Tag Archives: mental illness

World suicide prevention day 

Imagine that everything is black. You open your eyes and you can’t see anything. There’s a heavy weight pushing you down. It hurts. You’re being pushed down and down. Even sitting up is too hard. On top of that there’s a million thoughts bashing around your head.

You’re a bad person

Everyone hates you

You’re a burden 

You’re better off dead

I can’t.

It takes up every thought, every moment. You need a way out and suddenly suicide offers itself up. You gnaw on the idea obsessively. It’s almost a comfort at time. I feel awful but there’s a way out. 

The first time suicide entered my mind I was 14 and being bullied at school. I woke up dreading each day and then, one day, online i found a hate page about me. Someone had written how I was better off dead. That sentence got stuck for many years. It was years later that I made my first suicide attempt but I’ve been living with the spectre of suicide for 11ish years.

For a very long time after being sectioned I fought so hard to end my life. I spent 8 months on 1:1 being watched around the clock but I still tried and tried over again to take my life. I felt hopeless, I felt too broken, too damaged by my past to continue living. 
But things did change. I had my friends, my family, my boyfriend around me, holding my hope for me when I couldn’t hold it my self. I haven’t attempted suicide since January and I no longer feel suicidal. I am lucky, I’m genuinely glad I was found every time I attempted. At the time I was furious but now I feel differently. 

I wish I could say the same for some of my friends. Beautiful, kind souls who saw no way out. I think of them every day and I live my life for them. These women were failed by a system that leaves you falling on your own until crisis happens and you make an attempt. Where is the support to prevent these deaths? Because they are preventable. 

Imagine if we had a system that offered support before crisis? If we listened when someone started asking for help rather than sending them away to get sicker before they qualified for help. Or we never saw the ‘it was attention seeking/ a cry for help/ manipulative’ attitude from the professionals. Imagine how it feels to reach out only to be told ‘if you were serious you wouldn’t tell anyone’. Too many people are silenced.

 Suicide is such a taboo subject and it shouldn’t be. We put our hands over our ears and eyes and pretend we can’t see it. As do the mental health system. But it’s there and it’s taking too many lives. 

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DBT; a realisation.

Sat in the corner of my room, tying a ligature round my neck. Pinned to the floor and injected. Lying on a bed being wheeled through for ECT. Fainting and being sent to hospital for glucose multiple times. Being watched 24/7 for over 8 months, no privacy at all. Having a CT scan after headbanging. I came into hospital very unwell and there’s a lot I can’t remember, but I’ll never forget these things.

Thankfully I’m so much further on, the idea of tying a ligature is so far away, I never kick off. I am compliant. Those baby steps I mentioned in my last post? They’ve turned into giant leaps. I’m sat here at home on overnight leave, I’ve been out to town with mum and exercised my debit card! I’ve helped cook lunch. I’ve cleaned the kitchen. This time last year I was just starting to have home leave, escorted by a member of staff for 8 hours only. Now I’m a completely different person.

On Wednesday I completed my second and final cycle of DBT. I remember a year ago starting on the programme I was so, well, obstinate that it wouldn’t work. I didn’t understand it. I couldn’t open myself to it. Now I look back and it has helped me so much.  There were four modules; emotional regulation, distress tolerance, interpersonal effectiveness and mindfulness. Each taught me skills I can use to live with, control and maybe even overcome my illnesses.

Through DBT I found a way to manage situations where I needed or wanted specific outcomes. I learnt how to voice my opinion and ask for my needs to be met without shutting down or disregulating. I started being able to take part in my treatment and to get my needs heard and met. Mindfulness taught me how to recognise my emotions, how to observe them and employ my most effective skills to deal with that emotion, or, simply stop and watch the emotion pass by. I learnt to use pros and cons of a specific situation or behaviour to balance out whether the urge I was having would actually be effective.  I went from feeling awful all the time and reacting immediately  to being able to stop, use my skills to recognise that I was feeling bad and instead of self harming or ligaturing I would distract myself. I would ‘radically accept’ I sometimes cannot change the situation (for instance I have to come back to hospital after time at home) but I can employ techniques to help.

I never thought I’d say thank you to DBT. I really struggled to grasp it, it didn’t really fit with my illness but with help I could use skills from DBT anyway and slowly that opened up a way for me to engage in DBT. It’s very weird thinking I won’t have anymore DBT but I’m so thankful for it. And to anyone starting DBT, stick with it. Don’t let anyone derail your recovery by telling you horror stories of DBT. It’s hard, you will probably cry with frustration, you won’t understand at times, you’ll feel stuck. But, for me, there’s almost a sudden moment when I realised, I do understand this and I am actually using the  skills. I can only say thank you to the therapy team for not giving up on me.

And so from baby steps, this is a giant leap. I’m on the home run.

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.

 

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.

What does mental really look like?

I’m sorry for the long absence in posting, being in hospital makes every day monotonous and I’m pretty sure none of you are interested in the days I manage to get in the shower.

I wanted to post some misconceptions about inpatient treatment. When I used to use Instagram I regularly saw people wishing the could me inpatient on a ‘nice safe ward’ away from the stresses of life. I’ve been in hospital four times, some have been excellent, some awful. None of them (perhaps with the exception of the Priory) were safe little retreats. There is nothing safe or comforting about being restrained and injected to calm you down. There is an escape from real life but the ward is a world of its own, often more chaotic than your own home. Psychiatric wards are last resort places, when all else has failed to help. 

That said, neither are they places portrayed in films like Girl, Interrupted. Most have single rooms and staff monitor patients carefully. I’m on 1:1 and I can’t even sneak a hair band from the bathroom without questioning. The patients are not all obviously unwell, we all have our moments and there are some who are highly confused but most are quiet and reserved or sit in the living room watching TV and laughing, interrupted only by the call of ‘meds! ‘ yes one or two of us will be on one to one but even then you wouldn’t know we have life threatening mental illnesses. 

The staff are not the draconian strict staff of 90s psych movies but instead do their best to run a ward whilst often understaffed. They make time for 1:1 sessions with their named patient.

I am a patient currently in my 12th week of stay, half of which on section 3. I have a 2:1 in microbiology and an offer for two masters courses. I have a loving family and friends. I wear clean fashionable clothes most days and jewellery. If you saw me on the street the only sign of my battle with MH is the scars that stripe my skin. All in all I look pretty normal. And yet I’m diagnosed with severe depression with psychosis and on heavy duty psychiatric medication and on Tuesday will be starting a course of ECT. A terrifying prospect but one that everyone agrees is the right decision.

So there you go, we may be on hospital but many of us, you wouldn’t look twice at in the street.