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.

Proof I’m struggling

Last week the hospital psychologist I’m seeing, D, asked me to list the reasons/benefits of self harming. Besides the usual reasons; it distracts me from my emotions, it’s a way of punishing myself, it’s a way of releasing anger and frustration, etc. etc., I also said that it’s a way to “prove that I’m struggling.” He briefly brought that up during our session today.  He told us that the people who have treated us badly or abused us rarely feel guilt and the need to make it up to us. If years later we’re struggling, they’re not going to see it as they’re the ones to blame. Instead, they’re going to see it as we’re the ones who don’t have the willpower to get ourselves out of this. D told me a story about a Vietnam war veteran who spent thirty years on his porch drinking, telling people that the government had done him over. He also told me of a previous self harmer who was the victim of a paedophile ring and is now a counsellor, one of the things she said is that the best revenge is to make a success of yourself.

Objectively I can see his point. Looking in from the outside at these situations, I can see that destroying yourself to spite those who’ve wronged you is pointless. It doesn’t affect them and it’s letting them win. But when it’s you in that situation, it’s harder to have this insight. And when we’re engaging in these self-destructive behaviours, we’re not exactly thinking, “This’ll teach them!”

It’s also more than that. “We know you’re struggling,” D said to me. But do they really? I feel like if there’s no physical proof, people won’t believe me. I struggle with verbalizing how I feel. The closest I get to admitting I’m struggling is responding with “Umm, not that great…” when a mental health professional asks how I am. In a way, self harming acts as a voice, ‘proof’ I’m struggling. Then there’s the reaction to my scars by the few who have seen them; the first GP I saw, doctors and nurses in the emergency department, a doctor and nurse in the psych ward. Yes some of them have reacted with shock and revulsion. But there’s a part of me that feels satisfied I’ve done a proper job of it when what they do or say makes me suspect they’re thinking, “This girl really does have issues.”

Last week D also brought up that if I’ve stopped self harming, I could get the plastics people to have a look at my scars. Immediately my anxiety went up. I realised the absence of scars is another one of the barriers stopping me from ceasing to cut myself. As much as I dislike not being able to wear certain shorts, skirts, dresses and bathers, it scares me a whole lot more not to have something to show for my struggles.

Long term therapy

“Do you think you’ll always need psychological input?” we were asked during one of the hospital group sessions. The discussion was based around  the Better Access scheme limiting us to ten sessions with a psychologist per year. We paused. “You’d hope not,” another patient finally answered.

Are there actually people who completely rid themselves of psychological and/or psychiatric services and manage to stay well though? Not needing to see a psychologist, take medication, see a psychiatrist or be hospitalised again? I’m not asking this rhetorically, I actually want to know. Is it just that I don’t know enough people? Or are those who get and stay well a rarity?

Sometimes it seems as though my answer to the original question posed is “Yes”. I was told by my GP this week I’d probably need ‘long term therapy’. Which in itself, isn’t a statement that fazes me much anymore. I’ve been told the same by at least two psychiatrists.  Except that I’ve been in therapy for the past three years. How much more ‘long term therapy’ could I possibly need before I’m considered recovered? Surely three years is plenty long enough?