How to deal w/credible suicide threats that aren’t “imminent”

[Katie McLady]

Hi. I am the mom of a 19yo in crisis. He has been having a severe anxiety crisis for almost 3 wks now and has been making suicidal threats. We talked him into going to the ER about 2wks ago to talk to someone and they ended up putting him into a forced suicide evaluation which flipped him out that he was temporarily held against his will. Since he was not an "imminent threat" to himself, he was released back home.

He has been struggling each day to function. Has prescribed adderall for ADHD and just a few clonezapam left for fast-acting relief for anxiety. He has been taking inconsistently.  He just picked-up a Wellbutrin prescription yesterday to try, but hasn't taken one yet and not sure if he will or not.

Yesterday, his suicide threats became more credible. He had said he had some Percocet in his room to OD a few days ago, but he just showed me a baggie w/3 pills in it from a distance - don't know for sure if they are Percocet, but guessing they are.  I talked to him for hrs - took about 10hrs to talk him down (partly due to adderall, I think). 

He is adamant that he doesn't want to go to the ER - and I am sure he will deny being an imminent threat.  So, I feel like I am stuck waiting for him to decide he wants help or waiting for him to make a suicide attempt that will classify him as imminent threat and hoping he isn't successful. I know even if he were to be held on a 5150, it likely would only be for a couple days and then he would be released again, so I realize that we, his family, are the ones who will be supporting any long-term mental health needs. 

Know we are btwn a rock and a hard spot. Just wondering if you have any advice. I did call my husband hm from my brother's place late last night to be here to offer me support (other 17yo and 21yo kids stayed there).

Son is still sleeping now, I think, as we were all up until about 2:30am.  Hoping he tries Wellbutrin and has a more stable day, but don’t know what to do beyond that.

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[Swimmy55]

Hi ,
Is your son in therapy along with taking his prescription meds?

You can try to talk to him and ask him outright if he has a plan he is thinking about?   Don't fear putting any ideas in his head, you won't.   Would he be amenable to talking to a crisis team ?  He can even talk to them over the phone, or he can have have them come out.

Yes, I agree the emerg psych hold is iffy , but don't rule it out.  A couple of days can save his life for that time , if that is what you need to do
Here is something to peruse through :
https://www.bpdfamily.com/discussions/search-info3.htm
Scroll down to the where it says "If You Are Helping Someone Else with Suicidal thoughts"
Please write back as you are able and keep us posted.
 

[Katie McLady]

We have offered therapy but he thinks it won’t work b/c he already knows what he should be doing to stop anxiety (exercise, stay busy, etc) but just can’t get himself to do it.  His stress coping mechanisms work 95% of the time, so he is resistant tot along daily meds, but the setbacks from the episodes when he is overwhelmed are demoralizing (lost job once, might flunk JC classes now). But fast-acting episodes meds are only for short-term use due to additive props. 

Have offered crisis hotlines, chats, etc. but I think he is afraid they will call 911 on him or just knows he sounds irrational and doesn’t want to share that w/anyone.

We managed to talk him into visiting cousins for Thanksgiving dinner and the distraction seemed to be good. But he used up last of clonezapam to make it happen, so today could be rough. But so thankful he was able to have a good day yesterday and get a break from his scary thoughts.

[Swimmy55]

One day at a time, right?

Here is some reading on  some ideas with getting adult child to maybe recognize he needs therapy.  BTW, these are not guaranteed, they are just ideas/ things to try :
https://bpdfamily.com/content/how-to-get-borderline-into-therapy

There are also suggested readings in the library here on this forum.  Xavier Amador has a book" I am not sick I dont need Help"  .  This book did not help me out at all, but it's worth glancing through  and who knows, it may work for your situation.  

[Katie McLady]

Last night was rough - think he waited too long to tell us he needed to leave cousins’ earlier than planned. And likely suffering meds withdrawal. Where he used to never talk to us, he now wants to talk to us for hrs, but we just go in the same loops - try empathic listening and that doesn’t calm him, so then try to gently recommend help options as things he could choose not what we are saying he should do. Finally ends when we beg off to go to sleep or he is utterly exhausted.

Thanks for the recommendations. I watched a long video by that guy. Seems to me like it works better if the person is at least functioning in his/her life?  I keep hoping that all the pain my son is feeling will motivating him to make change. The Wellbutrin is a new med for him, but not sure if he started it yesterday or not.  Just trying to hang in there w/him as long as he can hang in there, but will need to figure out how to put some limits, so we parents and sibs in the house can cope and stay healthy, too.

[Swimmy55]

In the meantime , you need to cope as well.  In addition to being on this forum, some of us also have our own therapists ( I do) and go to 12 step family programs such as Codependents anonymous. These teach detachment, and keeping focus on ourselves. It is so easy to get lost in the BPD tornado. These meetings are online and free. His crisis is your crisis and you need help/ a network .  Reaching out here is a great first step.  Keep writing back as you have need.

[Katie McLady]

We parents have been seeing a therapist since last March.  And have a couple close friends who offer unconditional support.  Things still rocky, but slightly improved. Hoping meds are kicking in enough for a slight mindshift so he can help himself and communicate w/dr and teachers for help, too.

[missymoo]

HOW MANY RED FLAGS DO YOU NEED?
HAVE HIM ADMITTED TO A HOSPITAL FOR TREATMENT.

[Katie McLady]

He is over 18 and doesn’t want to be hospitalized for treatment.  We did get him to the ER a couple weeks ago and he was evaluated and found not to be an imminent threat to anyone and was released.