ward

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

Leaving the rehab unit

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I didn’t feel in control on the unit; was told by the staff to trust the staff and take the medication suggested, basically “take it”, and they then prescribed new medication after I said I didn’t want it. I’m already on medication, and haven’t even been on them long enough to know if my current meds are effective!

There is no way I was going to make myself endure another 7 days of isolation (no leave), so I left the premises, only to return 1.5 hours later and be told they had to search me and the isolation now had 14 days left (reset to the full time because I was off the premises).

I then left again, and slept in my flat overnight, before getting admitted to a psych ward because of my self-harm risk.

Leaving the unit gave me a sense of control that I had been missing from when I first arrived, however after returning to my flat I still felt that I didn’t have much control because of the lockdown making going out more stressful.

I don’t know how to restore the sense of control that I once had, but it feels like that is the only way to make me safe again.

Giving way

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Next step after being on a ward? Going to a recovery unit. Do I want to go? TBD.

Against

No leave for 2 weeks. That’s pretty much all my negatives.

It’s better than it was a couple of months ago, no leave at all; fortunately their policy has changed since then.

Would I have been under pressure (encouraged, advised, etc.) to go even if there wasn’t any leave? Maybe. Should I refuse to go based on that? Nope, that is hypothetical and deciding not to go based on an imaginary scenario is probably not a good idea.

For

Lots of positives.

  • Better environment than the psychiatric ward, more space (multiple rooms; kitchen, living area and garden to access)
  • I can have a power cord to plug my laptop in while using it (and a desk to use it on)
  • Own bathroom, no more sharing.
  • Psychologist who wants to help with my OCD
  • Staff (care coordinator and ward staff) view it as a good step forward.

Conclusion?

I feel like I should go. That it’s probably the right option. I’m just not convinced that I want to go.

Although as that that was how I felt about going onto a ward back in January and going onto the ward (eventually) helped, maybe this place will too.

Changing room on a ward

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Today I was told that I had to move to another room on the ward. Big deal? Turns out it was, as I really didn’t want to endure the anxiety associated with being a new room. Initially I thought “I can do this”.

I then become focussed on the anxiety about moving altogether, but over time (3 hours…) I figured that the staff could help with with the issues with the furnishings in the new room. The staff suggested swapping the chest of draws and dust bin with the ones from my old room.

A couple of hours later things were setup in a way I liked, after going for walk to calm down, and spending time adjusting things.

So magically all good? Not yet, my anxiety about being in a different room is still there, it should fade with time though 🙂

Rationalisations used

Remembering that I’ve experienced being in a “new” and “clean” room before, this is just the same, except for the fact I already have a room that’s setup – previously I went in “blind” as a I had no idea what to expect from the room, this time I could see the new room, compare it to where I was, etc.

I was probably moved because they needed a new patient to be close the the office, and putting them in a room at the far end of the ward wouldn’t do that.

That, and they must have really wanted the room, as me freezing not doing much for hours didn’t get them to change their position.

The new room is in a quieter location; I don’t need to put up with noise from a radio now 🙂

I do trust you [care coordinator]…

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…but my past experiences haunt me.

I always plan an escape route upon entering an area. I’m not going to be trapped with or by people.

I can’t agree to going onto a ward. I did before and on one occasion it was extremely unpleasant.

I can’t focus on the positives. The negatives feel overwhelming. Times when I have I’ve felt so awful that it wasn’t worth it to try again.

P.S. I’m not feeling that positive at the moment.

I’m restless, but have nowhere to go

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In normal times, if I was restless I’d go for a long walk, go to the library or take a bus to see my parents.

These aren’t normal times, and I can’t do any of those things. I miss my old coping strategies. I still have one hour a day out, holding onto what I have is really important for me to cope.

For me restlessness is feeling unsettled and unable to focus for long enough to get anything done. When I relax enough and forget the world around me I can focus, but any disruption breaks me away from what I’m doing.

It’s not pleasant, and at least partly due to a new medication, which has agitation, anxiety and restless are common side effects for the first few weeks.

My OCD has become so overwhelming, that enduring those side effects feels worth it. Its a turn about from feeling tha medication would never work. I now feel like medication can help, the clomipramine seemed to break me out of feeling hopeless.

With any luck this new medication will break me out of being trapped by obsessive thoughts. The odds aren’t great, and getting medication that works feels comparable to finding gold at the end of a rainbow. I keep going by focussing on how awesome it would be to escape my mind.

I’ve been hopeless for so long that it feels strange to have a hope of beating my once OCD again.

P.S. Still on a ward, not transitioning to rehab accommodation my “risk is too high” and I’m “too unwell” to go there; I’m relieved though, as I won’t have to fight for my leave, as the rehab accommodation wanted to restrict it to groceries, once a week, probably enforced by threatening discharge if I didn’t comply.

I don’t want to leave…

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…the psychiatric ward. And I didn’t even want to go onto the ward in the first place. What happened?

The plan was to transition to rehab accommodation, but I’ve been told it would mean only being allowed off the premises once a week (Covid-19 precautions), and even then to only visit a supermarket, not to have a a walk. Being able to get out of my living “zone” helps me cope when the anxiety in one place becomes too much, just change place (zone) until I feel a bit better. Relying on sedatives isn’t something I want.

I don’t want to go back to my existence before I came onto the ward, being dysfunctional is no fun whatsoever.

I don’t want to stay with my parents, I moved out because they had trouble dealing with my OCD, and its worse than it was back then, so it will become an unpleasant issue that isn’t addressed or quite ignored.

I don’t ever want to try swapping medications in a community setting again – back in May it felt like I’d been forgotten and left to deal with any side-effects unsupported; there’s no way I’d cope with my current switch alone or without adequate support (my anxiety is up, a lot, made worse by the fact that is was lower than usual before starting the medication.

My coping strategies at the moment revolve around the ward and the staff, if I move I’ll create new coping strategies, but going to someone I don’t want to go as a “voluntary” patient isn’t something I can consent to.

I can’t stay on a ward indefinitely, I need an exit plan that works for me, but I don’t what that is now. The rehab accommodation was that exit plan, but Covid-19 has made that unpalatable. It’s possible something will change (I hope), but my mental view of the future is some kind of darkness, with nothing good visible, just spectres out to get me.

A good day, for me… (2)

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Did a post with the same title months ago, but what a good day is has changed, again, I’m on a pysch ward now!

  • I wake up and get up at 07:00-08:30
  • My room is reasonably tidy.
  • Have breakfast (first time in months today)
  • Go on my laptop as a distraction (lockdown, so I can’t go out that much)
    • Wipe the outside of the laptop (its been on the side in the staff office) with disinfectant wipes and my table (splash on with water)
  • Have lunch, but served before any other patients to avoid “contamination”
  • Go out for one walk of at most an hour
    • This is enforced by the staff not letting me off the ward more than once in a day, and keeping track of how long I’m out for and (they’ve stopped now) bringing up the spectre of discharge to persuade patients/me to comply.
  • Read/play/something on my phone/laptop until dinner time (17:00)
  • Speak to family or friends over the telephone/snapchat/skype/texts/etc.

The previous “Good day” post is here.

This post isn’t focussed on “basic” items like the previous post was, that is partly because the ward ensures that “basic” stuff, like eating/getting food, clean sheets, etc is done – so I don’t need to worry about it.

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.

A thank you letter

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To the psychiatric ward staff who check in on me when I’m struggling.

To the staff who don’t give up even when I don’t verbally respond.

To the staff who listen when I talk.

To the staff who check for the yellow/red cards in my door’s window to see whether I’m ok, or too anxious to ask for help.

To my care coordinator who’s always on my side, even when getting me sectioned (not sure how that works, but it does).

To the staff who try to help again even if I won’t always (be able to) accept it.

To the staff who ask me what’s wrong when I act oddly rather than assume I want trouble.

To the staff who do their best to avoid me having another meltdown.

P.S. I know not everyone has a good experience, and it isn’t rainbows, sometimes they mess up, or do something normal that triggers me badly. Moving my stuff for any reason, but they know not to do that now, and avoid it. Being on a ward isn’t a good experience, but I do appreciate the staff who help me cope.

P.P.S. The staff won’t get to read this, but I just wanted to write it out anyway.