Category Archives: Coping Skills

Grateful

The last couple days have been thankfully, gratefully, blessed with lower anxiety. So even though I still have suicidal thoughts, they don’t hook into the anxiety and become obsessive. They float in as any thought does, and they float out, blessedly. It’s such a huge relief!

I’ve been busy doing nothing, and exercising occasionally, and moving forward with relearning some college algebra that should help when I start taking those science classes in the fall. I’ve been trying to read, but maybe I need to give up on this book. It’s just not getting anywhere. Or I can’t focus for very long, which is a feature I run into regularly. Maybe I’ll try another book for a while.

My mood is a little low, but still in the balanced arena, I think. As happens when I’m depressed, I’m fatigued for hours after I wake up, despite jolts from coffee. And I cancelled on some times to get together with people, another sign of depression for me. I’m not convinced either way that I’m depressed or not depressed. Time will tell?

Suicidal Ideation

A clawing, gnawing at the inside of my breastbone. Tears behind my eyes, but not released. Anxiety creases in the forehead. A fluttering heartbeat to my left, blankness and emptiness of the soul to the right. I see how I will do it in my head, over and over and over.

I’m noticing everything in this moment. This is what I experience in my body Every.Bloody.Time I have suicidal ideation. Which is minimally every couple hours, and right now intensely every other minute. It interrupts reading, watching tv, even doing algebra this afternoon, and while in conversations.

I watched youtube videos of Steven Hays giving ted talks about psychological flexibility and putting the mental brakes on thoughts. He is one of the founders of Acceptance and Commitment Therapy (ACT https://en.m.wikipedia.org/wiki/Acceptance_and_commitment_therapy) which is the therapy that finally worked for me. I’ve been practicing it for years now. The reminders in the videos helped me a bit. Hours later I’m still using tips.

I tried something, and stopped because it hurt more than planned. I’m not going to do anything, yet I’m plagued by the sensations and thoughts I described. It’s miserable and horrible.

I don’t want to go to the hospital, nor do I think it would help. My mom, though not currently in a position to help, has hidden things I could use to hurt myself. This is as safe an environment as it could be, I guess.

I don’t think more ECT would help, though my mood feels like it dipped, and I find it easy to fall into old thought patterns besides the suicidal ideation. I had a long and emotional Friday and Saturday getting certified as a NAMI support group facilitator, something I’ve wanted to do for years! But it wore me out mentally and emotionally. Which could lead to a natural mood dip, which is why I think ECT would be overkill since the depression should lift after more rest (my hunch).

Several doctors and several therapists have come to independent ideas that I just have suicidal ideations as obsessive thoughts (OCD) and there isn’t anything that will stop them. If I didn’t have the anxiety of whether my life was threatened or the bodily sensations I described, it would be a little easier. How do I live with this terrible debate and these sensations with no way to rid myself of them, to fight them, to welcome or accept them?

A Month of Me

Who am I in this new mental state? I really don’t know! I had my last ECT a month ago, a Month Ago! My mood is stable; my thoughts about death and suicide are not. They continue to come and go, intense sometimes, fleeting at others. I deal with them with some ACT (Acceptance and Commitment Therapy ) coping skills my therapist has me using. Sometimes those work to bring down my anxiety and miserableness. And sometimes not so much. He likes that I report back on how much skills work or not. I just want the thoughts to stop! But they don’t.

Along with a mood that is in the middle – neither depressed nor manic – I have energy to get out of bed in the morning, and energy for each day. I’ve even somehow managed to stop waiting for the other shoe to drop, that I’ll end up in a suicidal depression again and end up in the hospital. I have optimism and hope for the future and hope that I can accomplish a goal set in the future. In a week I’m doing a training to be a facilitator for NAMI Connection support groups. Starting next week I will be the short-term facilitator of a small group I’m in. In May I’m going to walk in the NAMIWalks 5K, which means training and fundraising for the next 3 months. AND I applied to the community college near me to take a bunch of science classes I never got to take during my college years. The first class starts in June, and there are several things to do before then.

Besides these plans I’ve made, I’m also currently on vacation in Chicago and its polar vortex, visiting friends and my old stomping grounds. My mood has remained calm despite a change in my return flight, cancelled plans and the weird memories. Yup, weird memories. I lost most of the geography of this area in the ECT, but it started coming back after seeing the routes I used to take. Places I used to go don’t have very many personal memories. And where I live now has very few personal memories as well. I’m almost only living in the moment, like a cat. (Yay! A cat!)

What have I discovered about myself in this month of… competency, flexibility, stability? First, I’m learning to trust myself to hold a steady mood, despite thoughts that scare and annoy and aggravate. Second, I now know that part of the reason I’m doing better is because I have housemates. I know I can’t live alone. Where I will live or move is up in the air, but many wise people have advised that I spend some time adjusting to this new phase before making big changes. Third, I’m recognizing the traits and values that make me, me. Compassion, justice, volunteerism, friendship, for a start.

I hope, hope, hope that I stay stable. I’m a little scared thoughts will take over. I want to take this time to get to know myself as a stable person – limits, weaknesses, strengths. I haven’t felt this good – ever! I’ve been in a mood state, untreated. Now? I have possibilities!

Sick, But Well

I am still steady, stable, in the middle with my mood! I have more energy. I wake up ready for the day. I have hope that I can do things in my life, not just have energy for them now, but also not be interrupted by a hospitalization. I haven’t felt this good perhaps ever!

But.

But I continually have breakthrough bipolar symptoms. I have obsessive suicidal thoughts and visions of me killing myself in one of several ways. (Sorry to be graphic.) I get anxious over little stuff. I get overwhelmed with too much stimuli, like too much driving or being in line at the pharmacy with lots of people around. I wake up too early sometimes and can’t get back to sleep.

The most distressing of the symptoms remains the intrusive, suicidal thoughts that are accompanied by such unhelpful thoughts as the world would be better without me, I don’t add much to anyone’s existence in any kind of unique way, and I would rather just check out and find eternal unconscious sleep. See? Unhelpful accompanying thoughts, besides visions of killing myself.

Then today I heard the Matchbox 20 song “Unwell” on the radio, and I’m again realizing that I am sick. I have bipolar (and other medical and mental illnesses), and it doesn’t go away. I’m always making allowances for how my brain works, whether fighting against how hard it is to concentrate or remember, or fighting against intrusive or obsessive or earworm thoughts. Bipolar runs my life.

But…my mood is stable now, for however long I get to have one. So, am I sick, or am I well? How is it that I have an even, good mood that lets me hope for a good future AND I have obsessive suicidal thoughts? AND near constant anxiety that breaks through regularly? And other symptoms? Am I sick, or am I well?

Post-It Note to Myself

You are feeling good! You can get to this place again!

So says the third post-it on my bathroom mirror. Both my psychiatrist and my therapist insisted I do something to remember this time. “Most people don’t remember their good times. They forget and think it has always been this bad.”

My first post-it says, “Bipolar is just one part of me.” I don’t believe that right now, but I used to believe it and maybe I will again. The second post-it says, “You are brave and courageous.” I believe that one finally, even after a couple friends have spent years telling me that. These post-its are signposts of health I want to follow. I added a third one only because it is so important.

I have changed so much in the last 10 months since my move to Texas. Healthier, mood stabilized (for now), happy, motivated, energized. I feel I have to put that caveat in there since, as my therapist said, moods change. I can be honest that I will fluctuate. And my psychiatrist expects narrower swings. So the future might be closer to a healthy person’s mood changes. I have to tell myself it might be possible to have a positive future.

My therapist reminded me that it’s not just the 23 ECT treatments that brought me here. I worked hard for this. I learned and practiced dozens of coping skills. I’ve been through dozens of medication changes. Each of my 40-something hospitalizations has led to increased health and stability. I have spent years in weekly therapy, and I have bared my soul to multiple psychiatrists. I cultivated caring and dedicated support systems. I could go on.

The two sentences on my post-it contain all I have written here. This blog post will be one I return to, I hope.

No ECT!!!

I showed up for my scheduled ECT this morning. And in the pre-screen I talked about how well I’m doing, back to baseline on everything. Somehow the conversation twisted and the PA asked if I even wanted a treatment today. Um, NO!

I waited an agonizing 5+ minutes while she talked with the treating psychiatrist. They agreed I was doing well enough not to have a treatment! I’m to call in a week for a phone screen to see if I’m still doing well or if I need a treatment. If I’m doing fine, they will discharge me and I can get the port out of my chest (used to access a vein easily since IV’s are hard to get on me).

Hooray! I celebrated my unexpected free day and good prognosis with a ginormous mocha from the coffee shop in the hospital lobby.

I also saw my regular psychiatrist today to ask about the fine tremors I have developed in my hands. But, I got to gloat about how well I was feeling. And I was shocked to be doing so well that he wanted to see me next In Three Months(!).

Even as I’m feeling well, and stable, and Good, I’m worried about the bottom falling out and plunging into suicidal depression for the millionth time. My doctor encouraged me not to worry about what might happen, and even to make a video or add to my mirror post-its that Yes, I was doing well. Something to help remember if (when?) things get bad, that I had been healthy and it would happen again.

Why do I expect suicidal depression to come again? Just because it has been a companion I could count on? And I got as good as one could get at dealing with it healthily?

How about I have no freaking clue how to be in a good space? I’m worried that the increased energy I feel is mania, and that the only way I have to express how good I’m feeling is to talk too much or to spend money. Both of those are things I do when I’m manic, yet I’m not manic.

I just don’t know how to be healthy! What are behaviors You have when You are healthy?

See! You Have a Purpose

So I was talking to my therapist, as one does, and we were exploring what to do with the ever-present suicidal thoughts. He had tried getting me to welcome them as just part of the landscape of my mind, something I’m pretty good at doing already. Most of the time I Accept that they are there, and recognize that they are just thoughts. At various and sundry times, intent to follow through on the thoughts accompanies the thoughts, adding fear and a third dimension to what had just been landscape. Then suicidal suggestions become action instigators, and I worry, fret, ruminate and finally find someone to talk to about the thoughts until they become landscape once again.

Even as mere landscape, suicidal thoughts are not at all pleasant. Just live-through-able. I don’t want them. Now, at least. Sometimes I want them and I want to act on them. But 97% of the time, I want them gone.

So I accept their presence, in good ACT fashion (Acceptance and Commitment Therapy). The next step, says Wise Therapist, is teaching them some boundaries. In a kind but firm way, order them away. As a small child I was often sent to my room to play, when the parents needed a break. So too, I must send the suicidal thoughts to their room when I need a break. Give myself some breathing room.

Now, we uncovered today that the undercurrent of the suicidal thoughts is the thought that I don’t have a purpose or goals. I have that thought a lot on its own, and it shows up again, subtly, with the suicidal thoughts. I hadn’t noticed it there before! I think if I send the thoughts to their room, then I need other thoughts to think about: my purpose in life and small and large goals. But I don’t have those, I protest!

And I change the subject, to my brother’s very recent colon cancer diagnosis and upcoming surgery (read more here: http://gofundme.com/markfightscoloncancer). Wise Therapist puts together that the same week I struggle with my Christmas Delusion and then persistent and pervasive suicidal thoughts, I manage not to go to pieces over my brother’s diagnosis and am the only family member to keep it together.

See! You do have a purpose! exclaims Wise Therapist. You didn’t set yourself and emotional needs aside, nor did the family situation exacerbate your symptoms so that you freaked out.

I think being steady through a volatile time for my family was the purpose he was getting at. I’m not sure I agree, but it did seem I was holding it together for people. I still don’t have goals or a larger purpose – in my mind – save for doing something interesting every day and surviving, or persisting as my bumper sticker says.

Is that all I need right now? Can I persist with no goals, no hopes, no plans. No real purpose, even for my upcoming trip to Chicago. Is persisting enough?