Sunday, 28 July 2019

WHAT HAPPENS IN THE BEGINNING OF POOR MENTAL HEALTH? (AND TIPS ON COPING WITH IT)

Earlier this week I met with my Psychiatrist for a review and to make plans on my medication reductions. She told me she was proud of how I’d come and that I’d managed my safety even though my anti-psychotic and mood stabilizer medications have been decreasing over the past month or two. It got me thinking just how much things have changed since the early days of my mental health deteriorating in 2009 and I thought that it’s worth recognizing that my readers with their own poorly mental health will be at different stages in their mental health journey. Not everyone is going to be in the same place as me and I think it’s important to produce content that can be helpful for everyone. So, here’s a little post about all of the initial aspects in the beginning of a person’s mental health deteriorating:




The initial panic & other emotions:

I guess that my mental health started to deteriorate before I started hallucinating in 2009 because when the abuse began in 2006, I had suicidal thoughts and began self-harming. I would imagine jumping out of a window in the building I was abused in or swallowing tablets, because I thought that was the only way to stop what was happening to me. I had no hope that it would ever end. I started self-harming when I developed the anger. The anger at the fact that he thought he had the right to hurt my body and I believed that I should be the only person who had the right to do that. So, I harnessed that anger and used it as energy to self-harm.



These things – the self-harm and the suicidal thoughts – almost felt as though they were just on the surface; like I wasn’t really affected by them. I didn’t feel sad that I was self-harming and I wasn’t scared that I was having suicidal thoughts. I think that my disassociation during the actual abuse made me somewhat removed from reality permanently so that it meant nothing seemed to really affect me, almost as though the abuse was more than enough for my brain to handle that it couldn’t take anything else so it just shut itself off from everything else. 


In contrast to this, when I first had an auditory hallucination, the panic I experienced was phenomenal. It was so intense it was like nothing I’d ever experienced before. It was all-consuming, undeniable, and over-powering. I remember looking all around me to see where the voice had come from even though I knew there was no one around. I didn’t want to believe that I’d hallucinated because I believed that would mean I was ‘crazy’ and that thought was so terrifying that, for ten days, I tried to ignore the voice and pretend that it wasn’t there and that nothing life-changing had happened.


TOP TIP: Remember that everyone has mental health (in the same way that we all have physical health) so we all have the potential to become poorly with it; you aren’t alone.



Recognizing you need help:

Yes, I’m going to say that cliché saying in mental health; recognizing when you need help is the first step to moving forwards. It really is! Other people can believe you need help, and support can be offered to you - even thrown at you! - but it won’t make a single bit of difference if you don’t recognize that you need/want it. I honestly believe that I didn’t really accept help until I was sectioned under the Mental Health Act and admitted to Cygnet Hospital Bierley in 2012. I wish it had been when I first attempted suicide in 2009 but I think I was just so poorly in those first three years that nothing really sunk in… Looking back, I think there was an aspect of long-term disassociation throughout that time and I think that maybe that was because everything was so scary that I just distanced myself from it all so that I could cope. Then all of the self-harm and hospital admissions became my life and it was as though it had always been that way and I knew no different. It’s probably because I’d accepted it all as my life that it took me so long to recognize that it should change and that I needed help to make those changes.


I think that even after I woke up from life support in Intensive Care, I didn’t accept help. I pretended that it had scared me into agreeing to go to Cygnet but really, I thought Cygnet would be a good opportunity to finally commit suicide away from all of the people and professionals who knew me. It was actually when I jumped over a few fences in the Cygnet grounds and ran off to a nearby city to attempt suicide through an overdose. I ended up on life support again and in Intensive Care but I was a lot more poorly this time and when I woke up I was transferred to the Psychiatric Intensive Care Unit (PICU) in Cygnet. Being on the PICU, on observations with the staff that meant I had to be within arm’s reach at all times, still vomiting from the anesthetic, and with a sore throat from the ventilator, I felt at my absolute lowest. Then that cliché thought came into my head; ‘things couldn’t get any worse - they can only get better now.’ I decided that I didn’t want all of those things to become my life; I needed help.


TOP TIP: Know that recognizing things need to change is not ‘admitting defeat’ or highlighting ‘weaknesses’ – it takes a considerable amount of strength to recognize when something needs to change.



Asking for help:

So, you’ve realized something isn’t right, you’ve realized something needs to change? I’m not sure if that’s the hardest part or if this is; the actual act of telling someone what’s going on. There’s a huge concentration in the media whenever a mental health story or plotline is covered about where to go for help, but I think this leads to the belief that there’s four choices in who to tell; your GP, your family, your teachers, or a helpline. Samaritans is probably the charity most commonly recommended but, in all honesty, I didn’t find them helpful; so, I think it’s important that people know that if you were to ring and don’t find them helpful then that doesn’t mean there’s no hope. 


The response to someone who discloses something about their mental health it so important and vital in that person’s journey because asking for help means someone is at their most vulnerable and most afraid. Asking for help is a huge step because it means acknowledging that there’s nothing you yourself can do to change the situation and that can leave you feeling like a weak failure. But really, it takes a very strong and clever person to acknowledge this and actually ask for help with it. I think that I’m naturally quite a stubborn person, so I find it very challenging to ask someone for their help and this was especially exacerbated by the fact that the help I needed was to do with my mental health. My conviction that hearing voices meant I was ‘crazy’ made me worried about what would happen if I told someone. I’d hear horror stories about my local psychiatric hospital and was terrified that if I spoke up then that’s where I’d be sent. In the end, I decided on telling the professionals what was going on first. On my very first hospital admission, I heard other inpatients talking about hearing voices and it gave me the courage to tell the Psychiatrist that I’d been hallucinating. I guess that I thought it couldn’t get any worse than being sectioned under the Mental Health Act, so what more could people do if I actually told them? The first person I asked for help with the abuse was a professional again - the Ward Manager of the Psychiatric Intensive Care Unit I was in on my second hospitalization. I think that was about being scared of what my Mum would do when I told her, I knew that in telling the Ward Manager my Mum would have to be told but at least I’d had some practice in talking about it. I was so scared about how my Mum would react; what she’d say, and what she’d do but I knew what the Ward Manager would do. I knew she’d have to tell the Police and I knew that she’d have to tell the other Ward staff and my Mum. Being certain on her reaction reassured me when asking for help.


TOP TIP: Don’t feel pressured into talking to a particular person out of obligation.



Thinking about what you need to get better:

Naturally, I was afraid of what would be done if I told someone that my mental health had deteriorated and like I said before, I had huge worries that I’d be admitted to the local psychiatric hospital I’d heard so many horror stories about. In the beginning, professionals seemed to be in a state of panic with me and there was a lot of dramatic reactions (such as having eight Police come into my Mum’s house to take me to Hospital!) but I think it was more about them being worried that things were going to escalate and they recognized the importance of getting someone the right help as soon as possible to avoid things worsening and the chance of suicide increasing. When professionals decided that I wasn’t Schizophrenic, their reactions changed and initially, this was scary and made me think that they no longer cared about me. Actually, though, their reaction changed because I was diagnosed with Borderline Personality Disorder (BPD) and the advice and recommendations for treating someone with that Disorder were different. It’s said that hospitalizations don’t help someone with BPD – that they exacerbate the mental state and there are studies to show that a lot of people with BPD don’t benefit from medication because the ‘symptoms’ are mostly trauma-related and not due to any chemical imbalances.


It took me a while to learn that being Hospital didn’t help because I – naturally – thought it made me safe; when really, it made very little long-term difference. After a while, it stopped making a short-term difference too when I discovered more and more ways to self-harm whilst an inpatient. Then I’d be discharged when things had ‘settled down’ and I was right back to square one and attempting suicide. After ending up on life support after overdosing, I think that professionals really did worry and panic because they all decided that a long-term, specialist hospitalization would be helpful.


One thing I have – sort of – argued with Psychiatrists over is medication. Recently, my Psychiatrist looked back through my records and came to the conclusion that my safety didn’t change when I was on medication – it remained just as dangerous as when I wasn’t taking any meds. I came to agree that perhaps things seemed the same but I’m confident that the right medication and the right doses have actually helped. Since coming out of Cygnet, I’ve been on psychiatric medication and the only changes to it has been increasing the doses and then adding in another! My Psychiatrist and I came to the agreement that there was evidence that the newest medication was beneficial for me, so I’ll be staying on it, but the rest are all being reduced until eventually being stopped.


TOP TIP: Don’t be afraid to voice your thoughts on what others could do for you to help – it doesn’t mean you’re telling professionals how to do their jobs.


It’s so scary to think of people going through all of these experiences or similar ones and with 1 in 4 people in the UK experiencing mental health, it’s saddening to know that there are people just beginning this terrifying and intimidating journey. I hope that this post has helped people by reassuring others that they aren’t alone in what they’re going through and by advising people how to cope with this journey. I also hope that this post has shed some light for others on what a loved one might be going through.