I finally feel like I'm just about ready to start Trauma Focused CBT. This is offered through my local Primary Care Mental Health team, and I can self refer for assessment. Last week, I rang up to give my details and was offered a telephone assessment last Thursday. They originally wanted to give me an appointment for last Wednesday, but after discussion amongst themselves, they decided I needed to speak to someone more senior because of my complex needs.
The telephone assessment went really well, and I managed to remember everything I needed to say (prompted by my notes as well, of course). The first part of the assessment was the more "objective" part; where we went through my answers to the PHQ9 and GAD7 questionnaires, as well as questions on specific phobias, functioning, employment, and recent appointments. My scores for the PHQ and GAD questionnaires were quite high; indicating my levels of Depression and Generalised Anxiety are quite severe. I knew this beforehand, and the complex issues that form part of my mental health problems just exacerbate those levels too. It's like my brain is constantly battling itself!
I was asked how I had been feeling recently (awful to be honest), how my family life was (ok, but a lot of stress about various things), my aims for therapy (to be able to talk about my termination with others, and help people who have been through similar experiences) and why I decided to contact the service this time (I was fed up of how easily triggered I got, and I want help to change this).
The telephone assessment was only supposed to take about 30 minutes. It ended up taking an hour, 10 minutes! Thankfully, I was given time to explain everything, and I certainly wasn't rushed! I do hope this helps them to get an idea of my needs and aims though.
The day after the assessment, I received a phone call to say they'd accepted me for CBT (I'm hoping they mean Trauma Focused, but we'll see).
I seem to have a lot of ideas for blog posts, and not enough energy to get them past a very rough draft stage! I can't promise my next post will be about my mental health, but you should hear from me, for updates on that subject, soon.
Wednesday, 18 September 2019
Friday, 13 September 2019
Another ENT follow up, and a Chronic Vestibular Migraines diagnosis
Today, I had my second follow up with the ENT department. I saw the consultant himself this time, and he was a very pleasant man. He introduced himself and asked me to take a seat, before asking me how I'd been. I told him that things were pretty much the same as before. My balance hadn't improved, despite the physio exercises, and the dizziness and flashing lights/floaters were pretty much the same too.
He told me the results of my Vestibular tests were relatively normal, so he didn't think it was my ears that were affecting my balance etc. He said it was more of a "central" problem.
I found he took me seriously and was sympathetic to my struggles with my physical symptoms. I also told him my physio had told me to speak to the doctor about Vestibular Migraines. The consultant wholeheartedly agreed with him and gave me the formal diagnosis of Chronic Vestibular Migraines
I've included a link which explains what Vestibular Migraines actually are, but these are the symptoms I experience:
Overall, I'm very pleased with how the appointment went and how I was treated. Most things were discussed and at least I'm still under the care of ENT.
Do you suffer from Vestibular Migraines? Please comment below with what helps/makes them worse.
Resources
Vestibular Function Tests: https://www.stgeorges.nhs.uk/service/general-medicine/audiology/vestibular-balance-and-dizziness-service/vestibular-function-tests/
Vestibular Migraines: https://www.webmd.com/migraines-headaches/vestibular-migraines#1
Floaters and flashes in the eyes: https://www.nhs.uk/conditions/floaters-and-flashes-in-the-eyes/
He told me the results of my Vestibular tests were relatively normal, so he didn't think it was my ears that were affecting my balance etc. He said it was more of a "central" problem.
I found he took me seriously and was sympathetic to my struggles with my physical symptoms. I also told him my physio had told me to speak to the doctor about Vestibular Migraines. The consultant wholeheartedly agreed with him and gave me the formal diagnosis of Chronic Vestibular Migraines
I've included a link which explains what Vestibular Migraines actually are, but these are the symptoms I experience:
- Dizziness: This tends to be all the time, but I do get acute bouts of dizziness where I feel as if I am going to fall over or faint
- Balance Problems: Again, I feel like I'm going to fall over. It is the primary reason why I use a walking stick, and is a problem I've had for years.
- Flashing lights: This does what it says on the tin. They are flashing lights in my field of vision. They can be incredibly distracting and I cannot concentrate when there are lots at a time.
- "Floaters": These are little shapes (wiggly lines is a typical one) in my field of vision. They float around then disappear
- Sensitivity to light/sound: I don't always get this, but I have noticed it happen a lot recently.
- Some nausea: This tends to come on with the acute bouts of dizziness
- Migraine headaches: I do still get classic migraines (with the headache) now and again. As I've experienced classic migraines in the past, the ENT consultant says I am more susceptible to Vestibular ones now
Vestibular migraines don't typically occur with the classic type headache/s. The primary symptom tends to be dizziness, so it is not usual that someone would think they are having a migraine at the time.
After I'd explained my symptoms and the consultant had given me the diagnosis, he wanted to know what medication I take. I listed off the medication that I could remember, and he told me that some of the medication (namely the Tramadol) could be exacerbating the dizziness, as it works as a sedative.
The next thing he suggested was to start by finding my triggers and exclude certain foods to see if they affect the migraine symptoms. He also wants to see me in about 3 or 4 months time
Overall, I'm very pleased with how the appointment went and how I was treated. Most things were discussed and at least I'm still under the care of ENT.
Do you suffer from Vestibular Migraines? Please comment below with what helps/makes them worse.
Resources
Vestibular Function Tests: https://www.stgeorges.nhs.uk/service/general-medicine/audiology/vestibular-balance-and-dizziness-service/vestibular-function-tests/
Vestibular Migraines: https://www.webmd.com/migraines-headaches/vestibular-migraines#1
Floaters and flashes in the eyes: https://www.nhs.uk/conditions/floaters-and-flashes-in-the-eyes/
Tuesday, 10 September 2019
"I can feel it in my bones"
The title describes a phrase I use very often, when it comes to some of the pain I experience with Fibromyalgia. As Summer ends, Autumn begins, and with it come stiff breezes and general cold, I really do feel it in my bones and it makes moving my joints very difficult.
I wake up with incredibly stiff joints, and the cold weather means it takes even more mental and physical effort to get out of bed and face the day. I know that the stiffness will ease, as long as I make sure I keep warm and moving, but the initial pain that comes with the stiffness is incredibly hard to push through.
Keeping warm of course is very important for people with Fibromyalgia. So is trying not to overheat. We often find it hard to regulate our body temperature, and being too hot or cold can cause all sorts of symptom flare ups. Below are my lists of symptoms that flare up when I'm too cold, and when I'm too hot.
When I'm too cold:
Do you have problems with temperature regulation? Comment below with your tips for dealing with it!
I wake up with incredibly stiff joints, and the cold weather means it takes even more mental and physical effort to get out of bed and face the day. I know that the stiffness will ease, as long as I make sure I keep warm and moving, but the initial pain that comes with the stiffness is incredibly hard to push through.
Keeping warm of course is very important for people with Fibromyalgia. So is trying not to overheat. We often find it hard to regulate our body temperature, and being too hot or cold can cause all sorts of symptom flare ups. Below are my lists of symptoms that flare up when I'm too cold, and when I'm too hot.
When I'm too cold:
- Joint pain
- Nerve pain
- Muscle cramps
- Joint stiffness
- Headaches
- Muscle twitching
- Fatigue
When I'm too hot:
- Dizziness
- Weakness
- Fatigue
- Subluxations
- Joints that are "too loose"
- Sweating
- Faintness
- Sleep problems
So, what do I do about it? Well, I can't completely control it obviously, but there are some things I can do that may help. These include:
- Drinking lots of water/squash. I use a bottle that has measurements with times at certain points. I have to make sure I've drunk enough by the time indicated on the bottle.
- Have light salty/sweet snacks. This helps keep my electrolytes up and sometimes helps the dizziness
- Sit down whenever I need to, if possible. I have to rest often, whether too hot or too cold. This may help the dizziness
- Have naps, but not too late in the day. I aim to nap around 2 or 3pm if I'm not at an appointment, meeting a friend etc. If I haven't rested by that time, I do usually feel extremely fatigued, especially if I am too hot. Some days my body will reserve more energy however, so I can do a bit more in my day.
- Wear layers instead of thick jumpers. This way I can add more if I'm cold, or take more off if I'm hot.
Do you have problems with temperature regulation? Comment below with your tips for dealing with it!
Thursday, 5 September 2019
Physiotherapy for Dizziness and Balance Problems
Over the past few months, I've been having physiotherapy for the dizziness I experience daily, and the balance problems I've had for years.
My first session consisted of a long assessment of my problems, and going over the forms that I had filled in prior to the appointment. I was asked all sorts of questions, including about any other symptoms I have, how severe, how often etc. I mentioned about headaches that come with the dizziness sometimes, as well as the flashing lights/"floaters" I get in my line of vision most days. I also have had a few falls; where my knees or ankles have just given way. I've bruised like a peach and sprained ankles because of those!
After all of the questions had been answered (and I was pretty exhausted), my physio decided to do a few tests; starting with blood pressure testing when lying down for 10 minutes, sitting up, and then standing. At the time, I was being investigated for symptoms of Postural Orthostatic Tachycardia Syndrome with a 48 hour portable ECG (the results turned out to be insignificant, so I never got round to having the tilt table test). The blood pressure results were relatively normal, so the physio said that excluded a few things (he didn't specify what).
Just before the session ended, my physio gave me a few simple exercises to do (If I remember correctly, they involved turning my head to each side, tilting my head each side, and turning my head upwards and downwards slowly) My next session would involve some balance tests.
Subsequent sessions mainly involved asking how I'd got on in previous weeks, how I'd found I'd managed with the exercises, then introducing me to more balance tests and exercises to try at home. Although my balance didn't seem to improve, despite the exercises (which I did do regularly, like a good patient!), I did find my physiotherapist very helpful with advice, and his findings. After speaking about some of my symptoms, he asked if I had been told (by doctors) that I may be suffering from a type of migraine that doesn't always present with the classic headache. I guess I hadn't really thought about migraines, although an optician did mention it to me due to the flashing lights I get in my vision. I'm due another eye test anyway (it's on the To Do list) so they'll probably want to investigate that more. As the flashing lights have been getting worse, and the dizziness hasn't improved, I decided to speak to my GP about it. He gave me Stemetil for the dizziness, but decided not to prescribe the usual migraine medication, as I don't often get the headaches. Sod's law, I'm getting them more now!
As well as this, at my penultimate physio appointment we spoke about my balance, and I mentioned how I believed a lot of it was down to my hypermobility. My ankles are very hypermobile and often give way. I used to get teased at school for falling down suddenly in the playground. I've been embarrassed by falling while in the middle of a town centre as well. Thankfully it's not resulted in serious problems (the worst has been a sprained ankle) but it's not pleasant anyway. I told my physio that I was thinking about asking my doctor to refer me to a rheumatologist to see if my Hypermobility Syndrome was actually Hypermobile Ehlers Danlos Syndrome . They used to be interchangeable diagnoses, but the criteria for HEDS is stricter now and they are believed to be different points of the Hypermobility Spectrum Disorders
I expected the physio to roll his eyes at me and dismiss my concerns, like various healthcare professionals have, but he actually took me seriously! He told me to definitely talk to the doctor and get a referral, so I can be properly assessed.
My last session was earlier today and when I told him the doctor had referred me to a Rheumatologist (Finally!) he was pleased, and wanted me to make sure the one I see either has a specialism in Ehlers Danlos Syndrome, or can refer me on to a Rheumatologist who specifically deals with EDS patients.
He was also pleased that I'd seen the doctor about my migraines. It looks like I've now been diagnosed with Vestibular Migraines . If the Stemetil doesn't help the dizziness or other symptoms, he will refer me on to a neurologist.
Lastly, we spoke about my balance problems. The physio decided there was no more he could do for me, so he has referred me on to a specialist rehab centre for balance problems. I'm not sure how long the waiting list is, but apparently the sessions are longer and the exercises a lot more intense. This should help my balance and give me better quality of life though.
Overall, I've been very pleased with these physio sessions. I may not have noticed improvements as such, but I've gained so much knowledge and advice, as well as support and advocacy from this physio, and I think these are invaluable. I feel that, with my physical health at least, I am starting to be taken seriously and actually getting the referrals and treatment I need.
I will of course blog about my referrals, when they finally come through, but in the meantime, I will try to keep you up to date with my physical and mental health progress. My next appointment is with the ENT specialist, so hopefully I will get more tests and/or treatment for the migraines!
Resources
1. Postural Tachycardia Syndrome: https://www.nhs.uk/conditions/postural-tachycardia-syndrome/
2. Tilt Test: https://www.bhf.org.uk/informationsupport/tests/tilt-test
3. Joint Hypermobility Syndrome: https://www.nhs.uk/conditions/joint-hypermobility-syndrome/
4. Ehlers Danlos Syndromes: https://www.nhs.uk/conditions/ehlers-danlos-syndromes/
5. Hypermobile EDS and Hypermobility Spectrum Disorders: https://www.ehlers-danlos.org/what-is-eds/information-on-eds/hypermobile-eds-and-hypermobility-spectrum-disorders/
6. Vestibular Migraines: https://www.webmd.com/migraines-headaches/vestibular-migraines#1
My first session consisted of a long assessment of my problems, and going over the forms that I had filled in prior to the appointment. I was asked all sorts of questions, including about any other symptoms I have, how severe, how often etc. I mentioned about headaches that come with the dizziness sometimes, as well as the flashing lights/"floaters" I get in my line of vision most days. I also have had a few falls; where my knees or ankles have just given way. I've bruised like a peach and sprained ankles because of those!
After all of the questions had been answered (and I was pretty exhausted), my physio decided to do a few tests; starting with blood pressure testing when lying down for 10 minutes, sitting up, and then standing. At the time, I was being investigated for symptoms of Postural Orthostatic Tachycardia Syndrome with a 48 hour portable ECG (the results turned out to be insignificant, so I never got round to having the tilt table test). The blood pressure results were relatively normal, so the physio said that excluded a few things (he didn't specify what).
Just before the session ended, my physio gave me a few simple exercises to do (If I remember correctly, they involved turning my head to each side, tilting my head each side, and turning my head upwards and downwards slowly) My next session would involve some balance tests.
Subsequent sessions mainly involved asking how I'd got on in previous weeks, how I'd found I'd managed with the exercises, then introducing me to more balance tests and exercises to try at home. Although my balance didn't seem to improve, despite the exercises (which I did do regularly, like a good patient!), I did find my physiotherapist very helpful with advice, and his findings. After speaking about some of my symptoms, he asked if I had been told (by doctors) that I may be suffering from a type of migraine that doesn't always present with the classic headache. I guess I hadn't really thought about migraines, although an optician did mention it to me due to the flashing lights I get in my vision. I'm due another eye test anyway (it's on the To Do list) so they'll probably want to investigate that more. As the flashing lights have been getting worse, and the dizziness hasn't improved, I decided to speak to my GP about it. He gave me Stemetil for the dizziness, but decided not to prescribe the usual migraine medication, as I don't often get the headaches. Sod's law, I'm getting them more now!
As well as this, at my penultimate physio appointment we spoke about my balance, and I mentioned how I believed a lot of it was down to my hypermobility. My ankles are very hypermobile and often give way. I used to get teased at school for falling down suddenly in the playground. I've been embarrassed by falling while in the middle of a town centre as well. Thankfully it's not resulted in serious problems (the worst has been a sprained ankle) but it's not pleasant anyway. I told my physio that I was thinking about asking my doctor to refer me to a rheumatologist to see if my Hypermobility Syndrome was actually Hypermobile Ehlers Danlos Syndrome . They used to be interchangeable diagnoses, but the criteria for HEDS is stricter now and they are believed to be different points of the Hypermobility Spectrum Disorders
I expected the physio to roll his eyes at me and dismiss my concerns, like various healthcare professionals have, but he actually took me seriously! He told me to definitely talk to the doctor and get a referral, so I can be properly assessed.
My last session was earlier today and when I told him the doctor had referred me to a Rheumatologist (Finally!) he was pleased, and wanted me to make sure the one I see either has a specialism in Ehlers Danlos Syndrome, or can refer me on to a Rheumatologist who specifically deals with EDS patients.
He was also pleased that I'd seen the doctor about my migraines. It looks like I've now been diagnosed with Vestibular Migraines . If the Stemetil doesn't help the dizziness or other symptoms, he will refer me on to a neurologist.
Lastly, we spoke about my balance problems. The physio decided there was no more he could do for me, so he has referred me on to a specialist rehab centre for balance problems. I'm not sure how long the waiting list is, but apparently the sessions are longer and the exercises a lot more intense. This should help my balance and give me better quality of life though.
Overall, I've been very pleased with these physio sessions. I may not have noticed improvements as such, but I've gained so much knowledge and advice, as well as support and advocacy from this physio, and I think these are invaluable. I feel that, with my physical health at least, I am starting to be taken seriously and actually getting the referrals and treatment I need.
I will of course blog about my referrals, when they finally come through, but in the meantime, I will try to keep you up to date with my physical and mental health progress. My next appointment is with the ENT specialist, so hopefully I will get more tests and/or treatment for the migraines!
Resources
1. Postural Tachycardia Syndrome: https://www.nhs.uk/conditions/postural-tachycardia-syndrome/
2. Tilt Test: https://www.bhf.org.uk/informationsupport/tests/tilt-test
3. Joint Hypermobility Syndrome: https://www.nhs.uk/conditions/joint-hypermobility-syndrome/
4. Ehlers Danlos Syndromes: https://www.nhs.uk/conditions/ehlers-danlos-syndromes/
5. Hypermobile EDS and Hypermobility Spectrum Disorders: https://www.ehlers-danlos.org/what-is-eds/information-on-eds/hypermobile-eds-and-hypermobility-spectrum-disorders/
6. Vestibular Migraines: https://www.webmd.com/migraines-headaches/vestibular-migraines#1
Friday, 9 August 2019
A Mental Health Nightmare
(Trigger Warning: Self Harm, Suicide, Trauma, and Medication)
This is a follow on from my previous blog post
On Wednesday, I had an assessment with a nurse from CMHT. I was referred for this by my counsellor at my last session. Primary care had decided that, because of my urges to self harm, & my strong suicidal feelings, I wasn't stable enough for them.
The CMHT assessment went worse than I expected. I was assessed by a very condescending, judgmental nurse (who turned out to be the useless nurse prescriber I saw last year, who kept me on Sertraline even though it'd stopped working). She got me to fill in a very short questionnaire (something to do with how often I feel useless, demotivated etc) then told me she'd only ask me a few questions because CMHT had seen me a few times before & they knew my history.
First of all, she wanted me to tell her how I'd been feeling. I told her that primary care had sent me to CMHT because they felt that I was too unstable for them. She seemed disbelieving about that and had this smug look on her face (not a great start). I can't remember exactly what she asked me, but it wasn't much. It was mainly me telling her how I was feeling, and my worries. I was having urges to self harm badly, flashbacks about my traumas (Which I reminded her of), graphic mental images. I was even having suicidal thoughts, although I didn't think I'd carry them out because I feel stuck having my parents and Billie. They were my protective factors but without them I would definitely have attempted suicide. What I would definitely be doing though is self harming/overdosing. She still didn't seem to believe me, and asked what I wanted from CMHT. I said I felt I needed a CPN to monitor me. She said they don't do that now. I said I needed a meds review because I'm on the maximum dose of Sertraline and it seems to have stopped working. She said it was probably helping a bit so I should stay on it regardless. I said I may as well stop them, and she insisted I didn't.
I also asked whether an assessment for PTSD would lead to more help & she said no and I probably had it anyway because I had counselling for trauma and I'd been told to refer myself for Trauma Focused CBT. So I guess I have a sort of diagnosis now. I then reminded her of how much I was struggling, that I was at crisis point & I would definitely harm myself when I get home. She didn't seem to believe me and she said that I just wasn't ill enough for any help from them. She repeated it was all short term anyway, and mental health services had changed.
She then started talking as if it was a job interview. She asked me where I saw myself in 5 years. I was in no state to think about that, so I just said I don't know, I felt like I wasn't getting any better so I wouldn't know how I'd cope on my own, but I hoped I'd have moved out by then. She seemed pleased about that. She asked me about my hobbies (I talked about blogging and gaming), whether I went to any classes (I said about Slimming World), whether I worked/was intending to. I said I wanted to do something online but there wasn't much regular work online that I could do. She said that all I seem to do is go online, talk to friends and not much else. I found her very judgmental and she completely got the wrong impression of me.
There wasn't much else after that and I was crying through pretty much the entire assessment. She asked me what my plans were for that day. I scoffed and said I wanted to harm myself & that was all I planned to do. Even though I was clearly a risk to myself, she dismissed it. She'd even said at the start that she would have to tell a colleague if I was at risk! I have a feeling she didn't though. So I came out of the assessment crying and desperate to harm myself. I felt out of control! I dashed to the toilet and looked around to see if I could find anything to hurt myself with (preferably something sharp). I couldn't find anything & Dad would be there any minute, so I had to gather myself together then go out of the toilet. I told Dad what had happened and he was furious at her.
When we got home, I was in a world of my own. All I could think about was harming myself, and I spent about an hour in silence, planning what to do. I opted for overdosing. I took my chance when Mum went to the bathroom. I overdosed on Stemetil (Prochlorperazine). I only stopped when Mum came in. I told her what I'd done & she was very worried. She asked me how I was feeling, then it was only an hour or so after that I had my urgent GP appointment (mum had booked it when I told her about the assessment).
The GP appointment went much better than the CMHT assessment. He took me seriously, wrote down what I told him, and asked how I was feeling (drowsy, dizzy, nauseous). Then he faced me, took a breath, & said I needed to go to the hospital, get checked over and see Psych Liaison team. He said I was "high risk" and should get to the hospital ASAP. He also wanted to see me the next day for a follow up. Soon after that, I was at my local hospital's A&E department. I explained to the receptionist what I'd done & how I felt and I didn't have to wait long to see the triage nurse.
She was very understanding but she misunderstood when I talked about my bullying trauma shaping my personality. She thought I meant my body and started talking about weight loss, checking thyroid. That confused me for a bit. Having thin privilege, I'd never had a healthcare professional mention my weight before. Anyway, she checked on her system what needed to happen with a Prochlorperazine overdose. She booked me in for blood tests and an ECG. I had the ECG which was fine, then I was brought through to cubicles by a really nice doctor. She did my bloods & asked me questions about physical health, mental health etc. I really felt listened to, and she made sure I wanted to see Psych Liaison team. She then got a colleague to do my blood sugar (4.4, so low end of normal) and said while I wait for blood test results to come back, I should have something to eat and drink to get blood sugar up a bit. It would take an hour for results to come back.
Then came a lot of waiting. My blood results were "not worrying" but indicated I was dehydrated, so the doctor told me to get some water. She asked how I was feeling. I said I had a banging headache, and was very drowsy and dizzy. She then said she had called Psych Liaison team and they aimed to see me within the hour, but couldn't guarantee it. I was sent back to the waiting area. I got some water, went to the loo and waited. It was almost 2 hours before I was seen. The person I was due to see had finished his shift so had to spend time updating the person I was going to see instead. I actually saw two people at the same time. I think one was a psychiatrist & the other, a psychologist. They knew why I was there and had contacted my CMHT again. All they could do was advise me, as CMHT still wouldn't take me on. Apparently, even though Primary Care said I wasn't stable enough, CMHT said I was. They couldn't offer me more support but they at least explained things in a kinder way, took me seriously, and made sure I had support at home. The psychologist (?) also gave me information about classes I could join, mental health organisations etc. They also told me to see my GP about my meds.
Apparently, if the GP wasn't comfortable changing my medication, they could refer me directly to a psychiatrist! So other than that, I was to keep myself safe and distracted, with help of parents, friends, my cat, and crisis team until I have my Trauma Focused CBT. I eventually got home (after a trip to the chip shop, I was starving!) and was absolutely exhausted. It was about 10pm (I had first got to A&E just before 4pm). After food, I took a Diazepam then slept.
So since then I've been feeling like hurting myself but I don't think I'll do it, so I feel safer. I've seen the GP again and he's changed my Sertraline to Citalopram, and added a week's worth of Diazepam. He also got me to book an appointment for 2 weeks time, so he can monitor my moods, side effects etc
I feel like, even though I couldn't get more practical support from CMHT etc, at least I can refer for Trauma Focused CBT, I have a sort of diagnosis of PTSD, my meds have been reviewed, and my GP is monitoring me. So it's turned out ok, and I'm hoping I will improve. I will refer myself for Trauma Focused CBT next week, as it will be about 10 weeks before the sessions start. In the meantime, I have to be more open and honest with my loved ones, and let them look after me and keep me safe. The other day feels like a blur, a really bad dream even. I guess I'm still recovering but at least I'm in a better place now.
This is a follow on from my previous blog post
On Wednesday, I had an assessment with a nurse from CMHT. I was referred for this by my counsellor at my last session. Primary care had decided that, because of my urges to self harm, & my strong suicidal feelings, I wasn't stable enough for them.
The CMHT assessment went worse than I expected. I was assessed by a very condescending, judgmental nurse (who turned out to be the useless nurse prescriber I saw last year, who kept me on Sertraline even though it'd stopped working). She got me to fill in a very short questionnaire (something to do with how often I feel useless, demotivated etc) then told me she'd only ask me a few questions because CMHT had seen me a few times before & they knew my history.
First of all, she wanted me to tell her how I'd been feeling. I told her that primary care had sent me to CMHT because they felt that I was too unstable for them. She seemed disbelieving about that and had this smug look on her face (not a great start). I can't remember exactly what she asked me, but it wasn't much. It was mainly me telling her how I was feeling, and my worries. I was having urges to self harm badly, flashbacks about my traumas (Which I reminded her of), graphic mental images. I was even having suicidal thoughts, although I didn't think I'd carry them out because I feel stuck having my parents and Billie. They were my protective factors but without them I would definitely have attempted suicide. What I would definitely be doing though is self harming/overdosing. She still didn't seem to believe me, and asked what I wanted from CMHT. I said I felt I needed a CPN to monitor me. She said they don't do that now. I said I needed a meds review because I'm on the maximum dose of Sertraline and it seems to have stopped working. She said it was probably helping a bit so I should stay on it regardless. I said I may as well stop them, and she insisted I didn't.
I also asked whether an assessment for PTSD would lead to more help & she said no and I probably had it anyway because I had counselling for trauma and I'd been told to refer myself for Trauma Focused CBT. So I guess I have a sort of diagnosis now. I then reminded her of how much I was struggling, that I was at crisis point & I would definitely harm myself when I get home. She didn't seem to believe me and she said that I just wasn't ill enough for any help from them. She repeated it was all short term anyway, and mental health services had changed.
She then started talking as if it was a job interview. She asked me where I saw myself in 5 years. I was in no state to think about that, so I just said I don't know, I felt like I wasn't getting any better so I wouldn't know how I'd cope on my own, but I hoped I'd have moved out by then. She seemed pleased about that. She asked me about my hobbies (I talked about blogging and gaming), whether I went to any classes (I said about Slimming World), whether I worked/was intending to. I said I wanted to do something online but there wasn't much regular work online that I could do. She said that all I seem to do is go online, talk to friends and not much else. I found her very judgmental and she completely got the wrong impression of me.
There wasn't much else after that and I was crying through pretty much the entire assessment. She asked me what my plans were for that day. I scoffed and said I wanted to harm myself & that was all I planned to do. Even though I was clearly a risk to myself, she dismissed it. She'd even said at the start that she would have to tell a colleague if I was at risk! I have a feeling she didn't though. So I came out of the assessment crying and desperate to harm myself. I felt out of control! I dashed to the toilet and looked around to see if I could find anything to hurt myself with (preferably something sharp). I couldn't find anything & Dad would be there any minute, so I had to gather myself together then go out of the toilet. I told Dad what had happened and he was furious at her.
When we got home, I was in a world of my own. All I could think about was harming myself, and I spent about an hour in silence, planning what to do. I opted for overdosing. I took my chance when Mum went to the bathroom. I overdosed on Stemetil (Prochlorperazine). I only stopped when Mum came in. I told her what I'd done & she was very worried. She asked me how I was feeling, then it was only an hour or so after that I had my urgent GP appointment (mum had booked it when I told her about the assessment).
The GP appointment went much better than the CMHT assessment. He took me seriously, wrote down what I told him, and asked how I was feeling (drowsy, dizzy, nauseous). Then he faced me, took a breath, & said I needed to go to the hospital, get checked over and see Psych Liaison team. He said I was "high risk" and should get to the hospital ASAP. He also wanted to see me the next day for a follow up. Soon after that, I was at my local hospital's A&E department. I explained to the receptionist what I'd done & how I felt and I didn't have to wait long to see the triage nurse.
She was very understanding but she misunderstood when I talked about my bullying trauma shaping my personality. She thought I meant my body and started talking about weight loss, checking thyroid. That confused me for a bit. Having thin privilege, I'd never had a healthcare professional mention my weight before. Anyway, she checked on her system what needed to happen with a Prochlorperazine overdose. She booked me in for blood tests and an ECG. I had the ECG which was fine, then I was brought through to cubicles by a really nice doctor. She did my bloods & asked me questions about physical health, mental health etc. I really felt listened to, and she made sure I wanted to see Psych Liaison team. She then got a colleague to do my blood sugar (4.4, so low end of normal) and said while I wait for blood test results to come back, I should have something to eat and drink to get blood sugar up a bit. It would take an hour for results to come back.
Then came a lot of waiting. My blood results were "not worrying" but indicated I was dehydrated, so the doctor told me to get some water. She asked how I was feeling. I said I had a banging headache, and was very drowsy and dizzy. She then said she had called Psych Liaison team and they aimed to see me within the hour, but couldn't guarantee it. I was sent back to the waiting area. I got some water, went to the loo and waited. It was almost 2 hours before I was seen. The person I was due to see had finished his shift so had to spend time updating the person I was going to see instead. I actually saw two people at the same time. I think one was a psychiatrist & the other, a psychologist. They knew why I was there and had contacted my CMHT again. All they could do was advise me, as CMHT still wouldn't take me on. Apparently, even though Primary Care said I wasn't stable enough, CMHT said I was. They couldn't offer me more support but they at least explained things in a kinder way, took me seriously, and made sure I had support at home. The psychologist (?) also gave me information about classes I could join, mental health organisations etc. They also told me to see my GP about my meds.
Apparently, if the GP wasn't comfortable changing my medication, they could refer me directly to a psychiatrist! So other than that, I was to keep myself safe and distracted, with help of parents, friends, my cat, and crisis team until I have my Trauma Focused CBT. I eventually got home (after a trip to the chip shop, I was starving!) and was absolutely exhausted. It was about 10pm (I had first got to A&E just before 4pm). After food, I took a Diazepam then slept.
So since then I've been feeling like hurting myself but I don't think I'll do it, so I feel safer. I've seen the GP again and he's changed my Sertraline to Citalopram, and added a week's worth of Diazepam. He also got me to book an appointment for 2 weeks time, so he can monitor my moods, side effects etc
I feel like, even though I couldn't get more practical support from CMHT etc, at least I can refer for Trauma Focused CBT, I have a sort of diagnosis of PTSD, my meds have been reviewed, and my GP is monitoring me. So it's turned out ok, and I'm hoping I will improve. I will refer myself for Trauma Focused CBT next week, as it will be about 10 weeks before the sessions start. In the meantime, I have to be more open and honest with my loved ones, and let them look after me and keep me safe. The other day feels like a blur, a really bad dream even. I guess I'm still recovering but at least I'm in a better place now.
Wednesday, 31 July 2019
My last Counselling session, and a referral to CMHT :Counselling Session 11
(Trigger Warning: Self Harm details, Suicide, and Abortion)
Mood Swings and Intrusive Thoughts:
A couple of days before my last counselling session, I was slightly hyper, overconfident, in a confrontational mood, and impulsive. I did not have much money to be impulsive with, so I just bought a jacket for my mum. Days before that, I had spent money online, buying lots of makeup and hair products. This hyper feeling only lasted a couple of hours, and then I became very anxious and paranoid; particularly about social media. I'd posted my response to an article about disabled people protesting and being reported to the Department for Work and Pensions (DWP) simply for protesting. I thought this malicious reporting was disgusting and I criticised the police who had done it. I fully expected an angry response from police officers/people who supported the police unconditionally, but thankfully I didn't get any. My Anxiety didn't subside much though, and I soon found myself in the deep pit of Depression. I was also very distressed, as I was experiencing graphic triggering mental images (mostly of abortion, and self harm) as well as intrusive thoughts and strong urges to self harm. I was supposed to call the Access team for some guidance, but I was too distressed and nervous, so I opted to email them instead.
The response I got the next day was very cold and dismissive. They basically told me I was right to say calling would result in a quicker response, and that I should do that instead. There was no sympathy for my situation. If anything, it nearly put me off calling, as I expected the call handler to be just as cold and dismissive.
By the end of the day, I was desperate to talk to someone though. I brought up the number on my phone and pressed "call" before I could talk myself out of it (again) due to thinking my situation wasn't urgent enough. The call handler was lovely though. They had a really calming voice, listened to me, and took me seriously. They also gave some helpful advice.
Counselling:
Skipping forward to my counselling session, I was still very distressed and depressed. As I explained to my counsellor, how I'd been feeling, I became more distressed, confused, and tearful. There were some things I hadn't realised about myself, that had now come to the forefront as I exposed myself to triggering conversations through counselling. The problem was, I needed support inbetween counselling sessions, as I had talked through my trauma in the session, and when it had ended, I was left to deal with the result of opening up. That's not to say counselling has caused my crisis (is it a crisis?) but it has brought some difficult things to the front of my mind; which has then led to a crisis.
I spoke to her about my intrusive thoughts, the mental images, the suicidal thoughts and urges to self harm (specifically cutting my arms and legs in the shower). This took over the session, as it was so urgent that I get help soon. My counsellor was very concerned and wanted to know how likely I was to harm myself.
She told me that to deal with the trauma and learn practical skills for coping, I needed to have trauma specific CBT. She then said that she didn't feel I was stable enough to commit to it at the moment though. Primary Care didn't have the resources to help people who are at risk of suicide or self harm, or the very complex issues that are causing me to need help straight away. She said that if I wanted, she would call the Access team so they could step me up to secondary care
She also asked what I felt I needed, if I were to be referred to Secondary Care (aka Community Mental Health Team). I took a minute to gather myself together, then told her I felt I needed a medication review, because I felt the Sertraline wasn't working anymore, and I shouldn't be in this state while on the highest dose. I also needed to be assessed for PTSD, and have a CPN to monitor my progress.
She asked me how I felt they could help me become more stable (other than the meds review) and I started crying as I said I wasn't sure, but I didn't want to keep struggling with the trauma I've experienced. I didn't want to feel this way anymore and I'm no expert so I don't have all the answers for how to help myself. I felt like I needed to have all the answers though, otherwise CMHT wouldn't know how to help me. I told my counsellor about the last time I was assessed by them. I did need their help though, so would like her to ring the Access team for me. She asked me to tell her what I wanted them to know. I said that I wanted her to tell them that I was having strong urges to self harm, I was having suicidal thoughts as well as graphic intrusive thoughts and mental images. I also was very depressed and distressed, and needed help very soon.
The session had come to a close at that point, and my counsellor confirmed she would ring Access team and tell them what I'd told her. I'd stopped crying by that point, and was checking my eyes weren't too red. I was very grateful to her for all her help, and I was very apologetic about how I'd behaved (I was worried that I had been rude and in her face. It turned out I hadn't though).
What Happened Next:
The next day, I expected a call from the Access team, but it never came. I rang them and explained everything. They checked my notes on the system, and said that I'd been stepped up to secondary care/CMHT straight away, and an appointment had been booked for me for 7th August.
I will blog about my appointment with CMHT soon. Please keep your fingers' crossed that they can offer me some help!
Resources:
Police force admits agreement to share information about protesters with DWP: https://www.disabilitynewsservice.com/police-force-admits-agreement-to-share-information-about-protesters-with-dwp/
Dealing with intrusive thoughts: https://www.mind.org.uk/information-support/your-stories/dealing-with-intrusive-thoughts/#.XUGQsehKiM8
Treatments for PTSD: https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd/treatments-for-ptsd/#.XUGRW-hKiM8
Community Mental Health Team: https://www.rethink.org/advice-and-information/living-with-mental-illness/treatment-and-support/community-mental-health-team-cmht/?gclid=CjwKCAjw-ITqBRB7EiwAZ1c5U6Ry5KJLjfr8k89GV4DpHT1_3NVTwxF-_nqPRrzqeF1QNV6cVwo2PRoCqIQQAvD_BwE
Post Traumatic Stress Disorder: https://www.nhs.uk/conditions/post-traumatic-stress-disorder-ptsd/
Mental health professionals: https://www.netdoctor.co.uk/conditions/depression/a638/mental-health-professionals/
Mood Swings and Intrusive Thoughts:
A couple of days before my last counselling session, I was slightly hyper, overconfident, in a confrontational mood, and impulsive. I did not have much money to be impulsive with, so I just bought a jacket for my mum. Days before that, I had spent money online, buying lots of makeup and hair products. This hyper feeling only lasted a couple of hours, and then I became very anxious and paranoid; particularly about social media. I'd posted my response to an article about disabled people protesting and being reported to the Department for Work and Pensions (DWP) simply for protesting. I thought this malicious reporting was disgusting and I criticised the police who had done it. I fully expected an angry response from police officers/people who supported the police unconditionally, but thankfully I didn't get any. My Anxiety didn't subside much though, and I soon found myself in the deep pit of Depression. I was also very distressed, as I was experiencing graphic triggering mental images (mostly of abortion, and self harm) as well as intrusive thoughts and strong urges to self harm. I was supposed to call the Access team for some guidance, but I was too distressed and nervous, so I opted to email them instead.
The response I got the next day was very cold and dismissive. They basically told me I was right to say calling would result in a quicker response, and that I should do that instead. There was no sympathy for my situation. If anything, it nearly put me off calling, as I expected the call handler to be just as cold and dismissive.
By the end of the day, I was desperate to talk to someone though. I brought up the number on my phone and pressed "call" before I could talk myself out of it (again) due to thinking my situation wasn't urgent enough. The call handler was lovely though. They had a really calming voice, listened to me, and took me seriously. They also gave some helpful advice.
Counselling:
Skipping forward to my counselling session, I was still very distressed and depressed. As I explained to my counsellor, how I'd been feeling, I became more distressed, confused, and tearful. There were some things I hadn't realised about myself, that had now come to the forefront as I exposed myself to triggering conversations through counselling. The problem was, I needed support inbetween counselling sessions, as I had talked through my trauma in the session, and when it had ended, I was left to deal with the result of opening up. That's not to say counselling has caused my crisis (is it a crisis?) but it has brought some difficult things to the front of my mind; which has then led to a crisis.
I spoke to her about my intrusive thoughts, the mental images, the suicidal thoughts and urges to self harm (specifically cutting my arms and legs in the shower). This took over the session, as it was so urgent that I get help soon. My counsellor was very concerned and wanted to know how likely I was to harm myself.
She told me that to deal with the trauma and learn practical skills for coping, I needed to have trauma specific CBT. She then said that she didn't feel I was stable enough to commit to it at the moment though. Primary Care didn't have the resources to help people who are at risk of suicide or self harm, or the very complex issues that are causing me to need help straight away. She said that if I wanted, she would call the Access team so they could step me up to secondary care
She also asked what I felt I needed, if I were to be referred to Secondary Care (aka Community Mental Health Team). I took a minute to gather myself together, then told her I felt I needed a medication review, because I felt the Sertraline wasn't working anymore, and I shouldn't be in this state while on the highest dose. I also needed to be assessed for PTSD, and have a CPN to monitor my progress.
She asked me how I felt they could help me become more stable (other than the meds review) and I started crying as I said I wasn't sure, but I didn't want to keep struggling with the trauma I've experienced. I didn't want to feel this way anymore and I'm no expert so I don't have all the answers for how to help myself. I felt like I needed to have all the answers though, otherwise CMHT wouldn't know how to help me. I told my counsellor about the last time I was assessed by them. I did need their help though, so would like her to ring the Access team for me. She asked me to tell her what I wanted them to know. I said that I wanted her to tell them that I was having strong urges to self harm, I was having suicidal thoughts as well as graphic intrusive thoughts and mental images. I also was very depressed and distressed, and needed help very soon.
The session had come to a close at that point, and my counsellor confirmed she would ring Access team and tell them what I'd told her. I'd stopped crying by that point, and was checking my eyes weren't too red. I was very grateful to her for all her help, and I was very apologetic about how I'd behaved (I was worried that I had been rude and in her face. It turned out I hadn't though).
What Happened Next:
The next day, I expected a call from the Access team, but it never came. I rang them and explained everything. They checked my notes on the system, and said that I'd been stepped up to secondary care/CMHT straight away, and an appointment had been booked for me for 7th August.
I will blog about my appointment with CMHT soon. Please keep your fingers' crossed that they can offer me some help!
Resources:
Police force admits agreement to share information about protesters with DWP: https://www.disabilitynewsservice.com/police-force-admits-agreement-to-share-information-about-protesters-with-dwp/
Dealing with intrusive thoughts: https://www.mind.org.uk/information-support/your-stories/dealing-with-intrusive-thoughts/#.XUGQsehKiM8
Treatments for PTSD: https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd/treatments-for-ptsd/#.XUGRW-hKiM8
Community Mental Health Team: https://www.rethink.org/advice-and-information/living-with-mental-illness/treatment-and-support/community-mental-health-team-cmht/?gclid=CjwKCAjw-ITqBRB7EiwAZ1c5U6Ry5KJLjfr8k89GV4DpHT1_3NVTwxF-_nqPRrzqeF1QNV6cVwo2PRoCqIQQAvD_BwE
Post Traumatic Stress Disorder: https://www.nhs.uk/conditions/post-traumatic-stress-disorder-ptsd/
Mental health professionals: https://www.netdoctor.co.uk/conditions/depression/a638/mental-health-professionals/
Friday, 26 July 2019
Lack of Resources: Counselling Session 10
(Trigger Warning: Mention of trauma, self harm, overdosing, and suicide)
I had been experiencing a lot of emotional numbness and the need to avoid my feelings; leading up to this counselling session. Because of that, I wasn't sure what to talk about. My counsellor did ask me to embellish on the numb feelings and avoidance though and we found I was doing this to protect myself from intense distress and depression. There'd been some triggering storylines on television, and instead of panicking, I found myself dissociating in order to protect myself from the horrible feelings of being triggered.
My mum has had to fill in a work capability questionnaire too, and helping her do this, seeing her so anxious and depressed, has really rubbed off on me. It also took me back to the times I've had to fill in these forms; how much I've struggled emotionally, remembering back to that awful first face to face assessment. I never want to go through that again. My mental health worsened partly because of that assessment, and I haven't significantly improved since. As for emotions rubbing off on me, I told my counsellor that this happened in many situations, and I found I even got affected by atmospheres in a room. If it's a depressing atmosphere, I feel depressed. If it's an anxious atmosphere, I feel panicky, and so on. If a person is upset, they don't have to be showing it obviously, or tell me. I can sense how they feel, and it makes me feel the same. I suppose I'm an empath, in that sense. I've always been told I am both sympathetic and empathetic to people's situations.
We talked about how my emotions tend to be very intense. Even being numb can feel intense. I find it hard to "catch" myself before my emotions have gone from 0-100, so balance is something I would love to strive for.
We also talked about the dissociation I experienced. I explained how it felt as if I was looking at the world through a thick glass window, or an out of body experience; where I'm watching myself do and say things. I'm not really there, I'm just a body without the human element to it. I also feel very spaced out. I find it hard to talk about things fluently. I can't concentrate properly and nothing feels real. When I'm like this, I worry about what I will say or do as I'm not really *there* to face the consequences.
I started experiencing dissociation when I was bullied at school. It was a way of protecting myself and escaping from the bullies' cruel words, the abandonment I felt when left out, the lack of support and understanding from my elders. I was avoiding my feelings, and it took a while to ground myself.
We then moved on to what would happen after the last session (session 11) of counselling. We'd decided that, although counselling had helped me to talk freely about what I needed to, and understand the problems I have with trauma, it was not a specific therapy for trauma. What I needed was something trauma focused. The counsellor said that the Wellbeing (Primary Care) Team only offer trauma focused CBT. I considered this, but wanted to know if secondary care would offer anything. She said she'd spoken to her manager, who had decided I'm not unwell enough for secondary care, and to be honest, they just didn't have the resources to offer the long term help I needed.
So it was CBT or nothing.
I told my counsellor that I had set up a fundraising page to try and raise enough money to fund a few private sessions of trauma therapy or EMDR . This would help me to get specialised help, but it cost around £80 for an hour's session. Unfortunately, the fundraiser was a flop. I had a grand total of one donation.
I decided to say yes to the CBT. It was my only choice. My counsellor had been under the impression that she could refer me straight on to be placed on the waiting list for CBT, but unfortunately it doesn't work like that. Once counselling has finished, I need to self refer, go through the telephone assessment, and then be placed on the (8-10 week I think?) waiting list. It's not ideal, but it really is that or no help at all.
I told my counsellor about how, although I was grateful for the help I had got, I was frustrated about the lack of choice of therapies in my local mental health team. I knew it wasn't the staff's fault, but it didn't stop me feeling as if I wasn't really getting the right help for me. I also felt abandoned by secondary care. Again, I was grateful for the help they had given me (a referral to a psychiatrist, and a couple of sessions with them, as well as a CPN, and support worker who gave me some very short rounds of self compassion therapy and emotional regulation therapy). The last time I was referred to them though, I was very unwell, self harming, overdosing, and even hallucinating, they would not help me. I was assessed then discharged; being advised to get CBT with the wellness team. Usually, they would tell me to call if I ever needed them. This time, they didn't. It could've been a mistake on their part, but my brain told me that they didn't want me to call them ever again. I felt as if they'd washed their hands of me because I didn't deserve the help, and I would have to have done something drastic if I ever was to get their help again.
I said to my counsellor that, when it came to urgent help, mental suffering was not seen as bad enough for assistance. It had to be that the mental suffering had led to physical consequences (such as self harm/overdosing/a suicide attempt) before anything would be done. Even then, help wasn't guaranteed. I suppose I did blame some of the staff for not taking me seriously enough, but it was also to do with lack of funding from the government, leading to lack of resources, and therefore lack of help and choice of care. It's such a shame. No one should be left to suffer in silence.
I have one more session left, then that's it for counselling. I told my counsellor at the end of the session, that I would miss her a lot, and I felt that we had a great therapeutic relationship. I think she appreciated that; she was grateful anyway.
So my plan now is to wait a few days after my last counselling session, then ring the mental health team to self refer for CBT. I'm hoping the therapist I see knows a lot about trauma, so that they understand the things I tell them. I'm keeping an open mind about going through CBT yet again (5th time now?) so I'll have to wait and see how it goes. I will of course blog (and maybe also vlog) about my sessions. In the meantime, "just keep swimming!"
Resources
My ESA Tribunal Experience: https://www.amysmysteryillness.co.uk/2014/03/my-esa-tribunal-experience.html
13 Signs That You're an Empath: https://highlysensitiverefuge.com/empath-signs/
Grounding techniques: https://www.mind.org.uk/information-support/types-of-mental-health-problems/dissociation-and-dissociative-disorders/self-care/#TryGroundingTechniques
Dissociation and Dissociative Disorders: https://www.mind.org.uk/information-support/types-of-mental-health-problems/dissociation-and-dissociative-disorders/#.XTtgYuhKiM8
Cognitive Behavioural Therapy https://www.mind.org.uk/information-support/drugs-and-treatments/cognitive-behavioural-therapy-cbt/#.XTtg2ehKiM8
My Ko-Fi fundraising page: https://ko-fi.com/W7W0XG96?
Eye Movement Desensitisation Reprocessing: https://www.ptsduk.org/treatment-options/eye-movement-desensitisation-reprocessing-emdr/?gclid=Cj0KCQjwyerpBRD9ARIsAH-ITn8wTsjUzlHWODMZO6to9j5467XJogbBYhhHsDZpozCQXg0x83b4DAwaAvmdEALw_wcB
I had been experiencing a lot of emotional numbness and the need to avoid my feelings; leading up to this counselling session. Because of that, I wasn't sure what to talk about. My counsellor did ask me to embellish on the numb feelings and avoidance though and we found I was doing this to protect myself from intense distress and depression. There'd been some triggering storylines on television, and instead of panicking, I found myself dissociating in order to protect myself from the horrible feelings of being triggered.
My mum has had to fill in a work capability questionnaire too, and helping her do this, seeing her so anxious and depressed, has really rubbed off on me. It also took me back to the times I've had to fill in these forms; how much I've struggled emotionally, remembering back to that awful first face to face assessment. I never want to go through that again. My mental health worsened partly because of that assessment, and I haven't significantly improved since. As for emotions rubbing off on me, I told my counsellor that this happened in many situations, and I found I even got affected by atmospheres in a room. If it's a depressing atmosphere, I feel depressed. If it's an anxious atmosphere, I feel panicky, and so on. If a person is upset, they don't have to be showing it obviously, or tell me. I can sense how they feel, and it makes me feel the same. I suppose I'm an empath, in that sense. I've always been told I am both sympathetic and empathetic to people's situations.
We talked about how my emotions tend to be very intense. Even being numb can feel intense. I find it hard to "catch" myself before my emotions have gone from 0-100, so balance is something I would love to strive for.
We also talked about the dissociation I experienced. I explained how it felt as if I was looking at the world through a thick glass window, or an out of body experience; where I'm watching myself do and say things. I'm not really there, I'm just a body without the human element to it. I also feel very spaced out. I find it hard to talk about things fluently. I can't concentrate properly and nothing feels real. When I'm like this, I worry about what I will say or do as I'm not really *there* to face the consequences.
I started experiencing dissociation when I was bullied at school. It was a way of protecting myself and escaping from the bullies' cruel words, the abandonment I felt when left out, the lack of support and understanding from my elders. I was avoiding my feelings, and it took a while to ground myself.
We then moved on to what would happen after the last session (session 11) of counselling. We'd decided that, although counselling had helped me to talk freely about what I needed to, and understand the problems I have with trauma, it was not a specific therapy for trauma. What I needed was something trauma focused. The counsellor said that the Wellbeing (Primary Care) Team only offer trauma focused CBT. I considered this, but wanted to know if secondary care would offer anything. She said she'd spoken to her manager, who had decided I'm not unwell enough for secondary care, and to be honest, they just didn't have the resources to offer the long term help I needed.
So it was CBT or nothing.
I told my counsellor that I had set up a fundraising page to try and raise enough money to fund a few private sessions of trauma therapy or EMDR . This would help me to get specialised help, but it cost around £80 for an hour's session. Unfortunately, the fundraiser was a flop. I had a grand total of one donation.
I decided to say yes to the CBT. It was my only choice. My counsellor had been under the impression that she could refer me straight on to be placed on the waiting list for CBT, but unfortunately it doesn't work like that. Once counselling has finished, I need to self refer, go through the telephone assessment, and then be placed on the (8-10 week I think?) waiting list. It's not ideal, but it really is that or no help at all.
I told my counsellor about how, although I was grateful for the help I had got, I was frustrated about the lack of choice of therapies in my local mental health team. I knew it wasn't the staff's fault, but it didn't stop me feeling as if I wasn't really getting the right help for me. I also felt abandoned by secondary care. Again, I was grateful for the help they had given me (a referral to a psychiatrist, and a couple of sessions with them, as well as a CPN, and support worker who gave me some very short rounds of self compassion therapy and emotional regulation therapy). The last time I was referred to them though, I was very unwell, self harming, overdosing, and even hallucinating, they would not help me. I was assessed then discharged; being advised to get CBT with the wellness team. Usually, they would tell me to call if I ever needed them. This time, they didn't. It could've been a mistake on their part, but my brain told me that they didn't want me to call them ever again. I felt as if they'd washed their hands of me because I didn't deserve the help, and I would have to have done something drastic if I ever was to get their help again.
I said to my counsellor that, when it came to urgent help, mental suffering was not seen as bad enough for assistance. It had to be that the mental suffering had led to physical consequences (such as self harm/overdosing/a suicide attempt) before anything would be done. Even then, help wasn't guaranteed. I suppose I did blame some of the staff for not taking me seriously enough, but it was also to do with lack of funding from the government, leading to lack of resources, and therefore lack of help and choice of care. It's such a shame. No one should be left to suffer in silence.
I have one more session left, then that's it for counselling. I told my counsellor at the end of the session, that I would miss her a lot, and I felt that we had a great therapeutic relationship. I think she appreciated that; she was grateful anyway.
So my plan now is to wait a few days after my last counselling session, then ring the mental health team to self refer for CBT. I'm hoping the therapist I see knows a lot about trauma, so that they understand the things I tell them. I'm keeping an open mind about going through CBT yet again (5th time now?) so I'll have to wait and see how it goes. I will of course blog (and maybe also vlog) about my sessions. In the meantime, "just keep swimming!"
Resources
My ESA Tribunal Experience: https://www.amysmysteryillness.co.uk/2014/03/my-esa-tribunal-experience.html
13 Signs That You're an Empath: https://highlysensitiverefuge.com/empath-signs/
Grounding techniques: https://www.mind.org.uk/information-support/types-of-mental-health-problems/dissociation-and-dissociative-disorders/self-care/#TryGroundingTechniques
Dissociation and Dissociative Disorders: https://www.mind.org.uk/information-support/types-of-mental-health-problems/dissociation-and-dissociative-disorders/#.XTtgYuhKiM8
Cognitive Behavioural Therapy https://www.mind.org.uk/information-support/drugs-and-treatments/cognitive-behavioural-therapy-cbt/#.XTtg2ehKiM8
My Ko-Fi fundraising page: https://ko-fi.com/W7W0XG96?
Eye Movement Desensitisation Reprocessing: https://www.ptsduk.org/treatment-options/eye-movement-desensitisation-reprocessing-emdr/?gclid=Cj0KCQjwyerpBRD9ARIsAH-ITn8wTsjUzlHWODMZO6to9j5467XJogbBYhhHsDZpozCQXg0x83b4DAwaAvmdEALw_wcB
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