-Willie Nelson, "Me and Paul"
Today is a special anniversary for me, Dear Reader. One year ago today, I began outpatient treatment at The Brook for suicidal depression. I'm not particularly interested in reviewing how I got to that point. You know your own experiences and if you've been to that point yourself, you know all that matters here is our common frame of reference. If you haven't been in that place, I sincerely hope you continue to avoid it. It ain't no fun, that's for sure.
I'd already spent some time inpatient at Our Lady of Peace in 2011, but I'd never done an outpatient program. One of my greatest fears going into treatment has always been being rejected by other patients because I fail the litmus test for who gets to "really" be depressed. I envision a room full of war veterans and people who have been failed at every turn by our society and have endured horrors I've been spared.
I have a mutually trusting and respecting relationship with my physician, Tiffany (no last names in my blog). I agreed years ago when we began treating my mental health that if or when we reached a point where she felt that I needed to seek hospitalization, I would go. One night last July, I sat up late with a couple of bottles of pain pills I'd been prescribed but hadn't really used. One of them was from a dentist who'd extracted two of my wisdom teeth. I forget why I had the other, but I know it hadn't been prescribed by Tiffany because I'd also promised her after my stint at Our Lady of Peace that I would never use anything she prescribed me to harm myself. I've honored that promise. I'd held onto those unused pain pills because they'd been given to me by other physicians, which created a loophole.
That night, as I contemplated combining every single one of those pills, I was chatting on Facebook with a friend about the dark place where I was. She lives in New Jersey, so she couldn't exactly drop by and sit with me, which in retrospect was part of why I felt comfortable reaching out to her at that time. She persuaded me to contact a suicide helpline. I found one online where I could chat via messenger rather than have to speak with someone. It felt easier to write than to speak at that point. Eventually, that person reported me to the police, who came to my home at something like 2:00 in the morning. There were two cars and three officers. I knew they were coming, so I went outside with my arms extended open and raised to greet them. I was sure they were worried when they got the call that I may have a firearm. Statistically, that's how the majority of males who take their own lives do it.
Once it was established that I do not even own such a weapon and that I was calming down, two of the officers left. The third sat down with me outside on the patio for probably an hour. His compassion, his patience, and his encouragement were everything that we collectively want to believe our law enforcement officers bring to their communities. I surrendered those bottles of pills to him and assured him that I would speak with my physician in the morning. He left me his card, emphasizing to me that I could call at any time of day or night and that he would gladly respond. He understood how to make me feel he was there for me without making me feel pressured.
My physician called in my promise to seek treatment if she deemed it necessary, and I honored that promise. I wasn't going because I gave a damn whether I got better. I didn't even believe I could get better. At best, I could maybe get to a lull in the pain, but it would only return. But I was going because I knew even in that state of mind that there were a lot of people who had invested in me. I owed it to them to exhaust all other options before hitting that little red button, and though I'd gone into inpatient treatment before, I had never done outpatient. I couldn't say I had tried everything and nothing worked, because there was still that left to try.
Back in high school, I learned how to make origami dogs. I've made them sporadically over the years; sometimes to amuse myself, sometimes as an icebreaker, and sometimes because they help me with anxiety. On my first morning of outpatient treatment, I made one while waiting for other patients and our group therapist to enter the room. This particular dog served two of the aforementioned three purposes; it helped with my anxiety, and it turned out to be an important icebreaker.
The first patient to join me in the room could not have been more welcoming. She immediately set me at ease and made me feel okay about being there. She set the tone for that entire first day for me. There was a strong sense of camaraderie in that room. And before our first break of the morning, I felt included in it, and a key reason was the welcome I'd been graciously given by that one patient.
During my check-in, I accounted for how I'd come to be there. One of the things weighing on my mind was the pervasive sense that I couldn't do anything of value. Our group therapist, Jessica, observed that the origami dog had made some of the other patients smile. It was something I was capable of doing, and even if its value was limited, it had value all the same. I rejected that characterization. I saw it as her artificially inflating something trivial.
But then Jessica challenged me to make an origami dog each day.
I had no interest in keeping the dog, so I decided to give it to a patient who'd made the biggest fuss over it. I asked if she had a name for him. She did: Waylon. I knew at that moment she and I were going to get along just fine!
It became a daily ritual. I made a dog first thing in the morning, always writing the date on the back of the head. Before the end of group, I would give it to another patient. Typically, I would decide the recipient early on and during break when most everyone else went outside to smoke in the fenced-in courtyard, I would place the dog on the table where that patient had been sitting. I never thought to ask if anyone ever discussed wondering who might get the dog when they returned to the room, but it honestly would not surprise me now to learn if they did. At some point, another patient actually bought me a pad of origami paper, already square shaped and in solid colors!
Someone joining the group for the first time went to the top of the list. I had, after all, benefited from the warm welcome. It seemed only right that I should make an effort to receive others in a manner consistent with that precedence. Similarly, someone being discharged would also receive one as a farewell memento. Sometimes the recipient was someone who had had a particularly rough session. It was a little consolation prize of sorts. The longer patients were there, the more they seemed to ascribe value to the dogs. There were times when, in the final minutes of a session, someone would ask me who that day's recipient would be. Because there were only so many other group members, there were patients who accrued several dogs as I rotated through the roster.
Jessica was right, though I doubt she envisioned the way those little origami dogs became a sort of mascot for our group. Generally, I explained the dogs to newcomers, but there were times when enthusiastic patients beat me to the punch. Those moments reminded me of children showing off something neat to one another. "And this one guy makes dogs and he might even give one to you since it's your first day!" The whole thing amused me, of course, though there were a few instances where I gave someone a dog and they expressed to me sincere appreciation for making them smile with it because they were having such a difficult time finding anything remotely positive in their world. In those moments, the dog became a tangible expression that that person was not alone, that we in that room cared about one another.
Despite the progress I made, it wasn't enough. By early September, I felt a return of that same despair. One night while out celebrating a friend's birthday, I sat alone at a booth while everyone else was on the dance floor or mingling elsewhere. I pulled out my phone and scrolled through my calendar, looking to see when my loved ones' birthdays were. I didn't want to ruin anyone's day, after all.
And then, out of nowhere, came a young woman who sat across from me in the booth. She looked me straight in the eye and said, "Don't do it."
I was, to say the least, stunned. I tried to ambiguously dodge her, asking what she meant. But we both knew exactly what she meant. She explained that she could tell just from looking at me where I was and what I was planning. Some of her friends came looking for her and when they found us sitting together, voiced their objections that she shouldn't be spending her time with someone as old as me. I tried to reassure them I had no romantic or sexual intentions of any kind, but I don't think they believed me.
No, I had none of those things on my mind. I was too consumed with processing what was happening. I could have understood it if someone who knew me had read me so accurately and quickly, but there was this stranger out of the ether who was challenging me to my face. That was a Saturday night. During Monday morning's check-in, I shared this and admitted that I didn't trust myself not to act on those urges. Jessica saw to it that I was admitted that day into the inpatient program. I spent a week there. I kept making origami dogs each day, because I told Jessica I would. Plus, they served the same purposes they always served; they amused me, they broke the ice with some other patients, and they gave me something to do while I was feeling anxious.
Though I was discharged from The Brook in October, Jessica introduced me to three important parts of my ongoing mental healthcare. One of them is a free meditation app called Stop, Breathe & Think. I had never tried meditating before, and I was surprised to find it so impacting. It's helped me significantly with finding peaceful moments, and it's helped me to establish and maintain some semblance of a healthy sleeping pattern. (It gets disrupted regularly, but the meditating has made a world of difference in helping me reestablish it.)
The second key element is my therapist, Carrie. The Brook insists on patients having an aftercare plan in place before being discharged, including at least one scheduled appointment with a therapist. I'd had a demoralizing experience with one therapist in 2013. (When I expressed to her that I was deflated because I know I'm going to die alone and be eaten by the cats, she told me I should work on accepting that and making my peace with it, for instance.) But Jessica played matchmaker and emphasized that she was confident that Carrie would be a good fit for me. She was entirely right. Carrie has been patient, compassionate, encouraging, and respectful. She has also called me out on things at times. One of the requirements I have for admitting someone into my inner circle is that I have to trust that that person will stand up to me. Not only do I know I need to be kept in check at times, but it makes it easier for me to accept kind words from such people because I know they're not trying to mollify me. (I still struggle with accepting those kind words, but I know I can't dismiss them as easily as I dismiss them from others.)
Lastly, Jessica encouraged me to attend a meeting of our local chapter of the Depression and Bipolar Support Alliance. DBSA is a nationwide organization. On 20 August 2015, I finally gave in and took a chance on it. Again, I felt the same anxieties; would they tell me to get out of there, that they only had time for people with real problems? And again, I was made to feel welcomed in short order. The regular attendees there have cultivated a warm, safe atmosphere. They have made me feel trusted, respected, and liked. I've become a facilitator there, generally every other Tuesday evening.
One thing I've learned over this last year is that I already know what I have to do to properly manage my mental health. But when I have reprieves, like many other patients with chronic conditions, I tend to lapse in maintaining those habits. Becoming a facilitator at DBSA has ensured that I continue attending, even now that I feel the stablest and happiest I've been in three years. (I can make that claim with the confidence that my inner circle has expressed a consensus about this, that they've seen a significant change in me over this past year. One friend who I'm still getting to know but has quickly earned my trust and admiration told me just last night that I'm almost a different person from the one she saw a year ago!)
I invite you to join us at a DBSA meeting, Dear Reader, should you feel that you might benefit from attending. I can assure you that you will be greeted with the same warmth and compassion that greeted me last August, and I can offer that assurance because I've seen it extended to others at every turn. You'll find a link to a group locator on their website below.
The very last patient to join my outpatient group at The Brook was an active duty soldier. As was typical, I was the first (and only) person in the room when he arrived that morning. I greeted him and tried to answer his questions and set him at ease. He had been deployed twelve times throughout his career, including five times to Afghanistan. And he told me the single scariest thing he'd ever done was coming to The Brook that morning. I share that because I hope it might give you, Dear Reader, a little more ease about seeking treatment yourself. It is scary. So scary that this man felt less comfortable than he felt about going into a literal war zone. But that scariness comes from the uncertainty of what will transpire.
My hope in sharing all of this is that those of you with similar experiences might come away from this post feeling a little less alone, and maybe a little more encouraged about the potential for improving your own mental health management. And as always, I also hope that those of you who haven't had these experiences have gained some insight into what people like me have gone through.
RESOURCESNational Suicide Prevention Lifeline (1-800-273-8255)
Stop, Breathe & Think