Tag: mood disorders

Of Suicidality

by Midnight Demon, posted in blogging, depression, mood disorders, psychache, suicidality, suicide, suicide attempt

Of suicidality

Since my last therapy session, I have been thinking about my suicidal career and how it relates to my identity as a trans person. My therapist is under the impression that it is my insurance hindering me from seeking another therapist and I told her, no. It is my suicidality. She seemed incredulous about this. So I wrote to her and told to contact at least 5 therapists and ask them if they would take on a suicidal client and see what she gets. I doubt she will do this.

I also told her in the message that I would like to continue talking about this because it is central and I think that I can heal if I talk about how I didn’t have the words to speak about being a boy all these years. In my first few years of therapy, it was difficult because I was also an active cutter. One therapist tried to push DBT on me and failed. I resisted. In one of the exercises she gave me was to think about cutting and note how many times I thought about it. It was over like 20 times a day I thought about it and it made me worse thinking about it this. I felt really bad about myself. I didn’t have much hope about this new therapy. This was back in the early 2000s, before I found a stable therapist. By then, my cutting had somewhat stopped. It didn’t provide the release it once did. Instead, I just became suicidal. It was extremely painful. I was hurting very bad. My psychache was off the scale. My therapist became my only source of support and hope. I was seeing her maybe three times a week but I still just eluded to how I was feeling. In looking back, she really didn’t have a strong sense of redirecting me when I went off course and that was a downfall of our therapy. It went on like this for years and I just became more and more suicidal. I didn’t know what was making me so suicidal. I just knew I was.

The pain of living not as my true self was literally killing me. I hated my body and myself. I actually loathed myself in ways I never thought of. I hated my face. I was convinced I was ugly and fat. My father had called me “facia bruta” (ugly face) for so long that I believed him. I had things on my chest telling me every day that I was not a man. I had periods that made me suicidal every month. The hormonal aspect of it was terrible before I was able to stop them. It literally was like a switch went off when I started bleeding and I was ok again. But before then I was in suicidal hell. All I thought about was killing myself and I had such pressure to do so. I usually ended up going in the hospital for a couple of weeks but that never helped me. It would keep me safe from myself but they never cared to work on why I was suicidal. It was to be dealt with on the outpatient therapist.

My last two hospitalizations I tried to get as much as I could out of them. I knew I was still suicidal and might be for some time. I have been suicidal for nearly forty years. It is a tough habit to break. That is why I want to talk about it in therapy. Being the wrong gender for so long really was painful. It took me a few years to even say the word without breaking down and crying. It didn’t relieve me of my suicidal thoughts though.

I remember I was first suicidal when I was just eight years old. I didn’t tell anyone but it felt like the right thing for me. At that age, I had all or nothing thinking and thought that if I couldn’t be a boy, then I should die. There were hardly any gender clinics in the 80s and I think there was just one doctor at the Children’s Hospital that did gender affirming care. I grew older and my suicidality got worse. I became a planner. I would set dates. I truly had a suicidal mind when it was active. The blinders would go on and that was all that I could see was my death. I still get that way sometimes. It just made sense at the time for me that it was the thing to do. I had planned my death right before my tenth birthday. I wanted to kill myself on my birthday. But my mother was throwing me this big party and as my birthday is near Christmas, I wanted to see what presents I got. I never acted on my feelings until a few months later when I got into an argument with my mother over something. I had talked about being suicidal to my childhood best friend. He wanted me to get help but I felt like I was crazy if I did. I didn’t get help until I was fifteen, after I made some scratches on my wrist in an attempt to end it. But there was more than just being in the wrong body that was causing me to be suicidal at the time. I had a lot of trauma in my family to process and most of it went unprocessed as the therapist was more interested in trying to stop me from cutting.

My suicidality, body image, and being transgender are all tied together. For years, I hated myself because I wasn’t my true self. I know the past couple of years, my suicidality took a life on its own. I think that was partly due to the misgendering and use of my deadname at home. I felt like I was still a girl in my mother’s eyes no matter how much facial hair I had. Being me was difficult and now that I have had top surgery and am my true self where my mind and body are congruent, is still tough. I don’t have bottom dysphoria, thank god. I can never have a prostate gland to make my penis work the way a cis man does. But then, I have never really liked the thought of having one.

I tried conveying to my therapist about how intertwined the suicidality and being trans is but I don’t think she got it. I have been wanting to be dead a long time now and even though I might not have a suicidal mind now, I still feel suicide is an option for me. The trouble is, the past four years so I have no filter between being suicidal and being safe. I used to plan dates. Now I don’t. I just act on my feelings and that is dangerous according to my therapist. I’ve felt like I have put it off so many times that I might as well act on it. I’ve always held on to Dr. Paul Quinnett’s thinking of giving yourself time between the actions and thoughts. Suicidal thoughts and feelings can happen in a matter of minutes and sometimes, depending on method, acting can be fatal. But giving yourself space between the action and thoughts gives you time to think on the matter. I’ve always give myself a few weeks time, sometimes, a month or more, when planning my death. Then when the date came, if I didn’t feel like acting on it, I didn’t have to. And most times, the feelings had passed and so did my thoughts to act. Sometimes I was in a better place mentally. I might still be depressed but not enough to want to end my life. I honestly wonder if I will ever not be suicidal while being my true self.

I have talked about my suicidality openly on social media and throughout my blog. Sometimes it triggered a well visit from police which I didn’t like. I had gone through some dissociative periods where I would write the most suicidal things and then wake up the next morning, wondering if it was a dream. Often I would send an email to my then psychiatrist, who would call me in the morning and I often had no idea what she was talking about until I read the sent message. I often felt alone late at night with my feelings and would text or email my psych team about them so I would feel less alone. This just created worry and sometimes hospitalization, or at least a trip to the ED. I am thankful that period of my suicidality has passed. My ideation is often triggered by any distress, real or imagined, and often goes to the planning stage. I no longer have a filter between my thoughts and planning. Usually there is some space between them as it takes a while to come up with a plan. For right now, I know what my method is so I just go right to planning when I feel suicidal. I will pick a date and then when that day comes, if I am feeling suicidal, I will act but most times I don’t. I have been working with my therapist about trying to put some kind of buffer between thought and planning as it has become an almost “automatic” thought. And planning usually calms me down as it gives me an option for my distress. I am trying to come up with another plan when my planning is active. It hasn’t been easy. I am thankful I can be frank with my therapist when I am suicidal and not be automatically hospitalized for my thinking/ideation. It is still a fear of mine when talking about this stuff but I try to inform her as much as I can. I was taught nearly thirty years ago to keep the thoughts to myself. I was hospitalized at the time and my stay was becoming long. I basically had to keep the thoughts to myself or there was no hope of leaving the hospital. This was still before DBT and CBT were the main forms of keeping suicidal ideation at bay. Today there is brief CBT that was formulated by researcher/clinician Dr. Craig Bryan. DBT (dialectical behavior therapy) was created by Dr. Marsha Linehan. Both of these therapies along with CAMS (collaborating, assessing, and managing of suicide) has been studied extensively to combat suicidal ideation. I love CAMS as it speaks to me and I feel really helps me focus on why I am suicidal. It is based on the works of the father of suicidology, Dr. Edwin Shneidman as well as other researchers. CAMS is easy to administer and rate within a session. And because it is collaborative, the client/patient has a say in what their treatment is. That is the focus of CAMS, it takes the client as expert rather than the therapist. This is often lacking in the mental health field. There is such a paternalistic approach to suicidal behavior. It makes it difficult to talk about and there is always the fear of suicidal people being labeled as “crazy”.

I believe Dr. Shneidman was correct in saying that suicidal ideation is due to psychache, the psychological pain of the mind. His book, The Suicidal Mind, resonated with me deeply. He talked about constriction of the mind where there are blinders and the suicidal person can only see suicide as an option. He also talks about things called lethality, perturbation, and press. He formulated a suicide cubic model of perturbation, press, and psychache that I find useful in gaging my own suicidal thoughts and where I am in whether I need crisis management or just an extra therapy session. I felt like Dr, Shneidman was on the mark. I am glad that CAMS took into account his work and includes a measurement of psychological pain. As Dr. Shneidman has stated, no psychache, no suicide.

Identities that shape us

by Midnight Demon, posted in blogging, depression, PTSD, suicidality, suicide, suicide attempt survivor, transgender

I had a good discussion with my therapist about how last session brought up how much I was a boy and developed as a girl. It was really confusing and I didn’t have anyone to talk to about it. The only person who I knew that was a man and dressed as a woman was the leader of the BAGLY support group. She was always surrounded by young males so I never had a chance for a one to one conversation with her. I think if I came out sooner, my life wouldn’t have been so painful. My therapist pointed out that she thinks I identify as being depressed and suicidal. She is right. But being depressed as well as being suicidal is transient. I have other states of being throughout the day. It comes down to my thoughts that go into the feelings that go into the behavior. All are connected in a triad. CBT can break the cycle. I told my therapist today what I thought about a year ago when I was back to my senses. I had a medically serious suicide attempt and I was pissed I was still alive. I didn’t tell her I thought my chance of surviving weren’t that great. The only thing keeping me in this world was having top surgery. It was what kept me going. It was crucial I identify more as a man than anything else in my life. As long as I had those things on my chest, I was not a man and it was literally killing me.

My therapist and I talked briefly about my parents. I know my father would never see me as his son. I don’t even think he would have accepted I liked women. My mother was a little more open but not by much. I will never know if she saw me as her son because she was dying or because her mental state was affected. I know when I came home from the hospital she still used the wrong pronouns. At that point, I didn’t care enough to correct her. It bothered me but there was nothing I could do about it. She wasn’t going to change. It took a lot just to have her call me G.

I like to think the suicidal stuff is behind me but I know it isn’t. It will always be an option for me. I’ve been suicidal since I was eight and even though I am more congruent with my thoughts, I have a shitload of trauma to deal with that could easily make me suicidal again. I learned today that even though I have a suicidal career, I can still change it to something else. It is going to take a lot of work though. As Dr. Doyle says, 1% is better than 0. I’ll be continuing to write about my midnight demons in this blog. It is the one thing that keeps me sane. And I hope that if you have found my blog because you are suicidal, there is hope. Things do change. It took a year for me but I’m not completely out of woods and that is ok. You are here now and I hope you stay.

sad and exhausted

by Midnight Demon, posted in blogging, depression, transgender, writing

Sad and exhausted

I was up in the wee hours of the morning. I had slept late and wasn’t really tired. I had finished the last of the casserole. I woke up and needed coffee. I had taken my morning meds and then went back to sleep for a couple of hours. I kind of planned the day of taking a shower, brushing my teeth, delivering the books to the Transgender Program, and then to Starbucks for coffee and lunch. I also planned on reading through my manuscript to see what else needed to be written.

The shower exhausted me. I had shaved and then I brushed my teeth. By the time I was in the shower, my back was flaring up. I had just finished washing my hair when I had to sit down. Cramps flooded my back and it was quite painful. I managed to get the bar of soap before sitting down so as I sat, I washed up. Drying off I nearly slipped in the shower stall. I managed okay then got dressed. I sat on my bed to rest and hydrate for a bit. I had no idea what I was going to wear. It was cool out but not quite cool enough for jeans. I decided on a button down shirt with my shorts. I then called a cab as I put my socks and shoes on. There was no way I was going to walk to my pcp’s office. I just didn’t have enough spoons for it.

The cab came. I put everything in my backpack and got in the cab. Traffic was bad. It normally takes like twenty minutes today took more than a half hour. I am glad I didn’t have an appointment or I would have been late. I dropped of the books and then ordered my drink and something to eat. I then walked to the Starbucks. There was a table free so I sat there and ate. After I ate, I tackled my manuscript. I got to like the 25th page and the printing was bad. The toner had already started to go and I didn’t notice it. Reading what I wrote stirred up some emotions and then I read the letter I sent my mother back in 2021. I got really sad. The pages were impossible to read so I called it off and then headed to the station. I got to the Square and picked up my meds that were ready. I thought about getting another coffee but it was past 3pm and I would be up late if I did so didn’t. I was exhausted and just wanted to go home. My nephew was in one of his moods as he didn’t even say hi to me when I greeted him. Whatever.

I thought about my mother all through the ride home. I was really sad. I still am sad. I am sad because my mom died and that I have no fucking clue where to go with my book. I couldn’t read what I wrote because there was a huge gap in the page. I am going to have to reprint the pages. I have a new toner that I haven’t installed yet. I’ve been lazy about it. People think writing a book is easy until they have to do it. I didn’t have pages to guide what I wrote so things just went on and then a new idea started and I was like WTF is going on here. I want to write more but I don’t know what I already wrote. I hate reading from a screen. I like pages in my hand to get something. This book is too important to me to just gloss over. I am going to try and see if Random House will publish it. No idea what is involved in the process. But I am half way where I want to be with 62 pages. I just need about 60-70 more to write. I’ll replace the toner in my printer sometime this weekend and then print out the 40 or so pages needed so I can read the rest of what I wrote. Hopefully it won’t hit me like a ton of bricks like it did today.

bad night of pain

by Midnight Demon, posted in baseball, blogging, depression, FTM, gender dysphoria, grief

Bad night of pain

I was listening to the game and it was tied so I decided to shower as I smelled. After the shower, as usual, I was exhausted and then my foot/ankle flared up on me. It is still hurting. The Sox lost and I am upset about it because they had so many chances to win. It was an up and down game so really hurt to lose.

I had therapy yesterday and my therapist really upset me. She said that I don’t need to be in the hospital and said I could go to the ED but they won’t do anything for me. I know this isn’t true. She didn’t evaluate me on my suicidal risk so she really doesn’t know how bad I just don’t want to be here. I think if she knew that, she might change her mind. She thinks I need partial but I don’t want to go to skill groups. I think they are a waste of time for me because I can’t really grasp things like I used to and besides, these things take practice. I can learn it from a book more than a group setting. The book I am reading now on CBT and suicidal thinking is helping more than anything else that I have read on the subject. Book is called choosing to live. It is an excellent book. I was in a mood yesterday so didn’t bring it up like I wanted to. There was a section I read that I wanted to share with her. She makes me so angry. I don’t know why she doesn’t trust me that I know better of what can help me when I need help. I think being in the hospital will help me because it has in the past. It kind of resets me. Right now I am not doing good. I am not eating or sleeping right. I am tired all the time. I wish I were dead. I also know that maybe spending a few nights away from home will help me with my PTSD of listening out for my mother so that maybe my sleep will get back on track. I know my mother is gone but I still listen out for her every time I am awake during the middle of the night. I’ve tried to calm myself by saying it is ok and that she is gone so no more looking out for her but that just makes me sad and I miss her even more. Grief is a hard thing.

I am so tired and wish I could sleep. My sister left her room so I am waiting for her to go back to it. It is so stupid that I am listening to this shit.

I made a bacon sandwich when I got up but it didn’t taste good. My taste buds are off. Even my coffee didn’t taste good. I had a pop tart, too. It was okay. That was the only thing that tasted right today. I haven’t eaten anything else today. I really want pasta but I don’t feel like cooking. I had an Ensure that I take with my meds as I need 350 calories to take for it.

Tomorrow I have three appointments. I have PT, then my pcp appointment, then the bereavement group. My therapist thinks I should have some time with the group before I go in the hospital as I said I would give it another two weeks time. She thinks grief is going to take longer. She might be right. I don’t know I just feel so damn lost.

I have been having nerve pain in my chest on the left side and it is freaking me out. I know it isn’t cardiac because I am not having any other symptoms but damn, the pain is so intense. It is like a stabbing pain. The swelling on my right hasn’t gone down and now I am wondering if maybe I should be massaging it or something. I sent a message to the NP to see if that will help. It just looks like I have breast tissue again and it is bothering me. I hope that what I feel isn’t fat as that will take more than massage to get rid of.

I haven’t had the time to think more about my personal statement for UMB. I got the letter from my psychiatrist which doesn’t say much other than that he cleared me for attending classes. I wish my psych was still my psych so she could write something for me that would help me other than just clearing me for classes. I guess they need detailed information. Just lovely. Ugh. I can do this. I wrote a damn memoir for crying out loud. Why is this so hard? I am currently working on another memoir. I have gotten so good at being concise in my writing, I find it hard to expand on things. Some story teller I am.

One of the groups I am in on Facebook posted about a trans book. I plan on getting it next week when I get paid. I am also planning on getting a t-shirt that says Baseball Isn’t Boring. I think that will be cool to get. I am a hard lover of baseball.