YRS phone call & no BPD = no DBT

It’s odd when an interview to determine appropriateness for a particular service seems a bit like a job interview. It almost feels as though you have to sell yourself a certain way in order for them to accept you into their service. “What do you think you need help with?” Ummm…. “What would you want to work on the most?” Err…I dunno! Good thing it’s not a job interview, I wouldn’t be in with half a chance otherwise. The woman on the other end of the line at YRS (youth mental health service) told me she had looked up my health records and noticed I’d been referred for DBT. I confirmed yes, the psychiatrist at the psych ward had recommended I do DBT and thus the psychiatrist I was seeing at the time referred me to the DBT program a year ago. She said she’d ring A St (DBT place) to find out my position on the wait list, discuss with the team whether their service are able to accept me or not, and ring me back probably on Friday.

That same day in the afternoon I had an appointment with D. I told him of the outcome, in which the lady will contact A St and get back to me. D told me he was aware of the referral, but wasn’t sure DBT would be the best treatment for me though some of the skills could be useful. “Have you heard of something called Borderline Personality Disorder?” he asked me. I told him that I have. “Has anyone ever told you you have Borderline Personality Disorder?” I shook my head no. He told me he “doesn’t think I have it.” I couldn’t help feeling relieved and a little pleased upon hearing that. Though he also said it probably means I’m not eligible for DBT as they require a BPD diagnosis for admission into the program. No DBT for me? Gee what a pity… Can’t say I’m all that disappointed to be honest.

Shorts

It’s great when I don’t even have to think of an excuse for the scars I have from self harming. Instead, people come up with them for me! “Did you burn yourself with an iron?” my auntie asked me of the couple of scars on my arm, before she found out about my mentalness. Taken by surprise, I gave a vague “mmmmm” in response. More recently in Indonesia, I was again questioned on my scars. This time by my uncle, asking if I got burnt by a frying pan. “Nope, by an iron,” I told him, using my auntie’s ready made explanation.

When I was in the private mental health unit in May, I met another patient who was about the same age as me. She had scars all up and down both arms yet she still wears t-shirts and singlet tops same as everybody else. We got talking about self harm and scars one day. “People aren’t actually that bad,” she told me. “There was one person who stared,” she said, “But other than that most people are fine.”

The two coupled together, and I think I may be a little bit braver. This summer season I bought shorts.  Prior to this season, last time I did was way back in 2008. And as long as I don’t have recent wounds on the show, I wear them too. The shorter ones I only wear with stockings. The slightly longer one I wear by itself. It covers most scars when I’m stood upright, but rides up to reveal scars when I’m sat down. I think I’m okay with that. Others don’t have to be. I’ll never be able to wear the denim underwear that is so popular with 15 year old girls these days. But then again, why would I want to? I’m just happy to be back out in non knee-length shorts, the first time in about three years.

Put off therapy and mental health professionals

“Maybe being alone and not caring is better than to risk getting hurt,” was the theory I posed to D, the hospital psychologist. He calls this avoidance. I call it protecting myself. “But you want to have relationships,” he pointed out, referring to the list I had written while in hospital naming what the ideal would be if I didn’t have my problems. I shrugged at him. Maybe I’ve changed my mind.

I didn’t want to see D today. Not when I’d taken a break for about a month and it almost felt like starting all over again with someone new. Not after the whole fiasco with Dr T which has put me off mental health professionals altogether. I was fighting the urge to burst into tears or get up and walk out the door during the whole session. Fortunately I did neither. Not least because then I may have to explain why, and I wanted to avoid getting into the whole issue with Dr T. Not that staying there was all that much better. I didn’t quite have the courage to tell him I don’t want to do therapy any more. And so I glanced around the room in silence, hoping he’d get the hint. It’s worked before. It’s been at about this point that I had ceased with my previous two psychologists, when we’d run out of things to talk about.

I can’t help judging my current situation based on previous experiences. And my previous experiences have hammered into my head that therapy won’t work, we’re going to hit a brick wall, and it’s going to end by us parting ways not on a good note. I’m even less inclined to keep on and accept help after Dr T dropped me like that. What’s to say others won’t simply do the same? Rejection hurts. Knowing treatment has failed yet again hurts.

Despite this, I’ve still agreed to an appointment next week to see D. Sigh.

Peeved at now ex-pdoc

I’m pissed off. I think I have a reason to be too. You would think if a psychiatrist dropped you as a patient, you’d at least be notified and told your appointment has been cancelled. But no.

I had suspected this was the case when my GP told me Dr T had suggested I’d do better at A St Clinic instead of seeing just one private psychiatrist. Also, when I asked, the hospital psychologist told me he got the impression Dr T wouldn’t be seeing me any more. But still, no one had told me outright.

I had previously had an appointment scheduled with Dr T for this Friday. Nobody had told me it was cancelled. Not my GP, not Dr T’s secretary… And so I called up today intending to cancel for the last time. I asked the secretary whether I was meant to have an appointment for this Friday. She took a moment to check the appointment book. “No, you don’t,” she informed me. “Okay then, thanks,” I replied, and quickly hung up. That’s humiliating. I’m embarrassed I called up only to find out I’ve been unceremoniously dropped. Then again, it’s lucky I did call. Turning up would’ve multiplied the humiliation factor by 1000. I should’ve just not turned up without calling. Surely they can’t charge a cancellation fee when you’re not even a patient any more? Actually what I should’ve done is followed my instinct the first time I met her and looked for a different psychiatrist then and there.

Mental illness in Indonesia

As much as I moan about the mental health system in Australia, it could be worse. I mean, I could’ve ended up living here in Indonesia instead, where I’m currently holidaying and visiting relatives. Would’ve, had my grandparents not decided to relocate the family to Australia over 20 years ago.

Of course, I don’t have any direct experience, nor much knowledge of the mental health system here. But judging by the situation described in this video, it’s nothing to be proud of. Even those who are anti psychiatry must admit that’s better than chaining people up with nothing but a bare floor and open sewer, with only ancient wisdom, prayer and herbal therapy as treatment. It makes public psych wards in Australia look like five star hotels.

Then there’s the beliefs held by a proportion of the people here. My aunt’s friend’s daughter has some mental health issues. She’s been to a doctor and attends counselling. Her relatives though believe that her issues are caused by black magic; someone wanting to harm her or the family. They’ve recommended she see a healer who will extinguish the supposed black magic. It’s a notion that sounds bizarre to most of us living in the western world. There are many possible causes of mental illness, whether it be trauma, stress, biological, abuse, etc etc. But what we do know is that black magic is not one of them. A belief that is not firmly held here. It isn’t the families’ fault though. There are cultural differences and a lack of mental health literacy and education and awareness programs.

I feel both lucky and guilty. Guilty when I read and hear about how people with mental illness are mistreated here. Guilty when I reflect on my life in comparison. Such states of poverty in this country; homeless people, dwellings in which naming them ‘houses’ would be generous, hard manual labour in which their wages in a day we’d easily earn in an hour. What right do I have to be depressed in my first world conditions and to receive competitively good mental health care? I admit that when I arrive home I’ll be relieved; relieved I receive the standard of mental health care there instead of here, relieved that I’m not reminded and guilt ridden everyday of how privileged I am, relieved I live in Australia instead of Indonesia or some other developing country.

TWIM Awards & 2011 Stats

I am very much delighted and honoured to have won a TWIM Award again, this year in the Best Mood Disorder Blog category, especially amongst so many wonderfully written blogs in the Madosphere. So thank you very much to all those who voted for Behind the Facade and congrats to all the other winners!

 

And because I have nothing better to post it’s so, umm, interesting…here is my stats summary for 2011. According to the report, this blog was viewed 38 000 times last year with the busiest day being December 6th with 291 views. To other bigger and better blogs, the numbers are probably nothing, but for my humble blog, I’m rather impressed! Oddly, or not, most viewers were from the UK, despite me living in Australia. I guess this reflects how outnumbered I am in terms of where Madosphere members are located in the world!

Thanks to the top commenters listed in the report, and thanks to all who read my blog, whether you comment or lurk

2011

Of all the days in the year, New Years is the one I hate the most. It’s a reminder that I’ve lived through another year I didn’t intend to. There’s feelings of sorrow when I think of all the tough times that I’ve had. The tears and desperation. Nights of self harm. ED visits and hospital admissions.

I’ve never been able to start the year with the same psychologist I had the year before. Next year I am seeing D, the hospital psych again, but he’s only temporary. I’m still waiting on the youth counselling agency to take me on.

Yet, it hasn’t all been bad. I started studying OT and despite the doubts I have at times, I think I may have found the career for me. I passed all my units. Passed without any supp exams. Passed despite having to defer assessments and exams both semesters due to being in hospital.

I’ve also continued to volunteer with hs and RO, the two youth mental health organisations I’m involved with. I met Professor Pat McGorry. I flew to Sydney to attend workshops. Attended various events and experienced great opportunities.

And so I say a bittersweet farewell to 2011. There’s been ups and downs and tears and triumphs. Hopefully 2012 brings an alright year for us all x

My (non) referral to YL & no more Dr T?

I had believed the hospital had sent a referral for me to attend YL, the youth counselling agency, when I was discharged. That’s what the doctor told me before I left, that’s what D, the hospital psychologist, has led me to believe for the past three weeks. Today however, D told me this wasn’t the case. This error was only realised yesterday and so it is only now an ‘urgent referral’ has been sent. “How come?” I asked him. He replied something to do with ‘hospital procedures.’ Right. Guess I shouldn’t be surprised. I should be much acquainted by now with how inefficient the mental health system can be. I’m lucky I have a GP who takes action in ensuring I am linked in with mental health services, and I’m lucky the hospital has made allowances for me to continue seeing D temporarily as an outpatient. Otherwise this error may not have even been picked up and I would have fallen through the cracks and been left with no support. It wouldn’t be the first time that’s happened.

At the end of the session, D assured me that he can continue seeing me until I start with YL, and I also have Dr L, my GP. It didn’t escape my attention however that he had failed to mention a certain someone. “So is Dr T not seeing me any more?” I enquired. “That’s the impression I get,” he confirmed. Great, well it’s nice of people to explicitly tell me these things. I would’ve thought it’d be kinda important for me to know that the woman who’s been my psychiatrist for the past 1.5 years is now…not. I actually had an appointment scheduled with Dr T for the 20th of January. Do I now cancel it for the third; and last time? A year ago the belief that Dr T was going to stop seeing me as a patient was enough to prompt me to overdose. But now…I think maybe it’s for the best. The number of times I’ve left her office feeling more upset and at times suicidal… And I also suspect she declined to treat me as a patient when they were looking to admit me to a private psych hospital from the ED.

According to D, YL have psychiatrists. On their website though, it states, ‘The team is staffed by clinical psychologists, social workers and community mental health nurses.’ No mention of psychiatrists. If I’m right, the prospect of potentially not having a psychiatrist worries me a bit. But then again, lots of people with mental health issues manage without a psychiatrist, right?

Isolation and loneliness

I know that isolation is not conducive for good mental health. I know that social relationships and interactions are important components of human occupation- I should as an OT student. I know it in theory and I know it from past experience. But I still become trapped in the confines of my bedroom, growing increasingly lonely as a result. Uni’s out, exams are over and for the past couple of weeks I’ve been mainly stuck at home. Loneliness is pushing me further into the grasps of depression. And I don’t know how to fix it.

‘Leave the house & have lunch with someone!’ tweeted M, whom I met during my most recent hospitalisation. Which is all well and good, except, LOL I don’t actually have anyone to have lunch with.

Earlier in the week I viewed some photos posted on Facebook and Twitter. Photos of three of my pharmacy friends at a get together. Without me. Awesome. It’s especially awesome given these pharmacy friends are the only ones I go out with to hang out. Two of them have also recently acquired boyfriends, meaning all four of them are now in a relationship. Except me. Fuelling the thought that they’re also now going to be too busy spending time with their boyfriends to bother with me and I’m going to be left forever alone. Friendless and boyfriendless.

In hospital I recall the Clinical Nurse Specialist responsible for conducting a number of the groups voicing his concern that I’d return home upon discharge, spend all my energy getting through my exams, then after that spend all my time alone at home with a resultant drop in mood. He suggested that even though I didn’t get all that much from groups, coming along as an outpatient anyway just to get out of the house and for something to do. On the day of my discharge, he again asked if I wanted to continue attending groups. Knowing he knows I’m not the biggest fan of group, I laughed and declined with a “Mmm, no thanks!” “Well I had to ask,” he replied good humouredly. I thought I’d be fine with the stress of exams behind me. How could he, someone who’d known me only for a few weeks, get his hypothesis so right, yet me knowing me my whole life, still get it so wrong?

What’s happening re: my mental health care?

Went to see Dr L today for a follow up from last week’s appointment. It seems as though her and my psychiatrist had a lovely tête-à-tête on the phone about me. Nothing was brought up by Dr L today about me having an earlier appointment with my psychiatrist before January 20th, when my next appointment is meant to be. Either Dr T can’t fit me in, doesn’t think I need to see her or doesn’t want to see me. Meh.

Tidbits of information I was given about the aforementioned phone conversation between them is that Dr T told Dr L I:

• tend to self harm more when I’m stressed;
• have been warned before about the legal issues of stealing medications from my old workplace to OD on, especially as a student health professional
• may benefit more from attending ASC (public outpatient mental health service) where they have psychiatrists and psychologists, rather than just seeing one psychiatrist.

Dr L also wrote a letter for me to give to the hospital psychologist I’m seeing:

At this point I’m not sure what’s happening in regards to my mental health care. I don’t know if Dr T is suggesting I see a different psychiatrist instead of her, I don’t know if I will get referred to ASC, I don’t know if/when the youth counselling service the hospital has referred me to will take me on. I’m not even meant to be seeing D, the hospital psychologist, as he’s really only meant to work with inpatients. I’m just lucky allowances have been made for me to continue seeing him as an outpatient until another psychologist is able to work with me.