Thursday, April 13, 2017

Four Letter Words: Hell and Hope

Present Storm

Last night I emailed my therapist about getting in to see her this Friday or next week. I promptly heard from her first thing this morning. She had time and thought it was necessary, according to my email, that I be seen immediately. I had described myself as 'barely stable.' Timing worked out, so I went in to work with her. When I go to see her, I often do a digital intake questionnaire. It can be annoying, but you grow used to it. She can then compare it against previous visits to see how I score on various indices, like stress level, depression, etc. 

Right off the bat she mentioned my indices jumping up to near max and that I was marked as high risk of suicide. Well no shit. She had a form and asked if I was comfortable filling it out. Uhhhhh.... I'm not sure. What is it for and what can it mean? I am not going to answer questions that will force me into hospitalization. I will die before I am hospitalized again. That is no hyperbole. I REFUSE to ruin my academic standing by showing this despicable weakness. That is, of course, one of the best things to say. Right? But I agreed to continue and we went through the assessment. Megan and I have good rapport. She is a therapist that I trust, and connecting with a therapist is incredibly difficult to find. When I think back to some of the awful therapists I have worked with over the years...I just cringe. The university limits how many sessions we can have a year, and try promote the use of our personal insurance, but after looking around at covered providers I just gave up. Last fall I was experiencing regular suicidal thoughts, but they were manageable. I called one therapist that literally said they do not accept suicidal patients and that I should go to the hospital. THANKS!! Megan is convenient to access and works well with me. 

Nit and Grit

Do you want to fill out the form? That is what it was meant for. No. My hands were shaking and I didn't want to touch it, so she asked all the questions and I answered honestly. Questions included: 

  • What hope did I have and what was keeping me alive? I began to cry and said that my main reason for living was keeping my wife from being saddled with my student debt. How horrible is that? My loved ones didn't come to mind. Desolation and depression warp the mind until you are numb to things that actually make sense.
  • How likely was I to hurt myself or attempt suicide? At the moment it was a 3, maybe a 4, out of 5. The other night it had been a solid 4 and creeping up towards 5.
  • What was driving my desire to die? My uncontrollable thoughts.
  • Did I have a plan and means to access said plan? Yes. I explained them. She asked if I would tell my wife where the items were. I was hesitant and refused to agree at that point in the session. I told her that my plan was pain free. If I truly was going to do this, that I would prefer a pain free option.
  • Had I practiced my plan? Yes, but inadvertently. I knew what they items would do together and tooken them at the same time for different reasons, not thinking much about it. The effects were obvious but not deadly at that dose.

What was my driving desire to die? My stupid brain. My deleterious thoughts. Unwelcome, disgusting, and intrusive thoughts. I have no reason to want to die, but my inner thought generator disagrees with my assessment. There are no voices, but there is a strong compulsion to do it. You, I, have to do it. Failure to kill myself only adds to the overall failure of my life.

I cry and the dumbest and most random things. A couple of times I started breaking down, but my male machismo crap thing started kicking in. Show no weakness! Oh, wait, I've shown plenty of it. I don't know why I have such a hard time crying in front of people. But I can tell you hands-down that my ECT treatments make me tear up and cry about 50 times more than I used to. That bastard side effects is second only to my memory issues and amongst my largest detriments of ECT.

A Bit of Help

A local psychiatric specialist, that has rounds on campus, was brought in to consult with me on my medications and treatment history. Everyone has their role. Yes, I take my medications. (Religiously. Probably once every other week I miss a morning or nighttime does. It is always on my daily task lists. It's an annoying reminder. Very hard to ignore or forget.) I am comfortable opening up to Megan, while Tracy was more of a business transaction. An exchange of information. She was able to point me in the correct direction for local doctors that I could consult with over ECT, ketamine, and possibly TMS. That is exactly what I want.

What is it that can get you through these thoughts at this time? Hope. The hope that reprieve will be coming soon. If that is pulled out from under me then everything will go to hell in a handbasket, very fast. 

I suppose that is something good, that I even have the concept of hope to hold onto. The last time I was hospitalized, in 2014, I had lost all sense of hope. The cycle of depression had won. It would never be destroyed and all that I had was desolation. That is why I told my doctor I would not longer take my medications. I know how my body works, and my dark spiral of self-destruction would take hold in no time. I gave up. Fuck depression and unwanted thoughts. They won. That is when he asked if I would consider something different. I remember telling him, "I am not opposed to happiness, I just don't think it is possible." I was given a choice between ECT and TMS and went with the more effective avenue.

The Cost

I let my wife know the other day that I was willing to undergo ECT again, but there is a problem with it. The associated memory problems are a major concern. What I conveyed to her was that it would save my body and destroy my sense of self, worth, and possibly hope. How the hell does that make any sense? I am in school. My brain and memories are some of the most important things in my world right now. If I lose those memories, any of them, I'm fucked. 

Perhaps to you this isn't a complicated situation, but to me it is incredibly intricate with its tendrils curling out in every direction. So much to take into consideration while trying to keep it together. 

Quo Vadis

Hopefully somewhere, but right now I still feel tossed about in a storm, and no damn parting in the clouds will be sufficient. I need the skies to clear, ocean to calm, and a tropical island to appear on the horizon. Only then will I believe that hope can still mean something.

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