If you or someone you know is thinking about suicide, call or text 988 to reach the 988 Suicide and Crisis Lifeline, available 24 hours a day. If someone is in immediate danger, call 911 or go to the nearest emergency room.
Some women feel disloyal even thinking about it. Her family doctor has known her for years, delivered good news and bad, and has tried hard to help with her depression. Asking someone else to take a look can feel like going behind his back.
It is not. Second opinions are a normal, respected part of medicine. When depression has not lifted, or when it has started to include thoughts of suicide, a fresh set of eyes can be one of the most useful things she does.
Signs a second opinion may help
- She has tried more than one treatment without feeling much better
- She has never seen a psychiatrist or depression specialist
- Her symptoms changed with perimenopause, a health problem or a major loss
- She feels rushed or unheard in appointments
- Thoughts of suicide have appeared or grown stronger
How to ask
She does not need to explain or apologize. A simple sentence works: "I would like to get another opinion on my depression, and I would like you to send my records." Most clinicians are glad to help, and many can suggest names.
She can also check with her insurance company about specialists in her network, ask her therapist for referrals, or look for clinics that focus on depression that has been hard to treat.
What to bring
A short summary saves time and makes the visit more useful:
- A list of treatments she has tried, roughly when, and how each one went
- Other health conditions and current medications
- Changes in her life: caregiving, divorce, job changes, grief, menopause symptoms
- Honest notes about suicidal thoughts, including how often they come
- Her questions, written down
A partner or friend can come along to listen and help her remember. That can matter a lot when the subject is heavy.
Options a specialist may bring up
A second opinion may include a conversation about newer options, such as Spravato. Spravato (esketamine) is a nasal spray the FDA has approved, taken along with an oral antidepressant, to treat depressive symptoms in adults with major depressive disorder who have acute suicidal thoughts or behavior. It is also approved for treatment-resistant depression. It is not a crisis treatment: it does not replace emergency care or a hospital stay when one is needed, and it has not been shown to prevent suicide or to reduce suicidal thoughts or behavior. It is given only in a certified clinic under a safety program called the Spravato REMS. The patient takes it there under supervision, stays at least two hours to be monitored, and does not drive until the next day after a full night of sleep. It is never dispensed for home use. Whether it fits is a clinician's decision after an evaluation.
A specialist may also suggest changes to her current medication, adding therapy, or checks for other health issues. A second opinion does not mean starting over. Often it adds to the work already done.
Keep watch in the meantime
Getting a second opinion takes time, and the weeks of waiting can be hard. People close to her can watch for warning signs: talk of being a burden or trapped, pulling away, big changes in sleep, giving belongings away, or a sudden calm after a long low stretch. If you notice them, ask her directly whether she is thinking about suicide. Asking does not plant the idea. Help her reach her current clinician or call 988 together if things get worse before the appointment.
Safe storage of medications and any firearms during a difficult period is a reasonable step for any household.
Advocating for herself is part of getting well
Women in midlife often spend years advocating for everyone else: children at school, parents at the hospital, coworkers at review time. Turning that skill toward her own care is not selfish. Depression is treatable, and people do recover, sometimes after the right clinician sees what others missed.
Some second opinions start with a free first meeting. Many clinics that offer this treatment hold one, giving her a chance to explain her history and learn whether a full evaluation would add something. Her notes, and a person she trusts, are welcome to come along.
If you or someone you know is thinking about suicide, call or text 988 to reach the 988 Suicide and Crisis Lifeline, available 24 hours a day. If someone is in immediate danger, call 911 or go to the nearest emergency room.