Thursday, November 23, 2017

When the System Fails You

Living with mental illness is a challenge in and of itself. Struggling through the different disorders and all the symptoms that come with it is a daily battle. Some days you win and some days you lose. One of the battles that comes with living with mental illness is learning to fight through the mental health system. While no system is ever perfect, the mental health system is clearly broken and in need of some major help. There are many areas in which it is lacking.
The first major area that it is lacking in is simply the number of professionals available to treat mental illness. There is currently a national shortage of psychiatrists. A study commissioned by the U.S. Department of Health and Human Services concluded that there is at least a 6% shortage throughout the country and that this deficit would continue to rise as time went on if something isn't changed. While this doesn't seem like much, spread that around the country and there are many counties that don't have a psychiatrist at all and some that have one to service an entire county. Additionally, there is also a pooling of doctors around schools so there are more psychiatrists in certain areas than others which makes it harder to get treatment if you don't live in one of those areas. The national shortage is the first thing that needs to be corrected in the mental health system because we need the professionals to help the people who struggle with mental illness. We need to get people trained to help those who are struggling.
The second area that the system needs to fix is the differences in cost and coverage. First I will give a disclaimer that we have come a long way in the past few years and it has gotten better but we still have a long way to go. Currently, Medicare only gives a limited of lifetime psychiatric hospitalization days and once they are used up the only way to get more is to get another plan and that plan also has limited days. Many insurance companies consider therapy to be a specialist service and charge higher copays for it which makes it difficult to do on a weekly or bi-weekly basis for people who really need counseling that often. There is a considerable cost difference between going to a regular doctor and going to a therapist or psychiatrist, simply because it is mental health and not physical health. Another part of this that comes into play is that many providers do not take insurance at all. They are self pay only which makes it even more challenging for people to get the care they need and leaves even fewer people to see who do take insurance. If people cannot get access to the care they need, simply because of funds, how are they supposed to get better?
The third thing that the system needs to correct is making sure they do not turn people away who need the help. I won't spend too much time on this point because I have an entire post about it (see When You're Turned Away). Simply, there are many people who various professionals and hospitals turn away simply because they are "too sick" and they don't know what to do to help them. They give various reason for this but ultimately it doesn't make sense why they would turn someone who needs help away. However, it does happen, and it does need to be fixed. Everyone deserves help, no matter how sick they are.
The fourth thing that the system needs to change is the number of long term facilities that are available. There are many long term facilities available throughout the country but most of those facilities however do not take insurance and require a massive down payment of thousands of dollars. There are close to no facilities that take insurance that are available to help people with real issues. This needs to be corrected. There are many people that are stuck in state hospitals for months, even years who could benefit from a long term facility if one was available. Long term facilities need to be created to help those who need them and need to be focused on the help, not the money.
Overall, these four things are major problems that need to be corrected in the mental health system. Of course, there are many other things as well that need work. Every system has room of improvement and the mental health system is no exception. With these improvements, many more people would benefit and would be able to get the help they so desperately need. It would make a world of difference in our country.

Wednesday, October 25, 2017

The Change

Hey everyone. I am here writing as myself. I just wanted to share with everyone what has happened this year and the experiences that have led me to where I am now.

When I began the year 2017, I never thought I would be where I am now. I was anticipating a hospitalization right off the bat. I initially created a health care power of attorney and psychiatric advanced directive to protect myself from being sent to hospitals that have been harmful in the past. I was going back to crisis group at the local mental health center and was going to go see my psychiatrist that first week of the year. That was when I discussed with him the idea of doing ECT or electroconvulsive therapy (see link at the bottom for information). We agreed and then started the process. My first hospitalization occurred in January and ECT began. I was committed to doing the full 6 month process and go as long as I needed to to see results. The problem was we weren't seeing results. I was still falling into self-harming behaviors as before and ending up in the ER time and time again. Starting in February I had hallucinations for the first time. I began seeing and hearing things that weren't there. I knew they weren't there so I wasn't totally gone but they were there. We still can't figure out why this occurred but it is something that we fought with for a little while. I ended up in the hospital for a second time in February for suicidal ideation. I was continuing with the ECT but with no improvement. Eventually after I was released the doctor decided that it was not working and that he wanted to stop. I had 11 treatments over 4 weeks before he decided to stop because it wasn't working.
From there, I went back to the mental health center for outpatient care. I didn't like the therapist I had and asked for a new one. My old therapist was being difficult about finding me a new one and I wasn't getting anywhere so I eventually stopped going to therapy. I started having reactions to my medications and couldn't get in to see a psychiatrist so I stopped all my meds. Things just crumbled from there.
During this break in therapy, my job was basically blocking me from going back to work so I had to switch jobs and give up the job that I loved and then my dog died. Things just continued to get worse.
When I finally admitted that I was on the edge of a breakdown, it was the end of March. I was suicidal and self-harming. I checked myself into a psychiatric hospital that was close to 4 hours from where I lived. When that hospital would not give any help that I desperately needed, I checked myself out after 4 days and found another hospital that would help me that was 2 hours away. I stayed there a month. They messed with my medications over and over again desperately trying to get a combination that would prove effective. My hallucinations returned during this hospitalization as well and had to be dealt with as well. It was at this hospital that I finally gave in to the idea about looking into something more long term. However, there was no long term hospital that would take me that would also take my insurance. From there it was decided to try ECT again. I was transferred to hospital #3 to restart ECT. Keep in mind during all of this time I was still suicidal and unsafe to be discharged.
Hospital #3 (End of April to Mid-May) was miserable. Staff were non-helpful and nurses were not consistent in giving me my medication which really messed with my head. I gave up on ECT after they did 4 sessions in a week and it took too much out of me combined with the poor care of the nurses. I discharged myself in hopes of going back to hospital #2 to get into a long term facility. When I got out and asked to go back to hospital #2, I was denied. The hospital would not take me. They had given up on me. I freaked out and overdosed, trying to end my life. My friend who lived in the city came (I was still 2 hours from home) and picked me up and took me to the ER which I have no memory of. I spent the next few days in a daze, waiting for another hospital to take me. Eventually a hospital in my hometown accepted me and I was transported by a cop. Except this time the transport was in handcuffs. Yes, you read that right. Handcuffs. Like I was a criminal. It was miserable.
Hospital #4 (Mid-May to Mid-June and end of June to beginning of August) was a hospital I had been at before and a hospital I liked. I made it very clear when I first got there that I wanted to do long term treatment. They began that search quickly and hit some roadblocks but we continued to search until finally I was accepted to a program. I was discharged after a month with hope that we could line all the insurance information up and set up an admission date while I was doing outpatient treatment. It didn't work out. I spent 8 days out and insurance wasn't cooperating and I was falling apart again. So I went back in for another 6 weeks. This time we had to wait for all the insurance information to get put together and then we had to figure out how to get through the 3 day period that I had to be out between stays. Once that was figured out, we made everything work and I was discharged. I made it through the 3 days and traveled to New Orleans, Louisiana, where hospital #5 also known as River Oaks was.
River Oaks is nationally recognized for their trauma program. People like Dr. Phil have sent people to River Oaks. News stations have asked River Oaks for guidance on how to handle situations like 9/11 because they are one of the top trauma programs in the country. Going in to this program I wasn't sure if I really deserved to be there, if I met the requirements. I had no idea what I was getting myself into.
I was pleasantly surprised by the whole experience. I learned more at River Oaks than all of my hospitalizations combined (and that's saying something considering there's 24 other hospitalizations). I learned very quickly that I deserved to be there and that I needed to be there. I received help and compassion and validation that I have never received in my entire life. Things I have needed and have been searching for so desperately. They had so many aspects of their program that put together made everything work. We had groups from 8:30 in the morning until 3pm or 5pm and then a 6:30pm reflections group. We had homework assignments to do. It was almost like being in college again. The therapy included art therapy, expressive therapy, music therapy, lectures on so many topics, dialectical behavioral therapy and so much more. We also received individual therapy 5 days a week which has never taken place in any other hospital I've been at. Everything was geared towards us working through our trauma and our emotions and our struggles that came out of that. We had trauma group to process what had happened to us, skills groups to learn specific skills to manage different aspects of ourselves, inner child groups and psychodrama to act out things we needed to get out. They focused on the root issues and things that grew from the roots. It was all-encompassing treatment. They also had a psychiatrist on staff to help make sure medications were regulated. They had a dietician on staff to make sure our nutricion needs were getting met. The whole experience was amazing.
What was most amazing about it was how much it changed me. So many people kept commenting on the changes they saw in me. I walked in with no hope. I walked out with hope. I walked in sheepish and quiet (according to my therapists) and walked out more comfortable with myself. I walked in completely depressed. I walked out with a smile and a hearty laugh. I walked in unable to handle stress. I walked out with the ability to handle stress in positive ways. I changed in so many ways because of them. They changed my life.
I never thought an end to the life that I was living was possible. I never thought I would shake the thoughts that constantly haunted me. I never thought living a life free of self-harm or suicidal thoughts would be a possibility. But I can say that I did not self-harm while at River Oaks (I had never not self-harmed in a hospital before) and have not self-harmed since I have been home and I have been home about a month. I haven't really had any suicidal thoughts either. I've had a LOT of stuff thrown my way since leaving the hospital and a LOT of stress put on me about many different things and I've been able to handle it. Life hasn't been unicorns and rainbows but I've managed. I feel completely different.
As I move forward in my recovery, because there is still a long way to go, I hope to continue to grow and maybe make another visit to River Oaks for a tune up but we will see what happens.
It's been a long year so far but it looks like things might just be turning around. I'm going to try to make these last couple of months count.



Information about ECT: https://www.mayoclinic.org/tests-procedures/electroconvulsive-therapy/basics/definition/prc-20014161

Thursday, August 17, 2017

Ways to Help When Family/Friend Discharges From the Hospital

Transitioning out of a psychiatric hospital is one of the most difficult and vulnerable times for someone. There is a high suicide risk right after someone discharges and some people will end up right back in the hospital if they are not careful. So what can you do to help a friend or family member transition from the hospital back to normal life?
     1) Help make sure the environment is safe to return to. This is something hospitals usually check for before discharging someone from the hospital and sometimes people need help making sure that everything is removed from the environment temporarily for when they return. This can be a variety of things depending on the person. Most hospitals check to make sure there aren't any weapons in the house and if there are, that they are locked up securely as to not be easily accessible. Other items can include sharps like knives, razors and excess medication. Not only does the environment have to be made safe physically, it also has to be made safe emotionally. What I mean by this is that for people who attempted before going into the hospital, there are often things left behind from that attempt that could remind that person of their attempt and this could be triggering for them. Removing these triggers help make the environment safe for them to return to from an emotional standpoint. Helping to make sure the environment is safe to return to is a key first step to helping a person transition from the hospital.
     2) Ask what specific household things you can do to help. When someone leaves the hospital, they go from having almost everything done for them to having to do it all for themselves again and this can be stressful to handle all at once. Additionally, transitions back to normal life can be stressful on families as a whole and many times doing specific household things can make a huge difference. These can include things like cooking a meal, helping clean the house before the person comes home, helping with transportation to appointment and things like that. The key to doing this is to offer specific things you know you can do. Instead of asking generally "what can I do to help" ask "can I help you clean your house before they come home" or "does your lawn need to be mowed" and things like that. Offering a specific service helps you know what you can do and takes pressure off the other person to come up with specific tasks that they need help with.
     3) Help them make and keep a schedule. Keeping a schedule is one of the key things someone can do when they are transitioning out of a hospital. In a hospital setting, every hour of the day is planned out and people are usually kept busy with going to groups and activities. This can make transitions difficult due to going from having everything scheduled to having nothing scheduled. One of the best things you can do to help someone is to help come up with a schedule for the first couple weeks of what you are planning to do hour by hour. Granted, this doesn't need to be kept to a T but having a guide and plan for each day really helps people transition from the hospital back into real life.
     4) Provide support during difficult times of day. For many people coming out of a hospital, there is usually a period of time during the day that they have a more difficult time with. For some people evenings are more challenging. For others mornings are more challenging. Asking the person coming out of the hospital which times of the day are more difficult for them and coming up with a plan on how to work through those difficult times can really help make sure that they stay safe during those times and even lessen the struggle that those times can create. This is something that can be critical to whether a person remains out of the hospital or not.
     5) Check-in with them often. This goes along with numbers three and four. In a hospital setting, people are used to having support 24/7. There are constantly staff there to help them through difficult times and through their struggles. This is one of the benefits of being in a hospital setting to begin with. So transitioning out of the hospital can be challenging because that constant support is lost. Having someone check-in with them throughout the day can be beneficial to them because they really need that support to transition out of the hospital. One thing I've seen done before is having someone stay with them at their house if they live alone so that they can have more support the first few days out of the hospital. Support is extremely critical when transitioning out of the hospital. At the same time, this is something you would want to check with the person with to make sure that it isn't too much and it isn't overwhelming. Giving them a healthy level support can really help make the transition easier from inpatient hospitalization to normal life again.

     Overall, these 5 things can really help friends and family transition out of the hospital and can help you know what to do to help them through this challenging time. Knowing how to help is the first key step in giving help. Ultimately, the love and care that you have for the friend/family member will shine through in whatever steps you take to help them and that is the most important thing.

Wednesday, August 16, 2017

Real Life

"The bravest thing I ever did was continuing my life when I wanted to die." ~ Juliette Lewis

     I'm going to start this post by being completely real. These past few months have been nothing but a struggle of whether I was going to live or going to die. I have been hospitalized 8 times this year for suicidal ideation, one of those times for an actual suicide attempt. 3 of my hospitalizations were at least a month long. I have been fighting my mind for my life all year long .I have gone through ups and downs, highs and lows, mountains and valleys. I've gone through many medication changes, 2 attempts at ECT and countless groups. Yet I'm still fighting for my life everyday. And that's where this quote fills in.
     So what is bravery? Merriam-Webster defines it as "having or showing mental or moral strength to face danger, fear, or difficulty." In simple terms, bravery is moving forward even though things are scary. Bravery is pushing through the fear to accomplish a goal. For me, bravery is continuously seeking out help even though things seem dark and hopeless and my brain just tells me to give up. By seeking out help, I am choosing to fight. By seeking out help, I am choosing to get back up after being knocked down. And ultimately, by seeking out help, I am choosing life. This is a reality of those who struggle with mental illness. Every person with a mental illness shows bravery by choosing life. Every day, every hour, every moment. Those of use with a mental illness fight a daily battle with ourselves. The battle can be from getting out of  bed to not letting the thoughts control you to just focusing on doing the next right thing. Sometimes we win, sometimes we lose. And it's okay to lose sometimes as long as you try again the next day. Bravery is fighting that battle day in and day out. Bravery is asking for help when it's needed. Bravery is continuing to live - not just survive - even though you feel like you want to die. So let's go out and fight our battles and show the world how brave we really can be.
     As for me, my bravery is taking the next step towards getting better by being at a longer term treatment facility designed to treat issues like mine. I am not sure what to expect or how long I'll be here but this is what I need to do to get better. This is my next step of bravery.

Monday, June 19, 2017

When You're Turned Away

       This post is a hard post to write for me. It's one that I have struggled with whether to write or not for quite a while, because I haven't seen this happen to anyone else I know but by doing research I know it happens. It is a failure in our mental health system, one that must be taken care of if we really want to help people with mental illness and lower the suicide rate. The issue? Blacklisting people or putting them on a "do not admit" list at a psychiatric hospital.
      Why do I write about this? Why would I want to highlight this? Because I've experienced it. Multiple times. Today, there are 5 hospitals that have me on their "do not admit" list. One of those hospitals I haven't even been a patient there.
      You may be thinking, can they even do that? Is that even allowed? General medical hospitals cannot turn away patients, that is known. However, psychiatric hospitals that are privately owned can. State psychiatric hospitals cannot because they are ran by the state. This is something that has been going on for a long time too. One article I read said this started back in the 1960's.
       The next question that comes up is why. Why would they not want to help someone? What I found in doing research about this is that sometimes hospitals won't take patients who are physically violent or have been physically violent toward staff in previous stays. If a person had assaulted staff in previous stays, they may be put on a "do not admit" list. The other reason I found in my research was that if a person had a severe personality disorder and the hospital felt that they would gain no benefit from the hospitalization. The reasons I personally have gotten from hospitals have ranged from "I have reached my therapeutic maximum" at that hospital or "I need long-term care" that they cannot provide or "the doctors there won't accept my case". It can also be a combination of these things. However, this still doesn't really answer the question though, does it?
       Why would a hospital deny a person the help they need? Unfortunately, I can't really answer this question. I can only say that this is one of the many ways that the mental health system fails people. The system that is supposed to help people leaves them helpless. The system that is supposed to give people hope leaves them hopeless. The system that is supposed to guide them through treatment leaves them wandering.
       It's almost oxymoronic in a way, how the system works. Those who are suicidal, have tried to end their life, homicidal, or psychotic are placed on commitment because we value life, or at least we claim to. Until the search to find a hospital becomes too difficult and then it's just easier to give up and let them go home.
       How do I know all of this? Because I've lived it, and not just once. Many times. I've gone to the ER to get help because I was suicidal and knew I needed to get into a hospital, only to get there to find a social worker who gave up after the first set of rejections came in. I've been put on commitment papers and taken off them less than 24 hours later because they gave up. I knew I needed help and I had to find it on my own because there wasn't anyone going to find it for me. I've sat in a hospital for two weeks after an attempt waiting for a hospital only to have the hospital give up and send me home because there was nothing they could do. I've been turned away by hospitals I've never been to before. I've been turned away by a total of 6 hospitals. I cannot even begin to explain the pain this brings to me. The hopeless feelings it has brought on. The dark places it has brought me to.
      This is just one of the many broken parts in our mental health system. One of the many parts that MUST be fixed if we want to see the suicide rate decrease and we want mental illness to be less debilitating. Fixing this will bring hope to more people and make sure that no one is left in the shadows wishing they had the help that so many others had access to. It will mean no one gets turned away.

Saturday, June 17, 2017

The Reality of Psychiatric Hospitalizations Part 2

This is a continuation of my previous post about psychiatric hospitals. Many people don't understand the realities of psychiatric hospitals and what the experience is truly like. So this is my way to help shed some light on the reality. In my last post, I outlined the process of getting admitted to a psychiatric hospital and the sometimes difficult process it can be. This post will focus more on what happens once you are admitted to the psychiatric hospital. Once you enter the hospital, the paperwork pile begins. Paperwork includes another evaluation once you are admitted (you probably go through 3 more after being admitted). This includes explaining why you are there and what led you to be there. This can include things like a suicide attempt, suicide thoughts, self-harm, family member's concern, hearing or seeing things and being delusional. It can also be simple things like you need a medication change and feel more comfortable doing it in a hospital setting. It also includes going through your history (previous hospitalizations, previous suicide attempts, family history and so much more). They also go over your medications and allergies. Usually included is taking your weight and giving your height. Probably the worst part of the entire thing is what is known as the "skin check". That is exactly what it sounds like. It is a check of all of your skin. They document any marks you have on your body including scars, birthmarks, acne, stretch marks, cuts, scrapes, bruises, everything. This is the most humiliating part of the entire process. Some places do it for security, others do it to get an overview of your physical condition when you are admitted. It can be equated to a strip search anywhere else.
       Once the physical check is done and a basic evaluation is done, rules and regulations are gone over. Most places give you a packet that includes these in it. Also included is a schedule. The schedule goes over when the groups are held, when meal times are, what meal procedures are, and when free times are. Additionally are a list of phone times and TV times (more on this soon). Once you go through the packet of information and the search, then your personal belongings are gone through. Sometimes this is done in your presence and sometimes it is not. Essentially, staff goes through everything you brought in to check for anything you may not be allowed to have. This includes sharps (you are not allowed to have a razor to shave with; if you want to shave you have to ask for permission and be observed the entire time to make sure you don't hurt yourself), strings or ties (so you can't try to hang yourself or hurt anyone else), medications (those are all controlled by the nurses there), any toiletries that may contain alcohol and anything else that could be considered hazardous. One surprising thing you aren't allowed to have are pens or pencils with erasers. They usually give you short pencils, often called golf pencils or what are known as flexipens which is the ink part of the pen covered in plastic (they don't work very well) and that is what you use to write with. Some places allow you to have your own personal pillow and blanket. Other places do not. Some places let you bring in coloring materials. Other places do not. Some places let you bring in your own toiletries including makeup. Some provide them (they are usually the cheap kind if they are provided). The hospital is who determines what you are allowed to have. Many times certain items require a doctor's note for you to have. For example, I wear wrist and ankle braces. For me to be able to wear them, I have to have a doctor's note from my assigned psychiatrist. If the doctor doesn't agree to write the note for them, then I don't get to have them and I suffer through excruciating pain. This has happened at many hospitals. One hospital I went to didn't allow you to have hard covered books or journals. Most that I have went to have allowed that. It varies by hospital policy.
        Once your personal belongings have been gone through and thoroughly searched, you are then usually brought to the room you are assigned to. This is another thing that varies by hospital. Some places you have your own room. Other places you have to share a room with someone. One hospital even had 3 people to a room. Bed quality is another thing that varies by hospital location. Some hospitals have hospital type beds that you can adjust up or down. Others have thin twin mattresses on a bed frame that's usually solid wood. The rooms usually have a place for you to store your clothing and personal items. Some places had a chest of drawers and then a nightstand. Others had a couple of shelves to put your things in. One place had each bed assigned to a wardrobe that had shelves in it but could be locked and you were given a key on a rubber band to use to lock and unlock the wardrobe. Some hospitals have a desk in the room, others don't. There aren't usually any useable electrical outlets (as people would try to use that to hurt themselves) and you aren't allowed anything with cords in the rooms. A couple hospitals I stayed in had adjustable heaters/coolers in the room that the patients could change the temperature as they wanted. Many did not. The beds are usually equipped with a set of hospital sheets (which are rarely comfortable) and then some sort of blanket or comforter. These can be thin in nature so many times patients required extras to stay warm during the night. The pillows were usually plastic on the outside for easy cleaning with a cheap pillowcase over it. The beds were rarely comfortable. The bathroom situation can also vary by hospital. One hospital I stayed at, 2 rooms shared a bathroom, meaning up to 4 people could be assigned to use a bathroom at one time. One hospital I was in had 2 showers and bathrooms for the whole unit to share. The bathroom was usually equipped with the basics of shower, sink and toilet. Most bathrooms had the handrails attached to the wall. However, unlike normal handrails which have a gap between the wall and the rail, these rails are covered on the bottom with a piece of metal, making it to where no one could use anything to try to hurt themselves. Some bathrooms had a door that you could shut. Others had just a curtain for the door. The showers also varied. One place had a shower that was a button. There was no temperature control and after a couple minutes, it would shut off and you would have to press the button again to get the water going again. Some showers didn't have a shower curtain and you just got extra towels to put on the floor when showering. Sometimes the bathrooms were really small and cramped and other times they had more room to move around. This is what the rooms were generally like.
      After putting your belongings in your room, you were usually let to roam around the unit a little. Each unit you were on depended on what it looked like. Some had group rooms on the units, some were off the unit. The day room or main area to congregate usually included a TV that played during certain times of the day. Sometimes patients were allowed to control the remote. Other times they weren't and staff controlled it. Usually there were tables and then chairs or couches to rest on. Day rooms also included phones. When using the phone in a psychiatric hospital, there were certain times you could use the phone throughout the day. If it was time for group, phones were shut off. Once a certain hour in the evening came, phones were shut off. When you did use the phone, your phone calls were supposed to be only ten minutes long and no more. Some places even limited you to a number of phone calls per shift. If the phones were on, friends and family could call you on that line but wouldn't always get through depending on if the phones were being used or not. It was definitely a difficult process only having limited phone time and thus limited contact with the outside world. One hospital I stayed in had pay phones on the unit and you could only make phone calls if you had the money to pay for them. Otherwise, you were given one phone call a week with your assigned social worker. It definitely made it difficult to keep any real connection with those on the outside during the time in the hospital. The other way you had contact with people from the outside world was through visitation. This also varied by the hospital. One hospital I was in had visitation every day (probably to make up for the pay phones) while others had it two to three times a week. The times are specific to the unit you are on and usually visitation lasted for an hour on those two to three days. Rules for visitation also vary by place and where visitation took place varied by hospital. Some hospitals had visitation on the unit (but not in patient rooms) while others had it in the cafeteria. Some allowed children to come visit with an adult, others wouldn't allow visitors under the age of 16. Visitors usually weren't allowed to bring their personal belongings like their cell phone or purse back so that they couldn't give anything to the patient that wasn't allowed (though we managed to sneak things in anyway). Visits are always supervised by staff, meaning there is usually a staff member in the room. The one major rule behind both phone calls and visitation was that if staff deemed them non-therapeutic, staff had the right to end them. I have seen this happen and had it happen to me.
       These are the basics of the admission process into a psychiatric hospital and some basics of the environment. Part 3 will go over what the daily schedule is like and the therapeutic aspect of it.

Friday, June 16, 2017

Before the Act

I have been pondering for a little while about what to post next here that others might find helpful and what might help others understand what goes through my head and why I do what I do.

One thing that so few people seem to be able to understand is why I attempt suicide. What goes through my head before I do it. What happens in the days, hours, minutes, seconds before I actually try. What thoughts do I have? What actions do I take? Why do I even get to that point in the first place?

Well I will first review some foundational information that I have covered in my previous blog posts. The first thing is that I am chronically suicidal. I feel hopeless on a daily basis. I am what is known as a high-risk patient to any psychiatric worker because of that. However, I cannot control that. I cannot control whether or not I have the thoughts.
The second thing is that I have BPD (Borderline Personality Disorder). While that is not an excuse, it is an explanation. It means I feel emotions much more intensely than the average person. Marsha Linehan, the creator of DBT, compared people with BPD to third degree burn victims. What would feel like a breeze of air passing by a normal person would be excruciating for a third degree burn victim. It's the same with emotions for people with BPD. A general letdown for someone can feel like the end of the world to someone with BPD. One rejection can feel like the ultimate rejection. It also means that happy things feel like top of the mountains and above.

Taking these two foundational principles into account, what leads me to attempt to end my life?

There are 2 types of attempts that occur: the planned and the impulsive.

For the planned one, the first step that leads me in that direction is a series of stressful events. Sometimes it can be a series of smaller stressful events or it can be one huge stressful event. Having BPD, I don't handle stress well. I feel stress a lot more intensely than most people do and that makes it even more difficult to handle even the smallest stressors. Once one stressor comes, everything after it seems even more stressful because by that point I am already in a vulnerable situation. For example, one morning my car doesn't start. This is the initial stressor. After that, I get a correction from my boss, I forget my lunch and then get into a small disagreement with my friend. This leads me to think (irrationally) that now I may lose my job and lose the friendship I have. All of these fears are intensified by the BPD and lead me to feel hopeless about the future. Then I feel hopeless about life in general. Other thoughts that can be included in this would be that I am a burden to other people and they would be better off without me, that I have no worth, and that this pain will never end. These are all distorted negative thoughts that I have when getting to the point that I am wanting to take my life. These thoughts, combined with the chronically suicidal thoughts, can lead to me deciding that I am going to try to take my life. Once I have made that decision, then the preparation for that comes. I usually try to figure out all the logistics. This includes when, where and what with. This is also the place where goodbye letters are written and last wishes are finalized. This is when the dangerous part comes in. If I get to this stage, this is where hospitalization would take place.

For the impulsive one, it is exactly that, impulsive. It means that there isn't much time between the thought of ending my life and the actual action. This is also something that is quite common as well. According to one study, anywhere from "one-third to 80% of all suicide attempts are impulsive acts" according to the New England Journal of Medicine. This type of suicide attempt is the most deadly and the hardest to help because it comes without warning. For me personally, it usually means an event has happened that upset me majorly and I don't feel like I can handle the pain that I am currently experiencing. It also usually indicates I have access to the means to attempt. This kind of attempt occurs quickly and without warning. I don't spend time thinking it over and I don't spend time preparing for it. I just act on the thoughts that I am having.

Usually when I attempt I tell someone or hint at it somewhere that I am going to do it. What this means is that I really don't want to die, but I just want people to understand how much suffering I am going through. It really is a cry for help and for someone to just notice what is going on with me and try to help me get help. This is also true for many other people. Many people who attempt suicide just want the pain to stop and just need help to get there. Many realize after the attempt that they didn't want to die, they just wanted help. That is what should be focused on.

What I am hoping to do with this post is help everyone realize that those who attempt suicide are not trying to be selfish in attempting. In their minds at that moment, they think they are helping the world and helping their family because they feel like such a burden to them that they would be better off without them. Their thinking is distorted by the pain they feel. People who attempt suicide need those around them to support them, to show them compassion, and to love them. Those things are what will make the difference in recovery.

Friday, February 17, 2017

Poems

12/09/16 Poem
What's the point in all this?
Nothing matters.
It all leads to a sea of misery
Where waves crash hard
And storms rain down
Lightning keeps flashing
Thunder keeps rolling

Were is the break in the clouds?
The sunrise
The dawn?
Where are the clear skies that show
The new day has come?

Can we not have just 1 ray of
Sunlight today?
Or is it just gray?
Will it always be that way?

Or maybe there will be a
Break in the clouds
Just enough for us to think
Hope has been found?
For us to take a breath,
Dream a new dream
Create new things the
World has never seen

But the break never sticks around
Hope doesn't last
Dreams are broken once again
And new ideas are thrown to the trash

The sun never hangs about
The clouds come back to play
The storms are my worst nightmare
As they take my life away

Piece by piece I lose myself
To the waters of the sea
Maybe someday it will wash to shore
And reach eternity

Maybe one day I'll pass on
As pieces here and there
Put together in eternity
With my Creator there

Until then I'll fall apart
Riding each new wave
Until my mind or body gives up
And sends me to the grave

Each storm will take a piece of me
I'll never be made whole
There really is no point of this
No point to stick around

The waves keep crashing
The sun keeps hiding
The sea keeps moving
To a life of misery
Maybe one day it will swallow me whole

12/10/16 Poem
I'm sinking with no life vest
Down into the deep dark sea
Who will come to my rescue
Does anybody hear me?

I've been holding on so tight
To what I thought was hope
But now it's stripped away again
And left me with some rope

Some rope to tie around my neck
Just hoping it will break
And end all of this craziness
Just for Heaven's sake

Give this world a rest at last
For their burden will be gone
There will not be anymore of me
To continue to lead them on

A break for the world
For my deep pain
Is long overdue
And I'll be swimming with the fishes
In a sea of ocean blue

My soul will finally be at home
In the dark blue sea
The drowning will be over
As will the misery
There will be no tears to
Cry, nor pain to feel at last
Cause finally my body
Will be at rest with the past

Sitting in the dirt thinking of
A dream I once thought I had
Wishing on stars I once thought
I could see
Then reality comes to my eyes
There were no stars, there were no dreams
Just broken hearts
Crying eyes
Missing pieces from a fractured life

Empty promises
Painted faces
And a lot of lies
That's when I realized
There's no point in this life

So why go on when all you see
Is destruction and misery?
Why press on if all that's there
Is another lie and an empty chair?
Why keep pushing to the end
When all that's there is another bend?
What's the point?
This just doesn't seem right

Let this world just move on
Let her just be gone
The world would be better anyway
So let her go on her way
Swim with the fishes in a new day
No more drowning, no more pain
Just a new freedom

Move on now, just like before
She doesn't even matter anymore
Life goes on like it did
Soon enough you'll forget what she did

And life will be what it was
It will continue on like before
People come and people go
Just like the ones you used to know
Life keeps going good and bad
It'll keep moving happy and sad
We all just have to deal with the mad!