Help Where do I go from here?

[Average Joe]

Over the years, I've tried various therapies and treatments. I've been prescribed multiple medications, including SSRIs like Fluoxetine, Sertraline, and Citalopram, as well as Mirtazapine. I'm currently on Venlafaxine.

I've engaged in therapies like DBT, CBT, counselling, and group therapy. Other efforts include meditation, mindfulness, routine-building, self-care practices, and exercise as well as other psychoeducation. Despite these efforts, I've been hospitalized 4-6 times for suicide attempts and self-harm however it's been 1000 days (on thursday) since my last **proper** attempt at taking my life.

I was known to CAMHS from about 13/14 up until my 18th birthday when I was moved to adult services. I was with the Community S&R team from 18 up until March 24. During this time I had multiple key workers,

Currently, I feel stuck and hopeless most of the time, with a low mood 95% of the time. I often dissociate and struggle with concentration and memory. Self-harm, specifically bloodletting, remains a coping mechanism.


Recently, reached out in January this year, got prescribed venlafaxine which the only affect I can notice from it is that my dick doesn't work. I was referred to mh team by my GP. I had one assessment done with the CMHT (community mental health team). She then referred me to Nexus NI for trauma counselling (raped multiple times as a child). I got a phone call a week later from the CMHT and was discharged.

Another week passed and I was chatting with Nexus. They noticed on the referral that the CMHT mentioned drug use and self harm, when they brought this up with me I told them I was willing to stop self harming and cut down on my drug use if it meant getting therapy. However, they said something that their sponsorship or something won't fund patients who are actively abusing drugs or self harming. Basically I'm not eligible for counselling. I've also finished counselling with Inspire NI, it was more of a weekly check-in rather than counselling.

Lucky me, I'm referred back with my GP. Absolutely devastated. And it's been 1000 days since my last proper attempt at suicide. It's funny how God / Life mocks me like this.

I just seem to get passed around like a joint in Snoop Dogs house. No service wants to deal with me even though I'm actively trying to engage, I take my prescribed meds, I have a hobby and I get out of the house as much as I can. I practice good sleep hygiene, work on my mindfulness and I've recently started consistently working on a routine.


TLDR: Nobody is coming. I cannot be fixed and I am destined to become a statistic.

What do I honestly do? I'm seriously asking for advice, I have nobody to turn to. I have nobody.

 

[lost_one]

suck dude, I am not a doctor and you should definetly consulte one before taking anything I say seriously, but have you tried ketamine or shock therapy? they are more extreme, but you case seems pretty severe.

Idk if you know why you feel this way, and I don't really hope to actually help you, since I am a mess myself, but to me the idea of giving my life some purpose brings me solace, and maybe would make me more happy. to do some good that is not focused on me.

I sucks the way people treat us, It's hard, I feel like therapists and doctor, hate someone that is actully deeply depressed, and not just surface level, cause it's a lot of work and I think they don't even know how to help.

 

[Average Joe]

suck dude, I am not a doctor and you should definetly consulte one before taking anything I say seriously, but have you tried ketamine or shock therapy? they are more extreme, but you case seems pretty severe.

Idk if you know why you feel this way, and I don't really hope to actually help you, since I am a mess myself, but to me the idea of giving my life some purpose brings me solace, and maybe would make me more happy. to do some good that is not focused on me.

I sucks the way people treat us, It's hard, I feel like therapists and doctor, hate someone that is actully deeply depressed, and not just surface level, cause it's a lot of work and I think they don't even know how to help.

I don't think we can get ketamine here "legally" anyways, I have often thought of microdosing with it however.
Doctors and therapists are really 50/50. They're usually good for people with mild depression. When every aspect of life is at chaos then it's so much easier for them to decline help.

I think in the 5% chance that I mess up my next attempt, I'll probably request ECT (electro-convulsive therapy).
Thankyou anyways brother/sister

 

[broken_stoic]

A few thoughts, I don't know exactly what your root causes are, how old your are etc, which does make a difference so adapt this as you see fit:

• SSRIs/SNRIs really only work for 40-60% of people with major depression
  • There are other classes of meds that might be better to try, but yes all meds have downsides (unless you are super lucky)
  • If you can get a psychiatrist as opposed to an MD I would strongly recommend that
  • See if your doctor/psychiatrist can order a genetics test to see if there are any medications that might be more likely to help/cause fewer side-effects
• Have you ever worked specifically with a trauma-therapist
  • I don't know that you do have trauma from your post, but if you do these therapists tend to be much hardier and better able to handle the hard cases like us
  • I haven't done DBT yet (I want to) but CBT can have limited effectiveness on some people depending on what your root issues are
  • Finding and keeping the same therapist for an extended period of time is important for real healing
• Do you have anyone who can advocate for you?
  • It sounds like probably not, and I'm sorry, I'm kind of in the same boat, but if there is anyone please consider the following
  • Do you have any family or friends who can go with you to doctor/psychiatrist appointments? Having someone to help you make decisions and explain things can be very helpful
    • If you don't, start writing things down, keep logs, keep notes on how past meds effected you, write down your mental health history and bring it with you to doctor appointments
    • Write down stuff that happens throughout the week whenever you think about it so you don't have to remember

Mental health issues fucking suck. Doing it alone fucking sucks. Having an unresponsive medical system fucking sucks. Hang in there and do your best.

 

[BeansOfRequirement]

This is far, far beyond anything I've dealt with, so feels weird to try to give "advice". Very sorry about this and that you're not getting all the help that's available. Which meditation techniques are you using? You mentioned having good sleep hygiene and doing exercise, what type of exercise are you doing (and how do feel when doing it and after), also how is the diet/light exposure/movement?

 

[Average Joe]

Hi I'll reply soon to both of your messages, I'm just in hospital at the moment and I'd rather send a proper reply rather than a quick comment to you both on my phone. @BeansOfRequirement & @broken_stoic

 

[Average Joe]

A few thoughts, I don't know exactly what your root causes are, how old your are etc, which does make a difference so adapt this as you see fit:

• SSRIs/SNRIs really only work for 40-60% of people with major depression
  • There are other classes of meds that might be better to try, but yes all meds have downsides (unless you are super lucky)
  • If you can get a psychiatrist as opposed to an MD I would strongly recommend that
  • See if your doctor/psychiatrist can order a genetics test to see if there are any medications that might be more likely to help/cause fewer side-effects
• Have you ever worked specifically with a trauma-therapist
  • I don't know that you do have trauma from your post, but if you do these therapists tend to be much hardier and better able to handle the hard cases like us
  • I haven't done DBT yet (I want to) but CBT can have limited effectiveness on some people depending on what your root issues are
  • Finding and keeping the same therapist for an extended period of time is important for real healing
• Do you have anyone who can advocate for you?
  • It sounds like probably not, and I'm sorry, I'm kind of in the same boat, but if there is anyone please consider the following
  • Do you have any family or friends who can go with you to doctor/psychiatrist appointments? Having someone to help you make decisions and explain things can be very helpful
    • If you don't, start writing things down, keep logs, keep notes on how past meds effected you, write down your mental health history and bring it with you to doctor appointments
    • Write down stuff that happens throughout the week whenever you think about it so you don't have to remember

Mental health issues fucking suck. Doing it alone fucking sucks. Having an unresponsive medical system fucking sucks. Hang in there and do your best.

Hi there, I think I'm in a slightly better place to reply now. I can definitely agree with the medication, I don't think it's for me. It didn't work even when I had mild depression in my early teens. I'm currently on an SNRI called Venlafaxine, which is a new class to me despite being an older form of medication I believe.

I was referred to a trauma therapist but declined due to my ongoing self-harm. I'm being referred to the mental health team again so I hope to discuss this with them! Before I left hospital yesterday I was seen by their 'emergency' psych team and they discussed trauma support. They also recommended doing another 'round' of DBT as I've done it a few years ago and have forgotten many of the skills. CBT wasn't all that effective, I really tried but it didn't resonate with me.

I definitely agree with finding and keeping the same therapist, I'm not opposed to change but it's hard to build a therapeutic relationship filled with trust when the therapist/mh nurse keeps moving or being allocated elsewhere.

I'm sorry that you have nobody to advocate for you, I'm in the same situation, I'm trying to be assertive and stand up for myself without it coming across as abusive or in a negative light, as I believe you can have a healthy confrontation if you know how.
I put everything either into my thread in the private suicide discussion forum or into ChatGPT as it's easier for me to summarise and recap with GPT. AI is great when you know how to use it.

Thanks for leaving kind words, I hope you're in a better situation and getting the right support too <3

This is far, far beyond anything I've dealt with, so feels weird to try to give "advice". Very sorry about this and that you're not getting all the help that's available. Which meditation techniques are you using? You mentioned having good sleep hygiene and doing exercise, what type of exercise are you doing (and how do feel when doing it and after), also how is the diet/light exposure/movement?

The meditation techniques I currently use are (excuse me as I struggle to describe them)

1: Observing thoughts and visualising them as leaves in a river - not trying to label them as good or bad, but just trying to visualise them in my mind and watch them pass.

2: Full body scan - I use this one in bed to try distract myself and prevent overthinking into the rabbit hole of life. A full body scan is observing how each part of my body feels, so I tend to start with my feet: so how my toes feel, if there's any tingling or coolness. I try avoid labeling them as good or bad sensations. The CALM app walks me though this and I enjoy the soothing female voice.

I do mild cardio by walking, it's pretty tough as the bloodless is incredibly tiring and gives me muscle pain, but I allow myself enough time in the daylight to take breaks while listening to my music. Before walking it feels daunting, while I'm walking I do get distracted and gives me some pain but afterwords I feel slight slight relief. Not sure if the relief is from the exercise or from the knowledge that it's over lolol.

I hope to get a small home workout plan without any equipment and stick to that with the likes of planking, situps, lunges, pushups etc etc.

My diet is alright, it's getting a bit better as I'm incorporating more fruit into my diet as well as cutting down on my takeaways during the week. Sometimes my mood is quite low that I just eat for the sake of eating, it's like all flavour is void and I'm just eating some bland cardboard. (note: I'm not actually eating cardboard but that's how it feels sometimes)

 

[BeansOfRequirement]

The meditation techniques I currently use are (excuse me as I struggle to describe them)

1: Observing thoughts and visualising them as leaves in a river - not trying to label them as good or bad, but just trying to visualise them in my mind and watch them pass.

2: Full body scan - I use this one in bed to try distract myself and prevent overthinking into the rabbit hole of life. A full body scan is observing how each part of my body feels, so I tend to start with my feet: so how my toes feel, if there's any tingling or coolness. I try avoid labeling them as good or bad sensations. The CALM app walks me though this and I enjoy the soothing female voice.

I do mild cardio by walking, it's pretty tough as the bloodless is incredibly tiring and gives me muscle pain, but I allow myself enough time in the daylight to take breaks while listening to my music. Before walking it feels daunting, while I'm walking I do get distracted and gives me some pain but afterwords I feel slight slight relief. Not sure if the relief is from the exercise or from the knowledge that it's over lolol.

I hope to get a small home workout plan without any equipment and stick to that with the likes of planking, situps, lunges, pushups etc etc.

My diet is alright, it's getting a bit better as I'm incorporating more fruit into my diet as well as cutting down on my takeaways during the week. Sometimes my mood is quite low that I just eat for the sake of eating, it's like all flavour is void and I'm just eating some bland cardboard. (note: I'm not actually eating cardboard but that's how it feels sometimes)

All-right, I have a meditation megathread if you want more options for types of meditation. https://sanctioned-suicide.net/threads/meditation-megathread-pin-this.187169/

You have some sort of physical pain that interferes with the exercise?

 

[Average Joe]

All-right, I have a meditation megathread if you want more options for types of meditation. https://sanctioned-suicide.net/threads/meditation-megathread-pin-this.187169/

You have some sort of physical pain that interferes with the exercise?

Thank you for this, I'll give it a read!
I was seen by podiatry and was told that I had a weak calf, but with my mental health I neglected my body and this exercise. I do try remind myself to continue the exercises 'prescribed' to me.