- To Change Your Mind - Details Matter
Suicide and Depression Questions: Va Beach Fire Dept
Medications for ADHD: Predictable Solutions Count
December 13, 2010ADHD and PEA – The Stealth Neurotransmitter
January 16, 2011Suicide Questions – Turn On Your Thinking
Fire and Public Safety Personnel, indeed anyone dealing with the public and depression or the mandatory suicide question: Get the most important question exactly right at the outset. Think about how the mind is working, how the person is thinking – then to the action question. See this video, a training interview for potentially suicidal women or men with Capt. April Elmore at the Virginia Beach Fire Training Center.
First:
Ask the suicide question this way: “Even though you wouldn't do it, have you ever considered seriously harming yourself?” So many ask the suicide question too imprecisely, almost too casually, and need to focus on the mind first, then the possible action. This is a what question.
Then:
Ask about the possibility of self destructive action, an active plan, or specific next moment thoughts. This is a how and a when question. Why will come much later after everyone is safe.
If we don't ask the suicide question from the thinking side of the fence we may miss it entirely.
cp
Related articles
- Where Do I Find Help for Someone Who Is Suicidal? (everydayhealth.com)
- Dayton VA center to make changes after suicide (dispatch.com)
- Are Teens With ADHD at Risk of Suicide? (everydayhealth.com)
- Depression and Resisting the Urge to Commit Suicide (everydayhealth.com)
31 Comments
Yep, this is your Dad at work over at the Fire Dept! Excellent guy!
[..YouTube..] Yep, this is your Dad at work over at the Fire Dept! Excellent guy!
[..YouTube..] @randomkatie23 Yep, this is your Dad at work over at the Fire Dept! Excellent guy!
[..YouTube..] @randomkatie23 Yep, this is your Dad at work over at the Fire Dept! Excellent guy!
[..YouTube..] @randomkatie23 Yep, this is your Dad at work over at the Fire Dept! Excellent guy!
[..YouTube..] @randomkatie23 Yep, this is your Dad at work over at the Fire Dept! Excellent guy!
hi dr.parker! its mary kate on my other youtube account, did my dad film this?
[..YouTube..] hi dr.parker! its mary kate on my other youtube account, did my dad film this?
[..YouTube..] hi dr.parker! its mary kate on my other youtube account, did my dad film this?
[..YouTube..] hi dr.parker! its mary kate on my other youtube account, did my dad film this?
[..YouTube..] hi dr.parker! its mary kate on my other youtube account, did my dad film this?
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Very interesting clip.
I’m 29, female, too intelligent and interested in research for my own good…and I have adhd, treated now with meds in addition to continued counseling/cbt/etc — thank goodness. Things were possible before, albeit extremely difficult! They’re sooooo much easier now. I also have anxiety and some obsessive issues that remain. And a lot of doubts, because nothing is that simple. But I digress.
What I wanted to ask you is this…even before meds I had gotten to the point where I was not completely depressed due to my continuing struggles/failures, but sometimes then and also now (when it’s past effective time of meds, but only sometimes) I would so quickly go to the idea of not existing anymore, just wanting it to be over, to die. Yet I was (and am) at the point where it was not even remotely a true consideration and one that I could change. What I want to know/understand is WHY I do that AT ALL? It doesn’t make sense, really, to me. In one way it does, but truly, it doesn’t. I don’t want that thought. I would never act on it. I am not sad all the time. I am not even frustrated and discouraged most of the time anymore. So, what gives………????
Another question I had was about omega 3’s. How do we know how much is enough? Are salmon and walnuts sufficient? (I may have had a reaction to walnuts a few days ago though, but a flu-type illness is also going around at the same time).
And lastly, can you comment on the supplements marketed by Juice+? I had looked into them once before, but it was brought up again by some friends, and so I was wondering about your take on it and the research. I’m also looking at practitioners who are more naturopathic, but I’m so skeptical…do you have any insights to offer in that regard?
Thanks again for all you do!
jm,
My quick take, without a complete review, is that you do have some neurotransmitter imbalances – and they are pre-existing the stimulant works. See this video [on Anxiety and ADHD] that discusses near then end imbalances between dopamine and serotonin. You do need, IMHO, neurotransmitter testing, and I wouldn’t be surprised if you had longer than 24 hr Transit time, and hints of estrogen dominance. We evaluate all those subsets with specific testing rather than speculate on maybes.
I am unfamiliar with Juice + vits. Usually 2-3 Gms of OM3FA is sufficient to start, 1 Gm for routine, but many studies go much higher.
Finding the right doc to deal with these underlying issues will be difficult as today not many have taken the time to look deeper – the future looks good tho, as everywhere I turn medical folks are asking me just how to measure and treat with these new biomarkers.
cp
JM,
Juice+ is a very low potency product distributed by the multi-level marketing firm NSA. Do you own research on them. I was fortunate to learn about orthomolecular therapy based on tissue mineral analysis in 1982 and have continued to the present day, enjoying excellent physical and mental health without prescription or over-the counter medications of any kind. I would caution anyone, and I’m sure Dr. Parker would agree, not to undertake a supplement program without testing for your individual needs, and to do follow-up testing every six months to a year.
This is also the most cost-effective and time-saving way to do supplementation, as you are taking only what you need in the optimum amounts and not shopping around and spending money on products you don’t need and may possibly harm you. I use Analytical Research Labs, Phoenix AZ http://www.arltma.com Their website has many educational papers and articles. You will need a referral from a health care professional to obtain testing and supplements, but the cost is quite reasonable.
Dr. Parker tested my neurotransmitter levels, which were pretty close to optimum, but suggested two other supplements that have given me an even greater feeling of well-being and he says “improved my sense of humor”. I had eight years of some hard-style psychiatric abuse from 1974 to 1982, and I can still tend to take that personally if I don’t remember myself.
Thanks Neal for weighing in… interesting what happens when you really make your care a priority.
cp
Ok. sounds good. What if, though, someone doesn’t have insurance and can’t afford to pay for the testing (which I know is less expensive than other companies that do it) and your consult fee (which is standard)? What do you do with your patients in your office if they can’t afford testing and insurance doesn’t cover it?
I do have normal transit time though 🙂
I get that testing first is, in the long run, less heartache and more beneficial as it can reveal underlying issues that meds don’t correct…but I think I’m beginning to understand why practice is the way it has been and why some are resistant to it changing. (not the DSM though — that needs an overhaul times a million! like from a completely different point of view)
thanks.
jm
jm,
Cool on the TT! If you don’t do the testing then hit the amino acid precursors for your specific condition – but I am not advising that you do that as my take on matters is not to simply throw the supplements around. I’ve seen many who tell you that it’s perfectly OK, no harm… and often it isn’t any harm – but then what do you do, how do you feel when those don’t work as expected?
I just don’t go down that path of “try this”… if they can’t afford it, they don’t see me. If they see me some of this is possible and we negotiate whatever we can do for them.
cp
jm,
Even though providers like most private insurance, Medicare and Veterans Affairs will not cover tissue mineral analysis or supplement cost (Medicare will pay for neurotransmitter testing but not the supplements), if you are on SSDI you can earn the additional money to pay for your therapy without affecting your benefits. All you need is a letter to Social Security from your doctor which states that your testing and supplements should be considered “reasonable and necessary work related expenses”. For example, if the maximum amount you can earn on SSDI is $1,000 per month, and your testing and supplements cost $300 per month, then you can earn up to $1300 per month and not affect your SSDI payments. You need to keep careful records, but this take only a few minutes a month.
There is some disinformation circulating regarding veterans who are rated 100% permanent and total for psychiatric conditions not being allowed to work without affecting benefits. This is false. Check the law.
Many thanks Neal for the details on this important matter!
cp
Thank you, Dr. Parker.
FYI, you’ve been afforded the highest compliment a doctor of psychiatric medicine can be given, having been listed amongst the most innovative professionals on my short list @ http://www.petesapper.com/2010/12/ethical-practitoner-index.html
I commend you once again on having provided this wonderful resource to patients like myself who simply won’t tolerate mediocrity with the ranks of modern medicine. Please keep the efforts to educate your colleagues and clients coming. It is this brand of leadership which raises the bar, thereby setting a more stringent standard for clinicians the world over.
Pete,
You are so kind, warms my heart. – Very much appreciate that I have entered your selected group of professionals – so much to learn, so little time!
cp
Suicide rates are high because many first responders are being trained for how to deal with the “mentally ill” by the corrupt NAMI organization which fronts for Big Pharma. The very same corporations that produce drugs which cause suicidal ideation are teaching our police and fire/rescue crews how to treat people who are suicidal. The top priority, shoot some psychiatric drugs into the troubled soul, and ask questions later.
Neal,
No matter who is pulling the trigger we have to set the scene first… and first responders can pitch in exceedingly well if we just take few moments to address their road experiences.
cp
Here’s your chance to make your case, Dr. Parker 9/11 right here in VB.
http://www.citi2011.com/
Otherwise warriors will continue to choose suicide.
“When you’re wounded and left on Afghanistan’s plains,
And the women come out to cut up what remains,
Jest roll to your rifle and blow out your brains
An’ go to your Gawd like a soldier.
Go, go, go like a soldier,
Go, go, go like a soldier,
Go, go, go like a soldier,
So-oldier ~of~ the Queen!”
Rudyard Kipling
“And so when man and horse go down
Beneath a saber keen,
Or in a roaring charge of fierce melee
You stop a bullet clean,
And the hostiles come to get your scalp,
Just empty your canteen,
And put your pistol to your head
And go to Fiddlers’ Green.”
The cavalrymen’s poem
Don’t be surprised if NAMI has the police take you away. You won’t like that RBCH place, but it would give you chance to bone up on the Quran!
Neal,
The Lone Ranger finds him/herself with no place to go, and the emptiness can wrap them up so tightly they can’t break out. Reading a terrific book by Tim O’Brien – The Things They Carried on his experience with depression and Nam – but he didn’t call it depression, even tho the evidence reeks in the telling. Very excellent reportage on the seduction of the jungle and coming to grips with the unpredictable in war – a metaphor for life – runs throughout.
cp
That’s why Miyamoto Musashi left us his Dokkodo, or the Way to Be Followed Alone, his final bit of wisdom before leaving this life.
1. Accept everything just the way it is.
2. Do not seek pleasure for its own sake.
3. Do not, under any circumstances, depend on a partial feeling.
4. Think lightly of yourself and deeply of the world.
5. Be detached from desire your whole life long.
6. Do not regret what you have done.
7. Never be jealous.
8. Never let yourself be saddened by a separation.
9. Resentment and complaint are appropriate neither for oneself nor others.
10. Do not let yourself be guided by the feeling of lust or love.
11. In all things have no preferences.
12. Be indifferent to where you live.
13. Do not pursue the taste of good food.
14. Do not hold on to possessions you no longer need.
15. Do not act following customary beliefs.
16. Do not collect weapons or practice with weapons beyond what is useful.
17. Do not fear death.
18. Do not seek to possess either goods or fiefs for your old age.
19. Respect Buddha and the gods without counting on their help.
20. You may abandon your own body but you must preserve your honour.
21. Never stray from the Way of Strategy
Special Ops types and service academy officers are sometimes been exposed to these philosophical ideas, but never the grunts who often find themselves thrown like kindling onto the the Fires of Freedom with no idea how or why. See Musashi, Book of Five Rings, Comparison of the Way of Strategy with the way of the Carpenter.
“Like the foreman carpenter, the commander must know natural rules, and the rules of the country, and the rules of houses. This is the Way of the foreman.
The foreman carpenter must know the architectural theory of towers and temples, and the plans of palaces, and must employ men to raise up houses. The Way of the foreman carpenter is the same as the Way of the commander of a warrior house.
In the construction of houses, choice of woods is made. Straight un-knotted timber of good appearance is used for the revealed pillars, straight timber with small defects is used for the inner pillars. Timbers of the finest appearance, even if a little weak, is used for the thresholds, lintels, doors, and sliding doors, and so on. Good strong timber, though it be gnarled and knotted, can always be used discreetly in construction. Timber which is weak or knotted throughout should be used as scaffolding, and later for firewood.”
Neal
Neal,
Thanks for taking the time to remind us of these valuable lessons from Musashi – the are timeless in any real life change, in any context.
On your reading list you would also much like The Zen Way to the Martial Arts by Taisen Desimaru – a long time favorite of mine on the combat in the ring, and in life.
cp
Such a brilliant insight by Dr. Parker. That inherent element of “machismo” is something that would have flown over the head of other physicians. It is a very valid assessment that resonates with the “warriors” of the world.
Pete,
Many thanks!
cp
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