Ketamine: The New Wonder Drug August 25, 2013Posted by Crazy Mermaid in Depression, Medication, Suicide.
Tags: Depression, Suicide
At our recent NAMI Washington conference in Ellensburg a few weeks ago, the most exciting thing I heard about was a drug called ketamine. It’s a drug that relieves severe depression symptoms almost immediately. It would save the lives of the 35,000 people who die of suicide in the United States each year and substantially improve the quality of life of those who suffer from depression.
But with all of the promise this drug elicits, the problem is that there aren’t enough studies to warrant adding “antidepressant” to its list of “on-label” uses. The best we can do right now is administer it as an “off-label” use at hospital emergency rooms or mental hospitals, which is where suicide wanna-be’s show up, or at psychiatrist offices, where people with severe depression seek help.
Ketamine has historically been used as an anesthetic in humans and animals, and its antidepressant quality was accidentally discovered when people undergoing surgery experienced a lifting of their depression upon awaking or shortly thereafter. The antidepressant effect was traced to ketamine.
Further studies, though limited in quantity, confirmed that 70% of people given ketamine injections experienced substantial relief of their depression symptoms after administration of this drug- some in as little as 2 hours after the drug was administered. That’s a world away from the 4 to 8 weeks needed for a traditional antidepressant to work. It can mean the difference between someone committing suicide and staying alive. Or it can mean a substantial improvement in quality of life for those suffering from depression.
One of the problems with getting enough documentation in order for the US Food and Drug Administration to approve ketamine as an antidepressant is that the drug is an old one, with an expired patent. That means that no drug company is willing to spend the money necessary to finance drug studies to prove the drug works as an antidepressant.
Although the cost of an injection seems like a lot of money to us, (about $900) that’s not enough money to entice drug companies to spend vast sums necessary to administer the necessary testing. So, instead of the traditional path through drug companies, testing will have to be done through grants from the National Institute of Mental Health or other bodies like that, with no financial interest in selling the drug. The best we can hope for from the drug companies is an isolation of the mechanism that works in ketamine, and a new drug developed from that mechanism. That could take years. In the meantime, its antidepressant use must be limited to “off-label”.
One of the challenges associated with ketamine is that it has an unfavorable image as a “club drug”, a drug used by young people frequenting clubs to get high. When used in large doses, it induces an out-of-body experience, something drug users are attracted to. This use impacts the politics of the drug, since no one wants to be caught developing a drug like LSD.
Since I haven’t seen him since my conference, I haven’t had the opportunity to talk with my psychiatrist about this drug. That conversation will be interesting. Stay tuned.
Suicide Attempts September 20, 2012Posted by Crazy Mermaid in Depression, Suicide.
Tags: Depression, Suicide
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A good friend’s 19 year old son has been suffering from depression for a few years now. Recently he started making suicide attempts. His mother is beside herself, not knowing what to do or where to turn. Her son is in counseling several times a week, and is now on antidepressants after checking himself into a mental hospital for five days. But he still talks about suicide. His psychiatrist recently added Lithium to the equation, which tells me just how serious the situation is. Lithium is a drug of last resort because of its severe side effects.
During the course of my involvement with NAMI (National Alliance on Mental Illness), I met a surprising number of people who lost children to suicide. Although these children were almost all over 18, that doesn’t make their deaths less painful. I know I can never truly comprehend the horribleness of the death of a child, but death by suicide is probably more painful, given the parent’s “beating themselves up” for their inability to stop it. Until their dying day, they will be asking themselves whether there was anything they could do to prevent it.
In my own case, the Haldol I was taking as part of my treatment (right out of the hospital) caused me to want to commit suicide. It’s difficult to put into words, but it’s an itch that has to be scratched. It turned out that a desire to commit suicide can be a side effect of high doses of Haldol or other drugs. My experience taught me that anyone, given the right brain chemistry, can be induced to want to commit suicide. It can be created by chemicals and stopped by chemicals (in many cases).
When my husband told my psychiatrist that I was suicidal, he said to stop taking the Haldol immediately. But it took days to get it out of my system, so I was in danger that whole time. My family wouldn’t allow me unsupervised access to my medication,and my guns were gone (they had to be gone before I was released) for obvious reasons, but they allowed me to take my dog for a walk, something that seemed harmless enough. After all, how much trouble could I get into by walking my dog? It turns out I could have gotten into quite a bit of trouble. I had a tremendous desire to walk in front of a fast-moving car. That would probably have done the trick. The only reason I didn’t do it was that I was worried about what would happen to my dog. Ironically enough, I didn’t want to hurt him.
While in the mental hospital, I met lots of people who had tried to commit suicide. They are what is called “unsuccessful suicides”. Because so many people who try to commit suicide end up at mental hospitals, the place is so structured and prison-like that it’s stifling. For example, no shoe strings or hair dryers (hanging) or glass bottles or forks (stabbing) are allowed, and everyone is checked on every fifteen minutes by the staff. Many of those who tried to commit suicide were homeless. That makes it at least a little understandable. But some were not.
While there, I met a handsome 60+ year old man who ended up at the mental hospital because he tried to get the cops to kill him. There’s even a term for it. It’s called “suicide by cop”. He wanted to do it himself but was too chicken (his words). His big problem, after he got involuntarily committed (something he hadn’t counted on) was that he had to miss his return trip on an Alaskan fishing boat because he was locked up. He wanted to die, but he didn’t want to miss work. Go figure.
Suicide attempts, like relatives who have a mental illness, are more common than people realize. In fact, it’s the tenth leading cause of death among Americans. There are far more suicides each year than homicides. In 2009, the number of suicides was about twice that of homicides. More than 36,000 people kill themselves each year. There are an estimated 12 attempted suicides for every one suicide death, and suicide is the third leading cause of death among 15-to-24 -year olds. Those are scary numbers.
My friend’s son has had two attempts so far. I just hope they remain in the “unsuccessful” category while he tries to get his brain chemistry under control. He seems relatively stable at this point, but that could be a well-constructed illusion on his part. With those who want to commit suicide, danger is just a pill-swallow or car “accident”- away. She’s on pins and needles, and so am I.
How to Cover A Suicide August 29, 2010Posted by Crazy Mermaid in mental illness, Suicide.
Tags: mental illness, Suicide
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This information was taken from a website addressing how to cover news event associated with suicide. http://depts.washington.edu/mhreport/WA
Quick Tips to Improve Mental Health Reporting
Tips for Reporting on Suicide
Copycat/ Suicide Contagion is real. Research shows that the incidence of suicide increases following news coverage of suicide. The following guidelines are suggested to minimize copycat attempts:
- Refrain from using photographs of grieving relatives and friends when a suicide has occurred. Photographs might encourage someone contemplating suicide to act as a way to get attention or get back at someone, creating a dangerous copycat effect. Youth are especially vulnerable to these effects.
- Do not report the method or place of suicide in detail. Exposure to suicide methods, including photographs, can encourage imitation among vulnerable individuals.
- Do not portray suicide as a heroic or romantic result of a single event or cause. This obscures the long and painful process that results in completing suicide. Over 90 percent of suicide victims have a significant psychiatric illness at the time of their death.
- Always include information about crisis intervention services in the area and a referral phone number.
- Do not use suicide in headlines, even when they take place in public. This unnecessarily dramatizes the event and shifts the focus from the tragic loss of life. There are exceptions, as in the term “suicide bomber” when reporting on terrorist activities.
Facts About Mental Illness and Suicide
The great majority of people who experience a mental illness do not die by suicide. However, of those who die from suicide, more than 90 percent have a diagnosable mental disorder.
People who die by suicide are frequently experiencing undiagnosed, undertreated, or untreated depression.
Worldwide, suicide is among the three leading causes of death among people aged 15 to 44.
- An estimated 2-15 % of persons who have been diagnosed with major depression die by suicide. Suicide risk is highest in depressed individuals who feel hopeless about the future, those who have just been discharged from the hospital, those who have a family history of suicide and those who have made a suicide attempt in the past.
- An estimated 3-20% of persons who have been diagnosed with bipolar disorder die by suicide. Hopelessness, recent hospital discharge, family history, and prior suicide attempts all raise the risk of suicide in these individuals.
- An estimated 6-15% of persons diagnosed with schizophrenia die by suicide. Suicide is the leading cause of premature death in those diagnosed with schizophrenia. Between 75 and 95% of these individuals are male.
- Also at high risk are individuals who suffer from depression at the same time as another mental illness. Specifically, the presence of substance abuse, anxiety disorders, schizophrenia and bipolar disorder put those with depression at greater risk for suicide.
- People with personality disorders are approximately three times as likely to die by suicide than those without. Between 25 and 50% of these individuals also have a substance abuse disorder or major depressive disorder.
Suicide and Mental Illness August 19, 2010Posted by Crazy Mermaid in Medication, mental illness, Mental Illness and Medication, Psychiatrists, Suicide.
Tags: mental illness, Mental Illness Medication, Suicide
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While at the NAMI Conference this past weekend, I was exposed to the concept of suicide in all its forms except for one. With the exception of seeing someone actually commit the act in front of me, almost all other aspects were covered in some form by someone or something at the conference.
There was the mother/daughter team that dealt with attempted suicide many times as a symptom of the daughter’s bipolar disorder. There was the wife who serenaded us about her survival from her husband’s unexpected suicide. There was the daughter whose father committed suicide during the filming of a documentary about him (“Unlisted”). There was the woman whose son committed suicide (“When Medicine Got It Wrong”). Suicide was everywhere. There was even a booth addressing the various aspects of suicide, all from the standpoint of the family.
Missing was in-depth coverage of suicide from the perspective of someone who considered it or tried it. I know these people are around. I qualify for the first part and know people who qualify for the second part.
Back in July 2008, after I was released from the mental hospital, I had a major relapse of symptoms. The choice I was given by my psychiatrist was to either return to the mental hospital or go on a drug called Haldol.
Wishing to stay out of the hospital at any cost, I chose the Haldol. I should have had a clue about the task I was to undertake (stopping the psychotic symptoms dead in their tracks) when I had trouble filling the prescription. The usual dose carried by pharmacies is .5 mg. My prescription was for 5 mg. Calling around to various pharmacies, we finally found a Fred Meyer pharmacy that carried the dose I needed.
Taking the pills the second I got in the car, I felt the symptoms subside within hours. But the prescription said to continue the Haldol beyond the point that the symptoms disappeared. As I continued the Haldol, I became more emotional, crying at nothing at all. My husband took me to a very nice restaurant for our 25th wedding anniversary, and I could do nothing but sit across from him and cry. Fortunately it was summertime, so I had an excuse for wearing dark sunglasses. It was a miserable time for both of us.
At around the second week of taking the drug, I got the twinge of a desire to commit suicide. As the days progressed, my desire got stronger. I cried and cried, wanting desperately to end my life. I spent hours thinking about the method I would use to do it. That was my sole focus. My guns were gone, confiscated by my dad as a condition of my release from the mental hospital. I didn’t think I could get away with a knife because someone would stop me. The same went for pills. I was stymied. I didn’t care one ounce about the people around me, who it would hurt, what kind of a terrible wake it would leave behind me. None of that mattered. All that I could focus on was how good it would feel to be dead.
In the meantime, my psychiatrist had given me his emergency telephone number during my first visit with him a month before, with strict instructions to use it to contact him during a crisis. Interestingly enough, I didn’t want to bother him with my crisis. Despite my family begging me to call him, I repeatedly refused to call him to tell him about what was going on. As I lay there suffering, my family swarmed around me, not knowing what to do. They were helpless. They were scared. They wanted to make the emotional pain go away, but they didn’t know how.
Finally, I was persuaded by my husband and sister that this was precisely the condition my doctor meant when he gave me his emergency number. So, after much cajoling, I made that call to my doctor. But he didn’t answer the phone immediately. So I left him a message, and then I got up from the couch that I had been sitting on and walked around the room. I felt a little better after having made the call, but I still felt like committing suicide.
Besides imparting the urge to commit suicide, one of the other side effects of Haldol was that it increased my anxiety level. Not able to just sit around and wait for his call, I decided to take a walk. I thought the activity would be good for me. My family didn’t know whether to leave me alone while I went on the walk, fearful that I might find a way to commit suicide while I was out. In the end, they decided to let me go for the walk unaccompanied. In hindsight, I realize that their decision could have been a huge mistake had I realized that all I had to do to die was to step in front of a moving car.
In the meantime, while I was on my walk, my doctor called. As I wasn’t there to take the call, he talked with my husband instead. He probably did a better job of explaining what was going on, being more objective that I could have been. When I returned from my walk, my husband told me the doctor said to stop the Haldol immediately. As I discontinued the Haldol, it left my system over a period of days. As it left my system, my suicide desire gradually left. But my family couldn’t be sure exactly when I was out of danger, so they continued to swarm around me, trying to assess when the danger was gone. Finally they satisfied themselves that I was out of danger and life returned to normal.
Having lived through this episode of wanting desperately to commit suicide due to a reaction to a medication, I am convinced that most, if not all, suicides are caused by brain function impairment of some sort. The brain chemistry of the suicide victim gets messed up, just like mine did. But the difference is that they aren’t put on “suicide watch” and aren’t under the care of an experienced psychiatrist. Those two things are what saved my life.
Suicide: Opting Out of Hearing Voices March 5, 2010Posted by Crazy Mermaid in Delusions, Hallucinations, Hearing Voices, mental illness, Suicide.
Tags: Delusions, Hallucinations, Hearing Voices, Insanity, mental illness, Suicide
As my psychosis progressed, I became increasingly more frustrated with the voices in my head. With me from the time I woke up to the time I went to sleep, their incessant talking was driving me crazy. I couldn’t be alone in my head. There was always at least one person- and most times more- with me in my head. It was like being at a perpetual party where the guests never left. It was never quiet. Finally, I decided that I had had enough. They needed to leave. All of them. So I started out by politely asking them to go away. They ignored me.
When that didn’t work, I used the mean route. I was nasty to them, answering their questions with rude comments or ignoring them. Fortunately for me, they never had been able to tell what I was thinking. Nevertheless, their incessant chatter wore me down. And, to make matters worse, they began to treat me the same way that I had treated them.
Failing the other attempts, I begged them to leave. I pleaded with them. I told them that if they really cared for me, they would leave me alone. I tried to reason with them, doing everything that I could think of to get rid of them. Despite my best efforts, they remained.
Then, they started filling my head with nightmare-type thoughts. Devils, blood, stabbing people, gore- that sort of thing would pop into my head. I was a little afraid, not knowing whether I was going to act on any of it. But I knew it was them, and not me, putting those images in my head as punishment. They were trying to control me with fear. It came close to working a few times, but in the end I was not going to let them win.
My choices, as far as I knew, were to live with the voices in my head for the rest of my life, to tell someone about the voices and be locked up in an insane asylum for the rest of my life, or to commit suicide.
As the voices continued to take their toll on me, the suicide option soon began to look good. Except for its effect on my family, that is. Strangely enough, it didn’t dawn on me how terrible their lives would be without me. My sole concern was protecting them from the embarrassment of my suicide. I was obsessed with making my suicide look like an accident. Then I came up with the perfect scenario. Hitting a bridge abutment at 60 miles per hour late at night fit the bill nicely. I would, I hoped, die quickly and painlessly, and it would look like an accident so my family would be spared of the pain associated with suicide. It was like one of those “death with dignity” situations- at least in my mind.
Armed with my new plan, I presented the voices in my head with a choice. Either they leave- forever- or I’d hit the bridge abutment. One way or the other, they were going to leave. If they stayed, I would kill myself and they would lose the body they were inhabiting. If they left, they would also lose the body they were inhabiting. Leave or else.
The first time I threatened them, they left for several days. But then they returned. I threatened again. They left again (for a shorter period of time) and returned. Soon, my threat started to lose its power. In the end, they came to believe that I didn’t really mean it.
I came very close several times. Driving down the road at night, looking for overpasses, I almost turned the wheel many times. It wouldn’t take much. Just a slight adjustment of the steering wheel and the voices would be gone forever. But in the end, I just couldn’t do it. I chose insanity over death.
NOTE: My suicide- had I committed it- would have appeared as an accident because absolutely nobody knew about the voices and delusions at that point.
Suicide By Cop Wannabe September 16, 2009Posted by Crazy Mermaid in Involuntary Committment, Suicide.
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At 9 am, a handsome, barefoot 60 year old man wearing a hospital gown obviously open in the back wheeled into our group meeting at Fairfax. His medium frame was covered in scratch marks and black and blue bruises. His dark blue bloodshot eyes were ringed with purple and black. He looked like he had survived a terrible car wreck. He said his name was Chuck.
Chuck explained that he had been bipolar for years, but like many manic-depressives, he never experienced the manic state. He only experienced the depressed state. And alcohol made things much, much worse. As he sat at a bar in downtown Seattle downing drink after drink, he became increasingly depressed the more he drank. He became so depressed that suicide started to look like his best option. But he was too chicken to do it himself. He wanted someone to do it for him. Then it came to him: he could get a cop to kill him! And so he decided to go the “suicide by cop” route. His intent was to escalate his bad behavior to such an outrageous, over-the-top point that a cop would be forced to kill him. He proceeded to put his plan into action, stirring up quite a scene until at last the cops were called. He fought hard with the cops, trying to force them to kill him. But instead of killing him, the cops were forced to beat him until they managed to subdue him. Then they hauled his ass to Fairfax. That outcome wasn’t in his plans at all. He expected to be dead.
Chuck was very angry about being at Fairfax. Know why? Because he was supposed to either be dead or ship out on a fishing boat back to Alaska in three days. He clearly wasn’t dead, and it didn’t look like he would be able to make that trip to Alaska. When the boat left, he would remain behind, locked up at the psych ward as an involuntarily committed mental patient. Boy was he pissed!