To tell or not to tell about suicidal ideations...

I am new to this site and using online support networks in general. Apologies in advance if this question has been addressed elsewhere or if I'm posting in the wrong forum, etc.

Here's the short version of my dilemma:

• I often feel suicidal and I have a plan to kill myself.
• It would take weeks to gather the items needed to carry out this plan, and I have days when I do not feel suicidal at all so I'm not in any imminent danger.
• I have been lying to my therapist/prescriber and telling her I'm doing well so that she would prescribe me ADD meds (i.e. stimulants, controlled substance.)
• I am currently on a low dose of a stimulant drug, but it is not enough to alleviate my depression/suicidal urges.
• Stimulants are the only thing that have ever given me reliable, long-lasting relief from depression and suicidal urges (and I've tried many things.)
• I have a history of drug and alcohol abuse and my doctor will not continue to prescribe me a stimulant or increase my dosage if my mood is unstable or she detects that I am drug seeking.

Bottom line:

Common sense tells me I should come clean with my doctor, because she is a trained professional who will know how to help me (whereas I am not.) However, I don't know how I'll cope with not being on a stimulant and telling the truth feels too risky.

---------------------------------------------------

Here's the long version (feel free to skip it):

I have a plan to kill myself, but it will take a few weeks to get everything in place. It is the only plan I can realistically see myself carrying out. I currently have no desire to kill myself, but I know its just a matter of time before suicidal urges set back in. I am tempted to set this plan in motion so that it will be ready to go if/when the time comes. I've started to see my "good days" as passing illusions and the "bad days" as the permanent reality underlying it all. So even when I'm in a positive mood I have this nagging feeling like these fleeting pleasures are just distractions from the true task at hand (i.e. ending my life.)

I'm not sure if I'm tempted to "get ready," because I find comfort in having an "exit plan" handy, or because I genuinely want to go through with it. Having the means to end my life literally in my hands is actually life affirming, because it sparks my survival instincts (I know this from previous experience.) Perhaps I'm just looking for that jolt to jumpstart my will to live. Maybe this is a cry for help and I'm unconsciously hoping to get caught. I really and truly don't know what my motivation is and therefore cannot assess how much danger I am in/what course of action to take.

I have a hard time following through on things so its highly likely that my interest in this plan will fade away because its too much work, but you never know. I don't know.

I don't have a therapist per se, but I do have a prescriber that provides some counseling above and beyond medication management. I have been lying to her and saying that my antidepressants are working, I'm not feeling suicidal, etc. I've been lying because she will only prescribe me ADD medication (i.e. stimulants) if my mood is stable. Stimulants are the only thing that have ever given me reliable, lasting relief from depression and suicidal urges (and I've tried lots of things.) However, I have a history of drug and alcohol abuse so coming clean to my prescriber will eliminate my chances of getting on an effective dose of any stimulant.

What do I do?

 

Welcome to the forum. I am glad you joined the forum. Yes, you stated what you need to do and tell the doctor what is really happening. What you have in the past is the past. You need to get the correct medication and try not give into temptation.

The doctor cannot refuse to treat you as its their duty but that dependant on the laws of your current country. I think you are a good person who needs someone to listen. I think you are brave in joining as it took guts to open up to this forum. I think you need to be strong for yourself as you are a survivor in my book.

Please speak to others in the chat room and they can also help. Don't worry if the post is long as YOU are important and need to express your feelings here.

Take care and please be safe.

 

What you are doing does not appear to be working for you. Your prescriber may not provide enough of the support you need either. I love mine but I only see him every 6 weeks.

I would start with finding a weekly therapist to deal with the suicidal planning and emotional regulation. Be honest and allow this therapist to work with your prescriber too.

 

Thanks everyone for your input. I'm currently looking for a weekly therapist. Deep down I already knew that I should be honest with my doctor, but its helpful to get a nudge in the right direction from you guys.

I have a really hard time being honest with doctors and therapists. When I first start seeing a new doctor/therapist I tell myself "this time will be different" and I truly intend to be honest, take their advice, and try my best to do what they ask me to do. I'll even warn them that I struggle with being dishonest/non-compliant, and that I'm trying to turn over a new leaf. Then there's a period of time when totally open with them and they start to trust me. It feels good to not have to lie, and I feel proud of myself for putting in the effort and actually dealing with my shit.

Eventually I get impatient and frustrated with my lack of progress and "take matters into my own hands" (i.e. lying and manipulating.) Inevitably I also get irritated with their insistence that I quit drinking, tired of failed attempts to quit, and sick of my therapist telling me to stop lying to my prescriber to get the meds I want. Thats when the lying really starts. After a while I realize that talking to my therapist is pointless since so little of what I say is true, so I stop going. Then things fall apart. I end up such an emotional wreck that I even fess up to my prescriber or get a new one and spill my guts to them. And so the cycle goes on.

I know that this kind of chronic, almost compulsive dishonesty is a hallmark of addicts and alcoholics. I just don't feel like my drinking or use of prescription drugs is extreme enough to warrant going to rehab. However, my inability/unwillingness to stop keeps me from being able to get real help for my emotional issues outside of a rehab (or other mental health) facility.

Sorry for getting kind of off topic. Is there a substance abuse forum where I should repost this?

 

Nvm, I just realized that the substance abuse forum is lumped together with self harm.