Just talk :)

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I’ve self-harmed and needed to go to A&E again (see last post).

However, on the plus side I’ve been reminded, again and again, by various people that I can just talk to people about how I am, and that they’d prefer to know, no matter how bad it is.

I love having people around me who feel that way, they’re the best kind of people.

I am sad that I forgot that they were there to talk to, as it has been so long since I’ve had an incident like that, that I just forgot.

Just wanted to say, people are there, and some even want you to talk to them 🙂

No, no, noooo….

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Warning: If you think about or have experience of self-harm or suicidal thoughts this post may be triggering

Yes, actually. I’m in A&E yet again, with yet another deliberate overdose.

This one is unusual for more than one reason.

Firstly, it’s been a significant amount of time since the last one took place.

Secondly, it was to replace an even worse behaviour, hanging myself.

At about 22 shops:00 my mind said (paraphrasing) “You’re gonna feel crap when you wake up tomorrow, might as well self harm now. Hang yourself”.

My response “Ok, I agree, let’s see how practical it is”

After testing a ligature point, I said to my mind “Is an overdose good enough to keep you quiet?”

My mind, “Yeah, that’s sufficiently bad”

At which point I looked up which shops were still open, purchased the medication, and after a few delays, took it.

I did immediately tell someone I’d taken it, and go straight to A&E, so there’s that, but as always it would have been preferably to avoid the self-harm in the first place.

Another assessment, another pointless exercise

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I had an assessment for CMHT support today, the conclusion being (pending review by the full CMHT staff) that I’m not at sufficient risk to be followed. And that the status-quo is OK, they can leave it for other services to eventually catch up and follow me.

Leaving whether that’s true or OK to the side.

What I want is specialist support for my OCD, especially a professional who has significant experience with it. I don’t know how to get that, and I’m stuck, in the same place as usual, asking other professionals “what support is there?” and “can you find out what is available?”.

Fingers crossed I’ll eventually get there, but I really don’t feel hopeful about it at the moment.

Bye for now.

P. S. I also feel abandoned by the services supposed to support me, on the grounds that “there isn’t anything” 😕

House flies

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As if it wasn’t difficult enough keeping things clean, now I have tiny insects contaminating everything they touch, mostly.

Looking this up, this appears to be a “benefit” of warmer weather. As this is my first summer in my own flat, I guess I’m noticing this for the first time now.

All the flies that rest for more than 5s on a surface find themselves dowsed with disinfectant spray, conveniently eliminating the fly, and cleaning the surface they landed on.

Usually my flat is a safe space, but these little insects damage even that. Kinda stuck on how to resolve it, beyond eliminate any flies, secure any areas that attract them, and leave doors closed behind me.

For now, I just have to wait for the current wave to pass, and any eggs they’ve left behind…

I’m not feeling great anyway. Got an assessment for CMHT support the day after tomorrow.

Time to “soldier on”. For me this means, continue trying to cope, no matter how unpleasant it becomes…

The mere possibility

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Warning: This post might be triggering for those affected by suicidal thoughts.

I’m not suicidal as I’m writing this, but I’ve thought about it a lot.

Conversations with mental health professionals after the event play out again, and again, and again in my head. There is one thing in common, in every one when asked some version of “Why didn’t you call before you did something?”, my response (should I choose to say it) would be “That I didn’t think you’d take me seriously”.

I’ve never experienced this myself, because I’ve never interacted with an NHS crisis service before the event, as I have no confidence in my own ability to tell if I’m about to hurt myself, so taking the risk of having someone else tell me the same thing deters me. Unfortunately I also know people who have spoken to crisis services before acting and been told that they wouldn’t be seeking help if they were really suicidal.

This is the tricky bit. I know when an incident is on the horizon. However when I’m stuck in the middle of one I feel incapable of reaching for help until it has resolved to the point I’m in need of A&E, minor injury, or I no longer plan to do anything, and just want to tell someone so it isn’t a secret or burden to hold forever.

I don’t know how to get away from the fear of being judged by a professional. There are amazing people who work in mental health services, where I have felt safe and not judged, but just the knowledge it is a “luck of the draw” whether I get a professional I can talk to or not is enough to make it really hard to initiate.

The fear of being judged permeates assessments by professionals, depending on the professional I’ll disclose different parts of my story, all of it true, just focussed on the stuff they already know, or sometimes (when with a more difficult professional) can’t do anything to make the situation any worse. I see all professionals on a spectrum from “perfect” to “awful”, so my stories go on the spectrum as well. The closer to “perfect”, the more of my story you get, and the more you get, the more I believe you can help.

Intrusive thoughts are restricted so tightly I’ve only initially disclosed them when already in significant distress as a last resort for finding help. On the plus side, the existence of them was written in my notes, so more professionals became aware, and eventually I could talk about them with my normal psychiatrist. I probably would have been comfortable discussing them anyway with the people I talked to, but having their mere existence in my notes gave me a starting point, and they started the conversation so I felt confident it wasn’t “attention seeking” behaviour.

And that brings me onto another part of a fear of being judged. A fear of being seen as “attention seeking”. I haven’t had this said to me, maybe because of the lack of attention I seek to avert an incident, only afterwards when there is a concrete physical ailment to treat.

The best I can do is honestly briefing a professional how I’ve been, not how I think I’m going to be. The past seems set in stone, I can’t alter my current behaviour to make my past more attention seeking. Discussing the future on the other hand (especially when my “choice” to self-harm is emphasised…).

If you can reach for help before something happens, then that is great, don’t feel bad about doing so, unlike me…

Its world of isolation

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Tonight as I write this I’ve cried, feeling isolated, and misunderstood.

In the last couple of days I have felt intensely suicidal (fortunately it has passed). Both times I’ve had to find a way to cope, as it feels impossible to burden someone I know, and care about, that I feel so bad.

Yesterday I called “Papyrus Hopeline”. Just talking about why I was feeling awful was enough to get the overwhelming thoughts of self-harming (which includes suicidal self-harm).

Today it was putting myself through the unpleasant task of cleaning my bathroom, which is unpleasant enough and distracting in its own right to cause my thoughts to quiet. That was almost enough, messaged a friend in the evening just so someone knew I wasn’t feeling great.

Just to be clear, I haven’t hurt myself. I’ve wanted to, pulled a cord tight around my neck just to see how it felt, and looked in a drawer for blades (turns out I disposed of them, so I couldn’t use them).

For now my coping mechanisms work, I’m safe. However I am terrified that they’ll fail, and I’ll end up in A&E, a police car as a result, or worse. Yep, if you didn’t know, when you don’t need immediate medical attention, but are at risk of serious harm the generally the police will attend, not medical professionals.

The frustration at my OCD isn’t new, but at times it feels unbearable, despite being the same as it always is.

That’s pretty much it. There are people, but burdening them with how I feel feels impossible, even when it isn’t.

Medication shock

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I tried a new medication last week risperidone, to replace the quetiapine I was taking to try and treat OCD. Something that isn’t always obvious is that the side-effects of the medication can be worse than what it is trying to treat. You should note that this is just my experience, and yours may differ, but this is the worst experience I’ve had with a medication.

In my case it caused me to wake up multiple times throughout the night, and by the second day of taking it I was highly anxious and agitated, both of which are common side-effects. This led me to me hating myself, a lot. The thoughts run through my head every so often, but function as intrusive thoughts that dissipate when I pay them no attention. Being agitated led to me paying a lot of attention to them

The effects took about 48 hours to wear off completely. Physical effects included my right eye not opening properly and being short of breath.

In a way it “helped” with my OCD, as it rendered doing any decontamination procedures so intensely distressing I took shortcuts and skipped steps to try and escape the procedures. I didn’t feel any better afterwards.

On the negative the agitation prevented me from watching TV and reading. I even burnt my mouth from eating too fast, as the agitation made me want to get eating out of the way as soon as possible. That is a disadvantage of rushing to escape agitation.

It permeated through the rest of my day, and the only time I felt sort of settled was when I was moving, on the bus. Walking was a problem as my breathing way short (a narrowed throat is a side effect of the medication, but anxiety can also tighten your chest shortening your breath). A normal way for me to cope with intense anxiety and distress is sprinting, but that wasn’t available when I couldn’t breathe normally.

After consulting my psychiatrist’s office I was advised to stop taking the medication, which I did. Unfortunately I still had to put up with the side effects until they wore off. To get to sleep I had to visit A&E, and got sedative to calm myself and averted any risk of me self-harming.

At the moment I’m just feeling the trauma of the event, but I’ve escaped the side effects now.

Coping with sleep

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My number one coping strategy is getting enough sleep. Should I fail to get enough sleep for long enough I will end up too exhausted to use any other coping strategies.

I forgot to get my repeat prescription on time this week, and as I usually rely on the sedative effect of quetiapine to get me to sleep, I had a few bad nights – when waking up the trouble of trying to get back to sleep made it feel like I was struggling to breathe. I don’t think that was the case, but my mind gave the illusion of it, probably because it had trouble expressing the feeling of being unable to sleep.

Historically a week with sleep disruption results in me acting implusively, not always dangerously, but always in a way that I regret.

Luckily this time around it was “just” two days, so I’m OK, and feeling, safe now, even if the feeling of fear when I try to go to sleep hasn’t faded yet.

Somehow, although it defies explanation I have found myself with too many things to do (programming, new series on Prime Video, and fitting in video games). That’s good, as it leaves me safe.

Bye for now.

Trusting professionals

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Lately I’ve been experiencing a large number of thoughts around self-harm. This has started my thinking about who do I trust to tell about them. The answer is, very few people, and just two professionals.

Trusting professionals is the subject of this post.

When I’m in crisis I’m advised to call the local CRHT (crisis resolution and home treatment) team. I don’t, ever. I am too terrified that I’ll call and be accused of threatening to self-harm. I don’t trust the CRHT to help me, and I have too many friends who have been dismissed by the CRHT as not at risk.

Comments made about me by professionals express that I’m too high functioning to need continued access to support, with the same arguments for removing me from the ward now being used to justify discharge from the CMHT (community mental health team). The reasoning being, that they don’t appear to do anything for me.

Then there is the incredibly common expression by psychriatric staff “it’s your choice to [self-harm/kill yourself/…]”. It doesn’t help, at all, it just works as a way to absolve the staff member of any responsibility to help you. This isn’t personal, it is just how they always respond, with the idea being that this will provide you with the willpower to not hurt yourself. It does not consider the case where you actually want to hurt yourself as it doesn’t feel like there is another option – they don’t explicitly provide another option. This also gives the staff grounds to disregard whatever you do to yourself as “your choice”, “your responsibility” and ignore the emotions and distress that led to the action. When seeing a psychologist this doesn’t happen, they understand that this method is extremely unhelpful and acknowledge your distress. Unfortunately staff are trained that reacting to your distress or expressed thoughts is a bad idea on the grounds that it encourages you to express yourself that way for attention. I’ve found it really doesn’t matter how little attention they issue, it doesn’t put me off self-harming, as the goal is internal and for me only, how they react isn’t relevant.

From my point of view that means I might as well self-harm without telling them, then they can’t accuse me of being attention seeking or say anything at all; at that point all that’s left to do is patch up and prevent any serious damage and send me out into the real world again (as stated by my care plan).

The staff reaction isn’t all bad. When I encounter A&E staff who are trained in treating physical problems I have found them sympathetic, supportive and worried. In a way I’m lucky, my diagnosis is OCD. If it was BPD there is a significant chance it might be the other way around.

Onto my two professionals, a psychologist, with whom my time is coming to a close. I did get more than the maximum allocated 20 sessions, which I am glad of – just 20 wouldn’t have been enough. The other is a social worker who has helped me navigate the benefits system and access a psychiatrist when necessary.

However I am going to lose both of them shortly, as I haven’t had any serious incidents since September (barring attempting to burn myself earlier this week). As such I am no longer view as appropriate for the CMHT to follow me.

The part that puzzles me is the remark that “my crisis plan will remain in place, with some follow up by CRHT”. It feels like it won’t matter how bad I get, I will not ever be brought back onto CMHT support. I do not like that. It feels that if I’m going to be at risk of hurting myself, I should still be on the CMHT, not the treat any phsyical problems, then discharge ASAP from A&E plan.

I have to admit this post isn’t the most cheerful, and is very busy expressing how I feel. That last paragraph is only expressed here, hasn’t been said anywhere else, and I wish it was, hopefully I’ll find a moment with a trusted professional to express that…

I don’t find it easy to trust staff, as there are way too many of them and they all react differently, trust only comes with extended positive interactions, which are rare.

Sorry I haven’t edited the post, it was too anxiety provoking to go back through it.