Tag: psychache

frustrating doc appt and cookies

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

Frustrating doc appt and cookies

I had my quarterly appointment with my PCP this morning. It didn’t go well as the jerk didn’t listen to me or pain concerns. He was reluctant to give me a month’s supply of my strong pain meds and things I have “hyperalgesia”, which means the pain meds are increasing my pain. I don’t think that is happening because pain it brought on when I stand or move my damn ankle. He gave me a referral to the CRPS specialist and wants to hear what she says before making any treatment changes. I see him again in four fucking months.

I am so frustrated. Idiot won’t give me a month supply, fine, I’ll just request a refill every fucking two weeks until he changes the damn count of the meds. I emailed my psychiatrist but haven’t heard back from her. He didn’t want to listen to how bad the pain was, especially when I told him it was bringing on suicidal episodes for me. He just asked if I was in contact with my psych and that seemed to make everything okay. WTF. I don’t see her for pain control. I see HIM! If my damn pain levels weren’t so damn high, my suicidal episodes would be less. Sure I would still be suicidal but it wouldn’t be every time my pain is a 15, especially when my flares are becoming more frequent, with no rhyme or reason.

I was hurting and tired when I came home but decided to make cookies anyway. It was a recipe I haven’t tried before so I didn’t know what to expect. The recipe said it would take 15 minutes to cook. It turned out to be close to a half hour or so and my mother increased the temp of the oven 25 degrees above what they said. Then they cooked. I made them a little bit too big and thick. The smaller ones were cooked more than the bigger ones. I am disappointed because they didn’t come out right. I might trash them. I was going to give them to my psych but I’m not now because they just didn’t cook right. I am frustrated because I aggravated my damn Achilles while making them. My back is also hurting, but it was hurting since this morning. I somehow aggravated my sciatica and it didn’t help that the doc was poking me in the back to see where I hurt.

I am really tired. There wasn’t much of a mess and I tried to clean up the best I could. My mother is making dinner and I am not hungry because I had two cookies plus the dough so I am full. I loved the dough more than the cookies. I might have some of the teriyaki chicken breast that I bought the other day if I get hungry later.

I think my mother’s taste buds are going because she couldn’t taste the butterscotch in the cookies. I put 2 packages of butterscotch pudding mix in the batter. I could taste it. She said all she tasted was dough. I don’t know. Just pissed me off more than I was already.

I sent another email to my psych and now I am crying out of the frustration of being in pain and not having a caring doc. He isn’t a jerk or anything, just inexperienced I think to deal with the complexity of my situation. I miss my former PCP so bad. I rather be nervous about my weight with him than deal with this incompetent young doc who I don’t think trusts me enough to judge my pain and how I manage it. I really think if he saw me more it would increase his awareness of just how bad my pain is and how to deal with it. The meds work and I don’t think I am getting hyperalgesia from them. I also said so in my email to my psych. She should know what this young doc is saying. I get his hesitancy to treat me but is it worth him signing my death certificate because he is under treating me? I was very up front with my former PCP about this and he understood that even though I was under the care of my psychiatrist and therapist I still had low suicidal moods that centered around my pain and suffering. He really wanted to help me and make me “better”, though there was nothing more that could be done. I have tried PT and injections. They just made my pain worse. I have seen countless docs. I hope the specialist can offer me something worthwhile but I am not holding my breath. The worst thing she can say is that I don’t have CRPS but just a pain syndrome. I think that will devastate me and might put me over the edge. I have been fighting this pain for so long now that I am just so sick of it. It makes me tired and cranky and suicidal at times. I can’t just stay at home all the time and stare at my four walls or write endless blogs. I need to go out some time and have a routine of some sort.

Tomorrow I don’t have nothing on my agenda and I am just going to rest. I see my psych on Friday so I want my Achilles pain to calm down some. I really don’t have a treatment for that other than taking ibuprofen and resting it. When it’s really bad, I have to take a couple of strong pain pills to quiet it down. Baking didn’t help it any but it’s not as painful as it was yesterday.

don’t call me daughter 4

by Midnight Demon, posted in Bipolar Disorder, blogging, cauda equina syndrome, chronic physical pain, depression, mood disorders, suicide, suicide attempt

Don’t call me daughter 4

My family had dinner at my house. We had lasagna that my mother made. It was going good. Then after dinner we just sat around chatting. That when someone said something about my haircut and my mother shrieked and said I was hideous. She couldn’t stand to look at me. And she kept calling me a her. That triggered my suicidal tendencies.

I felt like coming out as most of the family was around. I knew I would have the support of my sisters. But I couldn’t bring myself to do it because I felt like I would just leave and never come back. I would have grabbed my lethal bottle of pills along with my other pills so I don’t throw them up and make it to my suicide spot to have it over and done with.

I still am feeling hurt hours later. I felt like talking to my sister but I know she would just say that I should just “let it go”. How can I when you own mother tells you to your face you are hideous because of your military haircut? I get no support from her at all. This just seals the icing on the cake.

I so badly wanted to correct my sister and mother when they were calling me “she” and “her”. I felt so hurt. The pain was so indescribable that I could feel it and not feel it at the same time. I was just shocked because she said it in front of my sisters, my brother in law, and my nephew. I don’t remember if my little niece was there or not. My mother actually shivered in disgust as she talked about how hideous I looked with my haircut.

I love my haircut and I think I will continue to get this cut every time I go to the barber, if I don’t end up killing myself within the next week or so. I have never felt so ashamed to be my mother’s child as I did last night. I am her first born and to be treated this way, just kills me inside.

My physical pain has taken on it’s life on its own. I have had severe pain the last three days. It starts in my foot and then travels to my ankle. I am getting more and more reliant on my strong pain pill, which is just causing havoc with my bowels. And when you have a nerve injury, things don’t move the way they should anyway. Constipation makes it worse. I have been having to push so much that at times I feel like I am going to pass out. It fucking sucks. It’s only putting more nails in my coffin.

If the weather wasn’t supposed to be so shitty today, I would attempt to end my life. I had emailed my psychiatrist that I wished I was never born. I also posted it on social media and I got the typical “you shouldn’t say that”. Why the fuck not?? It’s my fucking life. You don’t know what I have been through. You don’t know the hell my mother is putting me through. Would it be better if I just died by suicide?? I think it would be. I am tired of living anyway. I have nothing worth living for. I am disabled and there is nothing I can do to change that. I can no longer work or even go to school, mostly because I don’t make the money to go. It’s hard to come up with or save $1200 for one college class on disability. It makes me sad that my dream of just even getting my bachelor’s degree is stuck. Looking back, I should have gone to UMB to get my degree rather than an Associate’s. But what is done is done.

random 410

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

Random 410

I didn’t have a good night sleeping. I woke up around 0200 having side effects from my trilafon. My arms felt like they were spaghetti and they were flailing. I was annoying that it woke me from a sound sleep. I stayed up half the night as I couldn’t go back to sleep right away. I would have blogged but my arms didn’t feel right.

I was hoping to sleep till at least 1100 but woke up at 0800. I was able to get back to sleep for a few hours and then I made breakfast. I didn’t feel like showering. After breakfast, it was time to catch the bus so I could have much needed espresso. I grabbed my bag and looked for my keys yet again. I still haven’t found them anywhere. My house ate them and until it pukes it up, I am without keys. I am glad I have a spare.

It was raining and cool as I waited at the bus stop. I didn’t dress warmly and froze while I was at Starbucks. I read a chapter of the CBT book but didn’t feel like summarizing it. I wrote in my journal until it was time for me to catch the train for therapy. While I was writing, my foot acted up and I was shitting bricks. I took my pain meds and hoped it would be enough to calm it down so I could walk to therapy. It was too late to cancel and too late to go home for strong meds.

I went to therapy and told my therapist that I was suicidal. I was hopeless and he wanted me to scream at someone. I thought that was queer. I wasn’t angry at anyone. We talked about different things and he has it in his head that I need people in my life. I don’t want people in my life. I have enough of them online that I manage. I don’t want every day conversations with people that I don’t know. He is starting to get on my nerves about this as it’s the third session he has mentioned this. Next week he is out of office because of the holiday. He is going to let me know if a spot opens up on his schedule if I want to see him. I rather not see him.

I walked to the train station and I was hurting. Both ankles were giving me grief. I decided to go to Chipotle for supper. I had a burrito bowl and I asked for extra rice. It was good and I got a little happy having my guacamole. The train was crowded so I didn’t have seat. I just made the bus home and it was crowded so I didn’t have a seat. My feet and ankles were wanting a divorce. I crawled home. I took some strong pain meds and regular meds when I got to my room. I didn’t care. I wasn’t going to be in pain all night like I have been the last few nights.

A friend called me while I was home. We set up a dinner date at our favorite Thai place. It will be good to see him if I don’t end up going through with my plans. I am still feeling suicidal after I left therapy, mostly because I was in fricken pain and that just put me in a bad mood. I’m going to talk to my psych tomorrow and tell her my plans. This therapist sucks for suicide prevention so I am not sure I can depend on him in a crisis or when I am having a hard time. He still expects me to see him in two weeks when I am not sure I am going to be around. FUCK. I am just so tired of having to do things myself in therapy. I am not sure it is worth it anymore. Not sure my life is worth anything anymore. I just feel so hopeless today and not sleeping and being in pain has not helped me one bit. Just don’t want to exist anymore, I really don’t!

Review: ASAD, Acute Suicidal Affective Disturbance

by Midnight Demon, posted in Bipolar Disorder, blogging, depression, mood disorders, suicide, suicide attempt

Review ASAD: Acute Suicidal Affective Disturbance

This article was written earlier this year and I was able to get it to evaluate it. The following are my thoughts about it:

Suicide affects over 800,000 people worldwide but there is not much in terms of preventing death by suicide or attempts. Risk factors mostly focus on suicide ideation. Even though the DSM 5 has created a SBD (suicidal behavior disorder), it is something to be explored but not a full diagnosis. The authors of this article have proposed the diagnosis of Acute Suicidal Affective Disturbance because it is a relatively immediate response to stress or some other factor. The criteria is:

• A geometric increase in suicidal intent over the course of hours or days, as opposed to weeks or months
• One of both of the following: marked social alienation (e.g., severe social withdrawal, disgust with others, perceptions that one is a burden on others) or marked self-alienation (e.g., self-disgust, perceptions that one’s psychological pain is a burden)
• Perceptions that the foregoing are hopelessly intractable
• Two or more manifestations of overarousal (i.e., agitation, insomnia, nightmares, irritability)

All four criteria must be present for a diagnosis and must not be the direct result of an exasperation of a mood disorder or substance use. I am guessing this means that a mixed state would exclude the diagnosis. I also wrote to the primary author, Megan Rogers, to find out if a medical condition would be exclusionary, such as a chronic pain condition, but it hasn’t been established.

Exclusionary criteria for the studies were active psychotic symptoms, imminent danger to self or others, and unmedicated bipolar spectrum disorders.

343 outpatients from a university-affiliated clinic were enrolled in the study. Various measures were used to assess anxiety, depression, suicide ideation, anger, dream activity, etc. 7,698 inpatients were enrolled in the second part of the study. Measures were a little different than the outpatient sample, as the SSF-II (Suicide Status Form) was used to measure ASAD symptoms as opposed to the Beck Scale for Suicide Ideation. The SSF-II has a good validity rate (Jobes et.al., 1997). Other measures were length of stay (mean 7.54 days, SD 6.41), PHQ-9, and past suicide attempts.
The statistics of the tables were confusing to me as I am not a stats person so I can’t really interpret the results. The discussion had good markers for ASAD being a diagnosis and I went from there. One take away was that ASAD was associated with numerous psych disorders but was not redundant in association to suicide risk. It was related to past suicide attempts above and beyond symptoms of depression, which I think is important. Depression symptoms only tell one side of the story and not all people with depression are suicidal or have thoughts of suicide.

As with this being relatively new, more research is needed in multiple areas to ascertain whether this can be a useful diagnosis in the management of suicidal behaviors or even to prevent suicide. The authors did note that once ASAD is established, good safety planning is necessary to monitor suicidality throughout the course of treatment. This is important in all therapeutic endeavors when dealing with suicidal individuals, even if the episode has passed. A tailor made plan must be made, not a “one size fits all” model.

Acute Suicidal affective disturbance: Factorial structure and initial validation across psychiatric outpatient and inpatient samples. Rogers,M. Chiurliza, B. Hagan, CR. Tzoneva, M., Hames, JL., Michaels, MS., Hitchfield, MJ., Palmer, BA., Lineberry, TW.,Jobes, DA., Joiner, TE. Journal of Affective Disorders 211 (2017) 1-11