Tag: depression

Saturday Blog 27: Struggle with Suicide and Bereavement of Others

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

Saturday Blog 27: Struggle with Suicide and Bereavement of Others

I will never again go to the Square on a Saturday! I got stranded there because there were no buses to take me home. I waited two hours and Twitter was no help in finding out why or the public transportation system for that matter. I had gotten a text saying severe delays due to traffic but not that there would be no service to the Square. I was so pissed. I hadn’t eaten anything but a bag of chips so was starving when I came home. I was lucky my sister was home and could pick me up. Then I got a migraine that just made things worse. So I am writing this blog a little later than usual because of the migraine.

I watched this video about “Life after Suicide”. It really made me think about the people I would be leaving behind and the affect it would have on my “kids”. It also made me feel grateful that I can talk about my suicidal feelings with my therapist and psychiatrist, openly and honestly. I think that if I kept those feelings to myself, I would probably act on it. It helps to hear my therapist say that she would be devastated if I went through with my thoughts. I don’t know how my psych would feel. Probably the same as I have known her for over twenty years. The thing is, I don’t want to live. I had made a decision with myself when I was young to take my life so I wouldn’t be old. Here it is twenty plus years later and I still struggle with suicide. It’s like it gets bashed around, deeply thought about, planned, and just never happens. I haven’t made a suicide attempt since I was eighteen and then I spent two and half months in a psych unit at the local hospital. I had met a psychiatric resident who believed in me and we worked together for three years. It was the most stable relationship I ever had with a professional, aside from my current therapist. I was still in and out of psych hospitals. When I was first hospitalized, I was damned if I was going to end up like the people around me. I was in a lot of psychological pain that I wanted it to end. Even though that pain has subsided somewhat, I still think about suicide. I now suffer chronic physical pain and it keeps the thoughts swirling around in my head.

In the video, the woman who talks throughout it says that you need to talk about suicide. In London, they have a place called the Maytree where suicidal people can stay for up to five days to deal with their crises. It is run by none other than a suicide attempt survivor. I have no idea if a place like that exists in the US. I know in my town, there is something called a residential place that is similar to what they were talking about. It was so long ago, I forget the criteria for going there. I know you had to be a part of the Department of Mental Health system to go to it. I was so ill then. I didn’t stay at the place. It was run down and dirty looking, nothing like the Maytree. But it was an alternative to the hospital. I don’t know if they exist anymore with budget cuts to the mental health system. They closed so many psych units in the last twenty years. Even the world famous McLean Hospital isn’t what it used to be.

Also in the video, there is a segment with Dr. Rory O’Connor (person that I got the video from) that talks about entrapment and how a suicidal person often feels trapped and feels the need to escape. This is often true. I feel trapped because of the guilt I would place on others by my death. I die and others feel hurt. In the meantime, I am left to deal with my own suffering that no one else can feel. How is that fair? And don’t dare tell me life is unfair. I know that already, I live with it every single day. I pissed and crapped my pants today and didn’t know it so don’t bother telling me that life is unfair. Another misery that I have to deal with and don’t want to. Dealing with the physical pain is one thing; it’s quite another to deal with your bodily functions not working right.

Throughout the video, I thought about my friends David and Melinda, who lost their significant others by suicide. David lost his fiancé almost six months ago. His fiancé was my friend Chris. I had felt guilty about his death because I am so involved with suicide prevention and yet I never reached out to Chris. I never knew the demons he was facing. He was always a stand up guy and looking at him, you never knew he was depressed. He hid it well. We will never know what made him take his life. David has been open about his grief on FB and it has been one of the reasons why I am still here. The grief he feels is so palpable it hurts to watch him go through it. Chris was the first friend of mine to die by suicide. I have had other friends die, but not like this. It is a unique death that no one can understand or make sense out of.

Review: Development and Prelim Validation of a Scale of Psychache

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

Review: Development and Preliminary Validation of a Scale of Psychache
Holden, Mehta, Cunningham, and Mcleod, 2001 Canadian Journal of Behavioural Science

Suicide kills more people in a year than auto accidents and cancer combined. It is currently, the tenth leading cause of death in the United States. What can be done about this? Researchers in Canada have developed and validated a scale to detect the suffering associated with suicide. This suffering is called psychache. It is the unbearable pain, intolerable despair, guilt, angst, and anguish one feels when contemplating suicide. This is based on Shneidman’s work, “Psychache as Suicide”. He is the father of suicidology and believed that if one does not have psychache, one will not die by suicide.

This seminal paper by Holden et. al, is fantastic. It gets to the heart of suffering people and can also be used as a gauge of whether treatment is decreasing psychache or not being helpful. In my experience using this scale, I have found it helpful. It really states what the therapist needs to know to help the client work on the issues surrounding suicidal ideation. The scale is easy to administer and doesn’t take long to tally up the numbers in a session to give a numerical value to psychache. The higher the number, the more likely the client is thinking about dying by suicide. The lower the number, the lower the risk.

In this paper, the authors did two studies. One to measure the validity of the scale and the other to cross validate the study using the same sample. In addition to the Psychache Scale, the following measures in the first study were given, in order, the Beck Hopelessness Scale (Beck et. al 1974), the Unusual Thinking Scale (Mazmanian et. al. 1987), Reasons for Attempting Suicide Scale (Holden et. al 1998), and the Suicidal Manifestations Questionnaire (Johns and Holden, 1997). There were 294 participants, mostly women (76%). Of these, 197 reported suicide ideation at some point in their lives, 46 thought about suicide in the past four weeks, and 30 participants reported at least one suicide attempt in their life with 21 attempting within the previous five years and 8 reporting multiple attempts. The mean age was 19.1 years (SD 1.6). No racial or ethnic data were collected.

The study found that the psychache scale appears to be reliable and valid in measuring deep psychological pain. It also seemed to be effective in weeding out those that are suicide attempters versus non-attempters.

The second study focused on the childhood abuse exclusively on the women. It was found that the scale was reliable and replicated the previous study in determining psychache.

The Psychache Scale is a thirteen item self report written to be responded on 5 point scales ranging from either never to always or from strongly agree to strongly disagree. It was originally longer than thirteen items but after trimming down the essence of psychache, the scale was finally brought to be a thirteen item report.

What I love about the scale is that it is very easy to spot suicidality. From my own self-report, I have found that the first 9 items focused on my psychological well-being. If the number was great or at its max, I was doing poorly. The last four items dealt with suicidality. It, in my opinion, states how imminent suicide is on the client’s mind. Taken together as a whole, you can monitor treatment goals and see if that decreases the numbers. The lowest to score on the item is thirteen. The highest sixty-five. My interpretation of the scale is that if the number is lower than the medium (33), the person is not in danger, unless the last four items equal a twenty, which I doubt will happen. It will depend on the measurements of the items to determine suicidality. The items themselves will provide clues to the client’s mental state. See the article to see the items.

random 694

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

From 1100 to 1600, I voted for Xander Bogearts via Twitter. The only time I was not voting was when I was meeting my psychiatrist. I have a lot of tweets today as I broke the 16,000 mark. I was at 15.8 before voting. I don’t know when the results are going to come out, maybe later tonight. I do hope he wins. He so deserve to play.

Met with my psychiatrist today. We mostly talked about the depression and how it seems to have lifted a little with the addition of vitamin D. I won’t say that I am “cured”, because I still have my down moments, but the heaviness that I was feeling seems to have lifted a little bit. She asked me about my date and if it was still on. I told her I don’t know. She still wants me to see her, regardless on how I am feeling, that day. I think if I don’t see her, I might be hospitalized. We also talked about pain and how it is shooting up my anxiety. I told her I don’t like it because it sometimes lead to agitation and that doesn’t mix well when you are suicidal. She said that it is a physiological fight or flight response. I guess the only thing I can really do IS take an Ativan. She didn’t say it, but implied it. She asked the reasoning of why I picked the date. I told her it was just out of a hat, but it had to be on a Friday so I could mess with statistics. She then told me that she doesn’t want me to be one. I could have argued that I already am one but I didn’t. She didn’t know about the whole suicides occurring more on Mondays than on any other days of the week. And I won’t be dying on a Monday.

I told her that I am going to feel defeated and lost because I didn’t go through with my plans. I already am feel dejected, and it’s still a week away. My life only lives to next week. I can’t see past it. My cousin invited us to his house for a lobster party in August and the first thought I had was that I couldn’t go because I would be dead. I don’t know what I am going to do. I feel so lost and disappointed in myself. I shouldn’t have told my therapist what I was planning. And I SHOULDN’T have told my psychiatrist either. I am such an idiot.

Last night, I was going through my Twitter feed and came across on of my BPD friends who tweeted that she took 26 pills of Tylenol 3. She said she should go to the hospital but she doesn’t want to because she has something planned for Saturday. I reported the tweet and she hasn’t tweeted since that message. I am kind of worried. I don’t know where she lives. I think she is in the UK, but I am not sure. There was no tweet before the one where she said she took the pills so it was obviously an overdose/suicide attempt. When I tried talking to her about the Tylenol damaging her liver, she seemed oblivious to the seriousness of what she did. She just blew it off as “it would take a long time”. I just hope the Twitter folks gets to her and she is in good care.

I got my Kati Kati coffee today. It was so good. I love it! I really got to get a bag. I just hope that by the time my next check comes, it is still around. I have never had this coffee hot before. I only make coffee at home hot because I don’t know how to make it iced. I know I got to double the amount of coffee and such but since I don’t have an ice mug, I kind of just been drinking hot coffee.

I am feeling low. My therapist wants me to write her a letter everyday. I haven’t done one today. I was too busy voting. I brought my tablet to today, thinking I would read while I waited for my doc but I voted then, too. It was too important not to vote. Now the voting has ended and I am blue. I hate when I don’t know what to do with myself. Game is on tonight, but I really don’t feel like watching it. A friend of mine called wanted to know if I was up to watching the game together. He would bring the snacks. But I am not up for company. I am in pain and I am kind of sleepy from the pain meds. I don’t think I will make it past the 4th inning.

Pain and Anxiety

by Midnight Demon, posted in Bipolar Disorder, blogging, Chronic pain, chronic physical pain, depression

Pain and Anxiety

Last night, I took my normal pain pills around 2200. At midnight, the pain got worse. My heart rate shot up and I became nervous, again. I had already taken my night meds at the same time I took my pain meds. It was too early for me to take my normal pills so I had to take a stronger pill. It took another hour for the pain to fade enough for me to sleep. I also took an Ativan to calm down. I spoke to my doc about this and she said the anxiety is the body’s response to not liking pain. Great. Now I have to deal with anxiety on top of my other problems. I don’t like being anxious or nervous. It really irritates me and makes me feel unsafe, like something terrible is going to happen. I have to mentally play with ideas of it just being a physiological reaction, that I am okay, even though I don’t feel that way. It’s very hard to mentalize when your heart is pounding like you ran several blocks. I don’t become out of breath but my breathing speeds up. I have to take deep breaths to calm down, or try to. It’s very difficult to do. And it also makes me feel helpless because other than taking drugs to stop the pain and anxiety, there is nothing I can do. I am not hyperventilating so breathing into a paper bag won’t help me. Music helps to a degree but not all the time. After a while, it just becomes background noise.

I have not been trained in any capacity to deal with anxiety. I don’t know how to deal with it other than take medication. But even then, I have to wait a half hour or more for it to work. In the meantime, I am very nervous, in terrible pain, and keep wondering what to do. I can’t walk because the pain is too intense in my foot, so pacing is out of the question. I usually just have grin and bear it. I don’t like doing this. It just messes with my head. And then I become agitated, which does me no favors. Last night, I tried to read. It didn’t work so I tried writing in my journal. If I could have done something physical, I would have but writing is the only thing that usually works when I am anxious. It is my go to whenever things are going wrong, or are perceived to be.

All this bullshit could be avoided if I didn’t have this pain syndrome. I didn’t do too much yesterday so I don’t know why my foot decided to explode at midnight. I had been resting for hours, but I got hungry and went downstairs to have something to eat. When I came back up stairs and propped my foot up, I got hit with the pain wave. Other than amputation, I don’t think there is anything I could have done to avoid it. I just don’t understand why because I had taken my normal pain meds two hours before hand and that should have avoided a 10+ pain flare. But that is the thing with pain syndromes. You never know when they are going to spike.

I need to pick up my niece later. I plan on ordering pizza before I pick her up. This way, the pizza is a little cooled off before gobbling it up. The last time I had pizza with my niece, she ate half a box! It was crazy but she was hungry. She ate all of it too, crust and all. She is too funny but is still growing like a weed. I just hope that walking to her school doesn’t aggravate my foot more than it already is. I really don’t want a repeat of last night. I have my appointment with my psych tomorrow so I really don’t want to be really drugged up or sleep deprived when I see her. It’s in the afternoon so I should be awake enough when I see her, but sometimes after a bad night of pain, I am not in a good mood the next day. Only day that I don’t have something planned is Saturday. I can rest all day then. I still need to finish my editing, which includes proofing what I have written and then putting those edits in the word doc. I have stuff to take out too, as one of my stories is listed twice, but under a different name. Don’t know how that happened.

So pain and anxiety is not a good thing for me, or anyone, really. Pain causes the anxiety and I don’t like it one bit. It makes me feel helpless. My therapist is on vacation for the next two weeks. I am to write her a letter and text her while she is away. She also wants me to send them to her so when she is back, they will be in her office. We talked about the anxiety part but really didn’t talk about what to do with it. She just wants me to take an Ativan. I am just afraid that I will become addicted to it, which is why I am so hesitant to even take the pill. But I guess, I need it so my heart rate slows down and calms my nervous agitation that doesn’t do me any good. I swear the pain is like drinking five cups of coffee the way it makes me feel. I just wish I had more control over it but I don’t and that is what is so frustrating! I hate not being in control. Pain takes that away from you and then your heart rate soars up and makes you feel even worse. So you are battling the demons in your head, the pain in your foot and the nervousness of it all because it’s a physiological response. How the hell do you combat it?? I guess I am going to have to research what to do about anxiety, an unknown entity to me. I never was an anxious person until pain entered my life. It doesn’t happen ALL the time but when it does, holy hell! I am noticing it more with each pain flare up. I really wish I had better control of my pain, like if I had a warning before the pain would flare, that would be awesome. But I don’t. It’s one minute low level pain and the next high level pain. Sometimes it is because I moved my ankle, either flexed it or moved my big toe. That is all it takes to set the pain off in my foot and/or ankle. It just sucks not knowing when to expect severe pain. It’s the million dollar question that no one can answer. And I am not okay with it, not one bit!