Handout 7b

 

Question 3: A friend of yours is talking about suiciding and you really think they might carry it through, but they've held you tight to a promise not to tell anyone. What should you do in this case?

 

  • You appraise the situation and decide on what to do next.
    1. How often has this person talked of suicide?
    2. How often has this person made a very serious effort to suicide?
    3. When was the last med change for this person?
    4. Does this friend have a regular mental health care professional that they are regularly in contact with?
    5. How do they feel about their mental health care professional?
    6. Has this person been med compliant?
    7. Is this person on or off their meds at this time?
    8. Does this person typically "act out"?
    9. Does this person listen and act on advice or do they continue down self-destructive paths despite your encouragement otherwise?
    10. How many times has this person called on you for support during a suicidal mood?
    11. What happens if you call the authorities in to handle the situation…the police or an ambulance for example?
    12. How do you feel when put into this position?
    13. Ask yourself if you get "something" from being a "rescuer/enabler" to this person.
    14. Is it worth it to you to constantly be put through this wringer called "caring too much?"
    15. Can you live with the results of calling the authorities and letting things go as they may?
    16. Can you live with the fact that some people cannot be saved and will end their lives despite your best efforts?
    17. Can you live with yourself if you tell this person to get help because you are completely tapped out and know not what next to offer for them and then they actually do commit suicide?
    18. What does guilt feel like and are you deserving of it if you turn out to be wrong about this person's state of mind?
    19. Think of this: Is suicide ever a right and if so does someone finally have a right to end the pain and have no one to feel guilty because of their decision?

 

Question 4: You're having a very hard time concentrating and being productive at work and the situation seems to be worsening. What might be your best course of action. Assume you need this job badly and think you can't afford to quit it.

  • Option 1: You ignore the building discordance.
      1. YOU feel the stress from having ignored the problem…not anyone else.
      2. The bad work situation begins to affect your family and friends.
      3. You realise that you are staying with the job only for the money you think is absolutely necessary to your continued well-being.
      4. A consequence of staying in the job is the continued deterioration of your mental health.
  • You face the problem:
      1. Consequence 1: You honestly reveal your mental status to your boss and ask for accomodation for your disorder.
      2. Consequence 2: Your boss says he/she doesn't think any less of you but you begin to notice that they offer you fewer key jobs.
      3. Consequence 3: You ask your boss if they are cutting you too much slack just because of your illness and ask that they not do so.
      4. Consequence 4: Your boss decides you can no longer be depended upon and asks that you take an extended leave.
      5. Consequence 5: You protest the leave and the conditions.
      6. Consequence 6: Your boss takes you at your word, gives you the desired time off to re-establish stability and life moves on.
      7. Consequence 7: You return to work in as good a shape as when you left.
      8. Consequence 8: You return to work , but find you are no better able to keep up with your tasks than when you were first feeling ill.
      9. Consequence 9: Do you quit for your mental health or do you plod on until fired?
      10. What does it mean to decide you can no longer function at the level you once did?
      11. What is your next option and why would you choose that option?
      12. Does the next option have something to do with what you feel you can cope with and those things which you know you definitely can't cope with? (have you asked for accomodation from your boss?)
      13. How much time is enough time off?
      14. Can you accept where you are in terms of your illness without blaming yourself?
      15. If where you are now indicates that you will never work in a similar position ever again can you mourn for that loss and then let it go?
      16. All of these are choices you face and can make…only you can decide if the outcome is something you can live….or die with. Choose well.

 

Question 5: You've taken your medications for being bipolar religiously, but now they seem not to be working and you are wondering if the side-effects you suffer are worth staying on the drugs. What is your next course of action?

  • You quit your medication cold turkey.
    1. Possible consequence: You suffer a horrid withdrawal from one or more of the drugs, making you physically quite ill.
    2. Possible consequence: You are plunged into either a manic or depressive episode due to abrupt withdrawal.
    3. Possible consequence: Due to abrupt withdrawal you end up being hospitalised to stabilise you.
    4. Possible consequence: You lose family, friend's and doctor's trust in your ability to manage your illness by yourself.
    5. Possible consequence: You hurt yourself or someone close to you either physically or emotionally.
    6. Possible consequence: The drugs you were taking fail to work for you due to having stopped them.
    7. Possible consequence: You have absolutely no problem at all with the sudden stopping of the medications and assume that you will be able to do the withdrawal thing any time you wish.
  • You quit the medications by gradually ramping down on them with the guidance of your psychiatrist.
    1. You have a safety net in place...everyone knows what you are doing including family and friends.
    2. Trust is increased on all fronts.
    3. You keep a journal of the entire process.
    4. You agree to let those who need to know if anything seems to be going amiss (such as an oncoming episode).
    5. Once de-toxed and med-free you agree to stay in touch with your psych professionals so they can continue to monitor your progress.
    6. You remain stable for a long period, only seeing your doctor for therapy or a general "state of your mental health" consultation.

Please see the Handbook for Non-compliance for more information on this last topic.