a Scarlet D

My mental health journey

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  • WordPress Help?

    I’m using WordPress for this site, and it’s served me fairly well. Unfortunately, it’s not organized well. There is the list of all posts but that’s just title vomit, and not much help for finding things. I *thought* I had been helping people by telling them to use the search function in the upper right corner. Turns out that was only on my interface as the site owner. So sorry!

    I know jetpack has some sort of search, but even a simple sitemap by date of post would be cool. So the question I ask of you: How do I add a search or a page with some sort of consumable index?

    I used to be the person people would ask these questions of, but I just spent a few hours trying to do any of the above with nowhere near anything that could be called luck. Unfortunately, what I thought might be an interesting and productive diversion has reminded me of my greatest anxiety: intellectual ability to return to work.

  • How do you survive a suicide?

    (Sorry if you saw my posts from the past two days or so, while an interesting example of someone losing their mind, they had some spelling errors. And coherency issues.)

    A couple days ago was a milestone reminder (want to stop saying anniversary) and I invited Drunk Robert back to my place and the rest is mostly gone, somewhat of a blur. I ended up in the hospital, spent a day there and they discharged me. I’ll admit it was a suicide attempt, and I started it by drinking, knowing my drunk self would try and kill me, though this one feels different.

    I have attempted four times now. The others were either well planned out, or spur of the moment things. Afterward I felt foolish or stupid (always disappointed in the outcome) or more depressed. But they were mine, and my responsibility. This one was too, but now, afterward, I feel all of that but also like it was something that happened to me. I guess because of the lost time/blackout.

    What I do remember over the 11 hours or so is screaming, crying, feeling out of control. I bought the alcohol myself. I called 911 myself. Between those two events is missing. I have bruises, carpet burns, cuts and abrasions, as well as bite marks. My favorite flower vase is destroyed, a drawer under my bed is broken, and part of a door jam was broken. The couch was moved to one end of the room, and I fully expect to find things missing or moved or broken in the days to come. I have no idea how there wasn’t a noise complaint, because none of that looks quiet. Honestly I’m surprised the balcony doors weren’t open, for obvious reasons.

    So now I’m past that. I’ll be dealing with it for a while. I’m confused and disappointed both in myself and in Drunk Robert (to some extent.). But honestly I don’t know what’s next. They keep letting my leave the hospital, or program, or my treatments. When is it no longer safe for me to be alone? Ever?

    I’m feeling much more safe now. I’m at the cabin ad I’m not alone, and having someone around helps. It doesn’t hurt to see a beautiful lake. I’m sore, which will pass. My wounds will heal. One of the bite marks is down to just an ugly bruise. I feel like this is all a massive setback for me. One of the clinical notes said that my current Day Program thinks I need a higher level of care. There’s only so far up the program ladder we can go though.

    I will have to do a lot of work with my therapist. She’s a saint, but I promised her I would call if I was going to do anything, and I didn’t. And if I were her I would be losing patience. I will meet with the rest of my care team and have to explain it all again and again.

    I know the subject is how to survive a suicide, not a suicide attempt. It feels like the correct way to put it, somehow. Like I didn’t just try it, I got partially through it. I’m so banged up, and it was such a violent experience. As I said before, it happened to me. Honestly I didn’t think I had it in me to beat me so violently, and that’s the scary part.

    That’s all. No long set of posts describing my hospitalization or memories of other events. I feel like I can leave those be this time.

  • How does it feel?

    This morning I’m really feeling it, and want to write about it.

    Waking up was hard as usual, getting out of bed took a few tries but eventually I slipped into the morning routine. Start coffee, lay out shower stuff, have OJ, grab coffee, start shower, etc. While I was in the shower the depression was a bit overwhelming, but I got through the routine okay. Go to the car, drive out to the suburbs. Sat in my car in the parking lot for a while, just trying to gather the energy? Motivation?

    It’s a drowsy feeling, no matter how awake you are. It feels like being pulled down by your chest, but there’s also usually the anxiety in the pit of my stomach. Shoulders pulled down, and I find myself looking down when I’m walking. Everything is like a thick fog you have to push through, hard to walk, hard to interact with people. Somehow even hard to just sit. And no patience for anyone.

    Sometimes it’s like drowning, but when someone makes you laugh you bob to the surface for a moment to breathe. But you’re always going to drop back down into the water. I had my usual TMS session and was relieved to see my favorite tech would be running it. It just felt difficult to get in the chair, and once it started I had the familiar feeling of intensified depression when the mallets were hitting me. The tech, as always, engaged me in nice conversation, talking about the State Fair, or proper condiments for hot dogs.

    I laughed, I smiled, I enjoyed our conversation. But so much of the time I felt like I was going to start crying. The overwhelm was so strong, and the depression so intense this morning that it all just worked against me. On one hand I’m glad I didn’t start sobbing in front of the tech, but on the other hand I think it would have felt like some kind of relief. In the end I was left with this heavy, thick, sad fog to push through whether I like it or not.

    So how was your morning?

  • Boring Entry

    The fact that I don’t tag these well makes this a lamely titled entry.

    It’s been a minute since I posted, and honestly it’s just the same old same old. I think I got a 26 on the PDQ-9, which ties a personal best. TMS hurts my head and my soul. Seriously it’s like tiny metal mallets, but when it’s firing it feels like the depression core of my brain is being poked with a sadness stick. Day Program is good, especially group. Haven’t had to convince anyone I was safe lately.

    The next stuff is truly horrible. The only redeeming thing I can say about it is that at least it isn’t poetry. You’re good to go just stopping here.

    Random quotes from the notebook of an angsty middle schooler:

    Better to sleep than to die – my Therapist

    I can’t seem to reconcile having bright days or hours with my depression. Nor can I comfortably accept a possible trend toward the light. Who am I if not my depression?

    Depression is so much easier in the winter because there’s less sunlight. [to wake you up]

    When I’m happy I feel as though I’m disrespecting my depression

    Stimulants feel like a scaffolding on an old, rotten church.

    Sauerkraut is just kimchi for midwesterners

    Isn’t it strange that we don’t know what’s after this? Not a single credible explanation. We’re all just over here on one side of the wall without a clue. What if there is no other side of the wall?

    I threw my pedigree at the facilitator and talked about a reason to live or a reason to die. He had no clear response.

    I am too lazy to get better, or just want to get worse until I die?

    I went for a walk yesterday, saw a bunch of pretty wildflowers, but didn’t find any more hemlock. But hey, it’s exercise!

  • TMS, week two

    Second week in on anything is usually not very newsworthy. I think this is worthy of a post. Also, I’m eating an eclair at one of my favorite shops and need to kill some time.

    The weekend was bad. I stayed in bed for most of it, just trying to escape. I remember a strong impulse to call someone to talk, but knew it would just be complaining, and it wouldn’t help. I was so low on energy that my suicidal ideation was super safe. But I didn’t want to feel like this anymore. At all, forever.

    Saturday was bad enough that I started worrying about Sunday’s concert. I’m known for having concert tickets during a funk and completely blowing the show off. I love love love Wang Chung and some of their soundtrack work. Had tickets, pretty good tickets at that. Never went. Too hard, mentally and thus physically.

    Told my best friend about my concern and he ordered me to drag myself to it. So I did. Nine Inch Nails are super important to me (see previous post about music) and I did enjoy it, though it was a little overwhelming to hear some of the more impactful songs live. It. was an assault of emotion, but reaally in a good way.

    Monday morning. I’m told right away that the monday after the first week can be tough. Also, we were turning up the intensity. And it hurt. It was clamping my jaw shut when it fired, and I could feel my hand twitch. But I sucked it up and made it through. Got a little headache, all done.

    Today (Tuesday) was a different story. I went in with a 24/27 on the PHQ-9 (scored as Severe Depression) and was just flat. Settled into the machine, got my earplugs halfway in as intended, and got myself into the Magnet beams deep into the brain. The little hammers were really hitting me hard. I’m still not ready to back it down to the previous intensity.

    It was the chatty tech that I have decided is my favorite one, but I just wasn’t in the mood. I had no headphones so conversation was the way of the day. We talked about the State Fair, which I love. But when the device fired, I clammed up. Not just from the automated jaw clench, but an overwhelming sad mood. It was like being pushed into something stronger than I already had, but only for the time it was firing. Doing that 54 times did not help my disposition, and I’m carrying a headache as a souvenir.

    Off to Day program, we’ll see if I feel any better after that. Luckily, a blank afternoon after.

  • Soundtrack to an Episode

    I’ve always been deeply connected to music. Happy, sad, doesn’t matter. Something is playing. Depressive episodes are no exception. While I tend to play music until I’m sick of it, it goes doubly so for depression. I guess instead of getting sick of it, it tunnels it’s way into me, and the more I play it the more it resonates. Like a coil buried deep inside me that hums when I play the music. Each episode, for the most part, has it’s own album. Something I play and play and it makes me feel something or nothing. If it’s depressing music, it lets me hold onto my sadness. If it’s angry, it lets me yell along with it in the car. You get the concept.

    1983-1987
    This Mortal Coil
    It'll End In Tears

    High school is tough for anyone, all those hormones and social situations. While my first depression experiences were in middle school, it wasn’t until high school that I felt the real sting. Being into music – the more obscure the better – I had friends who knew more than I did, and would offer suggestions. At one point I traded a low-end CD player for this CD and Joy Division’s “Closer.” A real double whammy. I didn’t like it as much as “Unknown Pleasures” so I focused on This Mortal Coil. While I appreciated the mood, I didn’t really understand the significance of the source of the music (Big Star) or the artists in the “group.” Performed by mostly artists from the 4AD label – also known for their downtempo content.

    I would lay on my bed and listen and put visuals to the soundscapes, listen to the impassioned singing, and disappear for 44 minutes.

    2006
    The Dresden Dolls
    The Dresden Dolls

    Work was a nightmare. I would go in at 9 or 10, then work until 6. I would go home and have dinner with the family (wife, 2 kids aged 3 and 6) and turn right around and go back to work around 8pm. I would work until 2 or 3, and go home. Every day. Weekdays. Weekends. This went on for what seems like years, but it was probably only one or two. It took it’s toll.

    Wife and I got matching shrinks. Psychiatrist for the meds, psychologist for the happy talk. I had been on only one med so far, and this was the introduction to experimenting with different options. My first med was in 2001, but I can’t think of an album for that time. I remember it was pretty quiet, but very loud. Baby with legendary colic and unemployment, not to mention 9/11.

    The Psychologist started by calling me out on my suicidal ideation. At the end of the first session she pushed me pretty hard on it, and at the beginning of the second I asked about it. She said some people just needed to do what they had to do. I mean, she’s not wrong, but it didn’t feel like the right thing a mental health professional should be saying..

    I would drive back to work (where else?) from my appointments, screaming along to Amanda Palmer’s super triggering lyrics. I was almost happy doing that.

    2019
    Nine Inch Nails
    Hesitation Marks

    Another big gap, but we’re skipping ahead a could of episodes here. This was the beginning of the end, taking a leave from the job I loved and loved me. My introduction to ECT, TMS, and a whole host of meds that didn’t work.

    I’ve been a fan of Nine Inch Nails from their first album, which actually holds up quite well 30 years later. But there was something in Hesitation Marks that caught me and held on. At some point one of the streaming services reported that I was in the top .02% of Nine Inch Nails listeners. I think it was for one specific date and there were probably other qualifiers, but I found it amusing.

    Again, loud in the car.

    The 2019 episode lasted for 4 long years. Three suicide attempts, more ECT, a spell in the actual hospital with no sharp objects. But by 2024 things were looking better.. for..

    2024
    Lady Gaga
    Mayhem

    .. about 5 minutes. Back in the dumpster. More Ketamine, more meds, another PHP, another Day Program, and now another TMS. My care team was pretty closely aligned, they all independantly told me to go PHP. So I took another leave from another job and went back into the game. I would get gentle suggestions from time to time that maybe I should consider a higher level of care, like inpatient. That long sentence is a suggestion. Later I would get sharper suggestions with a tone that indicated I was going to have to talk them out of it if I wanted to leave the room free. And that’s where I am now. My happy moments are when I’m flying along the freeway with the top down and Lady Gaga turned all the way up, I may or may not be singing along. (I am)

  • TMS, the second attempt

    Quick catch up:

    • Things seem about the same
    • My therapist accused me of seeming better
    • I don’t like good news
    • Still not eating much
    • About to run out of movies to watch

    TMS. Transcranial Magnetic Stimulation. It’s classified in the “we don’t know how it works, but sometimes it does..” therapy line, but this time I’m doing it at the Treatment Resistant Depression clinic, and they have more scientists than the last place, and it feels much more like something they may actually understand.

    Side track: After I was referred and confirmed for the TMS series, I got a call from a guy at the University. No idea why I picked up the call, but it was a good thing. He was from my psychiatrists lab, and they were running a study on the efficacy of TMS. Just single appointments before, during, and after. So Tuesday (apparently that’s only two days ago. Who knew) I went to the U and met Mr Study. (not his real name) and got to see my doc’s lab. I was expecting a huge, bright and white well lit lab with vials and people in lab coats and protective goggled. I don’t know why, maybe my brain just inserted that idea based on TV shows.

    What I got was a room about the size of two or three cubicles, with all sorts of computers and interesting looking displays. Wires criss-crossing the place. It reminded me of the student lab in Ghostbusters. It was just piled high with technology and a desk or two, but it was organized somehow. My station was a monitor, mouse, and keypad with 6 buttons on it. I was fitted with what looked like a bicycle helmet, with the addition of all sorts of electrodes poking my head. A couple sticker leads, two behind my ears and two on my chest.

    The study itself was a series if on screen exercises. The first was a display of three things. A house, A person, and a vehicle. You choose one and it tells you if you won a token. If you did, there was a possible likelihood of yielding a token the next time. Or not. So you play this choosing game and it modifies trends based on your behavior. The only thing was, it was a loooooong exercise. At some point I noticed a progress bar, and realized it was going to have 200 iterations. With a bike helmet poking your head. It tried my patience.

    The next exercise showed you a letter. And then another. If the current letter was the same as the first, you pressed the green button. If not, the red button. Fine, not so bad. But the next exercise wanted you to skip a letter and indicate a match. So it would show A (no), B (no), C (no), B (yes), B (no), B (yes) and so on. That was harder, keeping track of displayed letters. Next exercise? Skip two letters. Last exercise, skip three letters. Oh I forgot to mention each successive exercise speeds up. Needless to say, with my memory I simple randomly tapped red or gree.

    The final exercise had something to do with emotions. I can’t remember what the responses were, but they were effectively “good” or “bad.” They would show an image and you press a button. I was told, and the screen also mentioned, that the images may be quite graphic. Welcome to Clockwork Orange. Images that I remember:

    • Naked dead body being taken out of a house that had burned down
    • A pretty kitty
    • A topless woman on a beach
    • A charred body in wreckage
    • Children doing something cute and innocent
    • Two beautiful naked people having sex
    • Puppies!

    You get the gist of it. There were more good images but it was hard to remember with the dead bodies in my short term memory. Honestly that was the most interesting exercise. Seeing an obviously bad image but thinking “what if I was a serial killer? Would I press good?”

    Got a gift card for my efforts, and a handful of change for parking.

    Ok, back on track. Wednesday morning I went into the TRD clinic for my first TMS session, as well as the “mapping” to figure out where to shoot. Having done TMS a couple years ago at a different hospital/provider, I was excited to see the differences. And there were so many!

    A fabric cap was put on my head, and they trimmed it to fit. It would be my cap for the series. Lots of measuring was done, and there were strips of measurement tape on it, indicating how far in whatever direction the machine would be pointing. Then a doctor breezed in – a super cool exotic looking doctor. He had a cravat. Yeah, that cool. Had he told me he had hung out with Bowie I would have believed it. He adjusted the machine while the tech spouted out seemingly random numbers, His goal was to make my right thumb twitch, which would give him a reference point. More adjustments made, thumb twitched, all is well. After chatting with me for a bit, doctor breezes out. I seriously want to go to dinner with that guy. He’s got stories.

    Mapping being complete, it was time for my first session. As you may (likely not) recall from a previous post I’m too lazy to link, the last TMS experience felt like woodpeckers or hummingbirds tapping HARD on my temple. For an hour. This one feels like it’s fewer pulses or tiny little mallets tapping my temple, but like whomever is doing it kinda doesn’t care about their job. TAP, but not too hard. After each tapping there is 45 seconds of rest. Also, there are only 54 pulses like this in a session. So even though they strap a moderately heavy helmet to my head, it’s only 20 minutes and not too painful. Headaches and tiredness are potential side effects, but I haven’t had either, previous TMS or this one. (Although as I prepare to post this I realize I have a deep but not horrible headache. Will try breathing more). Another potential side effect is seizure, which sounds like fun to me, but that’s probably in poor taste. I was going to listen to music, but the tech is just sitting there, and it’s only 20 minutes, so we just chat. She’s really good at it. Guessing she spends much of her day

    So the TMS wasn’t bad. But there’s a gap I have to fill between TMS and Day program that’s too short to go home but too long to just show up early. So I got a haircut. And went to Target. Between all that and Day program, then the Ketamine uber shuffle (rush back to apartment, park, get uber to TRD clinic, trip balls, get uber back home, try not to think about having spent $80. Between all of that, it was a harried day. I’m on a new med – a stimulant – and it makes me feel manic. Which helps get through a day, but I don’t like how it makes me feel like I’m buzzing. Anyway, by the end of the day I was back to my old self. Stimulant having worn off, exhaustion crash coming back down on me, and my new eating problem: Being a little hungry but not looks like food. It’s all just cardboard, or worse, chicken.

    More as I continue my journey down the TMS road.

    Oh, I have pictures of me in both helmet getups, study and TMS. But you’ll never see them. Just imagine the dorkiest thing you can think of, and add wires.

  • Non Therapeutic Media

    In a post about a million years ago, I referenced something I call “Depression Porn” – I guess you could just say it would be media that’s triggering. After a productive day of being depressed, I thought I’d find a new movie that sounded interesting. A movie that’s been on my watch list has been “Aftersun” – it features an actor named Paul Mescal, he’s a cool Irish guy. Got nominated for best actor at the Oscars for this role. Had no idea what it was about.

    The premise is a father (Mescal) and his daughter (12 ish?) on a summer holiday to a resort in the mediterranean. That’s about it. Great character study, etc. Lots of good emotional moments. I connected so hard with the father, trying to be there for his daughter but clearly having issues. I could smell the depression right away. It was the little things like the look behind his eyes when he’s trying so hard to look like he’s having fun. The way he sags every so slightly when the focus is off of him, There were other more obvious things, but they were softly and slowly introduced to the storyline. And it was clear that this was all leading up to something bad. Every sharp noise was a tease.

    The end doesn’t solve or explain anything. I know I took my own ending from it, and I’m sure a lot of other people did too. But I’m guessing there are many different endings to the movie. Mine was, of course, that he committed suicide. It’s heavily hinted at but no clear indicator.

    I spent a long time during the movie and after thinking about grinning and bearing it with my youngest daughter. About the times where I put in all the effort I could muster to be able to be there for her. We had a lot of good times, but many of them were tinged with that gray crust that keeps me from feeling. Those times were some of the best and most important memories to me. Whatever’s left of them, anyway.

    I needed a palate cleanser, but then my addicted little mind started suggesting things like “Melancholia” or “Sylvia.”

    So I decided to go all in and watch Ordinary People. Holy cow, what a great movie. The first time I saw it was on the family black and white TV using headphones. There was something wrong with the TV or the headphones, there was bleed through from something else. So the whole time, there was this background noise like people talking. For a movie that is legendary for it’s use of silence, but broke that but somehow added something more. Successive viewings have carried that silence nicely. I wonder how many people adjust volume and check for mute as the movie begins in absolute quiet. These movies may not be the best thing for me to be watching, but they’re comforting. Like group, my co-patients bring up hard stuff, things that make ones mind wander to dark spots. It’s comforting because it’s people who get it. Like movies that understand.

    Anyway, Aftersun is great.

  • What is invaluable?

    I think of the different elements of past jobs and how I valued them. From the mentor back during the dotcom bubble, to the manager who taught me all about how Agile can actually work. My current boss has been nothing but supportive. He’s been clear that he wants to set me up for success, and in as much as I have shared my mental health issues, he has been completely supportive. “Just get better.” It sounds like a phrase I would write a whole negative ranting blog post about. But in this case he really means they want me to heal, to get better, and to come home to the job.

    My schedule firmed up quite a bit last week, with the addition of a series of TMS, combined with the Day program I’m in. Add in the ketamine appointments, the individual psychiatrist appointments, therapy, and the treatment resistant depression clinic and I have an extremely full schedule. It’ll be like that until the beginning of October when TMS ends, and go back to normal by the middle of October or so. I know I’ve written about this before. I think.

    The result was the need to talk to my boss. My therapist said I should do that sooner than later so my catastrophizing brain couldn’t rake me over the coals any longer than necessary. He got back to me in a timely manner and we just had a call. “Just get better.” He just wants me to take the time I need to be able to come back and succeed. My team is waiting for me, and things are pretty much the same as when I left a month and a half ago. He’s possibly going to get kicked upstairs, which is a bummer because he’s such an advocate, and I just don’t know his replacement that well. We’re talked and worked and such, but it’s different between coworker and manager.

    I’m in a really bad place. When I get pulled from program so they can talk about my safety, it’s feeling less and less like “hang in there, maybe do you need inpatient?” to “Convince us why we should let you go home today.” I had a pretty bad one of those on Thursday. It’s hard to argue with them, and honestly I’m really only about 75% open with them, because I feel like the other 25% they wouldn’t understand, and be next level concerned. (My brain’s been in this mode for half a decade now, and it’s all full of stuff that can be upsetting to others.)

    tl;dr Work still loves me, if schedule volume is what fixes things, I’ll be cured in a week. I still want to be gone. But I love all of my family, immediate and extended enough that it currently keeps me safe.

  • Day program and more

    It’s just turning into one big panic attack.  Can’t breathe, anxious, worrying. Getting used to days where I don’t eat at all.

    Left (graduated?) the partial hospitalization program because it’s only 15 days long. I have transitioned into the day program. Tuesday Wednesday Thursdays from 12:30 to 3:00. For like, ever.

    Seems like a great way to be able to introduce me back into the workplace. You know maybe working Friday Monday and then incorporating the midweek mornings, and so on. Except…

    My current hospital denied me for further TMS treatments because of my VNS. But the treatment resistant depression clinic does TMS and knows how to work their way around VNS as if needed. So I’m on for those starting next week, everyday of the week at 9:30 a.m.

    So much for going back to work.

    Between the day program and the TMS treatments I am not going to be able to go back until the beginning of October. FMLA will be long gone by then and I’m dreading having the conversation with my boss.

    On one hand, they’re so supportive and maybe they’ll continue to be supportive in an unpaid leave sort of way.

    But they wouldn’t surprise me if they basically said that was just too long and cut me loose. The first option would be great, maybe the TMS would even help me enough that I could go back to work and not end up suicidal again.

    If they decided to let me go, a collection of events would happen that would put my safety in extreme jeopardy.

    My confidence that I could find another job is pretty low, given my experience finding my current job. My cushy health insurance would go away and I would go on Medicaid. I know for a fact that my therapist and the treatment resistant depression clinic both don’t take Medicaid. I don’t even know about my meds psychiatrist. So I would have to try and find a new therapist that doesn’t know me and a new psychiatrist and someone who can do maintenance on my VNS.

    I would go back on disability, which would help, but I would have to move out of my apartment once I finished ruining my savings. Finding a new apartment, packing, moving, not living here. All of that just makes my heart hurt.

    I know I’m catastrophizing but all of those things are not unreasonable. I’ve recently trended from passive to active suicidal ideation. And I think all of that stuff above would be just enough to push me over the edge.

    Yeah, yeah, I’m safe right now. I do have a great care team at the moment. I love making therapists cry.