Category: suicide

venting ramble

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

Ankle has been bothering me all fucking day. Seems every time I am close to getting to sleep, it flares up angrily, like I wanted to use it or something. Or maybe it’s mad that I am resting it. I don’t know. It just hurts and I don’t know why. I never know why. Three years and no one has been able to tell me why. They think it’s this, that, but it doesn’t change the treatment or course. I think it is a little bit of complex regional pain syndrome. It has to be some kind of pain syndrome as I do have pain and swelling. I can’t walk as far as I used to because of pain. It just sucks.

I need to go out tomorrow to my father’s. His weekly visit. I wish I could stop doing this every week but out of obligation, I do it.

In addition to this lovely irritable mood that I have been in, I think I am getting my menses. Just what I fucking need to start off the New Year. It makes me depressed and pissed off. I guess that is why I gained so much weight. It’s probably all from feeling bloated. I hate being in this body so fucking much. Another year to remind me I am in the wrong body. It totally messes with my head and how I feel.

I wish I could just spontaneously combust so I wouldn’t have to think about killing myself. Of course, planning your death isn’t the same as going through with it. I plan and plan yet I am still fucking here. A 22 year-old died the other day while swimming. Just like that he was gone. Why couldn’t that happen to me? Why must I fucking live this life I so don’t want to live? I wish I didn’t have the SSD review hanging over my head. I just don’t know if I am disabled “enough” to meet their requirements. I still don’t know if I got it based on my physical and/or mental disability. I wish I knew so I could fill in the right doctors for their consents and stuff. I just hate waiting. And I also worry that I will have to see their doctor. That will fucking suck. And I am in so much pain more at night than during the day. The depression is year round so I don’t have to worry about that. I just worry that I will be denied and then I will be screwed financially.

I wish my therapist were here. I so need to talk to her. I have been texting her but I never get a response. Of course, she is out of office so why would she respond? Nothing I have been texting her needs a response anyways. I think this is the first time that I haven’t thought about leaving her. Usually, I always plan my escape when she is on vacation. It’s my way of getting away from her permanently. But she never usually allows a cancellation. And if I do need to cancel, she wants to make up that time.

I haven’t seen my psychiatrist in a month. She had her hip replaced the beginning of December. I am scheduled to see her next Friday. It will be good to see her again. I miss her, too. We have been emailing each other. She does respond and she tells me she is doing well. It’s kind of sad that when I see her next, I will be the one with the cane. I still can’t trust my leg. I don’t know how much of it is mental at this point. I just know there is a security there and I need that. Plus, my leg doesn’t hurt as much if I have that extra support. Wish I could say the same for my ankle.

I read a horribly written blog yesterday. It was by one of my BPD chat friends. There were a ton of run on sentences. And the grammar was just horrible. I want to say something but I don’t want to offend her. I am not close to her so I am not sure she will accept criticism well.

I cannot believe that I have done nothing but lie in bed all day and my ankle is screaming at me. I so want to tell it off, like what the hell are you hurting for when I didn’t do anything to hurt you. I didn’t overuse it. I didn’t go up and down stairs a million times. What the fuck gives??

Because I was a lazy bastard, I have to return a calendar I bought from Amazon. It was way bigger than I thought it would be. I should have known that a 12×17 wouldn’t fit on my wall. It would but I would have to move it over and put another nail in the wall. Too much effort for a lazy person when I don’t need that big of a calendar to begin with. I am an idiot. I was too lazy to get up to see the SKU for the calendar I do have. Now I have to go to Harvard to go to my favorite stationary store to get the calendar I need, which is what I should have done to begin with. I thought Amazon would get me what I needed and now it didn’t. I am a lazy bastard.

Shneidman’s Psychache Theory

by Midnight Demon, posted in Bipolar Disorder, blogging, depression, mental disorders, mental illness, mood disorders, psychache, suicidality, suicide, writing

“From the view of psychological factors in suicide, the key element in every case is psychological pain; psychache. All affective states (such as rage, hostility, depression, shame, guilt, affectiveness, hopelessness, etc.) are relevant to suicide only as they relate to unbearable psychological pain. If, for example, feeling guilty or depressed or having a bad conscience or an overwhelming unconscious rage makes one suicidal, it does so because it is painful. No psychache, no suicide”. Edwin Shneidman, Suicide as Psychache p56

 

Psychache is the unbearable guilt, despair, hopelessness, shame, pain, depression, and press one feels when thinking about suicide. It is the corner stone of what this paper is about. The pain of the mind can cause constriction, a narrowing of view of things. It can also lead to perturbation (an unrest that causes one to feel like doing something to alleviate the uneasiness one feels) and also to press, which is also known as stress or the pressure and weight one feels under. The combination of these three things, press, perturbation, and psychache is what is known as the cubic model of suicide.

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The cubic model of suicide is a 1-5 rating of the three things I just mentioned. The higher the rating, the higher the likelihood of suicide. The worst rating is a 5-5-5 scenario and suicide will be imminent. It is important to rate these items when dealing with a suicidal person. It will validate what they are feeling and make them feel at ease in talking about what is causing them to feel so pressured and hurt to make them think of killing themselves.

When dealing with constriction, the dichotomous thinking that a) suicide is the only way out or b) things are always going to stay the same, it is important to always bring in more options to the person so they can see things differently. In his book Suicide as Psychache, Shneidman gives the example of a young pregnant woman who was thinking of killing herself with a handgun. She couldn’t have the baby so therefore in her mind, suicide was the only way out. After discussing several options with her (calling her parents, having the baby and giving it up for adoption, discussing the situation with the baby’s father, etc.), it was agreed that the woman would call the baby’s father. Suicide was no longer the number one item on the list. To prevent a mishap, Shneidman did take the gun away from the woman. An excellent example about means restriction.

In almost every suicidal thinking, there is some measure of lethality and perturbation. You can have high lethality and high perturbation, but you don’t always have high perturbation with high lethality. Perturbation, as described above, is very much like anxiety. It is a perturbed feeling that causes one to feel pressured to do something. Lethality is the doing something.

Also in every case of suicidal thinking is the frustrated needs that bring about the suicidal feelings.

ABATEMENT The need to submit passively; to belittle oneself

ACHIEVEMENT To accomplish something difficult; to overcome

AFFILIATION To adhere to a friend or group; to affiliate

AGGRESSION To overcome opposition forcefully; fight, attack

AUTONOMY To be independent and free; to shake off restraint

COUNTERACTION To make up for loss by retrieving; get even

DEFENDANCE To vindicate the self against criticism or blame

DEFERENCE To admire and support, praise emulate a superior

DOMINANCE To control, influence, and direct others; dominate

EXHIBITION To excite, fascinate, amuse, entertain others

HARMAVOIDANCE To avoid pain, injury, illness, and death

INVIOLACY To protect the self and one’s psychological space

NURTURANCE To feed, help console, protect, nurture another

ORDER To achieve organization and order among things and ideas

PLAY To act for fun; to seek pleasure for its own sake

REJECTION To exclude, banish, jilt, or expel another person

SENTIENCE To seek sensuous, creature-comfort experience

SHAME-AVOIDANCE To avoid humiliation and embarrassment

SUCCORANCE To have one’s needs gratified; to be loved

UNDERSTANDING To know answers; to know the hows and whys

These twenty needs are what Shneidman has called the essential ones when people are suicidal. Most of them are not all twenty but five or six as it pertains to the individual. “The prevention of suicide with a highly lethal person is then primarily a matter of addressing and partially alleviating those frustrated psychological needs that are driving that person to suicide. The rule is simple. Mollify the psychache”. (p53) Shneidman believed that these frustrated needs are what caused psychache.

I believe there should be another need, validation. Everyone needs to be validated in order to feel secure and feel okay. Without this, most people feel shamed and dumb, that what they are feeling or experiencing has no meaning or purpose. They may also feel empty and alone as no one understands what they are going through. This need when frustrated or thwarted can lead to suicide.

Shneidman, Edwin. Suicide as Psychache. 1993. Jason Aronson, Inc.

Recovery…what does it mean?

by Midnight Demon, posted in Bipolar Disorder, blogging, chronic physical pain, depression, mood disorders, suicide, suicide attempt

Recovery…what does it mean?

I keep hearing people talk about recovery and I am at a loss. Can someone enlighten me on what the hell it is? And what exactly are you recovering from?

I hear from suicide attempt survivors all the time this word. Do people who think about suicide really recover after they attempt? Because I keep wanting to try again and again. I haven’t made an attempt in years but I think about suicide constantly. Or is recovery just something that happens after you learn different coping mechanisms?

The reason I do a lot of suicide research is because I want to find something to help me. If I never looked for it, I wouldn’t have found CAMS and the SSF so useful. I have also found other assessment tools but nothing else worked. Traditional therapy didn’t work for me. I had to find a therapist that treated me as an equal and collaborate with me on what works and what doesn’t. It’s still an ongoing process as my suicidality gets worse during certain times of the year than others.

I don’t think I will ever recover from my mental illness. I think it will wax and wane, just like my suicidality, but it will never get better. I might find symptom relief through medication but even with medication, my depressions get the better of me. They are too severe and too frequent to really get relief from them. Medication has been proven useless with treating them. I am just left to suffer through them until they pass.

Then I have the physical pain that I deal with. I don’t think I will ever recover from that. It just seems to get worse during the temps of New England. My former PCP thought that I can just do something to make me feel better and things would be better. Wishful thinking. As much as I don’t want to be on meds, I know it’s my new way of life. It’s the only way I can survive. Otherwise, I think I would entertain the thoughts of killing myself, and by entertain, I mean attempt.

Dealing with Pain, or lack there of

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

Dealing with Pain, or lack there of

I woke up this morning with my leg bothering me. I thought the pain would subside if I got out of bed. I was able to shower today and help my sister prepare Christmas dinner. It proved to be too much for me. I am now in excruciating pain and almost in tears. I went up to my room to take a pain pill and then went back down. I thought by the time I reached the last step my leg was going to give the final fuck you and let me fall. I was just in a lot of pain. I couldn’t stand and I couldn’t sit. As I am typing this, it’s the only thing that position that I am really comfortable. I am going to go to sleep soon as the pain meds kick in.

I wanted to watch a TV show tonight but it doesn’t look like that is going to happen. I usually watch “It’s a Wonderful Life” but I don’t know where the DVD is. I have to order a new one. I also need to order another Titanic DVD because I am missing disc 2. Granted I like the part 1 better than the sinking of the ship but it would be nice to see the whole movie rather than just the first half. I think I will just watch Home Alone. I could use a comedy.

Waking up in pain is no fun. It sort of ruins your whole day. If I wasn’t feeling so restless, I would probably be sleeping. I did have a big meal. I really tried to make Christmas this year but it always seems I am in pain or am sick. Last year I had a nasty cold. It would be preferable to this pain that I am having. At least I know the cold will go away. I am not so sure about this pain. This pain I have been having since before Thanksgiving. I thought it was nothing but it turned out to be something. I am currently waiting for an MRI to find out what it is. I might be facing surgery again. It’s something that I am dreading.

There is no guarantee that surgery will fix this. But I know there is something wrong with me. This pain shouldn’t be happening unless there is something wrong. And with it brings my anxiety up a few notches, making my PTSD symptoms worse. I am in constant vigilant mode, always on edge. It’s awful to be in this state. And waiting for this MRI is not helping matters. The secretary was supposed to call me Wednesday and I haven’t heard anything. I kind of want to call the office and see what the hold up is. I hope it’s not my insurance. My father gets his CT scans all the time and doesn’t have any problems. We both have the same insurance. This waiting is just killing me because the longer I wait the longer I suffer, both mentally and physically.

I am so tired of dealing with pain every day and now to have this leg pain that makes walking and going up and down stairs difficult is just torture. I can usually tolerate a lot of pain but I am almost burnt out at this point because there has been no relief. I am usually in pain with my ankle/foot. But my leg pain is worse than my ankle. I just have low tolerance these days because I get no relief. I can take pain meds for my ankle/foot and it works but the new pain doesn’t want to settle down with it. I am again thinking of ending my life because I can’t deal. And that isn’t a good place to be.