Friday, 27 August 2021

TO ALL THE PEOPLE WHO ARE WHERE I WAS

With recently reaching one year of being free of self-harm, I asked on social media whether anyone had something they wish they could have told their self, one year ago and was flooded with private messages! And those messages were the inspiration for this post. A reason to consider what I wanted to say to all the people who were in the various places – both mentally and physically – that I have been…

To those psychiatric hospital inpatients…

Having spent many admissions in psychiatric hospitals, and with my longest admission being for over two years, I feel I have a decent amount of insight into the experiences of psychiatric hospital inpatients. So, I completely appreciate that you are so vulnerable to witnessing some upsetting, scary scenes with other inpatients and the staff on the ward. There’s actually like an entire movement of services and professionals who campaign and spread the word that being hospitalised can end up being a whole new trauma and a catalyst to actually worsen your mental health. So please know that I – and lots of others – can appreciate your position and the things you might hear and see.

To get through horrible psychiatric hospital admissions, I used two coping skills:

1.      Concentrate on you – as ‘easy’ as it can be to build friendships with fellow inpatients, remember that you’re in there for your own reasons

2.      Use the poor environment as a reason to be discharged – this could help drive you to engage with staff and your treatment plans and speed up your discharge

To those collecting their psychiatric medication from the pharmacy…

No one should be ashamed to say that they take psychiatric medication. The thing which a lot of people say about this topic, is that you wouldn’t be ashamed to say you took painkillers for a headache. Whilst I agree that it’s probably more common to speak about pain relief, there can be the same reluctance in being afraid that others will judge you for it. The worry that someone might be thinking ‘I doubt it’s that bad!’ or that they’ll consider you ‘weak’ for taking medication.

So, to get through that fear of judgment and continue to take my medication, I focus on all of the benefits I get from it. I mean, when the pharmacy made an error with my antipsychotic medication; I found the auditory hallucinations overwhelming to the point that I self-harmed severe enough to require plastic surgery and to now have permanent nerve damage in my hand. Once the medication was back in my system and increased, the hallucinations were gone, and I have been safe ever since! So, whenever I feel self-conscious around my medication or I experience any side-effects (particularly the weight gain) I remember that without those tablets, I likely wouldn’t be alive!

To those under the care of their Crisis Team…

Firstly, whilst some may not have come to the attention of the Team voluntarily, to those who have; hats off to you for contacting them regardless of all the terrible reviews out there about the service! And if the contact wasn’t made voluntarily – if you were referred to the Crisis Team or have felt convinced that not cooperating with them would result in a whole other consequence; then please don’t allow the experiences of others, tarnish or shape your own. It’s all too ‘simple’ to take on someone else’s thoughts and opinions of something – even just a movie or a book! – and have them impact your own experience. You hear a book review that the novel was badly written and give it the power to influence your decision not to bother reading it to see what you think of it. To see if you have a different experience.

Honestly? I’ve had a number of difficult experiences of my local Crisis Team a good while ago, but with more recent instances; my care from them has been helpful and potentially lifesaving. Having that balance in my experiences of the service is hopefully a good sign that my views on them are also balanced and fair. I mean, I think that it’d be understandable and rational to say that there are professionals on Crisis Teams who really… well, whose attitude and response leave you questioning whether they’re even in the right career! And sometimes those staff and their decisions come at the most pivotal moment in a mental health crisis, and that has the power to influence your safety.

One thing I think is worth mentioning and keeping in mind in so far as the Crisis Team, is that similarly to a lot of psychiatric services, most of them lack the specialised training to ensure a more effective level of help and support for someone with a Personality Disorder. This often means two things:

1.      A belief of being misunderstood and a strong sense of miscommunication

2.      A feeling that the Team hold a stigma and discrimination to anyone with a Personality Disorder

I think that my greatest turning point in my view of the Crisis Team was in the recognition that if I was so convinced, they would be useless and unhelpful, what did I have to lose by ringing them anyway? I also went so far as to realise that at least if I called and they didn’t help, I could say that I had tried. Fortunately – and ironically – in giving the Team the opportunity to fail, they did actually end up being helpful and mitigating the situation!

To those standing on the ledge…

You don’t have to.

Something a lot of people don’t realise was that on my third suicide attempt, when I was put on life support; it was actually more about my life potentially being at risk than it was about me being in some sort of coma or having my organs failing or something! Obviously, there was a risk that would happen, but the main cause for the decision to put me on a ventilator was from my refusal to sit still and accept the medical treatment which was an antidote to everything I had taken.

And it wasn’t just a simple “will you have it?” “no”, “ok we’ll sedate you” kind of situation! I mean, it took numerous assessments to conclude that I didn’t have the capacity to refuse treatment, and then multiple attempts to restrain me… And I think that it was from those restraints where my suicidal brain is perfectly illustrated; I was being pinned to the hospital bed by four of the hospital’s security guards and two Nurses, and a Doctor was inserting a tube into a vein (a cannula) in my foot to administer the antidote. But my mind was so defiant of their attempts to save my life that I used my toes on my right foot to rip the cannula out and the Doctors realised they would have to take more drastic measures to combat just how suicidal I was.

So, standing on a ledge (literally and metaphorically depending on the attempt being of a different nature), if someone told me that I’d feel ‘lucky…’ – no matter at which point in my life they predicted it to happen – I’d have laughed in their face! But in all honesty, ‘lucky’ is exactly how I feel when I think about all the occasions when I acted on the fact that I had run out of hope and had no passion for life, and to now be so grateful and excited for my future!

You know that whole saying about how suicide doesn’t just take away the chance for things getting ‘worse’ it also eradicates any potential for things to improve? As someone who has stood on a ledge, it’s so true! I mean, I actually find it scary and upsetting when I realise that any one of my four suicide attempts could have taken away the possibility of me creating, I’m NOT Disordered, making all the achievements I have, and experiencing all of the amazing opportunities I have.

To those in out-of-area psychiatric hospitals…

In 2012, after another admission to my local psychiatric hospital, a Psychiatrist told my Community Mental Health Team that he thought the best way to help me would be to have me admitted to an out-of-area hospital specialising in Personality Disorders. He explained that his reasoning for this recommendation was that there seemed to be absolutely no psychiatric services in my locality that were sufficient enough to help me work through my symptoms and become safe. He bluntly stated that he believed that if I didn’t get a place in an out-of-area hospital, there was the very real, high possibility that I would kill myself.

I remember having two assessments with the two nearest Personality Disorder hospitals… The first one, after asking me a ton of questions about my history, concluded that they weren’t willing – or physically able – to accept my flight risk. The second, began telling me what I could expect as an inpatient on their Personality Disorder ward and I was instantly reluctant and point blank refused to go there!

When that third suicide attempt happened, I woke up in Intensive Care off of the ventilator and was told that I’d be going to that second hospital the following week! Aside from the fact that the days on the ward were completely timetabled with groups for reading, arts and crafts, and therapy, compulsory morning and evening ward meetings; there was also the fact that it was over 200 miles away from my home. In addition to this, the ward was labelled as ‘long-term’ with the ‘average length of admission’ being stated as 12 – 18 months; so, it wasn’t as though I’d only be gone for a short while!

And do you know, the hardest thing about going to that psychiatric hospital so far away, didn’t end up being the thought of all the structure to my days or the prospect of recounting the trauma in therapy; it was about all the social aspects that had to change…

1.      The fear that my cat would forget who I was

2.      Only being allowed one phone call per day with my Mum from the communal telephone

3.      Having hour-long phone calls with my Mum whenever we wanted

4.      Losing my wild nights out with Lauren!

5.      Not being able to just hop on a bus to go see my other best-friend, Ellie and her first son (my first godson), Jonas

6.      Being unable to do everyday things in my home with Mum

Overcoming these challenging changes to my social life was almost as difficult as the actual, intense, therapy sessions around the trauma of the abuse! But I ended up getting through it by firstly accepting that I was there! It sounds simple but, for a while I was convinced the staff there would either get sick of me or learn that there was no hope for my recovery, and I’d be discharged. So, finally accepting the reality of the situation (and deciding that I didn’t like it!) was the real key to providing me with the motivation and drive to engage and cooperate with the treatment plan and the staff in order to be discharged.

To combat the loneliness of being so far away from my loved ones, I looked to the other inpatients to form relationships of some kind. It was sort of tricky having to recognise that there were some inpatients who I would just never ‘click’ with. But there was also a balancing act in building friendships with those who I had the most in common with but remembering where we are… just in that I had to keep in mind that chances are one of us would be discharged sooner than the other. It also meant developing the acceptance and understanding that there was also a high chance that those I built friendships with could go on to hurt themselves…

With inpatient relationships being so difficult and challenging, I did find it much easier to concentrate on thinking about the best friends and loved ones I had back home. I repeatedly reminded myself that if I was really in a hurry to see them again, I needed to put my head down and work my butt off to be discharged!

To those feeling guilty for causing upset to their loved ones…

In all honesty, this is something I very occasionally still experience; however, I think that it’s now kind of healthy and understandable… There has been so many occasions in my ill mental health where I’ve seen my Mum cry or have heard my best friends panic, and those instances will probably always stay with me.

Whilst I was poorly, the upset of my loved ones were all reasons to continue to hurt myself because they all led to the belief that I deserved the pain and all the consequences that came from that act of self-harm. I guess I kind of thought ‘why should I be happy when I’m upsetting everyone else? Like, what right do I have to be happy over someone I love and someone who has done nothing wrong?!’

Over time though, I have come to realise three things:

1.      Everything that has happened has been done. That’s it. No matter how much you wish something could have gone differently, it’s too late. And the best thing you can do with that, is accept it for what it is and find a way to see some sort of ‘silver lining’ or a lesson you can take away from the experience.

2.      If the roles were reversed and one of my friends was feeling terrible over feeling that they had upset me, I would want to reassure them not to be harsh on themselves and not to feel like they deserve some sort of punishment. And if I would want to treat others that way, why not consider it for myself?

3.      I also find it helpful to remind myself that whilst it’s so important to accept responsibility for your actions, there needs to be a balance between doing that, and recognising when your mental health is so poorly and has deteriorated so much that you’re acting and responding in ways you might never have if you were well. Having that understanding and appreciation for the power of ill mental health, can be really fundamental in learning to cope with that guilt of upsetting others.

To those questioning the point in asking for help…

Sadly, I think that there are so many mental health service users out there who – when accessing a service – have felt that it’s made everything worse… I think that it’d be fair to say that the majority of instances like this have typically occurred because a very vulnerable person has reached out to professionals for help and support, and has felt that they were met with an unhelpful response…

Personally, this experience used to usually be the result of a call to my local Crisis Team who would more often than not, dismiss or misinterpret my attempts to explain just how unsafe I was. It was difficult because some psychiatric professionals have the mindset that you should ask for help as soon as you begin to struggle so as to hopefully ‘catch’ things before they get worse. There are other professionals however, who – when called at the point the others have recommended – decide that you need to be even more poorly to really ‘qualify’ or be ‘suitable’ for their care and treatment! It can very easily and understandably leave a service user feeling that they’ll never get it right and that no matter what they do, someone will disapprove or give the complete opposite advice! Like, you can’t win!

For me, to overcome that, I made the decision to always ring my Crisis Team where I could foresee an instance of self-harm because I felt comforted by the fact that at least I could say I tried and that it wasn’t my ‘fault’ if things got worse! I kind of – rightly or wrongly – developed the attitude that; ‘it can’t get any worse!’

Beyond the fear of the response, you’ll receive if you do ask for help, there can also be a panic and anxiety that if the service/professional were to try and offer support, and their advice didn’t work or help; would you still have hope that you’ll come through it? Or would you end up feeling even less positive and even more disappointed?!

In all honesty, this has been one of the reasons for my self-harm where I’ve learnt that it’s actually ok to experience the thought and emotion of disappointment. If you’ve put effort into something and it hasn’t gone how you would have liked it to, you’re more than entitled to feel let down. So rather than correct the emotion and decide it isn’t rational, I’ve learnt to cope with that emotion in a safer, more healthy way…. I know that writing isn’t to everyone’s taste, but that’s what I have found helpful for this – writing out all my disappointing thoughts and even having a rant where the disappointment seems to have was influenced by someone else.

One thing I would say there though, is to remember that the person who you feel has let you down, may not feel that same way. They might not understand why you feel that way, they might believe that actually, they’ve done nothing wrong in the situation… So, it’d maybe be a good idea to use the writing or ranting as not just an opportunity to release your thoughts and emotions, but to also take the time to recognise how the other party might be feeling. In doing this, the chance of you not holding that one instance as a rule against any future interactions with the professional/service, is heightened.

To those who aren’t speaking out about their experiences…

Writing such personal content on such a readily available platform and having the number of readers my blog attracts (heading to one million!), I am often asked how I do it! Like, how do I talk so openly and honestly about my experiences and my mental illness when I know how many people are reading it?

I very often create posts which illustrate my awareness of I’m NOT Disordered’s statistics, but to be honest, when I’m actually typing my posts, I pay no attention to how many people will read it! I actually think I kind of have to forget that, because I think I’d get some sort of ‘stage fright.’ And it’s not just the worry that I’d become reluctant to continue being so honest; it’s also that to think of the readers while I type could give me a sense of doubt. I mean, I’m definitely already someone who questions my own abilities, but to consider that almost one million readers could be critiquing my posts would probably be a huge blow to my confidence.

In choosing to blank out everyone I could be talking to in order to protect my honesty, I’ve also had to learn a balance in ensuring that in my blog posts, I’m still considering my readers – considering what they’d like to read about, what they want to know, and what they wouldn’t want included in I’m NOT Disordered’s content. And I think it is through that balance that I have found the motivation and passion to talk about my experiences. And I have so many reasons to continue to do that (here’s a few!):

1.      The thought that there could be someone out there who might have similar experiences and feel alone in those.

2.      My willingness to be open and honest might influence someone else to be too, and that could mean speaking about their mental health and that they then get more help and support in protecting their safety.

3.      That me talking about why I reported the abuse I experienced and how I got through making that report, could encourage someone else to speak up about any similar experiences.

4.      The amazing feeling, I get when I write out something that’s felt trapped inside my head.

And whilst I have all of these (and more) good reasons to talk about my experiences, someone may have a ton on why they aren’t speaking out. It might be about just basically not wanting the entire world to know what has happened to you. It could be that you worry the response you’ll get from your audience, or that talking about it will be triggering and upsetting… And whilst – for me – those possibilities have crossed my mind; they haven’t been powerful enough to overrule my decision to talk about things.

I think it should be about respecting a difference there amongst people. There’s a few times when friends or family have talked about something or experienced something which I’ve thought would be beneficial to speak about, but they’ve disagreed. And I’ve always respected and appreciated that – the same way that they do me and my thoughts on it. So please don’t ever feel pressured – no one should leave you feeling that you should be sharing your story. It’s your story – do what you want with it.

To those survivors of rape and abuse…

Experiencing something like you have and coming through it – coming out the other side breathing(!) is the greatest achievement! And it is for this reason that I choose to use the word ‘survivor’ over ‘victim.’

I think that abuse can be one of those things in life where you feel completely alone, but then someone tells you they’ve had a similar experience and you kind of wish you were alone because you can’t stand the thought of someone going through anything resembling what you have. And then, when you do know of someone else; it can go one of two ways: either the person isn’t coping and so you lose hope for your own future and recovery, or the other person is doing well, and they can become inspiration!

With those possibilities in mind, I have still decided to talk about my experiences of abuse – to a degree which keeps the details I disclose legal and which isn’t too overly detailed to a degree of being triggering and inappropriate. I made that decision because I found that talking about something which I felt I had spent years either pretending it didn’t exist, or at the very least being silent about it; has been an enormous relief. It’s like when you know about a surprise and you’re bursting to say it out loud, and then you get such a thrill when you announce it!

I think one of the biggest challenges in coming through the trauma – which means it’s something I feel is important to talk about – was getting through the anger, fury, and hatred that consumed my entire brain and body. I think that this anger – the anger around being a survivor of abuse and rape – can be frequently misunderstood and almost completely underestimated. So, to illustrate just how powerful my anger was (in the hope that you’ll appreciate I’m not someone who will do those things to your anger); if I were to self-harm and think of nothing then I’d usually draw blood… if I were to self-harm and allow the anger to be in control when doing it, I needed stitches and sometimes even plastic surgery!

This meant that combating the anger was definitely the biggest challenge when confronting the most detrimental aspects of the abuse. I actually found Dialectical Behaviour Therapy (DBT) helpful with this; particularly using radical acceptance to bluntly confront the feeling, and self-soothing exercises to stimulate my mind into activities other than hurting myself.

To those questioning their diagnosis…  

I think that being diagnosed with a mental illness can go one of two ways… It can either be a reassurance that you aren’t alone as the diagnosis has to have been established from the fact there were others with the same/similar symptoms; or it can be a hindrance where you feel that you’re treat differently because of – what you think is – a label.

When Borderline Personality Disorder (BPD) was first mentioned as a ‘possible diagnosis’ on a discharge summary, I asked my community mental health Nurse about it and was told that she didn’t want to ‘label’ me with that because it was ‘a death sentence.’ She explained that BPD is very hard to treat and that so many people ‘just end up killing themselves.’ Of course, that was a very terrible comment to make and it inevitably filled me with some concern over the fact that professionals were considering giving me a diagnosis that – from what the nurse had said – had a high mortality rate.

When the diagnosis was finally used to describe the ‘symptoms’ I had been experiencing (ranging from dissociating to intense mood fluctuations), my deep craving to have a label for everything in life was kind of fulfilled! I felt a sense of reassurance in the fact that for a diagnosis to be established, there must be others out there with similar experiences, which meant I wasn’t alone. And regardless of that nurse’s comment, I held the hope that in formalising the BPD diagnosis, that meant there would be some sort of recommended treatment for it.

Both attitudes – the anxiety and the hope – proved to be a long-term conflict because after the diagnosis, a lot of mental health professionals responded to me in a much different way than they had before BPD was ever mentioned. However, the diagnosis also enabled professionals to make the decision to admit me to a specialist hospital for treatment of it. And with that hospital being the key to me beginning my recovery from BPD, it sort of overruled the stigmatised responses I’d received from members of my local crisis team! My recovery was very obviously more important than those other experiences.

In finding the path to recovery, I seemed to coin the thought process that having a diagnosis like that, didn’t mean that was all I was. It shouldn’t define me. I’m still me! And with that, came the inspiration for the title of ‘I’m NOT Disordered!’ I wanted to make the direct reference to the fact that a person isn’t just completely made up of their psychiatric diagnosis; it should be acknowledged as one aspect of a person and the person be treat holistically with the entirety of the person in mind rather than just their symptoms.