A Little Of This And A Lot Of That

I haven't been in the writing mood for a while. I need to change that.

I've been doing ok. I was feeling the effects of winter, of SAD, like in my last post, so Dr. Barkin put me on 75 mg of Wellbutrin, along with my regular meds. I've been on that for about a week now and I can feel it working. I feel better. My labs came back looking really good. My vitamin D was really low though, not surprising since I haven't seen the sun in weeks. Gotta love the Pacific Northwest's winters. But I'll still take rain over snow any day. I've started using my light box almost everyday, hopefully that can help with the vitamin D levels. My thyroid is looking good. It's almost where it needs to be, so that's good news.

I went to the doctor's today to talk about my sleep. I have a hard time sleeping at night, and sleep a whole lot during the day. It's hard for me to breathe through my nose at night, and a good friend of mine told me I snore like a tractor. I'm not sure how to take that. Ha. It is what it is so I went in to talk to Cece. All of these symptoms point to sleep apnea. She said especially being on the Olanzapine that those prone to apnea tend to get it being on that medication. So she's ordering a sleep test for me and we'll see where that goes. I am SO grateful for my insurance that covers everything for me. It's been a miracle and I am so grateful.

I've been approved for social security disability. I cannot tell you how relieved I am, it makes me teary to feel such relief. I should be starting that in January. It will be nice to have my basic needs taken care of while I focus still on fixing my body and my mind. I have a long ways to go still. The lady who helped me fill out the paperwork said almost everyone is denied the first time applying, but I wasn't. I got approved and quickly too. I am again so grateful.

I also got approved for services through the Department of Vocational Rehabilitation, and am meeting with a counselor in January to go over some job opportunities. I still want to be a contributing member of society and do what I can.

All good things!

Zach and I are doing the 12 Days of Christmas to one of his former coworkers who has some sad stuff to deal with and remember around the holidays. This is my most favorite Christmas tradition. Tomorrow is the last night. We haven't been caught yet! I hope it's helped to brighten his December a little bit. I know it's brightened mine.

Well that's all I can think of for now. I hope everyone has a pleasant holiday. Stay safe and stay warm. Merry Christmas.

SAD: Seasonal Affective Disorder

This topic has been on my mind a lot lately, as the seasons are changing. Seasonal Affective Disorder, or SAD, is a type of depression that's related to changes in seasons. It begins and ends about the same times every year. For most people, the SAD symptoms start in the fall and continue into the winter, sapping energy and making you feel moody. Less often, though also important to note, SAD causes depression in spring or early summer.

Treatment for SAD can include light therapy, psychotherapy and medications.

Don't brush off the feeling as simply the "winter blues" or a seasonal funk that you have to tough out on your own. Take steps to keep yourself in check. Work to keep your mood and motivation steady throughout the year.

More often than not, SAD symptoms appear during late fall or early winter, when days are short and dark, and go away during the sunnier days of spring and summer. However, some people do have symptoms that begin in spring or summer. Either way, symptoms generally start out mild and become more severe as the season progresses.

Seasonal affective disorder is a subtype of major depression that comes and goes based on seasons. So symptoms of major depression may be part of SAD, such as:

•Feeling depressed most of the day, nearly every day
•Feeling hopeless or worthless
•Having low energy
•Losing interest in activities you once enjoyed
•Having problems with sleeping
•Experiencing changes in your appetite or weight
•Feeling sluggish or agitated
•Having difficulty concentrating
•Having frequent thoughts of death or suicide

Symptoms specific to fall/winter SAD may include:

•Irritability
•Tiredness or low energy
•Problems getting along with other people
•Hypersensitivity to rejection
•Heavy, "leaden" feeling in the arms or legs
•Oversleeping
•Appetite changes, especially a craving for foods high in carbohydrates
•Weight gain

Symptoms specific to spring/summer SAD may include:

•Depression
•Trouble sleeping
•Weight loss
•Poor appetite
•Agitation or anxiety
•Seasonal changes in bipolar disorder

The specific causes of SAD are unknown. Some factors that may come into play include:

•Your biological clock (circadian rhythm). The reduced level of sunlight in fall and winter may cause winter-onset SAD. The decrease in sunlight may disrupt your body's internal clock and lead to feelings of depression.

•A drop in serotonin, a brain that affects mood, might play a role in SAD. Reduced sunlight can cause a drop in serotonin that may trigger depression.

•Melatonin levels. The change in season can disrupt the balance of the body's level of melatonin, which plays a role in sleep patterns and mood.

Factors that may increase your risk of SAD include:

•Being female. SAD is diagnosed more often in women than in men.

•Age. Young people have a higher risk of winter SAD.

•Family history. People with SAD may be more likely to have blood relatives with SAD or another form of depression.

•Having clinical depression or bipolar disorder. Symptoms of depression may worsen seasonally if you have one of these conditions.

•Living far from the equator. SAD appears to be more common among people who live far north or south of the equator. This is probably due to decreased sunlight during the winter and longer days during the summer months.

Take signs and symptoms of seasonal affective disorder seriously! As with other types of depression, SAD can get worse and lead to problems if it's not treated. These can include:

•Suicidal thoughts or behavior
•Social withdrawal
•School or work problems
•Substance abuse

Treatment can help prevent complications, especially if SAD is diagnosed and treated before symptoms get bad. Don't be afraid or ashamed to see your doctor if you have any symptoms of SAD.

Remember that you are worth whatever it takes to help you feel better. There is nothing to miniscule or insignificant in the way you feel. Get help if you need it through these cold winter months. You're needed and wanted and you are worth the fight.

Everything Is Awful And I'm Not Ok. Questions to ask before giving up.

Someone gave me a handout once called Everything is Awful And I'm Not Ok. It has suggestions of things you can do in that very moment of crisis. Things that are good, logical, and practical, but in a moment of crisis do not come easily to mind. I suggest having a list like this at the ready at all times whether you're prone to depression and crisis or not.

1. Are you hydrated?
If not, get a glass of water now.

2. Have you eaten in the past three hours?
If not, get some food now. Get some food with protein in it if you can, not just simple carbs

3. Have you showered in the past day?
If not, take a shower right now.

4. Have you stretched your legs in the past day?
If not, do so now. Walk around the block, go to a big chain store and walk the aisles. Walk around your house. Just move.

5. Have you said something nice to someone in the past day?
Do so, whether online or in person. Make it genuine. Find something really wonderful someone did and compliment them on it.

6. Have you cuddled a living being in the past two days?
If not, do it now. Don't be afraid to ask for cuddles from friends, even pets.

7. Have you seen a therapist in the last few days? 
If not, hold on until your next session then talk things through.

8. Have you changed any of your medications in the last couple of week? Including skipped doses or changed to an off brand medication.
This can mess with your head. Give it a few days then talk to your doctor if things don't settle down.

9. If daytime, are you dressed? 
If not, put on some clean clothes that aren't pajamas.

10. If nighttime, are you sleepy and fatigued but resisting going to sleep?
Put on pajamas and make yourself cozy in bed. Lay there with your eyes closed for 15 minutes. No electronic screens allowed. If you're still awake after 15 minutes, you can get up. No pressure.

11. Do you feel ineffective? 
Pause right now and get something small completed. Load the dishwasher, check your email. Good job!

12. Do you feel unattractive? 
Take a bloody selfie. Your friends will tell you how great you look, and you can help fight societies stigma of beauty.

13. Do you feel paralyzed by indecision? 
Give yourself 10 minutes to sit back and figure out a game plan for the day. If a particular decision or problem is being a roadblock, give yourself permission to set it aside for now, and accomplish something doable. Right now we're just trying to get out of the stasis, even if it means doing something trivial.

14. Have you over exerted yourself lately? Phycically, emotionally, socially, or intellectually.
This can take a toll that can linger for days. Take time to yourself to regroup, whether that be some alone time, physical rest, or relaxing with some entertainment.

15. Have you waited a week?
Sometimes our perception of life is skewed. We can't tell were not thinking clearly, and there's no obvious external cause. It happens. Keep yourself going for a week and see if you feel different then.

Life is hard. But it can also be beautiful. You've made it this far, you can make it through again. You are stronger than you think.

Exhausted

I am so exhausted. I can barely lift my body to do anything. I sleep so much. I don't know why I'm so tired all the time. I don't know if it is my thyroid. I don't know if it's the depression. I don't know if something else is going on. Maybe it's all things combined. I don't know. Abull I know is that my body has no energy and all I want to do is rest.

Today was rough. Today is the first time in months I've fought off self harm thoughts. I've been feeling so much better since I was released from the hospital, that I had hope the real bad days were behind me. It makes me nervous to have these feelings creep up like this. I know where they can go. I hate that when I start to feel bad, it seems dying is still an option. That disappoints me. I don't want to be in that place still.

I haven't been overly impressed with my new therapist. I'll give it a few more times to see if our patient/client relationship improves. Then I guess I'll play by ear. I transfered to the Port Orchard office when I moved over here, and it's just a teeny little office, I don't even know if I could see anyone else. She's a nice person, just maybe not the best fit for me.

I see my new psychiatrist at this office on Tuesday. I'm only nervous because it's new. Change is hard for me. But my medication seems to be at a working level right now, so hopefully we won't change anything up and it'll be a quick appointment.

I know a lot of my loved ones are hurting right now. It hurts me to see so much pain. I wish I could just take it all away and make the world a safe place for everyone.

Until then I guess we just fight the good fight.

I'll update again soon.

35

Today is my birthday. I made it to 35. I didn't expect to. This has been the hardest year of my life. I look back and I can't believe I've survived. I have been through the very lowest of lows this year and I have come out on top. There were lots of incredibly scary times when I wasn't sure I'd make it to today. But I have. And I am stronger and better for it. I have faced my demons head on and I have been victorious. Out of sheer will to survive, I have. And I am proud of that. I'm here and I'm alive and I can honestly say right now that I'm glad I am.

Here's 35 totally random things you may or may not know about me. Because it's me day, so why not.

1. My elbows are double jointed
2. My favorite color is purple
3. My favorite movie is How To Train Your Dragon 2
4. I pick my nails
5. I hate country music
6. My favorite season is Spring
7. I think I would've been a hippie had I grown up in the 60s
8. I hate talking on the phone
9. I'm the oldest of 7 kids
10. I drive a stick shift
11. I hate flying bugs
12. My favorite food is sushi
13. I hated high school
14. I'm progressive minded
15. I love the ocean
16. I don't miss Utah at all
17. I fall in love too easily
18. I'm working on refraining my negative thoughts
19. I'm learning to hold my own power and not give it to others
20. I wear size 9 shoe
21. I don't enjoy shopping
22. I don't want kids
23. I'm going to live in Maine someday
24. I don't like Italian food
25. I'm a pretty open book once I'm comfortable with you
26. Series of Unfortunate Events is my favorite book series
27. I'm very introverted
28. I love to create
29. I make friends easily
30. My favorite TV show is MASH
31. I like vegetables more than fruit
32  I'm not a morning person
33. I want to get spider bite piercings
34. I hate doing dishes
35. I fulfilled the one thing on my bucket list I never thought I actually would. I saved a life. My own.

Happy Birthday to me.

Healing

I have a cold. It sucks. But that's the worst thing that's happening right now.

Things are still looking upwards. I get to move into my apartment on Friday! I am so very excited for that. I said goodbye to Colleen and Rosalie at the Bremerton office of KMH and have made appointments with my new therapist and psychiatrist in the Port Orchard Kitsap Mental Health office. I have an appointment in a couple days for my labs to be drawn with my primary care. Being on the Olanzapine they like to watch levels as it's not meant to be a long term medication.

I had my intake with the Division of Vocational Rehabilitation this last week. They have 60 days to decide if I qualify, but I don't see why I wouldn't. If I do get accepted I'll be given a job coach and they'll be able to help me find an appropriate job for my circumstances,  for the depression. I'm hopeful that I'll be able to find a fitting job that I will be able to be successful with and start some healing there.

I don't quite know how to describe how good it feels to be on a good, working dose of medication, and to have circumstances start working in my favor. I feel honored, I feel grateful, and I feel excited. There's a new beat to life that I am learning to dance to. And it feels good. I still feel fragile, definitely not on solid ground just yet, but I am getting there. For the first time in years I feel like I can say things are going my way.

I'm cautious though. I know things are still shakey. I know how depression works and how it is to be so wary of good times. It scares me a little. I fear the relapse. But every day that I feel good is a day towards kicking this thing in the ass. I am still SO incredibly tired all the time. I think that may have more to do with the hypothyroid condition than with depression right now, but it still makes life difficult when I have no energy. Hopefully in time with the medication it'll  ease itself out.

So right now I feel good, I feel hopeful for the first time in years. I am so magnificently grateful. I have learned to never take a day for granted. Each day is a new start, is a gift to behold. Each sunrise means the night is over and a fresh day is beginning. To even be alive is a miracle. The grandest miracle of all. And I am alive. I am healing.

After The Storm

I feel good. I haven't felt this well in years. Things are looking up. I don't feel great, I don't feel 100%, but I do feel good and I do feel better.

My energy is still really low. I sleep a lot and feel very fatigued when I'm not asleep. I have a hard time concentrating still. But my mood has stabilized, for which I am really grateful. The self harm and suicidal thoughts have been very minimal.

I noticed something interesting looking back over the last month or so, since I entered the hospital. The night I entered the ER, I removed from my life some very toxic people. I removed friends from Facebook, and even deleted numbers from my phone. I hit such a low point that I couldn't handle having any access or have anyone be able to have access to my life. Things immediately turned around. I was able to be placed in an amazing hospital with an amazing program. My dear friend invited me to stay in her home while I get life figured out. And I just recently got accepted and approved for housing through Kitsap Mental Health. That means I'm going to be moving into an apartment all my own soon. I am beyond excited. Good things are happening. I truly feel that I had to remove that toxicity from my life before things could look up. It does makes me sad, and yet I am so relieved and grateful for the good things that are happening to me. It does not good to hang on to toxic things, people or otherwise.

I was also just diagnosed with hypothyroid. Many of those symptoms mimic depression symptoms, so once that's under control, I'll feel even better. The doctor said it'll take about three months to get the medication where it needs to be.

So, all in all, things are looking better. I feel so much relief. I have found some amazing friends who love me and accept me exactly as I am. And what an amazing feeling that is.

I'm living after the storm for awhile now. And the rainbow is magic.

One Day At A Time

I'm doing ok. I have a dear friend who has opened her home to me while I work some things out and I am doing ok. I have a family I have chosen and I am happy. And I am lucky.

But I'm still depressed. Even though my mood has stabilized, I remain depressed. It's so interesting to me. It's what I have learned about depression, I've talked about it before, too. What it means to be depressed. http://paintingandsunshine.blogspot.com/2015/02/to-be-depressed

I sleep a lot still. I don't wake rested. I take naps that last for hours. I want to eat all the time. I never feel full, and even when I do I still want to eat. I have a hard time walking, my body is in pain. My back aches. I get winded so easily. I really struggled on my walk this evening, I had to stop and rest quite a bit. But I still did it. I still walked. I am retaining fluid in my feet and legs (I have a doctors appointment set up to discuss this). My concentration is improved. I can read now more than I was able before, but it still has a long way to go before I'd consider it "better".

All these depressive symptoms are still happening; I am depressed. But my mood is so much better. I have felt good for several days in a row. I have my moments throughout the day when I feel my depression knocking on the door of my mood, but I'm able to open the door and give it a swift kick in the ass! And I'm grateful for that. The self harm and suicidal thoughts are very minimal. I'm still so unsure about future events, but I am able to focus on today and get through one day at a time. The hopeless and helpless feelings are under my control right now. I feel I have some worth and that life is worth living. It is so good to feel these feelings and aspirations again and I am very much going to enjoy them while they are here! I am going to build a positive thought army to head off the negative thoughts as they come, now and in the future.

So, that's me and that's today. One day at a time.

Crisis Coping And Recovery Plan

One of the most helpful things for me inside the hospital was to come up with a Crisis Coping And Recovery Plan. It's just basically a map of healthy coping mechanisms, early warning signs of a crisis, and what to do if a crisis does occur. It's all written in small pamphlet form so it's easily attainable and easy to follow. It also contains important phone numbers, both doctors and support system. The plan can be used for any type of health concern.

It starts by reminding yourself to take care of your body, mind, and spirit, and lists several things you can do and use to help you feel better. Things such as:

• Eating healthy foods
• Drinking plenty of water
• Getting to bed at a regular time
• Exercising
• Doing a relaxation technique
• Writing in my journal
• Talking to a friend on the telephone
• Taking medications as prescribed
• Making times for hobbies/interests
• Avoiding alcohol and drugs

I added my own coping mechanisms as well:

• Play with P Man
• Make a bracelet
• Read
• Color
• Watch a movie

The plans talks about the importance of speaking kindly to yourself. It gives these suggestions:

• Today is a new day
• I deserve to feel better
• I am more than my mental illness

I added:

• I am worthwhile
• I have value
• It's ok to ask for help

Then the plan lists some positive affirmations such as:

• I am a kind, compassionate, and gentle person
• I like who I have become

I added:

• I am a good person
• I am strong
• I'm doing my best
• I'm trying

The next section is on early warning signs. I found this so incredibly helpful. I'd never realized before how many warning signs I experience that can alert me to crisis. The pamphlet says that in spite of your best efforts to take care if yourself, you can experience early warning signs. These may include:

• Anxiety
• Lack of motivation
• Decreased self care
• Avoiding others or isolating
• Distorted thinking

I added, specific to me:

• Paranoia
• Too much sleep
• Agitation
• Lack of concentration

It says if you notice these signs and symptoms to take action! To take care of yourself. Some examples are:

• Deep breathing
• Follow a healthy routine
• Listen to music
• Asking for help from a counselor or therapist
• Call a supportive friend
• Ensure that medications are taken as prescribed

I added:

• Call warm line (877-500-9276)
• Take a walk
• Write about it
• Give a time limit
• Positive self talk
• Drink water

Then there's the What Next section. Despite all our good efforts and intentions, crisis just happens sometimes. The pamphlet says, "If your symptoms become very uncomfortable, serious, or even dangerous, it is necessary to take immediate action to prevent a crisis. Make a plan that you think will help reduce your symptoms. This plan now needs to be very direcr, with few choices and with very clear instructions." Ideas include:

1. Call a doctor, or health care professional, ask for help, and follow their instructions
2. Call and talk to your support network
3. Schedule a consultation or exam with a health care provider
4. Make sure to do everything in the first part of your Prevention and Recovery Plan

I added:

• Call crisis line
• Take emergency meds
• Go to ER
• Go somewhere public

I'm so grateful for this plan. It's short enough and to the point enough that I can easily remember it and refer to it on a daily basis.

Remember, as always, that you're worth it. You're worth the effort and the fight, and you are loved beyond imagine.

Post Hospital

I left the hospital Monday after lunch. The social worker got me a taxi back to Gig Harbor, I got my car, which was still at the emergency room, and drove back to Bremerton. I felt empty leaving the hospital. I felt vulnerable. I felt fragile. I was scared to be on my own and in not the greatest situation. But I was ok.

Mr. Purrington was super happy to see me. That made me happy. I was afraid he was going to go the other way and hold a grudge against me for awhile. Cats are finicky like that. But he practically jumped into my arms and I received the head butt to end all head butts. It was adorable. I was SO glad to see him. He's been more clingy too, he's not normal a clingy cat. I'm so glad to be reunited with him again. I missed him so much.

I've tried to keep some kind of schedule since I've been out. I've had my own goal setting "group" in the morning after I wake up. I check in with my mood and make some realistic goals for the day. Then I plan out, hour by hour, what I'd like to do and accomplish for the day. It's been helpful. I haven't followed it to a tee, but it's been good for me to at least have some kind of plan laid out for the day. The structure is very helpful for my mind and my heart.

I practice deep breathing daily. Whenever I feel myself starting to get anxious I take some deep breathes to calm myself and hopefully avoid a panic attack. It's been helpful.

I continue to read and study the material I received. Just a section or two a day, nothing huge. I want to keep these helpful ideas and strategies fresh in my head.

My medication was increased while I was in the hospital. I now take 60 mg of Paxil and 10 mg of Zyprexa. The doctor also gave me Ativan as needed for anxiety.

I'm really grateful for my crisis coping plan, I think I'll do a post dedicated to just that in the near future. I have found it so helpful. I watch for warning signs of a crisis, and act accordingly if I see them. Just today I slept until 1:30pm, and one of my warning signs is too much sleep. So I forced myself to work on a bracelet and then go to the library. I'm disappointed I slept so much today. I was in the good habit of being up for breakfast while in the hospital, and I worry about slipping. But I'm taking one day at a time, it's all I can do. I need to work on being more gentle with myself. I'm doing the best I can.

I've applied with a contracting company that works with people with disabilities. Right now my depression is considered a disability. I talked to the HR assistant and she sent me some forms for Colleen and Rosalee (my psychiatrist) to fill out verifying the illness. I feel hopeful I'll be able to get this job and be able to hold onto it. I haven't felt that all year. So that makes me feel good. Getting a job is the first step to getting me some housing, which would be nice.

So overall I am doing much better than I was pre hospital. I feel hopeful for the first time in well over a year. I'm going to do my best to keep this hopeful feeling. I haven't had overwhelming and bombarding suicidal thoughts since I've been out. That's a huge improvement. Even my self harm thoughts are being kept at bay right now. I'm so grateful for that.

I know it's not going to be a picnic. The after hospital high is wearing off. But I am feeling in control still and have hope in my plan to contine what I learned in the hospital. I feel much more prepared to fight the battles as they come. And for that I am grateful.

The Good That You Do

I've have had an incredible experience here in the hospital. I have worked with incredible people who care so much for the well being of us, their patients. I have met some amazing people who are doing their very best not to let their demons win. I have felt understood, I have felt encouraged, I have felt acceptance, I have felt calm.

Much to my surprise, I have found group therapy so helpful. I am not a very social person when I feel good, so when I feel bad, even the thought of groups just about does me in. But I really felt strongly that I needed to immerse myself in this hospital stay, and so much of that was attending groups and actively being a part of the discussion and therapy. I have been so pleasantly surprised at finding such support in the group setting. To be seated with other people who are hurting and in pain, to openly be able to speak my mind with no fear of judgement, knowing I'm being heard and accepted. And having others there to share in the pain, or the heartache, and even the laughs. I have felt SUCH calm as I've immersed myself in group, and let myself grow and take in all that is taught. I have learned so many positive skills and techniques that I am going to take with me when I leave to help battle the tough times as they will come. I've received many wonderful handouts and booklets on positive self care and coping mechanisms. I'm grateful for the structure I've found here and I plan to keep that structure when I leave.

Every morning we have goal setting group, where we check in with our moods and set some small and realistic goals for the day. I'm going to continue with this practice daily. I'm going to set aside specific times for studying what I've learned here; times for studying stress management, or communication, healthy boundaries, etc.

I've made a solid crisis coping plan I am going to follow. One thing I've found very helpful is to identify my precursors for crisis. Certain moods or feelings or actions that happen before a crisis. And I've learned how to deal with those precursors before a crisis happens. Or if it does escalate into crisis, I have solid supports written out to help deal with those intense and scary feelings and emotions.

I'm sad for the events that led up to this hospital admission. It is still something I need to work through; it still breaks my heart. But I am overwhelmingly grateful there was a bed available in this particular facility right at the exact time I needed it. I'm grateful for that karma and that miracle.

My mood right now: I feel at peace.

Traición

It hit me like a ton of bricks. The hurtful comments; but mostly the invalidation of it all. The lack of compassion. And it hurt. And no one can tell I'm wrong, or don't feel what I feel, or have only myself to blame. Do you hear me? NO ONE can tell me those things.

I started cutting on my arm, then I moved to my neck, and my face. I couldn't stop. I didn't want to stop. The emotional pain was so intense I could hardly breathe. I was panicking and numb at the same time. I called Zach, who suggested I go to the ER. I did. I did not go to Harrison, as my experience last year was not a good one. I drove down to Gig Harbor to St. Anthony's.

My experience was a 180 from Harrison. People were so kind, and so attentive. I was seen immediately. Blood was drawn, they did an EKG. My ER doctor, Dr. Gates, came to see me almost immediately. He was so kind and compassionate and listened and empathized with what I was saying. He said I could go voluntary as inpatient, or if I wouldn't do that he'd have an involuntary admission. Meaning I didn't have a choice; he knew I was unsafe to myself and should not be alone and was in need of higher care. The social worker, who was also filled with empathy and compassion, talked with me for quite awhile. He also recommend I be admitted to a hospital. The two nearest me were full, and he said that historically when that happens on a Saturday night, there are also no beds in Seattle or the surrounding areas, but that he would still call them all and if there was not a bed available I would stay the night in the ER and we could reevaluate in the morning. A little while later he came back in and said that in his year as a social worker in the ER it'd never happened- but a bed was open at a really good facility in Seattle and I would be going there. I'd been in the ER for about 2 1/2 hours at this point. All I needed to do now was wait for an ambulance to transport me to Swedish Medical Center in Seattle.

So here I am. I am in a safe place, even if I don't feel safe yet. I am seen by many nurses and doctors. I have therapy groups several times a day. They've adjusted my medication. The psychiatrist says he wants me to stay at least through the week. Mr. Purrington is being taken care of by the family Zach lives with. I am so grateful for that and grateful he's in good hands, though I miss him dearly. I wish he could be here with me.

I'm having a hard time writing right now, but I wanted to take advantage of my free time and write down these raw feelings.

I feel sad. Mostly just sad. I feel numb. I feel anxious. I know it doesn't make a lot of sense to feel all these intensely different feelings at once, but I do. I feel like this is the right place for me to be right now. I feel betrayed, I was betrayed. I feel invalidated by those who should have my back no matter what. It's almost laughable how little I am known and how huge the judgements are. Traición. That's the word for it. Such a happening and such an emotion does not translate to English.

Traición.

Your Story

Tell me your story. Tell me what happened to you. What made you into who you are? Tell me how your heart soared, how it expanded. How it learned. Tell me how your heart aches, how it broke. How it heals. Tell it all to me. Tell me how you conquer, how you triumph, how you crumble and how you rebuild. I want to know your story. I want to know you. The genuine, raw, naked you. What happened to you; in you?

So we write our story. And everything that happened. We write to figure out who we are. What we think. How we feel. It's all written, engraved on our hearts. Some things we share, some stay secret and hidden within us. But it is us. It is you. Everything that's happened, it is you.

We all have a story to share. One that's constantly shifting and changing and shaping to mold to what surrounds us. But at the core is where we are. And that doesn't shift and change. At least it shouldn't. We are who we are for a reason and we should embrace every part of that.

I've been thinking about my story. My attempt at writing this blog has been to share with others what has made me who I am and what I have learned along that path. I hope I am succeeding, I hope I have been able to help someone and I hope my thoughts have been beneficial to others.

I've had a lot of negative things happen in my life. A lot of hurts. I've had a lot of confusion and a lot of doubt. I've struggled with happiness my whole life. And I've watch myself change over time. The world, though its tried, has not made me hard. I've taken the negative, the hurts, and with a lot of work I've been able to twist and turn them into something that has made me soft. My story has taught me compassion. Genuine love and empathy for the human race. I know, so deeply I know, what it is to hurt. And if I could take the all the hurt away from an aching soul I would. I know how it is to suffer. I know how it is to not love yourself. I know what it looks like to be so broken you just want to give up. I've been there. I understand. And I know what it is to rise up again. To struggle and work and bleed and cry and dig your way out of the pit. I know, I've done it. And I'm here to tell you that it is possible. And that you are worth any struggle to rise again. There is hope. There is love. There is reason to try one more day.

This is what my story has taught me. This is what I want you to know.

Let's Talk About Self Harm

I started cutting on myself when I was 17 years old. For me, it was a way to try to communicate and reach out to my parents that I was hurting and in pain, and that I wasn't feeling heard or receiving the help I needed. It has become a way over the years for me to cope with intense emotional pain and injuries.

Self harm generally starts as a way of coping with problems. It helps to express feelings that you're not able to put into words. It releases emotional pain and helps to distract you from life. It is a way to have control over something, anything, when your life feels out of control. Self harm can make you feel alive when you feel numb inside. Feeling something, even pain, is still feeling.

To get to the point of self harming, a deep emotional hurt has or is happening. There is often a connection between self harm and childhood trauma. Many people who self harm have deep rooted issues with self esteem. They see self harming behavior as deserved, or as a way to punish what they see as a worthless life.

Every act we do is done because it fulfills a purpose, and self harm is no exception. Although temporary, self harming does help you feel better. There is a great release of tension, anxiety, and self loathing when the act is finished. It has given you a choice when there didn't seem any choice was available.

But, it is a temporary release. Once the initial stressor has passed, many people feel a sense of shame towards the self harming act. They're embarrassed or think no one will understand. They then try to hide the self harm, often wearing long sleeves or pants even when it's summertime.

Generally there is a difference between self harm behavior and suicidal behavior and this is important to note. Self harming is a way to cope with pain before suicide becomes an option. Self injury can actually be a way to help one go on living. It's also important to note though that people who self harm have a much higher risk of suicide, so it is important to seek help.

Signs of self harm include: unexplained wounds or scars, blood stains on clothing, bedding, or blood stained tissues, sharp objects in the person's belongings, frequent "accidents"- sometimes those who self harm claim to be clumsy or accident prone so as to cover up their injuries. Again, wearing out of season clothing to cover up cuts or burns. Needing to be alone for long periods of time, and finally isolation and irritability can be signs of self injurious behavior.

What can you do to help someone who self harms? It can be very alarming and scary to find out a loved one engages in self harm. Remember, if they have confided this to you, they have a deep sense of trust that you will not betray their feelings. Remain calm and acknowledge your own feelings, whether they be shock, confusion, or even disgust. Acknowledging your own feelings is an important first step in helping a loved one. Focus on their feelings that led up to the self harm act, not on the act itself. Ask them if the want advice or simply need to release their secret with someone they trust. Learn what your loved one needs. Don't judge! It will only make things worse. Don't tell them it's silly or unnecessary. Don't tell them they have no reason to be self harming. Refrain from saying anything that shames them, such as the self harm acts make their body unattractive. Don't ask why they do it. Instead offer support and encourage communication. Listen without judgment. Reassure your loved one that they are not alone in this fight.

While it is ideal to stop the self harm acts, often it isn't as easy as it may sound. Self harming can become addicting and your loved one may not even want to stop. Remember, the self injurious act is fulfilling a need that isn't being fulfilled any other way. While the relief is real, in the long run self harm doesn't treat the issues that make you want to hurt yourself in the first place.

There are more effective ways of self soothing, but they take time to learn and master and it is often a very painful process, and you have to want them to help you. This is where outside help is vital- the support and encouragement given from a loved one can mean the difference between success or not. Identify your self harm triggers.  What makes you want to self harm? When you learn to recognize those feelings you can start developing healthier alternatives to self harm. If you're having trouble pinpointing the triggering feelings, you may need to work in emotional awareness- knowing what you are feeling and why. It's the ability to identify and express what you feel from moment to moment and to understand the connection between your feelings and your actions.

It can be a long, hard road to recovery, an upward battle. I still struggle with self harm. It has become an addiction and at times is still my only means of self preservation. I know and I can preach all day on how I understand where it starts, how it fulfills needs, how there are healthier ways of coping. I know these things in my mind and in my heart... but I still struggle. It still hurts. I have successful days, weeks, months, even years. But the urge and need to self harm is always there. It probably always will be. I still carry a small razor blade with me in my wallet. It is my protection, my shield against the wounds I face. Someday I hope to be able to follow my own advice and find healthier alternatives to the act, to be able to leave the razor behind for good. But for now, I am where I am in the healing process, and I am ok with that.

I am not ashamed of my self harm. I know I have significant, visible scarring and in some way I am proud of my scars.  They're times when I fought a battle against myself and I won. For now it is ok for me to look at it that way. I am open to discussions and questions about self harming. No I do not think self harming is wrong. Yes someday I hope to be able to stop, but I am not ready and do not want that day to be today. I very deeply understand how complicated it is, how scary it can be, and I am here to help.

Please, as always remember that you are not alone in this fight. You are cared for an loved beyond measure. I am here for you and together we can be unstoppable.  You are worth more than any secret or any doubt you may have. You are never alone.

Home

Home. What do you think of when you think of home? Four walls? A roof over your head? Trees and a playset outside? Maybe home is your mom and dad. Brothers and sisters. For so long I thought home was a place. An immovable object where my possessions stayed. Somewhere where I slept and ate. When I was little it's where I learned how to talk and how to walk. I learned how to feed myself and how to play nice with my siblings. My home was where I learned, or learned how to obtain, my core values.  But that isn't home to everyone. Some people grow up in two homes. Some grow up without a mom or a dad. Some  grow up with two moms or two dads. Some bounce from home to home until they're adults. Some grow up in brick homes, others mud. Some in a cardboard box. Some people learn their core values at school. Or from TV. Or on the streets. Some never learn at all... There are so many ways to define home it's a wonder we can use the word at all.

I grew up in the traditional sense of the word home. A dad, a mom, siblings. But I never felt at home. Maybe home is more than just a place.

I just lost my home. I am sick. I've been unable to work for some time. I'm getting help and I am improving, but it's taking a really long time. The world, it doesn't stop. It keeps moving and demanding whether you're able to keep up or not. And some aren't. Thus is the plight of depression. I couldn't make my rent. And I lost... my home.

It's just me now. Raw, vulnerable, exposed me. But I do not feel without a home. For the first time in years I feel free. I am one with the forces of nature. I have to be. I get to be. I am at their mercy and their command. I see for the very first time the true beauty of the trees, the brush, the grass, the sky. I breathe with the wind. I sleep with the sun. I have never felt more of a sense of home than I have the last couple if days, being forced to truly accept things as they are.

I have my cat. I have his unconditional love and acceptance. I respect him, he respect me. I trust him, he trusts me. We have each other and we are never alone. In losing a home, I have found home.

It could be said my situation isn't a good one. Some would feel bad for me. And while a consistent toilet will be nice again someday, for whatever reason I feel that this is where I need to be in my life right now. I feel a sure sense of calmness, a peace. And in no other way could I have learned this lesson of home. That it is true what is said- Home is where the heart is. And I am home.

Sometimes the only way I can express myself is through a poem.

Alone and in the dark
On the cold and hardened ground
Tears of quiet sobbing
The world's only sound.

Breath catches in her chest
As she's trying not to scream
No sense is to be made
At what is happening.

The pounding in her head
The gasping chokes for air
The knot down in her stomach
The hands clenched in her hair.

And within her heart a shatter
Within her heart a tear
Within her heart a sadness
That nothing can repair.

Lying on the floor
Unable to go on
She cries the silent tears
Of heartbreak's lowly song.

Good Days

I think it's important to recognize and realize when you're having a good day. Good, I suppose, being a relative term. For example yesterday I had a "good" day. It wasn't good by any means. But it was the best day I've had in months. I did some hard things and was successful at them, and felt a sense of accomplishment when I was finished. That, for right now, I can consider a good day. But, I've also had good days in the literal sense. Days full of small gems, where I could genuinely smile and laugh, days where the black cloud of depression wasn't looming so close overhead. And I recognize those days as they happen. Even if those days are mere hours, or moments. They still happen, they're still there.

I had a therapist tell me one time that our good times and our good days help to buoy us through the hard times. They provide a cushion for our hard times to land on and help to make them perhaps not so difficult or painful. I've always kept that image in my mind. I can remember a good time even many years past that can provide a softer break to the fall. And that safe cushion has saved my life on more than one occasion.

Colleen always begins our sessions by asking what my successes were for the week. I hate answering that question. I feel like I am failing at life, so have an extremely difficult time coming up with successes. But we don't move on until we talk about things I have succeeded in during the week. Now as I know the question is coming, I am able to look for a success I can share with her. I can realize I do hard things every day, even if that's simply getting out of bed. That is a success! And it's something to be proud of.

Many years ago I had to keep a daily diary card of emotions I felt throughout the day. There were the usual emotions we think of when we think of depression: sadness, anger, envy, shame, etc. But there was also joy and love. Because it is just as important to recognize those emotions throughout your day as it is to recognize and focus on the negative.  Like having to name a weekly success, we can train our minds to notice when good things happen to us too.

Maybe not all days will be good. Maybe there's only an hour a day when your mind and your heart don't hurt as much. Realize that. Recognize that in that moment you feel content. Say it to yourself, out loud if you can. Life is so incredibly hard. I talked with someone yesterday and had to share what has been going on the last several months and during that time, as I was saying it all out loud, I realized and thought to myself wow, my life sucks. I have been through some incredibly difficult times recently no wonder I'm so depressed! But there I was, talking to a stranger and getting more help and doing scary things, but succeeding in that moment! And that was good. I did not feel good. But for a moment there was a break in the cloud and I could feel a cushion forming.

Keep going. You are succeeding. You take those curve balls life throws at you and you run. It is not easy. Nothing about this journey has been easy. But fight. Give it your all. You will win. And when you have those good moments, no matter how fleeting or how few and far between they are, take notice. You are not alone. And you are worth it.

Rock Bottom

"And so rock bottom became the solid foundation on which I rebuilt my life." JK Rowling

Colleen: I know, and 100% understand, that you are done. You've heard of rock bottom.
Me: Yeah.
Colleen: I think you're there.
Me: Me too.
Colleen: The only way to go is up.

Something has to change. And it has to change now. That was the theme of our therapy session today. I've gotten worse the last several weeks; gone downhill fast. The self harm thoughts and actions, the suicidal ideations. I called the suicide hotline in tears Monday night. It was all I could do to keep from taking action to end my life. I was in so much pain. I was done. The depression had finally won. I'd fought so hard for so long and now there simply wasn't any fight left. In a last ditch effort I called.

And now here I sit. On the cold, stoney ground that is the bottom. The bottom of a deep, narrow pit. It's dark, it's damp. It smells of musk and old mildew. But it's there. It's firm. And I'm here. It feels like I'm alone, but I know I'm not. I can stand on this ground. I can see people above me on higher ground, reaching their hands down for me to hold onto. The walls are steep, the climb will be difficult. But there is light at the top. And there is no where to go but up.

And I feel empty. Drained. I feel fragile. But I'm not. I'm as strong as the stone beneath me. It will not be easy. I'm wary of the fights ahead. But after the downward spiral I couldn't control, after watching my life crumble around me, after feeling utterly hopeless and drained of all worth, after the monster of depression strangled my will to survive...

There is no where to go, but up.

...

I'm not sure I should have walked out of Kitsap Mental Health today, but I did. Colleen was very concerned. She talked to her supervisor; I had a Designated Mental Health Professional come in and talk to me. The DMHP said she thought I could be safe until Monday, when my next appointment with Colleen is. But ultimately she left it up to me. She would authorize a voluntary inpatient stay somewhere if I didn't think I could keep myself safe. I don't know if I made the right choice. But I walked out and drove home. Suicidal thoughts and urges running rampant through my head, through my body. My arm is cut significantly. I did it last night. I will do it again tonight. I need that release. It concerns me. I feel like it concerns me more than it concerns anyone else. I tried hard to convey how I felt to the DMHP, but she seemed to have her mind made up before she even came in to me. Nice enough lady, but I'm not ok. I left feeling surely I was going to harm myself almost immediately. I stopped at the food bank on the way home and got some bread. After eating a piece or two I felt a little better. I've hardly eaten anything all week. Just haven't been hungry.

I mourn for myself. Not in a selfish or narcissistic way, but a genuine mourning for a loss of life. For a life that never was, never will be. For right now, for a messy and hopeless situation. I mourn for having to choose daily between life and death. For a lack of love. I mourn for what was, when things were ok, and I was ok. It is not easy, deciding what will finally be enough. I have no fight left inside. And I'm scared.

So I walked out today. Time will tell if I made the right choice.

11:45 p.m.

I wish I had something glamorous to say. Something profound and inspiring. Some kind of wisdom or knowledge to share. Advice to give. But I don't. Instead I have tears to shed. Questions to ask. Dreams to watch shatter. Instead my heart is breaking. I can feel it burst inside me. I try to quiet my sobs in my blanket.

It's been a really bad day.

I hurt more than I know how to put into words. Every ounce of my body feels pain. My stomach hurts. My back hurts. My head hurts. My heart hurts. And thats the worst hurt of all.

I feel as if there is no good in the world for me. I feel defeated. I feel spent. I feel wiped of all good and all dreams that I once held dear. I feel forgotten. I feel empty. I feel unloved. I feel my efforts to love and be loved have been in vain.

I wish I had kidney disease, cancer, liver failure. I wish I had a disease that on its own would take me. I wish I had something that could be seen. Something that could be physically diagnosed with scientific tests in fancy laboratories.  Something that would require constant physical intervention. Something where I wouldn't have to fight alone. Something where I wouldn't be forgotten.

My cat. He keeps my heart going. If it wasn't for his dependence on me, I would have nothing to live for. I feel I have no one who needs me in their daily life. I see everyone having someone, but me. I feel so alone.

I see no reason to go on. My heart is in a million pieces on the floor right now. And every one of those pieces hurts. They ache. I ache. I hurt so much.

I see no way out of this.

Teetering

I haven't gotten out of bed for three days now. I have a box of cereal next to my bed I snack on when I'm hungry. I forget to take my pills most nights. I managed to shower last night. But I haven't gotten out of bed today.

For two and a half weeks I had company. First my sister, then my brother. It was constant go. I had to be on more than I was able. By the end I felt like I was dying. I was literally losing my ability to move. My feet were swollen to three times their normal size, my knees were stiff, my thighs wouldn't lift my legs anymore... I had pushed myself past my limits and not just mentally, but physically I was shutting down. But I had to keep going.

Now I'm crying in my bed. Feeling like I failed. Like I always fail. Always will fail. I can't function normally in society. And I teeter. Back and forth. Back and forth. What's worth it anymore? Life or death. Back and forth.

This isn't a fun place to be. Teetering on the edge like this, so often. I don't enjoy this. But I can't seem to change either. I haven't decided yet if my life is worth anything to me. And I think that's a huge part of the problem. My life is meaningless to me. I feel worthless. So what's the point in going on? In trying? I'm exhausted. Teetering back and forth between wanting to live and wanting to die. Grasping for hope and aching for relief.

This is my life. Far too often. More than it should be. Teetering.

I don't feel well today.

Treasure Box

Colleen had me make a treasure box this last week. I was to fill it with a treasure for each of the five senses. I keep it where I can see it and get to it with no obstacles, and in times of emotional distress I can get out my treasure box and soothe my five senses with my treasures to help regulate my emotions.

I had a nice box my cousin sent me awhile ago filled with tea that I painted silver and purple and painted on it a quote from How To Train Your Dragon 2, which is my favorite movie ever. The quote is when Stoick has died and Hiccup is struggling with the eulogy. His mother, Valka, comes up to him and tells him how small he was when he was born and how she was afraid he wouldn't make it. But that his father always believed and said he'd become the "strongest of them all. And he was right. You have the heart of a chief, and the soul of a dragon. This is who you are." This quote has touched me very, very deeply and holds such power for me and reminds me that I, too, have the heart of a chief and the soul of a dragon. So I painted that quote around my treasure box. I love it so much.

Inside my treasure box are my five senses treasures. For touch I used a smooth, shiny rock I held and rubbed as I was sitting watching the ocean one sunny day awhile ago. Rubbing that rock brings me back to that time of complete peace and comfort during a very distressful time in my life. Sight I put in a sand dollar, as I'll never forget the first time I found one in the sand and how incredibly happy I was. For sound I have a small ferry Christmas tree decoration I used. It reminds me of how much I love being on the ferry and hearing the water lapping against the boat as we sail. I put in a tea bag for taste. Tea is very comforting and soothing to me. For smell I used a crayon. I love the smell of crayons and it reminds me of all of art, and how much I love to create.

I'm happy to have done this little project. It was fun for me and I think it'll be a nice, quick go to when I'm feeling in distress. It's filled with things that calm my heart and that help me feel better. Maybe you can make a treasure box too! :-)

What Is Borderline Personality Disorder?

My psychiatrist, Rosalie, asked me how I felt about Borderline Personality Disorder when I saw her this last week. I told her it's been tough to take in. She wisely talked to me about how it's hard to put a human being into a diagnosis like that, or any diagnosis really. We're such complicated creatures, especially our minds, that to lump people into one category or another is almost unfair. But simply to provide better and more effective treatment, we do. One of my dearest friends, Jen, commented on facebook that one of her grad professors said we all have second axis traits. (Axis two is for assessing personality disorders; depression is on axis one.)

So what is a personality disorder? And what is Borderline Personality Disorder? This is what I know:

A personality disorder is an enduring pattern of inner experiences and behaviors that go against the norm of the individual's culture. They're inflexible and pervasive across a myriad of situations, social, personal, etc . Personality disorders generally develop in childhood and so aren't generally diagnosed until early adulthood, even into the 30s, like where I'm at.

In a grand nutshell, Borderline Personality Disorder is a mood disorder characterized by unstable moods, behavior, and relationships. It generates a significant amount of emotional instability, which in turn leads to many other mental and behavioral problems, such as depression. People with BPD have a severely distorted self image and feel worthless and fundamentally flawed.  They are very sensitive to environmental circumstances and have an insecure sense of self. Often, people with this disorder find it more difficult to distinguish between reality from their own misconceptions of the world and their surrounding environment. This may seem like a delusion disorder, but it is actually related to their emotions overwhelming regular cognitive functioning.

Other symptoms of BPD include:

*Frantic efforts to avoid real or imagined abandonment. I talked some in my last post about abandonment, and how much I struggle with it. The unstable pattern of interacting with others has persisted for years, and is so closely related to one's self image and early social interactions. The perception of impending separation or rejection, or loss of external structure, can lead to profound changes in self image, affect, cognition, and behavior. The perceived abandonment can leave the one with BPD feeling that they are inherently bad.

*A pattern of unstable and intense interpersonal relationships

*Identity disturbance

*Impulsivity

*Recurrent suicidal behavior

*Emotional instability

*Chronic feelings of emptiness

*Transient, stress related paranoid thoughts

Unfortunately researchers today don't know exactly what causes Borderline Personality Disorder. There are theories, however, about possible causes. Genetics may play a role. Some studies suggest personality disorders may be inherited or strongly associated with mental disorders among family members. Environmental factors also play a key role. Many people with BPD have a history of childhood abuse and neglect, and separation from caregivers or loved ones. Another theory is brain abnormalities. Some research shows change in certain areas of the brain involved in emotion regulation and impulsivity. Also certain brain chemicals that help to regulate mood may not function properly.

Treatment usually involves long term psychotherapy with a therapist trained in treating BPD. Medications may also be prescribed to help specific symptoms, but no medication treats Borderline Personality Disorder.

All I know is that I have a long, hard road ahead of me. But with it will come relief. I'm relieved to know I'm not alone, the there are people out there who have spent their lives studying the disorder, who have brought with them great wisdom and strength. I am relieved to have a name to put to the overwhelming emotions and moods and scary, dark places in my head. I am relieved that the depression is being treated effectively finally. I am hopeful for a light to begin to shine soon.

We'll stop there, with that sentence: I am hopeful.

Borderline Personality Disorder

They changed my diagnosis today. Or I should say added to my diagnosis. Borderline Personality Disorder. That's my Axis II diagnosis from my last post. It's tough to hear, tough to take in. I just feel kind of numb right now. And yet there is a part of me that is relieved. There is more than just depression going on that is making things so very difficult, and always has made things so difficult and so unresponsive to treatment. Maybe now we can treat and heal the wound instead of just putting a bandaid on the cut. I feel silly, I feel embarrassed. I feel small. Borderline Personality Disorder has such a yucky social stigma. I feel like it's still in the baby stages of being accepted, like where depression once was. Colleen was telling me that personality disorders start in childhood, as your personality is developing and you're watching others, particularly your family, and how they act and react and what you get or don't get from them. And sometimes when you're not getting what you need you develop your own methods to compensate, which are ok and work at that time, but then as you grow and mature into society, they aren't as effective or as accepted as they once were. Because personality disorders develop in childhood they're not generally diagnosed until adulthood, when you've seemingly failed to adapt to society.

One of the symptoms of BPD is intense fear of abandoment. This is the one I struggle with the most I think, at least right now. I've known for a long time abandonment is at the heart of all these problems. Feelings of abandonment growing up, of being all alone; not necessarily physically abandoned, but emotionally abandoned. So learning how to parent and take care of myself. And now I am deathly afraid of people abandoning me. I don't get close to people so they don't have a chance to hurt me. Or I'll abandon the relationship first before there's a chance the other person can abandon me. I can see how this has been happening for years. I have close friendships or relationships and one little thing happens and that's it for me. It's scary and it hurts.

I'll write an informational post about Borderline Personality Disorder later. Today is just about feeling and recognizing and facing the new and scary diagnosis and what it means for the future. I don't have to like it right now, but it still is what it is. And there is hope in being able to treat the disorder effectively which will at the same time treat my depression more effectively. That I can be ok with.

Axis II

I've met with my new therapist, Colleen, a couple times now. She's nice; I like her. She's not as blunt as Gemma. She's more your traditional therapist. My care plan was expiring the first time I saw her so we had to do that before anything. We finished it up the second time I saw her. It was uncomfortable. Mostly because I don't know Colleen well and we had to jump right into hard to talk about stuff, like self harm and suicidality. She asked me if I've ever been talked to about having an Axis II diagnosis. I haven't. I guess her team, in talking about me together, think I may have an undiagnosed personality disorder along with the depression that's never been treated, and that's why this time around is so difficult and I'm not making much progress. I don't know what to think. She named what they thought I could have and I felt a large pit in my stomach. It's a difficult one for me to hear. I'm not going to go into further detail until I meet with her again and we really talk about it. But I was supposed to research it this week and see if I think I fit the symptoms. For the most part I do. There are a couple major ones that aren't me, and I'll bring that up with her. So mostly I just kind of feel sick inside and I'm feeling pretty down about what could be. She's, and all of them, are probably right. She's mostly going off the again the self harming and the suicidality, as we've just met a couple of times. I'll write more about it after Tuesday, when I see her again.

So that's kind of where I'm at. Feeling a little less than human lately. Even though I know and I preach that I shouldn't, it doesn't change that that's how I feel right now. I know nothing will change who I am, but, it doesn't mean I have to like it.

Suicide Prevention: How To Help

Suicide Hotline: 1-800-273-TALK (8255)

Nothing is quite so tragic and heartbreaking as the feeling that your life no longer holds any worth, that you aren't worth fighting for. That the pain is so unbearable, death feels like the only way out.

When someone confides in you that they're feeling suicidal, or have had thoughts of suicide, it naturally can be unsettling and scary. You may not know how to act, or what to say, or wonder if you should say anything at all. You should. Taking action is always the best choice. It doesn't have to be so scary. This post takes on the subject of suicide; understanding, common misconceptions, warning signs, prevention, and risk factors. I really hope it helps bring understanding on a subject that has been taboo for far too long. It's time to bring light and knowledge to the subject. The problem is real and the pain is real. And it needs to be talked about right now.

● Understanding

If you've never been in the deep sorrow of suicidal depression and despair, suicide is difficult to understand. The suicidal person is in so much pain they see no other option or way out than by ending their life. Suicide becomes a desperate attempt to escape the pain and suffering that has become unbearable to them. When the feelings of self-loathing, isolation, and hopelessness become too great, it's hard to see any way of finding relief except through death. However, even if all they want is the pain to end, most suicidal people are deeply conflicted about ending their own lives. They wish there was an alternative, but are unable to see one.

● Common Misconceptions About Suicidal People

Unfortunately suicide and people wanting to commit suicide are so misunderstood. There's A LOT, too many actually, misconceptions about the subject. Here are the most common:

People who talk about suicide won't really do it. Almost everyone who commits or attempts suicide has given some kind of warning. Do not ignore suicidal threats.

People who attempt suicide must be crazy. Most suicidal people are not psychotic or insane. They're upset, grief-stricken, or depressed. But it's also important to remember that extreme distress and emotional pain are not necessarily signs of mental illness.

If someone is determined to kill themselves, nothing will stop them. Like I mentioned earlier, even the most severely depressed person has mixed feelings about death, wavering until the very last moment between wanting to live and wanting to die. Most suicidal people do not want death, they want the pain to stop.

Those who have successfully committed suicide were unwilling to get help. Studies on suicide have shown that in over half of successful suicides, the person sought help in the six months before their death.

Talking about suicide will give the person the idea. You don't give a suicidal person morbid ideas by talking about suicide. Actually the opposite is true. Bringing up the subject of suicide and discussing it openly is one of the most helpful things you can do.

*Remember that suicide is no respecter of persons. It doesn't care if you're rich or poor, black or white. The feelings leading up to suicide affect everyone and anyone equally.

● Warning Signs

Most suicidal people give warning signs or signals of their intentions. The best way to prevent suicide is to recognize these warning signs and know how to respond if you see them. The following is a list of the more common suicide warning signs.

*Talking about killing or harming oneself
*Talking or writing about death/dying
*Seeking out things that can be used in a suicide attempt
*Hopelessness- unbearable feelings, seeing a bleak future, having nothing to look forward to
*Dramatic mood swings
*Sudden personality changes
*Losing all interest in day to day activities
*Neglecting personal appearance
*Drastic changes in eating and sleeping habits
*Withdrawing or wanting to be alone
*Increase in alcohol or drug use
*Risky and self-destructive acts
*Giving away belongings
*Getting affairs in order when there is no logical reason to do so
*Saying goodbye to people like you won't see them again

● Prevention

Speak up if you're worried! You can't make a person suicidal by showing that you care. What you can do is provide relief from loneliness and pent up negative feelings.

Here are some ways to start a conversation:
"I have been feeling concerned about you lately."
"I have noticed some differences in you recently and wondered how you are doing."
"I wanted to check in with you because you haven’t seemed yourself lately."

Here are some questions you can ask:
"When did you begin feeling like this?"
"Did something happen that made you start feeling this way?"
"How can I best support you right now?"
"Have you thought about getting help?"

And here are some things you can say that help:
"You are not alone in this. I’m here for you."
"You may not believe it now, but the way you’re feeling will change."
"I may not be able to understand exactly how you feel, but I care about you and want to help."
"When you want to give up, tell yourself you will hold off for just one more day, hour, minute - whatever you can manage."

It's also good to have a list in your head of Dos and Don'ts when talking to a suicidal person.

Do:
*Be yourself. Let the person know you care and that they are not alone. The right words are often unimportant. If you are concerned, your voice and actions will show it.
*Listen. Let the suicidal person unload despair and ventilate anger. No matter how negative the conversation seems, the fact that it even exists is a positive sign.
*Be sympathetic, non-judgmental, patient, calm, and accepting. Your loved one is doing the right thing by talking about their feelings.
*Offer hope. Reassure the person that help is available and that the suicidal feelings are temporary. Let the person know that their life is important to you.
*If the person says things like, “I’m so depressed, I can’t go on,” ask the question: “Are you having thoughts of suicide?” You are not putting ideas in their head. You are showing that you are concerned and that you take them seriously and that it’s okay for them to share their pain with you.

Don’t:
*Argue with the suicidal person. Avoid saying things like: "You have so much to live for," "Your suicide will hurt your family," or “Look on the bright side.”
*Act shocked, lecture on the value of life, or say that suicide is wrong.
*Promise confidentiality. Refuse to be sworn to secrecy. A life is at stake and you may need to speak to a mental health professional in order to keep the suicidal person safe. If you promise to keep your discussions secret, you may have to break your word.
*Offer ways to fix their problems, or give advice, or make them feel like they have to justify their suicidal feelings. It is not about how bad the problem is, it's about how badly it’s hurting your loved one.

Respond quickly in a crisis. If a loved one tells you they are thinking about death or suicide, it's important to evaluate the immediate danger the person is in. Those at the highest risk for committing suicide in the near future have a specific suicide plan, the means to carry out the plan, a time set for doing it, and an intention to do it. Ask questions to assess the immediate danger. These are good questions to ask:

"Do you have a suicide plan?" (plan)
"Do you have what you need to carry out your plan (pills, gun, etc.)?" (means)
"Do you know when you would do it?" (time set)
"Do you intend to commit suicide?"(intention)

Take all suicidal comments very seriously. Try not to act shocked. The person is already highly distressed, and if you are shocked by what is said, the person will become more distressed. Stay calm, and talk with them in a matter-of-fact manner, but get help immediately. Do not handle the situation by yourself. If you feel the suicide is imminent, or are just plain worried, call 911.

Listen attentively to everything that the person has to say. Let them talk as much as they want. Listen closely so that you can be as supportive as possible, and learn as much as possible about what is causing the suicidal feelings. Comfort with words of encouragement. Use common sense to offer words of support. Remember that intense emotional pain can be overwhelming, so be as gentle and caring as possible. Listen carefully and offer encouraging words when appropriate. Let the person know that you are deeply concerned. Tell them you are concerned, and show them that you are concerned. A suicidal person is highly vulnerable and needs to feel that concern. Don't be judgmental. Do not invalidate anything that the person says or feels. Be supportive and caring. Be careful of the statements that you make. You do not want to make the person feel any worse than they already do. I think the commom thread here is listen, listen, listen! Be gentle, be kind, and be understanding. Let the person express emotion in the way that they want. Allow the person to cry, yell, swear and do what is necessary to release the emotion. However, do not allow the person to become violent or harm themselves. If the person is at a high risk of suicide, DO NOT leave them alone. Do not leave a critically suicidal person alone for even a second. Only after you get professional help for the person can you consider leaving.

Offer help and support. Once again, the best thing you can do is offer an empathetic and listening ear.

Help your loved one get professional help. Do everything in your power to get a suicidal person the help they need. Call a crisis line for advice and referrals. Encourage the person to see a mental health professional, help locate a treatment facility, or take them to a doctor's appointment. Then know and follow-up on their treatment. If the doctor prescribes medication, make sure your loved one takes it as directed. Be aware of possible side effects and be sure to notify the physician if the person seems to be getting worse. It often takes time and persistence to find the medication or therapy that’s right for a particular person.

Be proactive. Those contemplating suicide often don't believe they can be helped, so you may have to be more proactive at offering assistance. Saying, “Call me if you need anything” is too vague. Don’t wait for the person to call you or even to return your calls. Drop by, call again, invite the person out.

Make a safety plan. Help the person develop a set of steps that they promise to follow during a suicidal crisis. It should also identify any triggers that may lead to a crisis. Also include contact numbers for the person's doctor or therapist, as well as friends and family members who will help in an emergency.

Remove potential means of suicide, such as pills, knives, razors, or firearms.

Continue your support over the long haul. Even after the immediate suicidal crisis has passed, stay in touch with the person. Your support is vital to ensure your loved one remains on the recovery track.

Be aware of feelings. Many people at some time in their lives think about suicide. Many decide to live. However people having a crisis sometimes perceive their dilemma as inescapable and feel a complete loss of control. These are some of the feelings and thoughts they experience:

Can't stop the pain
Can't think clearly
Can't make decisions
Can't see any way out
Can't sleep, eat or work
Can't get out of depression
Can't make the sadness go away
Can't see a future without pain
Can't see themselves as worthwhile
Can't get someone's attention
Can't seem to get control

If your loved one is experiencing any of these feelings, help them get help!

● Risk Factors

According to the U.S. Department of Health and Human Services, at least 90% of all people who commit suicide suffer at least one mental disorder.

Depression in particular plays a large role in suicide. The difficulty suicidal people have imagining a solution to their suffering is due in part to the distorted thinking caused by depression.

Common suicide risk factors include:

Mental illness
Alcoholism or drug abuse
Previous suicide attempts
Family history of suicide
Terminal illness or chronic pain
Recent loss or stressful life event
Social isolation and loneliness
History of trauma or abuse

● Hope~

I know what it's like to feel and be suicidal. I know how scary and hopeless you feel. I know how heartbreaking it is to feel so utterly alone and defeated that all you want is to die. I know. I've been there. Many, many days I still am there. I know how bad it hurts. I also know how grateful I am for those people who have stuck by my side through it all. I understand how precious these beings are. Be that being. You can help save a life. If you're struggling with suicidal thoughts or actions, or even if you're not, know that I am here for you. Know that you are loved. You are worthwhile. You are worth every ounce of the fight. You are not alone. You can and you will survive. The feelings will pass. The sun will come out again. This I know. I love you, I care for you, and I need you. You are worth it.