Tim dragged himself into the school cafeteria where the photographers had set up equipment to take school pictures.

He felt angry, bitter, sullen, and hopeless. What purpose could there be in school pictures? What’s the point? he thought. Tim hated being at school. He felt like he would self-destruct if he didn’t get out of there. Then it was his turn for his portrait. He stared at the camera. The photographer said, “Smile!” (Does hopelessness accompany suicidal thoughts…or cause them?)

He just stared straight ahead. Enduring. He knew if he smiled it would make him look like a horror-movie character. Click. Flash. And it was over.

Tim got up, and dragged himself out of the cafeteria and out the back door of the school.  He shuffled home. He couldn’t stand being there any longer. 

Right behind Tim in the line a pretty girl waited her turn. Emily smiled for the camera. She didn’t want to. But she tried to do the right thing. Her sad eyes gave away her despair. Emily lived in a neighborhood where everyone knew each other, got together, barbecued, and enjoyed the community.

The problem with that is that one of her neighbors offered to spend time helping her with her music lessons. Her parents encouraged her to take advantage of the expertise of this “nice man.” Luis was 41, college educated, and very musical.

Emily didn’t know how to tell her parents that every time she went to his house, he had other ideas in mind. She felt ashamed. Troubled. Scared. Dirty.

She tried to be responsible and do everything expected of her. Her parents just knew she was a good student, kind, and obedient. Does hopelessness accompany suicidal thoughts…or cause them?

Once when Emily tried to tell her mom about Luis, her mom corrected her before she could get it out. She told her to be sure to be respectful toward him when she was at his house.

Emily clammed up.

But she was reaching the breaking point. After two years, she didn’t think she could take this any longer. She didn’t know how to stop it. She was feeling more and more hopeless that there would ever be an end to it. And Luis threatened that if she told anyone he would hurt her family.

So Does Hopelessness Accompany Suicidal Thoughts or Cause Them?

Both Tim and Emily were losing their strength to hang on. Of the two, Tim was the most likely to be identified by teachers as one who might need to see a psychiatrist. His facial expressions, attitude, and disposition made him a likely candidate for that kind of help.

Emily, on the other hand, seemed quiet, compliant, and responsible to the school staff. Her teachers guessed she must come from a very nice family.  Emily’s depression wasn’t easy to notice because she didn’t let it show. Her goal was to please those in authority in her life.

Tim’s doctor, on the other hand, diagnosed him with bipolar II disorder. He prescribed medication, but Tim did not feel much better.

Tim directed his anger at his dad. Because he felt his dad lacked understanding for his condition. He resented his dad expecting him to function when he felt so bad. He wished he could crawl into a hole and hide from the world.

Emily felt completely alone in the world because she couldn’t talk to anyone about what she was going through. And though her parents were good people, they had no idea she continuously faced such a horror.

We can look at Tim and Emily and draw our own conclusions. But you have to ask yourself does hopelessness accompany suicidal thoughts…or does it cause them?

Tim’s problem wasn’t his dad so much as the symptoms of his illness that weren’t relieved by his medicine. And Tim didn’t know how to approach his dad in a way to help him see what he was going through. His dad just felt he needed to discipline his belligerent son.

In Emily’s case, it seemed that her problems could be resolved by simply blowing the whistle on Luis. That message is plastered on the walls of the school… “Tell someone!”

She’d heard that message all her life.  She could go to the school nurse, or a teacher she trusted, or even a police officer. But she didn’t.  When she would think about it, all she could think of was how hurt her parents would be that she talked to a stranger instead of keeping their business in the family. 

She was also afraid her dad might do something crazy to Luis that would get him arrested, then  what would her mom and brothers do?

Every time she thought about talking to someone she hit a wall of all the reasons why she couldn’t…

Then, in a two week period, two students in the high school took their own lives.

Everyone wondered why. 

No one dreamed Emily was sad or had any reason to do such a thing. Except her heartbroken parents… because Emily left a note. And Luis was arrested.

Tim’s dad was devastated. He’d been doing his best to help Tim get the treatment he needed, but each new medication required several weeks –sometimes months — to see if it helped him feel better. Talk therapy takes time, everyone said. And he hadn’t heard of a treatment like IV ketamine. He just assumed Tim’s doctor would do what was best for his son.

It was so hard to know the difference between his son’s bipolar symptoms and just a bad rebellious attitude. He worried about it all the time. Just not knowing how to respond to Tim’s responses.  He wished he had a guide book. But now it was too late. He just didn’t realize how severe it was.

These two deaths stunned and rocked the school they both attended. Two very different students who didn’t know each other, but who both could have been helped…if only…

Does hopelessness accompany suicidal thoughts…or does it cause them?

If you knew Tim or Emily, you’d likely have been grief stricken by their deaths. Probably baffled.  And for good reason. Because hopelessness and despair come in different forms. And you probably wish you could have helped them.

Tim’s hopelessness was within him, as a symptom of a severe and difficult-to-treat illness.

Tim probably spent most of his time in the throes of bipolar depression. When your mind and outlook are so dark so much of the time, you can desperately need a break from it. 

But if you know of no medicine that will supply that break for you…  if your doctor knows of no medicine that will help without trying one after another… you get your hopes up over and over…only to experience a new type of grim despair. Hopelessness grows after years of this…and it may dawn on you there’s nothing that can help.

And you don’t know where to look for hope.

Emily’s hopelessness was internal, too. She felt trapped by an external force. If that external force could have been removed from her life, she probably could have recovered. Unless conditions like PTSD or severe depression complicated her condition. But even those conditions can be relieved with a novel and advanced treatment like IV ketamine.

Children and teens should be able to live healthy, active, trusting lives in a perfect world. But it’s not a perfect world.

When they’re assaulted, and wounded, they may need special care with a skilled therapist, support from friends and family, and treatment to help them heal. Sometimes that can be treatment with a novel, advanced treatment like IV ketamine.

A group of researchers led by Ilya Baryshnikov, M.D., asked whether the hopelessness people with depressive disorders experience is a crucial predictor of suicidal thoughts and plans.

They guessed that hopelessness was the sign that a person would be having suicidal thoughts, so they conducted an in-depth study which was just published this month in the Journal of Clinical Psychiatry.   

They followed 406 people for 10 years, and used diagnostic tools to determine what role hopelessness played, as well as what role the severity of the depression played, in each person’s experience with suicidal thoughts.

Standard tools like Scale for Suicidal Ideation, Beck Depression Inventory, Beck Hopelessness Scale, Beck Anxiety Inventory, Perceived Social Support Scale – Revised, and Eysenck Personality Inventory helped them evaluate the state of mind as well as personality traits of their subjects. 

They found that hopelessness served to explain the suicidal thoughts, but wasn’t so much a crucial prerequisite… and that it’s actually the severity of the depression that leads to suicidal thoughts.

In the cases of Tim and Emily, both needed intervention. For Tim, IV ketamine could have possibly changed his whole world. By helping him to achieve remission, and restoring his energy and hope, his world — and his relationship with his dad — could have been transformed. 

It’s likely his dad, like so many, had no idea that IV ketamine was an option. Much less understanding about what it could do for his son.

For Emily, it is possible the long term stress of abuse wore down her resilience, undermining her resolve to protect herself and report Luis. To trust her parents and make them listen, so they could help.

In her case, too, IV ketamine could have helped restore her emotional strength to do what was needed to make herself and other girls in her neighborhood safe …to speak up.

At Innovative Psychiatry, we see teens like Tim and Emily — and find the transformative effects of IV ketamine treatment can bring restoration not only to their outlook, but to many aspects of their lives. Relationships grow stronger, energy for school improves their performance, and their hope and joy billow. Not for everyone, certainly, but for most,

If you, or your teen, have been depressed from major depressive disorder or from bipolar depression, and oral antidepressants aren’t working, call us. Let’s talk about whether you’re a candidate for IV ketamine treatment.

If you’ve suffered from a major trauma that other treatments haven’t helped, call us. IV ketamine treatment can restore you if PTSD has impaired your function in life.

IV ketamine can be dramatically effective also with severe social anxiety, alcohol abuse disorder, substance abuse disorder, and can stop suicidal thinking in an afternoon.

We want you, and your teen, to be restored to the best you ever, and have a rewarding a fulfilling life with your own joy… and hope… abounding. 

To the restoration of your best self,

signature of Lori Calabrese, M.D.

Lori Calabrese, M.D.

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