The Right Time to Reach Out for Help

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On July 30, I posted How My Depression and Physical Illness Relate, about an encroaching depression and feeling overwhelmed by several medical situations that have been going on. At the end of the post, I wrote that I had a plan to reach out to my former therapist and psychiatrist, Dr. Lev and let her know what is going on.

I did email her that week and she wrote me back that she was sorry to hear about my medical issues. She said she was hesitant to recommend ketamine therapy due to the sheer number of medications I’m currently prescribed, both psychotropic and non-psychotropic. She recommended I look into transcranial magnetic stimulation, or TMS. I did, but the advised course of treatment was every weekday over six weeks which isn’t feasible for me due to my work schedule. I work from 8 am to 6 pm most days without a break long enough to allow me to go to a TMS provider’s office. As it is, I eat lunch and dinner at my desk while I write notes. Not the healthiest habits, but if I didn’t, I’d be working later into the night. So, I don’t think the TMS protocol will work for me.

The decision I eventually made was to return to therapy with a provider who accepts my insurance (Dr. Lev does not) so the therapy wouldn’t add to my financial stress. Between corresponding with Dr. Lev and reaching the decision to return to therapy, a situation at work stressed me out. My perception was that it impacted how I was viewed at my job in a supervisory capacity and I began to doubt my own skills. I woke up anxious every morning and remained in a heightened state of anxiety throughout the day. This situation took several meetings and about a week to resolve — and as it turned out, my actions had not directly impacted the client, which was what I had feared.

My internalized dialogue had gone immediately to extreme black-and-white thinking, something I thought I had for the most part overcome. It’s something I’d worked on extensively with Dr. Lev — an ability to tolerate living in the grey zone — but when I felt put under scrutiny with what I felt was my reputation on the line, my primitive defenses emerged: Hence the black-and-white thinking. As Jeremy Shapiro states in this post on black-and-white thinking, “This cognitive style prevents people from being aware of the full range of possibilities available to them. People feel they must make either/or choices when there are actually many options in between.”

The terror that I had screwed up was so heightened for a period of time that I thought about suicide, which scared the crap out of me. I thought I had progressed to the point where that was no longer an option for me. But I was convinced this situation at my job would destroy everything I had worked so hard for during the last six months and I didn’t want to deal with the fallout.

In April or May of this year, the president of the board of our condominium died by suicide when he leapt from the sun deck on the 11th floor of our building. His death and the method of his death hit me especially hard because that was one of the ways I had considered when I made my own attempt nine years ago. The day before I made my attempt, I had gone up to that deck and looked over the railing down to the courtyard below.

I did realize that one of the roots of this regression was related to my father and the feeling I was never good enough for him. And that I never heard those words come out of his mouth before he passed away — in fact, the older he got, as his cognition declined, the harsher he could be. I think in the back of my mind was that his 91st birthday would have been this past Wednesday. In this post, Elinor Greenberg reports on James Masterson’s belief that “regression occurs when clients outrun their ability to emotionally support themselves. All it means is that they need to do more work on their underlying issues and unhealed traumas before they are ready to restart their progress towards their goals.” To be honest, I truly believed my work with Dr. Lev had resolved this constellation of issues. I guess you never know what might trigger issues you thought resolved from deep in the psyche.

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My mother doesn’t get away scot-free either. Although the work that Dr. Lev and I did allowed me to knock her off the pedestal I’d put her upon, she was my role model for perfectionism. After she went back to school to update her computer skills, she quit the first job she got after six months, because she didn’t receive all “excellents” on her initial review.

In this post, Margaret Rutherford writes about the difference between constructive and destructive perfectionism. She states that constructive perfectionism is when “you can accept that you’re going to learn from your mistakes, have pride in what you do, and can work through guilt or remorse when things don’t go well.” Destructive perfectionism, she states, “is all about the goal, the prize, the end product. There’s no stumbling allowed; no hesitation or lapse into allowing vulnerability to show.”

I know my perfectionism is the destructive type. It fueled a life-threatening anorexia for over two decades. And it just made me think about killing myself for the first time in nearly 10 years. So I’m back in therapy to address what happened because I realize that every time there is an adverse event at work, my knee-jerk reaction can’t be suicide. And I’m overwhelmed by all the medical events that I’m currently dealing with. I need to find some sort of balance. I need to find some semblance of peace.

If you or someone you love is contemplating suicide, seek help immediately. For help 24/7 dial 988 for the National Suicide Prevention Lifeline, or reach out to the Crisis Text Line by texting TALK to 741741. To find a therapist near you, visit the Psychology Today Therapy Directory.