I Am Suicidal and Therapy is Not Working

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Reader’s Question

I am 56 years old with a diagnosis of borderline personality with severe MDD. I have attempted suicide 12 times since 2005. It seems like I have a 90% or higher chance of being successful considering the number of attempts and the fact that I am chronically suicidal. I live alone, have nothing to look forward to and hate my life. I have many losses. Life seems too painful to go on. If my chances are so high, why postpone the inevitable? I am in a year-long DBT program and it does not seem to be helping at all. What do you think of this? My chance of recovery seems low. Willingness to accept that I have a chance to have a life worth living is just not happening for me. I have heard repeatedly that “this is not forever” — too many times. Seven years in this state does seem like forever.

Psychologist’s Reply

When I read your post I hear a lot of hopelessness, losses, and pain. I want to say first that you have my utmost respect for approaching your problems head on in treatment. Borderline Personality Disorder and Major Depressive Disorder are difficult to tackle, and the fact that you are still here today despite being suicidal speaks to your strength as a person.

You mentioned that you are in a Dialectical Behavior Therapy (DBT) treatment program, so I assume you have a therapist whom you see regularly. So my first question would be, how much of what you have posted here does your therapist know? Sometimes in therapy it can feel as if things are not moving along at all or as quickly as you would like. It can even feel as if things are getting worse rather than better. These are common aspects of entering the therapeutic process, and your therapist would likely be able to speak candidly with you about those concerns. In some cases, treatment needs to go in a different direction. In others, a conversation about how you are feeling (e.g. frustrated, sad, hopeless) can be enough to shift things. Regardless, the “this is not working” conversation is one that most therapists are perfectly comfortable having.

The other aspect of your post that I want to address is that you have had several suicide attempts in the last seven years and are wondering whether you will eventually be successful. There are many reasons people attempt suicide, including trying to escape pain, feeling as if they are a burden to others, or having a sense that things will not improve, to name a few. You mentioned that you wonder what the point is to life when you expect that nothing will improve. When someone experiences suicidal thoughts in a frequent, intense, and long-lasting way, have a plan about how to commit suicide, access to the means to do so, and feels as if he or she cannot be safe, it is probably time to involve someone else who can help that person stay safe. Sometimes this means a friend or family member gets involved, sometimes a therapist is informed, sometimes a trip to the hospital emergency room is warranted, or sometimes this can mean inpatient treatment. I am not your therapist and therefore have only a limited amount of information here, but I would say that if you are feeling as if you are unable to keep yourself safe, it would be a good idea to let your therapist know. That way, you and he or she can take the necessary steps to keep you safe until things are looking more hopeful for you.

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