Every Moment a Burden

Thirty-nine days ago I got out of the hospital after ins and outs all fall. So, by one measure I’m doing well. I’m making it and not feeling suicidal enough where my safety is at stake to have to go back into the hospital. I appear to be surviving and maybe even thriving.

On the other hand, every moment, every minute, I feel a heavy burden to push through that moment to stay alive and try to be engaged in that activity or conversation. I’m plagued by suicidal thoughts, or at least thoughts of sweet death, every day multiple times, and every evening like clockwork at 7pm and worse 90 minutes after taking my dinner medication.

I’m so tired of all of this. I don’t know how I’ve made it 39 days, and I certainly don’t know how I can go another 39 like this. I don’t know how I can go another day like this. I wake up and don’t look forward to anything except sitting on the couch, even if there are things to do that day. I’m not engaging in the day. And every evening I’m disappointed that the day is over because I have to go through another day and another work out or getting to an activity or going to a social gathering. It literally hurts. I hurt. The pain sears my soul.

This is depression. Suicide is starting to look good again as a solution to depression, but I can’t think of a successful plan that I have access to. I feel at the beginning of a spiral into a dark, suicidal depression. It starts with every moment feeling like a heavy burden and not being able to take care of myself properly (which I’m not). Help.

19 Days and Counting

19I’ve been out of the hospital for 19 days. I was lucky. I didn’t get manic over Christmas. I did get scared that I was going to have manic symptoms, but I kept busy and with people, and I think that helped me keep my mind off religious stuff and the possible mania. I did get hypomanic for a week starting before Christmas – stayed up late, spent too much money. Then day after Christmas…CRASH. Depression. As is usual for bipolar. For every up there is an equal and opposite down. Wish it worked the opposite way – for each down there is up, or at least a normal. But alas, no.

I don’t have a lot of optimism for the new year. I have plans with friends for New Year’s Eve at least. As I think toward the new year, all I see is the ever-revolving moods from severely depressed with suicidality to slightly depressed with manageable suicidal thoughts. And throw in a couple hypomanias throughout the year to make it interesting. I don’t trust that I can keep myself safe, or want to. I’m sure I’m pessimistic about the future because I’m depressed and feeling somewhat suicidal.

But it’s only been 19 days of some stability where I was fearful for much of it. Hard to say that I was stable when I was worried about becoming too manic. I was thinking that once the new year started, it would be time to return to volunteering and schedules between working out, volunteering, seeing friends, online dating. I’m scared I’m not ready. I’ve got a stack of books I haven’t been reading because I was knitting for Christmas. I can barely get myself to the gym. I can barely get myself something to eat, let alone good and healthy to eat.

Then I remind myself it’s only been 19 days. And I can ease up on myself. Maybe I won’t be ready next week to start volunteering, or to increase work outs to 5 days a week. Maybe I need more stability before I can return to volunteering. I wasn’t going to return to online dating until I’ve been stable for at least a month. And like I said, I’ve been out for only 19 days and worried about moods and been through 2 moods in that time. Maybe stability starts on January 1.

Awaiting Xmas Mania

hospital
I ended up in the hospital for about a week after that last post, and I’ve had a week to do non-treatment oriented activities for a week now. I started getting better in the hospital when I stopped going to groups and stopped doing the workbooks that I had brought with me. So, my care team agreed that I should not do the home residential program anymore and focus instead on fun things and keeping busy with friends and knitting and reading and baking (if I feel like it) and other things. So far this plan is working. I’ve had a couple hard days where the suicidal thoughts I have every day were more insistent. But I’m still managing them.

I did just find out that a friend died by suicide. While I grieve for her and her family and friends who were closer to her than I was, I find I’m still ok. I do wish it was me. That’s the nature of my illness and daily suicidal thoughts.

mania1What I’m more imminently worried about, however, is the euphoria and delusion that I’ve gotten at Christmas for the last, oh, 30 years. The delusion is only 17-18 years old, but the 2 together have been strong for quite a few years together. They usually peak on Christmas Eve and resolve in the days after Christmas so that I’m usually ok by New Year’s Eve. The euphoria is a grandiose union with all things natural and supernatural and accompanied by increased energy. It’s disorienting. And the delusion is also grandiose – I personally am bringing and will bring salvation to the world’s problems.

My therapist says euphoria is ok and bearable as long as I don’t make decisions while experiencing it, and that a pattern doesn’t make it inevitable. A saving grace is that for both I’m usually aware of them, which keeps me safe even through the mania. If I was unaware of them, I would need others to be aware of them to keep me from making decisions in the grandiose state – like spending lots of money that I can’t repay. I made end-of-the-year donations yesterday and I’m second guessing that I was overspending. I think I’m ok, though, despite the amount. But that’s exactly what the grandiosity would say. So I should probably check this out with someone.

One behavior I have needed to keep in check since the beginning of November is over-anticipating this euphoria. Last year I had the euphoria for almost the whole month. It was horrible, and I ended up in the hospital. What a surprise (she said, deadpan). So, I’ve made it to the 19th of December and been ok. I’m heading into the week when the 2 usually start, and I’m trying to stop thinking that they are inevitable. But I think dying by suicide is inevitable too. So, inevitable is part of my disordered thinking. That’s something to work out with my therapist. Stopping the feeling of inevitability of something that’s a pattern and the inevitability of a gut feeling.

Miserable

Over the last couple weeks I’ve had to call a suicide prevention crisis line (1800-273-TALK – call them!), written a will and ruminated to no end on what possibly I could do to kill myself. My other plans will just land me in the ER, not what I’m searching for. I’m looking for an end. And I’m miserable waiting for one to show up – tortured by thoughts of wanting to hurt myself and tortured by the feelings behind those thoughts (sadness, anger, desperation, frustration).

But a part of me still asks for help and uses skills to make it through difficult moments. I do things that are healthy and seem to make a meaningful life.

My therapist surmises that I really want to live, and we need to wade into the painful waters of the feelings behind the suicidal thoughts and behaviors. It won’t be easy, will likely be very painful, but it will end the suicidal spiral I’ve been in for so long.

I decided after the time with my therapist that I didn’t need the safety of the hospital and could go home. I could be miserable at home or miserable in the hospital. Only difference is safety. And since I don’t have a viable suicide plan, I’m just miserable, which isn’t a real reason to go into the hospital.

All the way home, I questioned my decision as I wallowed in suicide visions and tried to think of a way and was miserable. I’m completely packed up and ready to go in the hospital today. Sometimes I don’t pack up all the things, and just carry the clothes in the trunk. But after the last couple days of misery, I was worried that my psychiatrist or my therapist would send me to the hospital. I was very, completely, gruesomely honest about my plans and actions. Both of them leave the decision to me to decide if I am safe or if I need the hospital. Why, O Why, don’t they help with the decision???

So, I’m heading to a NAMI support group meeting (National Alliance for Mental Illness) where I’ll have a chance to share this and get some support, I hope. But I think I should bring all my packed items in case it’s too much and the misery makes me unsafe. Or I come up with a plan that would work. Because I’m pretty sure I would follow through if I could be sure it would work.

Religious Euphoria and Mania

adventToday begins the ban on contact with religious anything for Advent and Christmas. Since childhood, and worse in the last 23 years of bipolar expression, I’ve had a religious euphoria where I get delusional around Christmas. The experience usually culminates on Christmas Eve. But the mystery and mysticism that many churches infuse in their Advent celebrations has been known to trigger the delusion earlier than the week of Christmas. Last year, for instance, I had the delusion for the whole month of December.

It is common for bipolar mania to be religious in nature. Mine happens to take the form of a heightened sense of spiritual and physical unity with all of the world – people, animals, nature. That’s the euphoria part. The delusion is that somehow I personally – not Mary – am bringing salvation into the world by bringing Christ into the world, and I have a mission to help everyone experience the mystical unity with Christ and with all of the world in order to make the world a more peaceful place. This experience is long ingrained into my experience of Christmas, and I don’t know that it will ever go away.

I have had the euphoria experience many, many times, each an expression of bipolar mania, and not a rich spiritual life as spiritual directors and other pastoral colleagues I’ve confided in have thought. Each euphoria, when it reaches its peak, has a piece of the delusion in it. I am to save the world with my actions using the power of Christ. During one manic experience, the mania before my first suicidal depression, I was inviting strangers into my home for movie discussions about the efficacy of religion. Fortunately, no one showed up for the series. I was convinced at the same time that my religious experiences were pushing me to become a Benedictine Oblate. I was flying so high in my euphoria that I was blogging about the breathless unity and clarity of vision and the visions I was having. I even started preaching about them (I was the solo pastor at a church at that time). That was the highest mania I have had, and it crashed hard into a suicidal depression that I have been dealing with off and on for over 5 years. It was the first time I felt suicidal. It is common for manias to be followed by an equal descent into depression. The higher you fly, the lower you crash.

Back to today. In order to prevent or lessen the euphoria and delusion that I’ve had at Christmastime since I was a child, I do not participate in anything religious about this time of year. It’s hard to give up what was my favorite season and holiday, but it was my favorite because of the manic expression and delusional euphoria I experienced. It felt good to fly so high and have a purpose for my life! It will still be years until I might be able to tolerate or celebrate Advent or Christmas again. Maybe it’s the way it’s celebrated in mainline churches that makes this time of year so hard for me. I find it hard to tell because I started attending mainline churches at the same time as my bipolar flowered and my mood cycles kicked in.

I’m having an especially hard time this fall, and now it is likely to get worse as the euphoria and delusion will probably kick in. I’m acutely aware of the community I’m missing by not attending church or fellowship. Even people I only know by sight. I’m losing a significant piece of my support system.

I will return to church after Jesus’ Baptism Sunday (baptism and communion as sacraments are hard for me too – a little too mystical and could trigger some euphoria). So sometime in January I can go back to church – until Holy Week and Easter, another banned time for me because of my tendency toward religious euphoria during mystical or special times in the church year.

I <3 bipolar.

10 Days into DIY Residential Program

I’ve made it a considerable amount of time into the program. I have adapted to the schedule, but I’m starting to notice days when I’m doing too much according to the Spoon Theory, and then having to make up for it with a mostly day of rest.  Therefore, I’m still trying to find the balance. I’m staying away from the gym as much as I usually go (5 days a week, down to 3, maybe 4). That reduction might be reasonable with what I have planned. I go to a NAMI support group twice a week and a MeetUp group once a week. I’m having meals or coffee with friends in person or online once or twice a day in order to keep social and not just be focusing on myself in my little corner. I see my psychiatrist and therapist once a week each, and my therapist calls me another day. I’m part of group therapy/class called AIM for an hour twice a week.

It’s a very busy and focused schedule, very much like how regimented a residential program is – which is the point of what I’m doing. The other thing that is going on that makes this likes a residential program – again, the point of what I’m doing – is that it is bringing up painful or uncomfortable issues that I need to address and resist addressing. Having places and people to process with, and expressive therapy such as art therapy every day, helps me try to change a little bit at a time.

I need to stay away from the hospital, or what it represents – safety from myself for feeling suicidal. I have many times come to the conclusion that I will always have suicidal thoughts, and many times I’m able to use Thought Defusion and Expansion/Acceptance to just let them be and go on with my life. I was especially able to do this after the residential experience in February, and stayed out the hospital for 6.5 months. Since early September, I’ve lost this ability and been in and out of the hospital. I had such a hard weekend that I thought I was going to end up in the hospital again. In my trunk I was carrying a bag of clothes and toiletries to go the hospital. It’s still there.

Addressing committed action according to my values – core idea of ACT – seems to trigger me toward believing that I’m not sure I want a life at all and suicide is a good idea. I’m ashamed that I believe in suicide, but the mental pain becomes so strong and I can’t find a way out or through. And the pain takes me by surprise and I try to use skills, to no avail most of the time.

Yesterday was the first day in a long time that the thoughts were less and I felt like I  could manage the thoughts. Today, not so much again. I think I need to fully pack for the hospital when I go out to see my psychiatrist since she is near the hospital. I’m ashamed of how many times I end up in the hospital for not being able to handle my suicidal visions and thoughts and the desire to die. I know that’s what they are there for, but I am embarrassed each time I go. I have the belief that using the hospital is a one- or two-time experience to stabilize you and then you use outside resources to keep going in your treatment. I shouldn’t need to be stabilized so freaking often! 30 times in 5 years. Sigh.

I hope I can continue in the DIY residential program, and I hope it keeps me out of the hospital.

One Week Done with DIY Residential

It’s been about a week of the DIY Residential Program. Following the strict schedule has been moderately easy. Dealing with suicidal thoughts has been HARD. As happened at my residential therapy experience in February, and is happening again – a rather normal reaction – I felt challenged by the material and resisted what my therapist and group therapy and classes presented. I’m resisting the ACT requirement of Committed Action toward your values, because I’m not at all sure I want to live or have a meaningful life. I think I’m just resisting and I’ll eventually break through, provided I don’t end up in the hospital first.

I looked up on the internet overdosing on my many medications, I called a suicide prevention hotline (1-800-273-TALK – they are amazing!). I keep a bag packed in the car in case I need to drive to the hospital. My support system has been life-saving, and I’m so sorry for dragging them through this horrible journey. Partly it’s because I don’t have residential staff to talk to about the terrible things I think about or see in my head, so I’m sharing them with my support system, local and national. Y’all have been great at encouraging me to keep moving forward and not follow through with the thoughts and visions. But as one of the images below says, I feel like I’m on a never-ending treadmill of suicidal voices and visions that I use defusion on every time they come up. Which is A LOT. In the middle of conversations, in the middle of reading, when I’m laughing at something someone said or at a funny show. Any time I’m alone, or with people. There they are, waiting for me to give in this time.

I started a new workbook that is specifically for using ACT with depression. I have high hopes for it. Until in one early chapter it makes the claim that depression is only a little bit biological and almost all about how we respond to situations – emotional avoidance or fusion with unhelpful thoughts. I’m still open to what it says, as clearly I need new ways of coping. But even though I’m depressed, I feel like I’m depressed more from the suicidal thoughts than I am in the traditional sense. I still get up and do everything I’m supposed to do as though I am following my values. But I still feel numb and separated from life, which is a feeling associated with depression. I’m avoiding feeling the emotional pain of suicidal thoughts? or what the suicidal thoughts are trying to tell me? (that I want things to be different? that I want to be strong again? that something needs to change?)

I also think I’m lying to myself in a couple different ways.

  1. I keep saying I want to die and need this life to be over. But I keep asking for help and I keep doing the positive things such as taking care of myself, exercising, socializing, going to the hospital to be safe, etc. Those are things that seem to say that I want to live and I want things to be different, not that I want to be dead. I really like the thought of being dead though. I’m very fused to that idea and I use a lot of defusion techniques with that one. So the lie is that I want to die, when my actions say I want to live. Which is what my therapist says too.
  2. I’ve started saying that I no longer have viable options for killing myself since the information I got about overdosing looks like I’d just end up waking up in the ER or ICU with heart and liver and other damage, or if I took enough I’d have seizures and a heart attack. Not the go to sleep forever image I have in my head. And I’ve mostly given up on slicing my arms or throat open after talking with people who have and still ended up waking up in the ER. So, the only plan that would really work involves a gun and I don’t have access to one, which everyone says is a great thing. It seems that I don’t have viable options. But I think I’m lying to myself, because maybe a heart attack from too many meds wouldn’t be so bad. I’m totally irrational on this lie. I really don’t think I’d do anything, I’d rather die from something that took my life and I didn’t have to do it. I just really want to be dead, which is the subject of Lie number 1 above.

With all of these lies and thoughts I’m continuously using skills to defuse from, to make room for them to just be, and just be words and just be pictures and not be imperatives I have to follow. I’m doing the right thing according to everyone in my care team (about 6 people, plus a bunch of auxiliary people when I’m in the hospital). I just still really want to be dead. And out of pain. It hurts a whole heck of a lot to feel like there is a black hole in the center that is slowly, tortuously sucking you dead into its center.

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