To understand suicide we must understand suffering and psychological pain and various thresholds for enduring it; to treat suicidal people (and prevent suicide) we must address and soften and reduce the psychache that drives it.
–Edwin Shneidman The Suicidal Mind
Category: psychache
No Breeze Stirs this Cauldron
“What I had begun to discover is that, mysteriously and in ways that are totally remote from normal experience, the grey drizzle of horror induced by depression takes on the quality of physical pain. But it is not an immediately identifiable pain, like that of a broken limb. It may be more accurate to say that despair, owing to some evil trick played upon the sick brain by the inhabiting psyche, comes to resemble the diabolical discomfort of being imprisoned in a fiercely overheated room. And because no breeze stirs this cauldron, because there is no escape from the smothering confinement, it is natural that the victim begins to think ceaselessly of oblivion”
― William Styron, Darkness Visible: A Memoir of Madness
The crash has started. I am once again thinking of quote that I hold dear to me when I am in a despair like state. I just emailed my psychiatrist telling her I am in despair but I am not quite suicidal. I can’t sleep because of pain and the pain meds have not kicked in yet. But the pain I am feeling now, is a different type of pain. It is psychache and there are no pain pills for that ache. My heart feels like it has been broken into a thousand pieces. I feel like I am being suffocated by this weight on my chest. Like Styron says, “there is no escape from the smothering confinement, it is natural the victim begins to think ceaseless of oblivion”. Except, I am not there yet. I am close to thinking of my oblivion but I think if I start thinking about it, I will act.
I started vacuuming my room a little bit at a time. I bought a hand held vacuum. I thought it was cordless but it is corded. No matter, it still does its job. Too bad it hurts me in the process. I can’t stand for too long before my hip goes out. It is this pain that I am feeling that the pain meds aren’t helping at the moment. They will soon, I hope. It is past midnight. I hate staying up this late because it can only lead to Hyde coming out when I am in this despair. I got to find my “Touched With Fire” book. It, I think, has the quote by Hugo Wolf about the heart being broken into a thousand pieces. I thought it was Byron but it’s not. I would like to have this quote on my quote page. I think it will be a nice addition.
I wasn’t expecting to crash this soon. I thought I would have a few days of “normal” before I headed to psychache land. I started writing in my journal. Five pages later, I got an idea for my next blog on “no-suicide” contracts. What got me thinking about this was that if I didn’t find the “Crisis Response Plan” how different my treatment would be with my therapist. No-harm or No suicide contract are stupid and have no validity. They are not even a legal contract in the eyes of the law (to the best of my knowledge) yet are used over and over again. Meds are kicking in so I can’t quite explain more as it is complicated.
I found the quote from Wolf, it is “I appear at times merry and in good heart, talk too before others quite reasonably, and it looks as if felt too. God knows how well within my skin yet the soul maintains it deathly sleep and the heart bleeds from a thousand wounds”. That is how I feel right now. I feel like I am faking being happy yet I so am falling apart and no one can see it. I feel utterly alone.
Earlier tonight, I was feeling fine. I don’t know what caused the downfall to occur. I was just writing in my journal and thought about writing this no contract paper and then I suddenly felt really sad. I got a notepad that has another quote on it, “people do not die by suicide, they die by sadness”. Anonymous
I think that is true. I have real sadness. Dark sadness that won’t leave me. It is like black storm clouds following me. And it came on just with the snap of your fingers. I wish I could snap my fingers again and have them leave. I am hungry. Maybe this sadness is caused by low blood sugar. I only had one thing to eat today, a half of roast beef club sandwich. I couldn’t finish the rest of the sandwich. It was too filling. I should have saved it but it was soggy and I had soggy sandwiches. Now I am hungry and want something to eat. Maybe I will have a pop tart. I don’t know. It’s getting later and later. I really just want to sleep. The hell with eating.
Can’t Die Without Explanations
“One can’t die without explanations”. Fyodor Dostoevsky p 513, the Idiot
This statement struck me tonight, in more ways than one. I think, this is the purpose of Hyde, to explain my death to people so they know of my suffering. I am very tired at the moment. I just woke up from a short nap and now I am in pain because I almost fell while getting up off the toilet. I lost my balance and fortunately, sat back down, but harder than I would have liked. My left knee didn’t like it much. I woke up with it hurting me. But once I started moving, the pain went away. Mysteriously as it came. Until I nearly lost my balance. Weird.
My back is hurting and I don’t like it. I can barely sit up. I keep thinking about death. I don’t want to live anymore. I know I have said these things time and time again, but it’s true. I don’t know what I am going to do when my date comes in the next few weeks and I am left all alone with my thoughts. If I don’t kill myself, it will be a defeat. If I try, at least I can say I tried. I won’t know if I succeed if I don’t try.
The quote is from a character in the Idiot, Ippolit, who has consumption (TB or Tuberculosis) and is in the last stages of the disease before death. He has been given just three weeks to live and keeps on telling people that he must tell his “confessions” before he dies. I feel the same way, though I don’t feel there is anything to confess. I have not done anything wrong. I just feel like a lowly human being that deserves to die. I am tired of the mental anguish I suffer day in and day out. I am tired of my physical pain that prevents me from working and “having a life worth living”. Today I drove and it cost me pain in my ankle. I don’t know why. I always feel this pain while driving/sitting for too long. It is a pain that starts at my ankle bone and goes into my foot. The pain is like a wrap that no one can see but I feel. They say it’s the peroneous tendon that is inflamed causing this pain. If you look at the skeletal structure of this tendon, you can clearly see how it goes from the ankle to the three damn toes of the foot. That is where I have most of my pain. The last three metatarsals in my foot. It haunts me like it does now. And I am in severe pain.
Aside from my transgender issues which will never be resolved, I have body image issues that are distorted. I am ugly, yet people have told me I am handsome and sometimes, cute. I don’t feel this way. I feel like I am very ugly that I will break a camera or mirror if I look into it long enough. I have a negative self-image. I can’t stand the way I look or how my body feels. I have a self-loathing so deeply ingrained in me that I doubt my therapist can ever get to the bottom of it. Having breasts is just one of the reasons I self-loathe. I cannot stand myself. I really want to die. I don’t want to breathe anymore. It hurts to breathe. I tell my psychiatrist this and she doesn’t think too much of it, about the hurting to breathe. But then, there is nothing she can really do about it. I am not in distress. My skin color isn’t blue. I am oxygenating very well. There are no obvious signs that there is a weight on my chest, unless you count the things that are there (breast tissue). But every woman has them and they don’t cause interference with breathing. No, I am not saying there is something pathologically wrong with me. I know that this heaviness is this depression that I feel. It makes everything heavier than what it should be. Probably why my knee hurts. It can no longer carry the weight that I have put on since my last hospitalization. I have tried to lose this weight but it is difficult. I eat the wrong things. But I eat the things that make me happy, like cheeseburgers, bacon, and ring dings. Not all the time. Just once a month when I get paid and can afford these things.
These things taste good when I am feeling up to eating them. Lately, my taste buds have failed me and nothing tastes good. I eat only because I need to, though I don’t enjoy it like I once did. Nothing brings me joy or pleasure. Used to be that I have a mocha from Starbucks and that made me happy. Now it just tastes like sugar and I don’t even taste the espresso like I used to. I feel like I am wasting my money on this drink. Maybe it’s time to try espresso by itself, but I am a creature of habit. I order the same thing all the time. It’s hard to break from that.
Today I was thinking about my diagnosis. Used to be that I had recurrent major depression, with psychotic features, NOS. Now I am depressed but it’s not under the same classification. Not that I need to know what it is. I don’t really care, but I would like to know if it is a bipolar depression that I am suffering. I had highs a few months ago, back in February. Those were lovely, though a bit terrifying. I am not used to feeling up. I am used to feeling down all the time. And this time I have hit an all time low. I think about death constantly and when I am not, I am dreaming of funerals and wakes. I often wonder, if I do have a wake, who will show up. I doubt I will get the same sympathy as a friend of mine who died from diabetes. People who die by suicide don’t get the same sympathy as other who die by illnesses. But that is a debate for another day.
My explanation of my death is this, I am tired of hurting, both physically and mentally. Physically, my pain is well controlled, though I still hurt every day causing me to be on medication to control it. Mentally, there is no medication for me. Sure I take my mood stabilizer and anti-psychotic pill to ease those symptoms caused by the bipolar and psychosis that I have. But it doesn’t help the mental pain, the psychache, the deep down to the bone ache that no one can see or feel. I have been struggling with this ache since I was 8 years old. I am tired of fighting it every single day. 32 years is a long time to be fighting something that no one else can feel or see or measure even. There is no test that my pdoc can give to see where it lives, where it abides. Sure, I know there are measures out there but no one uses them. My therapist has stopped using the psychache scale. I have even stopped using the psychache scale, not because it wasn’t effective, but because it just was a number that couldn’t be brought down. It was up and it stayed up, until my crisis was over. This time, I don’t think my crisis is going to be over. Hell, I don’t think I am going to last that long period. What the hell am I waiting for?? Why can’t I go through with it tonight. Fear. And that I don’t want my family to find my body. It will be hard to be dead by suicide. Harder still and more traumatic to find my body. I don’t have a place I can go to end my life. And that is really sad. So I just sit here and complain about why I cannot go on living knowing I can’t take my life because I have no place to end it. And that is the funny thing about my therapist and psychiatrist. They have never asked me how I am going to do it, where, when. I just tell them I am suicidal and they just leave it at that. They never know what my plan truly is.
Times Have Changed But My Suicidality Has Not
I woke up because of having to pee and now I can’t go back to sleep. My room was freezing so I turned off the AC but then I realized, if I went back to sleep, I would wake up hot. So I have the AC on energy saver and hope the turning off and on doesn’t disrupt my sleep too much.
I am kind of in a dark mood. I just bought three journals because I needed them. The ones that I have are half way filled and I know by the end of the year, I will need a new one. I like the ones I bought. I am glad Barnes and Noble has such large journals. I do a lot of writing, in case you haven’t noticed.
I read one of my journal blogs that I wrote back in 2014. It was an entry that said that I cut myself and I went on about how scared I was that my therapist was going to flip out. I also didn’t want my psychiatrist to know because I knew it would cause her concern. The weird thing is, I don’t remember the incident at all. I had cut because of my TG issues. Now I am just suicidal. I have been struggling with this for months and I can’t seem to walk away from it. Like I wrote to my psychiatrist, I think there is a chance that I will go through with ending my life in a couple of weeks. I want to try it anyways, even though I know I am not going to like doing it. Suffocating oneself is difficult to do. But it’s the only means I have available to me. Worst thing that can happen is that I will be found before I am dead. That is my fear. And if that happens, I could have brain damage from lack of oxygen. That fear of being brain damage really wants me to stay away from this method. But it’s not like you can just buy arsenic pills on the internet like you used to. Maybe you can. Google hasn’t been much help in this arena. Even buying hemlock juice has been tricky. So I have come to the simpler methods that I have on hand.
I want my pain to end, permanently. Funny how I am writing about buying journals to write with and yet I want to take my life. How will those journals be useful to me? Most likely they will just be donated or given to my niece after I am gone. I am not sure what will happen with my things. Trash most likely. I haven’t written a will. I still have time, though I am not looking forward to it.
Since writing to my psychiatrist, I am afraid to write to her anymore. I don’t want to get a phone call after an email because she is concerned about my safety. Literally, she sent the email and within ten minutes she called me, after I sent the email the night before. I am so tired of worrying her and my therapist. Both want me to live. A lot of people I know want me to live, but how can I do that when I want to die so badly? I have been following the zero suicide academy postings on Twitter the past 24 hours. Jobes was there giving a talk about evidence based treatment. DBT, CBT, CAMS, and non demand follow up were among those shown to help decrease suicide. It got me thinking that maybe I should try to see another therapist to help with my suicidal feelings. Only problem is, money. I no longer have the money for copayments and I am on Medicare which only covers 80% of the visit. I would be responsible for the 20%. I wrote to my consultant last night. I gave him a blog reading of the “Love/Hate” that I wrote. I know that he would be interested in reading it. He was always curious about the relationship factor between my therapist and I. Now he will know in greater detail.
I follow suicide prevention because I am hoping it provides me with something to help my own suicidality. I don’t feel hopelessness. I think my depression would be 10 times worse if I were hopeless. I just feel so down that I just want it to end. I really think that if I try and see someone new, maybe they will provide me with some insight that I am missing. But ultimately, the choice is mine. No one can stop me, though they can try. I don’t think going in the hospital would be in my best interest. All they do is babysit you for 24 hours every day and drug you up. No real treatment exists in the hospital anymore. It’s not like it was back in the old days, where treatment and care were more important than containment and safety. I literally had to beg to be kept in house because I told them I was going to kill myself when I got out. Their response, “You are putting us in a difficult position”. I kid you not! And this was at a world class hospital! I won’t go there again. I won’t be subjected to non-treatment. Besides, the only ones that really cared were the nursing staff members. They took the time to get to know you and try and help you deal with shit. More so than your “treatment team”. It has been almost 11 months since my last admission. I like to say I am doing well staying out, but am I? They call you “stable” if you are able to stay out of the hospital for at least a year. How stable can you be if you think about ending your life every day? I just am not impulsive to act on my feelings every time I have them. Some people have not learned that self-control. I learned the hard way. I learned to keep my feelings to myself or I would have ended up in a state ward. This was twenty years ago. And times have changed.
midnightdemons7 
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