how I manage being suicidal

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.

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.