A Mental Health Emergency is still an Emergency

I've been reading through this Guardian article today. The title was originally "Mental Health 'emergencies' expected to reach highest figures this winter" but was quickly changed to "Mental Health patient admissions to A&E set to reach record levels" after complaints on Twitter.

Not much better is it?

I'd love to know why they felt they had to put "emergencies" in single quotation marks. It feels as if they believe Mental Health emergencies are not real emergencies. If that is the case, then clearly they need to start listening more. Just looking through the Twitter hashtags #mentalwish  and #crisisteamfail would be a start.

I've been tempted to add "what if physical illnesses were treated like mental illnesses" but the fact is we shouldn't have to compare this in order for people to care enough to make mental health a priority.

"emergency doctors warned that overstretched A&E departments are the wrong place for people in mental distress." I agree that A&E is an extremely poorly designed place for people going through mental health crises, but it is actually where we are advised to go. Often, it's the only option available when someone is in crisis. From my own experiences, every medical professional (who I have been in contact with about my mental health) has told me to go to A&E if I feel I am at risk of harming myself, or have already harmed myself. The option of contacting Crisis Team is still there, but I have to be referred to them (through my GP, a psychotherapist etc) and I don't know about anyone else, but my crises don't always like to happen within office hours.

I've written more information about my own experiences (when in crisis) in my posts Last Night and Crisis (Trigger Warning for details of self harm and suicide in both posts)

I don't have all the answers (believe me, I'd be shouting them from the rooftops if I did!) but something needs to be done. A lot more funding, better education and training, some service that a person can access directly and quickly with well trained staff, more accessible and flexible services. The list goes on. 

An untitled poem

I recently sorted through some paperwork, old music sheets etc, and came across a poem I wrote when I was around 14, 15. It's not exactly a cheerful read, but I think in a way, it can be linked to the bullying I experienced at the time.

Since I was around 8 years old, I loved writing poetry and songs. Granted, they were probably terrible, but they gave me that opportunity to create something from my own thoughts and feelings. In the same way that music (I played flute, keyboard, guitar, and I sang in choirs) helped me to express myself, so did writing. I kept a lot of my songs quiet. This was partly due to how much I criticised myself, but was also due to the fact that I once brought to school a print out of a song I wrote about bullying and self harm. Clearly I showed this to the wrong person, and it was spread around the school. The words (that I had so honestly poured out onto paper) were suddenly exposed, and ridiculed; which made me even less likely to share something so personal to myself.

 I'm very critical of my own writing, and think the point of the poem should've been a little clearer, but as it is relevant to my previous post (Where it all started) I felt that I should post it here.

(TW: Suicidal thoughts, bullying)

The people in the street

They whisper about her as she goes by

They can't know the hurt inside

The pain they cause

She won't speak,

Because you don't listen

She can't love,

Because she's been hurt too many times before

She doesn't cry,

Because it hurts too much

To say goodbye.

And she goes home and cries at night

Because she's too tired to fight

She's given up,

Because there's nothing left but tears,

Because it hurts too much 

To say goodbye

Living in nothing

Worst nightmares come to life

You'll never know what you did to this girl

Because it hurts her too much to say goodbye

The people in the street

They whisper about her as she goes by

They can't know the hurt inside

The pain they cause

She'd never tell you

Just how much you hurt her

She'd never tell you

How the whispers cut so deep

She'd never tell you

Because it hurts too much to say goodbye

She won't speak

Because you don't listen

She can't love,

Because she's been hurt too many times before

She doesn't cry,

Because it hurts too much

To say goodbye

And the people in the street

They whisper about her as she goes by

They can't know the hurt inside

The pain they cause

Because it hurts too much to tell them why.

Where it all started

I'm not sure what brought me to think about the bullying I experienced throughout my childhood, but it's a big topic and I suppose right now I finally feel ready to speak about it more openly. There's a lot to it, and I still find it very hard to explain, but I'll try not to ramble too much.

Disclaimer: I'm simply speaking about some of my experiences, thoughts and opinions here. I'm not particularly aiming to give advice.

TRIGGER WARNING: Details of self harm, bullying, and violence.

I was always quite a chatty, friendly child right up to primary school. I thought that if I was nice to other people, then they'd be nice to me. I tried to get involved and make the first move when it came to getting to know people. I'd always been told to be polite too.

I can't pinpoint exactly when I started getting bullied, or even why. I made friends fairly easily, but there were also classmates who decided to boss me around. I wasn't very assertive, & usually if someone told me to do something, then I'd do it as I didn't want to argue or anger them. I was in the infants at that time, so it was all very childish & none of it physically violent thankfully. I had a best friend at the time, who was quite quiet but lovely. The bullies would tell me that I had to hang around with them, and not her. They were very pushy. I don't remember ever knowing what they'd do if I stood up for myself, but I must've found them pretty intimidating. I don't think this lasted the entire year, but I remember a couple of girls from a few years above me. They also bossed me around, cornered me in the playground etc. I remember a time I was late for my afternoon class, as one of the girls had locked me in the mobile toilets outside (the building was very old, so some of the classes and the toilets were in mobile blocks). They'd done this because I'd refused to deliberately hit a girl from my class, with a conker. They didn't say why, but I knew they didn't like her and obviously wanted me to be the one to get into trouble.

I'd not long started in the juniors (Year 3) when my parents and I moved house. Dad started work early and Mum couldn't drive, so she and I used to take two buses to my school. It got very difficult to get there in time, and she wasn't happy at my headteacher's failure to deal with the bullies (it basically involved a sit down meeting with me and the bullies, where they denied everything that had been reported, and I was too scared to speak up) so I moved schools to one just a couple of streets away.

Being the "new girl" was a bit of a novelty, and I did get a fair amount of attention, mainly from people in the year above me. There were a few people who made it very clear they didn't want to talk to me. I didn't know what I'd done, but then again you can't please everyone! I also joined choir, gymnastics and the local Brownies group, in order to socialise. I did make a few friends and really thought that my time at this new school would be much happier than at the old one. One person I thought I was close friends with started to boss me around and tease me. Anything I thought I was good at (singing etc) she judged me for. I had a fairly small, flat nose at that age. I wasn't aware that people saw this as a bad thing, until she tried to imitate it. She would pretty much humiliate me in front of most of my class. I still wasn't very good at sticking up for myself, so I guess she saw me as an easy target. The odd times where I lost my temper at her & we'd fall out, she'd make sure that she kept very close to my friends, so I'd end up on my own at break-times. I felt like it was better to keep quiet & put up with the bullying, than to alienate everybody. I won't go into detail, but there were times when she would try to make me believe certain upsetting things about my family. I didn't believe her at all, but it did mess with my head quite a lot. She lived very near me, so it's not as if I could escape the bullying away from school. It got to a point where I didn't feel safe on my own street (and sometimes my own home). I never used to get physically ill, but I would wish for this so I could at least stay at home and have a day or two away from the bullying. When I felt really upset/stressed out at home, I would bite, scratch or pinch my hands. It was never to a point where it was very noticeable the next day (only my parents noticed a few times) but it was enough to cause enough pain to distract me. It's not something I've spoken in depth to therapists about, but I guess this was a form of self harm.

I looked forward to secondary school. Only a couple of classmates went to the same one as me, and they were both friends. I started to be a little more chatty again, although I did get some teasing. I'd not tried to fit in when it came to fashion or music taste. I was ridiculously polite as well, and honestly I think a lot of people just thought I was weird. Year 7 wasn't too bad. A girl in our year was seen as a bit of an outcast. She was picked on quite badly. I wish I'd stuck up for her instead of being so selfish, but I felt as if I had to do what I could to fit in; especially when I started being teased. Year 8 was my absolute worst year for bullying. The girl from the previous year had left (due to the bullying she'd received. I wish so much that I'd been a better friend to her). Everything I said, or did, or wore was judged. I felt as if I couldn't do anything right, so decided it would be better if I stayed quiet. Of course then, I was targeted for being the "shy, quiet one". The friends I'd made in the same year as me, weren't in the same classes (we had to stay in our forms) and, due to staggered lunchtimes (big school with a small canteen), I didn't see them very often.

Around this time, I used to have extremely violent dreams about the classmates who had bullied me. I think this happened because I was so frustrated with myself for not standing up to them. I thought that it was my fault that I'd "let" myself be bullied again. In the dreams, I'd be kicking and punching them until they fell unconscious. I don't know if I could call these intrusive thoughts, but these dreams would be on my mind most days, and I'd worry so much that I'd act on them.

I had the odd outburst where I just couldn't put up with things that had been said/done that day. It usually involved me yelling a bunch of obscenities at the person though. I only ever once did anything physical, and it was in response to seeing a friend being teased/pushed around by one of the bullies. She had started tugging my friend's hair, and then went on to tug mine when I spoke up. I remember grabbing her fingers and bending them right back. I really did want to hurt her, but stopped when a teacher walked past. As far as I remember, she didn't give me any trouble after that. I'm not sure what the right thing to do would've been, but I definitely wouldn't advise doing that!

I used to be so worried that I was allowing the bullying to happen, that it was my fault, and that I'd humiliate myself in some way, that I'd start rituals of checking, and repeating (something I only realised recently). In year 9, myself and a few of my close friends began reading up on Paganism and Wicca. We didn't go into any real depth, & I don't know enough about it to consider myself pagan right now, but we learnt about blessings. I can't remember which ones exactly, but I used to recite a couple of blessings each night, and I became obsessed with repeating them three times at exactly midnight. I started to believe that if I did this every night, three times, and in the "right" order, that my next day at school wouldn't go too badly. I also started becoming interested in divination, and would keep certain "lucky charms" in each pocket of my blazer. If I didn't have them all on me, in the "right" pockets, then I believed I would have a very bad day. This carried on right through to 6th form. I started to get more confident in 6th form. I still had the odd bit of trouble, which I'm not sure even qualifies as bullying (just people being assholes!), but I found it a bit easier to brush off.

This is the first time I've described my experiences in such detail. I bottled a lot of it up. The only advice I ever received about bullying was to "tell the teacher/your parents". I did that a couple of times, but only ever found it made matters worse. I remember confiding in a friend as well, but they decided that telling my bullies would be the best course of action. They meant well, but this really wasn't helpful & I didn't feel as if I could speak to any other friends about this, in case they did the same.

Schools I've attended have claimed to have a "zero tolerance policy" on bullying, but no other details other than that. I'd be really interested to know the types of things that teachers & parents are told to look out for, as well as protocol when they find out that someone is being bullied. I don't think a "one size fits all" approach would be the best course of action, as bullying is a lot more complicated than we are led to believe. It isn't just about physical violence or name-calling. It can include teasing/putting someone down & making them feel bad about themself, exclusion/isolation from friendship groups, and other subtle but still very damaging methods.

Throughout school, I desperately needed to have someone to talk to about these things. Even though my friends were amazing, I worried so much about word getting to the bullies that I simply didn't talk to them about it, and preferred to distract myself. The school nurse was lovely, but only dealt with physical problems (as far as I was aware anyway). You had to approach a teacher before being allowed to see the nurse, so of course I didn't even try to see her about this. I wish that there had been a school counsellor that I could see in confidence.

I also wish that we'd learnt about mental health in school. I'm pretty sure that I experienced anxiety and depression even as a young child/young teenager. At the time, however, I saw the symptoms I had as my own personality flaws, rather than things that I experienced, that were triggered/exacerbated by the bullying. Maybe I could've at least learnt some healthier coping mechanisms, if I'd had that support available.

Just an "admin error"

Apologies for my lack of blogging recently. The colder darker days seem to be making my symptoms flare up so often & I've just not had the energy to do much more than the odd twitter rant and a lot of RTing.

I've posted this a fair few times on Twitter, but wanted to add it to my blog. Thankfully the situation's been sorted out now (and turned out to be some sort of "admin error) but I still feel it's worth sharing because this occurs so often, and it's unacceptable. I'm on ESA, now in the Support Group, but not too long ago I was in the Work Related Activity Group; mandated onto the Work Programme.

Nearly 3 weeks ago, I received this letter from the Work Programme Provider I'd been with up until around June/July this year (personal details edited out):

I'm not sure how clear the picture is, but some of the wording concerned me, e.g. "you are not obliged to attend however it is extremely important that you keep in contact with us so we can help you to find work as quickly as possible"

As the date of the appointment I "failed to attend" was a date when I was still in the WRAG, I did get quite worried, as I couldn't remember if I had attended an appointment then. I'd kept all of the action plans I'd been given at each appointment, so thankfully found the action plan for around that time. It turns out that I'd been ill on that day and had rearranged the appointment for 2 days later. Even though I knew I'd done nothing wrong, and that they couldn't sanction me, the sentence quoted above made me extremely nervous. I wasn't sure whether to get in contact with them, or ignore the letter altogether as my attendance would be voluntary (and I certainly hadn't volunteered after the stress they'd put me through!) It took Diazepam and a lot of rest to even start to calm me down. The whole reason I'm in the Support Group is because I'm not well enough to "find work as quickly as possible". I thought that had been proven many a time!

I'm lucky in that I live with my parents, so my mother could call the place for me to see why I'd received this letter. The first adviser she spoke to seemed very incompetent. For some reason, they thought that because I was in the Support Group, I shouldn't be on ESA! She didn't give a reason why, or where she got this information from but regardless, we didn't get anywhere with her. The next person my mother spoke to was a supervisor who seemed a lot more competent. It turns out that the Work Programme provider uses the same template in most cases (regardless of whether someone's attendance is mandated or voluntary) and this had been a simple admin error, so I wouldn't need to attend. 

For me, thankfully the situation was resolved relatively quickly, but had I lived by myself when this letter arrived, I dread to think how I would've responded. The wording is confusing and frankly intimidating. What may be a simple admin error to a Work Programme provider, or a government department, could be devastating and even dangerous for a claimant on the receiving end.

It is difficult enough to even qualify for ESA. The descriptors do not consider many complexities of chronic illness or disabilities for example. The face to face assessments are said to test someone's "fitness for work" but do not consider any types of work specifically. They are not medicals either so tend to underestimate (or even completely disregard) how debilitating symptoms, such as pain, nausea, anxiety & fatigue, can be. If you're found not fit for work, but are considered fit for work related activity, then you are placed into the Work Related Activity Group. You can also be placed onto the Work Programme. When in this group, I found that there was real pressure to attend every appointment regardless of how ill I felt, or how difficult accessing the building was. They could not force you to do anything you were too ill for, but they would certainly push you and threaten with sanctions. I also found it very difficult to get any reasonable adjustments; even when I could prove why I needed them. This post gives a bit more information about my experiences on the Work Programme. 

Recently, the hashtag #CameronMustGo started trending on Twitter. Journalists have suggested that this is a form of bullying. As someone who experienced bullying for over a decade (and sometimes even when working), of course I'm against bullying, but I do not think this hashtag qualifies as this. It may not lead to Cameron getting the sack, but it at least provides some sort of platform where twitter users can share their opinions, experiences, and reasons why they are against him, his party, and his policies. Thanks to him, benefit sanctions have sky rocketed, hatred against benefit claimants is widespread, more and more we are hearing of people who have died after having their benefits cut or stopped altogether. Just a simple Google search will show you how much devastation this has caused. Surely criticism of him should be expected? 

Crisis

This post follows on from the one entitled Last Night

(Trigger Warning: Details of Self Harm and mention of Suicide)

Tuesday

I still felt really awful on the Tuesday, but thankfully not so bad that I would need to contact Crisis Team ¹. The stomach pains were still there, but I was trying to take things easy and only have simple meals in small portions. I felt as if I knew what to do, if I did go into crisis, so I guess this reassured me. After all, I was "in the system" so they'd have to help, right?


Wednesday

Wednesday, things got much worse. I'd been feeling so down that day, and I couldn't concentrate on a thing. I had barely eaten anything either. Doing ANYTHING seemed completely pointless. All I could think about was ending my life. I did the right thing, and told mum how I was feeling. To be honest, she'd noticed something was wrong with me, so I don't think she'd have let me hide it. I was starting to talk about making plans, so mum decided to call Crisis Team.

They wanted to speak to me, so I thought that they'd finally do something to help! I explained (well, rambled) to the woman (possibly a CPN ²) that I thought I might be in crisis, I couldn't think of anything but suicide and I'd started making plans. I told her that in my last Therapy Contract ³, with the last therapist I saw, I had agreed that I would contact Crisis Team if I felt like this, and that I could be dealt with by them directly. From that information, I'd always thought that because I was "in the system" I could then self-refer. It turns out this information was wrong. The woman told me that I couldn't self-refer and would have to either go to my GP (closed by that time), go to the walk in centre (all the way across town, and would be closed by the time I got there) or A&E (they have a very poor reputation for dealing with mental illness). I choked out a "thank you, bye" before hanging up. So that was it. There was NOTHING I could do when I'm in crisis. Nowhere I could go where someone would be able to help. This made me feel even worse, so I decided to go to my room, pick up a pen and notepad, and write down my bank details, passwords etc. I hid this and told mum that I'd done this, in case anything happened. I wanted her to have that bit of money if she needed, and to have my online details so she could let friends know what had happened. It seemed to make sense to me to do these things. There was a plan I wanted to follow (which I won't detail here, as it could be very triggering) but mum wouldn't let me out of her sight. If I'd been on my own, I don't have any doubt that I would've followed through with it. So I was stuck. I couldn't do what I WANTED to do (suicide), or what I SHOULD do (get professional help). I still felt incredibly low, I still had the very strong urges, but all I could do was exist. I still had very bad pains, and wanted to escape from things, so I decided to start my Tramacet ⁴. I knew the side effects involved things like drowsiness, feeling spaced out etc. That sounded like the only thing I could do for myself at that time. It started to work, and even helped the pain,which I was so glad of. I thought I could just wait out these feelings, and that the Tramacet would help me escape them for a while. In the end, they made me very sick though. Clearly I should've eaten more, and just taken the one tablet instead of the prescribed 2. I had to throw up about 5 times, and the pain and exhaustion this caused, brought all the strong suicidal urges back.

Twitter was my outlet that day; more so than usual. I felt incredibly guilty for talking through everything, being so negative and moody. I am so sorry for worrying so many people. I wanted to let people know what was going on, but I think my tweets were getting pretty scary.

Mum decided to call NHS Direct (111?) around 11.30pm to see if there was anything they could suggest. I wasn't sure exactly what was going on (I was starting to dissociate ⁵) but she told me that a nurse wanted to speak to me. I tried my best to explain what had happened, how I was feeling etc. The nurse was very nice and said that I would be speaking to a doctor next, and that they may send a doctor out to me. I then explained everything I could do the doctor. I can't remember everything they said (I was very confused) but I remember them saying that an out of hours GP would be sent out & that it may be a few hours. When they hung up, all I wanted to do was go to sleep. I kept telling mum to cancel and (lied) that I would be fine. She didn't believe me though.

The GP arrived much sooner than expected (around 1am?). I didn't like that he asked so many questions that made me even more upset, but in hindsight he needed to get an idea of my medical history, childhood, family life etc. He asked me if I'd been abused, had I ever been sexually assaulted (this is something that happened when I was about 17. I've not spoken about it on this blog, but I may do at some point soon), how my relationship with family was, what my childhood was like (I rambled about bullying then, and the times I used to bite and scratch my hands), what I'm diagnosed with etc. We also spoke about the suicidal thoughts. He didn't exactly help, with the things he was saying. He spoke about consequences, and how I'm luckier than some people because I have a family etc. I thought he'd understand that Depression doesn't discriminate! I could be a millionaire and still be depressed. Granted, more contacts and money helps, but no one is immune from mental illness, just like no one is immune from a lot of physical illnesses. Sometimes these things just *happen*.

Once I'd answered all his questions, we discussed meds. I told him about all the antidepressants I'd tried, what I'm on at the moment, whether it helped (it didn't) and why the GP hadn't changed my meds. I told him that she was reluctant to try me on anything else at that point, because I was at a huge risk of suicide. He advised me to see my GP the next day, and ask to be referred directly to a Psychiatrist. I knew no better, so thought that she could do this (especially if I was having severe symptoms). He also gave me 2 Diazepam (2mg x 2) to get me through the night. I didn't think he'd be able to help further (why didn't they send someone trained in mental health??) so I gladly took the meds, and his advice. The Diazepam did calm me down a lot, stopped me throwing up, and helped me sleep.


Thursday

The Thursday I was really exhausted and felt fairly calm, so decided not to contact the GP yet. That could be done the next day. I just wanted to have a quiet day, where I was kind to myself. I did worry that if I didn't get further treatment, however, that I'd go back to being in crisis.


Friday

I managed to get a home visit with the GP on Friday. I told her everything that had happened on the Wednesday night, as well as what the out of hours GP had said about the psychiatry referral. She told me that she didn't have authority to refer me directly to a Psychiatrist. Everything went through the Referral team (RAS), or Crisis team. She told me that she would refer me to Crisis Team for an assessment, and that she would prescribe me a "rescue course" of Diazepam, to take on my worst days. Apparently it's a strong and addictive drug, so shouldn't be taken every day. She asked me if I'd been in contact with Healthy Minds. I'd told her that I had, and that they had put me on the (8 week) waiting list for High Intensity therapy (for one more go at CBT) and told me to ask my therapist to put me on the (9 month) waiting list to see the Wellbeing team. My GP was shocked that I hadn't already been referred to both, so said that I could ask the Crisis Team to refer me to the Wellbeing team and see if I could be seen by them, sooner. She said that the Wellbeing team consisted of CPNs, Support Workers (or something similar) and that they had a Psychiatrist; who I could hopefully see. It sounded as if there was more support there for me, so I was satisfied with the information I'd been given. I even felt hopeful that this assessment would open doors for more support for me. Surely this would be the turning point for me, so I wouldn't keep getting the same old generic CBT?

Later that day I received a phonecall from one of the CPNs in the Crisis Team. She made an appointment for me to see her on the Saturday morning, at the psychiatric hospital near me, where they are based.


Saturday

Dad drove me to the hospital in good time for my appointment. The CPN who greeted me, was the same one I had spoken to on the phone the previous day. She sounded very approachable and compassionate, which set my mind at ease slightly.

She asked a fair amount of questions, such as my medical history, what family life was like, childhood etc. I spoke about the self harm, the bullying, what I think made me worse etc. I know I wasn't being very fluent, but she did make a lot of notes. I also mentioned the dissociation. As far as I was aware, this wasn't a symptom of Generalised Anxiety Disorder or Depression. Not at the frequency I experienced it anyway. I told her what seemed to trigger it, when I started getting it and how I felt during. She seemed very interested to know more. I also spoke about the Agoraphobia and  the paranoia that came with it. She also wanted to know more about the suspected Obsessive Compulsive Disorder. I said I'd been reluctant to self-diagnose because of the information I had about it. Also the fact that I thought I only had obsessions and compulsions with one particular thing. She asked me whether I ever had any particular routines when I was younger. I had to think a bit but I realised that actually, I did. When I was a young teenager, and being badly bullied, I used to keep certain "lucky charms" in the pockets of my school blazer. I always kept certain objects in certain pockets. I also checked all of them a lot of times, to make sure they were still there. I told her that I knew it was ridiculous, but I thought that if I didn't make sure they were there, or if I forgot them, that I would have a really bad day.

I'd started learning about Paganism at that age too. I didn't mention this to her, but I used to say certain blessings the night before school. I felt that I had to say these blessings, otherwise something awful would happen the next day. The "awful" thing being the bullying getting really bad, or me being humiliated. I never spoke to anyone about this. It was a very private routine.

After hearing what I had to say, she made more notes and told me this did sound like OCD, but of course a therapist would have to confirm this.

She also told me that I couldn't be referred for High Intensity therapy as well as seeing the Wellbeing team. It was either/or. She didn't say why, but I gathered that this may be due to cutbacks to mental health services. The only other thing she said she would've signposted me to, was a group service for young adults with similar mental health problems. Unfortunately, it involved travelling into town to meet the group (not possible because of my Agoraphobia) and the service was only for people up to the age of 25 (I turn 25 next month) so they'd be unlikely to accept me anyway.

We then spoke about medication. She told me that I wouldn't be able to see the Psychiatrist, but she would speak to him to see if he could suggest a different medication to the Amitriptyline. In the meantime, I was to keep taking it. Another thing she said (which I found very interesting!) was that I could take the Diazepam every day if I needed to. Also that I was on a low dose, so that could be increased if needs be. Our session ended after this, and she asked me to wait at Reception while she looked for/spoke to the Psychiatrist. Unfortunately he was in the middle of an assessment, so she took my number and said she'd call me later with his verdict.

She kept her promise, and later that day I received the call from her. The Psychiatrist said that I was to stay on the Amitriptyline for now (as I'd only very recently had the dose increased) and to take the Diazepam as needed (so, not every day). If I still found the Amitriptyline unhelpful, then I could ask my GP to refer me to the Psychiatrist for a one off appointment, to review my medication. The CPN also said that if I felt I was at risk again, then I could call the Crisis Team, but I would only receive telephone support.

I'm glad that they are trying to give me a bit of extra support, but it doesn't feel as if this is nearly enough. A lot could happen in the 8 weeks I'm waiting to receive a High Intensity therapy appointment. Sure, I could ring the Crisis Team but, unless I have my crisis at a 'convenient' time, how on earth can I receive any actual support from them? I've been told so much conflicting information that I'm not sure what I can do if I go into crisis again (apart from take Diazepam and hope it knocks me out). I feel as if there has been a massive breakdown in communication between GPs and Mental Health Services. It's hard to know what the truth is, but from what I can gather, the referral team are the gatekeepers to extra support, and they appear to be keeping those gates firmly shut.

I'm lucky that I have my family and friends to support me in those times, and contact services when I refused to, but what if I lived alone? What if I'd alienated all of my friends and had no one to turn to? It doesn't bear thinking about.


Sources

1. Crisis Team - http://www.bcpft.nhs.uk/services/for-adults/83-community-services/14-crisis-resolution-and-home-treatment-team

2. CPN (Community Psychiatric Nurse) 
http://www.rcpsych.ac.uk/healthadvice/treatmentswellbeing/mentalhealthinthecommunity.aspx

3. Therapy Contract - http://www.privatepracticehub.co.uk/therapy-contract.php 

4. Tramacet - http://www.netdoctor.co.uk/aches-and-pains/medicines/tramacet.html

5."Dissociation (psychology)" - http://en.wikipedia.org/wiki/Dissociation_(psychology)

Last Night (TW self harm & suicide)

(Trigger Warning: Details of self harm & mention of suicide)

Last night was scary. I was either in crisis or very close to it. I’ve been having severe stomach pains and bleeding recently but, being me, I was leaving it in the hopes it was just some horrible bug. Last night got too much though. I was thinking about all of my mental health and physical health problems. It seems like the list just gets bigger, but with no extra help. I'm trying to just accept it and deal with it. I never really have "good" mental health or physical health days. I guess it's more split into "doing ok", "coping" and "not coping". I couldn’t stop crying and was very very close to hurting myself. I didn't realise this for a while, and luckily it wasn't actually causing any injuries, but I'd started biting and scratching my hands. Years ago, I used to bite the back of my hands, when I was being bullied and I felt really frustrated and weak for not being able to do much about it. I think it was my way of letting the frustration out, and also a way of punishing myself for not standing up to them. It's only very recently that I've realised it is a form of self harm. Up until now, I guess I didn't think it was, because it didn't result in bleeding or a trip to A&E. This shows how ignorant I'd been about it before. 

I think this is the worst mum’s seen me. I refused to call crisis team because last time they did nothing. Mum had to try the GP surgery twice before they’d let me have an emergency appointment. I also had to speak to my GP over the phone. I didn’t want to, and I could barely get my words out, but I knew I had to. 

She was really kind and understanding. There’s something about her voice and general attitude, that can be quite calming. Sometimes I feel like I get too attached to her because I’m afraid of never getting that support again if I move out of the area. I made it to the surgery about an hour after the phonecall, and spoke to her about how I was feeling. It turns out that the Naproxen I’d been prescribed was starting to damage the lining of my stomach and my oesophagus. I dread to think what it’d have done if I hadn’t made sure I had food at the same time. I was told to come off it completely. I don’t mind that, because it wasn’t helping the pains anyway. The bleeding was due to a fissure, so thankfully nothing serious, & I have some cream to pick up tomorrow. I’ve now been put on Tramacet (a combination of Tramadol and Paracetamol) and will go on Tramadol if it helps and doesn’t cause too severe side effects. I’m also on Lansoprazole for the pain, acid reflux and sickness. Finally my Amitriptyline has been increased from 75mg to 100mg. She didn’t want to prescribe anything different because of the suicide risk (I was already at a huge risk of hurting myself). She did tell me that I should’ve rang the crisis team. I got home and felt a bit calmer, so no need to call them. 

Today, I’ve still been feeling really awful. I've been trying to have small simple meals, but I'm still having a lot of pain. I've decided to give it a couple of days before I try the Tramacet, just to let my stomach etc calm down a bit. The bleeding isn't as bad either. There was a lot of it last night, and I worried that I might have to go to hospital (my local A&E are pretty terrible, so I avoid them as much as possible). I took my 100mg Amitriptyline last night, and got to sleep around 4am (it was 7am the other day, so this is an improvement). I've been feeling a bit sedated today, and I'm worried about going into crisis again, but I'm trying to take it easy and be kind to myself. If I go bad again, then I’ll ring the crisis team. 

I know I've been taking a long time getting back to messages. I've been finding it extremely difficult to concentrate, but I will get back to people even if I can't manage to say much. I'm so grateful for people who have been there for me. It helps a lot :)

I'm sorry.

(TW: body image/weight, suicidal thoughts)

That's all I can think of saying right now. I'm sorry. I really don't like myself very much these days and I hate when I'm like this. I take things personally, I try to support people but feel I'm saying all the wrong things. I hate myself for getting frustrated about that, because I think it makes me self pitying and self absorbed.

Therapists seem to think I'm so damn self aware and organised and good at understanding what's going on. The truth is, I'm trying to find answers and work out what's going on with me, because nobody else is trying to. I feel like the mental health diagnoses I have (Anxiety and Depression) don't fully cover what I'm feeling, and I'm really searching for answers but it gets so hard to put my finger on it, and describe it properly. Maybe it's something that's always there, right from school, but it's just much worse now. I don't know. Maybe it's nothing, and I'm just generally a pretty awful person.

I made it to 10'000 blog views today. I know that's probably nothing in comparison to more well known bloggers, but I never thought many people would actually want to read what I had to say. I actually felt pretty excited that I'd reached that sort of milestone. So why am I feeling like a terrible person who deserves nothing now?

I've had my phone assessment with Healthy Minds now. I'm amazed I managed to not cry though it. I explained some of the things I talked about in my last post. I've also emailed an OCD charity to get their opinion on my obsessions and compulsions. They said it definitely sounded like I could have a form of it, but obviously my GP, therapists etc are the ones to discuss this with. The therapist on the phone said that because these behaviours were disrupting my life so much, this is what we should be focusing on first. That's definitely a positive thing. Therapists in the past have just brushed it off as a bit of anxiety. It's something I really really need support with though. I know it won't be easy, and I know it will take a while, but I can't leave it to get so bad that I never ever leave the house.

Anyway, I digress. Long story short, the plan is for me to have one more go at High Intensity CBT, but they are putting a note on the system to say (because of my agoraphobia) that, for now at least, I would need either home visits or phone appointments. Also, I've been advised to ask my next therapist to refer me to the Wellbeing service. I need to look into this further, and will probably explain it in another blog post, but from what I've been told, this team consists of CPNs and Support Workers who can meet me at home and help with the agoraphobia, repetitive behaviour etc. If that's true, then this is definitely something I need. Maybe it'll be easier to get them to understand how things are going too. Lastly, I need to review my antidepressants with my GP. I have no idea what other ones she can suggest, because so many of them apparently cause weight gain, and my self esteem is so low, I just don't know what I'd do if I put on more weight. I wish I could just accept my body, love it even. I wouldn't think any less of anyone else putting on weight, so why do I hate myself so much when I do?

The waiting list is about 8 weeks for the CBT, and about 9 months for the Wellbeing service, so basically I have to try and cope in the meantime. I don't think I feel safe right now. I feel like I really want to do something, but I can't do anything because mum has a hospital appointment tomorrow and I can't mess things up for her. Just gotta get through tonight.