Well, I rang in the new year in the ER with pulmonary embolisms in both lungs. Turns out the shortness of breath I had been experiencing for weeks was neither allergies nor bronchitis, but blood clots. The ER and hospital stay experiences were anxiety-provoking whether it was getting blood from the same veins over and over, or hearing that You Have Blood Clots in Your Lungs! (And no one knows how I got them.)
From the anxiety and the very little sleep one gets in the hospital, to being in the ER and hospital at all and thereby reminded of all my psych hospitalization experiences, my mind was all over the place, though my mood remained stable (hallelujah!). I did, however, have the opportunity to evaluate and appreciate the facts that (1) I did want to live and (2) my body was trying hard to live – the survival instinct was hard at work. There have been so many times in my life when I wanted that survival instinct to just stop, and this time, I was grateful for it. Hallelujah again for more mental progress!
In the last month, even as I dealt with the shortness of breath, I also moved about an hour away, gave away about a third of what little I owned, and have spent lots of time alone and with my girlfriend despite her busy work schedule. I am acting more independently again, and my mood is still stable! It’s a strange experience, this stability, even in the face of so much change this last month. I am still waiting for the other shoe to drop and become unstable again. But I’m weathering life ok, and that is both a surprise and very welcome.
I’m relying heavily on coping skills such as distraction or grounding myself. But I really want to die. If I can hang on, the mixed mood will pass, which will make the suicidal images less intense (they never go away completely). My psychiatrist increased my antipsychotic med drastically a few days ago. And my therapist is checking in on me daily. There’s a bed waiting for me at the hospital if I need it, but everyone is rooting for me to hang on and cope through this bad spell at home.
Except I really, really want to hurt myself. I don’t have a good plan, and my access to any means has been extremely limited. But the various ways keep pounding through my brain relentlessly. I want something to work – a way out of life or a way to make the feelings and images stop. I’m still just trying to hold on, grasping on the ledge with my fingernails, despite coping skills.
My thoughts are singular. My access to any means is gone. I don’t want to live this way. I don’t want to live at all. And people telling me they care isn’t enough of a reason to stay on this earth. I believe my brain’s lies. I’m not in my right mind. I’m not ok.
So I’m still struggling with suicidal ideation. I found a recent medical journal article that described what I go through EXactly. “Intrusive Suicidal Imagery” that is unbidden and unwanted, yet can lead to suicidal behaviors just to try to stop the imagery that by being so intrusive leads to hopelessness and then desire to kill oneself. It’s an endless, eternal circle and cycle that I live with. Here’s the article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5551152/ The first third describes what I go through Every.Stinking.Day. The rest is about possible treatment…
What??? There might be treatment for chronic suicidal thoughts? Yes, EMDR as described in the above article has been successfully used for PTSD and trauma for about 30 years. In the last 10 it has been used successfully with other mental disorders and now finally with bipolar and with chronic suicidal ideation. Something to think about, research more, and see if insurance will cover.
This idea of possible EMDR is one of the really helpful things my therapist told me about last visit. The other is that by even trying just a little bit, just one teensy step, I Am Not Failing. Part of me thinks I fail every time I DON’T go through with suicide – too chicken maybe, since the suffering is so ridiculously unpleasant that I ought to have ended it already, having already gone through every.treatment.possible. Part of me believes doing so many coping skills all the time is failure because surely one of them ought to have worked by now – same with medications and other treatments. I must be doing something wrong.
I complained to my therapist that my brain is trying to kill me. He thinks it is just afraid, and again, that I am not failing. I continue to try: to live, to combat the thoughts or at least try to detach from them. And that struggle has made me who I am. And he thinks that’s a pretty awesome person. Meanwhile, I’m still over here planning my death, but I AM still trying to live. Aren’t there better ways to make someone an awesome person? Asking for a friend…
I’m having a hard time telling anyone close to me about my suicidal thoughts. So my therapist told me to write about my feelings. I’m not talking about them because I don’t want them to be real, maybe? I don’t want the ECT to be wearing off? and I don’t want anyone to encourage me to do ECT again? All of that probably.
But I have to remind myself that I’m in a new place with my bipolar and its treatment. I’m in control of my treatment. And if I want to use only medications, then that’s my choice. And if my psychiatrist can’t find medication to help the OCD suicidal thoughts, then I’m back to discussing how to manage them with my therapist and using coping skills.
So here I am using the writing coping skill as instructed by my therapist. I’ve got frequent images of one plan to kill myself in my head, and negative self-talk swirling through my mind. People would be better off without me, type of stuff. I can tell myself my brain is lying, but I still believe the negative self-talk for a while. And when the self-talk and images coincide – as they do regularly – I find myself rehearsing the plan, or starting and then stopping. I really don’t want to die, do I? It’s hard to tell. With all the crap in my head.
I haven’t been able to tell my family, or to contact the Crisis Text Line (741741) or the Natl Hotline (1800-273-TALK). Obviously I contacted my therapist, who told me to write at the minimum. I did tell my church and my online community of friends. After suffering in silence for two days. I’m tired of suffering and I’m scared to tell.
I feel… Balanced. Emotional. In the middle of the two poles, yet still experiencing polar emotions, such as highs where my thoughts zoom and my feelings soar and influence decisions, as well as lows where I again contemplate suicide though never with intent. But I’m never high enough or low enough or there long enough for it to be a mood state.
I haven’t had anything to “talk” about here with my mood so stable. I even had nothing to talk about at my last therapist appointment. Cool changes are going on in my life – new nutritious eating, trying some additional exercise, a new organization membership. All good things, and nothing too particularly about bipolar to write about.
Except maybe this? I’ve talked with a couple people in academia about what I could expect as a PhD student and adjunct or tenured professor so I can decide if I can expect it of myself with this limited brain. I know that “limited brain” sounds like negative self-talk, but in this case it’s self-care because I am learning to accept my limitations and have realistic expectations of myself. A couple of the limitations I have now are that I don’t remember what I read very well (fiction is easier than non-fiction!), and that in conversations or when asked a question I have a hard time coming up with an answer or sorting my thoughts out to sound coherent or finding the right word. So I have a lot to think about to decide if I can do PhD work.
Let’s just enjoy my normal and hope it lasts a while!
I felt alone. It seemed everyone around me wanted me to continue with ECT. Yet it’s my decision. It’s my body. I live with the illness – and it’s consequences. I live with the treatments and the symptoms of anxiety they cause in me. Here is what I decided after several conversations with my therapist, my psychiatrist, the ECT team, and my mom. I even read medical journal articles.
I want my life back. I want the anxiety I’ve been living with to be back to reasonable levels that I know how to live with. My mood has been stable and my psychiatrist expects it to stay that way. I hope he is right! I’d like to learn how to live with a mood that experiences many emotions without dropping or accelerating into a mood state.
I decided NOT to do ECT anymore. I want to try medications again if my mood becomes depressed or manic again, or if I become suicidal. I have to get the port in my chest removed again since I no longer want to do ECT. (The port was used to access a vein so that nurses didn’t have to try multiple times per treatment to create an IV.) ECT has been helpful for getting my mood to baseline, and perhaps it would help in the future too. I’m just not sure, I don’t like the reaction I have to treatments (days of anxiety), and I’d rather work with pills. ECT had been a last resort when I started it last fall, and resumed it this spring and summer. I just don’t think it has to be my Go-To treatment method anymore.
I will be super vigilant about routine, schedule, taking meds, nutrition, exercise, coping skills, and sociability as I try to maintain a stable mood with these things that have Not proven to work before. But I will do what is personally in my power to care for my multiple mental illnesses. I will work with my psychiatrist for meds and therapist for coping and exploration as needed. I will reach out to others for support on a regular basis. So don’t be surprised if I contact YOU!
I’m taking my life back.
Anxiety has been my constant companion at an elevated state since the f*** up at ECT nearly 10 days ago. If my anxiety was at a 9 last week at therapy, it was an 8 this week. Ooooo – totally getting better. Not. I cried through most of the session again this week. And off and on the rest of the day afterward.
This is what I am holding on to. My therapist reminded me that it is my decision whether or not to have ECT. I have been through trauma related to the anesthesia of ECT that I keep reliving every.single.day multiple.times.a.day. Leading to panic and anxiety going up and down all the time. I no longer feel safe in my home or alone. The anxiety is waiting to get me, sometimes as an anxiety attack or as people or things waiting to jump out at me. While ECT has helped my mood like no drug ever did – I found baseline for me! – it has now ruined my life, in my mind. I might be exaggerating, yet I’m miserable now.
Before my next treatment, I have a second opinion appointment which is designed to see if ECT is helping and still beneficial for me. I promised my therapist and mom, I will tell him everything, from how much better my mood is, to the plan to do maintenance treatments so the results last longer, and now how the anxiety from the anesthesia gaff has traumatized me and the anxiety is nearly unbearable.
While I want the decision from me and the second opinion dr to be to stop ECT, I will keep an open mind. Maybe I need to stop for now so the anxiety can subside. Maybe I would need to start up again in the future. Maybe I will ever do it again, and will play pharmaceutical roulette with my psychiatrist if I need it. I just know I Need To Take Care Of Myself. And I’m holding on to ECT being OVER.