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Posts Tagged ‘treatment’

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

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

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

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>Horrible day

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

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

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

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

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

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>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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>Just stop

>It is 5:15am and I am not remotely sleepy, and am feeling very tense, despite taking 10mg Diazepam. The suicidal thoughts are really in full swing, and although I am not intending to act on them tonight, it doesn’t make them any weaker or easier to cope with. I think I might have to have another Diazepam, as when I feel like this my thoughts just go into overdrive and I have absolutely no chance of sleeping.

I am feeling so alone. I know I have support online, and I am truly grateful for that, but in real life I have absolutely nothing, and it is hard. Actually it is much worse than hard. I desperately feel like I need some support, but there is nowhere to turn. My GP works Wednesdays, but there is no point contacting her, as I have grasped exactly what she thinks from my mum speaking to her last week, and she has certainly been turned against me. I could phone and speak to whoever is on duty at the CMHT, but a) I don’t trust that it won’t be a fuckwit on duty, as there are several of them, b) they will all be against me too, and c) they will either suggest going for a walk, having a bath, or listening to music, and none of those are remotely helpful suggestions at the moment. I always find walking very anxiety provoking – I am always paranoid that someone is following me, and it really does scare me. I find baths the opposite of relaxing. I hate just lying there with my thoughts. I don’t see how that is supposed to be relaxing or helpful. And I usually love music, but as I have explained on here before, I find it really difficult to listen to at the moment unless there is a particular song I need to hear – otherwise it just sounds like irritating noise that is drilling through my head, even if it is a CD I usually love. The TV is similar – I get a headache within about 5 minutes of turning it on as it just overwhelms me. And I can’t concentrate to read. So essentially, anything they might suggest I do is useless, and therefore I am fucked.

I miss L. I know that sounds weird, given that she has been turned against me, and hasn’t done anything to help me lately, but I do. I guess that is why attachment issues are such a bitch. Even when you know someone isn’t helping, you can’t get over them. I was thinking about it, and actually I don’t think things have ever been quite the same with her since that time in November when I felt very let down by her. Things did get back on track and feel ok after that, but I suppose I never had quite the same level of trust in her following that, and now I feel like she doesn’t care about me at all and doesn’t care what happens to me, as she just left me with an appointment for a fortnight’s time when she knew how awful I was feeling. And yet I still miss her. That is wrong, and it pisses me off. I am angry with myself for wanting to talk to her. I don’t want to miss her. I want to be angry with her. But every time I am feeling desperate I just get this overwhelming desire to talk to her. And yet last Thursday and Friday when she was in work, and I could have rung her, I didn’t because I was just too upset. I feel really confused about the whole thing. I suppose it is a bit like the situation with my mum. I still feel like she has been turned against me where my mental health is concerned, but I still love her despite that. I feel let down by her, and I feel like she either doesn’t believe me, or doesn’t care about me any more, in much the same way I feel about L, but she is still my mum, and I still love her. I just have to accept that I can’t rely on her for support. And I suppose it would be the same with L, except our whole relationship is based on support, as that is why she is there, which makes it much more awkward, But of the CMHT she is still the only person I want to talk to. I feel lost and alone and desperate, and like the people I have relied on and trusted the most are no longer there for me. I really feel like I can’t cope.

I have rehearsal again tonight. It is going to be a long one, as I have to get there an hour early to work on my solos with the musical director, and then I have the normal rehearsal, so I will be there from 6:30 until at least 10, possibly 10:30. It’s all too much. I want to scream and shout and cry but I don’t think that would be appreciated by my parents or my neighbours given that it is 5:30am. I just can’t cope. I want out. I want to make everything stop. Just stop. Why isn’t it getting any easier? Surely it should be getting easier. And it isn’t. It just gets harder and harder. I don’t believe that these thoughts and feelings are going to go away without me acting on them. It is too intense. And it feels like the right thing to do. I don’t want to wait for them to pass. I just want to make it all stop.

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>Crisis team phone call – 2

>The crisis team did call back as promised, at about 8pm. It was the same woman. Why is that I never get to speak to/see someone from the crisis team more than once unless I don’t like them? She asked if I had spoken to my parents, and I said no. She asked if I would like her to, and I said no thank you. She asked why not, and I said that I didn’t feel it would be helpful, as if I was going to act on my thoughts and knew my parents would be checking in on me in the morning, then I would use a method where time wasn’t an issue. She seemed to ignore that and said she really thought I needed to speak to them, and that if they felt I was at risk and I hadn’t spoken to them tomorrow then they could break confidentiality and speak to them without my consent. Just what I wanted to hear – that makes me feel so much more likely to be honest with them about my feelings. To be honest, I don’t understand breaking confidentiality. I feel like if they are concerned enough about you that they feel they have to break confidentiality in order for you to stay safe, then you aren’t receiving the right treatment – surely if they are that worried then they should be considering admitting you to hospital, and if they’re not then I don’t see what right they have to break confidentiality. That is something that really pisses me off. If I was living on my own or in supported housing they wouldn’t call my parents to let them know how I was, so why should they just because I live at home? It is something I have had problems with multiple times in the past, both with the crisis team and CMHTs. I think L is probably the only care coordinator I have never had that concern with – I know she wouldn’t do it, which is one of the reasons I trust her so much I suppose. So yes, that really annoyed me. She said to speak to my parents tonight and get them to come in and check on me before they go to work (which would probably be an hour after I got to sleep and would disturb me well and truly) and that then they would call me first thing in the morning (presumably to disturb me again). Bloody hope it isn’t her.

She went on again about how I had got through this before and so know I can do it, and that things do get better. I said that I feel like I could never feel good enough to make it worth feeling this bad. She said we were talking in circles. It is apparently ok for her to talk in circles though, as she repeated that things aren’t usually this bad, and that I have got through bad times in the past, and that I have obviously been doing a lot better in the last year or so because it has been a long time since I have been under their care. I didn’t bother to tell her that is because L doesn’t think it is helpful to see that and so usually just supports me herself when I am in crisis, unlike my previous care coordinator, who made me go to A&E and be assessed by them every time I was feeling suicidal. She also said that I am an intelligent girl and I understand my feelings, and that she thinks that by engaging with them that shows that I want help rather than to die. She is the type of professional I just don’t get on with. I am sure she is a perfectly nice person, but I do not like being treated like a child, and I find it patronising when a professional tries to tell me that I am not really suicidal because I am asking for help or something like that, as I know how I feel, and how difficult it is to ask for help, and how much my feelings regarding help vary. I am feeling really quite frustrated and wound up.

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