Just as the winter depression began lifting (with the help of pharmaceuticals), and anxiety seemed less (because of using fewer pharmaceuticals), covid-19 and quarantines kicked in. I’ve been limiting my excursions to grocery stores and mental health appointments for two weeks now. I am not ok. With each passing day I am more and more anxious about going out at all, even for a walk in my apartment complex. And depression is returning.
I realized I am feeling overly responsible NOT to spread the virus. With my lungs newly treated for pulmonary embolisms of unknown origins, plus asthma, being prone to bronchitis, and a few other conditions, I am at higher risk for complications when (not if) I get the virus. I figure it’s just a matter of time that I get it, but I’m Much More concerned about unknowingly spreading it before I know I have it. I have loved ones I don’t see in person anymore to prevent spreading it to them. And I am self-isolating as much as I can.
Yet the anxiety persists and grows. I know I’m not the only anxious person, though the solidarity isn’t helping my symptoms. I cry and cry. My stomach aches. My heart races. I have no reasons to give my loved ones or providers for why I feel this way. I’m crawling into myself to hibernate, depressed as I am, and in a desperate attempt to lessen the anxiety by lessening inputs. Hence, avoiding the outside world?
Depression DID kick in after the pulmonary embolisms of New Year’s fame. I’m told that is normal after major heart/lung issues, and so I’m not too concerned. This depression is a little easier than others – no hints of a hospitalization looming! Suicidal thoughts are present, but they are less frequent and less insistent. Plus, I’m so Very Clear that I want to live, as a response to the blood clots that could have done more serious damage. I’m still afraid of dying, and apparently I came close (well, was on the path?), and I don’t want to, despite the lying suicidal thoughts that persist. But I persist harder.
That is my mantra, ever since it was said of Elizabeth Warren, “Nevertheless, she persisted.” I persist. That’s what I do. Call it strength, call it bravery; those are not what I feel. I persist. I wake up everyday into a depressed reality with little to no sense of purpose, and I make a day of it: I do errands. I bill insurance or go to the doctor. I do housework. I watch too much tv. Sometimes I’m crafty or arty these days, as I watch tv. I cuddle my sweetheart. Then I go to bed into broken sleep, despite sleep meds. I wake up the next day to do it again. I persist.
I wish I could do more. I don’t have mental energy for more, even when my body wishes for it. Yet I persist in the belief that I will be capable for more someday. Some days I try. Some days I’m able to add something to errands and do something fun. Or I can go for a short walk to satisfy the itch in my body to move more (This happens infrequently as I live with severe chronic pain after a long spinal fusion as a child).
So even though I’m depressed, I persist. And there is some small glimmer of hope that persisting will lead to something more, someday. Persisting is boring, fwiw. But I’m alive.
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!