*This post is the second of 4 which will be posted every day for the following two days!*
The three most obvious, go-to answers that you seriously just expect to hear when you ask someone how they have recovered from their mental illness: hospital, medication, and therapy. Fortunately – or unfortunately, I guess, depending upon how you look at it – for me, all three are true…
When my mental health deteriorated it did so in the form of auditory hallucinations, which I somehow ‘tolerated’ for around ten days before finally making my first suicide attempt. After passing out at school I was taken to hospital in an ambulance and then I ran away. The Police were called and when they found me when I had almost reached the nearby bus station, they detained me under section 136 of the 1983 Mental Health Act and I was pretty much thrown into their car and driven back to hospital where a Mental Health Act assessment promptly took place in a little room I’d never been in before in A&E. I honestly don’t’ remember much about it, just that I was told the Police could finally go and if I continued to try and leave the hospital then the staff were now allowed to restrain me, sedate me, and force me to finish the necessary, potentially life-saving medical treatment to counteract my suicide attempt.
With nothing more being explained, I wasn’t fully aware of the fact that after finishing the treatment and it being labelled ‘successful’ in saving my life, I was being transferred to a psychiatric hospital where I could be held against my will for up to 28 days (it can then be extended by being transferred to section three) for a period of ‘assessment.’ I was an inpatient for around two weeks before I started considering going to College to enrol on a fashion course and the Psychiatrists saw this as a good sign that I was thinking about having a future and so I was discharged from the section and allowed home.
My second admission lasted slightly longer and came to an end when I finally told the psychiatric hospital staff that I had been raped and sexually abused over a six-month period when I was 15 (I was 18 at this point). I think the Psychiatrists saw it as both a step forward and a step onto earning the diagnosis of Borderline Personality Disorder where hospital admissions are not recommended; unlike the diagnosis they had been hesitating about giving me of Schizophrenia. I guess once you reveal you’ve been through a trauma, that completely eradicates the possibility of there being any sort of chemical imbalance or basically any illness that doesn’t rely upon going through a trauma to be diagnosed with it!
My third admission was the second longest at a few months and I have always found it ironic that it lasted that long, but actually hadn’t even come off the back of a suicide attempt! I found myself being transferred between different Psychiatric Intensive Care Units (PICU’s) and restrained and sedated so many times that they had to call an optician onto the ward because the muscles around my eyes were almost constantly relaxed and so my vision was going blurry!
After my discharge, I spent the following three years (2009 – 2012) almost constantly in and out of both psychiatric and medical hospitals. When I made my third suicide attempt in the summer of 2012, my records apparently indicated that I’d had over 60 hospital admissions in that three-year period. The professionals most involved in my care from the Community Mental Health Team (CMHT) used this as evidence so that when I came off life support from the attempt, I was given funding to be sectioned and transferred to a private psychiatric hospital over 100 miles away from home. My Community Psychiatric Nurse (CPN) and Psychologist claimed that the number of hospitalisations was evidence that they didn’t have the right help or supportive services in our locality to manage my presentation of my eventual, final diagnosis of Borderline Personality Disorder (BPD).
Initially, the admission to this hospital wasn’t really proving to be useful beyond the fact that because I was sectioned, and the hospital was named ‘medium secure’ (which meant that it was locked so tight I literally broke my foot trying to kick the doors open when I first got there!) it reduced my safety risk with the chances of me self-harming or making another suicide attempt being made a fair bit more difficult. However, after finally starting the recommended treatment for my BPD diagnosis; Dialectical Behaviour Therapy (DBT – yes, there are many acronyms in the mental health world!), I finally found myself making some progress.
Even though before going to the hospital I had known that the average length of admission there was listed as 12 – 18 months, I had remained convinced that the staff would give up on me as I felt so many others had done and just discharge me and leave me to my own devices. And so, in finally starting a Therapy programme that was typically described as requiring one year of therapeutic sessions to complete and benefit from it, I had recognised that they were going to keep trying to save me and so, on January 6th 2013, I had a 1:1 with my Key Nurse and I agreed to begin writing about the abuse and to show the staff my notes so that they could gain more knowledge and a better understanding of what had happened to me with her telling me the belief that it would leave them better placed at helping and supporting me. I remember coming back to my room from the 1:1 and seeing my laptop lying on the bed… We were only allowed them after our therapeutic timetable groups and Reflection meeting had finished and even then we were only given them if we asked. The staff had learnt, however, that I would always ask so if I was busy or talking to someone when they were able to start taking them out, they would just get mine automatically. So, coming into my room with it sat there and having the burning thought and desire in me to do something that would allow me to begin documenting the recovery journey I finally felt I was embarking on; it was almost destiny that I turned the laptop on and found myself setting up a blog…
It's kind of funny because now, when I give talks or write posts full of advice for starting a blog, I recommend that people put so much thought into it. I encourage budding Bloggers to give massive consideration to even just the thought of blogging and do their research into the ins and outs of it to ensure they make an informed decision as to whether they feel capable of going ahead and creating a blog. I also suggest people brainstorm title ideas for their blog and pay consideration to the general aesthetic design for it and particularly to developing/having a colour scheme and/or logo. I, however, didn’t pay any mind to literally any of that! I mean, I had no real idea what I was getting into in starting to blog – and whilst I very obviously never regret blogging; I do wish I’d perhaps researched what I could expect so that I felt more prepared and forewarned.
However, one thing in that very beginning of I’m NOT Disordered that I don’t regret, or wish had happened differently in any way, and which I honestly believe that despite not brainstorming it; I still thought it through – was in the naming of it! It was born from the notion that I’m not just my diagnosis; that it doesn’t and shouldn’t define me nor be one of the first things that is said about me if someone were to ask who I am. I also wanted the ‘not’ to be in capitals not just to empathise the word and its meaning, but also because I thought it seemed a bit childish and with the abuse having happened when I was 15, professionals have voiced the idea that it’s really prevented me from aging normally and that a part of me is stuck in that age because I disassociated for a lot of the abusive instances.
So, in addition to the hospital leading to the start of my blogging career, the other ways in which I benefited from the admission was the general fact that it meant I was safer than I would have been if I were at home for the entire two and a half years, I was an inpatient… Unfortunately, though, a massively common and popular misconception of being in a psychiatric hospital is that it’s the safest place in the world. The reasons leading to you self-harming can still be valid and present and with the ward rules banning certain objects, you become more inventive and creative in coming up with a new means to self-harm – which, can sometimes end up being more dangerous that your usual methods. I remember one girl being admitted to the ward with no self-harm scars or wounds because she abused her insulin medication as a means of self-harm… By the time I was being discharged, she needed plastic surgery to heal some of the wounds and to mend the damage they had caused to her tendons and nerves etc.
Fortunately, seeing this whilst going through therapy meant I had a more balanced, positive, and productive view of that situation and another incident that occurred which I will never forget... One of the inpatients snuck a blade back onto the ward after her leave and everyone passed it round each other until the staff realised people were coming to them with very similar injuries and eventually someone handed it in.
We were all made to sit in the communal sitting room whilst a lockdown and search were carried out of literally every nook and cranny in all our bedrooms and throughout the rest of the ward. I seriously couldn’t believe that these girls I’d come to know, and love could be so dangerous and harmful in basically providing each other with a means of self-harming and having the full understanding that in passing this blade on, that’s what the other person would do with it. In addition to recognising the sheer wrong-ness of this action, therapy also helped me to have not been involved in it at all – the lockdown was genuinely the first I had heard of it; no one had passed it to me… And I believe that was likely because they recognised, I was doing so well that I would likely speak up about it.
Another positive impact being in the hospital had been after the second time I managed to escape… I knew that if people didn’t come back from their unescorted leave on time, the staff would drive around the area looking for them, so I booked a taxi from a nearby shop. Then, on my leave in the grounds, I climbed over the boundary fence, over the fence of the elderly care home next door, and then walked out of a person’s side gate and jumped in the taxi asking the driver to take me to the nearest train station. I got a train to another city, bought the things I needed for a suicide attempt and boarded a bus to god knows where so that I had some place warm to continue to make my attempt and so that I was on the move to avoid any Police (being sectioned and going AWOL, the psychiatric staff are legally obliged to call the Police).
By the time the Police found me back in the train station, my attempt was complete, and they called an ambulance but were told that it’d be far quicker for them to take me to the medical hospital near the psychiatric one on their lights and sirens and have the psychiatric staff meet us there. I remember racing through the traffic and thinking ‘I wish I wasn’t poorly so I could enjoy this instead of it just making me feel even more sick!’ When we got to the hospital I refused the potentially life-saving medical treatment for the suicide attempt, and I vaguely remember my favourite Psychiatrist (the one below my Consultant) coming to the hospital and saying to the Doctors and Nurses “this isn’t like her at all, just do it.” Next thing I knew I was waking up from life support a while later and the treatment had been administered and my organs stabilised because apparently whilst I was out my blood tests turned bad and I had to have additional medication for a while.
When I was allowed back to the psychiatric hospital a ton of the staff came to take me from Intensive Care to there and I screamed and cried when they started guiding me upstairs to the Psychiatric Intensive Care Unit (PICU). The Unit was above the ward I’d been on for over a year by then, and I’d heard the screaming and alarms through the ceiling/floor, had been told horror stories of how patients were treat up there and what it was like, and then – believe it or not (but it’s still on BBC news online if you google) – a patient killed another patient by suffocating them. So, needless to say, I panicked and sat on the floor so that the staff literally had to drag me onto the PICU and into my new, empty bedroom. I spent the following two or three days alternating between sleeping, vomiting from all the medication and anaesthetic/sedation, crying, and – at one point – I ended up feeling like I just had to have a shower despite being on ‘eyesight’ observations (meaning a member of staff had to have me within eyesight 24/7)!
There came a point when I was being sick that I remember crying and thinking ‘it cannot get any worse.’ I felt like I’d hit absolute rock bottom – something which, to be honest, I actually thought I’d already experienced years ago! – and I found myself literally desperately begging the staff to move me back down to the ward where I now thought of four of the girls as ‘best-friends.’ When they finally agreed, I was put in an empty bedroom and was told I had to have a period of stability to begin earning the right to go back into my bedroom. I talked to the Ward Manager though and said that despite the risk and worry of me thinking I’ll be viewed as superficial, I wanted her to know that being with my own things, having them around me, would be the thing to make me feel better and the longer I was away from those things, the more upset I would become.
Thankfully, she told me I’d made some valid points, and I was allowed back in my room, but the entire ordeal didn’t stray far from my memory for such a long time after that. This ended up being a good thing though, because it provided me with a harsh reminder of what my life would become if I continued to not put in enough effort in DBT sessions. It was a huge motivation to cooperate more with staff and to try so much harder to take some real notice of all the safe and healthy coping skills we were being taught and encouraged to use in Therapy and to actually start really trying to apply them despite when everything in my body was telling me not to and instead, to self-harm or make a suicide attempt or run away. I finally saw that I didn’t want this to be my life. I didn’t want that to be the way my life actually ended, either.
Partaking in weekly group and 1:1 DBT sessions for over two years was incredibly challenging and sometimes felt like I’d imagine climbing a mountain or something might feel – like every time you think you see the top; you get there, and before you can even breathe, you realise that there’s still so much further to go! I think that the first hardest part to the Therapy was that it basically meant tearing all my reasons to keep quiet and not talk about my experiences, my thoughts, and my feelings; to pieces. So that everything was coming forwards and I was finally able to talk things through to a point where I got the strangest, and most unexpected sensation that I could properly breathe now. It felt as though all this time, I had been holding my breath and just waiting for the inevitable explosive relief that I somehow just knew would come with blurting everything out. Getting it all off my chest.
The second hardest thing with DBT was that literally every single coping skill you were taught across the four modules (Distress Tolerance, Interpersonal Effectiveness, Mindfulness, and Emotion Regulation) were things which I couldn’t believe I hadn’t already thought of trying to do myself. Things like writing or mentally doing a pros and cons list before acting or making decisions in order to ensure they’re balanced and healthy, using distracting or self-soothing activities to detract or counteract from unsafe, negative, or self-deprecating thoughts and feelings. I mean, how could I not have thought of these things? How could I not have wondered if these much more healthy and productive methods would help more so than self-harming or running away? It was frustrating, but the staff reassured me – and other inpatients who were experiencing similar thoughts and feelings – that they recognised and appreciated that when you’re so poorly and your mental health is so unwell; thinking things through straightly and reasonably can be really tricky, and unbalanced and ill-thought-out actions and coping mechanisms can engulf any ideas to do anything safer and more positive.
Finally – for this part, at least! – medication! Prescribing medication for me or for most others diagnosed with BPD; is a fraught, friction-worthy, and debatable issue amongst all in the mental health industry – even if they’re people who can’t actually prescribe medication! Being in that psychiatric hospital though, there wasn’t a single inpatient who didn’t take some kind of psychiatric medication and so it was there that I was prescribed my anti-depressant, anti-psychotic, and mood stabiliser.
After being discharged, I had to register with a new GP in my local town and I remember my first appointment with them I ended up crying because the GP said that he wanted to stop all of my medication because “it’s too much medication for one young person to be on!” I was so terrified because whilst I appreciated and recognised how helpful DBT had been, and how being sectioned in the hospital had helped with my safety and risk levels, I also believed that my medication had been hugely beneficial too. I felt that it had helped stabilise me to a point where I was able to begin Therapy and able and willing to actually follow any advice or new coping skills I was taught. Whilst I had been in hospital for over two years, I hadn’t forgotten everything I had gone through in those three years before that when my mental health was really poorly… And I couldn’t risk having that happen again – I felt that I’d just scraped through by the skin of my teeth (is that even the saying?!) and that if it were to all go backwards, I wouldn’t be so lucky. I wouldn’t make it out alive. Ironically, being in recovery meant that I had now seen the positives in life, and I had my blog… So, I really no longer wanted to die, but I felt fairly convinced that my medication was a huge part of this positivity and hopefulness too.
I can’t remember how, but the medication drama was sorted and I continued to take what the hospital has prescribed with the only major changes being when I was on caseload for the Crisis Team and they added another anti-depressant to the mix which I took for just over a year, and then the more recent fiasco with my anti-psychotic medication… Earlier this year – in February – I was sectioned again and admitted to a local psychiatric hospital where I spent probably the worst five consecutive days of my entire life. The entire admission was as complete disaster that actually resulted in me having to put in a formal complaint to the Care Quality Commission (CQC) who oversee such wards and services. The complaint was resolved in a 12-page report which literally listed that the investigator had found evidence the upheld every single instance and issue during the admission that I’d complained about. It was full of apologies and ‘actions’ of tasks and duties that would now be carried out to ensure these things didn’t happen to another inpatient – which had been my goal in making the complaint – it wasn’t about looking for a ton of apologies (though it was nice and appreciated of the Trust to issue them) – it was about making sure the staff learnt from their wrongdoing because perhaps the next person to go through it actually wouldn’t cope with it the way I had done. The way where I had managed to survive all of their failings and shortcomings.
After the admission, I met with a community Psychiatrist who absolutely refused point blank to increase my anti-psychotic medication – despite the psychosis being the reason for the admission! She kept talking about how she’d read my notes dating back to my first hospitalisation in 2009 and that there was no evidence that medication had helped me. I continued trying to point out that the fact that after the new anti-depressant was at an effective dose and when my anti-psychotic was last increased, I had actually been completely discharged from services for over a year. In the end, she gave me some sleeping tablets and a mild sedative medication! For me, this was useful but because of the risk of addiction to these tablets, it wasn’t really a long-term answer at all!
When, a few months later, I ended up under the care of the Crisis Team again and they arranged for me to see a different Psychiatrist who immediately offered (without me asking or even suggesting!) an increase to the anti-psychotic medication, it felt like a complete ‘told-you-so’ moment. A sad one, obviously. But still, it was hugely validating and helpful; it was just difficult to hold onto that when the majority of me was wondering whether I would have been doing so much ‘better’ by now if that first Psychiatrist had done the increase. However, I knew that I couldn’t change that, so I just had to focus on the fact that at least it was being done now.
Asking for help from professionals and taking medication for your mental health is often – and wrongly – seen as weak and as though it’s an illustration that you’re not strong enough or brave enough to find your way through, and out of, this by yourself. To me, this leaves the implication or assumption that to believe this means that you think that to ask for help and support is ‘easy’ when really, I’d say it’s incredibly difficult, takes an enormous amount of strength, resilience, determination, and purpose, and that for someone to do it, they should be seen as utterly inspirational and a force to be reckoned with!