contamination

Running, again

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Is exhilarating.

Is freeing.

Is a release.

Is the best.

Recently my trainers started to fall apart, so my body ached too much to run in them, got new trainers and it feels like I’m running on air.

I’m back in my flat. Yay!

Getting the trainers was a unique experience, as normally going into a shop and trying on random items would be too contaminating for me to do. Not this time, being unable to run was so important that it was worth taking the risk. That, and I cheated a bit by using a sedative to make me less anxious.

I’m in a good mood 🙂 🙂 🙂

P.S. I’m not technically a runner, its more of a series of sprints rather than one long run.

Intrusive sexual thoughts when feeling low

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Content Warning: sexual references (pretty vague references)

To me this feels unfair, why do I get thoughts and compulsions that I dislike when I’m low?

My perspective, I feel awful so my mind latches onto anything that might drag it away from the sensation of feeling bad.

The thoughts, despite being “normal” appear bad to me. The fact they increase when I’m feeling down only seems to reinforce this. When I’m ok my mind sometimes thinks them, but moves on, it doesn’t when I’m feeling low.

The thoughts are “pleasant”, but that doesn’t make them ok (to me).

For me feeling low and then having thoughts that make me feel useless at controlling my mind and coping over the fact I already feel useless, even if they are distracting at the time.

People can say stuff is “normal” and “ok”, but that doesn’t make it ok for me, or stop anything sexual being the worst possible contamination.

Talking about it feels “wrong” so I have to stick to being vague (mostly) just so I don’t stress myself out when I’m expressing how I feel. This is the case when explaining in person or even in a private journal entry nobody else will read.

P.S. Still on a ward. Trying a new medication, aripiprazole, that doesn’t leave me feeling great, yet (promises of feeling bad going away in a week – roughly)

What is real right now?

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Trigger Warning: this post discusses thoughts of suicide and self harm

Definitely real (at 23:49)

  • I’m anxious
  • I’m awake

Possibly imagined (as of 23:53)

  • I’m too anxious to sleep
  • I felt suicidal
  • That the red card (meltdown/crisis indicator) I put on my ward room door earlier was justified

What I think, on my anxiety level

I’m feeling lost in my mind. I feel that my anxieties about the impact the Covid-19 are real, but I don’t know if they’re any worse than everyone else’s.

For (high anxiety)

  • I inflicted pain on myself
  • Cut skin on my arms with my teeth (not that effective though).
  • Had suicide present as a real option to resolve a problem.
  • Being unable to go for a long walk removed an significant coping strategy

Against (normal anxiety)

  • When talking to my care coordinator earlier we got disconnected, and she didn’t ring back, presumably because she felt I was repeating the same anxieties as on the last call to them 2 days ago.
  • Ward staff waited 3 hours to respond to my crisis indicator (suggesting that they thought my feelings would be transient)

What I think, of crisis response

That it appears the ward staff have decided the best course of action in the event I am anxious is to ignore it, hoping that it dissipates. If it doesn’t, then offer me PRN and suggestions of coping strategies I’ve already exhausted, before finishing with that I need to talk to them so they can help, despite the indicator showing that means that I feel unable to talk.

For (me)

  • Leave any anxious person alone long enough (say 4 hours) and the anxiety will fade, even if it’s unpleasant for the anxious person.
  • They did ignore my red indicator, and remarked that I should have gone to the office (I did, but froze and turned back – too anxious to wait).
  • I was so anxious that relaxing made me cry (crying was suppressed as I was frozen up)

Against (me)

  • I did eventually fall asleep, however briefly 4 hours later, so maybe and crisis wasn’t a “real crisis” (remark by nurse on duty)
  • I seem to have upset every staff member I’ve come in contact with today

What I think, of me being alive

If I’m dead I can’t spread the Covid-19 disease, so why not end it all? I’ve got an untested plan for killing myself on the ward, but haven’t used it as if I get caught before completion I probably won’t get another chance.

For (do it)

  • If I’m dead, I really can’t infect anyone else (at least not in a way that’s my fault)
  • The staff used PPE (gloves, surgical mask and flimsy plastic apron) when dispensing medication this evening, suggesting that I am a real contamination threat.
  • The staff don’t know I felt suicidal earlier, so they can’t mitigate what they don’t know about. I don’t even want to tell them after how dismissive they’ve been of the anxiety.

Against (don’t do it)

  • Everyone else will still be alive and infecting each other.
  • Everyone is a threat, not just me, I’m just lost in trying to comprehend how big (or not) of a threat I am compared to everyone else.

What I think, of remaining on the ward

I can see the perks, food, reasonable clean facilities, and I won’t be left with an escalating mess in my room, but the loss of freedom is a big deal, I really want to go for long walks to deal with anxiety.

Don’t need a for/against. I’ve already done it in my thoughts.

Conclusion

I’m losing confidence in my ability to assess my anxiety level, with the reactions of staff, and the general population’s anxiety level impacting my assessment.

Shopping with OCD, during a pandemic

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This experience is strange, as for the first time how I act appears in line with everyone else:

  • Taking items from the back of the shelf
  • Using gloves to touch the self-service machine
  • Dodging and freezing in place to avoid getting too close to another human being
  • All round jumpiness

For me this feels wrong, somehow my OCD behaviour is so bad it can’t ever be treated as something to accept, but the world has changed to the point that it is acceptable.

Having a real threat to avoid makes it hard to justify not taking something off a shelf if I just saw someone else handle it. I can’t refute the logic that using a clean carrier bag is safer than reusing a shopping basket, or that taking two carrier bags, one to hold your shopping, and the second to put it after scanning; so your shopping never hits the surfaces on the self-checkout is excessive.

The sheer strangeness of a world where dodging contamination so overtly that others around you can’t help but notice is treated as “normal” isn’t something I’ll ever get used to.

Although despite the efforts of “normal” people to avoid contamination, their behaviour has so many holes in the avoidance, that it isn’t as effective as it seems it should be. My favourite examples are using gloves in a supermarket. I’ve seen people use disposable gloves, winter gloves and the cuffs of their sleeves to supposedly avoid contamination. As they try to shop their gloves/cuffs hit so many things, including themselves in the process – contamination avoidance isn’t a natural habit – that I’d probably experience a lot of distress if I reacted like them. My view still isn’t “normal”, but it’s closer than it has ever been 😛

It does seems like the world should be ending, as everyone has been thrown in a form of contamination hell, terrified that something bad could happen if they mess up and get contaminated (Covid-19).

P.S. Still in hospital, its possible this will persist until the lockdown ends. Finally felt safe enough to ask the staff for what I needed to eat food on the ward, so I’m eating on the ward now. The routine is that mine is served first, and I’m allowed to eat it in my room. Its works.

Coronavirus is terrifying, and it’s not just me!

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At the best of times I’m always worried about contamination, now it feels like reality has become a projection of my anxieties.

Watching someone who until the last few days would never used a hand sanitizer makes me feel guilty of their behalf for any excessive hand washing.

The focus on hand washing in the news leaves me feeling like normal behaviour and OCD completion compulsions overlap to the point I can’t tell what is “in my mind” and what isn’t.

I’m primarily worried about transmitting Covid-19, odds are it won’t affect me badly. I’m more worried about going out and causing people who wouldn’t otherwise have been infected to get it.

Outside my ward are posters, emphasised by being surrounded by bright pink paper. Visitors are asked if they have symptoms before coming onto the ward.

What is so strange is that in this new world, everyone is worried about cleanliness, not just me. The reasons aren’t exactly the same though.

The thing I’m going to notice the most is not visiting my parents and siblings. As we reside in different places there’s a risk of me bringing the virus to them (which my mum is worried about), or me bringing it from their house (which the hospital is worried about).

Being in hospital is probably for the best when my anxiety is still so incapacitating. I’d still jump towards being on a more open unit though (got a referral pending).

Getting hold of cleaning products would likely be a major stressor when living in my flat, at least in hospital I’ve got support, and don’t need to procure them.

P. S. Still in hospital, voluntarily, but my anxiety gets in the way of going missing (I tried it yesterday, couldn’t go near a bus or train) so I’m contained by my own mind 😕.

Life on a ward, with severe OCD

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I do not want to be on a ward. Who does? I guess me less than some as I’m sectioned. Although somehow I went onto a ward voluntarily in the past!

I’m here because my OCD has become so distressing and disruptive that I managed to concern my local CMHT a lot.

My daily routine, so far is:

  • Wake up in the morning, then not get up as I don’t want to feel any contamination anxiety.
  • Say I don’t want breakfast (08:15) when a member of staff asks (I do, just can’t face down the anxiety of getting stuff off a shared food trolley, contamination).
  • Get up when a nurse comes along with meds, and take them (10:00-ish).
  • Wash my hands, and partway up my arms.
  • Clean my teeth.
  • Ask a staff member for my phone – it’s been on charge in the locked office overnight, for those who don’t know, possession of cables is prohibited as they are high risk items.
  • Do stuff on my phone until about 11:45, or 15 minutes before lunch time.
  • Hang around the dining area to try and get my cutlery before anyone else, and get to the front of the lunch queue. Fail? Not having a hot lunch, maybe sandwiches instead, the staff seem to notice and supply them so I have something…
  • Water? Do I have an uncontaminated cup and can face down using a shared sink. Spoiler: nope.
  • More phone stuff.
  • Now I’m fed up with my phone, at approx. 15:00 and ask (and get) escorted leave to the hospital shop (getting a sandwich, bottled water and a chocolate bar) and a short walk.
  • Water? Yep, got a nice clean bottle 😁
  • Next mealtime, same as before, waiting from 16:45. If I can’t get desert before my anxiety (contamination and noise) overwhelms me, I’ll just skip it. So “wait 5 minutes until everyone else is served” is the equivalent to telling me no!
  • More playing on my phone, and possibly taking a nap as there isn’t anything better to do.
  • More meds (I do have meds in the middle of the day, but can’t remember when).
  • Sleep, I finally knock off sometime between 09:50 and 11:30.
  • Flashlight through the window of the door in my room, staff checks, which never, ever, wake me up 😛

Don’t have a change of clothes on me. Was not planning to get sectioned when the home treatment team (part of the mental health crisis team) assessed me on Wednesday (it’s Sunday as I’m writing). Fingers crossed I’ll get unescorted leave, or at least longer escorted leave, to visit my flat tomorrow and get some. I’m not a fan of having other people go into my flat to get stuff. Don’t know why…

Oh, and I haven’t told my parents I’m here – it feels too embarrassing to be in hospital for anxiety. Trying to kill yourself is easier to explain.

I’m on medication again technically voluntarily, but more because I don’t want to see if they’ll inject me if I refuse. I am aware that I’m struggling with my OCD, a lot. Having memories of agitation and feeling suicidal from a past med that I took for all of 36 hours is making me want to avoid medication, can’t any longer though.

Bye for now. Sleep incoming… Unless there’s something pointless I can do on my phone instead, got 2% left. Sleep it is, probably, I’ve still got 2% 📱

Fake, fake and another fake

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When making sense of my OCD I create jargon to summarise the various facets. The term “fake” means that it feels like I was contaminated, my mind (if asked) says, “yep, you’re contaminated right now”, but I’m not.

Some fakes aren’t a problem can be brushed off in seconds as it is overwhelmingly clear that I wasn’t anywhere near, anywhere from 20cm to 2m, the object that I was supposed to have made contact with and had it contaminate me. The most common example is going near a surface that isn’t clean enough to use on the way to doing something else.

This evening however the fakes were about hitting items in the bathroom, where cleaning off the contamination would generate needing to have a shower immediately (which normally takes 4 hours, on a good day, without any special contamination) if not cleaned by other methods. I was aware that I probably didn’t hit anything, and every time I repeated an action that supposedly hit something I could see that I didn’t actually hit anything.

That didn’t prevent spending 40 minutes dousing clothing and my hands with disinfectant in a desperate attempt to remove enough contamination to avoid suffering through a 4 hour shower.

Eventually, well and truly fed up with the procedure, and safe in the knowledge that from any “normal” person’s perspective I’d have obliterated, multiple times, any biological or other material that could potentially cause harm I decided that “I hadn’t actually hit anything” and stopped there. Deciding that I had been hit would have required more cleaning, and a more intense version of what I had just done.

I use the phrase “a hit” to describe becoming contaminated which something as a result of impacting a contaminant or a contaminated item.

When I manage to avoid actually hitting anything, my mind seems so determined for a cleaning procedure to take place that it creates fake hits that I’m “required” to clean, unless I can show that they didn’t happen. Figuring out that I could avoid the cleaning by showing that it didn’t happened wasn’t what happened initially though, so lots of stuff got cleaned pointlessly (or even more pointlessly, as OCD isn’t solving a real problem).

I can temporarily distract myself and avoid cleaning a hit, but minutes, hours, days, or even weeks later the memory of the hit can impacts me at which point I’m compelled to clean everything I can to obliterate the memory of the hit – the logic being that by virtue of not cleaning the original hit the contamination has spread a lot.

The experience of having a hit overcome me long after its actually happened is what drives me to clean even when I feel that the hit maybe, probably, sort of didn’t happen, as getting past my anxiety to convince myself that not cleaning is OK feels impossible. So far I’m only able to bypass my mind when I can reason that the hit isn’t bad enough to require cleaning.

This brings me to more jargon I use. A “bypass” is when a hit that would normally require cleaning occurs, but I’m trapped in an important (for me) social situation, or deadline, basically something else is stressing me, a lot. This means that so long as I can vaguely reason that the hit “isn’t that bad” I will skip the cleaning is possible. The threshold for “badness” is low, so hitting the floor or shaking hands usually the worst I can bypass.

When trying to deal with everyday hits that no-one else is bothered by its sometimes possible to create a “skip” or a “cheat”, basically a rule that says that “in this situation, with this hit, it doesn’t count”. The rule is created after analysing previous stuff I’ve done, what other people do, so using logic to “skip” my OCD ritual. These usually require a trivial hit (knives and forks, say from a café) and won’t work when my anxiety level is too high and I lack the energy to enforce the “skip” as valid.

There is some overlap between a “skip” and a “bypass” as both provide practical advantages. However a bypass is created by sufficient stress overwhelming the distress created by my OCD, and a “skip” is created by using logic to work around my OCD, without actually beating it. As a “skip” doesn’t actually beat my OCD its also cheating in a way, as I’m not beating my OCD by overcoming it, just by side-stepping, hence the fact that I sometimes call it a “cheat.

P.S. Its been a while since my last post, a couple of instances of superficial cuts, but nothing since September, but my OCD has become worse and more overwhelming. My psychiatrist is referring me to a specialist OCD unit in London though, so that’s hopefully going to make a big difference.

My worst psych ward experience: “Finish the job” … and “stop wasting [our] time”

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Warning: If you are affected by self-harm or suicidal thoughts, or have experienced mistreatment by psychiatric staff this post may be triggering

This ward admission happened in August 2018 last year, so 12 months ago now.

I had overdosed, for the third time in 3 weeks, and was being assessed by a member of the local crisis team after being treated in A&E for the overdose.

She asked me the usual questions, was very nice, and explained that my care coordinator (mental health social worker) and my community psychiatrist had written emails to her asking her to admit me to a ward while they figured out how to avoid another incident. Spoiler: They changed nothing about my care, so this ward admission was entirely pointless.

She said that it was up to me, going into a ward I hadn’t been to before, or being followed (with phone calls) by the local home treatment team.

I’d been followed by the home treatment team before, and discharged from them, and was in A&E just hours later, with a broken heel (my mind went a bit crazy and I went out a first floor window)… So I wasn’t anxious to repeat that, and had no confidence they could help me.

Being offered a different ward was a surprise. Had it been the ward I’d been in before, I would have answered no – had a bad experience there.

I wasn’t keen on the idea, but as care co and community psych had recommended it, and I wanted to be as “not difficult” as possible, so I agreed to it.

I’ve never been accused of being difficult my my care co, psychiatrist, or any therapy staff I’d interacted with. Some ward staff on the ward I’d been on before this one had viewed by OCD behaviour as being deliberately troublesome though…

Arriving at the ward, a new environment was unpleasant, but insignificant compared to letting a psychiatric nurse search through my stuff, mixing up all the contaminated and non-contaminated objects. I just pretended it didn’t happen in order to cope, despite the fact I was standing there, watching it happen!!! It was still very awful though.

So far, mostly OK, nothing abnormally bad. Maybe I need to get a new definition of bad, but escaping all the stuff that’s bad beyond a “normal” perception would mean getting rid my my mental health condition, which (as of August 2019), really hasn’t gone away, yet…

The following day I was assessed by the consultant psychiatrist, who told me I was wasting everyone’s time with the repeated self-harm harm, and I should either finish the job, or stop trying.

She also suggested that morphine would be a far more effective drug to take (it would take effect in minutes, not days, which I already knew). My verbal response to here was “If it didn’t kill me, I’d be left with brain damage, and I wouldn’t know how to get hold of it anyway”. She didn’t respond to that.

Her knowledge of the effects of the medication I had been treated for before coming to her ward was a bit sketchy, she seemed to assume I’d have to take it multiple times in a week for it take effect, which I guess appears the same as taking it once, and waiting a few days for it to take effect.

After she had finished asking questions, she said she wanted to discharge me immediately. My reaction (internally): I let all my stuff get contaminated, and watched it, for nothing!! I asked her to telephone my care co first, and my care co persuaded her to keep me for another 24 hours. Technically I still hadn’t been forced to do anything at this point.

I guess this is the part where my actions triggered a reaction, I took several photos of people free areas of the ward, and no anyone’s room but mine. I did accidentally take a photo of all the patients names on the “meals orders” sheet, that’s my mistake.

After the assessment had completed, and I was back in my room in the ward the psych knocked on the door, which 3/4 nursing staff behind here.

I was then accused of recording the assessment, because I had my phone in hand, by the psych and I was told to hand over my phone and laptop.

My phone was in hand as I didn’t want to leave it anywhere, for fear of getting it contaminated by the surface it hit, and no, I didn’t record the meeting, kinda wish I did – I didn’t realise how unpleasant it would be.

I called my care co to ask her about my options, which came down to “it’s her ward, I can’t do anything”. I asked “could I leave the ward”, she said I could, as I was voluntary, she didn’t attempt to persuade me to stay. It seems the psychiatrist called my care co before approaching me about any issues, and told them she had evidence of my photographing staff!!!!

Strangely enough, that wasn’t mentioned on my discharge papers, as they wasn’t any evidence – I hadn’t taken any, the other photos were!

In my mind I took my care co not trying to persuade me to stay, as an indication it would no longer make me look “difficult” if I just got discharged.

I let them take my laptop and phone, and then asked to be discharged.

As I walked away from the hospital building (which contained the ward) my mind focussed on jumping in front of a train. I was angry, frustrated, and just wanted to stop feeling so awful.

Fortunately my care co called me just moments later, as she had been told by the ward they’d discharged me, and calmed me down just by letting me explain the events I had been subjected to, and how I felt.

Conclusion: I am NOT agreeing to go in another ward, ever again! I was in there less than 24 hours, but it left an outsized mark on my mind, even a year later, so many of the details of the incident are still in my mind. The overdosing taking a background position.

Fortunately no-one has advised me going in a ward again, even though I have overdosed twice since then, and burned myself multiple times.

The knowledge that I react badly to wards, and wards react badly to me, has persuaded my care staff that its counterproductive to admit me.

P.S. Ongoing CMHT assessment (August, this year) update, got a new care coordinator, the old one from my last time under the CMHT is going on maternity leave shortly. Discussed some stuff, apparently the extended assessment is for the CMHT to review me, and identify whether my problems are as “intractable” (their words, not mine) as they appear, and is there anything they can do that will help.

P.P.S. My only diagnosis is “Severe OCD”. I have been considered for other things, but that’s the only label which stuck.

It was worth it…

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  • To call Samaritans about my worries (which took 45 minutes)
  • To have a shower (which took 3-4 hours)
  • To leave my flat (at 20:00…)
  • To visit my parents
  • To put up with the noisy crowed bus, where anyone could bump into me (OCD and contamination, not fun)
  • To go to the supermarket

Just so I can have moments of peace and quiet now that my day is done, and there’s no pressure to do anything

Just so I can listen to calm music.

Just so I can surf the internet without panicking every 30s that I haven’t done something.

Just so I can be happy, today wasn’t a disaster!

When life is hard, it’s the little things that really matter, doesn’t matter that you aren’t perfect, just that you’re here, and now.

Bye for now.

A good day, for me…

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In the last 24 hours I’ve

  • Tidied up the rubbish in my bathroom and taken it out
  • Cleaned my shower (as I put stuff in there while tidying the rest of the bathroom)
  • Changed, not, cleaned the shower curtain
  • Had a shower
  • Gone out of my flat
  • Got food
  • Got back

Six months ago that would have been a bad day, so I’ve deteriorated quite a bit.

Tidying my bathroom is hard, not just because its a bathroom, but because every time something hits my skin, clothing, whatever, the only way to adequately clean it is with bleach, for skin that means putting bleach on, and quickly washing it off before my skin starts to sting too much.

Onto the next day, fingers crossed, it’ll be better – at least because the first 3 items won’t take up any time, as they’ve been done 😉

P.S. CMHT have decided to do a six week extended assessment to try and get me “better” before deciding whether to put me on the books.