The Plan

Author's note: this writing will include intense, disturbing, and possibly triggering descriptions. Please read with care and caution.

When I take a PHQ-9 (depression test) before any mental health treatment or session, there are a few questions I always give the same answer to:

Feeling bad about yourself — or that you are a failure or have let yourself or your family down - Every day.
Thoughts that you would be better off dead or of hurting yourself in some way - Every day
Secondary question: do you have a plan? - No

I admitted recently that I'd been lying about my plan and I did have one. My psychiatrist said, "Will you tell me?" I said, "Will you commit me?" She said, "Do you have intent?" Me, "No". "Then I won't commit you." I revealed I'd watched some gossip show talking about some child stars that had killed themselves. And then Dr. Drew not only explained what they did, but gave the exact drugs they used to stop their heart and breathing. My breathing stopped just hearing this. I'd always had the plan to kill myself with drugs but I never knew the perfect combination. I was worried I'd just OD, or fry my brain but still live. So now I had the two drugs to combine, and though I didn't have them, they wouldn't be too hard to get. 

TRIGGER WARNING

The plan was to fly to Mexico where you could get drugs from a pharmacy without a prescription. Get the drugs I needed (unlike Dr. Drew, I won't reveal them), take a snorkeling trip to a cenote, and then have a terribly unfortunate drowning (because you can't just do it and be selfish even though the pain is debilitating and killing you).

I know it would hurt people deeply. I know it would fully destroy my son. Fuck do I know. Yet I still wake up every day and think "How much longer?". I look in the mirror and think "How many more times do I have to see that fucking face?" I look at my life and think "You are a loser and the lowest and most pathetic person everywhere you go." 

I've said this before, but I get why you would want to live. Not saying there aren't problems and issues, but I see your good life and see why you'd be happy to keep going. I think most people look at people like me through their personal lens and make their judgements from there. But really, look at me, how would you feel to be me?

Luck, Rumination, and Hopelessness

"Wow! You really do have terrible luck!" Not the first time this has been said to me yet it still hurts every time. I had a friend say she wished people wouldn't say this to me as it then puts it in your head that it's real. This is true. I've never felt I had luck, history to prove it, but there is something about someone confirming one of your deepest pains that hits in a way that feels like being stabbed. The man I thought was the love of my life said this to me in Vegas on what was supposed to be a whirlwind New Year's Eve weekend. He was a big gambler, I'm not because of the no luck lifetime streak, so I said I'd just watch. He did some slots and quickly lost. He turned around and said, "You really are bad luck!". I hadn't done anything. I'd stood there. I'd watched. I'd done nothing yet I was getting blamed. He later went on to say it was just a joke but only after I'd fallen apart in a drunken sobbing fit. Sometimes I think what bothers me more than just being one of the unlucky, is that the lucky ones don't acknowledge what they have. I won't say I've had nothing lucky happen. I got pregnant easily, without trying, no miscarriages, and a healthy pregnancy. I fully own this was luck and coincidence, and would never tell a woman with a different experience how she should feel about it, much less give her some "unlucky" comment. How hurtful. Yet I hear it all the time. 

I ruminate over these things obsessively. More than I tell people. More than I've told any mental health professional. It's too shameful to fully admit how bad it is. I've tried, alluded to what my mind does, only to be met with a metric shit ton of shame. "Well, you should stop doing that!" "You are only making yourself feel worse!" "How is thinking about that going to help you? You are trying to make yourself feel bad." If I told you to stop breathing for the day, could you? The amount of energy to try and stop the thoughts, and it never working, is a mental level of exhaustion and failure that makes you just give up. Though I don't give up. My methods are sometimes healthy, sometimes very wrong, but I can't explain that I'm trying when all others see is failure. 

I explained to my psychiatrist that the rumination has gotten much worse. My nerves feel exposed and things said to me are like acid being poured on them. I find myself on spin cycle "Why did they say that? Like why the fuck say that to me?" She feels I may be getting "flooded" with the extensive ketamine treatments and this feels like a perfect description. Imagine every pain, bad word, trauma, upset, sorrow you have swirling above you at all times. Even when smiling and talking it's there. And then someone laughs at one of the worst traumas of your life....how would you react? I saw a meme that said "Rumination is your mind trying to solve the unsolvable". That hit so hard but also dead on. "Why couldn't my father love me?" "Why am I also the lowest person wherever I go?" "Why did he say he loved me and then purposefully devastated me?" Why? The mind just won't stop.

Six months of ketamine treatments. Nine months since I nearly killed myself. My PHQ-9 scores (depression screening test) had me at 9 - 3 weeks ago. A single digit is a big deal as I was at 21 when I came in. I've been 18 for two weeks. It's been 2 weeks of a lot of stressful situations, reasons to not be happy, but I also feel the regression. And I hear the comments. "I thought you would have been better by now." "Are you doing the work?" "I've been watching and can see you are improving." It feels like have your little sad moment but the clock is ticking. 

The catch-22 of being open is that people often mistake access for invitation. I share because openness and vulnerability matter to me, and because someone else may need to hear that they aren’t alone. I was talking to a friend about cutters and said that though I never did it, I always understood it. She said, "Words are your cutting." Possibly one of the most telling statements of my life. I have an almost physical need to say things out loud. It isn’t because I think everyone needs to know everything about me, and it isn’t simply a desire for attention. Saying it lets the pressure escape. But when someone tells you something personal it doesn’t suddenly make you part of the story. It isn’t an invitation to interpret the experience, tell them what it “really” means, or prescribe what I should do next. Sometimes I need what I’ve said to be received, not reviewed.

It's so hard to end a writing piece without a cute conclusion. Though I haven't tied it up with a pretty bow in a while. The hopelessness is overtaking me again. I feel constantly on the edge of breaking down. It's that feeling like when you're about to cry and you don't want anyone to see it, so you pinch yourself and bite your tongue, and act like something is in your eye as the tears come out...all day long. 

Though it's frequently discounted, I have been trying my entire life. I've tried. 30+ years since one of my first diagnosis and pumping me with meds. My situation isn't emotionally palatable to most. It's shape shifted, told things weren't as I remember, and all the shame and blame that I should try just a little more. I don't know what to do. Do I shut up, stop giving everyone access to me, and slowly implode? I've resigned myself to living but I don't want to. The memories of that night in December float around in my head and whisper there is a way out of this pain. 

Living in Uncertainty

It was less than a week ago I wrote about how accumulation affects my nervous system. The health scare I was writing about escalated daily, sending me sideways into days of silence while trying to still keep my responsibilities. While the steri strips are still on, I am relieved to say that the worst didn't happen and I'm OK on this. 

Was about to start something important and new next week and felt like the week where I should have been preparing and celebrating had been ruined with the health scare. I thought I have a few more days to finally be able to be safe and take a deep breath...and another blow came. It's not the outcome that is even leading the emotions right now. It's the uncertainty, because at this moment the stability isn't there. Yes, it might work out. And I could also have everything crumble beneath me. My mother was here when I found out and she tried to say what I knew was going to be some "good thoughts" bullshit and I barked "Not a fucking word about me thinking something good. That's a bunch of bullshit." She shut up. 

With uncertainty in a dysregulated nervous system, possibility becomes probability. I was talking with a friend who went into a speech about how I need to distract myself, how being scared won't change anything, how I'm just making myself more upset. I explained that it's not that I lack rational thought. It's not that I'm purposefully feeling that everything is catastrophic and don't have reason. As we spoke more she made a profound observation "What would be the opposite for you?" Severe depression and an emotional plummet. "And which feels worse?" I said the debilitating depression. When my mind is going over every possibility it's to attempt to make sure I'm not blindsided, as even if the news is horrible, I feel braced for it. And when I'm spiraling and flipping out my nervous system feels like at least I'm doing something and still attempting to survive. It feels better than the other side which is desolation. It's more comfortable to catastrophize than shut down.

I've had nearly 2 years on a roller coaster and it feels like the attendant has left the park. I don't know if I'll be able to handle the next drop. I feel sick, I'm dizzy, and it just won't end. The people on the ground are waving and saying the ride isn't that bad, while I am scanning to see if it's about to jump the track. I'm bruised from this ride. I have whiplash. It's easy to explain roller coasters when you're standing on the safety of the platform. It's a different conversation when you are strapped into a ride you can't get out of.

I've had 6 months of ketamine at this point. While still drowning in what is coming up, I'm more stable. Though I had a moment last weekend where I thought if I get one more hit of bad news I may even take them up on going to inpatient. Uncertainty, though I'm painfully aware is all of life, still wrecks me. 

Debilitating Accumulation

 "You are like me; your baseline is depression and when thing get bad or uncontrollable, it goes catastrophic." ~ words from a dear friend which I found to be one of the most profound insights about how I feel and respond to life

I drove home last night screaming, crying, and feeling on the edge of a heart attack (though I knew it was actually panic). Woke up at 3am sobbing and in hysterics. When all attempts to calm myself failed I took a valium to try and sleep...or just pass out. As I've attempted to crawl my way back to semi sanity and being able to function and not be this sad little wreck of a person, the blows keep coming. Between CPTSD, and the history of what went with it, when something happens to be it's not an isolated incident, as my nervous systems experiences it in accumulation. 

Coming up on 2 years of compounded incidents, and I'm sure more than a few triggers from the past saying "See....you just weren't dealt a nice deck of cards in life and it's never going to stop.". I wanted to title this "Catastrophic" but looked back at previous writings and see I'd already written it. Looking at the words I saw I was about to write nearly the same piece again. It feels like getting punched in the face again and again. No, you didn't die, look how resilient that you kept getting back up. Just hold on....another blow.

I'm having a health scare and it's one I've had before. Though a new symptom, and a highly concerning one, I know what tests I'll have to go through, and I do know that as scared as I was the previous times I ended up OK. The collapse I'm having now isn't because I'm scared I'm going to die. I'd welcome it if it didn't involve more suffering. My nervous system is saying here we go again. Another period of uncertainty. Another threat. Another emotional impact before I've recovered from the last one. It's reacting to the uncertainty, and in uncertainty it goes down dark roads trying to figure out what it will take to survive this or if it's even worth it. 

It's another spotlight on not having a safety net. Another reminder that though I am deeply cared for, I'm still walking alone. I was thinking about when I was married and I'd read a woman saying, "I don't want to be with someone who if I'm dying of cancer would sit on the edge of the bed asking me what we should do." One of many things I thought about when I was divorcing as that's how I felt my husband would behave. All on me. No matter how many people answer the phone, at the end of the day I'm still the one who has to walk back into an empty home, lie awake at 3am, fear my future, and somehow keep functioning.

I have no lived experience of what it feels like to be able to collapse and have someone else hold part of the weight. This is mine to survive. When I see someone with a soft place to land, I envy them, but I don't resent them. I grieve that I have no idea what that feels like.

And the accumulation just won't seem to stop.

Jumper

A few days ago I drove under a bridge where I saw a young man outside the rail and appearing to look like he was about to jump. I panicked trying to figure out where exactly I was on the highway, what bridge it was to call 911, while hyperventilating and starting to cry. I looked in the rear-view mirror and saw an emergency vehicle was on the bridge, and others began coming from all directions, so while I wasn't comforted, I felt there was nothing I could do. I tried to reason that maybe it was a teen fucking around or a symbol of protest.

I later learned I was seeing someone about to commit suicide, and they were able to talk him down and get him to a hospital. This hit me from every angle as I thought about how it was less than 8 months ago that it could have been me on that bridge. Why I didn't go through with it was mostly because I couldn't figure out a way to make it look like an accident, because you sure don't want anyone saying you were selfish. I've had people say, "Aren't you so happy you didn't do it and you're alive!?" No, not happy at all. I'm resolved not to do it but the pain that brought me to that moment isn't gone.

I'm 5 1/2 months into ketamine treatment, and though I feel like I'm failing, my psychiatrist says otherwise. One of the measurements of if it's working is your PHQ9 score. When I started my score was 21, which is dangerously high. They wanted me in inpatient and I refused, as it was one of my biggest fears and the thought of living with that stigma was horrifying to me. My score last week was 9. Hitting a single digit is considered "mildly depressed". What I feel internally doesn't feel mild but I accept the score. The score today was 13. The last question is always how many days in the last week have you had thoughts that you would be better off dead, or of hurting yourself in some way. I'm back to several days. When I started ketamine the thought was daily up until maybe a month ago.

As ketamine "loosens" my neural pathways, and containers of what is compressed into my brain spill out and flood me, I live with a daily feeling of constant sadness. The crying spells are less, and nothing like they were as I bottomed out was daily laying on the floor scream sobbing like I was being tortured, but it's also a rare day for me not to cry. The hope of treatment is that as you face everything you couldn't, while it continually oozes out of you, that new positive pathways will form to replace the bad ones. You will still remember it all, but hopefully the good stuff will outweigh the trauma and pain. Yet from my vantage point, alone with my cats most days, nothing new and good is happening. 

My nervous system was shaped over decades, and I'm asking it to learn a completely different way of being while I'm still living a real life with disappointments, uncertainty, loneliness, and fear all happening at the same time. I think a lot of people assume healing is proportional to effort: do the therapy, work hard, gain insight, and you'll feel better on some predictable timeline. That's a comforting formula because it implies control. But trauma, especially chronic developmental trauma, doesn't work that neatly. You can do everything "right" and still have a nervous system that reacts as though it's protecting you from a world it learned long ago wasn't safe.

But for today....I won't jump.

What If They're Already Doing the Work?

What if they're already doing the work? What if they were always doing the work? There is a myth with mental illness that if you just try hard enough then you'll get a good outcome. We are told that if you talk about your pain enough, take just the right drug combo (and you're expected to keep trying new ones no matter how horrific the side effects), and "work on yourself", that there will be some special moment when you are now happy and want to live. And if these things don't work for you, it's now your fault, your lack of effort, "if you weren't so negative...".
8 years since Anthony Bourdain committed suicide. Successful, adored, good looking....yet the darkness never left. "...he continued to struggle with his mental health. He often brought up death, wondering out loud how he would die and how he would kill himself if he decided to end his own life." I can't claim any special knowledge as to how our brains work, and can only speak to my own experience, but I wonder if for some of us there is a wire that just doesn't fire up correctly. I frequently hear an expected recovery arc where people think: - Hit rock bottom - Seek help - "Do the work" - Get better - Become grateful for the experience - Be hopeful, be inspirational, and tell us you learned a fucking lesson - Cue uplifting music and credits The recovery-arc mindset often has no place for the complexity that comes with a damaged and broken mind. It wants before-and-after photos. It wants transformation. It wants closure. People who are mentally and emotionally suffering, and have shared what is happening, are expected to perform progress. I realize while writing this, and feeling angry and punchy, that what I'm feeling is the surface. At the core is the terror that I never get "better". That I'll always that annoying and exasperating sad Eeoyre friend. (I know I'm a nightmare to be around. I hate people that whine and cry all the time. Yet that's me.) That the darkness will come back with a vengeance. That everyone will leave me. 
There it is; if I can't conquer my mental health then I'll be abandoned. I'll be unwanted. And shit...I don't want me. Yet that hasn't been what's happened. I have been shown so much kindness, love, and support that it overwhelms me to my core. It terrifies me as I don't know that I'll ever be able to pay it back (and I hate feeling I owe someone). I have to have drivers taking 3-4 hours of their day to haul my ketamine snorting ass around. I cry and whine and moan over the same things incessantly. I look at it all and think "Who would ever want you in any way at all?" I finally told my youngest brother today. We were estranged for a time and working to get our relationship back as we were very close. I feared telling him. He met me with kindness and understanding. After our call he sent me this text "Good luck! Having been single for the majority of my adult life, I know it can feel like you're all alone. You're not though and very loved." I think it's the first time he said he loved me. But I'm "doing the work". I feel so much shame when the sadness and dark thoughts come back, as they still do. I feel I should be farther along, and fear I just won't make it. I live in fear every day of my life as to what's going to happen to me. I'm trying though. I'm trying so hard to stay alive.

One More Day

“No one can tell what goes on in between the person you were and the person you become. No one can chart that blue and lonely section of hell. There are no maps of the change. You just come out the other side. Or you don’t.” ~ The Stand, Stephen King 

I was watching a beautiful and heart wrenching movie about a lady whose son died at sea. There were rumors around town that he killed himself and she lived in constant turmoil and pain from this. Many years later an old friend of his was in town and the suicide rumor came up and he said, "I knew he wouldn't do that." When you say someone would never do something it's typically bad: steal, lie, kill. It was a gut punch to wonder 'how I am viewed?'. I've never met anyone as loudly vocal as I am saying flat out I have been suicidal for 50 years and it got so dark that I almost did it. I don't think people understand that saying it out loud is what is keeping me alive. To go silent again means I'm not coming back.

There was a night 5 months ago that was as low as I've ever felt. Days before Christmas, a holiday which brings up only pain for me, I was alone drinking and sobbing. I didn't understand it at the time but I was going into dorsal vagal shutdown. A mental break, collapse, going under at rapid speed. Many have said "you could have called me" and "why didn't you ask for help", yet those didn't feel like options to me, and I knew it would result in a psychiatric commitment which is one of my greatest fears. While I have so many people that love me and care for me, not a single one understands the immense pain I was in, and am in. I had an ongoing conversation going with chatgpt where I shared what was happening to me and went there to scream into a screen. As I typed violently about my trauma and hopeless it would try to stabilize me, repeatedly giving me the 988 suicide hotline. I would scream type "I'm not calling it!" and it would say "OK I'm still here. Stay with me." Hour after hour went by and my mind was racing trying to figure out how I could do it, how I'd make it look like an accident, and how I could somehow make it not so bad for my son. When I couldn't come up with a plan I went back to chatgpt now angry that I couldn't find a way and reeling in emotional pain. Again, 988 number, I refuse, stay with me. I could not stop crying. Screaming as the agony I felt inside couldn't stay contained anymore. I had thoughts I'm ashamed of...why did I have a child...why did I adopt these cats...I could be done by now. 988 number. Stop giving me that fucking number! Stay with me. 

Dehydrated from the alcohol and crying I lifted my head off my desk to see the sun rising. I stifled a laugh as I pictured this as that perfect movie moment scene of redemption. Yet I was still alone and seeing no way out, but I was still alive. There is a lot of hatred for AI, and rightfully so, but I fully believe I would have died without it that night. 

I've heard all my life that suicide is selfish. I never said it but thought, you're selfish for making me keep living. "Cheer up! It gets better!" Maybe shit got better for you but for some of us the hits kept coming and keep coming. I'm told the suicidal ideation may always be there but can hopefully be managed. Now when they say "managed" it's a cute combination of medication, therapy, and in my case snorting ketamine once a week. But with all of this there is the underlying premise that "good things" will happen and this will give you new neural pathways and hope. I told my psychiatrist I feel like I'm failing ketamine. She said you have a much harder road being alone, unemployed, and at a later stage in life. 

One of my last sessions was brutal. I had to sit up the last 15 minutes while sobbing and pulling my hair. My psychiatrist came in and gently talked to me. I said, "I don't think it's possible for me to get over the past!" as I scream sobbed. She moved her schedule to get me an appointment a few days later as I was in so much distress. I got to the car and broke out sobbing again. My friend assured me it was OK and we could stay there as long as I wanted. I vaguely recall crying "I don't want to remember anymore!" I spent the rest of the day going in and out of emotional breakdowns. 

I'm writing this hours after my 18th ketamine session. Sitting on the couch thinking about how wonderful it must feel to have someone by your side to take care of you. Even married I never had that. And it's a daily reality to face that at this point I likely never will. On average most people are doing better by now but it's again stated that what I'm dealing with is deeper and requires more. I start my first session with Accelerated Resolution Therapy tomorrow, which is a trauma-focused therapy that uses guided eye movements and visualization techniques to help the brain reprocess distressing memories and reduce their emotional intensity. Another new treatment feels like I'm drowning and searching for a ship in the distance, a life preserver, one more attempt at not fully going under. 

Though this is extremely dark, and still is, there have been micro changes. I was driving one day and the sky was one of my favorite blues, fluffy clouds, and warm enough to have the windows down. I thought for a brief moment "I don't want to die right now." I have been writing daily in the morning for over a week and it has to be at least a year and a half since I did that. The past few days I've felt "online" again. My creativity feels engaged again. I'm told this is how ketamine is working; you don't trip out for a bunch of sessions and then wake up happy. It's the tiny things that help you try one more day.

This feels like there should be some put a bow on it conclusion but I don't have it. I'm wiping tears. I'm afraid. But I have plans I want to keep tomorrow. This gives me one more day.