Tag: suicide attempt

Rant continues from last night, but no suicidality

by Midnight Demon, posted in chronic physical pain, depression, mood disorders, suicidality

Rant continues from last night, but no suicidality

I didn’t fall asleep until around 0300, woke up around 0630, and then finally at 0930 I gave up. It was a really bad night with side effects and pain. My arms and legs felt like they were being stretched. The spasticity was incredible. But luckily the Ativan did its magic and I got some relief. Too bad it also didn’t knock me out. The ball game ended around 0230. I figured I might as well listen to the game as I was up and they were playing extra innings in an already delayed game. We lost because an ineffective relief pitcher likes to give up homeruns. Every single time this guy is up, he gives up a homerun. Soon as he was called in with two men on you knew the game was over. I got pissed off but what can you do really. I sent some obnoxious tweets about the game, least I think I did. I was tweeting most of the night, either on my phone or on my computer.

Had therapy today and my therapist was in more of a talking mood than I was. I couldn’t get a word in edgewise. That really pissed me off. I wanted to talk about stuff, like my suicidality going on hiatus, but never really got the chance. Last night is usually a night where the demons come out and I become really suicidal but I never did. I don’t know why that is. It is strange to me. I am not saying I would have ended my life last night, but I am just wondering where the suicidality went. It was like the furthest thing from my mind. Maybe my coping strategies have improved around my physical pain. I certainly wasn’t feeling psychache, or psychological pain, last night, not even in the wee hours of the morning. I wasn’t hopeless about my situation and I think that is a key component. If I felt like the spasticity was going to go on forever or that the physical pain was unbearable, I think I might have become suicidal.

I told my therapist it is weird not being suicidal. She went off with her psychobabble about why that is. I don’t even remember half of what she said. I wasn’t really paying attention to her. But the gist is she thinks that the Cymbalta gave me a lift that neither one of us was expecting. She thinks I might be a little hypomanic as I texted her more frequently than I have in the past but that was because I was hurting and wanted her to know. I wanted someone to know that I was in bad shape. Who else you gonna tell at 0200?? I don’t think that I am hypomanic. I am eating. I am not euphoric or in a real good mood. I still feel run down but that is probably because my allergies are killing me. I feel okay. I am not terribly depressed and I am not terribly feeling up. I am just somewhere in the middle. I feel content, I guess you can say. I just hope it lasts. I know it won’t though. Something always happens to bring me down. Or maybe the effects of the Cymbalta will wear off and I will just feel down again. But I will deal with it when it comes. It is rare that I feel this way. I am not hopeful that things will stay this way but I am not going to knock it.

Feeling suicidal has been a such a big part of my life that when I am not feeling it, it feels weird. I wonder if this is how “normal” people feel. I just don’t feel so dragged down by stuff. I don’t know, maybe I just feel free but free from what, I don’t know. I am realizing that my parents don’t know me and never will. And being suicidal because I didn’t have their approval hurt really bad. But I will never have their approval. A friend of mine sent me a link saying that Medicare is banning transgender reassignment surgery. I feel really down about this, not saying that I was going to have it, but I would have liked the option now that I am on Medicare. Seems like I have to put my transgender stuff on hold, again. I can never move forward with it like I want to. I should be in a suicidal crisis because of this but I am not. I think I am just waiting for my chance to die. The other day as I was crossing the street, a semi was coming down the road. I quickly thought, “this is my chance”. But he wasn’t going fast enough. I knew that if I did jump in front I would have survived. And I might be in worst condition than I am now. So some suicidal elements are present. It just isn’t 24/7 like it used to be.

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.

Swedish study

by Midnight Demon, posted in chronic physical pain, depression

I just read about a Swedish study that said that depression and psychiatric conditions are major factors to suicide. DUH. But what was startling me more was that of the 18 suicide deaths in their study, all were diagnosed within a 13 week period, were seen by a health care professional (HCP), and my biggest question was WHY the hell weren’t they treated with follow up?? Other factors were being male, unemployed, and unmarried. Geez, I fit those criteria. So why am I not dead by suicide?? I am perplexed. Granted it has been more than 13 weeks since I was diagnosed with depression. But I do have the other factors. I have a spine condition, chronic pain, and other psychiatric disorder (I also suffer from psychosis). Why am I still alive?? I just don’t understand it. Now wonder why I am chronically suicidal. It all makes sense to me now. I am suicidal because statistically, I should be dead. I don’t think there will ever be a day when I am not suicidal.

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.