A Change in Perspective

When I wrote Hello Kidney, that was my reason to stay alive.  I’d had a rough day at work on Friday, and followed it up by reading a post on a mental illness message board that struck a nerve.  The board discourages discussion of personality disorders, under the premise that medication does not help them (which I disagree with – I believe there are some symptoms involved that medication can alleviate).  There was a poster who I had greatly admired due to his ability to work in an inpatient psych unit despite his own mental illness.  At least I admired him until he expressed his belief that people with Borderline Personality Disorder give themselves papercuts or take a single benzo and then run to the ER crying that they attempted suicide, taking up resources that should be saved for people with real mental illness.

I was angry.  I have never been openly judged for my mental illness, and to have it done by a fellow sufferer AND mental health professional was an extra blow.  Unfortunately, I internalize anger.  Instead of blaming him for making a callous comment, I blamed myself for being unfit for society.  Maybe all those nights I spent in inpatient last year really did mean resources were being wasted on me.  Maybe I’m not worth saving.  I was busy at my second job for a few more hours, but then I headed home, where I picked up a disposable razor and went back out to wander in the night time.

I thought I’d be going somewhere secluded and sitting in my car as I broke open the razor and slit my wrists with the blade.  First, though, I went to Steak ‘n Shake, where I stuffed myself with comfort food and wrote in my journal.  As I wrote, I thought about how I couldn’t die yet, as I still might be able to donate a kidney to mom.  So I planned for that potential surgery and started researching how I could increase my risk of dying from it.

Despite the lack of immediacy to my suicide plan, I knew I should be calling the on-call therapist.  I couldn’t make myself do it.  I can’t be anonymous if calling in the middle of the night, as the therapist has to be contacted and then return the call.  Also, the chances are ever-increasing that the person on-call will turn out to be someone I know.  Finally, I feared being asked to come to the ER for an in-person psych evaluation, and potentially having cops sent after me if I refused.

Instead of calling, I browsed the internet and found Crisis Text Line.  The idea of not having to speak aloud to someone was appealing.  I entered the number into my contacts, but hesitated before sending a text.  Some other customers were creating a spectacle, and watching them distracted and entertained me enough that I was able to safely return home and crawl into my bed.

I held on to the idea of donating a kidney, and on Monday morning I called the transplant center.  I was asked 5 questions in rapid succession before being rejected.  My name, mom’s name, whether I had high blood pressure, whether I was on medication for it, and my age.  I argued with the lady, questioning her about the reasoning and asking if I could get a clearance from my doctor to allow it.  She firmly said no.  I understand why high blood pressure is a problem – it’s a leading cause of kidney damage and they wouldn’t want to take a kidney from someone who might end up needing one later on.  However, it does not make sense to reject me when my blood pressure is normal with medication, and it especially does not make sense that my age would make a difference.  Would she have said yes if I were younger?  Older?

My new thing, apparently, is to throw up when I cry.  I hung up and started sobbing, racing for the bathroom as the force of my tears made me gag.  It would be one thing to have found out I wasn’t a match, as that would still leave the option of arranging a kidney exchange, where I donate to a stranger and their loved one donates to mom.  Being rejected entirely was devastating.

Mom can live on dialysis indefinitely, and at this point has accumulated 27 months of wait time, with it usually taking 3 to 5 years to get a kidney (her first one only took about 8 months).  It’s reasonable to think she’ll get one soon without my intervention, but I couldn’t stand the idea of her being on dialysis any longer than necessary.  My thoughts returned to my original suicide plan, the one that got me sent to inpatient the first time.  I had planned to accompany her to an appointment at the hospital, pin a note to my chest requesting she receive one of my kidneys, and shoot myself in the head.  Maybe that would be the best for all of us after all.

The next day I was sitting in the DBT group that I planned on quitting within the next couple of weeks (as soon as we complete the Emotion Regulation module), and on the break I pulled out my phone and started doing research for my plan.  A few minutes later, in the course of our weekly mindfulness exercise, I had a change of perspective.  The exercise consisted of three questions asking us to consider how we could view situations differently in order to change our feelings about them.  How could we make the best of those situations and hold out hope for the future?  I began writing answers that turned out to be about the kidney transplant and the things I could still do to support mom and the overall cause without being able to directly donate a kidney to her.

I had already notified the group leaders that I was quitting, but when I realized something enlightening had just taken place I questioned my decision.  The group ended and I asked Sierra if she had an opening in the next two days in which I could come speak with her.  We arranged it for 8 am today.  Later in the day I was also able to schedule a brief appointment with Sadie for 10:30 am today.

The alarm on my cellphone was set for 6:30 am, but it was the house phone that woke me, at 10:50 am.  Sadie was concerned because I hadn’t shown up for my appointment, and if I hadn’t answered the phone she’d have been sending the police.  Sierra was also concerned, but wondered if there’d been a miscommunication so she merely sent an e-mail to check in with me.  I was very upset to have missed both of these appointments as I really needed to talk to someone, and Sadie and I agreed that I would show up at CMHC at 2 pm and wait, because both her 2 o’clock and 3 o’clock clients have been flaking on their appointments lately.

I was there in the waiting room, doing some writing to fill the time, when Sadie came out at 2:10 pm and told me that client hadn’t shown up (and the next one had already called to cancel).  Our conversation looped around through a lot of topics.  She did her usual sneaky assessment of whether I was safe to roam free, and I assured her that I had no intention of killing myself right now.  A couple of days ago I wasn’t sure I could say that.  A part of me really felt like inpatient would be the best option, if only I thought there was anything they could do to make things better.

Sadie told me that mom still needed me, even if I couldn’t help her in the way that I wanted.  She named off all the people I had worked with at CMHC and said that if I killed myself it would impact them all, not to mention all the people I know through work and school and hobbies and family.  I told her this sounded like an argument in favor of not having relationships and she said it was too late, that even people I no longer have contact with, like Wendy, would be impacted.

I had a thought in my mind about a video I watched recently, made by the blogger when she was planning to kill herself.  I had shared it to Facebook, explaining that I’d had many of the same thoughts she expresses.  The only feedback I got was my mom saying, “You never really felt as bad as that girl, right?”  The thought that came up when Sadie was talking was that the impact would just be people thinking there was something they could have done, when they should have thought of that beforehand.  I didn’t get a chance to express this, as the conversation veered in another direction.

Aside from the issue of suicidal thoughts, Sadie and I discussed the rapid fluctuations in my mood.  Despite feeling down and suicidal one day, I can be bouncing off the walls the next.  The past couple of days I worked 3-11:30 pm and found that I could not get myself into bed afterward.  Last night I spent at least half an hour total pacing back and forth in the break room while waiting for work to do.  I was taking the stairs two at a time, and lately I’ve had the non-stop fidgeting of my left-hand that featured so prominently in last year’s manic episode.  I’m driving too fast (60-70 in a 45 mph zone), going out wandering late at night, getting too generous with gifts, and losing my social anxiety.  From the moment I showed up at work yesterday I answered every single phone call that came into the department, despite having a coworker there for the first 5 hours and despite my usual deep aversion to telephones.

On the one hand, Sadie said she was glad I would be seeing Brent next week because it seems like my medication’s not right.  On the other hand, she said she didn’t want me to pathologize everything about myself.  Some of these behaviors can be my personality without being a sign of illness, and the things I was expressing concern about weren’t actually dangerous, with the exception of speeding.  I tried to explain that it’s the combination of all these factors and the fact that it feels like I did before I ended up in inpatient the first time that worries me.  She asked if I had been manic, depressed, or mixed at that point.  I said mixed.  I’ve never directly said that to anyone in the mental health profession.  I know it was the case, but it’s not officially in my records.

She asked if I’m mixed now and I said no, that it’s rapidly switching between the two, which is a little less dangerous.  Mixed states are bad because you feel the despair of depression and the energy of mania simultaneously and are at increased risk of suicide.  We talked about how to describe my symptoms to Brent in a way that he will take seriously.

I fear what he will say when I complain about moods being up.  I had complained before about being down all the time and sleeping too much and he decreased my dose of Latuda, thinking I might be overmedicated.  Well, that’s clearly not a problem anymore.  Maybe what I want is not possible.  I want to have energy and motivation.  I want to not be bouncing off the walls.  I want to sleep 8-9 hours a night and wake up refreshed.  I want to be able to cry over sad things, but not become suicidal over them.  I want to not feel anxious.

What my medication does now:

Wellbutrin – Mostly keeps me out of suicidal despair.  I still have suicidal thoughts, but they get much worse if I go off the Wellbutrin.  Also, it usually prevents me from crying when I’m upset.  My eyes might get a bit watery, but it has to be something really bad (like the rejection from the transplant center) to induce real tears.

BuSpar – Wipes out the cripplingly severe anxiety, but I still have fear that prevents me from doing certain things.  Except, of course, when I get a bit manic and then all bets are off.

Latuda – Slows down reactions to situations.  Makes me sleep more than I’d like.  If I skip it, I’ll be up all night (although the past few days I’ve been wide awake despite taking it).

A few months ago, I had shared a few medication options with Brent and he said, “#6 is Not An Option“.  That was the point at which he reduced the Latuda.  In looking back over the options I provided, there should have been a #7 and #8.  I didn’t bring up the possibility of lithium, probably because the idea of the frequent blood tests intimidates me, and I didn’t account for the fact that the solution might involve more than one of those changes.  Brent and I need to have a serious conversation next week, because I am just not okay with the way things are right now.

This is why a small part of me wants to go hide in inpatient, because I know something needs changed, and I’m a little scared of doing that with minimal supervision.  I’ve reached the point that I haven’t experienced serious side effects from my medication in a long time, and the idea of new side effects hitting me as I try to make it through my work days is daunting.

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3 thoughts on “A Change in Perspective

  1. I really hope to everything that your mom can get a kidney transplant. I couldn’t read the first post you linked, I apologize, but because I know what that’s like I really, really do mean it: I’m hoping for the best for your mom.

    I’m having a tough time too. One day I’m peachy, next I want to quit. I keep pressing alt+ctrl+delete even when I don’t have a keyboard, because I want to “shut down this process” in the mental task manager. At any rate, I’m glad you’re here and taking steps to protect your life.

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    • The thing about the transplant is that it’s not literally life or death – she can stay on dialysis indefinitely – but in a way it’s life or metaphorical death. As long as she’s on dialysis, she is tied to home. You CAN travel on dialysis, and make arrangements to visit a facility where you are traveling, but as it’s 3 days a week for 4 hours at a time it seriously cuts into the vacation time. She just won’t do it.

      I really truly don’t want to die. The thoughts just keep milling around, almost like an obsession. I told Sadie I was “always” going to be considering suicide and she objected to such an absolute term. It feels like always though. Like now that I’ve gotten as dangerously close to it as I did last year, I don’t know how to not think of it as an option when I’m feeling down.

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  2. Pingback: A Change in My Change in Perspective | Stuff That Needs Saying

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