As I have in other blog entries I need to preface today's post with a few disclaimers.
I am not a professional
These are my experiences and thoughts and may or may not apply or connect to you
Please seek professional help if you need it
This is from an adult perspective and may or may not apply to teens. I was never suicidal as a teen
I often see on Twitter and other social media, mental health professionals scrambling to understand suicide, how to prevent it, why the rates on suicide continue to rise. (Source is NIMH) How do we treat it? How do we identify it? I see these questions and yes they do talk to suicide survivors and their families...but they don't talk to those of us that have had or have now, thoughts and even scenario's of suicide in their mind. How could they? They can't read minds and if we don't say anything....
Well they better figure out how. It sounds to me a little like "Don't ask, Don't tell"
But wait....they do ask (if you see a Psych or therapist) "Are you thinking about hurting anyone or yourself?"
I've wondered what percentage of people being seen professionally answer YES to that question.
I never have and never would say Yes. That is where the breakdown begins. I don't pretend to have all the answers...or even any. I don't pretend that even one other person feels exactly as I do. But maybe they do. Maybe someone will read this and it will change their perspective. As a writer and someone who has had a suicide attempt that is my hope.
I never told anyone about last fall. I haven't till today and now the world will know. In November of last year I thought about suicide a lot. It started becoming more than a passive "desire" to a serious contemplation. I could no longer look at the scales of my life...weighing so heavily with pain and loss. I could no longer look without feeling hopeless. I could no longer explain away the pain, I was (am still sometimes) angry. Angry at God, myself...anyone that passed my way. I felt like my family and I had more than paid a price for any transgression I had done.
I began feeling a distance from my wife and kids and couldn't understand why. This family has been in crisis since 2005, many deaths and losses. As we began to recover in 2011, by 2014 I had plunged us right back into crisis. I no longer felt guilty but rather resolved that I had single handily destroyed lives. I felt like I had little left to live for. I felt intense pain and guilt about how my wife and kids would feel. I struggled less and less with religious reasons "not to". I couldn't believe what I was thinking.
In August I had been in the ER with "self harm" thoughts. I was humiliated. Having worked for 13 years in Medical field I was terrified someone would see me that knew me. They left me in a hall rather than a room, dressed all in yellow. They came by, assessed me and discharged me.
At that moment I knew one thing. I would never seek help again at an ER for thoughts of these things. All my medical care is at this hospital so I can't just up and leave so every Dr. that sees me knows my diagnosis(es).
I present as an intelligent, conversational and outgoing person. No one ever seems to believe that is a defense mechanism/survival technique. No one. No one can accept that my "self-awareness" is soooo painful and less helpful that I am constantly told.
I still was able to drag myself into the local community mental health center in September. In fact my whole family went. The intake was great. The Dr. had gone to college at our rival and we just had lots in common. At the end of the intake he said he felt like I needed case management more than therapy...but we would put me on the therapy wait list anyway. I had never had case management. I'm sitting here thinking....how did I go from managing 85 people and millions of dollars of billing charges...to someone with a (State classification) serious and persistently mental illness...or SPMI.
All of my life I have resisted it when people tried to tell me they "knew better." Perhaps more than most so I preface this part with that.
When I was first diagnosed in 2014 (my blog has been my journey) I was devastated but it explained soooo much about my life. Almost immediately I had people throwing DBT at me and not listening to me. I resisted it. This piece has to stop or more people will turn away than use it and pieces of it work great. I needed to be heard.
I needed to lead. I needed to tell my story, share the pain. Try to heal. I did not need people telling me "all you need is DBT" Again...this is my story
I had 2 great therapists along the way. One had to move, another the I had to stop seeing because I didn't reside in their county (Really?) They let me lead. Leading can be passive and that's what I am picking at. I imagine a fair amount people that are suicidal can also be passive in life. o as you read, keep that in my mind
By the fall of 2017 I felt like I had no one but my Dad, wife and kids. I explained above how I was feeling about my wife and kids above. I can't encapsulate in this post what my Dad means to me...but its wearing on me (him too I think) about how deep in debt I am to him.
So that's where I was. Dealing with powerful emotions. Feelings at a level I had never experienced. I still wanted to believe that at the end of the day I would never do it. But I was no longer sure. The emotional dsyregulation was more than I could handle in a given day.
No one was listening to what I was "really" saying in conversations. I wasn't in therapy, I was waiting one and a case manager. My Psychiatrist acts like I'm "ok" as its a mere 2 months from my ER visit. They ask the "are you a danger to others or yourself" and I say No and they refill my meds and everyone in Pleasantville is happy.
I have no desire to go inpatient. Talk about driving me crazy. So I'm never going to say "YES" to that question.
As the fall began to turn to winter I started seeing a case manager. I liked her right away. She would let me just talk, talk about anything. My life, religion, bullying, legalization of marijuana....you name it. She let me lead.
I had just come off of writing a blog entry about trying to go "One more round"
One More Round https://myjourneywithbpd.weebly.com/1/post/2017/11/one-more-round.html
The emphasis of the post was I wasn't sure I could get up off the proverbial mat. I talked about the mental aspect a fighter faces when they try "to get up" I think its as much mental as physical sometimes. The post was 11/09/2017. I was pretty low...yet I had ended it with
I need compromise with my feelings. I need to know some days its ok to just let go and cry and other days that are better need to be enjoyed as they are happening. Maybe I should write a book....of course the blog itself is like a book.
I still believe and hope that day that re-energizes me will come. Hope and faith are about all I have left
I had the 1st therapy appt in December. Before I share that I want to share a conversation from last week at my Psychiatrist's office.
They were questioning why I am not in therapy. I looked at the 2 Doctor's and said "Doctor's...what do you think therapy is?"
Complete silence as it was clear the question had taken them off guard. I replied that it was always nice to get along with your Dr but even if you didn't they can treat you because they know medicine and "getting along" is secondary.
It doesn't work that way in therapy I explained. You MUST connect with the person. You need to feel safe. You need to be heard. You need to lead.
So back to early Dec at my first therapy appt. We did more of a traditional intake. I skirted through my life while she kept looking at the clock. Nothing too deep. At the end of the session she said "Well Mr Johnson, here at the center we are pretty booked out. I have been told that if you'll do DBT therapy for a year we can see you. Otherwise its like 3 visits to stabilize you so we can get to the next person waiting.
Are you laughing? Are you crying? Please tell me if you are a professional that at a minimum your appalled. Maybe you agree.
I scheduled a follow up with no real commitment and left. The few people I shared this with either laughed out loud or shook their head. Or both. I felt defeated. Case management was through the same place and I wasn't sure I wanted to continue though she had helped.
A day or so later I was laying in bed as my wife was gone and kids were in school. I began thinking about my life. The pain, shame, hopelessness. The hurt, anger and regrets. Then I laughed. I mean I laughed out loud even though I was alone.
I remembered my first therapist in 2014 telling me there was no way she could have gone through what I have. She let me lead. She helped me start to heal. She heard me.
Then she had to move. As a borderline who deals with abandonment while it was out of her control it still hurt and I went through 2-3 more therapists and stopped trying.
Then I tried a new therapist about 7 months later in fall of 2015. Again, instant connection. We met for 1 1/2 years. We met 3x a month on average. We met while I was in crisis' and we met when things were stable. We talked, mostly about my life. We talked about getting better, what that looked like. We could be on a roll and I could show up one day and just need to vent or talk about what I wanted to talk about. I had to stop seeing him due to not living in that county one of the last things he said was how much he admired me and there was just no way he thought he could have endured what I had...then he thanked me. He changed my life and somehow I know I changed his. I miss him greatly.
He let me lead.
As I began researching the meds I was on I saw that I had started Lyrica in the fall and suicidal ideation was a side effect. I contacted my Dr. to say it made me "feel funny" and they switched me to gabepentin and as you read the end of this you can draw your own conclusion if...and how much of this was med related
I sat up out of bed and blogged (Dec 9th entry I believe...) I called the therapist and cancelled my appointment and said I hoped that would free her up to see another patient (Yes a little snide and saying it 'nicely' sorta made it even better lol) Case management was over as well so I knew I was on my own to some extent. I've done well. I continue to do well even though I have bad days sometimes. From all the treatment and advice I use what works for me!
So...I don't have all the answers. I may not have any. I realize sometimes I rail against the system, I also try to point out its good things and at the end of the day this field is comprised of really great, under paid, people. I only hope to add some perspective. Here are some final thoughts and they can apply to anyone dealing with someone that may be suffering from severe depression and that depression may be clinical or related to life events. Always encourage someone to seek professional help.
Some people will take to DBT or CBT or meds or any combo and really get it quickly and move on. There are others that won't work that way. If a wound opens, just like a physical wound may, let us stop whatever "treatment" we are in and lets heal that first if that's what we need. I really think if we leave open wounds healing can never be complete
If the system can't accommodate that we have some real problems. Guess what...we have some real problems.
Don't tell us or act like you know better. You may..but if you don't accept that you may not, this won't work
Please hear us. Don't just listen, hear. If we feel you care we probably will open up to you.
It's ok if you "sneak" in the treatment. :-) It worked on me but if it was (is) presented too forcibly it can be treatment resistant.
Remind us to just breathe.
Because of cost and availability of seeking professional help a lot of this may be helpful for families and friends to know.
See, if you push too hard about "knowing what's best for us" we will shut down. Many suicides are by people "no one would ever suspect." We have to figure out why that happens so often. We have to have candid conversations and serious talks about other alternatives. There also has to be a balance with the medical component. We need the entire medical field aware of what to look for. Your primary care needs to lead the treatment and be able to diagnosis and treat as you may be awaiting a psych appt. I think this can be where a break down begins. Even though it was hell....in 2014 my PCP made me see a psych. to take my sleeping meds which led to my correct diagnosis at age 47. But he should have been able to treat it for the 4 month wait period. I quit a job and went manic I think. It's when I started this blog.
I can't over emphasize the importance of the Primary Care being trained in basic Mental Health. People develop a relationship with their PCP that already has trust and if the PCP can identify this person needs therapy or Psych they can get that going. I think its easier for people somewhat treatment resistant to Mental Health to hear that from a trusted PCP. Some Primary Care's are becoming trained/more familiar so kudo's to that.
Let us lead. Let us explore the different treatment options as this isn't an exact science and we know what works for us. Don't accuse of us of manipulation when it may be a cry for help. Talk to us. Get to know us before deciding you know all that we need.
For me....it really all came down to the below picture on that December day. I'm still smiling and fighting. I've opened up with my wife, spending time with my kids and Dad. I think I finally figured it out
As it say's below in so many words...only I can change the way my brain thinks. I can only do it if...drum roll please....I can only do it if
You let me lead