Tag: psychache

fighting side effects

by Midnight Demon, posted in depression

Cancelled my father’s doctor’s appointment today because I didn’t feel good and you would have thought I killed someone. My father was an irate bastard who didn’t give a damn that I was sick. He just felt like a “salami”. Thanks for the care dad!

I slept most of the day. I woke up really early this morning with bowel pain. That pretty much told me to stay near a bathroom. I wasn’t going to risk crapping my pants for an appointment that I didn’t want no part of anyway.

Then I got the depression sleeping sickness. That is what I call when all you want to do is sleep and stay in bed. So that is what I did all day for the rest of the day. I would be up for a few hours and then I would have to lie down because I would get so sleepy. Much like I am feeling now. I talked about it with my therapist tonight. She thinks I am just exhausted and need rest. Some help she is. I also have been having side effects from the abilify for the past three days. I didn’t take it tonight. I have been popping Ativan like it were candy. I hate feeling like a rubber ball. The only way I feel normal is if I am lying down. I might have to lower the dose of the abilify if I can’t keep this from happening.

I really need to take a shower but I think I will wait until tomorrow to take one. I just am spent. Fighting these side effects has been awful.

Different Theories of Suicide

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

Different Theories of Suicide

A few weeks ago I participated in a twitter chat (@SPSMChat). The discussion was about how Joiner’s Interpersonal Theory was the cause of suicide. The theory is the hypothesis that Perceived Burdensomeness (PB), Thwarted Belongingness (TB), and fearlessness of lethality all contribute to a suicide. Perceived Burdensomeness is when a person thinks they are a burden to society, their family, and their significant others. It is the “better off” type of feelings that are believed to go into suicidal thinking.

Thwarted belongingness (TB) is when a person believes that they are outcasts of society or group they belong to. They feel they do not belong to any such group and thus feel isolated and alone.

Fearlessness of lethality is a premise that the person doesn’t have a fear of death. It is like a Russian roulette towards death. An example of this is taken from the book Myth of suicide by Thomas joiner is Kurt Cobain. He was at first totally against the use of guns but then acclimated to them and then use a rifle to inflict his death. His lyrics speak to his struggle with suicide and depression as well as the pain he was feeling.

While Joiner’s theory does have some merit, it, like other theories of suicide cannot be proven due to the nature of the study. No ethic board would condone the death of the subject to prove a hypothesis.

The other theory that comes to mind is Shneidman’s theory of psychache as a causal factor in suicide. The here is that deep, unbearable pain is the reason behind suicidal thinking and action. In my own personal experience, I thought for a long time that I don’t belong to any group. And I also thought that I was a burden to others. But what drove me to the brink of death was the deep psychological pain that I was feeling, an element that I believe Joiner is lacking in his theory. If you combine psychological pain with TB and PB then you have a nice recipe for suicide.

There is some merits with Joiner’s Interpersonal theory of suicide but I believe whole heartedly he is missing the key element of pain. I really believe that if he adds psychological pain to his theory it will be a valid theory, in my opinion.

finding care in the off hours

by Midnight Demon, posted in depression

Last night I was in the throws of pain again. But my thoughts didn’t immediately turn to darkness Like they normally do. I wrote an email to my pdoc about what has transpired during the week and that I haven’t been faithful in taking the increase in my mood stabilizer for reasons beyond my control. Mostly because I have been driving and I don’t want to be drowsy behind the wheel. I also asked her if there was a hotline number she knew of to call in times of distress. She gave me one.

This all lead me to thinking maybe I should have a blog about this important issue…finding care during the off hours. For most people in therapy, when they are in distress after hours their and before their next session is to seek help in the local ER. This can be costly, as copays have more than doubled to deter such visits. But for mental health, there should be an exception made as there is really no other place to go while in distress. I understand that the cost is higher because care is more urgent and is most likely is trying to ward off unnecessary visits. But when you are in crisis, how can that be unnecessary? For the mental health field, there are no urgent care centers to go to in distress. It’s either you see your therapist or go to the ER (Emergency room). There is no in between. SO what are you supposed to do when you are somewhat distressed and cannot wait till your next visit with your therapist?

There are self-soothing measures. You take a bath/shower, read, journal, brush your hair for 100 strokes, eat something, etc. But when all is said and done, and you still feel terrible, then what? Most therapists have some kind of plan in place, or should be able to give you a hotline number such as Lifeline 1800-273-8255 (US only) or the national hotline number 1800-784-2433 (US only). I have tried calling the Lifeline hotline but have never been patient enough to wait to get transferred to someone. The other number I have not tried. There is also a text # 20121 and you text 121help. I don’t know where I got that number from but when I tried it the other day, it didn’t work. I never got connected to anyone, but that might be because of the hour.

There are chat groups, I am told, where you can discuss suicidal feelings and not be “punished/banned” or turned away. Unfortunately, I do not have that URL to share as I have not looked into that chat room. But when you are in distress, are you really going to google something??

There is something called a Crisis Response Plan that I sometimes use when I am in distress. UNfortnately, the last few times I have been in distress, all of the self-help went out the window and I didn’t use anything. I just ruminated about what I was going to do. It’s not perfect trying to save your life when you feel like ending it. I was not in the frame of mind to seek help.

Therapists think that a suicidal person always calls for help when in crisis and that simply is not true. Most clients become impulsive, wants to get rid of the negative feelings NOW and are in my experience, not likely to reach for help.

For me, writing has helped but not everyone has that option to them. I will blog my distress and might be fortunate to have a few bloggers comment to show support or to chat. But that doesn’t happen all the time. Most of the it’s hit or miss. My frequent blog readers might not be online at the time of my post and so not get it.

Sunday I participated in a chat that was for crisis intervention and I learned that there was a crisis text chat available. The intervention was either through chat or text message. I am going to looking into using this the next time I am in distress or when my mood goes south. It’s not always easy to think of these thing when your mind is thinking of ending your life. To use a DBT term, you just cannot tolerate the distress because it is unbearable.

I have been trying to identify when I am in distress so that I can reach out for help but it’s not so easy. The last few time I have used distraction or music to help me out of the intolerable feelings. I also will write in my blog or my journal but it seems like all bets are off if I am in intolerable physical pain. Chronic pain mixed in with getting my menses and dealing with it has been difficult this past two weeks. The waiting for pain medication to kick in is sometimes not fast enough to deal with mentally.

I wish there was some help I could have regarding physical pain and lethality but there are few pain specialists that deal with mental health issues and fewer still, psychologists that deal with pain issues. Even crisis help lines don’t know hot to deal with physical pain that is behind suicidal ideation. In a perfect world, you would like to see someone that is well rounded in chronic health issues and suicidality. Unfortunately, I don’t think they exist or they may just be too far and in between to help the greater good.

When I was being evaluated at my local pain clinic, I saw a pain psychologist. His job was to help me deal with pain. But he didn’t offer me an real advise the first time meeting him. I would have to set up a series of sessions with him but unfortunately this happened when I lost my car and he is too far out to see. If I saw him with public transportation, it would be a two hour commute, both ways.

The hardest part of being alone with your thoughts is that you are left to your own devices before the next session or when office hours are available. I wish there could be urgent care centers that are specific to mental health issues. Because not all crisis needs to result in a hospitalization. Sometimes just talking with an understanding person is the best treatment mental health professionals can provide.

beyond Exasperated

by Midnight Demon, posted in chronic physical pain, depression

Had an early morning today because my father had a doc appointment. It went ok, though my father had no clue what was going on and didn’t understand what the doc was saying. I had to explain it to him in smaller words.

While I was at the doc’s office, I had to use the bathroom. I found out, much to my dismay, that I sharted. Now I am in a very dark mood. I came home, washed up, and while making my way to my room, my ankle exploded. So in addition to losing my dignity, I am now in wicked bad physical pain. I took some pain medication and am calling it a day.

I wrote my therapist a letter that I had hoped to mail today but forget it now. I wrote her an excerpt of the blog I wrote last night. I felt she had the right to know what I wrote. I also added some things to it. I also texted her to try and have her call me. I really need to talk to her because I don’t think I can be ok till our next appointed time. I don’t know if she will call me or not. Some times she is able to and others she is not. I really am hoping someone cancels one of her appointments and I am able to get their time. A session would help me today. I could call my psych but I know she will just tell me to go to the ER and I don’t want to go. Besides, I don’t have a car and with my ankle the way it is, I can’t walk there. I just feel stuck.

Since the shart episode, I feel like I can’t trust myself. I am afraid to do anything that will cause my bowels to move. I hate feeling like an asshole. I know it isn’t my fault but the hardest part of dealing with CES is losing the ability to trust your own body. It’s gone and there is nothing I can do to get it back. The sensitive nerves are damaged and there is no getting these nerves back. I can’t feel myself and haven’t for the past eight years now. It’s the little things like this that bother me the most. And what is worse, is that I have no control over it when it happens. There are no warning signs. Just soiled underwear and skid marks. Luckily today I was wearing a feminine product because of my menses so my underwear didn’t get soiled. And that is the other thing that is frustrating me. That I am having to use feminine products because of my menses. I am beyond exasperated. I should not have to wear them but what choice do I have? It’s either that or really soil my underwear. I am just so frustrated by this. And no one understands, except another CES sufferer.

Why am I dealing with this? I should just be dead. To me that is the answer that I am looking for. I am tired of constantly dealing with a body that isn’t working anymore. I am tired of dealing with depression that makes my soul dark, that sucks the energy out of me. And that also goes for my body excretions as well. You have no idea how tiring it is to have a bowel movement sometimes. I feel like I am in labor. I sometimes am so weak afterwards that I need to rest. All because I can no move my movements because of the nerve damage. I literally have to push and push to get it all out. It is a very tiring process. And if this grosses you out, well, I am sorry. Every time this happens I want to kill myself. I just don’t think I can go on living this way. It’s just too much for me to bear. I am past my breaking point, well past it! I am so far from the edge that I still haven’t realized I am on standing on nothing. Yet gravity hasn’t knocked me down yet to kill me. Or maybe I am just falling in slow motion. I refuse to grab on to anything that might save me. I just am not good enough to go living anymore.