I feel like I’m crashing again… I don’t want to be crashing again… I want it to be just a few bad days. I want it to just be my shot of Abilify wearing off early, since it was the first one. I want to miraculously feel better after I get the next shot on Friday. Abilify is an antipsychotic that can be used as a mood stabilizer as well. Since the demons are more present in addition to my mood being crappy, I’m hoping that it’s just that the Abilify has worn off. I’m still on a small oral dose daily, until I get the next shot, which may be the only reason that I am even surviving at the moment.
The flashbacks and body memories are horrible right now. They are a daily thing; multiple times a day, sometimes multiple times an hour. They make it nearly impossible to speak, or even move, for a while. They make me tear up, and want to hide, curl up into a ball, and cry. But I can’t… I have to keep going, keep doing the things that are expected of me, keep going to appointments, keep going to PHP, prepare to start school again next week, deal with things that have been coming up, and appear to be okay to the people around me. At times, it’s too much to pretend to be okay. I just can’t do it. I’ll shut down.
The only place that is really safe to shut down, for me, is at PHP. I can’t shut down at home… mom doesn’t leave me alone long enough to just be by myself and hide in my room, on my bed, doing nothing. I can’t shut down around my friends… we usually get together at public places with other people around that I’m not as familiar with and don’t want to see me in “shut down” mode. Plus, my friends are more likely to force me into a car and drive me to the hospital if they see me in complete shut down. But at PHP, I can literally sit there the entire 5 hours and not say a word, staring at the table, barely moving or responding to anything… the therapist there doesn’t really say anything or push me to participate. At the end of the first 3 groups, he does ask the same question every day… in the same words, every day. “Is anybody having any suicidal or homicidal thoughts that they feel they need to speak with someone about before they leave to stay safe?” That’s the only time out of the entire day that he really requires a response. And if that response isn’t satisfactory, in one way or another, he’s gonna will grab that person before the end of the day for a private conversation. Mostly to go over a crisis plan and check if they feel they can be safe going home having a crisis plan or if they need to check into the hospital.
The therapist has said before that he’s not going to force someone to go inpatient. Strongly suggest, probably… spend as much time as needed to get someone to a point where all parties involved are comfortable with the client going home, yep… but *he* will not take the decision of going to the inpatient hospital away from the client. He has stated that he won’t take that power away from anyone. There may be an unspoken statement in there that he may have to defer to someone higher than him, who would make that decision for the client, if safety cannot be contracted and the client will not agree to the hospital. Obviously, there are legal requirements in the US and in my state that if someone is a danger to themselves or others, certain professionals are required to get that person treatment, or at least get them assessed for treatment by a psychiatrist or mental health police officer. Here, at least, mental health officers are able to put someone under orders of emergency commitment (POEC). I’ve been in the hospital under a police order 3 times, but signed the papers to stay when the orders ended each time.
Right now, it’s 12:30 am, and I am out on the front porch, listening to a podcast and writing this blog. I’m kind of just typing… not really even paying much attention to what is going from my brain out into the computer. I don’t want to go to bed yet… I’m not really tired. I want to wait until I am exhausted, so that I will just crash and hopefully just sleep all the way to morning, without waking up from any nightmares. Which may mean that I don’t go to bed for a few more hours… less hours of sleep but uninterrupted is better than waking up in terror multiple times. So now, what to do until then? I can’t just sit outside forever… it’s misting and I’m out here on my Chromebook, which probably isn’t the best idea. It’s also a little chilly out; it’s in the 60s (farhenheit). Not too cold, just chilly. I’m wearing socks and a hoodie with my PJs, just the breeze gets me a bit.
I don’t want to go to PHP tomorrow. I want to stay home and lie in bed all day. I had to miss today, because I had two doctor’s appointments, and I have to miss Friday for the same reason. With my insurance, I can only miss 5 groups a week, unless I have notes from the doctor. I have notes from both doctors today, and plan on getting notes for Friday also, but I don’t want to risk anything that would make my insurance discharge me prematurely. Friday, I see my psychiatrist, after seeing the psychiatrist at PHP on Thursday… but they can’t do the shot at PHP, so I have to go to my doctor. I’m kind of think I’m getting burnt out on psych treatment, but I’m scared if I give up on it, that I’ll just end up right where I was, in the depths of depression, having flashbacks and trauma lead me to the brink of suicide and without having some sort of more intense treatment than just my psychiatrist and my regular, once a week therapist, I wouldn’t have anything to prevent me from doing it or get in the way of completing if I went through with it. The only reason the second attempt wasn’t successful was because the therapist at PHP called the police for a welfare check. I was supposed to be there, and I didn’t answer the phone when he called. Knowing that I was suicidal, the clinic requires certain action, and that is what he did.
Now, I’ll admit, I’m having suicidal thoughts now, and I kind of always have a plan of how I would do it in the back of my mind that comes forefront when the thoughts pick back up. The question is always whether there is intent or not. That is where the PHP therapist and I make the distinction of safety. He’s okay with me having thoughts, and he’s relatively okay with me having a plan, and even a small amount of intent. As long as I can contract for safety for that night, until the next morning or until the next day of group, he’s okay with me going home. Okay and comfortable may be two different things, however. He lets me leave, but I don’t know what is going through his head, if he’s worried about whether I’ll be there the next day, if he made the right decision, if he should have trusted me again. Twice now, he’s trusted me, and I betrayed that trust and attempted suicide instead of going to group. I could have gone to group; I could have called the PHP clinic, or my individual therapist or psychiatrist, or even simply answered the phone when he called me; I could have gone to the emergency room and told them what I was planning or just gone to the psych hospital and walked in for an assessment; I could have done a lot of things. Instead, I attempted suicide twice, when he trusted my word that I was okay to go home and would be back the next day. The first time, I didn’t know I was going to attempt, but I knew it was only going to take a feather to knock me over the edge. The second time, I had been planning it for days, so when he outright asked me if I was safe to leave or if I needed to go to the hospital, I lied to his face. Straight up lied. Monday, when he asked his safety question at the end of the third group, I admitted to active thoughts with a plan, and he asked if I was going to attempt that night or this morning. I said no, and he asked “what about Friday?” because I had already told him I had to be out Friday too, for appointments. I said no again, and he kind of laughed and said that he was making jokes, with the Friday comment, although I kind of think he really wasn’t joking, since I had already told him that I had planned the December attempt out several days ahead and didn’t tell anyone and lied to him about it. It makes me think that every time I admit to having suicidal thoughts, it worries him. And probably the whole staff at the clinic.
Both attempts scared the staff at the clinic, my psychiatrist and individual therapist. Obviously, no mental health professional wants to lose a client. I can’t even imagine what that would be like on them. Family has one relationship with the person, friends have another type of relationship, but the relationship with the professionals that have been trying to help is a different kind. All to often, they know more about what has been going on with the person than friends and family do. There are things in my life that I’ve talked about with my psychiatrist and therapist and the people at PHP that I haven’t been able to say to most of my friends and definitely can’t say to my family. Sometimes, it feels like the professionals know me better than my friends or family do… that sounds weird, probably. Some things are nearly impossible to talk about. At least, it seems that way. It takes a lot of building up courage to get the words to come out of my mouth and then as soon as they do, I wish I could take them back immediately… even though, most of the time, everyone responds well to whatever I tell them that I’ve been afraid to say, thinking that I’ll be judged. Family and friends, when someone dies, will obviously have to grieve that loss. Most people don’t even consider that the mental health professionals, who have been trying to help someone, will also have to deal with the loss of the patient that commits suicide. There are bound to be a lot of complicated thoughts and feelings that would come up for them. What could they have done differently? Did they miss something? Could they have done more? Inadequecy, fear, grief, guilt, but in the midst of all of this, they have other patients that they have to treat, and they have to keep working.
But, speaking from my own experience, that doesn’t even cross my mind when I’m in that dark place. Friends, family… no one else really matters to me. Nothing matters except ending the pain. Escaping from this endless torture… If I can still think about how it affects other people, and use that as a deterrent, then I’m less likely to act on the thoughts. My friends, and how my death would affect them, has always been the one thing that has kept me going… it is when that doesn’t matter anymore that I am in the most danger. When ending the pain and torture is more important to me than any other thing… those are the times I have tried to die.
Well, I think I have rambled long enough. It is 2 am, and this blog has become a massive, jumbled mess of thoughts… if you made it this far, congratulations and thank you! I hope to see you again soon!