Trying therapy one last time

[dimstar]

I've been depressed for about a decade, self harm and social anxiety have added extra issues. I've tried therapy and meds before with no luck often making me feel worse. Lately suicidal thoughts are all that occupy me as well as cutting myself off from the world. I'm trying again in a week and already feel the knots in my stomach. I'm doing for people who care about to not put them through a loss I could care less about me as I feel trapped here by not wanting to hurt anyone else. Any tips that would make things easier? How open should I be about my suicidal thoughts? I obviously wont say I have a plan and the means but combined with my history of self harm I worry bringing up constant suicidal idealization would end me in the mental hospital. I do not think that would help only hurt as well cost me a large amount with my insurance. How do you guys get it to be more of help than a stressor?

 

[parader]

i don't know if i can be of much help because i think it's different in every country
but at least for me, i always told my therapists that i was suicidal, i was very open about it the same way i was open about not wanting to get locked up in a mental facility
i think i even went as far as saying "i'm suicidal but don't have anything planned, and yet if i find that someone is trying to get me hospitalized i will make sure they don't get the chance in time"
i barely escaped it once but it was after an attempt, at least in my country i never felt threatened to be locked up against my will for just talking and being open about it
i don't know if i was lucky that both my psychologist and my psychiatrist think mental facilities would only make me worse
i was never (much of a) cutter but have very visible scars of previous attempts

edit: i must add that after an attempt my psychiatrist took me off of lithium and primidone (the latter i got from a neurologist) and changed it to depakote instead, both lithium and primidone can be lethal so i guess he was worried at some level but not enough to lock me away thankfully since all my previous attempts always involved alcohol, prescribed drugs and cutting, but SI kicked in and i sought help for my own self, so maybe that's worth something for them

 

[western_heart]

I can relate with therapy being more stressful than it helps. I used to never talk about suicide with therapists so when I was suicidal it would be painful to go. I hated it and wanted to get out of it, but my ex wouldn't cancel my appointments for me and I wouldn't do it for myself either. I knew if I was totally honest about my worst it would cross a line, so I avoided getting on the topic at all. I always gauged therapists about what they think of medication- for example, if they think it's important you take meds and see a psychiatrist, they might be more likely to encourage medical interventions like hospitalization. If it wasn't safe for me to talk about not liking medication, it definitely wasn't safe for me to talk about suicide. It generally feels safe to talk about things like suicide attempts/ideation in past tense, as long as it's established that you aren't planning/don't have a way to do it again (regardless of whether that's true).
I don't know how therapists react to self harm.

One technique my ex said she used was to ask her therapist what it would take for her to call for involuntary hospitalization during one of the first sessions, she happens to have a therapist she can be pretty open with.

I didn't tell any professionals about being suicidal until after having attempted, I wish I'd been more open about it. It got a lot easier for me to talk about suicide with my therapist after attempting- during one of my last sessions I spoke openly about a past attempt- but I also felt "safe" against being hospitalized since I had just gotten out for my most recent attempt.

 

[dimstar]

i don't know if i can be of much help because i think it's different in every country
but at least for me, i always told my therapists that i was suicidal, i was very open about it the same way i was open about not wanting to get locked up in a mental facility
i think i even went as far as saying "i'm suicidal but don't have anything planned, and yet if i find that someone is trying to get me hospitalized i will make sure they don't get the chance in time"
i barely escaped it once but it was after an attempt, at least in my country i never felt threatened to be locked up against my will for just talking and being open about it
i don't know if i was lucky that both my psychologist and my psychiatrist think mental facilities would only make me worse
i was never (much of a) cutter but have very visible scars of previous attempts

edit: i must add that after an attempt my psychiatrist took me off of lithium and primidone (the latter i got from a neurologist) and changed it to depakote instead, both lithium and primidone can be lethal so i guess he was worried at some level but not enough to lock me away thankfully since all my previous attempts always involved alcohol, prescribed drugs and cutting, but SI kicked in and i sought help for my own self, so maybe that's worth something for them

Thanks it is helpful, I'm not particular to keep on trying a bunch of new meds but I know that will probably be a big part of it because I really struggle to talk about my feelings even have someone say something like you seem kind of down today sends my body into shock. Past therapist I've told I was actively self harming (burning at the time) but always had ointments and would go to a doc if things got infected. But never mentioned suicidal thoughts. I'm u.s. and do feel theres a decent threat here off being whisked off even if I've stated it's very much against my wishes to do so. I'll test the waters with the new one but it wont take long before I have to tell them. I appreciate your advice.

I can relate with therapy being more stressful than it helps. I used to never talk about suicide with therapists so when I was suicidal it would be painful to go. I hated it and wanted to get out of it, but my ex wouldn't cancel my appointments for me and I wouldn't do it for myself either. I knew if I was totally honest about my worst it would cross a line, so I avoided getting on the topic at all. I always gauged therapists about what they think of medication- for example, if they think it's important you take meds and see a psychiatrist, they might be more likely to encourage medical interventions like hospitalization. If it wasn't safe for me to talk about not liking medication, it definitely wasn't safe for me to talk about suicide. It generally feels safe to talk about things like suicide attempts/ideation in past tense, as long as it's established that you aren't planning/don't have a way to do it again (regardless of whether that's true).
I don't know how therapists react to self harm.

One technique my ex said she used was to ask her therapist what it would take for her to call for involuntary hospitalization during one of the first sessions, she happens to have a therapist she can be pretty open with.

I didn't tell any professionals about being suicidal until after having attempted, I wish I'd been more open about it. It got a lot easier for me to talk about suicide with my therapist after attempting- during one of my last sessions I spoke openly about a past attempt- but I also felt "safe" against being hospitalized since I had just gotten out for my most recent attempt.

I'm thinking that could be a part of why it feels so miserable to me, not being able to talk about what I'm really thinking about. My first appointment will be as much an interview of them then me. I know its not healthy but at the moment I'm only trying for those around who would be hurt so right there I think without talking about suicide I'll just be looking up the wrong tree. Thank you for sharing your experience.