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More Before Questions To Answer

• Why do I feel I need to hurt myself? What has brought me to this point?
  
  Nothing externally stressful really. I did become a bit exhausted over christmas, not because there were any unpleasant arguments or anything like that, everything was nice, I just overstretched myself. But I did make med changes in the beginning of december, which were necessary - I added a med in june and the plan so didn't work out. Since the med changes in december I have been sinking into depression, which makes sense considering which meds are involved.
• Have I been here before? What did I do to deal with it? How did I feel then?
  
  Yes, yes, yes. I used to SI with some frequency. Have written a lot, and later learned to talk to my husband and therapist. Distractions of the take a walk, bake a cake, listen to music, watch a comedy type are really only marginally helpful. The thoughts return so quickly. It's worst when I go to sleep, I have no trick for that one. What has worked, not forever but for longer stretches of time, for this particular type of SI thoughts (I have others too) is adjusting meds. Yeah, I also think that sounds like a bad excuse. But it's the connection I can see.
• What I have done to ease this discomfort so far? What else can I do that won't hurt me?
  
  Despite feeling depressed, I'm taking care of some of the basics. I sleep, eat homemade meals with vegetables, do a few chores such as laundry, take my medicines and vitamines. Work out twice a week. I should be taking walks but have been cheating there, the wet cold weather and slippery paths/side walks are not inspiring, but I just bought a set of those spikes that you put under your shoes so the slippery part should be less of an obstacle I hope. I keep up with a select number of friends, and have been pretty active online in an effort to stay busy. And I do my best to seem cheerful IRL.
  
  It doesn't make me feel that much better, they are mostly a series of "shoulds" and quite stressful and exhausting in their own way. But it would be worse to let everything go.
  
  I know I should talk to a pdoc but I don't have one right now (regional government politics, don't ask...) I'm uncomfortable discussing SI with a doctor I don't know, it's easy to be misunderstood. But if this situation doesn't get better soon, I will probably have to see one somehow but limit myself to talking about depression. I do have an appointment with my pnurse in two weeks, maybe we can figure something out.
• How do I feel right now?
  
  It's an intense, intruding thought mostly. Something churning in my mind. Quite graphic, and both emotional and cold and removed. I go through options of where on my body, how much, how to stop myself from overdoing it (would rather not need medical attention). Over and over.
• How will I feel when I am hurting myself?
  
  Relief, intense relief from letting go of control, maybe euphoria or maybe a numbing of feelings. After a while maybe dizzy and a little nauseaus.
• How will I feel after hurting myself? How will I feel tomorrow morning?
  
  At first, I will be sort of robotic about taking care of injuries. Then probably this strange mix of feeling free and feeling lika a horrible person for upsetting everyone. Strength and guilt and shame, confusing. I will be hoping to not have to deal with these urges for a while, which may or may not be true.
• Can I avoid this stressor, or deal with it better in the future?
  
  I really don't know, it's all so vague.
• Do I need to hurt myself?
  
  Can hold back right now. The thoughts can easily stick around for a week or a month, so I never know if I will make it, but for now I'm ok.

hi stellaria

are your med changes being helped by a dr? it sounds like your meds are a likely cause of your mood dropping and something you can do something about. i really hope you will talk to a dr about it as soon as you can.

i listen to a lot of guided meditations when i'm trying to fall asleep. it gives me something to concentrate on instead of my thoughts, but also helps me accept my thoughts as ok - it's normal for your brain to be trying to fix things, even if the 'fix' is si and not something you really want to think about. i usually listen to something like this - https://www.youtube.com/watch?v=Zljg2ptExHc

apart from things you 'should' do, are there things that you enjoy or that make you feel grounded or more positive? i find it helpful to write something on my todo list like 'read a book' so that i remember to do something relaxing and feel like it's ok to take a break from other tasks/worries.

Hi treasure

Thank you so much for replying and coming up with constructive ideas. Yesterday, my mood took a 180 degree turn for whatever reason and all SI thoughts flew out the window. For now at least.

The doctor situation is tricky, there is a general shortage of pdocs in Sweden, and for several years the solution has been rental docs which becomes expensive for the hospitals/clinics. The region where I live decided to stop using rental docs from January, somehow thinking that they are going to be able to recruit docs for ordinary positions (I'm not quite sure how they plan to do that). So... now my clinic has one doc I think, and one who is actually retired but works part time, which is why I think it will be hard to get an appointment unless it's an actual emergency. But it should sort itself out eventually, they have to find solutions. Unfortunately, it's not much of an option for me to go private, apart from that it's expensive I have heard that many private docs are not too interested in taking on "hard" cases.

Anyway, there are still a couple of weeks before the med change is complete, so unless things go totally crazy I really need to wait it out to see the end result.

Thank you for the meditation link. I don't know why, but these things have always made things worse for me, my brain is odd. Still, thank you for your consideration.

And I know I'm saying "yes but" now, but since I know that if I'm really low, I'm supposed to do things that are enjoyable to try to lift my mood a bit, watching a happy movie, eating some nice fruit, having a hot shower - they all seem like "shoulds" and don't make me feel good. Sometimes it's best to not overthink and just wait things out. I do find it a bit helpful to write difficult stuff out, like in this forum, as it gets easier to distance myself from it. But on the whole, it's moment by moment and wait.