Thursday, 1 March 2018

Family, Social Services, and a Whole Load of Stress

I'm sorry for my silence recently! I've had a lot going on, mainly with family and illness. I will try to explain this in a somewhat coherent manner.

A couple of months ago, my Nan went into hospital for a total hip replacement operation. She has other issues, such as Arthritis all over (we're not sure which type), a worn out total replacement on her other hip, Type 2 Diabetes, double incontinence, memory problems and could potentially have the onset of Dementia. The nurse at the hospital originally said Nan would be in for 7 days, but this was before all the other issues were noted.

The operation went as planned, but due to these other issues, she is still in hospital. As well as all of this, she contracted Norovirus, so has had to stay in another 2 weeks regardless. Despite extra infection control measures, visiting members of the family (including myself and my parents) caught Norovirus too! Because of this, we've not been able to visit Nan for over a week, which is a worry as she does not cope well by herself. She doesn't mix well with other patients and will only "socialise" (to use the word very loosely) with family members.

Another issue is the care home she lives in. It does not have an adjustable bed, so Nan spends 24 hours a day in her adjustable chair (bought by herself years ago). She sleeps in that chair, badly, and due to such poor mobility, is almost completely sedentary.

She has carers in, but she has cut their hours down to the bone, as she thinks struggling on her own (even with her risk of falls) is acceptable. The care she does get is not adequate in the slightest. Before she went into hospital, she was getting care for 15-30 minutes in the morning; which mainly consisted of a very quick wash from her chair. She did have carers come to take her laundry now and again, but clothes etc often came back still dirty. It appears she is also paying for more care than she is actually receiving.

The care home itself is vastly understaffed. At night, you are lucky to get two care assistants and in the daytime there are often only two carers covering the whole home (which has quite a few flats as well as bungalows attached to the home). Nan needs two carers to help her to shower, but the home is unable to provide this, so Nan's hygiene is unfortunately quite poor.

Onto Social Services! Well, they have been involved to assess Nan's needs and whether the care home is suitable for her anymore. My family have agreed that it is now a nursing home that Nan needs because of the amount of personal help she requires. Dad has been speaking to a social worker, but despite all of our concerns, the social worker is under the impression that the care home will be able to provide the levels of care required. This is something we struggle to believe but it looks as if we'll have to trust the care home to do this, and if it is not done then we are going to have to find a nursing home for Nan.

In the meantime, next week there will be a meeting with the care home manager and an occupational therapist (as far as we're aware?) at Nan's flat, to see what other equipment she needs before being discharged. There will also be a bigger meeting with whichever relatives are available, at the hospital, to come to an agreement as to what Nan needs and whether she will be ready to be discharged soon.
One of my uncles does have the legal right to invoke Power of Attorney, so we need to discuss whether this is something that needs to be done yet.

We want her to be happy, but we also want her to be safe. It is very difficult and has caused arguments as Nan is not good with change and is very home sick. I will do another post once everything is finalised.

Friday, 2 February 2018

CBT for Anxiety Session 2 - My Past

(TW: mentions of self harm, suicide, sexual abuse, psychological abuse, and diet)

I'd had a bad couple of weeks between session 1 and session 2 of CBT. I did, however, manage to do the homework my therapist set for me. This was to read and print off a booklet about Panic as well as doing an anxiety based thought record. I filled in quite a few entries for this record, so had a lot to talk about with the therapist. I also wanted to monitor my mood swings in order to help with filling in the questionnaires at the start of session 2 (as well as for my own benefit). One of my best friends suggested this and I found it a very helpful idea.

I used a mood diary template; where I recorded levels (from 1-10) of stress, mood, energy, and how many hours I'd slept. I also commented on my moods and things that had happened that day. I found that I had to add at least 2 or 3 entries for these topics throughout the day (except hours slept of course) as my moods changed. I found my moods changed rapidly and extremely in response to things that happened. I had a couple of days, for instance, where I had read too much into some things and got it into my head that some friends had got fed up of me. This resulted in me feeling very paranoid, angry, upset, and anxious to the point that friends noticed and reassured me. Reassurance helped my mood a bit, but did not completely alleviate those thoughts and feelings.

Moving on to my therapy session, I was a few minutes late but the therapist didn't seem to mind. Once we'd sat down, she gave me the usual questionnaires (see my previous post) as well as a Risk Assessment questionnaire. This yes/no questionnaire asked about suicidal and self harm thoughts, as well as plans and attempts. I did answer yes to some of these, so my therapist wanted to talk about this first. We moved on, once she was sure that I wasn't currently planning to end my life.

We next talked about the thoughts I have about myself, my family, strangers, and going outside. This brought us to various things that had happened in my past, and how they affected my thoughts, feelings, and behaviour nowadays.

Two particular things that were major factors in my mental illnesses were the bullying I experienced at school, and the psychologically and sexually abusive relationship I had when I was at university. These really affected how I saw, and still see myself. I don't see myself as a person of worth, I think of myself as "wrong" no matter what I do or say. I blame myself for everything and punish myself through regular self harm. Long story short,  I don't like myself very much. My therapist commented that I speak about myself very negatively.

The next topic we went onto was lifestyle. What did I do throughout my day? What is stopping me from working? Do I go out much/socially? I mentioned that this past couple of weeks had been difficult and I'd barely been out of the house at all. Partly this was because I felt very demotivated and low, but it was also the Agoraphobia making me avoid situations that make me panicky and anxious. My therapist said that I needed to go out more, and try a short walk at first. I pretty much promised her that I would try to go out more. I also explained why I didn't work, but that I would like to if/when I am ready. I explained that this work would have to be very flexible and accommodating as I have energy "crashes" in the afternoon and need a 2 hour nap when I get too exhausted. Ideally, this job would be a work-from-home one (not easy to find!).

We then went onto general health. Did I exercise much? What is my diet like? Can I cook for myself? I told her that my Fibromyalgia and Hypermobility Syndrome do cause a lot of pain, fatigue etc so cooking is difficult and I need help when cooking from scratch. I spoke about the kinds of things I ate for each meal and that I was doing Slimming World online. Overall, my therapist decided my diet was relatively healthy. She also mentioned how certain inflammatory foods could make my Fibromyalgia flare. I had read up about that when initially diagnosed, but have forgotten now, so will look into it.

The session was coming to a close by this time, as we'd been talking about a lot for a while! My homework for this time is to find 3 things each day that are positive (it could be about my day, myself, something I'm looking forward to or that someone said to me etc). I need to work on being compassionate to myself. She also wants me to carry on with the mood diary and fill in the activities in the Panic booklet.

So far, I'm liking my therapist (apart from her questions about getting back to work soon) and the sessions are at least giving me time and space to vent. I did find this session very emotionally and physically exhausting, however, so had to nap for a while once I'd got home.

My next session is in 3 weeks time, so I hope to write a post on a separate topic before my session 3 post. I hope this post is helpful in the meantime!

Thursday, 18 January 2018

CBT for Anxiety Session 1 - The Assessment

(TW Suicide and Mention of Sexual Assault)

I've decided to try Cognitive Behavioural Therapy again. This time, I want to focus on my anxiety issues with travelling alone. I've had CBT 3 times in the past, but without a specific goal so this is partly why I think it didn't work for me. I didn't know what exactly I wanted to achieve, apart from a lessening in symptoms. Previously, the focus was on my Depression and suicidal ideations. I found CBT unhelpful for this however, as I felt my issues were more complex than this type of therapy allowed for. At the time, I didn't know I had Borderline Personality Disorder however, and this is probably why CBT didn't work for me. Recently, however, I felt trying CBT with a focus on one of my anxiety disorders, with a specific goal/problem would probably be more effective.

After a self referral, a telephone assessment, and a few months on the waiting list, I had my first session earlier this week. As it was session 1, it was more of an assessment however. The therapist initially gave me the standard questionnaires to complete (PHQ-9, GAD-7, phobias and work and social adjustment scale (see page 5)) Once she had looked through my responses, she discussed my suicidal thoughts with me to find out whether I'd attempted in the past or made plans, and if I had plans to end my life right now. I reassured her that although I used to have quite strong suicidal thoughts, they are more passive now and would only be likely to become active if I were to suffer a sudden loss of support or someone from my support network (such as a close friend, parent, or my cat).

She then went through my diagnoses (both physical and mental) and asked how I felt about my BPD diagnosis. I said that the assessment for it was one I'd asked for, and although I did not like how stigmatised this disorder is, I'm relieved to put a name to my problems and to be believed. I mentioned to her that I had not been referred for Dialectical Behavioural Therapy when diagnosed (as this is the standard treatment recommended for BPD). She noted that I had been discharged from Secondary Care soon after my diagnosis, and she was very surprised about this. She told me that Primary Care mainly does CBT and it is Secondary Care that would carry out DBT.

We then went on to my anxiety problems; primarily anxiety with travelling alone. I explained how I felt when trying to travel alone, and problems I've had in the past that I think may have contributed. I used to be bullied and harassed on the coach to school for example. Because it happened for so many years, I expect it to happen on public transport (such as a bus). When I was 17, I was sexually assaulted at my local bus station. Although it has been 11 years, I still can't sit in a bus station by myself. Lastly, I had a panic attack a few years ago when changing trains, because I could not find the correct platform. It was so intense and scary that it put me off taking trains.

I also spoke about how often I have racing thoughts, and that it can get too much to cope with. The therapist asked how I would try to manage this, and I said through distraction (gaming mostly). She said that I was relying too much on distraction and mindfulness may help me to "sit with" my worries. Hopefully this will help me to face my fears and come up with solutions that could calm my anxiety down.

By this time, the session was running to a close. The therapist gave me some links to a worksheet for recording times I'm anxious and why. She also gave me a link to booklets online that described anxiety and panic. I'm to read these, fill in the worksheet and bring it to the next session (in a fortnight).

I hope this blog post has been helpful for anyone considering CBT for anxiety. My next post will be about Session 2.

RESOURCES

Sunday, 31 December 2017

Self Care New Year's Resolutions

The end of a year can be very difficult for many people; bringing up mixed emotions and placing expectations on us to think over the past year and make resolutions for the new year.

I find resolutions difficult to make/stick to, and the guilt and failure I feel when I don't stick to those resolutions can be very damaging for my mental health. Mental health problems, such as Depression include symptoms such as guilt and feeling like a failure, so another dose of that is definitely not welcome! I have general aims I'd like to meet, but no strict resolutions. I decided to put them here, in case they may be helpful for you. Of course, you can tailor them to your abilities/what you feel able to cope with!

1. Be kinder to myself.  Specifically, I want to try not to say such horrible things about myself and focus on the more positive things I can find. I can't be all bad, right?!

2. Do my best to set boundaries. If I am not comfortable with something, it's ok to say no! If I am finding a friendship is becoming toxic, it is ok to step away and even end that friendship if I feel able to.

3. Stay connected to loved ones. I am terrible at starting conversations. I know I expect people to talk to me first, and I feel very alone if no one does even for just a day. I want to take that step and say hello to someone first.

4. Let friends/family know if things aren't going well. I don't need to bottle up my physical or mental health problems. If I'm in pain, it's ok to say! If I'm feeling down, it's also ok to say! That bit of support I hopefully get in return can really help my mood.

5. Take time for myself. Although I shouldn't isolate, it's ok to take some time out for myself. Being round people can be exhausting and overwhelming, so it is a good idea to have that time and space for myself.

6. Do a nice thing for myself every day. This could be watching a movie I like, playing a game, treating myself to a favourite snack, or putting on makeup and taking a few selfies! Whatever I consider a positive, mood lifting thing counts.

7. Stay hydrated! I know I don't drink enough water, so I often try to aim to remedy that. Apart from other drinks, I manage half to a whole 500ml bottle a day. I want to double that.

8. Try not to put too much pressure on myself. There's quite a few resolutions here, but I need to remember that these aren't set in stone. They are just guidelines, suggestions even. If I only manage one or two next year, that's fine! I'm not a failure if I can't manage to meet all of the above.

Are you setting any resolutions for 2018? Comment below with your suggestions!

Whatever you do, I hope next year is the best year so far for you. See you then!

Sunday, 10 December 2017

Please Help my Friend with his Independence!

I have a close friend called Daryl, who is one of the kindest, most supportive and most generous people I've ever known. He volunteers, does a lot for disability sports and manages a charity that helps get disabled people into sport.

He does all this, whilst living with Marfan Syndrome and Epilepsy. He needs more support than he's getting right now; which is why I am asking for your help. Daryl lives with his brother, and they are both wheelchair users. They have been living in a bungalow which is not suitable for their needs. It is not adapted and what they really need is to be able to move into a bungalow that has been specially adapted. Daryl also needs a specialist wheelchair, so that he is able to move about freely whilst using the strength that he has left.

This, of course, comes at quite a cost, so he has had to set up a fundraiser. His target is £9000 and he has raised £1505 so far. He really needs as many people as possible to donate and share so that he can reach his target as soon as possible. This really is a life-changing amount for him and if you could donate just £5, it would really really help.

I've embedded the link to his fundraiser below. Please donate what you can, and share far and wide! I know he will appreciate this so so much.


(If the above link doesn't work, then please follow the following link to access Daryl's fundraiser: https://www.gofundme.com/funddaryl )

Thank you so much!

Wednesday, 6 December 2017

My Favourite Person

This blog post has been inspired by this article on The Mighty.

A Favourite Person (or FP) is someone you absolutely love, to an extreme extent. They really are your favourite person and you place responsibility of your happiness onto them. They can make you feel on top of the world, or in the deepest pit; depending on whether they are paying attention to you or not.

Looking back on past relationships, friendships etc, I can think of one particular person who became my FP. Let's call him M. M and I met while I was studying, and had a close friendship from the off. I was in an abusive relationship at the time, and M was always there for me. I confided in him a lot and the worse my relationship became, the stronger my friendship with M was. We continued talking after university and when single, we'd flirt as well. I always felt so grateful for how much he'd been there for me. We started flirting more, and even started talking about dating. I wasn't sure at first, but then the more we talked, the more attracted to him I became. I started to put him on a pedestal, and relied on him to talk to me constantly, and be there for me constantly. At first, it didn't seem a problem. I felt like I was his favourite person too.

But then he started dating others and I resented that. I really thought he was the best person ever, and that I was the only one he wanted to be with. I fell for him and saw him as The One. If we talked, everything was great, he was the best person ever and I loved him more than anything in the world. If we didn't talk for a day, or didn't talk much, I resented him and at times, I hated him. I felt so hurt and betrayed by him. I got very jealous of women he dated. I resented the closeness they had because I thought it should be me and him. I wasn't a very nice person to be honest.

He did mess with my feelings. I'm not denying that. He made me think we'd have a relationship soon, then next thing I know, he was in a relationship with somebody else. He should've told me. I wouldn't have liked it, but in time I'd accept it. But the way I was with him, the way I placed that responsibility of my happiness on him, wasn't healthy. We'd have big arguments because of it.

I ended our friendship when I found out he'd got engaged, and not bothered to tell me. It would've been nice for him to tell me this big news, especially as we were such close friends, but I think I made a bigger thing out of it than I should've. I saw it as the ultimate betrayal, and ended up blocking him for it.

Nowadays, I worry about getting another Favourite Person. I know I ask for reassurance constantly, and think someone hates me if they don't reply to me or start conversations with me. Whether it be with friendships or romantic/sexual relationships, when I love, I love extremely deeply. I have to be careful of that, and it has affected forming relationships.

Resources

1. What Having a Favourite Person Means to someone with Borderline Personality Disorder: https://themighty.com/2016/10/what-its-like-to-have-a-favorite-person-when-you-live-with-borderline/?utm_source=Mental%20Health&utm_medium=Email&utm_campaign=BPD%20Newsletter%20#4%20December%205,%202017

Friday, 1 December 2017

Another CMHT Assessment

TRIGGER WARNING: mentions of overdose

To catch up on my experiences with mental health services, please watch my playlist on Youtube.

After another sharp decline in my mental health, and a small overdose, I decided to call the Community Mental Health team (secondary services). It'd been just over 3 months since I'd been discharged back to my GP. I was feeling confused, panicky, lost, and honestly unsafe.

Some things had contributed to my mental ill health; one of them being a PIP reassessment. I knew there was the possibility of having a face to face one, but being given just two days' notice was a real shock. I felt like I wasn't able to properly prepare, and I didn't have time to arrange a recording of my assessment. I vented about this, how I'd felt, and what I'd done, on Twitter, and some close friends persuaded me to contact mental health services.

Doing this wasn't easy. I doubted myself, and wondered if I really was ill enough for their help. I took a deep breath and called though. The person I spoke to was lovely. She said I'd done the right thing and booked me an appointment for an assessment with a CPN (community psychiatric nurse).

The assessment itself was thorough. It wasn't with my old CPN unfortunately, but this one was just as kind. We went through my problems right now, things in the past, things in the present, possible triggers, my meds, what therapy I've had before, whether I'd been with secondary services before etc. She wrote a lot of notes, and I hoped she could do something for me.

Her decision however, was to advise me to try mindfulness at home, and wait for the CBT (cognitive behavioural therapy) sessions with the Primary Care team. I did ask about DBT (Dialectical Behaviour Therapy), as I'd been diagnosed with BPD (Borderline Personality Disorder) but she said things had changed with the mental health team, and I may not fit the criteria for that type of therapy. I was emotionally and physically exhausted, so I just accepted this, and said goodbye.

I'm not sure how I feel about this assessment. I think I feel listened to, and I guess I wasn't expecting much in the way of help, but last time I was assessed, I felt pretty much the same and was offered some help from secondary services. In all honesty, I feel I've been abandoned since my BPD diagnosis, even though there are therapies suggested for it. Why am I not getting access to these, when they could help me a lot? Is the diagnosis just not enough anymore?

Resources

My Mental Health Vlogs:  https://www.youtube.com/watch?v=0kX521jdPAU&list=PLLVKOK6LyfuspXXsZ0xdiKCW_Z6SYjTzO

CPN definition: https://en.wikipedia.org/wiki/Community_psychiatric_nurse

CBT definition: https://www.nhs.uk/conditions/cognitive-behavioural-therapy-cbt/

DBT definition: https://www.mind.org.uk/information-support/drugs-and-treatments/dialectical-behaviour-therapy-dbt/#.WiGLcUq6-M8

BPD definition: https://www.mind.org.uk/information-support/types-of-mental-health-problems/borderline-personality-disorder-bpd/#.WiGLtkq6-M8