Hi everyone I've been more on chat than in the forums lately, sometimes with acute depression and sometimes just to pass some time.

I've been feeling better. My partial hospital was reduced to intensive outpatient program a few weeks ago. The program is DBT based and I think I am responding well to that practice and I'm putting a lot of work into it.

I also think my new antidepressant is starting to kick in and is helping.

I stopped going in to work a few weeks ago. I haven't been to work at all and have had limited communication with them. Thinking about work had been giving me tons of anxiety leading to thoughts of suicide... Thinking about my lonliness was giving me tons of anxiety leading to thoughts of suicide... and thinking about work has made me think about my lonliness leading to... Well, you get the picture.

I've been thinking about suicide much less. Really, I had been having almost constant suicidal ideation but if you were following my posts I was also trying desperately hard to get help for myself. By the time I got into the partial hospital I was completely hopeless but willing to work had at it to give myself a chance. I really threw myself into the program. It was very hard.

But I am hoping it is starting to pay off. I am actually thinking of a specific plan to go back to work. I am going to contact my workplace tomorrow and ask if I can come in and discuss it.

My health has been faltering. I am completely recovered from the two bouts of pneumonia but they seems to have left some cardiac damage in their place. I can't walk more than a few minutes without feeling like I am having heart attack symptoms. This has made it impossible to excersize (which we know would be a good thing to help battle depression) but I've been able to take some short walks to get some sun and air and then sit and read to recover.

The heart problems have also made it difficult to reconnect to one of my favorite hobbies--rollercoaster riding. I've been OK riding but walking around the park and even walking in from the parking lot has been draining. I have to stop and rest a lot and then sit for a half hour before I feel ready to begin.

That just brings back the depression... While depressed the anhedonia makes me not enjoy this hobby and now that the anhedonia is receding the heart problems are making it hard to enjoy.

My cardiologist gave me a more advanced scan to see what is going on and confirmed that my heart is pumping at 35%. He spoke with me earlier this week to tell me about this and that is borderline for suggesting a implantable defibrillator be surgically place.

He wants to wait a while and see how things progress so I'm not stressed out about this. However I will have to make a decision. I am not at all afraid of surgery but after my stent was put in a few years ago I did decide that I can not go through a recovery process again. The recovery from the stent was very short and minor but they expect you to have some support and I have none. I physically recovered but the quality of my life was not that great before or after and the recovery just triggered a lot of lonliness. Lots of exit questions and interviews about who was going to help me take care of myself during recovery. In some cases I had to lie that a friend would help then I had to go home and do it myself.

I cannot do that again especially with major surgery which will be so much harder to recover from. I decided after the stent that I would not do that again, if it was my time I would accept it. This was before the depression relapse. With the depression that decision is as solid as ever, but I know it isn't "negative thinking" because I made this decision while I was not depressed and well after I was stressed from the recovery of the stent. IOW in the period in between when I was clear thinking.

So now I'm just doing a lot of research on a defibrillator... I do want something to help me feel better, but I don't want something that is simply going to keep me alive. I would do a minor procedure for that but not anything that requires a period of recovery. Something that would improve my cardiac health with invasive surgery I would have to decide it it was worth it to spend the difficult period of recovery in hopes of returning to a relatively healthy life that I'm not all that pleased with anyway.