dumbass 674 word blog at 1 am

Dumbass blog at 1 am

I cannot sleep even though I took some melatonin. Or I am fighting sleep because my ankle continues to be stabbed repeatedly in the same bloody spot that past 7 hours or so. I lost track. I am just disgruntled and want to fucking die but really am not sure what I plan to do is going to fucking work.

My bowels are backed up so I just took some Miralax. At 1 am. So I might have a bowel movement in maybe 12 hours from now, which will have me on the subway. I am brilliant, aren’t I???!!! I am so tired of keeping track of shit, literally and figuratively. I sent my therapist a text saying I won’t be seeing her tomorrow. But it’s still technically Sunday so that means today and the appointment is for Tuesday. My concussed brain fucked up. I am ready to give up on everything and just starve myself.

I posted some IG videos and pics today. I look like death hungover. Really, I look terrible and might take down the pics and video. I can’t believe I put them up to begin with. I am such an idiot sometimes. Ok, maybe all the fucking time.

I see the OT later today. I need to leave the house in about 9 hours. I am seeing her to talk about cathing. I am going to try and see if she can show me the best way to cath while lying down or sitting on the bed as that would be good on days I am in so much pain and don’t want to go downstairs because of causing more pain. I know eventually I will have to empty the container/urinal or whatever I use but the hope is not to be going to the bathroom when my pain is a 12+. She is very knowledgeable about spinal cord injuries and referred me to see someone that actually knows something about cauda equina syndrome AND CRPS! I am going to make an appointment with that doctor soon as I know what the hell is going on with my back and if I need surgery. Sucks I probably got to wait till next year to know as the holidays are up and I am sure the head honchos in radiology are on vacation. If I have to take the MRI again at the hospital where my surgeon is (MRI was taken at an affiliate hospital) then so be it. I don’t want to continue to lose function. I think my legs are starting to lose their stability as when I go downstairs, they shake. I have to go one step at a time or they just feel unstable but even then I have to hold on to the banister with two hands to make sure I am not going to fall. Hence another reason why I need to be taught to cath at the bedside. I will really be “set up” once I learn. I will have food (Ensure) and water so I really don’t need to leave my room except for appointments or something. HAHA OMG I have become an invalid or maybe I want that? I don’t know. I am just thinking of ways of staying off my damn fucking stupid ankle because standing hurts so damn much. Every time I stand up from bed, my ankle bones feel like they are being crushed.

I can’t stand this agony anymore. I really don’t know if I will go through with my idea tomorrow (today). I want to but I feel like a fucking chicken if I don’t try. I mean shit, I have been planning all fucking year and have not attempted. Came close a few times but did not attempt. I am starting to feel like such a loser for not trying. Just want to tempt fate a bit and see what happens. One day I will try it or maybe I will die in my sleep. What is wrong with that??

Psychache scale

hello,

I am probably breaking the rules but this is my version of the Holden psychache scale that he used in this paper Development and preliminary validation of a scale of psychache.
By Holden, Ronald R.,Mehta, Karishma,Cunningham, E. Jane,McLeod, Lindsay D.
Canadian Journal of Behavioural Science / Revue canadienne des sciences du comportement, Vol 33(4), Oct 2001, 224-232

I modified it from the original to suit my needs. You can get the original scale by getting the article. Here is also a blog I wrote on the research article (click here)

PS blank

About Therapists

About therapists

I have been thinking about writing this for a while, just an overview about the many therapists I have had from all different degrees and orientations. I started off seeing a school counselor. She was getting her degree in counseling, though I am not sure if it was as a school counselor or a social worker. We only saw each other for a few months and then when school started again, I started seeing a social worker that worked at another school. She was good. Had the idea that I shouldn’t use drugs or alcohol. We had a “safety contract”, which my first 10 or so did. It mostly said I wouldn’t kill myself until the next meeting and if I did feel like acting to go to the emergency room or call 911. I only saw her for about 10 months. She left and I saw someone new, a person who was also seeking their degree. I basically feel like she took advantage of me and was only interested in collecting my insurance. Nothing got worked on. I was hospitalized every three months, the last one was when I came out as “gay”. Transgender was never talked about with any therapist until the one I saw prior to my current therapist.

As I had state insurance, therapists were coming and going. By the 10th one, I was tired of them leaving so I left the system for private as I then had private insurance. Only problem was that this therapist didn’t take my insurance. When I switched in 2001, we saw each other for a month before my disc blew and then I didn’t see her again for another three months. We kept in touch by phone. It was a lot to go through. I didn’t talk about my psych issues as I just had my physical health jeopardized. We worked together for sixteen years. All throughout, I was suicidal. But I had the odd hospitalization because we worked on stabilizing using frequent contact. We saw each other sometimes three times a week when I was bad. Then we saw each other twice a week. She moved offices until she moved 30 miles away from Boston. It was tough because I didn’t have a car. I did but it broke down. We just had phone therapy. This went on for about five years. I would get a zipcar once a month to see her but that took some planning around my pain and weather.

The suicidal ideation I had made my therapist nervous. We tried different things, but she never consistently held me to them. I chided away from it because I knew what she was looking for or rather had an idea. I knew it wasn’t going to change. During the last year of therapy we had, we were constantly fighting over my suicidality. She just wasn’t listening to me anymore. I couldn’t explain why I was suicidal. I just mentioned it and she would “hog” the rest of the session with her endless talk, which I just took as her anxiety. It was interfering. I found out she was seeking consultation over me and I felt threatened by that. Eventually we just called it quits. I didn’t see anyone for few months. I had to collect myself. She gave me a few therapists but they weren’t taking on new clients.
Enter my current therapist. He had called back within a few hours of me leaving a message and we had set a time up with in a few days. He sent me his paperwork and other insurance stuff. All throughout seeing the previous therapist, we had tried different suicidal safety planning and scales and whatnots. This guy was not for it. I think the less paperwork, the better. And it bugs me! He just wants to talk things out. For the first six months I didn’t know if this was going to work out. But I had no where else to go. I was tired of searching for therapists only to be told no when I revealed I had a suicidal history. He wasn’t afraid of me talking about suicide and I ease up. Even when I told him I had a plan, he didn’t freak out on me. He understood why I felt that way and we talked it out. It decreased my feelings so I didn’t feel like no one was on my side. I often felt better after sessions but there were a few where I was more frustrated. I texted him a few times and got supportive responses, something my previous therapist did not do, at all. She only responded if we had to change appointment times.

I have been seeing this guy for 16 months. I still find it totally weird that we have an understanding of why I am suicidal yet there is no plan in place, so to speak. He is okay if I live and okay if I die, as long as I don’t do it in his office. He hasn’t taught me things I don’t already know. He would like me to be more social, but that is kind of hard with my physical pain. I like being alone anyway as noise can irritate me, like it is today. Hell, just being in Starbucks when their music is loud is enough to have me leave after I finish eating or when I am ready to write. He doesn’t try to pin things down and my biggest annoyance is when he says we will work on something but doesn’t go further than that. And then when I bring it up next session (I have to bring things up, he won’t), it still doesn’t go anywhere. But I have had that happen with the last therapist I saw, too. She would say we need to work on this and we never did.

I don’t mean to write this to defer you from seeking therapy, that isn’t my goal. I just wanted to write about my experiences with therapists and how they react to suicidal thoughts. Everyone is different. And maybe you started seeing a therapist and then the suicide thoughts started happening. The therapist freaks out and you are then forced to see someone else. Or you attempted and now the therapist doesn’t want to work with you anymore. That is sad and unfortunate but I know it does happen. Suicide is like an elephant (or hippo as someone called it that the other day) in the room that you both know is there but don’t want to face. Or maybe your therapist is trained and does work with you on the issues as long as there is a safety plan in place first with contact numbers and you collaborate on what will work and what will not work. The focus has to be on YOU not the therapist’s comfort level. While my therapist does that and gives me the time to try and work things out as well as support me in any way he can, I still sometimes feel like he just doesn’t get it or dropped the ball on an issue that is never going to see light of day again. I know they are busy people. They have lives outside the office. They see so many patients per day and then deal with the wonderful insurance that can or cannot accept their claims. I don’t know. I am not making excuses for them but if you have a therapist that cares about you and takes your suicidal thoughts seriously, works with you on keeping you safe, and the chronicity of the matter, great. I just am still trying to work with someone and cope with a therapist that says you can kill yourself as long as it isn’t in my office.

About depression that I have to get off my chest

About depression that I have to get off my chest

There has been a LOT of talk lately about depression being treatable. Let me say first, that for some, it is. Therapy has been helpful to some in dealing with it. Medications and therapy still prove to be useful in treatment of depression or actually any mental illness. It was once thought that schizophrenia was a medication only illness. But I learned through one of my suicidologists that isn’t always true, as there was a paper written by him about he helped decrease an individual’s suicide risk by seeing him weekly or more if suicide was more present. It helped the patient feel cared for. If I find the article in my files, I will share it if you care to read it.

I am in no way saying you should NOT get help if you are feeling depressed. But my experiences (which are not the same to the whole depression population) beg to differ. I have yet to find anything that helps the mood shifts. Since my long time therapist stopped seeing me for reasons I have still yet to learn, I have been the most unstable and hopeless I have been in the 16 years I was in “treatment” with her. We had our disagreements about treatment. Transference and countertranferences were helpful at times but were no long lasting. She stuck with the way she was treating me and I stuck to being, well, depressed and suicidal.

What I have to get off my chest is that sometimes, depression is untreatable in a small percentage of people. There is such a thing as treatment resistant depression. Despite ECT (“shock” therapy), medication, and therapy, one can still feel depressed. There are a trillion reasons for this. Sometimes it has to do with the trauma one experienced. Some has to do with biology itself, that the genetic predisposition of a person makes them depressed. Other times it has nothing to do with a trauma or situation. It just happens that you start withdrawing from life, slowly at first and before you know it, you can’t go back to things you loved because, frankly, you are too depressed. Sometimes you maybe too depressed to seek help and a friend or family member needs to push you to get it. The thing is, depression still exists despite treatment. Some people have suffered depression for years and have never told a single soul. They are the small percentage that still go on with their episodes after they pass. They are less likely to die by suicide. Hell you don’t NEED depression to end your life. It has happened. Look at the Shawshank Redemption movie. The warden was “well” mentally and rather than be arrested and humiliated, he killed himself. Would anyone have thought he would do such a thing? No. And that is what my point is. Although we know what the risks are for suicide, depression and mental illness is only a small window into those risks. There are some people who die that have no history of mental illness yet die by suicide. I won’t go into more discussion about it because this is a loaded issue. I suggest reading the Myths and Facts of Suicide by Thomas Joiner. It is a really good book about what I am talking about.

I can only talk about my experience, no one else’s. I have been depressed since I was 8, maybe younger. I only know this because I started thinking suicide was a good idea at that age. I was 10 when I tried to end my life for the first time. I suffered from depression and after taking Prozac, became bipolar because the medication caused mania like symptoms. Not once during my years of being on medication AND therapy did my thoughts of suicide leave me fully. Neither did depression. There were brief times where I felt contentment. I honestly don’t believe in happiness. Like anger, it is a fleeting emotion and doesn’t last. But feeling contentment does happen for me and I sometimes feel comfortable in it. I know it isn’t going to last long. It never does. The depression always finds a way back, maybe not right away but it does come back. Despite some of my successes in life, graduating from high school, getting my Associate’s degree, publishing two books, I still was depressed. I was elated for a little while but it was fleeing. Just like when I wrote the article for the New York Times. I couldn’t believe and still don’t, that it happened. I still have the check that one day I will frame along with the article. But soon after all the paperwork was filed and I was waiting for it to be published, I was intensely depressed. The New York fucking Times was publishing something I wrote and instead of being happy as a pig in shit, I was depressed. I learned that no matter what my success in life was, no matter how much money I made, good job that I had, I was going to always be depressed. I could do one of two things. I could accept that this was the way it was always going to be or fight it. I chose to accept it.

I knew I had been fighting it since I was 16 that I would always have to take medication for my mental illness. It wasn’t easy but I knew if I was to avoid a lifetime of hospitalizations, I would need to take medicine to hold off the demons. Yet despite this theory, I was still hospitalized. Many times. Some times it was like a revolving door during my worst episodes. In 1994, I suffered a huge major depressive episode. I was hospitalized almost every two weeks and then for two months because I tried to end my life. It was one of the lowest periods of my life. I couldn’t bring myself to do anything. Showering didn’t matter. I gained a ton of weight from the meds I was put on. I started living an almost double life. The life the psychiatrists wanted to see and who I really was at home, when I was by myself. Hopelessness was rampant and totally lost on me. I can’t say that I got better. I just got better at hiding from myself, to keep the darkness at a minimum so I wouldn’t be committed at the age of 19 to a state hospital. Even then the façade I built was hard to put down. I just did what I was told to do and when I felt like acting on my feelings of suicide, I told my therapist or psychiatrist, which inevitably led to another hospitalization. But the hospitals in the 1990s were different than they are today. Today they are nothing but holding pens. Two maybe three days you are in and then you are out. If you need more help and have an outpatient therapist, you see them. You don’t need to be in. Maybe you stay for a week or two. But never more than that. Insurance won’t pay for it. And you don’t really get “treated”. You are watched 24/7 to make sure you don’t harm yourself. You might find a “treatment team” that listens but that is ALL THEY DO. They don’t help you in what you came in for. That is for you and your outpatient therapist to work out. If you don’t have one, you might get referred to someone. I’ve never been in that situation so not sure how that works.

I have lost faith that my illness is “treatable”. Seems no matter what I do, I end up depressed or just stay depressed. I am okay with that. I’ve known for a while that there is no longer an antidepressant out there for me. I am grateful my mood stabilizer still works. I just hope that it does fuck up my sodium levels and I need to some off it. Then I will be really screwed. In that sense, I still take my meds because they help. I no longer have commanding voices every day and the accompanying paranoia and delusions. I have to take a med for that every day. But therapy is still elusive. I honestly don’t know if it helps. Talking with someone honestly, like writing this blog, has been useful. Sometimes it feels good to talk to my therapist and leave knowing that someone understands, even if he thinks I am crazy. He said that he is “taking my lead”, which I am not sure about but it is a learning curve like anything else. And I will stress again, that if you aren’t comfortable with the person you are talking to, if they make you uncomfortable or just not getting it, find someone else. There are a lot of different therapists out there. A lot of different degrees as well (but all should be licensed by the state you are in, if they aren’t, I wouldn’t see them). It will take some time to know if they fit with you. The average is about 3 or 4 sessions. Any more than that might be a waste of time if there is no connection.