The Costly Mistake

“A mistake was made.  Dr. G. needs a half an hour with you, so you have to come in at 4:15PM.”

The third attempt in three days on my doctor’s part to reschedule me.

I panicked.  The plan was for Xan to come home and cart me off to my 5:30PM appointment.  That in itself was stressful enough.  Xan rarely gets off of work on time anyhow.  I would be playing this pacing game where I wear a rut into the corkwood floor of my eroding living room.

“But, I can’t.  I don’t have transportation.”

She was uncompromising.  “Dr. G. leaves the office at 5PM.  It’s 4:15PM or she will not see you today.”

I anxiously stammered, “I’ll see what I can do.  I’ll call you back.”

In her cheery, patronizing voice she said, “Okay, we’ll pencil you in for 4:15PM.  Hope to see you then!  Bye!”

And the phone went dead.  I was cast off that easily.  Complete disregard for my needs.  She’s one of those people who is just doing their job and nothing more.  Patient care doesn’t matter.  My threads started coming loose as I desperately grasped at the fabric that remained.  Hope was dimming.  Trapped in my head, trapped in this perpetual hell called my life, completely alone with this demon so inadequately named Bipolar Disorder.

For a moment, I let the wholeness of the situation set deeply into myself.  I read my prescription bottles closely and they said in big, haunting letters NO REFILLS.  Waves of panic nipped at me at the shoreline.   The tide suddenly grabbed me, and ripped into murky, black waters with the undertow.  There was no sense of what was up and what was down.  The air escaped me, as if being viciously sucked from my lungs, and they shriveled into nothing.

My fingers flew fast as I texted Xan.  The idealization took control as my head filled with these surrounding waters.  My mind swam around my skull, looking for solutions.  Grasping at the fabric, the tearing fabric holding my sanity, my hope, any kind of connection to reality and sanity.

“Hold for a moment on this.”

I am a business call.  Twenty minutes elapsed.  It was like standing in a queue for my husband’s attention at a clear crisis.  Those glimmers faded as I clung to anger.  Anger, my failing life preserver as it began to deflate into complete hopelessness and despair.  I trashed with distress, but to no matter.  Anything.  Anything . . .

“I’m calling the scheduler.”  I warned him that wasn’t wise.  The ultimatum was set forth.  4:15PM or not at all today.  4:15PM I could see this new doctor, and maybe in coming days, I could exit the tunnel of misery and dimness.  I could reclaim myself, my life, and everything that awaited me on the other side.

I wanted to beg him.  I wanted to get down on my knees and plead with him to leave work early.  He would have put his eight hours in that day, and it would have been alright.  Be my knight in shining armor.  Save me.  Save me from myself.

I started crying, huge, loud sobs belting through my house.  My son, my little four year old son with autism spectrum disorder approached me.  And he said, “Mommy, are we okay?”  I cried even harder, despite any efforts to control myself.  My son’s first four word sentence, his first appropriately placed words relevant to the situation, occurred because his mother was hysterical.

I said to him, wiping the tears from my face and pushing everything down, “Yes, Beast.  We’re okay.”  I wish I could have meant what I said to him.  His first question, and I had to lie to him.

The phone rang, playing a melody that I hope meant promise.  Promise that someone had conceded or made an exception for my desperate pleas.  I answered despondently, even with my head overflowing with idealistic notions of the outcome.

“Here’s the good news,” he started.  My heart seized up, anxiously hopeful.  “The nurse agreed to put a fill in for your prescriptions.”

“And my appointment?”

He continued, “It’s a bit of bad news.  Dr. G. is booked up until December 11th.  I scheduled you in for that day.”

I choked on my own voice, the bile rising from my stomach and the wires of my brain sparking as they frayed.  “December 11th?!  I can’t wait until then!”

“It was the soonest she had.  It was the best I could possibly do for you.  But, at least you have your medication until then.”

The tears finally came, screaming down my faced as I sunk against the sink.  “I need a doctor.  I need to get this fixed.  I live every single day in this perpetual hell.  This was my last hope, my only hope.  It has been stolen away from me.  Is there nothing we can do?”

He started to become cross, “What do you want me to do?  What more could I possibly do?”

“You can’t leave work?” I pleaded desperately.

“It wouldn’t matter anyway,” he informed me, “The scheduler already complained to me about your poor attendance record, and gave your appointment to someone else, anyway.”

“My poor attendance record?!“ I screamed.  “I have no way to get to appointments!  And people keep blowing me off, like I don’t matter!  Like I’m not in a bad way! Like this can wait and as if I’m doing so well.  The only time I get to go to an appointment is to get this stupid medication that doesn’t even work filled.”

I paused, only for the brief moment it took for catch my already shallow breath, “I don’t know if anyone noticed, but I haven’t been well.  I have spent almost my entire year in one episode or another.  It’s beyond discouraging.  It’s thrown me into the jaws of despair and hopelessness that I will never get any better!“

We sat in silence for a few minutes.  I sobbed violently, just waiting for some kind of word.  Some kind of solace.  Any rescue from the deep, dark recesses of my own caged mind.  Finally, I asked, “Are you still there?”

“Read your text messages,” was all he could respond.

I have people three feet from me.  I can’t talk about it.

My being shattered so deeply that I had felt fractures of each bone in my entire body.  I became enraged at his choice.  Work.  Work over his ailing wife.  No exceptions could be made.  And in his mind, I’m sure the thought had occurred, This too shall pass.

“Goodbye,” I choked out without another word.

The anger, the scraps that remained, boiled in the water.  The blackness around me turned scarlet and thick like the blood coursing through my veins.  I grasped my phone with a crushing forced and launching it against a wall.  It exploded into three pieces, the unit, the battery, and the backing.

Screams erupted out of shrieking sobs, “I can’t go through this hell anymore!!!  Why do I have to go through this?!  Why?!“  Endlessly, I raved and ranted like a mad woman.  A mantra repeated, “I can’t do this!!!   I can’t!!!”

“That job!  I hate that f***ing job!  His work, his work!  Nobody cares!  Nobody!” I grabbed my “Teacher”coffee mug from the cabinet and smashed it against the linoleum floor.  I’m not a teacher anymore.  It is a lie every single time I drink from that mug.  I am a nothing now.  I am a nobody.

I stood there staring at the pile of the remaining shards of ceramic, heaving panting sobs.  I slid down against the stove, next to the pile and pulled me knees to my chest.  A ball.  Nobody can hurt me.  I can’t hurt me.  No one can come near me.

Alone.  I am slated to be alone.  Alone in my own mess.

I WANT TO DIE.

It’s all I could think.  There is no life ahead of me that I want to live.  It’s only a life full of pain and misery, where I am tragically locked in my head.  No one wants to hear of these complaints.  I have no perspective to gain.  No more words left to give the world.  No hope for myself or anyone else.  I have nothing.  I am nothing.  I will always be nothing.  To anyone, anywhere.

And if I were to say goodbye, I would be wished well.  I would be let go without another word, another prayer or any thoughts left for me.

There is no treatment that will make better.  I will always be like this, with this crushing weight upon me.  My eyes are constantly fixed on the rear view when I’m not navigating the endless series of trials within this tomb of a labyrinth.  Even in the fleeting happy, peaceful moments, I will always be cautiously watching over my shoulder for the monster who will eventually gain on me, and overtake me.  I will never find happiness.  I can never find a place of peace and solace within this madness.

A plan started hatching.  There will come a day where I will take my life.  I can’t truly know when, but the day is inevitable.  I must make preparations.  I took a handful of Xanax and considered washing it down with a swig of rum.  No, it would be bad enough that I am doped up around my child.  My child.  My beautiful baby has to witness this in his already confused life.  It fueled the fire to hate myself even more.

I will get my house in order.  I will not leave a mess to clean up, because there will be enough of a mess when I am gone.  I will get my son into a program and have him taken care of.  My belongings will end up in boxes, so that they may easily shipped off.  I will leave nothing but mournful whispers behind.

I wish I had something inspiring to say.  I wish I could tell you that I went on about my life, went to class last night, and came back in better shape.  I wish I could tell you that the rays of hope descended upon me, and I am determined to hold out until December 11th.  I wish I could tell you that I look forward to better days, where this awful, gnawing feeling dissolves into some kind of happiness.

But I can’t.  I can only give up and start to let go.  I can only start to say my goodbyes and write my heartfelt letters to those that I love.  Because in the end, whether I want it or not, this is my fate.  To eventually succumb to my illness.  To eventually self-destruct.

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Invitations to Narnia : 30 Days of Truth

Day 05 : Something you hope to do in your life.

As it stands, one can find me within the wardrobe amongst the coats, between the real world and my Narnia. This is not the Narnia as others know it. It is the absolutely surreal, ever shifting landscape, containing both horrific monsters and beautiful, majestic creatures. All of that world is tucked away, within a wardrobe, in an innocuous cranny of my home. Many unsuspecting people could stroll up to it, jam their coat in, and never give this unassuming wardrobe another thought.

Lunaria

But, this world is not meant to exist tucked away.  This world lives inside of me, wrapped up in an old world map, tied with a satin ribbon.  It waits to unfurl for all of the world to see.

Snapshots of this map are contained within every word, in each piece that I carefully create.  Some have been privy to view them, scanning the terrain, gazing upon the horrors and magesty.  Others have been lucky enough to set foot on the Terra Amici, The Land of Friends, specifically set aside to welcome guests who have braved the Sea of Aliquim.  And others, those closest to me, have journeyed through the deepest, darkest places of Lunaria.

I dream of the day that I allow Lunaria to emerge from the wardrobe.  This is the day that the earth will quake around me to birth Lunaria from within.  I will invite others to explore at will, without the requirement of the confines to Terra Amici.  To brave the fiery mountains, volcanoes spewing molten rock,shifting and shaping the landscape daily.  The mountains grow higher, only to be whittled away by the erosion.  Bask in Bad Wolf Bay.  Peer deeply into Mare Demersi, but still fear to tread too closely.  Lose themselves in Vac Saltus, and navigate the sullen, sunken lands of Val Mergullado.

All of this, one day will be accessible to all.  Lunaria will rise.  I can openly narrate the tales and history of Lunaria without fear of persecution and ostracism.  I hope to accomplish my quest of bringing this all out of the wardrobe.  I want others to see what my world, one world of a woman with Bipolar Disorder looks like.  It possibly connects to other places, to weave a global patchwork of personal worlds, connecting us all, to encompass every single person who has been hiding their own Narnia.

I hope to have a voice that can bring this all to the world.  And I hope to build the strength to do it.

Why Self-Injurious Behavior?

A response to carla’s post about self-destructive behavior. It expands upon the basic concepts noted in the reply.

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Most of the time, in the clinical world, it’s referred to as “self-injurious behavior”. That includes all kinds of harmful behaviors directed toward oneself across all diagnoses.

It’s fact that SIB (self-injurious behavior) is often a behavioral expression for emotions that have no other outlet. Many children with autism spectrum disorder engage in SIB. Most often, it is because they are developmentally delayed in the social and language domains. However, many times it does have the function of attention seeking behavior – but not in the way that some perceive it. It does not carry sole intentions of “acting out” in the role of negative reinforcement. It is a way of communicating, “I’m hurting. Please attend to the situation.”

But, SIB has many different functions in other diagnoses. SIB is absolutely complex in development, function, and reinforcement. Some people engage in the behavior as an outward expression of inward suffering, others do it for the adrenaline that it releases. But, most people who engage in SIB are never aware of the root cause that sparks the behavior, nor are they aware of the function.

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Reader beware: The following section may be disturbing and trigger inducing. Discretion is advised.

I have been engaging in SIB since the onset of symptoms in my early teens. Nowadays, SIB is a widely covered social issue through media outlets. So, it is pretty easy for children and teens to get some ideas and tips. However, when I was young, SIB was very hush-hush. I did not get the idea from anywhere in particular. It just occurred to me.

It became a regular and highly ritualized behavior. Dark room, so it would look like I was sleeping. Music in the background, nothing in particular. Just some background noise not to raise suspicions. My knife and me. Because, it was easier to get a hold of a kitchen knife than it was to obtain a razor. Besides, that didn’t occur to me until later on.

I will refrain from detailing it any further. The development is obvious, and needs little explanation. However, I will explain the function and reinforcement. I have had well over a decade to study it and witness it in for myself, through myself.

SIB has multiple functions for me. First, for me alone, it is a physical manifestation of the pain I experience. Sometimes, there are no words to pair with it. There are no words in the world to make the feeling go away, and the behavior has become an impulse, rather than a carefully planned, ritualistic behavior.

Second, it is a form of self-punishment. This is the behavioral response to emotional neglect and abuse as a child. I had no confidants. There were no adults that existed in my life that I could relate this awful depression to. And when I attempted to do so with my own parents, it was dismissed. PMS, a phase, attention seeking behavior, imaginary, excuses. I’ve heard all of the rationalizations there are for depressive symptoms.

As a form of self-punishment, much like those of the clergy in the old church, it represented all of the punishment I deserved for being a bad person. A failure. For being insignificant and terrible enough to be unworthy of love. All that a despicable person like myself deserves is wounds. Terrible wounds that will bleed, and scab, and scar so that I might be reminded every time I look upon them.

SIB also serves as a mechanism for control. I have always noticed a pattern about the stimuli that prompts this behavioral reaction. I get to a point where I am overwhelmed, and my life is spinning out of control. I feel helpless and hopeless. The only thing I have control over is my own body, even when I cannot temper my emotions. This mechanism is dangerous, because it is the gateway to an abundance of other methods of SIB.

It is also a small part of the lingering, highly romanticized desire for death. Suicide is something else entirely, so I will leave that at that for the moment. In a way, it is like blood letting of the barbaric medicine practiced in medieval times. When a person was afflicted, blood letting was a common practice. It was though to purge toxins and evil from the body and mind.

And lastly, and most importantly is the addictive component. The act of SIB releases endorphins in the body. It allows the mind to focus on the most immediate pain it perceives, distracting from emotional suffering. Instead of being trapped with those emotions, the mind can be set free from that cage. It focuses on the real pain and the real injury. These endorphins, once the climax of the pain has been reached, take over. For a moment, a brief moment in time, the mind is empty. Everything is numb, with the exception of the radiating pain from the wound. It is similar to taking a drug to escape.

SIB is really a dangerous behavior for all of those reasons, and many more in the realm of somatic damage. I have incredible amounts of scar tissue, some still visible more than ten years later. Other bloggers have related worse to me. Nerve damage, lasting pain, etc. For those that engage in other types of SIB, the risk becomes even greater. Especially with ED and promiscuous behaviors. I am typically a very faithful person, remaining monogamous. (I am completely monogamous in my marriage. Don’t get the wrong idea. That was then, and this is now.) And I still ended up with HPV, causing me to have cervical cancer and two surgeries. The more partners, the higher the risk.

In summation, SIB has an seriously addictive component, and is not a substance, so it makes it harder to control. With a substance, a person can refrain from the substance itself. SIB is a little different because devices of self-harm exist everywhere, and can be carried out in a variety of ways. SIB can be most effectively treated with ABA techniques, mostly behavioral replacement with positive reinforcement. It is a long and difficult process, but it can be accomplished.