coffee and therapists

Went out for coffee today. I didn’t feel like it but I forced myself to. I gave myself an incentive, that if I went I would get something sweet. I usually just get my coffee and maybe a sandwich, if I am hungry. But today I really wanted something sweet so didn’t need that much incentive to get a coffee cake. I like that the baristas are getting my order down pat. I don’t order anything fancy, just my favorite flavor, which is now Kati Kati, grande size but in a venti cup. This is so I have plenty of room for the half and half. I also put in several packets of sugar. I need my coffee sweet, which is why I usually don’t get something sweet.

I did accomplish something today and that was finishing the book why do people die by suicide by Thomas Joiner. I had an autographed copy but lost it on the train the first week I read it. Much to my sadness. The book was good and I learned a few things that I hope I retain. He is a cognitive therapist so he focused on that during the strategies for dealing with suicidality. I really liked the book because it not only dealt with personal experience (his dad died by suicide while in grad school), he also listed empirical data to back up what he was talking about. I am a research geek so I tend to like stuff like that. He also used terms that put people that couldn’t understand the technical stuff into words that people could understand, like how neurotransmitters interact. It was a very interesting book. I also bought another book that he wrote called Myths of Suicide, which I hope to read after I finish reading Lincoln’s Melancholy.

My reading voices are back, thank god. I can’t seem to focus unless they are there. I got a comment from my psychotic while reading blog and this person said that she only hears her voice while reading. I find that so interesting. I never hear my own voice. Unless my voice is male sounding, which I don’t think it is, not yet anyways. But then I do have enlarged ventricles in my brain that cause the voices. Not as large as those found in schizophrenia but enough to have a radiologist comment on it. I had the MRI the first time I was hospitalized when I was sixteen. They ran a bunch of tests on me the whole time I was there, from cortisol suppression studies to psychological tests such as the inkblot. I remember how much paperwork I had to do for the MMPI, the Minnesota Multiple Personality Inventory. I hated that. I did that more than once over my lifetime for various studies I was involved in. It is a LONG inventory. I am glad it is not used in clinical practice, unless you go specifically for psychological testing. It would make for a long afternoon or morning.

I have been feeling self-harm urges the past few days. I don’t know why that is. I just have the urge but usually distracting myself or listening to music helps. I have not cut in years and I like it stay that way, though I still have my “kit”. Even though I don’t use it, I still find it comforting to have it around. I also have been getting urges to overdose but these quickly pass as I just can’t do it in my house. Symptoms of my illness.

The dreaded nerve pain has come again. I really tried not to stand too long while waiting for the bus today to get my coffee. I tried not to jiggle my foot in a way that I know would upset it later. But I did do stretching exercises while I was on the phone with my therapist so maybe that is why it is angry at me. I never know what will make it upset. It’s like an untemperate, abusive person. You just never know what will set it off. The cold. The heat. Wearing socks. Not wearing socks. Moving it this way versus that. It’s a never ending battle. I am so sick of it. I am tired of hurting. And nothing helps curb the pain. My pain meds can only do so much, which is knock me out most of the time so I can sleep. But that is only for a few hours. Once the meds wear off, I am screwed. I wake up and sometimes it take a little but to register that I am awake before the pain starts. Other times it is because I am in pain that I wake up. My sleep has not been good the past week. I keep waking up between 0230-430 in the morning. No matter what time I go to sleep, I always wake up during those hours. If I fall asleep before ten, I am always up four hours later. I can’t stand it. I usually play my games or check twitter. If I am bullshit, I might write another blog or journal if I don’t feel like opening my laptop. Sometimes, I try reading and usually that works to put me back to sleep, unless I am in roaring pain. Then I just stay up until the pain meds kick in to knock me out again while withering in agony.

This week’s AAS blog is about finding a therapist that won’t run away or panic at the mention of suicidal thoughts. I want to laugh and say, have you read my therapist blog? I have had ten therapists run away from me soon as I mention that I have had suicidal thoughts in the past or been hospitalized because of them. Course I am hospitalized frequently so that doesn’t help my case. I have been hospitalized at least eight times since 2008. My last hospitalization was last June. So it has been a year but if these damn voices don’t stop, I might have to go back in. The voices and being suicidal doesn’t mix too well. But getting back to therapists, they can be tricky. I kept on being referred to another therapist, who would then refer me to yet another therapist. Before I knew it, I had ten within a month’s time. I finally gave up and stuck it out with my current therapist, even though I don’t see her in person frequently. I think I will see her next week. I will try and get my sister’s car.

I know why therapists don’t want to take on suicidal clients. They don’t want to be liable. They fear malpractice. They even fear losing the client. But I believe that despite this, with the right treatment, therapists can see suicidal clients. It just takes a little bit of courage and trust, a lot of it. Not only on the therapist’s part, but also the client. The client also needs to have a trust in the therapist that they aren’t going to be dumped in the hospital every single fricken time they get suicidal. The therapies out there that help are by David Jobes, CAMS and by using his suicide status form. Also using the Aeschi model helps. Knowing why the client wants to kill themselves says a lot. By not allowing the client to share his story, he gives his therapist a reason to distrust him. I do hope that there comes a day when graduate schools are mandated to have some kind of suicide preventions/treatment protocols in their curriculums. It shouldn’t be up to the therapist’s own style of interviewing that should be dependent on their suicide knowledge. That and the use of no-suicide contracts should be discontinued as long as something like CAMS is in place or the QPR by Paul Quinnett. I forget what QPR stands for but it is a useful resource.

Dysphoria of sorts

All I want to be is DONE.

I didn’t know what to write about today. It’s taken me a long while to come up with something to write. I tried writing in my journal while I was at Starbucks but I just left a blank page. I have been feeling paranoid lately. I feel like everyone is watching me. There were a lot more people in the store today than there usually is so I guess it kind of prevented me writing. I was also really hot and wanted to just sit in the air conditioned room. I also wanted to enjoy my new iced coffee, Kati Kati. I got an email from Starbucks last night about it and so tried it today. It is a little stronger than my Isla Flores but it is ok. I loved it! It was the one joy on this dismal day.

I had therapy this afternoon. I really didn’t want to talk but then I got really suicidal. I had fantasies where I would hang myself off the back porch while my family would be at my cousin’s house for the 4th of July BBQ. We worked out a safety plan that didn’t include me downing a bottle of one of my medication. I am to write and go through my crisis response plan (to what that entails, check out this blog). If these things don’t work, I am to try and get in touch with my therapist, psychiatrist, or go to the hospital. I truly have crashed. I don’t have the energy to do anything. I have no motivation. I just want to crawl under a rock and die.

I knew this crash was coming. I just didn’t think it would come this fast. I think it just came at the beginning of this grief that I am feeling. I also am feeling trapped by living. I don’t want to live. I just want to die. Life to me is just worthless. Nothing gives me pleasure except that one coffee I have from Starbucks a day. And watching baseball games. Least I can get lost for a little while watching the games because each pitch keeps me entertained. I love when the batter keeps fouling pitches and the at-bat count gets about five. My sox are good at working the pitch count in their favor.

I texted my therapist about what to write. She told me to write about something but I forgot what that is. I think it was on feeling trapped but that has many definitions. I feel trapped because I am now forced to live this thing called life and I don’t want to. I feel trapped because I am in the wrong body. And that truly is what is depressing me. I know my hormones are still going whacky. I just think that this whole business of transitioning to another gender is too hard. I can’t even talk about it anymore. I am starting to feel like a freak. Sure I can dress in male clothes all I want but that doesn’t help my huge chest. I wish they were just man boobs (which I guess technically they are) but it distresses me. I can’t stand looking at myself in the mirror because I am ugly. I know that I have some form of body dysmorphic dysphoria. But if I already am dysphoric in general, does that mean that I have all the other dysphorias? I have gender identity disorder, how can I not. I want to kill myself because I am in the wrong body. I want to be a boy. And sadly, I don’t think that is ever going to happen because of my damn menstrual cycle. In order for me to get rid of my menses, I had to pretty much tell the doc that I get more than just the typical depression with my periods. I get down right suicidal. So pre-menstrual dysphoric disorder was tacked on to my list of diagnoses. Another female diagnosis. It is a good thing that I don’t have access to guns. I think I would have blown my brains out by now.

Four Buses to Perform my Civic Duty

I had to take four buses today to vote for the Mass Senate election today. It would have been five had my cousin not dropped me off at Starbucks first. And it is hot and muggy out. I thought I was going to fry while waiting for my third bus.

UGH, Just got a text from my baseball network tweets that my favorite infielder is going to AAA and another infielder that I never heard of is taking his place. Took me I don’t know how many scrolls to figure out that this guy was an infielder because in the tweet that I got, it also listed the backup catcher on the 60-day disabled list. I wasn’t sure if we got another catcher or infielder. Wish they would be more clear but I understand that you have only so many letters to tweet.

I have a week off of therapy. I am glad as yesterday’s session annoyed me. She was the inquisitor asking me fifty million questions ranging from how I am doing to how I was feeling to when my next appointment was with my primary. I felt like I was getting drilled. And then we talked more about my suicidal plan. Today she wanted to know what I wanted to talk about but I had no clue. We tried to keep it light but it ended up going over to the dark side for a bit. She still insists that I cannot kill myself in the month of August and September. And I am like, the other months are ok? Killing myself in December would be ok? I just don’t know anymore. I don’t even know if I really want to kill myself. I haven’t been in intense pain for the past couple of weeks. We also talked about pain, but she kept referring to psychache and I was talking about my physical. Talk about being on opposite sides. On the other hand I could just kill myself because I can. I am just so torn. If I continue to live, would it be okay for me to do so? I know that might be a silly question, but given on hell bent I am/was on killing myself, wouldn’t I go against my own personal principles? Not like there is a law that says I have to. No one can really order me to kill myself (other than perhaps the voices in my head, which they have done before). Only I can make or break that decision. I guess since I have been feeling a little bit better, the land of the living seems ok, for now. But I also brought up the point that if I am in the throws of a flare up, I would be wishing for death and then feel a betrayal to myself for not following through.

In the midst of this, I have been reading Lincoln’s Melancholy. Lincoln has to be the my most favorite person in the world. I know he lived more than 160 yrs before I was born, before the time of even recognizing mental illness for what it is now. He suffered through I don’t know how many major depressive episodes and somehow got through them without killing himself. He once said during his first presidency, that he would have killed himself but what kind of message would that bring to the southern states? I have always admired him. He is the true staple of what resiliency is.

During our discussion in therapy, I brought up my scars on my wrist. My therapist said that I would get through this time like I have in the past, like my scars tell me. She kept on telling me that was what I wrote. At first I had no idea what she was talking about until I figured out it was this blog she was referring to. I forgot that I sent it to her. My mind is like a sieve. Soon as things filter their way through, I forget I did them. I probably won’t remember half of what I am writing here today. I guess it is a way for my head to get rid of what I am feeling in that moment.

I am eight hundred views shy of reaching ten thousand views. If I reach it before July 18th, that will be awesome. That is the start of my blog. Hard to believe my blog will be a year old. I just got five new followers within the last twenty-four hours. I surpassed two hundred. I would call my blog successful, I guess. But then I don’t know how my blog fairs with say the new AAS blog. I am sure they have more readers than I do, but I do get some filtering in when I post there or when someone reads the “who we are” page. I have fun writing for them.

hypomania sucks

Been going through a difficult past few days. I have been feeling up, almost happy, and I find it disturbing because I never have felt that way before. If I have I don’t remember it and it definitely has not lasted more than a day or so. I know it’s better than being down but I just am not used to being this way. I am waiting for the other shoe to drop. I just am not accustomed to feeling this way.

I wrote a blog this morning but I had the need to write another one tonight. I just can’t help but think that there is going to be some gloom soon because of the way I have been feeling. My cousin says that maybe I am “getting out of it”, what ever that means. I know that I can’t be happy for too long. I just don’t trust it. I also know that when I crash, I will crash big time. And I am not looking forward to it. I know it will happen, maybe not right away but it will happen. That is the pattern of being bipolar, though I mostly stay on the depression spectrum rather than the hypomania side of things. I just dread it because I know that I most likely will have to go into the hospital and I am not looking forward to that either. Every time I have crashed, I have needed to go in the hospital because I got intensely suicidal. How is that different than what I am planning? Easy, I just become more impulsive about taking my life and feel the urge to do so. It becomes a compulsion that I need to get out of my system so I don’t feel such misery. But after this phase passes, I am usually back to my norm and won’t feel good again for a long while. The last time I felt this good was back in 2002. I kid you not. I go for stretches of time between hypomania. That is why I am worried. But this time I am on a good mood stabilizer so I am hoping that by increasing it or tinkering with it, will bring me back to the doom and gloom that I always feel. I am comfortable with that. It’s not pleasant but it’s my norm.