Chronic ideation

[M2]

Hi,

Hopefully I'm within guidelines, let me know if not!

So I've always struggled with anxiety, depression and suicidal ideation. The three things are almost like domino's, anxiety leading to depression to ideation, quite quickly.

I finally had enough mid year and went to the GP and was put on SSRI. it helped a lot for months. Sadly, the crazy season tipped me over the edge and I feel hard.

Interestingly, the warning sign for me is the prevalence of suicidal ideation that occurs. Those thoughts are always there (even when I'm relatively happy) but the thoughts are coming thick and fast now. I won't go into detail, but it is always the same mechanism of death, over and over and over.

Last night I almost fell into old habits and called someone to stay using again (it has been a decade). The motivation for this was extremely scary, and holding back was hard. I woke up this morning again in a bad state (though better than yesterday).

Does anyone have any advice on pushing through this? I don't want to feel like this anymore.

Thanks

[Croix]

Dear M2

"I wasn't able to express the difference between thoughts, plans and actions"

Um,

I couldn't either as as far as I can see - at least in my own case - matters were too unstable for me to draw valid distinctions, even if I thought I could, the unexpected was always a possibility.

I can understand the mixed feelings you have about giving a more accurate account of how you feel to your wife, after all if she is very worried now it seems logical that saying more would increase her anxiety and distress.

I found that by including my partner in the steps I took to keep myself safe it gave her a sense she had some control over matters, which in turn relived a little bit of her worry. This allowed me to be entirely frank with her.

I did this by getting her help to fill in the BeyondNow safety plan app I mentioned before. I found I was terrible at filling it in, leaving sections blank, and not being able to remember what had made me feel good in the past. My wife did remember and the plan was filled out with exact references rather than generalizations, eg instead of 'listen to music' it was 'listen to the Stones "Paint it Black" or "the Muppet version of "Gods away on business"...

It applied to all sorts of media from books to films, and also places to go and people I could contact who she suggested would be sensible. You get the idea?

As BeyondNow really should not have fixed content but be dynamic, needing tweaking frequently to reflect new things in my life this gave an ideal opportunity to include her in things -and it did make a difference. I guess the technical term might be empowering.

Last time I tried to convey that the psych is your equal, they are the expert on treatment, you are the expert on you. I'd suggest you tell them about the lack of success of CBT, your reactions to EMDR and talk over which avenues are most likely to bear fruit. If the new psych takes no notice or the therapies are outside their range then please consider changing again.

CBT or its equivalent I think was given to me either too early or else in some other way that was not good, I felt consistently worse. Other therapies did better.

Hope to hear from you

Croix

[M2]

Thanks Croix,

You offer very good advice about reaching out to my wife for support. She is always there for me. During the depths of covid she had her own mental health struggles and I'm just a little worried I may trigger some of that. I have tentatively reached out to her for help, but I haven't opened up quite to the full extent just yet. My worry and concern for her seem to be a blocker I need to get through. Our relationship is great, so it seems strange that I'm holding back. It's just fear I guess. Fear and a long, long practice of holding it all in.

I had my first session today. It was a relief to talk through my current issues. I broke down a little, and later felt mortified and tried to convince myself that there are bigger issues in the world and that I should cancel my next session and just deal with it. I haven't yet done this, but the temptation is high. Sometimes I think my tendency to minimise my issues is some kind of self sabotage. The reality is my issues are many layers deep and seems to be self protecting itself from any help.

You should know that this thread has offered more support to me than anything else recently. Thankyou.

my therapist thinks my recent self harm is a coping mechanism, and that the fact that emdr was quite effective in the past indicates there may be a history of repressed trauma. I don't see how this is possible.

I've also recently been diagnosed with adhd (at 44!) Inattentive type. This came up as a side effect of my son being diagnosed recently. I'm told this can often impact self esteem, anxiety, depression. Knowing this helps I guess.

[M2]

One last, late night thought.

Is it possible, from a philosophical level, to concede that my moving on could possibly be a virtuous pursuit? My thoughts aren't currently strictly rational, but is it possible an objective argument could be reached that my non existence is perhaps a superior state - at least to others! - that should be considered? Recently my conclusions have tended to view only emotional ties (as important as they are!) that hold me here. Weighing this up is something of a cost benefit analysis, and it is very difficult to assign value for and against without at least some levels of subjectivity.

that understanding that I'm not perhaps thinking 100% rationally is a bit constraint on these thoughts, but I feel it could be possible to rationalise this down the track, with arguments for and against without resorting to emotion.

I guess at the end of the day this is what life is, weighing up the benefits of each decision and assessing each as fairly and with as few biases as possible

[Croix]

Dear M2~

No you are not thinking rationally I'm afraid. You have not realized the consequences of your actions, on yourself or others.

Mind you I felt the same way at one stage and it is only luck I'm here talking with you now. I thought people would either not notice, or in some cases be better off wihtout me being alive. They could go on with their lives unburdened as it were.

A long time later I told my partner about this and she was horrified, her world would have ended, as would that of my offspring. I also look back myself from my current life, the things I've done, people I've helped, people I've annoyed, satisfactions and defeats I've felt -and all the rest. That would never have happened if I'd taken my life. I'm glad to be alive, it's that simple.

Your mind has taken you down a false trail, as it did mine, caused in my case by depression which seems to do two things, the first being blocking everything out of my life except a few hopeless and insoluble 'facts' from which there was no escape. Never mind the world is actually much larger and filled with all sorts of things, including the interesting, fun, enjoyable as well as opportunities.

Actually a TV program I'd enjoyed before reminded me there were things outside that little sphere of misery and my thinking started to change.

The other think is depression seems to want to resit anything other than itself, filling my mind to overfull and making me resist all else. I had no time or patience or room in my mind to cope with others.

The above is all logic, and logic does not always cut the mustard when your thoughts take this turn.

Try, please, to think of things you have enjoyed in the past, it's a good way out. Then talk with another so you are not isolated like you are now.

It's at this point a well thought out BeyondNow Safety Plan would be a help (that's a hint:)

Croix

[M2]

This is all great, I'm just not able to relate to it right now.

I've been here before so many times I think I've lost the taste for it.

I'm sure I'll be fine. I downloaded the safety plan, I'll check it out. Thanks croix

[Croix]

Dear M2

No logic does not help, though sometimes like advertising it can creep in unnoticed. I'm glad you are going to downloads the safety plan, filling it out can itself be distraction and I've found the end product can be a comfort to posess.

Croix

[M2]

Thanks mate. Sorry for using up your time. I'm sure there are other more worthy ppl out there in need, so I appreciate it.

As an aside, as much as I truly believe my life is one I would prefer to end, I have decided the pain it would cause (for the moment) means I should remain. The maths involved sounds callous, but that's where I'm at. This might change down the track, and I'm disappointed, and agitated, but ideation will be just something I do, without plans.

I have decided to end my psych sessions, I'm not gelling with her, and the experience just underscores my disappointment with therapy I've had in the past.

I'm signing out here, it leaves a bad taste that I reach out here so much. For others this is great, but my needs are not as great as others.

Thanks Croix, You do good work

[Croix]

Dear M2~

My time is for you, and saying others need it more is bullshit - you are as deserving and in need as anyone I've talked with. I'm nothing special, just a volunteer who tries to stop others having all the anguish I had.

OK your therapy is not up to scratch, that means you change it, not give up! I've been fortunate in my psychiatrists, less so with psychologists and have gone from the state of thinking I should stay for my family and for my work, to thinking they would be better off without me, to trying to take my life. All the way from there to my current very good life.

I guess if I read back over most of what I've said to you they have been the more practical things, from treatment to enjoyment and distraction.

Maybe a different tack - talking of what else is in the world, perhaps that might help. My eyes were closed to this during the worst of it.

I can retreat into a different place at times, one far removed from everyday life. I'm standing on a plateau on the side of a mountain, the plateau edging cliffs. There is short sheep nibbled turf, with the occasional granite outcrop.

On three sides I can se the sea, not blue and calm, but grey and with white-caps to the waves right out to hte horizon. The sky is grey with low clouds and I an see rain squalls heading in towards me on the strong buffeting winds.

The winds are so strong I almost lose my balance and have to lean into them.

The rain stings my bare face and runs down like tears, but the rest of me is clothed, warm and dry. A seagull swoops past, driven by the wind, wings half closed.

It all reminds me there is more in life than in my limited horizons and gives me peace at the size and permanence of that little other corner of the world.How many corner are there?

There is more that is different, even exotic, than you can see now.

I hope you do respond

Croix

[M2]

Thanks mate. Believe me when I say you do good work, and that - if I have issues - they are not a result of any of the awesome and relevant advice you have given me. I have a great deal of respect for you and any others that volunteer their time here.

Yeah, I have self esteem issues that put me a bit lower than all others in my mind, but on did days I clearly see this. I figure knowing this is at least a minor positive. I suspect adhd lends itself to self esteem issues, as teachers, peers treat you differently, perhaps as broken or a bad egg. This stays with you decades later.

Self harm, self sabotage, depression, ideation, all of this is not new, it's just the scale that changes. I'm 44, and none of this is new. What's new is the fact that a lifetime has passed without me getting a grip on any of this, despite time, effort, money and intent being thrown at it. The thing that has changed is basically... fatigue, I guess you'd call it.

Again, I love your advice and your views. They work, they make a difference. Believe me. I've been working on distraction lately, focusing on the usual stressors of work (as crazy as that sounds) and it does offer some reprieve, so thank you.

why did psychiatry help where psychology could not? I had thought the only difference was the ability to dispense medication but I realise I am likely very far off here

[Croix]

Dear M2

Life is a work in progress, and you have amassed 44 years of experience that you will use in the next (statistically speaking ) forty-something. Life has not past you by, it has been lived - not ideal in all respects it's true - but lived and learned from. I most definitely use what I've learned in the past to help now -"I've been here before" is a great thing to be a able to think.

Yes one does get tired, fatigue trying to cope with all you feelings is a very real thing, and the answer to fatigue is of course some rest. That's why I have that corner of the world above the cliffs where nature reminds me I've not seen it all. That's why I suggest distraction, because it's not a constant reminder of effort expended and the unpleasant aspects of the past. A holiday if you will.

A psychiatrist is firstly a doctor, trained as an MD for 4-6 years, a year in a hospital or simialr practicing for a year, then another 5-6 years training in psychiatry. Clinical psychologists have 8 years training and as far as I'm aware cannot prescribe medications.

I've found psychiatrists have a more balanced view - though this is just my own impression, and a greater knowledge of a broader range of mental health and bodily conditions (I'm probably going to be corrected here, however I'm just going on my own experience). As a result if financially feasible I'd suggest a psychiatrist over a psychologist. In fact mine has sent me to psychologists for particular therapies they specialized in.

The down-side is the expense. There is a Medicare safety net that assists once one has spent over a certain threshold on approved treatment during any calendar year.

Can you think of anything in your mind to go to for a rest, like I have my cliffs?

Croix