“Yeah, everything is alright.” It’s easy to tell the psychiatrist that everything is fine so I don’t have to go into detail about anything. It’s easy to ignore certain things so that I can convince him that I’m making progress in my recovery. It’s easy to keep information from him that in any way shows that I might need a little more support than I’d care to admit. It’s easy, but it’s not necessarily for the best.
This week I was honest with my husband about still experiencing quite strong suicidal thoughts. Whilst I have no actual intent on carrying out any specific plans, suicidal thoughts still fill my mind and make it difficult for me to stay distracted with positive goals and aspirations.
My husband, at first, wrongly assumed that I had been honest with my psychiatrist, who I’ve been seeing weekly since a recent discharge from hospital. Needless to say he was quite frustrated and disappointed upon finding out that the psychiatrist was not made aware of how the suicidal thoughts had occupied my mind for much of the time. He argued that we pay the psychiatrist to help me, and that if the psychiatrist doesn’t know the extent of how my illness is affecting me, how can he possibly help me?
The truth is, I know that I should be honest with my psychiatrist. I know that I should tell him that I’m still struggling quite a lot with suicidal thoughts that occupy my mind for much of the time. But I’m scared. I’m scared that he’ll think I’m not making progress, like I know I am (despite the suicidal thoughts). I’m afraid he’ll read into it too much and consider me as a risk to myself, whereas at the moment, as bad as the suicidal thoughts are, I know that there’s no risk to my safety. I’m petrified he’ll suggest another hospital admission, where after spending weeks on end as an inpatient already this year, I’m not prepared to spend any more time admitted. It worries me that he’ll think I’m not trying. Most of all though, it means I have to admit to myself that I’m still struggling, as sharing it means I can’t keep ignoring it and pretending that I’m not experiencing any of it.
How do I tell my psychiatrist that my mind constantly wanders to thoughts of ending my life, and how much better things would be if I was to cease to exist? How do I tell him that these thoughts even fill my mind when I’m distracted with activities, albeit less intensely? How do I mention that every day I struggle to shower and complete basic tasks to face the day? How can I be honest about how much I struggle with housework, like doing laundry and sweeping floors? How can I possibly admit how much I struggle to leave the house or do anything that isn’t laying in bed or on the couch? I’m afraid that if I tell him any of these things he’ll judge me, he’ll think I’m not trying, he’ll write me off and give up.
Part of me knows that telling the psychiatrist is important. If I’m honest we can look at strategies together that may help improve those things I’m struggling with. Whether that’s tweaking medication, encouraging exercise, or even just having someone to talk to about it all, so I don’t feel so alone. Telling the psychiatrist allows him to be aware of where I’m at and lets him provide appropriate support. Somehow the part of me that knows honest communication is important, needs to convince the scared, depressed, suicidal part of me, that it’s for the best, and that’s perhaps the biggest struggle of all.