Hello, friends. In this episode, I answer two super important questions relating to depression and coping with suicidal thoughts. I talk about strategies to help with communication and provide resources to help get through difficult times.
Content warning: This episode covers sensitive topics including suicidality (Q2), which some listeners may find uncomfortable. Please use your own judgment and feel free to skip a question or leave the episode completely.
I don’t know if I have depression. I am a student and for the past 2 weeks I’ve been avoiding all my schoolwork – individual and group tasks. I’ve been worried that my friend would hate me after ignoring her attempts at contacting me and my groupmates kicking me out of the group. I feel nervous every time I get calls from her, so I ignored it. I told myself that I should contact them and explain but I am afraid that they would think that it is trivial, so I kept pushing it off. My friend then contacted my mother. I got scolded for not attending classes and now they think that all I do is watch k-drama and said that I was addicted to it. In fact, I don’t feel like doing anything. I feel listless and unmotivated. I read webcomics to distract myself from everything and avoid thinking about my problems. After getting scolded it got me thinking that maybe I have depression. I took an online test twice from different sites and the results came out that I may be suffering from moderate to severe depression. I don’t want to tell this to my parents. It’s always been hard for me to tell them things mostly because they’ll just think I’m just being petty. I don’t know anyone I can ask for help.
Oh man, I’m sorry that you are going through this. I don’t know how old you are from your question, so it’s hard to be totally specific about the strategy here. I am going to take a guess just from the language that you’ve used that you are a high school student, but please excuse me if I’m wrong.
I’m not here to diagnose you, but I will definitely say that you sound like you are on the right track with your thinking. I know it’s hard to know whether you are making a big deal about nothing or making it up in your head. You are definitely not just making this up in your head. We can all feel depressed at times, but when we start considering something to be a clinical disorder is when it is significantly impacting your life. For instance, impacting your work, school, or personal relationships. It kind of sounds like it is significantly impacting all of the above here. I am especially concerned given that your friend contacted your mother. If your friend is worried enough to make a move like that where they know they are probably betraying your trust, they must think that the situation is serious.
How is depression classified?
- 5 or more symptoms over a 2-week period
- depressed mood most of the day
- diminished interest or pleasure in activities
- significant weight loss or weight gain or decrease in appetite
- slowing down of thought and reduction of physical movement
- fatigue or loss of energy
- feelings of worthlessness or excessive/inappropriate guilt
- diminished ability to think or concentrate, or indecisiveness
- recurrent thoughts of death, suicidal ideation, suicide attempts, or plans
To receive a clinical diagnosis, these symptoms must cause clinically significant distress or impairment in social occupational, or other important areas of functioning.
I’m sure this is no surprise to you, given that you’ve taken a few questions, but you fit a lot of those criteria. I’m hearing depressed mood, diminished interest in activities, inappropriate guilt, and diminished concentration at the very least. Now one thing that I want to make sure I mention is that there are absolutely medical situations that can contribute to this, so it is important for you to mention these difficulties to your doctor. There could be a vitamin issue, a hormonal issue, or even something like a thyroid issue that is causing some of the depressive symptoms that you are experiencing. Even if you aren’t necessarily falling into a lifelong pattern of recurrent depression, times are difficult and you deserve to pay attention to this. You aren’t just being dramatic.
Talk about it!
I understand if your family is difficult to approach about mental health issues. I don’t know your background, but there are often cultural issues wrapped up in this. Some family cultures just don’t talk about mental health or expect you to be able to manage things on your own without burdening the family. However, I would ask for you to push back on any assumptions you have about this. You have to try. Even in some circumstances, when families make disparaging comments toward people with depression or other mental health difficulties, they change their attitude when they realize that it is happening to their own child. Not always, but it is a possibility.
You need to reach out for help. If you can’t bring yourself to talk to your parents directly about it, you might need to find another way around it. For instance, you could ask them to take you to the doctor because you haven’t been feeling well, have had low energy, and can’t concentrate. These aren’t lies. From there, you can talk to your doctor about your concerns in the exact same way that you wrote about them here. It might be possible for your doctor to explain to your parents what you are experiencing in a way that carries more authority. You can also get creative in how you communicate with your parents. Honestly, anything is better than nothing. So if you write them a letter, text or email them, or talk to a trusted family member and have them talk to your parents… any of these are valid ways of starting the process. There are also some cases where you can get your own treatment without your parents being involved. The age varies based on location, but in some circumstances, a minor can consent to their own treatment.
I think that self-help via podcasts like this, youtube videos, etc are definitely important and helpful but they may not be enough for your situation. Now is the perfect time to turn things around since you are aware of your struggles and clearly want to do better. I get the feeling that you may harbor a lot of guilt about being a burden on others, but you have to understand that things may not spontaneously get better without doing something about it and in fact, the most responsible thing you can do for yourself and for those around you is to reach out and get some help. For anyone having a hard time trying to express what depression feels like to those around them, you can check out http://duffthepsych.com/depressionletter.
Last thing I’d like to do is talk directly to your parents. This may or may not be something that you are comfortable sharing with them, but just in case – I’d like to try speaking directly to them.
My question for you is I don’t self-harm anymore as much but I do have constant thoughts of suicide and I’ve come to an understanding that if I don’t really reach a point in my life at a certain age that I feel I’m happy or I’ve met my goals I’ve come to terms with just ending it all, and honestly it doesn’t feel okay. I come from a long line of abuse and feeling unworthy, I was homeless for a couple years and recently my life has changed. I cleaned up, I’ve been sober, I have my own apartment, the girlfriend, a dog, like everything is significantly better but I still deal with these dark thoughts and I wonder if you had any advice for me. Anyways I hope you’re well Thank you for the consideration.
Thank you so much for writing in. First, let me say that I am super proud of you. You have done SO much for yourself. Between cleaning up, getting back on your feet, finding a relationship, and an apartment… amazing stuff. You are strong as f**k.
Depression and suicidality can be sticky problems. It can be even more confusing when you look at your life and see all of the good stuff yet you still have these dark thoughts. I think it’s clear that you want to want to live. You are having some trouble still feeling like you might want to end it someday, but there is a huge piece of you that is invested in continuing on. I say this because you said that the thoughts of suicide that you have “honestly don’t’ feel okay”. You also have clearly had to put in a lot of effort and push to overcome some of your challenges and get to where you are today. There’s a fire in you and I want you to keep that fire burning.
Give yourself some credit!
One thing that you need to keep in mind is just how much you are working against. You wrote that it’s basically only been recently that you’ve been able to make such a change in your life. Before this, you were in rough circumstances and come from a long line of abuse and feeling unworthy. That is a lot of programming that you are working to undo. You might still be waiting for the feelings to catch up with the changes in your circumstances that you’ve been able to make.
When you essentially develop within the context of abuse, it really f**ks with the way that you view the world. You have been trained to not see your worth and see yourself as powerless over your situation. You are absolutely proving them wrong right now, but it can take time to really start to recognize your own worth.
I think it’s also important to separate out the symptom of suicidality from your general mental health. It can definitely be an indicator that you are not doing well emotionally, but for some people they just experience chronic suicidality that sticks around even when their mood and life are good. It’s something that they need to develop a plan to cope with when it gets bad, but also learn to just live life in the context of it being there in the back of their mind.
Hearing about your story, it also strikes me that you have an opportunity here. If I’m interpreting what you wrote correctly, you have an opportunity to break a cycle within your family. I’m not sure if you plan on having kids but this applies regardless. You can put a fork in the road and leave a legacy that speaks to your resilience. I don’t say that to burden you with any sort of pressure. It’s just an amazing and powerful fact. You’ve already accomplished a lot and your story does not have to be over.
Safeguards and resources
You may not believe that you deserve to live, but you can resolve to stay alive regardless. In order to do that, you might need to put some safeguards in place. Do you have a therapist and/or a medical team? If not, let’s make sure you get yourself a good team to work with. Let your providers know about your situation exactly as you have to me. Be clear that you have no plans to end your life right now (unless you do), but you struggle with chronic thoughts of suicide and you want to be sure that it doesn’t happen. With a therapist, you would establish a safety plan. This might involve writing down options, people that you can call in crisis, and identifying your most likely means so that you can remove easy access to them. Suicidality becomes so much more dangerous when it’s suffered in silence. Don’t be silent about it. If your family, girlfriend, or other trusted loved ones don’t know, fill them in. You need a safety network – just in case. I also don’t know what sort of treatments you have engaged with, but there are many options out there including the treatments that I talk about in episode 107.
This is perhaps an odd suggestion, but when you have the opportunity to do so, I would suggest you get involved in helping others in some way. Volunteering and donating your time to causes that you believe in can really help you feel more connected to humanity and that you can bring value even if it’s just to a handful of people. Connecting to a community of some kind is also very helpful. Just yesterday, I saw someone on a Facebook group for a genre of books mention vaguely that they were probably going to end things and the outpouring of support and concern was just so massive. Feeling connected can be a protective factor. If you go to duffthepsych.com/suicide, I have a whole chapter from my book about suicide available for free. There are more tips and things to keep in mind there. There is also a video of me reading it to you.
I want to thank you for trusting me with this information and for writing in your question. If you or anyone else needs immediate resources, I have a whole list of them at duffthepsych.com/emergency
Greenbrook TMS provides Transcranial Magnetic Stimulation (TMS) therapy, an FDA-cleared, non-invasive therapy for the treatment of Major Depressive Disorder and other mental health disorders in the United States. Visit GreenbrookTMS.com for more information about TMS therapy or to see if TMS therapy is right for you.
EliteMD CBD produces high-quality CBD products that have been doctor-developed and recommended. Their CBD Sleep Tinctures are carefully crafted with concentrated doses of pure hemp CBD oil that delivers incredible results. As a special offer for listeners of the podcast, Elite MD is offering 20% off, and shipping is 100% free! Head to elitemdcbd.com/sleep and use the offer code HARDCORE20 for the extra 20% off and the free shipping.
Thanks for Listening!
If you know someone else who might benefit from today’s show, please do share it with them. Send them a link or shoot over a screenshot, and share it on social media to show your support – you never know who needs to hear this type of information.
Got a topic or a guest you’d like to appear on the show? Or interested in having Duff answer a question on the podcast? Please get in touch! Email Duff and maybe you’ll hear it on a future episode!
Want to help out the show and Duff the Psych?
- Subscribe to the podcast on iTunes.
- Leave a podcast review on iTunes. These reviews really help Duff reach potential listeners, and he appreciates every one!
- Share the show on Facebook or Twitter.
- You can also buy Duff a cup of coffee, which helps fuel the energy that goes straight back into creating more content for YOU!