Home from hospital

No matter how many times I go through this, being discharged always brings about a mix of emotions. Feeling glad to go home yet terrified at the same time. I was discharged yesterday afternoon. The first few days back home are always hard. Feelings of loneliness and everything being too much threaten to push down on me as I try to push them back.

I’ve reluctantly agreed to be referred to the group program. C, who runs the group program and is also my tutor at uni, came to see me briefly. One of the things she asked me is how I feel about her being someone who runs groups as well as my tutor. I wasn’t sure, and told her so. She said that although I may see her at the group place, I probably won’t have her as the actual group therapist because I did already know her. For the actual pre group assessment, someone else came to do that with me. It was explained that to do the DBT group, one must first complete two other groups before being assessed again for DBT. It was decided that I’d first do Introduction to Group Therapy then the Emotional Regulation group. There are two types of DBT groups on offer, DBT skills which runs for 16 weeks, and the full DBT program which runs for a year. All groups go for 2 hours weekly, with an additional 1 hour individual therapy session weekly for the full DBT. During her explanation of DBT, she told me that Marsha Linehan, the creator of DBT also had Borderline Personality Disorder. Is that supposed to make me feel better about it? When I asked her whether there is a waitlist for groups, she answered that sometimes there is, but they’re usually able to get through it pretty quickly. Given I was on the DBT waitlist for a year last time I was referred, it seemed at odds with my experience. I suspect what’s changed is this time I’ve had seven ODs resulting in ED treatment and five psych admissions under my belt plus I’m not seeing anyone on an outpatient basis. Last time I was referred I was still seeing a private psychiatrist, plus I’d only been in the ED twice and had one psych admission.

I’ve decided to go part time at uni, which means dropping out of two units this semester. In hindsight I should have done so at the beginning of the semester. Up to the point where I was hospitalised, I’d attended all classes and completed all the work, so it feels like such a shame that all that time and effort is going to waste. There are both pros and cons to going part time. The pros are that it means I will be less stressed and have more time to look after myself and do other things. The cons though are that obviously it will add more time to my degree and my friends will progress to the next year without me. I hate feeling left behind like this, while it seems everyone else my age has already graduated and gone on to get real jobs.

Torn

I’m feeling so torn between wanting to give life a good go and feeling like it’s all too hard and I want to just give up. I’m realising how BPD actually affects me, and I fear I’m going to be imprisoned within it for the rest of my life.

My boyfriend has been amazing and very supportive, especially given this is the first time he’s ever had to deal with the world of mental illness before. As much as I love him for it, it also terrifies me. The fear of abandonment has always stopped me from becoming too emotionally attached to anyone to protect myself from getting hurt. He’s told me that he’ll stick by me, that he loves me and wants to be with me. At this point my instinct is to run and push him away. I’ve played out this pattern with psychologists before and I don’t want to play this out in real life. But it feels like such a risk to let my guard down and I’m not sure I could cope with the fallout if he does eventually abandon me and let me down.

The psychiatrists are still keen for me to do DBT and apparently the woman who runs the groups will be coming to have a chat with me about it. Problem is, she is also my tutor for my Counselling and Group Work and I’m not sure how I’m going to face her in class after this. Up until now I’ve managed to keep my professional OT student role fairly separate from being a consumer of mental health services and now they’re about to collide. I’m reminded again how small the mental health sector is.

Involuntary treatment order

The Form 4 of the Mental Health Act I was out on which allows me to be detained in hospital for assessment was due to lapse last night. This meant that a consultant psychiatrist would have to assess me and decide whether to leave it and let me discharge myself, or put in involuntary treatment order in place.

I was not expecting to remain scheduled, yet that is what happened.

I don’t even understand why, as I said that being in hospital isn’t helping, and I don’t see how keeping me here will make any difference so might as well discharge me sooner rather than later. I’m still hoping however I can be discharged very soon. I know I need to come up with a plan, but it’s hard when I just can’t think of anything and if I’m honest, don’t give a shit, am not interested in treatment and couldn’t care less.

Locked ward to open ward

Well. It’s been a turbulent past few days to say the least.

Sunday afternoon I took an overdose of paracetamol. Felt really nauseous afterwards and called the ambulance myself. Was transported to the ED. The doctor suspected I had taken something else as my ECG was apparently “very abnormal.” I however, definitely had not. Was told something completely different the next day by another doctor who said my ECG was normal. And so I was put on a NAC infusion and a psych liaison nurse came to have a chat. The plan then was to discharge me after the NAC had all gone through.

The next day however, another group of psych doctors assessed me. Somehow on the second day I always feel worse, as I think about how it feels as though I always turn back to this and that nothing will ever help. My wishy washy answers to what my plans were after leaving the ED didn’t really help my case, and they talked of admitting me.

Upon the NAC infusion finishing at about 5pm, I was told that I had to wait around to be seen by a psych liaison nurse yet again, who didn’t start until 7:30pm. Waited around for a bit. Pulled my cannula out. Eventually I just walked out, as I didn’t feel like mental health services will do anything to help anyway and I felt frustrated.

Walked around town for a bit, sat crying and feeling hopeless for another bit. Got 2 missed calls and messages from the ED and ignored it. Eventually wound up at the train station and sat watching the trains, wondering what it’d be like to walk in front of one. Half wishing I had the guts to do so. A friend called and I talked to her for a bit, after which I intended to just take the bus home. However, I then got a call from the police, who said they had to spot me before they could write the job off as done. Was met by the police, and when I expressed by reluctance to return to hospital, I was told I had to come with them and “You’re under the Mental Health Act.” Wasn’t sure how serious they were, but I wasn’t willing to test it out. And so back in the ED I go.

Cue more waiting around, and me crying and feeling miserable. Was assessed by another psych doctor, after which I was transferred to a locked ward. Was patted down by a nurse in a bare room with a mattress with about 4 other nurse watching, then had my phone, jacket, necklace and bra taken off me.

The next day the doctors came to talk to me. It was then I was told I have Bullshit Psychiatric Diagnosis Borderline Personality Disorder. “Has anyone ever discussed this diagnosis with you before?” the doctor asked. Umm no, because I’ve never been diagnosed with BPD before- I’ve only been ever been told I don’t have BPD. Sigh. They thought it a good idea for me to do DBT, I was rather ambivalent.

Later on at night while I was in the TV room, a patient came it and told me “You better leave, as I’m going to start throwing things soon.” Told her I was staying as I was watching TV here first. She responded by saying she was going to start throwing things in the direction I was sitting. “Well throw it in the opposite direction then,” I said. True to her word, she started throwing things, nurses came and told me to leave, the duress alarm was pressed and she was restrained and escorted to a seclusion room.

The next day when the doctors came to see me again, I expressed that I didn’t find it helpful to be in hospital and that I didn’t see the point. Doctor responded by saying they still thought DBT would be helpful and maybe I’ll change my mind about it. Hmm yes. He also said that with a personality disorder, it’s very possible to get better, less difficult than a chemical disorder like major depression or bipolar. “But I thought a personality disorder is a lifelong thing,” I disputed. BPD more treatable and a better prognosis than depression?! First time I’ve heard that ever. The good news though is that I was them moved to an open ward, where I am at the moment. He warned me that I’d still be under the Mental Health Act, and if I abscond I will be brought back to hospital by the police. Currently I’m on 1:1 specials.

Was given a copy of the form I’m on at the moment, Form 4 under the Mental Health Act which means I can be detained for up to 72 hrs from admission to be assessed. It expires tomorrow night.

So far I’ve managed to keep this from my family. Not sure how long I’ll manage to keep this up, what I’m hoping is they’ll meet have to find out. My boyfriend has been visiting. It’s the first time he’s been exposed to when I’ve actually been unwell. He’s been good, but sometimes it’s hard when he’s never been exposed to mental illness prior to this. He obviously knows I’m under the Mental Health Act and I’ve told him about the BPD and the recommended DBT. I can’t help wondering though, “Wouldn’t you rather be with someone a lot less complicated?”

Struggles of the past week

The past week and a half has been hard. Numbness, apathy and anxiety have all been present. There have been a couple of nights where I’ve come very close to overdosing as a way to self harm. Knowing that I had things to do and places to be the next day stopped me on Tuesday night. Went and bought a pack of paracetamol on Wednesday night before going to the park and sitting by the riverside for a while. Tried to remind myself that this isn’t me any more, that I’ve gone over a year without overdosing. In the end I went home and the pack of paracetamol still remains in my shopping bag.

There’s a part of me that almost wants to dare things to slide to rock bottom so at least I know where I stand. Being stuck in limbo feels almost worse. Not feeling well, but also not quite at my worst. Waiting, waiting for either things to get better or to slip into “I can’t do this any more.”

This past week I haven’t had uni and thus have been able to sleep until 10, 11am and returned to bed when the tiredness, feelings of anxiety or the world has felt too much. This coming week uni returns and it could go either way.

Parents going overseas

About a week ago my mum told me that her and my father were planning to go on holiday at the end of the year and they wanted me to stay with my 16 year old brother while they’re gone. I didn’t give too much thought to it until yesterday when I asked my parents the details of their trip. Turns out they’re holidaying around Europe then going to Indonesia for an entire month. It’s been bothering me and I couldn’t quite work out why until now.

The first and last time my parents went away and left my brother and I at home was in April/May 2011. Which ended up being a disaster as I overdosed and subsequently landed myself in hospital. Ever since, they’ve been reluctant to leave us both home alone. Until now, apparently.

It should be a good thing that I’m now “trusted”. Except that it also really scares me that they and possibly everyone else assume that I’m completely better and that I’m not going to become unwell again. Just because I haven’t been in hospital or overdosed in over a year doesn’t mean that I don’t still get thoughts of doing so. It also puts me under immense pressure as everyone seems to expect that I’m well and I don’t want to disappoint anyone. I’m terrified of becoming unwell any time, but even more so if it happens while my parents are overseas and I’m meant to be looking after my brother. Additionally, staying at my parents’ home with my brother still holds bad memories of how it turned out last time.

Compassion fatigue

In our most recent Counselling and Group Work lecture, one of the things we learnt about was compassion fatigue. One aspect of it stuck out to me particularly, “Loss of compassion towards those who we once would have had compassion for (Figley, 1995).” It describes for me how I’ve been feeling gradually over the years. Obviously I’ve never been a professional counsellor, but online I’ve come across many people who have mental health issues.

It started off during my high school years with a self harm recovery online discussion board. Over three or so years I would visit the site every day, and totalled several thousand posts by responding to almost every thread. I then met both online and real life friends through the mental health volunteering I do, some of whom express their struggles through social media. I was also a peer moderator on the forums of an online mental health service. Then of course, there’s also blogging.

Once upon a time I would have had all the time in the world for people who were struggling. I would try my best to respond to almost everyone needing support with sympathy, encouragement or suggestions. These days however, I just can’t bring myself to do so. After being exposed to so many people’s issues over so many years, I’ve lost the patience and empathy I once had. I now avoid online forums altogether, I don’t read as many blogs as I did, and in the case of Twitter and Facebook where I can’t avoid it, I skip over those types of updates.

I guess it’s also a reflection of where I am at the moment. My sole source of support was once through a computer, but I’m past that stage of seeking help online now. I’m realising that sometimes in order for things to get better, you have to take action in your own life, and I find I get impatient when I see certain people who are stuck in a place of misery but keep making excuses when people offer them suggestions. I’ve learnt that going into hospital is not going to fix everything and it’s frustrating when there are some who think an inpatient admission will be the solution to all their issues.

I know that I’ve been that person too, so I don’t want to be cold and heartless towards people who are still at that stage. But somehow my compassion has waned and I don’t know how to get it back. Sometimes I wonder whether I should have spent less time trying to help people in my teens. Maybe then I wouldn’t have been burnt out before my career’s even begun.

One year

So I don’t quite know how it happened…but it seems it has been an entire year since I’d last taken a trip to the emergency department, been admitted to hospital or even taken an overdose. Okay, so I know for most people they manage not to do that ever so it shouldn’t really be such an achievement, but for me it is. Those who’ve followed my journey on this blog for some time may recall a girl who was quite consumed with her mental health issues. Who, for the past three or so years prior, could not go more than four or five months without overdosing and ending up in the ED. To be honest I’m not even entirely sure how this year happened, but here I am.

That’s not to say I don’t still struggle. I most certainly do. There are times when I still contemplate overdosing and that ending it all may be easier. Certain things and situations still will trigger me. At times I still self harm. There are times when I miss and long to receive the support of a mental health professional, and feel envious of those who do. But all in all, compared to how I used to be, I think I’m going okay. I just hope it continues not just for one year, but for many, many years.

Full time uni

Sometimes I wonder whether or not I should do part time at uni. For the past two years I’ve been doing full time, and somehow or another, have managed to pass everything. But I also think of the struggles it took to get through it, and that it may be worth it to cut back a bit on the workload. So that I’m not so exhausted and not so stressed. So that I don’t get completely overwhelmed and panic when I have four assessment tasks all due in the same week. So that I have time to relax and do the things that I enjoy and keep me well. Because if I’m honest with myself, stress is a big trigger for me, and I’d like to stay well for as long as I can. And unlike last semester where I had a GP who could write me a letter when I needed extensions on assignments, I don’t even have a GP currently.

At the same time, I reason with myself that I got through the past two years, so I should be able to get through this year and next too. I don’t want to extend my time at uni for longer than I have to. I’ve already been at uni for so many years while friends and people I know have graduated on gone on to get real jobs. Other people’s opinions and approval also matter to me, and I’m afraid of what friends and family may think. That I should just continue on so I can finish as soon as possible or that I’m just being slack. Some people manage/d full time university and jobs with many hours (as my boyfriend has told me he did). I don’t want to feel inadequate for not even being able to manage what everyone else is able to.

Why the need to ask?

I don’t quite get why people feel the need to ask the who/what/when/why of scars. Especially when there are a number of them, and let’s face it, aren’t my most attractive feature. I mean, I can kinda understand when there’s one recent wound, and people ask as a curiosity/sympathy/”are you okay” type thing. But when there’s a number of old scars…

A couple of OT friends noticed the scars on my legs and asked how I got them. I shrugged, said “I don’t know” and looked away. We then had a Counselling and Group Work tutorial in which our tutor briefly spoke about self harm, how it’s a way to cope and is not necessarily a suicide attempt. Straight after our tutorial one of the friends then asked me whether it’s from self harm. I ignored her and said nothing, while the other friend laughed and joked “We just had the tutorial so now you’re asking about self harm.”

Later on in the day my friend then took it upon herself to ask again, remarking that she doesn’t understand how I don’t know how I got them, that even if she fell, a person wouldn’t get that many scars. “Oh my gosh, why do you keep asking?” I asked in a light-heartedly exasperated way.

That night I received a text from my other friend which said that she thought it was quite immature for our two other friends to be joking about self harm like that, she noticed I looked uncomfortable and she was sorry I had to experience that. This is a friend who knows I have mental health issues so she could probably infer the scars are actually from self harm. I texted back that I appreciated her message and that I imagined our two friends joked about it because they didn’t realise what they were joking about was actually the truth.

Many of my scars have faded over the years and I’ve had a lot of time to get used to them so their questions about it don’t really bother me all that much as I just brush it off. I’m at the stage where though it’s not something I want to announce to everyone I know, it’s also not something I go to great lengths to hide any more. What I don’t understand though is why people are insistent on knowing how someone got their scars. I know what may seem obvious to me and others who have or know someone who has self harmed isn’t so obvious to them. But even if the scars aren’t from self harm, why do they probe so much curiosity? To me they’re just scars and not a big deal.