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How Can I Convince My Suicidal MD Husband To Be Evaluated?

Question:

My husband is an MD who is finishing his residency and starting a new fellowship in a couple weeks. We have been married for almost seven years, and he has gradually exhibited more extreme inappropriate reactions to minor irritations and perceived slights. Things are either “right” or “wrong” and “people who do stupid things deserve to be berated so they learn their lesson and don’t do it again.” If I sleep in on the weekend, it’s because I don’t want to spend time with him However, when we do spend time together, he doesn’t want to talk or do anything in particular. On the other hand, he can be sweet, thoughtful, and has always held providing for us and loyalty to friends as very important.

Last Friday we went to his graduation where several things severely irritated him. When we came home, he sat outside in the rain for a half hour, then came inside and was trying to hang an electrical extension cord over the eyebeam in the basement to hang himself when I caught him. He told me to close the basement door, turn up the TV and pretend nothing was happening. I of course refused and eventually ended up putting him to bed. During the course of the night, he said he had made a rational decision that his life would never be worthwhile, human life and society as a whole is meaningless, and I should respect his decision. He said if he has a right to life, he also has a right to death, and my stopping him was proving I did not care about him. He said he’d been thinking about suicide since he was eight, and that if I stopped him now, he would just bide his time until later. He then went on to describe all the times when he’s alone when I wouldn’t be able to intervene. He has said if I contact anyone or have him committed, he will file divorce papers the day he is released from the mandatory holding period and I will never see him again. He said he can easily fool people into thinking everything is fine, and I doubt he would be held longer than the mandated maximum of a few days.

I want to bring up the topic of evaluation and therapy again, when he’s not in the middle of a crisis, but I don’t know the best way to begin. He is resistant,  he says as a doctor himself, he is trained in all illness, and no one else could tell him anything he doesn’t already know. He has also balked at the idea of medications because he doesn’t want the mental side effects they can produce.

I love my husband and can tell he is in such pain. I want to help him with all my heart and don’t know how.

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Answer:

It is true that some, but not all doctors can be difficult to deal with because medical school seems to imbue them with a certain amount of arrogrance and, so, they think they know everything. Evidently, your husband seems to be one of them. However, it is clear that he needs help.

Judging from your description, he is attempting to intimidate you into doing nothing about his suicidal thinking and planning. The fact is that he can attempt to fool psychiatrists into thinking he is fine but they are trained to see through this. After all, he made a serious suicide attempt and you could have called 911 for a psychiatric emergency.

It seems to me that you can directly bring up to him his need for an evaluation and treatment at any time, regardless of his mood. In doing so you might remind him that his wanting to commit suicide impacts on you too and that if he cares about you he should get himself help. There are also medical patients who will need his help.

It might help him to know that depression and wanting to commit suicide is a common outcome of medical school because it is so extremely stressful. Also, medical doctors take care of their own and provide psychiatric services to them, separate and apart from the public. He could get help without worrying about the idea that patients could see him in a therapist’s office.

He should also know that he may not need medication if he gets cognitive behavior therapy and that the side effects of medication, if he needs them, is far better than committing suicide.

My suggestion is that you bring up his need for help now before things get worse again.

By the way, try not to be intimidated. Even if he divorces you in the event that you call 911,  it is still better that he be alive.

One last thing is that he does not know everything and he does not know about mental help despite his being an MD.

Best of Luck

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