I am always aware of the ethical dilemmas we face in daily life. There are particular types of conundrum psychiatric patients face. One of these is the “What do I choose to say?” conundrum.
For example: last Friday, my psychiatrist changed my medication. “Big deal”, the novices mutter dismissively; but to those in the know, when I mention that it was a rapid and radical medication change, the penny begins to drop – especially as he sent me away to make this change by myself, at home, with no extra professional support. (To put this in context, the last time I went through a comparable medication change, I was in hospital for about one month. And that was just one month ago.)
It has been hell. Yesterday the anguish was such that without the loving voice of my sister down the phone, a good dose of sedatives, and taking the time to blog about why I would never choose to kill myself (thank you, interwebs!) was sufficient to pull myself back from the brink.
Then came the dark of last night.
I took my usual evening medications, but the dark still pressed in around me. I’m afraid to say I was weak, and I overdosed. First up, I called my therapist’s message bank to say I didn’t think the medication change was going too well outside hospital. I then wrote down the medications and doses I’d already taken, then the current time and the extra doses I was about to take. Thirty-eight minutes later I did the same thing. Twenty minutes later, and forty five minutes after that, the exercise was repeated. If something went wrong, I needed there to be a record of what had been done, and why. Finally I attained oblivion.
I want to be clear here: the exercise was not to kill myself; I simply needed to escape consciousness, completely, and for a very long time. I deliberately ‘mixed and matched’ medications so the total load of one type was well below the lethal limit. This was the wrong thing to do, but last night the pain in my psyche justified the deed.
Today, I face the ethical aftermath of that decision. I clearly am not coping with this medication change on my own, but I do not want to go back into hospital. I need more support, but if I utter the word “overdose” then there will likely be just one direction the conversation will take.
So, I must proceed carefully. My therapist returned my call. He said that if I wasn’t coping, I must call my psychiatrist and let him know. My therapist did not ask me any questions, so I didn’t face any ethical dilemmas there. (You may have noticed I’m not the lying type.) I called my psychiatrist’s office and simply told his receptionist I was having difficulty with the medication change, and would the doctor please call me back at his convenience? He is a busy man: I may not receive a call until tomorrow. Tomorrow is Friday. The hospital will most likely be full, and no beds available. Admission averted (phew).
Excellent: I have discharged my moral duty to my therapist, and my psychiatrist. Now to the more difficult question of the duty I hold to myself.
I can still feel the residual drugs in my system, so it is not safe to drive. It is a cold, rainy day and an injury to my right ankle precludes walking anywhere. I am stuck at home, alone. My memory is too fleeting to read, and my concentration span too short for TV or DVDs to be sufficiently diverting.
Blogging helps. I know very few people read these notes, but the act of putting my thoughts in order on the screen acts as both a calmative and an anxiolytic.
I now know what I must do, what I have so often done in the darkest days: live just ten minutes at a time. Get a large sheet of lined paper and write down what I will be doing for the next ten minutes: “Drink cup of tea.” “Do dishes.” “Shower.” “Watch ten minutes of …”
Watch this space. I trust we will, in virtuality, meet again.