Sunday 26 September 2021

Going Round in Circles... (Part One)

(TW: mentions of Trauma, Domestic Abuse, Suicidal Feelings, and Overdose)

(Due to the length of the blog post, I have split this into two posts. This is part one, where I talk about my studies and my mental health.)

First of all, I want to apologise for not blogging in about 6 months (has it really been that long?!). I have had a lot going on this year; new beginnings, endings, new stresses, changes, relapses. A lot. I guess this will be another big update post, so I will try to organise it as best I can!

MSc Psychology

I can't remember if I mentioned this before (possibly not, as I was a little paranoid about DWP finding out before I told them) but I have now been studying for my Masters in Psychology since April. It is a distance learning course, which is technically part-time but the work load (and my stamina issues) make it feel very much full-time! Nevertheless, I am enjoying my studying and although my physical health and mental health have really taken a downturn recently, I am just about keeping up and coping with my lessons and assignments. 

I still have my dream of becoming a Clinical Psychologist. I was hoping I would be in some sort of psychology/mental health based job by my 30s (I'm nearly 32), but life has not turned out the way I expected and I guess it doesn't come with deadlines either! The main thing is, I am trying to achieve that dream despite all the hurdles in my way. 

I started this course at a time when I had just finished my course of Interpersonal Therapy, and I was feeling quite stable. I know I did not write about the last few sessions of this therapy, and I probably won't because it was a while back and I have far too much to talk about now. The main thing is, the therapy helped for a while and I felt I was on track. I was in a good place, I'd even started a new relationship! There were a lot of changes and I was coping with them, thanks to the work I'd put in. Unfortunately, I have relapsed since, and the relationship has ended very abruptly. I will speak more about my mental health in the next section. 

Mental Health

As I mentioned previously, my Interpersonal Therapy sessions were very helpful and put me in a good place, for a little while. I felt ready to take on a new degree and a new relationship. Unfortunately, something happened (I'm not sure what), and I became stressed, overwhelmed, insecure, panicky, and very depressed. I had mood swings too. 

I got in touch with Access Team as I felt I needed input from Community Mental Health Team/Secondary Care and I also needed a medication review with the Psychiatrist. All seemed well at first. I had a thorough assessment soon after contacting the Access/Crisis Team and I was given the impression that I would finally be given a decent amount of help. I was told of two types of therapy, with CMHT that would focus on stabilising my emotions and teaching me better life/coping skills. They would involve some group sessions and some one-to-one sessions. A multidisciplinary team would meet to discuss my case, and someone would be in touch soon. 

Eventually, I received a letter to summarise that assessment. It was pretty accurate in reiterating what I had told them, but I was disappointed to find out they had now decided I would just be having one appointment with my support worker to update my care plan. I would also be having my medication review with the psychiatrist soon-ish, but that was it as far as support went. So, I had my care plan appointment soon after the letter came. I was given time to explain how I'd been feeling, but it really was more focused on completing an updated care plan for myself. I didn't even receive the care plan until very recently, after chasing CMHT up. 

I had another downturn not long after this appointment; where I took a small overdose and was in contact with Access Team a couple of times to let them know this, and ask for more support from CMHT. They assessed me again and said they would try to get more support for me. I had to chase up CMHT again, and eventually got in touch with my Community Psychiatric Nurse (CPN). This was the only time I was able to speak with her. Even though I'd been allocated this CPN, there was no appointment booked to meet her (phone, video, face to face etc) or even a follow up to see how I was getting on! She seemed in a rush to get off the phone, as she explained that, despite the overdose, no more support was available and I was to wait for my Psychiatrist appointment. 

I felt so let down by mental health services. After just two 4 session courses of therapy with CMHT about four years ago, they had decided that I didn't qualify for any other psychological help. I felt demoralised, disheartened, distressed. I couldn't understand why the help just wasn't available and how I was expected to exist not being mentally well enough to function enough to even consider working. I had already had suicidal thoughts and feelings when I had this downturn, but they were getting stronger and more frequent. The only things keeping me going were friends, my parents, and my cat Billie. I had to stay alive for them, as much as I didn't want to exist in a future where I wouldn't get any better or have any more support. 

Soon after this, my partner broke up with me via social media. It came very abruptly. Part of the day he seemed loving and caring, the next, he was cold. I have seen him in a very different light since, but this set me back too. The small amount of moral support I got from him was gone, and I would have to deal with that. 

I think it was a day or two after this that I had my phone appointment with my Psychiatrist. I was very depressed, anxious, lonely and desperate. The appointment itself didn't start off brilliantly. She (the psychiatrist) told me that with my Borderline Personality Disorder diagnosis, there simply weren't any tablets that would alleviate the mood swings. I was to taper off my antipsychotic, Aripiprazole. I asked about my antidepressant Duloxetine and eventually in the conversation, we decided the dosage was to be doubled from 60mg to 120mg per day. If that still didn't help the depressive mood, I would be prescribed Paroxetine. (I'm waiting to speak to the GP about the dosage change). We then spoke about my struggles, my current diagnoses, current events and what psychological help I needed. After I'd spoken (rambled) about how I'd been feeling, what had been going on etc, the psychiatrist asked me some questions about sensory overload, past relationship issues (not in depth, just whether there was a pattern of suddenly being dumped without noticing things going wrong beforehand, unstable relationships etc), eye contact and confusion with social cues. She also asked me if I'd had any past trauma. I spoke about the traumatic abortion at 19, the psychologically and sexually abusive relationship soon after, and the fact I'd been bullied for 10 years at school. I felt they all had a long-lasting impact on the way I see the world, how I feel, the trust issues I have and my self-hatred. 

She then told me that she was going to ask me 10 questions that would screen for Autism. Now I've mentioned in passing about thinking I might be neurodivergent, but I never thought I really fit the criteria for being on the Autism Spectrum. I was surprised she mentioned it, but I answered the questions and it turned out I'd scored 8/10. She explained to me how a lot of people with the clusters of symptoms I have turn out to have Autism/Aspergers rather than the Borderline Personality Disorder diagnosis they were previously given. Apparently it is common for a person with Fibromyalgia and Hypermobility diagnoses to be Autistic also*! 

(*N.B: I'm purely passing on what she said here. I need to do my own research to verify this)

As I'd scored highly on the short screening questionnaire, she told me to complete the AQ50 and email CMHT with my score. (I did this soon after the phonecall and scored 41/50, which is significant!). As I read up more about Autism, especially in females (I am non-binary but as I am assigned female at birth, I have to gender myself as female for the sake of psychological/social factors). My psychiatrist told me that CMHT don't do diagnostic assessments for Autism formally, but there is an NHS assessment centre in Dudley that my GP can refer me to. I agreed, I would like this to happen as long as it meant more support in the long run. 

As for psychological help for my other mental health problems, my psychiatrist told me there is a short workshop (6 sessions) for Emotional Grounding that she will recommend to my CPN. If I do become more suicidal and my functioning gets worse, I will need reassessment and possible referral for Life Skills group sessions (I'm not holding my breath). 

(Please see next blog post for Part Two)

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