Category: psychache

still inpatient 2

by Midnight Demon, posted in depression, mood disorders, psychache, suicide attempt

It’s Sunday and I am still here. I probably will be here for a while as I found out last night that there is no set discharge date for me. This upsets me. I talked with my pdoc and told her that even though she is on vacation, I want to be discharged and that I will email her every day until I see her on the 22nd. I am still having suicidal thoughts and stuff but they are lessening. I think the new medication is helping me. I really want to be in my own bed again.

Since I have a bunch of time on my hands while I am in here, I have written a lot in my journal and written a few letters to my therapist. She is on vacation also. I really miss her and hope that when I get out of here I can borrow my sister’s car and see her. I haven’t seen her since June. She misses me as much as I miss her. I am trying my best to get out of here and still be safe.

I had an ankle flare up the other day and I can’t seem to calm it down. It is bugging the crap out of me. I had the doc change my medication orders so I take two pills instead of one. This has helped me tremendously. I feel like I can now be better now, least where my pain is concerned.

I wrote out a treatment plan for my case manager last night, I am hoping that it shows that I am trying to work on my issues. I know that this unit cannot work on ALL my issues but I just want to work at least on a little bit so that feel a little better. If I can work on the self-hate and “like” myself a little bit, I think that will decrease my suicidality enough that I can be okay. I will find out tomorrow if this plan is going to be acceptable to my treaters. It is the only think that I have going for me. If they tell me they cannot work with me on this a little bit than I have no other choice than to sign a 3 day and leave AMA [against medical advise]. Course, it might back fire on me and lead to a court commitment but I will worry about that later. Hopefully it doesn’t come to that.

Last night was rough for me as I wanted to write out my will and testament and a good bye letter to my friend. Actually, it was more to write out what I want him to do in case of my demise. My contact person talked me out of doing this. She wanted me to work on a self-compassionate letter instead. I have yet to write this. I might work on that today, though it is going to be difficult.

I had a tough day with family. One of my cousins called and wanted me to visit him but when I told him I was in the hospital, it was like I did it on purpose and didn’t want to see him as he told me in advance he was coming up {he lives in Virginia}. I felt very upset by this. I then told him not to tell my aunt about my being in the hospital because I don’t want her to know. He then flipped out about that. It was like a no win situation with him that just left me feeling upset. Then my sister texted me wanting me to tell her what medication I was on. I just felt like I was being bombarded by family. I didn’t answer my sister’s text.

I talked with my contact person. It was the same one I had last night. She is good and I like talking with her. I told her I was feeling depressed and wasn’t sure if I could keep my safety outside the hospital, which is true. I still am having suicidal thoughts and plans. I don’t know if I would act on those plans but I know that they are still there. I really feel like I should do something. I am feeling agitated and perturbed. I told my contact person that my “normal” voices aren’t there. I am missing them very badly and I think that is what is making me feel perturbed. I hope they come back so that I have someone to talk to. I feel lonely without them.

I am thinking of a good friend tonight. I found out she has suffered a stroke and is in the ICU. Her left side is affected and so is her speech. She is a very religious person so I know that god will take good care of her. I just hope she doesn’t suffer. If you bloggers can send her good thoughts, I would most appreciate it.

psychological pain and goal setting

by Midnight Demon, posted in blogging, chronic physical pain, depression, mood disorders, psychache, suicide

I was looking over the stats for today and noticed someone read my therapy and therapists blog. For some reason, I thought it was clear that it was for psychology but someone made a comment about physical therapy and I had to go back in and change the title to therapy and therapists (psychological). I still don’t know what made someone think that I was talking about physical therapy.

Been having another rough day with pain, both physical and psychological. It’s a good thing that my therapist is off because it is the weekend or I might have to go the ER, and not for the physical pain. My thoughts have been very dark. I can’t see a future. I feel really bad and I don’t know why. I still want to kill myself. Been thinking about writing a note and some instructions on what to do after my death. I just haven’t done it because I am afraid if I take that step forward there might not be any going back.

If I were to take a psychological pain scale assessment, I am sure I would score pretty high on it right now. Everything in my being hurts. It hurts to breathe. It hurts to write. I wrote a blog the other day on a notepad that is five pages long and I still haven’t typed it up. It is about my therapist and coffee. I typed up a page and a half and then had to stop. It got too tiring to continue. My psychache is unreal and is causing me to think slower than usual. Thing is, even if I were to devise a plan to kill myself, I doubt I would be able to execute it because I have no energy. I am not perturbed enough to go through with it. All I can do is write about how much I am in despair and hope that it will pass. But will it?

All month I have been meaning to change my bedding. So far, I have been successful in cleaning off the “office” side of my bed so I can change the sheets. I figure tomorrow I might be able to finish putting things aside and changing the sheets come Tuesday. That is, if I am not in too much pain. I woke up early this morning in physical pain and I have been miserable all day. I fell back to sleep and woke up really late. Too late to make coffee. I haven’t had a cup of coffee in days. I think Thursday was the last time I had a coffee drink. I am in withdrawal as I keep having a low level headache. I hate when I wake up late in the day. It throws everything off. I hope I can sleep most of the day tomorrow. I really don’t want to do a damn thing, except for maybe going out for coffee. I can make it at home, sure, but that involves work. Granted it would be faster making it at home but I really have to type of the blog and maybe I can do that at Starbucks. I have to set some goals during the day or otherwise I feel defeated and hopeless. But again, it all depends on what my pain levels are like and if I have the motivation to go through with those goals. Right now I am feeling good that I got some stuff off my bed. I just take a one thing off a day, so this way I am not overwhelmed by the entire task. Otherwise I would be stuck in the depression and not be able to do a damn thing. But I don’t feel like going out tomorrow. And I don’t feel like making coffee. So I will just sleep the day away, just take my meds and sleep. Maybe then the pain, both psychological and physical will go down enough for me to face Tuesday.

Weird dreams again and the SSF

by Midnight Demon, posted in chronic physical pain, depression, mood disorders, psychache, suicidality

I am having a horrible day. My day literally started at 0100. I slept for a few hours, from 2200 to 0100 and I was up for the night. I went back to sleep around dawn. Was up for a few hours and then tried to get back to sleep around 0800 or 0900. Fail. I finally gave up around 1130. In the times that I did sleep, I had another weird dream about children and elevators. It was winter time and we were going to take the children sledding but the elevator malfunctioned and we ended up at a hospital that was at an airport. I don’t know what that is about. Absolutely makes no sense. Other than me possibly wanting to get away either through an airport or a hospital admission. I don’t know.

I had therapy and we talked about the weird dream and me not sleeping. I told her I am getting to my wits end. The heat is not helping. I still have to clear a path for my bro in law to install the AC. Maybe I will do that after I write this blog. We also talked about my suicidality and the need to attempt suicide. I don’t know why I feel like this. I just feel like everybody will be better off without me. I just feel so low and useless. I know my sister needs me because I have to pick up my niece next week. She doesn’t have the after school program anymore. But I just hope my ankle doesn’t flare up other wise I will be in pain and I am not looking forward to that. I just wish I wasn’t in pain every single day. I have not had a “day off” from pain in weeks.

So because I am thinking of an attempt, my therapist is taking out the old SSF to assess where I am at. She will do this assessment tomorrow. The SSF (Suicide Status Form) is an assessment used to assess and evaluate suicidality. In addition to this assessment, it also lists goals of treatment that both the clinician and client agree upon. The beauty of this assessment is that it allows collaboration in the treatment of suicidality rather than have the clinician be the expert. And the assessment is easier for the clinician as it also lists all the necessary documentation you would need for a session such as Axis diagnosis, progress notes, and date of next appointment.

The SSF was developed by a suicidologist, my idol, Dr. David Jobes. He developed this assessment so that clients that were suicidal did not get “lost” in the system and were treated as equals in their treatment, rather than have treatment as usual. To learn more about this, check out his book on the subject, Managing Suicidal Risk. It is a great book and also teaches you how to score the assessment at the end of the book. There are also classes you can take. His assessment tool follows under his framework, CAMS, Collaborating and Assessing Management of Suicidality. I write a lot about his work on my blog because I can’t stress the importance of suicide prevention. And this is one tool to do that.

So my therapist is pulling out this assessment tool on me tomorrow. I am not happy about it. I know how to “cheat” on it as I am the one to bring it to her attention. She is not proficient in promoting it despite my several attempts for her to go to Jobes’s workshops. She feels, like many therapists, that her training is adequate (it’s not) and she does not want to be a suicidologist. I am not asking her to change her ways, just add to her skill set. Every time she brings it out, I cringe because I know she doesn’t use it all the way through and that pisses me off. I feel like it is a waste of time because it is not used properly.

Different Theories of Suicide

by Midnight Demon, posted in depression, mood disorders, psychache, suicidality, suicide, suicide attempt

Different Theories of Suicide

A few weeks ago I participated in a twitter chat (@SPSMChat). The discussion was about how Joiner’s Interpersonal Theory was the cause of suicide. The theory is the hypothesis that Perceived Burdensomeness (PB), Thwarted Belongingness (TB), and fearlessness of lethality all contribute to a suicide. Perceived Burdensomeness is when a person thinks they are a burden to society, their family, and their significant others. It is the “better off” type of feelings that are believed to go into suicidal thinking.

Thwarted belongingness (TB) is when a person believes that they are outcasts of society or group they belong to. They feel they do not belong to any such group and thus feel isolated and alone.

Fearlessness of lethality is a premise that the person doesn’t have a fear of death. It is like a Russian roulette towards death. An example of this is taken from the book Myth of suicide by Thomas joiner is Kurt Cobain. He was at first totally against the use of guns but then acclimated to them and then use a rifle to inflict his death. His lyrics speak to his struggle with suicide and depression as well as the pain he was feeling.

While Joiner’s theory does have some merit, it, like other theories of suicide cannot be proven due to the nature of the study. No ethic board would condone the death of the subject to prove a hypothesis.

The other theory that comes to mind is Shneidman’s theory of psychache as a causal factor in suicide. The here is that deep, unbearable pain is the reason behind suicidal thinking and action. In my own personal experience, I thought for a long time that I don’t belong to any group. And I also thought that I was a burden to others. But what drove me to the brink of death was the deep psychological pain that I was feeling, an element that I believe Joiner is lacking in his theory. If you combine psychological pain with TB and PB then you have a nice recipe for suicide.

There is some merits with Joiner’s Interpersonal theory of suicide but I believe whole heartedly he is missing the key element of pain. I really believe that if he adds psychological pain to his theory it will be a valid theory, in my opinion.