This is what happened.

This is what happened. Please don’t change your views on me. I know I share a lot on here; I guess I compensate for what I don’t say in words out loud. We all have to get things out somehow.

I cannot entirely remember what I previously posted, but I know I was on leave from the acute psychiatric ward and I thought that I was free. I was not free.

It is hard to write on here, and to be honest. I am aware that there are potentially more people reading this that know me in “real life” than ever before. This blog was initially a place just for me, or just for me to meet other people with similar experiences.

Stigma and all of that stuff has improved, but it has not gone. And while sharing experiences is good, I guess we all want some element of a private life. And yet writing is SO, SO cathartic. I am a person who expresses very little about herself and her feelings in words, or face-to-face with people. This includes professionals. One of the key things the inpatient ward has been trying with me is encouraging me to talk. It hasn’t totally failed, but it has definitely not been a success.

I have spent now, a month there. It is a month tomorrow since I was sectioned. I know this because my section lasts 28 days, and it runs out tomorrow. I had my leave revoked twice. The first time was after an appointment with my outpatient team. I was on leave, and went to see them to discuss the plan moving forward; I wanted to return and do the therapeutic community. A three day per week programme that I was thrown out of last year. Any way…the decision by them is that my risk is still too high to return. The hope was that I’d be ready by October, but now they think not, and the consequence was total discharge from their service.

I had my whole life plan based around going back. I had cancelled interviews for internships. I was ready to dedicate 1-2 years to therapy. And boom. Gone. And I melted down. I walked out. I was in the corridor banging my head against the wall. I was distraught. But they calmed me down, took me back inside, and we had a very emotional, but important talk. I realised the decision was hard for them, as much as it was hard for me. One of the nurses cried. It was painful, and the decision was made that it was in my best interests to return me to the ward for a few hours to calm down and get my head around it. Those few hours turned into a weekend when the consultant psychiatrist said there was no way he would let me leave again before the Monday.

I did go on leave again. And it was revoked. I took some meds and fell asleep. I didn’t overdose, but I took night time medication in the day time plus PRN. I was OUT OF IT, and I wasn’t answering calls from the crisis team who support me daily while on leave. And so of course boom…police knocked my door down, found me and took me back to the ward. I didn’t cope well, made an attempt on my life, was put in seclusion, and had a few days of hell.

But I am home! I had some day leave at the start of the week, then one night at home on Thursday. I went back Friday to discuss how it went and then they agreed I could come back home until Monday. It has gone…ok. Things feel unsteady. One part of me can see me going to my ward round tomorrow and getting taken off my section 2, not transferred to a 3, and being discharged completely. If not that, then being on leave for a week as a voluntary patient, then discharged. My section 2 cannot be extended, it is 28 days maximum, and that is the law. The way forward is either to take me off it, or put me onto a section 3 which is much more serious and not likely to happen at all. I am positive. I am looking into how to deal with my poor financial situation right now, I am looking at future job options, accommodation, social stuff to stop being so a damn recluse. While I haven’t in a few days, I had been working hard on my dissertation, and yeah…there are lots of positives.

But there is a part of me that knows the next 12ish hours are crucial and this is a high risk time for me. If I am going to land myself back in hospital, it will be during this time so I am on high alert. I have the crisis teams number, and the wards number. I know a name of a person from the crisis team I can ask to speak to, and I have PRN medication.

PRN medication is weird. I’ve never had it before, except for the odd week once or twice. PRN medication basically means you take it as/when you need it. I try to take as little as possible. During my first day at the ward I was angry and being kept “safe” and angry at being sectioned, and angry at being locked up. For the first time ever, the girl who never expresses anger, erupted. I kicked off and tried to escape, and this was when I found out that due to being under a section, if I refuse PRN medication when staff feel it is appropriate, it can be injected against my will. PRN medication doesn’t knock me out, but it makes the world feel slow and unreal. It’s like living in a bubble. It makes me very different. It also makes me very calm.

That first week is a long way behind me now, but I am still using PRN lorazepam 1-2 times per day. It’s a weird feeling it leaves you with. I definitely wouldn’t suggest driving!!!

I can’t believe it has been a month. A month tomorrow. I am ready to speak the words. I think I need to. Or I will feel ashamed and embarrassed and sick tomorrow when I remember writing this, and letting you read it.

A month ago tomorrow I came back to Leicester from visiting my family. I remember I went to a hospital appointment in the morning, then came home. I had some lunch while watching something on my laptop. The plan was to go to the gym, so I got changed into my gym stuff, and packed my water bottle, towel and purse in my bag, plus a Tesco bag for life as I had little food in after being away.

I was laid on the floor in my lounge (I prefer the floor to the sofa, don’t ask), and all I was thinking is, “I can’t keep on doing this.” I had been struggling for weeks with anxiety, rules, low mood, self-harm and all of the usual. The idea of going to work the next two days and facing the gym and all of my exercise rules, and then having to try do uni work while being surrounded by people…I just thought, “I can’t do this any more”. It wasn’t so much that things were worse than ‘normal’, but that I just couldn’t face doing the ‘normal’ any more.

I started walking to the gym, but I didn’t go in. I sat on a bench outside. I cried. And then the team that discharged me called me. I was gravitating towards a local multi-storey car park, and from past experience, she knew that was the risk. She tried to help me. And I wanted to work with her, but by 7.30pm (she finishes work at 5), we weren’t getting anywhere. She said we needed some outside help, and that the police mental heal triage car were going to be sent to see me. I met them in a grave yard of all places, and sat in their car. The decision was made to take me to A&E for an assessment, but while the police were discussing my situation with the nursing staff, I ran.

It was late by this point. Gone 10pm. I wasn’t thinking straight. I was walking at speed to the car park. There was no fear. There was no doubts. All of the usual thoughts that would pop into my head and stop me doing it had gone. It was a type of moment I have never experienced before. It felt like clarity. I had my headphones on, listening to a song by Halsey called ‘I am not afraid any more’, and I honestly felt like I was on one; I had the solution, this was it, and in a way I was excited. Nervously excited. Like something was pumping through my body and it was all going to be ok.

Rather than hover around the car park like I have done in the past, I went straight up to the top floor. I walked to the point where I knew it was easy to get over the edge, and I sat there for a little while with my legs on the inside of the car park. Then I moved one of my legs further towards the edge and I heard someone say my name. I didn’t turn around but I knew it was the police officers from before. They were trying to talk to me but all I was thinking is “You cannot survive this. Survivial is not an option.” and so I swung both of my legs over and pushed my arms to heave me over…

and next thing I knew my head hit the floor, pain seared through my right side…through my legs, hip, bum, shoulders, head. My hand and face was bleeding, and I was in the arms of a police officer. The police officer who saved me.

He was shaking. His arms tightly around me. He kept saying “we are going to be ok”, and “the worst is over now.”. All I was thinking was that the worst had just begun; that surviving this was going to be horrific. I kept trying to get back up. The car park security arrived, a negotiator arrived, and the two police officers sergeant. They arrested me under Section 136 of the Mental Health Act, which meant they would take me to a place of safety where I could be kept for up to 72hrs. Within those 72hrs two psychiatrists and an approved mental health practitioner assessed me, and without even the option of going into hospital voluntary, sectioned me under section 2. I was taken straight to one of the female-only acute wards.

This is the thing that stands out to me the most; since that night happened, that night has barely been mentioned. I have barely thought about it neither, and if I have, it has been brief.

You will read stories in the media and that night will be the point of the story. And yet so much has happened since. Further attempts at seriously hurting myself, having my room stripped, including all of my clothes…including all of the clothes I was wearing. There have been tears, restraints, and god…just more tears.

There have also been positive days, days with hope. Moments where I can see an alternative future for me, for my life after September. Moments where I laugh. Moments where I feel ok. Moments where staff help me to keep safe, and I feel proud of myself for letting them do that.

There have been so many important, terrifying, sad, happy and a combination thereof, moments, that nobody ever talks about. And here I am talking about them. Because I’m not out of hospital technically, yet. And it is insane what can change in a night. And even once I am fully discharged, which should be incredibly soon, potentially tomorrow…the journey from that terrible night, to where I am now, is such a small part of the journey. The journey is going to continue for the coming months, perhaps years, and people never read about that.

 

 

 

 

Positive vibes only please.

I screwed up. But maybe I need to stop saying it like that…I crumbled and everything became too much.

Last Monday I was sectioned. I was arrested under section 136 of the mental health act by the police (for anyone who does not know much, it is not a crime but for safety and a mental health assessment) and taken to a “place of safety”. At said place I was assessed by two psychiatrists and a social worker, put on a section 2 and admitted to an acute ward.

I am not sure I want to disclose what happened. I have not really spoken about it at all to anyone, nor how I feel about it now. I keep telling myself I should be glad that a police officer saved my life, but then I think that sounds ridiculously dramatic and it does; but then it is also true. If the police officer had reacted even just 5 seconds slower than he did, I would be dead right now and I want to be glad. I do. But right now I am just confused. I think wanting to be glad is a good place to start. When the incident happened the police knocked me to the ground; broke my nails, bruised my side and bum, ripped my coat and scratched my face. He was holding me, almost hugging me. He was shaking and he kept saying that we were safe and that it was all going to be ok, that the worst was over. I wanted him to get the hell off me and I tried to get away. But I also remember this little part of me that could see how relieved he was that he had made me safe, and I was jealous. Bad choice of words there, but I wanted to feel his relief. I was crying because I could not feel it. All the officers were relieved and happy, talking about it being a good outcome, and I was laid there on the floor wishing I felt the same – I take that as a sign that something in me wanted to be alive. Well, wanted to want to be alive, and when I remembered feeling this way on Friday, I realised I have to fight.

I only spent a week on the ward. It was a rubbish week. I have only been on an adult acute ward once and I acted fine, and “displayed no signs of mental illness” mostly because I was trying to get myself out, and I did within 3-4 days. This time I was not quite the same. I had to be medicated which I hated, because it feels like every time you get distressed and they cannot handle you, they just want to knock you out…I was restrained which has never happened before, I was attempting to escape, I was on 1:1 a lot, I had all of my stuff taken off me…given back, taken off me again.

But I am home. I came back home yesterday and I am home for a week, and if I keep how I am/improve, then I will be taken off the section next Monday and freeeeeee. And I am pretty proud of myself for picking myself up so quickly rather than ending up having a long admission. I cannot stand hospital and while I know most people can’t, I particularly can’t. I cannot handle feeling trapped or not getting space, or fresh air. I cannot manage to eat in hospital so I went 7 days without food. I get worked up and even my Mum knew that hospital was not the right place for me.

That is not to say it was the wrong place neither. What I did, what I nearly did…there was no other option. I could not go home. And yesterday afternoon I had an absolute meltdown. On my way home from the ward I went to see my mental health worker at uni, and I just lost it. She rang the ward and the consultant suggested going back, but I pushed through and I am still at home. I have cleaned, dealt with some physical health issues, I am eating again THANK THE LORD and I am engaging with home visits even though I tried to refuse them. I know if I refuse them I will be recalled aka back in hospital, but that is not why I am engaging. I am engaging because I want to, and because this is an opportunity for me to learn how to communicate how I feel and get things out, rather than bottling things up and exploding.

Two weeks ago I was struggling, but I would never have predicted this to happen. It has been horrible, and at time, traumatic. I could still be on the ward right now, on 1:1 with none of my belongings, hurting myself, arguing, kicking off, not eating and destroying any chance of returning to outpatient therapy. But I have another two and a half months to show I can regain control and be “stable” (bloody hate that word), so I can do the therapy, and so that is my goal.

There are lots of issues at the moment, and things that contributed to this, and consequences of this last week that I have to deal with. But ultimately I know all things can be dealt with. While I am finding it difficult to say I am glad the police saved my life, I am glad I am still here to have the chance to engage in therapy and perhaps one day be glad.

I am focusing on looking after myself physically, reading some positive books and focusing on positive things. Having positive conversations with friends, generally talking to friends to be distracted, working on putting my feelings into words and just, helping myself. It started with eating; I knew I was not going to be able to pick myself up and do the things that would help me, if I was not eating. So yesterday after my meltdown I had my trusty rice krispies, and since then I have been eating “properly”, and it is just a case of one foot in front of another. I do truly hope I can go to my ward round on Monday, surprise them at how different I am (better!), get discharged and resume life, but for now we shall focus on today.

 

Bad times happen. Good times happen too. We choose which we focus on.

I have had a difficult week. I mean bad days happen regularly, but they are normally just one-off days or hours, not days upon days, and probably not this bad. I don’t even really know where it came from, it just kind of hit me from nowhere and it worries me how this happens. I’m picking myself back up and eventually managed to get some help, but I know things could have become much worse and it scares me. It scares me that I will end up back in hospital long-term, or lose the good things in my life. It was like everything just hit me, like suddenly I hit a wall. I am a very active person, and as soon as I wake up I’m out of bed in 30 seconds. I exercise regularly. I never, ever, spend a whole day indoors. I can’t say when I last did, but it was years and years (except when I was in hospital because I wasn’t allowed out). But there have been a lot of periods of time this week where I haven’t even been able to leave my bedroom, nevermind the house. A couple of times where I couldn’t leave my bed. I just laid there, in the middle of the day, and felt paralysed.

At first I was angry with myself; I thought I was just being lazy and needed to “pull myself together”, but looking back it was nothing of the sort. The thing that made me realise that sounds a bit silly, and embarrassing, but basically I needed the toilet and I was in agony and yet the idea of moving, of walking…I just couldn’t. I was in so much pain and after 2 hours I was still just laid there. I was also crying non-stop and I NEVER cry. I’m always called the unemotional one in the family, which is awfully ironic given that by diagnosis is emotionally unstable personality disorder. I am emotional, but just not in a way that people can see. It’s often not visible. But when I get in a really bad place, that does change. The worst thing I’ve done is set myself up for failure…thinking “I’ll be fine tomorrow and I’ll do X, Y and Z” and then been the furthest thing from fine, and feeling guilty and telling myself I’ll be better tomorrow.

I have also been having horrendous headaches which they think is related to how I’ve been mentally feeling. It’s weird because the headaches started last week, before things got bad. I’ve had two types; one where it’s a dull ache that just will not go away, the other is very sudden and intense. For about 10 minutes max I will be in agony. It starts at the back of my neck and then runs around to my ears and it feels like the worst pain I’ve had in my life. And then as quick as it comes, it goes. I don’t know which is worse. The ones that won’t go away make the whole day even harder, but the short ones are agonising. Knowing it won’t last long helps. It’s really weird, and I feel like I am making them up because who gets a headache for ten minutes?!

I feel really guilty for how I have been this week, and really disappointed in myself. The only thing that is helping that is the fact that my mental health team think that I have been, and am, doing really well overall to manage it as safely as I can. Their number one priority is always safety, and between October and somewhere between January and March that was not something I was successfully doing. It got me taken out of treatment and that is why I am currently not really having any formal therapy, and it landed me on the psych ward. The team I am under were extremely vocal about their concerns and tried to get me into hospital sooner than I was admitted (I convinced the team that assess you for sections that I was ok to be at home more than once), and so I know that they genuinely think I am working hard at things; they would not say it if they did not mean it, and so it eases the guilt a bit. The last thing I want to do is ruin my hopes of returning to treatment.

I have had to spend some time in hospital this week, and the reality is that it might become necessary to have at least some time there over the weekend, but I am trying not to see that as failure neither. I have made some bad moves this week, and I’ll be honest and say that rather than admit to myself that I was disappointed or angry at myself, I took it out on professionals. I mean when I say that I don’t mean I was horrible or anything like that, and it was very brief, but in my head at points, they were the problem not me. I did not want to go into the hospital no matter how brief it would be. I find it embarrassing and I feel ashamed when it happens, and lets face it, nobody wants to be in a hospital.

I’ve had my meds temporarily increased. They’ve given me 9 days worth so I’m assuming it’s just for that long. I hate being overly medicated. Like I accept needing some medication and I take daily long-term medication…but I hate using PRN medication, and I hate that it just wipes me out. I am starting the PRN tonight and I know I am going to struggle to get up in mornings, and I’m going to feel zonked out. It feels like why on earth would I do that to myself? But I know the reasons. If it can prevent ending up in hospital and keep me stable so be it. But of course then I will also worry about coming off them so you can see why I want to avoid them; they wipe me out so being on them is hard, and then coming off them is also hard. But needs must, and this happens VERY infrequently for me so I can kind of accept it as a rare occasion kind of thing. Don’t think I am being critical of using PRN medication because I’m not, but it just isn’t really for me.

In terms of support I can go to the hospital any time. I can also ring my team between 9 and 5 Mon-Thurs, and 9-4 Friday. We have a scheduled 30min call next Fri, but I can ring before then. It’s reassuring just knowing it’s there as an option, and we spoke Monday, yesterday and today, plus I’ve had contact with my GP. Next week my mental health specialist mentor at university is increasing my contact with her to twice weekly (Monday and Thursday), and there’s room to consider having a 2hr session plus a 1hr, rather than two 1hrs. She is a life saver. She makes such a big difference to my life, and not only that but we genuinely get along. She said once I leave university she will keep in contact with me, and it just feels like we click. I feel like we are quite similar in some things and we don’t sit and talk about mental health related stuff all of the time, like we have genuine similar interests and good random conversations. I’m very lucky. (Also she is Irish and I love Irish accents).

My plan is to rest this weekend and take it easy while on these extra tablets. I have moments where I feel A LOT better and while they are brief, they seem to be lasting longer in the last day or so. The not so great moments, I need to start accepting. I make it so much harder for myself by getting frustrated and angry at how I feel…it just makes me even worse. Acceptance seems awfully important. I am also beginning to wonder if covering up what is going on from people is beneficial. I know I blog very openly, but in the rest of my life I’m not open at all so trying to be so is difficult. None of my friends know what is going on right now. But I think maybe not totally masking things helps, and I have shut myself from everyone this week which can’t be a helpful thing, and I think it is tough on the people who care.

I’m just going to take things as they come. The good and the bad. But I am going to push myself. I have to, because if I don’t I would trap myself in my room forever. Sure sometimes it is ok to have a rough week or day and need that, but it feels important to not let it turn into a ‘normal’ thing because otherwise I’d get really bad….so it means forcing myself to do things I don’t want to do. While I accept this week has happened and perhaps I needed it, I’m not going to be easy on myself because I don’t want to spiral downwards so next week I am going to do the things I need to, and usually, do and I am going to use the extra support available, take these meds, and push myself. I know that doing things, doing “normal” things, helps me, and it’s ok to have a down week, and to let myself, but it cannot continue for long. It’s that difficult thing between being compassionate to yourself and understanding bad weeks happen and it’s ok to withdraw from things a bit because as much as it doesn’t feel like it to me, this is an illness…while also taking responsibility and not letting yourself off from things, not giving up. A mental health problem is not a choice, but recovery is, and choices are involved.

My biggest mistake this week was not facing up to things from the start. I took a long time to tell someone how things were, and therefore to seek help, and even longer to actually use the help. But that being said a week is nothing! I used to go months in that state of denial of what was going on and hiding away, avoiding help. I feel like in less than a week I’ve managed to go through a process that used to take often up to a year! And I mean that is what I am focusing on; not just how far I have to go, but how far I have come. It is so easy to forget where you were before, and to focus on the bad, when there is so much to be proud of.

(I don’t mean to make it sound like this totally came out of nowhere, which I probably have made it seem. I think there had been signs this was coming and at least one person around me knew that, and I was just pulling the wool over my eyes with the “I’m fine, it’s fine, everything is fine” thing, but I had been managing to just have bad moments rather than longer periods.)

I have my fingers and toes crossed for a hospital free weekend though! Lots of rest and calmness please! And I look forward to being hyper and silly again, hitting the gym, working and getting on with some uni work! There’s nothing better than feeling like your usual self. I know normal every day life can seem boring for some, and feeling ‘ok’ might not feel like enough, but I think when you are someone who does have very bad times with your mental health and where things such as being in hospital become necessary, there is nothing more you enjoy than the apparently boring, normal every day stuff. Even finally cleaning and doing an essay suddenly feels good when I’ve had a bad week! And don’t get me started on my own bed, a shower or a nice walk. These things sometimes feel like the most amazing thing in the whole world. The relief of coming home and falling asleep in my own bed with fresh sheets sometimes feels like winning the lottery. It’s the little things that often feel like the big things.

This has been an awfully long rant, but I feel like getting things out is an important part of trying to draw a line under a bad week and start fresh, and to acknowledge that you can both be fighting hard and doing better, while also having tough times. One of the most reassuring things for me has been reading the blogs of people who are overall successful and doing well, but seeing that they have bad times too. Seeing people who seem to always have everything together doesn’t actually inspire me or help me any where near as much as the people who are open about their difficult times. It helps me to see the bigger picture in life, and that having a bad time doesn’t mean it is how things always are, or how things always will be, so if you are having a bad evening, day, or week, it’s ok. I know it is hard to believe right now, but this is not permanent. The only thing in life that is guaranteed is change, and our feelings tend to be one of the things that can change the most in a shockingly small amount of time. I hold onto that thought a lot – and the fact that a bad week doesn’t delete all of the good days; they are still just as real.

A move towards targeted mental health awareness?

It’s mental health awareness week so it’s like I should post. I blog on mental health so not posting would be kind of weird…but then isn’t my whole blog raising awareness? It’s not really my goal to raise awareness for one week annually.

I’ve read some thought provoking stuff surrounding the use of mental health awareness events, which I imagine could apply to other awareness days and weeks too. The first was on Twitter; someone talking about being sick of talking about mental illness and not actually doing anything about it. Tonight I’ve seen a great illustration by rubyetc. I’m sure a lot of you have heard of her and I’ve included the illustration for you – you should check out her work if you’ve never seen her stuff before! Any way, this illustration is based on mental health awareness events being tedious. The illustration contains the comment “Yes I am very aware, thank you very much.”

And I get it. Sometimes I don’t want to hear, write, talk or anything to do with mental illness. Sometimes I hate awareness stuff and as a mental health blogger and as a person living with mental illness, you feel like you are not supposed to feel that way.

I guess the point is that some people are not aware, or not enough. I think awareness campaigns for particular areas of mental health are particularly important such as more misunderstood, often neglected disorders or issues such as addiction, personality disorders, and self-harm in adults. As for more common mental health problems like depression, anxiety and increasingly so with schizophrenia, people are more aware of the symptoms and more understanding than ever; but this doesn’t mean awareness isn’t necessary, but that a focus on specific areas – myths, misconceptions and how to help someone – is required.

When you have a mental illness it can definitely be a bit tedious though. Sometimes it feels like people touch on the subject because it’s awareness week, but not because it really means anything to them. But then how can anyone do in-depth work on EVERY SINGLE awareness event?

All of this has definitely led me to do some reflecting – how can I actually do something that makes a real difference? How can I reach the people that really need reaching? What areas of mental health really do need focusing on?

I feel particularly concerned with raising awareness of borderline personality disorder for obvious reasons; it’s something I’m diagnosed with, and you’re always going to care more about something that has impacted upon your life. But there are a number of things that have impacted upon my life, and this one still stands out to me as something to speak up about because it is such a highly misunderstood disorder which carries such awful stigma, and to be honest I’m not convinced that many people could tell me what BPD is if I stopped them and asked them.

My dream would be to educate professionals that come into contact with those with BPD who need better understanding to improve their ability to help. From personal experience this would be A&E staff and the police, but I am sure there are many more people who would benefit.

So I’m left thinking, can little old me do something about that? And what if I came face-to-face with the people who have seen me at my worst that I never thought I would have to face again? The thought of it is a bit sickening!

A weird thing happened a week or so ago. Two police officers that were involved in an incident with me a while ago did a random courtesy (if you like) call to my house. They called it a welfare check – you can imagine my panic when I opened the door and they said my name. I didn’t remember them because I really wasn’t in a state to even notice what they looked like so I was stood there having an internal panic; what have I done? I can’t remember doing anything?!

The first thing they said was “you look better” and it was weird to see them when I was feeling good and “well”. I think it was even stranger for them. It makes you realise the striking difference between how you are when you are managing, and how you are when you’re not. And I think it’s important for professionals to see that who you are when they see you, in that time of desperation and crisis, is not the person you truly are. I think it increases understanding that for the person to be in such a state, is to show that they truly need help because it’s outside of their ‘norm’. I imagine it is quite easy to see someone in a crisis and think that those moments define them, and I get that. I don’t think it is wrong of people to think that; but it doesn’t define them and it’s going to take people showing who they are beyond their label to change this.

The Morning After the Night Before

I don’t drink. That’s right, not at all. A lot of people seem to struggle with the concept of not drinking at all and I’m pretty sure that says more about them, than me. I’ve had medical professionals be shocked because “people like me” usually drink and shouldn’t. When I say I don’t they have responded with “ok, but you shouldn’t drink at all if you can help it” like I don’t drink means I drink sometimes. Then there are the other times…taxi journeys where the driver brings up being a student in a city, and the night life. When I say I don’t go out they will usually go down the lines of “so you’re a pub girl”. No, not particularly. Next it’s “so do you just drink at home?”, followed by “a student that doesn’t drink, that’s odd!”.

It isn’t actually odd. I imagine many more students don’t drink that we would expect. My reasons for not drinking are complicated. I always say it is because of issues people in my life have had with alcohol and that it has put me off, but that would be a stretch of the truth. I want to say it is because when I first developed mental health problems at 14, I used to sneak alcohol out of my Mum’s vodka supply and take it to school in a water bottle and one time I went to a small party, got drunk, had a meltdown and locked myself in a bathroom, but again, the fact that drinking probably wouldn’t be good for me has very little to do with not actually drinking…just a lot to do with why it is probably a good thing. The honest reason is that it is a part of my eating disorder I have never overcome and really don’t feel a need to.

I didn’t go through the whole turning 18 and going out thing. I was at home starving myself to death, isolating myself from everyone and everything, and in my mind alcohol = a waste of calories. Why would I drink alcohol when I was only allowing myself 200 calories per day? Two vodkas and that would be all I could consume for the day. No thanks. And now I am “better” I challenge all of my disordered behaviours and thoughts, but with this one I just have no desire to. Take avoiding eating desserts. I have bundles of motivation to challenge that because you know, desserts are amazing and I genuinely want to be able to eat them. Hello cheesecake my long lost friend! But I’ve never enjoyed alcohol and it doesn’t interest me. I feel like I would be forcing myself to drink for the sake of drinking.

I do, however, know the feeling of the morning after the night before because having borderline personality disorder is great like that.

My mornings after the night before are filled with shame, embarrassment, and regret, and it is horrendous. Even months later the memories fill me with these emotions and when it is immediately after it quite literally makes me feel sick. I had one of these episodes this weekend. I won’t be going into the details because honestly, I am ashamed, and I really excelled myself this time. It went to a whole new level and the only thing I can think of to make myself feel better is ‘I won’t ever have to see the people involved again”. It has been a truly rock bottom moment and when it hit me what was going on and where I had led myself, I almost thought I was dreaming.

It is hard not to absolutely hate yourself for how you behave and feel at your worst. I feel like I want to rewind time and grab my own shoulders and give myself a good shake. WHAT ARE YOU DOING YOU FOOL?! Don’t be an idiot. Pull yourself together. Stop being so angry and take help.

However, there is a fine line between taking responsibility for your behaviour when you are mentally struggling, and blaming yourself to the point of hating yourself. While I absolutely believe I need to feel some degree of shame and regret in order to change, hating myself and over worrying about the way I was and the state others saw me in (aka what they were thinking of me) is not helpful; it makes me worse not better.

So after you have had a blip, a lapse, an episode or whatever else you want to call it, it is healthy to have some regrets and it’s a good thing to consider how you could have prevented yourself from getting to the stage of being out of control. BUT, if you blame yourself too much and are too hard on yourself, the guilt is going to eat you alive and you’re going to end up having another blip to cope with the guilt. Say your issue is drinking, and you get drunk and do something stupid and feel far too much guilt and self-blame…the risk is that you’re going to end up drinking again to manage that guilt. It’s counter-productive.

The line is fine and difficult to find, but it is a part of ‘recovery’ that you are going to have to keep working on because it is absolutely key to getting better. It’s all really about radical acceptance after these blips; you cannot change what has happened, and while you don’t have to be ok with what happened, you cannot punish yourself for it.

Learn. That is what you can do. Life is a series of lessons.

Borderline Personality Disorder and Emotional Dysregulation: Part One

There is a frequent debate about the term ‘Borderline Personality Disorder’ (BPD).

The term ‘borderline’ was coined in 1937 when it was believed that patients with the disorder were on the borderline between psychosis and neurosis. This is no longer seen as necessarily the case, and definitely not the case for everyone with the diagnosis, and today people prefer to call BPD ‘Emotionally Unstable Personality Disorder (EUPD).

I was actually asked which I prefer my diagnosis to be called, and I chose BPD. I know so many people hate this and choose EUPD, but being called ’emotionally unstable’, while probably accurate, just does not sit comfortably with me. To me, I think EUPD is a much more stigmatising label. ‘Emotionally unstable’ makes you sound, well, like an overly emotional mess and like someone to be avoided. It also sounds much more like one symptom of the disorder, albeit a major one, rather than a collective term for a set of symptoms. Ignoring that issue, I would prefer the term ‘Emotional Dysregulation Disorder’ which is occasionally used, but I actually think that BPD is more of an attachment disorder than anything else. There is a disorder called ‘Reactive Attachment Disorder’ but this is usually only diagnosed in children. I wonder what they think happens to these children when they hit 18? I think they probably, if their problems continue past that age, get diagnosed with BPD (which is usually only diagnosed in over 18’s).

That bothers me. Under 18 and I have an attachment disorder. Over 18 and I have a personality disorder, which is far more stigmatising.

Emotional instability, usually referred to as ’emotional dysregulation’ is a huge part of BPD. But this instability goes much further than emotions; it can be instability in a person’s sense of self/identity, and I think this can stem from being brought up in a very unstable environment. I think people would find out things about my childhood and call it pretty bad, and it was, sometimes. And sometimes it was not. Sometimes we were like any other family; happy and sad in “normal” ways. But things changed quickly and suddenly, usually without warning. I reckon growing up in that kind of environment, where you do not know what things are going to be like hour to hour, it makes you feel like nothing is safe, and that you do not know where you are going. One minute I had two solid, grounded parents and then in a blink of an eye one was back to abusing alcohol and the other was violent and would disappear off the face of the planet for a few days. There would be periods of stability in my Mum’s mental health, and then in the blink of an eye she would be carted off back to the psychiatric ward.

And to be honest, it felt normal. It was our normal. And when you live your life always ready for things to get worse, not knowing when it is going to happen, you become incredibly hypervigilant, and you develop ways of coping with it. Sometimes these coping mechanisms are unhealthy and dangerous, but regardless of that, they serve some kind of purpose. With regards to my anorexia and self-harm, I have often felt like those two things were always going to be there for me, that they were not going to abandon me, and so I clung onto them, sometimes with all my might, and other times just loosely, in case I needed them – never able to fully let go.

Education was my one positive coping mechanism, as I have wrote about before. School and college were always going to be there on a Monday morning at 9am. The supportive tutors, lecturers and support workers were always going to be there too. It was a safe haven, and especially during my time at school, it was the one place I did not have to pretend. This is quite different to some people’s experiences, where school is a place where they put on a mask, but for me school was where I could let myself feel my emotions and express them, and home was where I concealed everything. This was at times problematic as things would spill out uncontrollably. I would fall apart. But it was also needed at times. As I have become older I have gained a lot of control over this and while that seems like a good thing, it does mean that university tends to be a place I wear a mask to some extent – but I have a support worker within the university who I do not do this too. I guess it is more controlled now.

So, what is emotional dysregulation?

Emotional dysregulation (ED) is a term used in the mental health community to refer to an emotional response that is poorly modulated, and does not fall within the conventionally accepted range of emotive response. ED may be referred to as labile mood (marked fluctuation of mood) or mood swings.

This is something I have become increasingly aware of in myself over time. When I was in a child and adolescent psychiatric unit aged 15, I was diagnosed with cyclothymia, which is basically (and this is very simplified), a form of rapid cycling Bipolar disorder. This has never been mentioned again, and this is because while cyclothymia means that your moods change more frequently than found in typical Bipolar cases, my moods change much quicker than in cyclothymia, and approximately 50% of the time, in reaction to something happening around me.

It can be quite scary. Last Friday I ended up in A&E as I mentioned in my last post. I felt like I was at one of my worst points in a long time, and that was fair to say. Now, five days later, I am at one of my best points. It is a very unpredictable thing, that makes living difficult. I know that while I am feeling pretty good at this moment in time, in a few hours I could be laid in bed trying to sleep and having really negative, dangerous, thoughts and urges. While thoughts cannot hurt me, they can lead to me acting on them, which can hurt me. Learning to have these thoughts and feelings, these urges, and not act on them is one of the hardest parts of ‘recovery’.

When I am in the mindset of wanting to act on those thoughts, practically none of me can see any reason not to. I mean it varies; sometimes I can. Sometimes I can be very rational and recognise that feelings will pass, but other times the feelings are so intense and I lose grip of what I would call my “true self”, and there really is no talking me around when I am in that place.

I really want to end treatment and “get on with my life” as I keep saying. My support worker at university told me that while that would be very lovely for me to do, I need to think realistically about my ability to handle the responsibility of a full-time job right now. On my good days, I would be fantastic for a full-time job, but on my bad days, or during my rough patches, it would be a disaster. Right now, being a full-time student and working part-time is perfect for me. Work is absolutely perfect. I will admit I feel like I stumble my way through university. How I managed to get a degree, sometimes I really do not know. But it is manageable, and I am really lucky to have really accommodating lecturers. But in the working world, especially a full-time graduate scheme, this would be less likely to be the case which is why I am spending the next two days deciding whether it would be best to pull out of the graduate scheme assessment centre and focus on continuing with my treatment plan.

Does this mean someone with BPD can never have a full-time job? Of course not. I am sure thousands do. There are many extremely high-functioning people with BPD. BPD is often categorised into low functioning and high functioning (and I am pretty sure people can be a combination of the two). I think I am a combination of the two. Just the other day an A&E doctor told me he had never met someone with my diagnosis who was doing as well as I am, nor doing a masters. I reckon he would be surprised how many other people with BPD are doing high level qualifications, but that most of the people with BPD who find their ways into emergency departments are the ones who perhaps are not.

 

  • Low Functioning Borderline – The “Low Functioning” borderline is what most people think of when they are first introduced to the condition. Low functioning BPDs are a living train wreck. They have intense difficulties taking care of their basic needs, are constantly experiencing mood swings. They also have an extremely hard time managing any sort of relationship with another human being. Low Functioning BPDs are often hospitalized more than other BPD types, for the very reason that they can’t live productively without constant coaching and supervision. These patients are challenging for all but the most experienced psychiatrists. Unless otherwise treated, low functioning borderlines lead self destructive lives and attempt to manipulate those around them with desperate acts, including self harm (cutting, etc.).

(The comment regarding manipulation is not necessarily accurate. Often what appears like manipulation in BPD is just a person’s lack of ability to get their needs met, or express themselves, in a normal way – someone without BPD might need some extra support, and turn to a close friend and ask for it, whereas someone with BPD may struggle to recognise what they need and therefore find other ways to manage their feelings i.e. self-harm. Contrary to believing self-harm is a manipulative and attention seeking behaviour, self-harm is usually a very private, secretive thing – and any way, needing attention is not a bad thing. We all need attention.)

  • High Functioning Borderline – The High Functioning Borderline Personality shares many core aspects of the low functioning borderline personality, except for the fact that they can manage their lives, appear to be productive, and generally keep their relationships civil (even diplomatic in nature). High Functioning borderlines can appear to be normal, driven people one moment; then moody, inconsolable, and manipulative the next. Somehow, there is a mechanism within the minds of High Functioning Borderlines that allows them to lead somewhat “competent” lives, despite the fact that they are in a constant battle with BPD. High functioning BPDs are no better than low functioning: it’s basically the same face wearing a different mask.

 

 

These two “categories” are a bit too black and white for my liking. I am high functioning in terms of work and academically with my current workload. If I had a full-time job this would probably reduce. I am very low functioning in terms of mood swings, social functioning and self-destructive tendencies.

The thing about emotional dysregulation is, you can learn ways to manage it – and there are a huge number of ways that may or may not work for you personally, which I will discuss in a following blog (because I am on 1800 words and quite frankly that is ridiculous!)

It has been one of ‘those’ weekends

I guess I should know by now when things are deteriorating. It had been happening for a few weeks. I should also know by now that a holiday plus a bank holiday plus being alone would make things escalate. I guess sometimes I hide from the facts and hope that if I cover my ears enough and ignore the signs, it will all be ok.

And it is all ok. I am sat here writing this because things feel safe now. I can see now, that in many ways, the last four days could help me forward. But it does not mean it had to be that way. That I had to go through what I have just been through in order to make progress or feel ‘better’. I could have chosen to intervene sooner, but I succumbed to the darkness and it could have turned out differently. It is turning out ok. I have “survived”. I am taking positive steps now, but there was the risk this would not be the case.

I know. It sounds like I am talking in code. And I am. I do not really want to publish the in’s and out’s of what I am talking about, for a multitude of reasons. Let’s say, I was not in a great place between Friday and today. It was horrible, but one of the worst parts is coming out of it, and thinking “Girl, why did you put yourself through that? Why have you just thrown away four days of your time?”

Because everything stopped mattering. I stopped doing my university work, so I am behind my schedule I created for myself. I have messed up my sleep routine, which was not exactly great to begin with. I have damaged myself, physically and emotionally. I have withdrawn from people and just, life. It happened slowly, over a few weeks. It was not that bad at the start, it became gradually worse and then suddenly bad. It is hard because I should have taken myself and my thoughts more seriously before it got worse, but I just hoped it was going to get better by itself, somehow.

I entered a really dark place, and I do not know where it would have gone if I had not picked myself up. I mean, I guess I do know where it would have gone, but I don’t want to say it.

The ‘thing’ that broke the self-destruction was a dream. It was not an interesting dream. It was a very boring dream, if we are defining exciting dreams as being beyond the realms of ‘normal’ life. I never used to remember dreams or nightmares often. But since I have been on nicotine patches I have started to. To be honest, it is mostly a bad thing, to remember my dreams. But not last night.

I dreamt I was starting back at work. I am returning to where I did my internship for 5-6 months part-time. I dreamt about that. It was my first day back I think, or definitely first week or two. I was sat at my desk doing some work, and then a staff member came to talk to me, followed by one other, I think. We were just chatting about work and stuff going on, and I was laughing and happy.

I woke up this morning thinking about it.

It felt like a reason to fight.

So here I am. Fighting.