How to get the balance right about being honest

[knowinghowtobe]

I've had depression for about 14 months. It's fluctuated and I have been going generally downhill since Christmas. At that point, I started to be more honest with my CBT therapist and GP about how suicidal and useless I felt. That led to me being referred to the crisis team and mental health team. Crisis team pretty useless and MHT just tinkered with my medication, with little effect. After I took an overdose which only failed because I threw up, I was referred for psychotherapy which everyone said would be the key to me improving, along with continuing to open up about how I felt.

I'm not great at opening up unless I rate the person. CBT person is ok but she's passing me on to the psychotherapist. GP was great and really 'got' me but is now on maternity leave. I'm really struggling without having her to talk to, to be honest BUT in a way it is good because I had got to be far too open with her, which resulted in her writing to the MHT, which resulted in them giving me choice of hospitalisation or home treatment team intervention. They've now discharged me, which is good because I found it intrusive.

So now I have new GP and new therapist. I don't know how honest to be. I can fake ok. I am more scared of being hospitalised than I am of how I feel. I've felt suicidal for so many months that it has become normal. Being hospitalised would feel humiliating, as it would lead to too many people knowing what is going on. It won't help my situation either.

On the other hand, if I don't tell the truth about how I feel, can they help me?

Opinions welcomed.

[infiniteregression]

You can't be completely honest with yourself until you can be completely honest with someone else. Or put it this way, not telling the truth will definitely NOT make things better. However, if you don't trust the MH services, try putting everything down here on MN in this post. Tell us why you feel so bad and so useless. I count myself as a depression survivor, had serious suicidal thoughts when younger but now live a happy(ish) life, so it can be done.

[BisleyBoy]

Hi knowing, I think I could have written a lot of your post. I'm not sure if I can be of much help to you, but just wanted to say that I can empathise with what you're saying.
I don't talk easily to people about the darkest thoughts I have either. I will Only talk to people if I feel comfortable with them and like they can be trusted. So that's most of the mental health team out. I find them so insensitive.
I find some of the suicidal thoughts that I have to be humiliating too and so I feel almost embarrassed to tell anyone about them and so I generally don't.
I started twice-weekly psychotherapy just over a week ago and something that I have learned is that I am afraid of exposing myself emotionally to someone and to tell people my innermost thoughts about suicide is doing just that. It terrifies me. It might come from the fact that suicide was very much frowned upon in my family and that people who wanted to do it were 'attention seekers' and to seek attention was shameful. I'm afraid of emotional intimacy because there was never any of it when I was growing up.
Could any of this be the reason why you don't easily open up to people about your suicidal thoughts?

[NanaNina]

Yes I think you should be honest too, but not as someone suggested by posting everything on here. You already said you find it difficult to open up to people who you don't really know and that's understandable. You sound like you're getting a pretty good service from the MH people. I think suicidal thoughts are a symptom of mental illness and are very common (my depression fluctuates and on bad days I get suicidal thoughts that are pervasive) I tell my CPN and the psychiatrist and occasionally (like recently) my CPN was worried because I had devised a new plan. (NB please don't talk about specific methods of suicide on here as it is very triggering and MNHQ have agreed that any such posts will be deleted and the OP advised to phone Samaritans)

I don't believe that I will ever carry out any plans I make - as soon as the depression lifts I wonder how I could ever have had such thoughts and that's what they are I think - just thoughts, or suicide ideation. Having said that there is always a risk and you have made one attempt, so I imagine there will be concern. You won't be telling them anything they haven't heard many times before in any event.

SO yes be honest and talk about your feelings and thoughts - it will be a waste of their time and yours if you just act ok, and MH services are not exactly in abundant supply. If this is your first episode of depression you have a good chance of making a complete recovery but it the sort of illness that can re-occur, but on the other hand some people only ever have one episode.

[NotAJammyDodger]

I think it almost 'normal' for depressed people to have suicidal thoughts. When I am going though bad patches I become quite obsessive about it.
That said, a good psychotherapist will know this and should be able to help you work through your thoughts and feelings.
I find it very difficult to open up to others - I think though, because I find it so incredibly painful to share some feelings, my (well engrained) defences kick in to prevent that pain, so avoidance and resistance kick in. Feeling uncomfortable is because I hate the feelings I get, feel unbearably vulnerable and just don't want to go there. But that's why I am in therapy, because I know these feelings are messing me up.
A good therapist should focus on building a therapeutic relationship with you. This isn't about being like a good or sympathetic friend, it's about creating a safe place for you share your thoughts when you are ready, helping you get to a point where you can share, and then helping you with those feelings, thoughts and emotions.
The latter takes time and should go at a pace that you are comfortable with.
Don't be to hard on yourself, take small steps with your therapist.
Any therapist worth their salt knows hows hard it is for you.

[knowinghowtobe]

Thank you for all your responses.

I think I find talking difficult because my family are TOO open about feelings and I always hated the fact that my mum would openly discuss her suicidal feelings and cry etc. in front of us as kids. I suppose I've gone the opposite way.

I've always been the 'normal' one. This depression started after a miscarriage and it itself has led to me losing a lot of friends (some through choice) and totally messing up my career.

I am so angry with myself for feeling how I feel. I feel like a failure for not being able to just snap out of it. It took months to even admit that I was depressed, even though everyone kept telling me that I was. Therefore I used to minimise how bad things were and just attend the GP appts to get the anti-depressants. Then I found that my GP was actually good to talk to so I did. But then I felt like my words were used against me to escalate things to the point where I was threatened with being hospitalised. Apart from anything else, I wouldn't be able to smoke in hospital so that would be bad.

I just don't know what to do now. I want to be open, but I don't want to go into hospital. I want to get better, but I don't think I will. It's all looking very bleak.

[NanaNina]

Loss is almost always at the root of depression and it is a deceitful illness because it makes us feel like a failure and not being able to just "snap out of it" or do something to stop the dark clouds of depression dragging us down. Yes it makes us angry too because depression is like someone else has taken over your mind/brain and you are not like the person you used to be - this is another trick depression plays on us and just for good measure it convinces us that we will never get better - so that's what we are fighting against and it's utterly wearing. Also I think that sadly there is still a stigma attached to MH issues and others just don't understand. In fact I don't believe anyone can understand unless they have first hand experience of the torment of depression.

Maybe you need the meds reviewed/dosage changed. I think you should stop worrying about hospital. It is highly unlikely you would be sectioned under the MH Act as this only happens when people are psychotic as in out of touch with reality and don't realise they are ill, although severe depression and suicide attempts are taken seriously. I've been in hospital twice for severe depression (not sectioned) but agreed to go in and it was ok but very boring and time goes very slowly and the nurses aren't really bothered about you - they've seen it all before so many times. Where I was there were small gardens where smoking was allowed.

Jammydodger has written a brilliant post about therapy. How about you try some private therapy (www.bacp.org.ok) to find a properly qualified and accredited therapist in your area.