= 27d567bc2d48d9f40e9ccc20ea370b15)
Perplexed comments on Strategies for dealing with emotional nihilism - Less Wrong
You are viewing a comment permalink. View the original post to see all comments and the full post content.
= 783df68a0f980790206b9ea87794c5b6)
Loading…= b715d02e85f7b3b4ae65ca3d3e450868)
Subscribe to RSS Feed
Powered by Reddit
= f037147d6e6c911a85753b9abdedda8d)
You are viewing a comment permalink. View the original post to see all comments and the full post content.
Comments (170)
I have a friend who suffers from severe depression. He has stated on many occasions that he hates himself and wants to commit suicide, but he can't go through with it because even that would be accomplishing something and he can't accomplish anything.
He has a firm delusion that he cannot do anything worthwhile, that the world is going to hell in a handbasket and nothing can possibly be done by anyone about it, and everyone else feels the same way he does, but is repressing it.
This makes talking with him about many subjects exceedingly difficult, as he will ignore or rationalize away actual evidence as being, at best, an exception to the rule of pessimism. It's like talking to a patient with a disorder like somatoparaphrenia, where the ordinary person can see quite obviously that the patient has a problem, but the patient confabulates. He literally cannot see reason on these subjects -- his brain or this deep-seated delusion won't let him.
To the best of my knowledge he has been seeing therapists and psychologists and they have been unable to help him.
How should a rationalist deal with such a situation? Even if Singularity-level technology were available to repair the causes of his depression, he would refuse it if able. If such technology were available, would it be ethical to improve his quality of life against his will by changing his mind? I must confess I am almost at the point of not protesting his desire for suicide; he seems genuinely unhappy, and incapable of changing that fact of his own volition.
As you probably already know, therapists and psychologists generally cannot prescribe anti-depressants - that takes an MD (psychiatrist). I am not a psychiatrist, nor do I play one on the internet. I have no idea whether the cause of your friend's depression is biological or purely psychological. I have no idea whether his therapists have advised him to see a psychiatrist, or whether they are the kind of quacks who "don't buy into the biological model". So I don't have the information I think I need, and I don't even know enough about depression to know what information I do need to help you and your friend.
If I were in your shoes, I would call the local suicide prevention hotline. Tell them the story. They can give you good advice, which may include referring you to even better resources. Do it now. Those hotlines are open 24hrs, and the people (volunteers) who man them know what they are doing much more than I do.
He lives halfway across the continent, and he has been talking like this for months without doing physical harm to himself. Is it right for me to cause the intrusion into his life such a call would surely bring without stronger evidence that it's necessary?
Yes. You already have the strongest evidence it is possible to get without him dying.
I'm told that talking about suicide is a "cry for help". If he is your friend, you have a right and duty to help him.
Call your local suicide hotline. Educate yourself more efficiently than you are doing by asking questions here. Ask their advice, if you wish without giving your friend's name or geographic location. They can give you far better information and better moral arguments about whether and how to intervene.
I called a suicide hotline once. I was put on hold for a long time, got frustrated, and hung up.
He is probably safe unless he starts getting less depressed, because at that point he'll probably still be suicidal but have enough energy to do something about it. If he's been stably in that condition for months then I don't think it's an emergency.
I'm fairly torn on advice for this case. If he really has tried everything and it hasn't helped, then I don't think living is much of an end in and of itself and he should be assisted in his wishes, or at least not prevented.(Be aware that I am biased, this is my perspective as someone who empathises with your friend)
If you think he hasn't tried everything, then the intrusion is completely warranted. He is at the point where he literally can't help himself. Therapy can only work if the patient has an interest in getting better, which he doesn't.
Inklesspen, I also believe in respecting the guy's autonomy. But it sounds like he might be willing to listen to someone who accepts the possible validity of his negative feelings and treats those feelings with respect.
The best reason for going on living is simply to see what happens next. Tell your friend to find and watch the video "Little Miss Sunshine". Suggest that suicide might make sense, but then so might taking anti-depressant medication. But if he wants to try both, he has to do it in the right order. Shift him from talking about suicide to joking about suicide.
But, as I've already said, there are people who can give better advice than mine. Find out what they say.
I believe he does take medication; I remember him saying his psychologist started him on Abilify and he was terrified that Abilify would cause permanent muscle tics, as apparently it does in rare cases.
If he has a psychologist then there's not much you can do directly to help. That's sort of their job. However, it may help to just be there for him. And when he says something that's obviously negative about himself and likely to be wrong, explain why it is wrong. That won't do much, but it might help a tiny bit.