Tag Archives: Crisis

Succumb

I often feel like I want to succumb. Especially in the weeks after my first overdose last July, and again now, I find a form of peace and comfort in the thought that I could do it again. Note that I don’t want to die and the fact that apparently I could have died, makes these thoughts scary at the same time. I still envision myself coming out of a possible suicide attempt alive each time. It’s really hard to imagine anything else, as, you know, when I’m dead, there’s no longer me, so nothing to imagine for me. I mean, yes, I sometimes imagine what my funeral will be like, but the very fact that I can imagine it, means I’m alive.

I rationally know, these two times that I did something that could’ve cost me my life, that quite frankly there’s nothing positive about this. I mean, at the end of the day, each time, I still returned to my life as it was before my overdose. I didn’t even want to be taken to the psych unit and there was no need for it either.

How different were these events from my major crisis of 2007? At the time, I didn’t even take any actions that could’ve cost me my life – I just threatened suicide. However, I badly wanted, needed even, to escape the life I was in at the time. This was effective, as I went into the mental hospital and didn’t leave institutional life for almost a decade. Now I’m in the community again and it’s proving hard, but I must say, not as hard as I’d expected it to be. If things had gone as I expected them to, I would’ve been in chronic crisis mode. I’m not now. I don’t make any plans to end it all. Not that I did so back then, but I did run away from my home each day for a week before I finally crashed and threatened suicide.

I don’t know what makes my current thoughts that I can, if I want to, take my life any less serious than the thoughts I had back in 2007. After all, I did have these thoughts for several months following my crisis. Still, they feel less serious now. Is it because now, I don’t dramatically over-express them (unless this blog post counts)? Is it because, other than having these thoughts and being in a pretty depressed mood, I still go about my business as usual? Then again, I did most of the things I had to in 2007 too, up to taking an exam at university three days before being hospitalized.

I think honestly, the difference is that, back then, I was over-emotional, whereas now, I am under-emotional. Back then, I experienced and expressed quite intense emotions, whereas now, if anything at all, I feel numb.

I don’t know whether this is better or worse. I have a feeling that it is less serious, as I’m not emotionally dysregulated like I was back then. I don’t go about having public screaming and crying fits. I barely go about expressing myself at all, unless again this blog post counts. I don’t go about making suicide threats to random people. I don’t even know what I want to avoid or achieve anymore. As such, I don’t make any actual suicide plans, but I don’t know whether I care if I died right now either.

This post is linked up with The Daily Post’s prompt for today: sucuumb.

December 2015 Goals

Wow, it’s December, the last month of 2015. Last Thursday, when my husband and I got the keys to our new home, we had to pay the rent for the rest of the year. It’s amazing and shocking at the same time how we have only less than 31 day sleft till the end of 2015. Today, I’m going to list some goals I have for this last month of the year.

1. Blog at least twice a week on each of my blogs. I have restarted my Dutch blog (again!), which means I now have to divide my blogging attention between two blogs. It’s not much if you see how many blogs I’ve created over the past years, but the fact is I’ve never kept up with more than two, so this is hard enough. I am terrible at dividing my attention, so I hope that this time it’ll be a success.

2. Not put on any weight. I’m not going to aim for weight loss in this festive month, because I know that’s just not going to happen. However, last week I was at the exact point weight wise I was last March, which was the heaviest I’ve been ever. It’s only a bit heavier than where i was in September of 2014, but it’s still significant that this is my heaviest weight. I just can’t keep on cutting mysef slack, because then my BMI will be over 40 in no time.

3. Finish at least one of the books I started reading earlier this year but haven’t finished yet. I’ll probably go for Girl in Glass by Deanna Fei.

4. Spend at least one week-end at my new home. I’ll most likely have no difficulty reaching this goal, as we’ll have to hand in the key to our old apartment on the 18th.

5. Buy my husband and father their birhtday presents. My husband had his birthday in mid-November, but he wants a tree for in our garden. I really do hope we can still plant it. My father has his birthday in mid-January, but I want to be early.

6. Not end up in crisis. December is one of the hardest months of the year for me, because the staff are often busy with holiday preparations and stuff and the whole unit is decorated and furniture moved. I have been in crisis each December since being on this unit. Since my medication can’t be increased any, as it was last year and in 2013, I just hope I won’t end up in crisis.

I really do hope I’ll be able to enjoy the holidays some, but that’s going to be hard. I am already thinking of what to buy myself for the holidays (or for any occasion). Last week, I bought myself some products from The Body Shop and I won’t promise there will be no more spending on gifts for myself this month.

Tips for Coping with Suicidal Thoughts

Screw you, #BEDN. I screwed up the day after I planned to continue writing everyday this month. Yesterday was a bit stressful. I baked an apple pie to remember the eighth anniversary of my psychiatric institutionalization, but I also felt overwhelemd with memories from the day of my crisis. In addition, yesterday was designed to be plan your epitaph day by the inventors of weird holidays. I only found out through this week’s #TuesdayTen. I was originally planning on writing a post on tips for coping with suicidal thoughts for #TuesdayTen, but the pressure of having to think up ten coping strategies and the doubts as to whether it’d fit in, made me skip the occasion. The idea stuck around though, so I’m going to write down some coping tips today.

The first important key is realizing when depression or despair sets in before you reach rock bottom. When you are acutely suicidal, most of the tips I’ll mention below will sound completely useless. However, if you’ve realized you are depressed or otherwise severely distressed, you may be able to enlist the help of others in staying safe. Here are some tips that can help you through some suicidal ideation. When you are actively planning suicide, these tips may no longer work and you’ll need to go to the emergency room or psychiatric crisis service.

1. Enlist the support of family or friends. Like I already said, supporters, such as family may be able to help you remember why you want to live. If not, they may be able to intervene to keep you safe whilst getting a mental health professional involved. When I was in my crisis in 2007, I had no support in the city I was in at the time. That is, I had my parents, but they weren’t particularly helpful (and I honestly can’t fully blame them) at the time.

2. If you don’t have family or friends to support you, there are support sites and telephone hotlines for people in crisis around the world. While again, if you are in acute danger, you need to go to the emergency department or psychiatric crisis service, when you are still able to talk it through, do so.

3. Think of what your goals are, what you want to get or avoid with suicide. Obviously, religious beliefs about an afterlife aside, you won’t gain anything from suicide. That doesn’t mean it doesn’t seem like it. Some people believe: “At least I’ll be able to rest then.” In this sense, what you want to avoid through suicide is important too. Discuss with your family or a mental health professional how you can reach this goal while remaining alive. For example, I knew as I was talking to the crisis service psychiatrist in 2007 that I didn’t really want to die – I mean, who wants to? -, but that I couldn’t cope with my life as it was anymore.

4. Think of the people you’ll leave behind. No, I don’t mean thinking of them having to make funeral arrangements and how selfish you are for leaving your family with the financial burden. That is not going to be helpful. Just for your information, as a family member, don’t ever burden a suicidal relative with this kind of crap, no matter how confident you are that they are “just doing it for attention”. However, if you do have people you still care about when you’re in despair, thinking about them can help lift your mood. Despair is an incredibly lonely feeling, but there are people who care about you.

5. Be careful about chanigng medications or other treatments for depression while you are actively suicidal. Though electroconvulsive therapy (ECT) is relatively safe for severely depressed people, antidepressants carry the risk of increasing suicidality. Always be sure to discuss suicidal ideation with your mental health professional and don’t change your medication regimen without close supervision, preferably from a psychiatrist.

Breakdown: My Crisis of 2007 #Write31Days

31 Days of Mental Health

Welcome to day 30 in the #Write31Days challenge on mental health. Today, I discussed the details of the mental crisis that I had in 2007 with a nurse. This helped me feel heard but it also was a bit unsettling. I vividly remember many of the details. I feel compelled to share my story here, but I don’t know how safe a public blog on the Internet is to do so. I shared the details in a post on my old blog (which can still be more easily found by googling my name than this blog) about a month after the crisis happened. I published the raw story back then, complete with every detail of where I was and what I did. I edited it more than a year later for fear it’d ruin my chances of ever having a normal life. If future employers (of which I think I’ll have none) ever read that I’m a nut case and spent eight years in a mental institution, they’ll reject me no matter how vividly I describe the crisis that led to said institutionalization. That being said, the original story was quite badly written. I don’t want to read even the edited version now. I’ll just share what I feel like sharing now.

I remember the crisis state started right after daylight saving time ended on October 28, 2007. Of course, I was spiraling down into crisis from the moment I started livign on my own in August and I had a minor crisis about once a week. The week of October 29, I started completley losing my mind. I wandered about in the dark each evening. The police took me to the police station a couple of times that week and called the crsis service, but they couldn’t do anything.

In the afternoon of October 31, I was called by the crisis service. I still remember the name of the crisis service nurse calling me and if I ever run into her again, which is unlikely, I’m not going to be pleased. She told me that I just had to find ways to distract myself and that a hospitalization would mean I needed to go back on medication. (I’d quit an antipsychotic three weeks prior. No-one later on drew the connection.) I didn’t care about going on medication one way or the other, but I couldn’t mutter a proper response.

On November 1, I took a trip to my parents’ city to collect a landline phone. I don’t have a clue why I had to sleep over there for a night just to collect a phone. On the way back to my city the next day, I had a huge meltdown. This wasn’t unusual for me when returning to my city from my parents’, but for the first time, the railroad service employee who was assisting me to get on the train back to my city, called the police. I hardly realized I was speaking to the police when they told me to leave the station. I wasn’t sure what to do at first, so wandered around. I remember somoene, no clue who, told me that if I could behave, I could come back to the station and get on the train to my city.

I decided to go to the training home which I’d been a client of before going into independent living. I was allowed in, but once the staff found out the police had been called on me, they asked me to leave. I can’t remeber what I did throughout the afternoon. I was supposed to have an early train, but didn’t end up in my ultimate crisis till 8:00 PM. I remember getting some French fries at a cafeteria near the training home and calling my independent livign support worker that I’d forgotten to pay my rent for November the day before.

A housemate from the training home offered me to stay with her for the night so that we could find a solution the next morning. The staff went into her apartment and told me to leave. They initially gave me some time, but I left instantly and had the hugest breakdown I’ve ever had. I was hardly aware of my surroundings as I told some people’s voicemails that I was going to commit suicide. I inferred the time from what the bus driver, on whose bus I’d embarked, told the police. It was the 8:01 PM bus around the eastern part of the city (in that city, buses go in circular routes or at least they did back then).

I was taken to the police station by the police again. This time I was in my parents’ city so the route to crisis services was even longer. The police had to call a community physician who was the most umempahtetic jerk of a doctor I’d met by that time. (I later was treated by an authoritarian psychiatric resident, but she never had to talk to me in the midst of a crisis.) The doc told me I was making people feel responsible. While I can see eight years on that he was right, I couldn’t grasp this back then. I don’t remember my response. The community physician called the crisis service. I have recurrent dreams about the psychiatrist, the only one whose name I remember. In my dreams, I run into her again as I get treated at the mental health agency near the tiny village I’m moving to.

I am a million times thankful that this psychiatrist didn’t stick the BPD diagnosis on me, even though in retrospect my crisis could be interpreted as a typical BPD thing. Instead, she talked to me – she showed much more empathy than the community physician and eventually labeled me with adjustment disorder, which basically means an extreme response to stress. She suggested I be admitted and right away clarified that a suitable living solution would need to be found for me while I was in the hospital. No-one could’ve known back then that it’d take eight years and I’d be going to live independently once again after that.

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Was My Hospitalization Inevitable?

I was reminded yesterday about the situation surrounding my psychiatric hospitalization in 2007. I had been put on antipsychotic medication three months prior and had quit taking it again three weeks before I ended in crisis and was hospitalized. Yesterday, when talking to my therapist about this situation, she suggested more or less that being hospitalized could’ve been avoided if I just continued taking my meds.

Really, I consider my crisis inevitable. When I was still taking my medication, I was very irritable; just not irritable enough for the crisis team to intervene and hospitalize me. “But other people don’t like to be hospitalized,” my therapist said, as if by quitting my medication I’d somehow manipulated the crisis team into an unnecessary admission. The thing is, I’d been on the edge of a crisis ever since I moved into independent living. Maybe quitting my medication was the final straw, but is it all that strange that you want help when you’re struggling with meltdown after meltdown after meltdown?

I saw this reasoning all along when I still lived independently. I remember my care coordinator once saying that it was better for me to bang my head against the walls of my apartment, than to go outside and scream. Well, what the bleep? Isn’t a person’s safety more important than the person being a pain in the butt? Besides, it isn’t like I made a conscious choice either way.

For clarity’s sake: hospitalizations aren’t fun. The psychiatrist who admitted me, didn’t do so to please me. In fact, I didn’t ask to be hospitalized, as I didn’t know what I needed really. Hospitalizations happen as a last resort. Long-term institutionalizations are certainly not a choice either. And just so you know, the fact that I’m an informal patient doesn’t change that.

Why did I have a full-blown meltdown yesterday after my therapist asked me to name the pros and cons of asking for help less? Why did I feel offended when she suggested that, with medication, I could’ve been kept at home? Why do I struggle with all this “least restrictive environment” bullcrap that I hear everywhere? I’d like to consider my hospitalization avoidable, and maybe it was if I’d just continued taking those pills. But as I said, I was completely on the edge for all those three months. Apparently, however, intervention is only inevitable if you’re literally (nearly) dead, and if you aren’t, quality of life doesn’t matter. Especially not if you’re also a pain in the neck.

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Comfort Rooms: Not a Convenient Alternative to Seclusion

A few days ago, the owner of a blindness and mental health E-mail group I am on started a discussion about comfort rooms. Commonly, they’re seen as a kind of less restrictive alternative to seclusion or restraint, but this is a misconception. I have personally experienced being placed in the comfort room and not allowed to come out. Being blind, I also didn’t really notice the comfort room atmosphere, which should be relaxing. In all honesty, the comfort room at the locked ward in the big city institution I was in, was little more than a beautified seclusion room. While the comfort room at my current ward in the small town institution is more calming in its ambiance, I still sometimes get told that I can go into the comfort room in a tone of voice as if I’m being secluded.

In reality, comfort rooms are but one form of relaxation for an irritable patient. For others, going for a walk, listening to music or exercising on a stationary bike might help. I can see why nurses choose the comfort room over some of its alternatives, for a patient in a comfort room requires relatively little care. That is, they are presumed to require relativley little care. All five or so times I spent in comfort rooms, once in my current institution and about four times in the city one, I was left alone whether I wanted to be alone or could safely be alone or not. In this sense, the Netherlands is different from other countries, where patients in crisis are placed under special observation. Here, if you need more care than the staff can provide, you’ll be placed in seclusion or “seclusion light”, ie. the comfort room.

A key aspect of introducing comfort rooms, is that they need to be embedded in a philosophy where the patient is actively engaged in their treatment. Time in the comfort room needs to be a choice. I for one find the comfort room particularly ineffective, and would rather go for a walk or exercise. One reason why I find the comfort room ineffective, besides having been coerced into using it, is accessibility. I didn’t have a clue what was in the comfort room, so was essentially just seated on a couch or chair. Granted, the couch in my current ward’s comfort room is actually comfortable, but the chairs in the city institution comfort room were definitely not. I recommend staff acquaint patients, especially blind ones, with the comfort room at time they’re not irritable and maybe they’ll need to assist the patient sometimes again when they’re using the comfort room for relaxation for the first few times. Staff may not like this, as many view the comfort room as a convenient way not to have to bother with irritable patients while looking like saints for avoiding seclusion. However, seclusion is not a substitute for proper care, and neither is the comfort room.

If I Knew Then…

I don’t remember where I got it – maybe on a journaling site or in a forum game -, but the question was asked which time you’d travel back to if you could go back with all the knwoeldge you have now. This is an interesting question, as I’ve made quite a few mistakes in my life, or just things I would’ve done differently if I could go back.

Looking at the past seven years in my mental health journey alone, i’ve had a few regrets. The most obvious is of cours emy crisis in November of 2007. What would’ve happened if that hadn’t occurred and I hadn’t been hospitalized? Would I by now be living in a supported housing accommodation, which I was after all being considered for the waiting list for? Would I have had a university degree by now? Most likely not. Besides, the knowledge I have now could not have prevented this crisis. It wasn’t that I could think more than a few hours ahead, so knowing that my crisis would lead to long-term institutionalization, would not have helped. The thing about crises is that people in them can’t oversee the long-term consequences of their actions.

Once I was in the hospital, however, several possible long-term living solutions came by. One was a tiny accommodation in the middle of nowhere which I reected because of its rural location and because the intake people treated me like a freak. Both were irrational argumnts, but with my current knowledge, I wouldn’t go back and get in there, cause what I didn’t know then and do know now, is that the accommodation want bankrupt one or two years later.

Then came the organization my elementary school friend recommended in late 2008. It’s currently quite an established supported housing organization here in the province, but back then, it was relatively new. I had an introductory meeting and was advised to go to an accommodation in a town three hours by public transportation from where my husband lived at the time. I was sent some paperwork, including a list of patronizing house rules and the report from the introductory meeting. The report said that I’d had a psychotic break, and got a few other facts about me wrong. I didn’t want to go to the town far away from my husband, but did for a while consider going t o the accommodation that happens to be in the next or second next town from my current institttion and my husband.

I was at a meeting for autistics yesterday, and this organization was mentioned again. They have an accommodation for autistics in the nearest big city, which obviously they didn’t have back in 2008. They also now have two accomodatioons in that next or second next town. I am now considering asking to have an introductory meeting and possibly intake interview for one of these accommodations again. The accommodation for autistics doesn’t provide 24-hour care, but the two accommodations in the nearby town do.

To get back to the question of going back in time with current knowledge, I would likely go back there to 2008. Back then, I thought I could cope with part-time support, ie. living in an accommodation that had support available only at certain hours of the day. I found the organization too restrictive, but I realize now I need a somewhat restrictive environment Maybe I didn’t if I’d left the institution right in 2008. I’m now kind of afraid that these accommodations will not provide the support I need, but then again, I can only find out by asking.