Twenty-Three Years

Twenty-three years

Today marks twenty-three years that I have sought help for my depression and self-destructiveness. I actually didn’t seek help straight out. My English teacher noticed I was upset and pulled me aside and saw the marks on my wrist that I had made the night before. She then told me to stay after class, something no teacher has ever told me to do before. She took me to the nurse’s office. We chatted. I told her about what happened at my house the last two nights and how much I just wanted to die. She called my mother, who then took me to the local counseling center. By then, I told them “nothing was wrong” and that I was “okay”. I declined treatment and went on with my day. Daily visits to the nurse’s office became more frequent. I just stopped in to check in and told her what was going on. She wanted me to see someone so the following week I agreed to see the school counselor. Thus started my official journey into psychotherapy.

It hasn’t been an easy road. For the first ten years, I had a different therapist nearly every year. I think the only time I had two years was with the psych resident that wanted to see me or I would still be in the hospital. I went through a lot with this psychiatrist in training. While in her care, I attempt suicide and ended up being in the hospital for two and half months. When she ended her residency, I went to another psych in training. He wasn’t as good as she was. In fact, he was terrible. I felt like he was more my brother than a therapist but when I told him I was procuring more medication to end my life, he asked me if I was suicidal. That is when I knew he was an idiot. I pretty much ended our relationship within a few weeks and saw someone else. She was good, had years experience. But after I had an argument with my sister and she wanted to know more about my sister’s social life than my anger, I ended things with her. I went about a month without seeing someone. I then decided to go back to my town’s local mental health center. I saw someone there for a year and again, she decided to move on after that year mark. We were finally connected and I felt so betrayed. I didn’t think I was going to see another person again. I don’t know what changed my mind. I knew I didn’t want to see someone else at the local mental health center. I wanted to see someone private. I figured they were less likely to leave their practice. And I luckily found my current therapist and we have been together for fourteen years. It is the longest relationship I have had, outside of my psychiatrist. I am lucky that I have had just one psychiatrist for my medication all these years. She does more than just prescribe my medication. She also does some therapy and is my sounding board for the various medical issues that I have. And I can’t wait to see her again in a week after not seeing her for four long months. It is going to be weird seeing her again.

I don’t know why I have stuck it out in therapy all these years, especially when things were at their worst. I have been beyond hopeless and yet my psych team (therapist and psychiatrist) always made me see another day, sometimes against my wishes.

Response paper for Building a therapeutic alliance with suicidal patients

Response paper for Building a therapeutic alliance with suicidal patients.

This book is a work of genius among the top suicidologists in the U.S. and Europe. These people actually want to help suicidal people get better and try to make their life worth living. Like most of Drs. David Jobes and Konrad Michal work, they have done an excellent review of the literature and made the book easy to read without a lot of psychological jargon. This book should be used as a handbook for anyone dealing with suicidal individuals. As someone who has been through many suicidal episodes with many different therapists, this book is groundbreaking. It lists his classic work of CAMS (collaborating and managing suicidality) which is a tried and true way of dealing with lethal suicidality in an outpatient setting. The other evidence based therapists will enhance therapy around this work.
The Chapters are broken down easy enough and progress from good to bad in my opinion, of the treatments that work. The conclusion was brilliant by Dr. Jobes. He has stated with clarity the hardships that are faced with suicidality such as the IRB approvals for research, clinicians wanting to work with this population, and the need to try and keep these people in therapy.

Three feet from the bureau

Three feet from the bureau

In October of 2012, I was caught in another flare up. It was night time, well past business hours of doctors and therapists. Normally I am good at reaching out. I text my therapist. I write in my journal or blog to get through the episode. But this night was different. I snapped. I couldn’t bear any weight on my foot that night and it really made me feel like I couldn’t go on. I was so tired of feeling like an invalid. I wanted to die in an awful way. Problem was that I couldn’t get to my bureau three feet away to get the meds I needed to do me in. Any time I tried to move, I was in agony with horrible foot pain. I could barely move my foot out of the covers of my bed let alone stand long enough to shuffle to the bureau. I cried as there was nothing I could do but take what I had at my bedside. It wasn’t much but it was enough to make me unconscious and away to dreamland I went.

When I awoke the next morning, I was in a dreadful mood. I wondered if I had really done what I thought I did. I checked my pill box and it was empty. I checked the contents of my pain meds and it was close to empty. I couldn’t believe what I had done. But I survived it and am living to tell about it. How I woke up I don’t know. I felt ashamed of myself, not in surviving but of making an attempt and not seeking help. I had promised my doctors that if I felt like I did that night, I would call them. But no phone calls were made. I had a confidential suicide hotline to call but I didn’t. I had made suicide prevention part of my treatment plan but yet the crisis response plan went out the window that night. I didn’t implement any of it. I just took pill after pill until I passed out.

This scared me. I was no longer in pain yet who is to say that if this happened again I wouldn’t try to end my life again? Dealing with chronic pain is a beast. And so many times it doesn’t get a flag for suicide risk assessment. My better judgment wasn’t in gear that night. I not only wanted to end the pain, I wanted to end everything. I spend the next few days in a haze, and not from medication. I was scared to let my practitioners know what I had done. I finally broke down and told my therapist. It was very difficult admitting my attempt. I then told my psychiatrist and she shocked me by saying that if I wasn’t in pain, I wouldn’t have done what I did. And it’s true. Chronic pain changes you, not only physically but mentally as well. It took me a while to write about what I had done on my blog. After all three feet was the only thing stopping me from ending my life or attempting to. I’m still fearful about making another attempt while in the throws of another flare up. I keep a small portion of my meds by my bedside so they are not lethal. I was lucky I didn’t need medical intervention the next day. I still am not quite sure how many pills I took that night. And that also scares me because who is to say that the next time I won’t count them out.

Chronic pain is not something to underestimate. Hundreds try to end their life year after year because of physical pain. Most people see their doctors before an attempt is made. The question remains whether an assessment is made for either depression or suicidal thinking. My primary tries to assess my mental health but mostly just asks when my next appointment with my psychiatrist will be. It might be followed up by will I call him if I feel like taking an overdose of my pain medication. Yet he knows he is not the first person I will call. In my order of people to call: my psychiatrist, therapist, primary, then ER if I can’t get a hold of one of them.

That night, I didn’t call anyone. All of my safety plans went out of the window. All because I was overwhelmed by excruciating physical pain. I think if I could go back in time, I would have taken the time to breathe. And think more of self-preservation rather than self-destruction. I am more aware now of what to do but it’s not that easy when you are in the heat of the moment. A month ago I was again in excruciating pain for three days yet suicide was the furthest thing from my mind. I knew what to do to cope with the physical pain. And luckily that didn’t involve a bottle of pills. I felt the attack come on so treated my pain much earlier than I did in October. This helped to keep the suicide demons at bay. I texted my therapist, I emailed my primary that I was in excruciating pain. I also got in touch with my psychiatrist who help me to see there was a tomorrow. Doing these things didn’t make my physical pain hurt less but made my psychological pain bearable. It helped me to cope through this rough patch.

Being mindful about pain is how I get through bad flare ups. I have no control over these pain attacks. But I do have control over what I do with it. I learned my lesson from that October night.

Shit Day

Shit day

I haven’t decided if I am going to take a shower or not. Think I will wait to see if my stomach settles down. I feel awful. I looked for my Lincoln DVD and was unable to find it but I did find some suicidology books. I will add them to the pile that I have for them because I don’t have space in my bookcase yet. I am glad I found them because it gives me something to read other than the Civil War book. I was reading “Definition of Suicide” but that book is really taxing. I have to be really alert to pay attention to it because the vocabulary is quite unique.

Today was going okay until my bowels decided to explode on me. I just barely made it to the bathroom. A combination of coffee and laxatives has caused all hell to break loose. I am debating taking some Imodium to try and calm things down. I hate when this happens because I can’t do a damn thing. I have to be near a toilet or I risk shitting myself. I was supposed to go to my father’s but it’s freezing and icy out. My middle sister is going there now to do his laundry. I asked her if she could do his meds for me. Guy will go berserk if the box isn’t filled up. He is such a pain in the ass.

Ankle is still bothering me but I haven’t taken any meds for it. I am afraid of getting back up again if I do. I hate getting backed up and then have the explosive bowels. I usually don’t get them but damn, when I do, it’s bad. I guess I shouldn’t have had the coffee but I was feeling sleepy and needed to be awake. Today is my niece’s birthday. She is turning 19. The party is at 4 and I hoping my stomach settles by then. I was so hoping to get a shower in but damn bowels have left me feeling weak. I should probably take a nap but I really don’t want to. I have been having strange mini dreams today, mostly involving suicide of someone in the dream. I really don’t want to go back there.

I am still trying to get reviewers for my book. If anyone on my blog wants a FREE, signed copy of my book, let me know. I will send you my book in exchange for a review. Warning the book is powerful and may make you cry. I had two people tell me this. I wrote it from the heart.

There is supposed to be another damn storm coming in from tomorrow night into Monday morning. I hope I still have therapy Monday. The appointment is at noon. I hope the snow has stopped by then. If it is really bad out, I will cancel. I am not going to risk a fall.

I have been in a strange mood the past 24 hours. I feel really down but not really. I just want to die, to cease to exist. My cousin’s mother passed away this week. She and her son has been on my mind. I got him a sympathy card and plan on mailing it on Monday. She was a good woman.

I have been thinking of writing again on my co-authored book. Trouble is that I don’t know what I did with the list of phrases to work on. Maybe I will do that tomorrow. Or I could write some more about suicide. I like that topic best. It is my muse. It is something I write well in.