Monthly Archives: January 2015

Judgement in the MH services

The single biggest thing I hate about my experiences with the mental health system is having been diagnosed with BPD/ EUPD.

I understand that for some people receiving the diagnosis is a relief, it explains how things are for them and gives them a way forward. For me though, I don’t feel it fits. I received the diagnosis whilst on section on a psychiatric ward and very much not myself. I was angry at the world and fighting so hard not to be alive. I received the diagnosis from a psychiatrist who had known me for less than two months and had never seen how I presented when in a better place.

Today I had an appointment with my psychiatrist and care coordinator and it aptly portrayed everything which is wrong with the way mental health services treat those with BPD. It was meant to be a review but ended in me upset and angry because I didn’t feel listened to. I was trying to be honest in that I don’t feel safe with 7 day prescriptions and received the answer that I need to take responsibility for keeping myself safe. I feel that I am doing so, by admitting that I can’t manage more than 3 day prescriptions at a time. I was then told that I use my mental health problems to elicit care from others. At this point I lost it and cried and argued that for me that’s not true. I don’t want care from the services, I wish I never had to have any dealings with the mental health services. I wish I didn’t know what it’s like to have your personality ripped to shreds by psychiatrists. I wish I’d never been in hospital or had to take medication. I wish I could just be normal. My biggest fear is to be attention seeking or needy, it’s what stops me from reaching out when in crisis because almost always the response is ‘you have BPD, it’s not a true crisis/ you just need to practice mindfullness/ you need to stop attention seeking…’ I may have overreacted and lost my temper, but I meant what I said. A psychiatrist who has known me for 6 sessions does not know me well enough pass judgement on my personality. Luckily this psychiatrist is moving and I am changing teams so a mixture of circumstances mean I don’t have to deal with him again, but the fact remains that BPD is still on my notes.

I don’t agree with my diagnosis. And it doesn’t matter how many professionals tell me I fit the criteria I will continue to fight against it because I don’t think it explains things for me

Food shopping with an eating disorder

Something you don’t see when people talk about eating disorders is the effect it can have on simple every day tasks. For me, one of the hardest tasks is food shopping. This comes with a trigger warning.

In the depths of my anorexia I used to prowl the supermarkets, walking round and round the store for hours on end often attracting the attention of a security guard for suspicious behaviour. I still vividly remember the relief I felt when I was inpatient and discovered I wasn’t alone in that experience.
I would look forward to Saturday when I would walk 45 minutes to the big Asda in clapham with a sort of desperation and spend a good hour walking round the supermarket living vicariously through other people’s baskets. I would wander around the vegetable section looking for the perfect broccoli for dinner and picking out 5 flawless apples, always Braeburn, for my lunches. Then the frozen section for prawns and the drinks section for almond milk and diet coke. Finally I would buy sugar free jelly by the basketful and sachets of options hot chocolate. And that would be it. It would cost me the princely sum of £15 for a week’s shopping and walking back to my flat I would feel as if I had nourished myself. It was in fact the opposite, my shopping was usually carried out so as to skip lunch. I remember being so desperately embarrassed by people looking at my basket, fearing that they would consider me greedy or wonder why I was eating.
And there was the sheer overwhelming nature of a shopping trip which at times rendered me completely incapable of decision making. I remember being told by my therapist that I needed to have sandwiches for lunch. I went to the supermarket and spent nearly three hours picking up and putting down loaves of bread, reading and rereading nutritional information, frozen by panic. I came away with the lowest calorie bread of which I replaced my lunch of an apple with a single slice of bread folded in half. And I convinced myself it was a sandwich.
When I started getting overnight leave from inpatient food would scarcely feature and instead I would distract myself by going from supermarket to supermarket, I knew all the offers and new products even if I never bought them.

With bulimia too supermarkets became a place of pleasure and torment. Restricting somewhat outside of my binges I fall into the same routines I fell into as when I was anorexic. But there’s the added embarrassment and fear of binge food shopping. Again it involves so much time, time that could be so much better spent than spent in agony of indecision torn between 36 and 38 calories. And there’s the way you hover in front of fear foods, food you don’t want to eat but you also want eat and won’t allow yourself to normally. Then very suddenly it’s dropped into your basket. You feel like everyone is staring at you as your basket fills with food you are terrified of, food that will be all flushed down the toilet in a couple of hours time. It feels like you have this flashing sign ‘BULIMIC’ over your head as you pick up and put back the same product five times, walk round the shop three times before avoiding everyone’s eyes whilst you quickly scan everything at the self service till.

On the times you’re not binge shopping it’s still a numbers game. 400, too many. 300, maybe but hang on what’s the saturated fat? No? Okay well that one’s 289 so that one should do. But wait, there’s one there you really hate the sound of but it’s 267. That one then.

And on and on and on.

When mental health care works

My last post wasn’t the most positive of posts and didn’t really show mental health services in a glowing manner.

I owe them an apology because this week they’ve really stepped up. My mood has been terrible, I’ve been sitting for hours looking up the lethal dose of paracetamol, working out how long it would take to die and how would I hide it. I hit the bottom of the rabbit hole again and found myself crushed by the dark thoughts in my head.

And the mental health services have listened. I’ve had daily phone calls from the crisis team and whilst not life changing (how could they be?) they’ve given me something to face each day for and the opportunity to voice and have someone hear how awful I feel. On Friday I saw my CPN and she was kind and sympathetic, she heard me when I said I couldn’t go on. I’ve been referred to the day hospital again and have an assessment there next week. And whilst I wish it hadn’t come to that I’m hoping it can reinstate a bit of stability. I have a home visit from the crisis team tomorrow. From feeling very unsupported and lost I feel I’m being heard.

And I can’t talk about support without talking about my mum and how wonderful she’s been. Mum is my rock, every other time I’ve been unwell I’ve held her at arms length and refused to talk fully about how things are. But she’s never given up. This week has been horrible for her too and yet she’s listened to me when I’ve been suicidally low, she’s not given up when I’ve told her my plans and she’s been there to hug me when I’ve run out of words. Last night was one of my lowest points and she helped me turn around so instead of facing the bottom I could see a bit of light again. We drew up a list of my hopes and dreams for my future, challenged the suicidal thoughts and ran around a hill screaming and shouting until we couldn’t breathe for laughing.

Like many people I’m quick to see the negatives and catastrophise when things go wrong, but sometimes you have to acknowledge and celebrate the positives. This week has been hell, but I’ve not been left alone in that hell. And that’s important.

When help is a postcode lottery

So yesterday the government announced an aim to reduce the level of suicide related deaths to 0. On that same day I was feeling utterly suicidal, I was sat at the table counting out paracetamol, googling what dose I’d need to take and self harming. I managed not to take any pills but I came very very close.

In order to reduce the rate of suicide to this level we need better funding for mental health services. We need accessible services and services that listen to and hear service users. We need more than to be told to have a cup of tea or take a shower. We need to be heard.

Yesterday my mum came home to me in a soggy mess. I was torn between not wanting to hurt my family and wanting desperately to overdose and take my life. My mum is amazing and she was an utter lifeline last night. She phoned the crisis team for me to try to access some form of help.

Now you would think on a day where mental health and suicide were such prominent topics that it would be easy to access help?

Not so. Mum phoned the crisis team and reached the switchboard, it took half an hour to be transferred over to the correct team. Only that team wouldn’t deal with me. Despite being the team i’m currently treated under because my address falls under the remit of a different county team I’m suddenly not able to access them. Apparently I’m being referred to this other county’s team but that referral hasn’t been completed yet and so I couldn’t access help from them either. At a time when my mood has been crashing and I’ve been trying to tell my CPN that for weeks I suddenly found myself without the support of my mental health team all because of my postcode.

It took an hour before we got anywhere. And that anywhere was that I couldn’t access their service for help. Even though my CPN is on that team, even though I was suicidal and in crisis.

The only way we could get any support was for mum to take me to A&E, I had a self inflicted laceration to my arm which we wanted to get checked but mostly I needed some help and that was the only way we could access it. A&E were kind and understanding but it’s never an easy place to be. I did finally get to see someone from the mental health team and she was helpful. I was listened to, which was all I needed, and offered support including a possible day hospital admission. And it made a huge amount of difference. I came home feeling still very low and anxious but much less desperate and suicidal.

All I needed was access to the mental health team and for someone to help, yet my postcode made that nigh on impossible. And that shouldn’t happen.

Endings

Last June I was on the home straight of my degree. I was finally about to complete it and be done with my time at Imperial as a microbiology student. I should have been excited, planning the life I would lead. Instead I was visiting two or three pharmacies a day buying packets of paracetamol, sleeping in bed sheets crusted with blood where I’d opened deep wounds on my arms each night and fielding daily visits from the crisis team. Meanwhile I was going into university and completing days in the lab followed by hours writing my dissertation and presenting as a normal slightly stressed student to my supervisors.
Truth was I was planning to kill myself on the 6th June- the day I would complete my degree. In my mind my degree was the final loose end to tie up. To make everything neat and completed before I killed myself.

Yesterday I sat in an office presenting my dissertation to two academics. I ran through my PowerPoint and then was questioned, intensely, on aspects of my project and my entire degree. I would love to say it went well but my anxiety hijacked the meeting and I clammed up. Still I came out of the meeting and it hit me.

I’ve finished my degree. And I’m still alive.

The thought should bring me elation and gladness. Two years ago I was dying of self inflicted starvation. 7 months ago I was stockpiling for an overdose. I’ve been on self destruct for so long I don’t know how to feel now. I still feel very similar in terms of thoughts and mood. But I feel trapped in that if I act on those thoughts I would destroy my family. I’ve finished my degree and I’m still alive. And I don’t know how to live with that. I’m glad and I’m terrified and I’m angry. I don’t want to be like this but I can feel myself spiralling again.

The difference this time is I’m asking for help. It’s just getting people to hear me is hard. I saw the ED services on Friday and the overriding message was that unless I stabilise my weight, bloods, mood, self harm, purging, eating and suicidal thoughts before I start treatment I will be discharged as they’ll be unable to offer effective treatment. But no one can offer me any ways to help me do that. My CMHT team is moving my treatment to a different county team due to my postcode so I’m losing the CPN I’m only just beginning to trust. I’m trying to tell people I’m falling again but it’s so hard to be heard.

Stay bubbly

I read a book a while back called Pretties. In the book the characters lived in a world where everyone became pretty and in doing so gave up their ability for free thinking. There’s a description of the bright moments and fierce joy in being alive which they call ‘being Bubbly’.

Sometimes I think that’s what life with a mental illness is a bit like. For me I spend my days with my head and heart in a fog, I can’t see clearly or concentrate properly. The world is fuzzy round the edges and life ceases to have any importance. I feel like I’m watching the seconds of my life tick by, waiting for the next time I eat or sleep.

But there are moments. Moments where I am ‘bubbly’. Where I feel like a bottle of champagne shaken up with bubbles rising in glorious abandon to the surface. Those are the moments I’m going to write about today, because they are as important, if not more so than the bad moments. To paraphrase what a very close and wise friend once quoted Doctor Who to me ‘the good times do not cancel out the bad times, but that does not make them any less important’.

So these are the good moments, the bubbly moments of this week.

Last night I sat in a full cinema next to my mum and saw the most inspirational and moving film I’ve ever watched- the audience seemed as one, we laughed and gasped and held our breaths throughout, not a single person left the cinema in the entire screening. If you’ve not seen it then I urge you to put some time aside and allow yourself to be charmed by The Theory of Everything.

On Tuesday night I was to be found pouring sweat, dancing inelegantly and uncoordinatedly at my keep fit class, getting a big hug off the instructor who first saw me descending into anorexia, and leaving on an endorphin high.

Last weekend mum and I spent a happy hour wandering Oxford, taking photos, tourists in our home town.

It may be just three moments. But that’s three moments where for an hour or two the darkness lifted. And that’s not to be overlooked.

‘Stay bubbly’

2 years ago

Two years ago today I went into the unit I was a day patient on for what I thought would be another hard slog of a day filled with tears and food and purging.
I had therapy that morning and I remember breaking down and telling my therapist how I was purging on my way home from the unit, walking miles between every meal and snack (i decided one day to walk in the dark from Chelsea up to victoria and back in an hour), I was burning myself daily and had open sores all over my legs, I was exercising late into the night before getting up at 7am to come to the unit for breakfast. I remember crying and crying as I told her I couldn’t do this anymore and wanted to die. I don’t remember very many of my early therapy sessions but I remember this one vividly. She told me that she would be recommending that I was made an inpatient, that she would be talking to the team when our session finished. I didn’t believe her. In my eyes I was the pity patient on the unit- the one everyone laughed at for being the fattest there and being deluded enough to think she had an ED. It wasn’t true but at the time I was convinced of it.

My therapy session finished at ten and I was still crying when it came to morning snack at 10:30. I remember breaking each of my four biscuits into four pieces, crumbling the edges and gluing as much chewed up biscuit as I could to the roof of my mouth to spit out as soon as snack was over. Only half way through snack the ward matron came in and pulled me out. Everyone around the table seemed to know why except me. I was taken into the meeting room with him and the nurse who would become my key nurse and my greatest support and told that they’d spoken to E, my therapist, and that room 11 was being made up for me as I had to become an inpatient. They were kind and sympathetic, telling me I hadn’t done anything wrong, but I was beside myself. I’d managed to avoid any weight gain as a day patient but now that was impossible. I’m quite certain that had I refused I would have been sectioned but in my terrified state I sobbed and sobbed then followed them to room 11 where I stood staring around like a rabbit in the headlights. I wanted to go home to get my clothes and all the stuff I would need but I wasn’t allowed, instead I had to ring my flatmates and tearfully explain that I wouldn’t be coming home that night.

Throughout the day I had many knocks on my door from other patients checking I was okay but I hid away all day only appearing for meals and snacks. I just remember being freezing cold and terrified. And angry, as soon as I discovered I had no leave so my usual daily 10km walking wouldn’t happen. My flatmates arrived with a bag full of clothes and the ward gave me a set of primark pyjamas. I refused to unpack, certain that I’d be discharged in the next few days. As it turned out I spent the next 3.5 months as an inpatient before going back to day patients.

It’s weird thinking back to that first admission. I was so utterly terrified and although I was angry I barely spoke a word. I just cried. A very different story to my last few admissions which have been full of anger and refusals and challenging everyone who tried to help me.