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Posts Tagged ‘medication’

So I don’t blog anymore, but somehow when the shit hits the fan it seems that my reaction is to want to come here and write. As I said in my last post, I have been doing relatively well. No crisis team, visits to A&E etc etc. No lows so bad that I have completely crashed and ended up really ill – there have been dips, but they have just about stayed at a level I can deal with. The downsides are that emotionally I have felt very flat and numb, which I blame on the medication, and that despite being more stable, I have still not felt like I want to be here. But they have been passive, rather than active, thoughts.

Over the last couple of weeks this has been changing. Or couple of months according to www.ifnarky.com but let’s not do that because this is my blog, and I prefer to think of it as the last few days/weeks. Slowly at first, and then really fast the last couple of days. My mood has been crashing. It wasn’t entirely unexpected – it is my birthday on Monday, and long-term readers may remember that birthdays freak me out, as does New Year. Other things too, but those two particularly. So a little dip in my mood was almost expected. But it isn’t just a little dip. It’s a bloody big dip. More like a fall off the edge of a mountain style plummet. But. But but but, it is different. I am not going to be able to explain how it is different, because I’m not quite sure to be honest, but I know that it is different. For a start, I am feeling far less emotional than in the past. Again, I am attributing this to the meds. I know I am feeling very depressed because I have lots of the usual symptoms, but the one conspicuous by its absence is actually feeling, well, anything really. In terms of other symptoms, I’ve had some periods of dissociation, and the vast majority of the time I am feeling as though I am underwater – you know when everything sounds and feels blurry and distorted? Very disconnected and spacey. Which a couple of times has been quite scary when driving. Then of course, the biggest problem for me, the very strong negative thoughts that fill my head, urging me to kill myself. But all of this without really feeling any emotions? Strange. I can see how the lack of emotion can be perceived as a positive thing in that I don’t have the completely shit feelings, but it feels weird. And in a way it feels more unsafe, because I am not completely wiped out in the way I would be ordinarily – normally in really bad periods all I can do is lay in bed staring at the wall, but although I am tired at the moment from the busyness of my head, I am not wiped out in that way. Which means I have some energy, which kind of feels a bit scary combined with the thoughts. Which are largely centred around not wanting to be alive, and not wanting to be here for my birthday on Monday, therefore killing myself before then. The time pressure of that is not helpful in trying to deal with the thoughts.

Yesterday I had an appointment with my social worker. I had been very tempted not to go – I didn’t really want to talk to her, because although I like her a lot, I don’t find it helpful seeing her really, and I didn’t want to leave the house. But I went anyway. And within five minutes really regretted that. A little background – my social worker is pregnant, and will be going on maternity leave in September. The week before last she switched me from weekly appointments to fortnightly ones. As I said, I don’t find it that helpful seeing her, so I wasn’t too bothered about that, although I had told her it is a bad time of year for me, and that I therefore was slightly concerned about the timing.  But it was ok. So I didn’t see her last week, saw her yesterday. She asked how I was, I told her that I was struggling, that I was having strong suicidal thoughts etc. She told me that she had been speaking to the team manager and the psychologist that I used to see, and that they had decided that I would be ready to be discharged when she goes on maternity leave in September because I am doing so well. It was a ?!?! moment – I said I felt suicidal, she said I was doing so well that I was ready for discharge. Somewhat confusing. And to be honest I couldn’t take in what she was saying or think about it, because I was struggling too much with what was going on right now to listen to her go on about how brilliant it was that I am doing so well, and how exciting it is that I am ready to be discharged, and what a brilliantly positive step in my life this is. Maybe all of that is true, but really, was that the most appropriate time to bring it up? I’ve been under mental health services continually for 8 years, and it didn’t occur to her that it might be a good idea to have a CPA review with me, and whoever is involved in this decision, and discuss how I would feel about it? Or even just discuss it in an appointment? That presenting it as a fait accompli may not be the best way of doing it, and that when I have just said that I am really struggling seriously for the first time in over a year may not be an entirely sensitive time to bring it up?

This isn’t even a rant about being discharged. I don’t know enough about how I feel about that yet at the moment. I am trying not to give in to the thoughts and kill myself before my birthday. What I am ranting about is the lack of sensitivity, and basic common sense, displayed by mental health services. Telling me that when I had just said how much I was struggling was not a good idea. It was very bloody invalidating actually. Like she hadn’t even been listening to what I had been saying, because she was just waiting to get her good news in, which was very much presented as wonderful news. Does anyone else find this strange or is that just me?

So anyway, that hasn’t helped things. I didn’t need anything else to think about. I was already feeling shit. So today things have been even worse. I am really struggling. There are the thoughts. And then there is me. Not actually wanting to fight them. Even when things are better I don’t want to be here, so what on earth is the point of keeping going? That sort of thing. And this desire, which is actually stronger than a desire, more of a need, to not be here for my birthday. I don’t know. It’s tough. It feels incredibly difficult right now. And I just don’t know if I care enough to fight. Right now I feel like I don’t. And I want to stop my meds, but that is a whole new issue I’m not even getting into now, however related.

This is a horribly incoherent, mixed up post. I don’t write anymore. That is my excuse. Actually fuck it, I don’t need an excuse, it is my blog, and I needed to get my thoughts out somehow.

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

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

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

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

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

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

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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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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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I was lucky enough today to be visited by the lovely Karita. I can honestly say that she is one of the most caring, supportive people I have ever met. It was really good to have someone there, in ‘real life’ who I didn’t need to pretend with, and who was completely non judgemental and made me feel cared about. Despite having never met her before, I felt able to be completely honest with her, which although I do when writing on this blog, I find incredibly hard to do when actually speaking to someone, but I just felt completely at ease with her. She spent hours listening to me and cuddling me and letting me cry, and just being completely wonderful. I can’t say how much I appreciated her visit. Her husband, who is also lovely, drove her up here, and then left us to it for a few hours, and then I had my appointment with Dr O, which she came to with me, and then we came back home and they both came in for several hours, and left at about 9pm. They don’t live close to me, and so it really did mean such a lot that they had made so much effort to come and visit me. I am always amazed that anyone could care about me at all, let alone someone who had never even met me, and had to travel hours to come and see me, just because I am struggling so much. I am immensely grateful that she did though, and just for the record, she gives great hugs! I really can’t thank her enough.

My GP appointment was fairly uneventful I think. Karita may remember more if than I do – I don’t have a great memory about appointments. My mum had spoken to L at some point today, and told me that L had said to ask for blood tests to be done, which she did suggest to me a couple of weeks ago, but I forgot about, and that if my GP was happy to then she could prescribe an anti depressant. How kind! I have only been saying for about nine months that I thought I was better on medication, even if it was only slightly. My GP said that since I have problems sleeping as well then Mirtazapine might be a good one. I can’t remember if I actually laughed out loud at that or just in my head, but I said there was no way I was taking it, and she asked why, and I said because of the weight gain. She said that I knew too much, and that she wouldn’t have told me about that. Suggestion number two was Seroxat. Since I had no actual intention of taking anything that was prescribed due to the whole suicidal thing, I did let her give me a script for that, but it is not a medication I have ever wanted to take, primarily because of the controversy over it regarding stopping taking it, and also the fact that it increases suicidal thoughts in some people. I mentioned the Panorama programme and got told off for knowing too much again. I am sure Karita won’t mind me saying that my favourite part of the appointment was when Dr O was talking to her and asking where she had come from and if she worked etc, and then asked if she had taken time off work, ie meaning today to come and see me, and Karita was clearly thinking in mental health terms and replied ‘no, not recently’. My second favourite bit in the appointment was after telling my GP how suicidal I was feeling, she asked what my parents were doing tomorrow, and said (quite excitedly I thought) that there was point to pointing on, and seemed to be presenting that as a reason to stay alive. My GP is sweet, she is very well meaning, and she cares, but I think Karita would probably agree that mental health is not her speciality, and she does come out with some comments that are either very random, like the point to pointing suggestion, or quite unhelpful, like trying to guilt trip me into staying alive by telling me how it would destroy people’s lives if I killed myself etc. I never find comments like that at all helpful, as of course I think about it – I think about it non stop, and I hate myself for it, and I wish there was an alternative, which is why I continue to seek help even when I no longer want it for myself, but there does come a time when your pain is just too immense, and even knowing how much you will upset the people you care about just isn’t enough, but I think that is probably something that is incredibly difficult for anyone to understand unless they have actually felt that level of desperation themselves. I tried to be honest with Dr O. I think I was, although I did find I was getting more and more frustrated as the appointment went on, and so remembered less and less of what was being said. She just kept telling me that I could keep going, and that I could see the nurse for blood tests next week and then her again the following week, and I was getting more and more worked up as the suicidal thoughts are just so overwhelming. She told me to book the appointments for the blood test and to see her again, and also told Karita to talk to me about things or something when we got home (I’m not really sure – I think she was telling her to persuade me not to kill myself?) and then to phone and speak to her later, but I didn’t book the appointments, as it seemed entirely pointless, and I didn’t phone her, as I had seen her an hour before – I had nothing else to say. She did phone and spoke to my mum, but I have no idea what was said.

The suicidal thoughts are very strong and very overwhelming. I truly wish there was a way out of all of this without hurting people, but there isn’t. I can’t cope, I am completely desperate, and yet again I am in the position where I am next due to see someone in nearly two week’s time. I am out of options. I have told everyone how I feel. I have tried to get help, even when I haven’t wanted it. I have tried to keep going. I have tried doing the things I am supposed to be doing, like going to bed early the other night, going for a walk etc etc, but I still feel the same. It was really great to see Karita – she really was an absolute star, and I love her to pieces, and all of the support I get online is invaluable, but nobody can take away the thoughts, and at times like these when I am alone with them it is just all too much. I have no hope for the future, I have no fight left in me – I have nothing but desperation.

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>Emotional

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

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

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

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

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

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