Tag: psychological pain

still depressed

by Midnight Demon, posted in chronic physical pain

Had a productive day today. I worked on a paper and feel ok with it. My printer cooperated with printing it out so I can go over it for typos not picked up by spell-check (e.g., fro instead of for). I also added a little bit to it so I felt it was a complete paper.

Other than that I have been feeling off. I feel really sleepy since I woke up early in pain and then didn’t go back to sleep with the pain meds. The temperature has dropped so I am again hurting.

My therapist is back today. I was hoping for a time to talk with her but doesn’t look likely that she has an opening for today. I talk with her tomorrow. We have lots to talk about as I had some bad dreams last night about the bombings. I kept seeing the images of the shootout and the bomb going off at the finish line. I just couldn’t get the images out of my head. I guess that is why I woke up so early. Today we were supposed to have a minute of silence at 14:50 but I forgot to set my alarm so missed it. I hope that everyone affected ends up being ok. I still am on guard. Yesterday I saw a hummer and couldn’t help but think that there were armed guards inside. That is the type of week I have been going through, I am afraid to leave my house and go out. I haven’t been out since last night, to go for dinner with my family to celebrate my niece’s birthday.

I also have been afraid to leave the house because I don’t want to upset my ankle. I cannot believe that I still have tendonitis in it. I just want to scream.

This week is the annual conference for the American Association of Suicidology. I so wanted to go but didn’t have the financial means of getting there. I didn’t have a good experience last time I was there so it kind of foreboded me going this year. I hope to attend next year’s but I don’t think I will be able to as it is in California. I can’t wait for the conference to be back in Boston. I think it might be the year after this one, in 2015. Least I am hoping it will be.

I started reading a new book called the Team of Rivals. Part of the book is the base for the movie Lincoln. I had to buy it because I am such a Lincoln fanatic. I have a good library going on Lincoln. He is one of my favorite presidents.

Mood wise I have not been so great. Partly because of what happened last week and partly because I just was down, even though my Red Sox were doing good. I just feel out of sorts. I wish I could say my appetite has suffered but it hasn’t. Not that I am eating more, just not the right foods. I have been eating more junk food because I say why bother. I got to get back to my cereal diet. I need to lose at least fifteen to twenty pounds. That is my goal but it is so hard it depresses me. I then fall into the cycle and it just hurts. What is more depressing is that every time I see my PCP he brings my weight up. I can’t stand it and I am embarrassed by it. I hate being this heavy and I wish I had the will power to not eat junk food but when you don’t care for living, why care what you are eating?

Aeschi model and ramblings

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

Just woke up after a morning of pain. I decided to take my pain meds and go back to sleep. Like I figured, I woke up around 1400, which left me a half hour to shower and get dressed before the bus came. Well I did take a shower but going down the stairs to my sister’s apartment for coffee put a kink in me going out. I still plan on going out with my cane to Walgreens for some soda. I know I shouldn’t as I am trying to diet but I need something to drink other than water. I also need to get another bottle of water as I drank the one I had while watching the Sox game.

I am feeling energized by the coffee. I hope it doesn’t lead to a crash because I don’t want another nap today. I need to work on my writing today. I have been amiss doing so the past few weeks but now I think I know what to write about and I’ll just stick it in. I want to write about the Aeschi model for suicide and also how Dr. Jobes came into my life through his work. I really believe that if more clinicians took this approach to their clients or at least they had this approach in inpatient settings, there might be less suicides.

Aeschi model (pronounced Eshi) is a patient-oriented model, meaning that the patient has a say over treatment more than the clinician does. What has been found is that the provider-oriented model doesn’t work as patients can get frustrated over the “provider knows best” thinking. The Aeschi works toward a collaborative effort with the patient and provider working together to finding out what is at the heart of suicidality of the client.

Today I was at Starbucks taking notes on my Aeschi book. I was writing down what I had highlighted but there is too much information that I didn’t highlight that I needed to share so I gave up on it, for now. This book is so powerful that you really need time and energy not only to read it but to digest its contents.

The gist of it is to have the client be the person in charge of treatment and therapy, a novel idea when so many clinicians think they know it all better than the client and therefore take charge due do their discipline (CT, CBT, DBT, Etc.) I know that if my therapist had been in this category, I probably would not be here, or I would be seeing another therapist. I believe that if there is a collaborative effort of the therapist and client, there will be a higher success rate than if the therapist has the one track mind of he/she knows best. But the nice thing is that the Aeschi model doesn’t have to focus on one discipline. It can work for social workers, psychologists, psychiatrists, mental health workers, etc. It just takes a little courage to step out of the normal boundaries and put the client first. To let the client tell their story without being judgmental or critical.

After the client tells their story, there is an openness that can be trusted. Once the client has a sympathetic and empathic ear that is open to whatever the client is saying, the real journey begins.

This model is the new age of what therapy should be about. I know that if I didn’t develop a relationship with my therapist, I probably wouldn’t be here.

On another note: I did go out today and wasn’t in too much pain. I was able to walk a block with my AFO on. Now I don’t know if the brace is what calmed the pain down or if my ankle is finally calming down. I had a wicked bad night last night. Ice and pain meds were just not working for me. Usually ice helps but this time it didn’t. I am going to try again tonight. I have my foot elevated on a foam block. Best $60 I ever spent for a foam device. It really helps my back and legs.

A remembrance of the past

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

I read a blog today that really hit home and made me think. It was about a person that wrote about her experience of attempting suicide eight years ago this month. I also have an attempt anniversary this month, actually in a few days time it will be 21 years ago that I first attempted suicide with diphenhydramine, also known as Benedryl. I remember that it was a month after my then therapist told me she was leaving. I thought fine, so will I. I planned my death on a day I knew my family would not be home and took the pills. What I didn’t account for was puking, violently. If I hadn’t, I probably wouldn’t be here today. I still remember my eyes being dilated for almost a week afterwards. I was pretty mad and I felt like a failure, a huge one. Probably the biggest one on the planet at that point. Here I was, a very intelligent teenager who couldn’t kill himself right. I sunk into the worse depression after that. Actually, I had no idea I could sink worse than what I already felt but I did. I began losing weight, lost my appetite almost completely. I was sixteen years old and all I thought about was death. I was not sleeping. I would wake up at four in the morning nearly every day and couldn’t go back to sleep. I would wake up dreading the world, not wanting to go to my summer job but I had to. I couldn’t show that I was depressed. My mother had already freaked out when she found out I had overdosed thanks to the said therapist who told her after I told her what I had done. I didn’t know what to do. I think after several weeks of this and it just getting worse and worse I called Samaritans and talked with them about my situation. The person told me that I should be in the hospital and I contemplated that. I waited a few more days to see if things would get better and when I couldn’t take anymore, I told my mother I needed help. She took me to the hospital and I got diagnosed as major depression with psychotic features. Up until then, I had dreams of joining the navy. Those dreams died in the hospital emergency room when they told me I was psychotic because the voices in my head wouldn’t shut up. I actually felt free to talk with them for the first time in my life. My mother didn’t like that as it appeared that I was crazy. Well I was…

I got to the hospital and got sent to a local psych ward that was NOT for teens. I then got transferred to a better psych hospital the next day. I would have two more admissions there before I had a break. So my cycle of being in and out of the hospital began. I had three admissions all within a year. I blamed my next therapist for this as if she was doing her job, I wouldn’t be so sick. This is the therapist that I saw after the other one had left. I have seen many therapists in my lifetime, too many in fact. Before I turned twenty-five, I would have eleven therapists. Some therapists only saw me for ten months, others were year and a little over. I never had continuity in my care so I always remained unstable. Surprisingly, the only stable therapeutic relationship I have had was with my psychiatrist, whom I have been with since I was seventeen. I wished so badly at times that I could see her for therapy but she only does medication.

And here I am twenty odd years later and I still want to end my life. How sad is that…

vocabulary of suicide

by Midnight Demon, posted in suicide, suicide attempt

Suicidal words

Hopelessness, psychache, lethality, perceived burdensomeness, thwarted belongingness, press, perturbation, fearlessness and competence.

These words encompass suicidality. It has been shown that most of the people that are suicidal feel this way and then act on the pressure of these feelings and commit and act of suicide. When someone feels all of these at once, it is a terrible feeling. Some people might only feel a few of these things and still be suicidal. Some people will feel these things and just be depressed.

Hopelessness, the feeling of being lost in hope, that nothing is ever going to change, that things will always be the same no matter what.

Psychache is defined as despair, anguish, hopelessness, guilt, worthlessness, and psychological pain one feels. It is like pain in the heart that no one else can feel. Your heart feels heavy and you feel like a burden because of it. Nothing soothes this pain. No medication can touch it. And suicide seems like the only answer for this type of pain and anguish.

Lethality, the degree to which someone is at risk for suicide. Whether it be a loaded gun or a few bottle of pills or some cuts on the wrist. This is what determines how suicidal a person is and how they are going to act. If the risk is high and eminent, involuntary hospitalization is called for. If the risk is low, then more contact is need and assessment at every visit.

Perceived burdensomeness, the idea that you are a burden to those around you but in reality you are not,

Thwarted belongingness, the idea that you don’t belong anywhere and feel the need to belong somewhere. It is a very awkward and lonely place that hurts very badly. Everyone wants to feel like they belong somewhere or to something and when that need is not met, they feel detached and alone.

Press, similar to stress. It is as if the building of the press is similar to the pressure of a volcano ready to explode. It can lead to further perturbation and make things worse.

Perturbation, the need to feel or do something to ease the pressure and anguish and despair they are feeling and to feel better. It can lead to want to do something but the idea is that you need to do something to relieve the pressure of the feelings on your chest.

Fearlessness, the absence of fear. In this regard, it means that people may be fearless when trying to take their life, like a type of Russian roulette.

Competence, the meaning is the level of competence to carry out the means for their suicidal plan. Examples include rope for hanging, gun handling and shooting, knowledge of drugs, etc. High competency is a high risk factor.

All these elements can lead to a suicidal crisis. It is imperative that these elements be asked about on a consistent basis. Talking about the pressures of work or home life is important. If someone is saying they are a burden and wish they were dead is a huge tip off that something is going on and the elements I have just described are in full play. All of the elements depending on their degree, is an important indicator of how suicidal a person is. Merely asking about being suicidal is NOT enough as most suicidal individuals fear hospitalization or a thwarting of their plans and therefore will not be honest about their intention to commit suicide.

copyrighted 2013, Collerone, G