Suicide Prevention/suicidal thoughts

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QUESTION: rachel,
i was finally starting to feel a bit better from the previous situation with the mail carrier. now it seems as though he is at it again. i went outside the other morning and everything was fine and in order. that evening i noticed that the small pole, in our yard, with our address number on it was knocked crooked after the mailman had come. my anger flared up once again.  i wish i didn't have so much fear of approaching our mail carrier and letting him know how i feel. this new situation has got me having suicidal thoughts. my psychiatrist doesn't seem to think it's such a big deal. i really want to see a therapist/counselor, but i am unable to afford one. they only take private pay. i just feel i should let you know a little of what is going on in my mind. i am so upset and overwhelmed. as always thanks for your time.

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ANSWER: Dear Greg,
I'm sorry that you're so upset and distressed by what may or may not be happening with your mail carrier. I say 'may or may not' not because I doubt you, but because you can't be certain that it is he who is at fault, even as likely as it seems, and you can't be sure whether any acts of vandalism or harassment are being done deliberately to upset you, or are simply the result of the mail main (or other person) rushing by and accidentally bumping the mail box, or pot plants, etc. It is very difficult to prove these sorts of things, especially if you do not have a camera set up for surveillance. (By the way, what did you think of that idea?)

Far more important than what the mail man is or is not doing, is how you are affected by the situation. I'm sure you can see that the amount of worry, anxiety and stress that it is causing you is disproportionate to the problem itself. Recently I told sent you a link about obsessive compulsive thoughts.. would you agree that you may be affected by OCD? I would like to know what you felt about addressing this problem as the main issue, as opposed to the issue that you are worrying about at any particular point in time.

It is important that you learn skills to master your thoughts and regain control of your life. There are many cognitive therapies designed to reprogram the thinking patterns of those who suffer this disturbing and unsettling disorder. I note you say you see a psychiatrist.. have you raised this with him? You have not said what it is he is treating you for, but presumably he is aware of what he is attempting to help you with. Has he give you a formal diagnosis? Are you on any regular medications? If you do not feel he is helping you, try to find somebody who can.

Please could you tell me where you live so that I can look into what resources are available in your area. There are likely to be some free services that can provide a low or no-cost counselor or support groups in your area.

Greg please get back to me on this, and meanwhile I will see if I can find some general information specific to the USA. I'm sure if we work together we can find treatment that will be right for you and suited to your needs.

Please keep me posted, and try not to worry.

xoRachel



---------- FOLLOW-UP ----------

QUESTION: hello rachel,
i live in waco, texas, if you want to try to find counselors in this area who take medicare or have a low fee. i hope there is someone out there who can really help me with my issues. i'm pretty desperate.

ANSWER: I'll look into this Greg. Meanwhile, are you able to tell me more about your psychiatrist? What prompted you to seek out a psychiatrist? I presume his/her fees are covered by your medicaid..?  Speak soon.. xRachel

---------- FOLLOW-UP ----------

QUESTION: i had a mental breakdown a couple years back. i was sent to an institution for this problem. they got me on medication while i was there. after i left i knew i had to seek someone to prescribe my medication. there is a facility in my hometown that has psychiatrists who except medicaid. i knew i needed to sign up for this as soon as i could. my fees are covered with medicaid. i see my psychiatrist mainly for medication. he doesn't give much helpful feedback. this is why i really need to see a counselor who digs deep into my problems and searches for solutions. if i can get a good counselor, i would still plan on seeing my psychiatrist so he can continue prescribing my medication, which i absolutely need.

Answer
From what I can gather, medicaid is also able to provide you with a psychologist who could work through your issues with you. Greg, could I ask you to please entrust me with your psychiatrist's contact details, or the institution where you were evaluated at the time of your breakdown so that I could write to somebody in a position to help. I would ask that you be provided with the ongoing counseling you need and also some follow-up care.  However, if you would prefer, you could make an earlier appointment with your psychiatrist and TELL HIM exactly what's on your mind. If you find it hard to talk to him, print out our emails. It is possible that he may not have seen anything in you to warrant his concern, or the need for additional counseling, but that should not prevent him from listening to your concerns and helping to provide you with appropriate counseling services.

Whatever the case, there does seem to have been a breakdown in communication between the two of you. Perhaps he has not probed deep enough or been as thorough as he might, and maybe there's been some reluctance on your part to admit that you aren't coping as well as he seems to think. Clearly your problem is that he doesn't know what's really going on for you. The solution is to make sure that he does! If - between the two of us - we are able to communicate your situation and needs, he is obligated to provide you with access to the services you need. It is his job to do so.

If you would prefer not to go through your current psychiatrist, you could contact the institution and ask to meet with a case worker to discuss your current needs. Explain that you feel you are still having problems that have not yet been addressed, and would like to see a different psychiatrist - one that you might have a better rapport with - and one who will recommend adequate sessions with an appropriate psychologist. Don't be concerned about admitting that you don't feel your current psychiatrist is a good match for you - this happens with many people, and it's a matter of finding the right fit for you! The same applies with a counselor. When you are assigned a psychologist, try to be up front about whether he/she is right for you. It's also a good idea to specify if you feel you might relate better to a particular type of person - male instead of female, older instead of younger, - it's okay to have a preference given that you need to feel at ease to open up with that person.

Come what may, help IS available and accessible to you Greg, - It's a matter of knowing how to access it. I'm sure if we work together we can succeed in getting you the care you need.  Tell me your thoughts.. should I write on your behalf? Or would you prefer to speak to somebody yourself..?

Speak to you soon Greg, I hope you are having a lovely Friday. :-) Rachel

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Rachel Hurst

Expertise

All questions sent to me will receive a warm and caring response. I'll do my utmost to address a persons particular problem, but in most cases will also attempt to supply that individual with additional resources which might be of further benefit. There are many helpful online support groups where readers can benefit from the ongoing support of others who have suffered similar problems. These groups offer invaluable peer support from others who have 'been there'. As well as responding to your initial letter, I'll attempt to provide ongoing encouragement when this is needed. Advice will be focused on addressing the writers individual needs, and providing related information and resources. I would try to ensure that any person seeking advice has accurate and up-to-date information on the signs and symptoms of depression, and importantly, is made aware that help is available through many different avenues. Where I feel that it's relative and helpful I would mention my own life experiences with depression and coping with a loved one's suicide (however, only in context.) I would be on the lookout for warning signs that the person is in crisis and may require immediate intervention. As such I would arm myself with as much information as possible in order to refer them to the help they need. In cases where I believed the persons life to be in imminent danger I would contact authorities in their area, or if unknown, I would call the emergency services in my area in order for the person to be located through tracking.

Experience

I am by no means a trained professional. My knowledge comes mainly through life experience, having endured the devastating loss of my best friend through suicide, as well as my own subsequent battle with depression following his death. I found that my own experience of losing a loved one to suicide put me in a strong position to help others, due to my ability to empathize (as opposed to sympathizing). I became knowledgeable on the topic of grief, and the extensive repertoire of depressive illnesses, signs, symptoms, and treatment options available to people in crisis.

Organizations
S.O.L.O.S. Survivors of Loved Ones Suicide - Active member since 2003.

Publications
'Marie Claire' Australian, 'Cleo' (Australian), Online discussion forums (in which my submissions have stimulated discussion and generated much feedback).

Education/Credentials
I am a professional writer. I was trained in journalism. Please see my profile in Linked In. http://au.linkedin.com/pub/rachel-hurst/41/178/165 I have studied related subjects during training as a registered nurse. Both of my parents are mental health professionals. However most of reading widely and life experience has been my greatest teacher.

Past/Present Clients
I have helped a number of individuals who have sought my take on a particular problem, or whom I have felt concern for, for various reasons.

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