Suicidal ideation and self harm urges

Warning - this post could be triggering for some people. Helpline numbers are posted at the bottom of the page if you need to talk to someone.

I've really struggled today. Driving home today I had very strong urges to drink (alcohol) and cut myself. When I get like that, that is all I can think about. Those thoughts fill up my brain and I obsess about it. Today I kept telling myself 'this is not how I deal with problems and feelings now' and tried to understand why my brain has presented me with these urges.

A few weeks ago I was dealing with almost constant suicidal ideation. It was painful, indescribably so. How can you tell your support people that almost every waking minute of the day you think about killing yourself? That your head is full of images of you electrocuting yourself in the bath, falling and cracking your head open on concrete, gassing yourself in your car, hanging from the garage rafters, slicing your wrists open, driving your car into a concrete barrier/power pole/traffic, drowning in the sea.... That everywhere you look there is more ways to die. And that you fear that, in a moment of weakness when you are worn out from all the resisting, you will give in to an impulse and do something irreversible. When you spend time with loved ones you feel constant guilt about the thoughts you have about dieing. 

So, I'd been having these thoughts for quite some time, two or three weeks I think, when I began to feel quite desperate. It was really starting to worry me that I might act on an impulse and do something I would regret. I brought it up with my psychologist, which is a lot harder than you might think. Trying to get those words out that I was feeling this way and having those thoughts, the feelings were overwhelming my ability to speak or be coherent in any way. Which is another reason it is so hard to talk to my support people and family about things. When I am unwell I am often so full of thoughts and emotions that I struggle to put together words in a way that makes sense to others.

One other thing that I want to make clear - having these thoughts does not mean rational me wants to die. Rational/wise me knows that I have lots to live for, there are things I enjoy and people I love, and that I just need to hang on for a bit until things get better again. Because they do get better. Unfortunately I do have periods of time where I struggle with suicidal ideation. It's been an ongoing issue for me since my teens. Sometimes it's intense and lasts a day or two, sometimes it's nagging thoughts that are around for months on end. This time the length and strength of what was going on for me was wearing me out.

My psychologist was a massive help. He described my brain as trying to protect me. I have a problem, which is that I was having a depressive episode. This was making me miserable. My brain sees the problem - misery - and provides the solution - death - for me. But what it doesn't understand is that by giving me death as a solution it promotes further misery, as another part of me desperately doesn't want to die. So I have the two sides of me - depression/misery/suicidality, and the love for my family and friends/hope for the future - locked in conflict with each other. The guilt and shame I feel at having these thoughts effectively strengthen them. My negative emotions start to escalate leading to further misery, which causes my brain to further bring forward the 'solution' of death/suicide.

By thinking of my brain as this benevolent force trying to using black and white thinking (ie here's the problem, there's the solution) to help me, I could feel compassion towards myself and it completely changed my perspective on my suicidal thoughts and urges. Now when I get those thoughts I can understand it is my brain just providing me with what it thinks is a good solution to my depression. My brain is trying to help me end my suffering in the most immediate way. And now I have to teach it that life is worth living, even if sometimes it is messy and uncomfortable and it hurts.

In the same way I have worked with my psychologist on my binge drinking and self harming urges. These urges often pop up when I am feeling other negative emotions because over the years my brain has learnt that negative feelings and emotions are intolerable. So it provides self harming behavioural urges as a coping mechanism so I don't have to feel horrible things I don't want to feel. Pretty clever when you think about it. My brain has taught itself that it doesn't like anything negative and that it should get rid of those feelings, emotions and experiences at all costs. Even if that involves harming myself or killing myself.

So today when I was having a rough time with wanting to binge drink and cut, I could tell myself that I must be feeling something I didn't want to feel and that there are healthier ways to deal with my feelings. I'm tuned in to my feelings in that I feel everything x100 - joy, sadness, anger, etc. I know what I'm feeling as I'm usually feeling it incredibly intensely. But I often don't know why, what was it that caused me to feel that way. I find that confusing and alarming in itself, to be confronted by these big feelings and have no idea why.  

Today's feelings were brought to you by..... I don't know. Probably a combination of things. I'm unsettled at the moment as I have been thinking about starting a business. Or studying art. Or tech writing. Or anything else. Or.... And that's the problem. One minute I have an idea and am completely taken with it, researching the hell out of it and obsessed, unable to think of anything else. And the next minute I'm off on another tangent thinking of something else. A million thoughts are going through my head, and while I'm mentally walking through what it would be like to study again, several other concurrent lines of thought are going on - what business would I set up, how much would it cost to fund, could I get a student loan for study, should I give art lessons, how about buying a tripod and making you tube videos..... 

Another thing that's bothering me is something that was said to me about Little G. I agreed for us to take part in a research project being done by a service that supports kids who have parents with mental health and addiction issues. Which is fine, I did my interview, she did hers, all went well. But the psychologist who interviewed Little G made some remarks about how she presents and what her view is on Little G's diagnosis. And I don't quite know what to do with the information she presented me with. It hasn't come from a formal assessment so its an opinion, but it's one that's thrown me into a tail spin as basically it equates to the ASD diagnosis may not be right and there is actually something else going on with her. And that something else should be looked in to.

I'm not sleeping at the moment which is never a good sign. The last week or so, I haven't turned out the light before midnight, and most nights not before 2am. I get up at 7am so it could be worse, but I should really be in bed (light out) by 10.30pm as sleep is such an important part of my self care regime. Problem is that I can't bring myself to follow my self care regime at the moment.....

I'm also bored at work. Which is not good for me either. I need to be mentally occupied and challenged otherwise all the other thinking takes over (effectively what's happened) and my brain goes a million miles an hour in a whole lot of different directions. I have a lot of trouble concentrating when that happens, and I also tend to over think and obsess on things. 

So there's quite a bit swirling around in my brain and I guess maybe the self harm urges are trying to tell me that I am overwhelmed. That I need to try and get some sleep, eat some proper food (not just cereal) and try and stop thinking. Use my meditation and mindfulness techniques to get out of my brain and into my life (got that line from my psychologist lol). The trouble is finding the motivation to do those things when they are the absolute last thing I want to do. I have to just keep telling myself I want to be better so I can be a good Mum, family member and friend. And lead a life worth living.


Suicide - read this first

Coping with suicidal thoughts

If you need to talk to someone:

Free call or text 1737 any time for support from a trained counsellor. 

Lifeline

0800 543 354 or (09) 522 2999

Youthline

0800 376 633

Samaritans

0800 726 666

The last few months part 4

Welcome to part 4...

Trigger warning........there’s quite a bit of cutting at the end of this. Please be safe and don’t read if this could trigger you in any way.

So back to August. I’ve got all this turmoil going on in my life. I’ve had a complete meltdown, discovered I hate myself, am slowly decreasing my dosage of all my drugs, and I’m still pretty bloody miserable.

Work stuff happens. So much work stuff. Stressful things like clients getting mad at me for things that aren’t my fault. Work piles up and I can’t get through it and don’t know what to do about it. I can’t seem to get anything finished and every day someone emails or calls to ask where another piece of work is that I haven’t finished.

Meanwhile, my daughter is having some issues of her own. She’s often very sensitive to my moods and for whatever reason she’s having some emotional issues of her own at the same time. She’s crying a lot, very clingy, wetting the bed constantly (not wholly unusual - she’s not nighttime toilet trained even though she’s 8 but she’s wetting through her pull-up) which is causing me a lot of washing, and she’s basically refusing to do anything she’s told. I know it’s a relationship/connection problem - she’s reacting to my mental unwellness But I can’t seem to get back on track to do anything about it.

Self harm is still calling to me all the time. Suicidal thoughts are constantly with me. I get in the car and think about what it would be like to gas myself in the garage. I drive down the road and notice stuff I could run my car into. I drive by the sea (which is everywhere as my city is a series of peninsulas) and think about drowning. I’m constantly thinking about cutting, drugs, electrocuting myself. It’s tiring, all these thoughts of self harm and death.

Alcohol is my nemesis at this point. My body physically craves a drink, but having one lowers my defences and is a slippery slope to doing something I’m trying so hard not to do. But, after achieving something at work I feel like I could do with a drink to celebrate. I call in to the liquor store on the way home on a Friday night and buy some vodka and e-cigarettes.

I always try to take the appropriate positive actions. This time I read books, had a bath, got someone to take my daughter so I could have some alone time. I tried to go to bed early and get more sleep, and listened to music I enjoy.

On Sunday afternoon my thoughts were all over the place. I would feel momentarily calm and then get worked up and agitated about something. At the time I wrote “I don’t want to be me anymore. All the stress and the constant struggle. I’m trying to do the right thing but it feels like no matter how hard I try I always fall short”.

One beer turned into two. One temazepan became two. I did some cleaning. Didn’t feel tired in the slightest so smoked, drank some vodka and had another temazepan. I was getting manic, cleaning the house and dancing around. This was the opposite of the sleep I was craving, so I took more temazepan and drank more vodka.

That’s when the blades came out. Just so I could get some relief. A bit of cutting, some more vodka and another temazepan or two for the hell of it.

Things get a bit crazy. I dance in the kitchen and the blood running down my arms goes everywhere. I for some reason think this is funny. More cutting, dancing, drinking and taking of drugs ensues. I don’t care about anything anymore. I don’t care anymore. I feel like I can see me from the outside and the absurdity of what is happening but I’m powerless to stop and I don’t want to anyway.

I start drinking vodka straight from the bottle and slashing myself randomly with the blade. Arms, legs and stomach.  Take handfuls of drugs with the vodka. I am still trying to clean up the blood but I keep falling and hitting my head on the cupboards. I suddenly realise I have probably taken too many tamazepan and have a bit of a panic. I won’t be able to wake up for work tomorrow. That’s how screwed my mind is. I don’t want to live, and in fact am deliberately harming myself because I can’t cope, and then the responsible part of my brain is worried I won’t wake up for work. Never mind that if I was dead I wouldn’t make it in...

I rang the crisis team. I didn’t want to but I am started to get weirded out. My thoughts and my body aren’t connected anymore. The ambulance come and take me to hospital. For a while I refuse to let them ring anyone but when I start vomiting I want my Mum. She comes and sits with me. A nurses glue up the worst of the cuts while we wait for the crisis team. About 3 hours later they finally arrive. “There’s no beds so you’ll have to go home”. I feel weird about this. I don’t want to leave the safety of the hospital. Home is where people are, and the means to hurt myself. Mum takes me back to their place, I have the day off work and then back to work on Tuesday. No one from the hospital or mental health calls to see if I’m ok. I don’t know what to do. I still want to die. I feel guilty about what I did but not enough to regret it. Life goes on. Nothing’s changed.

The last few months part 3

So here’s part 3

After the major meltdown I had where I hit people and threw myself into the sea, I was still struggling massively with all these feelings. I worked through some of this stuff with my psychologist and tried to start identifying where it was all coming from and why I’d had such a major reaction.

I knew I did not have a good opinion of myself and that made me very dependent on feedback from other people. He helped me see that I felt that I was a horrible person (my core or true self) and I was unconsciously trying to cover this up all the time. I would try and try and then fail and beat myself up for not being good enough. I was looking for external validation, and when I was rejected it felt like my whole world was collapsing because that was reinforcing my core belief that I was a horrible person who didn’t deserve any better.

I don’t like myself much. I often feel like I am playing a part. Like the facade that I present to everyone is a cardboard cut out and I’m just hiding behind it, hoping no one will notice there’s no substance to the part I am playing.

This also contributes to my issues with identity. If you don’t trust yourself or your own opinions then how do you figure out who you are. I feel like I will put on a personality and try it out, adopting the clothes, music, mannerisms etc and then let it go. Like maybe this is who I am, oh no, maybe I’m like this person over here...

But here’s the problem. Knowing this stuff doesn’t make it any easier to live with. And in some ways it only makes things harder because I’m aware of how much work I still have to do. Just because I know I hate myself doesn’t mean I know what to do about it.

As time goes by and my experiences of being rejected get repeated, I build fences around my emotions to protect myself. The more times I’m smacked in the face by how much I hate myself, the more my subconscious does to not have to experience that again. I don’t get close to people. I don’t let people help me. And I certainly do not depend on anyone for anything. I don’t deserve anything from anyone, and other people have only let me down in the past and caused me pain. Better to be by myself.

Yes, I can see what a sad situation this is when I write it down, but it does make logical sense and it certainly makes a lot of sense to my subconscious.

And this is where self harm rears it’s ugly head again. There’s several ways it helps in this situation. I don’t want to feel painful emotions so I do something to cause myself pain. I hate myself, so I punish myself by self harming. And I feel pain emotionally and want to see it physically manifested, and I draw pleasure out of turning emotional pain into physical wounds.

Yes, I realise how unwell this makes me sound. But the drive to self harm is really really strong and this is why. It’s like an addiction. Feel a bad feeling = self harm and it will go away. Hate yourself = punish yourself by cutting and feel a bit better. Cut yourself = get satisfaction from having physical scars instead of pain inside your head.

I’m going to have to write part 4 I think. Still got more to say...

Progress is a series of tiny steps

It's been a while. I was pretty unwell for a while there and really struggling. When I felt ready to write again I had accidentally logged myself out and couldn't figure out my password, and Blogger couldn't verify my identity so I was unable to change my password to get back in. Thankfully I eventually figured out I had been using the wrong email address to try and log in.....

Anyway, that aside, it's nice to be back writing here again. I have written some stuff while I've been off Blogger so it's not like I haven't been writing at all, it just hasn't been quite the same.

The last month or so has been really hard. I've felt very down and things have been struggling along. I went through a period of not being able to get out of bed in the morning which is unusual for me. When I say not being able to get out of bed I mean consistantly running half an hour or more late for work. I set at least 3 alarms and I was turning off one or two of them in my sleep without even registering that they had gone off. Some mornings I'd only manage to wake up 20 minutes before I needed to be out of the house and I was not showering for several days in a row because I didn't have time or the energy.

Little G was quite difficult to deal with towards the end of the school term. Her anxiety levels were high and I was having trouble responding to her from a calm, empathetic place. She can read me like a book and her anxiety often feeds off mine so that wasn't helping, plus she also had some pretty big stuff she was dealing with emotionally. Her Dad was getting remarried and she was scared and unsure about what that was going to mean for her. When her anxiety levels run high she attempts to control all the other things in her life to make her feel safe and secure. I've been there, I get that, but as a parent it's incredibly frustrating to have an 8 year old try to run your life and your household. This leads to a battle of wills over almost everything, including school refusal which she has a long history of doing.

When I'm unwell and I have this child refusing point blank to go to school or do anything she's told, and throwing fits and stomping off every fifteen seconds, I struggle. My emotions are already hightened and so it doesn't take much to throw my system into high alert and it takes a long time to calm down again. I have constant thoughts about how I have ruined her, how it's my fault she struggles with anxiety in the first place, my fault she has the issues she does.I think I should be doing more for her. I worry that she'll turn out like me and have to deal with mental illness throughout her life. My brain tells me I am a terrible parent and a pathetic person and that she would be better off without me.

With these emotions running around in my head constantly, they play havoc with the rest of my system too. My stomach oftent feels like it's cramping or has butterflies, my heart palpitates, I get headaches and pain in my face from clenching my teeth and a stiff back and neck from hunching up, almost as if I am physically trying to protect myself. And let's not even mention the effect of all this stress on my bowels!!

Through all of this, plus work stress (major deadlines to meet for various clients at this time of year) and extended family issues, I've had individual events that each have momentarily pushed me off balance. One of those was an appointment I had with my psychiatrist at the end of June. Historically I don't have a good track record with psychiatrists. I've been under the care of Community Mental Health (CMH)/psychiatric outpatients for about 3.5 years and in that time I've seen something like 8 different psychiatrists. Unfortunately that's the way the system works - you see a registrar and so every 6 months the registrar assigned to that consultant moves on and you get a new one. Sometimes you get that registrar back again after 18 months or so when they have had a number of rotations. I've been under the care of  the consultant for 'red zone' the whole time, but I've only actually been seeing the consultant himself instead of the registrar for about a year. In that time there's been two or three different ones because they change jobs or leave.

(*registrar = trainee psychiatrist with degree and 1-4 years experience, consultant = fully qualified and 'boss' in charge of registrars for a certain area. The region I live in is divided into zones by CMH and I live in red zone).

So the consultant I saw at the end of June I've seen twice before (roughly every 3 months), but neither time went particularly well. I tend to be difficult to deal with as I don't understand what they are asking for or how to answer their questions, and I take offence to some of the things they have to say. For some reason the whole situation upsets me and the appointment often ends with me having said something I shouldn't have or refusing to speak to them at all. When this happens I know I am not behaving well but once I have been triggered I find it incredibly difficult to act rationally as my emotions are fully in the driving seat.

In the middle of all this Little G has been sick, we've had school holidays, we are supposed to be following a plan from the continence nurse for her to try and sort out her bed wetting (not happening - she refuses to follow it), I've had family issues and financial pressure, Little G's Dad got married, two of my colleague resigned - one I worked with particularly closely, and my back problem has flared up again. Not to mention that Little G was away in the school holidays so I was on my own for a week. And then the appointment with the communication and behaviour team that I've been waiting for since Little G was diagnosed with ASD two years ago finally happened, and it wasn't quite what I'd pictured.

Suddenly I again felt all this guilt and doubt about my child and shame about my own mental health affecting her, and scared of what they might suggest. I've hung so many hopes on this appointment and to finally get it and find that I was going to be expected to carry out their plan to change Little G's behaviour was very daunting. I don't know what I thought they would do but I hadn't imagined that I would be such a key part of it. For some reason I had thought it would be more about them working with her directly. And that really threw me. Because what if I wasn't good enough? It would be my fault again if the plan didn't work. I doubted my ability to carry anything out and suport her.

I freaked out. I think I subconsiously equated her communication and behaviour problems to my own as a child and I don't want her to go through what I have. The pressure of having to be the person to help her when I am so fully aware of the possible consquences of getting it wrong tore me apart. Then I started blaming myself for my poor mental health and the damage I'd already done to her. I know attachment is really important and forming a secure bond with your child sets them up for the best possible outcomes in life. I also know that I have been inconsistent and at times very unwell and that Little G's and my bond is not as secure as I'd like. I'm working on it but I'm always scared I'll screw up.  

I'd already been having suicidal thoughts for weeks. I live with them. Sometimes those thoughts are louder and sometimes quieter but they are almost always there. These are the ones that tell me I want to die, that no one would miss me, that there is no point to life, that people would be better off without me being a burden on them. When I really freak out I start also hallucinating suicide scenarios, which tend to scare me even further. I get in the car in my garage and I can see myself closing the doors, putting the windows down and killing myself with carbon monoxide from the exhaust fumes. I see myself in the bath with blood running down my arms, or head in a noose hanging from a tree. I frequently picture myself walking into the sea with all my clothes on and drowning. When I'm driving I can see myself plowing into power poles or into something solid.

Living with these thoughts and hallucinations is really scary sometimes, particularly when I tend to be impulsive and I'm aware I can't always trust myself when I feel like this. Telling anyone you have this mess in your head is impossible. I still can't quite believe I've written it down because it almost looks worse on the page than it did in my head. How do you tell someone who cares about you that you want to die so much that you vividly picture multiple suicide scenarios daily, sometimes hourly.

And yet, and yet.... if there is one tiny kernel of hope in all of this, it is that I am still here. I am still taking things moment by moment. I mostly remember and follow my crisis survival and distress tolerance strategies. I mostly take care of myself. Any one of these stressful situations would have triggered a full meltdown with alcohol and a lengthy cutting session only a few months ago. Not to say I haven't cut because unfortunately I have. But just a bit and it was the first time in four months which is something I feel proud of. I am ashamed that I have self harmed again, but I do acknowledge the progress I am making. Small steps. Progress is a series of steps, and even if they are tiny I am making them.

One song I am listening to a lot is Let It Be (The Beatles). It fits nicely with the mindset I'm trying to cultivate.

 Kia Kaha

Self harm and me

Trigger alert - today's post talks about self harm and it's causes. If self harm is a problem for you please get help from a professional. This post describes my experiences and is in no way designed to encourage anyone else to self harm. 

Just as an added note, I wrote the following post last weekend. I debated all week about whether to post it because the issue of self harm carries a huge amount of stigma. Many people know I have this problem because the scars are hard to hide, but no one (with the exception of my family and one other person) has ever raised the subject with me. 

The shame and stigma attached to self harm are overwhelming at times and it is perhaps one of the hardest aspects of mental illness to discuss. Many people can not understand why you would want to harm yourself, particularly using the method I do which is cutting. The following post describes what leads to this behaviour and the biological reasons why.

(Sunday)

Today....today was unfortunately one of those days that is so common for me as a person with BPD. A day where my moods changed with speed of the wind outside, sweeping away all traces of what I felt previously and hammering me again and again with intense emotion.

This morning I woke feeling motivated. Little G went off to her father's early, and then I got on with the washing and ate breakfast. I had decided to spend another hour or so in bed as it had been a long week and I was trying to take things easy so as not to get sick.

All morning my brain fought me. It was sunny outside and there was a war raging inside my head. One side telling me how lazy I was, and that I was wasting sunshine and time laying in bed reading. And the other side telling me I needed the rest, to give my body a chance to recharge and get ready for the next week. I recently found an article about boring self care and her drawings were the main reason I managed to stick to my guns this morning and try not to berate myself too much for resting and reading. She does cute little cartoons about the little things we can do to take care of ourselves, and today I knew that rest was what I needed. Didn't stop my brain from trying to take over with my normal pattern of non stop activity to fill a long day by myself though.

After lunch I stopped feeling like I should do something, and started feeling like I didn't want to do anything. This was particularly bad timing as this is when I'd actually planned to get moving and do chores and buy groceries. It took me several hours to force myself to have a shower and get lunch, put on shoes and go outside for a walk. My brain kept distracting me and I was having trouble focusing on what I should be doing. I wasn't actually doing anything during this time except wandering around pausing and looking at all the stuff I should have been doing. The thoughts in my head about me being useless and lazy were pretty loud, and were drowning out anything much else at that point.

I finally got outside and did about half an hour's walk. This week's goal is to be consistent with my exercise, and try and do 20-30 minutes on 5 or more days. I walked yesterday and today so was reasonably pleased by the time I got home. Off to the supermarket and for some inexplicable reason, the person in front of me drove at 35 km/h the whole way (speed limit is 50 km/h, I normally do more like 60!). The frustration and anger that overtook me was incredible, I was imagining setting up a punching bag and slamming my fists in to it over and over. After 5 minutes I was in full blown rage mode, though my rational/logical mind kept trying to tell me I wasn't in any hurry and that I should calm down.

Pull in to the supermarket car park and park the car in the far corner away from anyone else so I can have some deep breaths and calm down. Then on into the supermarket. After only a few minutes inside I start feeling really upset, then a sad song comes and I have tears in my eyes while I am picking out apples. After telling myself that I'm being ridiculous and have no reason for crying, I manage to pull myself together enough to continue with the shopping.

In the supermarket environment I'm overwhelmed by the number of people, the bright lights, tiredness and the music. My physical senses are often in overload in settings like that due to my autism.

My emotions have run the gauntlet from motivated to hyped up, to depressed, then to confused and distracted, happy after my walk, then tired, angry, full of rage, then to sad (complete with tears). I feel so overwhelmed by the large swings in my mood that my brain keeps trying to default to its standard method of taking the emotional pain away. 

All I can think about is drinking alcohol and cutting myself. I'm severely triggered walking past the wine and beer aisles. The craving for a drink is so strong that I can't stop myself from choosing a bottle of wine to take home, all the while knowing it is the first step on a disastrous path that only has one end.

I'm well aware of how destructive the drinking is, and how once I start drinking then what little control I have over my self harm urges subsides. This usually leaves me sitting in a pool of blood with a razor blade in my hand at some point.

I have to walk past the utility knives, don't need those as my house is littered with them, and anyway they don't provide the deep cuts that give me the relief. They have long since been replaced with razor blades.

I'm not buying blades today. My hands are shaking on the trolley as I walk past but I try and tell myself that if I don't buy them then all I'll do is drink. Unfortunately, this has not proved true in the past. I know full well how to take a razor apart when I'm drunk and in the grip of my compulsion. 

In situations like this in the past I've gone straight home after the supermarket, opened the bottle, sat down and cried about what I'm about to do. I'm normally a spirits girl and a shot is all it takes to release the flood gates. That is when the blades come out and I promise myself it will just be one or two cuts. That I'll see the blood and feel a bit better and then I'll stop. However, it usually takes 8 - 10 shots with small chasers of coke before I've cut myself enough to be able to control it enough to stop.

It's hard to describe the relief the cutting provides, and it can be different depending on the circumstances at the time I have the urge to self harm. For me, self harm is a compulsion. I've used it so many times in the past that my brain is wired up to want to complete acts of self harm to relieve my emotional pain. 

Part of the reason for this is because at some stage I accidentally tapped into the brain's ability to use it's natural painkiller, endorphins, to relieve my emotional pain. Our human brains are wired up to sense both physical and emotional pain using the same two areas: the anterior insula and anterior cingulate cortex. When you get hurt physically, your brain registers the pain in these two areas and prompts the production of endorphins, which is the brain's own natural morphine. Wikipedia says "The principal function of endorphins is to inhibit the transmission of pain signals; they may also produce a feeling of euphoria very similar to that produced by other opioids.^[3]   

Basically this means that if you cause yourself physical pain, the body produces endorphins which then act on your emotional pain as well. In terms of self harm, this is why it can be so addictive - create enough physical pain and your emotional pain will be relieved with endorphins your body has produced to get rid of physical pain. Unfortunately there is no way to stimulate an endorphin response to emotional pain without causing yourself physical pain. And it seems (though more research is being done on this) that you can not relieve emotional pain with painkillers made for physical pain.

The upshot of all this is that every time I create physical pain in response to my emotional pain, I force my body to produce endorphins which relieves both types of pain. This creates a feedback loop - emotional pain leads to physical pain which causes endorphins which relieves the pain. And every single time I use that response to my emotions, the feedback loop is reinforced, making that connection stronger and stronger. This makes the urge to harm myself become a compulsion when faced with situations that trigger overwhelming emotions.

This is not the only reason people self harm. Sometimes for me it is about punishing myself, causing myself pain because I believe I deserve it. Sometimes it is more about the scars and pain on the outside matching the black deadness you have on the inside. Often it is a combination of things - a triggering event may cause the compulsion but may also cause me shame because I'm not living up to my own expectations. I can spiral down as thoughts about what a terrible person and waste of space I am go around and around in my head. 

The therapy I'm doing, which is a combination of acceptance and commitment therapy and dialectical behavioural therapy with a few other things thrown in, is teaching me to recognise my triggers, to try and prevent them, and what to do when I am in this situation. In order to remove my self harm behaviour I have to have something to replace it with.  Not only do I need to recognise when I'm having thoughts that lead to overwhelm, I have to self care skills, triggers, be able to tune in to myself and my surroundings (mindfulness), and a range of coping skills to suit all sorts of situations.

So, last Sunday, despite the fact that I brought the wine, I came home and I did not drink it. I put it away at the back of the cupboard, then I ate dinner. I had forgotten to eat much during the day and it wasn't until I did some mindfulness on the way home from the supermarket I realised I was hungry. I switched on Netflix and watched a funny movie, with my soft sensory blanket on my knee and the cat on my lap. Then I got on here and wrote about my day. I did some other writing which was a bit of homework for my therapist and finally sat down to read. Crisis averted, till next time.

You might think, reading what I did to cope with that overwhelming urge to self harm, that the things I did were nothing special so how could they possibly have helped if I was really that bad. The answer to that is two fold. One, the whole time I did the things I outlined above my body was craving endorphins. The thoughts don't leave my mind, I just try and distract myself from acting on them. Two, it's taken a lot (a lot a lot) of hard work over the last two years to get this far. I have crisis strategies like holding cubes of ice (either in my hands or against my arms), submerging my face in cold water, intense exercise (like short sprints), and paced breathing. But first I try distraction and soothing my senses with things I know work for me (a really good link explaining this is here.

Things are slowly getting better but sometimes I fail, and sometimes I fall. I am always going to have to be mindful not to fall back in to old patterns. At times the amount of work I need to do to get and remain mentally healthy looks like an enormous burden. But I have learnt that there is a time to look at the big picture and a time to look only a little way in front of you. Sometimes it's best to try and deal with today and plan just for tomorrow rather than get too tangled up in what the future might hold. 

Ka kite ano

Chris Cornell, suicide and major depression

The death of Chris Cornell by suicide, and the subsequent discussion of his death in various forms of media, has had me thinking about my own major episodes of depression.

When I heard about Chris Cornell I was so incredibly sad. The man was a genius, and the Temple of the Dog song Hunger Strike (sung in duet with Eddie Vetter of Pearl Jam) is my favourite song of all time. Oddly enough, though I love most of Soundgarden and Audioslave's music, it's this song I most identify with. It's all about staying true to yourself and what you are doing, regardless of sucess or money. And that there is really no way of having more than you need without taking from someone else that can't really afford to give it to you. Interestingly, Temple of the Dog was a collaboration between artists who would go on to be in Pearl Jam, and Soundgarden, and was a tribute to their friend Andrew Wood who died of a heroin overdose in 1990. 

The lyrics of 'Hunger Strike' have been running through my head all day while I've been thinking about Chris and what frame of mind he must have been in. I know only too well what that pain is like, having suffered so terribly with suicidal depression myself. But I also feel so devastated for his wife, kids, family and friends, because I've been on that end of suicide as well. I know a number of men who have taken their lives, and I've witnessed what that does to people. You analyse every thought, every moment, every word spoken, to see if you can find the reason. You relentlessly ask yourself if you should have seen it, if you could have done more. Whether you would have been able to stop it.

The radio conversation I listened to this afternoon talked about how selfish Chris was to take his own life. Neither of the djs had experienced depression and had no idea how someone could feel that way and not be able to think of what it might do to the people around them. One of the djs made the comment that Chris had everything, money, talent, sucess, a family etc and how could he still be unhappy with all that going for him. That he should have used his kids as an anchor and remembered what it would do to them if he was to die that way.

Now, I know that not all people who die by suicide have depression. And maybe Chris wasn't depressed, sometimes overdoses and accidents happen. But he has said enough in the past about the struggles of depression to imagine that it could have been that, and even if someone doesn't look like they are struggling from the outside it doesn't mean that they aren't.

I have suffered from depression since the age of 10 or 11. I have had a number of major episodes, but the worst one by far started in 2013 and almost destroyed my life. By November of 2013 I was in such a mess that I couldn't follow a TV program or read a book, I certainly couldn't work. I sat and stared at the wall and wished I was dead. It was the most pain I've ever been in and I couldn't get away from it. It was inside my head and all I could picture was that permanent solution to it, death.

The first time I remember wishing I could die I was 11. I'd been bullied on and off for several years, and something expensive of mine got broken and needed replacing. I felt ashamed and guilty and like I was a waste of space on earth who just caused hassle and cost money. I wanted to die to escape from those feelings. On and off all through my teens I had dark periods, but as I got older they got longer in length and I fell that much further.

This is one of the poems I wrote in 2000, when I was about 17:

Darkness decends

And I am sitting alone

Outside

In the cold, crisp air

The rain stings

My sodden skin

As I watch the brightly lit house

Secure people bustling

Like ants in it's inards.

Warmth emits from it

But does not seem to 

Penetrate its walls.

It stands solid, fortress like

And unreachable.

I can see in

But they do not see out.

I shout until I am hoarse

My throat raw and bleeding

And still no one throws a glance

My way.

Then there is this one from 2001:

Can't stop the voices in my head

The demons rising up

From the firy hell in the 

Dark depths of my mind,

And trying to pull me down.

I kick them off and 

Avert my thoughts from the 

Sweet killing pain of the knife.

Surely I can find something worth 

Living for

Something the shadows can't touch

Which gives me some purpose.

The demons claw at my legs

Whisper thoughts of pain in my ears

And promise to free me from the 

Burdens of living life.

I can't make them stop.

Don't even know if I want to.

Maybe I should just give up

And refuse to live.

I don't think anyone would even notice.

And that's the thing about depression. It makes you feel like you are in this black cloud. You can't see anything but the bleakness. Life feels pointless and futile and I find myself questioning why humans crawled out of the sea and evolved from chimps and what we were we supposed to gain from that? And why I am I here, in this house, marking time?

I try so hard to think positively and be kind to myself but sometimes depression is not something you can tackle just by doing those things or getting more sleep/exercise/eating better etc. I am on meds and have been since my breakdown in 2013. I resisted them for so long, feeling like if I took them it would be like I'd failed or I was admitting I needed help. But they do help, even if sometimes all that means is that the edge is taken off things a bit so I can ask for help.

Asking for help can seem like scaling a very high mountain. You know you need to climb it to be able to move forward. But saying the words "I'm scared and I need you" can be incredibly difficult. How do you tell someone you care about that you are thinking of taking your own life? It's like saying them and their feelings don't matter to you - that you are prepared to hurt them in the most final way possible to end your own pain. But I've also been in the position where I've told a professional and been lectured about "how can you even consider doing that?", and "think of your child and your family". It took several years not to feel violently ill every time I thought of that conversation. When I opened up to someone and was honest about how dark my thoughts were they were more freaked out by them than I was. Once that's happened once or twice you learn not to be totally honest about what's in your head for fear of upsetting them or causing them to reject you completely.

There's been a number of times the pain in my head has been overwhelming and I've wanted to end my life. Sometimes I don't sleep properly for weeks, I can't go to sleep or I wake in the middle of the night and can't get back to sleep. Or I have terrible nightmares which make me fear closing my eyes at night. I've had hallucinations where I've been out walking and seen bodies hanging from the branches of trees. Some days everything looks grey and all the colour and happiness and goodness has been sucked out of life. I can go for weeks being tormented by thoughts of being a terrible person, a bad parent, a fat lazy ugly bitch, remembering everthing people have said to me about looking or acting strange and the times in my life when I've been bullied. Sometimes the demands of working and the house and being a parent get on top of me and the smallest thing can send me spiralling into despair. At times like these the thoughts can be so loud in my brain that I can't follow the plot of a TV program or movie, or read anything, because I can't concentrate. Occasionally the only thing that's stopped me from taking a handful of pills is imagining the horror of Little G finding me. I couldn't do that to her. Not that I didn't want to, but that I couldn't ruin her life like that.

Its really hard to explain what goes through my head in that position – its kind of like 'whats the point. I don't want to live my life but I can't leave, I can't do that to my girl and to my family. I really don't want to be here. All I can see is the struggle – the depression in my past and the struggle to dig myself out of the current episode. My life is never going to change, no body will ever love me. Can I face being alone forever. What the hell am I doing with my life'. And on and on and on it goes. 

You can see how I got to the point of self harming. When you mix underdeveloped coping skills with significant emotional disturbance like this, self harm by cutting relieved my pain without the final 'solution' of death that I craved. I was less conflicted by it. It released endorphins which helped ease emotional pain, allowing me to keep living. Not a healthy coping strategy at all but one which becomes slightly more understandable when you have some idea of the pain which causes the action.

And I guess this is the same type of behaviour that causes some people to drink and do drugs and engage in all sorts of other self harming behaviours. The trouble is that the more you use these 'strategies' to cope, the more you become addicted to them, and the stronger those pathways become in your brain.

Whatever killed Chris, whether it was depression or drugs or something else, the world is a slightly darker place without his musical genius in it. RIP Chris. May you find your peace. 

Just as an added note, if you are in crisis please please please tell someone

Lifeline – 0800 543 354

Suicide Crisis Helpline – 0508 828 865 

Healthline – 0800 611 116

Samaritans – 0800 726 666 

Go here and read it right to the end.