Act of Self-Harm Vs. Suicide Attempt

 

"To: [Psychiatrist], MD
From: [Jae Jagger]
Received: 3/21/2022 6:15 PM PDT

Hello Dr. [B.], On April 1st, I plan to overdose on Gabapentin (I have 120 pills of 600mg). Soon after ingesting the pills, I will walk into Stanford ED and receive help. I do believe I have no other options. [Jae]"

 

Today, in front of a group of Stanford resident doctors, I was asked what my thoughts were surrounding this note just before I sent it off. What was I thinking? 

 

First of all, I believe this would have been an act of self-harm, not an suicide attempt for two reasons. One, gabapentin is safe even in very high doses (according to the expert Sean Mackey). It only gives you bad diarrhea, and then you're fine.  Two, I was walking into the ER immediately afterwards.

 

 Obviously, if I really wanted to die, I'd do several things differently. One, take the super-size bottle of Tylenol in my drawer, add alcohol (definitely would go with the classic favorite Grey Goose and orange juice), and bam! Dead in several hours! It would be an excruciating several hours where you would doubt the will to die and the will to live, but you would get the job done. You could even throw yourself a little party, when drunk, everything is better. If you read Manic, you notice the author likes to mix in Tequila with her attempts.

No, I chose a safe medication and was planning on seeking help. It is true that 120 is a lot of pills, and 600mg is a high amount, and yes, during my googling, I did find one woman who died from gabapentin overdosing. It's possible. I was obviously risking my life.

Also, I was telling my psychiatrist my scheme days before I was planning on doing it. I told my psychotherapist about the note during our next session, and she prompted me to call my psychiatrist. During my therapy session, while my therapist, my mother, and I are discussing all of this, I brought up the really obvious question, why hasn't my psychiatrist called me? He returned my note with a shorter note. He wrote:

"To: [Jae Jagger]
From: [Psychiatrist], MD
Received: 3/22/2022 11:00 PM PDT

This sounds like a different plan than you've typically had in the past. Could you explain to me what you think this about?"

 

(Originally, during the previous Stanford G2P stay late February/early March of this year, I deflected many questions about my suicide plan, and back then, I had the ingenious idea to swallow one of my mother's fentanyl patches [with what? I never figured that out]. They can't save you from that. A few minutes and you're dead. I do have Narcan in my bedroom, but I probably wouldn't even stay conscious long enough to use that unless it was in the very same room.)

 

I was really trying to make a point to my Stanford outpatient psychiatrist, who blatantly told me that there was no medication that would help me (you're a fucking psychiatrist whose job is to dispense pills, so prescribe pills!), that yes, I was crazy enough to hurt myself, take those tablets--whether it be Tylenol, Norco's, Gabapentin--and that yes, I needed real help. Someone help me. If no one would have stopped me, I would have went through with my plan. There is another layer, and I spoke about this during my interview in front of the resident doctors this afternoon--I am in so much pain from hearing the awful voices (frequently off and on all day) and the depression that I have to act this way, risk my life, because I don't want to live like this. It's either I receive treatment, get better, or I pass away.

 

I was willing to accept if the doctor wanted to go up on the clozapine prescription, and wait and see for a couple of weeks if there were changes. Or admit me to the hospital again. 

Even being back in the hospital again, Dr. [Psychiatrist] has not suggested a medication change. Per our last conversation, he told me that "there's lots of things to try." When are we going to try them?