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Depression

Question
Posted by: Juterque | 2018/12/12

Q.

Suicide

Self-harm is the only way I feel alive as if I have control of the torrential range of feelings inside of me. I realize that no sensible doctor worthy of a doctorate would tell me explicitly how to kill myself, but I feel it worth mentioning that I do not like myself, I hate myself. I find, through all my thought processes that death is the only true answer for me. I don't care the effect my death will have on others, call me selfish, a coward, whatever. I no longer care. I have not told my doctor and therapist quite frankly, and I am afraid to as I don't want to end up at a useless hospital again, and I have tried therapy and seeing my doctor(s) for several years, is that not enough of a fair chance? I have put 100% effort into getting myself better, yet I would say overall I am worse than I was when I started treatment. I have been under treatment for seven almost eight years now, so please tell me, why I should continue trying? Also, I did not mean to insult you or cause offense, my apologies if I did.

Expert's Reply

A.

Depression expert
- 2018/12/12

Hello Juterque,
No offense taken. I hear what you're saying, especially now you have  provided more details. I obviously don't know the details of the various treatments you have had, so it's easy for someone outside of the process to think ( and hope ) that it might have been better done in some way, or might still be better done.
Having worked closely, over so many years, with people in similar situations to yours, and with similar responses to yours, I can't help feeling somewhat aggressive, not towards you ( not at all ) but towards the subversive condition that has had you in its grip for too long.  A crucially important issue is where you say that you hate yourself.  I wonder what form(s) of therapy you tried.  From my experience ( and I'm not popular with some therapists for saying so, and I don't mind that at all ), I sincerely believe that psychoanalysis and psychoanalytically based therapies are of very little value, and of none at all in situations such as you describe.  This is based both on my clinical and acadeic experience, and on the lack of convincing research establishing such value.  If you were in my family, I would want you to receive CBT ( Cognitive-Behaviour Therapy ) which does have good research to support it, and has a much more  compelling logic to it. But though it's fashionable enough that some offer to provide it without proper training or study to enable them to do it well, and I'd want only the best and most skilled help for you in this respect.
It also would need you to sincerely engage in CBT, with all the work that entails, and allow it to work, even for someone you dislike, such as yourself !


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