Surviving Suicidal Thoughts

         I’ve been hit by a Depression recently, and been hearing from people with Depression, so here is a recap of my survival strategies, made for times when you genuinely do not want to live. This will be a two-part blog.

         In severe Clinical Depression, you lose all will to live. It’s one of the worst things special chemistry can dish out. It’s just a chemical shortage, but that’s not what it feels like.

         The way I’ve always described it to myself is that the motor has died in me. Everyone has a little, crucial motor that wakes up with them each day and makes them want to go on – at least after a cup of coffee or two. In Clinical Depression, the motor STOPS. It is jammed or broken. Who knows why.

         And you don’t care. You are perfectly happy to stay in bed all day every day. People don’t realize till they’ve been there that it takes energy to give a damn. That’s something the people around you, trying frantically to get you ‘back to normal,’ don’t understand.

         With time, and maybe the navigation of some crucial life issues, that motor will kick in again. The job of anti-depressants is to jump start it. The danger is that people won’t live that long.

         In suicidal Depression, you have one job and one only: stay alive until the motor starts. It is gruesome, but possible. I have been suicidal, I forget how many times. Once I spent 2 whole years in bed. I survived it. This is how.

         First and most important: do not buy into how you feel. I know it seems like the world is one big kitty-litter box and you are buried at the bottom. But your brain is lying to you! That is vitally important to understand. When your thoughts say, “It’s not worth living,” you can respond, “What a load of crap!”

In rehab they taught us something I never forgot: Feelings are not facts. Feelings just are. It’s just a broken brain showing you everything through a black filter. It’s not real. It’s a movie-screen disaster. It cannot kill you all by itself! Only you can do that.

         If we have an ‘ordinary’ Depression and things look dark, we are usually best served by keeping busy and keeping in motion. But if we are flat out suicidal, it just may not be possible. The rules are different when all you can think of is how much you want to die.

Your only job right now is to stay alive, and here are a few tips to help you do that:

         1) Get rid of all weapons. I have a gun for self-protection (I know that’s not very PC). When I start thinking I don’t want to live, I give that gun to my therapist and say, ‘’Hold onto this for me for a while”. Pills are weapons. If you start thinking of overdosing on your pills, it’s time to get somebody to dole them out to you one day at a time. You can do this. Doctors are willing. Your friends would rather do this than see you die.

2) Get a crisis number and call it any time you have to. Call your therapist. Ask for extra sessions. Write long letters or journals about how bad you feel. But don’t expect your best friends to be able to listen to it every day. They can’t even understand, though they may be willing to try. There is no normal person on earth who will be able to stand your current point of view for as long or as often as you will need to vent it. Use the professionals. They’re there for exactly this.

         If there are local prayer lines, you might call them too. A lot of people praying might just make the difference. What could it hurt?

         3) Find something passive to keep yourself occupied. TV or books or audio tapes or crosswords – anything will do if it keeps you from sitting around brooding. Cuddling your cat or stuffed animal helps, too. If you just sit and think, you might crumble. If you have to watch reruns at 3 in the morning till you finally drift off into a coma, that is better than dying.

         This is a good time for that music collection I recommended. This is a good time to take up knitting. This is a good time to play Slinky, or Solitaire, or Marbles. This is a good time to surf endlessly on your computer. Go into a mindless zone where you are just slightly too busy to think about much you hurt. This is NOT a good time to take up drugs or alcohol. Your lens on the world is already way too distorted as it is.

                   4) Keep it simple, and take your medicine. I know hygiene and moving about socially don’t interest you very much right now. I’m going to be different than the textbooks and say that’s fine sometimes. If you want to lie dirty in bed all week except when you go get the groceries, OK. Just so you stay alive.

I have a request, though: when you do go for the groceries, take a shower first. It is the kind thing to do, and it will make you feel marginally better. Also, get up for therapy and to pick up your prescriptions, even if you don’t get out of bed for anything else.

NEVER neglect your pills. Especially now.

The above is an excerpt from Deborah Fruchey’s book, Is There Room For Me Too? 12 Steps & 12 Strategies for Coping with Mental Illness. It is available on Amazon.com, from Kindle Editions, and in Apple’s iBook store. You can visit the author’s web page at www.lafruche.net.

Coming Up for Air

Sometimes, when you are a mental patient, life becomes very simple. It's all about survival and sanity, period. There is just nothing else you can handle. That is fine, to a point. If you're living on SSI, $600 a month doesn't buy a lot of nights out clubbing.

But there are times when I find I have downsized my life until I am living in a very small terrarium indeed. It gets stifling. It gets depressing and boring. Suddenly I realize I want something more, but I have turned down the last 10 invitations out, and there are no more coming in.

When this happens to you, it's time to expand your interests a little. Start watching the news again, or at least the parts of it that don't depress you. A quick radio summary of headlines can be enough to give you some food for thought. Or check out a local meeting of the National Alliance for the Mentally Ill, or any other of the many national organizations for us, and find out what the resources and activities are in your area. You might be amazed at what's out there. I was.

Or just take a walk. If you walk to the coffeehouse or the library, you can look at people and maybe even some art too. Or go to some place that gives you sensual pleasure. A fabric warehouse is one good bet (touch the corduroy and the brocade), or a florist or nursery (breathe the air, drink in the colors), or an art gallery or pet store or aquarium. These things can perk up the senses. You don't have to spend a thing. Any local nature spot is a good visit, especially any bodies of water. A walk by a lake shore or stream can have amazing healing properties.

If you're not ready for that, if you prefer to stay home, what about burning some incense or scented candles and listening to music? Maybe drag out some old vinyl you haven't listened to since your teens? Play with your pet, if you have one. Make something with your hands. Paint something. Plant something. Most of all, call someone you know - maybe someone you haven't seen in a while - and just chat, a nice conversation that doesn't mention mental illness even once. Can you do that? If you can't, isn't that something to consider? When was the last time you paid attention to something besides how lousy you feel?

In our suffering, sometimes we box ourselves in. I'm speaking for myself - I just finished doing it once again, although I know better. It is important to let in some outside air once in a while. Maybe you can afford just one show, or attend a free lecture, or join the YMCA - did you know some branches give needs-based scholarships? If you went to a yoga class or a volleyball game once a week, wouldn't life change just a little? Or pretend you have a visiting friend who needs to be shown the town. Take yourself on a tour. We often forget what is interesting about the places we live.

Get involved somehow. If serious school is too demanding, how about merely auditing one appealing class? This is not about performance. It's OK if your participation in an outside interest is sporadic; it's OK if you have to drop out at times to care for yourself. I am not talking about responsibilities. I am talking about interests and hobbies, or just a taste of something new. Have you ever flown a kite?

Myself, I go to poetry readings. No, it's not everybody's cup of tea. But it's an intelligent, conversible crowd, the events are regular, and if I don't show up for a while someone is likely to miss me and ask where I've been. Sometimes that's all I need to pull me back towards life.

Deborah Fruchey is the author of  Is There Room For Me, Too? 12 Steps & 12 Strategies for Coping with Mental Illness. Available on Amazon.com, on Kindle, as an Apple iBook, or by request at your bookstore . See a film about the book at this  link: http://www.youtube.com/watch?v=sebsylD-iNI   or visit www.lafruche.net.

 

Getting Government Help (Part Three)

  Now that funds are so tight, government resources for the mentally ill are getting thin on the ground. Just because you qualify doesn't mean you'll get them. Here's the third installment of my 3-part series on struggling with bureaucracies:

Phrases to use when you hit a wall: “What is your name?” (write it down, in front of them. People act differently when they know they will be held responsible.) ”Is there someone else I can talk to?”  “Can I speak with your supervisor?” (If the supervisor/manager/boss is out, ask , “When can I reach him/her, then?”) Or, try calling another day, and speak to someone else. Not everybody has the same information – or the same chip on their shoulders.

If you are completely stuck? Memorize this one: “If you were in my shoes, where would you look next?” And then get the number. Inside numbers are often much more efficient than the general numbers, especially if they give you a specific person or department. Another reason to always write numbers down.

Always follow the rules. Read the fine print. Do not lie. If you play by their rules, they can’t throw you out.

It took me two years to get Disability. On appeal, they were going to say ‘no’ again because I had earned more money than their maximum in only one month out of the entire previous year. I studied the figures and saw that the month in question was a month with five weeks - and thus had one extra paycheck! I was not earning more per hour or more per month. It was just a longer month.

When I pointed that out to the investigator, I won my case.

Use reason. Use their own rules against them. Use the system’s loopholes. Read the fine print. There are such things as public-assistance lawyers to help you with this. Find one if you need one.

 It can be OK sometimes to leave something immaterial out of your answers. I once had my doctor look over a Disability Review form, and he said I should cross out the information that I took long walks every day. He said in their minds, if I could exercise, I wasn’t very sick. Ludicrous, but true. So I left that sentence out. It didn’t change the basic facts of my condition.

Having a doctor or experienced friend look your stuff over, if you can, is a good idea.

But don’t outright lie. If you get caught, the game is over. You have just made things harder for the next person in line, too.

Being in trouble does NOT excuse you from ethics.

Follow through to the bitter end. If they say ‘no,’ but there is an appeal process, then appeal! Some agencies routinely say ‘no’ just to weed people out. They may give you bogus reasons such as, “You can walk and follow instructions. Therefore you are employable.” (True story. Happened to a friend of mine, completely incapable of supporting himself for the last few decades.) Get a doctor on your side, and go for the second round. If there are community-service lawyers in your area, get one.

Do not call or show up while upset or symptomatic. Reschedule. This one is self-explanatory. The only exception is if you are in the throes of trying to prove how sick you are. In that case, a picture is worth a thousand words. But bring someone to interpret you.

Never give up.

I know this sounds like a lot, but think about it this way: How much is a free income and medical care, for life, worth to you? If someone said, “Look, the deal is, you have to work for us for two years, and it will be a really nutty two years, but after that you’ll never have to work again; we’ll just feed you, give you money”…would you do it? Hmmm?

Don’t be ashamed, and don’t have false pride. The American public, as a majority, over numerous decades, has decided that some people need to be helped, and is willing to pay for some of it. You are entitled to these services, if you can prove your case.

And keep your ears open. There are all kinds of services out there which are never advertised. For instance, if you were wondering how to afford the yoga class I recommended, go the YMCA and ask, and you will find that they offer scholarships for low-income people. Or, for instance, some charities help with deposit fees on apartments if all you have is one month’s rent. Some cities have groups that will actually pay for your pet care, or offer you help cleaning your apartment. The gas and electric company once paid my entire several-hundred-dollar heating bill, the worst bill of the winter, on proof of low income and my promise not to re-apply for a year. (This service was called REACH. I don’t know if it still exists.) There are telephone discounts, public-transportation discounts, and free mammograms for low-income patients, in some areas.

The point is, you have to stop being proud and ASK. Say, “I have a disability and a low income. Are there any special programs to help me out?”

 Trade info like this with friends, and listen to any services they know about – make a note even if you don’t need it now. You may someday. I keep a file called Community Resources full of these snippets and leads. They’ve saved me and my friends over the years.

You can do this. I did. Just keep good records and be very, very patient.

If you can’t do it, find someone who cares enough, show them this section, and ask for help.

The above is an excerpt from the book Is There Room For Me, Too? 12 Steps & 12 Strategies for Coping with Mental Illness, copyright 2010 by Deborah Fruchey. Available on Amazon.com, on Kindle, as an Apple iBook, or by request at your bookstore. See the link for a short video about the book, or visit www.lafruche.net.

Getting Government Help (Part II)

Now that funds are so tight, government resources for the mentally ill are getting scarce on the ground. Just because you qualify doesn't mean you'll get them. Here's the second installment of my 3-part series on struggling with bureaucracies:

Be concise and polite. Losing your temper will get you thrown out the door, hung up on, or given the worst possible service. If you do lose it, take a deep breath, then smile and say sincerely, “I’m sorry. This is a stressful process and sometimes I get angry.” Even though these people are dealing with the mentally ill all the time, they have few people skills and no psychological skills or patience  (my apologies to the few shining exceptions!). DO NOT TAKE IT PERSONALLY. Paranoia will end the conversation every time, and get you marked down as a troublemaker. Their attitude is NOT about you.

Do not tell a long, detailed sob story. Do not try to make them feel sorry for you or give them every last detail. They’ve heard it all. They don’t care.

Have plenty of proof of your claims. Back up your diagnosis, your work history, your hospitalizations, and anything else they’ll question. Get paperwork from doctors and employers, or their agreement to back you up if someone calls them. Have a lease to prove your residence, or a friend who will verify that you are staying with them.

In bureaucracies, paperwork is God. You cannot afford to be disorganized about this.

Getting Organized: What if you are disorganized by nature? Here’s a simple system.

  

1) Get a box. Not a huge box, just one about the size of a milk crate or a standard box of books.

2) Get some folders – one for each agency you’re trying to get help from. Write the name of each agency on a folder – Medicare, SSI, Disability, Housing, Medicare Part D, Therapist, Psychiatrist….whatever the issues are you’re working on.

3) Every time you get a piece of paper about that issue, put it in the right folder on top of whatever’s there.

4) Every time you send out something to that agency, put a copy of it on top of whatever’s there.

5) Every time you have a phone call or make notes or memos, or do ANYTHING about that issue or agency, you write it down and put it in the right folder on top.

6) DO NOT THROW AWAY ANY OF THE PAPERS.

This system keeps it simple. Whatever is most recent is right on top. Whatever is going on will be right there when you reach for it. Even if it’s old and somebody starts making a fuss about it, you know it’s just further down in the stack.

So all you have to do is develop a habit of putting each paper in the folder the second you put it down. Don’t put them anywhere else. Don’t leave them somewhere ‘temporarily’ or ‘till I can get to it.’ If you use this system your papers will always be in the same place every time, and nothing will be missing.

It doesn’t matter if the notes are crumpled or scribbled or have phone numbers scrawled on them in 3 colors of ink, or coffee spilled on them. It doesn’t have to be neat. It just has to be COMPLETE and FINDABLE. Just keep the box in the same old corner of the closet, or whatever.

The rest of your life can be as messy as you want.

The above is an excerpt from the book Is There Room For Me, Too? 12 Steps & 12 Strategies to Coping with Mental Illness, copyright 2010 by Deborah Fruchey. Available on Amazon.com, Kindle, as a Apple iBook, or by request at your bookstore. See the posted link for a short video about the book, or visit www.lafruche.net

Getting Government Help (Part I)

  Now that funds are so tight, government resources for the mentally ill are getting scarce on the ground. Just because you qualify doesn't mean you'll get them. So here's the beginning of my 3-part series on struggling with bureaucracies:

I have a reputation among my friends for getting the most out of the bureaucracy. Here are some tips gleaned from 20+ years in the mental health system.

First of all, don’t expect fast results. If you need housing next week, start counting up friends’ sofa-beds right now. Approaching the red-tape establishment in desperation puts you at a nasty disadvantage. Public employees often don’t listen well to the urgent or the stressed. They get very huffy about the pace at which they will move.

Expect that big benefits, like Disability, will take up to two years to achieve. Small ones, like assistance paying for your pet’s vaccinations, about six weeks. Government-sponsored benefits are always harder to get. There are more hoops to jump through. Volunteer groups have been formed strictly to help you. Government employees have been trained to safeguard the taxpayers’ money and keep out frauds – so, sadly, you are considered a fraud till proven otherwise.

So that’s the first rule: give it time.

The second is: never miss deadlines or appointments. Even if you are sick, or need an attendant, manage it or reschedule it. If you miss, you can mess up the whole works and they can deny your application on the grounds that you ‘didn’t do your part.’

The other tips follow in no particular order.

Get everything in writing – and keep the paperwork. If it’s an interview or a phone call, be sure to write down any instructions or promises made, along with the date and who told you.

Keep names and phone numbers you find helpful. If you find an employee with a surprisingly good attitude or good information, ask for that person by name next time you call that office. You may even want to call them again about more general info, or a referral. “Hi, Michael. It’s Deborah again. I just wanted to ask you: what department do I call for X situation? Do you have any numbers there?” Contacts are priceless, and might even become friends over the years. But don’t wear out your welcome.

Keep copies of everything YOU send. It is a savvy trick to send things by certified and/or registered mail, so you can prove an office got something on such-and-such a date. If the office completely loses the information you spent six weeks gathering, and you have no copies, you are S.O.L. It does happen. Horrifying but true. So be persnickety about this.

Get friendly with your phone book. When you need something and don’t know where to start, look in the city, county, and federal pages at the front. Think of other names for it if you can’t find it at once. It may be under ‘Human Resources’ instead of ‘Social Services.’ The Internet is great, but not all of us have it, or are good with it. The phone book is free.

Go in person if you can. If you want a service and you can get to the office, get presentable and go there. A friend of mine needed housing. We went together to the county office and received a 25-page handout of places to look and agencies to contact! Nobody’s going to give you that over the phone. You have to be there. And the human touch works wonders.

The above is an excerpt from the book Is There Room For Me, Too? 12 Steps & 12 Strategies to Coping with Mental Illness, copyright 2010 by Deborah Fruchey. Available on Amazon.com, Kindle, as a Apple iBook, or by request at your bookstore. See the posted link for a short video about the book, or visit www.lafruche.net

Pills

 

About the best thing you can do for yourself, if you have a major mental disorder, is take your medicine. And the best thing to do with your medicine is to take it regularly, and never run out. Here are a few tips on how.

Let your pill counting be an every-night or every-morning ritual. Never go to bed without taking the last pills of the evening, and setting out what you will need the next day. You may be fuzzy in the morning, especially before coffee; it would be easy to skip one (or double up on the wrong one) and suffer for it later. I take quite a few, so I do need to specifically count how many of each item I need for morning, lunchtime and bedtime doses. While I’m counting, I glance in each bottle to make sure I have enough to last at least 3 more days. If one of the bottles looks low, I turn it upside down on my dresser so the next morning I will notice it. When I see an upside down bottle, that’s my short-hand for “Call the pharmacy, today!”

Your morning pills belong just an arms-length away from your pillow, maybe on a little saucer by a glass of water. When you get up, you can grab them and swallow them down without even looking or thinking about it. That’s what you want: an instant, automatic action. The pills for the rest of the day should have a tiny container of their own that lives in your purse or wallet or back pocket. ALWAYS. Never be caught anywhere without your pills.  If you are on public transportation and start to hear voices, you need your antipsychotics with you, to take right now, not in some drawer at home.

In fact, I recommend you have an emergency supply of one extra days’ worth that you keep on your person at all times. This doesn’t have to take a lot of space. Mine goes in the cellphone pocket of my wallet. In even the best-ordered life, the unexpected can happen and you can be stuck somewhere overnight or caught in a disaster with no access to the pills that will keep you sane and functioning until you get to safety. How are you going to handle it without your meds? If this sounds like too much to bother with, let me put it another way: would you rather carry a few extra pills, or explain things to the police?

‘Nuff said.

About pharmacies: pick a national chain if you can, one that will hold your computer records even if you are traveling to another state. It’s a good idea to check, before a vacation, that you have enough of each medication to see you through, including a couple of days’ worth for after  you get home. Try to give your pharmacy two days’ notice at least for refills. Things go wrong with distressing regularity. What if you have no more refills, and they need special authorization? What if they have to call your doctor or your insurance and don’t get an answer right away? Lots of things can go wrong with your order. For instance, maybe you’ve needed a little more medicine than usual – so now you’ve used up your prescription early, and the insurance company says it won’t pay for replacements till some time next week. Twice I was held up because the pharmacy was faxing the old office number of a doctor I hadn't seen for years! Naturally, he didn’t bother answering them. Or what if they’ve simply run out of supplies? Give your pharmacy a little lead time to sort things out. They will appreciate that you don’t breathe down their necks and rush them – and when there really is a special hurry, the people behind the counter will be more likely to be helpful and understanding if you’re usually not a pain.

But what if, despite everything, you do run out?

If you always go to the same pharmacy, and they know you, they will probably help you out. Explain that you need X days of emergency supply. Tell them why (in as few words as possible – they don’t need a long sob story). Be sure to show them the bottle you just emptied so they can verify that you really do have this prescription in this exact dosage. They will probably give you the small supply you need – possibly without charge. It really pays to be a regular customer. But even if you are new in town, if you show the bottle, you may be able to get help; especially if you can say “I’m seeing Dr. So-and-so in 5 days.” Give them the doctor’s number so they can verify that, too. Psychotropic drugs are very powerful and can be dangerous to the wrong person, so they’re right to be cautious in giving these things out to strangers.

Don’t put new pills into old bottles, though. I did this by mistake once. The old bottle read “one refill remaining”, so I thought I was alright. But it was actually time for a new prescription, and I didn’t have any refills left! I had to make a rush appointment and get an emergency supply. So when you get your medicines refilled, any leftovers should go into the NEW pill bottle. Throw the old one away.

One last tip: If you give them a list of your usual meds, Walgreen’s is capable of making out a comparison chart of the various Medicare Part D plans in your area, including a cost comparison. It pays to do this each December, during the time when patients are eligible to switch coverage.

Be serious, disciplined and reliable in the way you handle your prescriptions, so they can give you serious and reliable results.

Deborah Fruchey is the author of a general self-help book for psychiatric patients. Entitled  Is There Room For Me, Too?, it is available on Amazon.com and other online bookstores. It is also available as an ebook on Kindle and in Apple's iBookstore. Or you can request a copy from your local book vendor. See the attached link for an explanatory video, or visit Deborah at www.lafruche.net.

Defining Normal

It happens sometimes that people get sidetracked into the swamp of defining what 'sanity' is, what ‘normal’ is. Usually they just leave the question hanging. If we are going to accurately monitor ourselves, however, we need a benchmark for sanity. We need to have some way to know when we have gone off the rails, when it is time to curb our behavior. We can’t decide what to do about psychosis, if we don’t know we are psychotic! The real question is, what does sanity feel like to YOU?

A lot depends on the age at which we became mentally ill. Obviously, if disease struck you at age 26, you have some kind of memory of what ‘sanity’ felt like, however you may define sanity. The world felt different. Perceptions were different. You can remember. You can compare. But what about those of us who started early? Some of us have never experienced adult ‘sanity’. We were kids, and then we were insane. No ‘before’ picture to measure by. Some of us were even insane as kids. What do you do then? How can you tell that things have gone further south than usual?

Well, if you’re lucky, at some point your medications will stabilize you – even if only for a little while – and that can become your measure of what adult normal feels like. I had to wait until I was 34, myself. But once I knew, I had a reliable way of telling when I had got too far from the beaten path. We have to pay attention to our bodies as well as our minds. There are certain sensations I associate with mental illness – a sort of tight, closed-in feeling, as if only my mind exists and my body is locked in a box, and I literally CANNOT notice what is around me, or change the topic my brain is stuck on, no matter how hard I try. I feel overwhelmed, over-stimulated, a little panicked, a little trapped. I cannot listen – the words inside me must be spewed out. I cannot calm down – there is a firestorm in my head that often turns into a very real physical headache. I certainly am not breathing very deeply. The irritation and tightness that accompany this are clues that I am losing it, and should go lie down.

If you observe yourself for a while, you will learn your own cues.

If your meds have never graced you with adult ‘normal’, it is trickier. You have to judge by lesser or greater, with no absolute benchmark. And you have to depend a lot on the reactions of other people. If everybody around you is concerned or hostile or telling you to stop or shut up, chances are real good you’ve crossed the line. You might want to set up a verbal or visual signal with someone you trust, a simple phrase like, “Honey, you don’t seem like your usual self today.” Something simple and inoffensive that will not set you off all by itself. And you will have to surround yourself with people that you trust.

This can be tricky, too. It is to easy for those who are not sick to label anything they do not like or understand as ‘insanity.’  Holding dissenting opinions is not insanity. Having an unusual idea is not insanity. Insanity is operating from a non-standard reality, and not knowing you are doing so. That doesn’t happen every day, for most of us. We need intimates who allow us to be our disparate selves, and this can be a challenge. New Year's Resolution: surround yourself with people you can trust.

It is difficult to be mentally ill partly because of the way it messes with our fundamental belief that we are right. A person with a mental disorder has to be ready to concede, at any given moment, that they may be wrong about virtually anything, even the smells wafting into their nostrils! The least we can do for ourselves is make sure those around us can be trusted to have a sense of what is our illness, and what is simple idiosyncrasy on our part.

There are individuals like that out there. Go and find them, and happy hunting.

Deborah Fruchey

Deborah's new book, Is There Room For Me, Too? 12 Steps & 12 Strategies for Coping with Mental Illness, is now available on Amazon.com, Kindle Editions, and Apple's iBookstore. See the above link for an introductory video.