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Posts Tagged ‘Dr E’

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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>(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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>Hopeless

>I can honestly say I have never felt so hopeless in my life. I saw L this morning. I had a hideous night last night, I was feeling truly desperate and really struggling a lot, and so I was exhausted and very tense by my appointment this morning, and to be honest I went in there wanting to die far more than I wanted to get better. I can’t remember it in too much detail, as my head was all over the place. At first I was finding it really difficult as there were lots of slamming doors and people talking and laughing really loudly and it was making me feel very on edge. She asked how I was. She asked what the most difficult thing to deal with was at the moment, and what was occupying most of my thoughts, and I said definitely suicidal thoughts. She asked how they had changed since I saw her 2 weeks ago: in intensity or frequency, or type, and I said all three. I had written down some of my thoughts last night, as when I was feeling so bad last night I was talking to Part of Being Sane and she said to tell L everything that was going on, and suggested I write down everything I had said to her about suicidal thoughts, images etc etc and write it down so that I could give it to L today. I wasn’t sure if I would be able to give it to her or not, but at this point I mentioned that I had written about it last night, as I felt like her reading it would be easier than me saying it, but she said she wanted me to try and explain first, so I did. She never mentioned what I had written again, so I didn’t show her. I said a lot of it anyway – I think there are probably things I did forget to say, but nothing too major really.

She asked about what had happened with the crisis team – what they had said and who had I seen etc. I said about speaking to someone Friday night, and then them visiting Saturday, and saying they would call the next morning, but that nobody did, and then they suddenly turned up without any warning and hadn’t read my notes, and then about speaking to the woman on the phone in the evening. I said they had talked about getting me to see either their team psychiatrist or Dr E as soon as possible, and said I now had no idea what was going on, as I had been told twice on Sunday that I would be called on Monday, and I hadn’t heard anything. She said that they had spoken to her Monday and discharged me back to her, and told her that they either had or would contact me, which obviously they didn’t, and that they hadn’t mentioned anything about arranging a psychiatrist appointment. I felt immensely frustrated by this, as it was the one thing that everyone from the crisis team that I saw or spoke to had said would happen, and I was also really annoyed that I had been discharged without being told – I think they should do what they say they are going to even if they are planning to discharge you, as the woman Sunday night just said I only needed to focus on getting through Sunday night, and then they would be ringing first thing, and seeing me again etc, and then I heard nothing all day yesterday, and although I wasn’t even sure whether or not I wanted to speak to them, I found it really hard that they didn’t call – partly because waiting for their calls or visits makes me very anxious, and so I spent the entire day in a state of anxiety. So that is the end of their involvement

She asked how I thought things could change, and I said I had absolutely no idea. She asked if I had been seeing or talking to friends, and I said I hadn’t seen or spoken to anyone on the phone, but that I had spoken to people online. For some reason she then went on to talk about relationships – how did I feel about them, did I ever feel like I wanted to be in a relationship with someone, how do I feel about it when things are better. She asked about my concentration, and whether anything at all helped at the moment. I suppose she was just asking the type of questions usually asked to gauge risk, and that things like relationships and thoughts about the future all come into that. She started saying something about getting through this, I can’t remember what, and I suddenly felt like I had been hit by a tonne of bricks – I felt physically sick and incredibly anxious, and all I could think was that I couldn’t cope and that I didn’t want to get through this. She asked what the matter was and I explained that, and also said that last night was just more hideous than I could possibly even begin to describe and that I just could not face another night like that, and that even things got better they would get worse again, and I couldn’t cope with that, and so the thought of getting through this wasn’t what I wanted – I wanted to die more than I wanted my current feelings to change, because I knew even if they changed, I would end up feeling really awful again at some point and I just couldn’t cope.

I can’t remember if she asked me anything else or not at this point. She said that if things were as bad as this, then she needed to think about involving my parents. I tried to explain that I genuinely didn’t feel it would help (I really don’t, and not because I am worried they would be able to stop me from killing myself or anything – I just do not find it helpful). I said about the woman on Sunday night telling me to ask my parents to look in on me before I went to work, and how since then the suicidal thoughts changed in nature because I felt like I needed something without a time restraint like that as a result of what she said, and that since then I had felt worse and that was really when I started getting a lot of graphic images etc. She said that she had to assess risk, and felt that with everything I was saying about how suicidal I was feeling, not being able to see a future, not caring about anything etc etc, that she had to consider what to do, and that she felt it would be appropriate to have a CPA review with my parents as well, and that we also needed to look at if anything she was doing was helping if I was feeling this bad, or whether she was using a wrong approach, or was the wrong person to be working with me. All of this made me feel even worse – I felt like I was being backed into a corner with the situation with my parents, which immediately made me start having thoughts about killing myself as soon as possible, and I then felt like the only person in mental health I had ever really trusted was going to abandon me even if I did get through this, which was another reason not to. I said that I didn’t understand how I could be considered high enough risk that my parents could be talked to against my wishes, and yet the crisis team had discharged me. She said that they had discharged me back to her, so it wasn’t though I had just been discharged completely, but that they had presumably done their own risk assessments.

I can’t really remember what happened then. I know she said that she was mindful of the time as she had a meeting to go to, but I can’t remember if that was before I said the previous things or after. She made an appointment to see me in two weeks and told me to think about things and what I wanted to change, because at the moment she felt like there was nothing to work with as my outlook just seemed so bleak, and that she would organise a CPA review at some point with my parents as well, which I am assuming will be in more than two weeks, as she is apparently on leave next week. I asked how I was supposed to get through the next two weeks alone when I didn’t feel able to get through another night like last night. I said that even the thought of knowing I am supposed to go to a rehearsal tonight made me feel really desperate and sends me into a panic. I know that I was difficult today. I was completely honest, but I was in a mood where I felt like I just wanted to die rather than get better, and said so, and I know that must have been really frustrating for her. I did explain that sometimes I did feel like I wanted to get better and wanted help, but that my mood just swings so quickly between the two. She said something about needing to make the decision to keep going or something, I can’t really remember. I had started to cry by this point, which is very rare for me, and she said she really needed to go, so I got up to put on my scarf and jumper and was really upset by this point, and really just wanted to sit and bawl for a while, but I knew she would need to lock up the room and so that wasn’t an option, so I just had to choke back the tears and leave. She said to take care and that she would see me in two weeks.

I am unsure if a) she doesn’t believe I am feeling as bad as I am, b) truly believes that I will be able to get through the next two weeks with no support as I have coped in the past since I have been seeing her, or c) doesn’t care what happens to me. I actually don’t think it is a) – she seemed to fully believe what I was saying, although she seemed to be at a bit of a loss about what to say some of the time. It could be b) but I don’t know how if she believes a). And it could be c) but she always used to care so I don’t understand what changed if it is that. I am honestly at a complete loss as to what to do. Despite feeling so ambivalent about wanting help today I was still completely honest with her and told her everything, and I still don’t understand how she can think a CPA with my parents is necessary, but giving me any support at all over the next two weeks isn’t. I told my GP on Friday. I was honest as I could be with the crisis team. I feel like I have done absolutely everything that I can.

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>I feel like today has gone completely wrong and I am feeling really hopeless. I was told yesterday that the crisis team would call today at about 10 – 10:30am, and then probably come out to see me again. I left my phone on vibrate so that it would wake me up, and didn’t bother setting an alarm because I knew that would wake me as it always does. I had said to my mum last night that I didn’t feel comfortable talking to people when they were in the house so could they go to see my sister or something, and she said that was fine, but how would they know what time to go, and I said that the crisis team would be calling in the morning and so I would know what time they were coming then. That was the plan. And then I was going to try and tell them how bad things were.

I woke up to my phone ringing at 1pm, and it was a woman from the crisis team asking if I could tell them how to find me. I was thoroughly confused, as I hadn’t had the morning phone call as planned. I assumed they needed vague directions, but when I asked where they were it turned out they were actually already outside the house – they just didn’t know which house it was, as we like to confuse people by not having a name or number or anything on display. So that threw me into a complete tail spin, as their phone call had woken me up, as yet again it had been about 6am before I got to sleep, and obviously my parents were home as we hadn’t had any warning, and I didn’t even have time to do things like go to the toilet, so I was feeling really flustered and confused.

My mum came upstairs to do housework and was hoovering etc, so I didn’t feel uncomfortable with her being there really, but my dad was downstairs, painting in a room virtually adjoining where I was sitting with the crisis team, he had very good hearing, and the man from the crisis team spoke very loudly and had an irritating habit of repeating everything I said. To be honest the whole thing was a complete fiasco. I felt paranoid that my dad would be listening in and so felt extremely uncomfortable, I was confused about why they had suddenly turned up without calling first like they were supposed to, and I was worried that I wouldn’t be able to be honest with them because I was feeling so tense and anxious. To make matters worse they knew absolutely nothing about me, and had never even seen my notes – the reason they had randomly arrived was because they were out this way seeing someone else who was only about 15 minutes away, and so decided to come straight on and see me. I still don’t understand a) why nobody called this morning, and b) why they couldn’t have called when they were 15 minutes away so that I would have had at least had a tiny bit of advance warning. So they literally knew absolutely nothing about me, my history, when I was referred to them, why I was referred to them, how long I had been under mental health services, what my diagnosis was – nothing. I know I complained yesterday about the crisis team not reading your notes properly, but this was a whole new level – they had to ask things like how old I was, and when had I been referred to them. I said I had been referred Friday by my GP, and they asked why he (she’s a she but I didn’t bother correcting them) had referred me – was it because I was feeling low, and I said it was because of suicidal thoughts, which he loudly repeated, which really set off my paranoia. He asked if the feelings had changed and I said no. I think it was at this point they told me they knew nothing about me and started asking things like how old was I, and did I work, and what had I done education wise etc, and how long had I been involved with mental health services for, and why I was originally referred, and about previous suicide attempts and hospital admissions etc. They were also in agreement with the people that I saw yesterday in that I should see a psychiatrist, they said urgently, and that they would speak to their team psychiatrist tomorrow, and I would either see them or Dr E as soon as possible. I don’t know if I will have any more visits from the crisis team, because they said they would speak to L tomorrow, and I am guessing she will probably not be too keen on me seeing them. He asked if I felt able to keep myself safe today and I just kind of shrugged. Saying yes would have been a lie, but I didn’t feel able to say no when I was feeling so paranoid with my parents being in the house etc. He asked if I would be able to call them if things really reached crisis point, and I once again explained that no I wouldn’t, because if things were any worse then I wouldn’t want help. He asked if it would be ok if someone called me this evening, and would I be able to tell them if I was feeling worse, and I said that would be ok.

I am feeling really confused. I don’t know what to do. I don’t know if I should wait for the call this evening and try and tell them how desperate I am, or whether I should call them before then, or whether I actually don’t really want to speak to anyone or want any help. I am frustrated with the way today turned out. I just felt so uncomfortable and I really had intended to try and be really blunt about how I was feeling, and I just couldn’t, and now I feel really hopeless and just don’t know what to do. I wish they had bloody called this morning like they had arranged to do rather than just turning up with no notice.

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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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>Support

>I’m not really sure what to say. I am feeling bad. I saw L this morning. It was fine, but I just felt completely numb throughout it really. I am having trouble to really concentrate and think properly. There is also some not great news that I could have done without at the moment – I am going to have to switch from seeing her weekly to fortnightly. She is having to cut down on her hours for personal reasons, which means that some people are being switched to other care coordinators, and then some people that she has been seeing fortnightly will be switched to monthly, and those like me who were being seen weekly are being switched to fortnightly. I understand why it is necessary, but that doesn’t make it any easier, particularly when I am feeling as terrible as I have been lately, and now am supposed to get through the next two weeks alone. I can’t help comparing the support I have now, with what I was getting this time last year – last year I was seeing L weekly, and then also my old support worker N weekly for a couple of hours, and my psychiatrist Dr E monthly. I am now reduced to seeing L fortnightly. If this was due to an improvement in how I was doing then that would be great, but it isn’t – it is unfortunately almost entirely due to staff circumstances.

N’s job was cut due to funding issues – she was only on a one year contract with MIND and was then seconded to the CMHT, but MIND had their funding cut, and so her contract was not renewed, so there was no longer a support worker for me to see. That didn’t bother me too much – I liked her, but I didn’t have any attachment issues with her, and although sometimes it was nice to get out the house with her etc, it wasn’t too difficult to stop seeing her as I still had L, who was my main source of support. My psychiatrist stopped seeing me because she had stopped all of my medications except my PRN Diazepam, which meant that she no longer felt like it was necessary to see me. Again, I didn’t really have an issue with that as 15 minutes every month or two with her never felt particularly helpful, and I didn’t really feel like she listened to me much. Now my contact with L is being cut because of her circumstances, which is really difficult, as essentially that hour or so a week I spend with her is the only time all week that I feel able to actually be honest about how I am feeling, and can be around someone without feeling a need to put on a front and pretend everything is fine.

Throughout my appointment I couldn’t stop thinking how much I wanted to die, and how I desperately didn’t still want to be alive in 2 weeks, and also what a long way away that felt, and how was I possibly meant to get through that on my own. I just felt like sitting there and crying my eyes out, but I didn’t want to make her feel guilty about something that isn’t her fault and that she can’t do anything about. When I left I wanted to burst into tears but I couldn’t because I was then in the car with my mum and a) she wouldn’t have understood why only seeing L fortnightly was such a big deal, and b) I don’t like showing emotion like that – I have never been good at it, and I just feel awkward and uncomfortable. I am on my own now but I just feel numb.

I have been really struggling with my weight and eating lately. Whenever my mood goes down I get increasingly fixated on my weight, and since it is post Christmas that isn’t really helping at the moment. I gained a couple of pounds over Christmas, which I was expecting and so could kind of accept. But now Christmas is all over, and I am still struggling with it. I always find that when I start eating more often, like I was over Christmas, I find it more difficult to go back to my usual eating patterns, and that is the only way that I am ever able to control my weight. It doesn’t help that I still have some chocolates left over from Christmas that I am working my way through, but it is more than that – I am just eating more generally than I feel comfortable with. On Saturday I was back down to my pre-Christmas weight (which is still higher than I was to be), but then Saturday and Sunday I ate too much, and so gained a pound, and expect I have gained even more as I ate a lot yesterday, but I haven’t weighed today because I had to be up early to go and see L, and I have particular times I will weigh myself. But my middle of the night weight last night was considerably higher than the night before, and that is generally a fairly accurate indicator. I feel disgusting. I hate myself for being so greedy. And yet I feel so shit, and food is somehow comforting, despite being distressing at the same time. So I am comfort eating I suppose, and yet not even remotely comforting because it makes me feel shit. I don’t know. I am just desperate I suppose, and in a way it feels like I may as well eat whatever the hell I want, because it isn’t going to matter anyway if I am dead.

I don’t know. I don’t know what I am doing. I don’t know how to cope with things. I don’t know how I am expected to get through my life with one hour of support every two weeks. I don’t even feel like I want to at the moment. I feel like such a fucking mess, and I am bloody exhausted.

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>I saw L this morning. It was quite a difficult appointment for me. It was constructive, I feel like we talked about quite a lot. But some of it was hard, and I wasn’t expecting it to be. We started off talking about my sister, which was ok – L asked about the whole Facebook scenario, and how she still isn’t speaking to me, and there is also an update on that. My mother found out on Sunday, via our old next door neighbour, that my sister and family are going to Scotland for Christmas. My sister hadn’t told my mum this, who was fairly understandably quite hurt, as she has still been spending time with my sister as usual, and there is no reason for her not to have told her. My mum wasn’t upset about my sister going to Scotland – that is where her partner is from, and so it is something they should do at some point – the reason they never have before is because my sister loathes her in laws. But seemingly not as much as she loathes me. It was the fact she hadn’t even told her, and that she had heard it from our old next door neighbour. She spoke to my sister yesterday and asked when she had planned on telling her, and my sister replied when she had asked. Since only 2 weeks ago my mum had asked my sister what the plans were for Christmas I thought this was unfair, and typically immature. Last year we (my parents and I) went to my sister for Christmas Day, despite my dad and I much preferring to stay at home, and so had things been ‘normal’ this year, they would probably have come to us Christmas Day, as we tend to alternate since everyone prefers to be at home, but seems to want to be together. But my sister made some dig at my mum saying that she knew we wouldn’t have gone there for Christmas Day, even though apparently parents are supposed to go to their children for Christmas if said children have children. I don’t think this is true anyway – I think it can work either way, and there are actually 4 of us – my sister is not an only child, and I am not sure why she feels like Christmas should be arranged to suit her every year. But she does. So since we wouldn’t be going there (partly because we went there last year, and partly because I don’t think I would have been welcome anyway and my parents wouldn’t have left me at home alone on Christmas Day) she decided to go up to Scotland instead, but not bother to tell my mother. I have to say, I do sometimes marvel at how selfish and inconsiderate my sister can be.

Anyway, then we talked about my care plan for a little while. Apparently it needs updating, so we briefly discussed what needs changing. I am pleased to report that the idea of telling me to go to A&E if I am feeling suicidal is being taken off. That was such a shit idea, implemented by my previous care coordinator, who insisted on it if I even mentioned the word suicide. It has proven to actually be quite unhelpful, because I already know that is an option anyway, so it being on there adds nothing to it, and is something I would be incredibly unlikely to do anyway. However, something I am slightly more likely to do, in that I have done it before through choice, is calling the out of hours number. This is not the crisis team. You can only see the crisis team if you are referred – there is no direct access to them (good system for when you are in crisis isn’t it?) This out of hours number goes through to the local psych ward, and one of the nurses there will talk to you. However, the last time I called it I spoke to someone who said that there was nothing they could do, and my care plan said to go to A&E. This was the middle of the night, and absolutely not something I was going to do, and not even what I needed. I needed to talk through my feelings with someone and hopefully get some suggestions as to how to cope. But because of my care plan saying to go to A&E that was what they had to tell me to do. So hopefully with that erased I will be able to actually have a conversation with them if I need to in the future – it does already say that I sometimes need to talk to someone, and obviously in hours that will generally be L, but that out of hours I can call them to talk, but she is going to make sure that is made more obvious, so that they don’t try and just fob me off onto A&E. Obviously I have now got a date through for the psychology assessment, so that will need updating. I think there were various other points too, but I believe they were the main ones.

We talked a bit about periods when I am in crisis. She explained more fully her reasoning for not wanting me to be involved with the crisis team, and also hospital, although we talked about that to a lesser extent. What she said was certainly not a revelation to me – it is something I have picked up on myself, and I am sure that many other people have too. Basically she said that she feels like the crisis team see mental illness in very black and white terms (does that mean they are all Borderline I wonder?), and that they will take referrals for people with psychosis, or clear Bipolar, for example if someone is very manic, seriously, but that they pretty much write off all other mental health problems as not needing their attention etc. She said she is worried that their attitude can do more harm than good, as they can be very invalidating (which I have experienced, and I know many other bloggers have too) which can actually result in making you feel even worse. She said they often just see people once to assess them, judge them as not actually being ill enough to need their help, and then refer them back to the CMHT, despite their care coordinator, who obviously knows them best, feeling that they need crisis input. Obviously my diagnosis being BPD, rather than just depression makes this even more of an issue, as there is so much stigma surrounding BPD still, and she said that she sees it an awful lot, both on the wards, and in the crisis team (and I have certainly seen it in other members of the CMHT) and that people with BPD are still so often dismissed as being attention seekers and all the other old stereotypes, and she thinks it can be very detrimental. I understand this, and I did suspect this may have been part of her reasoning behind not referring me when I asked a few weeks ago. I said that obviously during office hours, and when she is there it is ok, because I can call and talk to her, but out of hours, or if she isn’t there then it is very difficult as there isn’t really anyone I can turn to for support. I think that unfortunately that is just a failing of the system, and there isn’t much that can be done about it though. Obviously I can call the duty worker at the CMHT if she isn’t there, or I can call the out of hours number, but I think that talking to someone who doesn’t know you always has limited usefulness, as really they are fairly limited to suggesting the usual patronising things like going for a walk or having a bath. I also told her that I felt like I needed some help with coming up with things I could do when in crisis. Not when things were starting to slip, but when I am really at rock bottom and have no concentration or motivation, and can’t do anything. Not calling people, or any outside help, but things that I could do myself. I find it very difficult, because I just lose all ability to focus on anything, and so distracting myself is almost impossible. I try and write how I am feeling to get it out of me, but that isn’t really a distraction – it is just something to try and sort out my thoughts. When things are that bad reading is out of the question, and even watching TV or listening to music are more than I feel able to do. But one of the things I am consistantly asked if I speak to someone other than L when in crisis, is what have we discussed as distraction techniques for that, and I don’t think we have. It obviously needs to be really very basic stuff, as my IQ just seems to nose dive when my mood really crashes, and I don’t have the concentration to do anything for long. She said that she will try and come up with some things, and has asked me to as well, but I am struggling to really think of anything, so any suggestions would be welcome. Things that don’t involve much energy, concentration or motivation, and yet can still provide something of a distraction. Answers on a postcard….

I also mentioned medication, as I feel that whilst I had very bad episodes whilst on medication, overall I have struggled more since I haven’t been taking anything, and this last crisis period was particularly difficult, and was probably one of the lowest I have ever experienced. Which was perhaps something of a saving grace, as I was too exhausted to act on my thoughts, despite the strength of them. But my head being so noisy was very difficult to cope with, and it was just really hideous. So she is going to speak to Dr E about it. I suspect Dr E will stick to her view that you don’t medicate people with BPD, but I quite clearly have depression as well as BPD, and so I think medication for that would be appropriate. Whether or not it would help or not I don’t know, but I feel like I need to try something.

I can’t remember how, but we somehow got onto the issue of my childhood. I was going to go into what we talked about now, but I am actually feeling like I want to talk about all of my childhood, not just what I discussed with L today, and so I am going to continue this post tomorrow, as this is already very long, and although I have started writing about my childhood, there is still an awful lot to go, and I think it requires a post to itself. So I will finish this tomorrow. I will talk about my childhood generally, and also what I discussed with L, which was the part of the session that I found quite difficult. So to be continued…..

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