Posts Tagged ‘hospital’

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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>Useless friend

>I feel like a shit friend today. A friend of mine, who I met during Carousel, is moving to London next weekend as she has got a job there. I didn’t really get to know her very well until probably the week before the show – that was a strange show to rehearse, as I was only in the long dance scene, and then two other scenes, so until a couple of weeks before the show the only other cast members I really had much to do with were the people playing my parents, as they were who my scenes were with, the dancers and children who were in the ballet scene, and some of the other principals because you tend to get to know them at initial read throughs etc. So I had spoken to her a few times, but that was about it I think. Then on the day of the tech rehearsal between the band call and tech rehearsal, five of us, including her, went out for lunch, and we got on well and during show week chatted a fair bit, and talked online, and then a week or two after the show finished she came over one day etc. I haven’t seen her since then, which would have been early November, but we have continued to chat online. Anyway, because she is moving tonight she was having a farewell drinks thing. It wasn’t a massive thing – she had invited quite a few people, both people from Carousel, and friends of hers that I didn’t know, but I don’t think that many people were going. She told me about it weeks ago, and although I felt a bit anxious, as plans were all a bit vague and I find that stressful, I had intended to go. But then this week has been so hideous that I just couldn’t face it. And the pub people were meeting at is always packed, so she didn’t even know if they would be able to get in there, or if they would have to find someone else, and I just cannot do busy places, and on a Friday night pretty much everywhere is going to be busy. I would have liked to see her, and the girl who played my mother in Carousel, who is a really wonderful person, whom I also haven’t seen since November, was also going, and it would have been nice to see her, but I hate anywhere crowded, and although I would probably have tried to go had I been feeling better, there was just absolutely no way that it was going to happen this week. But I feel like a really shit friend for not going, because she told me about it so many weeks ago, and I just feel like she must hate me. I spoke to her online earlier and said that I was really sorry but that I wasn’t going to be able to make it – she does know that I have mental health problems, although I don’t talk about them in depth with her, and when I last spoke to her a few days ago I did say that I wasn’t doing very well depression wise at the moment, and so when I spoke to her today I apologised and said that was why. She said it was fine but I still feel guilty.

Then something happened with another friend today that also made me feel really guilty and like a shit friend. I have a friend who I have talked about on here before a few times – the last time would have been when she came to stay in October, and she was also here in July. Anyway, I will henceforth call her E, as I realised I don’t have a name for her. She has been severely anorexic for years now, and has spent a long time inpatient as a result of it, but was really very ill both times I saw her last year. She was on the waiting list for inpatient again, but comes from Ireland, where the system is very different, and there seem to be far too few ED beds for the number of patients, as there were something like 3 beds and 12 girls waiting for them. Anyway, when she was over in October she was talking a lot about wanting to get better, and hoping a bed would come up soon for her, but then soon after she went home she actually started doing much better. She was eating more, and managed to cut down a lot on the amount she was purging, and the number of laxatives she was taking, and was starting to gain weight. I was concerned that she would get to BMI 15.5/16ish and then hit a brick wall, as I know that is the point she has managed to get to several times in hospital, and has then relapsed, and I was worried because they took her off the IP waiting list as she was doing so well. Unfortunately it went more or less as I predicted – her BMI was high 15s before December, and she was really struggling with it and starting to cut back, and since then she has been finding it really hard, and has lost some weight again, although I don’t know how much, and then the last couple of weeks has been feeling increasingly depressed. I spoke to her last night and was quite concerned, as she did seem low, although I didn’t get the impression she was actively suicidal, although I may have been wrong, but she was certainly feeling bad and struggling a lot with her eating, and was back into her old patterns really. She was due to see her psychiatrist today, and she said she would be honest with them and tell them what was going on, and when I spoke to her this afternoon she had been admitted – not a long term ED admission, but a short term admission to try and lift her mood, and also stabilise her eating a little if possible. I had simultaneous thoughts – I was pleased that she was getting help, because I have felt for a long time like she needs it, although I don’t think a short term admission like this is the answer, and I was glad she was safe, but at the same time I felt jealous. I feel terrible for saying that, because she needed help, and I am pleased she got it, but at the same time I don’t understand why it often seems so simple for other people to access more help when they are struggling, and yet I never can. I am not saying I would want to be in hospital – it is always something I feel very ambivalent about, but when I spoke to her she said how it was a relief to have a break, and that just hit me really hard. I just felt like crying. Suicide is still my preferred option, but as at least a temporary alternative a break would be really bloody good right now. I am just too exhausted to keep going like this, and I feel like if I look at the short term I either need a break or I need to kill myself. Admittedly the local NHS psych ward wouldn’t actually be my place of choice for a break even if it were an option, but I don’t know. I guess I just feel so desperate, and this week has felt more horrific than I can even express, and so anything feels like it would be better than this. As I said, it isn’t an option anyway, and if it were then I am sure I would refuse, as there have been multiple times in the past when I have been offered admission and turned it down – the only times I have been in hospital were voluntary admissions, but I wasn’t actually given a choice about going. I just couldn’t help feeling jealous knowing that E saw her psychiatrist today and was admitted, when it doesn’t matter how much I struggle, or how desperate I am, I just seem to be left to do. But I feel really guilty, and like such an awful friend, not to mention really quite weird, for feeling jealous that E has been admitted to a psych ward. I suppose I just really am so desperate that even something I would usually avoid at all costs seems like a better alternative right now.

I spoke to L earlier. I rung and asked to speak to her, and they said she was with someone but they would get her to call me back. When three hours had passed and I still hadn’t heard anything from her I was starting to give up, but she did call back. I didn’t feel able to really say how bad things were – I tried, but at times like this it seems that the words don’t even exist. “depressed” “suicidal” “desperate” “hopeless” – none of them actually even begin to convey how horrific it feels. It is slightly easier when I can ramble at length, rather than trying to form coherent sentences, but I don’t believe the words exist to fully explain the extent of these feelings. I did try – I said it had been a really awful week and that I was feeling very depressed and was completely unable to distract myself, and that my sleep was awful and essentially that I just couldn’t cope. She said more or less all she could I suppose – to try and plan my time and do things to distract myself, and to keep writing things down, and that we could talk about it on Tuesday. It just feels so futile. Talking about it on Tuesday won’t make any difference whatsoever. I don’t even want to be alive by Tuesday, although I probably will be I suppose. But it won’t change anything. I am feeling really disillusioned with everything at the moment. I just see absolutely no way forward from here, and I don’t view continuing to feel like this as an option, which once again leads me back to suicide. Even when I try not to think about it, it always pops up as being the solution. The right thing to do. The answer. Maybe it is. I don’t think my brain would push it so hard, and so continuously, for so many years unless it was the right course of action. Brains are supposed to have survival instinct, but mine just tells me to kill myself.

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>I am a) absolutely furious, and b) feeling really shit. Which isn’t a great combination really. The anger is because as I wrote about a couple of months ago (here) I had to start looking after my 5 year old nephew after he finished school on Thursdays, until my sister could get here to pick him up. Although it doesn’t sound like a big deal, I have found it incredibly stressful, and I have got into a complete state at times as I have been so panicked about it. There were also a couple of times when I was supposed to be seeing T, but wasn’t able to because I had to be at home to look after my nephew, and that obviously annoyed me because I don’t often see friends, and so when I can, and feel like it, I don’t want to not be able to because I have to look after my nephew. So every week I told my mum that I really didn’t want to do it, and how anxious it made me, and then in the end after having to tell T yet again that I wouldn’t be able to see him because of looking after my nephew, I said to my mum that was the last week I would do it, and they would have to make other arrangements for the next week. Naturally they didn’t, and I had to do it again, and was really angry that I had been completely ignored yet again, and said I really was not going to do it anymore. She asked if I could just keep doing it until half term (last week) as that would give my sister time to make other arrangements, so I agreed to that, but said I was absolutely not going to do it after that, and that if I was needed for the odd afternoon because someone was ill or something then that was one thing, but I did not want it as a weekly commitment. So as far as I was concerned my responsibilites with that had finished a couple of weeks ago. Then on Monday, my mum asked me what was going to happen about him this week. I said I was under the impression that she had told my sister I wouldn’t be looking after him anymore weeks and weeks ago when we discussed it, as the whole point was that she would have time until after half term to find another arrangement. Turned out she hadn’t actually mentioned it at all, as she said she knew my sister would say how selfish and mean I was and how I only thought about myself, and she would be able to see her point. I said I didn’t care, I wasn’t doing it, and she said she would call her. I then didn’t think anything more about it, until I heard hammering on the door this afternoon. Assumed it was a delivery or something, went downstairs, and there was my nephew. I was absolutely furious. I hate that my feelings are just completely ignored – I have said so many times that I just find it too stressful, and it makes me really upset and anxious, plus I don’t want to be tied down and not able to arrange other things if I want to, but it seems like that is completely unimportant. My sister is such a bully, and as long as everything suits her then she doesn’t actually give a shit about whether something suits other people, or how it makes them feel. And I am really angry with my mum for telling me weeks and weeks ago that I only had to do it until half term, and then doing absolutely nothing about it, and then telling me again on Monday that she would speak to my sister, and again doing nothing about it. And after he had left I said to my mum how annoyed I was, and that naturally I hadn’t been expecting him today, and once again got the ‘Well I really don’t see why it is such a big deal, I don’t know why you can’t just look after him, and there is nothing about it that should make you anxious’ speech that I get from her every time. I have tried to explain that I think it is actually irrelevant that she doesn’t think it should make me anxious, as it does, and it also makes me very upset, but she is more concerned about not rocking the boat where my sister is concerned than she is about my feelings. So I am feeling really pissed off and upset about the whole thing. I don’t care if I am selfish for not doing it – I just get too stressed by it, and I don’t see why I should have to put myself through that much anxiety, just because my sister can’t be bothered to find someone to look after her child.

I think the feeling shit is primarily just the natural progression of how I have been feeling this week. My mood just seems to be dropping further. I hate this so much. Knowing what is happening, and yet being powerless to stop it. The depression is certainly getting stronger yet again, as are the suicidal thoughts. And it is continually in my mind that if I am going to act on them, I have to do it in the next few weeks, or I can’t for 2 months, and that does scare me quite a lot. I am also having thoughts that I don’t like and feel quite ashamed of. They annoy me, because they just sound so typically borderline, and I don’t want to be that. When I have thoughts that are typical of depression or disordered eating for example, obviously I hate having them because they make me feel bad, but I don’t feel anything negative towards the actual thoughts, whereas I really do about thoughts that I perceive as borderline. They always make me feel ashamed of myself and embarrassed, and so I try to just pretend they aren’t there – I often don’t write about them because I just don’t want to be thinking them. At the moment I think I am just feeling a bit envious of a couple of my friends, and I hate myself for that because they aren’t well, but I just can’t help it. It is one in particular really, my friend A who took the paracetamol overdose the other day. It sounds awful already, saying I am jealous of someone who took an overdose. She also spent around 9 months in hospital fairly recently, from about this time last year, until this summer. Anyway, she is fine, she was on a drip for a while, but she is back home now. She has been saying for a couple of weeks that she is feeling really crap and having suicidal thoughts, and obviously I have tried to be supportive and talk to her etc. But what I am finding difficult is the amount of help she gets. We had very similar histories, and she used to be in a similar position to me, and see someone weekly and that was about it. Then she started DBT, and so had quite a lot of support from that, and also got a lot of referrals to the crisis team. She had a couple of short admissions (1 week) when she was struggling. Then around this time last year she was admitted, and for some reason kept there for about 9 months. They did a lot of messing around with her meds to try and get her onto something that would help stabilise her, which made sense, but I was really amazed that they kept her in hospital for so long as she wasn’t manic or psychotic or anything else that people are usually hospitalised for a long time for, and it was just a normal acute NHS ward, not a therapeutic community or anything like that. I found it difficult sometimes when she was in hospital, as she would say she was feeling really bad for example, but some of those times I was also really struggling a lot, but on my own, without constant support like she had. But I knew that there was no way I would have wanted to be in hospital for that long when it had no therapeutic value etc, and I also thought it wasn’t a very good idea, as she would find it really hard when she left and suddenly didn’t have all of that support. As predicted, she found it difficult when she was discharged, as I think she had completely forgotten what it was like to feel really shit and not have 24/7 support, and what it is like to have suicidal thoughts and just have to get through them on your own because there is no alternative. But she had been doing ok. She was coping as well as could be expected really, and didn’t seem to be doing too badly really – the medication definitely helped her and she wasn’t self harming, and didn’t seem to be that low or suicidal – certainly a lot better than I have seen her other times. Then a couple of weeks ago she started feeling worse and telling me she was having suicidal thoughts but didn’t want to be admitted or see the crisis team, and so I tried to remind her of all the times in the past she had managed to cope with thoughts like that, and that she could do it again. And then the other day she took the overdose – it wasn’t a suicide attempt, as she told me she had done it about half an hour later, but she had bad news and she said she just did it before she had even thought about it, and she was planning to go to hospital for it etc. When I spoke to her earlier she said she was being seen by the crisis team, and if she wasn’t feeling better by Monday then she would be admitted, and she said she didn’t care either way. And for some reason I just found that really hard to hear. I think it is because of the countless times when I have been feeling so completely desperate because of how suicidal I have felt, and just how terrible I have been feeling, and just had to cope with the same amount of support as usual, ie a weekly appointment, or sometimes not even that if it has been a period when L has been away. I don’t get seen by the crisis team or offered admission. I haven’t even been admitted following suicide attempts, although I did have a couple of admissions back in 2005 when I was living away from home. And I have been feeling worse and worse over the last week or two, and the suicidal thoughts are getting stronger, but I know that it wouldn’t matter how bad things got, I still wouldn’t get that kind of support. And I do understand why, because I know I need to learn to cope with the suicidal thoughts without escaping into hospital, and that it really isn’t a solution in the long term, but sometimes I just feel so desperate, and a break from having to fight constantly to keep myself safe would just be such an enormous relief, and if I am honest I do feel jealous that she can have that if she asks, or even if she doesn’t, when I can be feeling exactly the same and get nothing. But I hate myself for thinking like that, because if she is getting more help it must be because she is more ill and needs it and deserves it more than I do, and I really shouldn’t be jealous of her for it. But I can’t help it.

I am feeling a bit stressed, as a friend I’ve not seen for 2 or 3 months sent me a text the other day asking if I was doing anything on Sunday. I said I had a concert rehearsal from 11 – 12, but was free after that. She replied asking if I would like to go out for lunch. Since I had just said I was free, I couldn’t then say I was busy, and she’s a very long term friend, who I have known since I was 4 and she was 2, and I would like to see her, but the thought of eating out is really scaring me. I always find it fairly difficult eating out, because I know it is likely to have a bad effect on my weight, but it is something I try and do anyway, because it is one of the most obvious ways of socialising with people, and actually I like some food a lot, and therefore quite like eating out – it just makes me feel guilty, and I quite often purge. But I still do it. But this time it is actually filling me with dread. I think it is because I finally, over the last week or so, seem to have got my body into a pattern of losing or maintaining every day, without really gaining at all, and I think I am just terrified of ruining that. I don’t think I have ever felt quite this scared about a meal out. I think it is because emotionally I am really feeling on the edge at the moment, and knowing that my weight is going down is the only positive I can see at all, and I am scared of what my reaction will be if the numbers start going up, as I just don’t think I can cope with any more bad feelings at the moment. I am angry with myself for letting my eating and weight get this much control over me – regardless of my weight, or what stage I have been at eating wise, ie whether I have been purging or restricting or whatever, I have always still gone for meals out, and I am just furious that I have now become so terrified by the thought of it. Why have I been able to do it for the last 7 years, and now suddenly it feels like the scariest thing evver?! I suppose it must just be because I am feeling so precarious mood wise, and so I am just desperate to cling on to the one thing in my life I can see as a positive, and I am scared that this meal will shatter that, and therefore any semblance of coping. I am scared.

I have an appointment with Dr O tomorrow. It is lucky they always book me a double slot, as I seem to have a string of things to tell her. My back still isn’t better, my hamstring/hip thing is bad, and then there is the lump thing that I should mention. Plus the usual getting my medications, her making assumptions on my mood based on whether or not I am smiling, and suggesting I learn to cross stitch if I am not doing well.

I need to sleep. I have been writing this on and off for 11 hours now. My concentration is just all over the place. I can’t think properly, and my brain just feels slowed down.

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>I am not feeling too great. It has been quite a tiring week really I suppose, and just quite hard to deal with. It has been tiring being out every night, and being around people. The play has been going alright I think. I have the last performance tonight. Got to leave for the theatre in half an hour, I really should be doing things like eating and showering and getting myself ready rather than sitting in bed writing this and watching Come Dine With Me. Ah well.

I don’t think I have written on here before about one of my closest friends. We will call her A. I first met her about 6 or 7 years ago on an Eating Disorder support message board. We then started talking on MSN, and on the phone, and then met up, and she has come to stay with me several times. She lives a few hours drive away so I don’t get to see her very often, but we have always talked a lot in between seeing each other etc. We are very similar. We have a very similar sense of humour (pretty black), and have always joked about how alike we are. She has pretty much the same diagnoses as me, and in terms of thoughts etc we have always been very similar. Behaviourally we are also fairly similar, although she has always self harmed more than me – I rarely self harm, whereas she does it quite a lot. We have always supported each other a lot and tried to be there when the other has been struggling.

A has spent the last 7 months in hospital on a section 3. I miss her. We still talk, but not as much as we used to. I have tried to be there for her as much as I can, but it is hard when I am struggling too. I think I have probably missed her support. It has also kind of scared me a bit. Like I said, we have always been very similar, and it scares me that she has been on a section for so long. Although I have been in hospital a couple of times it hasn’t been on a section. I don’t know – I suppose I just think that if it can happen to her than it could happen to me. I don’t really understand why they have kept her there for so long. She has been struggling, but I don’t really think more so than other times. Prior to this she had only ever had 1 week long voluntary crisis admissions, and then suddenly she has been on a section for 7 months.

They are looking into a theraputic community for her for when she leaves hospital. I shouldn’t be jealous of that but I am. For several years now I have felt like that would be what would be most likely to help me. Probably partly because it seems to be about the only thing that I haven’t tried. And partly because I feel like I would be able to move on more in a therapy sense if I was somewhere I felt safe rather than leaving sessions and going back home and having to cope with the suicidal thoughts on my own. I wish that a theraputic community was an option for me. A and I used to talk about how we thought that would be the most helpful thing for us. Now she is likely to be getting that, but no longer seems to want it. Which I can understand because I know she can’t see things getting changing and she thinks she is never going to get better. I can relate to that. But I wish I could have the opportunity of going to a theraputic community for treatment. But I feel guilty because she has spent the last 7 months in hospital, and will probably be there for quite a while longer yet. And I am not jealous of that – I think that would be really difficult. But I am jealous that she is going to get the treatment I feel could help me but I can’t have.

Edit – I just noticed that this was my 100th post!

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>I am getting really pissed off with my sleep. Or rather my inability to sleep at a reasonable time. The last 2 nights, it has been after 6:30am when I have finally got to sleep. I don’t know why I can’t sleep earlier – I can be completely exhausted and unable to keep my eyes open, but yet I just cannot get to sleep. Cue lots of stress and bad thoughts. I am spending the nights alternating between trying to sleep, and trying to read or do something else until my eyes get to the point where they won’t stay open again, at which point I attempt to sleep again, and so it goes on.

I had a really bizarre dream last night. I had taken an overdose and been taken to hospital, and was unconscious, and when I woke up again I asked a nurse what day it was, and she told me, but it was 3 years later, and I had been unconscious for 3 years. So everyone else was 3 years further on in their lives, but to me it still felt like the same time it had when I had taken the overdose, so it was all very confusing. I left the hospital, and when I was at home I went to log onto Facebook to see what people had been up to in the last 3 years. But Facebook had shut down – it had been sued or something. It was all very weird!

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>Skin games

>I was going to self harm now. I kind of did, but it wasn’t actual self harm. Actually it wasn’t self harm at all. It was more playing with my skin and a blade. Seeing how far I could dig the blade into the fat on my thigh. Pushing it hard. But not slicing. There is definitely far too much fat on my thighs. Looking at them makes me feel physically sick. It hurt like slicing does, but it didn’t really bleed. Skin is pretty tough really. I can push a sharp blade into my leg with all my strength and it only cuts through a few layers of skin. Quite impressive stuff when you think about it. I suppose this playing with a blade game should be win win really – the pain without the scar. But it isn’t the same without the blood. I want to do it properly now, but I know there is no point really. It will only make me feel better for about 5 minutes. I want to overdose really. That would be infinitely more satisfying. Even if it doesn’t work it is. Obviously it would be most satisfying if it did work. But even if it doesn’t, it still calms me down a bit. I suppose because the discomfort lasts for longer. And because I get taken care of for a few days somewhere safe. Safety is reassuring. But even small overdoses that I haven’t been to hospital for have been quite satisfying. Maybe because I know I am hurting myself inside.

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