Such a Long Day

I think lack of sleep induces mania for me. Due to my anxiety over the job interview with the temp agency and my first therapy appointment with the new counselor, I only got maybe 6 hours of sleep last night. Anxiety and insomnia go hand in hand. After all the running around I did today, I’m flat-out-wore-out!

First, the job interview, which wasn’t so much a job interview, it was basically just filling out paperwork to use the temp agency’s services and an employee looking over my resume. The position I’m interested in  is a temporary, seasonal position putting together gift baskets. That job won’t start until probably around the second week of December, so I have some time to get used to the idea of working again. It will most likely be full-time, so this will certainly test my ability to maintain my sanity. It’s also a factory-type setting which is something I didn’t want. Who cares? Force myself into something that will most likely overwhelm me in an attempt to prove a point, right?

Maybe I’ll get lucky this time and it won’t. 

After that I had some time to kill, so I stopped by Goodwill to take advantage of their 60% off everything sale. I got several pairs of dress slacks because I had none that fit properly. One of the two pairs I do own had holes all in them, like a mouse got into them or something; and the other pair still needs to be hemmed because they are way too long for my petite stature. The ones I found today at Goodwill are much more suitable interview clothing than what I wore today. KR told me temp agencies don’t care what you wear and to just wear jeans today. That must obviously be the case because most everyone I saw there was indeed wearing jeans. I wasn’t raised that way, though. A job interview is like church, you dress up to make a good impression! Whatever.

Then, it was on to the counseling session. I’m not really sure what to say about that. He seems nice enough. Yes, I was placed with another male counselor despite my wishes to see a female counselor. He was highly recommended by both my last facility and this one, and he has a lot of experience in the area of trauma; so maybe it’ll all work out okay. I don’t know. I waited more than 6 weeks for this first appointment. It’ll be another 7 weeks until my next one, and after that 3 weeks for the next. Long gone are the days of weekly (or even bi-weekly) counseling sessions, ya’ll. Welcome to the new and improved (yea, right) mental healthcare. Hence the reason why I keep coming back to this question of: What’s the fucking point?! I won’t apologize for my bitterness. I refuse. If I’m working full-time, I doubt an employer will allow missed work for such things anyway.

Get over it! You’re on your own.

Anyway, we only briefly touched on my history. He did offer another distraction method to help with the panic attacks: Set your sight on a fixed point in front of you. While staring at that fixed point, what do you see out of your peripheral to the right, then to the left, going back and forth until you’ve calmed. At least, that’s the gist of it. I’ll try that one these next few weeks when I remember it. That’s been the biggest problem with most of the distraction methods and grounding techniques I’ve learned — remembering to use them, especially in the moment. I’m getting better at using them, though. A nurse at CSU made a very valid point when she was helping me calm myself during a worse than normal panic attack one night during my last stay. Use these types of techniques while calm to help in remembering to use them when panicked.

After that appointment, my case manager and I met to talk for a bit. Apparently, my case worker from Vocational Rehabilitation had called her for more information about me and my psych history. My case manager forgot that I had already signed a release giving MHC permission to discuss “me” with VR, so she wouldn’t tell him anything. Ugh. She found that release after I brought up already having signed it and said she would email him to find out what he needed. That may very well be the reason why I haven’t heard anything else from VR. I ran through the list of things I’ve accomplished over the past few weeks. She acknowledge my ability to challenge myself to accomplish several of the goals I set for myself while validating my struggle to do so. See, that’s how this is supposed to work.

Recalling that conversation now, I recognize that I was far more optimistic at that moment than I am at this moment. I wonder if my mood always shifts this drastically throughout the day? I should pay closer attention to that, perhaps come up with a rating system that allows me to track my mood throughout the day for a time to see just how often this happens. It could simply be a fluke today, a result of so little sleep in addition to the added stressors of 2 new situations — the prospect of employment and a new counselor.

After that I had to stop for some food. My stomach was growling so badly during my appointment and with my case manager that it felt like an earthquake going off inside my body! I also stopped by Books A Million and our local public library to try to find a book my counselor recommended. I’ll have to order it since neither place had it. Then, I get home and realize KR didn’t take off the garbage. For a week, I’ve felt like I’m drowning in trash! Totally spent and pissed off by that point, I loaded up as much as I could get in the trunk of my car and took it myself. A load of laundry and remaining chores later and I can do no more. I’m done, positively depleted of energy! I just want to veg for the rest of the night.

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Life’s Bargain

A new part is in charge. I had to dig deep to find this one as all the others I’ve relied on in the past are spent, too exhausted to fight for survival. This one feels angry. She uses fear and anger as fuel for efficiency. She uses exhaustion as fuel for self-destruction, yet she gets done what needs to be done despite the cost. As a result I’ve accomplished more in the past month than I would have otherwise. I finally got 2 out of our 4 cats to the veterinarian. I decided since I had to get a complete physical, they should too. Turns out my 16-year-old female has hyperthyroidism which is why she was losing so much weight, eating voraciously, and so restless. She’s now on daily medication. My 17-year-old male wasn’t quite so cooperative. The vet barely got to glance him over because his anxiety was so high, but at least we did manage to get his nails trimmed. Older cats lose the ability to retract their claws. In a carpeted house, this can be torture for them. He may be losing his eyesight. This saddens me for him.

Next, I kept my first appointment with Vocational Rehabilitation and had a vocational evaluation on November 7th. That was a 4 hour-long process of assessment after assessment which wasn’t nearly as bad as my mind made it out to be. The person who evaluated me was a true delight. Had it not been for her comforting demeanor and friendly personality, I doubt I would have felt so at ease despite my anxiety. After I completed the computer assessment, she looked over my results as I was doing another assessment on paper. She surprised me as she kind of gasped and said, “Wow, you’re really smart!” She explained the results to me, though now, I can’t recall what was said. I just know I surprised myself because I don’t normally do well on timed assessments. I left more than half the questions blank on each section due to running out of time. Regrettably, I’ve heard nothing from Vocational Rehabilitation since that evaluation. If I hear nothing by Monday, I’ll call them.

Out of curiosity, I checked into UCReconnect, a program in Tennessee that helps adults return to college to finish their degrees. Although I desperately wish I could finish my degree, I doubt very seriously I would actually go back to college at this point in my life. I consider the fact that I returned to college back in 1999 to be one of the worst mistakes of my life considering how far in debt I am as a result. The fact that my student loans are in default would prevent me from doing so anyway. After speaking with someone from UCReconnect, I was put in touch with someone who could help me get my loans out of default. After a bit of phone tag, we exchanged several emails; but I haven’t heard back from him in more than a week either. I’ll give him until Monday as well before I call him. There may be nothing he can do to help me until I’m actually working again.

Saturday, November 4th, I went back to the Isha Institute for another free yoga day. This time I spent the entire day there. I tried their vegetarian meal which was positively delicious! I could eat food like that all the time and be perfectly content. I normally prefer lighter meals than what KR is accustomed to eating. No doubt my high cholesterol isn’t being helped any by eating so much meat. While at Isha I also went on the afternoon hike out to a waterfall and the bluffs. The view was simply awesome, and the large group of people with whom I hiked were wonderful. I met so many nice people. I honestly believe that both meditation and yoga have healing benefits that can’t be found in any other way. I thoroughly enjoyed every minute of my time spent there as I did the first time I went.

At my vocational evaluation, I was told I should go to Cookeville’s Art Prowl (this past weekend) after my evaluator glanced over a mini-portfolio/resume piece I had printed out for that appointment. Art Prowl is a yearly community event where a large number of artists in our community show their work at various venues throughout Cookeville’s west side and downtown areas. I’ve lived in this area for more than 7 years and never had the opportunity to attend for one reason or another. I forced myself to go this time, and I’m so glad I did. Again, I met so many wonderful people and talented artists in addition to getting a nice long walk in the process. My last stop for the day was the Cumberland Art Society. They have art classes and several other opportunities to connect to and be part of an “art community” — something I’ve missed greatly since leaving college.

I was invited to come to the open painting day at CAS on Monday. I wasn’t sure I would go; but that morning I managed to coax myself into the impulsive decision to go check it out. The warm welcome and friendly atmosphere made my decision to join CAS an easy one. Membership dues are only $35 per year, a small price to pay for an opportunity to re-socialize myself in this manner, with people who can actually appreciate the need for artists to create. Social anxiety can lead to a tragic loss of belonging and connection. I see this as a good opportunity to challenge myself and hopefully develop some friendships along the way with people who share my love of art.

Now if I could just find something like CAS to feed my love of music. There’s nothing better than getting together with other musicians to simply play music and sing.

That brings me to the present. I’ve spent much of this last month working on my resume, searching the job market, but not applying anywhere. Baby steps. That is until yesterday. I saw a part-time opening at Staples that I am interested in as well as another job listing on a temp agency’s website for putting together gift baskets. I applied to both. The temp agency called today to set up an interview for tomorrow. I set up the appointment, got off the phone, and had a proper freak out complete with minor panic attack. I keep telling myself, “It’s okay. No one ever died from going to a job interview.” No one that I know of, anyway. After that interview, I also have my first appointment with the new counselor — finally, after what feels like months of waiting (technically only 3 months of waiting, but still, that’s a long time).

So, yeah, my life has been incredibly busy lately. I don’t think I could have gotten through these last few months without falling into that disconnected, numb state of dissociation at least part of the time. It is what it is. I’m still having on average 3 good days (mindful awareness of my present state of mind and productive), 3 bad days (the opposite), and one day that can go either way per week. That’s not where I thought I would be when I reentered the workforce; but I have no choice in the matter. Ready or not, I’m forced to live up to society’s expectations or die trying. Either way, it doesn’t matter to me. That was the bargain — survive until I can no longer survive. Then, again, isn’t that technically everyone’s bargain in life?

I Found the “Perfect” Poem

I felt a Cleaving in my Mind — by Emily Dickinson
#937

I felt a Cleaving in my Mind —
As if my Brain had split —
I tried to match it — Seam by Seam —
But could not make them fit.

The thought behind, I strove to join
Unto the thought before —
But Sequence raveled out of Sound
Like Balls — upon a Floor.

Point of View

 

I needed an art day today. I couldn’t settle on anything too complicated to draw. The motivation simply isn’t there, hasn’t been for quite some time. I’m struggling with feeling numb and disconnected right now, too. This really is one of the worst bouts of depression I’ve struggled through in a long time. Sometimes, if I can’t find the words any other way, doing a collage like this streamlines the subconscious to help me figure out where my mind is. It’s the process rather than the end product that matters in this type of art creation. Quickly scanning some old copies of TN Magazine (a monthly publication our electric company sends out), I pulled out phrase after phrase of anything that caught my eye and “felt” right. The pasting process took forever! I have a severe aversion to sticky, so that part was much less enjoyable. Now, I’m not really sure what to make of the finished piece.

Several days ago I realized something. Trauma made processing my past far more difficult than it needed to be; but then again, it could simply be that my method of processing information is unique to my experience of life or possibly a biological flaw. I’m not sure which. I’ve never met anyone else who analyzes their life in the same manner as I do. I’m obsessive compulsive in how I analyze my life and how I ruminate on intrusive thoughts. On the plus side, I’m a historian, recording my life through writing, through detailed timelines, and through photography. I’m the same way with my family’s history, obsessing over genealogy in an attempt to understand “why” I am the way I am. I became a historian.

All of the research I’ve done on trauma points to a disorganized pattern of processing events due to the brain’s inability to process overwhelm in the moment trauma is experienced thus causing the individual to continue experiencing traumatic memories and emotions in the present moment when triggered. This makes perfect sense, yet it’s not very conducive to living one’s life. I’ve felt for years that I must reprocess everything before I can move on. The thing is that takes a considerable amount of energy and time, neither of which I have a lot of at this time in my life.

Still, I’m committed to doing this because it’s the only way that works for me to manage the symptoms of mental illness and the only way I feel I’ll be able to accomplish the goals I set for myself. I can’t let anyone else interfere with that process either. Too many have tried and made my life far more chaotic than it needed to be when all I really needed from anyone was someone to listen and validate my experience and offer encouragement. I’m a Leo. Stroke my ego and I’ll be perfectly capable of taking care of everything else because I’m also a leader. Maybe that’s why I relate so well to the feline population, far more so than the human population.

If I’m confused about something, everything is too hard. I become flustered, over-stimulated, and overwhelmed. I can only do one thing at a time, focus on one task at a time. I can’t even handle the simplest of tasks until the confusing factor is dealt with. Thankfully, growing up I had family and friends who helped me focus my attention when and where it was needed but who also gave me space to be “me” when tasks overwhelmed me. I don’t get a lot of that these days. I haven’t for a long time.

Kristi D., Renee S., “Duckie,” Nikki P., Mardena H., Martha R., and Glenn H. all come to mind as my cheerleaders and tutors who helped me throughout high school and taught me patience. To them I’ll be forever grateful because they taught me the value of friendship and respect for my peers, as well as the tenacity to never give up on tasks that seemed too difficult — take a break, sure, but never give up. Once something “clicks,” I’m seriously like an elephant — I forget nothing.

The filing system within my brain was fractured by traumatic events beyond my control. Eventually I’ll get to a point where I’ve reorganized everything in its proper order so I can make sense of it all. I’m just not there yet. I had hoped to have more time to finish this process, but too many demands on my time are frustrating me to a point of stubbornly refusing to do anything. Too little support has left me floundering like a fish out of water. I’m stuck in the “hurry up and wait” stage of treatment support, and it’ll be months before my system trusts another care-giver should they allow that at all.

In the mean time, I’ll simply do what I do best — cope.

Acedia

Starting around the end of 2008 through 2011, I managed to find some peace in my life, finding some space to do the things I love to do — draw, play piano, photography. The chaos of the decade prior ended with the small amount of financial stability that resulted not so much from receiving SSDI, though that helped some, but mostly from the inheritance I received from the sale of my family’s estate. I fear that will be the only time in my adult life I’ll ever have the privilege of experiencing that type of safety and security. So much of the chaos in my life was the result of lacking an emotional support system in addition to my inability to financially support myself. For a period of no less than 10 years, my survival was questionable because I had neither the emotional support I needed nor enough money to survive. No matter how hard I tried, maintaining steady employment was a huge challenge for me. My struggles with depression, anxiety, and unrecognized PTSD (at that time) interfered with my ability to manage my life.

THAT hasn’t changed.

I’m precisely back where I was prior to receiving that inheritance and SSDI. The pressure is on to go back to work, to somehow find some way to financially support myself and live independently. The resulting suicidal thoughts and voices of that pressure are every bit as bad as they were back then. In so many ways, that aspect of my mental illness is worse now because I feel like I’m compromising everything I was working toward these last 11 years. I’m told my goals are unreasonable for someone in my position. I tasted the freedom of being myself for a few years prior to running out money and losing SSDI. I cherished the time and contentment I found in living my life the way I needed to live it to protect my mental health. I found stability in managing my life within the confines of my home.

That’s no longer an option. If there’s anything these past 4 years have taught me, nothing I was doing is good enough. I either have to conform to societal expectations of maintaining actual employment or suffer in silence the pain of poverty, homelessness, and complete ruin. Why does society get to be so black-and-white while individuals are told nothing is so black-and-white? So many contradictions and hypocrisies….

Have you ever felt like everything and/or everyone in the world is trying to discourage you from fulfilling your dreams? I feel like I’m fighting an uphill battle, getting stomped in the mud underfoot every “professional” with whom I speak. Any contentment I had in my life was tossed under the bus yesterday at my first vocational rehabilitation appointment — 11 years wiped away in less than an hour. I was told that starting my own business as a freelance artist would be too difficult, pretty much impossible given the high standards by which Vocational Rehabilitation expects its clients to perform, impossible for someone with the severity of problems I face on a daily basis. My business would have to be successful and profitable within the first year of start-up. That’s not even feasible for someone who is highly motivated and hyper-focused. I expect to be forced to accept menial labor for minimum wage (or less than). I expect to be told to appreciate the generous offer of said menial labor or sent packing.

I don’t want to think about any of this any more. I’m sick and tired of being told what I can and can’t do. Every part of me stubbornly refuses to conform to anyone else’s expectations of me, each stating some rendition of, “If I can’t do what I love, I’ll do nothing at all!” Each part is content giving up rather than conform — even to my own detriment. I’m too exhausted to fight for my right to live my life as I see fit. Without an income, I can’t live anyway — which circles right back around to, “I wish I was dead,” and a chorus of vicious suicidal voices, leading to increased suicidal thoughts and ruminating on death.

Welcome to my circle of hell! Enjoy your stay.

Lasciate ogni speranza, voi ch’entrate.

When General Anxiety, PTSD, Social Anxiety, and Depression Collide

Just once I would like to have a complete physical without having the panic attacks and flashbacks that too often accompany doctor’s visits. Of course, it didn’t help matters any that my car wouldn’t start when I got in my car to leave for that appointment (10/5). Thankfully, KR was still home; so he checked it out and gave me a jump-start since, for whatever reason, my battery was dead. Also, thankfully, I still made it to that appointment on time.

Anxiety is a holy terror. The combination of stress at home, general anxiety over my car, and PTSD anxiety with regard to the “female exam” pushed me over the edge.

By the time the woman at the intake window called my number, I couldn’t think straight. Her questions sent me into a full-blown panic attack! Hyperventilating, tunnel vision, heart racing, panic to flee, dizziness — actually answering the voices inside my head out loud (!) with, “We need to get out of here!” — and somewhat lashing out (verbally) at the poor woman behind the glass who by this point was staring at me with confusion and impatience, telling me she just needed a rough estimate of how much financial support KR gives me each month since he still supports me.

I was completely mortified over my behavior.

Deep breaths… focusing everything I had in me on a kind of salt-rock-lamp-thing on a partition behind her, hoping I wouldn’t pass out, she finally sent me through the doors to another waiting area to fill out paperwork while waiting on a nurse to take my weight and blood pressure. The nurse checked my BP twice, in both arms, because it was so high. The doctor checked it a third time before I left. I’m so glad that exam is done and over with. Unfortunately, I had to go back the following Tuesday to have blood drawn after fasting since the doctor wanted to do a complete blood panel to check everything out. I can’t remember all the tests the doctor said she was testing for; but it was at least 10 different blood tests, including thyroid function, cholesterol levels, an ANA test to rule out RA and Lupus, sexually transmitted diseases, and whatever else.

A nurse called yesterday morning to discuss the results. Everything came back normal or negative except my cholesterol level is too high and my vitamin D3 level too low. I have 3 months to attempt lifestyle changes before I go back to have the cholesterol re-checked. Given my family’s history, I doubt anything I do will help much; but I’ll do my best to make the necessary dietary changes as well as exercise more. I was told to take a vitamin D3, 5000 IU, daily supplement to address that deficiency. Since the ANA test came back negative, neither Lupus nor RA explains the chronic fatigue or severe joint and back pain I’ve been experiencing for several months now (or any of the other physical symptoms). The nurse said those symptoms could simply be a result of the vitamin deficiency; however, I’m not convinced.

Same old same old.

Maybe it is all in my head, just symptoms of mental illness rather than a physical problem. This is one of the reasons why I don’t go to doctors.

Thursday night after I got home from that appointment, I was spent — no energy left for anything. I failed to cook dinner. KR came home from work that night in a horrible mood. I don’t remember what he was griping about, just his behavior of slamming things around in the kitchen and a lot of cursing (on his part; I remained silent, frozen as I expected the worst). At one point he took his aggression out on one of the plastic drinking cups, throwing it so hard against the kitchen wall that it shattered into several pieces. I’ve dropped those cups by accident a few times. They usually bounce a few times, but never break. The sheer force it would take to shatter one….

I kept a small piece of that shattered cup as a reminder of why I must leave this relationship. I’m still in the “planning phase” (Preparation/Determination), looking for a job so I can support myself and find my own place to live. It’s been horribly tense and awkward ever since KR ended our relationship. I’m thankful he hasn’t kicked me out. I’m not so sure I could cope with another homeless situation, but I know I have to leave. It’s a complicated matter nevertheless, much like a divorce considering how long we’ve lived together.

Everything I’ve been dealing with for so long hit me hard the next day (10/6). Physical, mental, emotional exhaustion — all consumed me as the clock ticked closer to the time KR was due to get off work that Friday night. Suicidal ideation and suicidal voices made it impossible to concentrate on anything. I finally packed a bag and went to speak to a crisis counselor after speaking with my case manager earlier that day and the crisis call-line prior to leaving. I was admitted to CSU for 5 days. It was the break I needed, as always, to catch my breath and calm down a little.

chose to accept psychiatric medication again — Zyprexa for the auditory hallucinations and paranoia and BuSpar for anxiety. I’m trying to keep an open mind with regard to the medication. I can’t self-medicate with either alcohol or marijuana if I’m to be employable, but I definitely can’t do this without some help. My depression, anxiety, and PTSD symptoms are simply too much right now. I’ve been sober for 22 days. Prior to that, my alcohol use was minimal (1 or 2 drinks, at most) for more than 2 months. I have no doubt in my mind I can remain sober. My future depends on my ability to have faith in myself (not a higher power).

KR’s extreme mood swings are no doubt from his alcohol use. I’m doing my best not to enable his behavior in any way. Ever since I got out of CSU, I go to bed around 11 pm (about an hour before he gets home from work) and wake around 8 am, either leaving the house until I’m sure he’s gone to work or holding my breath for that 30 minutes to an hour after he wakes and before he leaves. Most often I take the approach of remaining silent even during his outrageous tirades simply because I don’t wish to criticize him and make things worse. He’s not thinking rationally. He’s also not sleeping well. He drank over 2/3 of a 750 ml bottle of Jack Daniels last night into the early morning after I went to bed. He didn’t sleep either. He was still drunk, slurring his words this morning. He went to work anyway.

He did this 3 weeks ago, too. I honestly believe he’s in a state of crisis; but I don’t know what, if anything at all, to do about it. I know better than to nag him about anything. Today I simply stated as gently as I could, “I think you would benefit from speaking to a crisis counselor.” I desperately wanted him to take the day off of work and allow me to drive him to do just that. He grumbled something under his breath that I couldn’t make out. Maybe my comment came across as a criticism, but that wasn’t my intent. I’m sincerely worried for his safety (as well as public safety) and his physical, mental, and emotional health.

However, a question/thought occurred to me a couple of weeks ago, “Is this a relationship you would want your children or future grandchildren to be around?” The answer is, “No.” I honestly don’t even think I could remain friends with KR after everything he has put me through. I’m cautious and hypervigilent for good reason. I’ve researched domestic violence enough to know all the warning signs are there. I have to keep reminding myself, “This relationship is over. He chose to end it. Do what you’ve got to do to get out as soon as possible.”

And that is precisely where I’m focusing my energy at this time.

I’ve put up with enough already.

Some Days, I Surprise Myself

And today was one of those days.

Today, I made two important phone calls before I had the chance to talk myself out of doing so. That’s significant for 2 reasons:

  1. I took action to actually help myself rather than simply thinking about it and accomplishing nothing.
  2. I faced a few fears in the process.

After yesterday’s intake appointment at the new facility where I’ll be receiving mental healthcare, I felt hopeless, suicidal. This wasn’t because the appointment went badly or anything. On the contrary, both people I spoke with yesterday were kind, compassionate, and understanding. Rather, it was because I was told it could be late December before an appointment for therapy is available. That’s an excruciatingly long wait, especially for someone experiencing the level of suicidal ideation I have been for the past 2 weeks. However, in my overwhelm of being in a new place and having to start over again with a new facility and everything else going on in my life currently with mine and KR’s break up, I failed to mention that I’m experiencing suicidal ideation at a level of risk I haven’t experienced since 2005 or maybe as late as 2007/2008. I don’t know. This symptom is so difficult for me to pinpoint where it begins and ends. Too often, it “feels” so constant, despite knowing in my rational mind that it’s not.

Two weeks ago, I revisited a previous post, On Suicide and Suicidal Thoughts, in an attempt to put into perspective how I felt that night. That particular night I distracted myself from the thoughts and voices by literally “defining” my levels of suicidal risk. It helped. It got me through that evening, and that was the whole point. It helps to know your enemy. By defining my risk factors, I can also identify my triggers, measure and track these types of impulses, and seek out additional support when needed. Believe me when I say, this is very important when experiencing suicidal ideation. The levels of suicide risk are as much on a spectrum as the mental illnesses that cause these voices, thoughts, and/or feelings. I don’t know about anyone else’s range or levels of suicidality; but for me, it looks like this:

  1. Level 1 — No Risk of Suicide — Passive suicidal thoughts pop into my head out of seemingly nowhere. At this level the voices are actually helpful, encouraging me to “Wait it out,” distract myself, talk to someone, write about how I’m feeling, or use whatever creative method I can to prevent the thoughts from gaining control. Here, I can let the thoughts go usually by simply acknowledging them and reminding myself, “These are only thoughts. You don’t need to act on them.” Typically, frustration and lower levels of overwhelm or over-stimulation provoke these thoughts.
  2. Level 2 — Low Level of Suicide Risk — Suicidal thoughts increase in frequency and linger a while longer, yet no suicide plan or intent. Voices begin arguing among each other with most still encouraging and helpful while only a few are expressing discontent and fleeting despair. Still able to prevent ruminating thoughts and/or allow them only minimal expression for short periods of time, but it may take a bit longer to let them go. Higher levels of frustration, overwhelm, or over-stimulation trigger higher levels of suicide risk. At any level the trigger can be either internal or external.
  3. Level 3 — Moderate Level of Suicide Risk — Stronger and more frequent suicidal thoughts that may include a vague plan that isn’t lethal. I consider this to be the “romanticizing” level, where the voices (split right at 50/50 by this point) who are for suicide, glorify death and suicide as an act of great bravery while those against it are losing patience and compassion for those in pain, thus there’s A LOT of arguing going on inside my head. This is when I’m at greatest risk of using alcohol or marijuana in an attempt to “control” the voices, my mood, paranoia, and my level of distress.
  4. Level 4 — High Level of Suicide Risk — Obsessive, intrusive suicidal thoughts and thoughts about death, in general, are strong, frequent, and compulsive. Actively planning and researching methods of suicide with specific plans that are highly lethal. It’s rare at this level for me to focus on one single method. Indecision is a saving grace at this level of distress. Vivid imaginings of killing myself in a variety of ways. Aggressive voices bully me into submission and silence, preventing me from being honest with others about how I’m feeling due to severe paranoia. PTSD triggers can result in a jump from Level 1 to Level 4 with no warning. Non-lethal self-harm and suicidal gestures are at greater risk here, as well as a lower level increase in impulsiveness.
  5. Level 5 — Severe Level of Suicide Risk — Specific plan that is highly lethal with the means to do so, a time-frame in mind or high level of impulsivity (my greatest risk factor), and actual intention and determination to kill myself. Highly aggressive, loud voices that drown out any protesting voices. These are as constant as the ruminating thoughts of suicide and death. Let me reiterate: impulsive self-harm behavior can easily result in an impulsive attempt to take my life as the “will” to live is gone. Paranoia, distress, despair, and hopelessness are extremely high.

If you are feeling suicidal, please, call: 1-800-273-TALK (8255) or call a loved one or visit My Mental Health Toolkit for a list of tips and tricks that I use to help me de-stress and self soothe.


I’ve coped with suicidal ideation for more than half my life. Usually, I feel confident in my ability to manage this aspect of my mental health because I’ve had so much practice at managing my symptoms without any real emotional support system; but these past couple of weeks tested my will to survive as my level of suicide risk increased due to external stressors and internal triggers. These past couple of months have literally been one trigger after another, creating the perfect storm of circumstances and symptoms that make it feel like I’m reliving bits and pieces of my past in quick succession. It’s a frightening place to be. I wouldn’t wish this hell on anyone. Ever.

I keep telling myself I’ve already lived through all of this several times over — being discharged from treatment, starting over at a new facility, the storm of symptoms, the break-up, homelessness, all of it — and survived each one. I can do it again. It sucks, sure; but I survived.

Yesterday, I don’t think I managed to convey how dire my current situation is to either the intake counselor or the case manager with whom I spoke. The first phone call I made today was to the case manager who had told me to call with any questions or concerns I had. I thought of several and wrote them out before finally making myself call. First, I changed my mind about the psychiatric evaluation. I may need the support of a psychiatrist given the severity of symptoms I’m experiencing and considering how long it’s been since I’ve felt any relief from these symptoms. Words fail me in expressing the fear I’m facing in even acknowledging that this is the case, let alone the possibility of accepting that medication might be needed. I said I would talk with a psychiatrist. I can make that decision whether or not to take medication later. It may also take a while before I get an appointment for that, but I agreed to it.

I also made myself tell her how I’ve been feeling, about the severity of suicidal ideation. Maybe just admitting that to another person is enough. I don’t know; but I promised her (and myself) that I would continue reaching out whenever these voices, thoughts, and feelings become too much to handle on my own — like I’ve already been doing during these past 2 weeks.

We spoke briefly again about housing as well as my need to find employment before that can even be an option. I told her I called Vocational Rehabilitation last week, leaving a voicemail for the person I was told to speak to, but no one ever returned my call. Housing and employment, both, feel so overwhelming right now that they’re causing a lot of the flashbacks (to prior employment and homeless experiences) and suicidal despair, making it nearly impossible for me to accomplish anything with regard to either. I’m limiting any online searches for employment to brief, half-hour increments of time to try to avoid a lot of that; but it’s a HUGE challenge and an obstacle I have to overcome to reenter the workforce.

I also agreed to undergo a complete physical to rule out any physical causes for my symptoms, which brings me to my second important phone call and accomplishment of the day. I called the health department to schedule that physical. It’s this Thursday. I have two days to mentally prepare myself for that. I’ve been to the health department twice before; so it’s not a new place, which takes away some of that anxiety — not all but some. I don’t like to be touched, especially not by strangers. Doctor visits are particularly vulnerable situations, especially considering everything a “female exam” entails. No doubt I’ll leave the health department in that same dissociated state as the first two times I went, but I’ll go and get it over with nevertheless. This time, I plan on writing out a list of symptoms that have been bothering me, like the increased joint pain and chronic fatigue that have prevented me from taking my usual hikes for so many months, now. In the past when I’ve brought these things up, no one took me seriously. I really need someone to listen for a change rather than telling me, “It’s all in your head.”

These two phone calls may not sound like much of an accomplishment to most people. For me, though, they’re a big deal.

I began writing out this post at 5 pm. It’s now after 10 pm as I finish this up. My concentration and focus just aren’t there anymore. I struggle daily in every aspect of my life. The fact that I can’t even imagine a future, let alone prepare for it, makes my situation feel hopeless and out of control. There’s no doubt in my mind that A LOT of people are struggling to survive these days. The mental healthcare system wouldn’t be so overwhelmed if that wasn’t true. I don’t know what my future holds for me, and most days I don’t even care; but for the first time in 11 years, I don’t feel like I have to –prove- I’m struggling to cope. And that’s enough to get me through tonight.


If you are feeling suicidal, please, call: 1-800-273-TALK (8255). What you are experiencing, what you are feeling does not have to be fatal. Please, seek help. I know, easier said than done. If you find that you cannot call, wait it out, just wait it out.