiddle with this depending on side effects and how effective the med is, so something to take as-needed that will work right away is a must, imo.

 

As for food, the husband can pretty much just take any chunk of meat + cream of something soup + frozen vegetables, dump into a crock pot, and cook until done.  It won't be gourmet fare, but it'll keep them going.

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I agree with Laurie4b, a therapist is definitely warranted. A psychiatrist can prescribe medicine, but so can a GP. My GP put me on an anti-depressant before referring me to a psych. Visiting a therapist can be quite scary for some people. It's so worth it though. And if you don't like the first person you see, try someone new. Don't give up because serious depression really needs attention.

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Does she have health insurance?  Is she is a populated area with services? 

 

I would not recommend her getting herself committed unless there is no other way to get treatment.  From what I have observed and heard about, mental health facilities are generally very depressing places and more akin to a low security prison than to a hospital. If there is any way she can get outpatient treatment and be kept safe- maybe an adult could be there during the day while the husband works- that would be a much better solution. 

 

In terms of medications, the first thing she needs is a diagnosis.  Antidepressants shouldn't be used with people suffering from any of the bipolar conditions.  They would make everything worse.  And someone who isn't a specialist or hasn't observed the person for a long time, might miss that the depression alternates with a different state altogether. 

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I don't have anything to add other than see a therapist ASAP.  You can tell a therapist that this is an emergency.  There may be organizations that provide mental health services on a sliding scale and accept insurance.  I can offer prayers - I have been in that dark place and I know how awful it is. 

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Agreeing with the others.  Seeing a therapist is a good first start.  Stay away from facilities unless you are a danger to yourself or your children.   Your therapist should be willing to work together with your Dr. concerning which meds. would be most appropriate for your needs.

 

I would look at prescrip. meds as a good short-term solution to a bad situation.   After you've leveled out (and it can take a few weeks/months) then start educating yourself about nutritional issues related to depression & anxiety. 

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If you feel you need to go to the hospital, go.  You can get things in order with a therapist once the immediate threat of hurting yourself is over.  I don't like seeing the words "serious depression" and "suicidal thoughts" together.  When I had this experience with a loved one, while a hospital admittance was not ideal, it did get this person on the road to recovery through therapy and medication.

 

Best wishes. Your family can and will survive while you get yourself better :grouphug: .

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Here's some more info:

 

There's no therapist right now, and no primary care doc. When I went to a new primary care doc last year, I begged for meds and a referral to a therapist and the doc refused to give me meds until I quit smoking and basically said that my problem was having a family member with a serious medical issue and that I needed to deal with that. I never went back. I can get another primary care doc, but then I'm looking at a $30 copay to meet a doc and get established, and then another $30 copay to go back and actually talk about getting the meds.

This is a long history with depression and anxiety for me. This isn't a new depression. The suicide attempts are real. (I'm okay today - so, hush!). I have plans in place (DH has taken most of the medicines out of the house for this reason) and I have letters written to people. The latest round of paying down bills and getting everyone their doctor and dentist appointments and labs was an attempt to clean up loose ends before I... went.

 

I'm okay today, really. I'm only saying this to illustrate how very very real this is for me and that this is in no way metaphorical. I need help. Serious help. I'm going to Urgent Care tomorrow when DH gets paid and I'm going to beg there for meds. It costs me the same to go there as it does for one doctor visit. It takes a good month or two for meds to kick in for me, though, and I'll be brutally honest right here - I am terrified that I won't make it to a place where the medicine works. 

THAT'S why I'm reaching out to the Hive. I need some realistic, practical advice on holding myself together for a good month or so and how to help my family pick up the slack. I AM treating a serious Vit D deficiency with a prescription and time in the sun. That's not a quick fix for me. It's a six month treatment plan. I have no family to help out. I'm all out of ideas.

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I would suggest that you at least contact a friend who can immediately come over and be with you if you're alone, or in a tempting situation.

Honestly, it is just so much easier to treat before you act on these feelings.

Two dear dear friends have made attempts this past month, which shocked us all, but caused us to wonder why they didn't just call one of us to be there for them.

Please, please get a friend to get you to help, if you are unable to find the avenue yourself.

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This sounds quite scary. I've never dealt with depression myself, so I don't want to say anything too stupid regarding that.

 

Having a plan sounds like you should be heading to the ER. (Most) Meds aren't going to work overnight.

 

Vit D shouldn't need a 6 month treatment unless there are underlying problems. A doc can prescribe and monitor extremely high doses that shouldn't take more than 4-6 weeks to fix. Long term is another issue, but short term it can be boosted very quickly.

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Call 911 and follow the dispatcher's advice.

 

OR

 

Go directly to an emergency room.

 

Do not mess with "the bureaucracy" by working through your primary care doc.

 

Yes, many psychiatric meds do not kick in for four to six weeks. That is fact of how they work in the body. Sometimes an individual person will respond much more quickly. Each med is different in how it affects a specific person -- even meds grouped within the same "class."

 

With deepest sincerity, based on experience with myself, with family members, and with friends -- DO NOT WAIT TO TAKE ACTION. PLEASE.

 

That you are not at this moment in time considering suicide or other self-harm does not warrant waiting. You already have grappled with ideation. That was the operative signal.

 

I am pulling for you and gladly will correspond via PM if you so wish.

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My dear, I dont think I would focus on what husb & kids would eat right now. I would go to the local hospital, or urgent care, or call the local crisis hotline and tell them what you told us. I know you want to make plans to take care of the kids, that is what mothers do. But they can eat junk for a little while. What they really need most of all is a healthy mama. Getting well is your first job.

Also, a therapist once told me, "I dont think anyone ever gets over the suicide of a parent."

Hugs & tears.

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{{hidden poster}}

You are being so proactive and functional. You are managing to transcend your symptoms at a time when your body-brain are working against you. That is awesome. Good work.

It's obvious to me that you have the ability to advocate for yourself - it's my hope you can maintain enough care above the disease of depression to seek the best and most appropriate care given your entire context of budget, time, history, and comfort.

 

Remember, anxiety and depression are an illness; something is not functioning correctly. It might be a stabilizing stay in a psychiatric facility will give you access to specialists that can write more informed scripts. If not, I agree that getting in front of a medical professional for SOME relief is better than nothing.

Some metropolital areas have sliding scale or reduced rate therapists (which I recommend in addition to the meds). Please don't hesitate to use these services, they are often provided by perfectly qualified and skilled individuals who are trying to get their "internship" hours.

If, by chance, you are in the Houston metro area, let me know and I can help more specifically.

 

If you ever want or need to PM me, you are totally welcome to.

 

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Here's some more info:

 

There's no therapist right now, and no primary care doc. When I went to a new primary care doc last year, I begged for meds and a referral to a therapist and the doc refused to give me meds until I quit smoking and basically said that my problem was having a family member with a serious medical issue and that I needed to deal with that. I never went back. I can get another primary care doc, but then I'm looking at a $30 copay to meet a doc and get established, and then another $30 copay to go back and actually talk about getting the meds.

This is a long history with depression and anxiety for me. This isn't a new depression. The suicide attempts are real. (I'm okay today - so, hush!). I have plans in place (DH has taken most of the medicines out of the house for this reason) and I have letters written to people. The latest round of paying down bills and getting everyone their doctor and dentist appointments and labs was an attempt to clean up loose ends before I... went.

 

I'm okay today, really. I'm only saying this to illustrate how very very real this is for me and that this is in no way metaphorical. I need help. Serious help. I'm going to Urgent Care tomorrow when DH gets paid and I'm going to beg there for meds. It costs me the same to go there as it does for one doctor visit. It takes a good month or two for meds to kick in for me, though, and I'll be brutally honest right here - I am terrified that I won't make it to a place where the medicine works. 

 

THAT'S why I'm reaching out to the Hive. I need some realistic, practical advice on holding myself together for a good month or so and how to help my family pick up the slack. I AM treating a serious Vit D deficiency with a prescription and time in the sun. That's not a quick fix for me. It's a six month treatment plan. I have no family to help out. I'm all out of ideas.

 

In that case, I would go to the ER if your plan to go to urgent care doesn't work in terms of you getting meds. There are some anti-anxiety meds that may tide you over until the anti-depressant meds kick in.

 

You're doing proactive stuff by having dh keep the meds out of the house. 

 

 It's okay to eat cereal and sandwiches and even little kids can prepare those themselves. It's really, really okay. A family can do that for a couple months with no problem at all. No hot meals needed.

 

You have no family around to help--what about friends? Are you totally isolated?

 

How empathetic is your dh?

 

Things that can help: journaling, distraction (can you watch movies, read a mystery, any hobby that will get your mind off the pain for a while?), exercise (I know it's a catch-22--just when you need to most, is when it's hardest to do--try for 10 min,). Let yourself pay attention to your surroundings to get your thoughts out of your head. What do you hear, what does each part of your body feel like, what do you see? etc.  Music can be helpful.  You can write down the thoughts that run through your head down the left side of a piece of paper. Ask dh or a friend to help you write a counteracting thought on the right hand side. For instance, if you hear yourself say, " I am worthless. I can't do anything right," a friend or dh could help you formulate a counteracting truth: "My dh and my kids think I'm priceless. I am not good at everything, but I am good at xyz." You don't have to believe the right side initially, just say it to yourself when the other thought comes up. Try to replace the first thought with the truth. Take it one ____ at a time. It could be one hour at a time, it could be one day at a time. Whatever you need. 

 

For someone who loves her kids, which you obviously do since you're trying to plan for their welfare, it can be really helpful to let yourself think of the long-range consequences for them. It will not be better for them. I don't know exactly what state you're in and that's why it's important to see someone face-to-face, but for some people, realistically hearing the consequences to those they love gives them the wherewithal to resist the urges.

 

 

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My dear, I dont think I would focus on what husb & kids would eat right now. I would go to the local hospital, or urgent care, or call the local crisis hotline and tell them what you told us. I know you want to make plans to take care of the kids, that is what mothers do. But they can eat junk for a little while. What they really need most of all is a healthy mama. Getting well is your first job.

Also, a therapist once told me, "I dont think anyone ever gets over the suicide of a parent."

Hugs & tears.

No, it's been 10 years since my father killed himself, and I'm nowhere near over it. Some days it's as fresh as when I found him. Please please don't hesitate to go to the ER. Don't wait thinking you might feel better later. If not for yourself, do it for your kids. There is no getting over it for them if you're no longer there for them.

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I can't add to what others have said for suggestions... all I can add is that my cousin's mama committed suicide when he was semi-young.  Please don't do that to your children.  No amount of doctors or dentists or any other loose ends can make up for growing up without mom.  He's an adult now and still misses her.

 

Severe depression is a known medical problem.  We (humans) have no trouble getting help for all sorts of things (epilepsy, diabetes, broken bones, etc, etc, etc).  We shouldn't have "issues" with depression either, but I do know it can be hard.  :grouphug:

 

I'd be trying the hotline to see what is suggested locally.

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1. Call the area crisis line. If they are not helpful...

 

2. Go to an ER, preferably one at a hospital with a psych ward (not all have them).

 

If you are suicidal most ER's will admit you for at least one night and you'll get to see a psychiatrist. It is possible the psych ward will be full. It happens. But you should be taken seriously.  Don't wait.

 

You can also call 911 and tell them you are suicidal.

 

There is help, keep searching for help until someone listens.

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Please call your local hotline or 911. Or have dh call or have a friend call.

 

Please don't wait. You need help now!

 

You deserve to experience the joy of watching your children grow up, graduate from high school, get married, have your grandchildren . . .

 

Get help.

 

If the only thing holding you back from getting help is worrying about what your family will eat while you receive treatment, then I will mail your family a check. They can eat at restaurants and get takeout while you get better. I am completely serious (PM me).

 

There have been two suicides in my family. I wish they were still here. I wish I could have done something to help. I wish they had reached out to me or anyone.

 

You are reaching out, now take everyone's advice and get some help!

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I just want to echo the PP's posts to please reach out for help now. I had a friend who was dealing with depression. When she admitted to me that she had suicidal thoughts, she agreed to go to the ER (with a psych unit). This was a very smart move for her.

 

Please do not rely on urgent care. I think you need to look into help NOW.

 

Also, your children love you and need you. You are their mother. Please do whatever you can for them...and for you.

 

(((Hugs)))

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One of our local hospitals has an outpatient program that treats serious depression.  You check in each morning and get intensive therapy all day, but go home at night.  If a patient needs more intensive help, they can be immediately admitted to an inpatient program.  Maybe a local hospital might have something like that.  Many of these programs will allow self referral or referral by a therapist, especially if you are a threat to yourself or others.  In my area, it's hard to get into a psychiatrist within a short time, but patients admitted to this program are *immediately* seen by a psychiatrist.  If your hospital doesn't have a program like this, you can go to the ER and tell them you are a danger to yourself and they will probably admit you.  You must let someone know that you need immediate help!

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Go to the local psych hospital (assuming you know where one is.  ER if you don't).  

Tell them you are suicidal and just don't think you can hold off anymore.

Be CLEAR.  Yes you have a plan.  Yes you have made arrangements.  No you don't trust yourself anymore.

Take hubby or a friend who can simply be there for you or can speak for you if you don't feel you can be honest.  

Don't worry.  It is okay to send hubby or friend away if you need to also.  

Take a bag (a couple changes of clothes, a book or two, extra socks).

 

Please go immediately. 

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Go to the local psych hospital (assuming you know where one is. ER if you don't).

Tell them you are suicidal and just don't think you can hold off anymore.

Be CLEAR. Yes you have a plan. Yes you have made arrangements. No you don't trust yourself anymore.

Take hubby or a friend who can simply be there for you or can speak for you if you don't feel you can be honest.

Don't worry. It is okay to send hubby or friend away if you need to also.

Take a bag (a couple changes of clothes, a book or two, extra socks).

 

Please go immediately.

I agree. Anyone with suicide ideations should go to the nearest hospital, not try to come up with their own care plan.

 

DH and kids will survive, even if it is on sandwiches and not full, healthy meals.

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You need to go to the ER.  Now.  Docs at Urgent Care, or primary/family docs, don't always have direct access to the kind of professional help you need.  ER docs are trained to handle situations like yours.

Don't worry about your kids.  Your dh can feed them PBJ, cereal, eggs, fast food, fresh fruit, salad, soup, etc.  With the internet now, it's not hard to find simple recipes, and there's no shortage of convenience foods at the grocery store.  Your dh can always phone a friend or family member for advice.

Please - ER, now.  They can help. You can get through this.

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If you are worried about what your husband and kids will eat and how they will survive over the next few days, imagine what life will be like for them if you kill yourself. Just imagine it for a minute- the shock and horror of losing you, not having you when they are married, when they have babies, always remembering how you died, wondering if they were to blame.

 

Medications should help tremendously. I notice a difference almost immediately. Hugs. I will pray for you.

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:grouphug:  :grouphug:  :grouphug:

 

I hope you are able to get the help you need. 

 

Please don't discount walking into the ER. Some states have required protocol on how to treat those expressing suicidal thoughts regardless of your ability to pay. 

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