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.

2015-11-22 14.24.34


2015-11-22 14.42.23

A Rich and Meaningful Life

I’ve been working with the Thought Defusion as described in the previous post, and added Expansion, which is making room for thoughts, images and emotions to be there – don’t have to like them, just let them be there. And finally, getting in touch with Connection, the Observing Self that is always present, never judging, who only notices and sees what is thought about, felt, experienced (also known as Mindfulness in Acceptance and Commitment Therapy). These open the doors to being able to have a deep, rich, fulfilling, meaningful life based on your deepest values because you are no longer a slave to your thoughts, emotions, and images or memories.

That’s the theory anyway.

Then there’s me. Today I drew this.

2015-11-19 15.36.16

And I talked about the art and the thoughts with my therapist. I say I don’t want a fulfilling life and I want to die. She says I think I don’t deserve the fulfilling life and dying isn’t an option. That someone who goes to this much effort isn’t someone who wants to give up, but someone who wants change. OK. I’ll give her that. Change would be nice. I feel like I’ve worked my a$$ off for years and feel I’ve made very little progress. Even in the last few months the goals to meet my values of relationships and meaningful work – I added volunteering in more social atmospheres, joined more MeetUp groups and started attending them. And I still ended up suicidal and in the hospital. 4 times in 10 weeks.

Tonight I’m suicidal again. I can’t tell you how much I want to die and how much I don’t believe I’m worthwhile at all. I work hard toward my values, for what? Measly scraps of barely moving forward. Why try? I don’t want this magical, rich meaningful life. I want to be done. I can’t do this anymore. Therapist still says I think I don’t deserve the meaningful life. I say I just don’t want it. It’s too much bother. I’d rather turn in, thank you very much.

So, I’m using defusion skills as discussed in the previous post. In some small way I want to not believe myself. I’d like to think I want a meaningful life and I want to live. You’d think I want that with all the effort I’m going to in order to do this DIY residential program. But I’m defeated and can barely stand to live, much less follow my values. I’ll keep using skills. But I still don’t want to live.

Day 3 – DIY Residential Program

Well, I’ve made it to the third day of my strict schedule of workbooks, expressive therapies, meals, gym time and free time. I’ve had a FaceTime meet up with one of my supportive friends, dinner with another, and now lunch with another today. I’m still feeling pinched for time and tired a lot. I think I would feel that at an official residential program, because it takes a few days to acclimate. And that’s what I’m doing in the DIY program. Still acclimating to the schedule. The highly detailed google schedule is a life saver. I just have to look there to see what I’m doing, for how long, and with whom. And I’m logging whether I’ve done it so my supportive network can keep an eye on me. And they are! Thank you!

I’m noticing that I wish there were staff to process stuff with. I miss that daily check-in and extra work with a therapist to work on issues as they come up. I’m journaling, but mostly as notes for what I’m learning and not thoughts on what I’m learning. I do miss the staff portion of a residential program.

The topics I’ve studied so far have been self-worth (from a Cognitive Behavior Therapy workbook on Self-Esteem that I had from my therapist to review), and Thought Delusion (from an Acceptance and Commitment Therapy book, The Happiness Trap, which is the therapy I’m focusing on). The self-worth brought up tons of stuff, naturally, since I feel worthless much of the time which leads to feeling like throwing it all up in the air and exiting stage left.

However, the ACT topic of Thought Defusion, which I know and practice not as much as I should, reminded me that just exchanging negative thoughts with positive ones doesn’t work. And don’t we all know that. Better – stop being fused to them and believing them and following their commands. Instead, notice them as part of the thoughts that the brain churns out regularly and move forward with your life anyway. You can’t stop the thoughts from coming, but you CAN let them be and move on. And when you find yourself believing them, you can defuse from them with various techniques like saying to yourself, “I notice that I’m having the thought that…” or singing the thought to Happy Birthday or Jingle Bells, or saying them in a funny voice or thanking the mind nicely for offering its opinion. It takes the power away from the thoughts. You can use these with images and emotions too.

I had the opportunity to use Thought Delusion a lot yesterday as the old story of letting go of life via suicide reared its ugly head. I was defusing like mad. Eventually the emotion waned, as they do, and the thoughts were left with little power. But the anxiety and desire were hard to get through. You don’t use the skill to get rid of the thoughts, feelings or images, but to move past them by just noticing them and doing something else.

Here’s to the next topic!

I Need Your Help

30 Day Plan

30 Day Plan

I was just discharged from an 11-day stay at my local psychiatric facility. My 29th hospitalization in a little more than 5 years. Kind of a lot. Up until 4pm yesterday, the plan was for me to do another 30 day residential program at a place in Chicago. The timing was even good so that by the time I started, it would take me through Christmas when I tend to get delusional, if you remember. Last year I was delusional the whole month. Fun, fun!

Anyway… at 4pm on a Friday, we heard that a Vice President where I would do residential had ruled that they would not send the “Opt Out of Medicare” letter to my secondary insurance so that the secondary insurance would pay at the in-network prices that they were contracted to abide by. No. Supposedly they had tried that before and not been paid. Therefore, I would have to be a self-pay client and possibly get a loan for a considerable amount of money. I’m guessing $25,000 is a conservative number.

clockSo, with some coaching from the staff at the hospital where I was staying, and the wisdom of family and friends, I have devised a detailed, hour-by-hour,  month-long home version of a residential experience. All the skill-building and expressive therapy (workbooks, books, art and music supplies), minus staff and supportive environment. I will still see my therapist and psychiatrist weekly, so there is some staff oversight.

Here is the part where You, dear reader, come in. I need a supportive environment -people- who are willing to check on my progress using a google calendar, or do a google hangout/skype/facetime check-in and talk about anything, or go out to coffee, lunch, dinner or whatever with me (local peeps, natch). My goal is to have at least one social interaction a day for the 30 days I plan to do this.

If you can help, would you contact me via Facebook Private Message, Twitter Direct Message, Text or Email with what you might be willing to do and your email address? You can share the information in the comment section below, but then everyone will see your info – maybe not what you want to do.

I will make a group email to let you know how things are shaping up. You will need a gmail account to see the calendar or do a google hangout. You need an iPhone to do FaceTime. And it’s easy to sign up for Skype and then we friend each other.

Thank you for taking this journey with me! Let’s cross our fingers that this plan helps me feel less hopeless and worthless. And maybe I can stay out of the hospital for more than 6 months. Maybe years. It would be great not to feel suicidal for years, since I have the thoughts and visions every day. Le sigh.

Hospital and ECT

As you may have figured, I was hospitalized after that last post. I couldn’t deal with the desperation anymore and went to the hospital. I was there for 17 days. And when medications no longer offered help, I tried ECT again, 4 1/2 years after trying it and having long-term memory problems. I had 3 treatments and the whole situation weirded me out. The nervousness, the going to sleep, the waking up, the memory problems. And I stopped treatments. I couldn’t live with the side effects.

So, I’m back to hoping meds will reduce my depression, along with making some lifestyle changes – additional volunteering and in more social situations, getting involved with more social groups through MeetUp.com and doing some online dating. All of these are sanctioned and encouraged by my care team.

The reality, however, is that I am profoundly depressed and only being with other people seems to help a little bit, though I burst into tears for no reason. Sorry, friend. It’s not you, I swear.

I’ve also been still feeling the effects of ECT, I think. I’m afraid to be in my apartment. It doesn’t feel like home and especially going to bed and to sleep brings on anxiety. I’m out of sorts and off-kilter. It’s not so much anxiety I feel as fear and I don’t know what I’m afraid of. Perhaps being alone, or just that it doesn’t feel right yet, because I don’t feel right after ECT yet?  More side effects I couldn’t anticipate and that I can’t live with. The feeling of my life being strange to me. Spending time with friends and going to church felt weird too – I’m not myself yet. I’ve been through something that changed me and it’s hard to be the same with people. I’m different and my experience of the world is different, including how I feel around others. More weirdness around friends. Sorry.

I don’t know how long I can continue being depressed and out of the hospital. What will it be that triggers desperation again? Meanwhile, I’m just trying to ride the wave of the feelings and do opposite actions to my emotions (watch funny things though I feel sad, for instance). These are Dialectical Behavioral Therapy techniques that work really well for me. It’s hard to think I have only a few things that keep me from feeling so desperate in the depression that I want to kill myself. But I’m holding on as tight as I can to anything that is working. And I’m working closely with my care team. And I’m adding meaningful activities to my life so that hopefully soon I feel more joy again. It’s been a long time. And the summer was full of loss and depression.

Perhaps I’ll be able to last using these skills and meds until I get delusional in December when Advent and Christmas take over my consciousness. Which can lead to a hospitalization too. Grrr. August through December is my hardest time with my illness. Just one day at a time is the best I can do. Sometimes just an hour at a time. An hour when I convince myself that life is worth living and I’m not pond scum for feeling so depressed.

What I Want to Write

I haven’t written it yet. I have a little hope that I won’t. I’m suicidal again and have activated a safety plan that may keep me out of the hospital. Yesterday I was completely convinced I wanted to write a suicide note and overdose on my meds. Today the urge is less, but my friend has my meds, and so I have less ability to follow through. 

The urge is frantically searching for a way out of the deep pain I feel. Some other plan to die so the pain will stop. The pain of grief for 2 cats lost from my household, from a recent divorce, from the acceptance that I may never be able to work again, and be a part-time volunteer forever. The pain of a deep knowing that I will die young, perhaps at my own hand. The pain that is depression – a vice around my heart and one around my brain, squeezing life out of me, as my gut has a constant sinking feeling.

This is what I want to write:

It’s not your fault. I tried every conceivable way to deal with the intractable pain, and I couldn’t bear it anymore. I found the end of my rope and I can’t hang on anymore. I know you will weep for me, but weep also for the pain that had the power to drive me crazy. I’m not in my right mind, and I can’t find it anymore. Know that in my right mind I said and did things that showed I cared about you. And I meant it. Hold on to that, and let me go so that I don’t hurt so deeply anymore. There was nothing else you could do. Don’t blame yourself. I couldn’t fight anymore. Bipolar wins. Be mad at that.

That is what I want to write. And I’m ashamed of it, but I’m honest. At least give me credit for honesty.