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How to overcome suicidal thoughts in my mind?

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Practicing since : 2007
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My 23 year-old son just called. He is extremely depressed and wants to end his life, although he knows enough not to make a specific threat. He says that if we come to his apartment or call 911 his will either be dead or flee and we will never see him again. From the time he was 12 years old until about two years ago he received extensive treatment. He has been hospitalized, taken medication and had talk therapy. He now refuses to get any help whatsoever. I believe I talked him down tonight, but he consistently asserts that he will eventually do it. He is very isolated, his girlfriend broke up with him about a year ago, he can't get the interest of any girls and is down to about one friend, if that. The list of negatives goes on and on. Any suggestions?
Posted Thu, 23 Jan 2014 in Mental Health
Answered by Dr. Srikanth Reddy 36 minutes later
Brief Answer: Its an emergency Detailed Answer: Hello, Thanks for choosing health care magic for posting your query. I have gone through your question in detail and I can understand what you are going through. From what you have stated it appears that your son is having a severe depressive episode. I understand that he has not benefitted by the treatment. But at present the suicidal thoughts in his mind cannot be taken lightly. A person commiting a suicide does inform mostly to his near and dear ones before he commits the act. Modified electro convulsive therapy under anesthesia is the treatment of choice that you should consider. This treatment will give him maximum benefit without any significant side effect. Also if he refuses to cooperate, as per your state laws you can seek help from the legal framework and get him admitted under forced conditions. Worst come worst your son will get angry but that will save his life. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback. In future if you wish to contact me directly, you can use the below mentioned link: Wish you good health, Kind regards Dr. Srikanth Reddy M.D.
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Follow-up: How to overcome suicidal thoughts in my mind? 8 hours later
Court orders are extremely difficult to get. He is plenty smart enough to have not made specific threats indicating method or any immediate plans. As I understand the law, we would have to start with a 72 hour hold. In order to impose such a hold, the police would have to break into his apartment. We believe he is absolutely capable of putting on a good front for 3 days in the hospital at which time the hospital would have to release him. ECT seems extreme and I'm under the impression that it is a treatment of last resort. He hasn't been on meds for about 4 years. They weren't effective but it's hard to know whether they just didn't work, were not prescribed correctly and/or he was being manipulative. Actually, the manipulation is a given.
Answered by Dr. Srikanth Reddy 10 hours later
Brief Answer: ECT is not so harmful Detailed Answer: Hello I understand that law of the state varies from region to region, but in such circumstances you just have to put your best foot forward and wait for it. If you avoided doing this at this juncture and God forbid something bad happens then you will start blaming yourself in future. ECT is not that bad as it is portrayed in movies. Its one of the safest procedure in psychiatry and is infact the treatment of choice in suicidal cases and has the best response. I have given atleast 300-400 ECT in my life and none of them had any complications. If the compliance to medicine is poor, then ECT is all the more indicated and ones he is out of depression, he may take his own tablets. Regards Dr. Srikanth Reddy
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