This case fills me with all kinds of conflicting emotions.
Kerrie Wooltorton is believed to be the first person to have used a living will to kill herself. She was admitted to hospital after poisoning herself but doctors said they had no alternative but to allow her to die.
The 26-year-old had written the will on 15 September 2007, three days before she drank poison and phoned an ambulance, the inquest heard this week. She was taken to Norfolk and Norwich University hospital, where she presented staff with the document.
The will said that if she called for an ambulance it was not because she wanted life-saving treatment but because she did not want to die in her flat alone or in pain. Wooltorton died the next day in hospital.
As a general opinion, I’m of the view that suicide is not the answer, but I’m also strongly in favour of the principles of the Mental Capacity Act. Most people I work with who’ve attempted suicide have been glad to be saved afterwards. This lady, on the other hand, created a living will and was assessed to have been mentally competent to write it.
Naturally, the usual talking heads are out in force:
The ProLife Alliance today called for the law on living wills to be changed and said doctors had warned before the 2005 act was introduced that the legislation could put them in an “impossible situation”.
“Doctors treating attempted suicides say that the overwhelming majority are glad to have been saved,” said the ProLife chairman, Dominica Roberts. “A doctor should never act as if any person’s life is worthless.”
But Dignity in Dying said although the situation had been difficult for health professionals this should not detract from a patient’s wishes. “It is important that advance decisions are respected,” said Jo Cartwright, a spokeswoman. “But this is reliant on the person whose advance decision is being acted upon having the capacity to make the decision when it was made.”
One thing that does concern me about the living will is that it was written 3 days before she drank the poison. However, that doesn’t necessarily mean she didn’t have capacity to write the will under the terms of the Mental Capacity Act. Like I said, I’m conflicted over this one.
How sad. So so sad. Sad for Kerrie that she felt she had no other choice (i’ve been there). Sad she felt she had to write the end of her life up in a will. Sad she was afraid of dying alone or in pain. Sad for the medical staff trying to treat her. Sad for Kerrie that now her name will be synonomous with a living will suicide, instead of a human suffering in pain.
I dont think anyone can pick a side in this debate. I cant. A doctor should NEVER act as if any persons life is worhtless. Yet a persons decisions should ALWAYS be respected.
Who decided that Kerrie had the capacity to make that huge decision? Did it have to be witnessed? Was a second opinion asked for? Had treatment been sort before hand? Did she have a treating docotr or team?
Torah.
And if she did have capacity when she made the will did she still have capacity following the O/D? I have always thought that those people who do make an attempt are in a catch 22 situation, the fact you have made an attempt on your life by definition means you are suffering from a “treatable” ,mental illness and so lack capacity. The only way to truly give force to a living will any meaning would be to repeal the mental health act and remove the right to detain people and treat them against their will.
(cue Ted)
It reminds me of Roe v. Wade. Yes, abortion was finally legalized, but by that point, Roe had already given birth. Likewise, there is the assumption, on preventing suicide, that the person committing suicide is suffering from mental illness and that it is treatable (which in the strictest sense of the word, gives no indication of whether the treatment will be successful, which is also the most accurate representation of the situation and, unfortunately, not what people tend to mean or hear when they say mental illness is treatable). Even if you were operating under the assumption that mental illness being treatable means you should try some other things before resorting to suicide, if you ultimately find that none of the treatments are successful, you have prolonged suffering, and that person just has to do suicide again.
Prof Sheila McLean is one of the gurus on the issue of consent when it intersects with medical ethics and the law – she says’
“The fact that she (Ms Wooltorton) apparently had some form of personality disorder is not in itself persuasive evidence that she was not competent. It is well established in law that even the presence of mental illness is not a bar to the presumption of competence”.
http://blogs.bmj.com/bmj/2009/.....ooltorton/
The x9 previous episodes of self-poisoning (with anti-freeze) and subsequent dialysis had no direct bearing on the events once she was deemed competent to refuse treatment (in other words she was found NOT to lack capacity despite a history of mental illness and serious self harm).
Ms Wooltorton walked into A&E with a GCS of 15 – at this moment her immediate wishes overtook the note – in any event the refusal of treatment on the day was consistent with the contents of the recently drawn up advance directive.
The key legal principle is described by the Prof in the following terms;
“The observation of Ms Wooltorton’s treating physician, which it must be said he took great pains to have verified, was that Ms Wooltorton did not fail the competence test outlined in the Act, and was steadfast in her wish to reject treatment”.
A competent self-poisoner has exactly the same right to refuse treatment as a haemorrhaging Jehovah’s witness.
Why does it matter that she wrote it 3 days previously? No-one would care if someone wrote a last will and testament 3 days before their death, if they knew it was imminent and wanted to get their affairs in order. No-one would question “did they really want to leave half their fortune to their son, and the other half to the local cats’ home?” You could argue someone with a known terminal condition may not be completely mentally stable yet their wishes are not questioned. I myself wrote an advance directive during a dodgy patch about 18 months ago, so if I tried to top myself tomorrow would my document be of more value than Kerrie’s because it’s older?
E, isn’t that the point of a living will/advance directive of any description, to set out your wishes in advance while you are still able to make those decisions, in the event that there should come a time when you are not necessarily able to make those decisions in the future? Therefore it’s not Catch 22, she made the statement when she was well and hoped her wishes would be carried out when she was physically able to request/refuse treatment. Her mental state after she had poisoned herself shouldn’t have had any bearing, that’s the whole point.
Everyone seems to use the fact that most people report being glad to be saved as a reason to not abide by a person’s wishes. Hardly fair to use an apparent majority to treat everyone the same way with such an individual issue – you may as well say the majority of patients on any given ward aren’t vegetarian, therefore the veggies will just have to eat meat like everyone else. And in any case, of all these “I’m so happy you saved me” reports, who’s said they’re glad to be saved? and in what situation? My guess is most people who had been found and prevented from dying would of course say to the doctors they were glad to be saved – their freedom is at risk anyway due to the recent attempt, who’s going to give the docs more cause for concern by not professing their wish to grab life with both hands from now on? Even a long time after the event, a lot of people wouldn’t want to admit to still feeling suicidal to a professional if they’ve already got one or more attempts on their record for fear of unwanted repercussions.
The above Jehovah’s Witness analogy is an interesting one. Does a Jehovah’s Witness get assessed if they refuse life-saving treatment? Or are their wishes simply accepted without batting an eyelid? I assume (and weep at the unfairness of) the latter. If so, there’s the solution for anyone wanting to take their own life in future – choose a method where transfusion would be the treatment of choice and have it recorded that you’ve converted to JW before you go…
The decision to die may have been made while competent but was the individual competent at the time they actually decided to end their own life? The act of attempting to end ones life is assumed (by some practitioners) to be in itself a symptom of mental illness in an indication and therefore of that person’s lack of capacity even if the decision to end one’s life, taken when rational is not.
It’s a bit like when a nurse comes round and shines a light in your eyes to see if your asleep and then asks when you if you require night sedation.
“Excuse me but now we have saved your life are you sure you really want to die. Oh I see well as you were then.”
“when you are if you require night sedation”
sorry acute iritis is making it hard to type
I have thought about this (adopting a religion to get protection from forced medical treatment). I am sure this is the only way you would be allowed to die in the US – although even if you were a verifiable Jehovah’s Witness or Christian Scientist, they’d still probably forcibly treat you if you made a suicide attempt.
Person A has a well-thought-out, genuine wish to die. He knows that death means an end to his existence. Person B is a religious person who believes that God wants him to refuse medical care and thinks either that God will magically save him or that when he dies he will go to Heaven.
And yet . . . Person A is treated as necessarily irrational and forcibly saved, whereas Person B is left alone.
I’m going to be writing a psychiatric advance directive in the near-ish future. I think that a living will would make an interesting addendum. If I get to that point of desperation again where suicide has seemed tempting for a while and I’ve reasonably tried other alternatives to alleviate my suffering, I know how I want to die.
Personality Disorder, huh? Explains a lot.
Personality disorder? Why would that explain it?
PDs get such a bad name and that is not fair for many reasons.
I am for and against the ladies decision for a living will. It is a hard one.
PDs get such a bad name and that is not fair for many reasons.
I am for and against the ladies decision for a living will. It is a hard one.
That was precisely my point. I have some pretty strong feelings on the subject myself: http://rielouise.wordpress.com.....y-witches/
“The act of attempting to end ones life is assumed (by some practitioners) to be in itself a symptom of mental illness in an indication and therefore of that person’s lack of capacity” – no, that assumption is plain wrong, E.
Look at those who travel to Switzerland to avail themselves of the service offered by Dignitas – ending ones life is not ALWAYS synonymous with mental illness (although it might be) neither does it signify that a patient automatically lacks capacity, although in some circumstances it might.
Obviously, making this call can be fraught with difficulty when dealing with a patient who may (in effect) be dying in front of you?
although it might be
although in some circumstances it might.
and in the case of someone with a pre-existing mental health diagnosis it usually is. Hence the Catch 22 for people like Kerry Wooltorton.
I’m with Z, I’m conflicted, it’s a very sad story. I googled for more info, rather than clicking the guardian link at the top. Bad idea. The Sun had an awful headline, and focused on one area, the “reason” for her repeated suicide attempts being she couldn’t have a baby. The Daily Fail reported their usual, non-biased shite. Highlights include “untreatable personality disorder” wtf?!
I do wonder what people’s reaction would have been if the lady’s diagnosis had been “Major Depressive Disorder” or “Bipolar Disorder” rather than some variation on a theme of “Untreatable BPD”.
Everybody is nodding, saying it’s sad, so sad that she didn’t want to live anymore. If she had been bipolar then I imagine she would have been on a section 3 before the nurses had time to say “check yo’self before you wreck…” living will or no.
The personal is not always the political. I hope she died with dignity and respect – and as an atheist I believe that her pain truly is at an end. I also wish something, some treatment, someone could have made her life worth living. That someone could have stepped in and said “Look, it is not rational for you to want to die. You can be treated – there is hope”. But her decision was judged to be rational. Of course there are so many things about her circumstances that we do not know.
I feel pain, selfish pain – that professionals will think that I too have no reason to hope; that in my circumstances it is rational and reasonable to want to die. Perhaps my life has been downgraded.
(insert “typical PD” comments here)
Aliquant “…..E, isn’t that the point of a living will/advance directive of any description, to set out your wishes in advance while you are still able to make those decisions, in the event that there should come a time when you are not necessarily able to make those decisions in the future? Therefore it’s not Catch 22…..”
I feel that Aliquant has fundamentally misunderstood the purpose of a living will/advance directive. A distinction HAS to be made between the operation of such documents in physical illness and in mental illness.
With physical illnesses where no mental illness is present the purpose is most certainly to set out wishes before the patient is unable to make them himself. This is because the patient loses the phsycial ability to communicate their views. The reason that such documents are followed in these cases is that the patient’s decision was made without the influence of mental illness and in full understanding of the consequences. Most such patients also know that natural death is not far away and in reality their living wills merely operate to alter the mode and time of death rather than fact itself.
The difference in patients with mental illness is that although the document sets out a patient’s wishes at a given time, there is nothing preventing them changing their views at a later point. Furthermore, the mentally ill are not at risk of dying through their illness and as a result such documents do not merely operate to alter the mode and time of death, but rather to bring about death itself. This means that it is necessary to ascertain whether the patient has capacity upon presentation at the hospital rather than whether they had it three days, twelve weeks or 3 years beforehand when they penned a living will.
Due to the fact that wanting to die is not normal according our society’s norms and rules, and given the fact that mental illness is known to affect the mind such as to make decisions unreliable from time to time, surely even someone presenting at hospital in a coma should be helped. In such patients we know that there is a good chance that they will be glad to be alive if saved – and secondly, what if their state of mind ceased to be suicidal during the process of becoming unconscious?
We all know that mental illness usually comes and goes. We also know that in PD patients, although the disorder is always present, suicidal feelings come and go. We know that in both cases we have treatments available. Death is final.
I do not see any catch 22 situation here.
Comes and goes? You tell that to the people labelled untreatable and left to their own devices by the very people supposed to be trying to help them. You tell that to someone who has tried to end their own life nine times, not asking to be saved but simply asking to not be alone and in pain when they do (isn’t that what the magic ‘majority’ wants?).
“what if their state of mind ceased to be suicidal during the process of becoming unconscious?” Well what if someone with a physical condition ceased to want to decline further treatment on becoming unconscious??
How is knowing that you don’t want to continue physical suffering any different to knowing that if your mental distress grew so great in future that you will want to end your own life and do not want anyone to stop you from doing that?
I understand the difference you speak of about delaying the inevitable rather than actively causing death, however I think that’s just one godawful facet of mental distress: that no matter how bad the pain gets, no matter how awful you feel, you don’t have the luxury of knowing there will be an end to your suffering. Unless you are brave enough to try to do something about it yourself.
Even with physical conditions which are completely treatable and only life-threatening if left untreated, anyone is allowed to refuse that treatment if they so wish. Yeah they might have to fill in a couple of forms so the hospital doesn’t get sued, but they’re still allowed to make that decision with hardly anyone batting an eyelid. Likewise people who decline perfectly routine treatment on the basis of religion/other beliefs. “No doc, please don’t give me that life-saving blood transfusion, there’s a guy in my head whom I love dearly and live my life by and he says it’s wrong…” or “No doc, please don’t treat me after this overdose, my pain is far too much to bear and I’ve tried everything else I possibly can, this is a last resort and I just want you to help me go peacefully and with dignity”. Why does one get preference over the other?
I must echo aethelread’s comment: “What gives another individual – whatever job title they have, whatever powers an act of parliament has conferred upon them – the right to tell me that I must suffer endlessly, and without hope of respite, just because it makes ’society’ uncomfortable if I die by my own hand?”
This is precisely why, when I was suicidal for long stretches of my life, I envied those with terminal physical illness. And if I couldn’t have a terminal physical illness, I at least wanted one where I could be a vegetable, completely unaware of my surroundings and myself. For this reason, I begged for a lobotomy. A life where the vegetable-aftermath is something to beg for is not the kind of life that I find worth living.
“A distinction HAS to be made between the operation of such documents in physical illness and in mental illness.”
Why? If mental illness is an illness with a biological basis then the distinction between a physical illness and a mental illness is purely semantic.
Posey, I don’t understand how any of the points you are making about why advance directives are iffy for patients with mental illness don’t apply to patients without mental illness.
You say, “The difference in patients with mental illness is that although the document sets out a patient’s wishes at a given time, there is nothing preventing them changing their views at a later point.” I don’t disagree that patients with mental illness might change their minds after writing the advance directive, but I don’t think this means that a person without mental illness can’t change their minds. People change their minds all the time with or without mental illness. People also might think they would act or feel one way in a situation when looking at it as a future possibility, but act and feel in completely different ways when they are actually confronted with that situation.
The mentally ill may or may not be at risk of death directly through their illness (alcohol poisoning? starvation? drunk driving? accidental overdose?). Are you saying that it is okay for people with mental illness to write advance directives as long as it is not a sneaky way of committing suicide? (It doesn’t really sound like you are.) Are patients with mental illness allowed to plan for the future? For future accidents? Are patients with mental illness concurrent with physical illness allowed to plan for the future?
What about this scenario: A person makes an advance directive. She isn’t necessarily facing imminent death, she just wants to be prepared and take any potential burdens of decision off of her family members. Several years later, for whatever reason, she attempts suicide. She was never diagnosed with mental illness. (At this point, you can either assume that she had mental illness on account of her suicide attempt, which I would find repulsive, or you can say that we just don’t know.) She doesn’t succeed completely. She is found at a point where she is still alive, but would certainly die without intervention. Do you save her? Even though it was suicide, she is still in a physical state in which she has said she would not like to be resuscitated.
Would you let a mentally ill person write an advance directive that said, “save me if it is suicide, but don’t save me if it is anything else”? That is how people tend to treat living wills. Do you save people no matter what whenever you see a diagnosis of mental illness or suspect suicide? What if you are wrong? How long does someone have to be well from mental illness before they are allowed to write an advance directive that will be followed?
I’m understanding you as trying to draw a clear line between advance directives for physical illness and for mental illness. I don’t think that is possible because this is all too complicated.
We all know that mental illness usually comes and goes.
Usually. But what about those people for whom it doesn’t?
We also know that in PD patients, although the disorder is always present, suicidal feelings come and go.
But what if the person diagnosed with a PD decides that the non-suicidal times aren’t good enough to make it worthwhile enduring through the suicidal times?
I don’t have a PD, at least not as far as I know, but this is the knife-edge I walk. My depression varies over time, and I have good patches and bad patches. But the ‘good’ patches are only ‘good’ relative to the truly horrendous bad patches. I am never happy, not in the way that a non-depressed person would understand that term, so maybe it would be more accurate to say that I have bad patches and worse patches. I have not been told my depression is untreatable – who would be so cruel as to take away that last glimmer of hope? – but I have been told it is ‘treatment resistant’ and I have, demonstrably, reached the end of what Mental Health services in my area can do for me. All that was available to me was low-key monitoring, from which I have chosen to disengage.
So, what about me? What about someone like me, who can’t be helped, and won’t ever be happy, and will – inevitably, unavoidably – experience endless recurrences of a level of mental pain that it is beyond my ability to describe? Isn’t it my right – as the only person who knows the extent of the pain I’m in – to decide whether that pain is worth enduring? What gives another individual – whatever job title they have, whatever powers an act of parliament has conferred upon them – the right to tell me that I must suffer endlessly, and without hope of respite, just because it makes ‘society’ uncomfortable if I die by my own hand?
This is why I always lie when I am asked about suicide. It’s why I will never be completely honest with a MH professional. It’s why, if I do ever decide that the time has come for me to die, I will choose a place and a time and a method which will guarantee success. The right to choose death is mine, and I will not surrender it to anyone.
Kerrie Wooltorton’s life was her own. It belonged to her, not to the doctors treating her, or to her family, or to people discussing it on blogs, or newspaper pundits, or happy-clappy jesus freaks. It was her life, which means it was her life to end. It’s kind of people to feel sad about her death, but it’s irrelevant. She had a clear, unambiguous, persistent wish to die. It was her right to die. All the rest is irrelevant.
this is a difficult case isn’t it. what’s worrying though is that even the doctors disagree so that if this poor young lady had turned up on a different night she probably would have been saved. there is a discussion about it here:
http://blogs.bmj.com/ebmh-talk.....revisited/
The main question this raises is that of how to best help people who’s wish to live and die fluctuates in so much as they attempt suicide then reret it afterwards and do this on more than one occassion. I have met may patients who have had one attempt and deeply regretted it and gone on to live without feeling suicidal, but many who have had multiple attemps or varying seriousness and their should be work going into helping these people determine whether they wan’t to really die. If they aren’t sure or one minute they do, the next then help them get some sense and stability to their lives,if they are 100% certain they don’t want to live and they’re reasons are sound and they understand the implications to others in their lives if they die then they should be allowed to do so legally…
I think if people have this choice and are deemed of sound mind to make that choice then they should be able to. This way, people like the lady above would be able to book in a tiime, place and method to die of her choice and would be free to decline at any point prior to the death.
Just heard some guy on radio 4 talking about God giving us life and so we shouldn’t be able to end it ourselves, but the sooner we have the legal right for adults to die pecaefully without resorting to drinking bleach, overdosing on tablets, hanging, shooting, jumping off cliffs etc the better. There are people who are desperately trying to stay alive, starving, in poverty etc. and the world is so over populated, if people don’t really want to be here and can’t see themselves doing anything to help people in need then we should happily show them the door (and make it easier for people in great suffering to be free from it in peace if they choose).
I have seen the future and it is green.
And let us donate our organs, for that matter.
While driving into work, Richard Bacon on Radio 2 was interviewing Kerrie Wooltorton’s uncle, apparently her family were unaware of her living will and they are planning to sue the hospital. Kerrie’s uncle also stated that she had been the subject of several MHA sections in the past, and questions her mental capacity at the time of making the will.
Doctors are now being placed in a ‘no win’ position – if they refuse to carry-out advanced directives, the patient can sue, and if they do carrry it out they are in danger of being sued by next-of-kin, if they haven’t been informed.
Doctors are now being placed in a ‘no win’ position
Indeed. Especially when you consider stories like this:
http://www.cambridge-news.co.u.....?id=421337
Kerrie Wooltorton’s life was her own. It belonged to her, not to the doctors treating her, or to her family, or to people discussing it on blogs, or newspaper pundits, or happy-clappy jesus freaks. It was her life, which means it was her life to end
But having involved healthcare professionals by calling an ambulance to be transported to hospital, she made it other people’s business.
But having involved healthcare professionals by calling an ambulance to be transported to hospital, she made it other people’s business.
…to provide her the palliative care she had requested, not to second guess a decision she was competent and capacitated to make.
And it still made it their business, not just hers. There are numerous other methods of suicide she could have chosen that would have kept other people out of the picture altogether.
Ever tried to kill yourself? It’s really hard to find something you’re able/willing to do to yourself, she probably wasn’t thinking of what the docs would do when she decided on poisoning, she was probably more relieved that she’d found a method she was comfortable with.
None of which negates the fact that when she decided on this method and called an ambulance, she immediately made it other people’s business as well as her own. At that point in time, it didn’t become just her decision alone. As soon as you involve other people, it all becomes a lot less certain than “it’s her right to die”. It is other people’s right not to have to stand back and watch you die.
Is it really so bad in time of desperation to ask for help from the only people you know who can possibly give you close to what you want? I can’t believe that none of the doctors available were willing to help her do what she wanted (in the same way that medical professionals are allowed to opt out of performing abortions and there are others willing to do them). Yes she might have involved other people, but by doing so I don’t believe she somehow violated anyone’s right to not have to stand back and watch her die – someone must have been willing to do what she wanted.
People become Doctors and Nurses generally because we want to help people stay alive and not die. Palliative care is a different kettle of fish, it involves people who have an illness which is killing them and making their time as comfortable as possible.
Someone previously used a comparison to Jehovah’s Witnesses. Also not relevant they can be people who have not chosen to actively end their live but find themselves in a position where an external force (illness, accident) has put them in a position where they are going to die without intervention. There is a community of people who share these beliefs and will support them in their decision. Though I know of more than one case where a JW has accepted, willingly and knowingly, a ‘forbidden’ treatment to save their lives and then turned round and put in an official complaint against the hospital to save face with their fellow believers.
Kerrie, almost certainly, had planned her suicide (significant history, advance directive) and spent much time thinking about it and chose to do it in such a way that she knew there was a strong possibility she would end up dying in front of a group of people professionally (and morally?) obligated to save lives.
someone must have been willing to do what she wanted.
But what about those who weren’t willing, but found themselves forced to do so?
Would most doctors and nurses really want to prolong the suffering of someone in intolerable pain, just in the name of keeping them alive? Or would the natural compassion and caring which we hope would be inherent in all medical professionals go some way to helping them realise that here was someone in extreme distress, obviously willing to risk a lot to get what she wanted (any attempt to take one’s own life carries with it a risk of surviving and ending up worse than before either physically or mentally), having tried to do so several times before, planned out, written down, stated clearly upon arrival… and want to help her go through that process which she’s already started as easily and painlessly as possible with maximum dignity and minimum suffering?
How is mental distress resulting in frequent suicide attempts any different to a physical illness, how is it fair to help one person live out their last days with dignity and free of pain, yet subject someone else to unwanted treatment and send them back to what could be an unbearable existence? How is it OK for people to decide what is tolerable and not, other than the people going through it?
And I still believe that there would have been people around willing to help her carry out her wishes (even if they were saddened by the situation and possibly wishing it could have a different outcome, as thousands of other docs feel about thousands of other patients every single day) enough to prevent the need for anyone being forced to do so.
I’m glad she got what she wanted, I hope she’s found her peace and I couldn’t be happier for her.
Alinquant – I have looked after people who have made numerous suicide attempts and have one day, for whatever reason, “turned a corner” and turned their lives around. This is always the hope when otherwise perfectly healthy people try to take their own lives – that given another day and a change in circumstances, they would not want to be dead. Were services to develop a professional pessimism that allowed people to be considered beyond help after a certain number of attempts, which is implied by your post above, that would be a terrible, terrible turn of events if you ask me.
Also, with respect, you cannot just assume that there were probably enough people around who would have been willing to help this woman out so it was all OK then. She may have got what she wanted (and who knows if it was actually what she wanted at the moment she was allowed to die?), but she also made others accomplices in what amounts to assisted suicide, whether they liked it or not.
Services already have developed a professional pessimism that says that some people are beyond help after a certain point. For physical illnesses. Why is this not the case for mental illnesses? We know much less what we are doing and how it is working or why it is not working in mental health care, so I guess we hold out the hope that eventually we’ll hit on it? Whereas with physical illness we know what we can do and why it might work much more, and when it doesn’t work, we don’t just keep doing it over and over like we do in mental health care (doesn’t AA say that the definition of insanity is doing the same thing over and over while expecting different results?), we are much more willing to say that we have nothing more to offer. The closest thing mental health care does to admitting we’ve been beat is to send the patient to a state hospital (US) to rot for the rest of their lives.
Also, a lot of people would find life worth living if there were a change in circumstances, but so what? (That is always thrown around as a reason not to commit suicide and it annoys me.) Saying this doesn’t mean that circumstances are going to change. No, I probably wouldn’t be suicidal if I wasn’t depressed out of my mind, but I am depressed, so I am suicidal. No one would say they wanted to be taken off life support and allowed to die if they weren’t on life support. Just because someone on life support wouldn’t want to die if circumstances were different doesn’t invalidate their wish to die, to end life support. The only difference is that for the patient on life support, we are fairly certain that the life support circumstance will not change, whereas in mental illness we really just have no idea whether the circumstance will change or not. (And being uncertain doesn’t mean that it is okay to assume EITHER the positive or the negative outcome.) It is easy for someone who is not going through the painful bits to say, “just hang on to find out if things will change.” Of course, they usually assume that things will change and will never say, “okay, things haven’t changed, but you gave it a good enough trial, you can die now if you want.” And they discount the intense pain that the depressed person is going through. As someone who has been through that situation, it didn’t (and doesn’t) matter to me if there is a chance that things might get better if I hang on long enough, the present is far too painful for the possible future to be worth. It is easy for me to assume that a better time will never come, but even if I don’t assume that, I don’t necessarily want to live. Is the fact that I still feel this way despite having made it to a better time not enough to convince people of my sincerity in this?
As a former service user – massively relieved to hear about this. I’ve now got the option of seeking help if I get ill again.
As an MH worker – massively relieved, this is showing compassion beyond the ‘rules’ which say you must keep everyone alive at all costs – a position which I consider bordering on torture.
I’m not sure an unwitnessed AD three days before an OD is enough though, if she’d come in unconscious I would still have advocated for treating her. She didn’t, so I’m glad her wishes were respected.
Yes! I, too, consider the “keep everyone alive at all costs” bordering on torture. It is, to me, just about the cruelest act imaginable to keep someone alive who is suffering so so much.
No beakie, if I implied that, I’m sorry, I didn’t mean to. I don’t believe there is a magic number of attempts someone can make before they’re considered beyond help. That I agree is a huge danger.
But I do think in this case she very clearly wished to die, and it’s really unfair to not help her and expect her to continue to live in very obvious pain and suffering. You free yourself of responsibility for going against someone’s wishes unless you’re willing to take responsibility for the resulting suffering too, it goes both ways. Perhaps you could look at it as unfair of someone to put a medical professional in that position in the first place, but this woman was desperate, what else was there left to do?
Everyone keeps saying “who knows if it’s what she wanted” well who knows if it wasn’t? You can’t just presume to know better, in any other situation you can ever give that question would never be asked because her wishes would be recognised and respected.
Yes I can assume there were enough people willing to help her out, because if there weren’t they would have found a way to intervene. They would, of course they would, it’s as easy as anything for any member of staff to refuse to take part in any procedure or treatment of a patient (or not, as the case may be), or (perhaps more likely in this case) easy as anything to get a piece of paper that says the docs don’t believe she had mental capacity to either produce the living will or make her own decisions on time of arrival.
Interesting to note some schools of thought are actually saying that they didn’t challenge her hard enough because of her personality disorder status, not something I’m comfortable with commenting on here but it does show there were plenty of ways the docs could have not done what they did if they really wanted to.
It’s unfair that the mental health system thinks it knows better in that “who’s to say she knew that was what she wanted, there’s a guy over there who tried to kill himself years ago and now he’s happy” well good for that guy but don’t subject everyone else to an unbearable life just because of him, have a bit of compassion and take off that “we know best” hat and look at someone truly as an individual, take responsibility and if you’re (the system, not you personally!) not going to rest easy with helping someone who has taken steps to end their own life do so as pain-free and dignified as possible then you’re going to have to come up with a much better way of helping them to live, otherwise it’s exactly the same but with slower more painful death and a few easier consciences.
You free yourself of responsibility for going against someone’s wishes unless you’re willing to take responsibility for the resulting suffering too, it goes both ways. Sorry I meant “you can’t free yourself of responsibilty”
I’ve seen service users before who say they don’t want to be alive anymore and when they tell me their history and current circumstances some of them seem to have no reason to live and no means of even making any good reasons to live. Sometimes people with empty lives can turn them around, but in some cases people have been through so much and are so lonely that whatever you could suggest to try and make life worth living would not work and I feel they would be at peace if they died.
Once you face the harsh realities of life, either by deep thought or being forced into thinking about it by loss then there are different options, one is to be stoical and soldier on, almost martyr like (which in itself can reap rewards and replace the loss) or by ending your life, but some people seem to get stuck in the middle where they don’t have the courage to kill themselves alone or have the strength to soldier on. The people stuck in the middle often make attempts at suicide then call ambulances, family, friends etc. and I feel this could be as they are either saying ‘I’m confused, I don’t know if I want to live or die, but I wan’t love, company, to feel I belong’ or as mentioned above they want to die, but they want to do so around other humans with ‘paliative’ care (although, not ‘paliative’ in the traditional sense).
The problem with suicide is, that it is not a pro-active choice, no-one ever aspires to want to die, they simply do not want the life they have. Health professionals, as humans, know that individual circumstances and attitudes change over time, and to sit back and watch a young life fade-away must have been unbearable for the team who nursed Kerrie at the end.
But it is a mistake to believe that because it was Kerrie’s life then it was no business of other people what she did with it. The fact is from birth we are obliged to register marriages and deaths. If advanced directives/living wills become the orthodoxy, then it will be the law lords who will determine the criteria (and I’m quite sure that most people would want this to be the case) The body is political, like it or not.
beakie
I said a while ago that i found your attitude to things like this monstrous, and i still haven’t changed my mind. As i said then, i’m sure you are a nice person, and i’m sure you are sincerely convinced that you’re doing your best by people, but that just makes you more dangerous.
There are numerous other methods of suicide she could have chosen that would have kept other people out of the picture altogether.
Yes, of course there are. And every single one of them would have involved her dying alone, frightened, and in pain. Would this have been a better outcome? Would this have been a compassionate action – to force someone, at the end of an unbearable life, to endure a worse death? Is this really compassion? Because, to me, it looks like cruelty, the kind of cruelty that the strong always can inflict on the weak.
It is other people’s right not to have to stand back and watch you die.
You have a right to provide medical treatment? Really? Not a duty, but a right? Where do you find that written down, beakie? What ethical textbook tells you that you, as a nurse, have a right to inflict unwanted procedures that will prolong the suffering of a patient who has made her wishes clear, simply so that you can avoid the fleeting moral discomfort of watching her die?
I have looked after people who have made numerous suicide attempts and have one day, for whatever reason, “turned a corner” and turned their lives around. This is always the hope when otherwise perfectly healthy people try to take their own lives – that given another day and a change in circumstances, they would not want to be dead.
I know this is the story you tell to make yourself feel better, to pull the wool over your own eyes, to convince yourself that you’re one of the good guys, but don’t kid yourself, beakie. In some cases the desire to die is caused by a remitting illness, but you and i both know that there are many, many cases where it isn’t. You must have nursed people like this, before you became a teacher, so you must know what i’m talking about. When you threaten endless interventions against a person like this, you’re not talking about treatment, beakie, you’re talking about imprisonment. I don’t mean imprisonment in the sense of physical confinement, which anyone could learn to tolerate. I’m talking about imprisoning someone within a life they do not want, i’m talking about imprisoning them inside their own skull. How can someone ever experience a reduction in their pain, when their pain is imprisoned with them?
Don’t kid yourself, beakie. You can’t use the language and the concept of treatment to describe what you would be doing in the case of people like Kerrie Wooltorton. There was no treatment, and no possibility of treatment. But there were three choices: offering a vulnerable woman in intolerable pain an easier death; forcing her on to a worse death; intervening continuously to keep her imprisoned in her own life against her always-unchanging will. None of those choices were easy, none were ideal, but one was best – and it’s obvious which one that was.
This attitude you have, beakie – this unquestioned, unquestioning assumption that you always, inevitably know best, and that if you order a fellow human being to suffer endlessly without possibility of reprieve, you’re acting in their own best interests – it terrifies me. It would be bad enough if you were a nurse, but you’re a lecturer, which means you’re instilling this attitude in generation after generation of other nurses. All this suffering you’re causing, beakie. The endless, unrelenting, unendurable-but-forcibly-endured misery and anguish you are inflicting by proxy on people you’ll never meet, and for whom you’ll never feel the tiniest shred of concern. It’s terrifying, beakie, and it’s monstrous, too.
Not sure if this will help or not but here is a extract from the current popular model of mental health nursing.
Tidal Model: Engagement Process
In order for the practitioner to begin the process of engagement using the Tidal Model, the following needs to be accepted:
Recovery in this context does not have to mean getting ‘better’, I normally take it to mean improving a person’s quality of life. This goes for people with progressive deteriorating conditions, we work to improve the quality of life that people have at the time.
So yes I personally believe that recovery is a possibility for all my patients. It is possibly wrong, but if I (or the system) draw a line between those who have the potential to ‘recover’ and those who do not we will be very wrong.
I know people are looking at point three and think that maybe Kerrie knew what was best for her. Maybe she did.
She was legally felt to be capable of making the decision to refuse life saving treatment, at the time she needed it. So mentally ill or not the only argument is about the right to end you own life and prevent other people from saving it.
I concede (based on what I have read) that staff had no legal right to interfere and save her life.
I still think, as I have stated before, that life is almost always better than death. I can imagine exceptions which I would apply to myself in specific circumstances. If someone is alive there is always the possibility their emotional pain may be lessened. There are no possibilities when dead. Trite, but true.
Recovery is possible, but like I have mentioned before, that doesn’t mean much for an individual. If one person ever recovers, the statement, “recovery is possible,” is true. That statement is not a guarantee.
That people know what is best for themselves is very important, yet frequently discounted. In mental health care I was often told to take care of myself instead of taking care of other people or just doing what was expected of me. Looking back, I still believe that the best way to take care of myself would have been to commit suicide. Looking forward, I can imagine that being the case again.
Even if recovery were guarantee-able, that doesn’t mean that the recovery is worth the wait, because that wait can be very very miserable.
Yes, but – forced psych treatment doesn’t allow people to decide that going through more illness / treatment isn’t worth the possibility of recovery. If KW had cancer and had asked for palliative care only, because she couldn’t face more chemo, there would be no public handwringing. Maybe KW could have got better, and in a few years she could have an emotionally stable & ‘happy’ life – but that’s not necessarily worth keeping going through serious mental illness for. Why should a doctor who barely knows someone be better placed to decide that than the person who is living it?
Yes! Yes! Yes! I love you Squawk!
“… forced psych treatment doesn’t allow people to decide that going through more illness / treatment isn’t worth the possibility of recovery.”
Well no. Forced psychiatric treatment when it happens does not allow people any choice.
But this is not what happened here. Kerrie was deemed to be fully capable of making this decision at the time it was made. Her mental health diagnosis in this case became a non issue. If her life was so full of suffering without expectation of relief I can certainly understand why she would choose to end it.
Yep – which is why I’m so happy that this has happened, & despite feeling desperately sad for KW’s family & friends having to cope with intrusive media too, that it’s happening in public. I hope that this encourages more realisation that having a mental illness does not necessarily make you incapable of an informed refusal.
It interests me that a lot of the comments suggest that people will eventually ‘get better’ from feeling suicidal. I know that for me this is very likely – I’ve been basically well for years, and am currently well & enjoying life. To suggest that because someone will get better they should be forcibly treated until they do is to miss the point. There are some things that aren’t worth going through, even for another 60 years of ‘well’ life. And there are definitely some things that, having gone through once, I would sooner be dead than go through again. What might happen after being ill is simply not relevant.
Here`s me thinking stupidity is in perpetual motion and Mental declares “nothing lasts”. Despite the seriousness of the debate, using a psychiatric nursing model as a basis for an argument has given me a good chuckle.
Unfortunately, Aethelred, highlighting the fact that Beakie`s is a pompous know all ( he does make some sustained attacks on common sense but I hardly think he`s dangerous, most student nurses are highly contemptuous of their tutors so I wouldn`t be worrying about his influence )doesn`t advance your argument. I agree with virtually everything you say. I have an implacable belief in my own right to self determination and I`d be incensed if anyone ignored an AD I`d made. HOWEVER, if you expect someone to even passively assist in your suicide you have something of a duty to ensure they are 100% convinced that is exactly what you want. A tall order, I know, when you`re in a pit of despair but over riding the inate human instinct to help and to care is a tall order too.
For me, the act of walking into A and E, where the staff are trained, primed and keen to save life, raises a question mark. I concede it might well be a very small question mark but it`s a question mark nonetheless. When in doubt, there is no doubt as far as I`m concerned.
HOWEVER, if you expect someone to even passively assist in your suicide you have something of a duty to ensure they are 100% convinced that is exactly what you want. How d’you do that then? What more could she have done?
“… using a psychiatric nursing model as a basis for an argument has given me a good chuckle.”
Me too.
OK so now I’m a monster for finding the idea of allowing young people to die somewhat difficult. It really is time to leave this site and stay well away this time.
It isn’t that you find this idea difficult that bothers me, it is that you already seem have your course of action settled.
Keeping someone alive who wants desperately to die because their life is full of profound suffering is something I find incredibly cruel. I would definitely feel conflicted about it, but ultimately, I would not want to force someone to endure that suffering if they decided they didn’t want to take it. And, yes, I understand that it is incredibly difficult to know how much someone else is suffering and how sure they are about not wanting to endure it. But I do not think that is an excuse for a hard line “no one dies” policy. The stakes are so high, I understand that, and that is precisely why I think that this is way too important to have such a simplistic policy of action. I also think that if someone does not have a big enough imagination to empathize with the experience of someone who is chronically suicidal or just doesn’t want to face the fact that human suffering can be so immense, they need to keep themselves away from these situations, rather than doing things like crusading for absolutist suicide prevention. (And to be clear, I’m not saying that you personally, beakie, actually think these things, because I don’t know. I’m just addressing you here because this is the position you have come to symbolize in this discussion.)
And I hope you don’t leave just because you are on the unpopular side of this discussion. I find your input, as a voice of dissent, quite valuable, both in challenging my own view and in helping me better understand your view.
There is a short, obvious and brutal answer to your question, Aliquant. It doesn`t help this discussion though.
We`re having an interesting. and worrying, polarisation of views here. The professionals camp ( it won`t filter through to the ivory tower but that barely matters ) have to accept the legitimacy of the Aethelred camps argument. The Aethelred camp have to understand that it is predominantly the experience of professionals that overwhelming suicidal ideation is not insurmountable. Those of us who believe in self determination have to respect the views of those who believe in the sanctity of life. Mental has to understand that change, in the context of coming to understand the rhythm of your life and concluding that recurring episodes of hideous pain are not tolerable, can itself be an argument for suicide.
I doubt anyone has noticed but there are issues I avoid on MN. I`m never critical of the MHA simply because I really wouldn`t want the job of drafting a new one. Trying to please everyone would, I fear, prove impossible. I`m more than arrogant enough to believe that a self written AD of my own should more than suffice. That can`t be the objective view. Some type of independent / familial / medical or legal corroboration should be required. I don`t want the job of deciding which.
BEAKIE. I think you`ve tried the taking your ball home strategy before. Have you thought of the manning up, take it on the chin and getting on with it approach ?
OSB I wasn’t expecting an answer, I was making the point that she did everything she could to make her wishes known, and I can’t see what else she could have done to satisfy the ‘duty’ of which you spoke.
I fully recognize that my argument is on behalf of the rare suicidal individual. I know that most people who consider or attempt suicide would regret it. I have no problem with a policy of general suicide prevention, preventing suicide in most cases. What I have a problem with is absolutist suicide prevention, preventing suicide in all cases, because that forces a very small number of people to endure immense suffering. I know that an absolutist suicide prevention policy isn’t going to consign very many people to that level of suffering, but I find it incredibly cruel to consign anyone to that level of suffering.
I try so hard to keep the perspective of professionals in mind in these discussions, as best I can know it. I try to treat it as valid, not discount it, and to compromise. But so often that doesn’t seem to make any difference, and rarely do I see professionals try to keep my perspective in mind as much. I often see professionals say, “yes, I know you feel that way,” as the full extent of keeping my perspective in mind, but they don’t treat my perspective as valid and true, just as the feelings of a crazy person, something to be verbally acknowledged but ignored in practice, not worth compromising with. This happens much less here at Mental Nurse, but it does still happen. What am I supposed to do? I thank you so much, OSB, for identifying that problem in communicating and acknowledging the other that happens on both sides. If any of you ever feel like I am being overly dismissive of the professional perspective, please, please tell me.
I would love it if having these discussions could eventually lead to actual policy changes. But before aspiring to that, my goal is just to have professionals acknowledge that a policy of absolutist suicide prevention will consign some patients to immense suffering. I find it tragically irresponsible for someone who is directly preventing people from committing suicide not to acknowledge all of the potential consequences of their actions. For now, even if acknowledging those consequences wouldn’t actually change how you handle these situations, simply acknowledging this is a huge step in the right direction. I can totally understand why, even if professionals acknowledge the potentially tragic consequences of suicide prevention, they might still do things the same way (laws, the difficulty of knowing who will and won’t regret suicide coupled with the fact that most people do regret suicide, etc.).
I know that drafting new policy for suicide prevention would be incredibly difficult and could never be perfect. However, I think it is irresponsible not to try. This is so so important, the consequences are so immense, and what we have now is a lazily formed policy that encourages people not to acknowledge the consequences of absolutist suicide prevention. Don’t the people who are suffering most among us deserve better than that?
OSB – you’re quite right, it’s cowardly of me to run away from this and I’ve since had time to calm down and consider my response.
aethelred – It’s very uncomfortable to be called “monstrous” and “terrifying” for holding an opinion you had kind of taken for granted as a professional for many years (that suicide prevention is a good thing). But it’s in those moments of discomfort that perhaps the greatest learning can take place, and I’d like to thank you for enabling me to reflect on what I think and feel.
However, I think it doesn’t help to polarize such a complex debate by characterizing those who present other views to yours as ” monstrous” individuals who want to condemn others to lives of unremitting torture. You might contend that this is exactly what I am arguing for, but that is to misrepresent my views.
Suicide is a solitary act, yes, but it has effects and impacts way beyond the purely personal. At the most extreme level, there are people who choose methods of suicide that actively harm others: I heard of a case of a man who killed himself by gas explosion, which also injured several others in his building, for instance. People who throw themselves in front of trains leave drivers with a legacy of psychological damage. But even those who choose “gentler” methods create ripples in a pond that affect those around them – family, friends, loved ones, the wider community. I am not suggesting that makes their actions “wrong” per se, simply illustrating a point.
There’s another issue here as well – at what point should professionals decide that the person is sincere in their wish and therefore allow them to die? How many attempts at suicide add up to a person that is beyond help?
I’m fortunate in that I have never felt so awful that death seemed a viable alternative. I’ve skated very close to the edge of it, particularly when I first experienced what I now know to be an obsessive disorder when I was 17 and also following the death of my mum three years ago. Perhaps this disqualifies me from commenting at all, I don’t know.
I find consigning people to live of unremitting torture to be monstrous and terrifying. While I think that is the logical conclusion of what I understand your position to be, I don’t really think that you are consigning people to lives of unremitting torture for fun. I do not think you are a sadist. I think it is your sincere attempt at doing the best you can. However, I think it is irresponsible for you not to acknowledge the consequences of your position, that it can consign people to lives of unremitting torture. You say you’ve taken this for granted for many years. Maybe it is time to take a more nuanced position?
Oh, and one other thing, aethelred. You grant me too much power to suggest I can influence future generations of nurses. It’s not my role to offer opinions as facts, but to facilitate students’ own exploration of issues. I present ideas, theories, research and leave it up to students to make up their own minds.
Beakie
I had written a fairly long and (hopefully) concilliatory response to you, but i’m not sure it would be a good idea to post it. This issue is way too personal for me to be able to write about it dispassionately, and it seems that i am not able to get sufficient distance from the subject to say what i think needs to be said without causing personal offence, or upsetting people. I did not mean to insult or offend you, beakie, and i am sincerely sorry that i have done so. I do not think you are a monster.
For these reasons i think it will be best if i duck out of the rest of this discussion. There is a lot that i would like still to say – but i do not think i can trust myself to say it in a reasonable and appropriate way.
Take care,
A.
aethelred – it’s an emotive subject for all of us, I’d wager though of course it’s much closer to home for some of us than for others. I just want to reiterate that any discomfort I’ve experienced has been far outweighed by the learning your posts and those of others like jessa and Aliquint has afforded me. My assumptions have been taken out, shaken up and turned on their heads and that is always a very welcome experience. Thank you.
Beakie, I want to kiss you on the forehead right now.
Errr you don’t know where he has been!!!!!
jessa – are you willing to divulge a little of why or how your life became one of unremitting torture? Did anything in particular happen to you? I’m just wondering as there are ways that people can use their own personal suffering to help others who are suffering, but I often see people who complain about how they find life so harsh who are so wrapped up in themselves that they will be bound to want to die. I know that the nautural thing for some people to do is become self absorbed, I understand from my own past experiences that this happens and have been through phases or great despair and feelings that life is not worth living and wanting to end it, but if you lose yourself in helping others through this harsh life then it can become more bearable and you can experience true love and feelings of wanting to live and your suffering and that of others can be greatly diminished.
Yes. I will tell you, briefly, how I became depressed, although I don’t really understand how that is relevent. When I was 14 I got depressed. It was gradual, but came on fairly quickly. Nothing really “happened”, although plenty of people have theories about what “made” me depressed. As far as I am concerned, the cause is unknown. I dealt with it for a while, but it wasn’t going away, and at 14, having an inexplicable depression becomes unbearable pretty quickly. I decided to cope with it by making up a list of reasons why I was a horrible person, so that I could explain my depression as my punishment for being a terrible person. I knew that this was contrived at first, but I eventually came to believe in my awfulness whole-heartedly. I lived like this for several years. Then, accepting my punishment passively wasn’t enough, I needed to add to the punishment, so I became anorexic (also as a way of thinking of something else, my thought were unbearable, boring, repetitive, frantic, useless). Soon, anorexia wasn’t an acute enough way of punishing myself, so I began self-injuring, which was also a way of feeling something other than emotional pain, even if my only option was physical pain. When I was told that suicide was not an option, I understood this to mean that I was such a bad person (which I sincerely believed at this point) that I did not deserve an end to my suffering, that I must endure a long life of unbearable suffering as punishment. I started feeling better when I was 22. I’m 25 now.
For the first few years of that, while I was in high school, I was incredibly active. I was told, once I started getting treatment that a very good coping skill was to distract myself by doing things, any things, and in particular, helping people type things. While that may have been helpful to some people, I can say definitively that it was not helpful to me. In high school I was in “gifted” programs, which really meant having to do a lot more homework than everyone else, I was in choir, I was in latin club, I figure skated, I was in girl scouts, I was on badminton team for a year, I made a full size quilt for a school project, I was in 2 musicals. I also taught children figure skating, I taught vacation Bible school and Sunday school, I raised money for Habitat for Humanity and Church World Service, I mentored and tutored grade school kids. While doing these things, I was still depressed, though my rumination was only maybe an 8 of 10, but as soon as I had time to think to myself, it was back at 10. I couldn’t sleep, so despite all of the things I was doing, my ruminations had a lot of time on 10. No one can say I didn’t give distractions and helping people as coping methods a fair shot.
I want to join the debate, but I’m not expressing myself as clearly as I’d like tonight. What’s prompted me to join in is a discussion elsewhere, not about suicide, but where someone who does not have severe mental illness was very insistent that she knows better than I do all about it. She systematically does the same with everyone with severe mental illness.
But this isn’t about one person. You see, one person may speak out like that on one website, but in my daily life I meet people every day of the week who think they know more about SMI than I do. They’ve seen a television programme or they’ve a friend of a friend with it, or they have read about it.
But they haven’t experienced it.
My reaction to the person I’ve mentioned, summed up, is that we’ve a right to self-define. We’re way behind physical disability groups in that.
So what’s this got to do with this topic? Well, it’s about my right to self-define whether my life is worth living. I’m the one that lives in my head. I’m the one that has to go to bed with SMI and live my days with it. I’m the one that’s alone with it when the rest of the world is getting on with their own lives.
So when I read health professionals talking about what they should or shouldn’t do about a person’s decision whether to die or not, I wonder how that person is spoken to, how they are treated, how they are listened to, because when your own view of the value of your life isn’t seen as valid, then you have no starting point from which anyone can even begin to connect with you.
If you want to tell me not to kill myself, first accept that my desire to die is a valid reaction by me to my experience of life. Let me define the quality and value of my life before you try to persuade me that I should take a different course of action. You can’t walk alongside someone to a common destination if you’re starting from different places.
thanks jessa. I wanted to know as it helps me understand others who experience or have experienced depression and suicidal thoughts. Your story is different in ways, but not too dissimilar from mine in others and started around the same age. I am 37 now and it has only been in the last few years that I have really started to get on top of my negative thoughts and I’m still learning how to do so, but it is working and recently the suicidal thoughts have gone. I guess a lot of that is through not being so self absorbed, which isn’t easy, I know giving myself to others has helped and is helping me so wanted to see what other perspectives were. thanks jessa.
I love you! (This is turning into one big jessa-love-fest.) So many people who have been depressed have told me to do the thing that made them ultimately feel better, have said that thing is The Cure for depression. Many strangers have written books like this. It makes me want to hit them. Just because it helped you doesn’t mean it will help me. Furthermore, they don’t necessarily even know that it was that thing that “cured” them, it could have been something else going on concurrently or it could have been simply the passage of time. As far as I can tell, the thing that made the difference for me was effexor/venlafaxine, but I don’t go around touting venlafaxine as some sort of magic bullet, and I would really appreciate it if others did the same. Encouraging people to try different treatments for their depression = good. Telling them that the treatment that worked for you is The Cure = bad.
I searched the comments for “drug” or “drugs” but to no avail. Without drug prohibition people would be able to peacefully and privately terminate their lives. It should go without saying that people who ignore others’ living wills are morally repugnant. The willingness of so many to find mental illness wherever they look (in order to overturn such expressions of preference) is a sad thing indeed.
People write books for all kinds of spurious reasons, not necessarily with you in mind, in fact not you in mind as they’ve never met you. Some seem genuinely helpful, usually the ones where the authors treat you like your you and not ‘the depressed person’ in general, who doesn’t exist in reality.
I would never even suggest a ‘cure’ for depression, I feel that low mood is as an important part of life and that there is too much pressure for people to be TV smiley happy all the time. However I feel that once people become depressed it can be hard to come out of it without help and that help, as you say, is about helping people find what will work for them, whether that be anti-depressants, relaxation, music, work, a hobby, help sorting out relationship problems, physical health, diet, the whole spectrum of factors that contribute to one’s state of mind…and of course, ‘time’, as you mention.
When I say about losing yourself in helping others I don’t so much mean the traditional way of helping through charitable work etc. but more just loving and accepting others non judgementally and I genuinelly feel that universal love and acceptance of others really is a big part of it as a nurse and as a human who gets depressed.
Jessa, thanks for helping me become a more understanding person. Really appreciate the comments.
[...] right to die Posted on October 3, 2009 by aethelreadtheunread This is a re-posting of a comment I left a little while ago over at Mental Nurse. The post I was commenting on was discussing the [...]