Mismatched

**Trigger Warning**

I am bothered tonight and choosing to write about the amazing differences between my thoughts and my actions or my thoughts and my words.. or for that matter my actions and my words. Pretty much, the inconsistencies are growing by the day, and I am unsure how concerned I should be (I'm guessing greatly disturbed).

I saw my new therapist from IOP for an individual session today. The things she said and the way she was sitting there made me feel like I was being studied. I'm not sure how to explain this. Most of the time therapists just look like their listening to you like a relatively normal human being. There is a different way people look at you when you're acting unusual or unique in some way. She mainly seemed fascinated by how calmly and unemotionally I was able to discuss my suicidal thoughts and the last 3 suicide attempts. I guess most people would get emotional? For me it's all matter of fact.. it happened, it didn't work, and it seems pretty likely to happen again eventually. She actually asked some very intelligent questions and make some very reasonable observations. She understood when I talked about calling 911 that I didn't suddenly come to the realization that I wanted to live. It was more like I realized it wasn't happening quickly or like I wanted (or I didn't think it was going to work) or the 2nd time that I didn't feel like wandering the streets of Dallas at night with no phone and no money hoping to die. It was more like that attempt wasn't going right, and I needed to stop and try again. We talked about why my method has always been the same because I hope I will just fall asleep and if the powers that be (God or other humans) intervene I will wake up and if that's not meant to happen I won't.

I was not entirely honest about what's going on though.. I mean she asked me to rate on a scale of 1 to 10 the likelihood of me acting on the thoughts today. I said 3 because today it was very unlikely to happen. I neglected to explain the amount of thought I have been putting into the plan and some things I have done that might be concerning. Mainly I have two files on my computer.. 1 is a suicide note of sorts and 1 is a list of hotels/addresses/pharmacy etc that might be needed if I decide to do it. I didn't mention that during IOP I have trouble focusing, so I sit and look up the hotels and the prices and what sort of restaurants deliver food there. She seemed to find it interesting that I plan out the food because I think she thought I was planning to binge, but it's just like how prisoners on death row get to choose their last meal. That also includes planning my last drinks.

Tonight we can add to the list of concerning behaviors printing some reading material on DNR orders because on 2 of the last attempts at least I was intubated, and I'm wondering if I can prevent that.. although the form I printed has a place for a doctor to sign that I was competent when I signed the form but have shown evidence of being incompetent later.. and I don't know if a suicide attempt would automatically indicate you are not mentally competent to make such decisions. I haven't done anything with the form. I just want to look into it.

So yeah.. I am not all that depressed tonight. I am kind of numb and sometimes almost a bit happy. I've had casual conversations about random things with my parents. Everyone at IOP said I seemed more upbeat than last time. I had to carefully choose words to explain that I was less depressed but in all honesty, I am not well. I didn't want to explain the searches and obsessive things I was researching while listening to everyone else check in. I didn't want to say earlier that I was entirely unlikely to act on anything tonight, but it isn't a good sign when I tackle some obstacle standing between me and the actual act. There was another thing I did but it isn't a definite indication of intention to act because I reason that it can be undone if I change my mind later. I wrote all this and thought of another thing I did that I haven't told her... actually it has to do with a semi-lie I told the other day when she was asking questions after group trying to gauge how suicidal I was.

The more and more I try to explain this, the more removed I feel from my feelings. Does that make sense? I suppose tomorrow I may email my therapist if I am still concerned. I think I should sleep on it and see how I feel tomorrow.

Small talk

I started IOP last night. It's through the same center I did residential at, although it's online right now because of covid. I am struggling with it. We did a check in last night and I said I was depressed. I otherwise basically summarized my current situation (that I just got out of residential over the weekend) but didn't go into the whole mess that led up to me being in rehab this time. That's a bit heavy to bring up so soon, and I need to know people a bit better before I talk about anything involving suicidal thoughts. I guess it was an ok group.. I couldn't focus. My head was off in the worst kind of obsession. I was looking up hotels for if I run away again.. I looked at prices and pictures to see if the rooms would have a fridge and a microwave. I made sure they'd have wi-fi. Then I looked up what sorts of restaurants deliver food there. I already had figured out some hotels within walking distance of a liquor store.. and close enough to a pharmacy and other stores for other necessary supplies. I was looking at all this with IOP open in the background. I was listening, but I was in my head.

Well, today I tried to listen to IOP.. but it was not helpful. Somehow during check ins they got off on discussing one of the women needing to get her hair done and her telling a story of a time she spent a ridiculous amount of money getting her hair done. This went on for probably 15 minutes. Meanwhile, I am sitting there fighting back tears. I am sitting there with the depression closing in and the ever present suicidal thoughts, and they're just chatting. I had to leave and get a tissue. At the end of the group, the therapist was asking about what people like about the group and what they'd find helpful. Several people talked about how they like the small talk because they get to know each other better. Someone talked about wanting people to be more open. It got around to me.. and I basically said I didn't know what to say. I said that I have realized in the past couple days how unready I was to leave residential. I said so much hadn't gotten better, so I am very pessimistic about treatment. At this point, I was crying.. and everyone was supportive. They said they hadn't realized I was struggling. I don't know.. I said something about just not wanting to end up back in the hospital.

So of course, the therapist was concerned. I had to convince her I wasn't actively suicidal (which is a lie) and was safe tonight (which is true). I tried to explain that I just don't know what to do.. and how my next psych appointment is late in August. She asked if I was out of my meds, I said no.. they just aren't helping. So I think this will all get brought up in treatment team, and I am honestly just hoping I don't get sent to a psych ward. Residential was helpful, but the psych ward wasn't. I just don't know how to sit there in IOP like it helps to chat cheerfully with everyone when I am sinking. I can't explain that I can put on a brave face and act fine but then continue with actions that clearly indicate something is wrong (writing notes, doing research, etc). But I'm ok tonight. I just don't know what will happen if this doesn't get better. Tonight I just want to go to sleep. I see the therapist individually on Thursday, so at least I'll have a chance to talk more then. I just don't like putting anything so heavy on the other patients, so I hope that I can be honest with the therapist at least.

3 months

I am considering using my blog again now after all that's happened the past several months. I will start with a summary of this year.

February- 1st suicide attempt of the year. This is the one that I took pills while black out drunk and woke up in the hospital. I was in the medical hospital for a week followed by 5 days inpatient and a few weeks IOP. (days in hospital 12)

April- toward the end of March I got kicked out of IOP for relapsing with alcohol. They recommended I go to rehab before I could come back, so off to rehab I went. (days in 28)

May- I spent 28 days in rehab, and I was continuously telling them my depression was getting worse and so were the suicidal thoughts. I had a plan in my head, and I only couldn't do it because if I left they said they'd call the cops (because I was suicidal). Well, they started talking about transferring me to a psych facility, but my therapist was terrible about communicating what was going on. I got angry with him for leaving 2 days in a row after I agreed to transfer somewhere without telling me what was going on with the transfer. I asked to leave AMA, and various people at the facility panicked even though I never even got so far as to sign the AMA form. I once again agreed to be transferred, but they went ahead and called the cops anyway instead of doing what we had agreed on. I end up having a cop show up for a welfare check and then went to a psych hospital for an evaluation. I lied about how I was doing, and I had hoped I could go back to rehab. Well, that didn't happen. They called my parents to come get me and said the facility wasn't appropriate for me.

So I was home for 1 night and then was supposed to go to a psych hospital. I convinced my parents to drop me off and went in for my evaluation. I changed my mind during the seemingly endless waiting and dealing with some very rude people at this hospital. I told them I didn't want to go in, and I was safe to leave. I left and got a hotel room. I drank for a night or two.. it's a bit blurry. I changed hotels because I somehow lost track of what day it was and when I was supposed to check out. I got to the 2nd hotel and took a lot of pills.. both prescription and Tylenol PM. I sat around waiting for them to do something, and I panicked. I called 911.. I remember the ambulance coming (and the paramedics were really cute). I kept trying to explain what I took and answer questions and them saying I wasn't making sense. I was taken to the ER, and I don't really remember much of the couple days I was in the hospital. I guess I was intubated at some point, and my liver was in really bad shape. Somehow when I was conscious again I convinced them to let me leave AMA. I went to Walmart planning to buy more pills. I managed to leave my phone in the Lyft and didn't know where my debit card was. I end up shoplifting a bottle of tylenol PM and wandering around the area taking them and trying to decide what to do. I was somewhere in Dallas with no real clue how to get anywhere and no phone. I finally borrow a phone from someone in the parking lot of a gas station (after actually asking a cop for help and being told he was too busy to even call for an ambulance) and get taken by ambulance to the same hospital I left earlier that day. I repeat the process of drinking charcoal and being given all sorts of meds.. and that's all a blur. I agree to go to a psych hospital once my liver is back to being ok. (days in hospital 5)

May/June- I spend 18 days in a psych hospital where they try to sort out my meds. I am crying daily and suicidal. I get talked into going to a residential facility because clearly I need more help. They only agree to let me leave if I go straight there. I actually planned to agree to be picked up by the facility staff and then say I changed my mind and go kill myself, but I somehow got talked into actually going to the next rehab. (days in hospital 18)

June/July- I went to a residential facility that does dual diagnosis (alcohol and mental health) and actually also eating disorders. I had been sober 3 weeks when I got there, but my depression was still out of control. I spent the first 3 days crying pretty much constantly. I eventually started going to groups and doing assignments, and I really tried despite the depression being bad. My therapist kept trying to argue there's something in my childhood I need to deal with that's causing the depression, and I kept arguing that there might be but the pressing issue is that I was suicidal and self harming daily (and purging but didn't mention that). So I managed to spend over 45 days there and the depression is still bad, but insurance says no more residential. I have mixed feelings about leaving. I don't think I'm ready, but I also feel like it wasn't getting better anyway so I was wasting time. At least here at home, I have my cats and my parents. I have been home just that one day since I first went to rehab in April. Total days in hospital/inpatient/residential 63 so far this year.. and I start IOP again on Monday. I am pretty burnt out