Ask Me Anything: Mental Illness Questions about Suicide & Patient-Doctor Tension. ~ Gabe Howard

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~

Dear Elephants,

Welcome to this week’s Mental Illness Q&A! My name is Gabe Howard and I am a man living with severe bipolar and anxiety disorders. To submit questions of your own, please email me at [email protected] Questions that are selected will always remain anonymous. I enjoy reading your thoughts in the comments section. Be respectful, but don’t be shy!

Dear Gabe,

My child committed suicide just over a year ago and the anniversary of his death has brought forth so many emotions, especially anger. I miss him terribly, but I just cannot get over how selfish he was. How could he not even think about what this would do to his family?

Angry Mom

Dear Angry Mom,

Of all the misinformation about mental illness that exists in the world, the mentally ill committing suicide is the cruelest one. This bit of misinformation strips the dignity from the dead, vilifies people living with mental illness, and bullies the deceased’s loved ones.

Mental illness has no cure. It is a disease, and people do suffer greatly. And, like many severe illnesses, people do die. But unlike when a person dies of cancer, victims of mental illness are often blamed by the survivors for their own deaths.

To be clear: the person who has died isn’t faking, seeking attention, or manipulating anyone. They are just dead. Their illness was so severe that it literally ended their life.

The mentally ill do not “commit” suicide. It makes it sound like they did it on purpose or that they had a say in the matter. But they don’t, really. Their illnesses were in control.

The entire concept of “committing” suicide, as it relates to mental illness, is nothing short of tragedy. Your son died by suicide. More specifically, he died from his mental illness, which caused him so much torment and suffering that he ultimately succumbed to it. It was not his fault, nor was it his desire. Most importantly, it wasn’t his choice.

Your son didn’t kill himself; the illness killed him. I understand your desire, even your need, to be angry, but please direct it where it belongs. It is not your son’s fault for dying from mental illness any more than it is my grandfather’s for dying from cancer.

I can only imagine the emotions that you, and your family, are experiencing because of your loss. I have experienced loss in my life, but I am certain it doesn’t compare. Please accept my sympathy and I sincerely hope you can forgive your child.

~

Dear Gabe,

I also live with a mental illness and I find it frustrating that I am always told what is wrong with me and what medicine will fix it, rather than what I am doing well. I acknowledge that I’m sick. I’m not trying to insult doctors, or medicine, but why is the medical community so quick to dismiss the patient?

A Person, Not a Problem

Dear Person,

Your complaint is common in advocacy circles. There is often a tense relationship between medical professionals and patients. Ironically, both sides agree that this tension exists, although each side is quick to blame the other.

First, let’s dismiss the notion that anything unethical or illegal is occurring. I understand that doctors are human and, as such, make mistakes. But for the purpose of this answer, let’s assume we are just dealing with a philosophical difference of opinion and discuss ways to “bridge the gap.”

Second, we have many different types of mental health professionals. The negative grumbling most often occurs about psychiatrists, who are the only ones who can prescribe medication and, more often than not, have the least amount of interaction with the patient. Let’s focus our attention there.

The lack of time is a huge impediment to positive interactions and outcomes. No one likes to be rushed, especially when sick. People with mental illness want help realizing their hopes and dreams. They don’t just want a pill or a diagnosis. They want to be well so they can worry about something other than being sick.

Because we have a definite shortage of psychiatrists in the United States, it’s common for psychiatrists to spend an inadequate amount of time with patients, so they are unable to truly understand what the patient wants. They have a small window of opportunity to get the information they need to make a diagnosis, prescribe treatment, and move on. The time you have with a psychiatrist can be as little as ten minutes, and you may have to wait months for an appointment.

To make the best use of your limited time with your doctor, write down your symptoms in advance, keep a mood journal, or perhaps bring a trusted friend or family member to help remember questions or report side effects or concerns.

The best outcomes involve the doctor and the patient working together. If you are frustrated at the amount of time you get with your doctor, there are better than average odds that they are frustrated, too. They want you to be well as much as you want to get well.

Both sides need to realize they are victims of a broken and overloaded system and not put the blame on each other.

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Gabe Howard

Gabe Howard is a motivational speaker, award-winning advocate, mental illness blogger and writer, as well a person living with severe bipolar and anxiety disorders. In the past ten years, he has made it his mission to put a face on mental illness that isn’t stereotypical. Society often sees people living with mental illness at their worst and he works to add a more balanced view to the conversation. Gabe is frequently irreverent, often too loud, and always unpredictable, but anyone who knows him will tell you that life would be so boring without him. You can connect with Gabe on TwitterFacebook and his website.

Comments

9 Responses to “Ask Me Anything: Mental Illness Questions about Suicide & Patient-Doctor Tension. ~ Gabe Howard”

  1. Jinpa Heyer says:

    Hi Gabe,

    As a person who has suffered from both mood and personality disorder for decades, I am truly grateful for your response to the question about suicide. Successful suicide is no more the patient's fault than dying of cancer would be for a cancer patient. It is refreshing to see that changing attitudes about suicide are making it out into the world.

    I would like to add that suicidal ideation is also not a ploy for attention or even necessarily an actual desire to die. For many it is an indication of something wrong in life or relationships of the patient that needs to be addressed. Just as a personal example, I had frequent suicidal thoughts just before leaving my last boyfriend – it was a terribly codependent relationship that was holding me back during a time of great progress. The moment I left, I felt a lot better and have continued to improve.

    Your response to the second question left a bit to be desired. Firstly, I'm not sure it's a shortage of psychiatrists that is the problem in terms of getting face time, but the reluctance of the insurance industry to pay for more than the bare minimum of time for visits, and the fact that clinics can often only afford to keep one or two psychiatrists on staff. I would further say that the whole medication-modality is deeply flawed and needs to be questioned.

    I would hope that the person who wrote that second letter can manage to get some time with a strengths-based social worker or some other talking therapy that emphasizes strengths while providing whatever balance of practical advice and unconditional positive regard is needed in the moment. I wish "Person" the best of luck in obtaining that; it's not an easy process, but it sounds like you already have a good head on your shoulders; knowing what you want is the best first step.

    • Gabe Howard says:

      Hello Jinpa –

      I appreciate your reading and comments. I agree with you — I could write a book on the subject of doctor-patient relations. There are many factors that contribute to misunderstandings and poor care — just as there are many factors that contribute to good care and positive outcomes.

      I enjoyed your viewpoints and I am thankful you shared them. I wish I had more than a few hundred words sometimes — it would be great to be able to share more details and even the viewpoints from the people directly impacted (instead of just general information).

      Thanks again for reading and sharing. I believe that all conversations about mental illness can be productive ones.

      ~Gabe

  2. Gabe, that's one of the best description on suicide I've read, you really are spot on…it's the illness/disorder that's the really to blame. More education and needed to stop this epidemic. I to hope that "Angry Mom" one day can reach a point in her grieving to find peace and forgiveness. Also to know she probably did all she could.

  3. Anon says:

    Thank you so much Gabe for your comments on suicide. One of my greatest regrets is a suicide attempt I made several years ago. It happened about four months after I was date raped and during a breakup from a subsequent volatile relationship. I did it because I really felt there was no other way, which seems ridiculous now but felt very real then. Even as I did it I remember feeling heart broken at what I was trying to do, so I genuinely relate when you say to Angry Mom that suicide is not a choice because at the time I felt I had no other choice.

    Obviously I was lucky, I survived and got another chance at life but the fact that it happened is something that I felt deep shame, regret and guilt over ever since. It is something that if hurts to even think about. I was never diagnosed with a mental illness so perhaps what you've written doesn't really apply to me but it helps to know that perhaps not everyone out there would vilify me for what I did were I to ever talk about all of this.

    Thanks for your post and my heart-felt sympathies to Angry Mom and her family.

    • Thank you so much for reading and commenting. I am very glad that you enjoyed the blog but, more importantly, I am glad that you are still with us. It is important to know that thoughts of suicide are never "normal." Wanting to die is a sign that something is wrong and that you may need help.

      No matter what the underlying cause — Suicide is a permanent solution to a temporary issue. More importantly, people are important and have immense value.

      ~Gabe

      • Anon says:

        Couldn't agree more, I know its a cliché but 'life is precious' and I value mine and the second chance I am lucky enough to have. What I tried to do is one of my biggest regrets and something I am deeply ashamed of doing.

  4. Ted Folke says:

    As someone who was official caregiver for his bipolar mother for more than two decades, I would appreciate a discussion of the resources provided by the states in the US to help caregivers, who often have jobs and famiiies, as I did. I was in the state of Connecticut, which is a relatively enlightened state, but not when it comes to mental health. I worked closely with my mother's excellent psychologist and psychiatrist, but received no support from the state whatsoever. Ironically, if my mother had had Alzheimers or cancer, for example, home health assistance wouldhave been covered.

    • Ted – There is a shortage of support for people with mental illness and that, as you have seen, trickles down to caregivers. More support needs to be provide on all levels.

      I am going to keep this and hopefully use it for a future column, as there is much that can be said on this subject.

      Thank you for reading and commenting. It is much appreciated.

      ~Gabe

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