Uni doubts

The commencement of Uni 2011 is so near. I begin my classes in the Tuesday of the coming week. The week before I had found myself alternating between enthusiasm and absolute terror at starting a new course, Occupational Therapy. As my Uni-free days come to a close, the enthusiasm has vanished and I’ve been paralysed with anxiety. I can probably bid farewell to the relative stability in mood and the absence of any real thoughts of suicide or overdosing I have enjoyed over the previous month.

I’ve been plagued with self doubt, and I don’t think my fears are unfounded either. I’m unsure about my ability to do it. Any of it. The study. The absorbing of information in lectures, tutorials and practicals. The assignments, presentations and exams. OT is going to be a hard course, and I’m not sure I have the academic ability to be successful within it.

Then there’s the social side of things. I’ve attended orientation and I’ve talked to a couple of people, but actual friends? What if I’m unable to make any? I feel socially inept, and the thought of the at least four years, assuming I don’t fail/drop out, without any friends…oh gosh…

My energy levels have been rather low, and I’m exhausted from working a couple of days a week. Being a full time Uni student? How am I going to manage?

Already I’m contemplating overdosing, because of the overwhelming feelings of panic and trepidation. I won’t, but the thoughts are there. And I’ve not even started the course yet.

Keep up my overdosing behaviours, and I also face the threat of being monitored by AHPRA, according to my psychiatrist. I’ve since had a look around on their website, and it is written;

If health practitioners or students have a health impairment, conditions may be imposed upon their registration to ensure that they are able to practise safely.

Impairment is defined as a physical or mental impairment, disability, condition or disorder (including substance abuse or dependence), that detrimentally affects or is likely to detrimentally affect a:

• registered health practitioner’s capacity to safely practise the profession
• student’s capacity to undertake clinical training

Practitioners, employers and education providers are all mandated by law to report certain notifiable conduct relating to a practitioner or student. This includes a health impairment that may place the public at risk of substantial harm.

Great.

Can’tdothiscan’tdothiscan’tdothis.

Following from the previous post, I finally got my act together and made an appointment with one of the psychologists whose name and phone number had been given. I gave a call to R, the person without a website, and left a message on her voicemail. After two missed calls and a voicemail message to me, two text messages to her and a return one, an email from her with all the necessary information, an appointment has finally been made. 12 March at 1:30pm. She only works on Saturdays, and I’m not sure if that’s a bad sign or not…

How to choose the psychologist?

The last appointment with my psychiatrist was a month and a half ago. Which means it was a month and a half ago that I was given the phone numbers of two potential clinical psychologists. Whether I’ve made any progress from potential to current psychologist? Well… Does Googling their names count?

It would be somewhat easier if my psychiatrist just gave me the number of one psychologist and said, “Here, this is the person I want you to see.” Basically what she did last time. But no. This time she gave me two numbers. How on earth am I supposed to choose? By which name sounds better? By where they’re located? As mentioned, I’ve attempted to Google both. One has a website; the services she provides, her specializations, even a mugshot of herself. From the description she provides, I’m unsure as to whether she’d be the right person to me. Glancing at her photo, well…I’d prefer someone a little closer to my age. On the other hand, the other potential clinical psychologist does not provide a website. So do I take a chance?

I’ve thought about giving each of them a call, having a quick chat and deciding from there. The dilemma with this method is, how do I go about doing so? What do I ask of them? I imagine the conclusion of that conversation would be a little bit awkward, “Thanks, so I’ll err…call you back if you’re the uh…better person….”

Then there’s the matter of picking up my phone, punching in the numbers and physically making the call. One aspect of my social anxiety is a fear of telephone conversations. Just thinking about picking up the phone and calling; my heart beats faster, my throat constricts, and it gets a little harder to breathe. And that’s not even at the dialling stage yet, that’s just thinking about dialling.

I’ve put this off now for a month and a half, I probably shouldn’t delay any longer. Especially given my next appointment with my psychiatrist is less than two weeks away, I need to tell Dr T who I’m seeing so that she can send off the referral to enable me to receive Medicare rebates for clinical psychology sessions.

Someone want to save me the trouble, choose a psychologist, and make an appointment for me?

Unfriendliness towards me due to mental illness?

My aunt asked me today at work, “Have you noticed that P (workmate) has become more unfriendly towards you recently?” I answered that I wasn’t sure, but she hadn’t been talking to me much of late. “I think I know why,” my aunt mused. She went on to hypothesise it’s because P saw what I had posted on Facebook about my mental health issues. Umm, what? My aunt’s lesson is this: you can email your friends but don’t post this type of thing to Facebook where everyone can see.

Her husband has a mental illness, he experiences psychosis and takes Zyprexa. She tried to make an example of herself, “I don’t tell anyone about your uncle’s illness, not even my best friend in Canada because there’s stigma,” hinting that I should follow her lead. If you want to keep your husband’s mental illness under wraps that’s your prerogative, but how and to whom I reveal my own mental illness, it’s mine to choose.

The reasoning behind her advice not to post any hints of my mental illness on Facebook, “I’m telling you because you’re still young and maybe you don’t know how cruel people can be.” I don’t know how cruel people can be? I don’t know how harshly society can judge those with mental illness? Puh-lease. Give me some credit here. I have had mental health issues for years. I am a volunteer for two youth mental health organisations. I have friends with mental illness. I read a number of mental health blogs. I think I know a bit about stigma against mental illness.  The implication of that statement, that I am so naive and have no social awareness, is just insulting.

She’s even gone so far as to already have reported to my grandparents and other aunt that P has been ‘unfriendly’ ever since I posted comments of my mental health issues on Facebook. Yet she has no proof P has even read those comments, let alone acted accordingly towards me because of it. Apparently my other aunt has attributed P’s ‘negative attitude towards me/my mental illness’ to ‘having Asian beliefs’.

I tried to tell my aunt that I don’t care, others have been open about their mental illness and have been none the worse off. I told her I’ve given a speech telling my story to employees of an accounting firm, and consequently revealed to sixty strangers a part of my mental health journey. I emphasised that I do know about stigma, which is why I used to keep my mental health issues hidden from everyone, but as time progressed I have become more open. Unfortunately I don’t think I got my point across.

I was feeling irritated and slightly upset after this conversation. Why must she insist I keep my mental health issues completely hidden and to submit to the stigma it can carry? As well as this, my insecurities were starting to creep in. Prior to this, I hadn’t even noticed P’s ‘unfriendliness’. Was my aunt right? Did P’s opinion of me really fall so low, just because I’m ill?

As it happened, the lunch break after this conversation took place, P and I, along with a couple of other workmates, had a lovely cheery conversation together. No sign of disrespect nor looking down upon me. This occurred whilst my aunt was in the same room. Goes to show her suspicions are unfounded.

Me: 1 Aunt: 0

I’ll admit I feel rather smug.

DBT Handout

Today I made my way back to where I was hospitalised over a month ago, the Psychiatry Department of the general hospital. They don’t exactly make it easy to find. Must be something to do with hiding away the crazy people and all… Yes, I was an inpatient there, but going in I was wheeled from the Emergency Department to the psych ward in the middle of the night, and the darkness combined with my fear didn’t make for a good sense of where I was. Walking out of the psych ward upon discharge, I wasn’t exactly looking to find out how to make my way back in again.

I had an appointment scheduled with one of the social workers from the counselling service for those who present to the ED with self harm and/or thoughts of suicide. I had spoken to R on the phone once, but had yet to meet him in person. My anxiety levels were raised when I learnt he was a man who looked to be in his 50s…he turned out to be a nice enough chap, but even so, I don’t really feel as though middle aged men can relate well to nineteen year old females like me.

We established that I was still seeing Dr T and had been referred to a DBT program, as had been discussed during our telephone conversation. Told him I was starting OT at Uni this year, which he said they had mentioned. By ‘they,’ I assume he was referring to the doctors I spoke with whilst an inpatient. He also enquired as to how things were at home, as he was aware things aren’t great with my father. Bearing in mind I had never met him before and only had a five minute phone conversation prior to the appointment, I was a little disconcerted that he knew all this about me already. I assume it’s through my notes being passed around, which makes me rather uncomfortable.

He informed me that the reason I was here today meeting with him is so that they could help me stop self harming. Right. As long as I’m not engaging in cutting behaviours, it means I’m cured.

He thought it a good idea for me to be introduced to some DBT skills as I am being referred for the very program, and so he handed me a sheet entitled ‘Distress Tolerance Handout 1′, an excerpt from the book Skills Training Manual for Treating Borderline Personality Disorder by Marsha Linehan.

We went through the handout, the three sections being DISTRACT with “Wise Mind ACCEPTS“, SELF SOOTHE the FIVE SENSES and IMPROVE THE MOMENT. Unfortunately it was not even halfway down the first page that I decided it was a patronising pile of crap. It was this suggestion for distracting oneself that did it,

With Comparisons:

[...] Compare yourself to those less fortunate than you. Watch soap operas; read about disasters, others’ suffering.

R suggested thinking of those Australians recently hit by the natural disasters and being grateful not to be amongst those affected. I do feel awful for them, but really. Being mindful of the fact that there are others less fortunate than I is not going to divert from my own crisis and thoughts of self harm and suicide.

Similar cheery suggestions for distress tolerance are given throughout the handout. My favourite include; ‘call 800 or other information numbers to hear a human voice’, ‘half smile; change facial expression’, ‘go sit in the lobby of a beautiful old hotel’ and… ‘sex’.

The DBT program I am being referred to runs for a year. A. Whole. Year. If I am eventually accepted into it, how am I going to tolerate going through this useless drivel for an entire year? Maybe it is a blessing that the DBT Co-ordinator hasn’t contacted me after all…

I know I should keep an open mind and not display such terrible attitude. But… I guess I’m just way too cynical for my own good…

In any case, I don’t think I’m willing, nor do I even want to let go of self harming just yet. Which suggests if I embark on the DBT program it would be rather pointless.

At the close of the appointment, R told me he’d give me a call next week to see how I get on with these Distress Tolerance techniques and whether another appointment should be made or not. I’m thinking not.

Cutting back on food *PT- EDs*

These past few days, the Wii Fit has reported back to me that I’m ‘underweight’. Barely, but underweight nonetheless. Prior to this, the whole month that we’ve had it, it had told me I was of a ‘healthy weight’. I believe I had found my body’s set-point. I was eating cakes, sweets, chocolate, fried food, and my weight was remaining relatively stable.

It’s hard to believe a simple statement of opinion could have such immense impact. But ever since my grandma, aunt and uncles’ comments, I’ve reacted by turning back to old behaviours. Cutting back on food. Food that just two weeks ago, I would have happily dug into. Lying to my mother, telling her I’d eaten sandwiches when in reality all I’d consumed was a Coke Zero. Purging after dinner, despite it not even being a very large one by ordinary standards. Being too afraid to swallow and instead chewing and spitting cake and cookies into the bin. Weighing myself a few times a day and being thrilled when the number has dropped and being mad at myself, wanting to slice off my flesh when the number’s gone up.

This could go two ways. I could grow weary with the restriction game, get too hungry, give in to temptation and resume normal eating habits. Or it could all go downhill and I end up with the symptoms of an eating disorder. Again.

There is a part of me that’s disappointed with myself. I really thought I was over this particular aspect of my mental illnesses and when I look back on my blog, it’s been six months since the last ED themed post. The lure of thinness and a decreasing number on the scale is also strong however. Stronger than my appetite for food and a desire to be healthy and free from an eating disorder? I’m not sure.