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

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

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

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

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>I had an appointment with my GP this afternoon, as I mentioned yesterday. I had quite mixed feelings about what to say to her. I didn’t know how much to say. I didn’t know if I wanted help or not. I didn’t know whether I would be able to get help or not, even if I did ask for it. I just knew how suicidal I was feeling, and that if I left there without asking for/getting support then I would not get through the weekend – it just wasn’t going to happen. Within a couple of minutes of me going in she commented that I seemed to be having trouble with my concentration, which I am. I keep losing my train of thought in the middle of a sentence and then just kind of drifting off and forgetting what I was answering. I can’t really remember the appointment very well, I don’t remember what order things happened, or even what she asked really. I know I was in there for quite a long time. I told her how bad my sleep was, and she asked if I had any of the sleeping tablets left, and I said that I did but they didn’t help, which was why I hadn’t been taking them really. She had received a letter from the psychologist that had been sent to L that she had been CCed on, and asked me what that was about. I told her I had an assessment with the psychologist and she had put me on the waiting list for CAT. She asked if there being a psychologist there was new, as she never seems to have any patients who are seeing them, and I said that it wasn’t, but since there is only one part time psychologist in the team not many people get to see her. She asked what CAT was, and how it was different from CBT, and I tried to explain, but my mind was really wandering, so she is probably none the wiser. She asked how long the therapy lasts for, and I said either 16 or 24 sessions, and she asked how long the waiting list was and I said up to 18 weeks. She got very frustrated by that – she said how ridiculous it is that there are such long waiting lists for things like that, particularly when the government are so keen to get people back to work and all that sort of thing – she said it really winds her up that mental health services are so underfunded. At some point I started getting slightly upset – I wasn’t crying, but I knew that if I tried to speak I would start crying, so I just sat there trying to breathe for a minute. She was very sweet and asked what the matter was. When I finally felt like I could speak without bursting into tears I told her that I was just really struggling and feeling really bad. She asked how long I had been feeling like this for, and said (as predicted!) what a shame it was when I had been doing so well. I said I was just feeling really awful and the suicidal thoughts were really strong, and she said how I have felt like this before and that I know it will pass and so I could get through it, and I said that I didn’t want to, I just wanted to die. She joked that if I said that she would have to suggest I started cross stitching again. She asked when I was seeing L, and I said that I was due to see her Tuesday. She talked to me for quite a while asking if I had any plans over the weekend, and if I had any friends I could see or talk to or anything who were supportive. She was very supportive and kept trying to encourage me that I could get through, and said to try and find something I could do over the weekend, and then go and talk to L on Tuesday, and that I could see her again sooner than usual if I felt I needed to, and that she was really sorry I was feeling so bad, but that it would get better etc. I didn’t really know what to say – I find it really difficult to be totally blunt about how bad things are when I am actually speaking to someone, and I just felt so drained, and like I was going to burst into tears, so I said goodbye, and got about 2 feet outside her door and turned around and went back in and said I really didn’t feel able to get through the weekend. She asked what I would like her to do, and I said I had no idea, I just couldn’t cope. She asked if I had the out of hours number, and I briefly explained the mess of when I tried to call a couple of weeks ago. She said that was ridiculous, and that she was going to call the crisis team and ask them to make contact with me over the weekend, and that hopefully having that support would make it easier to keep going. Overall she was very supportive, and I felt like she actually gave a shit about what happened to me. Obviously mental health isn’t her area of expertise, but when I am truly in crisis she does seem to try hard to support me. She spent a long time with me today – I must have been with her for about 40 minutes, and she did genuinely seem to care.

About an hour later I got a call from the crisis team. To be honest I wasn’t really expecting them to call today – I thought it would be tomorrow, so I was quite surprised. I spoke to a man whose name I can’t remember who actually seemed perfectly nice. Initially I thought it was going to be one of those quick ‘oh great, we’ve had a Borderline referred, better give them a quick ring’ calls that I have had in the past. He did things like asking if this was the first time I had felt like this (I always wonder why they ask things like that when they quite clearly have your notes in front of them) and then asking what had helped me get through in the past, or if after a while I just started feeling better, and when was I next seeing L. I said that nothing really helped, but that after a while it would start to get a bit easier. He said the stuff about how if I have got through it before then I could again, and I said that I didn’t want to. That I was sick of getting through a really horrible patch just for another one to come along, and that I just didn’t want to be here any more. I also said that this was actually the worst I had felt for quite a long time – that the suicidal thoughts were stronger this time than they have been for a long time. He asked how long, but I didn’t really know – again, my whole conversation with him was rather stumbling and confused as I just couldn’t think properly. I said I have been feeling bad for years now, and things never get any better and that I have just had enough – that I don’t want to be here. He asked if I had any plans regarding suicide, and I said that it was all I could think about. He asked what I would do, and I said that I didn’t want to say because that makes things rather awkward (as in my experience they have then merely attempted to take away whatever method I say I am planning, which doesn’t solve anything, as I am still left with the feelings). He asked if I had the means to carry it out, and I said yes, and that if I couldn’t use one method then I would use the other that I consider. He asked if I would call someone if I felt I was going to act on my thoughts, and I said no – that if I was any closer to suicide then I wouldn’t want to speak to anyone because I wouldn’t want to be stopped, and that it was difficult enough to tell Dr O how I was feeling, but that if I was about to do something then I would not call anyone, as it would seem completely counterproductive – if I was any more suicidal than I am now then I would just want to die, I wouldn’t want to talk to someone. We talked about my sleep, and how the nights are when I feel most unsafe, as I know I have quite a few hours when my parents are asleep, and so it would be quite a long time before anyone found me etc. He asked about plans for the weekend etc, and I said I didn’t have any. He said that the crisis team could visit me tomorrow, but that I needed to commit to keeping myself safe and would that be ok. I said I couldn’t promise that – that I could try, but I couldn’t give him a guarantee, because I didn’t know for sure, and there would be a chance I wouldn’t be able to. He asked why not, and I said that if things got too overwhelming then I couldn’t be sure I wouldn’t act on the thoughts, and he said that he was hoping that if they were seeing me and giving me support then it would stop that from happening, but that he understood and wouldn’t ask me to promise, and that they would come out to see me tomorrow. He did ask me more, but I can’t remember, and I can’t remember the order of most of the conversation. At first I felt like he was just going to make a quick five minute phone call where he would ask when I was seeing L, reassure me that I had got through times like this before, and say to talk to L about it when I saw her, but actually he talked to me for a long time, and was pretty thorough and reasonable. He said they would come out and visit me tomorrow, but that if I needed to speak to someone before then I could call, and he said that he would give me their number, which he shouldn’t really do until after they had seen me and assessed me, but that if I needed to call then to phone that, which goes through to a call centre where you leave your name and number, and someone would then call me back as soon as possible. So I have them coming out to see me sometime tomorrow, which I am quite nervous about. I would actually really like it to be him that came out, but that is very unlikely. It’s funny, as usually I am much more comfortable with women than men, but the women who work for the crisis team seem to be either patronising, dismissive, intimidating, or a combination of the above, whereas there have actually been a couple of men who have seemed very reasonable. I am pretty much expecting it to be a couple of the scary women (there is one in particular who I have seen several times who I find really intimidating so am really hoping it isn’t her) who will come out and either be very dismissive and say that I seem to have suicidal thoughts frequently and that I can get through this and to talk to L on Tuesday, perhaps also breaking my confidentiality by talking to my mum and telling her to confiscate all pills and dressing gown cords etc as I am a suicide risk, as that tends to be my experience with the crisis team, but I am really hoping it isn’t like that. It is over two years since they last came out to see me etc – I think I have been referred one other time since then, but someone just spoke to me on the phone and decided I would be ok, and I have been assessed by them several times in A&E, during Summer ’09, but I haven’t actually had a visit from them for over two years, and I am a bit nervous. I hate the way they always visit in pairs – it feels really intimidating. I just really, really hope that it is someone who actually takes me seriously and tries to help, rather than just dismisses how I am feeling in the way that they so often seem to. I tried to be really honest with the man on the phone, as I figured it couldn’t do any harm – it couldn’t take suicide away as an option, but it might get me some support. I hope that I can do the same tomorrow, and that they actually take me seriously like he seemed to. I suppose if they don’t I won’t be any worse off than I would have been had I not seen them though. And it might help. The difficulty is, that as I explained to him, it is the night time that I feel most unsafe, and even if they are doing daily visits, they can’t be here now, when the thoughts are at their strongest. But I will just have to see how it goes.

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>I have tried

>Firstly, thank you all so much for the comments on my last entry. You were all so supportive and caring, and it really did mean a lot. Quite a few people suggested I should be in hospital, or go to A&E, and a few people asked why my care plan says to avoid being admitted. That is kind of difficult to explain, partially because I don’t completely understand myself. This entire paragraph will attempt to explain, and is long, so please skip to next paragraph if this doesn’t interest you! I do know a few reasons why L wants to avoid it, and therefore put it on my care plan, and I can completely see where she is coming from in that sense. There is still a lot of stigma surrounding BPD, and this is apparently pretty rife both amongst the hospital staff and the crisis team staff. I haven’t been in hospital since being given the BPD diagnosis, so can’t comment on that, but from my experience I would agree that the crisis team seem to have a poor attitude towards PDs – when I switched GP a couple of years ago which put me back under this trust for Mental Health, I was seeing the crisis team (the GP referred me) and they said they would continue to see me until I was taken on my the CMHT, which was likely to be a few weeks away still. Then one day they had contact with the old CMHT, were told I had a PD diagnosis, and when they visited that day their attitude was completely different, and they didn’t see me after that, despite it still being a couple of weeks before I was due to see the CMHT. I can only assume that was down to seeing a PD diagnosis, rather than the depression etc the GP had discussed when referring me. It didn’t seem to matter that I was still feeling very suicidal and had attempted suicide only a month or two earlier – they just dropped me. So I could see that attitude in the crisis team then, and it is apparently equally bad amongst the hospital staff. During summer 2009 I ended up presenting at A&E three or four times due to suicidal thoughts etc. Despite making my feelings and thoughts known clearly, I was sent home every time, after perhaps a 10 minute chat with the crisis team, who would generally then speak to my mum and tell her to make sure I didn’t have access to any tablets or dressing gown cords etc, as I was suicidal. One time she asked them to admit me as she said she couldn’t cope, but I was still sent home. At that time I really was not well at all – I was possibly a slightly lower suicide risk than I have been at some other times as I was just so confused etc. I wouldn’t go anywhere, even outside of my room, without my teddy bear, as I thought that he could protect me and I thought people wanted to hurt me. I didn’t trust anyone, even my family. I wouldn’t put the teddy bear down under any circumstances. I spent the whole time crying, I was possibly a bit delusional, and I was also having suicidal thoughts. I sat there crying, clutching my teddy bear (yes, I was 23) telling them that I wanted to die and that I was going to kill myself but that people were trying to get me. I was still just sent home with no follow up, despite my mum asking them to admit me. That was the last time I went to A&E, and the last time I saw anyone from the crisis team. I have no trust in the crisis team – I don’t feel like they care if I live or die, except for any inconvenience I might cause by dying, but luckily for them I have a BPD label, and therefore if I did successfully commit suicide after seeing them they wouldn’t have to explain anything too fully, because they can always say with BPD that there is constant risk and therefore you can’t be kept safe, or something along those lines. So essentially my diagnosis is a major reason why L doesn’t think hospital is appropriate – not because she has a problem with it, because she is one of the few professionals I know who gets really angry about the way people with BPD are treated in services etc, but because she doesn’t want me exposed to the type of attitude that so many of the acute services staff do have. I think that is a valid point, and I can understand the reasoning behind it. Another reason is that she thinks that the vast majority of times hospital actually makes people worse rather than better. Therapeutically it has no value, as there is no therapy there, and so unless it is essential for medications to be altered or something, she thinks it rarely helps. Again, I have to agree that there is no therapeutic value – it is essentially somewhere to keep you safe until you can be safe at home – for that reason I think it can have value, but she has pointed out in the past that if someone is determined to kill themselves then they will do it wherever they are, and that people do successfully commit suicide in hospital. Another reason is that she thinks it is really important that I get through bad patches without hospital or crisis team intervention, to see that I can do it. She doesn’t want me to get reliant on hospital, and feel like I need admission every time I feel suicidal. Again, I think that is a good point, and it is certainly something I have seen happen, both with friends in real life, and on blogs I have read. If you don’t start learning to cope with the feelings outside of hospital, then you never will be able to, and she doesn’t want me to be a revolving door patient. I really do understand where she is coming from with this – I don’t want that either, and I know that even in the past year for example, there has been more than one period where I have felt bad enough that I haven’t felt safe, and other care coordinators perhaps would have had me admitted, and yet I have got through them. However, I also know that if I look back at my history, there have been two genuine suicide attempts, three years apart, and both times I was honest about how I was feeling beforehand and tried to get help, but couldn’t. There have been other times when I know I would have acted on the thoughts had I not received the extra help that I had at the time, whether that be from the crisis team or hospital admissions. So I suppose that is a kind of risky strategy in that most times, yes, I will cope without hospital, and that is obviously a positive thing, but there will also be times when I can’t, and if more help isn’t available then that could lead to a suicide attempt, which could of course kill me, as that is the intention. So basically they are the reasons why my care plan says to avoid admission wherever possible.

For those who suggested that perhaps I hadn’t been able to explain fully how bad things are – I do think that is something that is difficult to do, and that I am not always able to do in person. However, the day before I am due to see her I always email her everything I have written since the last time I saw her, which is primarily what I write on this blog. It is edited slightly – sometimes I will write things in what I send to her that I won’t post on here for various reasons, and there are things I write on here that I don’t send to her. But not anything to do with my mood or thoughts – all of that remains unedited, and so essentially she gets to read everything that people who read this blog read. The things I don’t send are for example if I have discussed what happened in an appointment, I don’t bother sending that to her because she already knows. In general though I am very honest, and I do send her things that I find difficult to imagine her reading, which is why I try to edit as little as possible, or I would end up cutting a lot of things out, so for example I leave in things like my views on the mental health service, and when I don’t feel like I am getting enough support, and when I feel like she has let me down or isn’t there for me etc. So it is very honest, and is difficult to do, but I know that the more she knows the more she can help me. So whilst I may not always express quite how bad things are in person, she reads virtually the same as all of you read, therefore I don’t think I can really make things any clearer. Seemingly what I write here is enough to concern people at times, judging from comments, and she sees the same thing. I think the fact that a lot of times I have managed to cope, leads her to have more belief in my ability to get by than I have, and means that even if I say outright that I can’t cope, she generally believes that I will manage to. I appreciate that she has that belief in me, and I am more pleased than I can express that she isn’t like my old care coordinator, who sent me to A&E if he thought there was any chance of me acting on my thoughts, and also insisted on breaking confidentiality and speaking to my mum if I mentioned the word suicide, as that means I am far more honest with her than I could ever have even considered being with him. However, it does sometimes mean that there are times like now, when I don’t feel able to cope, and yet I am left without any support, and I honestly don’t know how to deal with that.

A couple of hours after posting last night, when I had read the first few comments on the post, I decided to email L. I didn’t know what to say. So I said that. I then rambled a little about feeling like things were getting worse every day, and I really felt like I needed more help if I was going to get through this, but that I didn’t know what or if it was an option, but that I felt like I needed to ask so that I could tick it off in my head as trying to get help, and then went on to say I had attached what I had written in the last week (basically sent everything from last Wednesday to last night’s post – I think the only edit was describing what happened in the appointment with the psychologist, because she will already have been told about that. I left in everything else, including all the stuff about not feeling like I was getting enough support, and that I feel like services assume I will just get by because I usually do. I then apologised multiple times for being a nuisance and said how desperate I feel, and I think that was about it. Except it somehow took about three times as long to say. Just add some more confusion in and you get the idea. I then sent it and within about 10 minutes wished I hadn’t, as it seemed pointless and kind of scary, even though I trust her. I nearly sent another email telling her to ignore the last one, but I thought she would probably read it anyway, and that it might then look a bit manipulative or something so send a second one saying not to look at the first one. So I left it. I haven’t heard anything. She didn’t reply or phone. I don’t know if she wasn’t in work, or if she was too busy to contact me, or if she didn’t see the point or what. But at least I have tried. She now knows exactly how I feel, or as much as I feel able to put into words anyway, and I have actually directly said that I need more help. If I can’t have more help, which I suspect will be the outcome if she does get back to me, then at least I have tried, and so kind of feel like I have done everything that I can and explored all options, which is what I always say I feel people should do if possible. But I have tried.

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