Tag: psychological pain

another month of existing

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

Another month of existing

Despite being suicidal for almost 16 days straight, I lived to tell the tale. I honestly don’t know what gets me through the hardest of moments when I am in so much pain and all I can think about is death. I think fantasizing my death has gotten me through, only because I was so immobilized by pain, I couldn’t act on my thoughts. Then the next day, the pain was down and I didn’t feel so terrible. I didn’t feel like ending my life.

Sometime in the beginning of September or the end of August, I thought that if I had 41 consecutive days of suicidal thoughts, that on day 42 I would end my life. If by some chance, I had a day that I didn’t think those thoughts, I would have to start all over. I kept a spreadsheet of the days. Some nights when I was in pure agony, I would bargain with myself saying just x many days more and then I would end it. I kept these thoughts pretty much to myself. I had texted my therapist this plan but we never talked about it. I don’t remember if I let my psych know either.

I don’t know what really changed that stopped the suicidal feelings from occurring. I still had pain every day and night. But after my PT evaluation, I felt like things could be better. I was sad that the days of me working were truly over because too much time had past for me to recover. I was diagnosed too late with CRPS, Complex Regional Pain Syndrome. Now I just want to be able to make pancakes without having to take breaks in between the prep, the mixing, and the cooking. Small stuff but it would be a goal. I left the PT office feeling a little hopeful that things might change for the better. It didn’t take away my suicidal feelings completely. I still thought about ending my life, but there was no urgency to it. I just put it in the back of my head.

Suicidal thoughts have become so much apart of my life that I can’t imagine my life without it. Will I my life end one day at my own hands? I don’t know. I think so and have felt that way for quite some time. Little things stop me. My nieces or nephew’s love and care. A friend online that needs me. Having a low pain day so I could get out of the house to have my espresso at Starbucks. Being able to shower, make breakfast, and then go out to do what I have to do. It doesn’t happen every day as some days I can barely get out of bed, either because of pain or my mood. Sometimes both. Sometimes a good word from my therapist or psychiatrist is enough to lift the heavy coat to make it through the day. I honestly didn’t think I was going to make it through September without making a suicide attempt. But I did.

Tomorrow starts a new month, with the same challenges. Hell, I have appts all this week with no rest days at all. It’s going to be hard. I hope it doesn’t set me off in a flare for days on end. The weather is also going to be cooler. If it remains stable, I should be okay. If it fluctuates more than 10 or more degrees, I am going to hurt more than any activity that I do. I have a lot of appts this month. I don’t know how that is going to make me feel, physically and mentally. Dealing with chronic pain every day is difficult to say the least. I have mixed feelings about this month. I hope that I survive and I hope that I die. We’ll see if I make it to Oct 31st.

hot day, therapy, and other things

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

Hot day, therapy, and other things

I woke up around 0630 in pain. I took some meds and then checked my bank account to see if my check was deposited. It was so I paid some bills and reordered my grocery as I had to cancel the order because of my PT appt yesterday. I just ordered the bare minimum because PeaPod hasn’t yet credited my acct and I didn’t want to spend that much. I’ll just buy what I need at the grocery store if I’m up to it. I might do another order for the stuff I didn’t get but I am hesitant because I want to make sure I have enough money for changing my name in two weeks.

After I paid my bills, I set my alarm and went back to sleep. My mother called me around noon, before my alarm went off. She wanted to know where I was and what I was doing. I’m 41 and still get asked this, every single day! It’s annoying but there is nothing I can do about it. My alarm went off and I didn’t want to get out of bed. I forced myself to and went downstairs to brush my teeth and get ready to go out. My aunt was over again so I exchanged pleasantries. On the way back up to my room, my ankle went out. Not a good sign. Luckily, it wasn’t painful. I limped back up to my room and then took more pain meds. I got dressed and then left the house.

There was construction on the sidewalk. A big machine was blocking my view of the street to see if the bus was coming. Luckily, I got up in time to check and it was coming. When I got on the bus, I ordered my Starbucks and something to eat. I had timed it right for my therapy appt as I only had about a half hour to write in my journal, which kind of sucked. I went to the train station and it was hot as an oven and by the time I got to my therapist’s office, I was sweating. I wished I had brought a facecloth to wipe off the sweat but I wasn’t thinking.

Therapy went well. I thanked him for rescheduling the appt. We talked about what went on yesterday with PT and that I am starting with a PT specialized in CRPS. Then we talked about my father and my suicidality. Yesterday was the first day in about 16 days straight that I didn’t think of wanting to kill myself. We talked about that for a while. Then we talked some more about my father and his death. It was a good session.

I went back to the Square to wait for the bus home. It was late. I was really sweating by the time I reached home. I had to go to Walgreens to pick up my meds. On the way in, I saw one of the pharm tech girls with her dog. It was cute. I think it was a bulldog, my favorite kind of breed, well one of many. She was walking down the street with him the way I had to go. I almost caught up to her when she reached my house but she wasn’t paying attention so I just let her keep walking. My t-shirt was soaked and it was hot in my room. I put the AC on before I dried off and peeled off my shirt. I waited till I cooled down before I put on another shirt. Then I ordered food as my mother didn’t cook anything. She just reheated some soup from the other night.

My therapist said that I needed to do some “fun shit”. I said I don’t have much things that I do. If I make it to Starbucks for the day, then it’s a good day. He said that I should work on doing that more often. I was kind of stunned because I thought he wanted something more but going to Starbucks does make me happy, if for a little while. I need my espresso fix as they no longer have any Clover coffees that I like. I can’t remember the last time I had coffee at Starbucks. I do make it at home as I don’t have an espresso machine. I will never get one of those because I may never leave the house again.

My Thoughts on Zero Suicide as a Person with Lived Experience

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

My thoughts about Zero Suicide as a person with Lived Experience

There has been a lot of talk on Twitter about Zero Suicide and it’s mission to reduce the suicide rate to zero, because 1 is just too many. At first, I was appalled that clinicians think that is possible. I for one think that it is outrageous because there is always going to be someone who dies by suicide. Maybe not in their organization but outside their organization. But then I learned that it’s not an individual’s practice but an organization or health system that strives to achieve this goal. They have trainings and meeting with those in the suicidology world.

Something kept bugging me about this. I kept quiet because I didn’t want to anger those that are for it, though I think there are a few blogs that I wrote about it before I understood the mission. While talking to a friend that is a suicide loss survivor, the bells went off. She said that it goes against Shneidman’s questions, where do you hurt and how can I help?

I am a big supporter of Dr. David Jobes work with his framework called CAMS (Collaborating, Assessment, and Management of Suicidality). I don’t know if Dr. Jobes trains these Zero Suicide clinicians. And even if they are trained, I am not sure it will be used. Most clinicians have the attitude that their skills on suicide risk are good enough when it could be faulty. Worse, they go through the training yet don’t use what they are taught. That drives me up the wall. Why bother going to a training (unless it’s a mandatory thing) if you aren’t going to take away from it?

I really think CAMS is a tried and true framework to prevent suicide based on my experience of using it in my former therapy. I also used the Suicide Status Form. Unfortunately, my therapist did not want training in CAMS and we drifted apart, thus ending our relationship. We did, while we worked together, use the initial and tracking forms but unfortunately, we never got to the outcome form. She wasn’t committed enough to see it through and that kind of pissed me off. Every time I had a suicidal episode, she just wanted to know one question on the form, The one thing that would help me no longer feel suicidal. It is an open ended statement where the client fills in their thoughts on the matter. Unfortunately, I could never come up with a satisfactory answer as I really didn’t know the reason for my suicidality. I just wanted to die and that was that. I wrote a blog about CAMS if you would like more information about how it is formed and the use of the Suicide Status Form.

I went on the website for Zero Suicide but could not seem to find the specific training that they went through. From what I gathered on Twitter from their live tweets, some of it is CAMS and some of it is using risk factors for suicide. Unfortunately, risk factors alone are not predictive of a suicide attempt. CBT has been useful in reducing suicide attempts but not all clinicians are trained in this modality. The book by Craig Bryan on CBT for preventing suicide attempts is a good book to learn more about it. I also wrote a review on the book that you can see here.
The other thing that gets me is that no where among Zero Suicide is there talk of a person’s psychological pain. There are measures, if you look for it. Dr. Holden at Queen University in Canada has created a scale to measure what Dr. Shneidman calls psychache. See my review on the research article for more information. I think it is a good psychometric to gauge a person’s level of suicidality and pain, which ultimately leads to thoughts of suicide. This must be included in any talk of preventing or intervention of suicide and also postvention, should a suicide attempt occur.

My final thoughts of Zero Suicide is that it is a novel idea but as Dr. Shneidman says, “How many suicides do you want, and I say I don’t want any, but I want there to be the freedom to do it. I study suicide but I am not pro-suicide. I’m for suicide prevention.” I share his sentiments. I do not like the talk of “suicide is not an option”. To me, that is hindering free will. I do hope the rate of suicides goes down, but the way that health care and mental health are going, I think there will be more before it lowers, especially among the chronic pain patient population.

same shit different cold bleak day

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

Same shit different cold bleak day

I woke up around 6 and didn’t feel well. My back and ankle were hurting pretty bad. I took some meds and played with my phone. It was too early to go anywhere and I didn’t want to spend all day at Starbucks. My psych had moved the appt up to noon. It was raining out and windy. Jose was blearing. I went to lie down for a few hours before I had to catch the bus. That is when my back gave out and I just said fuck it, I’m not leaving the house. I emailed my psych and canceled the appt.

I’ve been sleeping on and off all day. My mother called around supper time but she made something I didn’t like and then got mad that I wasn’t going to eat it. Whatever. I didn’t want to move. I hadn’t eaten anything all day. I really wasn’t hungry. My mood was in the abyss and I didn’t care if it stayed there or not. I thought about killing myself at least a hundred times. Thing was, I couldn’t move too good with my back hurting so trying to end it today just wasn’t going to happen. That just made me more depressed.

I must have chewed the inside of my cheek while sleeping because it’s really sore. I’m feeling kind of irritable. My mood just sucks. I feel like I am on a lethal path. I just want to sleep.