Outpatient Fail

All of our therapy is outpatient. We see our therapist in their office every two weeks. We talk. They push us to talk about the things we’re obviously avoiding. Mostly it works. Until it doesn’t.

That was this week. This week therapy turned to shit. Shit. Complete and utter shit.

I’ve written about our excellent ability to zone out before. It doesn’t tend to end well.

Often it happens during therapy sessions. We’ll be discussing something and become emotionally overwhelmed. Often I feel incredibly anxious, sometimes sad or scared, but whatever the emotion – very overwhelmed.

By this point the conversation will stall. My responses become slower, my voice quieter, and I say ‘I don’t know’ repeatedly. I’ve already stepped back from my body without actually choosing to. At this point there’s nothing anyone can do to help me become more responsive.

Usually I’ll be asked to move by whoever I’m with (psychologist, psychiatrist, nurse) and be unable to. My body is frozen, and although I can hear and feel (and see if my eyes are open) I can’t move. Eventually my head tips to the side, the weight of it seeming to drag it towards my shoulder. From there my body can slowly slide sideways, and if I’m in a chair, out of the chair and on to the floor.

This time wasn’t that different. It’s just that this time was the first time this therapist had to manage it outpatient. They’ve dealt with it repeatedly in an inpatient setting. That’s much less dramatic. They let the nursing staff know what’s going on so I can be monitored, but generally leave me alone to come out of that state at my own pace.

Outpatient though? It’s a downright disaster. I couldn’t be moved. My therapist had other clients to see, but had to reschedule at least two of them. Eventually they had no choice but to call an ambulance to take me to the local hospital emergency department.

That’s when it got worse. I was unfortunate enough to get two male paramedics. Ordinarily that wouldn’t bother me. In such a dissociated state they were terrifying. They were men. Men are bad. Men are not safe.

To make it worse they repeatedly inflicted pain to check my level of consciousness. They did this four times with minimal response from me. Meanwhile I could feel all the pain, but wasn’t able to properly respond. The most they got was a mild grimace, yet they continued. Being conscious, but unable to move or talk is not fun. Throw in pain being repeatedly inflicted and it’s terrifying.

After being released from the emergency department I went home, crawled into bed, and slept. The following day was time to face the music. One super brief phone call from my therapist later, and we’ve planned a hospital admission for August.

August. The month where I had multiple medical appointments. The month where I was finally going to get my pesky wisdom tooth (last one!) removed. Everything has to be rescheduled.

It feels like defeat. Complete and utter defeat.

I can’t safely manage outpatient therapy. I have two more appointments booked with my therapist, but I’m not sure if I’ll go. I’m scared after this week. Scared that I’ll zone out again.

I did have a few thing against me this week. I’d overdosed (wishful suicide attempt) the day before and had a huge hangover from the medication I’d taken. I was rejected for the NDIS for my physical health issues. An outreach worker told me they’d be moving on, and someone else would be taking over my care. Then throw in a trauma anniversary, and the unrelenting depression that’s been haunting me for a year. All of that, even on a good day, is a bad combination.

Trying to stay present with all of that going on is next to impossible. Add in an emotional conversation with my therapist, and I don’t think I had any chance.

Anyhow, hospital it is. Hospital because outpatient therapy is a fail. Again.

Cancelled

I’m free. No healthcare appointment for three weeks. By chance my next appointment with my psychiatrist is in three weeks, not the usual two. I cancelled the appointment I had with my GP today, and I’ve seen all my other specialists recently.

I’m just done. I’m so emotionally exhausted from talking about symptoms, treatments, response to treatments, managing medication side effects and withdrawals. Mostly the talking though.

I’m mostly housebound. I manage to leave the house for appointments, and that’s about it. I see family when there’s time for me to spend the night there and properly rest. I see friends most when they can visit me. Just getting to and from medical appointments all over Melbourne exhausts me.

I don’t drive because a) I don’t have a license b) I can’t afford to buy, or run a car and c) I wouldn’t be safe to drive a  car the majority of the time. That means relying on public transport. It’s pretty good in Melbourne. I can get to most places without too much trouble, but it does take a lot of energy. I’ve applied for funding for either a mobility scooter or power chair, but whether or not that happens is another matter.

I just need a break. Physically I need to rest and regain some energy. Emotionally I need a break from the near constant health talk. All of the healthcare appointments have meant talking to, and seeing friends even less. So the majority of the interactions I’ve had with people have been with healthcare providers about different aspects of my health.

I’m done. Just done. 100% done.

Trying to Tread Water

I haven’t written a proper post for close to a year.

That’s how long depression has been kicking my butt. Not constantly. There have been light, happy, joyful moments and days sparsely sprinkled amongst the doom. The doom, however, heavily outweighs any lightness and joy.

Tweaking my antidepressant no longer helps. I suffer horrid side effects when I increase the dose. My psychiatrist is hesitant to change medications, but it’s something I’ll be pushing for soon.

Along with the unrelenting depression has come almost all the unhelpful behaviours you could think of. Aside from alcohol or illicit drug use. I rarely drink, and have never used drugs. I have enough going on physically and mentally without adding unknown substances to the mix!

Self-harm. Multiple overdoses. Binge eating. Not eating. Not drinking water.

The same behaviours over, and over in moments of ‘I can’t do this anymore’.

I had an inpatient psych admission a couple of months ago. It was helpful, and I was discharged in a much better space. However… within a month I’d overdosed and self-harmed.

I’m supposed to be journaling when I feel anxious or otherwise not okay. Journaling instead of leaping into unhelpful behaviours. I did. Once. That stirred up something inside. Flashbacks started, and small, scared chatter began inside.

I shut that shit down and dove headfirst, straight into an unhelpful behaviour.

Damn it. Not unhelpful. Self-harm, overdoses, eating disorder behaviours. They all help in some way, otherwise I wouldn’t be using them. They are helpful, but in a very short-term way, and they have unhelpful consequences. They don’t help me longterm.

I feel like I’m drowning. I’m trying to keep my head above water, but I’m struggling to do that. I keep going under, gulping water instead of air, only to rise again, cough up all the water, and start breathing…. before going under.

I don’t know how to fix this, and I don’t know what would help.

Pancake Days

A few weeks ago Miss 5 was insistent that we have pancakes for lunch. Having the sweet tooth that she does they were served covered in copious amounts of maple syrup. After devouring them (and more sugar than we ever needed!) she watched Sesame Street on TV.

When Sesame Street finished Miss 5 disappeared back inside, and Miss 7 came out to watch the show that was on next. Miss 7 stuck around for several different kids shows, then also disappeared back inside. Then Miss 3C came out and quietly watched another TV show.

In between all the TV watching that was going on different parts wrote in our journal. Lots of conversation was had, and a few issues raised to discuss in therapy. It turned out to be an incredibly productive afternoon.

Given how helpful it was, we tried it again a week or so later. This time Miss 7 got to help with making the pancakes, and thankfully, there was less maple syrup involved! Then, as with the week before, there were more kids TV shows, lots of journalling, and talking inside.

Now we’re waiting for groceries to be delivered so we have the ingredients to make more pancakes. This time Miss 21 is going to be making the pancakes. Before she starts cooking  I’ll get out our journal, pens, pencils, and other art supplies. Then, once we’ve eaten, anything goes.

Allowing time for everyone to come out has been really helpful. There aren’t any rules aside from keeping the body safe, and not leaving the house. Older parts, myself included, are always around to help out if need be. Younger parts can play with their toys, draw, watch TV, or write with help from others.

The other part we’ve had to be careful of is making sure we’re home alone. We have a lovely housemate, but they don’t know the extent of our mental health issues. We’ve mentioned depression and anxiety to them, but nothing about trauma, dissociation, or DID. These pancake afternoons are very carefully planned to make sure we’re alone, and won’t be interrupted.