This is a Really Real Mental Health Post.

Trigger Warning: Mention of Suicidal Thoughts.

Chances are, this isn’t the last time I will be hospitalized.

I’ve always been really good about reaching out for help, and in the last couple of years, the line between safe and unsafe has blurred.

Most of the time the suicidal thoughts are just background noise. I can see them as just thoughts, and I go between seeing them as dumb, to seeing them as annoying, to seeing them as depressing.

But, sometimes I get actively suicidal, with a plan, time, and intent, and that’s dangerous, I’m not safe during that period. When that happens it can last for as little as 10 minutes or so.  Then just as quickly, I’m fine again, seeing a future for myself, knowing that the suicidal thoughts are just thoughts and that I can ignore them.  It may not get dangerous again. Or it may be dangerous again in 20 minutes or an hour. Sometimes the dangerous period lasts longer, even as much as an hour. Sometimes I go back and forth between dangerous and safe. We have no way of knowing when it will start and when it will stop. We have no way of knowing if it’ll be one episode, or days full of them.

Part of the problem is the fact that my active suicidal thoughts (plan, time, intent) pass relatively quickly. By the time I get to the ER, if I’m not actively suicidal, it’s really iffy if they’ll keep me. It’s borderline if they need to keep me, because the truth is, it may not come back.

I have a hard time reaching out for help when I’m like that, because during the actively suicidal moments I don’t want help. When it passes I feel stable enough that I don’t really need help any more, especially since sometimes the episodes are over.

Wednesday morning I had an extra appointment with my therapist via phone because I knew I wasn’t doing well. I knew I needed the extra support. I’m lucky to have a therapist who will fit me in (even if it’s a phone appointment) for a second appointment in a week whenever she can. I also text her when I’m having a rough time and she stays in contact during those periods.

We had discussed inpatient but decided on partial hospitalization because I was still future oriented most of the time and we didn’t feel I was quite at the point where inpatient hospitalization was warranted. Throughout Wednesday I got a lot worse and ended up making the decision to go inpatient instead.

This may not be the last time I see the inside of a psych unit. But I also won’t be inpatient every time I get suicidal. So far, with the help of some close friends and my therapist, I’ve been really good at making the judgement call.

I do the best I can to stay on the safe side, even though the lines are blurred.