689 How to Help the Suicidally Depressed Person - Dr. Peter Breggin

How to Help the Suicidally Depressed Person - Dr. Peter Breggin

Newsletter published on 17 October 2014

http://www.youtube.com/watch?v=t7OPWRqjaSQ

How to Help the Suicidally Depressed Person--Dr. Peter Breggin's 5th
'SimpleTruths About Psychiatry'

Peter Breggin MD

Published on 20 Sep 2013

Psychiatrist Peter R. Breggin MD talks with us about how to help a
person who is suicidally depressed. Depression is a total loss of hope.
Dr. Breggin details how to help someone to rediscover their hope and how
they want to live. See the rest of Dr. Breggin's 'Simple Truths' series
via his website http://www.breggin.com; or on his main youtube channel:
http://www.youtube.com/user/PeterBreggin. For more information see Dr.
Breggin's professional webpage http://www.breggin.com and his books,
including Heart of Being Helpful and his most recent book, Psychiatric
Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and Their
Families.

TRANSCRIPT - transcribed by Peter Myers

I'm Peter R. Breggin MD, and I am a Psychiatrist, and the subject today
is the Suicidally Depressed Person, and it is number 5 in my series of
Simple Truths about Psychiatry.

In some of the earlier presentations I talked a lot about the problems
of using drugs. I'm going to talk more about that, in more detail, in
later presentations. But I'm taking a break to talk about more positive
things. And my previous presentation, No. 4, was about dealing with the
very disturbed person who gets labelled Schizophrenic, and helping them.

And this time I'm going to talk about another really frightening
experience, which is the suicidal patient.

Let me say that I've been doing Psychotherapy since 1968. For most of my
life I've had a very full practice – of like 30 hours, 35 hours a week –
which is many more patients than that, since I often see couples and
families. Then I moved up here, to live in upstate New York - I live on
a lake, that's where we are right now – and I've been here for 10 years,
and I do about half that many patients a week; many people consider that
still a full practice.

And during this entire time, I've never had a suicide in my practice.

Now, one could attribute that, in part, to doing good therapy. But I
think that a very good therapist could have suicides in their practice,
even more than once. I think some of it is luck – sometimes I feel
protected in my reform work – but I think another big reason is that I
never give psychiatric drugs to people for their problems.

I don't start people on drugs. If you come to me feeling suicidal, I
don't give you the drugs. Why would I want to give you an
anti-depressant, when it's got a big box warning on it that up to age 24
you even see an increased suicide rate on anti-depressants in controlled
clinical trials, and then we've got lots of other studies showing that,
as you might expect, the suicide rates also increase in older people?
Why would I want to give a drug that has lots of warnings about
worsening your condition, to someone whose condition is already worse?

So what is the answer to being so depressed you want to kill yourself?

When I talked about Psychosis, I talked about the breakdown of the
fabric of all the connections to human beings, which end up in a state
that looks crazy and nightmarish. In Depression what happens is there's
a total Loss of Hope.

Hope. What keeps us going? Why do we get up in the morning? Well, we
expect to live; we have hopes of doing something worthwhile; we think we
have a future.

But when your internal conflicts, or the effects of your childhood, or
the stresses in your marriage, or the loss of loved ones, or the loss of
hope for a wonderful life and career - when Hope fails, that's when we
fall back into Depression.

So, what's the answer to Depression, from the viewpoint of the
therapist? Well, the most important thing is to be hopeful. You want to
be a really hopeful, hopeful therapist. Just like when you're dealing
with a person who's lost their social fabric, and can't connect and is
distrustful, you want to be a really connecting therapist. In this case
you want to be connecting and really hopeful, to overcome the loss of
hope. And we know that's just about the only factor in mental health,
that we can point to and say it reduces the suicide rate, that is
Rapport.  That's the more technical term, but I don't like that at all -
I like the straightforward, a Hopeful person.

Now, if you go to a Psychiatrist and you tell him, "I feel so horrible,
I feel like my body's rotting, I feel like there's something wrong with
my brain, it's hopeless", and the Psychiatrist says, "Well there is
something wrong with your brain - a bio-chemical imbalance", is that
Hopeful? Does that give you the sense of "I can triumph; it's in my
hands; I can turn my life around; I can stop thinking of compromising; I
can start thinking of what I really want to do; I can actually dare
love; I can dare stand up for myself; I can dare, maybe, even, change my
work, maybe even become more spiritual, maybe find God"?

That's not what you hear. And does your average Psychiatrist look
hopeful? [shakes head] Go to an American Psychiatric Association meeting
- uh uh - because people who give drugs and diagnose people, they become
unhappy people, they're not hopeful people.

And can you be hopeful, doing a 10-minute Med check? Of course not. So
the most fundamental thing for helping the really depressed and suicidal
person is to build a hopeful relationship. You find their strengths, you
find their dreams, you help them discover what they really want to do
with their lives. And, as in much of the work I do, I find that if there
is a family that this person wants to be in, and wants to have a life
with, then you work with the whole family. And you help them love, you
help them get that love out, that's been buried by the anger, and the
rage, and the fighting, and the disappointment. You help all the members
of the family begin to think not only about themselves but each other,
and also better about themselves, about their own qualities to love and
to create, be responsible and to take charge of life, you can work with
the whole family in that regard, or with the couple - husband and wife -
with the kids coming in once in a while, giving them a little dose of
hopefulness.

You can also do the more therapeutic thing, because sometimes you find
the person's been depressed all their lives - it's not some acute
situation, quite often it's all their lives - and it's easy to explain,
if you've been depressed your whole life, you need to go back and see
where you lost hope as a child. And you'll be surprised how quickly
people can begin to discover where they lost hope: the alcoholic father,
the absent mother, the bullying in school, the feeling humiliated about
being Gay, whatever. It's not hard usually to then to get some semblance
of what was going on, and you work with that, and you explain, "Well,
those terrible lessons of hopelessness, and just deciding you weren't
going to wish for anything, you weren't going to want anything, and if
you did want something it would be taken away - we can change that
[unclear], you can begin to think, "Wow, I can only get what I seek, I
can only enjoy life if I'm doing things I want and love to do. I have to
take charge of all of that."

Now this is pretty simple stuff I'm describing, it's not the whole
picture, it's not the whole story, but I do want to let you know, that
if you're suicidally depressed, it's a good sign. It's a good sign. Why?
Because you're full of feeling. The extent to which you hate yourself,
and you want to die, reflects another vision that you must have that's
led to your disappointment.

I'm more concerned about the person who comes in without feelings;
that's another reason why I don't want to give people drugs, if they
don't have feelings. But the person who's suicidally depressed and
really wants to die, invariably is a passionate person with a huge
capacity for life, that's been thwarted and inhibited, and distorted by
life and by bad decisions and by giving up. So, I welcome suicidal
thoughts, I don't try to drive them away, I welcome them and say,
"Alright, let's look at why you would want to die; what are you missing?
What do imagine you could have? What have you lost? What's going on
inside you that's such a conflict, that you can't move forward? Welcome
your feelings; your feelings are your signals, and that's your answer.
They're your signals of how to go, and where to go, and where to take
your life. And have lots of hope, because it's in your hands to find out
how you want to live, and to do it as nearily that way as you possibly
can. Thanks."

== Peter Breggin has made expert presentations to the US Congress. His
books include Toxic Psychiatry, and Psychiatric Drug Withdrawal.

https://www.youtube.com/watch?v=0F_kLbtnWWM

How to Help Deeply Disturbed Persons

Peter R. Breggin MD

Fourth in the" Simple Truths" Series.

The topic today is going to be the person who is Psychotic, and gets
labelled Schizophrenic, what what would really most effectively help
that individual. The first three presentations in this series have been
about the limits of psychiatric drugs, and how they are harmful to the
brain, and I think it's time to take a little break from that, and look
at how do we help, without using drugs, some of the most very upset people.