finding care in the off hours

Last night I was in the throws of pain again. But my thoughts didn’t immediately turn to darkness Like they normally do. I wrote an email to my pdoc about what has transpired during the week and that I haven’t been faithful in taking the increase in my mood stabilizer for reasons beyond my control. Mostly because I have been driving and I don’t want to be drowsy behind the wheel. I also asked her if there was a hotline number she knew of to call in times of distress. She gave me one.

This all lead me to thinking maybe I should have a blog about this important issue…finding care during the off hours. For most people in therapy, when they are in distress after hours their and before their next session is to seek help in the local ER. This can be costly, as copays have more than doubled to deter such visits. But for mental health, there should be an exception made as there is really no other place to go while in distress. I understand that the cost is higher because care is more urgent and is most likely is trying to ward off unnecessary visits. But when you are in crisis, how can that be unnecessary? For the mental health field, there are no urgent care centers to go to in distress. It’s either you see your therapist or go to the ER (Emergency room). There is no in between. SO what are you supposed to do when you are somewhat distressed and cannot wait till your next visit with your therapist?

There are self-soothing measures. You take a bath/shower, read, journal, brush your hair for 100 strokes, eat something, etc. But when all is said and done, and you still feel terrible, then what? Most therapists have some kind of plan in place, or should be able to give you a hotline number such as Lifeline 1800-273-8255 (US only) or the national hotline number 1800-784-2433 (US only). I have tried calling the Lifeline hotline but have never been patient enough to wait to get transferred to someone. The other number I have not tried. There is also a text # 20121 and you text 121help. I don’t know where I got that number from but when I tried it the other day, it didn’t work. I never got connected to anyone, but that might be because of the hour.

There are chat groups, I am told, where you can discuss suicidal feelings and not be “punished/banned” or turned away. Unfortunately, I do not have that URL to share as I have not looked into that chat room. But when you are in distress, are you really going to google something??

There is something called a Crisis Response Plan that I sometimes use when I am in distress. UNfortnately, the last few times I have been in distress, all of the self-help went out the window and I didn’t use anything. I just ruminated about what I was going to do. It’s not perfect trying to save your life when you feel like ending it. I was not in the frame of mind to seek help.

Therapists think that a suicidal person always calls for help when in crisis and that simply is not true. Most clients become impulsive, wants to get rid of the negative feelings NOW and are in my experience, not likely to reach for help.

For me, writing has helped but not everyone has that option to them. I will blog my distress and might be fortunate to have a few bloggers comment to show support or to chat. But that doesn’t happen all the time. Most of the it’s hit or miss. My frequent blog readers might not be online at the time of my post and so not get it.

Sunday I participated in a chat that was for crisis intervention and I learned that there was a crisis text chat available. The intervention was either through chat or text message. I am going to looking into using this the next time I am in distress or when my mood goes south. It’s not always easy to think of these thing when your mind is thinking of ending your life. To use a DBT term, you just cannot tolerate the distress because it is unbearable.

I have been trying to identify when I am in distress so that I can reach out for help but it’s not so easy. The last few time I have used distraction or music to help me out of the intolerable feelings. I also will write in my blog or my journal but it seems like all bets are off if I am in intolerable physical pain. Chronic pain mixed in with getting my menses and dealing with it has been difficult this past two weeks. The waiting for pain medication to kick in is sometimes not fast enough to deal with mentally.

I wish there was some help I could have regarding physical pain and lethality but there are few pain specialists that deal with mental health issues and fewer still, psychologists that deal with pain issues. Even crisis help lines don’t know hot to deal with physical pain that is behind suicidal ideation. In a perfect world, you would like to see someone that is well rounded in chronic health issues and suicidality. Unfortunately, I don’t think they exist or they may just be too far and in between to help the greater good.

When I was being evaluated at my local pain clinic, I saw a pain psychologist. His job was to help me deal with pain. But he didn’t offer me an real advise the first time meeting him. I would have to set up a series of sessions with him but unfortunately this happened when I lost my car and he is too far out to see. If I saw him with public transportation, it would be a two hour commute, both ways.

The hardest part of being alone with your thoughts is that you are left to your own devices before the next session or when office hours are available. I wish there could be urgent care centers that are specific to mental health issues. Because not all crisis needs to result in a hospitalization. Sometimes just talking with an understanding person is the best treatment mental health professionals can provide.