Existential Crisis

My therapist had a cancellation today, so she was able to schedule me in last-minute. I usually enjoy our appointments, as I typically leave them with a better understanding of my problems and their solutions. Today was different.

My entire one-hour appointment consisted of my therapist convincing me to do the intensive DBT program. I am usually a very compliant patient as I am terrified of authority, but in the last 4 days, I have told 4 different healthcare professionals that I will probably not be doing what they are asking of me. My brain is telling me that I must be wrong, because two psychiatrists, a GP, and a therapist must know better than I do. But I feel so strongly that not doing this treatment is the right decision.

I spent much of today’s appointment detailing the following reasons for so stubbornly refusing to put school on hold: I will already be graduating two years behind my peers; with an expected graduation date of April 2018, I am already sick of undergrad and more than ready to move on with my life; my roommate, who started university one year later than I did, will be graduating in 2018 and we have considered going to grad school in BC together. Most importantly, school is all I have right now. I worry that taking that away would only make me feel worse.

That last point sparked a chain of conversation that ended with me not knowing who I am or what reality is.

For the past month, I have been thinking on a very small scale. Get through this day. Go to this class. Don’t overdose this weekend. When my therapist began talking about my future, like my future future, it really threw me off. Further, she encouraged me to re-frame some of my firm beliefs about school and failure, which caused me to question every belief I have.

She asked what I planned on doing with my degree, and I told her about my current, tentative plans (grad school and a career in public policy analysis). She asked if this is what I see myself doing in the future. I said yes, and I meant it.

But then I started wondering, “Is public policy really what I want to do?”, “Will I be happy doing that?”, “Will I ever be happy?”, “What does it mean to be happy?”, “What is the purpose of life?”. I pretended to continue listening while I experienced this existential crisis. I didn’t have words for the places my mind was going. Even now, I am having a hard time explaining it.

I started thinking, “Do I even know anything about what I like?”, “Do I know anything about myself?”, “Do I know anything about anything?”. It was obviously incredibly disorienting. This thought-spiral was further fueled by my inability to trust my own judgement after disagreeing with so many professionals. In theory, I can be sure I know the answers to these questions, and still be wrong.

I am still questioning my firmly-held belief that I can recover from this episode without intensive treatment. I really, really, really believe it to be true. But the evidence seems to suggest otherwise. And I never think I’m going to overdose again until I do, so there’s a good chance I’m being overly optimistic. I don’t know.

This has all left me feeling incredibly disoriented and anxious, and I hope these feelings pass soon because I am not too keen on them. I also hope I end up being right about treatment, because I don’t think I could handle pushing school back right now. She mentioned the possibility of a weekly DBT group, but said she would only feel comfortable with me doing that if I was incredibly serious about it and the staff paid extra-close attention to me. I’ll go to my assessment for intensive DBT, but I would greatly prefer this weekly group, and I am willing to work hard to make sure it’s enough.

I don’t really know how to end this post because my mind is still in a pretty strange place, so I guess I’ll just go.

Sarah

I wish I wasn’t sick

TW: SELF HARM, SUICIDE

My psychiatrist is really concerned about my recent overdoses, so she managed to fit me in for an appointment today. The appointment did not go well.

Despite my severe depression, frequent suicidal ideation, increasing self-harm, and repeated overdoses, I didn’t realize how serious things have become. Until last week, when I decided to drop one course, I was taking a full course load (five courses) and had no intention of changing this.

I have been working on my undergrad degree since September 2012, and plan to graduate in April 2018 by taking a nearly-full course load for the next two years, including the Summer. I need to move forwards in my life because I am SO TIRED of always standing still. The idea of pushing my tentative graduation date back is really upsetting, and yet, I am having to consider this.

The hospital psychiatrist referred me to an intensive DBT program that runs for six hours plus an additional individual session every week. I doubt I can complete this program while taking four courses. But most of my current classes are pre-requisites to the ones I plan to take next term, so dropping them will probably set me back an entire year. I told both the hospital psychiatrist and my psychiatrist that I would attend the assessment, but that I was unlikely to accept a spot in the program. Both doctors accepted this, but were clear that they think I need this treatment.

Intensive outpatient treatment is one thing. But it was a much bigger shock to be told that my psychiatrist is starting to think I need to be admitted as an inpatient. She mentioned this more than once, and said she doesn’t feel comfortable making huge adjustments to my meds while I am an outpatient. She also somewhat-threatened that I would have to go inpatient if I overdose again. That would obviously ruin my current plans for school. I have never been done inpatient treatment, and I hate spending even two nights in the hospital. I also haven’t said a word to my parents about how I’ve been doing, so it would be a big surprise to them. Now I have “Rehab” by Amy Winehouse stuck in my head. Great.

On the bright side, this appointment served as a wake-up call. I am ready to work incredibly hard to stay out of the hospital. I got rid of some items that threatened my safety. I am eating more in the hopes that my mood will become more regulated. I am trying to get to the gym and to social events, which I know will make me feel better long-term. I will do whatever I need to do.

I have slight faith in mental health professionals, so there is a decent chance that they are right and I will need more intensive treatment to survive this. But I personally think my feelings of worthlessness and self-loathing will only increase if I take more time away from school. So I am going to try incredibly hard to avoid that scenario.

The problem is, I can’t will an illness away. I can take steps that increase my chances of feeling better sooner, but if my brain decides we’re going to be depressed this month, then that’s the situation. And that’s really scary. So I will try my very best to pull myself out of this rut without the help of intensive treatment. But I know that I may end up needing more help, or even that I’ll be sent to an inpatient ward involuntarily under the Mental Health Act.

I guess what I am trying to say is that I wish I wasn’t sick. But my “Relapse Prevention” therapist told me after my first Day Hospital admission in an Eating Disorders program that “wishing and hoping isn’t a good strategy”. And then I relapsed. So, we’ll have to wait and see whether that’s enough this time.

Sarah