I have to avoid being hospitalized!

[Toby]

I have PTSD and DID but am extremely high functioning.  I struggle a lot with suicidal thoughts and feelings, and have been having a really hard time lately.  If I'm honest with my doctor or therapist, I will very likely be hospitalized.  I have been hospitalized before and I know that, at least in my case, it makes a bad situation worse.  I get intensely triggered by the feelings of confinement and lack of control - even with things as simple as feeling trapped and being locked in, having someone tell me to go to bed at a designated time or regular bedchecks when some strange person omes into my room every hour in the middle of the night (and with my history I'm expected to be ok with that!)  Hospitalization will bring up issues that are secondary to what I'm actually dealing with right now, and really impact my ability to maintain my job, which I am very invested in.  I am trying to keep it all together, but the emotional cost of hospitalization is simply too high for me.

If I don't talk with my caregivers they can't help me and I'm really stuck.  How is a client supposed to talk about suicidal thoughts and feelings in a real and honest way, get the help that s/he needs, and stay out of the hospital?  I know doctors are concerned about liability - and even this forum has a standard line at the end of most replies saying "if you feel suicidal go to the hospital".  Everyone is so alarmist about suicidal ideation and it feels to me more like an issue of doctors protecting themselves rather than thinking about what might really be most helpful for me.  What am I supposed to do?

[HFHS-M.D.-HG]

Dear Toby
Suicidal thoughts are difficult to control without acting on them. If the person experiences suicidal thoughts, it is always advisable to talk to a professional immediately. You can be honest with your therapist and still avoid hospitalisation. A good physician / therapist will avoid hospitalisation  as long as they can trust that you are not harmful to yourself or others.  Communicating your feelings / thoughts to your therapist helps you deal with the situation much positively. Some times hospitalisation would be the best choice considering your safety. You need to discuss with your physician about your concerns regarding hospitalisation and other options that are available. I wish you good luck.

[crazy in al]

seems like a no win situation, doesnt it. i can relate. if i dare to tell my psych what im feeling, ill be in the hospital.  but i know he cant help if he doesnt know whats going on, so what do you do? i am beginning to be afraid of acting out my thoughts so i think its time to level with him. i can refuse to go, i guess. wish me luck! crazy in al.

[heidi]

My stepdad also is suffering from PTSD.Reconizing the problem is the fist step-you have already done that.When the time permits sit down and write a list of what you like about yourself and one you dont like.Then go and make a small journal starting today of your thoughts and feelings.Don't forget to put one nice thing about yourself in the journal everyday.Instead of dwelling on death, dwell on all of the wonderful things in life that you would miss out on.Watching the sunset and sunrise,waves crashing upon the beach,and of course the mars experiment.Seriously though even when you are struggling to find an answer-it lies with in you.For life is a percious gift at times it's not fair.More than you realize there are others who feel the same as you do.Support groups are something to consider when you are ready to make the step.Hospitals aren't camp if you can deal with death then lights out at a certain time won't be a problem.Be up front and honest you have no one to impress but yourself.Your the one who counts
might even make some life long friends there.There is no such thing as a perfect person.So don't be so hard on your self.
My stepdad went a few years ago it really helped our family.

Best Wishes
Heidi

[marcia]

If you have a good relationship with your therapist, you may be able to talk comfortably about it by assuring him/her that you're not making THREATS, just expressing feelings. I, too, come from a sexually and physically abusive background, and often have suicidal feelings--which I haven't acted on in nearly 15 years. My therapist has never threated to hospitalize me for talking about them; he says such thoughts are common, especially for abuse survivors.

Maybe you could start by expressing your fear of discussing the subject, and see what kind of reaction you get? I wonder if you don't feel lonely and isolated, keeping these feelings to yourself?

marcia

[Toby]

Thanx for everyone's response - I'll address each one.

Al, I do wish you luck - and I believe being straight with your therapist is generally the right thing to do.

Marcia, I too have been in therapy for more than 15 years and I have been hospitalized before. I have also never acted on my suicidal feelings - I have never made a single attempt.  She knows my concerns about hospitalization and is generally supportive.  Im glad you have a therapist who has never hospitalized you and I hope you don't have to experience that.  

Heidi, I hope you can take these comments in the spirit in which they are intended.  I have been in longterm therapy for over 15 years.  I have been hospitalized before.  I found your comments discounting and dismissive.  I didn't just wake up yesterday and "recognize" that I had a problem like PTSD.  I have lived with it my whole life.  I have journals enough to fill a library, and enough unhealthy friends from hospitalizations to fill several support groups (which I have also done).  I'm not suicidal because "life isn't fair".  I'm suicidal for very specific reasons which are too complicated for this forum.  I'm glad that you think "life is a gift" - but all that does is tell me about your value system.  I don't mean to argue with you - but given that your stepdad has PTSD I thought you might want to know that my experience suggests (which comes not just from my own life but from other people with mental illness some of which have committed suicide) that cliches like "life isn't fair", "life is a gift", "tomorrow's another day", etc. are not helpful and, as you can see with me, can unintentionally generate a pretty negative response.  And by the way, it's monday and NASA still hasn't heard from the Mars orbiter which cost $163 million dollars and  if they don't hear from it the entire Mars program will probably be considered a failure.  Keep loving and being there for your stepdad.

[marcia]

Toby, I HAVE been hospitalized--several times--but not for discussing my feelings. And I do understand not wanting to go back. The (unnamed) hospital I go to strip searches incoming patients, does bed checks every 15 minutes, lights out at 10:00, wake up at 7:00, or you lose priveledges. Locked wards are scary, restraints are scary, seclusion is scary, being followed around by a male psych tech because you're on "precautions" is scary. I empathize with your feelings about that. I'm just suggesting that talking about suicide in the absence of a threat shouldn't land you there. But it was just a thought.

Best wishes,
marcia