Tag: suicide

venting ramble

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

Ankle has been bothering me all fucking day. Seems every time I am close to getting to sleep, it flares up angrily, like I wanted to use it or something. Or maybe it’s mad that I am resting it. I don’t know. It just hurts and I don’t know why. I never know why. Three years and no one has been able to tell me why. They think it’s this, that, but it doesn’t change the treatment or course. I think it is a little bit of complex regional pain syndrome. It has to be some kind of pain syndrome as I do have pain and swelling. I can’t walk as far as I used to because of pain. It just sucks.

I need to go out tomorrow to my father’s. His weekly visit. I wish I could stop doing this every week but out of obligation, I do it.

In addition to this lovely irritable mood that I have been in, I think I am getting my menses. Just what I fucking need to start off the New Year. It makes me depressed and pissed off. I guess that is why I gained so much weight. It’s probably all from feeling bloated. I hate being in this body so fucking much. Another year to remind me I am in the wrong body. It totally messes with my head and how I feel.

I wish I could just spontaneously combust so I wouldn’t have to think about killing myself. Of course, planning your death isn’t the same as going through with it. I plan and plan yet I am still fucking here. A 22 year-old died the other day while swimming. Just like that he was gone. Why couldn’t that happen to me? Why must I fucking live this life I so don’t want to live? I wish I didn’t have the SSD review hanging over my head. I just don’t know if I am disabled “enough” to meet their requirements. I still don’t know if I got it based on my physical and/or mental disability. I wish I knew so I could fill in the right doctors for their consents and stuff. I just hate waiting. And I also worry that I will have to see their doctor. That will fucking suck. And I am in so much pain more at night than during the day. The depression is year round so I don’t have to worry about that. I just worry that I will be denied and then I will be screwed financially.

I wish my therapist were here. I so need to talk to her. I have been texting her but I never get a response. Of course, she is out of office so why would she respond? Nothing I have been texting her needs a response anyways. I think this is the first time that I haven’t thought about leaving her. Usually, I always plan my escape when she is on vacation. It’s my way of getting away from her permanently. But she never usually allows a cancellation. And if I do need to cancel, she wants to make up that time.

I haven’t seen my psychiatrist in a month. She had her hip replaced the beginning of December. I am scheduled to see her next Friday. It will be good to see her again. I miss her, too. We have been emailing each other. She does respond and she tells me she is doing well. It’s kind of sad that when I see her next, I will be the one with the cane. I still can’t trust my leg. I don’t know how much of it is mental at this point. I just know there is a security there and I need that. Plus, my leg doesn’t hurt as much if I have that extra support. Wish I could say the same for my ankle.

I read a horribly written blog yesterday. It was by one of my BPD chat friends. There were a ton of run on sentences. And the grammar was just horrible. I want to say something but I don’t want to offend her. I am not close to her so I am not sure she will accept criticism well.

I cannot believe that I have done nothing but lie in bed all day and my ankle is screaming at me. I so want to tell it off, like what the hell are you hurting for when I didn’t do anything to hurt you. I didn’t overuse it. I didn’t go up and down stairs a million times. What the fuck gives??

Because I was a lazy bastard, I have to return a calendar I bought from Amazon. It was way bigger than I thought it would be. I should have known that a 12×17 wouldn’t fit on my wall. It would but I would have to move it over and put another nail in the wall. Too much effort for a lazy person when I don’t need that big of a calendar to begin with. I am an idiot. I was too lazy to get up to see the SKU for the calendar I do have. Now I have to go to Harvard to go to my favorite stationary store to get the calendar I need, which is what I should have done to begin with. I thought Amazon would get me what I needed and now it didn’t. I am a lazy bastard.

Shneidman’s Psychache Theory

by Midnight Demon, posted in Bipolar Disorder, blogging, depression, mental disorders, mental illness, mood disorders, psychache, suicidality, suicide, writing

“From the view of psychological factors in suicide, the key element in every case is psychological pain; psychache. All affective states (such as rage, hostility, depression, shame, guilt, affectiveness, hopelessness, etc.) are relevant to suicide only as they relate to unbearable psychological pain. If, for example, feeling guilty or depressed or having a bad conscience or an overwhelming unconscious rage makes one suicidal, it does so because it is painful. No psychache, no suicide”. Edwin Shneidman, Suicide as Psychache p56

 

Psychache is the unbearable guilt, despair, hopelessness, shame, pain, depression, and press one feels when thinking about suicide. It is the corner stone of what this paper is about. The pain of the mind can cause constriction, a narrowing of view of things. It can also lead to perturbation (an unrest that causes one to feel like doing something to alleviate the uneasiness one feels) and also to press, which is also known as stress or the pressure and weight one feels under. The combination of these three things, press, perturbation, and psychache is what is known as the cubic model of suicide.

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The cubic model of suicide is a 1-5 rating of the three things I just mentioned. The higher the rating, the higher the likelihood of suicide. The worst rating is a 5-5-5 scenario and suicide will be imminent. It is important to rate these items when dealing with a suicidal person. It will validate what they are feeling and make them feel at ease in talking about what is causing them to feel so pressured and hurt to make them think of killing themselves.

When dealing with constriction, the dichotomous thinking that a) suicide is the only way out or b) things are always going to stay the same, it is important to always bring in more options to the person so they can see things differently. In his book Suicide as Psychache, Shneidman gives the example of a young pregnant woman who was thinking of killing herself with a handgun. She couldn’t have the baby so therefore in her mind, suicide was the only way out. After discussing several options with her (calling her parents, having the baby and giving it up for adoption, discussing the situation with the baby’s father, etc.), it was agreed that the woman would call the baby’s father. Suicide was no longer the number one item on the list. To prevent a mishap, Shneidman did take the gun away from the woman. An excellent example about means restriction.

In almost every suicidal thinking, there is some measure of lethality and perturbation. You can have high lethality and high perturbation, but you don’t always have high perturbation with high lethality. Perturbation, as described above, is very much like anxiety. It is a perturbed feeling that causes one to feel pressured to do something. Lethality is the doing something.

Also in every case of suicidal thinking is the frustrated needs that bring about the suicidal feelings.

ABATEMENT The need to submit passively; to belittle oneself

ACHIEVEMENT To accomplish something difficult; to overcome

AFFILIATION To adhere to a friend or group; to affiliate

AGGRESSION To overcome opposition forcefully; fight, attack

AUTONOMY To be independent and free; to shake off restraint

COUNTERACTION To make up for loss by retrieving; get even

DEFENDANCE To vindicate the self against criticism or blame

DEFERENCE To admire and support, praise emulate a superior

DOMINANCE To control, influence, and direct others; dominate

EXHIBITION To excite, fascinate, amuse, entertain others

HARMAVOIDANCE To avoid pain, injury, illness, and death

INVIOLACY To protect the self and one’s psychological space

NURTURANCE To feed, help console, protect, nurture another

ORDER To achieve organization and order among things and ideas

PLAY To act for fun; to seek pleasure for its own sake

REJECTION To exclude, banish, jilt, or expel another person

SENTIENCE To seek sensuous, creature-comfort experience

SHAME-AVOIDANCE To avoid humiliation and embarrassment

SUCCORANCE To have one’s needs gratified; to be loved

UNDERSTANDING To know answers; to know the hows and whys

These twenty needs are what Shneidman has called the essential ones when people are suicidal. Most of them are not all twenty but five or six as it pertains to the individual. “The prevention of suicide with a highly lethal person is then primarily a matter of addressing and partially alleviating those frustrated psychological needs that are driving that person to suicide. The rule is simple. Mollify the psychache”. (p53) Shneidman believed that these frustrated needs are what caused psychache.

I believe there should be another need, validation. Everyone needs to be validated in order to feel secure and feel okay. Without this, most people feel shamed and dumb, that what they are feeling or experiencing has no meaning or purpose. They may also feel empty and alone as no one understands what they are going through. This need when frustrated or thwarted can lead to suicide.

Shneidman, Edwin. Suicide as Psychache. 1993. Jason Aronson, Inc.

Recovery…what does it mean?

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

Recovery…what does it mean?

I keep hearing people talk about recovery and I am at a loss. Can someone enlighten me on what the hell it is? And what exactly are you recovering from?

I hear from suicide attempt survivors all the time this word. Do people who think about suicide really recover after they attempt? Because I keep wanting to try again and again. I haven’t made an attempt in years but I think about suicide constantly. Or is recovery just something that happens after you learn different coping mechanisms?

The reason I do a lot of suicide research is because I want to find something to help me. If I never looked for it, I wouldn’t have found CAMS and the SSF so useful. I have also found other assessment tools but nothing else worked. Traditional therapy didn’t work for me. I had to find a therapist that treated me as an equal and collaborate with me on what works and what doesn’t. It’s still an ongoing process as my suicidality gets worse during certain times of the year than others.

I don’t think I will ever recover from my mental illness. I think it will wax and wane, just like my suicidality, but it will never get better. I might find symptom relief through medication but even with medication, my depressions get the better of me. They are too severe and too frequent to really get relief from them. Medication has been proven useless with treating them. I am just left to suffer through them until they pass.

Then I have the physical pain that I deal with. I don’t think I will ever recover from that. It just seems to get worse during the temps of New England. My former PCP thought that I can just do something to make me feel better and things would be better. Wishful thinking. As much as I don’t want to be on meds, I know it’s my new way of life. It’s the only way I can survive. Otherwise, I think I would entertain the thoughts of killing myself, and by entertain, I mean attempt.

Saturday Blog 39

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

My sisters and I went out. It was a good time. We had plenty of Chinese food and brought most of it home. We just couldn’t finish it all. I came home and there was mail, mostly for me. Two good friends sent me Christmas tidings. My friend from Texas was very kind. She sent me a Hope coin. She wants me to hold on to it on my bad days. I am grateful to have her in my life. We always have good chats. She understands how dark my depressions are and doesn’t shy away from them. She wishes I don’t have them but she isn’t judgmental about it. She is a really good friend.

Even though I didn’t do too much of anything today, my thigh is hurting. I think if I sit too long, it aggravates it. So I try not to sit too long and walk around a little bit. I hate having this pain. It’s really driving me nuts. It’s making me more nervous about seeing the neurosurgeon on Tuesday. I just hope I am not wasting our time with this. The pain is not consistent and it doesn’t always come on when I sit too long, or at least when I think I have sat too long. It also has been brought on by walking home, after doing all that I did. I wish my fears would just go away but I have good reason to be fearful. Having a bad back is never an easy thing to not be afraid of. I just want an MRI to see if there are changes. I know that because I don’t have weakness or bowel/bladder problems there is probably nothing to worry about but I worry anyway.

I got an email from my favorite author. He finally described what a short story, novella, and novel were, in terms of word count. He will be coming out with a revised book about writing sometime in the next year. I will be getting this book because I love his writing style. He has been doing this for more than forty years so I think he knows something about writing.

My mother needed technical help with the TV as she was using one remote to shut the TV off and the other to shut off the cable box. Then was wondering why the TV wasn’t working. Going down and then back up the stairs really hurt my thigh. Seems anything to flex the muscles hurt. Dammit. I hope it calms down. I took a pain pill because my ankle is flaring. Hope it calms down both. I hate being in so much pain. I really want to end things tomorrow. But I promised my therapist I wouldn’t. It’s too bad I always keep my promises, but I never keep a promise to myself. Funny how that works.

My birthday is the day after the meeting with the surgeon. I am tempted to ask my therapist if I can stay with her overnight. I just am dreading this day so much. Why can’t I just stay 39? I just wish my family wouldn’t make a big deal out of it. It’s just another day.