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MuddyBoots
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Default Apr 28, 2024 at 09:36 PM
  #1
Right now I only have a case manager who is trying to get me into therapy sooner than the average bear, and she said she has an emergency line I could call if I needed to. I called it once I think a few nights ago, and she basically said "there are struggles, yes," and my *** just kept going on and on "yeah, but...""the struggles aren't worth whatever else there is." "is there anything but struggles?" "should I ease other people's struggles by removing myself?"

I don't sit there and accept a saying without a discussion of how it was meant to be interpreted and how I interpreted it. Obstinate? Maybe. I really just want people to prove they know their shyt before spewing it.

I'm afraid to call my case manager. I don't want to call for trivial things that may seem like a crisis to me at the time. I don't want to flood her voicemail. I don't want her to think I'm a needy bytch that can't do anything on her own.

But then I don't want her to ask why she's even my case manager because I don't reach out. I don't want her to not know whatever's going on. I do want her to be able to help.

So, at what point do I try to discuss something with my case manager or therapist when I get one that could be urgent or could be nothing.

Possible trigger:


So clearly I need some guidance in recognizing an urgent matter.

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Default Apr 29, 2024 at 02:09 AM
  #2
Bring it whenever you want.. Other people have their own boundaries..
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LonesomeTonight
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Default Apr 29, 2024 at 07:14 AM
  #3
I'd ask your case manager all of this. You could even show/read to her what you've written here. And I hope she can find you a therapist sooner than later.
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Default Apr 30, 2024 at 03:57 PM
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My case manager said I'd see a therapist. Friday!

I asked her if she or my therapist would get too frustrated with me and leave me high and dry. She said she can tell I'm doing my best despite a lot of struggles and as long as I keep trying they won't abandon me.

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Default May 01, 2024 at 02:57 PM
  #5
Welp. Got the call that T had to cancel for Friday.

Have they been surveilling me? Thinking I'm going to be a hopeless, untreatable liability? Or that I'm going to run off hours away and they'll be wasting their time?

UGH!

I'd stay in town and with the CMHC if I had good treatment.
I'd stay on this planet if I had good reason to. Right now I'm thinking that's not so.

Are they already sick of me? I haven't even been with my case manager a month and she said "call if you need anything" and I was told that could be anything from "I don't know where to get food" to "I want to jump off the bridge," so naturally I called I think five times (okay, yeah, generally in the middle of the night from a park about how there was a small thing and then I did the wrong thing and now it's a big thing). They probably think I'm going to be too much, and if they're not giving up on me right now, they will quickly. Gonna just leave them alone, let them focus on better things.

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Last edited by MuddyBoots; May 01, 2024 at 03:17 PM..
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Default May 01, 2024 at 03:19 PM
  #6
Ugh, I'm sorry your therapist cancelled. Is there a chance they could schedule for early next week maybe?
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Default May 01, 2024 at 06:01 PM
  #7
Yeah you know some people hafta climb Mt Everest to get these constantly on edge feelings. Wussies!
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Default May 02, 2024 at 06:00 PM
  #8
It's like I have to be all secretive now and not tell my CM my current thought process and some of the stuff I'm doing to avoid another POINTLESS IP stay. Yeah, I have have made some less than great decisions over the past month or two, and last night was the icing on the cake. I KNOW if I told her what I did she would try to hospitalize me, and that will NOT help because by they time they even move me to the psych building I'll be fine, just pissed that I'm there, be discharged pretty quickly because I AM at baseline and there's really no getting BETTER, and then get out and go back to the same poor decisions after a week of thinking "I'm going to do well and not be a POS."

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Default May 02, 2024 at 07:45 PM
  #9
I don’t know, have you ever thought about acceptance of IP? Accepting that you’re there and using that time to get the most out of the experience instead of getting pissed? Your basic needs are met, you get a bed and shelter. Food should you want it.

When I’ve been ip there’s usually groups of some kind. Instead of being augmentative you could just listen and maybe learn a new coping skill. Sure there’s rules and **** but hey, it could be a learning opportunity. A step towards your goal of getting help.

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Default May 02, 2024 at 08:36 PM
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When I am IP, I do try to get things out of it, but I simply don't. Their goal is to get you to a place where you won't kill yourself the day you get discharged which they are generally successful at. Do I have enough coping skills to distract myself enough to survive? Sure. Do I want to use those coping skills? No. Just passing through life with (a guitar, book, walks, deep breathing, music, yoga, etc.) is going pass time and distract me from SH/sui, but I've never WANTED or felt like I deserve to live. IP will do the same. I get through however long I'm there, but I don't think I've ever been okay for more than two days after being discharged.

I don't want to run to the hospital every time I feel unsafe anymore. I'm a risk to myself more often than not, and I'd rather not live there.

Quote:
When patients with borderline personality disorder are admitted, they enter an environment that reinforces the very behaviors that therapy is trying to extinguish. Procedures developed for treatment of acute suicidality among patients with mood disorders are rarely appropriate for chronic suicidality. Most clinicians recognize the scenario in which a patient with borderline personality disorder escalates suicidal or self-mutilating behaviors in the hospital. Two mechanisms account for this phenomenon. First, for patients with poor social supports, a week on a ward, or even a night in an emergency department, provides a reinforcing level of social contact. Second, the environment of a psychiatric ward acts as a reinforcer, since patients who cut themselves or who carry out parasuicidal actions receive more, not less, nursing care.
Quote:
If, as so often happens, the patient becomes suicidal again shortly after discharge, little has been accomplished. A patient who eventually recovered from borderline personality disorder illustrated this problem with the following admonition: "Do not hospitalize a person with borderline personality disorder for any more than 48 hours. My self-destructive episodes—one leading right into another—came out only after my first and subsequent hospital admissions, after I learned the system was usually obligated to respond"
(From Chronic Suicidality Among Patients...)

I want to live. Actually live, not just be breathing while time passes.

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Default May 02, 2024 at 09:33 PM
  #11
Ahh, I didn’t know that. Thanks. That explains a woman I met once in the hospital. She told me she was going to harm herself( I don’t remember any more how, but it was sneaky) I told her I’d tell the staff and she seemed delighted. And yeah, she got more attention. That was decades ago so maybe they didn’t know that back then.

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Default May 02, 2024 at 09:47 PM
  #12
I have BPD. I agree to some degree that hospitalization doesn't help. In my experience, it just delays the inevitable. Life still goes on when you leave. Right back to where you started. But it can also calm you down for a few days to allow you to hopefully not be in such a dire frame of mind.

For chronically suicidal people, I believe that hospitalization is necessary even if they have BPD. It's a safety measure. You're no better out there than in, so might as well be some place safe that meets your basic needs.

I think the main issue here is not hospitalization. It doesn't seem like you're using your support that you do have. Instead of giving into your patterns, why not try to follow your cm and Ts (when you see one) direction. You are already unhappy. Try something different?

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Default May 02, 2024 at 11:06 PM
  #13
I don't know how to express myself to my CM though. I don't even know what's going on most of the time, and I can't answer questions like "what's going on right now?" and "what can I do to help/what do you need?" and yeah, I say I don't know because I don't, but that doesn't help either of us. I don't want her to get sick of me calling for vague, unpleasant feelings that, good chance, will pass in an hour or two.

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Default May 02, 2024 at 11:19 PM
  #14
Maybe just start with that? Learning how to answer those questions. They're good questions to learn how to answer. I know I struggled with knowing how to answer them. They're not easy questions even if they seem easy. And how do you know the answers if you don't know the options. Even I still struggle with "what do you need" sometimes, and I know my options with L. For me, I try to be small and not ask for things so that I'm not a burden and therefore she won't leave me. AND I have also learned that if you don't ask, you don't get help.

Maybe you can ask her how to answer those questions?

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Default May 03, 2024 at 12:51 PM
  #15
I guess I got rescheduled with the T to the 10th. I'm considering just dropping completely out of treatment forever and using warm lines when they're available and crisis lines when I need to.

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Default May 03, 2024 at 03:17 PM
  #16
Next time my CM calls, should I tell her I intentionally overdosed a couple nights ago? I don't want her to overreact and send me to the hospital needlessly. I feel fine right now.

I get I should be honest or I won't get help, but I also won't get help being in the hospital a fourth of the year purely because I am frequently a threat to myself. I need to learn to deal with sui thoughts/urges without acting on them because they WILL NOT magically disappear.

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Default May 03, 2024 at 03:34 PM
  #17
I think, yes, you should. You also should tell her why you waited to tell her and why you don’t want to go to the hospital. Your reasons are very good.

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