Suicide

Precipice

So today’s prompt is “Precipice”.  How fitting.  I seem to be teetering on one myself.  Even with the med changes (and un-changes), I’m still really struggling with depression and anxiety and voices.  I realized how bad things were when Dr. W spent 40 minutes with me rather than the usual 30.  I love going to UH because they book med checks as 30 minutes.  I once say a psychiatrist who a) always ran late, b) tried to hoist me off on his NP when insurance was paying for him and c) was lucky to spend 5 minutes with me.  I have no idea why I stayed with him so long.  Another plus side to UH is that they are on the same electronic medical records system so all my doctors can keep up with my (very) long med list and conditions.

Back to precipice.  I wrote last time that I was hearing voices and it had gotten worse.  I started hearing them again back in February.  I didn’t tell anyone because I was afraid to.  I just kept saying I was getting better as I walked toward the cliff.  Even though I was having suicidal thoughts, I kept covering everything up.  I guess I still am.  I haven’t been totally honest with what the voices are saying.  They’re getting quite nasty and telling me that I should kill myself for various reasons.  I don’t know why I don’t want to tell Dr. W and Dr. D.  I think it might be because I’m in the middle of radiation and I don’t want to be hospitalized right now.  Do I need it?  Maybe.  I’m looking at a long way down off the precipice.

Most of all, I’m scared.  When I was having symptoms like this before, I did end up in the hospital.  Twice.  I don’t know if I can do that again.  The second time was useless.  No med changes.  Not that I wanted them to change meds.  But seeing a psychiatrist more than once in 6 days would have been useful.  No therapy to speak of.  You were basically left to fend for yourself all day.  It didn’t help they didn’t get my med list and I was off things for almost a week.  Although I was a UH hospital, their EMR wasn’t hooked up with the central EMR.  Looking back, I was safe from falling off the precipice, but it didn’t do much to pull me back from it.  I pretty much lied to get out of there.  I though I could make more progress with Dr. D and Dr. W than I could just hanging around all day.

I don’t like this brink of the precipice thing.  The voices keep getting worse despite how much Haldol Dr. W adds.  I was up to 10 mg before, so it’s not surprising the 1/2/4 mg dosage wasn’t working.  I’m up to 6 mg now in a divided dose.  I think once I get the voices under control, I’ll be able to step back from that ledge.

I’m tired too.  The fibro makes me tired.   Fatigue has always been part of my depressive symptoms.  And now I have the fatigue from radiation.  I’m sleeping at least 10 hours at night with a couple hour nap during the day.  I’m asleep more than I’m awake.  I wonder if this is anyway to live.

I’m tired of telling people I’m tired.  They don’t understand.  My family doesn’t understand mental illness.  And even if they did, they wouldn’t care.  That much I’m certain of.  And part of me doesn’t care anymore too.  I’m too tired to care.

Standing on the precipice looking down.  What to do?  What to do?  Closer.  Closer.  Closer.

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Away for a Bit

Let’s just say I went off the deep end yesterday.  Suicidal, plan, taking cats to vet to be adopted out.  The whole nine yards.  I managed to talk Dr. P from throwing me in the loony bin (though the Korean loony bin might have been interesting, goodness knows the American ones are).

So he got my endocrinologist to admit me to a regular floor.  The biggest thing is I’m exhausted.  Like beyond belief.  In the middle of a fibro flare and then I quit my job.  But that’s for another post.  Let”s just say it’s the best thing I’ve done for myself in a long time.  I have baby winduhs and I have wifi.  So I can check email and stuff.  But right now I’m going back to bed.

 

Oh yeah.  They weren’t too happy when the resident came for rounds and I hadn’t eaten.  Apparently they bring trays at 7:30 (who wants to eat at that hour?).  I didn’t even hear them.  She said in a slightly snotty voice that I had to eat.  Duh.  I will.  Can you let me get my eyes open and you into focus first?

 

 

Courage

I’ve been described as courageous.  Somehow I never associated that word with myself.  But, you know, maybe I am.  It takes a lot of guts to move to the other side of the globe where you don’t speak the language.

People have said it’s courage to live through what I’ve lived through.  No, I don’t think so.  That was pure survival.  I distinctly remember wanting to kill myself at 5.  That’s not courage, that’s just trying to stay alive in madness.  When asked about why I didn’t tell anyone, I didn’t know.  And I felt super guilty that I didn’t tell.  But I can see now it’s survival.  The abuse would have gotten worse and I can only imagine the punishment.

So now I have a life of my own.  My Christmas tree (small it may be) is up and so are the light.  I’m still in the tunnel, but closer to the other side.

Trains

I have issues with trains.  No, not the riding on them part of it.  Well, the slow Korean trains suck, but the high-speed KTX is nice.  It’s the standing on the platform part.  I’m one of those perpetually early people.  So I’m always down by the tracks waiting for my particular train.  As I’m waiting various trains come through.  And all I can think of is how easy it would be to just jump in front of one of those trains.  The only thing I remember from college physics is F=ma.  That is, the force an object imparts is equal the product of the mass of the object and its acceleration.  Now those trains might not be moving too fast, but they certainly are heavy.

Somehow though, every time I take a train somewhere I manage to resist the urge.  Sometimes it seems so pointless.  I go through the motions, but what I have really done with my life?  Nothing.  I’m a 35-year-old ESL teacher in Korea because I’m not qualified to do anything in the US.  Like I said, life seems pointless.

I’m tired and I hurt.  I feel stupid on a daily basis.  I failed at doing the python course (which was free, thankfully).  I can’t wrap my head around it.  I’ve stopped asking God “Why?” because there is never an answer.  I don’t know why I exist.  And at the moment, I don’t care why and if I do.

Rest

Today was a day of rest for me.  One of the cable channels was doing a Harry Potter marathon, so I left that one and slept on and off.  I did go out for dinner and then to a coffee shop to finish grading tests.  It’s  nice not having that hanging over me.  Tomorrow I have to see Dr. P and Dr. K.  I basically need med refills from both.  And I have PT too.

I have this sharp pain in a new place, right under my collar bone on the left side.  The same side on the right is tender but not painful like the other.  I hate this.  I finally get my neck and shoulders under control and something new pops up.  I know fibro isn’t fatal, but I can see how it could drive someone to suicide.

Hell, the suicidal thoughts I’ve been having haven’t gone away, nor have the SI ones.  I’m just trying to take things one at a time.  Doing art has helped some.  But right now I feel blocked.  I feel like there’s a brick wall between my brain and my hand.  We all know most of my work is abstract, so why not just put some color on paper?  Because it has to mean something to me.  I could do that, but it would be nothing more than colors.

General Health & ETC

Aside from being crazy, I’m generally healthy, despite my weight (which is still going down).  Had a full checkup with blood work and all.  Kidneys and liver both checked out fine.  Thyroid is back in the normal range with medication.  Blood pressure and heart rate are fine.  No diabetes or anemia.  Cholesterol is slightly elevated, which I’ll be treating with diet and exercise.  Doctor feels no need for medication yet.  Some blood test showed evidence of inflammation in my body.  Well duh, tendonitis in my wrist.  Doctor agrees that’s probably it.

So all in all, I’m just crazy.  I haven’t been sleeping as well, despite medication.  Same with the anxiety.   Terrible nightmares where I’m being raped or tortured.  Afterwards when doctors try to help me (usually involving giving me something like IV benzos to help me calm down so they can treat the injuries) I beg them to stop.  Strangely enough, the doctor in the dream is usually “Ducky” from NCIS.  I have no idea why, outside of the fact I’ve been watching a lot of NCIS lately.

Two weeks ago, my shrink gave me some IV compazine to combat the nausea I was having.  I can definitely say having an IV placed at the base of your wrist, palm side is probably the most painful site.  For some reasons, the nice veins in my hands went diving for cover.  I was so tired and felt so sick and overwhelmed, I just lay there silently crying.  The following week the doc asked why I had been crying.  I explained and added that I was tired of feeling crazy and I was mad at my parents for contributing to my craziness (both genetically and environmentally).

It feels like I’m in a PTSD flare-up right now.  They physical pain in my wrist doesn’t help.  I think the touching, while helping on one level is making me more jumpy and anxious and flashbacky than usual.  I guess I’ll try to explain that to Dr. P when I see him on Monday.  It’s a good thing that he only gives me a week of meds at a time.  I’ve got some niggling suicidal and Si urges going on as well.

Holy crap.  I didn’t realize all this was going on until I started typing (sans splint, I’ll be a good girl and put it on as soon as I finish).  I don’t want to feel like this.  That’s different from 10 years ago.  Then I thought I deserved to suffer and be punished.  Now I just want to be happy.  And I want it to be real.  I don’t want it to be the forced happy mask I’ve been putting on at work.

And I guess I should clean up the apartment.  The general level of pain and exhaustion has led to a mess of a living space.  Doesn’t help that my washer is slightly unbalanced and it takes about 10x longer to do laundry than it should.

And damn it.  I’m not going to cry!  No.  Stop it Kathryn  Crap.  Not working.

 

TTYL

Zoloft

Before I go any further into writing this…

Yes, I know that taking an antidepressant isn’t a sign of weakness.

But that doesn’t really change the way I feel. I feel like I’ve completely failed. I feel like I’m a total screw up. Are either of those things true? Probably not. But again, that doesn’t really change the way I feel.

I’m working on talking back to the irrational thoughts and emotions. But at this moment, they are really powerful. And it’s really hard to fight back against them.

And yet again, I digress. So on Wednesday I went to see the doctor again. My sinus infection has pretty much cleared up. I’m still pretty congested, especially at night, but that’s getting better. What isn’t improving is my mood. Keeping the mood diary was pretty much a waste of time. It basically said the same thing every day. I feel like shit. Well, not in quite those words, but you get the general idea. So when I went back on Wednesday I asked him to prescribe an antidepressant. I need some relief from this. I need to sleep. I need to be able to actually look at food without getting nauseous. I need to be able to go to work and not want to cry every time I set foot in my classroom.

I explained all of this the best I could. Holding back the tears was close to impossible. I didn’t want to let him see me cry. A lot of that goes back to my old fears about crying. But I think part of it too was I was (am?) afraid of him. Damn it! He’s never done anything remotely bad to me (except shoving that vacuum thing up my nose to see what my snot looks like, but that’s a medical doctor thing). He’s probably one of the most soft spoken and kind doctors I’ve come across in Korea.

So after all of the talking and making sure I wasn’t planning on killing myself (I won’t lie to you all, I do have some suicidal thoughts, but not intense enough to worry about) he wanted to prescribe Prozac. I put a stop to that really fast. Prozac was the first antidepressant I tried back in college. Let’s just say it was NOT a good experience. I was having trouble sleeping to begin with. Prozac completely trashed my sleep cycle. Wait, there was no cycle. I basically didn’t sleep for almost two weeks and ended up in the hospital after coming within about five minutes of attempting to kill myself. So yeah, I don’t think trying Prozac again is a great idea, especially when living in a country where you don’t speak the language.

Why Prozac? Apparently the pharmacy in LotteMart only carries Prozac. Anything else has to be special ordered. I’m finding that the selection of medications in most pharmacies (read not the ones inside of the hospitals) is pretty bad. I have a hard time tolerating many antibiotics. So I tend to stick with the ones that I know won’t make me break out in rashes or other fun things. It’s been very difficult to find pharmacies that carry these. I’ve never heard of a pharmacy carrying ONE antidepressant. But I guess I’m just used to how things work back home.

Okay. Scratch the Prozac idea. He asked if I had tried other medications. That actually almost made me chuckle. It might be easier to list the ones I haven’t tried. But I digress. I didn’t get very far in my list when he stopped me. I guess he was at least slightly familiar with Zoloft. So that’s what he decided to prescribe. That was fine with me. It was an effective antidepressant when I took it. It was pretty activating the first time I tried it. Well, that might be an understatement. Zoloft is the only antidepressant that’s ever pushed me over into hypomania. I’m not bipolar by any stretch of the imagination. I don’t remember exactly how it’s stated in the DSM, but drug induced mania doesn’t qualify a person for a bipolar diagnosis. And I digress yet again. You would think I’ve started the Zoloft the way my thoughts are scattered all over the place.

The other thing Zoloft has going for it is that it seems to be somewhat effective in reducing PTSD symptoms. If I remember correctly, it even has FDA approval to be labeled to treat PTSD. So yeah, Zoloft is probably a good choice.

The doctor (I wish I knew his name) wrote the script for 14 days. He also warned me that it would be expensive. Apparently my definition of expensive and his definition of expensive are two different things. My 14 days of Zoloft plus a couple days of decongestants and assorted other goodies came to 8,500 Won. According to my favorite currency converter, that’s $9.37. A quick glance at drugstore.com shows that a 30 day supply of Zoloft is $87.14. And I really do have the real deal, no generics. The pills look just like these. So even if you round up and double, my 14 day supply is less than a quarter of what I would have paid back in the US. So, expensive? Not by any stretch of my (U.S. raised) imagination.

So I’ll start it in the morning. Like I said, it was pretty activating for me. Given I’ve been having issues sleeping, taking it at night probably isn’t the brightest thing I could do.  I need this to work.  I need this to help.  I really do.  I’m not looking forward to waiting out the four to six weeks to see if will work, but that’s just life.

Doctor visit

I ended up going to the doctors a week ago. I was having allergy symptoms and over night I started seeing signs of having a sinus infection. I’m not one to take those things lightly. They tend to migrate to my chest. Give my bought with pneumonia this summer, I really don’t want to tempt the fates on this one.

Because the symptoms had just started, he wanted to wait a few days before prescribing antibiotics. So he put me on a decongestant and some other stuff for 3 days. I went back last Wednesday as he asked and because I was no better, he put me on another 3 days of that stuff plus an antibiotic. He asked if I was eating and sleeping OK. He wanted to make sure I kept my strength up. I had to be honest with him. I haven’t had a good nights sleep in quite a while, nor have I been eating much. He asked why. So I told him that I had seen my general mood slip downhill for the last few weeks. He asked if I had ever had problems with depression in the past. So of course I told him that it had been a part of my life dating back to early childhood. Like the good doctor he asked about suicidal ideation. I wasn’t completely honest there.  Yes, I’ve been having both SI urges and suicidal thoughts.  I won’t act on them (at least at the moment) so I don’t see any need to tell the doctor.  And yes, I promise, if they get to the point where I think I would actually act on them, I’ll tell the doctor.

So basically now the doctor asked me to think about going back on meds.  For the moment, I’m to keep a mood diary.  I saw him again yesterday because he wanted to follow up on the sinus infection.  He gave me another 4 days of antibiotics and told me to come back on Wednesday.  It’s been so rough the past few weeks, I really think I’m just going to break down and ask him to prescribe an antidepressant when I see him on Wednesday.

If this drop in mood had been sudden, I’d be more inclined to think I’d “snap out out of it”.  But it isn’t.  It’s been going on for a while now.  And it’s getting into late fall/winter.  My mood usually takes a nose dive this time of the year.  I don’t know if it’s necessarily SAD, but the fact it’s getting close to the holidays doesn’t help.

All I know is that I’m tired.  I’m not only physically tired (the whole not sleeping thing), but I’m emotionally exhausted.  I’m tired of fighting against my mind.  I’m tired of fighting against my memories.  Sometimes it just doesn’t seem worth the fight anymore.  But I keep on trying.