More Complications

I’m not doing well. It could be said I’m having a complicated depression or a complicated grieving process. Ruth at Off LabelArchives of General Psychiatry that argues that grieving and loss should not be labeled depression unless they are “complicated”. She summarizes and comments:
discusses the study from the

‘Complicated’ episodes, whether triggered by bereavement or other forms of loss, were distinguished by the authors from ‘uncomplicated’ episodes by the existence of at least two of the following: morbid preoccupation with worthlessness, suicidal ideation, marked functional impairment (not being able to work or socialise) or psychomotor retardation, prolonged duration (> 12 weeks) or a suicide attempt. Such ‘complications’ would enable a diagnosis of depression regardless of any precipitating factors.I think most of us would agree that someone suffering from at least two of the above might benefit from (and indeed require) some kind of intervention, although those of us who have been damaged and marginalised by the excessive emphasis that mainstream psychiatry places on biogenetic causes would have to seriously question whether psychiatric interventions would be of any use. (emphasis mine)

I am indeed having a “complicated” response. Complete with suicidal ideation and marked functional impairment–perhaps a little morbid preoccupation of worthlessness thrown in there too. I haven’t reached the 12 week mark…so we’ll see how far this goes.

As far as benefiting or even requiring intervention I, like Ruth, doubt that a psychiatric intervention would be helpful. As I’ve said a number of times, I don’t respond to antidepressants and even if I did, I am at this point philosophically opposed to such intervention. So what kind of intervention is needed? I have no idea.

To further illuminate my circumstance I should say that while, yes, I’m having suicidal ideation–it is nothing new for me. I’ve never been one to act on suicidal thoughts however. I have one incidence of overdosing in my history, but I was manic and my intent was not to kill myself. I don’t know what my intent was–God was speaking to me and I did what “he” said. I did end up in the hospital, the visit being complete with my stomach being pumped. Other than that there has never been an attempt and I am in no way dangerous to myself at this time. (other than perhaps my determination to push through and help my father move)

The suicidal thoughts are intrusive now and bothersome, but not dangerous. I’m also not particularly functional. My stress tolerance has for quite sometime been next to nil, since beginning my withdrawal. I’m sensitive to noise and light and too much activity. I need to lay down a lot. I have to absent myself from activity. I often go home early, or, as while my mom was visiting, retreat to my room and/or ask my mom to come late in the morning (she was staying at a hotel) or go back early in the evening. This does not please me.

I’m quite petrified about helping my father move. My siblings can’t help and I will be with him 6 days helping manage the move. He is not capable of doing much of anything. Will I be? I figure worst case scenario–I employ the movers to do everything. I’m already imagining that after the flight to the west coast where I arrive at 2 am my time, I will spend the next day at my father’s in bed. I don’t imagine I will sleep once I get to bed the night before. My med schedule and sleep schedule will be so interrupted that I don’t think I’ll be functional at all. Traveling has been difficult for me ever since I started the withdrawal. I need 24 to 48 hours to re-acclimate.

You might ask why I am determined to go through with this. It’s due to a complicated relationship with my sister. She lives near my father and has done a lot already in spite of working a demanding job and managing a family. She has been financially responsible for much of what my father needs–something I’m unable to help with. And she is completely clueless as to how debilitated I am no matter how much I tell her I am limited. She has never been supportive of my sensitivities and I imagine she simply cannot fathom being limited in the way that I am right now. She boasts of once going to perform surgery while sick with the stomach flu. Not a slight flu, but one in which she required fluids and was hooked up to an IV up until minutes before performing the surgery. This story leaves me dumbfounded. Where are her ethics? She may be able to “pull herself up by the bootstraps,” but I think she put someones life in danger. There is something good to be said about accepting your limitations. She does not accept mine and clearly does not consider hers in a responsible fashion.

And I am scared of her. She is condescending and when I told her that I might not be able to do a whole lot on a daily basis with my father she yelled at me saying I’ve told her innumerable times that I’m limited and that she understands. (I have to say, I’m not prone to whining–I simply never feel that she hears me) Seems hard to believe she understands–if she did she might show some compassion. I could still say no. Yes, I could. But I won’t because I the situation is also complicated by the fact that I want to help my father. I, too, don’t want to accept my limitations. My fear at this point is that I’ll be in the way. But really, if I’m only able to drive him to his new home, I will have been a help. No one can do that on Monday when he needs to vacate.

So again–why am I doing this? I love my father. He is ill. He may not live to the end of the year. I greatly desire to be supportive and I want to spend some of the rest of his life with him. He is not prone to worry, so I don’t think I will be a nuisance to him. He will appreciate my being there and he will respect my limitations. I’ll just do what I can and spend some valuable time with him. I don’t think that is so terribly misguided. And I know I’ll come out the other end. I recover quickly once I’m home and able to have a regular schedule.

Of course recovery may be complicated with my brother’s terminal illness. I won’t be going to take care of him after all. He understands my limitations. He asked me not to come. He didn’t want to worry about me–he’s the one who needs support. This made me cry. Not on the phone with him, but once I got off. I so deeply want to help him. But he is right. And he always got me. And he said when he goes to the west coast to die that he wants me there, where I won’t be responsible for him, but I can offer emotional support. He does appreciate what I can give him and says I give him a lot–I know he means it. It’s just in this case of helping with his family while he gets chemo that he doubts I will be helpful. Taking care of his children is a big effort. They are not well behaved and he needs someone strong. Not someone who needs to lay down for half an hour every two hours.

So…I haven’t wanted to write much lately. I had hoped, not knowing so, that I could keep this account of my withdrawals positive. That I would come through with flying colors and no one would doubt the wisdom of what I am doing. I still don’t doubt. I am simply going through a dark spell. It may last for a while. It may last a long time given my circumstances. But the key is they are circumstances–external to me. And withdrawal is never a walk in the park. It’s a slow painful process and that is part of what I must share. I’ve been on drugs for 15 years–high doses. My neuropsychologist tells me that this is not for the weak at heart. He’s seen many people get off drugs and he clearly admires me and supports and believes in my efforts.

So there you go–this is my particular not so happy process at the moment.