How to help a friend when they're half a world away?

As I sit here, my ulcer gnaws at my stomach, because I know my friend is in very serious trouble. We've gotten to know one another on the Internet, but the wonderful anonymity that it offers is also its drawback: I can't contact authorities to let them know she is in danger.

I desparately try to leave messages all over the net for her, but I don't know if she'll look at the net right now. That's simply not in her mind. She's in excruciating pain and can see nothing else. I do all I can do, and it's not enough. And the if's come in: If only I had stayed online when she told me to go do some research, if only I had had the forethought that she was so vulnerable and really needed me, if only... But the if's won't do any good either. All I can say is I've tried what I can try, and just pray that it is enough.

Life is so fragile, such a delicate thing. And when you have additional problems, life makes a person even more vulnerable to the harshnesses that it dishes out. In DBT there is the saying, "It is what it is." I just hope that I can accept that, regardless of the outcome.

2nd post today - sinking into suicidal ideation

Called the hotline again; this time the guy was less sympathetic and viewed my Xanax as addictive even though I'm taking it as prescribed. He suggested to try DBT skills of mindfulness and breathing, and to break up my day into little events, like walking my dogs or watching tv. He also suggested I call my T on Monday and get a sooner appt. with her. I don't know how I'm going to make it through this weekend. I can't wait to see my dr on Monday. At least she understands where I'm coming from as far as being totally debilitated, in bed, unable to go to the store, etc., as little as two years ago.

Obviously calling the hotline is a gamble: Sometimes you get someone sympathetic, and sometimes you don't. He didn't seem particularly concerned that I was feeling suicidal - a step down from wanting to cut myself. I don't know how I'm going to make it. I have no one to call. Can't get in touch with my T on the weekends. Tried to call a friend but she was on her way to her 2nd job. I don't know what I'm going to do. I'm panicked and thinking about ending it all.

Feeling suicidal & like hurting myself

Despite the fact that I've talked to my dr's nurse, who was very supportive of me and encouraged me to speak with my dr because of the pdoc's recommendation to reduce Xanax, and despite the fact that I've got an appt with my dr on Monday morning, I'm feeling panicked, chest pains, suicidal, and like hurting myself. I've called the hotline, though I didn't leave my name or personal information, although one of the counselors there said that it would varifiy what a strong reaction I am having against this proposed change and would be part of the record for the pdoc. They are suggesting I put up all knives and sharp objects. I'm just not touching them.

The counsellor suggested I come forth to let the pdoc know of my background where less than 2 years ago I was in bed, couldn't go to the grocery store, took my son with me to the drs offices, and generally just huddled in my corner, and that Xanax has allowed me some freedom to at least try working, even though I still get panicked, try school, and hunt for a job. She said to let my pdoc know that I am not pill seeking but am legitimately afraid of reverting back to the non-functioning way that I was before I was on Xanax. I'm going to tell my dr on Monday about it too.

But I still feel desparate and like hurting myself, if not cutting my throat, because a strong support is going to be yanked out from under me and I will not be able to stand. I've fought so hard to get where I am, that it seems vastly unfair for the pdoc to cut out the Xanax. If there were a safe alternative, like an antipsychotic for instance, that treated panic and anxiety, I'd be all for it, because Xanax wears off and I would like a more long lasting and safe remedy. But there isn't anything that they've developed as a good alternative to it. I am so terrified on things like my externship that my low self-esteem and self-confidence shows through and puts me in a bad light. The same thing happens when I am working for the temporary agency. How am I going to get a job if I am so panicked by the prospect that it shows up in the interview? They don't want people who are unsure of themselves.

I know I need to calm down, but that is so hard even with Xanax because I'm in a perpetual state of panic. It would be much worse without it, though. I'm feeling incompetent and like I'm going to land on the streets without a job. I don't know what to do, because there aren't many phlebotomist positions available. I will call the supervisor where I did my externship on Monday to see if she will consider me for any of their positions open, even part-time.

I am torn apart by fear. And I tend to withdraw into myself when I feel that way, and to not reach out to others. At least I've been calling the hotline. Maybe I should leave my name and my pdoc's name to document what I'm going through. I think I'll do that. She needs to know the trouble she has caused by even suggeting that I go off Xanax against my approval.

I'm trying not to cut or get out a knife that could slit my throat. I'm doing a good job of it. I have been using meditation to try to calm myself, and that has helped some. I'm going to go call the hotline and put it on record what has been happening to myself.

Pdoc, DBT and T - a Rant

I am furious. My pdoc wants to eliminate my Xanax, after already reducing it from 8 mg to 6 mg. In the meantime, I have occasionally taken some lorazepam as needed to fill in for the missing 2 mg. But I was honest with my pdoc about that and she has planned my decrease to get off the lorazepam. I can handle that. But I am under extreme stress. I had a panic attack when she said that she was going to decrease the Xanax, and my ulcer kicked in with a vengence. I am almost out of money, don't have a job, and don't know how I'm going to survive. I'm worried sick about it most of the time despite doing what I can do to apply for the very few phlebotomy positions available.

So I called my dr and left a message about what the clinic plans to do, and stated my objections to it. I don't know when I'll hear from her, but I hope she will be on my side. I have been with her for about 20 years now, and she has always been very supportive in a variety of ways, so I hope I can count on her now. She sent me to the clinic because the psychotropics were getting way over her head. Now that they have been adjusting my meds, medically I don't need to be there.

However, I am in DBT now until I find a job, and the DBT skills I find are moderately helpful. I need to practice them more and I'm sure I'd get more out of it. I want to continue with DBT, and continue with my T, plus the clinic is giving me free meds now that I am out of work and that is helping tremendously.

I just don't happen to agree with their philosophy, which is cut you off your meds before you even have the DBT skills to try to deal with it. How am I going to deal with constant panic attacks on the job which I've experienced repeatedly in the past? My life is held together by a slender thread as it is. Plus they push you through DBT at double the rate that it is supposed to go (6 months instead of one year). It's like they are doing a crash course in patient therapy which includes minimal to no medications. I just don't buy into that. I want to gain skills in therapy, but I also want the support of my medications, which run the gamut of antidepressants, antipsychotics (going down to one), to the antianxiety drug Xanax. Plus the pdoc doesn't want me taking the sleep med my dr gave me, and I have for years had great difficulty in falling asleep. I easily reverse my hours. So I won't have sleep support, except for an antihistimine that she prescribed. Antihistimines don't put me to sleep. And with lack of sleep comes serious bouts of bronchitis, which has already scarred my lungs.

I know that I am a walking pharmacy, but my life has been hell, to put it lightly, and these pharmaceuticals have gotten me through.

I'm mad as hell that the pdoc is doing this. Has anyone else experienced similar things with their pdocs, and if so, what did you do?

I go to a public clinic, and I really feel like they are trying to run me through the paces to get me off all drugs and buy into their way of thinking. But I'm not a wholistic sort of person. If I were, I would be supporting all the changes, no matter how difficult they might be. But I'm not. I have been a part of the medical community for 12 years now (as an EMT and phlebotomist), and I have great respect for medical doctors. They were the ones that removed my seriously diseased gallbladder that was too big to take out by scope (they had to open me up). They have been treating my migraines for years. I am going to lose some more weight to help prevent me from getting diabetes. I've already lost a ton of weight.

Ok, I'm through now. But I'm still furious.

Overwhelmed and panicked

This week two big events happened. My computer crashed and so I have been down for the better part of a week. Now I have to reinstall programs, etc. A pain, but doable. I may have to purchase some programs that other people have given me. The biggest problem was being out of touch with everybody. I basically lost a key part of my support group, and that sucked, I'll tell you.

And the other big thing was I went through my externship for phlebotomy. It was hard. I chose to work in a hospital, but I now see I should have taken my instructor's advise and gone to a clinic. Now I think I'll have to arrange for another period of time in a clinic doing sticks, if that's even possible. The hospital part was hard because I was with constantly new instructors (other phlebotomists, mostly) who did things differently from each other, who set up their carts and trays of equipment differently, and who would change at midday when the shift changed. So with all this difference all day every day, it was hard to concentrate on doing my sticking well. I always started off very nervous in the morning, and tended to miss the sticks, but then as the week went on I got better in the afternoons.

But the hardest part was just being with another person all day long who was observing me and commenting (I appreciate the feedback, but still it was overwhelming at times). I had frequent panic attacks. Xanax got me through the week, plus remembering a refuge in the Buddha saying, which helped me calm my breathing down. But mostly I stayed panicked. I was having to pay so much attention to getting my equipment found and set up that I didn't have much attention left over for the actual stick, let alone pay attention to the poor patients, many of whom had been stuck repeatedly and didn't want to see another needle. I can sympathize. Now, that is. I was too panicked to empathize then.

I got through the week, though. I didn't get as many sticks as I should have, because several "helpful" phlebotomists filled in extra sticks on a sign off sheet for me because it is so difficult getting 100 sticks in a hospital. That really worked against me because I didn't get the experience I should have. But I was limited on time and wouldn't have gotten the experience anyway, I guess. I feel bad about it though.

So not being in touch with ppl I care about on the internet and going through a very tough week without support was very hard. It's still hard. I will be glad to see my T on Tuesday.

I don't know how I am actually going to get a job doing this and be able to handle it personally. Maybe after more practice like on the job training I will be able to focus on the patients. Or maybe I'll have to find work at a clinic.

This was way overwhelming for me. But now I've got to find a job. If I can. And yet I don't feel capable of handling it in some ways. I don't know how I am going to make it. Panic!

DBT and honesty

Today was my first day of DBT. Most of it was introductory. One of the things we have to do everyday is to keep track of our actions (like self-harm), emotions, urges, etc., including self-medicating. The form requires you to rate the urge to self-medicate, then tell how many and what medication you are taking it, whether illegal drugs or over the counter medicine. So here's my problem. You have to give the cards to your therapist who reads this very intimate portrait of your inner life and then evaluates it with you.

I don't know if I'm ready for that level of honesty. I turned in all my needles after self-harming, and that's ok. But since I self-medicate using a prescription drug that could easily be cut off if it is known that I use it for that, I really don't want to be honest about that yet. If I knew it were safe to tell, that my T wouldn't run to my doctors and cut me off, I think I could open up about it and work with her to decrease my self-medication.

But it needs to be safe. When I know I won't be cut off abruptly, then I am willing to be honest about the problem and address it in therapy. But there has to be some trust there. And I wouldn't be as willing to be as forthcoming about other things if the trust was not there. I guess it depends upon my T. Somehow I've got to ask her if she will keep it confidential while we're working on it. I don't know how to ask that and not give away what the problem is. I believe that DBT can help me deal with my urges and the emotions behind them.

It comes down to being scared: Of being honest with myself, with my therapist, and with my DBT group, to the extent that I want to share that with them.

Oh, and the funny thing about today was that there were supposed to be 8 people there and only 2 showed up, including me. So we got pretty closely watched and supervised.

I'm also scared of DBT and the changes it will potentially make in my life, even though I know that they are good changes. Change can be scary. Who knows, if I get a job, I might not even be able to continue to go to it. And that would be scariest of all.

Bad driving

First I rearend a car while stopped at a stop light and something fell forward. I leaned forward to get it, and my foot must have slipped off the break, because the next thing you know I was in the back of a Subaru.

Then today while I was driving home from a seminar, I was driving up a twisting road up the mountain when I was pulled over. I was doing 64 in a 45 zone. The officer asked me if I knew what he had pulled me over for, and I didn't have a clue. He asked me if I knew what the speed limit was, and I told him I didn't know (which was also true). He let me off with just a warning I'm sure because I still have on my firefighter license plates from when I was on the fire department, plus stickers saying I'm a firefighter and an Emergency Medical Technician. I'm sure it was professional courtesy. But I have been driving so badly in the last year that it has been seriously dangerous. That bad wreck 6 months ago or less. Sliding off the road into the ditch in the winter 3 times. Count them. One, two, three. Borderline Personality Disorder has as one of its symptoms wreckless driving, and I am sure falling into that category in a big way.

And I'm trying to be safe. I probably drive a little fast, but not most of the time. And S suggested that I talk to myself while driving, saying "now I am approaching this sign, now I am turning left" so that I will be more aware of my driving and not space it out. I'm going to hurt or kill somebody at this rate. I'm trying to be aware, slow down, allow for space between me and the next car, etc. etc. But even so, I am getting into bad situations. Anybody else have this problem? Am I suicidal and just don't realize it?

Cutting and needles

It's been a while since my last blog. In the meantime, I have gone through several bouts of wanting to cut myself, but only actually cut myself once and in a small way. I called the hotline, and they said I should get an emergency appt with my therapist. On the way home from seeing her one day, I hit a car by rearending it when my foot slipped off the brake. Everybody's fine, and only minor damage, but my insurance company is going to hit the roof. This is the second accident in 6 months.

Back to the cutting: I had good reasons to do it sometimes, and lousy reasons to do it other times. I chose a lousy time to actually do it, and I don't know why. It had to do with panicking over jobs that were advertised online for a phlebotomist at the hospital where I am going to do my externship. And I just panicked. But the urges had been so strong all day, that I cut myself. My pdoc told me to bring in all my IV needles to my T, which I wasn't thrilled about doing. But with some encouragement from P, I decided it was the way my T was trying to help me. I even turned in the IV lines that I could use to start an IV on myself if I got sick. So I turned them ALL in. That was a tough one.

I am still self-medicating, and can't bring myself to tell my T yet. I need to get a better handle on it somehow. I don't want to be cut off all of a sudden.

But DBT starts on Tuesday, and we will be dealing with distress tolerance, which I can certainly use right now. I have anxiety and/or panic attacks every day. I've even had serious chest pains, and I'm going to tell my doc about that for my annual physical soon. But I'm sure it's inside, in the painful places of my metaphorical heart, not the muscular pump.

I'm panicked over finances and jobs and DBT. One good thing about DBT is that I will see my T every 2 weeks instead of once every 3-4 weeks. And she is one of the DBT counselors, so I'll see her every week then. I'm afraid that DBT will go too fast for me and that I won't be able to keep up and "get" the ideas they are teaching. And I'm afraid of what it might uncover. I have dark secret things hidden where no one but me can find them, and I don't even want to find them. But I need relief from the pain of everyday life right now, so I may have to peek.