Sunday, 10 November 2019

Trauma Focused CBT: Session Two

(TRIGGER WARNING: Descriptions of termination and discussion related to it)

My homework from session one was to go through the PTSD self help book and answer some of the questions. These involved check boxes for feelings, thoughts, behaviours etc that I could relate to. I found I'd ticked almost all of these! I didn't know I could relate to this diagnosis so much, but there you go. I'm hoping that, even if I don't necessarily get more support from this (because my local mental health team literally doesn't offer more than Trauma Focused CBT for PTSD) I will at least find it personally helpful as a way to put a name to the struggles I have.

I got up to a certain point in the booklet, but found it very hard to answer one of the questions in particular. This one asked me to describe the nightmares and flashbacks I have, in as much detail as I can manage. I gave some basic, vague answer, but found myself getting panicky, the more I thought about my termination and the nightmares and flashbacks I have about it.

In session two, my therapist went through my answers to some of the questions in the booklet. She asked me to embellish, and give examples of some of the times I have engaged in the behaviours I ticked, feelings, and thoughts I related to. A type of behaviour I engaged in was to react to pretty normal events in a tense and jumpy way. For example, when waiting for therapy, I was very anxious due to how busy the waiting area was. My therapist came to get me, and I jumped when she called my name. Another example I can think of is a bit of a silly one. Every single time the toaster goes off, I jump! It doesn't matter if I was expecting it to go off at that particular time or not. My body acts as if something scary has happened. Of course I get teased for this, but if you've ever jumped at something, you'll know how much it can shake you up, even if just for a few seconds.

We also went through some of the thoughts I had, and questions I asked myself constantly, in relation to the traumatic termination I had. I had made the decision so quickly, I still doubt whether it was something I ever wanted to do. I of course ruminate over them and weigh up pros and cons. I wish I could say for certain whether it was the "right" thing to do or not (for me I mean, I strongly believe anyone can have a termination if that is the right thing for them). If I had continued with the pregnancy and kept my child, I would've struggled but I think I would've been a good mother. I've always wanted to be a mother too, so I hope so so much that this wasn't my only chance.

I guess, because I don't think it would be the end of the world to keep my child, it makes me wonder whether I made the right decision. On the other hand, I was just learning to become an independent adult, living in my own place, having further education etc. It would've been very hard to do that whilst heavily pregnant. Halls would hardly be an ideal place for a baby either. But again, there would be things that could be done. See, I'm forever second guessing myself and not being sure of what would've been the right thing to do for me.

The termination itself was horrible. I won't go through the graphic, physical things. I feel sick and panicky even thinking about what I went through. This is something I will eventually have to go through with my therapist, but thankfully she is not rushing me. Even in session two, I was going through my thoughts about it, hypotheticals etc, and I was dissociating, struggling to speak etc.

This took up most of the session. We went through a couple of worksheets as I described various behaviours, thoughts etc. One was about the "Fight or Flight" response. The worksheet displayed a diagram of a body, with organs shown. Each part of the body was labelled and each function, to do with the fight or flight response, explained. For example, the mouth getting dryer when anxious, and the heart beating faster. These things happen due to the body's primal instincts. We are "supposed" to get anxious when faced with a dangerous situation. The mouth gets dryer because digestion is not needed at that time, and energy is diverted towards the muscles in order to get them ready to run or face the danger. The heart also beats faster in order to pump more blood to the muscles to help them work more efficiently. Other functions include shallower breathing, adrenaline being released, and muscles tensing etc. Unfortunately this can happen even when the situation isn't dangerous. When we have an anxiety disorder for example, we perceive things as dangerous even if they are not, or are very unlikely to be.

The next worksheet talked about unhelpful thinking habits. There are different types of thoughts that can be unhelpful to our mental health. These include the "mental filter". This is when we only notice certain comments, thoughts, events etc. These are usually negative ones, so we exaggerate the negatives as being absolutely awful and incessant.

Another unhelpful thinking habit could be saying/thinking we "should" or "must" do/think or not do/think something. This puts an unrealistic expectation and pressure on ourselves. A particular "should" I have is that I "should" earn my rests. As you may know, I have physical health conditions including Fibromyalgia and Hypermobility. These cause lots of pain and exhaustion. I feel like I "should" be productive every day though, no matter how ill I feel. So because of that, I "should" be productive before I am allowed to rest, otherwise I'm doing nothing but resting (in my eyes).

There are many other "unhelpful thinking habits" that I can relate to, but it would take all day to describe them, and this blog post is long enough! Onto the last topic of this session:

Lastly, we spoke briefly about having a "safe place". This is a visualisation of a nice place, where I feel safe and happy. Somewhere I can go to in my head when things are getting too intense or negative. As I am facing some traumatic things in these therapy sessions, I will need to have time to have a breather and "escape" to somewhere calm. My homework for the next session is to think of a safe place in my head; a sandy beach for example.

I am starting to think of that safe place, which I will describe in my next blog post.

Saturday, 19 October 2019

Trauma Focused CBT: Session One

(Trigger Warning: PTSD, abortion, self harm, and suicide mentions)

Last Thursday, I had my first session of Trauma Focused CBT. I was nervous and reluctant to go, leading up to this appointment. I was worried that I would be made to talk about things before I was ready. I didn't want to be in floods of tears in a public place, and I didn't want to be badly triggered either.

The therapist I saw, was the same one I saw for general CBT a while back. She is a compassionate, yet matter of fact therapist, which I find is a good balance for me. I don't like people to sugar coat things. I'd rather be told straight out if something needs to be said. Of course, I need the compassion too, especially when talking through some very difficult events.

At the start of the session, I was asked to fill in the usual PHQ etc forms (for Depression, Generalised Anxiety, Phobias etc) as well as a risk assessment for suicide/self harm. I gave similar answers to that of the questionnaires I filled in during my phone assessment. I think it will be very difficult to find a way to improve my scores on these; especially as I am on a low dose of Citalopram now and it's not doing a lot yet.

After this, my therapist asked me to give a brief description of my (main) trauma. This was about my termination 10 years ago. I told her some things, but she realised when I was getting distressed, and didn't push for me to carry on.

She then explained the difference between general CBT and Trauma Focused CBT. That is, that with general CBT, cognitions (thoughts) are challenged. This does not happen with trauma focused. Thoughts themselves are not challenged, but different perceptions are considered. So, in a way, ideas around the traumatic event are broadened, and other perspectives are allowed in.

My therapist then showed me the theory of CBT by drawing on a piece of paper. She wrote "Thoughts" "Emotions" "Behaviours" and "Physical Symptoms" round in a circle shape, with arrows to show how one leads to the other. We went through the main thoughts I had around my termination (she also asked me why I preferred to use the word "termination" rather than "abortion". I told her that "termination" seemed like a softer, more distant term, even though I knew they meant the same thing. She said one aim she wanted me to work towards was to be able to say "abortion" comfortably).

The thoughts, or themes, I felt around my termination were "guilt" "regret" and "loneliness". The emotions I had were low mood, and feeling like this was my only chance to have children (I can't remember what else I wrote). The behaviours included avoiding conversations, and becoming triggered when exposed to conversations, television storylines etc based around termination. She asked me what happens when I am triggered. I told her it was one of two things really. I could become inconsolable; in floods of tears, and panicky, as if I couldn't cope with life. On the other hand, I could dissociate.

She wanted me to explain what happened when I dissociate. I said I felt spaced out, as if I was having an out of body experience. I may go very quiet, and will freeze, as if I can't do anything. I will also stare at walls. It could take hours before I can ground myself. The ways I ground myself include grabbing something near me (a pen, for example) in order to remind myself that I am in my body and I do exist. I could also focus on what I can see, smell, or taste. So it's all based on focusing on what stimulates my senses. It's not easy, but it works eventually.

As for "physical symptoms" I explained that I found it very hard to separate the ones I had due to my mental health problems, and the ones I had due to my physical conditions (i.e. Fibromyalgia and Hypermobility Syndrome/Hypermobile Ehlers Danlos Syndrome). After thinking about it for a while, I found that I felt exhausted, achier, tensed up (especially from clenching my jaw throughout the day) and dizzier.

She also said that we would go through my trauma in little chunks, at my own pace. Sometimes I might want to talk about it all at once, sometimes I might only manage some brief detail. She explained also that some of the topics we will go through include grounding skills, and establishing a "safe place". She asked me if I'd come across the term "safe place" before, and if I knew what it was. I said I'd used the term before and I suppose my safe place would be my home.

My therapist explained that it was a vision/memory of a place that makes me feel calm and safe (a sandy beach for example). I would use this safe place to escape to, in my mind. I would think about what I could see, smell, hear, feel etc and I may do a gesture (such as clenching my fist) to bring me to that place in my mind. I suppose clenching my fist could indicate wanting to hold some sand in my hand, and feel the soft grains running through my fingers.

We talked through what my aims were for therapy. I said that I felt I hadn't processed my trauma properly, and I needed guidance in order to do this. I would also like to be able to talk through my trauma with more balanced emotions. I wanted to not be so triggered, and I would like to ground myself more easily if I dissociate.

Finally, we did a screening questionnaire. These were 22 questions that my therapist would read out to me, and I would answer "not at all", "a bit", "moderately", "quite a bit" and "extremely" depending on how severely I related to the statement. I found that my answers were mainly "quite a bit" and "extremely". To meet the criteria for PTSD, I had to get a score of about 33. It turned out that my score was 65, so showed that I had very significant PTSD. So there's another diagnosis to add to the list!

Although I wish I didn't have so many diagnoses, I am glad that my problems are validated and I have a name to put to them. For about a year, I suspected I had PTSD, but I wasn't sure if I quite fit the criteria. At least now I know that I do, and I hope that Trauma Focused CBT will at least lessen some of my struggles.

After my appointment, I felt very overwhelmed and in my own head. I'm only just starting to come out of this, but I still feel rather overwhelmed. Things from my past are coming to the forefront now, and I'm finding them very hard to face. I know that I need to face these things if I ever want to move on though.

Resources

Treatments for PTSD: https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd/treatments-for-ptsd/#.Xarjl-hKiM8

PHQ-9 Depression Test Questionnaire: https://patient.info/doctor/patient-health-questionnaire-phq-9

Dissociation and dissociative disorders: https://www.mind.org.uk/information-support/types-of-mental-health-problems/dissociation-and-dissociative-disorders/#.XarkROhKiM8

Grounding exercises: https://www.livingwell.org.au/well-being/mental-health/grounding-exercises/

Finding a Safe Place is Important for PTSD Recovery: https://www.healthyplace.com/blogs/traumaptsdblog/2015/11/finding-a-safe-place-is-important-for-ptsd-recovery

Online PTSD questionnaire: https://www.dynamicyou.org/mental-health-questionnaires/online-post-traumatic-stress-disorder-ptsd-questionnaire/

Tuesday, 8 October 2019

Let's make sure "Every Mind Matters", by funding our Mental Health Services!

It's "Time to Talk", "Ask Twice", "Be in your mate's corner", and currently "Every Mind Matters". These buzz-phrases are easy to remember, and uplifting I suppose, but how helpful can they be for mental illness?

A lot of these mental health awareness campaigns aim to get people reaching out, talking about their mental health; whether they have a diagnosable mental illness, or their mental health isn't as good as it could be (mental health and mental illness are two different things, but that particular thing is for another blog post). They also aim to get people reaching in and checking if their loved ones are really OK.


I took part in the "Every Mind Matters" Mind Plan quiz today (you can take it yourself here ) and was given these 5 pieces of advice:


  1. Relax your muscles and mind - I was given a video to watch, in order to help me with this.
  1. Move more every day - "Why not try getting off the bus or train a stop earlier, or taking the stairs more often?"
  1. Make time to do something you enjoy - It suggested going to the cinema, or listening to music.
  1. Make time to chat - The emphasis was on chatting over the phone or in person
  1. Take time to reflect - This piece of advice wanted me to focus on the good things about my day.

None of these are necessarily bad pieces of advice, but they are extremely simplistic considering the answers I gave. I have severe Clinical Depression, severe Generalised Anxiety Disorder, as well as Obsessive Compulsive Disorder, Borderline Personality Disorder, and possibly Post Traumatic Stress Disorder (not officially diagnosed, mainly because specific treatment isn't available with my local mental health team). My answers included statements that I was often extremely stressed, anxious, low, and struggling to sleep well. This barely touches on the big messy knot that is my (extremely poor) mental health, but even taking this miniscule fraction of it, I'd expect to be getting better advice than moving more, thinking positive, and chatting to a mate.

It's great that there's more awareness of mental health problems, and that people are being encouraged to talk to each other (whether that's reaching out or reaching in) but the appropriate services need to be there when people ask for help.


Just as medication, advice, and possibly seeing specialists is usually what happens when diagnosing and treating physical health problems, so should it be considered when diagnosing and treating mental health problems. Specifically, we need more choice of psychotherapy, better crisis services, more psych beds. We need less of a wait for therapy full stop. Community Mental Health Teams (for people with more serious/complex mental illness) need sorting out too. Too many people fall through the ever widening gaps because their needs are not able to be met.


Do you know how disheartening, even dangerous it can be when you finally muster up the courage to ring for help (whether that be IAPT, CMHT, GP etc) and be told there's either a wait, you need to ring someone else, or even that the help isn't available? I've become suicidal after being knocked back by mental health services. They are supposed to help you get better, not make you worse! Mental Health services in areas such as mine are woefully underfunded, and those with complex/serious mental health problems are given barely any therapy, if any.


If #everymindmatters
then make sure our minds are looked after, by properly funding our NHS mental health services!


Resources

Your Mind Plan - Every Mind Matters:  https://www.nhs.uk/oneyou/every-mind-matters/your-mind-plan-quiz/?WT.tsrc=Search&WT.mc_id=Brand&gclid=CjwKCAjw5_DsBRBPEiwAIEDRW4JL3hTok4A793ZCwPbRexXE7BNfGIC9cGn5PX9mK5eSI4-dp-4P8xoCKkgQAvD_BwE


Improving Access to Psychological Therapies: https://www.nice.org.uk/about/what-we-do/our-programmes/nice-advice/iapt

What is a Community Mental Health Team?: https://www.rethink.org/advice-and-information/living-with-mental-illness/treatment-and-support/community-mental-health-team-cmht/


Wednesday, 18 September 2019

Getting the ball rolling: Primary Care

I finally feel like I'm just about ready to start Trauma Focused CBT. This is offered through my local Primary Care Mental Health team, and I can self refer for assessment. Last week, I rang up to give my details and was offered a telephone assessment last Thursday. They originally wanted to give me an appointment for last Wednesday, but after discussion amongst themselves, they decided I needed to speak to someone more senior because of my complex needs.

The telephone assessment went really well, and I managed to remember everything I needed to say (prompted by my notes as well, of course). The first part of the assessment was the more "objective" part; where we went through my answers to the PHQ9 and GAD7 questionnaires, as well as questions on specific phobias, functioning, employment, and recent appointments. My scores for the PHQ and GAD questionnaires were quite high; indicating my levels of Depression and Generalised Anxiety are quite severe. I knew this beforehand, and the complex issues that form part of my mental health problems just exacerbate those levels too. It's like my brain is constantly battling itself!

I was asked how I had been feeling recently (awful to be honest), how my family life was (ok, but a lot of stress about various things), my aims for therapy (to be able to talk about my termination with others, and help people who have been through similar experiences) and why I decided to contact the service this time (I was fed up of how easily triggered I got, and I want help to change this).

The telephone assessment was only supposed to take about 30 minutes. It ended up taking an hour, 10 minutes! Thankfully, I was given time to explain everything, and I certainly wasn't rushed! I do hope this helps them to get an idea of my needs and aims though.

The day after the assessment, I received a phone call to say they'd accepted me for CBT (I'm hoping they mean Trauma Focused, but we'll see).

I seem to have a lot of ideas for blog posts, and not enough energy to get them past a very rough draft stage! I can't promise my next post will be about my mental health, but you should hear from me, for updates on that subject, soon.


Friday, 13 September 2019

Another ENT follow up, and a Chronic Vestibular Migraines diagnosis

Today, I had my second follow up with the ENT department. I saw the consultant himself this time, and he was a very pleasant man. He introduced himself and asked me to take a seat, before asking me how I'd been. I told him that things were pretty much the same as before. My balance hadn't improved, despite the physio exercises, and the dizziness and flashing lights/floaters were pretty much the same too.

He told me the results of my Vestibular tests were relatively normal, so he didn't think it was my ears that were affecting my balance etc. He said it was more of a "central" problem.


I found he took me seriously and was sympathetic to my struggles with my physical symptoms. I also told him my physio had told me to speak to the doctor about Vestibular Migraines. The consultant wholeheartedly agreed with him and gave me the formal diagnosis of Chronic Vestibular Migraines

I've included a link which explains what Vestibular Migraines actually are, but these are the symptoms I experience:


  • Dizziness: This tends to be all the time, but I do get acute bouts of dizziness where I feel as if I am going to fall over or faint
  • Balance Problems: Again, I feel like I'm going to fall over. It is the primary reason why I use a walking stick, and is a problem I've had for years. 
  • Flashing lights: This does what it says on the tin. They are flashing lights in my field of vision. They can be incredibly distracting and I cannot concentrate when there are lots at a time.
  • "Floaters": These are little shapes (wiggly lines is a typical one) in my field of vision. They float around then disappear
  • Sensitivity to light/sound: I don't always get this, but I have noticed it happen a lot recently.
  • Some nausea: This tends to come on with the acute bouts of dizziness
  • Migraine headaches: I do still get classic migraines (with the headache) now and again. As I've experienced classic migraines in the past, the ENT consultant says I am more susceptible to Vestibular ones now
Vestibular migraines don't typically occur with the classic type headache/s. The primary symptom tends to be dizziness, so it is not usual that someone would think they are having a migraine at the time.

After I'd explained my symptoms and the consultant had given me the diagnosis, he wanted to know what medication I take. I listed off the medication that I could remember, and he told me that some of the medication (namely the Tramadol) could be exacerbating the dizziness, as it works as a sedative. 

The next thing he suggested was to start by finding my triggers and exclude certain foods to see if they affect the migraine symptoms. He also wants to see me in about 3 or 4 months time


Overall, I'm very pleased with how the appointment went and how I was treated. Most things were discussed and at least I'm still under the care of ENT.

Do you suffer from Vestibular Migraines? Please comment below with what helps/makes them worse.


Resources

Vestibular Function Tests: https://www.stgeorges.nhs.uk/service/general-medicine/audiology/vestibular-balance-and-dizziness-service/vestibular-function-tests/

Vestibular Migraines: https://www.webmd.com/migraines-headaches/vestibular-migraines#1

Floaters and flashes in the eyes: https://www.nhs.uk/conditions/floaters-and-flashes-in-the-eyes/


Tuesday, 10 September 2019

"I can feel it in my bones"

The title describes a phrase I use very often, when it comes to some of the pain I experience with Fibromyalgia. As Summer ends, Autumn begins, and with it come stiff breezes and general cold, I really do feel it in my bones and it makes moving my joints very difficult.

I wake up with incredibly stiff joints, and the cold weather means it takes even more mental and physical effort to get out of bed and face the day. I know that the stiffness will ease, as long as I make sure I keep warm and moving, but the initial pain that comes with the stiffness is incredibly hard to push through.

Keeping warm of course is very important for people with Fibromyalgia. So is trying not to overheat. We often find it hard to regulate our body temperature, and being too hot or cold can cause all sorts of symptom flare ups. Below are my lists of symptoms that flare up when I'm too cold, and when I'm too hot.


When I'm too cold:


  • Joint pain
  • Nerve pain
  • Muscle cramps
  • Joint stiffness
  • Headaches
  • Muscle twitching
  • Fatigue

When I'm too hot:

  • Dizziness
  • Weakness
  • Fatigue
  • Subluxations
  • Joints that are "too loose"
  • Sweating
  • Faintness
  • Sleep problems

So, what do I do about it? Well, I can't completely control it obviously, but there are some things I can do that may help. These include:

  • Drinking lots of water/squash. I use a bottle that has measurements with times at certain points. I have to make sure I've drunk enough by the time indicated on the bottle. 
  • Have light salty/sweet snacks. This helps keep my electrolytes up and sometimes helps the dizziness
  • Sit down whenever I need to, if possible. I have to rest often, whether too hot or too cold. This may help the dizziness
  • Have naps, but not too late in the day. I aim to nap around 2 or 3pm if I'm not at an appointment, meeting a friend etc. If I haven't rested by that time, I do usually feel extremely fatigued, especially if I am too hot. Some days my body will reserve more energy however, so I can do a bit more in my day.
  • Wear layers instead of thick jumpers. This way I can add more if I'm cold, or take more off if I'm hot. 


Do you have problems with temperature regulation? Comment below with your tips for dealing with it!

Thursday, 5 September 2019

Physiotherapy for Dizziness and Balance Problems

Over the past few months, I've been having physiotherapy for the dizziness I experience daily, and the balance problems I've had for years.

My first session consisted of a long assessment of my problems, and going over the forms that I had filled in prior to the appointment. I was asked all sorts of questions, including about any other symptoms I have, how severe, how often etc. I mentioned about headaches that come with the dizziness sometimes, as well as the flashing lights/"floaters" I get in my line of vision most days. I also have had a few falls; where my knees or ankles have just given way. I've bruised like a peach and sprained ankles because of those!

After all of the questions had been answered (and I was pretty exhausted), my physio decided to do a few tests; starting with blood pressure testing when lying down for 10 minutes, sitting up, and then standing. At the time, I was being investigated for symptoms of Postural Orthostatic Tachycardia Syndrome with a 48 hour portable ECG (the results turned out to be insignificant, so I never got round to having the tilt table test). The blood pressure results were relatively normal, so the physio said that excluded a few things (he didn't specify what).

Just before the session ended, my physio gave me a few simple exercises to do (If I remember correctly, they involved turning my head to each side, tilting my head each side, and turning my head upwards and downwards slowly) My next session would involve some balance tests.

Subsequent sessions mainly involved asking how I'd got on in previous weeks, how I'd found I'd managed with the exercises, then introducing me to more balance tests and exercises to try at home. Although my balance didn't seem to improve, despite the exercises (which I did do regularly, like a good patient!), I did find my physiotherapist very helpful with advice, and his findings. After speaking about some of my symptoms, he asked if I had been told (by doctors) that I may be suffering from a type of migraine that doesn't always present with the classic headache. I guess I hadn't really thought about migraines, although an optician did mention it to me due to the flashing lights I get in my vision. I'm due another eye test anyway (it's on the To Do list) so they'll probably want to investigate that more. As the flashing lights have been getting worse, and the dizziness hasn't improved, I decided to speak to my GP about it. He gave me Stemetil for the dizziness, but decided not to prescribe the usual migraine medication, as I don't often get the headaches. Sod's law, I'm getting them more now!

As well as this, at my penultimate physio appointment we spoke about my balance, and I mentioned how I believed a lot of it was down to my hypermobility. My ankles are very hypermobile and often give way. I used to get teased at school for falling down suddenly in the playground. I've been embarrassed by falling while in the middle of a town centre as well. Thankfully it's not resulted in serious problems (the worst has been a sprained ankle) but it's not pleasant anyway. I told my physio that I was thinking about asking my doctor to refer me to a rheumatologist to see if my Hypermobility Syndrome was actually Hypermobile Ehlers Danlos Syndrome . They used to be interchangeable diagnoses, but the criteria for HEDS is stricter now and they are believed to be different points of the Hypermobility Spectrum Disorders

I expected the physio to roll his eyes at me and dismiss my concerns, like various healthcare professionals have, but he actually took me seriously! He told me to definitely talk to the doctor and get a referral, so I can be properly assessed.

My last session was earlier today and when I told him the doctor had referred me to a Rheumatologist (Finally!) he was pleased, and wanted me to make sure the one I see either has a specialism in Ehlers Danlos Syndrome, or can refer me on to a Rheumatologist who specifically deals with EDS patients.

He was also pleased that I'd seen the doctor about my migraines. It looks like I've now been diagnosed with Vestibular Migraines . If the Stemetil doesn't help the dizziness or other symptoms, he will refer me on to a neurologist.

Lastly, we spoke about my balance problems. The physio decided there was no more he could do for me, so he has referred me on to a specialist rehab centre for balance problems. I'm not sure how long the waiting list is, but apparently the sessions are longer and the exercises a lot more intense. This should help my balance and give me better quality of life though.

Overall, I've been very pleased with these physio sessions. I may not have noticed improvements as such, but I've gained so much knowledge and advice, as well as support and advocacy from this physio, and I think these are invaluable. I feel that, with my physical health at least, I am starting to be taken seriously and actually getting the referrals and treatment I need.

I will of course blog about my referrals, when they finally come through, but in the meantime, I will try to keep you up to date with my physical and mental health progress. My next appointment is with the ENT specialist, so hopefully I will get more tests and/or treatment for the migraines!

Resources

1. Postural Tachycardia Syndrome: https://www.nhs.uk/conditions/postural-tachycardia-syndrome/ 

2. Tilt Test: https://www.bhf.org.uk/informationsupport/tests/tilt-test

3. Joint Hypermobility Syndrome: https://www.nhs.uk/conditions/joint-hypermobility-syndrome/

4. Ehlers Danlos Syndromes: https://www.nhs.uk/conditions/ehlers-danlos-syndromes/ 

5. Hypermobile EDS and Hypermobility Spectrum Disorders: https://www.ehlers-danlos.org/what-is-eds/information-on-eds/hypermobile-eds-and-hypermobility-spectrum-disorders/

6. Vestibular Migraines:  https://www.webmd.com/migraines-headaches/vestibular-migraines#1

Friday, 9 August 2019

A Mental Health Nightmare

(Trigger Warning: Self Harm, Suicide, Trauma, and Medication)

This is a follow on from my previous blog post


On Wednesday, I had an assessment with a nurse from CMHT. I was referred for this by my counsellor at my last session. Primary care had decided that, because of my urges to self harm, & my strong suicidal feelings, I wasn't stable enough for them.


The CMHT assessment went worse than I expected. I was assessed by a very condescending, judgmental nurse (who turned out to be the useless nurse prescriber I saw last year, who kept me on Sertraline even though it'd stopped working). She got me to fill in a very short questionnaire (something to do with how often I feel useless, demotivated etc) then told me she'd only ask me a few questions because CMHT had seen me a few times before & they knew my history.


First of all, she wanted me to tell her how I'd been feeling. I told her that primary care had sent me to CMHT because they felt that I was too unstable for them. She seemed disbelieving about that and had this smug look on her face (not a great start). I can't remember exactly what she asked me, but it wasn't much. It was mainly me telling her how I was feeling, and my worries. I was having urges to self harm badly, flashbacks about my traumas (Which I reminded her of), graphic mental images. I was even having suicidal thoughts, although I didn't think I'd carry them out because I feel stuck having my parents and Billie. They were my protective factors but without them I would definitely have attempted suicide. What I would definitely be doing though is self harming/overdosing. She still didn't seem to believe me, and asked what I wanted from CMHT. I said I felt I needed a CPN to monitor me. She said they don't do that now. I said I needed a meds review because I'm on the maximum dose of Sertraline and it seems to have stopped working. She said it was probably helping a bit so I should stay on it regardless. I said I may as well stop them, and she insisted I didn't.


I also asked whether an assessment for PTSD would lead to more help & she said no and I probably had it anyway because I had counselling for trauma and I'd been told to refer myself for Trauma Focused CBT. So I guess I have a sort of diagnosis now. I then reminded her of how much I was struggling, that I was at crisis point & I would definitely harm myself when I get home. She didn't seem to believe me and she said that I just wasn't ill enough for any help from them. She repeated it was all short term anyway, and mental health services had changed.


She then started talking as if it was a job interview. She asked me where I saw myself in 5 years. I was in no state to think about that, so I just said I don't know, I felt like I wasn't getting any better so I wouldn't know how I'd cope on my own, but I hoped I'd have moved out by then. She seemed pleased about that. She asked me about my hobbies (I talked about blogging and gaming), whether I went to any classes (I said about Slimming World), whether I worked/was intending to. I said I wanted to do something online but there wasn't much regular work online that I could do. She said that all I seem to do is go online, talk to friends and not much else. I found her very judgmental and she completely got the wrong impression of me.


There wasn't much else after that and I was crying through pretty much the entire assessment. She asked me what my plans were for that day. I scoffed and said I wanted to harm myself & that was all I planned to do. Even though I was clearly a risk to myself, she dismissed it. She'd even said at the start that she would have to tell a colleague if I was at risk! I have a feeling she didn't though. So I came out of the assessment crying and desperate to harm myself. I felt out of control! I dashed to the toilet and looked around to see if I could find anything to hurt myself with (preferably something sharp). I couldn't find anything & Dad would be there any minute, so I had to gather myself together then go out of the toilet. I told Dad what had happened and he was furious at her.


When we got home, I was in a world of my own. All I could think about was harming myself, and I spent about an hour in silence, planning what to do. I opted for overdosing. I took my chance when Mum went to the bathroom. I overdosed on Stemetil (Prochlorperazine). I only stopped when Mum came in. I told her what I'd done & she was very worried. She asked me how I was feeling, then it was only an hour or so after that I had my urgent GP appointment (mum had booked it when I told her about the assessment).


The GP appointment went much better than the CMHT assessment. He took me seriously, wrote down what I told him, and asked how I was feeling (drowsy, dizzy, nauseous). Then he faced me, took a breath, & said I needed to go to the hospital, get checked over and see Psych Liaison team. He said I was "high risk" and should get to the hospital ASAP. He also wanted to see me the next day for a follow up. Soon after that, I was at my local hospital's A&E department. I explained to the receptionist what I'd done & how I felt and I didn't have to wait long to see the triage nurse.


She was very understanding but she misunderstood when I talked about my bullying trauma shaping my personality. She thought I meant my body and started talking about weight loss, checking thyroid. That confused me for a bit. Having thin privilege, I'd never had a healthcare professional mention my weight before. Anyway, she checked on her system what needed to happen with a Prochlorperazine overdose. She booked me in for blood tests and an ECG. I had the ECG which was fine, then I was brought through to cubicles by a really nice doctor. She did my bloods & asked me questions about physical health, mental health etc. I really felt listened to, and she made sure I wanted to see Psych Liaison team. She then got a colleague to do my blood sugar (4.4, so low end of normal) and said while I wait for blood test results to come back, I should have something to eat and drink to get blood sugar up a bit. It would take an hour for results to come back.


Then came a lot of waiting. My blood results were "not worrying" but indicated I was dehydrated, so the doctor told me to get some water. She asked how I was feeling. I said I had a banging headache, and was very drowsy and dizzy. She then said she had called Psych Liaison team and they aimed to see me within the hour, but couldn't guarantee it. I was sent back to the waiting area. I got some water, went to the loo and waited. It was almost 2 hours before I was seen. The person I was due to see had finished his shift so had to spend time updating the person I was going to see instead. I actually saw two people at the same time. I think one was a psychiatrist & the other, a psychologist. They knew why I was there and had contacted my CMHT again. All they could do was advise me, as CMHT still wouldn't take me on. Apparently, even though Primary Care said I wasn't stable enough, CMHT said I was. They couldn't offer me more support but they at least explained things in a kinder way, took me seriously, and made sure I had support at home. The psychologist (?) also gave me information about classes I could join, mental health organisations etc. They also told me to see my GP about my meds.


Apparently, if the GP wasn't comfortable changing my medication, they could refer me directly to a psychiatrist! So other than that, I was to keep myself safe and distracted, with help of parents, friends, my cat, and crisis team until I have my Trauma Focused CBT. I eventually got home (after a trip to the chip shop, I was starving!) and was absolutely exhausted. It was about 10pm (I had first got to A&E just before 4pm). After food, I took a Diazepam then slept.


So since then I've been feeling like hurting myself but I don't think I'll do it, so I feel safer. I've seen the GP again and he's changed my Sertraline to Citalopram, and added a week's worth of Diazepam. He also got me to book an appointment for 2 weeks time, so he can monitor my moods, side effects etc


I feel like, even though I couldn't get more practical support from CMHT etc, at least I can refer for Trauma Focused CBT, I have a sort of diagnosis of PTSD, my meds have been reviewed, and my GP is monitoring me. So it's turned out ok, and I'm hoping I will improve. I will refer myself for Trauma Focused CBT next week, as it will be about 10 weeks before the sessions start. In the meantime, I have to be more open and honest with my loved ones, and let them look after me and keep me safe. The other day feels like a blur, a really bad dream even. I guess I'm still recovering but at least I'm in a better place now.

Wednesday, 31 July 2019

My last Counselling session, and a referral to CMHT :Counselling Session 11

(Trigger Warning: Self Harm details, Suicide, and Abortion)


Mood Swings and Intrusive Thoughts:

A couple of days before my last counselling session, I was slightly hyper, overconfident, in a confrontational mood, and impulsive. I did not have much money to be impulsive with, so I just bought a jacket for my mum. Days before that, I had spent money online, buying lots of makeup and hair products. This hyper feeling only lasted a couple of hours, and then I became very anxious and paranoid; particularly about social media. I'd posted my response to an article about disabled people protesting and being reported to the Department for Work and Pensions (DWP) simply for protesting. I thought this malicious reporting was disgusting and I criticised the police who had done it. I fully expected an angry response from police officers/people who supported the police unconditionally, but thankfully I didn't get any. My Anxiety didn't subside much though, and I soon found myself in the deep pit of Depression. I was also very distressed, as I was experiencing graphic triggering mental images (mostly of abortion, and self harm) as well as intrusive thoughts and strong urges to self harm. I was supposed to call the Access team for some guidance, but I was too distressed and nervous, so I opted to email them instead.

The response I got the next day was very cold and dismissive. They basically told me I was right to say calling would result in a quicker response, and that I should do that instead. There was no sympathy for my situation. If anything, it nearly put me off calling, as I expected the call handler to be just as cold and dismissive.

By the end of the day, I was desperate to talk to someone though. I brought up the number on my phone and pressed "call" before I could talk myself out of it (again) due to thinking my situation wasn't urgent enough. The call handler was lovely though. They had a really calming voice, listened to me, and took me seriously. They also gave some helpful advice.

Counselling:

Skipping forward to my counselling session,  I was still very distressed and depressed. As I explained to my counsellor, how I'd been feeling, I became more distressed, confused, and tearful. There were some things I hadn't realised about myself, that had now come to the forefront as I exposed myself to triggering conversations through counselling. The problem was, I needed support inbetween counselling sessions, as I had talked through my trauma in the session, and when it had ended, I was left to deal with the result of opening up. That's not to say counselling has caused my crisis (is it a crisis?) but it has brought some difficult things to the front of my mind; which has then led to a crisis.

I spoke to her about my intrusive thoughts, the mental images, the suicidal thoughts and urges to self harm (specifically cutting my arms and legs in the shower). This took over the session, as it was so urgent that I get help soon. My counsellor was very concerned and wanted to know how likely I was to harm myself.

She told me that to deal with the trauma and learn practical skills for coping, I needed to have trauma specific CBT. She then said that she didn't feel I was stable enough to commit to it at the moment though. Primary Care didn't have the resources to help people who are at risk of suicide or self harm, or the very complex issues that are causing me to need help straight away. She said that if I wanted, she would call the Access team so they could step me up to secondary care

She also asked what I felt I needed, if I were to be referred to Secondary Care (aka Community Mental Health Team). I took a minute to gather myself together, then told her I felt I needed a medication review, because I felt the Sertraline wasn't working anymore, and I shouldn't be in this state while on the highest dose. I also needed to be assessed for PTSD, and have a CPN to monitor my progress.

She asked me how I felt they could help me become more stable (other than the meds review) and I started crying as I said I wasn't sure, but I didn't want to keep struggling with the trauma I've experienced. I didn't want to feel this way anymore and I'm no expert so I don't have all the answers for how to help myself. I felt like I needed to have all the answers though, otherwise CMHT wouldn't know how to help me. I told my counsellor about the last time I was assessed by them. I did need their help though, so would like her to ring the Access team for me. She asked me to tell her what I wanted them to know. I said that I wanted her to tell them that I was having strong urges to self harm, I was having suicidal thoughts as well as graphic intrusive thoughts and mental images. I also was very depressed and distressed, and needed help very soon.

The session had come to a close at that point, and my counsellor confirmed she would ring Access team and tell them what I'd told her. I'd stopped crying by that point, and was checking my eyes weren't too red. I was very grateful to her for all her help, and I was very apologetic about how I'd behaved (I was worried that I had been rude and in her face. It turned out I hadn't though).

What Happened Next:

The next day, I expected a call from the Access team, but it never came. I rang them and explained everything. They checked my notes on the system, and said that I'd been stepped up to secondary care/CMHT straight away, and an appointment had been booked for me for 7th August.

I will blog about my appointment with CMHT soon. Please keep your fingers' crossed that they can offer me some help!


Resources:

Police force admits agreement to share information about protesters with DWP: https://www.disabilitynewsservice.com/police-force-admits-agreement-to-share-information-about-protesters-with-dwp/

Dealing with intrusive thoughts: https://www.mind.org.uk/information-support/your-stories/dealing-with-intrusive-thoughts/#.XUGQsehKiM8

Treatments for PTSD: https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd/treatments-for-ptsd/#.XUGRW-hKiM8

Community Mental Health Team: https://www.rethink.org/advice-and-information/living-with-mental-illness/treatment-and-support/community-mental-health-team-cmht/?gclid=CjwKCAjw-ITqBRB7EiwAZ1c5U6Ry5KJLjfr8k89GV4DpHT1_3NVTwxF-_nqPRrzqeF1QNV6cVwo2PRoCqIQQAvD_BwE

Post Traumatic Stress Disorder: https://www.nhs.uk/conditions/post-traumatic-stress-disorder-ptsd/

Mental health professionals: https://www.netdoctor.co.uk/conditions/depression/a638/mental-health-professionals/


Friday, 26 July 2019

Lack of Resources: Counselling Session 10

(Trigger Warning: Mention of trauma, self harm, overdosing, and suicide)

I had been experiencing a lot of emotional numbness and the need to avoid my feelings; leading up to this counselling session. Because of that, I wasn't sure what to talk about. My counsellor did ask me to embellish on the numb feelings and avoidance though and we found I was doing this to protect myself from intense distress and depression. There'd been some triggering storylines on television, and instead of panicking, I found myself dissociating in order to protect myself from the horrible feelings of being triggered.

My mum has had to fill in a work capability questionnaire too, and helping her do this, seeing her so anxious and depressed, has really rubbed off on me. It also took me back to the times I've had to fill in these forms; how much I've struggled emotionally, remembering back to that awful first face to face assessment. I never want to go through that again. My mental health worsened partly because of that assessment, and I haven't significantly improved since. As for emotions rubbing off on me, I told my counsellor that this happened in many situations, and I found I even got affected by atmospheres in a room. If it's a depressing atmosphere, I feel depressed. If it's an anxious atmosphere, I feel panicky, and so on. If a person is upset, they don't have to be showing it obviously, or tell me. I can sense how they feel, and it makes me feel the same. I suppose I'm an empath, in that sense. I've always been told I am both sympathetic and empathetic to people's situations.

We talked about how my emotions tend to be very intense. Even being numb can feel intense.  I find it hard to "catch" myself before my emotions have gone from 0-100, so balance is something I would love to strive for.

We also talked about the dissociation I experienced. I explained how it felt as if I was looking at the world through a thick glass window, or an out of body experience; where I'm watching myself do and say things. I'm not really there, I'm just a body without the human element to it. I also feel very spaced out. I find it hard to talk about things fluently. I can't concentrate properly and nothing feels real. When I'm like this, I worry about what I will say or do as I'm not really *there* to face the consequences.

I started experiencing dissociation when I was bullied at school. It was a way of protecting myself and escaping from the bullies' cruel words, the abandonment I felt when left out, the lack of support and understanding from my elders. I was avoiding my feelings, and it took a while to ground myself.

We then moved on to what would happen after the last session (session 11) of counselling. We'd decided that, although counselling had helped me to talk freely about what I needed to, and understand the problems I have with trauma, it was not a specific therapy for trauma. What I needed was something trauma focused. The counsellor said that the Wellbeing (Primary Care) Team only offer trauma focused CBT. I considered this, but wanted to know if secondary care would offer anything. She said she'd spoken to her manager, who had decided I'm not unwell enough for secondary care, and to be honest, they just didn't have the resources to offer the long term help I needed.

So it was CBT or nothing.

I told my counsellor that I had set up a fundraising page to try and raise enough money to fund a few private sessions of trauma therapy or EMDR . This would help me to get specialised help, but it cost around £80 for an hour's session. Unfortunately, the fundraiser was a flop. I had a grand total of one donation.

I decided to say yes to the CBT. It was my only choice. My counsellor had been under the impression that she could refer me straight on to be placed on the waiting list for CBT, but unfortunately it doesn't work like that. Once counselling has finished, I need to self refer, go through the telephone assessment, and then be placed on the (8-10 week I think?) waiting list. It's not ideal, but it really is that or no help at all.

I told my counsellor about how, although I was grateful for the help I had got, I was frustrated about the lack of choice of therapies in my local mental health team. I knew it wasn't the staff's fault, but it didn't stop me feeling as if I wasn't really getting the right help for me. I also felt abandoned by secondary care. Again, I was grateful for the help they had given me (a referral to a psychiatrist, and a couple of sessions with them, as well as a CPN, and support worker who gave me some very short rounds of self compassion therapy and emotional regulation therapy). The last time I was referred to them though, I was very unwell, self harming, overdosing, and even hallucinating, they would not help me. I was assessed then discharged; being advised to get CBT with the wellness team. Usually, they would tell me to call if I ever needed them. This time, they didn't. It could've been a mistake on their part, but my brain told me that they didn't want me to call them ever again. I felt as if they'd washed their hands of me because I didn't deserve the help, and I would have to have done something drastic if I ever was to get their help again.

I said to my counsellor that, when it came to urgent help, mental suffering was not seen as bad enough for assistance. It had to be that the mental suffering had led to physical consequences (such as self harm/overdosing/a suicide attempt) before anything would be done. Even then, help wasn't guaranteed. I suppose I did blame some of the staff for not taking me seriously enough, but it was also to do with lack of funding from the government, leading to lack of resources, and therefore lack of help and choice of care. It's such a shame. No one should be left to suffer in silence.

I have one more session left, then that's it for counselling. I told my counsellor at the end of the session, that I would miss her a lot, and I felt that we had a great therapeutic relationship. I think she appreciated that; she was grateful anyway.

So my plan now is to wait a few days after my last counselling session, then ring the mental health team to self refer for CBT. I'm hoping the therapist I see knows a lot about trauma, so that they understand the things I tell them. I'm keeping an open mind about going through CBT yet again (5th time now?) so I'll have to wait and see how it goes. I will of course blog (and maybe also vlog) about my sessions. In the meantime, "just keep swimming!"



Resources

My ESA Tribunal Experience: https://www.amysmysteryillness.co.uk/2014/03/my-esa-tribunal-experience.html

13 Signs That You're an Empath: https://highlysensitiverefuge.com/empath-signs/

Grounding techniques: https://www.mind.org.uk/information-support/types-of-mental-health-problems/dissociation-and-dissociative-disorders/self-care/#TryGroundingTechniques

Dissociation and Dissociative Disorders: https://www.mind.org.uk/information-support/types-of-mental-health-problems/dissociation-and-dissociative-disorders/#.XTtgYuhKiM8

Cognitive Behavioural Therapy https://www.mind.org.uk/information-support/drugs-and-treatments/cognitive-behavioural-therapy-cbt/#.XTtg2ehKiM8

My Ko-Fi fundraising page: https://ko-fi.com/W7W0XG96?

Eye Movement Desensitisation Reprocessing: https://www.ptsduk.org/treatment-options/eye-movement-desensitisation-reprocessing-emdr/?gclid=Cj0KCQjwyerpBRD9ARIsAH-ITn8wTsjUzlHWODMZO6to9j5467XJogbBYhhHsDZpozCQXg0x83b4DAwaAvmdEALw_wcB





Tuesday, 16 July 2019

What's Next? : Counselling Session 9

(TW: Abortion, abuse, and bullying mentions)

I'd been very emotional; leading up to this session. I'm not sure what set it off, but everything had felt so intense. I also wanted to control situations more, and had more flashbacks. It didn't help that I'd had flare ups of my physical conditions; especially the pains. TV shows had been full of abortion story-lines, and coupled with being on my period, I really wasn't having a great time.

I don't think I've been very open about how I've been feeling to be honest. This is a sign that I'm isolating; not something I always realise for myself. I do hate feeling like this though.

I let everything out at my counselling appointment. Thankfully, I don't really feel judged by my counsellor and I feel like I can tell her anything.

We went through how things linked to other things, and how my past had such an impact on how I react to things now. We also discussed the main things affecting my mental health at the moment. We decided that my main issues were my trauma (from bullying, the abortion, and the abusive relationship), as well as my need for control, and my anxiety.

In the previous session, we'd created a time-line to determine what led to my need for control, and what the consequences were/could be. Right at the start was the bullying; where my belief that people would be kind to me if I was kind to them, was challenged. Because they acted in a way I didn't expect, and they were horrible to me, I wondered if I was a horrible person and I questioned whether I deserved to feel good. This then led onto me not trusting people or situations, and therefore wanting to read minds, know what the future would bring/what would happen next, as well as feeling bad about myself. This led onto the need to control.

The consequences of controlling or wanting control over situations or people, was categorised into Pros and Cons. Pros were gaining reassurance and certainty, feeling strong, and knowing how to respond. The cons were the risk to relationships, feeling less reassured if trying to control didn't work, lack of nice surprises and spontaneity, and the fear that I may manipulate others.

This session, we did a similar time-line, but with anxiety in the middle. Right at the start, we established my true persona was that of a leader and decision maker. Being bullied changed my role from leader to follower however. As the bullying had made me a follower who was quite sensitive, I expected certain people to take care giving roles. When I had my abortion, I expected the nurses to be compassionate and supportive. After all, I was making a potentially upsetting decision and going through something quite big; so the least I could expect was support and understanding. When I didn't get it though, I felt very vulnerable. Similarly with the abusive relationship. I expected to be looked after, not taken advantage of and abused.

These made me feel misled, and again I felt people weren't acting in ways that I expected them too; which made it hard for me to trust others. A lack of trust in society/the world made me feel insecure and scared of what the future would bring, which then led to the anxiety.

From anxiety came pros and cons. The pros were that my need for survival was achieved by my anxiety. This would release adrenaline, which made me prepared for any perceived threats. The cons were much more however. These were the inability to relax, finding it hard to concentrate, not trusting people or situations, judgement being clouded. not giving people a chance, holding myself back, and not being as sociable. This also led to potentially affecting relationships, feeding others' anxiety (especially if I socialise with them less), being stuck, not moving on, not grabbing as many opportunities, not meeting people as much, and therefore a lesser quality of life.

We then moved onto an overview of our sessions, and what I needed help with most right now. For me, I found the trauma bothered me most, and was holding me back. I said I needed some sort of trauma therapy or EMDR. My counsellor said I definitely needed something more long term, but unfortunately all that Primary Care could offer was CBT. I was reluctant to agree to this, as I'd not had great experiences with it in the past. I've always found it far too rigid and simplistic for the problems I have. I asked whether Secondary Care offered anything, as my problems were complex and they were supposed to help with complex mental health problems. She told me that it was unlikely I'd have anything long term with them, but she would have a word and see if they could offer anything. She said she'd be happy to step me up to that level if they could help. If they couldn't though, would I consider the CBT? I reluctantly said yes. I would rather have that than no help at all.

We only have 2 sessions left, so we booked those in for me, and my counsellor said we'd make a plan for what help I could get next. She checked I was OK with finishing in 2 sessions' time too. I expected it, so I was OK. I just hope that something will help me address the trauma I've been through!

Although my Ko-Fi fundraiser has been a complete flop (only raising £12 from one lovely donor) I'm still keeping it up if anyone can help me to afford private trauma therapy. Please click this link to get to my page, and share and/or donate. I would really appreciate it! In return, maybe I could write something on a topic you would like to read about?

Tuesday, 2 July 2019

Connecting the Dots: Counselling Session 8

(TW: Abortion discussion)

This session, I told my counsellor how I'd been feeling very overwhelmed with everything. She asked me to embellish, and I said how a lot of it was due to triggering news and discussions, as well as bad political news items. I read up on this because I'm interested in it, but it does get me down; especially when it seems that a lot is going wrong in the country or the world. I've also found it hard to reply to private messages from friends, due to being so overwhelmed. As much as I love talking to friends, it can be a draining process when there's lots of messages, and/or long messages. I think about what I need to do in order to reply. It includes:


  1. Reading the message
  2. Processing each point made
  3. Thinking about what to reply with
  4. Writing it out, while re reading parts of the message received so I don't miss anything out
  5. Reading through my reply to make sure I've written it properly and the tone is alright
  6. Sending the message
  7. Waiting for a reply
  8. Go back to step 1 and repeat
Eventually, I have to distract myself from messages and reply again in a day or two (or a week or two if I forget!). I feel bad for ignoring my friends, but I literally don't have the energy for long conversations anymore. 

As for the triggering news, a lot of it was about abortion, and a certain politician's views on it. I just can't seem to cope with other people's opinions on this topic. Whenever there's a negative view towards it, I take it so personally, and it brings me right back to my own traumatic experience. It took a while for me to realise this was a trauma for me, and I haven't processed what happened, and my feelings about it properly. The way I was treated was in a cold, uncaring, judgmental way. I didn't feel supported by the medical professionals I was under the care of. I was not offered the counselling I so desperately needed after it was over. I just had to get on with life at university as if nothing had happened. I remember feeling so numb sometimes, and so low other times. I would spend time with my then partner (the one who turned out to be abusive) in silence. I know it affected him too, even though he wasn't the father. Nowadays, discussion (or even mention) of abortion makes me panic, feel scared (as if I'm in danger), very low, guilty, I have graphic mental images of the abortion itself, I can even feel the physical pain I was in. I think I do actually have flashbacks now.

I certainly wasn't as fluent in talking about the abortion face to face, as I am, writing it now. I can sort of disconnect when I'm the one talking about it. It's almost as if I'm talking about a character in a book; not myself. Face to face, talking it through with another person, and hearing their views on my experiences, is different though. As I tried my best to talk through what happened and how I felt, as well as the feelings and mental images I have when experiencing flashbacks, I began to feel breathless and panicky. I also became dizzy and struggled to pronounce words. Every time I said a long word, I kept repeating it, and saying to the counsellor that I wasn't sure if I'd pronounced it properly. It was all very weird. I felt very weird, and it took a little while for me to get to a point where I could talk about other things.

The bad news around the country and the world fed into my low mood. I felt as if everything was going wrong. I catastrophised things and felt hopeless about it all. I wanted to help people, but with situations in the country being so bad, I didn't know if I would be able to do it. 

After listening to all of this, my counsellor said we should do an exercise. She handed me a sheet of paper, and asked me to write "Low Mood" in the middle of it. I was then asked to draw a spider diagram; writing the things that related to this feeling, or happened to lead to it etc. The things I wrote included the following:

  • Abortion - Not processing what happened properly. Feeling trauma, panic, shame, guilt and loss. Complex thoughts around the foetus; thanks to pro life/anti choice opinions. Worrying about this being a loss, and I might never have a chance to have a baby again
  • Low self esteem 
  • Bullying
  • Frustration with myself - not being able to fully control my mental health
  • Feeling I'm lacking a sense of purpose
  • Using therapeutic techniques, but them not working
  • Wanting to control things, e.g. my own mental health
I explained each of these things, as I wrote them down. A running theme seemed to be wanting to control things. We then went onto another exercise. This time, I would draw a sort of timeline, with the word "Control" in the middle, things that fed into or led to the need for control, along the left hand side of the timeline, and pros and cons of having control, on the right hand side. 

Left Hand Side:
  • My early beliefs about the world, and people. I'd been taught that if I was nice to people, they'd be nice back. If I helped people, they would do the same for me. 
  • When I was bullied, I found that the bullies acted in a way that I didn't expect, so this threw me off. I wasn't prepared for this, so I had no idea how to respond.
  • After a long time being bullied, I began to wonder if I even deserved to feel good and have people being nice to me. After all, these people had been horrible, so surely they wouldn't do that if I didn't deserve it? (Remember, these were my early views, I know the world doesn't work like this now)
  • Because of all this, I began to want to know what would happen next, in situations, conversations, people bullying me etc.
  • I wanted to predict the future, and read people's minds, so I knew how to respond.
  • I felt helpless, weak, useless, like a failure, like I would humiliate myself
  • So in order to fix this, I needed to gain control.
Right Hand Side:

  • Control would lead to reassurance, certainty, feeling strong, knowing how to respond to situations and people. 
As for the negative side to gaining control, this will be discussed in my next session. My counsellor told me that there were only 4 sessions left, so to be aware of that. We discussed what I wanted to do next. I said that counselling is helping me progress, but I need something more intense and specialist in order to focus on and hopefully process properly, the traumatic abortion that I had. I felt I needed some sort of trauma therapy or EMDR. I asked my counsellor what was available. She told me that under this mental health team, the only therapy they offer for trauma is CBT. This is something I've had before, for Depression and Generalised Anxiety Disorder. I didn't find it helpful, so I didn't feel very sure that it would help my trauma either. I told her that I'd give it another go, but only because it was that or nothing, so I'm not sure if I'm in the right frame of mind to be having it at all. 

My only other option is to consider private trauma therapy. I've looked up what's available in my area, and the prices start from around £80 for an hour's session. My only regular income is from ESA and PIP, so there is no way I could afford this, on top of all my other bills. I recently decided to set up a Ko-Fi page, which asks donors to buy "coffees" for the person whose page it is. You click on the amount of "coffees" you want to buy, and that goes directly to the person's Paypal account. I have had one donor so far, who I am so grateful to. I need to raise around £800 though, so I can get enough sessions of trauma therapy. The button that links to my page is on my blog, but I've placed the link again here in case anyone would be kind enough to donate and/or share.


Resources




Wednesday, 26 June 2019

Smear Tests - My Experience

(TW: details of a medical test)

I've been thinking about writing this blog post about my experience having a smear test. It is mostly targeted at people who are having/thinking about having their first test and they're not completely sure what to expect. There's information online about smear tests (aka Cervical Screening), on websites such as the NHS website. These tell you what one is, what it tests for, what will happen, when the results will come through, and what each result means. I do not feel by any means this blog post is something to read instead, but I find personal accounts of these tests can be a good supplement to "official" information. Some of what I say will be similar to the information on websites such as the NHS, but I hope to give more of a personal touch to my account.

(Disclaimer: My experience is by no means a universal one, and I do not want to insinuate that it is. People having a smear test may have very different needs to myself, for example, due to disability. Although I am disabled, my physical difficulties do not prevent me from getting onto the couch, in the examination room, unaided. I also use the term "people" rather than "women" as there are many genders where the person may have a cervix, and I would like to be as inclusive as possible.)

Yesterday was the second time in about 6 years that I have had a smear test/cervical screening. I had finished my period the week before, but was finding that I still had pains particularly round my cervix area. It was not debilitating, but was painful enough that it stopped me in my tracks for a minute or so. Because of this, I was nervous about the test and what it might find. I'm also very self conscious about my body, so was very aware of myself when undressing my bottom half.

I only had to wait a few minutes, before being called through by the nurse. She was someone I had seen (for other reasons) a few times before, so that put me more at ease. She asked me how I'd been recently, so I mentioned the throbbing cervix pain. I found that I played it down a bit (by saying it only happened now and again) possibly due to nerves. She took note of what I said, took me seriously, and was compassionate.

She also asked me some questions about my period ( the approximate date my latest one finished, whether it was regular, how heavy the bleeding was, how bad pains were etc) as well as the contraceptive pill I was on, any side effects etc. I told her I've been on Microgynon for a while, I had no side effects, and on this pill my periods are regular and usually not too heavy. My period pain is bad, but not agonising.

The nurse explained what would happen next. I was asked to undress my bottom half, lie down on the couch, bend my knees up then out; putting the soles of my feet together. I found little difficulty with getting onto the couch, as it was at a comfortable level (around hip level). I told her my hips might sublux in this position, as they are very hypermobile, but thankfully they stayed in place. She then explained what she would do next, before inserting a speculum into my vagina and opening it slowly, in order to gain access to my cervix.

It turned out that my cervix was higher up than normal, so a longer speculum was needed. (but the nurse reassured me this was nothing to worry about). She inserted the longer speculum (after removing the shorter one of course!) before opening it and inserting a thin instrument to take a sample from around my cervix. Due to my concerns about the pain I'd experienced after my period had finished, she took a larger sample than usual. She wanted to ensure that there was enough of a sample for thorough testing, to be on the safe side.

She told me that the outer and inner parts of my vagina did not look red or sore, and she wasn't concerned about them right now, but we'd see how the results are.

I found this second test much less uncomfortable than the first test I'd had. The thing I noticed most was the insertion of the speculum. I could feel the sample being taken, but it was barely uncomfortable at all, only lasted a few seconds, and I felt no pain.

Throughout the test, the nurse checked I was feeling alright, and she explained everything she was doing. I felt very at ease to be honest. The test itself only took about 5 minutes, and the nurse checked I was alright and didn't have any concerns or questions afterwards. I was quite dizzy after standing up from lying down, so I sat down to dress, but other than that, I was ok. She also told me that there may be some light bleeding and/or mild stomach pain later that day. The results of the test will be sent to me in about 4 weeks' time. Lastly, she said that if I had any abnormal heavy bleeding, or severe pain around my stomach, vaginal etc areas, to contact the surgery straight away.

I found my experience of this test, a very positive one, with a considerate nurse. I do hope your test, (whether it's your first one or your 10th one!) goes just as well.