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Holly MathNerd's avatar

Correct. I have wrestled with the demon of self-termination regularly since before puberty (really shitty childhood, nothing more interesting than that). You describe the way it actually works, accurately and eloquently.

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Peter Liepmann's avatar

High energy ppl w depression are often bipolar spectrum.

Treatment resistant depression is often somewhere on the bipolar spectrum, and meds for mood stabilization (in any case, DIFFERENT from the usual antidepressants) can be very effective for treatment.

Ketamine (and esketamine/Spravato, for ppl with good insurance) can also be effective.

The most common first symptom of bipolar spectrum disorder is depression. It's often many years before someone has a high energy period.

If your primary doctor is unwilling/unable to try Rxing them, talk w a psychiatrist.

Know that most psychiatrists DON'T participate in insurance, because insurance companies are terribly abusive, and those of us who recognize abuse don't willingly tolerate abuse.

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Spouting Thomas's avatar

Fully agree with this description of suicide. The last suicide to affect my life, 2 years ago, was characterized by an utter impulsiveness that drove this point home in a way that I never fully internalized from the prior suicide to affect my life, 7-8 years ago.

At that time, I suppose I still thought about suicide more as the culmination of a sort of grim, natural progression. A capstone to everything that friend's life had been building to, between a failed marriage and a failed career and a son that flunked out of college. He worked in sales, and so the Willy Loman analogies are inevitable, and I suppose putting the words "Death of a Salesman" on the playbill sets us up to think about suicide this way.

But the most recent suicide had none of that. A young man with a young wife and a baby and a good job and his whole life ahead of him, but also a handgun readily available and some bad but survivable news, and I suspect too much to drink. Sometimes that's all it takes: a loaded gun that happens to be in your hand on the worst night of your short life.

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Peter Liepmann's avatar

Treatment resistant depression is often somewhere on the bipolar spectrum, and meds for mood stabilization (in any case, DIFFERENT from the usual antidepressants) can be very effective for treatment.

Ketamine (and esketamine/Spravato, for ppl with good insurance) can also be effective.

The most common first symptom of bipolar spectrum disorder is depression. It's often many years before someone has a high energy period.

If your primary doctor is unwilling/unable to try Rxing them, talk w a psychiatrist.

Know that most psychiatrists DON'T participate in insurance, because insurance companies are terribly abusive, and those of us who recognize abuse don't willingly tolerate abuse.

Expand full comment