What’s next?

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Last week of 2022 now.

Progress check

Positives

  • Want to be alive (except in a few instances, but haven’t done anything to progress dangerous thoughts)
  • Interacted with more people
    • DnD group
    • New care worker who works with my CPN
    • Social group for individuals who have self-harmed (at any point in their lives)
  • Completed an assessment for a unit to treat my OCD and been accepted, pending 1.5 years on a waiting list
  • Taking medication (the odd dose forgotten though)
  • Run a DnD group as the dungeon master online and play in person at a local group.

Still not happy with

  • Still get really anxious
  • OCD and associated distress and limitations to what I feel able to do.
  • Self-harm thoughts still play through my mind (most of the time they’re gone)
  • Negative scenarios playing out in my mind for interacting with psychiatric crisis ward staff – despite not having been near a ward all year.

Analysis

I feel there should be more on the positives listing. I know my CPN is happy with my progress.

I’m disappointed with the continued existence of the self-harm thoughts, and I would have hoped that the fear of a disastrous interaction with staff would have gone.

Looking forward. What do I want?

  • More friends
  • Seeing my sister
  • Able to enter a situation without my focus being avoiding contamination
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Blank, blank, blank

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I had a stressful meeting with my CPN (community psychriatric nurse) this morning.

My CPN had to fill out a form for a OCD treatment referral to a unit, and the unit had requested more details.

As a result my CPN asked about whether I had any intrusive thoughts about harming other people.

The answer was yes. And I then spent about 15 minutes trying to express what they were, which was unpleasant as I really don’t like thinking about them.

After that my CPN also asked whether I had any intent to act upon them. The answer being no.

It just felt like I wasn’t trusted enough for my non-intention to be taken implicitly. Why did they have to ask? It made me feel awful.

How do I feel safe telling them thoughts in the future. If they’re intrusive with no intent I’ll still get challenged with questions about whether I plan to act on them. I don’t want to be treated as a possible threat – why can’t that be something agreed upon without extra questions.

Some of this might be irrational, but at the moment it feels too real to dismiss.

P.S. The title is a reference to how I wish my mind would just be blank so I didn’t have to feel any of the frustrated emotions.

Have I done that yet? (anxiety thoughts)

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Possible triggers: Anxiety thought sequences.

After each thought sequence insert

Why? So I can justify liking myself. As when I haven’t done absolutely everything to try and boost my mood and to try to cope I must be a failure.”

My mind

Yes? What should I do next…

No? You’re a failure, anyone normal could have done that.

Can I move on? Yes, so long as I did it properly.

OK, analysis mode, I’m feeling anxious and like not doing much.

Solution? Go for a long walk.

Melting down?

Are the thoughts persistent? (ie the thoughts that trigger it can sustain the feelings of distress over an extended period of time)

Did I want to self-harm? (however briefly)

Yes to all 3? I can justify using a sedative…

Is it just that my anxiety level is high? Nope, can’t justify using a sedative, independently of how awful I feel, as that would be cheating.

I want to do that.

Why on earth does my head now feel like its going to explode with pressure. I did this before. I can and will do it again, just not now…

What happens if I don’t qualify for an inpatient OCD treatment?

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Trigger Warning: This post contains feelings and thoughts about self-harm.

I really don’t want this to happen.

The last time it felt like support was unavailable when I was discharged from local CMHT (community mental health team) and it turned out that the referral for primary care had gotten lost, a couple of years ago. life seemed hopeless and I seriously self-harmed.

My parents have mentioned moving on with life and getting a job if the admission falls through. When asking my CPN what would happen if I didn’t qualify for the mental health inpatient admission it is that I’d have to do “something”, which could include getting a job (mentioned) or something else (left vague) and find a way to deal with my OCD in the community.

I don’t want that to be the case, as if its possible to manage my anxiety with a community intervention (and not an admission) it means that I am currently useless for not having managed it yet.

I’m scared of being in an environment with big deadlines when I can’t cope with them. I never want to feel that the only “exit strategy” is self-harm again. At the moment the promise of treatment feels like it makes self-harm unnecessary to coping as there’s always the promise of treatment and I have ongoing support.

There are bad memories of flunking out of university in the second year. This came from feeling unable to engage in academic work and deadlines, with an crippling anxiety about doing the “wrong thing”. Frustratingly I finished my first year with a score of approximately 80% – I can’t explain what then went so badly wrong that the second year ended with me not even passing.

Minor deadlines can leave me feeling too anxious to do the stuff necessary to complete them. I make slow progress – doing stuff intensively feels like way too much.

I don’t want to self-harm, but can’t help feeling worried that it could trigger in the future.

Discussing self-harm as a risk if I don’t get access to treatment feels too close to threatening to self-harm so I don’t want to bring it up with the CMHT. I’ve never been accused of threatening self-harm, however I am paranoid about being perceived to threaten self-harm. Second guessing people’s perception of how I’m behaving feels like an inhibitor to open discussion when my anxiety spikes.

All this risk could be resolved if I have a coping strategy that doesn’t revolve around the safety blanket of ongoing support. I don’t know how to build a better method yet; I’ll figure it out.

I’m feeling agitated this evening, so I’ve taken a sedative (lorezepam, 1mg, prescribed to me as PRN). I’ll shoud feel better tomorrow, as sleep usually helps.

How am I?

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I’m alone.

I can access support if needed to avoid self-harm. My CMHT (community mental health team) is supportive.

My family speak to me (and meet up, I’m in a support bubble).

I feel broken.

How can I recover from OCD when I feel like a fraud – I’m not sure how to feel unwell when I’m not in incapacitating distress.

All my routines feel so ingrained and optimised to avoid any OCD triggers that it seems impossible to change them further. I can’t see how to ever add working into the mix – and if I can’t get to working, how can I ever feel recovered.

I consume 800 disposable gloves a month to avoid touching (and hence handwashing), so the time taken up by my OCD is reduced, but its impact isn’t removed.

CBT is intense as we’ve eliminated all the easy topics, so we’re looking at core beliefs. They drive my behaviour, but are distressing to identify. Exposure response prevention feels ineffective as it doesn’t generate as much distress as it needs to work. Imaginary exposure drags up memories of when my OCD prevented me from functioning, which I really really want to avoid – I felt trapped in darkness and couldn’t see a way out – and can trigger me feeling unable to speak.

There’s a secret blacklist of things that I can’t ever do. Speech occasionally gets on the list when my distress spikes. There are times when trying to distract myself feels wrong and sleep is the only way to cope.

I can zone out and go into “objective mode” which lets me do virtually anything, at the expense of feeling in control of my actions. Zoning out is also how I unlock the ability to seriously self-harm; which terrifies me.

I think that’s everything for now.

I don’t feel OK, but I can’t pick any one thing that makes it so.

To Protect

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  • From sadness
  • From fear
  • From pain
  • From those who want to harm

That sums up my ideal superhero.

Thinking about it makes me cry, as I feel so powerless and unable to protect.

Reading a crisis scenario in a fantasy book I cry because the loss is beyond my ability to stop.

Postscript

The emotion involved with wanting to protect is significant and can feel overwhelming. I don’t know how I want to deal with the emotion. The usual techniques of distraction or rationalising thoughts help, but don’t deal with the emotion coming up again and again.

Let there be light

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I sucked in air with all my might

Like I was trying to light a fire in all my cells

Make your blood and sweat your sacrifice, desire your holy flame

And shout at full volume:

“Let there be light”

Intro song to Haikyu!! Season 3 (anime series about a volleyball team)

I’m still here. Still carrying on. Still dealing with OCD and anxiety. Still have days when I wonder if the effort is worth it.

I think it is. There is definitely light at the end of the tunnel.

After taking a break from running (I overdid it and hurt my knees), I’m trying again, but this time using the NHS “Couch to 5k” app to pace myself better, I’m on week 3, so far so good…

My care coordinator is changing jobs so I’ll have a new care coordinator (I’ve already been told who it will be, its a CPN I like). I’ll miss my old care coordinator.

I think that’s everything.

Coping, just about

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In the last few days I’ve set some personal records for time spent running (not for time spent walking though) – feeling anxious is a strong motivator to run/walk a lot more than usual.

For me running is a way to forget how I feel. The sense of euphoria after running makes it feel worth it, as how awful I felt beforehand is just gone.

I don’t always get the sense of euphoria though. Often running/walking is just a way to burn time without negative consequences – although while writing this post I’ve come to the conclusion that I need new running trainers – 360 miles of use (mostly walking, as I don’t keep multiple pairs of shoes…) and my legs aching today and yesterday seems to indicate they’re at their limit.

Today running wasn’t enough to escape how I felt. At the end of the day (19:00) I was agitated. I did identify that I was at the limit (distractions were not working) of what safe (not self-harm) coping strategies were working. I used a (prescribed medication, PRN), sedative that calmed me down enough to use distractions to cope. Using medication is something to try when multiple coping strategies have failed, not as a first option.

For me not coping is any of:

  • Wanting to self-harm
  • Melting down in tears
  • Persistent agitation/not settling down on any task

Melting down in tears I usually let happen as I tend to feel better afterwards.

When struggling to cope distraction is the first strategy. Speaking to someone (about something irrelevant) is (for me) the next best option. Using medication works in the rare instances it’s used, but as it doesn’t tend to address whatever is stressing me out it isn’t a silver bullet – it works best when I calm down enough to resolve what is actually bothering me.

For me “only just coping” means I’ve had to use medication to cope, which is what happened today.

Going to sleep now, so looking forward to a better tomorrow 🙂

I’m not OK

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Trigger Warning: This post contains feelings and thoughts about self-harm.

I don’t feel able to say that.

I have wanted to cut myself, but stopped before I did it.

I’ve had thoughts of overdosing, but haven’t done it.

I feel frustrated at my own uselessness.

I feel not great.

I should probably telephone my care coordinator, but I feel like I’m not meant to do that, and I’m only meant to need my care co when they call me. It doesn’t matter that I have been told repeatedly to call them if I don’t feel great, it still feels wrong.

I did call them (as I was writing this post) – they’re in a meeting at the moment so unavailable.

I still don’t feel great.