Tag: David Jobes

how I manage being suicidal

by Midnight Demon, posted in cauda equina syndrome, chronic physical pain, depression

It’s well past 2 in the morning. This may well be a Mr. Hyde blog as I am very tired but feel the need to write. Mr. Hyde likes to write things, very bad things and depressing things at this hour so this is a warning that this might be a suicidal blog.

I have been up the last few hours battling pain. My foot exploded around 11 pm (2300) and has now settled down some after putting on some gel and taking my pain meds. But then I got sick, I felt like I had to go throw up. So I laid down only it made it worse with reflux.

I wrote my psychiatrist a letter that I am hopelessly depressed and why bother with treatment of any kind as it is not helping me. I tried to get out of therapy with my therapist for today’s session and failed. I just don’t see the point. I am deeply depressed and if I could I would do something to end my life but I have no idea what I would do. Sure I have pills, but that might just make me sick and I hate to clean up vomit, if I survived. My luck, I probably will. I hate being in pain and can’t sleep. It drives me absolutely nuts.

A fellow blogger is battling her demons too. Her psych team wants to hospitalize her because she is suicidal. I suggested an alternative, the SSF to help deal with suicidal thoughts and to come up with a treatment plan. I told her to get the Managing suicidal risk book. It is a good book, if you are trying to manage suicidality. I don’t know what I did with my copy of the book. I know it is somewhere in my room or in my office. I can never find it when I need it. I have the SSF (suicide status forms) all over the place but not the actual book. And, no, because of copyright rules, I cannot post the forms as much as I would absolutely love to. There is one online, used, but helpful just to give you an idea of what they look like. I think I might ask my therapist to use it tomorrow. Or use Holden’s psychache scale. And again, as much as I would love to post it, I cannot because of copyright rules. I just am so hopeless. Everything is dark and gray, and I don’t mean the weather. I feel like I have no future, no purpose in life. Sure I published a book and that is a huge accomplishment. But why am I being “punished” with this depression?? What have I done that is so wrong? I hate my life.

My ex blocked me on Facebook today. I am actually glad because I was getting uncomfortable with the questions she was asking. She wanted to get back together. That is not going to happen. I guess me telling her I just wanted an online relationship pissed her off. Oh well. First time I have been blocked by someone. But this is kind of good because I don’t need her drama in my life. Yes, it bothers me but only because I thought this time we could just be friends and I have no idea what set her off and I will never know. Oh well.

Tonight was the first time all week that I took all my meds that I was supposed to take. I think that is why my stomach is bothering me. I usually have something to eat when I take them but tonight, I didn’t eat anything. I just am not hungry. And feeling sick to your stomach doesn’t make you want to eat anything. And oh joy, I think I may have a UTI. I have been leaking the past few days, more so than usual. Oh the joys of CES. That has me down too, because who likes to piss their pants? I am so tired of dealing with wet underwear. And having to take a shower every time I leak. It sucks because I hate showering. I had a good shower tonight. The water was nice and hot and it relaxed me. It was the first time in a while I felt that way. But I couldn’t stay too long because I knew my foot would act up and it did. Damn foot! Always ruins things. But I did a lot of stairs today and walking so it is my fault it flared up. I wish I could chop it off. Least with the ghost pain, it will be a real reason why it hurts. I don’t have a clear reason why my ankle/foot hurts. They think it is tendonitis. I think it is just nerve damage and over usage from fatigue. My foot gets tired and then it needs to rest but I don’t know it so I keep using it and then it flares up on me late at night. I then write blogs like this because I have nothing better to do and I can’t sleep anyways. I wish I was dead than deal with this pain every night. My heart is so heavy with heartache. I really don’t know why I keep going on. But tomorrow I will call my PCP and hopefully not talk to the stupid nurse about my UTI symptoms because other than leaking, I have no burning or pain. I don’t feel it because of nerve damage down there. I just have had bladder spasms. But those have subsided. But now my urine reeks so I know something is going on. Fucking CES always has to throw a wrench in the works. Can’t always be a simple case. I still will need to give a urine sample and I hope I will be able to. That is always the tricky part. I have to make sure I drink a lot before the appointment. Otherwise, I might not go when they give me the cup to pee. Oh the joys of retention! I no longer get the signal to my brain when I am full. Usually, I have to start leaking and then the signal goes to my brain that I am full. Fucking CES. Wrecks your life forever. And people don’t get it when you tell them. I was telling my cousin tonight the story about how I got CEs and the surgeries I went through. He still didn’t get it. But oh well. Not his life to live.

on my soapbox

by Midnight Demon, posted in mood disorders, suicide, suicide attempt

Productive day

I had a productive day. I have been up since six and then went on a caffeine high. That was fun seeing my psychiatrist when I was all racy and talkative. My mood has been up and down all week and I have finally been able to spend some time on my book. I just have seventeen pages to go, which I probably will either do tonight or tomorrow. I haven’t decided. I just read one bleak, downhearted blog entry that I included in the book and it brought my high down. I couldn’t/can’t believe how down I really was. Not to say that I haven’t been down all week but still. My writing was very touching to me and I am the author! I don’t know if I should keep it though. In the book, I made several mentions of my upcoming suicidal plan and also of my plan that I had back in August. But as my therapist calls me, I am a planner. I just am not a do-er. Which sucks for me because I have to continue living this crap every day. I guess it’s good that once I write the dark stuff I don’t think about it as much anymore.

My psychiatrist answered an email I sent her from Monday. I told her that I could no longer “live like this anymore” because I got my menses (which thankfully have gone away!) We talked a little bit about doing something about the transgender issues but I am just not ready to go ahead with it as much as my therapist wants me to. I think she gets it but I still don’t think she (pdoc) knows just how much I want to kill myself because I am in the wrong body. I read about my struggles today in my book and it just killed me. Knowing that I can’t go ahead because of my family and being forced to stay in the wrong body. I just feel like a transvestite because I wear men’s clothes. That is what I am. Whatever you want to call me, it hurts. It causes a huge whole in my heart that can never be filled up.

On another note, I belong to a CRPS support kind of group on Facebook. In one of their posts, they listed oil of wintergreen to help with joint pain. At this stage, I am willing to try anything to ease my ankle pain that throbs me night and day, day and night. Well I bought the stuff from VitaminShoppe but it was the wrong kind. I bought the aroma therapy version and not the application version. Who the hell knew there were different kinds! Now I have to plan a day to go to Harvard Sq and return the bottle. I feel stupid. The bottle didn’t have instructions on it, which I thought kind of weird. I am just glad that I didn’t use it as it probably would have irritated my skin. It should have said that on the website and I would have bought another kind.

Last night I made Nutella cookies for the first time. Now it turns out that I have some kind of allergy to nuts. I had a peanut butter and jelly sandwich and then the Nutella cookies and my stomach got wicked bloated. I just had another cookie to see if it was the peanut butter or the hazelnut and I am hurting. DAMMIT! I love these two nuts. I hope this doesn’t include all nuts because I will be pissed! I am going to miss having a peanut butter and jelly sandwich. *sad face*

On yet another note, I got an tweet from Medscape Psychiatry today about how a single question can lead to a suicide risk. I read the article and low and behold, if someone is thinking about dying nearly every day it is a risk factor for death by suicide or suicide attempt! Really??? I want to tweet one of the authors and scream DUH!!! One of the authors is actually a tweet follower of mine. But what is sad is that there were 709 suicide attempts and 46 death by suicides that could have been avoided had someone CARED to ask more about their feelings. It’s like being asked do you have heart disease or high cholesterol in your family and NOT being tested for it, in my opinion! That is just negligence. And another sad thing is that the questionnaire used was the same one used by Jobes to help initiate his CAMS framework and SSF (see this blog for more info). Just kills me that people are so afraid of death that they can’t deal with people talking about it so people have to kill themselves because no one fucking cares they are hurting. And you don’t need a whole fucking questionnaire to find out if someone is suicidal. Just ask! 9 out 10 times they will say yes. The one person will probably just end up denying it because of being labeled crazy. But the important thing is to be open about it. Ok I am off my soapbox, for now…

A Special Blog Post

by Midnight Demon, posted in blogging, suicide

This is my 500th blog post. I wanted it to be memorable. And it will be, I hope, to me anyways.

I thought I would talk about David Jobes. He is my idol in the field of suicidology. I talk a lot about his work on my blog because I want to spread the word that there are treatment plans and assessment scales available for those who are suicidal. It took twenty-five years for this to happen. It might not catch on like DBT (Dialectical Behavior Therapy) did for borderline personality disorder but I am hoping that through my blog, someone has at least an inkling about it.

His work is CAMS: the Collaborating Assessment and Managing of Suicide. It is a framework that allows the suicidal patient/client to work with the therapist in his or her treatment plan. By working together, therapist and client, it is hoped that suicidal thinking will decrease enough so a completed suicide is avoided. This does not mean that the suicidal thinking will go away completely. Nor does it totally prevent a suicide. During one of his talks, he spoke of a clinician in Texas that followed the CAMS and the assessment tool, SSF (suicide Status Form) to the letter with one of his suicidal clients. The client ended up killing himself. The clinician did everything that he could. But sometimes, there is still the risk.

The SSF is a seven page form that uses an initial, tracking, and outcome form to monitor and assess suicidality. It is based on the work of several clinicians. I won’t go into great detail about this because you can find out more in Dr. Jobes’s book, Managing Suicidal Risk. The link it to the Amazon website where you can purchase it. I would love to post the SSF one day but I would be violating copyrights, though in the book you can make copies of the form. I just can’t do it electronically, yet.

The wonderful thing about this form is that it is a self report about the client’s thinking about suicide and also has clinical information in the end so that both client and clinician fill it out to assess and document the suicide risk. It doesn’t take more than 10-15 minutes to fill it out (might take longer if the person has trouble understanding reading and writing English or has a disability that prevents that from happening, such as dyslexia). It is individualized for the client and that is a huge thing Jobes tries to do. It is not a fit all in one box, so to speak. It should broaden the thinking of the client and clinician to help bring together and work together to prevent the client from committing suicide. In the SSF, it talks about reasons for living and dying, assess psychological pain, hopelessness, the need to escape, and also asks the question, what would make you not kill yourself? I have used this form in my therapy sessions and that is the first question my therapist asks me when I am in the throws of a suicidal crisis, which happens more times than not for various reasons.
Mostly it has been my word that has kept me alive and I do hate myself for it at times. I have told my therapist that I would keep myself safe and I have, though sometimes, I overmedicate to do so.

Background information of Jobes is that he is a professor at the Catholic University of America and also has a private practice in the Washington, D.C. He has written in at least a half dozen books (some of which I own, if I could afford it I would own all) and countless research articles relating to his work and also to the field of suicidology. He not only write about his work but also about the legality and ethical matters of dealing with a suicidal client.

tiring but exciting day

by Midnight Demon, posted in blogging

I am feeling really tired today. I woke up early and couldn’t really go back to sleep. I had a weird dream that I woke up at around four o’clock in the morning. I was having back surgery again for cauda equina syndrome and it was really weird because I could see myself lying on the OR table with my mother. Then after the surgery and I woke up, they had me walk to my room rather than wheel me. Once I got to my “room” which was like an amphitheater, I was asked a bunch of questions to determine what my diagnosis was by amateur actors. I don’t know what the hell that dream means but it was interesting to say the least.

I saw my PCP today for my monthly pain management. Every month it’s the same thing and every month he pokes and prods and I am in agony for the rest of the day. I am hurting so much like I was last night I could just cry. Last night was really bad. I had cutting urges really bad because I just couldn’t take the pain anymore. It got to be a nine before I was able to finally doze off to sleep. I think that was why I was dreaming about surgery.

I am tired, did I mention that? I feel like I am coming down with a cold or something so I got to increase my fluids over the next few days. I think a cup of chamomile tea will be on the docket for tonight. I cannot wait for tomorrow night. I am all excited about the World Series. I didn’t realize the Sox was playing in town. The city is going to be nuts tomorrow. I am staying in. All I want to do tomorrow is pick up my prescription and have Pad Thai.

I was talking with a former coworker today. He is so funny. I love him as he always makes me laugh. He wishes me well with my book. OMG I forgot to tell you guys that I emailed my Idol and he gave me his consent to write about his stuff. I got a beautiful email and I am just ecstatic!!! I felt really good about it. He remembered me from my Poster session when he was inn Boston. I didn’t really talk to him much when he was in Baltimore. Course I was crying the whole time he was giving his acceptance speech for the award he got for his work in suicidology. I really adore this guy. In case you don’t know who I am talking about, my Idol is David Jobes. I love his work with CAMS and if you do a search on my blog for Jobes, you will find the relevant blogs associated with that name. I write a lot about his work because I believe in it. He is the only one to have a systematic approach to assessing and treating suicidality with the Suicide Status Form. I could go on and on about him but I don’t want to bore you.

So his email made my day. I cannot wait to tell my therapist tomorrow. She is going to be so fricken crazy, more than I am. I literally was not going to check my email for the rest of the day but his email came in like almost an hour after I sent it off. I get to keep all that I wrote about his works and the Aeschi model. I had to read the email twice to make sure it said what I thought it said. He really hopes that my book does well.

I emailed my psychiatrist today to let her know I was doing well and was off the trilafon. I had to stop taking it as it was really making me fuzzy brain and interfering with my thought processes, which is its main function. Also told her about Jobes’s email. I had to let someone know!