Fall down, get back up.

I haven’t wrote in a while. It’s the usual, what do I actually want to share scenario.

I have good news any way. I have been taken off my section 3 and discharged from the unit. I am back tomorrow for an appointment with their inreach team but after that I will never be back on the ward, just the outpatient clinic.

The time I was on a section 2 was horrendous. I was doing things to myself, and it appeared like I was getting worse, both for me and the staff. I started getting more leave in an attempt to improve things, however things became even worse. I went back one Monday about a month ago expecting discharge, and instead was placed onto a section 3. This marked change. I think I knew that because I had just been placed onto a section 3, and because the consultant was going away, there was no chance of me leaving for at least two weeks, so I sort of admitted defeat.

The day after being moved onto the section 3, I had my first proper chat with a nurse. I hated said nurse with a passion. She turned out to be the person who helped me most, the person I opened up to, and a big part of me being where I am now. I never expected that. The biggest thing I have gained from this admission is the ability to use my words to express myself.

There were a lot of awful times where I was unable to keep myself safe, or look after myself. I do not remember the first week. I did not eat, drink, or leave my bed. I do not remember any staff from this time except for one, despite the fact I was on constant 1:1 meaning I had to be with a staff member at all times who could see me, including if I wanted to shower or use the toilet.

After that week I made a slight improvement in terms of eating and being out of bed, but there continued to be a lot of risky behaviours. It is strange to look back and remember certain things. I remember looking in the mirror having lost weight, with marks all over my body, bloodshot eyes, a bruised head like you have never seen before, burst blood vessels all over my eyelids, cheeks and neck. I hadn’t been washing. I hadn’t had any change of clothes because I had none.

And now? Now I have gained weight. I am dressing, showering, wearing make-up, doing my hair. I look happy. Nurses have told me I have a sparkle in my eye. I smile a lot. I laugh. When I have been back to the ward lately I talk to the other patients, check on them, get them into the garden and have a kick around with them. I’ve spent a lot of time in that garden kicking a ball against a wall. I talk to staff, joke, laugh, smile. Cry with happiness, not anything else.

That is not to say the last few weeks have been problem free. I had my leave taken off me over bank holiday after going on a 30 minute walk and not returning, and needing a lot of support to keep myself safe and return. I lied to staff, to their faces, to get out that day because they were concerned, and I am shocked at the fact I did that. Losing my leave led to the second time I have become extremely distressed in there. I dived out the door when a member of staff was coming through, and had several nurses drag me back onto the ward. But the thing is, in there, each day is a chance to start again.

I got my 8 hours leave back last Tuesday, for each day. Then had overnight leave Saturday and Sunday, and was discharged today. I was given the option of a weeks leave, then discharge, but it felt best to have a clear cut discharge.

The night I was placed onto the section 2, I was distraught at going into hospital. It started with a phone call with my community team, led to an A&E visit escorted by the police from which I managed to escape from, and led to an incident that saw me being arrested on a 136. I’m not going to go into the incident, but when I was arrested the police officer was shaking, he was holding me down on the ground and he kept saying that everything was going to be ok; the worst was over.

I did not believe him. I was thinking that the worst had just begun. He saved my life, quite literally, and I was angry. Yet deep down a part of me wanted to feel his relief, and I think I was able to recognise that was something to hold onto. I can honestly say that very slowly, I am beginning to feel relieved. If the police officer had reacted a few seconds slower it is highly unlikely, if not definitely unlikely, that I would be alive right now. A few seconds where I stopped feeling fear and found myself at a total loss, could have ended my life and destroyed the people who care about me. He stopped me from doing that.

I was angry at being in hospital for probably 70% of my admission, and not happy about the situation for about 95%. But now I look back and I wouldn’t take it back. I am grateful that I was forced to stay in hospital when I wasn’t able to see that it was needed, and I am grateful to have been allowed out now that I am strong enough to support myself.

A lot has, and is, changing in my community support. I was discharged from the service I was under when admitted. I can return in February, but I doubt I will. I am now about to start private therapy with a low fee service and my NHS support is completely different, and has not really begun yet.

I will be seeing a new psychiatrist, who I have met once. She was amazing, I have to admit. I cried like no tomorrow, but it also felt good. I have been referred for the 3rd time to CMHT, and that will take some time. But what is the biggest thing right now is this new service. It is small; it has less than 10 staff members, and has only been open for 2 years. In those 2 years it has seen 120 patients which is nothing in comparison to most teams. It is funded by the police, and is a partnership between them, the NHS and a charity. They provide short-term intensive support, so for now I will be seeing them twice weekly at home. That will decrease pretty quickly, and after 6 to 8 weeks approximately, it will stop, and I will then be under the care of CMHT and the psychiatrist.

I am a bit anxious about it, and about the fact that right now it means all new people again. They attended my discharge ward round today and basically I will be seeing the nurses and the police officers. The police involvement panicked me a bit, but they are specialised in mental health, and will be much more like seeing a nurse, than a police officer. They don’t wear uniform and if you didn’t know they were police, you’d think they were nurses.

I am also moving this month, into a new houseshare. Said houseshare is with the loveliest live-in landlady ever, a beautiful home and a goregous chihuahua called Tilly. I was honestly terrified of post-discharge due to living and money and work, but I honestly feel like things are falling together so perfectly that it is almost unbelievable.

I know that difficult times are likely to come, although right now I can’t imagine it. I know that things won’t always be easy, but I also feel like a brand new person.

I never thought I’d go onto an adult acute ward. I never thought I would be sectioned. I never thought I would have both those things happen, and end up concluding that while I would never want to go through it again, I would not take it back. But I wouldn’t. I feel fresh. I feel new. I feel happy.

I don’t feel afraid of being here tomorrow.

I honestly could not speak higher of the professionals who have worked with me.

I honestly could not be prouder of myself if I tried.

I have a heap of regrets with university, work, and many of the things that have happened over the last 2-3 months. I have a heap of things I would do differently. I could sit here and list them all…if I wanted to. But I don’t. I don’t care. It was all worth it. Things fell apart, and then they came back together, stronger than ever.

That’s all that really counts.

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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.

 

While There is Life, There is Hope.

Pre-warning: This is a long post (like 99.97% of my posts). Sorry, not sorry.

I have quite a lot of rough patches every week, often at night time. It is not uncommon for me to spend the early hours of the morning walking around the city. More often than not I wake up in the morning wondering why the hell I was in such a state (and tired!)

I have also been doing a lot of reflecting while walking.

I think I have mentioned in brief that things took a turn for the worse in late December. I went to my hometown for Christmas. I stayed at my sisters new house and it was nice to begin with, although a little weird to see my sister independent and in her own place. I was supposed to stay until after New Year, but then something happened on the 28th of December and on the 29th I got the early coach back to Leicester.

I was not in a good place. I had stopped taking one of my medications a few months before; at first it was forgetfulness more than anything else, then it was a case of “well I didn’t take it most of last week so clearly I don’t need it.” My mood was dropping rapidly, and the obsessions that the medication was prescribed to treat became a lot worse. I cannot say it was stopping the medication that caused that, because it could just be coincidental, but what it did mean was that when I got back to Leicester I had a huge amount of medication sat in my bedroom.

I took them.

It’s hard to admit this. I am not sure why. Fear of being judged maybe. Fear of being open having an impact on how people see me, and on my future prospects. Fear of people who know me reading this, when only my family and a couple of close friends know about it.

I fell asleep in 2016, and when I woke up it was 2017. I was confused. Apparently on the day I gained consciousness I made a nurse call my Mum, before falling to sleep for 24 hours. When I woke up I made a different nurse call my Mum, panicking about the fact she would be worried about not hearing from me over New Year. The nurse told me that my Mum was saying I had contacted her the day before, but I did not remember at all. I do not remember anything.

I know it was serious. I know things could have worked out differently. But I feel extremely aware of the fact that for me personally, it was not the worst experience I have had. I was unconscious, and if at any time I was aware of pain or what was going on around me, I sure as hell do not remember it now. The worst part of what happened was feeling embarrassed. I had a catheter in, and when I tried to walk for the first couple of days I couldn’t. The medication gave me the side effect of a tremor when I was taking the normal dose, so the overdose left me violently shaking and my legs just buckled underneath me. But it honestly was not that bad.

Not that bad in comparison to other less “serious” things that I have done. There have been things I have done to myself that have been far more terrifying, far more painful, and to be honest, quite horrific. Largely because I was conscious. I have also been arrested while in a crisis, and when you are in that kind of state and locked in a prison cell for 16 hours, I can tell you that you leave even worse than you were to start with.

I have been thinking about these things a lot while walking, and the consequences of the suicide attempt; I was assessed under the mental health act, and told I had a choice between voluntary admission, or being sectioned. I agreed to go in voluntarily, which I am beyond relieved about. I got myself out quick, and I mean quick. Even the psychiatrist admitted he would not normally let someone out as fast as I got out. I was determined. I was thinking that if I stayed in there I was choosing to fight, and if I was going to choose to fight, I would be far better off fighting at home.

The hospital environment was bad for my eating; I was not eating at all and my weight was dropping, and I felt like my anorexia was re-gaining control shockingly fast. I knew if I stayed in there I was going to find myself with more problems, rather than less. I was dizzy and light-headed, and more to the point, it was making me feel better. I knew that was not good, and I knew it needed to stop. I was also due to start an internship, and that felt extremely important to me, and I made it very clear to the psychiatrist. I knew that I needed to prove to myself that I was capable of doing it, and that not doing it would have a really negative impact on me. I was terrified, of course. I wanted to run a mile, make up excuses not to do it, and avoid facing my anxiety; but I also wanted it, badly. I wanted it more than I was afraid of it, and doing it was one of the best decisions I made. In fact, in January it was just about the only good decision I made.

I was scared. I begged and begged my way out of hospital. I jumped through the hoops. I did what was expected of me to prove I was safe. I gave them no reason to use the mental health act against me again. It could probably have gone two ways; it could have gone badly. I remember getting home and while I was insanely relieved to get my freedom back because I cannot cope being stuck indoors for a whole day, never mind longer…I walked into my house very overwhelmed. I panicked. I thought I had made a mistake. I remembered what things had been like leading up to the admission, and as to be expected, I was doubting my ability to cope.

It also could have gone well. And it did. Sometimes there is such thing as ‘positive risk taking’ and this was that.

I still get myself in bad places. Having Borderline Personality Disorder means I often get myself into the worst kind of states, and then several hours later I am thinking “Girl, what was that about?!” It is extreme, a little dramatic and very frightening; I know I can do things that feel right in the moment, that in less than 24hrs time will seem ridiculous.

At my worst points, and on my walks, I have established some facts that help me to keep safe:

  1. I want my life to mean something. I do not want to be remembered as the girl who ended her own life. I want to do things that help people, and make my mark. I do not care how big or small that mark is, but I want to make it. Even in the darkest of times, the idea that in my lifetime I might make a difference to a single persons life, feels like a good enough reason to fight.
  2. People. And I do not mean fighting for people, or because people love me and losing me would hurt them…but that there are people who have done so much to help me, and I just cannot chuck that away. My Mum and sister have stood by me through thick and thin, even when I least deserved it. And professionals including my previous psychiatrist and various people at my secondary school, college and university who have still believed in me when I lost all hope, who have fought for me and simply never given up on me.
  3. Things can change for the better, and quickly. Just as things can get suddenly worse, they can get suddenly better. There are endless nights I have survived, and woke up relieved. One of the hardest things to do is be in a state of despair and believe that it is not permanent, but one thing I remind myself is that change is actually the only thing in life that is guaranteed.
  4. One of my common thoughts when struggling is that I have been fighting for so long, and that giving up is only logical. My mentor at university challenged this by saying that surely having been fighting for so long is a reason not to give up now, not to throw all of that hard work away. I’m not going to lie, when she first said that I was thinking that she did not get it, and it was a load of rubbish. BUT, on reflection, it is true. I did not come this far, to only come this far.
  5. Future treatment. During a recent bad night it hit me; I have an opportunity to go back to the therapeutic community and dedicate some time to working on myself. If I truly put everything into it, and do not self-sabotage it, it could really make a difference. I mean it might not, but it might. What is more the point is that it is with a service that I have gained a lot of faith in, with people I have begun to trust, which I did not previously. I mean regardless of whether the treatment method is ideal, I know the staff and other patients from experience are in equal amounts supportive and challenging; they are tough and sometimes hard on you, but in a helpful way. How can I give up before I have exhausted all options?

The biggest thing is, how can I throw my life away when there is hope for change, people who will stand by me, people who will not give up on me even when I do, and when I have the power within me in some small form, to do good?

If I give up there will be no more trying.  And while often trying feels much more like struggling, I will take the struggle because struggling can lead somewhere. I hate struggling, but at least struggling means there is hope.

While there is life, there is hope. 

I hope that if you cannot see a reason to make it through another day, you can hold onto the possibility that one day you will find a reason. I hope you know that although I am just a random stranger sat behind a computer screen who does not even know your name, I believe in you.

I hope you know that your kindness has to extend to yourself, and that your place in this world is important.

And I know this is cheesy, but I hope that you know that I am a human. I am real. And I am always only a message away. I care.

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.

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!)

In Which I Rant About Everything.

Apologies in advance for the abnormally open and long post.

I am a bubble of stress and anxiety. Mostly anxiety. I have in this learnt that anxiety is one of my biggest triggers for negative coping mechanisms and now I am looking at the past, I can’t see why I didn’t realise this sooner. I think I was in denial of it, because two people had brought up the idea that my negative behaviours are often a reaction to anxiety, and I totally dismissed it and to be honest, quite frankly felt annoyed at the suggestion.

It all just got too much on Friday and I ended up in A&E at 4am which was incredibly stressful, not helped by the A&E department moving to a new building with new procedures. I was a mess, but maybe I needed to be a mess. Maybe it helped as horrible as it was. A&E is usually the place where my meltdowns occur, like I’ve been holding myself together and then I just fall apart. Any way, I got physically sorted and had this lovely doctor who knew me already. He spent absolutely ages with me before I managed to talk but it was helpful, although kindness and people saying nice things about me always makes me upset and he seemed extremely worried. He said normally I seem a bit better after what had happened to end up there, but that this time I seemed a lot worse. I saw the mental health team after treatment for a few minutes, but that was unhelpful or rather, pointless. I was tired and calm, and not bothered about talking. I felt like I did the talking with the doctor and to be honest, considering he wasn’t a mental health professional, he was a lot better at helping me than the mental health team ever have been. I guess I got lucky there. When I first saw him I was thinking ‘oh god not him’ because I knew him, but he was amazing with me. He also said some interesting things about my diagnosis and treatment, and that he has never met someone with my diagnosis who is managing as well as I am, and studying for an MA which made me feel both good but a bit annoyed that being outwardly functional sometimes makes people over estimate how ‘well’ you are doing.

The doctor was discussing admission to the psych ward or crisis team input but as soon as I saw mental health it was clear that was out of the window, which was mostly a relief.  The following days were full of feeling anti-treatment and spending pretty much all night every night walking in the dark which on the first couple of nights was very dangerous, but on the last night, was very peaceful and reflective and last night I was sat up till 4am arguing with myself over a decision. I made the healthiest decision, the safest one,  and I feel calmer now. I’ve overcome most of the guilt and regret of ending up in A&E because I am a work in progress and that is ok. I pick myself up quicker and better than ever, and that is an improvement. I have time to improve further. This is not a race.

So yeah, I have *picked* myself back up again, which is good, but not exactly fun or pleasant. I’d rather not. I’d rather crumble. Correction, in the short-term I’d rather crumble because it is easier. In the long-term I will be glad I am not crumbling. I know where crumbling ends and I will not like it.

I think a big part of my stress is to do with treatment. Like, I was kicked out of the TC in November and things have felt so unstable since. It is like I am supposed to make myself stable while everything around me is the exact opposite. It doesn’t feel like the easiest of things to do.  I’m meant to be starting counselling privately but I’m re-considering doing a group at the PD service (same service as the TC) instead. I don’t know which will be best for me. I think I would prefer to do the counselling, but that perhaps the group would actually be best for me. But I have no idea what day the group is on, or if it is still an option, so I need to find out which means ringing them tomorrow. I don’t want to wait till next Friday because I’m starting my new job on Wednesday and if I am going to have to ask to swap my days around I want to do so in a way that is the least annoying for work so my plan is to find out what day the group is tomorrow, so when I go to work on Wednesday I can ask to change my days to fit the group, just in case I do the group. It feels like the best option rather than messing work around in a months time or whenever.

Now I want to do the group I regret stretching the truth with my responses to the initial questionnaire thing for it. And regret ruling it straight out without thinking. I am scared now that I won’t be able to do it aka more anxiety.

I am also stressed about life post-September aka post-university. I will be unemployed and that makes finding a grad scheme very attractive and I only have a few options that way because of timing. But then there is the idea of going back to the TC, which I had to be honest, ruled out, but I think that is largely a fear of what if it doesn’t work? Which makes me feel like not even trying for fear of ‘failing’, a fear of coping financially and really not wanting to return to a house share because it is SO bad for my mental health and my eating and my anxiety. And then a fear of not being allowed back even if I am “stable”. I don’t know how real that fear is. I’m just scared of rejection and uncertainty.

Also, I don’t know what timescales will be and that is probably quite unpredictable for anyone to say. I mean say I got referred back at the end of November, assessed or whatever by Jan..approved for prep, joined prep in say Feb or March? Like, what do I do between October and March. Financially speaking, and in every other way, it’s a worry.

I mean the best I can hope for is to get myself to this new job without using negative coping mechanisms/sabotaging it completely, ring tomorrow to find out about the day of the group, ask to do the group in my next appointment on the 12th, them agree to let me join, join ASAP, work on “stabilising” further, then when I finish uni look for more part time work in anything though I’d prefer something career related that might be difficult if I want part-time which realistically I do, apply for help financially and find a cheap as possible one bed place (house sharing would be financially better but it feels like such a bad move), finish the group and be re-assessed for the TC, then wait to join the prep group.

I don’t know how realistic the plan is. I’m worried that I won’t be allowed in this group now, but that can be replaced with the counselling and I will just have to work on not letting the issue I am worried with re: counselling, become an issue. I’m also worried that if I do still want to join the TC which at the moment I mostly do, that they will decide I am too well or something. You know, 2016: you are too unstable. 2017/18: you are too stable. That would be a turn of events and not ideal for me. Like stable does not equate well, or happy, or where I want to be at the end of all of this.

Then yeah, going back to work is making me a bit/a lot anxious. And other little things like this walk I am supposed to be doing to fundraise for a charity, some volunteering etc. And then university is a huge stress right now because I’m behind and not sure if I can make up the work, never mind get a decent grade. And then there’s other stuff, like sorting out my routine and sleep, which is a massive issue right now, and exercise and injury and eating.

I just really want some stability around me. I guess the primary things I think I need is a stable once weekly appointment of some kind, either the counselling or the group. To settle back into working. And to be managing a better routine – sleep, exercise, uni work and work being the priorities. Then adding in little things like the volunteering and actually seeing friends at least occasionally without getting so anxious that I cope using negative behaviours.

My psych appointment got cancelled, and while I am bothered, I am less bothered than I was because although I still want medication, that feels suddenly less important to me. Like sure the meds I want to go back on help my mood/anxiety/obsessions and it would definitely help stable me out a bit and ease those things, but there are other methods too. Of course ideally I would have meds plus the other methods but I guess there is no rush and hopefully I will get another psych appointment soon. Pinning my hopes on being allowed back on meds isn’t helpful and is potentially dangerous as I could be disappointed, so I am taking a few steps back from that idea.

I have an interview for a grad scheme and I’ve seen two other things I’d be interested in applying for, but it doesn’t fit in well with my current job which I need to be working in September for. I mean I know a longer-term job should be a priority over the temporary job but I really REALLY want to work there in September because it’s a key part of the campaign and I mean, yeah, I want to badly. And also, starting a grad scheme/job somewhere else in September really does not fit what I want treatment wise and so I am weighing up my options. While I really want to get a proper full time, permanent career job, I’m not sure I am “there” yet. I want to be there and I am trying to work out if I can just y’know, do it and find my way through it as I go…force myself to manage it. Or whether I just need to try and be ok with taking another year or so before getting into that kind of scheme or job and being 27 years old and just starting my career. I do feel a lot of pressure about being 24 and in this position, pressure to be doing what other people my age are doing and to be on the whole career route thing and I hate it. And I know, people say 27 is still young but I wanted to be in a career by 22 and it just really gets to me.

So if I am going to take the treatment route and take time out, I am going to really prioritise therapy and give it everything I have got so that once I am done, I truly am done. Which is very good motivation, it makes me feel very determined. I feel like if I go to the appointment on the 12th and have a clearer plan in my mind, I will probably improve a lot in terms of my mood and negative coping mechanisms and so that feels really important right now. I want to give up and run a few hundred miles from treatment for fear of failure and rejection, but I know what I need more than anything is to feel…I don’t know, contained and safe, and stable.

The sooner the 12th is here the better right now. Going a couple of months between appointments and having no set clear plan is just really unhelpful for me. It’s unsettling and it makes me feel unstable. I struggle to hang onto the plan at the previous appointment for such a long period of time.

I sent them a letter asking to be discharged on the 12th and while I am proud of myself for clearly asserting what I wanted at the time, I think it could have been a wrong decision. I literally woke up that morning with the idea and wrote the letter and sent it all in the space of two hours. It wasn’t exactly the best thing to do so quickly. I’m going to find out about the options with the group and not make a decision right now. I’ll go to my appointment on the 12th and discuss all options openly and without putting a heavy preference on any option, and decide there and then based on the positives and negatives, the options, and just in an appointment where I will be thinking rationally and won’t be making decisions based on feelings or misinterpretations of what other people are thinking.

Plan. My focus between now and then is manning up and going to work on Wednesday, working on my routine and university work. Keeping up the exercise while managing injury, and doing this sponsored walk. I also think I need to stop being so negative about trying mindfulness because a lot of my impulsive behaviour is connected to thinking far too ahead and panicking and the whole being in the moment thing sounds like a very good thing despite my dislike of the idea of mindfulness. Plan. Plan. Plan.

When you say “they hate me”, do you really mean you hate yourself?: Avoidance and (lack of) Mind Reading Abilities

I think I believe I am a mind reader and I absolutely without any doubt know what people think about me. And usually that is that they hate me.

I use the word ‘hate’ loosely. I do not mean they seriously hate me or despise me. When I say I think someone hates me I usually mean:

  • They think I am a bad person
  • They are sick/tired/fed up of my “issues” and sick of me/sick of hearing about me/sick of having to deal with me
  • They think I am annoying, a drain of their time etc.
  • They do not exactly like me
  • They are judging me on my “issues”

There have been a huge number of examples of how I have felt this way over a number of years, and I can recall my previous psychiatrist telling me that I am not a mind reader and that maybe I should give people a chance, and let people form their own opinions of me rather than doing that for them. In that sense it sounds quite unfair that I assume what people are thinking, because in some ways I am almost judging how I think they think or feel. And on top of that it can lead to me avoiding said people to either a) not make them any more fed up of me, or b) the whole thing where I would rather reject someone first than hang around to be rejected by them.

Just lately there have been a number of examples of this, and I am becoming acutely aware of it because I have both been able to vocalise feeling this way in some examples, and also been given information that suggests the opposite of what I think. (And the fact there has been a number of examples in a short space of time). What I mean is, either I have asked the person if they hate me in a jokingly but not joking manner, or someone has told me something that has been quite the opposite of “they hate you.”

I have to admit that often despite a severe amount of evidence to suggest people do not hate me, these lessons often serve no real purpose. For example, in December I saw my mental health team and I was quite upset and feeling very much like they were very angry and fed up of me, which I translated to “they hate me”. I was given evidence on the contrary, and in said appointment I felt reassured. But come the next day I was straight back into “they hate me” mode. However more interestingly, I saw them again in March and received said reassurance again, and this time I am able to hold onto it much more than before. That is not to say that I have not felt annoying when I have had to speak to them over the phone, but the ‘hate’ bit has been a bit weaker.

My learning whatever mentor (I do not really know what her title is) from my university came to the appointment in March. On the way there I asked her to look out for “any signs that they hate me.” I wanted her to sit in the appointment as an outsider and see what she thought, of which I thought the outcome would be very supporting of my views, although I did add that perhaps they would act differently with her there. Looking back it was ridiculous. The two therapists that were in my appointment are absolutely bloody lovely and I feel awful looking back now at just how suspicious I was of them. Act differently? What was I thinking? That they would “act” because my mentor was there? I think I just thought that maybe my mentor would come to the conclusion they do not hate me, and I would then be able to argue back against that by telling myself that they were just pretending for her sake.

Thinking I know what other people think, and being so suspicious of peoples motives, really is not the best quality I have. It is actually unfair on others and I was yet again surprised today to find out when speaking to someone else, that a person I thought really, really hated me/judged me, really does not.

I think the obvious answer as to why I fall into this way of thinking is what most people will conclude; that I transfer my feelings about myself onto other people. I feel reluctant to agree with this, but then the obvious answer is quite often the answer. I feel insane guilt for my behaviour sometimes, albeit related to not managing to do things i.e. university work, meeting friends etc. or my self-destructive tendencies. I feel bad, guilty, ashamed and disappointed in myself, and I assume everyone else feels said things too, and therefore that they think I am a bad person aka they hate me.

It is a vicious cycle because feeling bad about myself leads to me doing more things that I feel bad about. I avoid university because I feel bad at not being a good enough student, and then avoid university even more because I am scared to face people and feel bad about being bad. I think my mental health team hate me because of my behaviours, avoid contacting them for support because I think they hate me, and then end up engaging in said behaviours even more, leading to more hate and more avoidance. And the same goes for a lot of situations including with friends and family.

Feeling bad about something quite often has no positive outcome. Even with other situations; I feel bad about not going to the gym/not doing a task, and then feeling bad about it makes me even less likely to do it, leading to feeling even worse. How fun!

My best advice in these kind of situations is:

  • Get yourself some actual evidence rather than evidence gathered from your so-called telepathic powers. When your reason for someone hating you is “because they do”, that does not cut it. Ask them. Discuss it with someone else. Give people a chance!
  • DO NOT BEAT YOURSELF UP. Feeling bad about something is just going to lead you to feeling worse in most cases. Very, very rarely I will find motivation through being disappointed in myself, but it is rare, and it does not usually last.
  • Remind yourself of what a truly “bad” person is. For a start I reckon most “bad” people do not worry about being “bad”. I mean, what even is the definition of bad? I don’t know, that is open to interpretation, but struggling with university work and struggling with self-destructive behaviours does not make you a bad person. It makes you a person who tries very hard but is having a rough time.
  • We also have to look at why we are so bothered about other peoples opinions. I spend more time worrying about the opinions of people I know in a more “professional” relationship, than I do about the opinions of people I know more personally. This is a whole other issue/blog post. But remember that you need to try and focus being much more concerned about how you feel about yourself, because that is what is ultimately important (and if you work on how you feel about yourself, it is quite likely you will begin to stop thinking that everyone else hates you – I had not thought about this until typing it, but it makes sense!)