Well…

We were still in Trauma IOP up until today. We started back in the partial hospitalization program today. We’ve been having more and more suicidal thoughts, and getting closer to acting on them. The therapist from the IOP asked, on more than one occasion, if we needed a higher level of care. We refused to go back inpatient, which we honestly think is what she would have been more comfortable with. She still advocated for what we wanted, though, when it came down to it.

Last week on Wednesday, we were literally at the top of a cliff, waiting for the other people to leave. This past weekend, we were counting pills and seeing if we had “enough.” We were honest with the IOP therapist after both.

Thursday, last week, when we checked in, we just wanted to get through it and be done. We sailed through our day in about 30 seconds, hoping she would miss the cliff part (?) or just not bring it up or something… that seemed to be the only thing she heard, honestly. She immediately asked about it, and the longer we were on the topic, the foggier the room got. The therapist could see we were slipping, and tried moving from asking us questions to having the other members of group talk to us, relating their experiences with suicidal thoughts. Check in that day took the whole day, because people had a lot to talk about, and we were the last one to check in (on purpose). By the end of it, we were barely holding on by a thread. The therapist held us after to talk, but we were too far gone to talk. We were semi-aware, we could hear, but everything else was completely gone. We heard her telling us she was there, and that she wasn’t going anywhere. We were hitting our head on the wall. She was still there. We were counting the ceiling tiles. Eventually, we started coming out of the dissociative state and into a massive panic attack. We were able to contract that we would be back in the morning, and she let us leave.

Coming back after the weekend, on Tuesday, we completely dissociated during check in. The therapist saw it a little too late. She saw us trying to hold on to what little bit of awareness we had. We couldn’t even say why we had dissociated, after the fact. Once group was over, we asked to talk to her, and told her we needed to step up to PHP. She said usually the clinic and the doctor want the patient to go into the hospital before going back into PHP. The IOP therapist said she would ask if I could just go straight to PHP, mainly because I was desperate to not go inpatient again. I would have just stayed in IOP and discharge at the beginning of next week, instead of going inpatient again. I guess because I’ve been in so many times, and also because of Covid-19, they decided that wasn’t necessary this time. She let me know yesterday what they had decided and I started PHP today.

The clinic, because of the coronavirus, is checking every patient’s temperature and doing a screening before they can go to the group rooms. We get it, everyone has to take precautions, these days. The clinic even discharged all the patients over 60 and those with preexisting conditions that put them at a higher risk of becoming seriously ill. But, so far, they are staying open. We don’t know how long we would survive if the clinic closed. We would not make it, we know that. The question is only how long…

So far, for right now, we are okay. We aren’t going to do anything tonight that would make it where we aren’t at PHP in the morning. We will be at PHP in the morning.

Change is scary…

I finished the partial hospitalization program last week. On Thursday, January 30th. I started a Trauma Focused Intensive Outpatient Program yesterday, February 3rd.

Change is scary.

I’ve pretty much been in PHP since June. There have been breaks for trips to the hospital, and one short step down to IOP for a few days before I was stepped back up to PHP because it was agreed I needed a higher level of care. So I have been in PHP since June.

I don’t even know if I’m ready for this group. The trauma focused IOP. Maybe I should be doing the dual diagnosis IOP or the DBT (Dialectical Behavior Therapy) group. I mean, DBT is THE treatment for Borderline Personality Disorder, and even though my personal therapist is adament that I do not have it, other providers who see me on shorter terms usually say I do. Simply because I self injure, in my opinion, and it makes me angry sometimes. I have done DBT groups many, many times. I know the material backwards and forewards… but, I did self injure a week ago, on Tuesday, the 28th. I also relapsed on alcohol, for 4 days each time, and showed up to PHP intoxicated 3 times. My clean date is January 29, 2020, at the moment. So the dual diagnosis IOP would make sense too, but there probably not much they could teach me that I don’t already know, having been doing the getting clean thing since 2006.

But am I ready for the trauma IOP? Can I handle it? I dissociated hard yesterday, and it was the first day of IOP…

During the first hour, we checked in. There were only three of us there yesterday, so we all had a decent amount of time. That was nice. It was awkward for me, even though I knew the therapist and one of the other group member a little. I don’t know, just saying some of the things I deal with, like the self injury (I mentioned the specific methods I use) and suicidal thoughts and I was able to say that part of the trauma relates to a loss that was too soon… saying those things was difficult in front of people that I have only really just met.

During the second hour, we discussed our goals for the week. The therapist wanted three goals: a physical, social and emotional goal. My physical goal is to not self injure this week. Social is to go to 3 meetings. And the emotional goal is to show up for IOP. As weird as this may sound, those goals are hard for me. Right now, those are pushing my limits. IOP starts in 3 1/2 hours and I have not slept. The sun is starting to come up… The sky is starting to lighten at the horizon behind the houses across from mine. People are starting to leave for work. And I have not slept. At all. Normally, my alarm would be going off in one hour, so it’s not even worth trying at this point. I’m just going to have to caffeinate, caffeinate, caffeinate. It’s the only way I will be able to make it to IOP today. And to the other things I have scheduled later.

During the third and final hour, we do mindfulness every day. Yesterday, the therapist did a self compassion guided meditation. I normally am not really that okay with guided meditation, except for breathing ones, body scans, or progressive muscle relaxation. I gave it a try. It didn’t go well for me. As I said above, I dissociated hard. Less that a minute in, I could tell I was losing my body. Then the tunnel vision started, all the way to a pinpoint. Then I lost my hearing completely. Usually, when I dissociate, I don’t lose my hearing. I am still semi-aware. I can still hear what is going on around me, I just can’t respond at all for a bit. But this time, I lost everything. I was completely gone. I don’t remember the rest of the meditation. The next thing I know, the therapist is asking me a question. I didn’t hear the question, but I could tell it was aimed at me. I couldn’t speak yet, however. I made a gesture with my hand to indicate “kind of.” It was all I could manage. I was zoned out again, when I realized she was asking me another question again, after a minute or two. I made the same gesture with my hand, because I still couldn’t manage words. At that point, she realized. She asked if I had dissociated, because I had mentioned earlier that certain guided meditations (safe space) make me dissociate. I nodded. She asked what would help bring me out of it, and I was able to squeak out a very quiet “time.”

The therapist did hold me after group for a bit, just to make sure I was okay to drive, and also check in with the level of suicidality I had marked on the check in sheet and check that I could be safe overnight and be back today. So I kind of have to go today. I can’t just not show up…

Some day, hopefully soon…

I will write about the traumatic event that has me in this mess. That led to the suicide attempts. That kept me depressed practically my entire life. That is giving me flashbacks and body memories daily. That has me still actively suicidal on a daily basis.

Don’t even know where to start…

I want to write… I have wanted to write for over a week now… I want to write the right thing. I want to make it perfect. There are things I need to write about, but I don’t know where to start.

I had a friend commit suicide on January 12th. I relapsed on alcohol shortly after, tried to stop again, and relapsed again yesterday. In my head, drinking is better than attempting suicide again. I tell myself that if I get suicidal to the point that I am actually going to do it, it is okay to use, even though I am an addict.

I don’t know what to say about my friend. He is the second one, recently, to commit suicide. I had one friend die in September and then now this one in January. I wish there was something I could have done, something that could have stopped them. But I know the feeling… I know how it feels to have no hope anymore. I attempted in October and December. My head keeps going into suicidal thoughts, even today.

I wish I could get past the thoughts… I wish I could never be suicidal again, but the chances of that are slim to none. That’s just what my brain does. That’s where my brain goes.

I want to not be depressed. I want to be happy. I don’t see that happening. I don’t think I will ever get past and over the mood crap. And that is the hardest part. Having no hope makes it harder to keep going.