The Life Plan

My life plan right now is better known as the treatment plan. I’ve had a bit of a dilemma recently. I have a place at an assessment centre for a grad scheme. It was unexpected and it threw a spanner in the works. My plan was to fight to get back into the therapeutic community aka take time out, and then when I got onto the assessment centre I was thinking ‘Maybe I could just never go back to treatment and get “better” by just “getting on” with my life’. And it could work out. Treatment isn’t always the way to get better. Sometimes living life is. Maybe moving to London and doing a full-time grad scheme would help me get “better”.

However a draft email has been sat in my outlook account for the last week. A draft email stating that right now, due to health reasons, I can’t accept a grad scheme offer, therefore I need to pull out now. The reluctance to send it is the ‘But what if I actually got offered a place on the scheme? How can I turn that down?’ which is why I need to hit send. Because if I did get offered it, it would make my life even harder.

I had an “interim appointment” with the PD service today. A brief explanation if you don’t already know from my other posts is that in November I was, in short, chucked out of the therapeutic community (TC). I was “too unstable” and “too high risk”. I ended up on an acute psychiatric ward, and if you are deemed as being acutely unwell, you are not deemed ready for therapy. Since then I have just had an interim appointment in March.

Today a plan was made. My options were private, self-funded counselling which I was assessed for, and found for a VERY reasonable price; it’s with a charity, and they do student rates of £12 an hour! If you’ve ever looked into private counselling you’ll know you can pay £40-50 an hour minimum. So that was option 1, and would involve being discharged from the PD team with re-referral for the TC once ready and suitable (I’m not allowed back while people I was in treatment with last year are still there). Option 2 was to do a smaller, once weekly group for 6 months, starting in Jan with an interim appointment in May and fortnightly scheduled telephone support, then re-referral to the TC in July 2018. Option 3, which was the option I put forward, was to skip the once weekly group, have the interim appointment/phonecalls, and be re-referred to the TC as soon as I can be.

We are going with option 3! The downside is I won’t be having any formal support until that time comes, which should be November/December – but I will have an appointment in August, and fortnightly phone calls with my lead professional. They are going to work out the date they *think* should be the point at which I can go back into the TC process and let me know. I’m expecting it to be no later than December.

The TC process is a long one. You have to do a prep group first, on a Tuesday morning. If I started that in January, I’d expect to be finished in March/April. It took 4 months last time but I think this time I could be quicker. Then the actual TC is for one year. The TC is 3 days per week, with the occasional extra half day where you are expected to help run the prep group in blocks. Halfway (or 3/4 way) through the TC you join another group called Thrive, which would increase it further…Thrive is basically like the prep group, but it’s a post-therapy group…it’s preparing you for leaving the TC…and when you leave the TC after the one year, you continue going to thrive for either three or six months, I can’t remember. All in all you’re looking at 18-24months.

I am dreading it. The TC was the most exhausting, at times soul destroying, intense, sometimes toxic, environment I have ever been in. I found going there three days per week more exhausting than I would find a full-time job. All I wanted to do when I left each day was sleep. Weekends were spent recovering from the week.

The idea of going back terrifies me. It is by no means the easy option. It would actually be easier for me to try get on this grad scheme. I wouldn’t have to feel bad for not being in full-time employment. I wouldn’t feel like a failure because all of my friends are working and living their lives and going somewhere…and I am sat in a hospital. I wouldn’t have to turn down an amazing grad scheme. I wouldn’t have to worry about money. I wouldn’t have to go through intense therapy that is going to bring up some tough stuff; I am not a person who openly talks about stuff with people, so group therapy is really difficult for me. I am sat here right now thinking ‘oh f**ck what am I doing?!’.

But it’s the plan. And it is a good one. I can finish my current job because I will still be here in September, and honestly I was worried at the idea of having to leave the job early to move away for a grad scheme (grad schemes start in Sept) because I would honestly be absolutely gutted about it. People kept saying to me that I can’t not take a 1-2yr grad scheme because I want to finish the last month of a temporary contract and I was like UMMMM YES I CAN IF I CARE. So this works out soooo well for that. A grad scheme would also mean moving from Leicester at the start of Sept when my MA finishes on the 31st aka I would need to get my dissertation finished a month early which would be fun!

And how I am seeing this is…yes I am 25 this year and I thought I would be well into a career by now…but what is 1-2 years of my life if this treatment actually helps? Do I want a full time job where I am struggling and spending evenings and weekends in hospital or prison cells? Or do I want to focus on treatment, get myself sorted, and then focus on my career? In the long-term this could be the best decision I have made. I will be fully dedicating myself to treatment this time…rather than doing treatment plus university. This time I am going to give it everything. If I am taking a year or two out, I am going to make it worth it. While I do want to find part-time work, the part-time work will have to be second on my list of priorities.

So now I just need to work out how to get myself ready for returning so that I don’t get chucked out for a second time!

PLAN.

We also had some interesting conversations regarding diagnosis which I might write about another day, and it was raised that my exercise might be becoming excessive and/or obsessive and how to manage that.

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If they had really wanted to die, they would not have called for help

Is a suicide attempt only really a suicide attempt if the person intended to kill themselves? Is a suicide attempt only serious if the person intended on ending their life?

Often it appears that suicide attempts are not taken seriously. You will hear a whole range of statements; ‘Well, if they had really wanted to die they would not have called for help.” “It probably would not have killed them anyway.” “If they really wanted to kill themselves they would just do it.”

I do not know why people say or believe these things. I think people do not think about it enough to hear what they are really saying, or they are just too far from being able to put themselves into a suicidal persons shoes to be able to understand what it is really like to be that person who attempts to end their own life. In some cases I think people do not want to believe that someone really actually meant to cause themselves life changing, or life ending, harm.

People do not understand that even if a suicide attempt is not successful, it could have been. People do not realise the state of mind a person has to be in to even attempt to end their own life. They do not understand just how traumatic going through that kind of act is.

No, not everyone that attempts to end their own lives wants to actually kill themselves. Does this mean they are not suicidal? No. People do not want to be suicidal. People do not want to feel like death is the only way out. People wish there was an alternative option.

People are desperate, and they can only see that one solution. People make suicide attempts because they feel like there is no choice remaining, so yes, sometimes people do something and call for help. They call for help because they are scared, they call for help because dying is terrifying, and dying alone is even more so. People call for help because they did it because in that moment they could not see a way out, but they also know now that this is not the way through it – but does that mean they did not have an intention of dying? Does that mean it is not serious? No.

Being suicidal, and not wanting to be, is one of the worst types of suicidal experiences there are. You are trapped, and there is no correct way forward. If you do not act on your thoughts you are going to be left with them and nothing will change, if you do act on them you will be left with a million more (but different) problems.

Taking time out.

I have *stuff* going on, and *stuff* in my head, but I seem to be having a few seconds where it comes into my mind, and then I push it under.

Some things happened in my family in April, and then it got took further in December. We heard from the people dealing with the *stuff* today. It has been really quiet since December, and over the next couple of weeks it seems like it is going to suddenly get quite busy with it all. It is like the calm before the storm right now, and I know it is only going to get harder. I did not initiate the *stuff*, but now I am involved in it. It could take a year to be dealt with, and the “ideal” outcome really is not my ideal outcome. I am kind of questioning why I am doing this. The guilt is awful, and I know the guilt should not be mine, but when it is family, it is hard. Family. Family should be all loving and stick together, and when you are basically potentially destroying your families lives, it is hard not to feel guilty. But I suppose the reality is these people are not my family. They were. Technically they are. By blood they are. But that is where it ends now. It is terrifying how much things can change in less than a year.

I also hate that I cannot talk about the *stuff*. I cannot talk about it because it is private and personal, and scary, and also probably for legal reasons. It makes it hard. I do not have “support” at the moment, but that is likely to change on Friday. I am terrified about Friday. I am being assessed for a different mental health service, after being chucked out of the other. And a non-mental health service is attending the assessment, at my home, because they want mental health services to know what is going on with my physical health so that everyone is talking to each other. I’m not keen on this; I like to tell people what I want them to know, I like to be in control of who knows what. Nor am I keen on them all coming to my house. I will be glad when Friday morning is over. It has been hanging over me all week. I am barely sleeping, and we all know lack of sleep is never a good thing. It would be nice to fall asleep without hours of waiting for it to happen, and it would be even nicer to stay asleep. My medication does not seem to be helping, which is odd.

I have been looking, and applying, for graduate schemes. In the back of my head I know that my plan should be to take a year out, or at the maximum, carrying on studying. The service that chucked me out, do want to take me back on once it has been a year from discharge, if I am “ready”. It is just such a huge commitment, both emotionally and in terms of time – it is a day programme for 12 months, plus a few months before and after at reduced days per week. I do not know if I can face going back there, but I know that is not a good reason not to. I also do not want to invest into going back there, and it not work out. I cannot handle failing twice. I was supposed to go and do it during my masters, and that plan fell apart when I was chucked out. They probably would not describe it as being chucked out, but that is the reality of the situation.

It is also the whole taking a year out for “treatment” thing. It feels bad. It feels like failure. I kind of want to stop applying for jobs and graduate schemes, purely because I do not want to end up in a position where I have to turn interviews or an offer down. Like, what if I get a fantastic opportunity that could help me with my career? That has the potential to be the stepping stone into my ideal future, and I have to say no, sorry, because I am going to be a “patient”. I do not want the patient identity to be everything I am for a year. I also know if I had a physical illness I would feel differently. But it is not really something you can whack on your CV. And it is hard to feel OK with explaining a gap in my CV when it is for what it is. If I had a physical illness I would just say “I had a year out because I had (insert illness)”…but this will never be that easy.

But then, what is one year if it changes my life? I am not going to sit here and feel sorry for myself. I have to turn whatever choice I make into a positive. Nothing is bad or good, it is what you do with it that makes it bad or good. I firmly believe that. A positive mental attitude is required.

I know the sensible thing to do. I just do not like it.

This was not the situation I was supposed to be back in, again, but it is the situation and I can own it, or I can let it control me. I do not have to let the “patient” identity be my identity, even if I go down that route of taking time out. I can volunteer, I can write, I can do other things.

And at the end of the day, other peoples opinions are not really that important. If people do not like what I am doing, or think less of me for it, that really is not my problem. And will people even do that? Or am I stigmatising myself?

I am really interested in the concept of the “stigmatised” assuming the stigma is there, and paradoxically causing themselves to be stigmatised. I am probably guilty of it. Is being open really as bad as it feels? If I take a year out, and then go to an interview and respond to the questioning of what I did in that year truthfully, and tell them the other things I did in that year, will people think what I think they will?

We cannot assume what people are thinking. People are entitled to be given the chance to think for themselves.

 

 

 

Mental Illness Doesn’t Discriminate, So Why Do We?

I was at an appointment the other day. The staff were aware of my mental health problems, and they asked me what I do in my free time. I said at the moment I am working and at university. She looked shocked. She then said “unpaid work, though?” because obviously us crazy folk cannot hold down a paid job. I mean, what kind of fool would pay me to work?

It annoys me. Number one unpaid work is a brilliant thing to do for experience, and for giving something. Number two, why would you assume my job is unpaid?

I was then further annoyed when she said I needed to come back on Monday to see their consultant. I told her I had work, and couldn’t make it. She looked at me and said “well, you have to have see the consultant” and then booked me an appointment any way. I was stood there thinking ‘yup, please ignore me, my words mean nothing’.

I honestly do not think that if I was ten years older, and not in for something mental health related, she wouldn’t have ignored me. But hey, I am crazy so my job cannot be that important, right?!

We think that we have progressed with our attitudes towards mental illness, and my gut reaction is to say some progress has definitely been made. I mean, we do not lock everyone away in asylums anymore, people are not oblivious to mental illness, and people know what depression is. Mental health is talked about more. Being homosexual is no longer a sign of insanity, and we do not drill into peoples brains hoping it will ‘fix’ them like we did in 1935.

My research in my undergraduate degree proved that making a definitive conclusion is not that easy. Some things have improved, some things have not. Do you know what schizoaffective disorder is? What about obsessive compulsive personality disorder? Unless you have an interest in mental illness, or personal experience, probably not. Even spellcheck does not think ‘schizoaffective’ is a word.

While general attitudes have become better, I would argue it is something we are fine about as long as we do not have to come face-to-face with it, and for a lot of people mental illness is something that affects others, not themselves. Did you know that only 46.9% of disabled people are in employment? Which is a gap 33.1% higher compared to people without a disability. The disability employment gap is one of the most significant inequalities today.

In 2015 the Conservative Party stated that to half the gap they would need to change policies, practices and public attitudes.

Not all disabled people can work, fact. That is why there is no goal to get rid of the gap completely. But some can, and some want to. It is easy for people to respond to this huge gap by saying that disabled people do not want to work, that they want to live off benefits, and all of that other rubbish that realistically applies to a very small percentage of those with disabilities, and actually also to a larger number of people without

I do not personally have much of an issue with the term disability. I would agree that I do have a disability, and that it can be extremely disabling. But it can also be worked with if I am surrounded by people who are willing to be understanding, and to provide me the right environment to minimise the impact my disability has on my ability to work, and to succeed.

Starting my recent internship has made me aware of the difficulty I would definitely have to work full-time, while juggling my medical appointments. I can see why this could be unattractive for an employer, and even for me; even if I managed to find an employer who was happy for me to take time off work for appointments, it would mean that my disability would still be impacting my ability to work full-time, and receive full pay. But this is the thing. I would not think about that; that is something I have to live with, but being discriminated against, is not.

I would be overwhelmed by the amazing support of my workplace to enable me to work. I would arrange my appointments as best I could to avoid interruption. I would stay late at work if I could, or arrive early. I would give everything I could and more, and being able to have my necessary appointments would actually boost my productivity at work, compared to if I was having to delay them, hide them, or become stressed at managing them.

The thing is, people can discriminate against people with mental illness, but mental illness is never going to discriminate against you. You might have a negative attitude towards those with a mental health problem, but they are still going to come into your life. It is going to affect your colleagues, employees, friends or family, whether you like it or not. Whether you think it is something that happens in your life or not.

More scarily perhaps, is that one day it might be you. You could be the top dog in a major company who does not take particularly take an interest in disability in the workplace. You might be a bit irritated that your PA, Janice, has to take two hours off on a Wednesday afternoon because she has a one hour appointment with her community psychiatric nurse, plus has to travel to and from the clinic. You will forget Janice stayed at work for an extra hour on three days last week. You will forget Janice doesn’t take lunch breaks, and always emails back at weekends. You will forget that since Janice started her role, she has made your day-to-day life easier, and taken on many extra roles that you never expected her to take.

You will be reluctant to hire the best applicant for your new events manager because she disclosed that she has physical health problems that will mean she has to take some time off work once per month to travel to a hospital out of the local area. You will think that you need someone who does not have these needs, and that they are not suitable for your company, just like the principal that once said to my support worker that students with severe mental health problems are not going to achieve A-Levels, so why support them in trying to do so?

And then fast forward, it is 2027. You have been getting very stressed at work. Janice left, and her replacement is struggling. Your wife has been working away a lot, your kids have left home, and it is like you never see neither them or your wife any more; she admitted a few months back that she is not happy in your marriage. Your mother has Alzheimer’s (which is a mental illness too, but for some reason that doesn’t count) and she is deteriorating. Last time you saw her she did not know who you were. You have begun thinking a lot about your childhood growing up, and how she used to be. You keep remembering things you had forgotten; maybe your childhood was not as rosy as you had convinced yourself. You remember your father being very violent to your mother, and having to witness that. Bit by bit it is coming back to you, like a tap that no matter how hard you tighten it, it just will not stop dripping.

You feel low. You know you do. You say low, because you do not want to say depressed. Men do not get depressed, not strong men like you. Not top of the company men. Not men who earn £100, 00o per annum. Not men who are well educated, and whose parents were too. You tell yourself you will ‘snap out of it’ soon. Maybe you just need to work harder. Only weak people take a step back, take a break. But it is getting worse, and you end up going to see your GP. I mean, he will just say you are fine.

Well, apparently not. Apparently you have signs of depression, but mental illness is not something you will ever experience, right? He must be wrong.

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Does having a mental illness make you a negative person?

I really aspire to be one of those people who are always positive. One of those people who are always smiling and laughing. I used to be at secondary school, before my mental health problems really began and I have often questioned whether I am a negative or a positive person. I’ve come to the conclusion that I am positive..  yet I don’t see how that is possible given how I feel a lot of the time. People describe me as positive and I think “yeah, you’re thinking that because I don’t let you see the other side of me.”

But is feeling low, is feeling suicidal, really the same as being negative? It sounds like a stupid question. How can wanting to hurt yourself be positive? I’m not saying it is. It isn’t.

(Here comes the but)

I spent Friday night in A&E. I was there from 1.30am to 9.30am cycling between crying my eyes out, scratching my face off and sitting in silence. Saturday I spent asleep. Sunday and today I haven’t exactly been bursting with energy and thirst for life. I have had moments where I want to fight, but I have had a lot of moments, more moments, where I am extremely upset, distressed, angry, or denying having emotions, denying needing people, not allowing myself to like myself, blocking people off and hiding away. Is that negativity? Do we judge me by these facts? Or do we look at the fact that this evening I managed to take myself on a nice walk in the sunshine and come home and do a little exercise and put my positive head on? Is positivity the absence of negativity, or is it coming out of the negative mindset with an overall positive attitude? Isn’t someone who can come out of such a horrible place, still fighting, one of the most positive people of them all? Surely it’s easier to be positive when things are all good. Does being positive when things are all good really make you one of those optimistic people? Or is an optimistic person one who can experience the worst possible feelings but still smile at the end of the day?

No, hurting myself isn’t positive. And no, it isn’t the person I want to be. Feeling low and hopeless isn’t the kind of person I want to be neither. But I have borderline personality disorder and this is how my life is, and to varying extents, probably always will be. I’m probably never going to be the exact person I want to be, who never lets things get her down. But maybe that’s okay. To live with this illness, to spend 9 hours in A&E crying my eyes out, to hurt myself again and again and hibernate in bed for a few days and then to get up, get dressed, go out, smile, talk to people.. to carry on in spite of everything. Maybe I should be proud of being that person. Proud of being what I am, rather than being disappointed in myself for what I’m not.

Never let anyone make you feel like you are are a negative person to be around because sometimes you feel less than ecstatic. Everyone gets down, and some of us get it worse than others. Some of us aren’t momentarily unhappy. Some of us have an illness that makes this more frequent, more intense and harder to live with, but never let that make you feel like you’re not an optimistic, positive person. To keep getting up and trying again is one of the most amazing traits you can ever have. To let yourself feel all of your emotions, including the terrifying ones, and to still get yourself back up, is a part of your personality that will take you further than you can imagine.

 

 

 

The A Word.

This is my first post about this, and the word still feels too big to come out of my mouth. Ironically it’s only five letters long.

Abuse.

My Mum was abused as a child and she always said “I’ll never let anything happen to you.” and I always thought if someone was being abused, surely they would know. When I started going to CAMHS (Child and Adolescent Mental Health Services) my Mum went to my initial appointment with me. The problem, in everyone’s eyes, was the fact that I had lived with my Mum in and out of psychiatric hospitals. I went along with this, and so I never spoke a word of my relationship with my Dad.

That was when I was 14. I am 24 this year. Almost a decade later, a diagnosis of Anorexia Nervosa and Borderline Personality Disorder. Weight restored from the Anorexia. Scars. Hospitalisations. Overdoses. Other suicide attempts. And that word is suddenly being said.

The cost is massive.

The cost has been not just my Dad, but most of my family. Not only now do I have no contact with my mothers family after they sided with her father when her abuse came out, but now I have no contact with mine.

I graduated last week, and this was the first time there was a Dad shaped hole. I’m not sure this is ever going to get easier. I didn’t just cry because he wasn’t there, I cried because I know he would be just as upset as I was. It wasn’t supposed to go this way. He was supposed to admit to what he did, apologise, and we were supposed to move on. That is what I wanted. But he didn’t admit to it, there was no apology, and it all exploded.

This happened in March/April. Things kicked off again this month. I thought I wouldn’t survive it. In April I relapsed into my self-harm on a grand scale, ended up ringing my Mum for the first time ever and she had to come to get me from where I live. I was desperate. Then this month when it kicked off, rather than hurting myself, I called my psychiatrist and cried down the phone. Since then I’ve not cried at all, till my graduation.

He was supposed to be there. Him, and my step-mum. I love them both dearly. The situation when I was a child was complex. My Dad could not cope. I’m not trying to justify what he did to my sister and I, I am simply putting it into context. I didn’t want this to destroy our relationship, I just wanted him to acknowledge what he had done. He didn’t. And that was his choice, but it’s not only him it affects.

My sister has struggled tremendously, she is currently back on the acute ward and that itself has been chaotic. I was always a Daddy’s girl and it’s hard to get to grips with the fact that before March I was close to my Dad, and now we don’t talk at all.

Through it all though, the people who matter most to me have stuck by me, and I try to hold onto that. I try to see the positive. I try to tell myself that the people who walk away because it is easier than facing the truth do not deserve me.

But it’s not really that easy.