ramblings 4

My blog had quite a lot of views and comments yesterday which made me happy for a little while but I was in a deep funk and still am in a deep funk. I don’t know why but I should stop reading about suicidal stuff because it is giving me ideas. I know I already have them in my head but I keep thinking, if I am not suicidal, then should I kill myself? As the saying goes, you should NOT kill yourself when you ARE suicidal. Mostly that is because you are thinking irrationally. But if you have been thinking irrationally for so long, does it become rational at some point? That is where my thinking is heading. I tend to think about killing myself nearly every day. I have yet to act on it for various reasons. Usually it is an in the moment type of thing but lately I have been thinking of a plan and a date. I KNOW it is because of the time of year. Every late September/early October I get seriously depressed, more so than anything. Since 2005 I have planned my death every single year without fail. I don’t know what it is about this time of year that makes me want to kill myself. I know that baseball season is over and that saddens me to no end. I no longer see pitchers on the mound and balls and strikes being called. Right now it is Postseason but I know that baseball will truly end by mid-October. Around that time is when I always think of ending my life.

I don’t know why this time of year brings me to my knees. I just don’t feel like life is worth living anymore. It is a seasonal pattern but doesn’t fit the usual SAD (Season Affective Disorder) criteria (mostly because I have recurrent depression throughout the year anyways). If it did fit, I probably would not be so crazy this time of the year. I’d get a light box and be done with it. But this is something more. I call it the black dog as I show more signs of depression than at any other time of the year. I just feel so worthless and guilty that all I can do is think about my own demise. The physical symptoms I get is more psychological pain, lethargy, fatigue, loss of pleasure and loss of interest (also known as anhedonia), loss of appetite, crying for no reason, worthlessness, guilt, etc.

I don’t know what takes me out of the black dog. Sometimes it is just perseverance, sometimes it is just means extra support from my therapist and psychopharm. I also have the hospital when it gets too much to bear, but I only use that as the last resort. Some people would say that is not right but I have had over thirty hospitalizations over the past twenty years that I know when I need to be in and when I don’t.  Though there is some literature saying that the hospital is under-utilized for suicidal patients the same can be said that it is over utilized as most clinicians do not know how to treat suicidal clients. And that bothers the hell out of me because there is (going on my Jobes soapbox) there is an assessment form easy to use and is applicable to all modes of therapy called the Suicide Status Form (see Jobes, 2009). If more clinicians used this, there would be less hospitalization and suffering and possibly less suicides. Granted my therapist tries to use this during each suicidal crisis but I wave her off. Not because I am a hypocrite, but because it was my idea and not hers mostly. Could this save my life? Possibly but the thing that bothers me is that she only uses one piece of the form. If you are going to use the form, use the whole of it. It will make your notes easier and all you have to do is have each person sign it (it is a collaborative effort on both the client and clinician parts). I love this ingenious form but I hate it when it is not used properly. But then my therapist has known me for upteen years now so knows what information to get from me to get me away from my suicidal thinking. Another form that is NOT used at all that should is the psychache form by Richard Holden at Queen’s University in Canada. That I have used to monitor my psychache and even modified the form for my needs. Every journal I have has the psychache scale in it. I would reproduce it here but it’s not kosher and I don’t want to get in trouble with the web police for copyrighted information. Holden wrote the article in 2001 and it is printed in the Canadian Journal of Behavioural Science, 33(4), 224-232. I find Jobes and Holden to be the best suicidologists in the world because they have come up with assessments that are clinically useful and empirically validated.

a little of this, a little of that

To write or not to write, that is the question. Been trying the past few days to write something, anything and I came up with nothing. I had jotted down one of my statuses as a starter to write but it too has not gone anywhere. Right now as I am writing this I am becoming exhausted. I was hoping my therapist would call me tonight but it doesn’t look promising.

Been thinking the past few days about needs. Everyone has some need that is not being fulfilled at any given time. Shneidman, the father of suicidology thought there were 20 needs that lead to suicide. I talk about him a lot in my writing so people know this sweet man that called me out of the blue one day. I was actually shaken up by his phone call. To me, he was as famous as Richard Gere. I was so honored that I didn’t know what to say to him when I called. Time was of the essence because his health was frail and if he died before I called him, I would never had the courage to talk with him for a half hour that truly was the highlight of my life. Now if Dr. Jobes ever calls me, I will have a heart attack. He is another person I deeply respect because he writes about suicide and what it is like and not only this but developed an assessment that can be used to help save someone’s life. I will write about his works until my dying day because he has the knowhow of what it is to be suicidal. I am not saying that he is or ever has been suicidal, but he has lead the way in the collaboration of so many professionals for one goal, to end suicide. Granted not all suicidal people can be saved, but he is willing to try, which is more than what I can say for some of the top professionals in Boston. I had my doubts ever since I tried getting a new therapist and failed, ten times!! No one would take me on and then the one, the last one that did was afraid of me. I couldn’t be in that therapy if someone is afraid of me because I am high risk. Sure, statistically I should be dead. But by the grace of some higher power, I am not.

That brings me back to the needs. I have been thinking about what my needs are that are not being met that drive me suicidal. I know that I am not loved, I have a need to feel important because I think I am nothing, I have a drive to succeed but yet I know I will fail. That truly is my biggest thing. I failed at killing myself and feel terrible at that loss. It is a loss that I have yet to get over. I still truly believe that I am meant to die by my own hand though there still is a drive to keep me going. I was asked recently on what it is that keeps me here. To tell the truth I have no idea. Some part of it is faith and hope, others is a pesky therapist that will “die” if I die. The aftermath of a suicide is not pretty. I sometimes wish I could be a part of Jobes world for a little bit and see what he sees in a hopeless case like me. What he would say or do to try and ease my suffering and then I look at my therapist who is doing all she can to keep me sane and alive. There is nothing more that she can do that what she is doing. Suicidal thinking has become a part of me that I can’t let go. I read about it every day to try and ease my pain, I work with my therapist who is a pain in the ass sometimes and she is open to my ideas of what treatment is and does not have the “I know it all you know nothing” attitude. If she did, I doubt that I would have stayed with her for this long.

The twenty needs are abatement, achievement, affiliation, aggression, autonomy, counteraction, defendence, deference, dominance, exhibition, harm avoidance, inviolacy, nurturance, order, play, rejection, sentience, shame avoidance, succorance, and understanding. If I was to fill out the model of the needs, my highest would be affiliation, achievement, succorance, nurturance, and understanding. As I have written in a previous paper (https://midnightdemons7.wordpress.com/2012/09/03/is-suicide-caused-by-psychological-pain/),  the twenty needs are weighted on the sum of 100, though Dr. Shneidman does not say what the scale is for each of the 20, and as much as I have tried to ascertain this information through his research, I have not been able to find it. Everyone has these needs in some way shape or form. And when they become blocked or frustrated, suicidal thinking occurs. I know my need for affiliation is great at times that sometimes I get frustrated. I don’t necessarily become suicidal all the time because I have not been friends with someone but I’ll admit that it is lonely when you don’t have too many friends that call you anymore or that just keep in touch via email. I am a loner by nature but that doesn’t mean that I am friendless.  My online contacts mean more to me than my non-online friends. My family does not know too much about what I write, if they read my blogs at all. But this is my livelihood, writing about suicide because it means so much to me. It is the biggest demon I have had to face in my life and sometimes it gets the better part of me.

This past April I went to the annual conference of the American Association of Suicidology and found out some things I already knew. I met my favorite suicidologist and his trainees again. One of his trainees has become a good friend of mine. I also found out that I am a hopeless case that no one in their right mind would want. I am high risk, psychotic and delusional at times, and have multiple suicide attempts. I asked one of the guys from Mayo about this “case” I was working on and he wouldn’t touch it with a ten foot pole. Thanks dude, you really shown me how much hope I have for my future. It was an exhausting trip. Next one is in Texas and I am not sure if I am going to go. I have never been that far out west. I really don’t know anyone close by. I would have to stay at a hotel for the few days. But it might be fun to meet up with my co-author and discuss my book that she wants me to write. She is the biggest proponent in my writing right now. She had me publish my blog and it has done well so far. Since I started it in July, I have had almost a thousand views. I hope that I am able to meet up with her in Texas but I don’t think I will have the financial resources to pull it off.

I got notification this week that I am found to be disabled. My social security disability has gone through. I now can collect a check every month while I write and not have to worry about how I am going to pay for my Starbucks coffee habit. Starbucks is truly what keeps  me going some days. It is a chance for me to go out of the house, even if it exhausts me. To have that one cup of joy a day is usually all I can get out of my day. Instead of my mocha, lately I have been enjoying the Blue Java of Indonesia. It has a full bodied flavor that I like. I have tried the Panama but wasn’t too thrilled with it. It was a little too earthly flavored. I am going to try the blue mountain as it seems like I will like it. But none of this would be possible if I was not deemed disabled due to my mental illness. Since I found out I have been more depressed. I find it more exhausting to do tasks. Even my writing as dwindled to what it was. I try journaling to keep the ideas going and sometimes I will write something I think worthy of a blog but mostly I keep my personal thoughts personal. There was a time when I used to share my journal with my therapist as a sort of therapeutic processing, but seeing as I don’t see her physically anymore, I might end up sending her an email about my thoughts on certain things. Like my suicide attempt paper I wrote that was extremely difficult for me to write. It stirred up a lot of emotions, some of which I had no idea I was still carrying around.

The reasons I am still around are many but sometimes that is not so obvious in a crisis. It truly is up to the individual to make the choice and no one can take it away. But if they let a professional know they are hurting and thinking of taking their life, they might be able to get the help they need. I just hope that with that help the person finds someone who is understanding and asks, “where do you hurt”?  Because otherwise it is going to be a long road for that person to find the help they need. Not all professionals are alike. They have different disciplines and treatment plans. But if they are able to find a therapist who is willing to take them as they are, that therapist is worth their weight in gold.