Nastassja Riemermann (tsukikage85) wrote,
Nastassja Riemermann
tsukikage85

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Catching people up (kind of) on my mental health situation

Ever since I started high school I've been having difficulty with academics, work, family and friends, obligations, and more. After 15 years of trying to will myself to be successful, becoming increasingly disappointed in myself, and eventually losing hope and becoming suicidal, on May 27th, for the first time in my life I had a suicide plan that I thought I could follow through on. However, I had enough of a moment of pause during my crying to decide to ask Sandy to take me to the ER. This started a chain of events that left me on indefinite unpaid leave from work, four nights at Nancy Paige Crisis Residence, and significant intervention from family and my social worker.

Fast forward through lots of bureaucratic tape, unknown unknowns, a few known unknowns, and perhaps more stress than what put me into the hospital in the first place, and we're at this week. (I might fill in those blanks in later entries.) This week was full of appointments: a consultation with an otolaryngological surgeon on Monday, 3 hours of DBT on Tuesday (including my first skills group), first meeting with my ARMHS worker on Wednesday, and an appointment with my social worker on Thursday to have her help me fill out my SMRT application. Add to that a number of events that I wanted to go to...

So, I'm seriously considering getting a septo-/rhinoplasty (to correct my deviated septum and malformed nose) in the near future. I had the option to get the rhinoplasty when I got my orthognathic surgery when I was 18, but I decided against it back then partly because I felt that it was a bit vain and I believed my nose formed a good "jerk deterrent", but also because I wanted to have something left of the birth defect that probably influenced my childhood and personality quite heavily. However, when I discovered I had a significant septal deviation that was causing some noticeable negative side-effects, I decided that although I probably wouldn't get the septoplasty on it's own, and I probably wouldn't get the rhinoplasty on its own, it might be a good idea to get them both done at once, especially since I believed I was in a sweet spot with regards to my insurance that would only last until the end of December. (It turns out I was a far distance from that sweet spot, but now that I'm on medical assistance, as long as I have that I should have next to no co-pay/co-insurance for the surgery.)

Anyway, my dad is VERY concerned that getting this surgery will cause significant stress and anxiety in my life, and that now would be the WORST time to undergo major surgery, especially if it's not urgent. However, I decided that I still wanted to consult with the surgeon and get a better idea of what he could do and what the recovery would be like. Apparently he would have to take some cartilage from my rib (with the incision/scar being in the crease below my breast, so extremely well hidden) and some from my ear. The most painful part of the recovery would be my rib, since it would feel like I had fractured it and I would feel it with every breath, and I think he said the recovery for that would last roughly two weeks. After I give the surgeon the green light, he figures it'll take 6 weeks for MA to process the authorization, and I should be able to schedule the surgery for about 4 weeks after that. After talking it through with my mom and a number of my care professionals, I decided I'm going to give him the green light once I know that I'll have stable housing at the time of the surgery. (My mom did say that I could stay with her during the recovery.)

Tuesday I had DBT, which my mom also came to (at least for the individual session). I can't really remember anything in particular about how that went, so whatever. However, after that I had my first group session. I don't entirely know why, since it was a small group, but going into the session I was definitely anxious, and had forgotten to bring my lorazepam with me. This of course wasn't ideal, but then one of the clients started getting angry with another client and that escalated into enough of a conflict that I had a panic attack and had to leave the room. I sat right to the left of the door, and soon after saw one of the two facilitators leave the room, I assumed to go get another staff member to help de-escalate the situation; soon after the agitated client left the room.

The co-facilitator came back with Mark (my therapist) - it turned out she was looking for me. She helped me with a "mindfulness" exercise (just breathing in through my nose and out through my mouth while looking at her) while Mark brought me some water. After passing through a bit of hyperventilation I finally calmed down enough to re-enter the room, and it turned out the agitated client had threatened another client and the facilitator who was still in the room had asked him to leave. We then had a discussion about what happened, and what we all drew from the experience, as well as how to incorporate that into our handling of future sessions. What a perfect segue into going over rules for group and coming up with our own rules! Seriously, though, it kind of amused me that my first skills group involved me having a panic attack less than half-way through! However, if I'm going to have a panic attack, the best place to have it is surrounded by mental health professionals. It's kind of like when my grandpa had a heart attack (or was it a stroke) right in a hospital.

The rest of the group went relatively well, and it's hard to have any anxiety after the adrenaline wears off. :-P I can't say I learned much in the very first session, but I still found it enlightening and beneficial. If nothing else, it helped us to understand each-other better.

My ARMHS (Adult Rehabilitative Mental Health Services) worker came over for the first time on Wednesday. Her name's Mary, she's very nice, and she loves cats. :) We talked about all sorts of stuff, a lot of which I can't remember any more (it's late Saturday night as I write this). One of the things we talked about is my potential living situation if I can't go back to work (which is looking more and more likely at this point), and she told me about the adult foster care model, which is basically approximately 4 adults living in a county-owned home, enjoying relative independence with staff coming in as frequently as is warranted by the needs of the clients living in the home. It sounds like the staff of the adult foster home would serve much the same role as an ARMHS-worker - that is, an on-site professional who can help me with whatever practical or emotional issues I need the most help with at the time. I was actually just Googling "adult foster home" to find a good link to send someone I was IMing, and came across assisted living apartments for mentally ill adults, and I wonder if that might be a good option to look into as well.

Mary also was saying that what I really need is to get on SSI (social security income), which I've been told will take a year or even two to be accepted, but she thinks that if/when my SMRT (state medical review team) application is accepted, that should fast-track my SSI application. We also spent a fair amount of time talking about my view of the future, my misgivings about the way my treatment path seems to be heading (I'm imagining myself as one of those people who works for $2/hour doing menial tasks, with my value being measured by volunteer work I do rather than any sort of actual life success, and maybe being a foster parent instead of eventually BEING a parent). As much as it's been out of sight and mind due to the current financial impossibility of it, my ultimate goal is still to finish a college degree, get a real job, find a life partner, and have children as soon as fucking possible. There's just so much I need to take care of between now and eventually returning to school, but I'm currently nowhere near accepting any other life path seriously (other than perhaps being a stay-at-home mom). Anyway, my next appointment with her is on Monday (11/03, or tomorrow if I'm able to finally upload this tonight).

Thursday I had my appointment with my social worker to fill out my SMRT application. So, I'm finally going to get around to explaining what that is. So, many of the programs I'm in/trying to get in, including ARMHS services, require me to be on MA (medical assistance), which is Minnesota's Medicaid program. Currently I'm on Medicaid based on my income (i.e., I have none), and if I start making more than $719/month I would lose it, and thus access to various services that various professionals have deemed necessary for my mental health recovery. In addition, I can't turn down hours in order to stay under that income amount (unless a medical provider has deemed it necessary, which currently my psychiatrist has). IN ANY CASE, the SMRT application is submitted to the state medical review team, and they decide whether I qualify as "disabled" by the state of Minnesota. If my application is approved, I will be switched to Medical Assistance for Employed Persons with Disabilities (MA-EPD), which will allow me to receive the benefits of MA with a sliding scale premium based on my income (which would end up being at least $35 but very likely no more than $50). As I mentioned earlier, Mary also believes this will expedite the process of getting me on SSI, which would make me able to actually afford rent! Anyway, I had pretty much filled out all the objective answers, and I was shocked and how quickly she blew through the subjective responses with me. Like, her answers were almost all as little as one short sentence, whereas the few subjective replies I had made out were maybe 6 sentences long in tiny handwriting... Regardless, I'm glad I asked her to help with that, since I figure she knows best the kind of language that the SMRT will be looking for.

So, that pretty much covers all my appointments this week. Socially... Things have been a mess. Spent Halloween pent up in bed rather than going to MAS-o-Ween. Fought tooth and nail to bring myself to go to a LAN party at the U with my friend Bryan and his brother, David, and once I got there I spent as much as two hours fighting anxiety and taking a whole 3 mg of Ativan (the maximum recommended dose is 1 mg) before I managed to just relax and enjoy myself. Of course, by the time the LAN was actually working Bryan had to leave, but I did get David to play some Ticket to Ride with me (which I may or may not have bought both Bryan and David despite having no income ><;). Saturday I managed to get to Japanese Speaking Group RELATIVELY easily, except for the part where I forgot my bike on the bus... ><; Once I got there I was in a horribly unsocial mood and just sat there listening to and playing with my iPod, hoping that my mood would change and I could participate.

Eventually I was able to break out of my shell when a beginning student (he's in JPN 1011 right now) needed help with the difference between ありません(私はテレビがありません。)/いません and ではありません(私は学生ではありません。), and why you can't say 「ではいません」 - after quizzing him and having him explain it back to me, I'm fairly confident he understood it, but I'm a little concerned that he'll forget what I explained to him. ANYWAY, after that I was my normal, participative self, and went to an acquaintance's goodbye party nearby afterwards which was rather enjoyable.

However, after being there for about an hour I started to get really tired so I napped on the host's bed for maybe an hour. I also managed to spill red wine all over my blue jeans ><; (they're soaking in the washer now), and not too long before I had to leave I started getting really anxious. I'm not at all sure what was causing it, but I think somehow the music they were listening to (which was music I would normally quite enjoy) contributed to it. I took two Ativan and asked one of the female guests if I could hold her hands for a bit (the closest I felt comfortable to asking instead of hugs/cuddles), and when that didn't work I decided to leave early. She kept asking if she should turn off the music, and I kept saying no, I was going to leave anyway, and I felt bad for telling them to turn their music off. However, when I went into the coat room one of the host's cats was lying on the bed just asking to be cuddled, and apparently she turned the music off after all, and almost immediately the anxiety went away. Yay, being able to cuddle with cats. And when I left... I left my wallet on the 18. So now I have TWO things to cross my fingers that they'll be returned and I can pick them up on Monday...

So yeah, that's pretty much my tl;dr of my last week, mental health-wise. Today I'm feeling relatively good, and I have a lot of chores (including catching up on my DBT diary card) that desperately need to be done, so I'm hoping to make a SERIOUS dent in that. (Because there's no better place to put this, I'll mention here that I got a good DBT app on the iTunes store for $5, and am in the process of customizing the diary card to match my group's card and my personal needs - should make it easier to keep up.) Monday I have an ARMHS and dental appointment, and possibly tea ceremony in the afternoon and the Saloon at night (I've made a few friends there and go occasionally), the ARMHS nurse assessment (not sure what that's about) and DBT on Tuesday, and I'll be hanging out with Bryan and crashing at his place Wednesday night before leaving for Champaign at 6:30 am for ellie_desu's wedding (I'll arrive back in Minneapolis at 6:20 PM.) Not looking forward to the 7 hour layover in Chicago on the way out, but I'm used to chilling in the Union Station food court with my laptop and some Jamba Juice, so it should be fine.

Honestly, I'm more concerned that I'll end up somehow getting freaked out and not go to Illinois at all, the way I didn't make it to Katie's wedding five years ago, my uncle's wedding three weeks ago, or my grandpa's funeral two weeks ago... I figure my best measure against that will be to pack well in advance, and Bryan's coming over in the evening to meet Boo and play games or whatever before we head back to his apartment, so I'm hoping that'll protect me from bailing out too. *chews my lip nervously*

Anyway, I think that's all. Now that I'm caught up, I'll try my best to update on a regular basis so you guys don't have to deal with these massive wall-o-texts.
Tags: anxiety, armhs, being poor, bike, bryan, bureaucracy, caringbridge, chambana, dbt, depression, elizabeth, family, finances, friends, health insurance, housing, ma, mental health, mom, productivity, schedule, septo-/rhinoplasty, smrt, ssi, surgeries
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