Couch 209: The Kummer Couch

This level of Anxiety I have is a job for Klonopin but I’m still 32 days away from getting some.

Why 32 days away? Is that your P-doc appointment?

Yes. She can’t see me until Jan. 9th. That was her first available appointment.

Ugh. Other things you could try in the meantime (if you haven't already) are magnesium and/or L-theanine--both act on GABA receptors (which is the same thing that Klonopin and other benzos act on--alcohol affects them, too). There are also supplements that contain straight GABA, but I'm not sure those are as effective?

At a real live gym for the first time since med school (I’ve been going to yoga or using the spin bike at home or, more commonly, not exercising at all). Going to do the elliptical, some weights, and then the steam room.

Today, the whateveritis is coming in waves. 'Maintain grip intensity' as Nathan W. Pyle would say, I guess.

Thanks. I’ll look those up and read about them.

I told my parents last night about my recent sui attempt. That was well....awkward. it went okay-ish. I just dont want to hurt them. I always want to protect them. Then they always freak out and it's so not helpful. But I knew they needed to know. A friend of mine was pushing me to tell them. And I'm seeing Pastor T tomorrow, so I guess I will tell him, and he might tell my parents so I thought I had better tell them myself. My friend who is wants to talk to me today. I'm pretty freaked out about that. And apparently I didn't make it clear to her that I had attempted. I thought she got it, but I guess not. So, when I told her that I told my parents it was like opening Pandoras box. FML. I swear. So stressed. Sigh.

Don't know if anybody has already mentioned it, but kava kava has been clinically proven to be effective for anxiety. You can order it on Amazon.

Didn't know that. Amazing what you can learn on the couch!!

SK, I know you've been telling a lot of people about the attempt. I guess it makes sense to tell your parents, therapists, and the friend holding the meds, but I'm not sure how helpful it is to share recent attempts with other people. Suicide is pretty stigmatized, and even if it wasn't, people don't really know how to respond or what they are supposed to do with the information. Maybe think about how you would feel if one of them told you they had recently tried to kill themselves. You would probably feel really worried about them and might feel that since they told you, you have some sort of responsibility towards them to make sure they don't do it again. Yet the average person is not equipped to assess whether you're an imminent risk to yourself - and it would be harder to do that when you have a personal relationship and are scared of losing that person.

Basically, I think disclosure of recent suicide attempts generally makes people feel scared and helpless, and that isn't helpful to the discloser. They might even feel angry or betrayed. A better strategy might be to just share how bad you've been feeling without disclosing the attempt.

Just my opinion and not a criticism. I just know you mentioned elsewhere that sharing hasn't been very helpful, and I wanted to share my viewpoint even if it might be unpopular.

Hugs, Kit. Glad it went OK with your parents. And, for the record, Pastor T shouldn't have been able to tell them about the attempt without your consent (as you're not a minor).

Btw LT, I think I saw you mention in the past that you and your psychiatrist weren't going to try one of the newer meds because insurance wouldn't pay or it was really expensive. I thought maybe it was Trintellix because it is pretty new and when I first went on it, it cost $120/month - but they had a coupon online that anyone can use that brought the cost down to $20. Anyway, a couple months ago, my insurance suddenly started paying most of it so that my copay is only $20 without the coupon. I figure something must have happened* to effect this change. Anyway, just thought I'd mention it. When my psychiatrist prescribed it, she said it is an SSRI but can also help anxiety (I haven't found that to be true personally).

* Found an article that explains the price thing.

Went to a poetry workshop at a local museum and found the other participants to be totally intolerable. Still glad I went because the instructor was useful, but dear God what a bunch of self-important people! I actually left early before people started reading their stuff; couldn’t stand the thought.

The gym was great though! It’s a women’s only gym and they’ve really thought of everything—nice shampoo in the showers, a great steam room, hairdryers everywhere. I’ll be back for sure!

Oh thanks, that's helpful to know! I forget if it was Trintellix or Rexulti--or possibly Latuda? I know for one of them, she said usually insurance will only cover it if you've tried most other cheaper options first (though...I suppose I have, actually!) I need to make another appointment with her soon, so maybe I'll bring that up then.

Thanks. I’ll look that up right now.

So is Pastor T not bound by the normal confidentiality rules? That's kind of worrying. Who else might he be talking about you to?

That sounds like Trintellix from what I just read. My psychiatrist said Rexulti is like a newer version of abilify, which I hated because it made me so restless. Never been on Latuda.

I'm in the UK, so I could be wrong, but I am under the impression that sui ideation/attempts are the one circumstance in which providers can breach confidentiality, if they have reason to be concerned.

True, but isn't the reasoning to prevent harm. Since the attempt is in the past, my thinking is that it should be treated as confidential. If there was a current threat, then yes, confidentiality shouldn't apply. Of course, I'm not a therapist and this is just the way I'm looking at it. I'd be pretty pissed if my therapist called my parents without my consent (and I was not a minor) and told them I had attempted suicide after the fact.

Pastor T seems to have weird boundaries. I think it's really strange that he thinks it's appropriate to have his wife involved.

Yes, I think it’s an imminent danger thing. Not something that happened in the past. Like if A client were leaving session, and the T thought they were imminent threat to self or others, then may be able to inform the emergency contact client gave them (and/or police). But not to tell them something they’d already done.

Agreed. I asked my T a long time ago about his emergency plan (whatever it’s called), to find out how clients would be informed if something happened to him. And his plan was that his wife knew how to access files and would contact clients. Felt a bit weird about that (plus, I mean, she’d probably be dealing with her own grief in that case...). Wasn’t so much a concern with ex-T and ex-MC, as they were part of practice with office staff. I’d definitely feel weird if he otherwise wanted to involve his wife in my care (plus I wonder if they’re even still together, but that’s another topic...though actually, that could make it even more awkward if she has access to his files).

How could he tell your parents about a past act if he is acting as a therapist? He is bound by confidentiality.
Are you finding this guy useful?

It seems like you are doing a great job lately of taking care of yourself. I'm truly impressed that you're getting out of the house and making plans for yourself while you're struggling with a more intense round of depression lately. What's your secret? I am barely managing getting off the couch.