One Long Year Later

For the past year I have wrestled with demons, good times, manic phases…you name it. I have been trying to fly below the radar…keeps things that much easier. I want so much to be anonymous, but in today’s climate, that is virtually impossible. I hate the fact that my fingerprints are in the system (not that I plan on going out and committing a crime, mind you).

This past year was a hard one at my job (let me say this right now…I am blessed with employment!). I was still on a learning curve. But what soon became evident were the issues plaguing me during recovery. I still have short-term memory loss and we don’t know if it will be permanent. Things got so bad that I was put in a sort of probationary 3-month re-evaluation subject to my work performance. I’ve lost four accounts because of the mistakes I have made. However, that period soon passed once they understood it to be the cause of a medical condition.

Ironically, I have had a great month at work so far for January. I’ve shifted my focus. I now get up at the crack of dawn (0400, to log on to the employer’s VPN at 0700). That leaves me with 3 hours before I have to be at work. Now, every morning, I am drinking my hot tea while doing my devotions and Bible reading and praying. I am also starting to record Joyce Meyer so I can pause it here and there while I take notes. I figure that’s about the best way I can start the day.

My beloved little church finally succumbed to lack of attendance, so the Pastor chose to close the church. I have tried a few and I have come across one that I am going to attend a few more times before I commit to anything. This is a much larger church and is not affiliated with a denomination which I like. Their praise & worship is a little different from what I’ve become used to, but that can change in time. What’s nice is that my pastor from the previous church and his wife, one other couple and a single dad have decided that they really like this church as well.

There is so much I want to say and I don’t even know where to start. My mom celebrated her 90th birthday last September and she is feisty as ever. She mall walks everyday, plays bridge twice a week and attends several social butterfly lunches. You’d never know it to see her. I have this picture of my Mom and I with our heads together and we have the same colour hair considering I am 36 years younger than she is. I sure hope I come from her gene pool!

Unfortunately, my niece and all of the “precious” great-grand children came with her. She knows she smells like a rose and can do no harm. That pure bull. While she can smile and laugh with the best of them, she is quite devious underneath. Just remember that she is the one who refuses to invite me to the family holiday festivities. I am the only one not invited. Well, after everyone had eaten their dinner and was just sitting around the table in the restaurant, I pulled K outside to finally end it all and call a truce even though I still don’t know how I ever pissed her off that much (hell, maybe she’s homophobic, I don’t know). I pointedly asked her why had I been excluded all these years and she said, “but I only invite my family.” Heck, I am her Godmother and her Aunt. What part of “her family” does that not fit? So what am I, chopped liver…LOL?

My Mom once told me to rise above the circumstances. So, regardless of what K said, I still decided to send her a 5x7 close-up of Mom already framed and a framed wallet-sized photo of Mom and Santa. I also happened to send it to my nephew (her brother) and my brother (yeah, I know, surprise, surprise). Today is 13 January and I have gotten a thank you from everyone except K. Well, now I can wash my hands of her. The next time I will see her will most likely be at my Mom’s funeral. My intention after my mother dies is to make no overtures towards anyone left in the family. If someone calls me, then that’s a different story. But I am an adult and I don’t have time for such foolishness. The only person I can see having a loose relationship with is my older sister P. We have been on good terms, but she is so much like Dad was. Always offering advice when none is asked, and always reminding me of how I could have done something better. Come to think of it, my brother L has the same rock to stumble over.

And so it begins—a new year filled with possibilities. Last October and the ensuing months were the absolute low point in my life. I don’t wish to be faced with the same set of circumstances that led me to attempt suicide.

I quit seeing the therapist I was first assigned to because her available hours conflicted with my work schedule. So she graciously referred me to another therapist she had good words to say regarding her, but I went to two sessions with her and she was a tad bit over the top. Look, I don’t care what time of day it is, I cannot deal with chirpiness. She was just wa-a-ay to happy a camper. So, I called the office, indicating that the second therapist was not a good fit and could I return to seeing the first therapist. The woman who answered the phone said they would have to check my medical records and have the request referred to the nurse and someone would get back to me. Well, it’s been a month and I haven’t heard anything. Yeah, I know, I should probably call and follow-up; I just haven’t had the energy to accomplish much of anything.

I am still seeing my psychiatrist and now my visits are once every three months—more of a med and status check than anything. Nevertheless, he is quite concerned about my lack of attention, focus and my short-term memory issues that have had a measureable impact on my job. He wants me to go in for neurophysiologic testing to see if we can pinpoint either the cause of the problems or if it’s temporary or not (it’s been over a year now…sounds kinda permanent to me). My psychiatrist is worried that I may have caused some injury to my brain when I attempted suicide (God only knows what flowed through my veins that night). Then, after the results are in (I have no idea what tests they would be performing), I may have to do neurocognitive rehab. I have no idea what that is all about either.

Well, I’ve now had my car for one year and I am still happy with it. But get this, I only have 3900 miles on it. I just don’t have long distances to drive around the city. Almost everything I do except for grocery shopping is within walking distance. That’s my effort of getting off my lazy ass and generating some energy burn. I found out yesterday from my Mom that the Honda Fit made Consumers Reports their best value, and Car and Driver put the Fit in their top ten for five years in a row.

OK, shift in focus. Sunday night it began to snow heavily here (I live in the southeast US). We usually don’t get snow, but ice storms instead. At night, it was so serene and picturesque. It was like looking at a huge Ansell Adams mural. When all was said and done, we ended up with 10 inches of snow. I had so much fun. However, I did learn one lesson…don’t attempt to make a snow angel in 10 inches of snow. When you fall back, it’s a longer way down than it looks, and then, once you’ve landed, all the snow falls in and buries you (my most graceful move yet). 4 days later, only the streets are finally cleared, but all of our yards are still covered with the leftover snow. The fact that the temp hasn’t risen above freezing all this time is making it harder for the snow to dissipate. But it sure was peaceful and beautiful. That, most probably, will be our big storm of the season.

I can tell I am losing some of the ground I gained when I was in that outpatient therapy program for 3 hours a day Mon, Wed, and Fri that lasted for three months. I feel the BPD becoming an issue again. I am isolating again and at the same time having a pity party that I don’t have more friends, then I take solace in my aloneness (I prefer that to loneliness). When I really think about it, I love living alone so much that I don’t even entertain the idea of dating much less having a girlfriend move in. I love my privacy. I love not answering my door (unless I know already that someone is on their way…I make them call me when they get in my driveway). I had fun with the Census Bureau. I did not fill out the form and mail it in. I feel it’s an invasion of privacy despite all their protestations that ALL information will be kept confidential. HA! They started coming by the house, first one, then another for a total of five visits. I ignored them completely. They even went to my neighbours twice (they had already been coached to answer in such a way that it did not reveal gender and number of people living in my house). I just don’t want someone knowing my business. While I applaud the medical community and their HIPAA regulations, we could sure use some of that stringent guideline in the private sector. Face it. Too many people know too much information on everyone. All it takes is this wonderful Ethernet world.

I promise, I promise to get back into my blogging on a regular basis. I guess too many of you are sick of listening to Santana. I left it as my playlist for this past year. Today, when I post this entry, I will change the music (I promise). It sure is nice to be back again.©2011

Week in Review 23 January 2010

There are subjects that I have not caught you up on since returning to work full-time. I am going to use this week in review to address the various issues that actually encompass more than just this past week.

Iron Infusions: The study included receiving 1000mg of IV iron infusions. I received 200mg Mondays and Wednesdays for 5 days. Throughout the process, the clinical specialist drew blood to check my haemoglobin and ferritin levels. This study will go on for a year although no more iron infusions are to be given. All subsequent visits are geared towards monitoring my blood levels to see how I fare over the course of the year. On day 35, after the final infusion, my haemoglobin only rose to 12.1 (normal is around 12.3-16). However, my ferritin level (one of the key indicators in my case) rose from 5 before the study to 96. While I am pleased with the ferritin level, I still have borderline iron deficient anaemia. I am disappointed that my haemoglobin did not rise any higher. I am curious to see how the blood level results will be over the rest of the year. My savings grace is that I have not had to pay for any of this as being part of this clinical trial, and the added bonus is, once I have completed the yearlong study, I will be compensated for my travelling costs.

Vitamin and Mineral Deficiencies: If you recall, I began having symptoms of ataxia on 13 November 2009. It began with being unable to keep my balance then progressing to ocular involvement called nystagmus then to short-term memory loss. I failed certain neurological tests (most notable the Romberg test. The combination of all three symptoms indicated that I had Wernicke’s encephalopathy that does, in effect, eventually causes organic problems with my brain. If left untreated, the transient symptoms will become permanent. It was suspected that mine was caused by a vitamin B1-Thiamine deficiency. As a result, my GP decided to run a huge panel of vitamin and mineral blood work. The results showed that my B1 levels were undetectable as well as my Selenium levels (essential for the proper functioning of the immune system). I was ordered to start taking 100mg of B1 twice a day and 200mg of Selenium once a day. After six weeks, the repeat blood tests showed marked improvement and my balance had almost come full circle, although I still have some ocular involvement and short-term memory loss (my brain is healing slowly). Another level that was far below normal was vitamin D. Instead of taking an OTC version of vitamin D, my GP wrote a prescription that I am to take once a week for eight weeks, then once a month forever. This does not even include the fact that I have to give myself 1000mcg vitamin B12 shots monthly forever. My doctor essentially told me that I would be taking these vitamins and minerals forever, along with a multi-vitamin that I am supposed to start taking. Coupled with all of my bipolar medications and the ones for my continued high blood pressure, I am swallowing a horde of pills a day.

Individual Therapy: Now that I am no longer in group therapy, I have starting seeing an individual therapist. 20 January was actually my third visit with her following the intake assessment and one follow-up appointment a couple of months ago (my group therapy took precedence). This visit I determined that one of the first factors I had to deal with was my borderline personality disorder.  You’ll note further down in the link what the causes are—I meet all of them. In examining the causes, I decided to deal with my disruptive family history first. I have discussed at length in previous entries how I have been treated as a pariah at holiday gatherings these past seven or eight years always celebrated at my niece’s home. She patently exclaimed that I was not welcome the first time she hosted these events. I ended up attending, even though I had not received an individual invitation, as a result of my nephew’s insistence. He said, “Alix, family is family. You belong there.” When I showed up at the front door with my nephew, my niece clearly displayed her anger and let me know I was not welcome, but she could not refuse my entry because other people had already noticed me, so she was stuck. The entire time, even my mother showed her displeasure, I was uncomfortable. Always the queen of protocol, she said I should not have come because I did not receive an invitation. To this day, I have no idea why my niece hates me—my mother will not volunteer any information and my sister even told me not to confront her daughter. So much for my supportive family.

Getting back to my early years, I was sexually abused at age five. Upon my mother and older sister finding out, my mother shook my shoulders and told me I was never to ever speak of this to anyone. This was during a generation when it was not understood nor dealt with. I was made to feel as though it was my fault. The family dynamic changed forever after that. I felt abandoned by everyone because no one would help me with all of the shame and guilt I felt. Years later, those memories were buried during the haze of my years-long addiction to smack and coke (I used to shoot speedballs). I eventually cleaned up and have been clean for 23 years. However, during my detox period, all those memories came flooding back. I worked up the courage to confront my mother about the sexual abuse and at first, she denied it ever happened. Then, with further insistence, she simply said it was in the past and refused to discuss it with me ever.

A few years later, my parents had a huge celebration for their 50th wedding anniversary. I was living out of town, but my mother wanted my son and me to attend. I simply asked if that particular family member who abused me would be there and she replied yes. Then she told me that I was only welcome if I did not create a scene. I promised I would not (always being the dutiful little girl trying to find that ever so elusive but never found approval). However, I was very anxious about seeing this family member (whom I shall refer here as L). I had not seen L since the memories surfaced. I was not sure how I would react. When I saw him I felt a flood of emotions wash over me and I was not sure I would be able to control myself, but I remembered the promise I had made to my mother. He acted as if nothing had ever happened. I kept my limited contact to perfunctory responses and immediately found someone else with whom to interact.

The next two obligatory times I had to be around L was my father’s funeral and my nephew’s first wedding. I could not keep my distance as far as I wanted because these events were small family gatherings, but I was determined never to attend any events where he would be present with the exception of my mother’s eventual funeral.

Or so I thought. My sister called me this week and told me she wanted to do something special for my mother’s 90th birthday in September. She wanted everyone to be there. Not only will I have to deal with my niece (a favoured one as she has produced my mother’s only great grandchildren), but there is an outside chance that L will be there. My sister did mention that L had declined because he had already booked a hike in Italy and that was his priority. To tell you the truth, that pissed me off. Isn’t my mother’s 90th birthday, an occasion that will never come again, something that should take precedence above all else? Tell me that he did not know that the week he booked his hike was during my mother’s birthday and that it was her 90th. How callous can someone be? Of course I already had a very poor opinion of him (to say the very least), but this was the last straw. As oxymoronic as this sounds, I hope he changes his mind, if only for my mother’s sake.

So, getting back to my therapy session…I made it a special point to tell P that this celebration would be coming up in September, one that is creating enormous anxiety for me, even now. I need to process all that has happened since childhood. Since the event is not until September, this will give me quite a while to try to come to terms with everything. I wonder what the process will be concerning trying to deal with everything. I can only afford to see her every two weeks, so I hope we can accomplish a lot.

My Psychiatrist: I am now seeing him every three weeks—a far cry from weekly appointments along with daily phone check-ins. R seems pleased with the state of my bipolar disorder, and so am I. The cocktail he has me on (Lamictal 200mg 2/day, Geodon 80mg in the morning and 240mg at bedtime, Provigil 200mg 2x/day, Lexapro 40mg daily, Ativan 2mg 4x/day, and Ambien 20mg at bedtime) has been very productive. I am being cautious about the Lexapro since it is an anti-depressant. In bipolar patients, while these types of drugs can battle the profound depression I found myself in, I have to be aware if I progress to any mania since these drugs can produce this side effect. I am monitoring this very carefully. I do not want to mess with this cocktail as it is servicing a precious need of keeping everything in balance right now. However, R has discussed getting me down to a maintenance cocktail that would probably result in taking me off some of this medication. I do not think I am ready for this yet. It been too soon since I tried to commit suicide. While I have made great strides, I still feel as though, at times, I am teetering on the edge. Even though my next appointment is not until 04 February, I know I can call him at any time. He always calls me back and spends however much time I need without the cost of an office visit. I am very blessed to have such a wonderful psychiatrist.

My return to work: The days leading up to my first day back to work on 04 January was met with much trepidation. I was full of fear and anxiety as much as I tried to stay in the moment. As part of my medical disability status, R sent a letter to the group managing my FMLA program indicating that I should only work four-hour days the first week and six-hour days the second week. My manager was very supportive about that suggestion. I also asked my manager if I could adjust my schedule to work 0700-1530 opposed to 0800-1630 which he agreed to. This serves a two-fold purpose. First, it frees up the afternoon to make available opportunities to have my continued appointments without missing work. Second, I am finished working while the sun is still shining—something that is important to me. I used to hate waking up in the dark and finishing my day in the dark, especially during the Standard Time Zone in winter.

The first two weeks my manager wanted me to concentrate on taking some mandatory computer-based training that was indicated during my absence. Then he wanted me to cull through the 1000+ emails that had collected during the three months I had been away. Just as an aside, no one from work ever knew why I had been on medical leave. Nevertheless, I had to explain to my manager that one of the side effects of my “treatments” was a vitamin B1 deficiency which resulted in a transient short-term memory loss. He seemed to take that OK. But that factor gives me a lot of anxiety as I don’t remember how to do a lot of my job. I was only in this new job for two-and-a-half months before being gone for three. So, I am still on my learning curve. My team may not appreciate the fact that I still have to ask questions, especially on some things of which I had already displayed knowledge.

After the first two weeks, then all of my clients were informed that I was back to supporting their accounts. Just when I had cleaned up my email box, as of the 19th they started flooding in again, yet another source of anxiety. I made it clear that I was not capable of working any overtime, so I am always left with emails that I have not read by the end of the day only to snowball into the next day. Too many critical projects are all happening at the same time. Meanwhile, my day-to-day responsibilities go on.

I try to stay in the moment each day and that, along with relaxation techniques such as being mindful and deep breathing, are helping somewhat. I have to admit, my Ativan plays a roll here as well. My goal is to do the best I can for my clients during my eight-hour day, and when that is over, to simply walk away from the laptop and let my business line go to voicemail (I work from home). I am giving myself room to acknowledge that I am going to be slow on the uptake for a while, but I have to believe that, at some point, I will be back up to speed.

Overall, I am now in a much better space than three months ago. I am quite surprised at the insight I have discovered about myself along the way. I know I will never “recover” from my bipolar disorder and will be on my meds for the rest of my life. That is a sobering thought (and an expensive one—the Geodon alone costs about $1200 before my $1200 yearly deductible is met). It hurt to pay that much a week ago for my refill, but how many people can say that they have met their deductible during the second week of January! At least now, my coverage for everything is at 90%.

I know this was a long entry, but I had so much to review. It is my intention to do a week in review each Saturday since I am back to work full-time. I have to admit, after being on the computer all day at work, sometimes the last thing I want to do is to get back onto my own computer after work.©2009

Three Months Since…

I cannot believe it has been three months since I was involuntarily committed  when I tried to commit suicide. It seems like a lifetime ago (no pun intended). So many of the details have just become a hazy dream.

I still do not remember any of the events that led up to being committed. I guess I never will. At least I have all of the medical records to give me an idea of what and how it transpired—what a rollercoaster ride these 90 days have been.

I can say right now that I am in a much better space than I was on 11 October. It has been several weeks now since I have had any suicide ideation. For a while there, after I was discharged, it was a nightly event. I have done a lot of hard work in my group therapy sessions that ended 30 December. And, it appears that my psychiatrist has come up with a sustainable cocktail that has stabilised my bipolar disorder.

Do I regret what I have gone through? Absolutely not. The end result has been incredible. I am stronger mentally than I can ever remember since being diagnosed in 2000. I had what I thought was a pretty good cocktail all those years having nothing to which to compare. What I did not have before was a strong handle on specific coping skills that made the difference this time. Oh, sure, when I tried to commit suicide in 2005, I was exposed to DBT, but never felt it was for me. Truth be told, I thought it was all a bunch of bullshit. And, I’m not saying that I am totally sold on DBT even now—some of the tools have worked well for me; others have been not so much. This time around, I made a concerted effort to learn these tools even, if at first, I resisted strongly.

Lessons learned? I am not sure I can even address that facet yet. I am still feeling my through this maze. OK, one lesson I did learn hard was to never go off my medication. However, when I made the choice to go off my meds in April of last year, it was because I had just found out I had been laid off and could not justify the enormous expense. Now that my insurance has rolled over to a new calendar year, I still have to meet my $1200 deductible for this year. That means I have to pay 100% of all my meds at retail price until the deductible is met. Even though I have a job now, I am pretty tight financially and I am not sure where I am going to come up with the money. But, if I have to, I will put it on my credit card even though it pains me to have to resort to that possibility. I simply do not have the option to go off my meds.

Another thing I think I have learned is the enormous help therapy has been. Now that I am back at work, I can no longer participate in my group therapy sessions (they were always held for three hours three times a week during the middle of the day). I have hooked up with an individual therapist now and saw her last week (I had already had my intake appointment some time ago and one follow-up, but I had to concentrate on my group therapy then). I am not sure how individual therapy will help me as the dynamic is going to be different from group. When I met with her last week, I actually told her I was not sure where to start. She asked me what issues I had that were most pressing to me. Not wanting to bite off more than I can chew, I told her that I wanted to focus on my stress now that I am back to work after being on short-term disability for 12 weeks.

Now that my BP has stabilised, I am going to have to start to deal with my borderline personality disorder and my anxiety disorder. Now, that is going to open up a whole big can of worms. I think that I am only going to put one foot in front of the other and take everything slowly. I have made some significant process and I do not want to find myself in a spot where I begin to regress. I value where I am today and that is what I am going to hold onto—the here and now. As someone once told me, yesterday was over last night and I have no control over tomorrow.©2009

Outpatient Therapy-Final Session

Yesterday was the last session of my group therapy program. I began this intensive program 21 October and we have met three hours/day on Mondays, Wednesdays and Fridays. Yesterday marked my 30th session.

Initially, I was very phobic to these sessions. Similar to my attitude when I was involuntarily committed , and knowing I was only obligated to attend for two weeks, my original intention was to skate through those six sessions with no effort on my part. I was still pissed off at the world for how I had been treated to date; I did not want to be in therapy and I certainly did not want to get better.

You just cannot imagine the amount of rage that pulsed through my veins—think Incredible Hulk. However, as the mandatory two weeks came to a close, something was triggered inside of me. Somehow, I came up with the idea that I no longer wanted to go on feeling the way that I did. That level of rage and profound depression was eating away at me and I simply had no more energy left. I voluntarily agreed to stay in the program having no idea that it would take this long.

There was a very detailed daily check-in sheet we each had to fill out. It was basically a way for the therapist to determine and track our progress. The dynamics of the group evolved over time with old patients being discharged and new ones being admitted during my stay. While the overall group was large (in my eyes), averaging around 18-20 folks, once everyone took the 10-15 minutes to fill out the check-in sheet, we always split into two smaller groups. The groups remained split while everyone reviewed their sheets, and we all came back together as one group after the break to start the second half.

I could handle the smaller group in which we each shared what was on our sheets. Based on our input, the therapist would probe further with each of us and ask penetrating questions. The sharing half had a tendency to be somewhat tedious at times. Every so often, there would be patients that liked to hear themselves talk. Repetition is the key word here. They would go on and on about one particular issue and even talk over the therapist as if they had no interest in listening to her feedback. I could see the frustration on the therapist’s face every once and a while. As a result, sometimes the first half of the session would take a long time.

After the break, when we all gathered back together, I had a major problem. I had a rough time being around large groups of people. The noise level would always increase and sometimes everyone would talk at once. That started freaking me out. Therefore, I retreated from the large table in the room (it was actually five conference room-sized tables arranged in a large square) and sat in the chair against the door right by the back emergency exit—it was as far as I could get from the group. The emergency exit was not wired to an alarm, and when it got to be too much for me, I’d walk out the door and take a breather. Being that it was the end of autumn as winter approached, the cool, brisk breezes usually refreshed me.

The second half of the session was psycho-education [I’m sure that Alfred Hitchcock could have had valuable input here :)]. This outpatient therapy program was based on dialectical behaviour therapy (DBT).  When I tried to commit suicide back in 2005, I went through a DBT program after I got out of the hospital. At that time, I thought that DBT was pure bullshit. It all centres on learning tools or coping skills to manage various stressors (depression, anger, rage, anxiety, etc). Being that I had been diagnosed with Bipolar I Disorder (BP) and Borderline Personality Disorder (BPD), everyone thought that this type of therapy would be one from which I would benefit. Back then, I thought all these coping skills were stupid. Sure, it might work for some, but I just could not imagine me taking the time to think through whatever emotion I was feeling at the time and remembering which tool would help me through that situation most effectively.

When I realised that this time around would be centred on DBT, I was quite cynical. However, after about four weeks into it, I discovered some tools that could actually serve me well (see this for a list of tools). Without a doubt, using these skills effectively requires constant practise. You cannot expect to utilise a skill and then have it at your fingertips until you practise it. Once practised, when you face an emotional obstacle, you can more readily adapt effectively.

I also realise that there is a lot of controversy around DBT. Some who have been through the training think that it is bunk as I did. I can say that I do not agree with the entire skill set. I learned what tools I knew I could use and left the others behind (there are some I still think are bullshit). All I can say is that it is up to each individual to determine what works in his or her best interests.

That being said, the first half of my last session was great. Our small group only consisted of seven patients and our small group never had the loud mouths (I am grateful that Mr. Noisy was in the other group!). I knew three of them; the rest were new patients. When I finished sharing my check-in sheet, I received wonderful feedback from the therapist. She basically said that I had done a 180˚ from the time I started the program and was extremely pleased to see the progress I had made. It had taken me all this time to see the huge steps I had made. Don’t get me wrong; I am far from being all fixed up. That is why I am going to continue with an individual therapist. BP and especially BPD can take quite some time to manage. While some professionals banter about the word recovery, I think the best I will be able to muster is to manage my BP and BPD to a tolerable level. Only time will tell.

The second half of my last session was surprisingly smooth. While Mr. Noisy was present and accounted for (as well as the other few loud mouths), the group discussion on the continuing module of assertiveness was quite ordered. It was quite appropriate that my last module would be on this topic. As I have mentioned previously, despite my butch bravado, I really could bolster this skill.

Saying goodbye was harder than I thought. All of the patients who had been around for a while (with the exception of one other patient, I had been there for the longest duration) took their time saying goodbye to me and wishing me luck for my future. As someone laughingly said, “Hope to see you at Wal-Mart should our paths ever cross again.”

Overall, I have to agree with the therapist. I have come a long way since I tried to commit suicide on 10 October. It has been a long road for me, some of it fought tooth and nail against any type of recovery. I know I still have a long way to go, but for now I will just accept the fact that I am in a better space than I was almost 12 weeks ago.©2009

Appt With Psychiatrist #10 (Thursday 17 December AM)

Today is going to be the last weekly session I will be attending. From this point forward, I will be seeing my psychiatrist every two weeks for a while, then once a month. I will miss the weekly visits, but he and I both agreed that I have made tremendous strides since I tried to commit suicide. It will also be much easier on my billfold as my insurance does not cover any of his fees (he is out-of-network and that deductible is $5500—it will be quite a stretch to incur that much of a balance any time soon).

He has decided to increase my Lexapro to 40mg/day. We have both been pleased with how effective it has been even though I am currently experiencing a setback in my depression (which is the reason increasing the dosage). It has been the only anti-depressant I have ever taken that has had such a marked difference in my depression without tripping a manic phase.

I learned something new today. I just happened to mention the strange reaction I experienced on Monday after my first iron infusion. He said it sounded like I experienced Cataplexy that would explain the sudden onset of fatigue along with the loss of muscle tone. It is frequently associated with narcolepsy and Provigil just happens to be one of the drugs that combat narcolepsy, which might explain why I did not have that reaction yesterday.

Overall, I am glad that I have made such progress thus far. I have received excellent therapy support from both my group and my psychiatrist. I think I am going to have therapy withdrawal once I go back to work. I have arranged to start seeing an individual therapist once I finish with group. I have already seen her two times and I think we have the chance to build a good rapport.

What was nice about today is that my appointment was at 0700 and I have nothing else scheduled for today. It will be nice to have some down time.©2009

Outpatient Therapy, Day 22

Yesterday was the first day that I have driven anywhere outside of my own neighbourhood area for a couple of weeks, since I sideswiped the 18-wheeler on the interstate. I have not had one of those dissociative episodes when driving in a while, so I thought I would take a chance yesterday and drive myself. The weather was just awful. It was pouring and visibility was cut to almost 500 yards/457 metres. I left an hour early just in case and was quite anxious about driving on the interstate the whole way, but I got there OK.

Had the weather been fine, having arrived so early, I could have sat outside and smoked until group started, but I was relegated to sitting in our room for a while before some of the others started to file in. I had my daily check in sheet already filled out since I do it from home before I get there (gives me more time to think and try to remember the details).

After the huge group split we started out “sharing” routine. I volunteered to go first as I had to leave early since I had an early appt with my GP yesterday as well. I had a good report to share and even had a smile on my face that everyone made a big deal about. Afterwards, the therapist commented that I was showing marked improvements exponentially. I think it has a lot to do with my psychiatrist putting me on the Lexapro a couple of weeks ago. I asked the therapist if she could mark some time for me after one of our sessions as I want to talk with her about my discharge from the program. While I have made huge strides over the last eight weeks (it was eight weeks ago today that I tried to commit suicide), I knew it was getting to the point that I could no longer afford to be in this program. Yes, my insurance is helping, but 10% of this, that, and the other adds up with all of the appts I have been having. I feel that my seeing my individual therapist now, along with my psychiatrist should be enough to continue with my recovery. I do not necessarily want to leave the group, but I have to make some decisions financially.

I cannot believe it has been eight weeks since I tried to commit suicide. The whole memory seems like such a hazy nightmare to me. On the one hand, I want to forget about everything. Yet, I have to remember it all to keep where I am at now in proper perspective. I have made some huge strides since then and I cannot forget this. So much has changed for me. There are more evenings than not where I can be in my house all alone at night and be safe. I am not sure what “normal” is supposed to feel like, but I do know that I am not as profoundly depressed as I have been. It seems that my bipolar is slowly being reigned in. The positive aspect is that I haven’t swung onto the manic side since starting the Lexapro, a valid concern my psychiatrist has as giving anti-depressants to bipolar patients in a profound depression can kick off a manic episode since the anti-depressant can kick you over to the other side. I have been carefully watching for that. I am getting more sleep now than I have been, and my talking does not seem to be any more excitable than normal. When I am manic, that is the first sign I can spot. I will get on the phone with someone and not shut up the entire time and I talk fast and excitedly. So far, I do not see any evidence to that.

Could it be that my bipolar is finally coming into balance? I am almost afraid to think that one aloud. Once my bipolar is in check, then I can start looking at my borderline personality disorder issues that, for obvious reasons, have been put on the back burner. I can continue that work with my psychiatrist and individual therapist, although I am not sure how to begin that whole scenario. There are some deep-seated issues that I have to work out, and this is going to take some time.

Meanwhile I am socialising more. My friend A called me as she was leaving work last night to check in with me and I asked her if she wanted to stop by my house on her way home. She enthusiastically said yes and I thoroughly enjoyed having her visit for almost 90 minutes. It is so nice to have people with whom I can talk about every day things. This is one area that I have seen positive changes in me. I am not isolating nearly as much. Right now, all my socialising is one-on-one; I have not tried to be in a group of people yet outside of my group therapy sessions, so I am not sure how I am going to handle that. I am going to try to start attending the NAMI meetings (National Alliance on Mental Illness) that take place Monday evenings right around the corner from my house. It is going to be similar to group with a different twist. According to the facilitator I spoke with the other day, there are only about 10-12 people that attend regularly and I will not have to say anything if I do not want to. I imagine I will just sit quietly for the first couple of meetings until I can get the lay of the land.

I am still on full-time short-term FMLA disability, but that runs out January 18th. Right now I am approved through December 16th, but I am now going to have my psychiatrist (instead of the group therapist) put in for the remainder of the time to see if they will approve the extension. My psychiatrist does not think I am ready to return to work anyway, and he wants me to start back only working half-days. I’m thinking, with the deadline coming up (yes, I could always convert to long-term disability, but that’s only at 70% of my pay which I cannot afford) I could put a return to work start date for the 4th of January to work half-days until the 18th. I personally think I need more time than that, but I am financially constrained. To tell you the truth, what I dearly wish I could afford is to go on full time SS disability, but I cannot afford what they would pay out, and Medicaid will not kick in until you’ve been on disability for one full year. I cannot afford to be without insurance. Sure, I could get COBRA from my employer, but since I cannot already afford what disability would pay, there is no way I could also afford the COBRA coverage. Caught between a rock and a hard place.©2009

Being Christian and Queer-Revisited

I’ve examined in some of my posts how I’ve missed my church since my whole debacle began. As I’ve alluded to, two of my biggest stumbling blocks to returning is (a) being around a group of people [thanks to my borderline personality disorder-BPD] and (b) how to explain my continued absence since being involuntarily committed due to my suicide attempt seven weeks ago.

When I attended a previous church, also an Assemblies of God, it was inherently homophobic because it preached, as they say, the full gospel—meaning that the Bible is the word of God chapter and verse. I was new to my relationship with God, and under the pastor’s teaching (at this point I had not been hit with those legendary homophobic clobber verses) I watched my relation with God grow immeasurably: it was close and personal—something I had never experienced before. My heart and spirit was full. Having been raised as a Roman Catholic when I was a child and teenager, I never got this.

I am not a theologian, but as I began to read the Bible, when I got to Leviticus 20, I continued to read all those laws set forth by God. So many of these “laws” had since been dismissed as we migrated to modern times [e.g., verse 10: “If a man commits adultery with his neighbour’s wife, both the man and the woman who have committed adultery must be put to death.” (NLT)]. I read that with a grain of salt as today adulterers are merely given a pass for a divorce. So, when I got to verse 13 “If a man practices homosexuality, having sex with another man as with a woman, both men have committed a detestable act. They must both be put to death, for they are guilty of a capital offense.” (NLT) I took this verse equally with a grain of salt. I am a lesbian and did not feel compelled to fall upon my sword, as it were.

Then this particular preacher, one Sunday, spent his whole sermon on why homosexuality was the worst sin in the bible. I was truly taken aback by his statement. Aside from quoting the verse in Leviticus, he did not proffer any specific verses that backed up what he said. I was enraged. After the service, I challenged him. I asked him to refer to the specific scripture that said that (because I never read that despite reading through various translations). He wanted to avoid this conversation with me totally, but I countered with reminding him that he always said that the Bible would prove its own truth. Again, I challenged him to point out where in the Bible was that specifically quoted and he hemmed and hawed. I told him, according to the Bible in Revelations 21:8 “But the cowardly, unbelieving, abominable, murderers, sexually immoral, sorcerers, idolaters, and all liars shall have their part in the lake which burns with fire and brimstone, which is the second death.” (NKJV). Nowhere did it say that only the homosexuals would burn in this lake of fire, and even pointed out that the sexually immoral were not even listed first! He could not respond and just walked away and greeted other members.

Well, my identity as a lesbian was then outed and I was essentially shown the door unless I repented of my sins and turned from my evil ways—translation: become celibate. That only harkened back memories of the nightmares I had read on reparative therapy where there were retreats gays and lesbians could attend to be “cured” of their homosexuality (Exodus International comes to mind). Being a lesbian is who I am, not what I chose to be. I did not have something from which to be “cured.” I was incensed that there was this organisation whose primary focus was to brainwash these unsuspecting attendees.

As a result, I left this church. I also remember being angry with God for allowing His word to be selectively be taken out of context on this one particular verse. If the other verses throughout Leviticus had for the most part been dismissed as being a product of the times (e.g., not mixing clothes of mixed fabric and all of the dietary laws), why was this solitary verse being held accountable? As the times progressed and gay rights became the new poison pill upon which many political platforms were based (the new litmus test as abortion rights were before then), I saw how the war against gay rights was being funded and waged by so called Christian fundamentalists. Gay rights (or the lack thereof) were being slammed left and right from statehood amendments on same-sex marriages, employment discrimination (there are 29 states where it is legal to fire someone who is gay), to housing statutes, and economic parity through health insurance, not to even begin to mention how partners are treated when one of them is in the hospital and are denied visitation rights or not allowed to carry out the final wishes.

I became an ardent political activist lending my voice where it counted to fight these so-called arbitrary arguments. I live in the buckle of the Bible belt where churches are like gas stations—there is one on every corner. I had plenty of opportunities and venues to lend my voice to counter these fundamentalists. I still remember how I was treated in a discount chain store while wearing my equal rights t-shirt on the banner of the rainbow flag. I was bible-thumped from quite a few people (“shame on you,” “your kind will burn in hell,” etc.). I would not be reduced to their fanaticism and merely walked away from most of them. I was, however, trapped while standing in the cashier’s lane. The couple behind me started preaching to me to repent of my evil ways as all eyes were on me. You could hear a pin drop. At first I was not going to say anything (anything I could have said would only fall on deaf ears anyway), but the cashier smiled at me and said, “You aren’t going to let them get away with that crap, are you?” So I looked at this couple and calmly said that, while I respected that they had a right to their own opinion, this was one area that that we would have to agree to disagree—no rhetoric on my part. However, that did silence them.

During this intervening time, I met my then partner and I continued to wage my war. I was quite surprised to learn that she went to church. I asked her where could she possibly go without encountering what I had experienced and she told me all about the Metropolitan Community Church (MCC) that primarily caters to lesbian, gay, bi-sexual and transgendered persons (LGBT). Sorely missing my connection to God and the community of fellowship, I eagerly started attending with her. However, my spirit was not fed here. It was static and ritualistic and there didn’t seem to be any room for the Spirit to move. I continued to go with her for the duration of our partnership, but when that ended, I no longer attended.

I moved to a different area of town and laughingly I noticed there was a church right across the street from me. Being new to the neighbourhood, one of my neighbours left a beautiful potted plant on my front porch with a nice note welcoming me to the neighbourhood. This level of hospitality, I thought, had all gone the way of other pleasant Southern ways with everyone too busy with their jobs and lives. I walked over to thank her and we had a nice conversation. There was no doubt that I was a lesbian when we met from the bumper stickers on my car to the t-shirt I was wearing, but that did not seem to phase her. Then she cordially asked me if I attended a church (my warning signals were piqued at this point) and told her no and recounted my experience with my first pastor. She thought that story was horrible and invited me to attend their church’s fall picnic. When I reminder her that I was a lesbian, she didn’t care, said that her pastor was open-minded, and that I would not be judged. Therefore, I told her I would attend with full expectation to talk to the pastor at the outset and inform him that I was a lesbian. He didn’t seem to bat an eyelash and told me that I would be welcome at his church, but he did say this one thing, that he did preach the whole Bible and said that he did think homosexuality was a sin. But I was welcomed just the same as in “Whosoever….” We agreed to disagree and he told me that his congregation wouldn’t judge me.

At this point, I had missed my relationship with God, not because I had walked away in the intervening years, but I had missed hearing God’s word being preached and the fellowship of other believers. Being the butch that I am, when I dressed up for church I wore a coat and tie even amidst those that wore blue jeans and t-shirts. I liked his style of preaching and everything he said resonated deeply within me. I felt for the first time that I had found a church home. There were times after the services where the pastor and I would get involved in conversations about my homosexuality and he just smiled and told me that he always appreciated my honesty, and felt that I had contributed to his knowledge base as he had never had the chance to really get to know someone who was gay, and thought that our conversations were refreshing for him—a chance to learn something new. I respected him greatly and considered him a friend, a friendship that continued to grow over the three years that I have been attending.

Then something happened to me. While I was reading the Bible, I came across an important passage that became the cornerstone upon which I wanted to live my life. It was Romans 12:1-2: “(1) And so, dear brothers and sisters, I plead with you to give your bodies to God because of all he has done for you. Let them be a living and holy sacrifice—the kind he will find acceptable. This is truly the way to worship him. (2) Don’t copy the behaviour and customs of this world, but let God transform you into a new person by changing the way you think. Then you will learn to know God’s will for you, which is good and pleasing and perfect.” (NLT).

I thought long and hard what these verses meant to me. I came to the conclusion that I wanted my close personal relationship with God more than I needed my identity as a lesbian (however skewed that logic may seem to you). I felt by choosing to be celibate was my living sacrifice, and that turning my back on the gay community would be no longer conforming to customs of the world. This was a decision that did not come easily as it was fought with much prayer. Nevertheless, it was a decision that I felt at peace with at the time. I never denied that I was a lesbian, but like an ambassador without papers. I lived my life from that perspective for two years.

Well, politics raised its ugly head with what was up for grabs both in Congress and at the statewide level during this year. My hackles were raised again and my anger towards this massive inequality subjugating all LGBT persons to second-class citizens put me on fire. I became politically active again renewing my passion to see true justice served. I was truly saddened to see how forthright and mean-spirited the Christian fundamentalists had become since the previous elections, not to mention the incredible amounts of money they raised to fund their own political agenda (what ever happened to the separation of church and state?).

Unforeseen by me, my personal life became a disaster as my bipolar and borderline personality disorders (BP and BPD) reared their ugly head pushing me into a downward spiral that led me to my aforementioned attempted suicide. There was so much conflict swirling within me. When I was discharged from the hospital after 11 days, I couldn’t face going back to my church having done what I had. After my continued absence, what would have I told everyone, “Oh yeah, by the way, I tried to commit suicide.” I didn’t think that would go over well. I had a long talk with my pastor and told him of my renewed passion to fight for LGBT equality. In one post to this blog, where I bemoaned how miserable my life had become, someone commented “Even though you have turned away from Him - He still loves you and wants you back. Your dilemma is trying to hold on to both worlds. It's not possible. God wants you to choose to lay down your old life and allow Him to make you totally new. He has a peace waiting for you that you've never known (but are desperately seeking)- You've never known this peace because you've never fully turned your life over to Him.”

I couldn’t believe what I read. For the first time I was being judged, and I was accused that I had never fully turned my life over to God when that couldn’t have been further from the truth considered the sacrificial decision I had made only two years before. I was torn. Knowing what I did now, could I ever be welcomed back into that church under the circumstances of how I was living my life as a queer political activist. I was hurt because this church and its people meant so very much to me. I was filled with the Spirit at this church as I had never known before; the pastor’s teaching had always deeply affected me. A subsequent conversation with this person helped me understand the spirit it which the comment was made--not to judge, but wanting to reach out so desperately to me. Can I return and just let the chips fall where they may, or do I want to search for another church that is gay-affirming, not knowing if I would be filled and fed in the same way? My heart wants to return to this little church, but at what expense.©2009

How I Handled Yesterday

Knowing I was feeling very depressed yesterday (see post below), I was afraid to be alone in my house for fear that my suicide ideation would begin. I decided to be proactive during the day. I already know that my front porch does not offer me much solace as it once did, so I decided to try the backyard. I sat in my camp chair (very comfortable with two cup holders) in the full sun while listening to my iPod for the duration of the day until the sun went down. It was 61˚F/16˚C and absolutely beautiful. I was still very depressed, but not suicidal. When the sun went down, I went inside to bundle up and stayed outside until the stars cam out and watched the moon rise. I was out of my house and safe, and that is all that mattered.©2009

Utter Contempt

This post was never meant to be. Late last night, with full resolve, I put into place my deeply rooted desire to carry out my intended plan so foolishly done with exacting ineptitude only five  weeks earlier. However, quite obviously, this did not transpire.

Instead, I have been up all night, in my castle without a drawbridge, inspecting and taking inventory of how fucking miserable my life really is. I am fuming, livid if you will that, I have been unable to carry forth my intent. I sat there looking at everything and just wailed at my utter, incompetent nature to go through this and curled up in fetal position and cried all this whole time, getting even more enraged at the stupid lack of action (spinelessness, my Achilles' heel) which only proliferated my feeling of being a total failure. Despite the fact that I actually carried out my intent 5 weeks ago, I am fuming that I was unable to go through this in view of the knowledge of the abject uselessness of my desolate life. I am quite numb at the moment, steeling myself from all other emotion. I cannot understand why the fuck I cannot go through with my actions now—so easily attainable such a short time before. I take back the feeling of being numb—I am enraged beyond all comparison. All I heard was this loud voice that kept yelling over, “Go ahead, kill yourself, I dare you to have the balls to do this, you inept asshole,” over and over, covering my ears and yelling at it to shut the fuck up as if covering my ears would make such a difference. I cannot believe, nor do I have the words, to describe the contempt in which I hold myself. My utter failure at my most piercing desire only proves to myself how stupid, miserable and useless I am.©2009

I Miss My Church

Gosh, today is absolutely beautiful outside. It’s 64˚. The sun is shining brightly with a piercing blue sky. I’m out here on my front porch just listening to the acorns pelt my roof and driveway (yeah, I know I should be out there sweeping them—they’re as dangerous as ball bearings as you try to walk among them. Here it is two weeks into November and only now the leaves are starting to turn.). There must be some truth about the sun’s effects on depression. I always feel more peaceful sitting out here, even with the noise of the steady traffic. If only I got suicidal during the daytime. The first couple of times I felt suicidal after I came home from the psych ward, I tried to retreat from inside my house to the porch, but the darkness was still around me. It’s a shame that my porch is only a safe haven for me during the day.

I’ve been out here most of the morning and afternoon. This morning I watched my church parking lot fill with cars. This whole issue about going back to church really has me confused. I want so badly to attend, but I still cannot deal with all of the people and the eventual greetings and questions. How I wish I could sneak in where no one would see me.

Even before my world came tumbling down around me one month ago, I had already begun to isolate. I’d still attend church, but I started planning my entrance just around the time praise & worship had begun. Most didn’t see me as the doors are on the side. They sat in front of the doors, so I wasn’t immediately noticed when I’d take my usual seat. Then I began the habit of leaving the building immediately after the service was over to avoid everyone. The last time I even sat further in the back to make the getaway a little faster.

There is a row of chairs right by the door I always use, but there are a couple of folks that sit there. I cannot sit next to anyone. If I sit back too far, it just takes that much longer to get away. No, I’m not ready to go back my church. So, here I sit on my porch watching my church to which I so much want to return.©2009 (continued above...)

Appt with Psychiatrist Week 3

My calendar said that we had our second appointment on the 29th, but I don’t remember that one. I can tell my meds have changed because I found his instruction sheet. He always writes everything out because he knows I may not remember. This visit was on 05 November.

My meds have changed again. Now my Geodon has changed from 240mg at bedtime to also include taking an 80mg dose in the morning along with a new drug called Provigil @ 200mg in the morning to help sharpen my focus and concentration. Its primary use is for the treatment of narcolepsy, shift work sleep disorder and excessive daytime sleepiness associated with obstructive sleep apnea. Other potentially effective, but similarly unapproved targets include the treatment of depression, schizophrenia, and disease-related fatigue. I guess my disease-related fatigue is the insomnia due to the depression

His primary concern is that I can keep myself safe. He has always been the only one with whom I’ve been able to be completely honest. I have been seeing him since June, 2000 when I was first diagnosed with BP (BPD didn’t become diagnosed until 2005 after my previous attempt at suicide). Aside from wanting to keep me safe, he is very concerned over my lack of sleep. He told me that I couldn’t expect to see measurable progress until I can overcome the insomnia. He’s also concerned about my weight loss. I’ve lost eight pounds since 28 October because I’m not eating. The only thing I eat is a small snack when I take my two doses of Geodon because it has to be absorbed with food.

Today he increased my Lamictal to 200mg QD. My short-term goals are 1) work on severe depression with medication changes as needed, 2) directly deal with my persistent suicide ideation as depression lessens and while my coping skills are still effective, 3) work on my rage issues as my depression lessens, and 4) work on my isolation as the depression lessens. He knows I am in the OP Therapy program Mon-Wed-Fri, so I am to call his office on Tuesdays and Thursdays and request a call back so he can check in with me. He also wants me to call his service on Saturdays and Sundays for the same purpose. He wants to keep me safe, and feels with this constant monitoring, if needed, he can make a med change on the fly. I couldn’t ask for a better psychiatrist. He gets me. And he said that once my bipolar balances out, he wants to work on my borderline personality disorder. He is more than just a psychiatrist. The time he spends with me and what we talk about is better than any individual therapist I’ve ever seen. I’m very grateful that the circumstances back in 2000 brought us together.©2009

Outpatient Therapy, Day 6

I couldn’t resist this video. It actually had ME chuckling a bit! It’s well worth listening to for you group therapy gurus out there!.

Yesterday I was a little more active about filling information on the daily check-in sheet we use for “sharing” (gag). I was able to verbalize and demonstrate (what they are looking for according to my treatment plan) three skills I have been using to further my treatment.

You know how I mentioned that I can be out driving my car and all of a sudden I don’t where I am, how I got there or how to get home? (which only causes an anxiety attack to no end). Well, what I’ve come up is this plan: I Google the map from house to location (and also do a return map) and I keep that in my car. I study the map so I know what exits to pay attention to if I’m on the interstate. I have been using “mindfulness” (skill #1) by concentrating hard on where I am at all times, mentally checking off the exits. In addition, I will call the location ahead of time (even if it’s been a place where I have gone before) and ask for prominent landmarks that I can start looking for as I approach the location. I mark these landmarks on my map.

When it comes to more locally centered destinations, I can zoom in on Google and it will note landmarks (restaurants, gas stations, churches, etc). It’s still up to me to study them ahead of time so I don’t have to be looking at them while I’m driving. I’ve have even had to resort to do this when I plan to take a long walk around my neighborhood. The other night, when I just wanted to get fresh air, I Googled the diameter of the area usually a minimum of a two-mile stretch (residential, no populated landmarks) and made notes on the map with regard to street addresses to go with the street names and would place arrows to make sure I would know how to get home. In addition, I take my walks when it is very late at night—no traffic, no noise. You might wonder if I’m taking a risk doing this so late. All I can say, pity the fool who wants to fuck with me whether he has a gun or knife. Besides, you’ve heard the phrase, “suicide by cop,” well, couldn’t this be just as easily “suicide by rapist?”

The other immediate issue I have been working on is facing being around a large group of people. When our whole group therapy rejoins us for the second session (we always split into two smaller groups for the “sharing” session), I can’t handle the room that is now filled of people. All of the chairs are taken. I can’t sit next to someone, or even be in close proximity. My coping skill has been to “retreat” (skill #2) where I find a chair alongside the wall, as far as away from the table that is possible. Again, I use “mindfulness” when I start freaking out and the walls feeling like they are closing in around me. I simply close my eyes so I don’t have to see anyone and just zone on what the therapist says. Sometimes I have to use my “deep breathing” (skill 3) when I actually have to open my eyes and look at the white board, or have to participate in the discussion (my extent of participation is usually having to ask her to repeat what she just said because I don’t understand something, or my poor concentration is acting up).

So, I am using three skills so far that seem to be working to an extent. I’ve developed quite a lot of neighborhood maps, by the way. I’m not one to retrace my steps every night. Since I am still alive writing this, the severe suicide ideation I experience on an all too familiar basis, what I have been doing for that one is to get out of my house, because it seems that being all alone in my house has become a trigger, so I “retreat” and take a long, hard walk. The exertion helps dissipate the wrathful rage I am experiencing at the moment, so by the time come home I am usually spent and exhausted. I simply take my bedtime meds knowing that they will knock me out for about two hours tops. When I wake up, the suicide ideation is usually at bay, even when I go into the other room and put all my “instruments” back in their lockbox for no one to find. I’ve carefully labeled it quite prominently Bank Statements, so no one would even bother looking there if the cops ever had the probable cause to search my house.

I am missing a time block from the time I left group therapy this past Friday from about 1215 until I woke up @ 0135 (you know, when I eventually go back to work, there is no point in having to set an alarm!). However, what concerns me most about the dissociative states is wondering what I do when I am in that headspace. I have to ask the obvious question: what happens if I become suicidal during a dissociative state? Will I have the frame of mind to attempt to use my coping skills? I only have this as a vital concern because the last time I committed suicide I cannot remember almost nine hours (which of course could actually have been precipitated by the incredible amount of ETOH I consumed along with the benzos).©2009

Outpatient Therapy, Day 5

This morning was rather interesting. Did the usual sharing, but when I commented that I couldn’t remember anything from the time I left group last Friday (but that I remembered Saturday and Sunday) she asked me if I remembered calling her Friday afternoon. I drew a complete blank. She said I wanted to meet with her afterwards today to discuss my treatment plan. It was news to me (as she scribbled).
Well, we did discuss my treatment plan. I asked why, under master problem list, it listed merely “depression” and no indication of persistent suicide ideation. She explained that I had not been honest from the beginning about that on my daily check-in sheets, and only just started mentioning it. I tried to explain to her that the ideation isn’t just something I think about here and there, but that I struggle with this almost every evening. The only thing that has kept me alive has actually been using one of the coping skills. I am discovering that my house…my fucking house (or rather, being in it all alone), has become a trigger. I have to leave the house and I end up going for a walk—a long walk. My reasoning? It’s late at night, and walking releases so much of my energy. When I finally get home, I’m worn out—physically and emotionally—utterly spent.

She looked at me and told me that she thought I needed go back inside the Big House—that this outpatient treatment program, in her opinion, wasn’t going to be sufficient to keep me safe. I pleaded with her not to make that recommendation (i.e., have me committed again), that I had shown that I was successful in using my skills. I practically begged her to let me go as long as I made the commitment to her that I would use my skills when I was in that head space. I tried to stay calm, although my heart was banging so hard. However, she relented but there was this look in her eyes that scared the shit out of me. All I kept thinking to myself was to just deep breathe and stay calm. I didn’t want to trigger any action on her part.

When I got home later, I looked at my entries on the blog and, sure enough, there was my entry about Friday that I posted on Sunday morning. Evidently, I did remember at that moment actually coming home, but it doesn’t say anything else about the rest of the day. And today, the last thing I could remember was someone making a comment about the fact that I actually smiled for the first time just before we left group. My mind is so fucked up. I swear there are times when I don’t know what is real and what isn’t.©2009

For Sharon—

Sharon, from the comment you made to my post below, I know you must feel that you mean well by passing along “the perfect scripture” and to remind me that the people at the church are my friends. However, while on the surface everyone is nice—and I acknowledge that they have been there when I have needed them during trying times by praying for me—as soon as I walk out the door, that’s it. Yes, A and I actually had lunch the Thursday before my debacle; she brought me my cell phone before I was transferred to the psych ward, and has texted me a couple of times since (which I have patently refused to respond). D did call once after I missed the second service wondering if I was OK or sick, or something; and no, I did not return her call either.

It’s not that I believe they don’t care. I believe there is an intrinsic obligation from Godly Christians to feel they “ought” to care because it is their duty. There is no friendship base there. There is no level playing field. I have nothing in common with anyone. I am the only single, queer, mental case of the lot. How could anyone possible begin to relate to me—to be able to truly “get it?” A friend is someone who is there no matter what whenever you need them. And I can’t operate with just one friend because, realistically speaking, one person may not be able to be “there” due to his or her own personal obligations at that time. Everyone at the church is married and has (or will be having) children. They are all wrapped up in their own lives and obligations. I am a mere blip on the radar screen. With the exception of A and D, there has never been any interaction outside of church (and those were limited at best and the one time A and I actually made plans, I had to initiate the action—something that I am extremely uncomfortable doing). OK, yes, A was truly there when I needed her as she did bring me my cell phone. But as with all of the couples, my only down time is after 1900 on weekdays and weekends—the time they all spend with their spouses/family. I feel as though I am an intruder taking away from their time together. And I don’t want to be the fifth wheel, either—easily the situation since I am the only single person there.

There are just too many people at the church right now. When I walk through those doors, I feel paralyzed for fear that someone will speak to me. I have felt, crossing that threshold of just wanting to stand there and quietly walk out the door, hoping that no one notices me. I can’t be myself, so I put on my façade and pretend that all is well. What should I say? That I am full of uncontrollable rage; don’t forget that I am queer and missing being a part of that community I so desperately want to belong; oh yeah, and by the way, I tried to commit suicide—and most likely will again (it’s all I think about. But have no fear, I will not make the same mistake I did last time)? I don’t want to have scripture quoted to me; I don’t want to be prayed for. I just want to be left alone. You see, that is the conundrum that bipolar and borderline personality persons face. I ache so much for contact, yet at the same time, I am repulsed by it. I can’t walk into a room full of people without feeling so full of fear and anxiety. I don’t expect you, or any of the others to understand that.

So, that brings everything back full circle. No one at the church can possibly understand what I am going through, much less know who the real “me” is. All interactions have been and would continue to be quite superficial at best. I am tired of the façade I must present every single Sunday. Sure, I let my hair down when I was facing that strike, being laid off, and that Six Sigma training I was terrified of taking—but those issues in and of themselves are also superficial. I won’t share anything about who Alix really is for fear that I will become someone to avoid so that they don’t have to deal with my “issues.” Then when that happens, everything has boiled to the surface and, once again, I will see their subtle detachment slowly begin to occur as I have seen with other people to whom I have attempted to reach out over the years of my life. Very simply put, I am tired of the rollercoaster ride—my life such as it is. I’m done with it all.

Surprised as I am, I appreciate the time you took to make the comment. I am not trying to trivialize your effort, but the simplistic approach of dashing off a scripture and telling me of course that I still have a group of friends only validates my perceptions, hence this post.©2009

My Nancy Drew Act: The Quest To Find Out What The Hell Happened, Wednesday, 21 October, 1230

(If you haven't already read this saga from the beginning of this nightmare, go here first)

Immediately after the outpatient session was over I raced over to the trauma center I was taken to and put in a request to receive my complete medical record of my ER visit. I detailed that I wanted all the doctors’ notes, the nurses’ notes, all lab results, and any legal paperwork filed against me—or at least evidence that they were requested and ordered by the doctor. I was told it would take approximately 15 days. Then I thought to stop by the business office and get a copy of my bill. At least I could determine from that what tests were ordered and what medications were given and anything else that was billable. That they gave me immediately. It was a start.

What a fucking rip-off. The entire bill was $3910. Here is how it broke down: 5 0.1mg clonidine tabs @ $3 each, 40meq of potassium chloride @ $3/10meq, 1 800mg ibuprofen @ $3, venipuncture @ $25, blood alcohol level @ $196, 2 basic metabolic blood tests @ $200 each, 11 drug screens @ $88 each, CBC @ $105, urine culture @ $171, urinalysis @$93, ER Fee-Level V @ $1,524 (I was charged twice for that one), EKG @ $250, and finally the ER physician’s fee of $234. If I were that doctor, I would be humiliated to know that the damn EKG cost more than I did.

I can’t wait to get my hands on the medical records. I am going to match each billable item to an order in the chart. If I don’t see 11 orders for the separate tox screens, I’m sure as hell not going to pay for all of them

Aside from the ridiculous costs of each item and why the hell they had to run 11 tox screens, everything billed seemed to be a reasonable action taken by the ER considering my supposed presenting symptoms. But, just what were those presenting symptoms? I still can’t remember shit.

Then I went over to the E911 administrative offices. I told them I wanted a copy of the paramedics’ record on me that would reveal the time the 911 call came in, how they found me, what condition I was in, etc. I also told them that I wanted a copy of the 911 recording (they could send me the .wav file via email). While I got a hard copy of the record right away, I was told it would take about a week to get the recording.

As I sat there and read it, I was totally blown away. As best as I assumed before reading this, someone called 911 reporting a suicide attempt. Yet, at the top of the record, it states that they were dispatched at 0259 on 10 October with no lights and sirens. Hmmm…guess they must not take suicide attempts very seriously! They arrived at my house at 0313. But get this—they departed my location to transport me to the ER at 0330 (arrival to the ER @ 0338—again with no lights and sirens). They spent only 17 minutes at my home (btw, that bill was $250).

Then I flip to the second page. This only gets more bizarre. According to the report, “patient found sitting on porch with city police talking with her.” Talking??? So, I was up and talking. Explains HOW they gained access to my house. But, why were the police there? Oh yeah, that’s right, in my state it’s against the law to commit suicide.

I kept reading…”Chief Complaint: Category-Psychiatric Problems,” (geniuses, aren’t they?), “History of Present Illness: patient states that she has been having suicidal thoughts recently. Patient states she sent a message to her pastor detailing that she was going to overdose on medication with alcohol. Patient states she has been off her psychiatric meds for about three months. Patient agreed to go to the ER after admitting to sending her pastor the message about intentions of overdosing. Patient states she has not made an attempt to overdose or any other type of suicide yet.”

Third page “Neurological Exam—Level of Consciousness: alert, Orientation: oriented to people place and time, Loss of Consciousness: No, Chemically Paralyzed: No, Motor Comments: moves all extremities equally well, Sensory Comments: equal and normal sensory functions, Pupils: normal and reactive.” The GCS, airway, respiratory and cardiovascular entries all reported “within normal limits.” “Injury Details—Drugs/Alcohol? Alcohol, Drugs/Alcohol Indicators: patient admits to alcohol use, smell of alcohol on breath” Here is my favorite entry… “Impression/Diagnosis: mental/psych” (God love their training!).

Fourth page “Patient Authorization Signature Form” There was my signature, plain as day and clear as a bell. This was followed by a similar page for the receiving nurse’s signature at the ER.

Reading all of this only raised more questions. If I was so fucking alert and oriented, why the hell can I not remember a damn thing? Why would I send a message to my pastor of all people (sure enough, I checked my cell and there was an outbound text message basically saying what was in the report, so I now know WHO called 911)

What I do remember was being depressed at being so alone and pissed off that I couldn’t go to sleep, and making that huge Kamikaze. I don’t remember being suicidal (well, enough to actually do something about it). Besides, I already know how I plan to commit suicide—with an IV overdose of potassium chloride or insulin, whichever I can get my hands on (which I can quite easily). As I’ve said in previous posts, I’m certainly not going to take a chance by swallowing a boatload of pills and chasing it down with alcohol only to risk vomiting up all my resources. Plus, as evidenced by this occurrence, there is no telling what I might do in that period of time as my mental state starts altering after drinking a lot of alcohol (God forbid I make the mistake of sending another text message). With an overdose of the pills that I do have, there is the risk of resuscitation. With IV potassium chloride or insulin, especially the former, hell, I’ll be doing good to be around long enough to pull out the damn needle. No chance of resuscitation. It’s quick and it’s permanent.

Nevertheless, there are still more questions. Why were all the lights on in my house? Did the cops search my house? There didn’t seem to be any evidence of that. The only things out of place were the coffee table and the two speakers. Why were they moved if I was found sitting on my porch talking to the cops? Well, at least I know HOW the paramedics got in and WHO called 911. Huh, I wonder if the cops’ lights were flashing the whole time they were in my driveway? I’m sure the neighbors loved that. Well, at that hour, that’s probably a moot point. Besides, I don’t even know who they are, so I could give a flying fuck what they think.

Now I want to get in touch with the police department and talk to these cops who were on my porch. Maybe they can fill in some more of the blanks. And the nightmare continues…©2009

Suicide Is Painless

I woke up with a start at 0500 this morning. What a bite. It’s Sunday, a day when my alarm is not set. Why do I have to be awake so early? The nicest thing about sleep? My racing thoughts are quelled; the anxiety, the terror and the state of panic are at bay.

When I wake up, especially far earlier than intended, I can never go back to sleep. I just lie there and my thoughts just go to town. I can’t shut them up. All I could think about this morning was all the crap I didn’t finish before I logged out of the network Friday and all of the unread (118) emails still in my inbox. It’s SUNDAY for God’s sake…my supposed day off from work.

My thoughts quickly gravitate to suicide once again. I keep hearing the lyrics to M*A*S*H in my head, “That suicide is painless, it brings on many changes, and I can take or leave it if I please…” Right now, suicide is the painless option. There is too much pain just trying to eek out my day-to-day existence. I am so tired physically, emotionally…just too much crap. I just want to close my eyes and let everything go. I just don’t give a damn about anything. There is nothing to hold on to in my life that can make the difference.

I made a grave error in judgment about a month ago. I knew I was off my meds. I knew I was spiraling down big time. Tried my old DBT efforts of “mindfulness.” Didn’t work. Then I thought, you know, I could try to be responsible, for a change, with my bipolar. I could try being accountable to someone about how I am feeling. Way big mistake there. I actually called up the one friend I have and made the biggest mistake ever. I told her how I was feeling. Not that I was going to commit suicide, but that my depressive state was so bad that this is where my thoughts were taking me. Oh God, how I ever wish I had never made that phone call. I actually forgot that she has a key to my house. To make a long story short, she made it quite clear that if she couldn’t get in touch with me and if I wasn’t answering my phone at some point, she was going to march her ass right over to my house. I eventually convinced her that I was really OK (of course I was lying through my teeth), so she finally backed down. Now I have to pretend that everything is always FINE to her, the one person I thought I could be honest with about my feelings. Now I have to decide if I am going to go through the ordeal of changing all of the locks on my house.

Why is suicide so attractive? I don’t have to worry about the pressures from my job. I don’t have to worry about the awful pain I feel from being alone. I don’t have to worry about all of the things I do to myself when the pain of living exceeds my tolerance level just short of suicide. I don’t have to worry about living The Great Lie to the entire world (you know, that wonderful façade). That gets incredibly wearisome over time. I no longer have to be accountable to anyone (especially family) for what is going on in my life (yet another continuation of The Great Lie).

I have managed to keep the thoughts of self-mutilation at bay for quite a while. The function it served no longer works. There is no release in the pain felt. There is no release in watching the bloodletting. It’s like, “skip Go, do not collect $200.” I now just simply gravitate straight to suicide. Very bluntly, I am oh so ready just to lie down and quit. I am just so tired of it all. These racing thoughts are taking over everything and I can no longer control them. They won’t shut up. I can’t shut them out. They are taking over everything. I JUST WANT TO TURN OFF THE FUCKING NOISE IN MY FUCKING HEAD. Suicide equals silence.

Everything is ready to go. It’s all in the other room. All I have to do is set everything up. All I have to do is insert the butterfly syringe. Once that is in place, instant access to my veins. The bolus of KCl is waiting for me. Or I can opt for the insulin. Too much of either and it’s all over. Oh, sure, I have plenty of pills I could swallow and chase with alcohol, but there is always the chance I could vomit. The IV solution is sure fire…no accidents. The desire right now is so damn attractive. It too damn easy. I am angry that I am even having this discussion with myself. I’m wasting time sitting here and talking about it. What is holding me back from just walking into the other room and being done with it all? That pisses me off more than anything else right now.

I used to think if I could just take the time and capture all these feelings and write them down that it would provide a release for me. Writing no longer provides that catharsis. Sure, it gives me the chance to capture the thoughts, to force me in examining what emotions I am really feeling, but it now only boils down to realizing one thing: I’m empty. There is nothing left.

Yet at the same time, my mind is not in the same space it has been when I have attempted suicide before. I really haven’t made all of the preparations this time. The last two times the house was ready to go. Anyone coming into my house after the fact would have found everything neat and tidy. No, I’m not talking about making sure my house is clean. I’m talking about making sure all of the necessary paperwork is out in the open for anyone to find so that whoever will have to be responsible for picking up the pieces can take care of all of the arrangements. All my paperwork is in its lockbox right now. I have no idea who will ever discover me after the fact, or how much time will have to pass before someone comes knocking down my door. Sad to say, it will probably take quite some time before someone finally figures out that something might actually be amiss.

Sure, when my body is discovered, there will be no problem identifying me. Nevertheless, I have no emergency contact information anywhere except in that lockbox. Even my friend would have no clue as to who to call to make any announcements. I’ve always kept all of that information to myself for obvious reasons. I have nothing on file anywhere else (doctors, hospitals, etc.).

This is the worst part about suicide ideation…the pure desire and the means are there…yet something is holding me back at this exact moment. That really pisses me off. I have no reasons whatsoever NOT to do it, so why don’t I? What the fuck is holding me back this time? That only makes me more angry. Yeah, like I’m making a whole hell of a lot of sense right now.©2009