Tag: suicide ideation

late night, wicked tired

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

Late night, wicked tired

Last night, despite being tired, I was unable to sleep till almost 0230 in the morning. I had been up almost 24 hours. Hyde came out but I think I removed the damage he might have caused. Though, I haven’t gone through my Twitter account to see if he left any messages there. From what I remember, I went south, fast and furiously. I was suicidal but had no intent on going through with the thoughts. I was just too tired.

I sent an old blog post about body image to my therapist. I wish I didn’t. OMG she just did not shut up the whole session. I don’t remember what it was about, I just tuned her out. She just kept rattling on and on about Teflon shields. I was getting pissed. Then I called her a bitch, which she thought Jack did. She said I can’t be “hitting him” anymore. WTF does that mean?? I never hit anyone, unless it was my sister and I was pissed off at her, but that was when we were kids. Never in my adult life have I hit someone in anger. Maybe in joking around, but that is all. A slap on the hand or a slight punch on the arm, that sort of thing. But I don’t intentionally go around hitting people, for fuck’s sake. And Jack is not someone I can hit. He is too angry and might kill me. So what the hell she was talking about, I have no fucking clue. She also wanted me to talk back to my mother. Yea, that will happen when hell freezes over.

My mood just turned bleak and if I make one more typing error, I am done with this blog. I am so tired I can’t type. Sure I am fixing them, but the errors are making me angry at myself. No, this blog doesn’t have to be perfect but it drives me crazy to misspell something. But getting back to my mood, I am really down. I am going to either listen to the ball game tonight or watch it. I want to at least try and see if I can get into it. But with this sleep deprivation, I might not last. All ready I want to sleep. I went to my father’s and I was hoping to snooze on the bus but that didn’t happen. I did have coffee today, so that is helping me to keep toothpicks in my eyes.

I have decided that I am just going to eat protein bars today. I have NO energy to cook anything. If my mother makes something tonight, I will eat it. I think she is making pizza as I saw dough thawing on the kitchen counter. That will be good. Last night I overate. I had a cheeseburger and then some stuffed chicken. My stomach couldn’t handle all the food, which is part of the reason I stayed up so late. I felt so sick.

I told my therapist, again, that I am only going to be around for a few more months. She still has not read her goodbye letter because of the anxiety it is causing her. I understand that. I told her she could read my story. Maybe that might be better. As I think I mentioned to Twitter last night, I just am never going to be accepted by society as a male. Hell, not even my own mother can accept that. And that is why things must end. I am not going to live or start another decade living like this, though I really have no idea what “living” really means. My therapist also knows that I have a date though she doesn’t know the specifics and she is not going to. I am not changing my mind this time. I have to do this. I just have to die. I am tired of struggling all the time. I am a man of my word and this is what I have to do.

Last night I wrote my psychiatrist her note. It was exhausting, to say the least. How can you say goodbye to someone you have known for over 20 years. It was the most difficult thing I had to do. I expected it to be longer but I think a page and a half is good enough. I kept telling her to seek help after my death. I hope she does. I also hope my therapist does, too. There are a lot more support networks for clinicians who lose their clients to suicide. I also told my psychiatrist that she isn’t a failure. She tried more than anyone to keep me here. And thinking about leaving her is the hardest thing that I have to do but I need to stay the course with this plan. I don’t want to turn 40. I don’t want to write another book. I just want my ashes to be spread over Chelsea Creek.

Twenty-Three Years

by Midnight Demon, posted in Bipolar Disorder, depression, mental illness, suicidality

Twenty-three years

Today marks twenty-three years that I have sought help for my depression and self-destructiveness. I actually didn’t seek help straight out. My English teacher noticed I was upset and pulled me aside and saw the marks on my wrist that I had made the night before. She then told me to stay after class, something no teacher has ever told me to do before. She took me to the nurse’s office. We chatted. I told her about what happened at my house the last two nights and how much I just wanted to die. She called my mother, who then took me to the local counseling center. By then, I told them “nothing was wrong” and that I was “okay”. I declined treatment and went on with my day. Daily visits to the nurse’s office became more frequent. I just stopped in to check in and told her what was going on. She wanted me to see someone so the following week I agreed to see the school counselor. Thus started my official journey into psychotherapy.

It hasn’t been an easy road. For the first ten years, I had a different therapist nearly every year. I think the only time I had two years was with the psych resident that wanted to see me or I would still be in the hospital. I went through a lot with this psychiatrist in training. While in her care, I attempt suicide and ended up being in the hospital for two and half months. When she ended her residency, I went to another psych in training. He wasn’t as good as she was. In fact, he was terrible. I felt like he was more my brother than a therapist but when I told him I was procuring more medication to end my life, he asked me if I was suicidal. That is when I knew he was an idiot. I pretty much ended our relationship within a few weeks and saw someone else. She was good, had years experience. But after I had an argument with my sister and she wanted to know more about my sister’s social life than my anger, I ended things with her. I went about a month without seeing someone. I then decided to go back to my town’s local mental health center. I saw someone there for a year and again, she decided to move on after that year mark. We were finally connected and I felt so betrayed. I didn’t think I was going to see another person again. I don’t know what changed my mind. I knew I didn’t want to see someone else at the local mental health center. I wanted to see someone private. I figured they were less likely to leave their practice. And I luckily found my current therapist and we have been together for fourteen years. It is the longest relationship I have had, outside of my psychiatrist. I am lucky that I have had just one psychiatrist for my medication all these years. She does more than just prescribe my medication. She also does some therapy and is my sounding board for the various medical issues that I have. And I can’t wait to see her again in a week after not seeing her for four long months. It is going to be weird seeing her again.

I don’t know why I have stuck it out in therapy all these years, especially when things were at their worst. I have been beyond hopeless and yet my psych team (therapist and psychiatrist) always made me see another day, sometimes against my wishes.

Response paper for Building a therapeutic alliance with suicidal patients

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

Response paper for Building a therapeutic alliance with suicidal patients.

This book is a work of genius among the top suicidologists in the U.S. and Europe. These people actually want to help suicidal people get better and try to make their life worth living. Like most of Drs. David Jobes and Konrad Michal work, they have done an excellent review of the literature and made the book easy to read without a lot of psychological jargon. This book should be used as a handbook for anyone dealing with suicidal individuals. As someone who has been through many suicidal episodes with many different therapists, this book is groundbreaking. It lists his classic work of CAMS (collaborating and managing suicidality) which is a tried and true way of dealing with lethal suicidality in an outpatient setting. The other evidence based therapists will enhance therapy around this work.
The Chapters are broken down easy enough and progress from good to bad in my opinion, of the treatments that work. The conclusion was brilliant by Dr. Jobes. He has stated with clarity the hardships that are faced with suicidality such as the IRB approvals for research, clinicians wanting to work with this population, and the need to try and keep these people in therapy.

Three feet from the bureau

by Midnight Demon, posted in Chronic pain, chronic physical pain, depression, suicide attempt

Three feet from the bureau

In October of 2012, I was caught in another flare up. It was night time, well past business hours of doctors and therapists. Normally I am good at reaching out. I text my therapist. I write in my journal or blog to get through the episode. But this night was different. I snapped. I couldn’t bear any weight on my foot that night and it really made me feel like I couldn’t go on. I was so tired of feeling like an invalid. I wanted to die in an awful way. Problem was that I couldn’t get to my bureau three feet away to get the meds I needed to do me in. Any time I tried to move, I was in agony with horrible foot pain. I could barely move my foot out of the covers of my bed let alone stand long enough to shuffle to the bureau. I cried as there was nothing I could do but take what I had at my bedside. It wasn’t much but it was enough to make me unconscious and away to dreamland I went.

When I awoke the next morning, I was in a dreadful mood. I wondered if I had really done what I thought I did. I checked my pill box and it was empty. I checked the contents of my pain meds and it was close to empty. I couldn’t believe what I had done. But I survived it and am living to tell about it. How I woke up I don’t know. I felt ashamed of myself, not in surviving but of making an attempt and not seeking help. I had promised my doctors that if I felt like I did that night, I would call them. But no phone calls were made. I had a confidential suicide hotline to call but I didn’t. I had made suicide prevention part of my treatment plan but yet the crisis response plan went out the window that night. I didn’t implement any of it. I just took pill after pill until I passed out.

This scared me. I was no longer in pain yet who is to say that if this happened again I wouldn’t try to end my life again? Dealing with chronic pain is a beast. And so many times it doesn’t get a flag for suicide risk assessment. My better judgment wasn’t in gear that night. I not only wanted to end the pain, I wanted to end everything. I spend the next few days in a haze, and not from medication. I was scared to let my practitioners know what I had done. I finally broke down and told my therapist. It was very difficult admitting my attempt. I then told my psychiatrist and she shocked me by saying that if I wasn’t in pain, I wouldn’t have done what I did. And it’s true. Chronic pain changes you, not only physically but mentally as well. It took me a while to write about what I had done on my blog. After all three feet was the only thing stopping me from ending my life or attempting to. I’m still fearful about making another attempt while in the throws of another flare up. I keep a small portion of my meds by my bedside so they are not lethal. I was lucky I didn’t need medical intervention the next day. I still am not quite sure how many pills I took that night. And that also scares me because who is to say that the next time I won’t count them out.

Chronic pain is not something to underestimate. Hundreds try to end their life year after year because of physical pain. Most people see their doctors before an attempt is made. The question remains whether an assessment is made for either depression or suicidal thinking. My primary tries to assess my mental health but mostly just asks when my next appointment with my psychiatrist will be. It might be followed up by will I call him if I feel like taking an overdose of my pain medication. Yet he knows he is not the first person I will call. In my order of people to call: my psychiatrist, therapist, primary, then ER if I can’t get a hold of one of them.

That night, I didn’t call anyone. All of my safety plans went out of the window. All because I was overwhelmed by excruciating physical pain. I think if I could go back in time, I would have taken the time to breathe. And think more of self-preservation rather than self-destruction. I am more aware now of what to do but it’s not that easy when you are in the heat of the moment. A month ago I was again in excruciating pain for three days yet suicide was the furthest thing from my mind. I knew what to do to cope with the physical pain. And luckily that didn’t involve a bottle of pills. I felt the attack come on so treated my pain much earlier than I did in October. This helped to keep the suicide demons at bay. I texted my therapist, I emailed my primary that I was in excruciating pain. I also got in touch with my psychiatrist who help me to see there was a tomorrow. Doing these things didn’t make my physical pain hurt less but made my psychological pain bearable. It helped me to cope through this rough patch.

Being mindful about pain is how I get through bad flare ups. I have no control over these pain attacks. But I do have control over what I do with it. I learned my lesson from that October night.