tag:blogger.com,1999:blog-48961143467471505722024-03-13T11:50:14.038+00:00Amy's Mystery IllnessAmziehttp://www.blogger.com/profile/01639288209900035382noreply@blogger.comBlogger191125tag:blogger.com,1999:blog-4896114346747150572.post-29472740832817259182021-09-26T11:37:00.002+01:002021-09-26T13:07:52.967+01:00Going Round in Circles... (Part One)<p><b>(TW: mentions of Trauma, Domestic Abuse, Suicidal Feelings, and Overdose)</b></p><p>(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.)</p><p>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!</p><p><br /></p><p><b>MSc Psychology</b></p><p>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. </p><p>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. </p><p>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. <br /><br /></p><p><b>Mental Health</b></p><p>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. <br /><br />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. </p><p>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. </p><p>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. <br /><br />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. </p><p>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. </p><p>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. <br /><br />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*! </p><p>(*N.B: I'm purely passing on what she said here. I need to do my own research to verify this)</p><p>As I'd scored highly on the short screening questionnaire, she told me to complete the <a href="https://psychology-tools.com/test/autism-spectrum-quotient" target="_blank">AQ50</a> 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 <a href="https://www.blackcountryhealthcare.nhs.uk/our-services/adult-adhd-autism-service" target="_blank">NHS assessment centre</a> 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. <br /></p><p>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). </p><p>(Please see next blog post for Part Two)</p>Amziehttp://www.blogger.com/profile/01639288209900035382noreply@blogger.com0tag:blogger.com,1999:blog-4896114346747150572.post-31378088511986390382021-03-13T13:02:00.003+00:002021-03-13T13:02:25.295+00:00Interpersonal Therapy (Take Two) - Session 5<p><b>(TRIGGER WARNING: Mentions of Suicide, Trauma, Abortion, Domestic Abuse, and TMI Symptoms)</b></p><p>This session was the end of the first section of Interpersonal Therapy. My therapist had written a Formulation of my Depression as a whole, as well as recent depressive episodes, support networks, triggers etc. I will go into this in more detail at the end of this post. </p><p>My PHQ-9 was 20/27, and my GAD score was 14/21, indicating moderate to severe Depression and Generalised Anxiety. My phobia scale stayed constant; between 5 and 6 for each score. My Work and Social Adjustment score was 20, which shows how severely my mental health affects my ability to maintain relationships, function socially, privately, and my ability to take on household chores and work. I am still not working, but this is due to physical as well as mental health problems. </p><p>I picked 5 most powerful symptoms in my Symptom Review this past week. These were:</p><p></p><ul style="text-align: left;"><li><b>No motivation - </b>I seem to have a sort of "tunnel vision" when something big is on my mind. In this case, it is my most recent physical health problems (See my post, "<a href="https://www.amysmysteryillness.co.uk/2021/02/a-pain-in-arse.html" target="_blank">A Pain in the Arse</a>"). I had been waiting a long time to finally hear about my blood test results and before I got them, I had been worrying a lot that something was very wrong. I had no motivation to do anything else because it seemed I had used it all up with chasing up and worrying about them.</li></ul><div><ul style="text-align: left;"><li><b>Irritable - </b>I felt annoyed that no one had told me about my test results, and that I'd have to wait for a letter from my Gastroenterologist. I didn't want any distractions from this, unless they were important. I had been irritable due to disturbed sleep as well. It seemed any casual conversation annoyed me when I couldn't concentrate on it.</li></ul></div><div><ul style="text-align: left;"><li><b>No energy - </b>I'd used up so much energy with worrying, and feeling depressed, that I couldn't muster up much more for daily tasks (housework, cooking etc). I also found that my Depression made me feel tired all the time. </li></ul></div><div><ul style="text-align: left;"><li><b>Anxiety - </b>For most of the week, I felt very anxious to the point of having physical symptoms. These included dizziness, a tight chest, "butterflies" in my stomach, a lump in my throat, dissociation etc. It turned out that I didn't need to worry too much, as my letter finally came and I had slightly raised Inflammation markers, and low Iron levels. Regardless, my stomach and bowel symptoms were concerning. </li></ul></div><div><ul style="text-align: left;"><li><b>Helpless - </b>I've been feeling very out of control, since I had these stomach and bowel problems. I have tried many things to ease the symptoms but I couldn't get the right balance between constipation and diarrhea, finding something to ease the stomach/rectal pain and so on. I'd also been thinking about my mental and physical health in general, my future home, work, studying etc. It has been weighing me down a lot, and it's been hard to just find small amounts of things to think about right now. I can't seem to put other thoughts/worries aside. </li></ul><div><br /></div></div><div>Soon after going through my Symptom Review, my therapist said she would read through my Formulation with me. As mentioned at the top of this post, it involves a recap of my depressive episodes, symptoms, triggers, support network etc.</div><div><br /></div><div>Symptoms: I find that my Depression manifests in a number of ways, creating certain themes. These involve physical symptoms (such as lack of sleep and appetite), my thoughts and behaviours towards others (by becoming irritable for example), the negative ways I feel about myself (guilt, down on myself, feeling worthless), alongside feelings of anxiety, worry, and sadness.</div><div><br /></div><div>Recurrent thoughts: I often have passive suicidal thoughts (i.e. thoughts that I am unlikely to act on or plan) but I am likely to ask for help. I often feel "stuck" in situations as well, and when I feel that way, the suicidal thoughts worsen as it seems I have little choice of methods for getting out of those situations.</div><div><br /></div><div>Medication: I am prescribed 90mg Duloxetine, and 10mg Aripiprazole per day, and find they only slightly help (I do want a review of Duloxetine though). </div><div><br /></div><div>Depressive episodes: Although my Depression is usually constant, I am mostly able to split it up into episodes or flare-ups. My most recent one was triggered by my worsening physical health, a few before that involved friendship break ups, trauma from a <a href="https://www.amysmysteryillness.co.uk/2014/03/am-i-triggered.html" target="_blank">traumatic abortion</a>, and an <a href="https://www.amysmysteryillness.co.uk/2018/07/im-survivor.html" target="_blank">abusive relationship</a>, and my earliest (around age 13) was in response to mostly psychological bullying. </div><div><br /></div><div><a href="https://www.amysmysteryillness.co.uk/2021/02/interpersonal-therapy-take-two-session-4.html" target="_blank">Support network</a>: I have my parents and many close friends to turn to, when needing help for my mental health problems. Each of these loved ones provides support in different ways (practical, social, moral etc)</div><div><br /></div><div>Types of Interpersonal Relationship Issues: My therapist explained 4 focal areas that occur in Interpersonal Therapy - </div><div><br /></div><div><span> </span><span> </span><span> </span><span> 1. Role Transition - Life changes that trigger depressive episodes</span></div><div><span><br /></span></div><div><span> </span><span> </span><span> </span><span> 2. Complicated Grief - Where a person struggles to cope with grief</span></div><div><span><br /></span></div><div><span> </span><span> </span><span> </span><span> 3. Relationship Dispute - Conflicts with a loved one that may trigger episodes of Depression</span> </div><div><br /></div><div><span> </span><span> </span><span> </span><span> 4. Interpersonal Sensitivities - Struggling to start and/or maintain relationships, and how that relates to or exacerbates Depression.</span><br /></div><div><span><br /></span></div><div><span><br /></span></div><div><span>Although I can think of at least one example where each of these areas have been a factor in previous depressive episodes, the most frequently recurring one most recently has been Interpersonal Sensitivities. Going forward, this is what will be focused on most strongly within therapy. </span></div><div><span><br /></span></div><div><span>The next step is to figure out some goals to help with measuring how successful this type of therapy has been. I also find goals helpful, as I find a sense of achievement does improve my symptoms of Depression. </span></div><div><br /></div><div><br /></div><div><br /></div><div><b>Resources</b></div><div><b><br /></b></div><div><b>Amy's Mystery Illness: A Pain in the Arse: </b><a href="https://www.amysmysteryillness.co.uk/2021/02/a-pain-in-arse.html">https://www.amysmysteryillness.co.uk/2021/02/a-pain-in-arse.html</a></div><div><br /></div><div><b>Amy's Mystery Illness: Am I "Triggered?":</b> <a href="https://www.amysmysteryillness.co.uk/2014/03/am-i-triggered.html">https://www.amysmysteryillness.co.uk/2014/03/am-i-triggered.html</a></div><div><br /></div><div><b>Amy's Mystery Illness: I'm a Survivor: </b> <a href="https://www.amysmysteryillness.co.uk/2018/07/im-survivor.html">https://www.amysmysteryillness.co.uk/2018/07/im-survivor.html</a></div><div><br /></div><div><b>Amy's Mystery Illness: Interpersonal Therapy (Take Two) - Session 4: </b><a href="https://www.amysmysteryillness.co.uk/2021/02/interpersonal-therapy-take-two-session-4.html">https://www.amysmysteryillness.co.uk/2021/02/interpersonal-therapy-take-two-session-4.html</a></div><p></p>Amziehttp://www.blogger.com/profile/01639288209900035382noreply@blogger.com0tag:blogger.com,1999:blog-4896114346747150572.post-52496840253213982172021-02-11T14:39:00.001+00:002021-02-11T14:39:31.405+00:00A Pain in the Arse<p><b>(TRIGGER WARNING: Mention of Cancer, Laxatives, Appetite Changes, and TMI symptoms)</b></p><p> I've mentioned a bit about my stomach and bowel problems in recent posts, where it has affected my mental health. Up until now, I haven't told you the whole story though. </p><p>I've had Irritable Bowel Syndrome for over 10 years; it being suggested by a GP well before my Fibromyalgia diagnosis, and then finally finding its way on to my ever-growing list of medical conditions. I've found it affecting me in a pretty mild way, with constipation being the main problem, and diarrhea only occurring when very stressed out.</p><p>The past 5 or 6 months have been very different though. Tell a lie, I notice a lump in my backside just over a year ago, but it didn't really give me any problems until about 5 or 6 months ago, when it grew quite big. I assumed it might be an internal hemorrhoid, or a small prolapse that would need sorting at some point. Over the past few months, I have been experiencing severe constipation, only relieved with 3 kinds of laxatives (Senokot/Dulcolax, Lactulose, and Dulcoease), as well as appetite changes, fluctuating abdominal pain, a lot of noise coming from my stomach, bleeding when wiping with toilet paper, nausea, bloating, mucus with streaks of fresh blood when trying to poo, constant pressure, anal spasms that make me feel the need to poo constantly, and shooting pains up my backside. All in all, not very nice and quite embarrassing to have to talk about. </p><p>After about a month, I decided I needed to talk to the GP about it. It was them who got me on the 3 kinds of laxatives and eventually I was prescribed Laxido to replace Dulcoease (Dulcoease is tolerated very easily so the effects can wear off quickly). I had some initial blood tests to check my thyroid, which all came back negative/normal. I still had problems a couple of months later, however, so I was referred to a Gastroenterologist who sent me for more blood tests and an Ultrasound of my stomach (which I will have at the start of March). These blood tests showed low iron levels (almost to the point of full blown Anaemia) as well as raised CRP and ESR levels (inflammation markers). I was only told about the iron levels at first; being advised to take iron tablets and wait for my ultrasound, and the Gastroenterologist will be in touch in the near future. </p><p>I thought "near future" would mean months away, so I took my laxatives, ordered my iron tablets, upped my fluid and fibre, and accepted I would have to wait. </p><p>Some of the symptoms worsened, however, and the pressure, pain, and constant urges to poo were getting increasingly hard to deal with. After some unsuccessful 111 calls, with uninterested out of hours GPs, I decided an urgent GP appointment was needed. </p><p>I explained all my symptoms, including the fact I thought I had a prolapse that maybe was exacerbating my stomach and bowel problems. I thought I'd need surgery to sort it out. The GP on the phone got me to see a female GP in person later that day. I was hoping I would get something to calm the urges, rather than simply more laxatives. It was a more interesting (and nerve wracking!) appointment than I expected, however.</p><p>The GP was a lovely one, I had seen before for other issues (including my now sort-of-diagnosed Raynauds). I told her everything, and really pressed the fact that the pressure, urges, and pain were horrendous, and the "prolapse" needed sorting. She wrote down a lot of what I said, and decided a rectal exam was needed. I had one with another GP initially but nothing "worrying" was found. This time, I was asked to relax, and then push though. Although no bleeding was present at the time of the examination, a very large lump was found inside me. What I thought was a prolapse could be something very different. At best, a hemorrhoid, but it could be more serious. </p><p>Because of this, and my worsening symptoms, the GP decided to refer me to the "2 week wait" Lower GI Clinic for an urgent Colonoscopy. I remember making a face and saying "urgent?!". My GP reassured me it probably wasn't Cancer, but because of my symptoms and presence of a very large lump, it was necessary to get me seen ASAP. If it was a Hemorrhoid, I would need a small procedure called Rubber Banding, to cut off the circulation to it and it would eventually fall off. Until then, I was to take my laxatives (including Laxido this time), take my iron tablets, wait for my referral, and try not to worry too much. </p><p>I had my referral review letter come through yesterday, and made the mistake of Googling what it said. Good ole' Google managed to convince me that it was most probably Colorectal Cancer, as I strongly fit the criteria. Good friends managed to bring me back to Earth however (as my Anxiety had hit the roof at this point!) and I am less distressed today, although still worried that the Big C is a possibility at all. I should get my appointment letter through very soon as they are Triaging my case. (The letter was dated the 8th, and said to call on the 10th if nothing else had come through). </p><p>I also had a letter come from my Gastroenterologist, with a surprisingly quick approaching telephone appointment on 25th February. </p><p>I can only imagine it is very soon because of my GP finding the lump and doing the urgent referral. Again, it made me worry that it was so quick. I usually wait ages for appointments, and initially the Gastroenterologist didn't even think I needed to speak to him. </p><p>So this is where I am, at the moment. I am in a lot of pain, I feel constantly drained and bloated. The laxatives are helping to ease some of the pressure, my appetite is better, and at least I am able to go however. I guess all I can do is what the GP advised and try not to worry (and stay well away from Googling anything to do with my symptoms, test results, or referrals!).</p><p>I feel extremely grateful for the support my friends have shown me so far. They have kept me grounded, been realistic with me, but also have been sympathetic, caring, and loving. Whatever the results are, bad news or good, I know they are there when I need them. </p>Amziehttp://www.blogger.com/profile/01639288209900035382noreply@blogger.com1tag:blogger.com,1999:blog-4896114346747150572.post-19481530063162135332021-02-10T13:12:00.000+00:002021-02-10T13:12:14.221+00:00Interpersonal Therapy (Take Two) - Session 4<p>As with other sessions, I had to fill in my PHQ9 etc and my Symptom Review. I scored quite highly on the Depression and Anxiety questionnaires particularly, but this was mainly for reasons related to my physical health. For about 5 months now, I have been having some awful stomach and bowel problems. I am already diagnosed with <a href="https://www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/" target="_blank">Irritable Bowel Syndrome</a> (IBS), but what I have been experiencing is out of the ordinary for me. Waiting for test results had me worrying about all sorts of possible diagnoses, including Bowel Cancer. (I will talk about this in full in the next blog post). </p><p>My 5 most powerful symptoms this week are as below:</p><p></p><ul style="text-align: left;"><li><b>Anxiety:</b> This was mainly about some blood test results that had just come through to my <a href="https://www.healthcareers.nhs.uk/explore-roles/doctors/roles-doctors/medicine/gastroenterology" target="_blank">Gastroenterologist</a>. The secretary would not tell me the results, and said I would get a letter and a phone appointment to discuss them. This set off my Anxiety, as I worried there might be very bad news. I spent the week waiting for the results and hearing nothing back, which only made me worry more.</li></ul><div><ul style="text-align: left;"><li><b>Wake early in the morning:</b> I have had disturbed sleep through worrying about various things. I'm scared of missing calls or post, in case it is some news about my physical health problems. I have been extremely fatigued, but I have been forcing myself to get up if I haven't naturally woken early anyway. </li></ul></div><div><ul style="text-align: left;"><li><b>Can't concentrate:</b> I was hoping to do more "antidepressant activities" such as playing musical instruments and singing. I have not been able to focus on doing that, or watching full television programmes. This is because worrying and fixating on my test results has given me a sort of mental "tunnel vision" where I can't see anything aside from the problem at hand, in front of me. </li></ul></div><div><ul style="text-align: left;"><li><b>Sadness:</b> I feel extremely negative about my results. I am sure that I will be given bad, worrying news and will suddenly have something huge to deal with. The constant anxiety is draining any positivity from me too. I have been trying not to be too negative, as I know that has an impact on others, but I can't seem to help myself out of this hole. </li></ul></div><div><ul style="text-align: left;"><li><b>Can't get going:</b> I feel far too tired and distracted to do much, and getting started with things such as blogging, housework etc, has become a really difficult task. I have been worried that friends wouldn't understand why I'm so fixated on my current health problems. My To Do list has been getting bigger and bigger. I have been really stressed out, which has exacerbated physical symptoms and made it physically harder to get things started. I particularly notice my Vestibular Migraines have returned with a vengeance, and my Fibromyalgia/Hypermobility pain is worse.</li></ul><div><br /></div></div><div>Alongside talking through my Symptom Review, this session was mainly about my support network; i.e. friends, family members etc that I felt close to for various reasons. My homework, leading up to this session, was to draw a social map of people in my life, using increasing circles (with me in the middle) to plot how close I felt each person was to me. I also had to think about why I felt they were so close, how they help me, the roles they play in my life etc. </div><p></p><p>I won't say who featured in these circles, as I don't think it is fair to list my favourites in case friends see this. I'm sure the ones who are close to me know they're close anyway. I will use numbers instead of names.</p><p>Persons 1-6 are very close to me for different reasons:</p><p>Person 1: They have been a support to me all my life; but especially since I turned 18. They provide emotional support, as well as some practical support. I feel I can tell them almost anything and I feel they can tell me almost anything too. There is a lot of trust in this relationship. We both have mental health problems, so have an understanding when one or both of us is depressed. We advise each other and aren't afraid to help out when needed. </p><p>Person 2: This person has also been a support all my life. They do not understand mental health quite as well as Person 1, but they will listen to what I feel comfortable telling them. They are also brilliant with practical help, such as lifts to appointments and sitting with me for assessments/appointments when allowed to. I feel like they are on my side and I try to help them out too.</p><p>Person 3: I've known this person since the start of university and I'm not sure if they know this but I see them as my rock. They have been there for me through some of my darkest moments, including the <a href="https://www.amysmysteryillness.co.uk/2014/03/am-i-triggered.html" target="_blank">traumatic abortion</a> and the <a href="https://www.amysmysteryillness.co.uk/2018/07/im-survivor.html" target="_blank">abusive relationship</a> I had. I have had times where I have been afraid of losing them to other people, but they have never given me reason to doubt our friendship. They wouldn't agree, but I feel I owe them everything. This person gives me practical, as well as emotional support, and I can tell them anything that is on my mind without fear of them taking it personally.</p><p>Person 4: I became friends with this person from out of the blue. I met them in a club when I was 18. I thought they were part of my friendship group, as they happened to be sitting near us, but years later found they didn't know each other! We hit it off straight away. We have had our differences, and don't talk every day, but I know we have each other's back. This person has seen my disaster of a love life and is not afraid to be honest about it! I respect them for that and I give as good as I get.</p><p>Person 5: I met this person online many years ago, and we have met in person a few times. We support each other a lot, especially emotionally. We talk nearly every day and know a lot about each other's mental health, for example. We are very honest with each other and seem to know when the other one needs extra help. They have seen me through some very dark moments too, and I really appreciate their support, honesty, and ability to keep my feet on solid ground.</p><p>Person 6: I also met this person at university, while I was with my abusive ex. We have got on well for many years, despite some falling out times. They showed so much support during my abusive relationship especially, and they noticed things that many others didn't. I could confide in them and they would turn up at any time for a good chat, watching a funny TV show, and the best of hugs. We may not be able to meet up much now, but I still feel we are close and have each other's back. </p><p><br /></p><p>I talked through most of this with my therapist, and told her I felt I was lucky to have such a large and solid support network. Not everyone has this, and I can't understand why I'm still so paranoid about friends when I feel so supported by the above people especially. Alongside these, I have other close friends, but I worry more that I might lose them. It may not be that I get as much reassurance, although that is neither of our faults. It just shows how different friendships can be. My therapist found this interesting, although she could understand where I was coming from. She sympathised with my worries about my test results too, and said that if anything changed and an appointment clashed with the next therapy session, then to email or phone her as soon as I knew. </p><p>The next session would be about going through all the information I'd given her about my most recent, and some of my past Depressive episodes, as well as my support network, recent events, triggers, interests etc. These would be summarised and she would read them out to me so I could agree with them, amend anything that wasn't quite right etc. We would then move onto the next phase of therapy; where we use skills to improve my symptoms of Depression and my social skills. My homework this time was just to complete the PHQ9 etc questionnaires, and the Symptom Review. </p><p><br /></p><p><b>Resources</b></p><p><b>Irritable Bowel Syndrome: </b><a href="https://www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/">https://www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/</a></p><p><b>Gastroenterology: </b><a href="https://www.healthcareers.nhs.uk/explore-roles/doctors/roles-doctors/medicine/gastroenterology">https://www.healthcareers.nhs.uk/explore-roles/doctors/roles-doctors/medicine/gastroenterology</a></p><p><b>Am I "Triggered"?: Amy's Mystery Illness: </b><a href="https://www.amysmysteryillness.co.uk/2014/03/am-i-triggered.html">https://www.amysmysteryillness.co.uk/2014/03/am-i-triggered.html</a></p><p><b>I'm a Survivor: Amy's Mystery Illness: </b><a href="https://www.amysmysteryillness.co.uk/2018/07/im-survivor.html">https://www.amysmysteryillness.co.uk/2018/07/im-survivor.html</a></p><p><br /></p>Amziehttp://www.blogger.com/profile/01639288209900035382noreply@blogger.com0tag:blogger.com,1999:blog-4896114346747150572.post-70932474900143051622021-01-29T14:36:00.001+00:002021-01-29T14:36:06.219+00:00Interpersonal Therapy (Take Two) Session 3<p><b>(TRIGGER WARNING: Mentions of Suicide, Self Harm, and Childhood Bullying)</b></p><p><br /></p><p> This session, we were to speak about previous depressive episodes, in order to create a "timeline" of events and declines in my mental health. We were also going to start to draw up a diagram of my key relationships (family, friends, any romantic partners etc).</p><p>In the week leading up to this session, I had a lot of times where I felt quite on edge and irritable. I do tend to have a hatred of sound sometimes, usually when I'm overwhelmed. It tends to be more sounds of people's voices rather than inanimate objects (the washing machine, music etc). The technical term for this is <a href="https://www.webmd.com/mental-health/what-is-misophonia#1" target="_blank">Misophonia</a>, although I am not actually diagnosed with this. I find sounds of voices can instil anxiety in me, or even rage. I go into a <a href="https://www.psychologytools.com/resource/fight-or-flight-response/" target="_blank">fight or flight</a> mode, where I want to either escape the sounds or yell at them in order to hopefully make them stop.</p><p>We did the usual <a href="https://www.mdcalc.com/phq-9-patient-health-questionnaire-9" target="_blank">PHQ9</a>, <a href="https://patient.info/doctor/generalised-anxiety-disorder-assessment-gad-7" target="_blank">GAD</a> etc questionnaires in which I scored more severely for Depression than Generalised Anxiety (which makes me a good fit for this type of therapy, as it is specifically for Depression). We also went through my Symptom Review; where I picked out 5 most prominent symptoms for me in that past week.</p><p>As explained above, irritability was one of the main symptoms of my Depression in that week. I explained examples of conversations that had set me off, and how I reacted. I told my therapist about how I find it hard to process information when there is more than one voice speaking at the same time as well. It does either make me very anxious, or very angry, and people don't tend to understand that.</p><p>As well as irritability, I found the following symptoms had been either very strong or very frequent recently:</p><p></p><ul style="text-align: left;"><li><b>Always tired: </b>I believe this could be a mixture of fatigue due to mental health problems, as well as the fatigue I experience with my <a href="https://www.nhs.uk/conditions/fibromyalgia/" target="_blank">Fibromyalgia</a>. The weather tends to make my Fibro flare up too. Either way, I struggled with my energy levels and felt relieved on any occasion I could get into bed and nap. I found it hard to do much else really.</li></ul><div><ul style="text-align: left;"><li><b>Think other people don't like me: </b>I think I've mentioned this before, but I find it difficult to reassure myself that my friends still like me. I look for clues that they are drifting away from me, or simply don't like me anymore. It could range from someone cutting off contact online (unfriending on Facebook for instance) to something as silly as not being one of the friends tagged in a post I can relate to. I keep having recurring dreams about a friend who cut contact with me around 8 years ago. In the dream, I am asking her why but never getting a clear answer. I believe some of this paranoia around friends stems from the times I was bullied. Part of the tactics they used were to pretend to be my friend, then leave me out of things. It made it hard to trust who was my real friend, and whether they actually liked me</li></ul></div><div><ul style="text-align: left;"><li><b>Down on myself: </b>My homework for this session was to play some music on one of my instruments, or to sing. It was supposed to be an "antidepressant activity" that I could enjoy and feel a sense of achievement from. When I struggled to do this more than once or twice in a week, I felt very down on myself. I enjoyed it when I did do it, even though I was quite rusty, but I was very self critical afterwards. When I didn't do it, I felt guilty, as if I was letting myself and my therapist down by not trying hard enough to ease my Depression.</li></ul></div><div><ul style="text-align: left;"><li><b>Worrying: </b>Although my Generalised Anxiety score on the GAD questionnaire was lower than my Depression score on the PHQ, I still found I worried a lot about things in that week. Various things got to me, and I was apprehensive about when I would get my Gastroenterology appointment through, when I would get my PIP decision, would my therapist be annoyed at me for not doing my homework "enough" etc.</li></ul><div>I explained all these things to my therapist; trying not to go off topic too much, and having her guide me back on topic when I did. She also reassured me that she was glad I'd at least tried to do my music practice, and that my struggle to get going with it was something that needed addressing. </div></div><div><br /></div><div>We then went onto the topic of a Depression timeline. This is a recollection of past depressive episodes, what caused/triggered them, how you felt at the time, how you noticed you were depressed, and what happened. I find it hard to split my Depression into clear cut episodes, as it mostly feels quite constant, but I tried my best to recall times it had flared up and the symptoms I noticed first.</div><div><br /></div><div>My most recent episode started about 4 or 5 months ago and coincided with my stomach and bowel issues. (I will do a separate post about my Gastroenterology journey soon). I had been experiencing pains and severe constipation that was making me miserable. Alongside this, family disputes had come to light, and I finally decided to get help when I had a sort of public breakdown on social media. The symptoms I noticed that made me think my Depression was flaring up, were lack of appetite and sleep problems. I usually sleep fairly well (for a chronically ill person!) and my appetite is usually moderate-large. Waking up in the night many more times, and not feeling like eating had become disturbing symptoms for me. </div><div><br /></div><div>The episode before this, I don't remember very clearly. It may have been about a year ago; involving losing a few friends. My Depressive episodes are very interpersonal (hence why I feel optimistic about this type of therapy!) and disputes, anxieties, lack of contact etc can set them off quite badly. I deeply fear rejection, and I constantly seek reassurance. My emotions can feel very unstable too, especially when it feels like things around me are falling apart. I suppose I noticed the start of this episode, when I began to feel out of control with my emotions, and I started tweeting a lot about losing friends. </div><div><br /></div><div>I struggled to recall details about previous episodes, and tried to explain how I mostly remember episodes from years ago, when I was suicidal. My therapist then asked if I remembered my first ever Depressive episode.</div><div><br /></div><div>I was about 13, in my most hated year of Secondary School; year 8. I remember I had strong suicidal feelings, due to the constant bullying I experienced. I confided in a friend, who broke my trust and told the bullies about my urge to attempt suicide and why. They ganged up on me, and I could not trust anyone with my deepest darkest secrets for a while after that. It also helped shape my ideas about people; whether I could trust them, how I expect them to react, how I always felt inferior to them etc. I never sought help for my mental health at that age, partly because I didn't know it was available. There was a school nurse, but you had to be physically unwell to see her. I just didn't feel I had anyone to talk to and my only outlet was to self harm. This is when I started, and it carried on for many years, whilst I was being bullied. I didn't know a lot about Depression at the time, but I knew it wasn't "normal" to feel suicidal or to want to harm myself. I also knew I felt desperately low, and motivation went out of the window. I strongly believe it was music that saved me. I engaged in extra curricular activities, such as junior, then senior band and choir. None of my bullies were in those groups, and I enjoyed music so much that it became my saviour. </div><div><br /></div><div>After we had gone through all this, there was only a bit of time left in the session. We were yet to go onto my key relationships. My therapist briefly explained this task, and how it would be presented on paper. I was to use my time before session 4 to have a go at starting the task, and we would go through it properly in this next session.</div><div><br /></div><div>So far, I think my therapy sessions are going well. I have wanted to explain about various traumas in my life (as they still need addressing) but my therapist hesitates to let me, as this type of therapy doesn't deal with that. I will have to stay on topic and hope that what I can talk about, and address, helps my Depression in the long run. </div><p></p><p><b><br /></b></p><p><b>Resources</b></p><p><b>What Is Misophonia?: </b><a href="https://www.webmd.com/mental-health/what-is-misophonia#1">https://www.webmd.com/mental-health/what-is-misophonia#1</a></p><p><b>Fight or Flight Response: </b><a href="https://www.psychologytools.com/resource/fight-or-flight-response/">https://www.psychologytools.com/resource/fight-or-flight-response/</a></p><p><b>Patient Health Questionnaire 9: </b><a href="https://www.mdcalc.com/phq-9-patient-health-questionnaire-9">https://www.mdcalc.com/phq-9-patient-health-questionnaire-9</a></p><p><b>GAD 7 Anxiety Test Questionnaire: </b><a href="https://patient.info/doctor/generalised-anxiety-disorder-assessment-gad-7">https://patient.info/doctor/generalised-anxiety-disorder-assessment-gad-7</a></p><p><b>Fibromyalgia - NHS: </b><a href="https://www.nhs.uk/conditions/fibromyalgia/">https://www.nhs.uk/conditions/fibromyalgia/</a></p>Amziehttp://www.blogger.com/profile/01639288209900035382noreply@blogger.com0tag:blogger.com,1999:blog-4896114346747150572.post-27610247271666801302021-01-18T12:20:00.004+00:002021-01-18T12:20:58.742+00:00Interpersonal Therapy (Take two) Session 2<p><b>(TRIGGER WARNING: Mention of past trauma, and an abusive relationship)</b></p><p><br /></p><p>Leading up to session 2 of <a href="https://www.healthline.com/health/depression/interpersonal-therapy#how-ipt-works" target="_blank">Interpersonal Therapy</a>, I thought I would have to talk about past trauma and previous episodes of Depression. I spent the past week ruminating over this, feeling much worse by the time session 2 came around. I even had a horribly triggering dream; the night before therapy. It involved confronting my <a href="https://www.amysmysteryillness.co.uk/2018/07/im-survivor.html" target="_blank">abusive ex</a> about everything he'd done, and him denying everything. His friends, and some of my ex friends didn't believe me either. It made me feel so invalidated and unsafe. I woke up paranoid, and unable to do much. It took a while to get out of bed, as I wanted to stay away from everyone. I just felt that no one around me was a safe person (even though the people I live with, my parents and my cat, are extremely safe). </p><p>Even before this dream, I spent the week depressed most days and unable to motivate myself to do much. I tried to do enjoyable things; activities my therapist refer to as "anti-depressant". The one thing I could get myself to do was play casual games. I found this had become more of a habit than something enjoyable though. It distracted me from awful thoughts and feelings, but it didn't do anything to lift my mood as such. </p><p>As it turned out, session 2 of IPT was mostly about my most recent depressive episode. At first, we went through the <a href="https://www.efficacy.org.uk/therapy/phq-9-and-gad-7/" target="_blank">PHQ</a>, GAD etc questionnaires (to assess and quantify levels of depression, anxiety, and daily functioning/lifestyle), then we went on to the symptom review. I will list below the 5 most prominent symptoms for me:</p><p>1. No motivation - I had to go back to past trauma to explain how it linked to my feelings now. I felt stuck in one place. Memories of the past seemed to hold me back. I guess I was triggered by thoughts of past trauma, and they held me in one place when I ruminated on them. I felt like I couldn't move on, especially as I anticipated talking about my past yet again. I know I need to address things, but I'd really rather avoid them.</p><p>2. No energy - The energy that constantly worrying about the past takes is exhausting. Thinking about what I need to talk about takes all my energy as well. I think we forget that just thinking can take its toll on our energy levels. Even if all we're doing is sitting and remembering, we are still exerting ourselves. A phrase I used to describe my frame of mind is that I felt the weight of the world on my shoulders.</p><p>3. Feel guilty - I am taking a long time to do things, because of the symptoms of my depression. I am slowed down, and motivation levels are low. Because of this, I may take ages in the shower, planning things, getting dressed, cooking etc. I feel guilty because people may have to wait for me, or wait to use the bathroom. The way I behave has an impact on others, it doesn't happen in a vacuum. I also worry that my problems have an impact on others; such as my frame of mind, my feelings, the way I talk etc. I also assume that my mood has an impact on others. I suppose I'm an empath because of the way a room's atmosphere or a person's mood affects me. I understand other's emotions a lot too. I'm like a sponge to be honest! Not everyone is like that though, and I have to remember that me being sad won't always bring others down. I'm allowed to feel how I feel without guilt!</p><p>4. Think other people don't like me - I read into everything! I look for clues that someone doesn't like me, or is drifting away from me. I talk about it on Twitter, because I want that reassurance even though deep down I know it won't help me in the long run. I need to reassure myself and trust others. My lack of trust, my paranoia, and the things I type, I feel are pushing people away. This is a big big part of why I decided to try Interpersonal Therapy. As I said in <a href="https://www.amysmysteryillness.co.uk/2021/01/interpersonal-therapy-take-two-session-1.html" target="_blank">Session 1</a> , it involves addressing problems in relationships, role changes, disputes etc. Part of my <a href=" https://www.mind.org.uk/information-support/types-of-mental-health-problems/borderline-personality-disorder-bpd/about-bpd/" target="_blank">Borderline Personality Disorder</a> symptoms involves being terrified of rejection and abandonment. I do things to avoid that rejection or maintain that friendship, even if it has turned toxic. In the past, I have begged bullies to stay "friends" with me, so I don't end up alone.</p><p>5. Can't make decisions - Due to lack of energy and motivation, I have been finding it do hard to come to a decision about simple things, such as what to eat, what to do to entertain myself etc. It takes me ages to decide, I talk myself out of it, or I spend so long thinking about it, or flicking between activities etc, that there is simply no time left to actually engage in the activity. Alongside this, my concentration levels have been low, so I haven't been able to focus on things, or I worry that I won't be able to focus on or enjoy something. I may have mentioned this before, but the thought of being bored/not enjoying something becomes unbearable rather than slightly disappointing. I think it is part of the extreme mood swings and emotions I get, especially with BPD. </p><p>After going through the symptom review, my therapist noted that I take on so much pressure from assumptions about other people's thoughts about me, how my moods/behaviour impacts others and so on. It's no wonder I have no energy! She then asked about my most recent depressive episode.</p><p>I explained to her that I believe it started during lockdown, about 4 months ago when my physical gastro symptoms developed. I have experienced chronic constipation, moderate/severe abdominal pain, appetite changes, bloating, and bloody mucus in my stools. Because of all these symptoms, I started off fed up, then my appetite changed even more, and I noticed something wasn't right when my sleep changed. I would wake up many times in the night (not just because of pain) and I would be deep in thought for a while before I could settle down to sleep again. I would get more tired, much earlier, and therefore would wake up much earlier. I usually take a nap halfway through the day, to try and replenish my energy slightly (it never fully replenishes, due to the nature of my chronic physical conditions such as Fibromyalgia). I found recently that I needed more and more, or longer and longer naps however, and I was desperate to sleep all the time!</p><p>My moods were low anyway, but I wasn't sure how low exactly until it affected my sleep first of all. </p><p>As well as having physical gastro symptoms which frustrated and worried me, I had conflicts with some family members I used to be close to. I won't go into details, but it involved some nastiness that I wouldn't tolerate. Trying to make the peace didn't work, and because I saw certain people in a different light, it affected how I expected others to be and therefore affected my moods further. My support circle seemed to be getting smaller and smaller.</p><p>Another thing that kept this particular depressive episode going, was my worries about pushing friends away. I wrote some fairly bitter things on social media, that didn't go down well. What I was looking for was support and reassurance, but quite understandably, it was misinterpreted and now I worry that others are drifting away from me, or beginning to see me in the way I see myself (i.e. as some kind of horrible monster who craves attention constantly).</p><p>I told my therapist that I do tend to be extremely self critical, and it's something I'm trying to work on, but not getting very far with. She said that I am very critical of myself and conflicts with relationships seem to be a big part of this latest depressive episode, but she would explore other reasons too. Conflicts in relationships need to be addressed first though.</p><p>We finally moved on to antidepressant activities. The gaming needed to be put to one side really, as it served no real purpose other than as a slight distraction. She asked me what else I enjoyed doing, and I mentioned my musical side. I play flute, guitar, and keyboard. I also enjoy singing and writing lyrics. Apparently, when I said this to her, my tone of voice became much brighter and happier sounding. She set me "homework" to do more musical things, then tell her how it went in the next session. </p><p>Again, time went on very quickly, and we had been speaking for over an hour, so we had to leave it there. Next session is 1pm on 18th Jan. </p><p><br /></p><div style="background-color: #eeeeee; color: #181818; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 13.2px;"><b>Resources</b></div><div style="background-color: #eeeeee; color: #181818; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 13.2px;"><b><br /></b></div><div style="background-color: #eeeeee; color: #181818; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 13.2px;"><b>Interpersonal Therapy for Depression: </b><a href="https://www.healthline.com/health/depression/interpersonal-therapy#how-ipt-works" style="color: #937da2; text-decoration-line: none;">https://www.healthline.com/health/depression/interpersonal-therapy#how-ipt-works</a></div><div style="background-color: #eeeeee; color: #181818; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 13.2px;"><br /></div><div style="background-color: #eeeeee;"><b style="color: #181818; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 13.2px;">Amy's Mystery Illness: "I'm a Survivor": </b><span style="background-color: transparent; font-size: 13.2px;"><span style="color: #181818; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif;"><a href="https://www.amysmysteryillness.co.uk/2018/07/im-survivor.html">https://www.amysmysteryillness.co.uk/2018/07/im-survivor.html</a></span></span></div><div style="background-color: #eeeeee; color: #181818; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 13.2px;"><br /></div><div style="background-color: #eeeeee; color: #181818; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 13.2px;"><b style="font-size: 13.2px;">PHQ 9 Score Interpretation: </b><a href="https://www.efficacy.org.uk/therapy/phq-9-and-gad-7/" style="color: #937da2; font-size: 13.2px; text-decoration-line: none;">https://www.efficacy.org.uk/therapy/phq-9-and-gad-7/</a></div><div style="background-color: #eeeeee; color: #181818; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 13.2px;"><br /></div><div style="background-color: #eeeeee;"><b style="color: #181818; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 13.2px;">Amy's Mystery Illness: Interpersonal Therapy (Take two) Session 1:<a href="https://www.amysmysteryillness.co.uk/2021/01/interpersonal-therapy-take-two-session-1.html" target="_blank"> </a></b><span style="background-color: transparent; font-size: 13.2px;"><span style="color: #181818; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif;"><a href="https://www.amysmysteryillness.co.uk/2021/01/interpersonal-therapy-take-two-session-1.html" target="_blank">https://www.amysmysteryillness.co.uk/2021/01/interpersonal-therapy-take-two-session-1.html</a></span></span></div><div style="background-color: #eeeeee;"><br /></div><div style="background-color: #eeeeee; color: #181818; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 13.2px;"><b style="font-size: 13.2px;">About BPD: Mind: </b><a href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/borderline-personality-disorder-bpd/about-bpd/" style="color: #937da2; font-size: 13.2px; text-decoration-line: none;">https://www.mind.org.uk/information-support/types-of-mental-health-problems/borderline-personality-disorder-bpd/about-bpd/</a></div><div style="background-color: #eeeeee; color: #181818; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 13.2px;"><br /></div>Amziehttp://www.blogger.com/profile/01639288209900035382noreply@blogger.com0tag:blogger.com,1999:blog-4896114346747150572.post-37091620511399984612021-01-05T15:14:00.003+00:002021-01-05T15:14:34.844+00:00Interpersonal Therapy (Take Two) Session 1<p><b>(TRIGGER WARNING: Mentions of Self Harm and Suicidal Feelings)</b></p><p> After a major Depression and mood swings relapse, and encouraging words from loved ones, I decided to ask for help again. Initially, I thought I just needed my medication/dose changing but when calling Access/Crisis team, I was told I would probably benefit from therapy again, and my GP should be able to review my mental health medication. I reluctantly called Primary Care/IAPT to book an assessment and see what therapies were available (thinking they would just put me onto CBT again) but luckily was assessed by a wellbeing practitioner who realised that I had been through CBT many a time; resulting in some help for my anxiety disorders, but no improvement of my depressive episodes. The Primary Care team decided that I would be a good fit for Interpersonal Therapy instead. </p><p><a href="https://www.healthline.com/health/depression/interpersonal-therapy#how-ipt-works" target="_blank">Interpersonal Therapy</a> is intended as a treatment specifically for Depression (whether as a condition in itself or a part of another diagnosis) and focuses on how relationships can have a significant impact on our mental health. It could be things such as role changes (becoming a parent, carer, taking on a new job to name some examples), a loss or bereavement, arguments within relationships of any kind, or a major life event. This type of therapy aims to look at these factors and help the client to build up skills around them in order to improve their symptoms of Depression. There are 16 sessions to this type of therapy. The first 4 aim to get a picture of how Depression manifests for the client specifically, the middle 8 sessions aim to help build up skills to help improve symptoms, and the last 4 aim to conclude the therapy and get the client ready to continue practising those skills once therapy has ended. </p><p>I had a few sessions of Interpersonal Therapy with someone prior to my diagnosis of <a href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/borderline-personality-disorder-bpd/about-bpd/" target="_blank">Borderline Personality Disorder</a>. I was very unwell at the time, however, and due to some things my therapist said as well, the therapeutic relationship broke down and I was unable to continue. I am looking forward to going through the process of this therapy with a different therapist though. </p><p>My initial phone call with the new therapist went very well. I felt she was easy to talk to, and listened well to my problems. We decided that my diagnoses, symptoms, and issues would be a good fit for this type of therapy, and I was happy to go ahead. </p><p>Before the first appointment, I had the <a href="https://www.efficacy.org.uk/therapy/phq-9-and-gad-7/" target="_blank">PHQ</a>/GAD/Phobia etc questionnaires to fill in, as well as a <a href="https://www.umcpt.co.uk/questionnaires/therapy-agreements/#:~:text=A%20Therapy%20Agreement%20is%20a,abide%20by%20throughout%20your%20sessions." target="_blank">therapy agreement</a>, consent for my therapist to record our appointments (she is a trainee IPT therapist, so her supervisor needs to monitor the sessions), and a symptom review sheet. </p><p>The Symptom Review worksheet is a grid containing many different possible symptoms of Depression. My task was to tick each symptom I felt had been a problem within the last week, then pick 5 that specifically needed addressing. I did tick a lot of the symptoms, and found it hard to pick just 5. I put a star next to the most pressing symptoms, but through talking to my therapist in our first session, I found that each of those branched out into the other ones, were very similar in the way they manifested, or were linked quite closely together. What looked like a simple task, became a more complex one, the more I tried to explain each of the symptoms!<br /><br />I felt like I was rambling throughout the conversation, and I worried that the therapist would not be able to organise what I'd said into cohesive notes. I should've had more faith though, she was very helpful and understanding. She would bring me back on topic when needed and would focus on the symptoms that seemed to bother me most. Between us, we decided that I was struggling with the following issues most in the past week:</p><p></p><ul style="text-align: left;"><li>Irritability - I would find conversations and too much noise overwhelming, with led to a type of sensory overload which resulted in irritability. I may not always have made this apparent to the person/people I'm around, but I coped with it by turning on myself and either punishing myself (self harm) or isolating myself (going in my room). Generally, this is something I do if conversations online become too overwhelming or difficult. It's as if I'm suffering an emotional pain and I either want to escape it or turn it into a pain that I find easier to deal with. </li></ul><div><ul style="text-align: left;"><li>Always tired - I experience extreme fatigue, due to my physical health problems, but I know that Depression plays a big part too. I find this symptom links in with lack of motivation and lack of energy (other symptoms on the symptom review sheet). This week especially, I have found I am constantly exhausted and want to stay in bed for longer and longer. I know that this is partly due to the Depression because my moods affect my levels of energy, and the worse I feel, the more sleep I need. Unfortunately, although sleep can have a positive effect on mood, oversleeping can have the opposite effect. I felt as if I hadn't achieved much at all in my week, I saw myself as lazy, and I worried others would see me as lazy too. </li></ul></div><div><ul style="text-align: left;"><li>Mood swings - These are problems I have experienced a lot recently, which is why I think my mood stabilizers (Aripiprazole) have stopped working. I feel things in the extremes, to a point where I can feel as if I can't cope or I am out of control. The extremes weren't as bad as they could have been this week, but they were bad enough for it to be a problem. I didn't get the hypomanic emotions this time, but I did swing from considerably depressed and down, to irritable/angry, tearful, anxious, and even numb. I explained the numbness further, as my therapist said that it wasn't written down as a particular depressive symptom (which I found interesting, as a lot of people I know with Depression do feel numb quite a lot!). It's something I hadn't realised in myself until I connected with others with similar conditions and symptoms. When numb, my self awareness of how ill I am tends to decrease, and I'm not sure how to respond to the question "How are you?" because I simply don't know. When numb, I can dissociate too, although not always. I explained how I experience dissociation, to my therapist. She found that interesting too. We discussed how some of my symptoms had become coping mechanisms, as my numbness and dissociation can occur after days/events/conversations that I had found overwhelming. Again, it was a matter of extremes. I either felt too much, or not enough. </li></ul></div><div><ul style="text-align: left;"><li>Feel worthless - I am often very self critical, although this is something I am trying to work on. I try to say more positive things about myself these days, but I do worry about coming across as arrogant, or just being wrong. When I'm not able/don't have the motivation to do much in my day, then I feel worthless and pointless as a person. This can lead to the suicidal feelings, as, in order to feel like I should be on this earth, I want to feel I have some sort of purpose, I am doing something to improve myself, or I'm doing some good for other people. It's a bit of a chicken and egg situation, as if I feel worthless, I lack motivation, but if I lack motivation and therefore don't do much, I feel worthless. I'm never sure which started first, but it seems endless! </li></ul></div><div><ul style="text-align: left;"><li>Bored - As a symptom, this seems like a very mild one, but boredom can be unbearable for me. When I lack motivation and are not doing much, obviously I get bored. I have things I could do, but the thought of being disappointed if I do not enjoy them, or struggle to progress with them, can be very hard to deal with. Being bored can lead to becoming frustrated, angry at myself, extremely low and self critical, and even lead to suicidal feelings if I feel everything is going wrong. Doing something I enjoy (seeing a friend, not possible at the moment of course! Playing a musical instrument, cross stitch, a TV show etc) can lift my mood, but overthinking the possible result (not enjoying it) can make me talk myself out of even starting. I can usually push past this worry and do the activity anyway, but when very low, any disappointment feels like a big risk. </li></ul><div><br /></div></div><div>As you can imagine, going through the symptom review took up most of the time in the therapy session. I was very apologetic and nervous throughout, but my therapist tried to put me at ease by saying she could understand what I was saying/what I meant, and she felt she had learnt a lot about me that day. She confirmed that, going on the questionnaires and what I had told her, I was still suffering from moderate to severe Depression. Apparently this type of therapy expects a diagnosis to be made and for Depression to be the main problem that needs addressing in order to go ahead. I know labels aren't useful for everyone but I like to have a name to put to the problems I experience, so I know what I am dealing with and what is likely to be helpful for me. </div><div><br /></div><div>She then told me what the other sessions would cover (possible past trauma/events, key relationships, arguments, role transitions etc) and asked me to complete the PHQ etc questionnaires and symptom review for next session as well. </div><div><br /></div><div>This concluded the session, and after checking there was nothing else I needed to discuss, we booked in for the same time next Monday. </div><div><br /></div><div><br /></div><div><b>Resources</b></div><div><b><br /></b></div><div><b>Interpersonal Therapy for Depression: </b><a href="https://www.healthline.com/health/depression/interpersonal-therapy#how-ipt-works">https://www.healthline.com/health/depression/interpersonal-therapy#how-ipt-works</a></div><div><br /></div><div><b>About BPD: Mind: </b><a href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/borderline-personality-disorder-bpd/about-bpd/">https://www.mind.org.uk/information-support/types-of-mental-health-problems/borderline-personality-disorder-bpd/about-bpd/</a></div><div><br /></div><div><b>PHQ 9 Score Interpretation: </b><a href="https://www.efficacy.org.uk/therapy/phq-9-and-gad-7/">https://www.efficacy.org.uk/therapy/phq-9-and-gad-7/</a></div><div><br /></div><div><b>Therapy Agreements: </b><a href="https://www.umcpt.co.uk/questionnaires/therapy-agreements/#:~:text=A%20Therapy%20Agreement%20is%20a,abide%20by%20throughout%20your%20sessions.">https://www.umcpt.co.uk/questionnaires/therapy-agreements/#:~:text=A%20Therapy%20Agreement%20is%20a,abide%20by%20throughout%20your%20sessions.</a></div><p></p>Amziehttp://www.blogger.com/profile/01639288209900035382noreply@blogger.com0tag:blogger.com,1999:blog-4896114346747150572.post-15992703061008170072020-11-22T15:55:00.000+00:002020-11-22T15:55:42.666+00:00The Connection between Chronic Illness and Self Esteem<p><span style="font-family: inherit;"><b> <span style="background-color: white; white-space: pre-wrap;">(TRIGGER WARNING: Internalised fatphobia, body image, weight, mental illness, medication) </span></b></span></p><p><span style="background-color: white; font-family: inherit; white-space: pre-wrap;">I've rarely had high self esteem, thanks to years of bullying, but my self esteem has taken such a knock since I've had chronic illnesses.</span></p><p><span style="background-color: white;"><span style="font-family: inherit;"><span style="white-space: pre-wrap;">Throughout my treatment of chronic physical and mental illness, I have been on various medications, some of which have caused considerable weight gain. </span></span><span style="white-space: pre-wrap;">I try so hard to be body positive but I don't feel like me anymore and I'm desperate to get back some of my old self. I worry that others will think I've given up taking care of myself even though a combination of meds with weight gain side effects, inability to exercise sufficiently, and comfort/stress eating due to depression and anxiety, have led to significant weight gain and body change. I follow body positive people on Instagram in order to help with the disordered thinking I have about weight and diet. I read anti-diet books too. I think any change (not just weight gain) can have a serious effect on a person's self esteem. In my experience, in the past I have been known as the "skinny one", so I suppose, wrongly, I have made it part of my identity. I have liked being called things like "pixie", "petite" etc and when I don't see myself that way anymore, I feel very disappointed, at a loss, as if I've lost part of my identity and need to take on a whole new one which I don't particularly like. I know that this counts as fatphobia and I try so hard to reject those awful thoughts. </span></span></p><p><span style="background-color: white; white-space: pre-wrap;">My balance problems and chronic pain, that come with Fibromyalgia and Hypermobility Syndrome, have changed the way I walk. I am a bit wobbly, I walk with my feet turned in (as much as I try not to), sometimes I limp. I have been stared at and mocked for this, and so my self esteem has taken a hit. I try not to let it bother me, but if I notice someone is staring, I am extremely aware of my manner of walking.</span></p><p><span style="background-color: white; white-space: pre-wrap;">I often need to go to the toilet, due to Irritable Bowel Syndrome, Overactive Bladder Syndrome, and some bowel/stomach problems that are yet undiagnosed. If I'm particularly bad, I have to cancel plans last minute. Even if my friends are very understanding and compassionate, friends in the past haven't been and this has affected my self esteem too. I feel like a flaky, disappointing inconvenience, rather than a valuable friend. I feel all I do is annoy people and let them down. I know I cannot help this, because I would not do this if it weren't for my physical and mental illnesses, but it does not stop me from feeling this way.</span></p><p><span style="background-color: white;">Bladder and bowel issues can be (although they needn't be!) embarrassing and seen as a bit disgusting. I find I refer to them as "TMI problems" and try to describe them as delicately as possible to friends or people in Facebook groups. A lot of people have problems like this though, and a problem with bladder or bowel is nothing to be ashamed of! I do worry about it affecting my dating prospects though, although I would not want to be with a partner who was immature and easily disgusted by my health issues!</span></p><p><span style="background-color: white;">Part of mental health is self esteem, but mental health problems in themselves can have a severe impact upon self esteem. (Are you with me?). I'll explain. Anxiety can hold back so many things a person may want to accomplish for example. This could be taking on a dream job, travelling, or maybe even just meeting a friend for coffee. When someone has to cancel plans like these, or when they feel panicky whilst doing them, it can have a real knock-on effect. They can be frustrated with themselves for cancelling or acting in a "not normal" way. They may worry that others will pick up on the anxiety or the fact that they have cancelled multiple plans, and may treat them differently. I've certainly lost friends due to the way I've acted! These were friends I had felt quite close to as well. It does make you feel very low about yourself, as if there is something fundamentally wrong with you. </span></p><p><span style="background-color: white;">Carrying on the mental health conversation, when very depressed we may push people away and isolate, maybe because we don't see a point in talking, maybe because we feel we are not worthy of friendship, maybe because we feel overwhelmed. There are many reasons why someone may isolate. The consequences of this could be losing friends, friends acting differently, friends not reaching in to persuade you to talk. Of course there could be many reasons why a friend might act differently that doesn't necessarily mean they see you as any less of a friend to them. When very depressed though, personally, I will perceive any change in their behaviour as a direct reflection on me and my personality. I may isolate, but I still want friends to reach in and try to contact me. If they don't, I feel that maybe they weren't that close to me after all and "of course" that's my fault for acting the way I do. I feel I can't help how I act though, so I believe I can't do anything about it. And therefore, self esteem = rock bottom. </span></p><div class="o9v6fnle cxmmr5t8 oygrvhab hcukyx3x c1et5uql ii04i59q" style="margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto"><span style="background-color: white; font-family: inherit;">I'm constantly told by friends to not care what people think. I'm OK and I don't need to change for anyone. This is easier said than done though, especially when chronic physical and mental illness have ripped away my sense of self and confidence. I have a lot of paperwork from past CBT sessions, to do with negative thinking, all or nothing thinking etc. When very depressed, I don't see the point in looking through them. I also don't feel I deserve to have high self esteem. I think we all deserve to feel good about ourselves if we are good to others though. We beat ourselves up far too often, and usually for very small (although not to us) reasons. </span></div><div dir="auto"><span style="background-color: white; font-family: inherit;"><br /></span></div><div dir="auto"><span style="background-color: white; font-family: inherit;">I hope, in time and with practise, we will get that self confidence back.</span></div><div dir="auto"><span style="background-color: white; font-family: inherit;"><br /></span></div><div dir="auto"><span style="background-color: white; font-family: inherit;">What knocks your self esteem? Have you found ways of building yourself back up? Comment below!</span></div><div dir="auto" style="color: #e4e6eb; font-family: inherit;"><span style="background-color: white;"><br /></span></div><div dir="auto" style="color: #e4e6eb; font-family: inherit; font-size: 15px;"><br /></div></div>Amziehttp://www.blogger.com/profile/01639288209900035382noreply@blogger.com0tag:blogger.com,1999:blog-4896114346747150572.post-27990583206575322512020-10-15T12:28:00.000+01:002020-10-15T12:28:03.878+01:00My Experiences with Borderline Personality Disorder<p><b>(Disclaimer: The information given here is mainly about my own experiences of Borderline Personality Disorder. The ways I act, react and feel are not necessarily universal to all people with BPD and this should not be used as medical advice or a replacement for formal assessment. If you feel you have any symptoms such as mine, and especially if you have been self harming or suicidal, I urge you to contact your GP as soon as you can. Please let someone know how you feel. You deserve to get help.)</b></p><p><b>(TRIGGER WARNING: Mentions of Poor mental health treatment, Stigma against BPD, Self harm, Suicide, Alcohol and Sexual behaviour)</b></p><p><br /></p><p>It was World Mental Health Day a few days ago. A day where I always feel the obligation, as a person with multiple mental illnesses, to do something such as write a blog post. I try to vary the specific subjects such as talking about one of my illnesses, how I cope with various ones, and/or the importance of awareness days, as well as supporting people every day.</p><p>Unfortunately life got in the way this time (doesn't it always?!) and I didn't manage to write my blog post in time. Mental illness happens every day though, not just on awareness days, so any day is a good day to raise awareness, talk about the importance of support, reaching in as well as out, having appropriate services for anyone who needs them etc.</p><p>Today I want to talk about a mental health diagnosis I have that is often misunderstood and stigmatised; Borderline Personality Disorder (BPD). Let's start with the diagnostic criteria:</p><p>The following is found on the <a href="https://www.nhs.uk/conditions/borderline-personality-disorder/diagnosis/" target="_blank">NHS</a> website:</p><h2 style="background-color: #f0f4f5; box-sizing: inherit; color: #212b32; line-height: 1.25; margin-bottom: 24px; margin-top: 0px; padding-top: 16px;"><span style="font-family: inherit; font-size: small;">Assessment</span></h2><p style="background-color: #f0f4f5; box-sizing: inherit; color: #212b32; line-height: 1.47368; margin-bottom: 24px; margin-top: 0px;"><span style="font-family: inherit;">Internationally recognised criteria are used to diagnose BPD. A diagnosis can usually be made if you answer "yes" to 5 or more of the following questions:</span></p><ul style="background-color: #f0f4f5; box-sizing: inherit; color: #212b32; line-height: 1.47368; margin-bottom: 24px; margin-top: 0px; padding-left: 20px;"><li style="box-sizing: inherit; margin-bottom: 8px;"><span style="font-family: inherit;">Do you have an intense fear of being left alone, which causes you to act in ways that, on reflection, seem out of the ordinary or extreme, such as constantly phoning somebody (but not including <a href="https://www.nhs.uk/conditions/self-harm/" style="box-sizing: inherit; color: #330072;">self-harming</a> or <a href="https://www.nhs.uk/conditions/suicide/" style="box-sizing: inherit; color: #330072;">suicidal</a> behaviour)?</span></li><li style="box-sizing: inherit; margin-bottom: 8px;"><span style="font-family: inherit;">Do you have a pattern of intense and unstable relationships with other people that switch between thinking you love that person and they're wonderful to hating that person and thinking they're terrible?</span></li><li style="box-sizing: inherit; margin-bottom: 8px;"><span style="font-family: inherit;">Do you ever feel you do not have a strong sense of your own self and are unclear about your self-image?</span></li><li style="box-sizing: inherit; margin-bottom: 8px;"><span style="font-family: inherit;">Do you engage in impulsive activities in 2 areas that are potentially damaging, such as unsafe sex, drug misuse or reckless spending (but not including self-harming or suicidal behaviour)?</span></li><li style="box-sizing: inherit; margin-bottom: 8px;"><span style="font-family: inherit;">Have you made repeated suicide threats or attempts in your past and engaged in self-harming?</span></li><li style="box-sizing: inherit; margin-bottom: 8px;"><span style="font-family: inherit;">Do you have severe mood swings, such as feeling intensely depressed, anxious or irritable, which last from a few hours to a few days?</span></li><li style="box-sizing: inherit; margin-bottom: 8px;"><span style="font-family: inherit;">Do you have long-term feelings of emptiness and loneliness?</span></li><li style="box-sizing: inherit; margin-bottom: 8px;"><span style="font-family: inherit;">Do you have sudden and intense feelings of anger and aggression, and often find it difficult to control your anger?</span></li><li style="box-sizing: inherit; margin-bottom: 0px;"><span style="font-family: inherit;">When you find yourself in stressful situations, do you have feelings of paranoia, or do you feel like you're disconnected from the world or from your own body, thoughts and behaviour?</span></li></ul><div><span style="color: #212b32;">As well as talking about what BPD is, how it is diagnosed and treated etc, I want to speak about my experience of living with it. I have had symptoms of BPD for as long as I can remember, but I have been formally diagnosed since 2017. I have various mental illnesses, whose symptoms overlap, but the ones I think I can attribute to Borderline Personality Disorder are explained below:</span></div><div><span style="color: #212b32;"><br /></span></div><div><ul style="text-align: left;"><li><span style="color: #212b32;">I am terrified of being alone, as well as rejection. I have practically begged bullies to stay "friends" with me so that they wouldn't take away my real friends and leave me without anyone. I have constantly phoned a partner when they hadn't spoken to me for a few days, to find out why, in the hope I could convince them to not dump me. (It didn't work). I go through regular phases of reassurance seeking which I'm sure annoys my friends, no matter how kindly they respond. No matter how many times I try to get reassurance that my friends won't leave me however, I can never reassure myself. I go round in circles with this. I admit I have checked a partner's messages too, to make sure they hadn't found someone else. I also wanted to find out what they "really" thought of me. What I found out upset me a lot, but honestly I should've just spoken to my partner. Communication is so important! There are probably more examples of seeking reassurance, avoiding rejection/perceived rejection etc but I think I've said enough on that subject.</span></li></ul><div><span style="color: #212b32;"><br /></span></div><ul style="text-align: left;"><li><span style="color: #212b32;">In the past, I have gone from relationship to relationship, with not much of a break between them. I just couldn't bear being alone and single. A lot of the relationships I've been in have been pretty intense and unstable; not always through my fault though. I have been in at least one definitely abusive relationship, and although I made mistakes myself, I would never blame myself for how they treated me. Other relationships have involved love, marriage, and children being mentioned very quickly; burning out almost as soon as they began. I have also mistaken having feelings for someone, for being deeply in love with them. I have made everything about them and believed we had a future, even when it is pretty clear they didn't feel anywhere near the same way. </span></li></ul><div><span style="color: #212b32;"><br /></span></div><ul style="text-align: left;"><li><span style="color: #212b32;">I still don't know what kind of person I am. I can say that I believe I am kind, passionate, and determined, but even then, I doubt that. I always rely on other people to prove they know me, and to tell me what kind of person I am, what makes me "me", what I'm good at, what my trademark is etc. Any comments about my character, I feel deeply. Good and bad. I'm more likely to believe the bad ones of course, but that's not necessarily a BPD thing. My unstable sense of self can even get so rocky that I literally don't recognise my own reflection in the mirror. The person in the mirror could be anyone, but I do not feel they are me. I have days where I feel attractive, and days where I feel extremely ugly. Nothing has physically changed, only my moods. Again, not necessarily a BPD thing, but it's worth mentioning as a mental health thing. I would love to truly know who I am, and I often feel lost and not grounded because I don't know.</span></li></ul><div><span style="color: #212b32;"><br /></span></div><ul style="text-align: left;"><li><span style="color: #212b32;">As for impulsive activities, I do engage in some, but not as many as I used to. At university in particular, I would engage in risky sexual behaviour. The only way I can explain why, is to say that I had very low self esteem, I often felt alone and unwanted, and that one night with someone I barely knew would make me feel wanted, if only for a few minutes. I would always feel guilty and ashamed afterwards, but I try not to now. As well as this, I am prone to drinking impulsively. It is a coping mechanism and although I know it is unlikely to lift my mood when I am particularly depressed, it feels like a good idea at the time! I drank a lot in my later teens and 20's. It was something I'd do to celebrate, commiserate, destress, forget, or just cope. It was binge drinking and thankfully I don't do it nearly as much now. It didn't help and I could've damaged myself. Right now, I don't self harm much, but I do still do it impulsively. A bad day, a bad comment, a low mood, a stressed mood, agitation, too many thought, too many mood swings. It doesn't take much. These are some of the most potentially dangerous impulses I have/had, but there are others that would take all day to talk about. </span></li></ul><div><span style="color: #212b32;"><br /></span></div><ul style="text-align: left;"><li><span style="color: #212b32;"> I am suicidal. I'd say passively nowadays (thanks to good antidepressants and mood stabilizers), but I have had plans, and almost-attempts in the past. I have made "threats" too, although I do not like the term. It feeds into the stigma (which I will explain below). As in the previous post, I self harm occasionally too (it used to be every day though). </span></li></ul><div><span style="color: #212b32;"><br /></span></div><ul style="text-align: left;"><li><span style="color: #212b32;">I used to have very severe mood swings, but thanks, again, to mood stabilizers, these are not so bad now. These mood swings can go on for hours, days, maybe even a week. They are very hard to cope with and when my moods are particularly high, I am scared about the comedown. Sometimes I can very rapidly go from deeply depressed, to anxious, angry, and hyper, then back down again. Sometimes I feel all these at once. For me, that is the worst and is often when I will feel more suicidal or self harm badly.</span></li></ul><div><span style="color: #212b32;"><br /></span></div><ul style="text-align: left;"><li><span style="color: #212b32;">I feel very lonely and empty on a regular basis. Most of the time, this is how I feel when I'm not having mood swings. When I feel empty, I find it hard to respond to the question "how are you?". Sometimes I even think I'm doing ok, when I'm really not. </span></li></ul><div><span style="color: #212b32;"><br /></span></div><ul style="text-align: left;"><li><span style="color: #212b32;">I can feel intensely angry, but not very often. I act in rather than out too (punishing myself rather than lashing out at others). I can have kneejerk reactions to things but find it hard to express myself. Sometimes I will act without thinking but thankfully that has not involved me doing anything physical as a result. </span></li></ul><div><span style="color: #212b32;"><br /></span></div><ul style="text-align: left;"><li><span style="color: #212b32;">In stressful situations I often dissociate. This involves feeling as if nothing is real. I might not feel as if I am in my own body, or even that I am real. It can last from a few minutes to a few hours. The stressful day, or moment can go by like a blur and I'm often not sure of what I said during that time. I may have lashed out verbally, or had a big panic attack, and I just don't remember the details. There are a couple of times I can think of. One time, I was on holiday with a partner. He was threatened by someone in a bar. I knew I was shouting and swearing at this person but I honestly cannot remember what I said. I burst into tears and was shaking afterwards. Another time, I was at a Work Programme induction, where I was taken into a group session without my prior knowledge. At the time I found group situations terrifying and extremely stressful. I know I spoke over the person leading the session, and apparently had a panic attack that was severe enough for me to be led out of the room. I know I spent the rest of the session signing some documents a work advisor put in front of me. I couldn't even tell you at the time what they were about though. I managed to sign them but I didn't read them and it was as if I was on autopilot. I often found Work Programme appointments very stressful and if I wasn't dissociating, I was paranoid. I used to believe any unfamiliar car or van outside my drive was a government official spying on me. If a stranger looked at me for a few seconds longer than "normal", I would believe they were spying on me too. I still find myself getting paranoid about various things, but I am a little better at calming myself down. I can ground myself a little more effectively too.</span></li></ul></div><p><b>Treatment</b></p><p>I feel like all these symptoms are a lot to cope with. I have been at crisis point on multiple occasions and you'd be forgiven for thinking I had somewhere to turn when things become too much. Unfortunately, a common misconception about BPD is that people with it are too reliant on services, so mental health teams often discharge us before we are ready. It is very hard to convince someone you need help, especially when you are in a distressed state. It can look like over-reliance even when you truly need that help because you are in crisis. If you look at some of my previous posts, you will know that I have been assessed multiple times by the Access (Crisis) team and Community Mental Health team, and discharged straight after, or after a few sessions of help, even when I clearly wasn't ready. I believe it would take something drastic before I would have any intense help. Due to lack of funding and resources, however, I don't think I will ever get enough appropriate help.</p><p>According to <a href="https://www.nice.org.uk/guidance/cg78/chapter/1-Guidance#general-principles-for-working-with-people-with-borderline-personality-disorder" target="_blank">NICE</a>, therapy for BPD may include <a href="https://www.mind.org.uk/information-support/drugs-and-treatments/talking-therapy-and-counselling/dialectical-behaviour-therapy-dbt/" target="_blank">Dialectical Behaviour Therapy</a> (DBT) if self harm is a particular issue. Brief psychological interventions (less than 3 months) are not recommended specifically for BPD either. Choice of therapy should be tailored to the individual's needs. In theory, this sounds promising, but as someone who was only ever offered a few months of <a href="https://www.mind.org.uk/information-support/drugs-and-treatments/cognitive-behavioural-therapy-cbt/about-cbt/" target="_blank">CBT</a> in Primary Care, and 4 sessions each of Distress Tolerance, and Self Compassion Therapy, in practice the needs of an individual with BPD are not always met. I think it mainly depends on how much knowledge your healthcare professionals have of this condition, and what sort of resources are actually available in your local Mental Health Team (be that <a href="https://www.nhs.uk/service-search/find-a-psychological-therapies-service/" target="_blank">Primary Care</a> / IAPT or <a href="https://www.derbyshirehealthcareft.nhs.uk/services/mental-health-and-emotional-wellbeing/neighbourhood-community-support/cmht-adults-working-age" target="_blank">Community Mental Health Team</a>/Secondary Care). </p><p><b>Medication</b></p><p>In my experience, various mental health professionals have said that, with BPD, medication rarely helps and certainly isn't the be all and end all of treatment. It can help though, and does have a place in treatment. For me, Duloxetine helps the depressive moods I have, and Aripiprazole helps my mood swings. It allows me to get to a level of mental wellbeing where I am able to actually engage with therapy. Without medication, I would simply be too unstable and suicidal to accept any help. This might sound drastic too, but I do believe I would be dead without mental health medication.</p><p><b>Myths</b></p><p>There are various <a href="https://www.sane.org/information-stories/the-sane-blog/mythbusters/five-things-people-get-wrong-about-bpd" target="_blank">myths</a> about people with Borderline Personality Disorder. A big one is that we are seen as manipulative. The truth though, is that we struggle to reassure ourselves that people actually want to spend time with us. We are scared of being rejected and sometimes we will do seemingly drastic things to gain that reassurance. </p><p>We are seen as "threatening" self harm and suicide too. Actually, many of us are suicidal and do self harm but we do not do this/talk about this as a threat. We may in fact be asking for help and trying to be honest about how ill we are. People often misconstrue this though, especially when we have the BPD label. </p><p>Also, we are said to be over-reliant on mental health services. That is not necessarily true though, and certainly isn't a particular symptom of BPD. We ask for help because we need that help. Mental illness is invisible too. Someone can seem fine on the outside, when they desperately need assistance. It can take presenting with physical injury for a mental illness to be taken seriously. Even then, the person may just be patched up in A&E then sent on their way with little to no aftercare. Last time I overdosed, I had to specifically ask to be seen by the Psychiatry Liaison team. I feel I've had to fight and almost beg for any scrap of help I've received. </p><p>You can read about other myths <a href="https://www.sane.org/information-stories/the-sane-blog/mythbusters/five-things-people-get-wrong-about-bpd" target="_blank">here</a> but I would advise avoiding this, or at least being careful not to overload yourself if you find these triggering at all. I am careful to only go on the myth-busting sites, rather than exposing myself to places with very upsetting misinformation. </p><p><br /></p><p><b>How Do I Cope?</b></p><p>I do have some unhealthy coping mechanisms, which I certainly wouldn't recommend, but I am learning healthy coping mechanisms too, and trying to replace the not-so-healthy ones.</p><p>For me, talking to trusted friends and family helps, but being in therapy can give me space to vent my feelings without judgment or fear of a loved one's reaction. It all depends what you feel ready for but in my experience, bottling it all up is a very bad idea</p><p>Having distractions can help with coping too. Gaming, cross stitch, going for a short walk (only when not in an unstable, suicidal place in my head though), studying short courses, reading, watching an episode of something or even a short Youtube video can help. I find I get overloaded very easily, and that can lead to major stress and self harm. I may manage a film, but when it seems too long or too involving, a few simple funny or cute Youtube videos will at least get me through some of the day.</p><p>If I'm particularly agitated, keeping my hands busy can help calm me down or at least channel some of my frustration. I am a lover of baking, and focusing on a task such as this, and creating something delicious can help me get through if not boost my mood even! The result is a tasty treat and the fact that I haven't punished myself for however many minutes or hours that particular bake takes.</p><p>When dissociating, I have learnt two things that sometimes help. </p><p><span> </span><span> </span><span> </span><span> </span><span> 1. Grounding. This involves doing simple things to reconnect myself with the outside world. It intends to remind me that the world around me, the people around me, and myself are real. It also brings me to the present time. One way of grounding myself involves focusing on one thing that stimulates each of my senses i.e. something I can see, something I can hear, something I can smell, something I can feel, and something I can taste. Even focusing on just some of these senses can ground me slightly.</span><br /></p><p><span><span> </span><span> </span><span> </span><span> </span><span> 2. Safe Place. I'm still learning and practising this one, as I find it hard to focus and take myself away from whatever stressful situation has triggered my dissociation. It involves imagining a pleasant, calm place that can either be real or something completely made up. An example could be a quiet, sandy beach. I imagine myself there at night, with no one around. Again, I can focus on my senses in order to make that place as real for me as possible. I may think about the taste of a fruity cocktail, the smell of the sea, the sound of the waves or the feel of a gentle breeze through my hair. Once I feel calmer, I can gently bring my awareness back to the present moment in the hopes that I will have stopped dissociating and feel more able to deal with the situation I am in, or simply walk away from it if that is possible. </span><br /></span></p><p><span><span><br /></span></span></p><p><span><span><b>Conclusion</b></span></span></p><p>So, I am in no way a success story, and I'm definitely not looking for sympathy (well, maybe a bit if I'm having a bad day?). I simply wrote this blog post to let you know about how Borderline Personality Disorder feels for me, and how my experiences of it compare to the diagnostic criteria, recommended treatments etc. </p><p><br /></p><p><b>Resources</b></p><p>Diagnostic Criteria - <a href="https://www.nhs.uk/conditions/borderline-personality-disorder/diagnosis/">https://www.nhs.uk/conditions/borderline-personality-disorder/diagnosis/</a></p><p>NICE guidelines for Borderline Personality Disorder - <a href="https://www.nice.org.uk/guidance/cg78/chapter/1-Guidance#general-principles-for-working-with-people-with-borderline-personality-disorder">https://www.nice.org.uk/guidance/cg78/chapter/1-Guidance#general-principles-for-working-with-people-with-borderline-personality-disorder</a></p><p>MIND Dialectical Behaviour Therapy - <a href="https://www.mind.org.uk/information-support/drugs-and-treatments/talking-therapy-and-counselling/dialectical-behaviour-therapy-dbt/">https://www.mind.org.uk/information-support/drugs-and-treatments/talking-therapy-and-counselling/dialectical-behaviour-therapy-dbt/</a></p><p>MIND About CBT - <a href="https://www.mind.org.uk/information-support/drugs-and-treatments/cognitive-behavioural-therapy-cbt/about-cbt/">https://www.mind.org.uk/information-support/drugs-and-treatments/cognitive-behavioural-therapy-cbt/about-cbt/</a></p><p>IAPT - <a href="https://www.nhs.uk/service-search/find-a-psychological-therapies-service/">https://www.nhs.uk/service-search/find-a-psychological-therapies-service/</a></p><p>Community Mental Health Teams - <a href="https://www.derbyshirehealthcareft.nhs.uk/services/mental-health-and-emotional-wellbeing/neighbourhood-community-support/cmht-adults-working-age">https://www.derbyshirehealthcareft.nhs.uk/services/mental-health-and-emotional-wellbeing/neighbourhood-community-support/cmht-adults-working-age</a></p><p>Five things people get wrong about BPD - <a href="https://www.sane.org/information-stories/the-sane-blog/mythbusters/five-things-people-get-wrong-about-bpd">https://www.sane.org/information-stories/the-sane-blog/mythbusters/five-things-people-get-wrong-about-bpd</a></p><p><br /></p><p>If you feel you need to speak to someone, after reading this blog post, I am leaving some mental health links below. Please also comment below, if you know of any other links to inclusive mental health helplines.</p><p><b>Samaritans: <a href="https://www.samaritans.org/how-we-can-help/contact-samaritan/?gclid=CjwKCAjw5p_8BRBUEiwAPpJO61KYfF83b5CLcYslbI7Nz2_yJ-SwSqWHR31ZLgMF0nGpFFFqDv_VDRoCN9kQAvD_BwE">https://www.samaritans.org/how-we-can-help/contact-samaritan/?gclid=CjwKCAjw5p_8BRBUEiwAPpJO61KYfF83b5CLcYslbI7Nz2_yJ-SwSqWHR31ZLgMF0nGpFFFqDv_VDRoCN9kQAvD_BwE</a></b></p><p><b>Mind: <a href="https://www.mind.org.uk/about-us/contact-us/">https://www.mind.org.uk/about-us/contact-us/</a></b></p><p><b>Stonewall: <a href="https://www.stonewall.org.uk/help-and-advice">https://www.stonewall.org.uk/help-and-advice</a></b></p><p>(Please be aware that a lot of these links are for listening services. The people you speak to are unlikely to be allowed to advise you, and should not replace speaking to your GP, mental health professional, or even A&E if urgent. They do have a place in mental wellbeing however, and it can be helpful to hear a friendly, compassionate voice).</p><p><b><br /></b></p>Amziehttp://www.blogger.com/profile/01639288209900035382noreply@blogger.com0tag:blogger.com,1999:blog-4896114346747150572.post-46646021204521309132020-07-18T11:29:00.001+01:002020-07-18T11:29:35.283+01:00"Square Peg....Round Hole"(TRIGGER WARNING: Medication, including dosage and overdose, mentions of self harm, suicide, trauma, hallucinations, domestic abuse, and abortion)<br />
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For many months, I've been on Citalopram for my Depression. The past month or so, I've been on 40mg (the highest dose). At first, I seemed to be doing well but, especially since trying to contact some charities to help me with my trauma from the <a href="https://www.amysmysteryillness.co.uk/2018/07/im-survivor.html" target="_blank">abusive relationship</a> I was in, I relapsed badly.<br />
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My suicidal thoughts have returned, I am being more impulsive with drinking, self harm, and taking small overdoses to help me sleep. I have not been sleeping well recently, I have had very graphic nightmares and <a href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd/symptoms-of-ptsd/#:~:text=A%20flashback%20is%20a%20vivid,events%20from%20start%20to%20finish." target="_blank">flashbacks</a>, and my appetite has been all over the place. Getting out of bed has been very difficult, as I am either very distressed or extremely low. Everything seems pointless.<br />
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I finally decided to speak to my GP on the phone the other day. I was due to have my mental health medication reviewed anyway, and I guess I was just expecting her to put me onto something else and book another review in a few weeks' time.<br />
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When she rang, she asked me how I'd been getting on with the higher dose of Citalopram, and how I'd been feeling recently. I explained everything, and I think I sounded quite panicky. She was very concerned, especially about the suicidal thoughts. She told me to ring the <a href="https://www.rethink.org/advice-and-information/living-with-mental-illness/treatment-and-support/community-mental-health-team-cmht/" target="_blank">Community Mental Health Team</a>, to see if they would see me. She also said that I would need them to refer me to a psychiatrist to see what other medication I could be put on.<br />
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I guess I didn't realise how bad things had become. I suppose I've been so used to having suicidal thoughts, but no real help for them, that I'd given up fighting for support (especially immediate support from crisis team/access team etc). I told her about my previous experiences with CMHT and how the last time I went to A&E after an overdose, I spoke to the <a href="https://www.amysmysteryillness.co.uk/2019/08/a-mental-health-nightmare.html" target="_blank">Psychiatry Liaison Team</a> who said that I wasn't ill in the "right way" for CMHT. My GP still insisted I rang them though, and got back to her with what they'd decided.<br />
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I was very panicky by the time I rang access/crisis team (you ring them to be triaged and referred to CMHT) but I spoke to a very nice, compassionate person. They listened to what I had to say, asked about my mental health medication (40mg Citalopram, 10mg Aripiprazole), asked me how I'd been feeling, and went through the risk assessment with me (suicidal thoughts, plans, self harm history, hallucinations etc). I also mentioned the trauma I had experienced from a <a href="https://www.amysmysteryillness.co.uk/2014/03/am-i-triggered.html" target="_blank">medical abortion</a> at 19 and an <a href="https://www.amysmysteryillness.co.uk/2018/07/im-survivor.html" target="_blank">abusive relationship </a>soon after. I told them I'd spoken to some LGBTQ charities to try and get support for the trauma. I'm bisexual and agender. I didn't expect to come out as agender to this person, but it sort of slipped out when I was explaining why I'd decided to contact LGBTQ charities instead of Women's Aid (the place I was signposted to by my last therapist). I was quite worried that I'd come out so suddenly. In the past, I had come out as agender to a therapist/nurse who then proceeded to deliberately call me a "lady" multiple times. This set off my gender dysphoria, and I didn't feel mental health services would understand me being non binary.<br />
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The person on the phone acknowledged my gender (although I'm not sure if they understood or believed me). They then asked about my daily functioning, and whether my symptoms had affected that. I told them about the nightmares, flashbacks, lack of sleep due to feeling unsafe, distressed, and having a lot on my mind. My appetite has been quite bad recently too. I've eaten, but I haven't been very interested in it. Again, everything feels pointless. I'm extremely stressed about the future too. I'm on ESA and PIP (sickness and disability benefits) and at the age of 30, I really want to move on with my life and rent a place of my own. I would have to get a job if I am to afford it though. I really do want to get a job, but I'm not sure how I would manage it physically or mentally. If I can't move on with my life though, do I want a life at all?<br /><br />The person asked a few more questions then told me they would speak to one of their colleagues and get back to me with their decision at lunchtime. They called soon after lunch and told me that they want me to have a telephone appointment with a CPN (mental health nurse). We booked the appointment, then they told me that I should ring anytime if I need them urgently. I thanked them for their time and for how kind they'd been.<br />
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Since then, I've been looking forward to the appointment, in a way. It's at least a crumb of support from mental health services, and for me to be referred for assessment at least means they feel my symptoms are complex and serious enough. My previous experiences of being assessed then discharged are making me pessimistic about it though. I remember the A&E Psychiatry Liaison Team trying to explain to me why I never seemed to be taken on by CMHT. They described me as a "square peg" and CMHT as a "round hole". I didn't fully understand why that was the case though.<br />
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What makes me so different as to not being right for CMHT? I have a history of self harm and suicidal thoughts (plans even, sometimes). I've suffered multiple trauma. I have experienced <a href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/hypomania-and-mania/about-hypomania-and-mania/#:~:text=What%20are%20hypomania%20and%20mania,period%20(usually%20a%20few%20days)" target="_blank">hypomania</a> on rare occasions. Very very rarely I have had visual hallucinations (usually after an antidepressant overdose). I do not have <a href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/psychosis/about-psychosis/" target="_blank">psychosis</a>, so I understand why I wouldn't fit the criteria for some of the CMHT pathways, but there's at least one pathway that I think I do fit the description for.<br />
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The one pathway that seems to fit me is the one called the "<a href="https://www.mpft.nhs.uk/services/mental-health-community-services" target="_blank">Community Intervention Pathway</a>". It says it "provides assessment and evidence based time limited interventions for people who have complex mental health difficulties that are significantly impacting on daily life. This would include mood disorders, anxiety disorders, trauma related conditions, and other severe emotional difficulties"<br />
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I have Depression, Generalised Anxiety Disorder, Obsessive Compulsive Disorder, Borderline Personality Disorder, and Post Traumatic Stress Disorder. These fit into various categories mentioned above and at least some of these affect my daily life significantly. I socialise rarely (especially since Covid of course), I am currently unable to work (although I want to try), my sleep and appetite are affected. I think some of my relationships with others have been affected too. I've certainly lost some friends anyway. Sometimes I freeze and <a href="https://www.nhs.uk/conditions/dissociative-disorders/#:~:text=Dissociation%20is%20a%20way%20the,longer%20(weeks%20or%20months)." target="_blank">dissociate</a>, which can affect me for hours; as I'll be staring at whatever is in front of me. I'll be sort of "stuck", unable to take in conversation, or focus on anything else. When I'm very depressed or anxious, I cannot process anything that isn't to do with whatever is making me anxious or how I'm feeling when depressed.<br />
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I think my problems are complex and severe enough for intervention from Community Mental Health Team, and I know I need psychiatric input in order to sort out my medication. Past experience is making me worry that I will simply be discharged with no support whatsoever. People are telling me to be positive and "cross that bridge when I come to it". I don't want to get my hopes up though.<br />
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<b>Resources</b><br />
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Amy's Mystery Illness blog: I'm a Survivor - <a href="https://www.amysmysteryillness.co.uk/2018/07/im-survivor.html">https://www.amysmysteryillness.co.uk/2018/07/im-survivor.html</a><br />
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Symptoms of PTSD: <a href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd/symptoms-of-ptsd/#:~:text=A%20flashback%20is%20a%20vivid,events%20from%20start%20to%20finish.">https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd/symptoms-of-ptsd/#:~:text=A%20flashback%20is%20a%20vivid,events%20from%20start%20to%20finish.</a><br />
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Rethink: What is a Community Mental Health Team? <a href="https://www.rethink.org/advice-and-information/living-with-mental-illness/treatment-and-support/community-mental-health-team-cmht/">https://www.rethink.org/advice-and-information/living-with-mental-illness/treatment-and-support/community-mental-health-team-cmht/</a><br />
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Amy's Mystery Illness blog: A Mental Health Nightmare - <a href="https://www.amysmysteryillness.co.uk/2019/08/a-mental-health-nightmare.html">https://www.amysmysteryillness.co.uk/2019/08/a-mental-health-nightmare.html</a><br />
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Amy's Mystery Illness blog: Am I Triggered? - <a href="https://www.amysmysteryillness.co.uk/2014/03/am-i-triggered.html">https://www.amysmysteryillness.co.uk/2014/03/am-i-triggered.html</a><br />
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Mind Charity: About hypomania and mania - <a href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/hypomania-and-mania/about-hypomania-and-mania/#:~:text=What%20are%20hypomania%20and%20mania,period%20(usually%20a%20few%20days)">https://www.mind.org.uk/information-support/types-of-mental-health-problems/hypomania-and-mania/about-hypomania-and-mania/#:~:text=What%20are%20hypomania%20and%20mania,period%20(usually%20a%20few%20days)</a><br />
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Mind Charity: About Psychosis - <a href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/psychosis/about-psychosis/">https://www.mind.org.uk/information-support/types-of-mental-health-problems/psychosis/about-psychosis/</a><br />
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Mental Health Community Services: <a href="https://www.mpft.nhs.uk/services/mental-health-community-services">https://www.mpft.nhs.uk/services/mental-health-community-services</a><br />
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Dissociative Disorders: <a href="https://www.nhs.uk/conditions/dissociative-disorders/#:~:text=Dissociation%20is%20a%20way%20the,longer%20(weeks%20or%20months).">https://www.nhs.uk/conditions/dissociative-disorders/#:~:text=Dissociation%20is%20a%20way%20the,longer%20(weeks%20or%20months).</a><br />
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<br />Amziehttp://www.blogger.com/profile/01639288209900035382noreply@blogger.com0tag:blogger.com,1999:blog-4896114346747150572.post-47437648339740108872020-05-24T11:43:00.002+01:002020-05-24T11:43:56.721+01:00Trauma Focused CBT: Session Twelve<b>(TRIGGER WARNING: Details of early medical abortion, and mention of domestic abuse)</b><br />
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This was my last session with my therapist. I felt that I had come a long way, and although I still have the <a href="https://www.nhs.uk/conditions/post-traumatic-stress-disorder-ptsd/" target="_blank">Post Traumatic Stress Disorder</a> diagnosis, my symptoms are much less severe and persistent, at least in relation to my <a href="https://www.amysmysteryillness.co.uk/2014/03/am-i-triggered.html" target="_blank">traumatic abortion</a>.<br />
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This session was just to check in on me really, and see how I'd been getting on. I had managed to do more tasks for facing my feared situations, and I was continuing journalling in order to monitor my moods.<br />
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One particular thing I needed to do was contact <a href="https://www.bpas.org/" target="_blank">BPAS</a> to voice my concerns about my abortion and ask their advice, or for reassurance at least. When having an early medical abortion, the process was that you would take an oral pill in clinic on your first visit, then a number (I thought 6 at the time) of vaginal pills in clinic on the second visit; in order to complete the abortion.<br />
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When looking at <a href="https://www.bpas.org/abortion-care/abortion-treatments/the-abortion-pill/abortion-pill-up-to-10-weeks/" target="_blank">early medical abortion advice</a> on the BPAS website, it said to take 4 vaginal pills in clinic, and then 2 a few hours later. I thought I'd taken all 6 at the time, so worried that there may have been complications, which then led to me worrying about potential fertility problems.<br />
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I emailed BPAS to tell them about my concerns, and a couple of days later I received a call. When I spoke to one of the BPAS managers, she put my mind at rest. She said that, as my abortion was 11 years ago, the process was slightly different. I would've only been given 4 vaginal pills back then, whereas now it is 4 to take at first, then 2 later on. She also told me that she had spoken to their medical director. She asked me a few questions about how I felt physically when having the abortion. I told her about the excruciating pain, and huge amount of blood at first. She asked if it lessened over the days and weeks I was recovering, and it had. She told me this was to be expected of a medical abortion without complications. As I had normal, regular periods nowadays too, fertility shouldn't be a problem.<br />
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We had a long chat, which was difficult and triggering in some parts but overall, I was actually glad to get it all off my chest and speak to someone in the know. She was so apologetic about the way the nurses had treated me, and assured me that training is much more stringent nowadays. Although there are very rare instances of nurses being less than kind, they are dealt with through further training and disciplinary action if needs be.<br />
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I felt surprisingly light and relieved after the conversation! It felt as if I'd had closure finally, and although my worries were not completely gone, I felt I had made massive progress and was able to cope with my PTSD over this (for the most part).<br />
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In the future, I would love to be a psychotherapist or a clinical psychologist. I would also like to help counsel people who have been through similar situations as me. I feel like I am almost ready to do that!<br /><br />Back to therapy, I told my therapist about the phone call and my feelings during and after. She was so pleased to hear about the progress I had made! She asked if I felt I needed any more sessions regarding this, but I said I felt I could cope with my feelings etc about this on my own now, and had learnt enough skills for dealing with setbacks.<br />
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The next thing we spoke briefly about was the<a href="https://www.amysmysteryillness.co.uk/2018/07/im-survivor.html" target="_blank"> abusive relationship</a> I'd been in. As it had happened at such a sensitive time for me (straight after the abortion in fact) it had become a double trauma, which needed dealing with. She reminded me that we had spoken <a href="https://www.amysmysteryillness.co.uk/2020/04/trauma-focused-cbt-session-eleven.html" target="_blank">last session</a> about me contacting <a href="https://www.womensaid.org.uk/" target="_blank">Women's Aid</a> to see if they could help with counselling etc. I said I would leave it a month or two, as I felt I needed a break from therapy first. It's also the case that they are inundated with calls from domestic abuse survivors right now, who are in terrible situations (partly due to lockdown) that they need help to escape from. I do not want to take up the line with my feelings about something I am not in danger from anymore. I want to at least give a bit of time before ringing them.<br />
<br />
My therapist recently sent me a form to fill in for my own resources, so I know what to do, who to contact etc should I have setbacks. This is very helpful because I often feel lost when in crisis, and need clear instructions.<br />
<br />
Right now, I am doing ok though. I still have dreams and flashbacks, but I am able to distract myself most of the time. I'm trying to plan my days too, so I eat a bit better, exercise within my physical limits, and talk to friends too.<br />
<br />
When/if I manage to get any counselling sessions with Women's Aid, I will blog about them.<br />
<br />
<b>Resources</b><br />
<b><br /></b>
NHS website: Post Traumatic Stress Disorder: <a href="https://www.nhs.uk/conditions/post-traumatic-stress-disorder-ptsd/">https://www.nhs.uk/conditions/post-traumatic-stress-disorder-ptsd/</a><br />
<b><br /></b>
Amys Mystery Illness- Am I Triggered?: <a href="https://www.amysmysteryillness.co.uk/2014/03/am-i-triggered.html">https://www.amysmysteryillness.co.uk/2014/03/am-i-triggered.html</a><br />
<br />
British Pregnancy Advisory Service: <a href="https://www.bpas.org/">https://www.bpas.org/</a><br />
<br />
Medical Abortion Up to 10 Weeks: <a href="https://www.bpas.org/abortion-care/abortion-treatments/the-abortion-pill/abortion-pill-up-to-10-weeks/">https://www.bpas.org/abortion-care/abortion-treatments/the-abortion-pill/abortion-pill-up-to-10-weeks/</a><br />
<br />
Amys Mystery Illness: I'm a Survivor: <a href="https://www.amysmysteryillness.co.uk/2018/07/im-survivor.html">https://www.amysmysteryillness.co.uk/2018/07/im-survivor.html</a><br />
<b><br /></b>
Amys Mystery Illness- Trauma Focused CBT: Session Eleven: <a href="https://www.amysmysteryillness.co.uk/2020/04/trauma-focused-cbt-session-eleven.html">https://www.amysmysteryillness.co.uk/2020/04/trauma-focused-cbt-session-eleven.html</a><br />
<br />
Women's Aid: <a href="https://www.womensaid.org.uk/">https://www.womensaid.org.uk/</a>Amziehttp://www.blogger.com/profile/01639288209900035382noreply@blogger.com0tag:blogger.com,1999:blog-4896114346747150572.post-87855193114916253332020-04-11T11:46:00.001+01:002020-04-11T11:46:20.917+01:00Trauma Focused CBT: Session Eleven<b>(TRIGGER WARNING: Description of medical abortion, pregnancy, and sexual domestic abuse)</b><br />
<br />
Although my moods (mainly due to Coronavirus) have been fairly bad, my moods overall (and specific to my abortion trauma) have improved. I thought this session might be my last one.<br />
<br />
I was very overwhelmed on the day of this phone CBT session, as I'd been catching up on my homework. The things I needed to do for this session were to watch a programme about abortion, and to look up information about the process of medical abortion.<br />
<br />
The week before this session, I'd seen a news piece about the change in abortion laws in Northern Ireland. From what I remember, it'd been legalised but the problem was that there was a distinct lack of services that actually offered abortion treatment. A woman in the piece had to travel to England for her surgical abortion and if I remember correctly, she'd been under anaesthetic but rules meant she had to travel back home that evening. It sounded extremely distressing. I thought I'd dissociate straight away or I'd avoid the news item altogether, but I found myself fixated on it. I did dissociate afterwards, after getting quite upset. It did stay with me for the rest of that day, even when I'd grounded myself. Even though this was pretty bad though, it wasn't as bad a reaction as I expected.<br />
<br />
The day of the session, I'd been on the <a href="https://www.bpas.org/" target="_blank">BPAS</a> (British Pregnancy Advisory Service) website, looking through the process of medical abortion specifically (When I was 19, I had a medical abortion at 5 weeks pregnant). I did find it very upsetting and particularly triggering when looking up the physical effects of termination. It was very descriptive and brought on flashbacks of my trauma.<br />
<br />
My scores on the <a href="https://patient.info/doctor/patient-health-questionnaire-phq-9" target="_blank">PHQ-9</a> , <a href="https://patient.info/doctor/generalised-anxiety-disorder-assessment-gad-7" target="_blank">GAD-7</a> , phobias and lifestyle effects questionnaires were a little better than the previous fortnight, so my therapist was pleased about that. I did tell her that I felt I reacted less extremely to topics of abortion too, although I still got triggered by descriptions of the physical effects. She asked if there was anything else I needed to talk about or ask that day. I explained about what happens when having a medical abortion. The first visit for the treatment itself, you take one oral pill. The second visit, you are given <a href="https://www.bpas.org/abortion-care/abortion-treatments/the-abortion-pill/abortion-pill-up-to-10-weeks/" target="_blank">6 vaginal pills</a> to take. According to the BPAS website, you are only supposed to take 4 though (I said I think the spare 2 were for if any fell out). When I went though, I got confused and took all 6. Because of this, I was now worried that I may have caused complications and maybe that was why I was so ill/in horrendous pain so soon after treatment and for so long.<br />
<br />
I got a bit worked up, when talking about the physical side of things. I also blamed myself a lot for doing things incorrectly. My therapist said I don't need to be so harsh on myself though. On the second day of the abortion, I had a lot of information to take in, and it was no wonder that I couldn't remember everything. It was a really distressing time for me throughout. The nurses should've been more compassionate and clearer with their instructions.<br />
<br />
My therapist asked if there was a number I could contact BPAS from, in order to ask about what happens if I take all 6 pills instead of just the 4. Of course she couldn't give me medical advice, but maybe someone from BPAS could tell me, or signpost me to an organisation that could advise. I told her I wasn't sure if 11 years post abortion was too late to ring them, but we decided it would be worth ringing. Even if they couldn't offer me support, they most likely could signpost me to somewhere that could. <br />
<br />
After this discussion, my therapist asked about the <a href="https://www.amysmysteryillness.co.uk/2018/07/im-survivor.html" target="_blank">abusive relationship</a> I'd been in, after my abortion. She wanted to know whether I felt I needed help with that too. I said I reacted to storylines, information etc about it in the same way as I used to, about the abortion, so yes I did need help. I explained how the sexual abuse affected me the most, and I found that I would feel like I needed to scrub myself "clean" when thinking back to it. I reminded her that she'd told me to contact <a href="https://www.womensaid.org.uk/" target="_blank">Women's Aid</a> for support. I told her that I'd be calling them in about a month, as I felt I needed at least that much time for a break from therapy. I felt I'd be overwhelmed if I went from one form of therapy, straight to another, especially when discussing such traumatic things. She agreed that this would be a sensible idea, and that I needed time to process things, carry on with practising the skills I'd learnt etc.<br />
<br />
At the end of this session, we booked me in for another phone session. As I had improved so much and I felt that I'd had enough therapy recently, I asked whether this could be the last or penultimate one. I explained I felt I am starting to depend less on therapy for this particular trauma, and I have improved enough to cope with the homework on my own. The therapist was fine with this, and was pleased that I felt this way.<br />
<br />
I feel really pleased too. Not just because of improving so much, but because of how helpful and supportive my therapist has been. She has been encouraging, empowering, and has never rushed me. We have focused on my strengths as well as my struggles, and any homework etc has been discussed between us (mainly led by me to be honest) instead of her pushing me to do things I don't feel ready for. I would recommend this therapist to anyone struggling with trauma.<br />
<br />
My homework for next session is to call BPAS and ask about the pills. At least then I won't be dwelling too much on the mistake I made in how many pills I took. It could be that it wouldn't cause any complications, but even if there was a risk, at least I'd know.<br />
<br />
<br />
UPDATE: After reading the advice on the BPAS website again (probably with a clearer head too!) it recommends taking 4 of the 6 pills straight away, then the remaining 2 a few hours afterwards. I still don't know if taking 6 all at once would cause problems, but I will update this blog post again once I have contacted BPAS.<br />
<br />
<br />
<br />
<b>Resources</b><br />
<b><br /></b>
British Pregnancy Advisory Service: <a href="https://www.bpas.org/">https://www.bpas.org/</a><br />
<br />
Depression Test PHQ-9: <a href="https://patient.info/doctor/patient-health-questionnaire-phq-9">https://patient.info/doctor/patient-health-questionnaire-phq-9</a><br />
<br />
Generalised Anxiety Disorder Assessment: <a href="https://patient.info/doctor/generalised-anxiety-disorder-assessment-gad-7">https://patient.info/doctor/generalised-anxiety-disorder-assessment-gad-7</a><br />
<br />
Medical Abortion Up to 10 weeks: <a href="https://www.bpas.org/abortion-care/abortion-treatments/the-abortion-pill/abortion-pill-up-to-10-weeks/">https://www.bpas.org/abortion-care/abortion-treatments/the-abortion-pill/abortion-pill-up-to-10-weeks/</a><br />
<br />
Amy's Mystery Illness - I'm a Survivor: <a href="https://www.amysmysteryillness.co.uk/2018/07/im-survivor.html">https://www.amysmysteryillness.co.uk/2018/07/im-survivor.html</a><br />
<br />
Women's Aid: <a href="https://www.womensaid.org.uk/">https://www.womensaid.org.uk/</a><br />
<br />
<br />
<br />Amziehttp://www.blogger.com/profile/01639288209900035382noreply@blogger.com0tag:blogger.com,1999:blog-4896114346747150572.post-55158809444757886592020-03-25T07:47:00.001+00:002020-03-25T07:47:57.231+00:00Trauma Focused CBT: Session Ten<b>(TRIGGER WARNING: Covid-19, Mentions of abortion, trauma, domestic abuse, physical, psychological, and sexual abuse)</b><br />
<br />
In the week leading up to this therapy appointment, a lot had happened in the news. Coronavirus became a pandemic, hundreds of people dying from the virus, places (like cafes, bars, cinemas etc) closing, people urged to stay at home unless needing supplies from the supermarket, and <a href="https://en.wikipedia.org/wiki/Lockdown" target="_blank">lockdown</a> was looking very likely. It's a very worrying time for everyone, even without an anxiety disorder on top.<br />
<br />
Amongst other things, I have Generalised Anxiety Disorder, Obsessive Compulsive Disorder, and Post Traumatic Stress Disorder. I have found these have all flared up in different ways. I worry about everything more, I'm doing my checking rituals more often, and I have these thoughts that I am unsafe and something really dangerous is about to happen to myself or my loved ones. As well as this, my <a href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd/symptoms-of-ptsd/#WhatAreFlashbacks" target="_blank">flashbacks</a> have increased.<br />
<br />
I am coming to the end of Trauma Focused CBT for my traumatic abortion specifically. My therapist and I have come to realise that my abusive relationship with an ex brought up traumatic symptoms for me too, but this lot of therapy is nearly over so I'd have to re-refer myself or find some other therapy or counselling to help.<br />
<br />
As for the traumatic abortion, I think my PTSD symptoms have lessened slightly (overall, I mean) but the physical pain etc from it still crops up as vivid flashbacks. I may need the odd couple of sessions to give me tools to work on my feelings about this, but I think I am coping well enough to deal with this trauma generally, and use the skills I have been taught for this.<br />
<br />
My therapist and I did talk about the abusive relationship, and how memories of that affect me now. It was a long conversation with lots of questions about how my ex partner treated me, how I reacted, and how I feel about it now. I spoke about a few things he had said and done, that affected me badly. I know that I'm not coping well with it, I do get intrusive thoughts, flashbacks, bad dreams etc and I find it very hard to trust men who are interested in me.<br />
<br />
This relationship started just as I'd had my abortion, and I believe I was looking for a fresh start, as well as someone to look after me and support me. (You can read more about my abusive relationship <a href="https://www.amysmysteryillness.co.uk/2018/07/im-survivor.html" target="_blank">here</a>, but I will mention a few things that he said and did.)<br />
<br />
My ex partner was very nice and gentlemanly at first. He bought me flowers, took me to nice restaurants, said lovely things and didn't push me to do too much. This soon changed though. I thought he understood that my abortion had been very distressing for me and this is why I was so depressed and quiet. In later arguments, he would bring this up and tell me that I (and others) should've focused on how he was feeling and paid attention to him more.<br />
<br />
I found that everything was ok, as long as I agreed with him and everything was on his terms. As soon as I didn't, or they weren't, he would be cold, callous, and cruel. He would push and push me to do things I didn't want to do. On one occasion in particular, he tricked/forced me into doing something sexual that I wasn't comfortable with. Straight after, he acted as if nothing was wrong. I was left feeling confused, violated, and as if I was overreacting.<br />
<br />
He would use the old cliche "you'd do this if you really loved me".<br />
<br />
As well as this, he was psychologically controlling, he <a href="https://www.psychologytoday.com/gb/blog/here-there-and-everywhere/201701/11-warning-signs-gaslighting" target="_blank">gaslit</a> me, and tried to keep me away from my friends. It was as if he wanted to control any situation we were in. It took me a while to realise that he was so toxic. I tried to break up with him at one point, and he wrote me a long letter to supposedly apologise and promise to change. I foolishly took him back and things had unfortunately not changed.<br />
<br />
When we did finally break up, we would still argue, and at one point he followed me back to my student house to "talk". I didn't want to, but he wouldn't take no for an answer (a running theme in our relationship...). I tried to walk away from him, but he grabbed me hard. At this point, I was scared that he would hit me. I couldn't get away because his grip was too strong. It was only when my housemate walked by and saw, that he let me go and ran off. I was understandably really distressed and it took a while for me to calm down. <br />
<br />
I told my therapist about this (amongst other things that had occurred in our relationship) and she confirmed that my ex was very abusive and toxic. She also believed that although he made me feel vulnerable, I was actually very strong for arguing back despite my fears about the consequences.<br />
<br />
She told me that although these sessions of CBT were for the abortion specifically, after a break I could get re-referred so we could focus on this abusive relationship. She did recommend I contacted <a href="https://www.womensaid.org.uk/" target="_blank">Women's Aid</a> though, as they are apparently very good at providing support to do with domestic abuse. I could even get some counselling from them.<br />
<br />
After this telephone therapy session, I felt very uncomfortable, unsafe, and as if I was being violated all over again. The psychological control was personally very hard to cope with, but I seem to be most affected by the sexual abuse I experienced. I feel so uncomfortable in my own skin, as if I want to scrub it all away?<br />
<br />
I have decided that once these therapy sessions are finished, I will take a month or two's break, then I will contact Women's Aid to see what they could offer. I guess any counselling will be done over the phone for now (because of Covid-19 restrictions).<br />
<br />
In the meantime, I aim to use my time to distract myself with games, movies, cross stitch even. I also want to be very kind to myself and as supportive as I can be towards my friends and family.<br />
<br />
<b>Resources</b><br />
<b><br /></b>
<b>Lockdown: </b><a href="https://en.wikipedia.org/wiki/Lockdown">https://en.wikipedia.org/wiki/Lockdown</a><br />
<b><br /></b>
<b>Symptoms of PTSD- What are flashbacks?: </b><a href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd/symptoms-of-ptsd/#WhatAreFlashbacks">https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd/symptoms-of-ptsd/#WhatAreFlashbacks</a><br />
<br />
<b>Amys Mystery Illness- I'm a Survivor: </b><a href="https://www.amysmysteryillness.co.uk/2018/07/im-survivor.html">https://www.amysmysteryillness.co.uk/2018/07/im-survivor.html</a><br />
<br />
<b>11 Warning Signs of Gaslighting: </b><a href="https://www.psychologytoday.com/gb/blog/here-there-and-everywhere/201701/11-warning-signs-gaslighting">https://www.psychologytoday.com/gb/blog/here-there-and-everywhere/201701/11-warning-signs-gaslighting</a><br />
<br />
<b>Women's Aid: </b><a href="https://www.womensaid.org.uk/">https://www.womensaid.org.uk/</a><br />
<br />
<br />
<br />
<br />Amziehttp://www.blogger.com/profile/01639288209900035382noreply@blogger.com0tag:blogger.com,1999:blog-4896114346747150572.post-33363639112393245322020-03-18T11:12:00.003+00:002020-03-18T11:12:42.257+00:00Trauma Focused CBT: Session Nine<b>(TRIGGER WARNING: Abortion details, domestic abuse, sexual abuse, psychological abuse, mental health stigma)</b><br />
<b><br /></b>
<b>"Double Trauma"</b><br />
<b><br /></b>
I'd been in quite a good mood; leading up to this latest session. At baseline, my moods have been stable and rarely very low. I'd even had some days where I could say I felt happy, or at least calm. I'd not reacted so severely to things that usually upset or anger me either. Generally, I think I'd been coping well.<br />
<br />
I've been feeling that I'm coping with people's attitudes to abortion because I finally believe I made the right decision at the time. The thing I've been struggling most with is the physical side of things. The blood, tissue etc, distressed me because they were so graphic and result in such vivid flashbacks.<br />
<br />
At this latest session, I explained all of this, and my therapist was pleased. She left it up to me to talk about what I wanted to, and the abortion appointments cropped up in conversation. She asked me some in depth questions, in order to gently expose me to my most feared memories. I coped, but I did get very worked up and shaky as I explained everything.<br />
<br />
When asking about support from friends etc, my abusive ex partner came up in conversation. He appeared to be supportive and gentlemanly at first, but only when I was doing what he wanted/agreeing with him.<br />
<br />
When things didn't go his way, he would be very cold and controlling. He made everything about him, rather than considering my feelings. He made digs in conversations and arguments. He also forced and tricked me into doing things he wanted sexually. I found that he expected me to do what he wanted because he was the virgin and I was experienced; so it was (in his eyes) my "duty" to teach him and let him experience new things with me.<br />
<br />
I described a time he tricked me into doing something I didn't want to do, then carried on as if nothing had happened. I felt violated and confused. Did I let him? Was it my fault or his? Was this normal or abusive?<br />
<br />
I got quite distressed when describing this relationship, and my therapist said it seems like being in the abusive relationship straight after the abortion made this a double trauma for me.<br />
<br />
I thought about it a bit, then agreed. I thought I'd moved on from it, but it still affects me now and I'd buried it for a while.<br />
<br />
Overall, I've been coping with my trauma from the abortion, but I have not really dealt with the trauma from the abusive relationship. I did feel I had to hide it from people for a while, in case I wasn't believed. My ex partner made sure lots of people thought I was "crazy" when we broke up. He called me many different names and turned people against me. Even when we broke up, he wanted to control some of my life.<br />
<br />
The friends that stayed by my side were invaluable though. They defended me, and made sure I was ok. I thought I was at the time, but years on I realise how it has affected my trust in men especially. I feel scared to disagree or say I'm not comfortable doing certain things. Hopefully, in time, I will be able to be more assertive and be part of a more equal partnership.<br />
<br />
Thankfully he's also halfway across the world from me now. I just wish I could move on from this, but I know it will take time.<br />
<br />
I was hoping to finish my Trauma Focused CBT sessions very soon, but I think I will need a few more with a focus on this.Amziehttp://www.blogger.com/profile/01639288209900035382noreply@blogger.com0tag:blogger.com,1999:blog-4896114346747150572.post-24229392526528076042020-03-06T13:16:00.000+00:002020-03-06T13:16:07.928+00:00I Decided to take a Social Media BreakAs of last Monday, I decided to take a Social Media break.<br />
<br />
I'd been scrolling on Facebook and Twitter particularly, and had noticed symptoms of my mental illnesses flaring up, as well as a general sheer drop in mood. The kinds of anxieties I had were about friends. I'd found that not many people were replying to me and some were replying in a more blunt way than usual. Naturally, I thought that they were finally getting fed up of me, and as much as I tried to believe that maybe they were having a bad day/week etc themselves, I couldn't help but place the blame on myself and criticise myself for "pushing them away".<br />
<br />
The more I ruminated over this, the worse I felt. That, coupled with my worries over getting more ill and having no help from the Community Mental Health team, meant that I was heading towards crisis point. I broke down in my last CBT session and stayed that way for days afterwards. Eventually I decided I had the choice of either returning to a very dark scary place in my mind, where I actually am pushing everyone away and making dangerous decisions, or I could make a vow to change my mindset.<br />
<br />
Of course, this is easier said than done, but I was at a point where I could "catch" myself before I went over the edge, At this point, choosing was difficult, but possible.<br />
<br />
I decided that because the Community Mental Health Team wouldn't save me, I had to try and save myself. I started with a social media break. I needed to stop scrolling through my timelines; letting everything get to me and being bombarded with bad news and more people to "cancel".<br />
<br />
I have taken social media breaks before, but usually this was with the ulterior motive of seeing if anyone noticed and would message me. I often feel like people would barely remember me if I was gone. I also worry no one sees me as close a friend as I see them.<br />
<br />
The main reasons for this break were to have time in the "real world", take time for myself to reassess how I feel about friendship, reassurance, and myself. I need to become more self compassionate and self reliant especially.<br />
<br />
Although I wasn't necessarily expecting messages, I did get some from a couple of friends. I've missed talking to people (barely anyone texts me these days), so getting some messages has helped.<br />
<br />
I've also recently been reading a book called "The Compassionate Mind" by Paul Gilbert. I've been finding it very useful. I can relate to a lot of things in the book (my mindset, things I worry about, things I do etc) and it has a lot of exercises I can do. These exercises aim to conjure up self compassion and compassion for others. It involves a lot of meditative mindfulness tasks too.<br />
<br />
Since reading this book, and completing some of the exercises, I have found I've had times where I feel peaceful. I still have a long way to go, but I am doing better than I was. I think I've managed to pull myself further away from a crisis; which is such a relief.<br />
<br />
In case I do get to crisis point again, a friend helped me to plan what I could do. This would involve letting my parents know so they could get in touch with the GP who I find is most helpful for my mental health. He would possibly see me for an urgent appointment, and I would get advice and/or emergency medication (depending on what he felt was appropriate). Alongside this, I could also talk to trusted friends and ring my local mental health helpline. They may be able to advise me as to what to do, or help me calm down and think more clearly. The problem with being at crisis point is that you often don't feel in control of your thoughts, feelings, or actions. It can be a very risky time and it is important to have a plan that is easy to follow.<br />
<br />
For now, thankfully, I'm not at that point though. I also don't feel as worried about friends who don't contact me much/at all. I know that the true friends will stick by my side and it is important to concentrate on them, as well as being reliant on myself.<br />
<br />
I will continue to read the compassion book and complete the exercises every day. I seem to be using it as a guide, and maybe that is what I need right now. My next CBT session is on Monday, and I'm hoping I can give some positive news to my therapist then. I do not feel I made much progress in the last session, but I think I needed to get to that point in order for something to change within me.<br />
<br />
So right now, I can't say I'm exactly happy, but I'm OK and I think I'm making slow but steady progress. My next blog post will be about my next Trauma Focused CBT session.Amziehttp://www.blogger.com/profile/01639288209900035382noreply@blogger.com2tag:blogger.com,1999:blog-4896114346747150572.post-13568322180062235072020-02-26T11:22:00.004+00:002020-02-26T11:22:51.025+00:00Trauma Focused CBT: Session Eight(TRIGGER WARNING: Mentions of abortion, self harm, and details of attempted suicide)<br />
<br />
I felt very on edge, leading up to this latest appointment. I think it was for various reasons. Firstly, I was waiting on results of some scans and a possible follow up appointment with my Rheumatologist. Secondly, it'd been a while since my previous session, and I felt I hadn't done enough homework in that time. Thirdly, I'd been very down recently and felt I'd lost some of the progress I'd made with my PTSD. There were probably other reasons too, but the above states the main ones.<br />
<br />
As expected, I scored highly on the Anxiety, Depression etc questionnaires. My moods had affected my behaviours and functioning, and they weren't helping my ability to keep myself occupied and maintain relationships either. I felt disappointed in myself and as if I'd failed my therapist. She asked me how things had been recently and if anything had happened in particular.<br />
<br />
I explained that I had been very low and anxious recently, about various things including friendship. I felt very alone and distant from people I loved. I'd been very quiet recently and have felt that even when I have interacted with friends etc, I'd been saying all the wrong things.<br />
<br />
My therapist wanted me to see how my moods were linked to the trauma from the abortion. I told her how I'd spoken to a friend who'd helped me through the abortion, and one who had an abortion herself a while back.<br />
<br />
The main topic, surrounding my abortion, that I spoke about with the first friend. were the attitudes experienced from the nurses involved in my care, as well as the man who would've been the father of my child, and the new boyfriend I had at the time. I felt I'd had very little support from them, and judgement more than anything. The nurses judged my resulting in becoming pregnant, and my decision to have the abortion. The father-to-be also judged my decision to have the abortion, and treated it as a tragic loss (even lighting a candle to "mourn" when we were speaking via video call online). The new boyfriend judged my sexual history as well as my becoming pregnant, although he was all for me having an abortion (I don't think he wanted children).<br />
<br />
When we spoke about the father-to-be, we discussed what might've happened had I carried on the pregnancy. My friend believed that he probably wouldn't have stuck by me, especially going by our on/off relationship. He seemed to find any excuse to dump me to be honest. The more I think about him, and our relationship, the more I realise that maybe he wasn't the right man for me after all. I think part of me never really got over him, and even saw the pregnancy as a bond between us (even after it was over). I feel I have moved on from him, if not the trauma however.<br />
<br />
The friend I spoke to, who had experienced an abortion too, had similar judgement from the nurses involved in her care. In time, and with a lot of therapy, she had managed to move on as much as possible, and did not find memories of this traumatic anymore. I found it eye opening that the nurses had been just as unprofessional towards her, and I felt angry and upset for her. To know that she could move past this gave me hope though. Maybe I could do this too, in time?<br />
<br />
We spoke about how I hadn't gone into much detail about the abortion, and that I find it hard to face. I'm still avoiding a fair amount of things, including carrying on conversations about abortions, reading views on them etc. I explained that I was scared of being badly triggered and becoming very unwell again as I felt I wouldn't be able to get any help.<br />
<br />
I then talked about how my thoughts still go to self harm/suicide when I find myself in a situation I cannot/easily get out of. She asked if I remembered a time in the past when that happened. We spoke about a time I was threatened with sanction on the Work Programme (Part of Work Related Activity for Employment and Support Allowance), for a situation I could not help. Basically, at that time I was too anxious to travel places on my own. My dad worked shifts at that time, and his shift patterns changed so that he would not be able to take me to appointments with the Work Programme. No one else I trusted could take me, so I suggested having telephone appointments, but was refused. Being in this catch-22 situation, worrying about loss of income, I became so suicidal I nearly ran into traffic.<br />
<br />
I got very upset in this therapy session, as I explained how scared I am of going back to that point.<br />
<br />
She asked what would happen if I got to that point. I explained about my experiences with CMHT assessing then discharging me because I'd already had help from them in the past, and they felt there was nothing more they could do. I also told her what the A&E Psych Liaison team had said (They described me as a square peg, and the CMHT as a round hole. This implied that I was simply too different to be helped by them) and that I felt the door was permanently shut to me even though I couldn't understand why I should be any different to anyone else when I need that sort of help.<br />
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The session came to an end soon after this, once I had calmed down. My therapist gave me homework to be kinder to myself, read bits of the self compassion book she had recommended (I can't remember the exact name, but it is by Paul Gilbert) and try to talk to friends more directly.<br />
<br />
I still feel affected by this session, but having a good cry and venting my fears has helped. I know that I need to make a change, for the sake of myself and my loved ones. I need to be much kinder to myself; practising self acceptance and forgiveness.Amziehttp://www.blogger.com/profile/01639288209900035382noreply@blogger.com0tag:blogger.com,1999:blog-4896114346747150572.post-25571826524268767982020-02-06T12:18:00.003+00:002020-02-06T12:18:48.005+00:00Trauma Focused CBT: Session Seven<b>(Trigger Warning: Mentions of Abortion, Stillbirth, and Miscarriage)</b><br />
<b><br /></b>
I felt quite down leading up to, and during session seven. My homework was to pick some of the feared situations from the list I'd made in my <a href="https://www.amysmysteryillness.co.uk/2020/01/trauma-focused-cbt-session-six.html" target="_blank">last session</a> . I decided I would try to look at some pregnancy scans on Facebook, as well as watch some story lines on television, of stillbirth and miscarriage. I was also to carry on using the term "Abortion" rather than "Termination". As well as this, I was to keep on journalling and noting down how putting myself in these situations made me feel and how I coped with that.<br />
<br />
I find using the term "abortion" isn't so fearful now. My feelings about the term are more the way someone would react when a word makes them cringe (e.g. "moist"). For the record, this does not mean I am against abortion, it's just that the traumatic one I had makes certain things affect me in different ways. So saying the word brings me back to that time, but not so intensely that I panic and get particularly triggered.<br />
<br />
I can also cope better with seeing pregnancy scans. Before I exposed myself therapeutically to this, I found being faced with any pregnancy scan triggered me and would bring back flashbacks of being told I'm pregnant and feeling scared about what was to come next. I can separate other people's scans from my own now, and am not brought back to that time so uncontrollably.<br />
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Watching story lines about any kind of baby/fetal loss is still very difficult though. I'm forcing myself to stop avoiding these story lines, or zoning out (although I do still find myself dissociating sometimes). Stillbirth isn't as triggering, although it upsets me as much as it would upset anyone, if not slightly more. The physical side of miscarriage and the attitudes towards abortion that you see on medical dramas for example can be very triggering however. It can trigger flashbacks of the most graphic parts of my traumatic abortion; including the sickness and pain. The attitudes also remind me of the judgmental attitudes of some of the nurses I saw at that time. I was made to feel like an irresponsible teenager. I was also made to feel guilty by the potential father (he lit a candle to "mourn our loss") and made to feel like a burden by my partner at the time, in subsequent arguments around this subject.<br />
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I explained all of this at my latest session, and my therapist helped me to understand that although I had made the decision to have the abortion, the attitudes of those around me and the physical pain etc was not my fault. I had made the right decision for me at the time, even if I thought I may have coped if I'd kept the baby. It still would've affected a lot of my life.<br />
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My next piece of homework was to go through more feared situations. This time, I decided to try and talk to the best friend who supported me throughout, about my abortion. I also decided, if appropriate and carefully planned, to talk to a friend of mine who has also had an abortion. This would hopefully help open me up to other perspectives, their views on what I/they went through, and importantly, to feel less alone and more connected with people who have been through similar.<br />
<br />
So far I have managed a short talk with the best friend; where we mainly spoke about the attitudes of people around me at the time. I found this very helpful, validating, and eye-opening. I won't go into much detail but we discussed the potential father and how flaky he could be when it came to supporting me. I hadn't fully realised this at the time, but I know now that it was true. I was so in love with him, but I'm glad to have moved on. I don't know what the future will bring, but I do hope I find the right partner for me, who would like to have children too. I also hope it is not too late to have children by the time I am ready.<br />
<br />
<br />
<b>Resources</b><br />
<b><br /></b>
Amys Mystery Illness - Trauma Focused CBT: Session Six: <a href="https://www.amysmysteryillness.co.uk/2020/01/trauma-focused-cbt-session-six.html">https://www.amysmysteryillness.co.uk/2020/01/trauma-focused-cbt-session-six.html</a>Amziehttp://www.blogger.com/profile/01639288209900035382noreply@blogger.com2tag:blogger.com,1999:blog-4896114346747150572.post-41434294240335355082020-01-15T12:12:00.002+00:002020-01-15T12:12:47.805+00:00Trauma Focused CBT: Session Six<b>(Trigger Warning: Mentions of Abortion, Miscarriage, and Stillbirth)</b><br />
<b><br /></b>
I went into session six feeling quite positive, after seeing a friend the day before. I'm finding making plans with friends gives me something to look forward to, and distracts me from things. I'm trying to talk about abortion more with close friends too (and actually use the term "abortion" rather than "termination", in order to face my fear of using that term).<br />
<br />
My last piece of homework for CBT was to list my 10 most to least feared situations related to my trauma. For me, these include saying the word "abortion" out loud, looking at a pregnancy scan, conversations/television storylines about other people's abortions, miscarriages, or stillbirths, conversations about my traumatic abortion (especially details), and hearing an anti-choice person's opinion of abortion. The latter one is my most feared as it challenges a very personal decision and puts the blame of my trauma on me.<br />
<br />
I have recently managed to say "abortion" out loud and pregnancy scans don't make me feel as down now. I can't totally explain why certain things <a href="https://www.verywellmind.com/what-does-it-mean-to-be-triggered-4175432" target="_blank">trigger</a> me, but some make more sense than others I suppose.<br />
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I decided to focus more on the positive side of things in this latest session, as I wanted to remind myself what I'd actually achieved and I wanted to see for myself if I had progressed. I'm definitely taking baby steps, but there is a definite improvement in how I react to certain things. My therapist was so pleased to hear this, which made me worry that she would make this the last session (I'm so used to mental health professionals cutting off support at the slightest hint of progress) but thankfully she does want to see me again and hasn't even mentioned bringing these sessions to an end.<br />
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My homework for the next session is to go through 2 or 3 of the "feared situations" and try to face them. We discussed which ones I could manage, and which I would struggle too much with. We decided that I would watch a storyline about baby loss or abortion, look at a pregnancy scan, and try to talk more about my abortion. So far I've managed to do these without too much panic. I'm finding it so helpful to have learnt skills to help cope with the feelings I have when exposed to these situations. If I'm properly triggered by something, it's very hard to use the <a href="https://www.amysmysteryillness.co.uk/2019/12/trauma-focused-cbt-sessions-3-5.html" target="_blank">skills</a> (Safe Place, Breathing Exercises, Grounding etc) but if I can "nip it in the bud" so to say, then I can avoid or minimise the triggered feelings.<br />
<br />
So overall I'm finding I am very slowly progressing, but I do still need at least a few more sessions of therapy. I'm being realistic too. My therapist and I agree that I'll never be totally desensitised to talk of/memories of my abortion, but I will be able to get to a point where I can still function with these things on my mind. Maybe I can even lessen/stop the <a href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd/symptoms-of-ptsd/#b" target="_blank">flashbacks</a> I get.<br />
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My next session is on Monday, and I will try not to leave it so long before I blog about it.<br />
<br />
<b>Resources:</b><br />
<b><br /></b>
<b>What Does It Mean to be Triggered?</b> <a href="https://www.verywellmind.com/what-does-it-mean-to-be-triggered-4175432">https://www.verywellmind.com/what-does-it-mean-to-be-triggered-4175432</a><br />
<b><br /></b>
<b>Amy's Mystery Illness- Trauma Focused CBT: Sessions 3-5</b> <a href="https://www.amysmysteryillness.co.uk/2019/12/trauma-focused-cbt-sessions-3-5.html">https://www.amysmysteryillness.co.uk/2019/12/trauma-focused-cbt-sessions-3-5.html</a><br />
<br />
<b>Symptoms of PTSD</b> <a href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd/symptoms-of-ptsd/#b">https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd/symptoms-of-ptsd/#b</a><br />
<br />
<br />Amziehttp://www.blogger.com/profile/01639288209900035382noreply@blogger.com0tag:blogger.com,1999:blog-4896114346747150572.post-90399913051792023342019-12-30T12:17:00.000+00:002019-12-30T12:17:34.294+00:00Trauma Focused CBT: Sessions 3-5<b>(Trigger Warning: Multiple mentions of Abortion)</b><br />
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I'm sorry for my lack of posts recently. A lot has happened generally; including in my personal life. I've been feeling very down and anxious, as well as angry, upset, and irritable. It's made concentrating on blogging pretty much impossible. I think I'm starting to come round now, and at least try to keep up to date with my blogging.<br />
<br />
I have had about 5 sessions of Trauma Focused CBT now, and although I don't feel like there's been much/any progress yet, I do feel positive that this is the right type of therapy for me and I will find things easier to cope with in time. I'm not sure how many sessions of this type of CBT I'm allowed, but I'm hoping there are at least a few more!<br />
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The sessions have been difficult, but productive. I have had times where I could talk in detail about the abortion, and times where I want to talk about anything but. For the times I am getting triggered/overwhelmed however, there are tools I have obtained to deal with it. I will explain some below:<br />
<br />
<b>Grounding:</b> This is very useful for when I dissociate. A type of grounding I use, involves the 5 senses. When I find myself dissociating, I have to try and find/describe something I can see, smell, hear, touch, or taste. This reminds me that I am physically here right now, in the present time. When dissociating, I can often feel like I am not real, my body is not in the physical world, I'm not in the present time even. Grounding helps me to remind and reassure myself that this is not true. I am here, the past is in the past, the trauma I have been through is not happening now etc. I won't lie, it's not easy and it does take time, but most of the time this technique works.<br />
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<b>Safe Place: </b>This visualisation technique is used for when I am overwhelmed and panicky after talking about my trauma. A safe place is somewhere in my mind that can be anywhere; fictional or real. Personally, I like to visualise a sandy secluded beach in a warm climate. I can visualise this on my own, or my therapist can guide me to focus on certain things about it (e.g. the sight of the waves, the smell of the sea, the feel of sand between my toes etc). Performing a gesture such as clenching an object or my fist can help bring me to this place too. I clench my fist and imagine I am grasping a handful of warm, soft sand. Like <b>grounding, </b>this is difficult and takes time to focus on, but it can give me a short break from thinking about my trauma. This also slows down my breathing, heartbeat, racing thoughts etc.<br />
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<b>Mindfulness: </b>I find having a guided meditation video/audio recording, or having my therapist guide me, helps with this. I can use this when I'm feeling overwhelmed and panicky, or even when dissociating. It brings me back to the present time and helps me to focus my attention on things happening, stimulating my senses etc in the here and now. During mindfulness meditation I may be asked to focus on how my chair feels against my legs or back. I may also be asked to focus and describe the sounds in the room. If I have any thoughts about the traumatic abortion, instead of fighting them, I need to accept they are there, but try to shift my focus back to the present and remind myself that the trauma is not happening anymore.<br />
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I have been working through my PTSD booklet as well, and have got up to the part where I list feared situations, from most feared to least feared. For me, feared situations involve conversations about my abortion, someone else's abortion, using the word itself, stories about baby loss, and pregnancy scans. I may go into this in detail in the next CBT based blog post. The point of this task is to slowly expose myself to each of these situations. As you can see in this post, I am trying my best to use the word "abortion" instead of "termination", because this is the scary word for me. To me, it sounds more harsh, although I couldn't really explain why. It's not healthy to avoid using a word however (unless the word is a slur of course!) so I need to train myself to feel less scared about this.<br />
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My next session is coming up in about a week's time, and we will be focusing on the specific fears I have. This will be a difficult session, so I may need a few days to process things before I blog. In the meantime, I hope everyone's Christmas went well and the New Year brings good things.Amziehttp://www.blogger.com/profile/01639288209900035382noreply@blogger.com0tag:blogger.com,1999:blog-4896114346747150572.post-49093733640133149232019-11-10T11:32:00.000+00:002019-11-10T11:32:02.068+00:00Trauma Focused CBT: Session Two<b>(TRIGGER WARNING: Descriptions of termination and discussion related to it)</b><br />
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My homework from <a href="https://www.amysmysteryillness.co.uk/2019/10/trauma-focused-cbt-session-one.html" target="_blank">session one</a> 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.<br />
<br />
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.<br />
<br />
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.<br />
<br />
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.<br />
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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.<br />
<br />
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.<br />
<br />
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.<br />
<br />
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.<br />
<br />
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).<br />
<br />
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:<br />
<br />
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.<br />
<br />
I am starting to think of that safe place, which I will describe in my next blog post.Amziehttp://www.blogger.com/profile/01639288209900035382noreply@blogger.com0tag:blogger.com,1999:blog-4896114346747150572.post-23964171819814188842019-10-19T11:33:00.000+01:002019-10-19T11:33:09.928+01:00Trauma Focused CBT: Session One<b>(Trigger Warning: PTSD, abortion, self harm, and suicide mentions)</b><br />
<br />
Last Thursday, I had my first session of <a href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd/treatments-for-ptsd/#.Xarjl-hKiM8" target="_blank">Trauma Focused CBT</a>. 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.<br />
<br />
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.<br />
<br />
At the start of the session, I was asked to fill in the usual <a href="https://patient.info/doctor/patient-health-questionnaire-phq-9" target="_blank">PHQ</a> 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.<br />
<br />
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.<br />
<br />
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.<br />
<br />
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).<br />
<br />
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 <a href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/dissociation-and-dissociative-disorders/#.XarkROhKiM8" target="_blank">dissociate</a>.<br />
<br />
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 <a href="https://www.livingwell.org.au/well-being/mental-health/grounding-exercises/" target="_blank">ground</a> 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.<br />
<br />
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.<br />
<br />
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 "<a href="https://www.healthyplace.com/blogs/traumaptsdblog/2015/11/finding-a-safe-place-is-important-for-ptsd-recovery" target="_blank">safe place</a>" 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.<br />
<br />
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.<br />
<br />
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.<br />
<br />
Finally, we did a <a href="https://www.dynamicyou.org/mental-health-questionnaires/online-post-traumatic-stress-disorder-ptsd-questionnaire/" target="_blank">screening questionnaire</a>. 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!<br />
<br />
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.<br />
<br />
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.<br />
<br />
<b>Resources</b><br />
<b><br /></b>
<b>Treatments for PTSD:</b> <a href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd/treatments-for-ptsd/#.Xarjl-hKiM8">https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd/treatments-for-ptsd/#.Xarjl-hKiM8</a><br />
<br />
<b>PHQ-9 Depression Test Questionnaire:</b> <a href="https://patient.info/doctor/patient-health-questionnaire-phq-9">https://patient.info/doctor/patient-health-questionnaire-phq-9</a><br />
<br />
<b>Dissociation and dissociative disorders:</b> <a href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/dissociation-and-dissociative-disorders/#.XarkROhKiM8">https://www.mind.org.uk/information-support/types-of-mental-health-problems/dissociation-and-dissociative-disorders/#.XarkROhKiM8</a><br />
<br />
<b>Grounding exercises:</b> <a href="https://www.livingwell.org.au/well-being/mental-health/grounding-exercises/">https://www.livingwell.org.au/well-being/mental-health/grounding-exercises/</a><br />
<br />
<b>Finding a Safe Place is Important for PTSD Recovery:</b> <a href="https://www.healthyplace.com/blogs/traumaptsdblog/2015/11/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</a><br />
<br />
<b>Online PTSD questionnaire:</b> <a href="https://www.dynamicyou.org/mental-health-questionnaires/online-post-traumatic-stress-disorder-ptsd-questionnaire/">https://www.dynamicyou.org/mental-health-questionnaires/online-post-traumatic-stress-disorder-ptsd-questionnaire/</a>Amziehttp://www.blogger.com/profile/01639288209900035382noreply@blogger.com0tag:blogger.com,1999:blog-4896114346747150572.post-59933400025954910512019-10-08T18:04:00.000+01:002019-10-08T18:05:44.606+01:00Let's make sure "Every Mind Matters", by funding our Mental Health Services!<span class="css-901oao css-16my406 r-1qd0xha r-ad9z0x r-bcqeeo r-qvutc0" style="background-color: #f5f8fa; border: 0px solid black; box-sizing: border-box; color: #14171a; display: inline; font-stretch: inherit; line-height: 1.3125; margin: 0px; min-width: 0px; overflow-wrap: break-word; padding: 0px; white-space: pre-wrap;"><span style="font-family: inherit;">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?</span></span><br />
<span style="font-family: inherit;"><span class="css-901oao css-16my406 r-1qd0xha r-ad9z0x r-bcqeeo r-qvutc0" style="background-color: #f5f8fa; border: 0px solid black; box-sizing: border-box; color: #14171a; display: inline; font-stretch: inherit; line-height: 1.3125; margin: 0px; min-width: 0px; overflow-wrap: break-word; padding: 0px; white-space: pre-wrap;"><span style="font-family: inherit;"><br /></span></span>
<span style="color: #14171a; font-family: inherit;"><span style="background-color: #f5f8fa; white-space: pre-wrap;">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. </span></span></span><br />
<span style="font-family: inherit;"><span style="color: #14171a; font-family: inherit;"><span style="background-color: #f5f8fa; white-space: pre-wrap;"><br /></span></span>
<span style="color: #14171a; font-family: inherit;"><span style="background-color: #f5f8fa; white-space: pre-wrap;">I took part in the "Every Mind Matters" Mind Plan quiz today (you can take it yourself <a href="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" target="_blank">here</a> ) and was given these 5 pieces of advice:</span></span></span><br />
<br />
<ol>
<li><span style="color: #14171a; font-family: inherit;"><span style="background-color: #f5f8fa; font-family: inherit; white-space: pre-wrap;"><b>Relax your muscles and mind - </b>I was given a video to watch, in order to help me with this.</span></span></li>
</ol>
<ol>
<li><span style="color: #14171a; font-family: inherit;"><span style="background-color: #f5f8fa; font-family: inherit; white-space: pre-wrap;"><b>Move more every day - </b>"Why not try getting off the bus or train a stop earlier, or taking the stairs more often?"</span></span></li>
</ol>
<ol>
<li><span style="color: #14171a; font-family: inherit;"><span style="background-color: #f5f8fa; font-family: inherit; white-space: pre-wrap;"><b>Make time to do something you enjoy - </b>It suggested going to the cinema, or listening to music.</span></span></li>
</ol>
<ol>
<li><span style="color: #14171a; font-family: inherit;"><span style="background-color: #f5f8fa; font-family: inherit; white-space: pre-wrap;"><b>Make time to chat - </b>The emphasis was on chatting over the phone or in person</span></span></li>
</ol>
<ol>
<li><span style="color: #14171a; font-family: inherit;"><span style="background-color: #f5f8fa; font-family: inherit; white-space: pre-wrap;"><b>Take time to reflect - </b>This piece of advice wanted me to focus on the good things about my day. </span></span></li>
</ol>
<br />
<span style="color: #14171a; font-family: inherit;"><span style="background-color: #f5f8fa; font-family: inherit; white-space: pre-wrap;">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.</span></span><br />
<span style="font-family: inherit;"><span style="font-family: inherit;"><br /></span>
<span class="css-901oao css-16my406 r-1qd0xha r-ad9z0x r-bcqeeo r-qvutc0" style="background-color: #f5f8fa; border: 0px solid black; box-sizing: border-box; color: #14171a; display: inline; font-stretch: inherit; line-height: 1.3125; margin: 0px; min-width: 0px; overflow-wrap: break-word; padding: 0px; white-space: pre-wrap;"><span style="font-family: inherit;">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. </span></span></span><br />
<span style="font-family: inherit;"><span class="css-901oao css-16my406 r-1qd0xha r-ad9z0x r-bcqeeo r-qvutc0" style="background-color: #f5f8fa; border: 0px solid black; box-sizing: border-box; color: #14171a; display: inline; font-stretch: inherit; line-height: 1.3125; margin: 0px; min-width: 0px; overflow-wrap: break-word; padding: 0px; white-space: pre-wrap;"><span style="font-family: inherit;"><br /></span></span>
<span class="css-901oao css-16my406 r-1qd0xha r-ad9z0x r-bcqeeo r-qvutc0" style="background-color: #f5f8fa; border: 0px solid black; box-sizing: border-box; color: #14171a; display: inline; font-stretch: inherit; line-height: 1.3125; margin: 0px; min-width: 0px; overflow-wrap: break-word; padding: 0px; white-space: pre-wrap;"><span style="font-family: inherit;">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, w</span></span><span class="css-901oao css-16my406 r-1qd0xha r-ad9z0x r-bcqeeo r-qvutc0" style="background-color: #f5f8fa; border: 0px solid black; box-sizing: border-box; color: #14171a; display: inline; font-stretch: inherit; line-height: 1.3125; margin: 0px; min-width: 0px; overflow-wrap: break-word; padding: 0px; white-space: pre-wrap;">e need more choice of </span><span class="r-18u37iz" style="background-color: #f5f8fa; color: #14171a; white-space: pre-wrap;">psychotherapy</span><span class="css-901oao css-16my406 r-1qd0xha r-ad9z0x r-bcqeeo r-qvutc0" style="background-color: #f5f8fa; border: 0px solid black; box-sizing: border-box; color: #14171a; display: inline; font-stretch: inherit; line-height: 1.3125; margin: 0px; min-width: 0px; overflow-wrap: break-word; padding: 0px; white-space: pre-wrap;">, 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)</span><span class="css-901oao css-16my406 r-1qd0xha r-ad9z0x r-bcqeeo r-qvutc0" style="background-color: #f5f8fa; border: 0px solid black; box-sizing: border-box; color: #14171a; display: inline; font-stretch: inherit; line-height: 1.3125; margin: 0px; min-width: 0px; overflow-wrap: break-word; padding: 0px; white-space: pre-wrap;"> need sorting out too. Too many people fall through the ever widening gaps because their needs are not able to be met.</span></span><br />
<span style="font-family: inherit;"><span style="font-family: inherit;"><br /></span>
<span class="css-901oao css-16my406 r-1qd0xha r-ad9z0x r-bcqeeo r-qvutc0" style="background-color: white; border: 0px solid black; box-sizing: border-box; color: #14171a; display: inline; font-stretch: inherit; line-height: 1.3125; margin: 0px; min-width: 0px; overflow-wrap: break-word; padding: 0px; white-space: pre-wrap;"><span class="css-901oao css-16my406 r-1qd0xha r-ad9z0x r-bcqeeo r-qvutc0" style="background-color: #f5f8fa; border: 0px solid black; box-sizing: border-box; display: inline; font-stretch: inherit; font-variant-east-asian: inherit; font-variant-numeric: inherit; line-height: 1.3125; margin: 0px; min-width: 0px; overflow-wrap: break-word; padding: 0px;"><span style="font-family: inherit;">Do you know how disheartening, even dangerous it can be when you finally muster up the courage to ring for help (whether that be <a href="https://www.nice.org.uk/about/what-we-do/our-programmes/nice-advice/iapt" target="_blank">IAPT</a>, <a href="https://www.rethink.org/advice-and-information/living-with-mental-illness/treatment-and-support/community-mental-health-team-cmht/" target="_blank">CMHT</a>, GP etc) and be told there's either a wait, you need to ring someone else, or even that the help isn't available? </span></span></span><span style="background-color: #f5f8fa; color: #14171a; white-space: pre-wrap;">I've become suicidal after being knocked back by mental health services. They are supposed to help you get better, not make you worse! </span><span class="css-901oao css-16my406 r-1qd0xha r-ad9z0x r-bcqeeo r-qvutc0" style="background-color: white; border: 0px solid black; box-sizing: border-box; color: #14171a; display: inline; font-stretch: inherit; line-height: 1.3125; margin: 0px; min-width: 0px; overflow-wrap: break-word; padding: 0px; white-space: pre-wrap;">M</span><span class="r-18u37iz" style="background-color: white; color: #14171a; white-space: pre-wrap;">ental Health </span><span style="background-color: white; color: #14171a; white-space: pre-wrap;">services in areas such as mine are woefully underfunded, and those with complex/serious mental health problems are given barely any therapy, if any.</span></span><br />
<span style="font-family: inherit;"><span style="background-color: #f5f8fa; color: #14171a; white-space: pre-wrap;"><br /></span>
<span class="css-901oao css-16my406 r-1qd0xha r-ad9z0x r-bcqeeo r-qvutc0" style="background-color: white; border: 0px solid black; box-sizing: border-box; color: #14171a; display: inline; font-stretch: inherit; line-height: 1.3125; margin: 0px; min-width: 0px; overflow-wrap: break-word; padding: 0px; white-space: pre-wrap;">If </span><span class="r-18u37iz" style="background-color: white; color: #14171a; white-space: pre-wrap;"><a class="css-4rbku5 css-18t94o4 css-901oao css-16my406 r-1n1174f r-1loqt21 r-1qd0xha r-ad9z0x r-bcqeeo r-qvutc0" data-focusable="true" dir="ltr" href="https://twitter.com/hashtag/everymindmatters?src=hashtag_click" role="link" style="background-color: rgba(0, 0, 0, 0); border: 0px solid black; box-sizing: border-box; color: #1b95e0; cursor: pointer; display: inline; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.3125; list-style: none; margin: 0px; min-width: 0px; overflow-wrap: break-word; padding: 0px; text-align: inherit; text-decoration-line: none; white-space: inherit;">#everymindmatters</a></span></span><img alt="" class="css-9pa8cd" draggable="false" src="https://abs.twimg.com/hashflags/Public_Health_England_Emoji/Public_Health_England_Emoji.png" style="bottom: 0px; height: 18px; left: 0px; opacity: 0; position: absolute; right: 0px; top: 0px; width: 18px; z-index: -1;" /><span style="font-family: inherit;"><span class="css-901oao css-16my406 r-1qd0xha r-ad9z0x r-bcqeeo r-qvutc0" style="background-color: white; border: 0px solid black; box-sizing: border-box; color: #14171a; display: inline; font-stretch: inherit; line-height: 1.3125; margin: 0px; min-width: 0px; overflow-wrap: break-word; padding: 0px; white-space: pre-wrap;"> then make sure our minds are looked after, by properly funding our </span><span class="r-18u37iz" style="background-color: white; color: #14171a; white-space: pre-wrap;">NHS </span><span class="css-901oao css-16my406 r-1qd0xha r-ad9z0x r-bcqeeo r-qvutc0" style="background-color: white; border: 0px solid black; box-sizing: border-box; color: #14171a; display: inline; font-stretch: inherit; line-height: 1.3125; margin: 0px; min-width: 0px; overflow-wrap: break-word; padding: 0px; white-space: pre-wrap;">mental health services! </span></span><br />
<span style="font-family: inherit;"><span class="css-901oao css-16my406 r-1qd0xha r-ad9z0x r-bcqeeo r-qvutc0" style="background-color: white; border: 0px solid black; box-sizing: border-box; color: #14171a; display: inline; font-stretch: inherit; line-height: 1.3125; margin: 0px; min-width: 0px; overflow-wrap: break-word; padding: 0px; white-space: pre-wrap;"><span class="css-901oao css-16my406 r-1qd0xha r-ad9z0x r-bcqeeo r-qvutc0" style="background-color: #f5f8fa; border: 0px solid black; box-sizing: border-box; display: inline; font-stretch: inherit; font-variant-east-asian: inherit; font-variant-numeric: inherit; line-height: 1.3125; margin: 0px; min-width: 0px; overflow-wrap: break-word; padding: 0px;"><span style="font-family: inherit;"><br /></span></span></span>
<span style="font-family: inherit;"><span class="r-18u37iz" style="background-color: white; color: #14171a; white-space: pre-wrap;"><a class="css-4rbku5 css-18t94o4 css-901oao css-16my406 r-1n1174f r-1loqt21 r-1qd0xha r-ad9z0x r-bcqeeo r-qvutc0" data-focusable="true" dir="ltr" href="https://twitter.com/hashtag/everymindmatters?src=hashtag_click" role="link" style="background-color: rgba(0, 0, 0, 0); border: 0px solid black; box-sizing: border-box; color: #1b95e0; cursor: pointer; display: inline; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: 1.3125; list-style: none; margin: 0px; min-width: 0px; overflow-wrap: break-word; padding: 0px; text-align: inherit; text-decoration-line: none; white-space: inherit;"><span class="css-901oao css-16my406 r-4qtqp9 r-ip8ujx r-9cviqr r-zw8f10 r-bnwqim r-h9hxbl" dir="auto" style="border: 0px solid black; box-sizing: border-box; color: inherit; display: inline-block; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; height: 1em; line-height: inherit; margin: 0px 0.075em 0px 2px; overflow-wrap: break-word; padding: 0px; position: relative; white-space: inherit; width: 1.2em;"></span></a></span></span></span><br />
<span class="css-901oao css-16my406 r-1qd0xha r-ad9z0x r-bcqeeo r-qvutc0" style="background-color: white; border: 0px solid black; box-sizing: border-box; color: #14171a; display: inline; font-stretch: inherit; line-height: 1.3125; margin: 0px; min-width: 0px; overflow-wrap: break-word; padding: 0px; white-space: pre-wrap;"><span style="font-family: inherit;"><b>Resources</b></span></span><br />
<span style="font-family: inherit;"><span class="css-901oao css-16my406 r-1qd0xha r-ad9z0x r-bcqeeo r-qvutc0" style="background-color: white; border: 0px solid black; box-sizing: border-box; color: #14171a; display: inline; font-stretch: inherit; line-height: 1.3125; margin: 0px; min-width: 0px; overflow-wrap: break-word; padding: 0px; white-space: pre-wrap;"><span style="font-family: inherit;"><b><br /></b></span></span>
Your Mind Plan - Every Mind Matters: <a href="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" style="white-space: pre-wrap;"><span style="white-space: pre-wrap;">ht</span><span style="white-space: pre-wrap;">tps://www.nhs.uk/oneyou/every-mind-matters/your-mind-plan-quiz/?WT.tsrc=Search&WT.mc_id=Brand&gclid=CjwKCAjw5_DsBRBPEiwAIEDRW4JL3hTok4A793ZCwPbRexXE7BNfGIC9cGn5PX9mK5eSI4-dp-4P8xoCKkgQAvD_BwE</span></a></span><br />
<span style="font-family: inherit;"><br /></span>
<span style="font-family: inherit;">Improving Access to Psychological Therapies: <a href="https://www.nice.org.uk/about/what-we-do/our-programmes/nice-advice/iapt">https://www.nice.org.uk/about/what-we-do/our-programmes/nice-advice/iapt</a></span><br />
<span style="font-family: inherit;"><br /></span>
<span style="font-family: inherit;">What is a Community Mental Health Team?: <a href="https://www.rethink.org/advice-and-information/living-with-mental-illness/treatment-and-support/community-mental-health-team-cmht/">https://www.rethink.org/advice-and-information/living-with-mental-illness/treatment-and-support/community-mental-health-team-cmht/</a></span><br />
<span style="font-family: inherit;"><br /></span>
<br />Amziehttp://www.blogger.com/profile/01639288209900035382noreply@blogger.com0tag:blogger.com,1999:blog-4896114346747150572.post-31691505432358121832019-09-18T23:42:00.000+01:002019-09-18T23:42:53.213+01:00Getting the ball rolling: Primary CareI finally feel like I'm just about ready to start <a href="https://www.psychologytoday.com/gb/therapy-types/trauma-focused-cognitive-behavior-therapy" target="_blank">Trauma Focused CBT</a>. 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.<br />
<br />
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 <a href="https://patient.info/doctor/patient-health-questionnaire-phq-9" target="_blank">PHQ9</a> and <a href="https://patient.info/doctor/generalised-anxiety-disorder-assessment-gad-7" target="_blank">GAD7</a> 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!<br />
<br />
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).<br /><br />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.<br /><br />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).<br />
<br />
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.<br />
<br />
<br />Amziehttp://www.blogger.com/profile/01639288209900035382noreply@blogger.com0tag:blogger.com,1999:blog-4896114346747150572.post-2096481473775330382019-09-13T23:47:00.002+01:002019-09-13T23:47:43.054+01:00Another ENT follow up, and a Chronic Vestibular Migraines diagnosisToday, 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.<br />
<br />
He told me the results of my <a href="https://www.stgeorges.nhs.uk/service/general-medicine/audiology/vestibular-balance-and-dizziness-service/vestibular-function-tests/" target="_blank">Vestibular tests</a> 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.<br />
<br />
<br />
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 <a href="https://www.webmd.com/migraines-headaches/vestibular-migraines#1" target="_blank">Chronic Vestibular Migraines</a><br />
<br />
I've included a link which explains what Vestibular Migraines actually are, but these are the symptoms I experience:<br />
<br />
<br />
<ul>
<li>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</li>
</ul>
<ul>
<li>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. </li>
</ul>
<ul>
<li><a href="https://www.nhs.uk/conditions/floaters-and-flashes-in-the-eyes/" target="_blank">Flashing lights</a>: 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.</li>
</ul>
<ul>
<li>"Floaters": These are little shapes (wiggly lines is a typical one) in my field of vision. They float around then disappear</li>
</ul>
<ul>
<li>Sensitivity to light/sound: I don't always get this, but I have noticed it happen a lot recently.</li>
</ul>
<ul>
<li>Some nausea: This tends to come on with the acute bouts of dizziness</li>
</ul>
<ul>
<li>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</li>
</ul>
<div>
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.</div>
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<div>
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. </div>
<div>
<br /></div>
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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</div>
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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.<br />
<br />
Do you suffer from Vestibular Migraines? Please comment below with what helps/makes them worse.<br />
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<b>Resources</b><br />
<b><br /></b>
Vestibular Function Tests: <a href="https://www.stgeorges.nhs.uk/service/general-medicine/audiology/vestibular-balance-and-dizziness-service/vestibular-function-tests/">https://www.stgeorges.nhs.uk/service/general-medicine/audiology/vestibular-balance-and-dizziness-service/vestibular-function-tests/</a><br />
<b><br /></b>
Vestibular Migraines: <a href="https://www.webmd.com/migraines-headaches/vestibular-migraines#1">https://www.webmd.com/migraines-headaches/vestibular-migraines#1</a><br />
<br />
Floaters and flashes in the eyes: <a href="https://www.nhs.uk/conditions/floaters-and-flashes-in-the-eyes/">https://www.nhs.uk/conditions/floaters-and-flashes-in-the-eyes/</a><br />
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<br />Amziehttp://www.blogger.com/profile/01639288209900035382noreply@blogger.com1tag:blogger.com,1999:blog-4896114346747150572.post-22097592959662674242019-09-10T20:04:00.001+01:002019-09-10T20:04:28.765+01:00"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.<br />
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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.<br />
<br />
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.<br />
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<b>When I'm too cold:</b><br />
<b><br /></b>
<br />
<ul>
<li><b>Joint pain</b></li>
<li><b>Nerve pain</b></li>
<li><b>Muscle cramps</b></li>
<li><b>Joint stiffness</b></li>
<li><b>Headaches</b></li>
<li><b>Muscle twitching</b></li>
<li><b>Fatigue</b></li>
</ul>
<div>
<b><br /></b></div>
<div>
<b>When I'm too hot:</b></div>
<div>
<b><br /></b></div>
<div>
<ul>
<li><b>Dizziness</b></li>
<li><b>Weakness</b></li>
<li><b>Fatigue</b></li>
<li><b>Subluxations</b></li>
<li><b>Joints that are "too loose"</b></li>
<li><b>Sweating</b></li>
<li><b>Faintness</b></li>
<li><b>Sleep problems</b></li>
</ul>
<div>
<b><br /></b></div>
</div>
<div>
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:</div>
<div>
<br /></div>
<div>
<ul>
<li><b>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.</b><b> </b></li>
<li><b>Have light salty/sweet snacks. This helps keep my electrolytes up and sometimes helps the dizziness</b></li>
<li><b>Sit down whenever I need to, if possible. I have to rest often, whether too hot or too cold. This may help the dizziness</b></li>
<li><b>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.</b></li>
<li><b>Wear layers instead of thick jumpers. This way I can add more if I'm cold, or take more off if I'm hot. </b></li>
</ul>
</div>
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Do you have problems with temperature regulation? Comment below with your tips for dealing with it!Amziehttp://www.blogger.com/profile/01639288209900035382noreply@blogger.com0