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Posts Tagged ‘borderline personality disorder’

So. It is exactly a year since I last wrote anything here. That is strange. In a way it feels far less time, but it also feels like a lifetime ago that I was blogging. I am not sure if this is a return to blogging, or just a one-off post to let people know what has been happening over the last year etc. Most of the time I don’t feel the same need to write anymore as I used to, but I do miss the community and the support, and sometimes something happens and I feel like blogging about it, so we’ll see.

So, what’s been going on then? Last time I wrote I had been going through a particularly bad patch, and had just seen Dr E and been restarted on anti depressants. I am pleased to say that these seemed to have a gradual but noticeable impact on my mood, and things improved to some extent. Probably the most noticeable effect was decreased anxiety – after I had been taking them for a while I needed far less Diazepam than I had been using, which was a very positive thing. I did have a lot of difficulty in the spring and summer with my eating however. I lost quite a lot of weight, and got down to a fairly low, significantly underweight BMI, and there was a lot of talk about referring me to the eating disorder service, which I really didn’t want, and I was told that if I continued to lose weight I would have no choice but to see them, and that hospital would be likely as I clearly wasn’t going to engage with them in the community. I don’t really know what triggered off this episode, although it was at least partially related to my mood, and I remember saying that if I died from my weight then that would be a slightly more socially acceptable way of dying than actively killing myself. But I don’t know why then, and why food became such a massive issue. I did have an awful lot of difficulty with food, and I was actually finding it really terrifying – it was certainly the worst my eating disorder has ever been. I was completely taken over by it, and in retrospect it is somewhat scary how much of a grip it gained over me, and how easily I could have gone further down that path. Of course at the time I was just delighted to be losing weight. Again, that gradually begun to improve, and I started to gain weight and feel a bit stronger and less in pain – it is amazing how much more uncomfortable things like chairs become, and how much more easily you bruise etc, and I remember my laptop hurting my hip bones quite a lot if I was leaning back with my laptop on my lap, as I tend to do. I have to confess, I would be lying if I said a large part of me wouldn’t like to go back to being underweight like I was, as I did feel more comfortable with my body, and certainly more in control of things. And I can’t say it will never happen again. But at the moment my weight seems to be reasonably stable, and I am not engaging in any ED behaviours, although a lot of the thoughts are still present, and probably always will be.

Hmmm, what else? I did open air Shakespeare again last summer, and also a couple of charity concerts. I also did a ballet exam at the beginning of July. I did another charity concert in the Autumn, with the same team as the one the previous Autumn, and with the same singer headlining, and again, that was a great experience. I also finally got managed to get back to driving, and had some lessons, and then passed my test in October, which has been really fantastic. As most of you probably know, I live in a very rural area, with very little public transport, and so was very reliant on my mum to drive me around. Early in July she had to go into hospital for an operation, and wasn’t allowed to drive for several months after that, which is partially what finally stirred me into action I think! Prior to that, L nagged me every single time I saw her about taking my theory (I had done it twice before, but both had expired) and I actually eventually booked that to get her off my back! And then my mum not being able to drive was the push to get the practical out the way. I have to say, I now can’t imagine my life without my car. The thought of not having it scares me so much that I won’t even book it into the garage on a day when I shouldn’t need it, because being without it just makes me feel really trapped. So I think that has been a really big thing for me.

Some things have been very difficult, besides the eating. At the beginning of July L went off sick. After she’d been off for a couple of weeks I began to see J regularly, who is the social worker that I had mentioned I would be seeing when L wasn’t around. I got on very well with her, and liked her a lot, but didn’t find seeing her very helpful. However, L was off for quite some time, and after a while I was told that because they didn’t know when she would be back they were reallocating her case load, and so I was switched to J for good. This was incredibly difficult, as although I liked J a lot, I was very attached to L, and also did find her really helpful. So I found that very hard for a very long time. She returned to work at the beginning of September, but I wasn’t able to go back to seeing her, and the whole thing was very difficult and very upsetting. I still find it difficult going to the CMHT and seeing her car there, or being in the waiting room when she comes through or anything. I miss seeing her a lot, and I do still feel angry that I had to stop seeing her when she was one of the few people I have ever seen who I have felt was helping me. So that was something that was a fairly big deal, and over a long time period. Just before L went off sick, I began therapy with the psychologist. I had been referred some time before, for CAT, but had been on the waiting list for a long time. I saw her until January, and that was really good, although I was frustrated by how time limited it was. There was still so much left to do by the end of the allocated number of sessions, and we had really only reached the point in the therapy where it becomes helpful in terms of helping you find other options and strategies etc, so again, that was very difficult. I had also had to spend several of those sessions talking about the situation with L, which obviously gave us less time than we would have ordinarily had, and both the psychologist and I found it difficult that the ending came when it did, when there was obviously things we needed to work on, but for anyone unfamiliar with CAT, the number of sessions is settled at the very beginning of the therapy, and doesn’t get changed. The CAT was interesting – I found it far more relevant than a lot of other therapies, particularly CBT, which I was worried it might be similar to, and which I have a very low opinion of. I also begun attending a BPD group at my local MIND in the Autumn, and I am still doing that. It’s a good group, and I’m glad I’m able to go to it. It’s something I wasn’t able to do when I wasn’t driving as it is during the day, and so my mum was at work.

Despite my mood having improved a little on the medication, I was struggling quite a lot in the early autumn, and I saw a psychiatrist (not Dr E as she is on maternity leave) and he prescribed another anti-depressant to work alongside the first one, and I do think the combination of the two has helped. There have still been times when my mood has started to crash, and I have been worried about where it will end up, but so far it has stopped it short of the very bottom – it has got pretty bad, but it hasn’t crashed through the floor like it did this time last year. I don’t like to tempt fate, but I have been feeling more stable. I’m not better, and my mood overall is still low, but the crashes haven’t been quite as bad, and I am taking that as a positive thing. Additionally, being able to drive and get out to places has meant that I have had more going on, and have been able to do things that I wouldn’t have been able to before, like the BPD group. I’m not claiming to be cured – I still have days when I can’t get out of bed, and I still get completely exhausted and wiped out by a busier day, and my mood is still low overall. But it is an improvement. And I realised this week that I think I am starting to feel a bit more like myself, and just a bit more alive and less like a zombie. The zombie times still happen, and I would be lying if I said I didn’t still think about suicide and wish I was dead at times, but the percentage of alive days has increased, and I can’t say how welcome that is.

So essentially that has been the last year for me. Apologies for rambling on so much, but it is difficult to sum up a year! I should have just said ‘Meds have helped. Still not great, but some improvement’ really, but that’s not my style! I am still not sure whether I will continue writing here or not. I love the madosphere, and loved meeting those of you who were at the last madup. But I don’t want to get into recording and analysing everything again, as I’m not sure how healthy that would be for me at the moment. Blogging has certainly served a purpose for me, but what I need to decide now is if it will continue to do so, and if so whether this is the appropriate place for that or whether I should start anew with a more subject neutral blog and try to focus less on the mental health side of things, to avoid getting stuck in navel gazing land. I’ll have a think and let you know! But thank you so much to everyone who has commented on here and sent me emails and Facebook messages and tweets asking how things are and whether I will go back to blogging etc. I have really appreciated the support, and I am very sorry for doing a disappearing act and just not being around. But truly, thank you. There are people I have met through blogging who I really don’t think I would still be alive without, particularly the wonderful http://ifnarky.com who has been an absolute rock over the past year or so. Anyway, must go to bed, I will update soon whether I decide to stay here or not. Oh, and thank you very much to everyone who voted for me for the most missed blog in the TWIM awards – it was very unexpected, but much appreciated!

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I am absolutely exhausted, to the point where I don’t think I can keep my eyes open any more. I got very little sleep last night, and it has been a really draining day. I feel gutted. I was really determined to kill myself tonight, but my parents will still be up for another hour/hour and a half, and I don’t think I can say awake that long. I feel immensely frustrated. My GP rung me earlier, after afternoon surgery. Actually she rung the landline and spoke to my mum first, but I don’t know what she said to her. Then she spoke to me and said that things were really tough at the moment weren’t they, and I said yes. She said how it seemed a particularly bad period, and I said it is. I talked to her for quite a while. I got quite upset several times. She said she wanted me to go and see her Friday – I said I couldn’t cope and I intended to be dead by then. She said that she had spoken to L, and L had very clearly told her not to refer me to the crisis team under any circumstances. She kept saying she really wanted to see me on Friday and we could talk about things then. I said there was no point, as there was nothing she could do, and I wanted to die today, but she said she was putting it in her diary anyway and would expect to see me. She said I sounded too exhausted to act on my thoughts. I said I was absolutely shattered but that I would find the energy. And yet now I don’t seem to be able to, and it is upsetting me. I can’t remember what else my GP said. She was very supportive, but it was also very clear she had been told by L not to suggest admission or crisis team input, as she responded different to how she usually would, and did make a point a couple of times of saying she had spoken to L. I said how pissed off and upset I was that I felt like I was being treated like a typical Borderline, and given no support or help, when this was quite clearly a depressive episode, and that if I didn’t have a BPD diagnosis there was no way on earth that I would just be left to get on with things like this with no support, and people knowing I was planning to kill myself. She didn’t disagree.

My mum then wanted to talk to me. I explained to her the same BPD/Depression frustrations, and how I don’t understand why when I meet every criteria without exception for one illness, and just about manage to get the 5 criteria needed for diagnosis for the other, that is seen as my primary diagnosis and I am treated based on that. She asked to see the diagnostic criteria and printed it off and said she would call L tomorrow. I also told her how much L had changed – that she used to be really supportive and caring and how she is just totally unhelpful and I think she hates me, and I think she has been taken over or replaced or something, because it is genuinely like she is a different person – based on the way she speaks to me now compared with six months ago I wouldn’t recognise her as the same person. I am worried about my mum talked to L. L can clearly force her way of thinking onto others, in the way that she has with my GP (although I believe it was somehow forced onto L in the first place, but I am not sure how) and so she will make my mum think she is right about everything. All of this was probably about a ten minute conversation and then she seemed to get bored of the wanting to talk thing and went off downstairs, and then later when I said I thought she wanted to talk, she first of all said that I wouldn’t ever talk to her, then remembered I had and said that we had already talked and that she wanted to go downstairs and drink her wine. I can’t trust anyone. Nobody is reliable. I was prepared to tell my mum everything, including my suicidal intent, but she was more interested in going and having a glass of wine. My GP has been restricted so she is as good as useless, as she can’t even refer me to someone, and it doesn’t matter how sympathetic she is, if she can’t do anything it doesn’t help. And L has changed beyond recognition.

I can’t keep my eyes open. I suppose I am going to have to sleep. Maybe I will be able to wake up in the night. I don’t know. I don’t want to sleep. I don’t want to get through tonight. I want to die. But it appears that my GP was right and I am too bloody exhausted to even do that. I feel thoroughly useless.

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>I am not sure what to say or where to start. Actually, I think I will begin by addressing the comments regarding the previous post. I was going to reply in the comments, but it would have ended up ridiculously long. Firstly, I did not intend to cause the kind of tension that I have done. As usual, I was just writing what I was thinking, because that is what I do. I should point out that the original comments I quoted in my post were not made anonymously – I just didn’t name any names as I didn’t wish to cause that person to receive messages from people defending me. Thank you for all of the comments, regardless of what you said. I have never tried to censor the comments I receive on my blog, or deleted comments I dislike, because I believe everyone is entitled to express their opinion. For those of you who said you don’t find me self pitying, thank you. I don’t mean to be. And actually I don’t consider that I am particularly. Yes, I feel shit, and I will write about that, but I don’t think of it in a ‘poor me, I feel worse than anyone else’ way in the least. I feel shit, that is a fact, and I will write about the feelings I have, because I have been told it is good for me to express how I am feeling in writing, but I don’t actually feel sorry for myself – I am actually more likely to assume that things are my fault, for example that if I am not receiving as much support as I feel I need, that it is my fault for not asking properly or something. I do try and take responsibility for my thoughts and feelings when I can. But I can also see that talking about how I feel all the time can come across as self indulgent etc. But surely that is what blogs are for? This is a place for me to express how I feel and what I am thinking, and by nature that is self indulgent, but that is why this blog exists. But I do appreciate all of those of you who showed concern and cared enough to post. Lexie, thank you for your comments. I just wanted to say regarding the second, although I have a BPD diagnosis in that I meet the criteria, I have been told by multiple professionals that I am not a ‘typical’ Borderline – I am not attention seeking – if I wanted attention I know exactly how I could get it, and I do not do those things. This is very much a depressive episode, and L agrees with that, and I believe that overall the depression is the primary problem rather than the BPD. I am not saying anything for attention. I don’t feel like I get ignored when things are going well, and in terms of treatment from professionals, I actually get less support when I am feeling like this than when I am able to work more productively towards recovery, so feeling like this is certainly not a way of trying to get attention, and is not a trait of BPD that any professional has ever claimed I display. I am not sure if there are one or two anonymous posters, so I will reply to the actual comments. First anonymous comment, I want to address a couple of points you made. You said ‘This you can’t go out for a walk or eat is crap. You are fucking depressed not dying of a serious illness. You have a pair of legs, arms and the ability to get up and go for a walk.’ At no point did I say I was physically unable to eat or walk. But actually, you can be stopped from doing things as a result of mental health problems just as you can be stopped from doing things as a result of physical health problems. As I explained, I have problems with anxiety, which makes going for walks very difficult. And I have an eating disorder, which makes eating regularly very difficult. You said you have been reading for a long time, but I am slightly confused by that, as several things you said would imply you know very little about me. My parents do not, to my knowledge, know about this blog. The disclaimer at the top is there in case they happen to find it. If you read back a couple of weeks you will see I talked to them about how bad I am feeling, so they are aware of that though. If you think what I write is garbage and attention seeking though, please just don’t read. And please, please don’t be rude to other commenters on my blog. My Black Fog is a lovely, caring person, and I thought your comments to her were rude and upsetting – she is struggling enough with her own problems, and I appreciate that she even takes the time to comment on my blog, but calling her a ‘jumped up little turd’ was rude and uncalled for. To both the first and second anonymous comments, hospital is not an option, because my care coordinator does not believe it is helpful. That is not my decision. I do not have the option of having myself admitted to hospital because I am feeling suicidal, as it doesn’t work like that. I have told literally everyone – my GP, the crisis team when they would see me, and L how I feel. It makes no difference. For some reason I am unable to get any help. I am not writing here in the hope that someone who knows me will contact anyone on my behalf, as I have already told all the professionals involved in my care exactly how I feel, and it has made no difference. Friends have in fact offered to do so, but if the professionals aren’t taking any notice of me, I very much doubt they will take any notice of my friends either. I have tried so, so hard over the last few weeks to get help, and it hasn’t happened, and that has left me feeling utterly alone and hopeless. Some see that as being self pitying evidently, but I have been fighting as hard as I can, to get through the thoughts, and to speak to someone who may be able to help me, but it hasn’t made any difference. But if you read my posts over the last few weeks you will see that I have tried desperately hard to get help, despite not always feeling like I want it.

If you find my writing self pitying, irritating, garbage, etc etc, I am now going to go on and write more of what you will probably consider drivel, so I would probably suggest you stop reading now.

My appointment this afternoon felt really quite hideous. I don’t know what to say about it. It was much as I expected it to be really. L started by asking how I was, although obviously she knew from speaking to her yesterday that things are not good. She asked me to rate my mood from 1 – 10, which was interesting, as although many people have asked me to do that before, she never has. She said based on how I was feeling right then, if 1 was feeling normal, ok, etc, and 10 was the worst I have ever felt, how was I feeling. I said a 9 or a 10, and she said to pick one, and so I said 9, as although I was feeling hideous, there have been points in the last few days and weeks when I have felt even more desperate, so they would be the 10s. But overall I would rate this whole episode as a 10 – it is equally as bad as I have ever felt, possibly more so. She asked what I wanted, and I said not to feel like this. She agreed with that, and asked how I thought that could happen. I knew it would frustrate her so I was hesitant about answering, but I said that it felt like the only way I could stop feeling like this was by killing myself. She said that she didn’t want to talk about suicidal thoughts as there was no mileage in it and it wouldn’t help or get me anywhere. She said their job is not about preventing suicide, and that it is very rare they will actually take any steps to try and stop someone killing themselves, and that there was no point in talking about it. I said that I knew that, but she had asked me, and so I was just telling her my honest response. She said she is finding it difficult because she feels like I want to die more than I want to get better at the moment, which I explained is certainly true some of the time, but at other times I really want to get better but just don’t feel able to. She talked again about what she had said on the phone yesterday – that I needed to get some routine in my life, and work on getting my sleep pattern sorted, and eating regularly, and finding things to occupy me and that I could look forward to. I said that I agreed I needed more structure, and that if I was in a slightly better place than I am now then I definitely think that would be the way forward, but at the moment I was finding such small things, like getting up to go to the toilet, and getting dressed, enormous mountains, that just took all my energy. I also explained that I was finding it impossible to distract myself at the moment – that I had tried everything I could think of, but nothing helped, but she said she didn’t believe nothing helped. She asked if I was saying I couldn’t do it, and I said that at the moment I didn’t see how I could, when such small things were so exhausting, but that I could see that was what was needed. I can’t remember exactly what was said – she talked a lot, but essentially what she was saying was that I needed to make a decision between doing what she was saying, and being discharged, and if I couldn’t do what she was saying then she would discharge me. She sat talking about planning activities and I just had sheer panic going through my head, and I honestly don’t feel able to do what I am being asked to do at the moment without any support, but I couldn’t say that because it would result in me being kicked out of mental health services, which she reminded me would also mean I would no longer be on the waiting list to see the psychologist, which she thought would be a ‘shame’ as that could help. I found during my appointment that the suicidal thoughts were getting stronger and stronger, as I am feeling so awful, and feel desperately like I need help, but am being told that the only way I can continue to receive help (fortnightly sessions) is by doing things that I just can’t do whilst I am feeling this bad. I couldn’t be feeling more desperate or hopeless – I have tried so hard to get help, but it is not forthcoming, and I can’t do this on my own at the moment. L spent about 45 minutes with me, rather than the hour to hour and a half that she normally spends with me, made an appointment to see me in a fortnight, and said she expected me to have made a decision and thought about what I could do by then. After feeling very numb and blank all session, I burst into tears at the end, and she opened the door and said goodbye. I went and sat in the most private place in the waiting room, where nobody would see me, and just cried for a while, as I couldn’t face leaving the building so upset, and I was just feeling so desperate. I have tried so hard to get help, as I really feel like that is the only way I can get through this, but it hasn’t worked. I genuinely do understand what she is saying I need to do, but I do not understand how she is expecting me to do it, feeling like this, with no help or support. If she had said I needed to do that, helped me come up with exactly what I needed to do, and arranged some type of support to help me do it, for example seeing the crisis team for a little while to help get things on track, then that would have been an entirely different matter. But just to be told I have to structure my days, on my own, with no help, and with no support for another two weeks, when I am feeling so exhausted and depressed that just getting out of bed is an immense struggle just feels impossible. To be honest I wish that I had listened to my instincts yesterday and not gone to the appointment today. I didn’t think it could make me feel worse or more desperate, but it has.

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>I have grown increasingly frustrated regarding diagnosis the last couple of weeks. I feel quite sure that if I didn’t have a BPD diagnosis, I would have received more support than I have done. I am totally convinced. What my GP said to my mum about having BPD, not depression, really clinched it for me. She had said nothing like that when she spoke to me on Wednesday and thought the crisis team should be seeing me, so either the crisis team or the CMHT manager must have told her that. And the only reason they would have told her that would be as justification for why I wasn’t getting more help. The frustrating thing is, I don’t even see it as relevant. I don’t actually think diagnosis should ever be relevant – I think symptoms should be treated/given support for, rather than the diagnosis. But I am particularly pissed off because actually I don’t even feel like BPD is relevant at the moment even in terms of treating diagnoses. I am not disputing that I meet the diagnostic criteria for BPD. However, if I look at the diagnostic criteria for Depression I literally meet every single criteria at the moment. Therefore surely that is the current problem rather than BPD, and should be treated accordingly. The diagnostic criteria for BPD relating to mood is ‘Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability or anxiety usually lasting a few hours and only rarely more than a few days).’ That is not me. My mood is not reactive, and it has lasted weeks, not hours or days. The only time that applies is when I have episodes when I am particularly irritable or hyper for a few hours. It never applies to my depressed or suicidal periods, and I would not consider my mood unstable – it is consistantly very low, and has been for weeks. It makes me so angry that there is still so much prejudice surrounding BPD, which there absolutely is. I don’t self harm or take small overdoses and then turn up at A&E – I have never, ever done that. I don’t make threats regarding suicide – I only talk about feeling suicidal if I am feeling genuinely suicidal and unable to keep myself safe. And the times I have attempted suicide have not been impulsive – it has been at times like this when I have been feeling desperate and reach a point where I can no longer cope – they have been planned. But I feel like I am being treated as though I am the ‘stereotypical’ borderline who takes overdoses for attention and that giving me support would be encouraging attention seeking etc. I know I meet the BPD criteria. But I also meet the criteria for Depression, and more closely in my opinion, and that is what is making me feel like this at the moment. And I honestly feel that if Depression was my only diagnosis, I would be receiving different treatment at the moment. I am sure that would be denied by the crisis team or any other professionals, but I have seen from the experiences of friends the difference in the support given to people with a BPD diagnosis, and the support given to people with mood disorder diagnoses, even if presenting with the same symptoms, and except in a few exceptional cases, those with mood disorders virtually always seem to get given more support in crisis. I know the medications I have tried have seemed to have little effect, but I am sure that if Depression was my only diagnosis then medicaations would continue to be tried until something helped. I would not just be left, when feeling suicidal, and expected to get on with things. The crisis team would have arranged the appointment with the psychiatrist that they talked about, and they would probably have continued to visit, and although they aren’t always helpful, when I am feeling like this I do find it helpful to know that I have some form of support, and knowing there will be daily visits etc does make a difference. It doesn’t change how I feel, but I know from past experience that it makes it easier to take things one day at a time, which is something I am struggling with at the moment, and various other things. As I said, I am sure it would be denied, but I am convinced that had my diagnosis been different, I would have received different treatment these last few weeks, and that makes me angry.

I spoke to L earlier. I can’t remember what we talked about. It was only a few hours ago, but my brain just isn’t working. I remember that she was supportive though, and I didn’t feel like she didn’t care about me. I trust her a bit more than I did. It all feels rather irrelevant though. Nobody can change how I feel, and I still have the same level of help. Or lack of.

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>I don’t have much to say. Things are much the same. I was absolutely exhausted yesterday, and a combination of that, Diazepam, and Zopiclone managed to knock me out enough that I could sleep last night. The sleep was welcome, although I am still exhausted, but what I was more concerned about was not being awake during the night and feeling as desperate as I was the night before. I have no idea what will happen tonight, as I very much doubt I will be able to sleep again.

I spoke to my GP earlier. She seemed a bit perplexed that the crisis team had discharged me and I was back to just seeing L fortnightly. She said that she would speak to L, and I said that she wasn’t there today, and she she said she would speak to her tomorrow. We talked a bit more and she decided she was going to call the crisis team again and get them to make contact with me this afternoon. I am assuming they told her to fuck off essentially, and that she then contacted the CMHT, as I have heard nothing from the crisis team, but I did get a phone call from the CMHT manager, saying that he had spoken to Dr O, and that he just wanted me to know that they are aware of how I am feeling. It was essentially a lot of patronising bollocks with him asking me if I knew I would be seeing the psychologist when I felt up to it, and me saying I know I am on the waiting list, and him then having to correct himself and admit that yes, I was on the waiting list. It pissed me off that he tried to imply that if I felt up to it then it could start now, which is clearly bollocks. She has apparently given them a good indication of what she feels is going on, which is lovely for them, and why I might feel like people aren’t listening to me or rejected or abandoned (BPD anyone?) Anyway, he went on to say that they do understand how difficult I am finding things, and that the plan is that until I can see the psychologist (in 3 months time) to continue seeing L fortnightly, and have phone contact when required, and that he just wanted me to know that. So, the same as was happening before I was feeling suicidally depressed then? That’s helpful. I appreciate my GP’s efforts, but they appear to be in vain, as have my attempts at getting help been. I have tried absolutely everything now, apart from going to A&E, but I see that as entirely pointless, because that means being seen by the crisis team who discharged me two days ago, and presumably refused to take me on again today. I don’t think anyone could claim that I haven’t tried to get help to get through this.

I have to go to a rehearsal tonight which I am absolutely dreading, but I got out of Monday’s by saying I had an upset stomach, and still got a rather narky text from the director, so there is no way of getting out of going tonight. That means I have to do things like get dressed and wash my hair, which feel ridiculously beyond me at the moment. I have to leave in an hour and a quarter and I’ve been trying to make myself get out of bed for about 3 hours now and failed.

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>I have had a visit from the crisis team. They called about 2:30 and checked it was ok to come, and arrived about an hour later. It was a man and a woman, both of whom I have seen before, but don’t really remember much about. I had a vague recollection of the man when I saw him but if he hadn’t said that he had seen me before I doubt I would have remembered. The woman I recognised by her voice – she has a lovely Irish accent, and so when she spoke I remembered seeing her before. It all feels a bit of a blur, I feel a bit like I have been hit by a bus. Not implying that they were bus-like or anything. It is just exhausting. The man did all the talking whilst the woman wrote notes.

They asked how I was, and I fairly stupidly said ok. Because it seems like the polite reply? What I find confusing about the crisis team is that they ask questions that either they already know the answer to, or if they don’t then they should, as it would only take a quick peek at the notes. There seemed to be a bit of confusion as they started by saying I had switched GPs to the one I go to now, and that I used to be under another county, and I said yes, but that was two and a half years ago. I have been under the care of the crisis team since then. They then went on to say I had been under a CMHT in the other county, and I said yes, but again, that was two and a half years ago, and I have been under my current one since, and they then asked if I was still under my current team and who my care coordinator was, and when I last saw her. Surely this is all fairly simple stuff that would literally have taken a quick glance at my notes to find out? Anyway, then they said I had been to my GP yesterday and told her I was feeling depressed and suicidal and so she had referred me to them. It sounded slightly accusatory – I really didn’t want them to think I was being attention seeking and to be written off as being another Borderline etc. I explained that I see my GP monthly and yesterday was just a routine appointment, but that obviously we had discussed how I was feeling. They asked some questions about how my mood was, how long it had been like it etc, and asked what had concerned my GP and made her contact them, and I said that she hadn’t said she was concerned, but presumably saying I was suicidal? Seemed a bit obvious to be honest…. They asked about medication and I said that I was only on PRN Diazepam (again, perhaps check the notes?) but that when I spoke to L earlier in the week she had said perhaps it was time to consider medication again, and they agreed with that and said that they thought I should see Dr E. It is all a bit vague. I was finding a lot of things quite distracting – my head for a start, but then I have been having a lot of issues with external noises lately – I can’t even have music or the TV on in the background like I would usually as I find it stressful and irritating, so noises like the wind howling (and my house is 16th century and therefore one big draft – the wind really howls) and the dog barking etc make me very tense. It appears that this was obvious in the way that I was behaving, because at one point when I talked about how difficult it was to distract myself because of not liking any noise, they said that they had noticed how tense and agitated I seemed by the dog barking and when the wind got louder etc. They talked about my sleep and went through the usual things of no caffeine too late at night, try having a bath before bed to relax you, try taking extra Diazepam etc. They asked about getting out of the house and seeing friends etc, and I said I didn’t really see any friends, and that apart from my appointment with my GP yesterday I last left the house on Wednesday for rehearsal. They asked about my suicidal thoughts, and I talked for a few minutes about wanting to die, and how I feel it is perfectly reasonable given how long I have been feeling bad for etc. I think it was around this time the woman took over the talking. I liked her voice. Her accent was soothing. They asked if I thought about suicide methods, and I said constantly, and they asked if I could tell them what. I hesitated over this for a minute, as I didn’t want anything taken from me or anything, so I said that I didn’t really like talking about a plan. They asked if there was anything I could do to make myself safer so that I would be less likely to act on it, like give them anything, and I said that at the moment I didn’t feel like I wanted to be safe – that I wanted to be able to act on the thoughts, because I didn’t want to be alive. They asked if I would call if I needed to – if I was feeling worse, and I tried to explain what I had said to the man yesterday – that if I was feeling like I was going to act on my thoughts then I couldn’t call because I would be too determined by that point and I wouldn’t want help.

She got a bit tougher at that point – prior to then she had been quite softly spoken and gentle, and I kind of assumed she was just that type, but she got a lot more kind of authoritative and assertive and I realised she wasn’t the type of person to try and bullshit actually. She went on to talk about supporting me over the weekend – she said they could call me tomorrow, and visit again if necessary, and that then on Monday they would talk to L about what the best option was, but that I had to be willing to work with them and to try and keep myself safe etc. She said one of the things that I would be expected to do was call them if I needed to, if I was feeling at risk or something. I said I understood what she was saying, but that I would not be able to call if I was feeling like I was going to act on my thoughts, because if things felt any worse and I was feeling any more overwhelmed then I wouldn’t want help. She said she understood that, but that she would want me to call before it got to that point, if I felt like things were getting worse, rather than waiting until it was at the point where I was about to kill myself. That made sense, but at the same time it didn’t – if things were any worse then I would be at the point where I was about to kill myself. That was why I had told my GP and the crisis team man I spoke to last night how I was feeling. I don’t think there would be a middle step between here, and being at the point where it was too late for me to want help. I was feeling ambivalent about it anyway. So I wasn’t really sure what to do about that, and I’m still not to be honest. I am feeling unsafe, although I think I can probably get through tonight because it isn’t a night I would consider suitable, but I am struggling with that. For some reason I didn’t know how to put that into words, so I couldn’t explain, so I just said that I would try. She said how the crisis team is an alternative to hospital admission, and how obviously in hospital you have staff around you all the time, which you obviously don’t with them, but that was why they gave out this number, and to call it if I needed to talk to someone. And that was more or less it really. Or at least it wasn’t, but it was all I can remember.

I am not sure what to feel. I am absolutely exhausted. I have been writing this on and off for 4 hours now – they hadn’t long left when I started it, and it is now 8:30. My head is all over the place. I just can’t think or concentrate and I am finding my thoughts really distracting. I am glad they weren’t completely dismissive like I was concerned they might be, but I am still feeling unsure about whether I can get through this, even with their support. I do feel like I need to see them again tomorrow, but it is difficult as my parents will be home all day, and I feel extremely uncomfortable trying to talk to someone if my parents are in the house, partly because I am worried about being overhead, and that makes me not want to be honest, and partly because I don’t trust them not to insist on speaking to my parents as has happened in the past, which I don’t think is fair when I am an adult who just happens to live with my parents. I am so tired, and I have a headache, but I think that if I try and sleep now I will wake up in a few hours and not be able to get back to sleep. I don’t know what to think about everything. I need to stop writing because trying to think is hurting my head.

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>I had an appointment with my GP this afternoon, as I mentioned yesterday. I had quite mixed feelings about what to say to her. I didn’t know how much to say. I didn’t know if I wanted help or not. I didn’t know whether I would be able to get help or not, even if I did ask for it. I just knew how suicidal I was feeling, and that if I left there without asking for/getting support then I would not get through the weekend – it just wasn’t going to happen. Within a couple of minutes of me going in she commented that I seemed to be having trouble with my concentration, which I am. I keep losing my train of thought in the middle of a sentence and then just kind of drifting off and forgetting what I was answering. I can’t really remember the appointment very well, I don’t remember what order things happened, or even what she asked really. I know I was in there for quite a long time. I told her how bad my sleep was, and she asked if I had any of the sleeping tablets left, and I said that I did but they didn’t help, which was why I hadn’t been taking them really. She had received a letter from the psychologist that had been sent to L that she had been CCed on, and asked me what that was about. I told her I had an assessment with the psychologist and she had put me on the waiting list for CAT. She asked if there being a psychologist there was new, as she never seems to have any patients who are seeing them, and I said that it wasn’t, but since there is only one part time psychologist in the team not many people get to see her. She asked what CAT was, and how it was different from CBT, and I tried to explain, but my mind was really wandering, so she is probably none the wiser. She asked how long the therapy lasts for, and I said either 16 or 24 sessions, and she asked how long the waiting list was and I said up to 18 weeks. She got very frustrated by that – she said how ridiculous it is that there are such long waiting lists for things like that, particularly when the government are so keen to get people back to work and all that sort of thing – she said it really winds her up that mental health services are so underfunded. At some point I started getting slightly upset – I wasn’t crying, but I knew that if I tried to speak I would start crying, so I just sat there trying to breathe for a minute. She was very sweet and asked what the matter was. When I finally felt like I could speak without bursting into tears I told her that I was just really struggling and feeling really bad. She asked how long I had been feeling like this for, and said (as predicted!) what a shame it was when I had been doing so well. I said I was just feeling really awful and the suicidal thoughts were really strong, and she said how I have felt like this before and that I know it will pass and so I could get through it, and I said that I didn’t want to, I just wanted to die. She joked that if I said that she would have to suggest I started cross stitching again. She asked when I was seeing L, and I said that I was due to see her Tuesday. She talked to me for quite a while asking if I had any plans over the weekend, and if I had any friends I could see or talk to or anything who were supportive. She was very supportive and kept trying to encourage me that I could get through, and said to try and find something I could do over the weekend, and then go and talk to L on Tuesday, and that I could see her again sooner than usual if I felt I needed to, and that she was really sorry I was feeling so bad, but that it would get better etc. I didn’t really know what to say – I find it really difficult to be totally blunt about how bad things are when I am actually speaking to someone, and I just felt so drained, and like I was going to burst into tears, so I said goodbye, and got about 2 feet outside her door and turned around and went back in and said I really didn’t feel able to get through the weekend. She asked what I would like her to do, and I said I had no idea, I just couldn’t cope. She asked if I had the out of hours number, and I briefly explained the mess of when I tried to call a couple of weeks ago. She said that was ridiculous, and that she was going to call the crisis team and ask them to make contact with me over the weekend, and that hopefully having that support would make it easier to keep going. Overall she was very supportive, and I felt like she actually gave a shit about what happened to me. Obviously mental health isn’t her area of expertise, but when I am truly in crisis she does seem to try hard to support me. She spent a long time with me today – I must have been with her for about 40 minutes, and she did genuinely seem to care.

About an hour later I got a call from the crisis team. To be honest I wasn’t really expecting them to call today – I thought it would be tomorrow, so I was quite surprised. I spoke to a man whose name I can’t remember who actually seemed perfectly nice. Initially I thought it was going to be one of those quick ‘oh great, we’ve had a Borderline referred, better give them a quick ring’ calls that I have had in the past. He did things like asking if this was the first time I had felt like this (I always wonder why they ask things like that when they quite clearly have your notes in front of them) and then asking what had helped me get through in the past, or if after a while I just started feeling better, and when was I next seeing L. I said that nothing really helped, but that after a while it would start to get a bit easier. He said the stuff about how if I have got through it before then I could again, and I said that I didn’t want to. That I was sick of getting through a really horrible patch just for another one to come along, and that I just didn’t want to be here any more. I also said that this was actually the worst I had felt for quite a long time – that the suicidal thoughts were stronger this time than they have been for a long time. He asked how long, but I didn’t really know – again, my whole conversation with him was rather stumbling and confused as I just couldn’t think properly. I said I have been feeling bad for years now, and things never get any better and that I have just had enough – that I don’t want to be here. He asked if I had any plans regarding suicide, and I said that it was all I could think about. He asked what I would do, and I said that I didn’t want to say because that makes things rather awkward (as in my experience they have then merely attempted to take away whatever method I say I am planning, which doesn’t solve anything, as I am still left with the feelings). He asked if I had the means to carry it out, and I said yes, and that if I couldn’t use one method then I would use the other that I consider. He asked if I would call someone if I felt I was going to act on my thoughts, and I said no – that if I was any closer to suicide then I wouldn’t want to speak to anyone because I wouldn’t want to be stopped, and that it was difficult enough to tell Dr O how I was feeling, but that if I was about to do something then I would not call anyone, as it would seem completely counterproductive – if I was any more suicidal than I am now then I would just want to die, I wouldn’t want to talk to someone. We talked about my sleep, and how the nights are when I feel most unsafe, as I know I have quite a few hours when my parents are asleep, and so it would be quite a long time before anyone found me etc. He asked about plans for the weekend etc, and I said I didn’t have any. He said that the crisis team could visit me tomorrow, but that I needed to commit to keeping myself safe and would that be ok. I said I couldn’t promise that – that I could try, but I couldn’t give him a guarantee, because I didn’t know for sure, and there would be a chance I wouldn’t be able to. He asked why not, and I said that if things got too overwhelming then I couldn’t be sure I wouldn’t act on the thoughts, and he said that he was hoping that if they were seeing me and giving me support then it would stop that from happening, but that he understood and wouldn’t ask me to promise, and that they would come out to see me tomorrow. He did ask me more, but I can’t remember, and I can’t remember the order of most of the conversation. At first I felt like he was just going to make a quick five minute phone call where he would ask when I was seeing L, reassure me that I had got through times like this before, and say to talk to L about it when I saw her, but actually he talked to me for a long time, and was pretty thorough and reasonable. He said they would come out and visit me tomorrow, but that if I needed to speak to someone before then I could call, and he said that he would give me their number, which he shouldn’t really do until after they had seen me and assessed me, but that if I needed to call then to phone that, which goes through to a call centre where you leave your name and number, and someone would then call me back as soon as possible. So I have them coming out to see me sometime tomorrow, which I am quite nervous about. I would actually really like it to be him that came out, but that is very unlikely. It’s funny, as usually I am much more comfortable with women than men, but the women who work for the crisis team seem to be either patronising, dismissive, intimidating, or a combination of the above, whereas there have actually been a couple of men who have seemed very reasonable. I am pretty much expecting it to be a couple of the scary women (there is one in particular who I have seen several times who I find really intimidating so am really hoping it isn’t her) who will come out and either be very dismissive and say that I seem to have suicidal thoughts frequently and that I can get through this and to talk to L on Tuesday, perhaps also breaking my confidentiality by talking to my mum and telling her to confiscate all pills and dressing gown cords etc as I am a suicide risk, as that tends to be my experience with the crisis team, but I am really hoping it isn’t like that. It is over two years since they last came out to see me etc – I think I have been referred one other time since then, but someone just spoke to me on the phone and decided I would be ok, and I have been assessed by them several times in A&E, during Summer ’09, but I haven’t actually had a visit from them for over two years, and I am a bit nervous. I hate the way they always visit in pairs – it feels really intimidating. I just really, really hope that it is someone who actually takes me seriously and tries to help, rather than just dismisses how I am feeling in the way that they so often seem to. I tried to be really honest with the man on the phone, as I figured it couldn’t do any harm – it couldn’t take suicide away as an option, but it might get me some support. I hope that I can do the same tomorrow, and that they actually take me seriously like he seemed to. I suppose if they don’t I won’t be any worse off than I would have been had I not seen them though. And it might help. The difficulty is, that as I explained to him, it is the night time that I feel most unsafe, and even if they are doing daily visits, they can’t be here now, when the thoughts are at their strongest. But I will just have to see how it goes.

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