[TW: self harm. Also suicide mention]

Dear T,

I really need to talk to you before Friday. I'm drowning. I can't handle life right now. I'm overwhelmed and panicking. I really want to call the office to see if you might be able to find an opening, but this is not something we've discussed and I don't know what the boundaries are. I'm worried you'll think I'm manufacturing a crisis. And honestly maybe I am. But the overwhelming anxiety I'm feeling is definitely real, and I can't handle it.

I self harmed this morning and ended up going to the ER for stitches. Is that a good enough excuse to get an extra session? Maybe I did it partly in the hope that the hospital would contact you (as they did with my pdoc the last time I got stitches, before I started seeing you). But they didn't even put me on a hold or make me go through a psych consult this time.

It didn't even help. Usually when I self harm to the point of needing stitches I get a few hours of respite from my anxiety. This time it barely took the edge off and now it's back again even worse than before. Maybe that's because of the naltrexone killing the "high."

Tomorrow is the 4 year anniversary of the suicide of the man who was basically my step father for 7 years. March is always hard because of this. I didn't tell you on Friday though because I didn't want to spend the session talking about my grief. At this point there wouldn't be much you could say that would help. I can handle the grief itself. The problem is that I can't handle all my other issues on top of the grief.

Can I call your office and ask for an appointment? Would you be willing to make time for that? Would you think less of me for being so needy?