Tag: schizoaffective disorder

in a very depressed mood

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

In a very depressed mood

Pain has been with me for most of the day. I tried to nap and then my ankle was like “no, you can’t.” I got tired from my night meds and tried to sleep and the same thing happened. I just took some Neurontin, hoping it knocks out some of the nerve pain that I am feeling. My teeth hurt, the whole top so I am not sure if I should see a dentist or a doctor. It could be sinuses as I have been stuffy the past few weeks due to allergies. I am so frustrated that I am having yet another pain in my body.

As I was lying there pondering if I should just lay in bed or take yet more medication, I started to think about ending my life in a couple of weeks. I have the plan. I have the meds. I just need a solid date to play it all out. I want out of this world. I don’t see the good in it and I don’t feel so great about it.

I was going through my blogs. I do this from time to time. I came across one that was very depressing as I was talking about my transgender issues and how people see me. It’s bothering me more and more. I don’t have the energy to correct people anymore. I just let it go.

Apparently sitting up decreases my pain but I can’t sleep sitting up so I am fucking screwed. I hate being in pain. It’s driving the suicidal buttons to a new level. I emailed my neurologist about a TENS unit to see if that would help. She wrote back this morning and said it could help. There is a 50% chance. I don’t like those odds, especially as the device is expensive. I’ll put it on my back burner though and see how it goes.

I just can’t get out of this pain cycle that I am in. Today is really hot. I am glad I have the AC cranking. I had to put a long sleeved shirt on because I got kind of cold. I am wearing a tank top. I just had my lunch and my mother will be making spaghetti soon. I am getting hungry, even though I just ate. I didn’t eat anything all day as I woke up late. I really want a damn burger so tomorrow after my psych appointment I am going to get some.

I am feeling really depressed, like I can’t cope anymore. Everything is either pissing me off or depressing me. I know it’s the pain. Always the pain. I just can’t get away from it. It’s will me all the time, in one form or another. I was thinking of increasing the Zoloft but why bother. I just had an increase a few months ago. It helped for a while and now I am back to being depressed. Seems I always need a higher dose and then I am maxed out. The meds stop working for me. I should just end my life and be done with it.

I heard another musician died by suicide. I don’t know him as I never heard the group Soundgarden. One of my friends went off about suicide not being the answer, ever. If she only knew of the pain that I deal with on a daily basis. This is worse than a cancer patient’s pain. Least they will have an end. I don’t have an end unless I make one.

My mother jibed at me again today, because I was wearing a long sleeved shirt. It’s 90 degrees or more in the house and she asked if I was cold in her condescending tone. I just walked away. I don’t even think I answered her. I was tired of taking it off when going downstairs. I don’t know why she always has to give me a hard time on the way I dress, like I am a little kid.

I feel like life is unbearable right now. I just am so underground. There is no daylight. My heart is heavy and my ankle is throbbing again. I get no relief whatsoever. Death is all I think about these days. It makes me happy knowing I have a way out of this damned misery. One day I will end my pain. One day. And soon.

don’t call me daughter 3

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

Don’t call me daughter 3

Warning I am very tired so this might be a little ragged and out of sorts…

I’m having withdrawal symptoms because I forgot to take my pain meds before therapy. I usually take it when I reach his office because it’s around the time I usually take it. Idiot I am. Anyways, I came to a realization after therapy that got me thinking of the title of this blog.

We were talking and he absentmindedly called me a she instead of a he. I guess my reaction was unconscious because he quickly corrected himself. I realized after therapy as I was walking to the station why my mother had upset me so much yesterday and that was because she called me “daughter”. Any female pronouns or use of the word “daughter” will set off a suicidal cascade, which we talked about in therapy. Well, not so much about being the wrong gender but the fact she called me a lazy bastard on Mother’s day.

We spent some time talking about it. He wanted to know my plan because he got the sense I was suicidal. Sometimes I am without me knowing about it because it’s second nature to me. When he miscued and called me a she instead of a he, I really felt degraded. I have been thinking about talking about transgender with him the last 24 hours and I just didn’t bring it up today because the whole Mother’s day incident really had me upset.

I didn’t talk about the nerve pain that sent me over the edge over the weekend and that I was feeling while in his office. I had a bowel movement and it hurt really bad. It wasn’t a crime scene like it was the other day but I was still bleeding a lot. I am going to have to see my doc about what I can do because the pain is so damn bad. He is too new to talk to about this stuff. I wish I could just send him my blogs but he wants me to read them to him. I don’t like reading what I write up, unless it’s a clinical paper or something.

I really need to talk about the transgender piece because it drives me to suicide whenever my mother calls me a “Miss” or “my dear” in her condescending tone that she uses. I just feel so misunderstood about who I am though I know I am a male but to the world I am a fucking female because of the fucking things on my chest.

diets and other things

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

Diets and other things

I had a hard time sleeping because of pain and the voices. The voices started up around 1800 last night and they were telling me people were out to get me, they hated me, and were trying to steal my thoughts. I became really anxious so I called my psych, who told me to take some Ativan. I had taken a strong pain pill and I think that is why my sleep was disrupted. My psych wanted me to call her today.

I didn’t stick to my diet today. I just ate what I wanted. I wasn’t planning on going out today but I wanted a burrito so I went to the Square and got one. Then I went to Starbucks to eat it and have my espresso and write a little bit. I tried writing for about a half hour with my new pen. It was a fine point and wrote smooth. I liked it but I prefer my medium point. I saw my bus go by and checked my watch. The next bus was coming so I left to go to the bus stop.

I went to Walgreens for my mother and they still didn’t have what she wanted so I got a raincheck for the item. I got some instant pasta so I could have it for supper. My mother called me to say she was making spaghetti. I will just have the pasta tomorrow. I hate skipping my diet but I wanted real food. Just having liquid protein is tough. I made it through yesterday okay but I was starving when I woke up at 0230 this morning. I had another Ensure and tried to go back to sleep.

I was on Twitter for most of the day. I saw that the Star Trek Twitter had posted a game from Think Geek. It’s a Monopoly game with a Klingon theme. I want it really bad! I think it will be fun to play with my nieces and nephew. I will get it when my check comes in next.

My ankle is still fucking hurting really bad. I am tempted to take another strong pain pill as I can’t take my regular meds for the next couple of hours. I took Neurontin this morning to keep the burning away. I feel groggy from it and the espresso helped but I am feeling really sleepy now that I am home. My psych called me back and I told her about the stressors that contributed to my psychosis yesterday. I would write about it but I am being watched so I can’t talk about it.

I didn’t have any sweets today though I really wanted to get a donut at Starbucks. I am trying to lay off junk food and sweets. It’s hard because I like those things.

I caved in and took a strong pain pill. I couldn’t help it. The pain is getting worse and I am going nuts from it. My suicidality is increasing because of it. I figure if I stop the pain, the suicidality will go down. I just want to end my life anyway, just for the hell of it. Just try it and see what happens. I die, I die. If I live, I live. I don’t fricken care. I just want to get the devil out of my system.

I think tomorrow, if I am not hungover or in really bad pain, I will change my sheets. The sheets I have on now keep coming off the bed, which is annoying me. The stupid foam topper keeps shifting and I don’t know why, which takes the sheet with it. I have had to adjust the thing every other day and I am getting tired of it!

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