Chronic Pain

Imagine you are at your best friend’s wedding.  The ceremony has ended and the reception just begun when a trivial matter comes between the two of you.  You end up in an explosive fight, and she is so upset that she rushes out of her own reception.  She drives away, tears impairing her vision, and has a fiery car crash in which she is killed.

Imagine the pain you would be in.  The shame over ruining her wedding day.  The guilt over her death that is seemingly your fault.  The anger that you can’t go back and apologize.  Imagine those images playing over and over in your mind.

Now imagine that you feel this pain, this shame and guilt and anger, every time you think or say or do anything wrong.  Imagine that every minor mistake and every real or perceived criticism triggers gut-wrenching sobs.  You cry so long and so hard that you vomit.  Your nose gets so congested you can’t breathe.  Your heart physically aches.

Imagine being in this much pain on a regular basis for days, months, years, decades.  Imagine that you barely remember the time before this pain.  Sometimes it abates, maybe even for months, but the pain always returns.  It is the one part of life you can always count on.

I wish Sadie could feel this pain just once.  I wish she could know that I would never choose to stay in pain if I could find my way out of it.  No amount of caretaking by others would be worth prolonging such a horrible feeling.

Walking Out of Therapy

Twenty minutes into my therapy session today I grabbed my things, mumbled “I don’t want to be here.  I’m sorry.” and ran out the door before Sadie could do anything other than sit in shocked silence.  I was crying by the time I stepped out into the sunshine, and despite making stops at three stores I still arrived home before my appointment should have ended.

I decided to give Sadie until the end of the week to reach out to me, before making a decision about what to do.  I really had no idea if I would reach out to her if she didn’t, or wait until my next scheduled appointment, or cancel all my appointments.  I got an e-mail from her later this afternoon, asking me to let her know when I’m ready to discuss why I left early.

I wrote back within 15-20 minutes, asking if she wanted to do that before Wednesday or wait for my appointment.  I gave her a brief explanation of the three reasons I got upset.  It had been compounding from the moment I walked in, and I reached a point where I was about to burst into tears if I didn’t get away.  Obviously I haven’t gotten comfortable with the idea of crying in front of her.  I wish I had spoken up before it reached that point, but I was trying to just get through the session and not make waves.

First she was telling me that although medication helps, it doesn’t fix everything, and my thoughts are causing me problems.  What I heard was that I am totally to blame for being depressed and if I could just be better and think better then I’d be fine.  My struggle here is that I get two kinds of depressed moods.  There’s the one that comes from bipolar, where I’m physically run-down and have no motivation and can’t focus and end up having crying spells because I just feel so bad.  Then there’s the BPD form of depression, which is totally triggered by negative events and I cry about those things.

I can have suicidal thoughts in either case.  When there are negative events triggering the depression, it’s that everything is too hard and I want to die so I don’t have to deal with it.  The suicidal thoughts from bipolar depression are much different.  In those cases, I don’t want to die – I feel like I deserve to, like the world would be better off without me in it.

To me, bipolar is an illness and the answer is medication, whereas BPD is a character flaw and the answer is to be a better person.  What I was hearing in Sadie’s words was that it’s all my fault I’ve been feeling poorly, and that it’s not even remotely possible that my medication could be anything less than perfect at this point.  And maybe I hear that because I feel like by now it should be right.  The thing is, I’m trying so hard and using the skills she has drilled into my head, and I see where they help but it’s not enough.

Then she was laughing over things I said.  She told me she wasn’t trying to be insensitive, that I was laughing too, so I must know that those thoughts are irrational.  I did say that she knows I laugh when I’m uncomfortable, but it didn’t seem like she took me any more seriously after that.

Then we got into a discussion on intrinsic value.  In the course of this conversation I ended up making a comment that proves what a horrible person I am.  I regretted it as soon as I said it (although we’ve had this same basic conversation before), and although she has said many times that she’s not there to judge me I find it completely impossible that she could hear me say these things and avoid judging.  And that’s the point at which I walked out.

I e-mailed her an abbreviated form of this, and she wrote back that she was shocked at how I had interpreted what she said, that it proved her point about the power that thoughts have, and she wanted me to think about how else I could have interpreted things.

I.  Don’t.  Know.  Clearly I couldn’t interpret things differently, or I wouldn’t have gotten so upset.  If I could see even a glimmer of an alternative interpretation, then I’d have been able to stop her and ask for clarification.

I’m just so tired.

Dragging Through Depression

When I saw Brent on Friday I reported being exhausted and unmotivated for the past week.  I’ve done the basic necessities, but otherwise spend most of my time lying around like a useless blob.  I didn’t refer to this as depression, but he did.  Then he proceeded to make no changes and tell me to come back in a month.  He did mention both Lamictal and Wellbutrin as things we could potentially increase, but not right now as “it’s only been a week”.

I’m to call sooner if things get worse, but I’m not clear on how much worse.  I feel like crap and I’m crying several times a day.  I still go to work, but yesterday I kept thinking about walking out in the middle of the day.  I don’t want to die, but I also feel like things will never improve.  I want to go off my meds since clearly it’s pointless to take them.  I keep thinking about cutting myself.  I don’t really feel the urge to do it but I keep wondering if it would make me feel better.

I’ve wanted to see Deputy Wayne again for over a year.  About 6 months ago I learned it might be possible some day, and now I’m less than a week away from it actually happening and I’m dreading it.  I don’t want him to be disappointed that I’m still struggling so much.  I’ve actually considered skipping the event, but I’ll feel guilty letting my issues get in the way of someone else’s happiness.  Then again, I don’t feel like this person has any reason to care whether I’m there.

I feel terrible that I still see Sadie weekly and Brent monthly.  Even though I want to see them it feels like a failure that I need to. 

Nothing is actually wrong with my life at the moment.  I have no reason for feeling so lousy.  I am worried that if I don’t start feeling better fast I am going to end up screwing up the job that I finally enjoy.  I mean, I’m not enjoying it this week, because I’m not enjoying anything, but overall I’m glad to have the job.

Exactly 2 years ago today was my first inpatient admission.  I guess I should be grateful that I don’t need to be there now.  I feel horrible, but I’m not unsafe.

A Change in My Change in Perspective

In my last post, A Change in Perspective, I commented that a small part of me wanted to go hide in inpatient.  That has become a very large part of me.  The hypomania from Monday-Wednesday started to fade on Thursday.  I still had energy, but wasn’t bouncing off the walls, and I would almost say I felt normal.  Then I went to the final night of the haunted cornfield.

The past two years I was out in the cornfield scaring people, but last year the medication I was taking at the time made me very anxious about standing out there in the costume and mask and waiting all that time, never knowing when a group would come through.  This year I’m not on that medication anymore but still didn’t feel comfortable with the idea of being out in the cornfield so I worked in the shop, selling tickets and souvenirs.  I had a coworker in the shop, Roberta, who is sort of kind of dating the owner’s son.

Roberta and I had some disagreements on how things should be done, and I also shook my head in amazement at things she didn’t know about running a cash register.  In previous weeks I brushed these thoughts off, but on this final night everything was on my nerves.  I particularly got angry with her when she was judgmental about a complaint some customers had – that one of the actors had grabbed his daughter’s arm.  After they were gone she kept ranting about how stupid it was that they were complaining and I wanted to be brave enough to chew her out over it.  We told customers there would be no touching.  An accidental bump in the dark is one thing, but actually grabbing the customer is a big no-no and they had every right to be upset.  If that happened to me, I’d probably have an anxiety attack and have to be escorted out.

The really upsetting moment though was when a customer asked if we got paid to scare people.  Roberta said, “Donna’s an employee, but I’m a friend of the family.”  I thought I was a friend of the family.  Maybe I’m not.  Maybe that explains why I always feel so excluded, because I’m actually that employee who doesn’t catch on that she’s hanging around too much.  There was a party after the closing and I went inside for it, but wasn’t there 5 minutes before I slipped out to my car and drove off crying.  I felt out of place and in the way, and was way too fragile to be handling a big crowd.

I got home and mom was surprised to see me so early.  I told her I didn’t want to talk about it, but as we sat there on the couch the story gradually started spilling out.  I wanted to go out somewhere, which leaves three choices at that time of the night, and hinted to mom that she should go with me.  I thought she was planning to go but then she started watching House Hunters.  I curled up on my bed and cried, and thought maybe she’d go after the show ended.  Instead she headed to her bedroom.  I went in there and ended up saying that I guessed I’d go alone, and that’s when she said, “Oh, you wanted me to go?”

Mom got dressed and we went to Steak ‘n Shake.  I was trying to work up the nerve to talk to her about some serious topics, and finally managed to start blurting things out in the car.  In some order, I explained to her the mood shifts of the past few weeks and told her that I had e-mailed my therapist Friday saying that I was seriously considering inpatient.  I didn’t think I could hold out nearly a week to see Brent, and then longer to adjust to whatever medication change he might make.

Sadie knows I am trying my hardest to avoid inpatient, so the fact that I was considering going should have set off some alarm bells.  She gets off work early on Fridays but I thought I might get a quick response from her before she left the office.  When I didn’t, I started worrying that she had instead called the cops to come get me.  I spent the rest of the day looking over my shoulder for men in uniform.

Throughout yesterday and today I’ve tried repeatedly to hold conversations with mom about this subject, but everything I say gets a brief response that in no way furthers the conversation.  I began getting more depressed over that, and tried reaching out to some friends via text message.  Then mom went out for her choir rehearsal and I finally changed out of my pajamas and started driving to White Castle.  I’d been desperate to talk to someone and couldn’t bring myself to call the on-call therapist, but on my drive I had nearly decided to text Deputy Wayne and beg him to please call me.  Tell him I really needed help and was too scared to call anyone.

My best friend, who I had texted, called at that moment.  I couldn’t answer while driving, but called her back as soon as I arrived at White Castle, and ended up sitting in the parking lot talking to her for about 45 minutes.  For a while it felt really unhelpful, with the conversation focusing on something that seemed like the biggest concern but really wasn’t.  It did eventually shift to what was really upsetting me, and by the time we got done talking I felt better enough that I didn’t think I needed to talk to anyone else at this point.

However, I came to a conclusion, which she supported.  When I finally see Brent on Thursday, I am going to tell him that he has to change something, and that if he doesn’t I’ll be going to the ER and trying to check myself into inpatient.  He has to know how serious the situation is.

“Rumors”

I have never been quiet about my bipolar diagnosis.  My family members know, my friends know, my coworkers (even my supervisor) know.  The one area where I’ve kept it secret is with my employer’s HR department.  Until last week.

I do a combination of inventory control and quality assurance for a fulfillment center contracted by a major national brand.  I work 3-4 days per week, spending up to 12 hours per day at work.  This was all well and good when I was manic and had boundless energy (and needed virtually no sleep so I was able to do fun things in the evening), but once I sank into depression it became torture.  Actually, the job may have contributed to the depression.  My manic episode ended and I wasn’t exactly depressed, but due to a series of unfortunate events I spent weeks working in extreme pain.  Also, my blood pressure was ridiculously high, which was not helping my stress level.

At any rate, depression + long work days = bad.  Depression + long work days where I don’t know exactly how long they’ll be and what I’ll be doing that day = extra bad.  Depression plus long work days blahblahblah in which I sometimes have to spend all day on a task I loathe = unbearable.  It actually got to the point that my therapist wrote my supervisor a letter recommending that I not do that particular type of task.  I’ve done it much less since then, but recently it has been unavoidable.

Said therapist has highly encouraged me to find a new job, and by “encouraged” I mean “pressured to the point that I asked her to please stop”.  Then I ended up in an unscheduled appointment with her the following day to tell her she was right.  It’s been a few weeks since then, maybe about a month, and I have not made much progress in the job hunt.  I managed to write my first resume though, and baby steps are better than nothing.

Last week, the secret came out when I went to the HR department to see if they could suggest an alternate position in the company that may be more suited to my skill set and scheduling needs.  The HR rep I spoke with, who we’ll call “Kara”, came up with several possibilities.  None of them were ideal, but I made a very rational decision to apply for an available job at our other local warehouse.  The hours might actually be a bit worse in some ways, but it was the biggest change out of all the options and I figured if my life’s not working I should make a radical change.

A few days later my supervisor hunted me down where I was working (on that task that causes me so much emotional distress) and said Kara wanted to speak with me.  I figured it was news about the job I applied for, but then he escorted me all the way to HR.  I was anxious, but had no idea what was about to happen.  Kara took me to the conference room, shut the door, and sat much closer to me than she did last time I was there.  She told me that the job I applied for had been filled by someone else.  I relaxed a little.

Then she dropped the bombshell.  She said that she’d heard some rumors that may or may not be true about things I was doing at work.  I knew exactly what she meant, but was terrified I was about to be fired and pretended I didn’t know what she was talking about.  She said she wouldn’t pry if I wasn’t comfortable talking to her, and handed me a brochure for the Employee Assistance Program.

It took a few rounds of her saying she wasn’t sure if it was true, but it finally sunk in that I was not going to be fired and I admitted that it was true that I injure myself, sometimes while at work.  She said she wished she knew how to help.  She went over the possible job alternatives again, including a new suggestion for one that would be available in a few months.  She told me I could come talk to her anytime.

Of course that meant I couldn’t do it.  I have a tendency to drive people away somehow, and I knew without a shadow of a doubt that I couldn’t let that happen with her.  There was something on my mind that she might be able to help with, but I kept it to myself for days.  Then this happened:

arm-writing

It’s not as bad as it looks.  Last time I made such a list (on paper) it was much longer and I actually felt what I was writing.  Now I just feel blank.  Like maybe writing this would make me feel something.  Even if it was a bad feeling, it would be better than this inability to cry, to smile, to get angry.  It only made me feel a detached sort of worry that I would take the next step in trying to feel and do it in a way that would leave a scar.

I wasn’t feeling that impulse yet, but knowing that I could led me to finally go see Kara.  I told her that one of the techniques I had learned to avoid injuring myself was to put ice on my wrists, but the only place to do that at work is in the break room, where security will come yell at me and make me leave if I walk in there outside what they think should be my break time.

In reality, my particular department is so small that we are allowed to take our breaks whenever we feel like it, as long as we spend the appropriate amount of time on break.  Also, the idea of me spending a few extra minutes “on break” is a lot better than spending those same minutes in the bathroom, crying or hurting myself.

Kara’s response to the statement that security would yell at me was, “It’s none of their business.”  It may not be, but they’ve done it in the past and I told her as much.  So we now have an agreement that if I feel a need to go ice my wrists I will come see her and she will tell security I have permission to be in the break room.

So writing all over my arm led somewhere positive in the end, and although I was terrified by the idea of HR finding out about all this I’m starting to be thankful that someone spread those “rumors” in their direction.

What If No One Is Listening?

This was originally posted on December 30, 2013 as a Facebook note. I have made a few minor edits from the original to improve some wording, but there’s no change to the content.  It was with this post that I realized I might have a few things to say that others could benefit from reading, and so, after a bit of time to ponder potential content, this blog was born.

Image

The essence of this post has been on my mind for quite some time, but I keep hesitating about posting it. Because some people might be surprised. Because some people might make inaccurate assumptions. Because some people might recognize the anonymized versions of themselves and be offended. Or feel guilty. Or just generally hate that they are in the story even if nobody else will know it’s them. The thing is, this really needs to be said, and it’s more important than whatever probably irrational anxieties I have.

This summer, a television actor shot himself. It doesn’t matter which one, as this has happened many times before, will unfortunately happen many times again, and the reactions always seem to be the same: “But so many people loved him!”, “But nobody knew there was anything wrong!” My reaction to these reactions is always: “Maybe no one told him.”, “Maybe no one was listening.” Hard to believe with the famous actor? Okay, so fill it in with “a boy from my school” or “a woman I work with”. It might still be a little hard to believe, as you may be that person who admired the boy’s articulate answers in literature class, or always saw how chipper the woman was when she arrived at work in the morning. Did you compliment that boy? Did you ask that woman how she was doing and genuinely want an answer, not just “I’m great, and you?”?

Humans do not just get a hangnail and decide to kill themselves over it. Maybe that hangnail (real or metaphorical) happens, maybe it’s even the very last in a long string of things going wrong before the suicide actually takes place, but suicide happens when there’s simply no hope left at all. Do you realize how long it takes to completely lose hope? Do you realize what tiny acts can reignite it? Sometimes people have struggled with depression or other mental illnesses for years – decades even – before all the hope is gone. Sometimes, life circumstances simply are bad enough to create depression that wouldn’t otherwise exist. Either way, we’re all fighting to survive another day, and some of us are just losing the fight.

I do not remember life before depression. It sounds overly dramatic, but it’s the truth. I didn’t always have a word for it, but I can look back to at least middle school and see it with that amazing 20/20 hindsight. This is not to say that I’ve spent 20+ years doing nothing but wallowing in misery. This is true for all depressed people and probably a big reason that everyone says “I didn’t know there was anything wrong”. We’re very good at hiding the bad times. Get a little quieter, act like we’re too busy to socialize when really we’re hiding out in a blanket fort eating comfort food and crying inexplicably. Above all else, keep our lips zipped about the very shameful act of not being happy and grateful about every positive part of our lives, and not appreciating the life lessons in every negative part of our lives.

This past year has been one of the worst. I say “one of”, because I frankly have had so many really crappy years that it’s impossible to choose one. As these cycles always go, life was looking up. Nothing terribly bad or dramatic had happened in some time. I had plans for the future. I had great friends. There are generally 2 to 3 years of rebuilding and gaining hope that life might actually work out, then the next disaster hits. This is not to say that there’s no depression in that time…the depression is always there, hovering, making it take many times more effort to get through than it would for the average person, but at least I’ll be coping. Then suddenly everything starts to go wrong. Things will spiral until that teeny flame of hope is nearly extinguished.

This year began with my job finally starting to really suit me and be truly enjoyable. This year began with plans to move to a new city, with more opportunity to go out and explore, and near family that I do not see nearly often enough. This year began with a compliment that made me almost regret these plans to move. This year began with a truly close friendship that was actually with someone I got to see face-to-face on a regular basis. Things were downright rosy.

A few months into the year, the rosy outlook disintegrated. Plans to move were halted due to mom’s health. I lost the job, and the friend. The friend was actually my boss, and I’ve already heard the “you deserve it for becoming friends with your boss” judgement. Let me say that I fought against it for years, but we were eventually closer to equals than to boss/employee, despite my title and pay not reflecting that fact. She was the one who initiated the step into actual friendship. So while some may disapprove of my friendship choices, I must point out that “you made a stupid decision” is not a very helpful thing to say to someone who is clearly hurting.

As it turns out, losing the job and the friendship turned into losing basically all of the benefit of having worked there. I won’t deny that I’m still bitter. I won’t even deny that I still go in the bathroom of my current job on breaks and cry over the fact that I’m there instead of at the job I loved, despite the many aspects that made me grumble. Imagine spending 3 years of your life meeting people, building friendships and business relationships, gathering experience for your resume, and then having one person take it all away from you, like those 3 years never happened. Oh, except for the fact that you remember them and can’t stop going over and over it all in your head.

Now imagine that simultaneously you have to contend with a family member’s medical issues, and with removal of any hope for a major positive life change you’d been planning for well over a year. Sounds tough? Oh, and you’ve spent 2/3 of your life struggling with depression. Gee, it would be nice to go for coffee with a friend, or exchange some long e-mails to sort out some of your thoughts. What if no one is listening?

I had to tell myself every day for months to keep fighting, that this thing was not going to beat me, that I was not going to let an evil ex-friend ruin my life. Oh wait, I still loved her and didn’t think of her as evil. I had to keep putting myself out there, trying to contact people, arrange dinners, nag when I was being ignored. I think most people find that to be a lot of effort, even when they feel good. Well, it didn’t work. I am again not being overly dramatic. I sent e-mails, texts, and Facebook messages to dozens of people, giving them plenty of time to respond before sending followup messages. By plenty of time, I mean up to 2 weeks despite seeing that they were online daily. The vast majority of people have never responded, even though it has been 6+ months. Some I gave up on, some I continued to contact occasionally and still get no response. 

I sent postcards from vacation. I sent Christmas cards. I don’t expect people who otherwise don’t send cards to suddenly do so in response, but a quick “Hey, thanks for the card! How have you been?” on Facebook would be nice. I tried to make plans with people who repeatedly cancelled. I tried to make plans with people who were really busy, and didn’t seem to understand that seeing them for 15 minutes in a place convenient for them would be enough. I called someone I haven’t seen in years, but who I’ve always thought I could someday contact if I really needed to talk. He didn’t call back.

People, if this is not a hope-extinguisher, I cannot tell you what is. It’s one thing to contact a friend and have them not respond for several days. It’s one thing to have plans cancelled once because something urgent came up. If you’ve never had this happen dozens and dozens of times over several months, I’m sure you probably don’t understand how completely isolated, rejected, and unloved you would feel. If it happens enough, even the responses you do get stop helping, because you second-guess whether those people actually wanted to contact you. If so many people didn’t, you’re probably just that unlovable and the responses you get are out of pity. Eventually, you’re not going to bother reaching out at all, because it hurts less than the inevitable silence.

Obviously, I’m still here. I’m not going to be one of those aforementioned suicides, mainly because I’m too stubborn to die. But I’m still hurting a lot, and most of it is about things I have not discussed with a single other person, because there was no one to discuss them with. Please, if someone is reaching out to you, answer. If you get busy and it takes a week, start with “I’m sorry I was busy”. If you don’t know what to say, stop worrying about it being the perfect response and just respond. The content truly doesn’t matter. If a friend wants to make plans and all you have is the 15 minutes you’re on break at work, see if she can meet you there. Or if you need to run errands, maybe she could keep you company while you do it. If you have been admiring someone, for whatever reason, pay him a compliment. No, you can’t magically erase someone’s problems or cure depression, but the fact that you cared may very well keep that person alive just one more day, and that one more day may be the difference between getting help and losing the battle.