Hello again. 

It’s been such a long time since I’ve posted. So I guess I better say hello. I’m Becca. I’m still inpatient at the same hospital. I’ve been here just over a year now. It’s weird looking back to my acute where I was being restrained and injected every day. That doesn’t happen here. 

Things can be so tough. The new year for me is a very difficult  time. I saw in the new year with a Pepsi max sat in my room. I really didn’t want to see in the new year. As things slipped I lost things- home leave was taken away. My bedroom door was locked. And then they started me on clozapine. I’ll be honest, when my consultant prescribed it was terrified. It’s one of those drugs that seems so frightening and hard. But I’ve been on it for a while now and apart from knocking me out it’s not been too bad. Maybe it even has helped my nighttime sleep! 

But as I write this I am unescorted in the car park- for only the third time I’ve been outside on my own in nearly 18months. And I’m counting down the hours until I go home tomorrow. It’s hard, inside feels such a struggle and unmanageable, sometimes I don’t think I’m going to be free of my past and my illness. Often I feel hopeless, but even then my family, my friends and my boyfriend help carry hope for me. 

Thank you all for sticking by me, for reading my blog. I love writing my blog it’s just so restricted here. 

An update

I realised I haven’t really updated you on where I’ve been when I disappeared for a while.

A few months ago things were starting to look brighter and I felt like the old me was there, just slightly out of reach. I remember going to my CPA armed with the fact I was the happiest I’d been in years. I had persuaded myself that I might get home overnight leave, that my section would be lifted. I remember being so angry when it became clear neither of those dreams would be happening. I couldn’t understand why they couldn’t see how happy I was.

A few weeks later I found myself spiralling again. I was spending hours looking for anything I could self harm with. I remember one leave where I spent the whole time secretly searching the ground for sharps. I catalogued every sharp I saw, planning to get them on my way back. I soon discovered I was never going to be able to pick them up. My eating slipped again and very quickly I found myself fully in the throws of my eating disorder. It took several hospital visits for me to relent and stop refusing my ensures. I still haven’t got up the courage to eat instead of using ensures and fruit. I hate ensures, but at the same time I couldn’t move onto solid food, they became my safety net. As my weight dropped so did my mood and I lost control of my hallucinations. It stayed like that for a long time. As I wasn’t eating and I was fainting around the ward I lost my leave, I lost my unsupervised shower. I felt like everyone was the enemy, that they couldn’t understand.

Then slowly again things began to pick up. There was a lot of tinkering with my medication but slowly it seemed to be helping, finally. I came into hospital taking only two psychiatric medications. Now I take a lot more. Haloperidol worked but gave me painful side effects. Respiradol might as well have been a sugar pill. But now I’m taking a different anti-psychotic and suddenly I found myself again. I started reading again, I started DBT which really helped, I was able to smile and talk to staff, I wasn’t afraid of laughing with other patients. The side effects kicked in, I’m so shaky I cant hold a cup or walk down stairs. I get verbal ticks when I’m talking. But it’s given me myself back and I’m not willing to lose that. My leave was reinstated. I got home leave and I got to see my house for the first time in over a year. I get time out with my boyfriend too and we go to the cinema. I love being surrounded by people who had no idea I am sectioned.And as the weather improved found the courage to wear t shirts that didn’t cover my scars, and no-one even blinked. Things are good. Yes I’m still very stuck in my eating disorder but otherwise I’m content. I’m starting to see a future. I have my books and time to see my family and my boyfriend outside of a visitors room. Yes I get lows but I’m getting there and that feels wonderful.

 

Acute services with an eating disorder

Inpatient wards are never nice places to be; they can be frightening, frustrating, dictative  wards. Anything other than specialist eating disorder units where the service is designed to support and treat the eating disorder service users are suffering with can make acute or other specialised support all the more difficult.

My first inpatient experience was to an eating disorder unit. I remember sitting in costa after being told I was going to have to start inpatient treatment for anorexia nervosa the next day and phoning to mum to break the news and then having to tell my university that I would have to defer absolutely terrifying. I had only been involved with the eating disorder outpatient service 4 weeks and still hadn’t accepted my diagnosis, it all felt rushed and I was resistant to being classed as an anorexia sufferer. I can’t remember my first month or so but slowly came around to being in treatment and it was refreshing to find others like me who had the same thoughts and experiences with anorexia. The groups were all designed directly to focus on anorexia and drive the sufferer forward in their recovery. There was the medical side of it which never stopped being utterly traumatic in my ten months there and I resisted the weight gain side of treatment and at discharge I barely made any head weigh with the weight side of things but I also left with a whole set of skills and a group of friends who truly got it.

Maybe my experience having first been such a safety net and so understanding has made me biased but I’ve never been able to recreate the experience in acute wards. All my admissions since the EDU have been to acute wards and suddenly I was thrown into the world of adult mental health. Each time I have been hospitalised I’ve relapsed to anorexia, maybe not in weight although in some cases lost a significant amount of weight but in behaviours. Every time it’s reached the level where I stop eating and drinking completely. It’s hard on an acute ward to cater to account for all service users difficulties where the funding is low and the supply so demanding. It means though that eating disorder patients can easily slip through the net and only picked up upon when crisis level has been reached. I’ve found that as I’ve moved through services my ability to sustain a low weight and lack of nutrition has deteriorated and in this admission found myself in general hospital for IV fluids. It’s come to the point now that everyone accepts I won’t eat meals and instead have ensure drinks. It can be quite isolating not finding myself able to eat meals in the dining room and I find myself wondering how have I found myself in this position, again.

Acute wards are all about survival and crisis management but this is often to the detriment where specialist services are called in. The level of support and guidance an eating disorder patient is simply not available and in an ideal world that wouldn’t be the case. But for now it’s not and that needs to change.

What’s it like to feel suicidal?

First off a bit of an update. I disappeared over a couple of weeks due to slipping backwards with my eating and drinking and then my mood followed. I was admitted to hospital rehydrated. But I’m not fainting everywhere so I’m allowed off the ward to blog.

Now onto the topic I wanted to address this week.

People don’t talk about, it’s shoved in the corner and not allowed out. But it happens. Suicide is one of the biggest killers of males under the age of 25.But for some people feeling suicidal and not able to shove it in a corner is a harsh reality of their life. I’ve felt suicidal many times and over long periods and it’s been one the hardest parts o my illness for them.

So what’s it like to feel suicidal. For me it’s like smoke, it fills your eyes and nose and mouth so you can’t breathe or scream for help. Talking is an effort, breathing is an effort. The black smoke weighs you down so you can only shuffle. It convinces me not to talk to staff as they’re too busy or you don’t deserve anyway. You search endlessly for a sharp object is you’re a self harmer. I’ve literally gone through everything in my room searching for something to harm with. Usually it’s futile.

That’s my experience of suicidal feelings. I’ve not spoken about other people’s experiences because I’m not in their heads and have no idea what it’s like for them. But male, female, race, sexual orientation and all of them, we need to speak more about suicide, take away the shame by taking it out the corner.

 

Not waving but drowning

Imagine that you are underwater, but yours eyes and ears are open. You can breathe so you’re not drowning. You’re not drowning but your body is screaming at you that you are. You want to ask for help but you’re under water so how can you?

That is what a flashback is like me. When I was first transferred here I had big flashbacks that would me me to harming myself. Staff would try and talk to me but I was under water so couldn’t hear them. All I could understand was they were trying to stop me doing the one thing that would stop the flashback. So I fought and scream (not very often, normally you’d have to strain to hear me!) and I cried but eventually I started swimming up out of the water, baby steps and first then longer and longer. Now I still get flashbacks but they’re smaller, distressing but manageable on my own.

That’s my experience of flashbacks. I know it’s different for everyone so oe experience may differ to another’s.

Thanks for reading everyone, I’ll be back in two weeks.

Chemical sedation versus verbal deescalation

This is going to be quite a personal post as I’m going to focus my writing on my own experiences of the two. It may contain triggering content for some so if it does stop reading and find someone you can speak to.

Chemical sedation

The first time I was restrained and injected was possibly the most terrifying moments of my life. I was pushed through the ward to the seclusion room and restrained by a mixed gender team and injected. There was no explanation, no attempt at verbal deescalation and no debrief. I was left half asleep in seclusion with my new key nurse watching me. This was a situation I found myself in many times. Though sometimes there was a relief in finally being knocked out and not having to face the pain anymore.

I’m not sure what I feel about chemical sedation. I think it has its place in psychiatric settings but sometimes it is used as a punishment or too quickly without any attempt at deescalating the situation.

Verbal Deescalation

This is a method that has worked really well for my sometimes and not so well others.

First I’m going to tell you about the time the didn’t inject me and tried verbal deescalation. It involved being restrained to the quiet room, me sobbing and shouting, and sat there for two hours with three members of staff trying to keep e sat down not desperately running at walls. It was the most painful night of my life. They tried to talk me down and talk me into taking the tablets but two hours later and we were all flagging. I did eventually concede that taking my medication was the only option if I didn’t want the injection.

That was a fairly negative experience of verbal deescalation. There’s been a change since I’ve moved units. Verbal deescalation is the norm and very rarely is the injection used. When I was constantly headbanging the staff unfailingly talked to me until I was grounded enough to be removed or walk away from the wall. There’s a much greater feeling of ownership for your emotions if you’ve been talked down rather than forced down on a bed.

I can’t give you an answer as to what is the better option. Both have their merits and disadvantages. But I do think verbal deescalation should always be the first line of treatment before the injection is considered.

Slipping back into my eating disorder

Anorexia. We’ve all heard about it. Bulimia less so but very much in the public domain. But what about EDNOS?

I’m currently diagnosed with EDNOS although I have a history of severe anorexia and bulimia. Recently the anorexia has slipped back in to my head and things are harder again. But I have the support of staff, others are not so lucky. Suffering in silence.

There is a lure to anorexia, especially to past sufferers. When I look back I remember a clean homely ward. I remember sipping diet coke in cafe nero with my ward friends. I remember going out on leave to get illicit piercings.

But this is rose tinted glasses. There was nothing homely to quieing up at 6 am to be weighed and have your vitals done. There was nothing fun about orange juice at midnight because you blood sugars are too low.There was nothing glamorous about crying over an extra potato whilst others complained about their broccoli portion or juice level.

What I’m saying is there’s nothing glamorous or safe for anorexia.

And neither is it the same for the other two. I knew I was out of control with my bulimia when the bank rang to check I’d made those purchases.

We need more awareness around eating disorders and not the glamorous image displayed in newspapers and magazines. ALL eating disorders are deadly. Anorexia has the highest mortality of any mental illness.We need to step back when the lure of anorexia or bulimia or EDNOS creeps in and not let us fall down the rabbit hole again.