Well, it has been way too long, dear reader, since I have checked in. A week after finishing the outpatient program, I flew from Chicago to Dallas to spend a couple months with my family. The purpose is establishing healthy routines I’ve fallen out of. The very routines that could anchor me and my moods in an environment that will help stabilize the swings. Plus I’ll be in a supportive, social environment to help make the process a success.
That stabilization is the theory anyway. 😀 My therapists and psychiatrists are on board. And so I’m giving this a try.
We are focusing on getting up and going to bed at the same time (something I’m already ok at), showering regularly (which I’m not good at), eating regular meals with more healthy snacks. I’m also focusing on regular exercise by walking after breakfast and water jogging three times a week, with some treadmill thrown in. I’m going to church on Sundays, an important part of my spiritual practices.
I also brought all my art supplies and books and paper, and there are puzzles here, to do some art therapy and some mental exercising. It’s been two weeks and I’ve already finished my first 500-piece puzzle ever!.
Sadly, with all we are doing, I’m still heading into a depressive episode now and I’ve been feeling alone, fearful and suicidal (with plans) too. I can’t win. And I’ve gained weight even with all the focus on losing weight. Gah! Not helping.
I talk to my therapist once a week. Today we talked about my resistance to defusing from my thoughts (ACT skill), and how I can use my support system better, when I’m out of my home and close to them.
I just don’t want to feel alone and fearful anymore. Here or at home.
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Now that my shameless plugging is done…
I am doing an all-morning outpatient program Monday through Friday. Group therapy, skills, expressive therapy – all working to put me back together again. Following the program, I’ll be going to Texas for a couple months to be with family for reestablishing healthy ADLs (Activities of Daily Living – hygiene, cooking, exercise, cleaning, etc.) that I can then use and not neglect when I return to my little apartment. One of my friends will board my cat for me while I’m gone – very generous!
An important revelation occurred to me in the last couple days. I’ve felt shame, ashamed of myself, since I was a very young child. Guilt is something you feel when you make a mistake. You can make restitution, ask for forgiveness, and change. Shame says “I am a mistake,” leaving very little room for fixing anything. I think this shame I’ve felt for so long may be fueling my suicidal ideation. If I’m not worth anything, then might as well take me out. It’s a wonder I only came across suicidal ideation after the fall of a high mania when I landed in the hospital with suicidal depression. The visions of me killing myself have plagued me since – almost 7 years now. And yes, I still feel shame. Not sure that will ever go away.
asMid January through early February I spent in the hospital. Yes. Again. My psychiatrist was adamant we need to find another way than bouncing in and out of the hospital. I agree! The changes we agreed upon were staying with friends if I didn’t feel safe. That would allow me to ride the wave of emotions longer without using the hospital before I need it. And it would provide a chance for me to trust myself to keep myself safe. These things seem basic and “Why didn’t you try them before?” We have, but not with the same rigorous energy to keep me out of the hospital. The bouncing this time was ridiculous.
In other news, I’m still in physical therapy after shoulder surgery in early December. It still hurts, and the exercises seem to make it hurt even more. This pain has kept me from getting back into the pool for water aerobics. I’m too concerned about damaging the progress we’ve made. I could go to the gym and focus on the lower body. I’d be moving and re-establishing the habit of going to the gym. The water aerobics classes that are best for me are in the evening. But going to the gym in the afternoon and evening uses up any available energy. I’m a better morning exerciser.
A real factor in the exercise department is that I’m depressed and low energy from the depression. Any extra energy anywhere is like pulling teeth. So even though there is concern about hurting my shoulder in the pool exercises, the going-to-the-gym option seems less of an option because I am depressed. I already feel bad about myself. Now I can have guilt for not exercising added to that. Another real factor is that my drugs keep me hungover for most of the day too. And yet another real factor is that I made the decision I’d rather be healthy than skinny. That doesn’t help motivation to get back to the gym. I do still want to work out, but I’m less concerned with weight loss. Might be a mistake, but my mood affects the decisions too. I’m still trying to manage the mood. How am I supposed to manage pain and weight loss too, when my energy is zapped and I feel horrible about myself anyway?
One foot in front of the other in a boring life right now.
I’ve been out of the hospital for a month now. That is a milestone for this past year. Last time I was out for a significant period of time was last spring and summer for 6 months. I wasn’t happy, but I was out of the hospital. Not suicidal at all.
It was a mostly good time. I was doing important volunteer work, but it wasn’t feeding me. What was missing was something that seemed meaningful to me and used my skills that I still had from being a pastor. I wanted to speak and teach, two of my greatest strengths and what I imagined I would do in the future. Instead I was volunteering where I was mostly alone.
This time around I am putting together a presentation that I will share with churches. “Hear the story of the Rev. Deborah xxxx and her life with mental illness and how congregations can be involved in mental illness help in and outside their doors.” I’m offering it for free – there is no barrier for small churches with little or no budgets for adult education. I think this will help with reducing my own stigma about myself, as well as stigma in society. Congregations can be powerful actions for change. I can start somewhere.
I feel like I’m doing meaningful work and using the skills I love the best. I hope this keeps me out of the hospital for a very long time.
My longest stay occurred from early March to late May. I was mostly confident I could discharge since I was going to a friends’ house to stay and daily spend some hours at home for a couple weeks.
I was overwhelmed with my first time back at home, even with friends there. And then again today when there alone. It’s filthy, with even just one cat living there alone. I guess she really does need staff to look after her. I called a cleaning service but they are booked out till the following week, which is probably the case for most places. So, I’m looking for teens who need spending money. 🙂 I can’t do this alone. I’ve got to keep asking for help. I spent 80 days institutionalized. Living on the outside takes some time.
Some details about my time inside. My doctor increased my mood stabilizer and lowered my anti-depressant. That led to a depression that led to a suicide attempt. So we spent 6-8 weeks coming back up from depression. Then we tried a different mood stabilizer cocktail. That didn’t seem to help. Then we added an additional anti-depressant to help the one I was already on. That would take 4-6 weeks to kick in, and we figured I’d be out before it kicked in but ECT would speed up the process. So I tried one ECT again and called it quits. It’s just not for me. Never got results from it anyway. And as it turned out, I was in the hospital the 4-6 weeks needed for the second anti-depressant. Meanwhile I’m taking heavy duty prns to handle anxiety and agitation. Finally got a day of stabilization without having to take haldol or thorazine on a huge increase of mood stabilizer. I got sent home with haldol and accompanying drugs just in case.
All the while I’m in daily group therapy with a very good therapist. And we uncovered the shame and anger and embarrassment of being in the hospital again, of having and living with bipolar and having to ask for help. Lots to talk with my regular therapist about.
For about 9 weeks I felt like this:
Death is not. It is nothing
I am not. I am nothing.
I don’t want to die. I want to die.
Make it end. Make the thoughts of hurting myself end.
Make the emotional pain end – anger sadness.
I am less than human because of them – thoughts, feelings.
I am pain, a hemorrhage of negativity.
No one understands unless they know this darkness.
Black hole, sucked into nothingness from images of gruesome death.
Am I romanticizing it, or speaking truthfully from a hurting being?
I am not thinking of others.
Their pan will be deep and unending.
I will not be in pain anymore.
Whose pain is worse?
Do I deserve to be less human because others will have pain?
It’s been well over two months since hospitalization, but I had such a difficult time around Christmas that I feel like stability started with the first of the year. I feel mostly stable – mood pretty solid and thoughts of suicide everyday (my baseline) with varying intensity. I’ve had a cold which kept me down a few weeks, still recovering from that. At its height I had fewer suicidal thoughts, which my doctor expected. “Your brain isn’t thinking well and shuts down.” Hallelujah for sick brain! Got a few days off from thinking I need to die.
I haven’t been volunteering (or exercising – sick), so my schedule revolves around television and being social. I’m starting to get an itch again to volunteer – the first I’ve felt in several months. I want it to be in mental health though, which has been my dream for a few years. Sharing my story or teaching a class. Office work. I have to be out of the hospital for at least 6 months for one main place that is the obvious place to volunteer as a speaker. I’ve found a few places in the local area worth a phone call. Maybe there is something I haven’t thought of in the depths of google.
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.