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It’s not meant as a legal contract but as a means of you making a promise you won’t commit suicide. When I worked on the suicide hotline we used this as it was very effective way of helping someone commit to NOT hurting themselves and getting in touch with a crisis counselor or their psychiatrist.
This. Make sure to give the antidepressants time to work...can often take weeks to feel the difference. Most side effects likely will decrease over time.
I'm going to repeat my usual advice based on my own experience: Get your Vitamin D levels checked. It made a huge difference for me, but a low dose of Zoloft also shored up that improvement. I think the Zoloft took something like 6 weeks to kick in.
Consider meditation for your intrusive thoughts. You need to learn how to push them away. Acknowledge the weirdness and then move on mentally to the next thought.
It's a terrible way to feel - trust me, I know. But for most people, treatment does alleviate the problem. Just be kind to yourself now. Figure out what soothes you and develop a little ritual around that. I like to sit on my couch with tea and watch a mindless show while petting the dogs. Or take the dogs for a walk.
I'm glad you're seeking help - I think this will be a huge help.
My experience with a "no-suicide contract" was almost 20 years ago, it wasn't anything formal, but I will say it did help. It was with/from a guy whom I knew in a chat room, and he basically wanted me to agree to get out and experience things in the world. I never met this guy in person, we didn't keep in touch for very long, but his taking the time to talk me through a depressive episode meant the world to me.
I think the contract is a way to show the depressed person that someone cares about him/her. I suspect that many suicides are due to feeling isolated, that no one cares.
Sign it and mean it. I am so sorry you are going through this! I promise you, it gets better. It really does. Depression is temporary, and life will be good again in the future.
Essentially, if a patient cannot "contract" (promise) to not commit suicide, then it's appropriate to temporarily hospitalize them so that they cannot commit suicide while treatment kicks in.
A puppy or a dog can be very therapeutic. Wonderful idea. Go to the pound. There are any number of adult dogs there, already housebroken, who would love to go home with you. People with wonderful dogs come upon hard times, have to move, have to move to a place where they cannot take their pets. Sometimes they turn in wonderful dogs, like an older lab or golden or whatever, that were turned in with their own toys, blanket, bed, and a note telling what a wonderful dog they are, and how it broke their heart to turn them in. That's the dog for you, a proven loving animal who will bond to you.
Another great thing about a dog is you have to walk them, two or three times a day. This gets you out of the house, walking outside, which is therapeutic, too.
Ignore the statement that you're in no position to get a pet. I wouldn't necessarily get a puppy that might stress you, but adopting an already housebroken dog from the shelter is a fantastic idea. YOU ARE WORTH IT! And you could be saving a dog that needs a home.
I wish you a speedy recovery. Believe me, it DOES get better, really, it does.
I think the contract is a way to show the depressed person that someone cares about him/her. I suspect that many suicides are due to feeling isolated, that no one cares.
This is indeed the intent, and the theory...it's a symbolic gesture, and intended to remind the person that they're cared about, not isolated, and that their presence matters to others.
However, in practice, there is no body of evidence that indicates any greater patterns of effectiveness than other interventions.
You don't state with U.S. state you live in, but as others have done, I'd suggest looking for a new doctor. In Florida, what is known as the Baker Act allows a medical practitioner to get involuntary commitment for a patient considered to be a danger to him- or herself. https://en.wikipedia.org/wiki/Florida_Mental_Health_Act
For a medical professional to encourage some kind of written oath attesting to the fact that you feel suicidal would in Florida be a kind of entrapment. (I recently read the story of a young man who fled the state in order to avoid a psychiatrist who believed he was a danger to himself, when the young man is employed, admits he is troubled, but denies having 1) suicidal ideation and 2) a suicide plan.
You know yourself best, friend. But a doctor should know you well, and I would be very wary of anyone who urges you to engage in any activity at all outside the confidential sharing that goes on in a private counseling session.
The best of luck to you. We're rooting for you here.
A behavioral contract wouldn't breach confidentiality, however.
And even if it did, mental health practitioners operate under informed consent. Typically, one piece of the informed consent when a person begins therapy is the practitioner explaining the boundaries of confidentiality, and the therapist believing that the client poses a threat to him/herself or others represents an exception to the boundaries of confidentiality. The client knows this. Ethically, they are informed of their right to confidentiality and its exclusions, and can make the informed choice to continue sessions or not, based on that.
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