structure AND chaos

Please note: This is my entry for June’s Blog Carnival of Mental Health. The topic is hope and despair.

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Structure is my one true love. I love going to bed every night at ten and getting up at six. I love running three miles on Wednesday, five miles on Friday, and six miles on Sunday, and I love knowing that my distance for each of those days increases by ten percent each and every week. I love reading a chapter from a book on my commute into work every morning and then another chapter at night before bed. I love planning activities way in advance, so when I do have to deviate from my schedule, I can plan accordingly.

I could go on and on and on.

Structure serves a purpose for me: it provides hope amongst chaos. It’s also synonymous with perfection. When I know exactly what I’m doing and when I’m doing it, I can remain free from uncertainty, and anxiety stays somewhat at bay.

The problem becomes when uncertainty, chaos, and despair creep back in, which is inevitable. This sends me into a downward spiral. When an unexpected social situation comes up that keeps me out late and floods me with anxiety, I get worn down and it takes a few days to recover. The more deviations, the longer and harder it is for me to recover.

For those who don’t know, last January I entered a downward spiral that stole all hope and ended in two hasty suicide attempts and one well thought out attempt that probably would have killed me if I had carried it out. There’s plenty of triggers to look at, but I think my obsession with structure is the main culprit.

Up until that point I thought I had everything under control–that is, I had developed a set of routines that I thought were impenetrable. However, I went from only going to school online and being subject to few real social situations to having a full-time job and an internship. It was too much. They broke down my structures so much I couldn’t recover. And so I gave up.

I let myself be taken by chaos. I let myself fall further and further down. Granted, I started planning for suicide, which ironically in itself brought structure. But for the most part, I let all structure go.

Now that I’m stable and can look more objectively at what happened, I know that I need structure. I’m just that type of person. The question, though, becomes–How can I have structure but still allow some chaos and uncertainty in without letting it destroy me?

I don’t have an answer. But I do believe it starts with awareness. It starts with knowing that life is full of uncertainties and I cannot possibly plan for every little thing. I mean life isn’t some science experiment with set variables, yet so far it’s been my best defense against anxiety to treat it as such. I am learning that there is a balance between structure and chaos; it’s not an either/or situation. There will always be hope and despair in my life, sometimes at the same time–and I’m learning that that’s okay.

no direction

There’s no way around it: the depression has lifted. Unfortunately, now that I’m no longer depressed, I have to deal with the triggers as well as finding preventions so I don’t get trapped again.

I feel good so far about Nardil. I’m still in the early phase, so I’m on a very low dose and experiencing no side-effects (but no benefits either), but I do feel hopeful about this drug. I’ve never felt good about medication in the past. I question it. I think about it too much–Is it working? Is this me or the medication? Etc. But I’m not doing that this time. I have faith, I guess.

The bigger issue for me is what direction should I go in career-wise. I feel stuck. I don’t like my accounting job–and I dislike my boss even more–but I could stick it out just because it’s easy if it paid more. My boss, on the other hand, believes I want more from the job. He wants me to eventually take over running the business. Again, I have no idea what he sees in me. Regardless, the work is not something I particularly like doing and I don’t feel like the work helps people–so I’m not fulfilled at the moment.

Then there’s my education. For those who don’t know, I’m in graduate school, training to become a librarian. I have 3 classes left to take. I guess this is the ideal path for me because I may get more enjoyment out of the work and it definitely helps people. But I’m worried that I won’t be able to find a job after I graduate. I wish I could just push my worries aside, let things happen, and worry about finding a job when I’m actually finding a job .. but that’s not me.

So, at the moment I feel lost. When the episode of major depression hit, I had just started my accounting job. I cannot ignore that. I think that when you’re already dealing with mental health issues, dissatisfaction with other life circumstances–i.e., my job–can make it seem like your issues are even more insurmountable, which exasperated my depression.

I have no answers right now, and I probably won’t have any answers for a while. One day I may be content with my circumstances, just not today. I guess that’s okay for right now.

starting nardil

I just picked up my script. I’m scared. This drug is old and nasty and has terrible side effects, but apparently it really reeeally works. It seems like it’s the last line of defense, medication-wise, for depression. It’s also supposed to be really reeeally great for social anxiety.  But there’s so many food restrictions–http://www.dr-bob.org/tips/maoi.html

I have to eliminate so much from my diet. I’m vegetarian, and I can’t have soy products or protein shakes or nuts. I guess I’m going to start eating meat again.

Aside for the food restrictions, there’s, again, really reeeally bad side effects, which apparently according to my research mysteriously go away after a few months and you’re left in bliss. With my history of medication, though, I’m not feeling very hopeful.

I just want something to work. I just want to feel better. I’m not expecting a miracle or a quick fix, just a little relief.

If the ends justify the means ..

an example of avoidance

Yesterday my boss asked me to go downtown today to pick up some tax documents at the state’s local field office. I didn’t think they could provide the documents, but I didn’t have the nerve or desire to argue with him so I reluctantly agreed.

I’ve had to go to this field office a few times before. Each time, I’ve had to endure a rather difficult social situation because the receptionist is very attractive and socially adept. In other words, she’s beautiful and perfect, and I’m not. These thoughts happen in a split second and ensure that I will fail. Now, CBT has taught me to catch these thoughts before they happen, to counter them with positive, rational thoughts. But this never seems to happen quick enough. I sum up that she’s perfect and place her on a pedestal before my rational mind has a chance to kick in–and I’m left playing catch up.

Anyhow, earlier I started having anticipatory anxiety about the situation: Not only would I have to face this perfect being but I also don’t feel comfortable asking for the documents since I don’t think they could provide them. And so, I started coming up with ways to get out of going–

  1. I could lie to my boss by telling him that I went and that they either didn’t have the documents or couldn’t give them to me.
  2. I could call in sick.
  3. I could call the tax office to see if they could even provide the documents.

The third choice seemed the most logical, but I’m terrified of making phone calls, especially when I have time to think about what I’m going to say beforehand, so I wanted to do the first choice. Eventually though, I talked myself into calling, which was horrible in itself, but I found that I was right: They couldn’t give me the documents after all.

I’m now beating myself up, telling myself that it wasn’t that bad and I shouldn’t have been fretting about the situation at all. I’m also disappointed in myself for avoiding another social situation.

Why can’t I look at the good parts? I mean, I made the phone call even though I was terrified and obtained an answer without lying. Those are positives, I guess.

If I’m not perfect then I’m nothing at all.

a setback

As expected, depression caught up to me last night. Along with it came intense claustrophobia, which brought anxiety and at times near panic; sadness; unfulfillment; and the inability to do even the most basic tasks.

I tried to just go with it, to let the feelings pass by actually feeling them, but they became too intense. I binged on food, which didn’t help, and then tried to binge on alcohol but after one drink I felt sick. I spent most of the night lying on my bed in the fetal position unable to move.

Suicidal thoughts returned in full force. I felt like I did two weeks ago. I’m disappointed with myself for succumbing to the depression and binging.

my mom and dad and my boss

I thought I’d drop by
to see how you see the sun.

As you know, I told many people about my suicide attempt, including my parents and my boss. I’m not the closest with my parents so telling them wasn’t easy. Fortunately, when in the midst of a crisis things become easier. I called my mom while I was still high on Ativan–I barely remember the conversation, actually; I just remember her saying over and over again to stay away from alcohol–and I told my dad while I was in the urgent care facility. He took it well. I mean as well as one could, I guess–very grateful I was alive and communicating with him.

Further, I also told my boss while in the urgent care facility via text messages. I told him I wouldn’t be coming in the rest of the week because I had a “psychiatric emergency.” I should have been more specific as he seemed worried, because he tried calling many times. But I did tell him that I was okay and that I would explain everything face-to-face.

That face-to-face conversation went well. I didn’t tell him about my social anxiety but I did share with him my suicidal intentions as well as my subsequent overdose. He understands that I am a perfectionist and take a lot of what he says personally. He wants me to be more open with him when I’m feeling stressed or angry at him, rather than bottling it up–easier said than done, of course. I also told him I wanted to work more, as I need more structure, and that I enjoy the work (most of it). He’s been pressuring me to take more interest in the work, as he actually wants me to take over the business some day (not sure what he sees in me), but I told him during our conversation that I’d like to be working there for a long time but in the background. “I do not want to take over the business,” I told him. I feel a bit trapped, I guess. I’m not sure what I want to do with my life, yet this job isn’t very demanding, socially-speaking–so it’s working for me right now.

I feel really bad because my boss is probably going to lay someone off thinking that I can take over his role. Granted this person has really stopped caring about his work, but I can’t help but feel bad. He has a very difficult time communicating, even more than I do, and he must be struggling from some form of social anxiety. Then again, I think he may want to get laid off to pick up unemployment.

But do I really want to put someone out of a job for a job I’m not sure I want? I keep telling myself it’s out of my hands, but there are options; I’m just choosing the easiest one for me, which may be best considering all I’ve been through.

***

I talked to my parents yesterday after everything calmed down with me. I apologized many times for not confining in them about my problems. I will do my best to be more honest with them in the future about my depressions. (But I have my doubts about whether I will really be able to do that.)

I now feel really depressed and somewhat anxious about my relationship to my parents. I put myself out there–I mean really out there–and now I feel a lot of pressure to keep an open dialogue going with them regarding my mental issues, which is a common theme in our relationship as of late. During those calls, we  grew closer than ever before, and it scares the hell out of me. It’s as if five years of emotional bonding and connection passed before us all at once. (My dad even said he loved me, which hasn’t happened in like ten years. It was very awkward, and I must admit my “I love you” back was equally awkward. We both meant  it; it’s just we both lack an emotional connection to the other. He’s not a perfect dad, and I’m not a perfect son–that’s okay.)

What’s more, they say they understand but I don’t think they have a clue. They may have been depressed most of their lives but they address it differently. They ignore it and try to push it away while I’ve tried to address it. I don’t think they’re any closer to seeing the sun the way I see it.

***

P.S. I think my manic energy is starting to wear off. I may not post for a while, but don’t worry, I’ll be fine. Take care.

short timeline ***warning: trigger alert***

I just thought I’d summarize my recent events surrounding suicide ..

February 14th: I took too many Vicodins and ended up in the emergency room. I’m not entirely sure if I wanted to kill myself, but my normal destructive methods of dealing with pain weren’t working–so I tried to knock myself out.

May 14th: I had been planning to kill myself for months. I laid out all the pills, which I won’t mention by name as I don’t want to trigger anyone (anymore than I probably already am–sorry!), but couldn’t bring myself to do it. Instead, I drank 16 beers, and took a few sedatives while blacked out. I woke up the next day hungover but alive.

May 20th: This is the day that I had been planning to kill myself for over two months. Again, I laid out the pills, and again, I couldn’t do it.

May 24th: Not wanting to return to reality–that is, school, my job, reconnecting with friends, etc.–I purposely overdosed on sedatives. My plan was a success: I ended up in an urgent care clinic and got to avoid dealing with life for another few days.

I’m now having to pick up the pieces, rummaging through the ruins I’ve left behind. I’m back at work. I’m talking to friends. It’s hard. But I am alive.

three things (and four stages)

First, sometimes I cannot trust myself. Losing your capacity to reason isn’t quite as bad as thinking you can still reason when it’s clearly illogical (in retrospect, of course). I need to do my best to question my logic. Logic can be its own monster. That is, fallacies and distortions can build on one another, creating what appears to be logic–but it’s far from it. Staying connected with others and communicating more with them will help me stay on top of my own distorted thinking.

That said, I think there are instances where death makes logical sense–and suffering from mental illness(es) can be one of them. However, I owe it to others and more importantly myself to exhaust all options before even considering death. I need to grind away at each day no matter how difficult life becomes.

Second, killing myself will affect so many more people than I realized. I tried my best to push people away. But I now know that no matter how much distance I put between myself and others, they can still see me–and will be greatly affected by my loss in ways I cannot even begin to imagine. I thought I could simply die unnoticed. I was wrong.

Finally, I need structure now more than ever. In The Four Stages of Spiritual Development, the author, Scott Peck, posits that there are four stages of spiritual growth (from Wikipedia)–

  1. Stage I is chaotic, disordered, and reckless. Very young children are in Stage I. They tend to defy and disobey, and are unwilling to accept a will greater than their own. They are extremely egoistic and lack empathy for others. Many criminals are people who have never grown out of Stage I.
  2. Stage II is the stage at which a person has blind faith in authority figures and sees the world as divided simply into good and evil, right and wrong, us and them. Once children learn to obey their parents and other authority figures, often out of fear or shame, they reach Stage II. Many so-called religious people are essentially Stage II people, in the sense that they have blind faith in God, and do not question His existence. With blind faith comes humility and a willingness to obey and serve. The majority of good, law-abiding citizens never move out of Stage II.
  3. Stage III is the stage of scientific skepticism and questioning. A Stage III person does not accept things on faith but only accepts them if convinced logically. Many people working in scientific and technological research are in Stage III. They often reject the existence of spiritual or supernatural forces since these are difficult to measure or prove scientifically. Those who do retain their spiritual beliefs move away from the simple, official doctrines of fundamentalism.
  4. Stage IV is the stage where an individual starts enjoying the mystery and beauty of nature and existence. While retaining skepticism, he starts perceiving grand patterns in nature and develops a deeper understanding of good and evil, forgiveness and mercy, compassion and love. His religiousness and spirituality differ significantly from that of a Stage II person, in the sense that he does not accept things through blind faith or out of fear, but does so because of genuine belief, and he does not judge people harshly or seek to inflict punishment on them for their transgressions. This is the stage of loving others as yourself, losing your attachment to your ego, and forgiving your enemies. Stage IV people are labeled as Mystics.

I for one believe that no one person is totally in only one stage at a time–we fluctuate across many stages throughout our  lifetimes, often residing in more than one stage at a given time and between stages as well. At this point, I find myself mostly in stage one. I still carry with me pieces from the other stages, but, for the most part, I unraveled, tried to kill myself, and now am left vulnerable, disordered, and reckless.

Now, I don’t believe that organized religion is the only means of finding structure in Stage II. I’ve decided to focus more on my job, as well as to start studying for an Enrolled Agent exam so I can move up in my company and get a raise. I’d also like to spend more time writing and connecting with others through my blog. Reading, exercising, and cooking are also on the agenda.

Sorting through the pieces of what’s left from my suicide attempt is all I can do at this point, and I need to take it slow, one day at a time.

does your mother know?

So, on the way home from therapy on Tuesday I took an overdose of Ativan. The session itself was difficult, as we discussed my recent suicide attempt and the fact that I found a new therapist and would like to start seeing him next month. I also tried to ensure my therapist that the events are mutually exclusive. ( I thought this was very important.) In other words, I’ve been contemplating a change in therapists for some time now (which is true).

Furthermore, I was dreadfully scared of having to go back to work yesterday, so instead of addressing it proactively–by either talking to my therapist or boss, trying to go on disability or something, etc.–I felt it best to OD. That will grab attention, I thought; and it sure did.

Without doing much damage I skipped the emergency room and went right to my psychiatrist’s office. He suggested I spend the night somewhere safe at a urgent care clinic, which I did (which wasn’t so bad), and then possibly go on disability leave from my job. There’s also plenty of options for low-cost inpatient care treatment here in San Francisco (we love our social services here!), so that’s an option. But to be honest, I really think I just want to switch anti-depressants–to Nardil–and go back to my normal routine.

I’m proud of myself because I told both my parents what’s been going on with me over the phone, and they were both very supportive. I also texted my boss. I haven’t given him all the details yet–I just told him I couldn’t come in because I had a psychiatric emergency. He’s provided support, and he wants me to call him–and I will as soon as I get up the courage.

I am feeling loads better. I see my psychiatrist again today to hopefully get on Nardil. I am also no longer feeling suicidal. Yay!

live or die, heads or tails

There is only one really serious philosophical question, and that is suicide. Deciding whether or not life is worth living is to answer the fundamental question in philosophy. All other questions follow from that.      – Albert Camus

I woke up last Friday certain that it would be my last day on this planet. I took an anti-emetic, as I was pre-loading, staggered into the kitchen, made toast, and then stared at a picture of my parents–all the while shoving back tears. On Thursday, I put up pictures of my family and girlfriend throughout my apartment. I didn’t want to be alone when I took the pills. They would give me strength. In a way, I would be doing it for them.

After breakfast, I started thinking about death–and what that means. I went to a window and pushed open the drapes, allowing the light to pour in. It wasn’t a particularly sunny day, but I still felt it’s warmth against my skin.

As a nihilist I haven’t given much thought about the after life. Whenever I do think about it, I just get pushed back to my nihilistic beliefs. What’s the point? No one knows for sure what happens after we die—it’s all subjective. Plus, even if I did believe in something after all this, I cannot imagine it resembles anything that’s depicted by popular religions. I do believe there is something out there, that connects us all. That connection is what I believe in, which is why I knew that if I had killed myself on Friday it would have affected so much more than I can possibly imagine.

I’ve relied on that connection for a long time; it gets me through the day; it provides meaning to my life. Depression took it away. I cannot extract meaning from anything anymore, and, although I still believe on a theoretical level that this connection exists, I no longer feel it deep down—and that’s where it matters. It’s hard to do anything when faced with a meaningless life.

On Friday everything pointed toward death. I felt so certain about it. Sure, the week before I tried to kill myself and couldn’t go through with it, but something felt different on Friday. I didn’t feel happy or terribly sad. I may have spent the majority of the day crying, but those tears were okay. The days leading up to Friday were much worse. I was in agony thinking about the shit-storm of pain I would be leaving behind. But on Friday, the path seemed clear. I could do no wrong.

But then when it came down to it–after I took the final anti-emetics, after I deleted all my email and everything from my hard-drive, after I scheduled an email to be sent to my girlfriend on Sunday, after I lined up the pills, after I took one last look at myself in the mirror–I couldn’t do it. Terror rose up from somewhere unknown, pushing the depression and pain aside.

A part of me wanted to go on. Where was this part of me a month ago when I was living like I had a month to live?

On Saturday I felt numb. I barely ate. I guess numb and starving is better than binging and suicidal (my normal state). I cleaned everything up. Out of sight, out of mind. And now, it’s like it never happened. I feel myself moving on to the next phase, without giving much thought to my suicidal feelings.

This is how I operate. I push things aside. I move on. I adapt. I do not dwell, and I do not feel. It’s like a game. One minute I’m suicidal, and the very next everything’s okay again. There’s never been any balance in my life. All or nothing. This way, or that. The suicidal feelings flicked off (unconsciously) and now I’m not even taking them seriously. I don’t know how close to death I came, but this is something that should demand attention, yet I am somewhere else, in the future, trying to plan my life, as always.

My answer to Camus is this: Life and death are the same. Neither matters to me. My desire to live didn’t keep me alive; my fear of uncertainty kept me going.

P.S. Today is my birthday and the only person I heard from is my dentist (via email). I guess it doesn’t help that I’ve pushed almost everyone away these past few months and that I got off Facebook and that my phone doesn’t have a battery. But it’s nice because I get to reinforce all the negative feelings about myself–nobody loves me or cares about me, because nobody even realizes it’s my birthday. I am nothing.