Category Archives: suicide attempt

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.

in a hopeless state of mind

In a hopeless state of mind

I can’t sleep because of pain and too much on my mind. I keep reading people’s messages about the two people that died by suicide this week and the CDC supposed data that suicide is increasing. I don’t trust the CDC anymore because it fudged data just to push an agenda that hurt people like me with chronic pain.

Some of the messages I read concerned helplines. Do people think that talking with someone for five minutes can help a lifetime of anguish? Probably not. Can it bring enough hope so that person can see to tomorrow? Maybe.

The past few months I have wrestled and anguished with my own thoughts of death. Hell, the beginning of the week, I was tormented with psychache, spoke about it on social media, and then was reported. In the email from Twitter, it said that I could speak to a hotline and there are resources. I deleted the email. What it comes down to, is whether I seek help or not. My choice, really. No one else’s to make. Just like you, reading this. You don’t have to read my blog. No one is holding a gun to head saying to read Midnight Demon. We all have battles that we face, some bigger than others but that doesn’t make them any less of a battle. It could be drugs, alcohol, depression, suicide, mania, voices, paranoia, etc. Some times someone feels too good to get help. Some times someone feels too bad to get help. Others may not think they are worthy or are too afraid what others might think of them if they seek help.

If you have a problem, whatever it is, someone else might have it too. You are not alone. There are people who have alcohol issues, mania issues, depression, trauma, sexual abuse, physical abuse, etc. and live to face another day though they may not want to. Some people, like me, think of suicide often. And that is really scary to some people, so much so they think by reporting them or calling the cops on them is the answer. But let me tell you what happens when you don’t face that person and ask, how can I help or if you need to talk I am here. It shuts them down. That was their one chance of opening up these vulnerable feelings and you just slammed the door, possibly forever, of them ever talking about their dark side ever again. Reporting does not help. I got an email with a hotline and a link to a resource. Did I use it? No, I deleted it. Someone once reported my online activities to the police. The local cops came and scared the crap out of my aunt and pissed me the fuck off. You think I am going to write in my blog the same way again? Fuck no. And why? Because of people like you who are too stupid to understand someone else’s pain and despair. To sit with it and deal with it rather than throwing it at someone else because you can’t be the better person.

I may end my life one day and sadly, even though I talk about it on my blog, you will never know about it because of this one person that sent cops to my door one morning a few years ago. It shuts people down. So I understand why Kate Spade didn’t seek help. She was afraid. I can’t say anything about the other guy. I never heard of him until he died a couple days after Kate. Would either of them have called a hotline? Would either of them have opened the link to the resources that were provided to them? Probably not. Their battle was theirs alone. Their decision was theirs to make. I understand it because I have lived it time and time again. In one of the legal pads I was trying to find to write this down on, I came across a story I wrote that I later published. It is also on my blog (I think). It was about a night where I was in so much pain, I wanted to end my life. And though I had promised my therapist and psychiatrist that I would call them should I feel like ending my life, I didn’t. I had hotlines to call. I had coping skills to use. Instead I wanted to end my life right there and then because of the agony of my foot and ankle but because I couldn’t walk three friggen feet to my bureau, 36 inches away from me to get more pills to take to end my life, it saved me. I woke up and wondered what I did. I will never forget that fear and the shame I felt. I was scared to tell my therapist and psychiatrist what I went through. Terrified that I would be once again be on the psych unit of some hospital never to breathe fresh air again.

Lately, I have been saying, Always be kind. You never know who might need it and is depending on it to survive another day. If you are still reading this and not dialing 911, reach out in other ways. Call that friend you haven’t spoke to in a while that seemed to have stopped posting on social media. Or that friend that was supposed to go to a cookout but didn’t show up. They just might need to know that someone other than the demons in their head care for them. And be kind and non-judgmental. Ask them if they need help with something that is important to them. They might not tell you everything or they might not even want to talk, just listen. Sit with their darkness. It will mean the world to them.

When suicide becomes the option due to the opioid epidemic

When suicide becomes the option due to the opioid epidemic

I have been involved in the suicide prevention things for the past eleven years or so. I have been reading research articles from those in the field. Then I became disabled and my suicidality increased but I have not made any attempts. The reason I say this is because I am now involved in the chronic pain community and found that there have been a lot of suicides since the crack down on opioids really started bearing down on patients and their doctors.

Recently there has been a woman in Montana that ended her life after the DEA went after her doctor. I find this, sadly, preventable. These pain patients have severe pain and need opioids to get relief. Since October, I have been trying to get adequate pain meds to relieve my pain but have been facing nothing but red tape. I have had two psych hospitalizations, which have not been helpful in the least. My psychiatrist is really worried about me. I have a plan to end things in a few months. It is a coping mechanism for me to make these plans. I don’t know if I will go through with it but it’s helpful for me to know there is an end to my suffering.

In the suicide prevention community, specifically a social media twitter group called SPSM (suicide prevention social media) there has been a lot of talk about getting the medical professionals to talk openly about asking about suicide as there has been research stating most suicides happen a within a period of time after seeking a medical professional. I argue that the psych professionals also have to ask the question, which sometimes does not happen for a variety of reasons. What is missing in those with chronic pain, is also lacking the talk of asking about suicide after pain meds have been forcibly cut or stopped all together. This kind of action has lead to multiple suicide that Dr. Kline, a pain physician, has written about.

I really think that if the pain psychologist in these pain clinics ask about it or even the health care professionals do, there might be a chance of saving a life. These patients feel their backs are against a wall and they cannot function without these meds anymore. The epidemic is nothing but hysteria. The CDC lied about their statistics and made it look like prescription opioids were the problem when it was really illicit drugs. Compounding the problem with chronic pain patients not getting the meds they need are the patients that have substance abuse disorder. The stigma surrounding substance abuse is probably as bad as those with suicidal ideation. There are no easy answers as some chronic pain patients has been grouped with the substance use and vice versa. Both need to be treated with meds but stigma and thoughts of not being able to be “strong” enough to stand the withdrawals or handle pain is just not a way of doing it. Unlike alcohol abuse where abstinence helps, substance use need medical assisted treatment with meds such as suboxone. There needs to be no legal punishment for those seeking treatment. More overdoses have happened due to people being released from jail and then using again because their tolerance has been lowered while being away from their substance.

With chronic pain, those that have been stable for years and being taken off abruptly, often turn to suicide because their pain is making their lives miserable. They can no longer do the things they did while on pain meds for their chronic pain. Often these patients feel abandoned by their doctors and some have been and are unable to find another doctor to treat them. Some have to travel far from their homes for care. It is a sad situation. Pain needs to be addressed. It was the 5th vital sign but the crisis has done away with it. So those with deep emotional pain don’t get asked about suicide and those with deep physical pain are neglected and never asked about their suicidal thoughts. Can we bridge this huge gap? Tough question to be answered.

Pity Party

Pity Party

I rarely have pity parties. But tonight, something embarrassing happened to me that has been happening for a while and it just hit the wrong nerve. It depressed me because despite recovering from cauda equina syndrome (CES), not once but twice, I was ultimately disabled because of CRPS and chronic pain. Whether CES had a hand in it, I don’t know. It is doubtful as my last surgery was four years before my injury, a sprained ankle that was caused by intense spasms of my foot and ankle. That surgery was higher up the spine than my first surgery so I am not sure it affected my ankle and foot. There are a lot of what ifs, and I was pondering them today. Then the embarrassing incident happened and it hit me in the gut.

I can’t do much over what I have been dealt. I try to move on as best I can despite horrible pain. I am grateful my hands and upper extremities are not affected by pain. I don’t know what I would do if I couldn’t write anymore. I know there are speech to text things but I like the feel of pen on paper or the keys of the keyboard. I have my outlet with my blog to talk about how crappy the pain is and how it brings on my suicidality.

I was talking to my voices today, as I often do. We were discussing the use of testosterone and the effects of what they would do to me. That is if I don’t kill myself when I plan on it, which is soon. It all depends on how next week goes. I am nervous about it. I have even thought about assisted suicide, which may mean leaving the state and going to Oregon where it is legal there. It might take me a few months to save up for it, but what the hell. I can’t seem to get it right on my own. If a doc can prescribe me something to end it, that will help me. I don’t want to be in this level of pain or worse as I get older. It’s bad enough that just making my bed hurts. Making breakfast should not cause pain and I’m not talking something fancy, just making scrambled eggs and toast is a chore. I wanted to go to Starbucks today but my back was too painful because of the shitty weather, which is going to continue until tomorrow afternoon/evening. I’ll probably be in pain the rest of the week, more than my usual pain.

Right now my foot feels like it is being crushed. I’ve had to take my strong pain pill to quiet it down. That was an hour ago and I am still hurting. I am so frustrated that I have to wait for meds to work. Sometimes it’s 45 minutes. Others, up to two hours. I play with the Neurontin dose because I don’t want to be foggy the next day. I’ll take anywhere from 600 mg to 1200 mg a night. Some nights I don’t need it. It all depends. But when I flare, all the guns need firing. Pain today has been mostly in my foot. But my ankle hurt briefly. It piggybacks going up and down, from foot to ankle and back again. Sometimes it is the same pain, sometimes it’s a different pain in the different area of my foot or ankle. I never know what kind of pain I will get. The bone pain is the worse because that is harder to treat. It can be my malleolus or the metatarsals. And is always severe, like can’t move at all severe. I wish there was just one pill I could take for all of the CRPS pain. But there isn’t. And then there is an MGH resident that says opioids don’t work on pain at all. I like him to have CRPS. The meds might not take away my pain 100% but it brings it to a bearable level and that is all I need. Lately my pain has been rampant, a 7 or higher. Used to be a 6, now a 7 is my new “normal”. Before then, it was a 3. That was at least two years ago, maybe? What happens when my pain is a 10 every day? I probably won’t be alive to know. I hope so, anyway.