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Posts Tagged ‘crisis team’

So I am still a week and a half behind with what has been going on. Oops.

That Saturday night I was having really strong suicidal thoughts; they seemed to be getting stronger and stronger each day, and I seriously considered acting on them – I had planned what I wanted to write in my note, I had planned what I wanted to happen to what money I have etc etc. But since I had agreed to seeing the crisis team the next morning, as I didn’t want to go to A&E again, I found I was in a difficult position, as although remote, there was a chance they may have offered some more help or something, and as I have said before, I feel like if there is an option other than suicide, then that needs exploring first. I don’t mean distant, long-term things that are months away, but things that are immediate possibilities. So I forced myself to get through Saturday night, and saw the crisis team on Sunday morning. They were predictably useless. I was feeling absolutely horrific, and they just did the usual of telling me to try to distract myself, and said that they would speak to L the next morning. It was entirely pointless, which I had been virtually sure it would be, and I was desperately wishing I had just acted on the thoughts the night before.

That afternoon I had to go to a rehearsal. I desperately didn’t want to go, and was really looking for any excuse whatsoever – I had hoped the crisis team visit would coincide with it, but unfortunately it didn’t, and my mum said to me that if I was going to go ahead with the show, which essentially I had to do as it was only two weeks until the performance week, and to me dropping out at that point was not a valid option unless I was dead. The rehearsal was one of the hardest things I have ever done I think. I know that sounds melodramatic, but it was just horrible. I was there for over four hours, and I was just feeling like complete shit – I was exhausted, I couldn’t concentrate, I was very anxious, there were too many people, it was too much noise – it was just everything I couldn’t cope with. I also clearly looked like absolute crap as so many people asked if I was ok – I used the headache and tiredness excuse, both of which were actually true, as I had a really bad stress headache, and was obviously exhausted. Several times I just found the main rehearsal room too much and had to go off into another room and ended up bursting into tears, despite the Diazepam. I was also very stressed as I didn’t know my lines, because of my complete lack of concentration, and the director was insistent that everyone knew them for the rehearsal the next day when we were running Act 1, so when I got home from the rehearsal I had to try to learn lines, which was just the last thing I felt up to doing. I was wishing more and more that I had acted on my thoughts weeks before, as I was utterly convinced that was the right thing to do.

Monday was fairly uneventful, but there had been a very slight shift in my mood. Although I was still feeling terrible, I didn’t have quite the same level of desperation as I had in the days before. I skipped ballet yet again that day, and went to rehearsal – again looking and feeling like shit, but I got through it. Diazepam really is a wonderful drug! Tuesday I saw L. There was obviously quite a lot to talk about, as I hadn’t seen her for two weeks, although I had spoken to her the previous week, and of course a lot had been going on. She was really supportive, as she had been on the phone the previous week. She told me some things which explained why she had been more distant lately, and apologised for not giving me as much support as I needed. The previous week I had spoken to the manager one day, as he had been the duty worker when I phoned in, and he said that they would look into allocating someone else to see me on the alternate weeks that L couldn’t, as it seemed that fortnightly contact wasn’t enough, and that there was a new social worker starting in a few weeks and that she would be a possibility. When I saw L though, she said that she had decided that she was going back to seeing me weekly whenever possible. Although she has cut down her hours, most weeks she is there at least part of the time, and some weeks all of the time, so she said she would see me weekly unless things changed and she had to have more time off, in which case she would ask someone else, probably the new social worker, to become involved and see me when she couldn’t. So I am now back to seeing her weekly, although there are conditions involved – she said we need to make sure we are working to some specific goals and targets, rather than just talking about things generally, although obviously we will be doing that as well. I appreciate that she has gone back to seeing me weekly, as I think it was a little bit of controversy over it with her manager from what she said, as most people she is only seeing monthly, and some fortnightly. She also said that I could see Dr E the next day, but rather than seeing her at the CMHT where I usually see her, it would mean going up to the hospital, as she was the psychiatrist on duty for MHA assessments that day, and when they do that they have to be based at the hospital, but she could apparently see me first thing. I said that would be fine, and so L said she would pick me up at 8:30am. Ouch.

My appointment with Dr E was ok. When we were in the car park, L had her window wound down as she had to put her ticket in to get into the car park, and as L was parking someone got out of a car near us and dropped quite a lot of stuff. I said ‘oopsy!’ and L asked what had happened, and I said ‘they dropped stuff everywhere’ followed by ‘oh crap, I forgot your window was open’. Then the person turned around, and of course it was Dr E. Naturally. Her and L and gone to talk alone so that L could bring her up to speed whilst I stayed in the waiting room, and when she came to get me she apologised for running late and said she was having one of those mornings, as she thought I had seen in the car park. Ah. Yes. She did hear me then. The actual appointment was fine. Dr E isn’t the terribly sympathetic kind – she is nice but she is very matter of fact and straight talking. She didn’t really ask much about how I was feeling – it was mostly about symptoms etc. She asked about the anti depressants the GP had prescribed, and why I hadn’t taken them, which I told her, and she said that was fair enough and she wasn’t that keen on Seroxat anyway – that she found that for most people it didn’t have a massive impact in terms of benefit, and was then a nightmare to come off. She asked why I thought anti depressants might help now when they didn’t seem to have helped in the past, and I said that this had been the worst patch I had ever experienced, and that it was over a year since I had been on anti depressants, and I thought it was worth a try. She said that was fine, and that she was happy to prescribe something, but that she didn’t want to get into a pattern of one medication not working and trying another and another and another etc – that she would prescribe one, or perhaps two, but that was it – if they didn’t help then we stopped looking down the medication route. I am not entirely sure about this, as I know quite a few people who have needed to try lots of different medications, and combinations of medications, before they have found one that helps them, but I agreed to that. She asked if there was anything I didn’t want to take, and I said Mirtazapine or anything else that would make me gain weight. She said she would prescribe Sertraline, which is a medication I have been on before, but that was six years ago. She said that recent studies have shown it to be the most effective, or one of the most effective, of the SSRIs, and that it has few side effects. So she prescribed 50mg for one week, then 100mg for the next 5 weeks, then she would see me again to see how it was going, and probably increase it further then. So that was that. Actually, she did spend quite a long time with me – probably far longer than what I have written here would imply, and was quite thorough in going over everything that had happened, and what was going on, and then discussing medications – it was actually fairly long for a psychiatrist appointment. But then that was the first time I had seen her since June.

This is another stupidly long post, so I will stop now, and write Part 4, which will bring me up to date (finally!) either tonight, or sometime tomorrow.

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After going to A&E, nothing much happened. We had been told at the hospital that someone from the CMHT would see me the next day – possibly L, as that was the one day that week that she was in work, or if not her then the duty worker. However, nobody did see me. My mum phoned and spoke to L in the morning but I can’t remember why, except to say what had happened and how the crisis team had claimed to be acting under direction from the CMHT, which L denied. At this point I was really quite upset with her – my last two appointments with her hadn’t gone well, I was feeling very unsupported, and I was holding her responsible to a large extent for the fiasco at the hospital, and did actually believe she had somehow been replaced or brainwashed as she had seemed to change so  much. In the afternoon she rung and talked to me, and asked how I was and what was going on etc, and was really caring and supportive, and that made a difference, because I went from thinking she was against me to feeling like she did care again – talking to her that time was like talking to a version of her I hadn’t really spoken to or seen for months. It did help to feel like I had someone back on my side, but as that was the only day that she was in that week I obviously couldn’t see her or anything, and so I was still left with no support, except the option of ringing and speaking to the duty worker at the CMHT or the out of hours number.

On Wednesday and Thursday evenings I had to go to rehearsal. I can’t even describe how difficult that was. I was feeling so terrible, and I looked dreadful. I think virtually the whole cast said I looked ill and was I alright. I was completely run down and exhausted. I never have problems with my skin really, and suddenly I had 8 red spots covering my face – I never even got that many spots when I was going through adolescence! I felt hideous, and I was really anxious about having to be around people and out of my house and with all the noise etc. Diazepam is a life saver. Wednesday’s rehearsal was spent finishing the choreography of a big full cast dance number, so at least I didn’t have to think too much or say anything – I just had to learn the choreography, but it completely drained and exhausted me mentally, and I was feeling really on edge the whole time. Thursday was worse, as it was just the male lead and I working with the director, which sounds like it should have been easier as there was less people and noise, both of which are issues for me at the moment, but it was horrible. We were working on dialogue, and I just felt completely useless. I find the director quite difficult to work with anyway, as I find she gives quite contradictory directions, but if you query anything she looks at you as though you are incredibly stupid – she is not a very collaborative director. And she kept saying she wanted to see my character be more cheerful and happy, which was obviously incredibly difficult because of how I was feeling, but actually didn’t really even make sense in some of the scenes – she is quite a feisty character with lots of yelling at people etc, and in those scenes it is obviously difficult to be soft and happy. I left the rehearsal feeling really awful, and unfortunately my mood slipped even further that evening. I hadn’t thought that was even possible, as things had already been the worst they had ever been, but by Thursday night I was just feeling indescribably awful. The pressure of the show was making me feel worse, but I didn’t see dropping out with less than 3 weeks to go as an option, as I don’t have an understudy, and it would be a nightmare for someone else to have to take the part over with that little rehearsal time. So although dropping out would have served a purpose in that it would have alleviated pressure short term, the guilt would have been enormous, and I know that word would get around that I was unreliable, and no company in this area would ever cast me in anything again. If I was going to be dead that would be a different matter – it wouldn’t matter that nobody would cast me, because I wouldn’t be around to be cast, but to me the options were either doing the show, or dying, and it absolutely had to be death – a failed attempt would be a disaster.

On Friday morning my mum phoned the CMHT and asked to speak to the duty worker, and said how bad things were. He said he could have a quick chat with me, but my mum said that wasn’t enough and so he said he would see me that afternoon. He wasn’t terribly helpful – he talked in cliches for a while, and said he would do a referral to the crisis team. Friday night the crisis team phoned me, and when I finished speaking to them, I was genuinely wondering whether they intentionally hire stupid people. She asked what I usually did to distract myself, and I explained the usual things – that I usually read, or watch TV, or listen to music, or talk to friends online etc, but that none of those things were options, as I had no concentration, and was really sensitive to noise, and it made me feel worse rather than better. She then suggested I read. I repeated that I just couldn’t concentrate to read – it didn’t work, and she said that she got the impression that anything she suggested I would dismiss, which I thought was somewhat unfair, as she had only suggested one thing, and I had already told her it wasn’t an option. I could look at a page of a really quite simple book (we’re talking James Patterson here, not War and Peace!) and ‘read’ it, but at the end of a page I wouldn’t actually even be able to say vaguely what had happened. I suppose it would be like giving a book without pictures to a child who hadn’t yet learnt to read in terms of how useful it would be. She had quite clearly been given instructions not to discuss what had happened Monday, as she suggested I go to A&E if I felt safe, and I mentioned that I had tried that on Monday, and she immediately cut in saying she couldn’t comment on what happened on Monday as she wasn’t involved, but that would be her advice if I felt unsafe. She said that they would call again the next evening, and I asked if it would be possible for someone to see me instead as I found that more helpful, so she said that somebody would ring in the morning. During the night I was feeling really desperate and very unsafe, and so I rung the out of hours number. I talked to a really nice nurse who was very supportive, and said I clearly wasn’t getting the help I needed and that they were obviously getting things wrong for me to be feeling this bad, and to be left at home feeling this desperate with only fortnightly appointments. He talked to me for a long time – I think it was about an hour and a quarter, and let me talk about how I was feeling, and the nightmare situation with the crisis team. He was pretty unimpressed by the lack of support I had from the crisis team, and said that it was frustrating that they were the only ones with the power to admit now. He said he was going to phone and speak to the crisis team and tell them how bad things were, and see what they suggested, although I told him there was no way I was going back to A&E, which he accepted. He rung back after a little while and said he had spoken to them and that he had actually had more luck than he was expecting to (which I think says a lot about the opinion the ward staff have of the crisis team to be honest) and that they would ring in the morning as arranged, but would talk to me properly and try and come up with some kind of plan. I have to say that apart from a couple of times I have always spoken to really supportive staff when I have rung the out of hours number – it is just a shame they work for the ward and therefore have absolutely no power to do anything, as they seem to be the only ones who actually listen and take me seriously.

Saturday morning someone did phone, and it was actually amazing – it was the first person in the crisis team I have ever seen or spoken to who a) was willing to just let me talk and listen, without constantly just telling me to use distraction techniques and get me off the phone as soon as possible, and b) actually seemed to give a shit. She spent a long time talking to me and wasn’t dismissive, and was sympathetic about the experience at A&E on the Monday, and made it very clear she wanted to help. I feel like most members of the crisis team have a couple of set things they suggest – distraction, which is usually in the form of having a bath, going for a walk, watching TV, reading, or listening to music; or going to A&E. She didn’t try to tell me to do any of those things. She asked what I felt like I might be able to do that day, and did I think I could maybe try to have a shower and something small to eat? Since I had said that things generally got worse during the day, she said that she would phone back later to see how I was getting on, and to try to do those things in the meantime, and attempt to find some way of passing the time. I did have a slice of bread, and managed to shower at some point. Apart from that I watched the athletics on television, but mostly muted, as I found the  noise too much, but when it was just the picture I could cope with it and it was a reasonably good way of passing time, as it wasn’t something that required any concentration, and I didn’t have to have sound to see what was going on. When I spoke to her later she was really pleased with what I had done, and was really encouraging, but by that time I was really feeling very suicidal. She said it really did sound like I should be in hospital at the moment, and that despite what had happened on Monday that I could go to A&E, and since it was the weekend then the crisis team would have to see me, or the alternative would be for someone from the crisis team to come out and assess me the next morning. I was quite honest with her and said that it really didn’t matter what happened, because she was the only member of the crisis team to have ever taken me seriously or cared at all about what happened to me, and since I wouldn’t see her whether I went to A&E or was assessed at home (her shift was about to finish and she wasn’t working the next day) then nothing would happen either way, as everyone else was too obsessed with sticking to my care plan, which says to avoid admission if possible. She pointed out that sometimes it isn’t possible, which is exactly what the ward nurse who had assessed me in A&E had said when I told him the same thing, but there seem to be very few people working in the NHS who don’t view the care plan as some type of sacred document that must be followed to the letter. Except when it suits them, as my care plan is from Autumn 09, and there are a lot of things listed on there that no longer apply, like seeing my old support worker N weekly, who left a year ago. So either way I wasn’t holding out any hope of anything happening, but I agreed to being seen at home the next morning – I was absolutely not going to go through the fiasco of sitting in A&E for hours just to be sent home.

Again, this is more than long enough already, so I will continue tomorrow – should be able to bring things up to date then!

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I am not sure where to start really. It has been so long since I wrote a proper update, and so many things seem to have happened in that time that it is hard to know where to begin. I suppose I will carry on from where I left off, which was the weekend following Karita’s visit, but I will try and keep things as brief as possible.

I had made the decision not to take the Seroxat that the GP had prescribed for multiple reasons; firstly, I was feeling so low that it seemed completely pointless, as I didn’t see myself still being alive in a few days, let alone the weeks it would take for it to kick in. Secondly, if I was alive, I had been told that L was trying to get an appointment for me to see Dr E for as soon as possible, and I decided I would prefer to wait to see what she would prescribe, rather than do what I have done in the past, and taken something prescribed by a GP, to then be told by a psychiatrist that they would have prescribed something else, but now that I was on X I may as well stay on it. And thirdly, I was worried about starting it. There is always a risk with anti depressants that they will make things worse in some way before they start to help (if they do help), and I was already feeling incredibly unsafe, and it really was primarily my complete lack of energy that was stopping me from acting on my thoughts, and I was concerned that starting a new medication when I was feeling that bad, not due to see anyone for a week and a half, and my CPN was on leave was just not a good idea. So I didn’t take it.

Over the weekend I was a complete mess. I was feeling desperately suicidal, completely exhausted, couldn’t stop crying, etc. By Saturday night it had reached a point where my mum felt she really had to do something, as I was having to sleep in her bed to stay safe etc, so on Sunday morning she spoke to the out of hours Dr, and arranged for me to be seen. I was supposed to be at a rehearsal that afternoon, but I didn’t go, and instead went off to see the GP. She said she would phone the crisis team and that they would come out and see me, and to wait in the waiting room whilst she spoke to them, and then she would see me again to let me know what was going on. Seemingly they refused to see me, which was no great surprise, but said they would speak to me on the phone, and would call later. They did call, and I can’t really remember much of what was discussed, except the usual telling me to try to distract myself. My mum also spoke to them and told them she really felt I should be in hospital, as this was the worst I had ever been, but they predictably refused to even see me to assess me, but said that if my mum was concerned about my safety then to take me to A&E where I would be assessed. Their final words to me that night were that it was my decision whether or not to kill myself. By the night-time I was feeling desperately suicidal, and phoned and spoke to the out of hours number. I spoke to a man who was very understanding, and said it sounded like I wasn’t getting enough help, and that I should probably be in hospital, and I explained about the difficulty with the crisis team, who were refusing to even see me. He said that he would recommend I go to A&E during the daytime, in ‘office hours’, as I would then be assessed by the duty psychiatrist and one of the nurses from the ward rather than the crisis team. So Sunday night I slept in my mum’s bed again, and then Monday we went to A&E.

We arrived there around 1:30pm – it would have been earlier but my mum had phoned the CMHT first, and had spoken to the manager and received the same advice about going to A&E if she felt I was unsafe. The saga of A&E is actually worthy of its own post, but it isn’t going to get one. Basically we waited a few hours, during which time I saw the triage nurse, and then an A&E Dr, who called the duty Psychiatrist to come and assess me. They turned up – the psychiatrist was in a big rush, so didn’t talk to me for that long, but did do an assessment, and made the decision that admission was appropriate, firstly to keep me safe and give me some support, and secondly to get me started on some medication in an environment where I could be monitored closely. I agreed to this, as although I didn’t want help or to be kept safe for myself, I didn’t want to hurt people. She said that she would get the crisis team down to assess me. It turns out that even a psychiatrist can’t admit someone anymore; every admission has to go through the crisis team. I immediately knew that nothing would come of it, and explained some of the problems I had been having with them over the previous couple of weeks. The psychiatrist dashed off about this point, but the nurse from the ward who had also assessed me stayed and talked to me for a while longer, and I said that there was no way the crisis team would take me seriously or do anything, and he said that he thought that things would be different this time given their assessment, and that he would go and phone the crisis team and ask them to come to A&E to assess me, and that he would probably see me later. So then it was back to A&E to wait for the crisis team.

The Director of A&E was really lovely, and came in a couple of times to check I was ok, and said that the crisis team would be coming to assess me and he understood I was going to be admitted and was I feeling ok about that etc. After a couple of hours of waiting in a tiny A&E area he came and said he was sorry that the crisis team were taking so long, and that if we went to the Emergency Assessment Unit area they had a lounge with sofas etc and that we could wait there instead, and that I could also talk to the crisis team there, so we went off there. However, when we got to the EAU we got put on a couple of chairs in a cubicle of the main ward, and it was really loud. After we had been there for about 45 mins the A&E Director came up and said he was really sorry we had ended up waiting there, and that he had intended us to wait in the lounge, but it turned out there were men in there and apparently there is some new NHS rule that meant that because they were in there then I couldn’t be, but that they should be there to assess me soon.

Finally someone turned up, but it wasn’t the crisis team – it was the next duty psychiatrist. And he wasn’t there to assess me – he was there to tell me that the crisis team were not going to come and see me; that they had been spoken to on the phone and that they had decided, without seeing or speaking to me, to ignore the assessment carried out by the psychiatrist and psychiatric nurse, and to send me home with no support, knowing that my CPN was on leave all week. In fact, worse than that, they apparently said they hadn’t been given the impression that admission had been recommended, which was a complete lie. My mum was absolutely furious, and I just ended up getting really emotional and sat there sobbing. We had been waiting four hours for the crisis team to turn up after I had been assessed, I was exhausted as I had only had three hours sleep the night before, and now we were being told that the assessment in the afternoon had been seen as irrelevant by the crisis team, without them even seeing me, and that I was being left with no support at all. My mum threatened to go home and leave me there and said they would just have to find somewhere for me to go because she couldn’t cope with me at home, at which the (young looking, and therefore probably fairly inexperienced) psychiatrist looked fairly panicked and said that he would go and ring the crisis team again. He came back and said that the crisis team had agreed they would see me if the CMHT referred me, but not otherwise, and that he would phone the CMHT first thing in the morning and ask someone to see me. But of course nobody did. By the time we left the hospital we had been there for seven hours, and had achieved absolutely nothing. I have to say that I am quite amazed by how much power the crisis team have – I am aware they gate keep the beds, but I was surprised that they could overrule an assessment carried out by a psychiatrist and psychiatric nurse without even seeing or speaking to me. Considering they are based on the same site, I can’t think it would have taken that much effort to send someone to assess me – even if they had disagreed with the view of the earlier assessment they would at least have seen me. Needless to say it went down like a lead balloon, particularly with my mum, who I think was probably as desperate as I was. She immediately said she was going to be writing a formal letter of complaint, which she told to the psychiatrist who spoke to us in the evening, who agreed we had grounds to do so.

When we got home she rung the hospital to try and speak to the Director of A&E, as he had been very supportive, and had also been told that I was going to be admitted, and she didn’t want the crisis team to be able to turn around and say they had been told it wasn’t recommended when both my mum and I had – she wanted the backing of a professional. They said he usually only worked office hours, but he had been there when we had left at 8:30pm, and was in fact still there when she phoned soon after 9pm – he said immediately that he knew why she was ringing and was absolutely horrified by the way that we had been treated, and that he had already been making complaints to the people high up in the hospital about what had happened. He also said he was happy for my mum to say on the letter that he had been told by the psychiatric nurse who assessed me, who was also the person who contacted the crisis team, that I was going to be admitted, so that they couldn’t deny it. The really ridiculous thing about the whole saga was that it was the crisis team who said to go to A&E in the first place, and then when we went there they didn’t even see me. It was a very long, stressful, horrible day, and I wish they had just said before we went that there was no point as they would block any attempts at getting me help, which they clearly intended to do from the start, as we then wouldn’t have gone. Needless to say I didn’t make rehearsal that night either…..

Since I have so much to catch up on, I will continue tomorrow, as I think this is long enough already. I clearly failed at keeping things brief, sorry!

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>Horrible day

>I called the out of hours number again last night. I felt awkward doing so – I didn’t know what to say, and it felt wrong as I wasn’t intending to kill myself then, as today was the funeral of my mum’s boss who died last week, and she was obviously going to that, and I was supposed to be as well, and something about his funeral today made me feel like it would be disrespectful and unfair to try and kill myself the night before. But I got to a point where I was feeling really tense and desperate, and although I didn’t plan to kill myself then, I really needed to talk to someone, so I rung them. I spoke to a different woman to the other night, but again, she was very nice. She asked what was going on, and so I told her I had been struggling a lot and that things had been bad for several weeks, but were getting even worse. She asked when I had last been seen by the CMHT, and I said that day, and she asked if plans had been put in place to support me and I said no. I said how suicidal I was feeling, and she asked if I had a plan, and I said yes, and explained about not being able to act on it that night. She asked if I had told L I had a plan and I said she hadn’t asked – that she knew I was feeling suicidal but that she says it is pointless talking about suicide and there is no mileage in it. The out of hours woman sounded a bit baffled by the whole thing to be honest. She asked if I had been honest and actually told her how bad I was feeling, and not just said I was a bit low or something, and I told her I had definitely been honest, and there was nothing I had told her that I haven’t told other professionals over the last few weeks. She said they couldn’t just leave me like this and that I clearly needed help, and it was urgent, and that I had to try again today. She said to speak to my GP and ask for a crisis team referral at the very least, and also to make sure L knows just how bad I feel. She was very supportive, but seemed kind of bemused by the fact that I was getting no support other than fortnightly appointments.

Following that I sent L an email, saying I had spoken to out of hours, and saying I had been advised to contact GP and ask for a crisis team referral etc, and went on to tell her how strong the thoughts were etc, and the reasons why I hadn’t acted on them last night, and basically everything I had spoken to the out of hours woman about. I got a reply saying it wasn’t appropriate to email those thoughts and she would prefer if I rung next time. She also said that the crisis team wouldn’t get involved as I have a care coordinator, which I know is not true – they might not get involved because she tells them not to, but the fact that I have a care coordinator is completely irrelevant. I replied saying that I thought perhaps the crisis team could help, and certainly if I was to try and do the things she was suggesting then it could help, and that I thought they were there for when you are in crisis regardless of whether or not you had a care coordinator. I got a reply this afternoon saying that if I needed support to do things we could discuss a support worker next time I saw her (I had said months ago that I wished I still had a support worker but she didn’t mention anything about it being a possibility then) and that the crisis team do sometimes get involved when you have a care coordinator but only in certain situations. I replied that I couldn’t cope, that I couldn’t even put into words how desperate I was feeling, and that I know things could improve or that things might help in the future, but that right now I just can’t cope, that this is as bad as I have ever felt, if not worse, and that I have kept going for as long as I can, but I didn’t get a reply to that.

I tried calling my GP this morning. She was in morning surgery, which I knew she would be, but they said they would get her to phone me when she was finished. They did the usual of asking if I could say what it was about, and I said that I was suicidal and had been told to phone her – I don’t usually tell them things like that but I am just totally desperate. Morning surgery finishes at 12:30pm, although she often runs over, but I still hadn’t heard anything by 2pm so I rung back and asked if they had any idea what time she might be able to ring me, and they checked that the note to call me was on the system, which it was, and said she was out at the moment but shouldn’t be long and they would ask her again when she got back. Afternoon surgery starts at 4pm, and I still hadn’t heard anything, and it is now 5:15. I suppose there is still a small chance my GP will call me back after afternoon surgery, but I am not holding my breath, and I don’t think there is much she can do anyway. I was just calling her because the out of hours woman made me promise to.

I don’t know what I am supposed to do. I have done absolutely everything I have been told to do. I have been completely honest about how bad things are. I have asked for help. I have done what the woman from the out of hours number said and tried to contact my GP, and I have made sure L knows how bad things are. But I cannot get any support at all, and I can’t cope. I have tried so, so hard, and it is just hopeless. It is so clear that they either don’t give a shit whether I kill myself or not, or they don’t believe me. But either way there is nothing more that I can do. I have spent the last three weeks desperately trying to keep going, and get some support, but I can’t get anything more than a fortnightly appointment, and my mood has just been getting lower and lower, and I just can’t cope. I really wish I knew what they expected me to do. I am completely exhausted, and feel utterly hopeless.

And yes, I am sure this is all self pitying drivel and I need to stop feeling sorry for myself. But the fact is I have been trying incredibly hard to get the support I need to keep going, and it just isn’t there for me. And I can’t do this alone.

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>Emotional

>I am feeling really emotional tonight. The suicidal thoughts are very strong and everything is just feeling really overwhelming. I am frustrated and upset that I have been feeling so low and desperate for so long now – I thought that if I did keep going things would have started to lift by now, but every day seems to be as hard, or harder than the one before, and it isn’t getting any easier at all.

I just phoned the out of hours number that goes through to the local psych ward. I find that incredibly hard to do, so I have to be really quite desperate to phone them, and therefore it happens very rarely. But it was 3am and I was desperate and lonely and I didn’t know what else to do, so I called them. The woman I spoke to was actually really lovely. She was really sweet and caring and although she obviously couldn’t suggest anything earth shattering, because there isn’t anything, she was very supportive and understanding and she talked to me for about half an hour. She told me multiple times that I must call L in the morning and tell her how bad I am feeling and about the suicidal thoughts, and that I had to ring the ward tonight because things felt so hard. L already knows how I am feeling of course, and I did tell her that, but she was very insistent that I call her, and made me promise that I would, so I guess I will do that. She also said she would be contacting the crisis team to let them know I had phoned. I told her they probably wouldn’t want to know, and she said it was likely they would leave it to L, but that was the only thing that she could do. She kept telling me to just get through tonight and speak to L tomorrow, and if I was feeling really unsafe tonight then to wake my mum up etc. She was very sweet and kept telling me I mustn’t give up and to keep hopeful, and that there was something out there that would help, because there is for everything apparently. She said she thought I needed a medication review (I wonder how many more people will say that before it actually happens?) and that seeing the psychologist might really help. I told her how hopeless I felt, and how I just get through one bad patch to go into another one a few months later, and how this time it just seemed to be getting worse and worse and harder and harder and how I had been trying so hard and being honest about how I felt but that it just felt so hopeless, and how things like medication and seeing the psychologist felt like such a long term thing compared to where I am now and how I am feeling, and that I wished I had killed myself weeks ago when the thoughts first started getting strong. She said again how I really needed to talk to L and tell her all of this. I tried to explain that she does know, but she said she needs to know that the suicidal thoughts were bad enough tonight that I had to call the ward etc. I will speak to L, because I promised I would, but I know there is nothing she can do. Nobody can take these thoughts or feelings away and I am just so exhausted.

But I am glad I rung. She was just so sweet. It made me cry, just because she was being so kind and supportive, and when I am really struggling, as soon as someone is nice to me I just fall to pieces. So I did get a bit upset and sniffled my way through half the conversation. She seemed genuinely concerned, and I hadn’t even told her a quarter of what I have told L or the crisis team or my GP over the last few weeks. But just being listened to and feeling like I was being taken seriously just made me feel so emotional. She said she was sure there were a lot of people who cared about me and what happened to me, and that she didn’t even know me, but that she cared about me. It just made a really nice change to speak to a professional who didn’t seem to be against me, and who cared about what happened to me etc. It hasn’t changed how I feel, because I don’t think anyone can do that at the moment, but just speaking to someone who took the time to talk to me and listen and made me feel like I was worthy of their time etc meant a lot. And it is reassuring that there are mental health professionals out there who do care.

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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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>(Mis)Trust

>I wrote the buttercream off as a disaster. I have no idea what went wrong. Who would have thought it was possible to mess up mixing butter and sugar? The number of times I have made buttercream too. It really isn’t hard. I suppose I will have to try again tomorrow, because at the moment my mum still doesn’t have a birthday cake. I feel sorry for her – she had a bad birthday. I think she had a really tough day at work with her boss dying this morning so unexpectedly – all of the staff were really upset, and so she was quite emotional all day at work I think, and then had to come home and only have an hour at home before taking me off to ballet and rehearsal. She went to see my brother whilst I was in ballet, and then we had a little bit of time between ballet and rehearsal so we got take away pizzas from a nice bar in town, and then she went to see a friend whilst I was rehearsing, so I guess she had an ok evening, but I think overall it can’t have been a very nice day. I will try again with icing the cake tomorrow. I want to make it look really pretty but I can’t quite decide how. I am a bit rubbish at doing anything other than basic icing. I made quite a pretty cake for Mother’s Day last year, but I would have liked to do something a bit different decoration wise, but I either lack the imagination or the skill to pull off anything much more creative. Whilst I am on the subject of food, the last few days my weight has started to go back up and I am really struggling with it. It was going down, and that was literally the only thing that I felt was going right in my life. Now it is going back up, which is making me feel even more hopeless, and I would be lying if I said it wasn’t adding to the suicidal thoughts, which were certainly strong enough without dealing with weight gain as well.

Well I got through ballet and rehearsal. It was an enormous relief to get home and know that I don’t have to go anywhere tomorrow – that there is absolutely no need to leave my house for anything. Rehearsal was difficult yet again. I feel like I am completely useless and they cast the wrong person in the part, and like by now they will have realised that and be regretting their decision. The girl who is playing the second female part has a stunning voice – vocally she is definitely stronger than I am, and I hear people talking about how good she is, and I am sure they are thinking that she should have been cast in my part. When I hear her sing I think she should have been cast in my part. I also had to have the publicity shots taken tonight, which weren’t terribly attractive I don’t think, but I kind of don’t give a shit at the moment. What was more difficult was talking with someone about the show etc as part of the publicity. They asked the easy questions I could answer, like where I live and how old I am, where I went to school, what other companies I have worked with etc. Then came the ‘What do you do?’ question. I do nothing. I said something along those lines. She said so are you still studying or anything? No…. I do nothing. How do you say that without sounding like a complete idiot? And then she followed that up by asking if I had been to drama school or university. No, I haven’t done that either. I actually am 24, not studying, not working, and haven’t done anything since the age of 19. Not that I said all of that of course. Then it was why did you want to audition for the show, and what attracted you to this part, which were easy enough to answer, followed by how are you finding it – are you enjoying it? Mmm. Enjoying. That doesn’t seem to be the word that has been springing to mind lately when I have thought about rehearsals. Dreading? Yup, that will be the one. That doesn’t sound so good in an interview though, so I switched it for enjoying. White lies don’t hurt anyone right? So that felt quite difficult, because it just reminded me of everything I should have achieved and haven’t, and the things I should be feeling about the show and am not. And then I always hate having my photo taken. Oh, and finally, to add insult to injury the costume woman was there to take measurements. Perfect! That cheered me up no end.

I wrote yesterday how I have found I am cutting myself off from people online a lot – usually I spend most of my day online, and am always logged into Twitter, MSN, Facebook chat, Skype, and usually have several conversations on the go. Lately I have been appearing offline on MSN a fair bit, not signing into Skype, not signing into Facebook chat, and watching Twitter but rarely engaging with anyone. I think I am just terrified of the same thing happening with the people I trust online as it did with the people I trust in real life. I am also generally ignoring texts, and most people know better than to phone me anyway. I can’t cope with feeling let down or abandoned by any more people. I am scared that somehow people from the internet will be taken over too, despite knowing that makes no sense, as I don’t believe that my mum or GP etc were taken over by some form of mind control and had thoughts beamed into their heads or anything like that. I believe that the crisis team and the CMHT manager (who is probably influenced by my psych, as I feel like she is involved, despite my not seeing her since June – perhaps because of my not seeing her since June) managed to persuade L, and my GP in particular, of things that they hadn’t previously believed or thought, and my GP to the extent that she did a complete 180, and went from trying to get me more support from them last Wednesday, to telling my mum they couldn’t do anything because I have BPD etc on Friday, and persuading my mum of the same thing. So I know logically that unless someone from online speaks to someone from my treatment team, which is not going to happen, they can’t be taken over. But that doesn’t stop me feeling paranoid that they just might. Or that the crisis team and psych and everyone else are right and I am just an attention seeking, manipulative borderline who doesn’t deserve any help, and people will start to see through me if I talk to them. I feel incredibly alone. I really, really feel like I need some professional support at the moment, but I have exhausted that, and now there is nowhere to turn to, and it is still a whole week before I am due to see L, who at the moment I don’t even trust. I just feel so isolated and I don’t know what I can possibly do.

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