[LonesomeTonight]

So I've been going through a lot lately. Was having depression and anxiety issues, then generally doing well for a while. Then had an incident

Possible trigger:

of self-harm, but nothing that serious, some really shallow cuts that were more scratches really

about a month and a half ago. Was kinda OK (had self-harm thoughts again but didn't act on them), had a medication change, got through a few weeks, then last weekend was at the beach and ended up texting my marriage counselor at 3 a.m. because I was feeling alone. He responded kindly to that. Drive home from the beach was a nightmare, with me having multiple long panic attacks that required us to stop a couple times, then we hit bad traffic, and when we were almost home I freaked out so much from 5 hours in the car, that we had to pull over on the highway so I could get out for a bit, then let my H drive.

Had sessions with both T and MC Tuesday (just the way the schedule worked out), which ended up going into some deep stuff, with H at first thinking I wanted out of the marriage, then discussion of me having a sort of "void" from the past that can't be filled from someone in the present, like my H. It's something I need to figure out how to fill myself, with the help of T and MC.

Today was World Suicide Prevention Day, so I decided to be open on Facebook (blocking those who would be upset by it) and post about

Possible trigger:

my suicide attempt almost 20 years ago

and saying how I should have reached out and that people feeling that way should do so too. I was flooded with "Likes" on my post, plus some comments saying people were glad I was still here and their own stories of depression. I also got a PM from a friend I hadn't talked to in years who said my post probably kept him alive for another day. Which felt really good but also scary, and we messaged a bit till his dad came over.

Today's also the anniversary of my H's close friend's death (3 years), and he initially seemed to be dealing OK, but then got weepy while we were watching the football game. I tried to comfort him as best I could. We ended up talking a bit about stuff with us, and my transference for our marriage counselor. Seemed basically OK (I've discussed it with H inside and outside of sessions before, so it's nothing new). Then we both went upstairs, and I got the sense he wanted to be intimate.

For some reason, that kind of freaked me out, and I retreated downstairs. Felt really bad about myself and

Possible trigger:

kept feeling the urge to self-harm again. so I ended up making a couple very shallow cuts with a fairly dull knife

. I realized that was a bad thing and it was time to try contacting my T (not my marriage counselor, who I also have permission to contact in emergencies, but this time I called T first). She was asleep, because it was midnight here, but answered on the second call. She asked if maybe I needed to go to the ER, but I made a contract with her not to hurt myself any more before my appointment with my p-doc tomorrow morning. She suggested that maybe I needed to be hospitalized, which I strongly resisted. I've never been before, and I feel like I'm mostly OK, just think I'm having some med issues (currently Zoloft and Wellbutrin, think I may need to lose the Wellbutrin due to agitation effects). I asked if I could wait to talk with p-doc tomorrow to see what she says.

Now I'm really scared--could p-doc require my hospitalization? I really really don't want that. I kind of regret calling my T now. If I hadn't, this wouldn't be on their radar, and I could just act like it didn't happen. (I know, not the healthiest.) If I don't have suicidal feelings or plans (which I don't!), they can't make me go inpatient, right? T made me promise to update her in the afternoon.

Any words of advice? Something I can say to resist hospitalization? For the record, I have generalized anxiety disorder, panic disorder (which had been doing better), some OCD, and am currently in the middle of a major depressive episode. On Zoloft and Wellbutrin.

Any advice or words of comfort welcome. I think I was just really thrown and scared that she suggested hospitalization...

[Petra5ed]

Hi Lonesome!

I'm sorry things have been so rough lately. They have been that way for me too... one more thing we have in common!

I understand the desperation, the suicidal ideation... I don't SH but I do other things. Anyways, just to say, I feel like I do understand exactly where you're at. I know what it's like to feel empty inside. I want to scream that I want to die, but on the other hand I don't really! What I want is to not hurt so desperately, and feel so hopeless.

After years of trying to figure this **** out, finally I can see that depression has it's chinks. Depression is a liar. It tells you that things won't change and are hopeless, and that's just ********. Feelings are fleeting. Just think about it. I think ultimately we have to find a way to acknowledge and gently let go of these heavy feelings, which takes self compassion. I really wish that you could feel happy and enjoy your life, but I cant reach into your brain to help, but maybe if you love yourself enough you can do it?!

I wish it wasn't so damn hard But seriously, when you are really hurting like that I think you need to get busy. You can create that change to lift up out of the depression which usually means to stop isolating and get active, the two things depression wont let you do.

[monkeybrains21]

I've never been in hospital either. I violently resist. I have such a hatred of hospitals I would have to go heavily sedated and against my will. From my understanding as long as u don't seem or show being dangerous to urself or others they cannot make u. They may suggest but ultimately it's ur decision at that point. U needn't worry. Just be calm and show no aggression and no threat. U should be alright.

[ScarletPimpernel]

Sadly, they can force a hold on you in the hospital for up to 72 hrs. But they won't do that unless they feel you're a danger to yourself or others. I had an ER doctor put me on a 48 hr hold. I begged him to not do it since I was in the ER on my own accord. Thankfully, he removed the hold.

I'm sorry you're struggling right now. Try to ride the waves as best you can. Be careful with the SI. It might be minor now, but it can easily escalate. Just try to be patient with yourself. It's an episode. Maybe track how long it lasts. Mine tend to last 2 weeks, so I know about how long I have to survive it. It helps so it doesn't seem like it will last forever. Take care of yourself as best as you can. And hopefully your Pdoc can readjust your meds.

[SkyscraperMeow]

I'm guessing it's the fact that you need to wake someone up by calling not once, but twice at midnight which is making your therapist say that.

To be honest, from what I've seen on this forum, therapists refer out / terminate / recommend in-patient care, etc when their clients require frequent attention outside appointment times. In your case, you required attention not only outside appointment hours, not after office hours, but outside any kind of remotely reasonable hour.

It's great that you reached out for help, but someone who needs help in the middle of the night is someone who needs around the clock help - which means in patient, I guess. Therapists can only do so much. Imagine how exhausted a therapist would get if they had a even a handful of clients who called that late.

Maybe inpatient isn't the worst thing in the world if this is what you need right now to get stable medication etc, sorry to hear you're having such a hard time. I hope you can get some help to feel better soon, in any form that takes.

[LonesomeTonight]

Originally Posted by SkyscraperMeow

I'm guessing it's the fact that you need to wake someone up by calling not once, but twice at midnight which is making your therapist say that.

To be honest, from what I've seen on this forum, therapists refer out / terminate / recommend in-patient care, etc when their clients require frequent attention outside appointment times. In your case, you required attention not only outside appointment hours, not after office hours, but outside any kind of remotely reasonable hour.

It's great that you reached out for help, but someone who needs help in the middle of the night is someone who needs around the clock help - which means in patient, I guess. Therapists can only do so much. Imagine how exhausted a therapist would get if they had a even a handful of clients who called that late.

Maybe inpatient isn't the worst thing in the world if this is what you need right now to get stable medication etc, sorry to hear you're having such a hard time. I hope you can get some help to feel better soon, in any form that takes.

So basically my T doesn't want to deal with me anymore. I just feel betrayed or something. I'm going through a rough patch and she just wants to pawn me off on someone else. I guess MC will be next.

[nervous puppy]

Originally Posted by LonesomeTonight

So basically my T doesn't want to deal with me anymore. I just feel betrayed or something. I'm going through a rough patch and she just wants to pawn me off on someone else. I guess MC will be next.

NOT TRUE!
I don't think you should take it that way, so please try not to. I know it's hard to think that way now, but please try.
It's what they are trained to do. Your T is still there for you. Has not abandoned you. Has not betrayed you. Your T is trying their best to get you the help you need to get better.

I hope today is better for you.

[LonesomeTonight]

Originally Posted by nervous puppy

NOT TRUE!
I don't think you should take it that way, so please try not to. I know it's hard to think that way now, but please try.
It's what they are trained to do. Your T is still there for you. Has not abandoned you. Has not betrayed you. Your T is trying their best to get you the help you need to get better.

I hope today is better for you.

Thanks, Nervous Puppy. I guess I just feel like I was doing what I was supposed to do, which is reaching out, and now I'm afraid I shouldn't have done that. I was a pretty easy patient for like 3.5 years. So hoping T can take that into account. I think one midnight call in 4 years isn't too bad... (Yeah, we've had a few other conversations outside of office hours, but they were at reasonable times.)

In addition to the strong paternal transference for MC, I have a bit of maternal transference for T. So maybe this kind of feels like, I'm going to my mom for something, and it's like being grounded for sharing my feelings. (Actually there might be something to that, since my mom is/was all about keeping feelings inside and putting on a happy face to the world.) So this probably is about more than just feeling like T is pawning me off or punishing me. It's childhood stuff in there too. Part of me wants to run to "dad" (MC), but then it's like, what if he pushes me away, too? He's already put up with a lot from me and remained kind and caring (at least in how he presents himself to me).

I guess I'll just see what happens when I see p-doc in 3.5 hours. Hopefully she'll believe that I'm able to keep myself safe and won't send me away. (I've only been with her like 8 months, and no real transference there, so not sure how she'll handle things.)

Thanks for listening.

[iheartjacques]

I had such a bad experience I never want to go back again. I refused to tell current T for a very long time how I really felt until afterwards.
But he now believes me when I say I feel like doing it, but I won't actually do it. He said I have a rational point and very strong protective factors - my kids. I won't abandon my kids.
We have instead been working on strategies for when I feel like that. They didn't work so well last month, but I was so angry, not suicidal, so it was different. So now I need a list for when I'm angry again.

I don't think she is trying to pawn you off or is tired of you. Reaching out to her is something she was okay with so I wouldn't worry about that. I also doubt your psychiatrist will force you to be hospitalized. It doesn't sound like you have suicidal plans. To me it sounds like you were triggered by many things at once. Just be honest with all of them. It really doesn't sound like she is tired of you, just concerned and wanting to do the best thing for you.

If you're having medication issues just talk to the psychiatrist and stay in close touch with her.

Originally Posted by LonesomeTonight

So basically my T doesn't want to deal with me anymore. I just feel betrayed or something. I'm going through a rough patch and she just wants to pawn me off on someone else. I guess MC will be next.

No, no, no. Your T is simply concerned and just asking the necessary questions about your safety and asking if you feel that you might need further intervention to stay safe and get through this episode. That isn't pawning you off; it's just doing her due diligence to be sure you are being cared for with whatever attention and help might be necessary.

Your T is deferring to your pdoc on this one because this very well may be a med issue going on. You pdoc will talk to you and discuss the best options on how to proceed to help you through this rough patch. My pdoc rarely would not have hospitalized me if I was not a danger to myself. The only exception to that was on an occasion that he needed to make a pretty serious med switch up to one that had the potential to cause some medical side effects that he wanted me inpatient to monitor. Inpatient allowed him the ability to make a more aggressive med change quicker and under medical supervision 24/7 in case there were problems (which there were so it was the right move on his part).

[ruh roh]

I agree that she's not trying to pawn you off. Not even close. If it helps, consider all the stressors that led to this--world suicide prevention day, the friend who reached out before taking his own life, the anniversary of your H's friend's death, and the threat of intimacy (not sure what else to call that). And it's followed by two intense sessions earlier in the week, which probably left you feeling more fragile. That's a lot on one day and plenty of reasons to take care not to add more stressors.

I think your therapist brought up hospitalization out of concern, not to get rid of you. Hospitalization is only helpful if you're at immediate risk and need medication adjustments quickly so that they can monitor you. Since you're seeing your pdoc, you can deal with the med issue during your appt. And if hospitalization doesn't suit you or make any sense, explain all the stressors from the day which were non medication related and put a plan in place to reduce your stress this weekend and see your therapist in a few days. That's what I would do. They want to know there's something in place to keep you safe.

(Also, I wonder if your therapist would prefer a call before you sh, and not after?)

[SallyBrown]

Deep breaths girlfriend.

I cosign lolagrace's post. I think SkyscraperMeow was merely being pragmatic, so maybe it came across as a lack of feeling or care on T's part, but I think that Ts are in the unfortunate position of having to make pragmatic decisions about emotional issues.

I will say I don't know too much about hospitalization and the logistics around it, although I came very very close a couple of years ago. I brought it up with my pdoc because I was doing very badly at the time and was temporarily without a T, and she was also very practical about it.

I think all the stuff you wrote here, especially about going to "mom" and getting sent off somewhere else seemingly because of your feelings, is REALLY important stuff to bring up in therapy. I am really sorry it feels that way. Similar things have happened to me and I needed distance from it before I could feel like it wasn't that T was trying to get rid of me, it was that he sincerely thought that someone else would be more helpful than he was. In the moment, though, it felt like a crisis.

Your T may have very solid reasons for believing that hospitalization was the best for you, and that she wasn't. I know that's not how you FEEL, but I am saying that your reading of *her* perspective may be off. I hope you guys can come up with a good plan for what to do the next time something like this comes up, something that will allow you to feel heard and cared for, and will allow her to feel like she is being helpful without risking burnout (I would guess that may be part of what she is trying to safeguard against --- this is a *good* thing overall, but it hurts when the boundaries/protocols aren't clear up front and there's the potential for misunderstanding and poor communication... it's her job to right that).

Possible trigger:

I am also a (former? so far former) self-harmer who scratches rather than cuts. For me it doesn't have to be extreme, it just has to hurt enough. Plus scratches don't leave scars.

I hope you can talk to your H about this, too, when you're up to it. For my H, it could be hard for him when I seemed to be retreating from intimacy, and explaining why was helpful in keeping us on track. I'm not trying to be like "boo hoo poor H", just that I know you are also balancing marriage stuff right now and the last thing I'd want for you is to be suffering through this AND having a sulky H on the side.

How are you feeling today? Let us know how pdoc appointment goes!

[Rive.]

Try not to worry Lonesome (I know, easier said than done...). Her purpose is simply to keep you safe. Please, don't see it as a rejection. It actually shows she cares. From what you wrote, and seeing you have no 'plan', I don't really think this incident wouldn't warrant keeping you in... provided you also respect the 'contract' re not harming any further etc. I will be thinking of ya.

Let us know how it goes.

[AllHeart]

Sending you hugs and support!

[Suraya]

I don't think they will hospitalize you unless you have specific plans and a time and date and means of carrying out a plan. At least that's what my T says. Even though she knows how I would "do it" when my depression is at it's worst, I never have the intention of going home and doing it at a specific time in a specific place so she has never hospitalized me.

[Chummy]

T can't force you to go into hospital unless you're a danger to yourself or to others. She could recommend that it's maybe better for you to be inpatient for a while, but then it's your choice.
It's better to continue therapy with your T and talk about what you could do in that kind of situations, what you could do if you feel the need to self-harm. Going inpatient won't solve anything, it just keeps you safe for the time you're there (I think, I'm not sure what you do when you're inpatient). You need to learn how to deal with the self-harm urges.

[junkDNA]

i dont think a magistrate will involuntarily commit you. like chummy said, your T can suggest it and then it's your decision, but she can't force it unless an official signs off on it. they look for specific things in order to commit someone and since you said you are not suicidal then i think you are ok.

[atisketatasket]

I think you're OK on hospitalization, too. But I think to your therapist and marriage counselor, midnight phone calls and 3 am texts may indicate something seriously wrong - maybe they think that there is more going on that you're not telling them?

You must have had your appointment by now, how did it go?

[LonesomeTonight]

Thanks for all the support. Quick update now, will post more later. After I told p-doc everything that had been going on, she said that she thinks a day program, where I'd spend 4 hours as an outpatient 3-5 days a week for a month, would be best for me. I started getting upset and crying as soon as she mentioned that. And I got more upset, to the point of sobbing and shaking, when she clarified that would also mean I wouldn't be able to see my T or MC for that month. So basically, I'd be spending like 4 hours a day with a T (or T's) I'd never met before and who know nothing about me, plus presumably other patients in a group setting.

I asked if I could have time to think about it, and she said she'd like for the decision to be made within a week and for me, her, T, and MC to have a conference call (not sure why not in person--they're all in the same office) to discuss it. I asked if they would have already made a decision before the call, and she said no, that we'd discuss it together and it was voluntary. But that she thought I needed a higher level of care. I asked if I could try something else first, like cutting back on or eliminating drinking, checking in with T regularly, different meds, etc. She seemed reluctant, though did reduce my Wellbutrin a bit (on that and Zoloft now--have tried various other SNRIs and SSRIs over the past 8 months) since I've noticed more anxiety since I started taking it. But she said she strongly recommended the hospital thing.

My T doesn't work on Fridays but said to call her this afternoon after the appointment. After talking with my husband for a bit, I came up with the idea of a "care plan, " where I come up with ways to care for myself better, like regular exercise, eating healthier, reducing/eliminating drinking, regular check-ins with her, etc. And see how that goes for a week or two, then reevaluate hospital idea. I nervously called T and proposed that to her, and she thought that was a great idea, combined with a safety plan where I promise to call her (or possibly MC or p-doc) if I feel the urge to harm myself or to end things. Will post more on conversation later, but she also reassured me that she/they aren't trying to get rid of me or anything, they just want to make sure I'm safe and receiving the care I need. And she's going to call p-doc and MC to tell them about it and how she thinks it's a good idea, then let me know when she does. I'm so relieved and so thankful for my awesome T right now...

[PinkFlamingo99]

It's a bit different here in Canada but they definitely can't hospitalize you for "shallow cuts." I have been hospitalized against my will for a combination of very very (many stitches) deep cuts combined with very serious suicidal thinking/plans or for an overdose (each time I was held for about a week). Never for self-harm alone, even when it's bad. And I've prob gotten stitches at the ER somewhere between 20-25 times.

The only time I was held for SH alone was the last time and it was the worst I had ever cut, combined with them talking to my pdoc AND the fact that I didn't get stitches when I needed them bad. Even that was only 48 hours, and it was in the psych ER not the psych ward.

It takes a lot to put an involuntary psych hold on someone. Is it possible your T just isn't used to dealing with SH and doesn't know this? Usually they will ask if you have suicide plans, a date, the means to kill yourself, and won't keep you against your will unless those things are true, or you're psychotic.

Either way, things sound painful and hard. Maybe there is a way to get more help in a more frequent basis. An outpatient day program?

[unaluna]

The alcohol may be interacting or interfering with your meds. I just googled it, and it could be causing your panic attacks. Maybe the question is, how difficult will it be for you to leave off the booze? As dr phil says, is this a dual diagnosis thingie? (Okay maybe not EXACTLY as dr phil would say! ) maybe throw in AA meetings?

[LonesomeTonight]

Originally Posted by hankster

The alcohol may be interacting or interfering with your meds. I just googled it, and it could be causing your panic attacks. Maybe the question is, how difficult will it be for you to leave off the booze? As dr phil says, is this a dual diagnosis thingie? (Okay maybe not EXACTLY as dr phil would say! ) maybe throw in AA meetings?

Hankster, my T mentioned this about the meds/alcohol comb0 as well as just alcohol alone causing panic attacks. I'm guessing because the alcohol is a depressant, then when that fades off, it can turn to panic? And I've been worried that I'm drinking too much, too (my H also drinks quite a bit so we're likely enabling each other.) And for some reason, this combo of meds seems to leave me with no hangover even if I have a lot, so that deterrent is gone. I've also heard that some SSRIs cause alcohol cravings (I drank a lot while on Paxil last year too, but less on Cymbalta), but my p-doc said that hasn't been proven.

I actually was going to suggest AA meetings as part of my plan if p-doc and/or T didn't think what I proposed was enough. This is a probably dumb question, but am I allowed to attend an AA meeting if I haven't completely stopped drinking yet? I'm not that familiar with how they work except for what I've seen on TV, which is probably not fully accurate.

[atisketatasket]

Originally Posted by LonesomeTonight

Hankster, my T mentioned this about the meds/alcohol comb as well as just alcohol alone causing panic attacks. I'm guessing because the alcohol is a depressant, then when that fades off, it can turn to panic? And I've been worried that I'm drinking too much, too (my H also drinks quite a bit so we're likely enabling each other.)

I actually was going to suggest AA meetings as part of my plan if p-doc and/or T didn't think what I proposed was enough. This is a probably dumb question, but am I allowed to attend an AA meeting if I haven't completely stopped drinking yet? I'm not that familiar with how they work except for what I've seen on TV, which is probably not fully accurate.

Yes, you can go. (My first husband did while still drinking quite heavily.). AA doesn't track your alcohol use or anything even if you talk about it; they want you to get better voluntarily. Many people continue to go even when they have become "cured," which leads to a misconception about who can attend.

Sent from my iPad using Tapatalk

[unaluna]

Hey thats why they have a big supply of one day sober pins

I dont know the exact mechanics of what wears off when and causes what, i do know i am very sensitive to alcohol, and the meds make my moods on booze even more unpredictable, which is also what dr google says.

I tend to see it as two kinda unrelated issues - if your medical team is unaware of the extent you and h do drink, then its like youre hiding half the problem from them but still expecting them to fix it. Like not telling them youve been exposed to ebola but yeah you have a fever. Well maybe not exactly like that! But along those lines. Im sorry for being harsh but i come from a family of addicts and wonder about my own propensity for addiction and denial.