This past week I was hospitalized for an “accidental “ overdose. I did accidentally take 600 mg of an XR medication. (Forgot I had already taken my med)  Then I called poison control who flipped out and sent me to the ER. Where my ER docs I worked with for 15 yrs saw me. I had to tell them I also took a “couple” of Ambien too. I told them to “counteract “ the other Med. This was not entirely true. I was too embarrassed to tell them that I wanted to sleep and not wake up  I never had an opportunity to speak with the admitting Dr alone. My husband was in the room. Plus I don’t remember anything after I fell asleep for hours and everything was blurry and I was seeing double. I can’t tell my husband the truth. He still thinks it’s an accident. I see my family Dr for a follow up ALONE. So I will get to tell him. My psychiatrist knows and told me to up my therapy sessions with my therapist to twice a week. I don’t see psychiatrist again for 5 wks. Do I need to tell my husband and family the truth? I am afraid to. I’m afraid I will be looked down on. Like there is something wrong with me. I don’t want people to push me away because they think I’m crazy.

First off, I’m so sorry that you’re going through this. I’m glad that you are alive and thinking about how to approach this. I know that you may be ambivalent about being alive or may just be here for other people at this point, but I am glad that you’re around to ask this question. I’m also glad that you at least have one person, your psychiatrist, that you are able to be honest with about this. Upping therapy sessions to twice a week is a good plan. I hope that your psychiatrist and therapist have also already gone through some safety planning with you in the event that you find yourself this low again in the near future.

I can understand the urge to keep this to yourself. It’s a VERY hard thing to talk about. There is a lot of internal and external stigma attached to suicide still, so it may be scary and feel embarrassing to admit that this is an issue for you. Your mental health is also your own business. HOWEVER, suffering through suicidal ideation in isolation is much more dangerous.

Think of it this way, you may find that you are struggling and on the verge of serious suicidal ideation. However, you can’t bring yourself to tell your husband that you need to take certain steps to get help because that would mean worrying him and letting the cat out of the bag. All the while, the issue continues to get worse and you start to feel more helpless and out of options. That feeling of being out of options is one big contributor to actually harming yourself. Unless your husband is totally aloof and not in the picture at all, I think he probably knows or suspects more than you think. At the very least, it is probably clear to him that you are having a really hard time. It may be hard for him to hear and for you to speak about, but I don’t know that it will be completely out of the left field that you’ve been feeling hopeless and suicidal.

So this choice is yours, but I am absolutely a big advocate for dragging suicide out into the light. When things stay hidden and you fear them getting out, they tend to get bigger. You almost have an unconscious commitment to them and that can be dangerous. Clearly, there is a part of you that wants to get through this. At the very least you want to want to live. You want to be able to enjoy the things that are good and make it through the hard times. So with that framing in mind, being honest with your spouse about this is a great way to make sure that you have access to the resources that you need when you need them.

Rather than having to find a way to beat around the bush, you can address it just like you would any other health problem. My wife has chronic suicidality and it’s something that we try to talk about openly. A couple of times hospitalization has been necessary to stabilize things. Other times, it’s just an indicator that we are at a fork in the road. This might mean a big change needs to happen to make life more bearable or it might mean that we need to weather the storm and adjust our approach for a while until the intensity fades. All of this would be a lot scarier for me as a spouse to hear about after the fact. I wish for her sake that my wife did not struggle with suicidality, but it means a lot to me that she trusts me with that information and that we are able to try to address it as best we can. It also allows us to develop some vocabulary around it. “I don’t feel great” is different from “I’m not doing well”, which is different from “I don’t feel safe”. Within the context of our relationship, the latter is sort of a “snap out of it” phrase for me that makes me go okay we need to plan and get things moving here. All of this becomes much harder when you are hiding the symptom.

If you decide to talk with him about this, I encourage you to be honest and clear. You could even write a note and talk to him after he reads it if that is easier for you. You might say that you have been nervous to tell him because you are embarrassed, which is on you not him. That you feel like you know he will be supportive but you also don’t want to scare him. You can say that you have been feeling hopeless and you weren’t actively planning to hurt yourself, but before you knew it you were overdosing and hoping that this was the time that you wouldn’t wake up. You can let him know that you want to live, but it’s hard right now. You can reassure him that you love him and losing him is one of the scariest things to you. And from there you can work on how he might support you.

I don’t know if this is the case for you, but I want you to try your best to be honest with yourself. Is there a part of you that doesn’t want this to get out because you don’t want the option taken away from you? In many cases, with safety planning, it makes sense to limit someone’s access to whatever they are most likely to harm themselves with. If your pills were managed by someone else or certain ones that were not available right at your disposal, would that be difficult? This isn’t the only option, but if there is resistance for this reason, you might want to reflect on that.

There are a variety of ways that someone might be able to support you and show that they understand what you are going through. I have a chapter about suicide in my depression book and you can actually get it for free or watch me read at duffthepsych.com/suicide. This may be something to review yourself and possibly pass on to someone else that you want to understand.

I don’t think you are crazy. But I do think you are suffering. I also think that it will be hard to speak about, but finding a way to open up the topic of conversation will help you suffer less and will help you be safer in the end. If he came to you with the revelation that he has been feeling suicidal, would you pull away because he’s crazy? No way. You would be REALLY concerned (which can be hard to deal with too), but mostly you would be happy that he’s safe and want to figure out how to help in the future.

These are some things to consider. I’m glad you’re around and thank you for trusting me with this question.

I am writing to you because I am interested in becoming a clinical psychologist. I would ideally like to practice therapy (and possibly art therapy) in addition to teaching psychology at the undergraduate level. This has been my dream since I was 15, but once I became extremely ill with bipolar I disorder I renounced this dream, deeming it no longer possible. I am 22 and I have been manic to the point of psychosis and depressed to the point of a suicide attempt, and have been hospitalized twice. Lately, however, I have started to have more hope for my stability in the future and have decided to pursue the path of clinical psychology. I have more motivation than ever to adhere closely to my treatment plan now that I have a path. In your opinion is it possible to be a clinical psychologist with a mental illness? What advice do you have for me on this journey?

Thanks for the question. It sounds like you really have a passion for mental health and the field of psychology. Let me start by answering your overall question first. Yes. Yes, it is definitely possible to be a clinical psychologist with mental illness. In fact, a lot of us DO have mental illness. I think some people have the assumption that all therapists have great mental health. This is not always the case. We don’t all have significant mental health issues, but a lot of us got into the field in the first place due to our own experiences.

Now, I won’t lie to you – it will be a challenge. Bipolar 1 can be brutal. Everyone is different, but if you’ve had mania to the point of psychosis, you know what it’s like to be really derailed by the issue. Not only is it more of a challenge to be a therapist with bipolar, but it will also be more of a challenge to get through a training program. HOWEVER. I hope you do it. The world needs people like you. There is nothing more validating than someone who actually GETS it. Nothing can help you empathize with clients like firsthand experience. Imagine that you were a therapist and you had a bipolar client that feels as though their mental health issues prevent them from becoming what they would like to be. You would want to encourage them to adjust and adapt. To plan and work around the bipolar, but not to be limited by it. Same thing here.

There ARE therapists that have bipolar 1 and bipolar 2. Just like success in any dimension of life with bipolar, it just takes knowledge, treatment, and the right approach. Over time, you will start to become more and more familiar with your patterns and learn more about what to do when you find yourself in a manic or significantly depressed phase. There are some simple things that can be done to prepare for these phases once you are able to recognize them. For instance, being sure to have a backup clinician for each of your clients. That way if you need to take some time off, you will have backup coverage. This is possibly something you will be able to be upfront with your clients about. I can actually see this being a really positive point in your profile if you wanted to disclose it there. Speaking honestly about your experience and bringing both clinical and life expertise could attract people to you that want to make sure they aren’t talking to someone who only has book knowledge. It also is a demonstration that people living with significant mental illness can achieve higher education, good jobs, etc. It might also make sense to always be in a group practice setting rather than private practice so you can have some feedback mechanisms. Stuff like that. There are definitely ways to adapt. If you were to go for a PhD as it sounds like you would like to, you also have options. I can imagine doing therapy full time will perhaps be a lot to take on emotionally. But you could break up your time and practice, teach, and even research.

In terms of advice for this journey, I would encourage you to do exactly what you’re doing. Stick with your treatment program. Use the struggle as a prompt to find good compensation strategies. Expect that bipolar will get in the way but know that it won’t be the end of the world. You can do it. It may also help to be adaptable. There is bravery in taking a shot. Even if you start off on a certain academic or career path and then realize that you need to make a pivot to something else, that doesn’t mean you failed. It sounds like you really want this and there is nothing like a purpose and a vocation to motivate you and push you to finding your own ways to work through this.

I believe in you!