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?”

Therapy is too hard

I attended the appointment yesterday with the psychiatrist and the clinical psychologist who is meant to be taking me on. Afterwards I spent some time sitting on the garden ledge with my sunglasses donned, crying.

Did I like the psychiatrist? Well it doesn’t really matter seeing as my medications remain unchanged and he’s told me to simply continue seeing my GP. Alrighty then, back to Dr L I go. Did I like the psychologist? I’m not entirely sure and that’s part of what upset me. The advantages of the public system are of course that it’s free, but it means you don’t get a choice as to who treats you. I’m afraid of being stuck with someone I dislike and whom I don’t feel I can work with.

I also felt as though I was being pushed into doing DBT and that is the only option I have if I want to receive treatment through A St. As you may recall I don’t have the fondest impressions of DBT. I also dislike that so many mental health professionals seem to think DBT will be the magic answer that cures all. Because I was intimidated though, I wasn’t able to voice the issues I have with it. So I reluctantly shrugged and okayed doing DBT even though I despise feeling like I’ve been pushed into doing something I really do not want to do.

Unsurprisingly, as is always the case with people I don’t know, I found it difficult to talk. They were lucky if they got more than a “Don’t know”, “I guess” or “Okay…” out of me. I don’t want to do this any more. I’m completely fed up with continually having to start all over again with someone new. It’s hard to start to open up and trust a person. By the time I start to do so, I’ll find that therapy with them ceases. Yet again. Plus, the clinical psychologist I am meant to be starting with is going away for a few weeks, so it has been suggested I see his replacement before starting with him. Considering how hard it is for me to open up, I see little point in doing so.

I had an appointment with D this afternoon. The majority of the session was spent in tears, noticing that he wears brown shoes with red socks and that the carpet in the room is chequered, alternating between a lighter and darker shade of blue. After lots of prompting on his part and shrugging on mine, he eventually established I was upset by the appointment yesterday. I told him it’s “too hard” and “I don’t want to do [therapy] any more.” Upon him saying he would see me again next Wednesday, I replied that I have fieldwork. Every Wednesday. “What about Monday?” he asked. “I have uni,” I told him. “What about a later time on Monday?” I again replied that I have uni. He asked until when? “June,” I replied. “Did you have fieldwork today?” I confirmed I indeed did. “Did you have to leave early to come here?” A little sheepishly I admitted I did not. He said he’d see me next Wednesday. I’ve never not turned up to an appointment because a) I don’t have the guts, b) it is rather rude and c) other people could have used that appointment slot. If I don’t turn up next week though, well, he did have prior warning…

D also suggested I may be upset due to the change of having to cease seeing him. I cannot emphasize enough how much I resented that statement coming from him. Even more so that a few more tears escaped when he said it. I am absolutely repulsed at needing and relying on someone, especially when the feeling is not reciprocal. I refuse to need anyone emotionally more than they need me. It puts me in a vulnerable position and gives the other person immense power. Can’t let that happen.

Upcoming Pdoc appt and Mentalism & Driving

It was surprising how many of the other patients when I was an inpatient didn’t actually have a regular psychiatrist. Many of them had their mental illness managed by their GP. Which has led me to believe psychiatrists, particularly those in the public system, are really for those with more severe mental illness like schizophrenia or bipolar disorder. If the statistics are correct, 1 in 5 of us have depression. In other words, it’s rather common. Too common to be seeing a specialist in the public mental health system for?

One of my fears when meeting with a new mental health professional is that they won’t take me seriously. Or they think I don’t really need to be seeing them as there are plenty of people sicker than me. I tend not to talk very much when confronted with mental health professionals. When it’s someone new who knows nothing about me, what if they take my reluctance to talk about my issues and struggles to mean that nothing’s wrong? Or assume that I’m deliberately being ‘shy and secretive’ as the first psychiatrist I saw accused me of being? Another barrier to talking is I can’t help thinking if I do describe in detail what I’m struggling with it will be assumed I’m exaggerating. That I’m deliberately talking up my symptoms to ‘prove’ I have depression and therefore deserve help.

Hopefully what may make tomorrow’s psychiatrist appointment a little easier is that D has been in contact with I, one of the clinical psychologists at A St, and told him a bit about me. While I’m not exactly keen on being discussed without knowing what’s been said about me, if it helps them understand a bit more about where I’m coming from I won’t object.

I’m meant to make an appointment to see my GP as well, but on top of a psychiatrist appointment on Tuesday and a psychologist appointment on Wednesday, a third appointment in a week seems rather excessive. I went to renew my Learner’s Permit in relation to driving and because I’m mental, the Department of Transport seems to be questioning whether I’m fit to drive. Being the honest person I am, I ticked Depression where it asked us to tick whether we have any of the medical conditions listed, and dutifully wrote down Pristiq and Seroquel where it asks for medications. I was then told because of that I have to have a medical, get my GP to fill in a form stating whether I’m fit to drive, and come back next time. Ugh, seriously? My ability to drive isn’t affected at all. And I’m smart enough to know not to drive after taking Seroquel because of the drowsiness it causes. Ever since I’ve been thinking I should have left those sections blank to save the hassle it’s causing.

Counterattacking schemas

I received a letter on Thursday from A St informing me I have an appointment with one of their psychiatrists on March 13. An appointment less than a month away? In the public system too? A-mayyyy-zing. Is this really the same service that left me on the DBT waitlist for over a year before removing my name without my knowledge? I’m not quite certain how it works though. Do I only get one appointment for a psych review and that’s it? Or do I get ongoing sessions with this psychiatrist?

You’d think it gets easier to say what you want and need to tell them after starting over so many times, but in fact I’ve become more reluctant to do so. It’s become tiresome having to retell the same story over and over again that I don’t know what to say any more.

In the meantime I’m still seeing D. Same problem. Not that I had much to say to start with. We, or rather he, has been talking about some of the schema stuff I had done when I was still seeing R in therapy. One of the schemas R and I had identified for me was subjugation. According to this sheet;

This schema refers to the belief that one must submit to the control of others in order to avoid negative consequences. Often these clients fear that, unless they submit, others will get angry or reject them. Clients who subjugate ignore their own desires and feelings. In childhood there was generally a very controlling parent.

According to the Reinventing Your Life book there are three ways you can cope with your lifetrap: surrender, escape or counterattack. These three terms are fancy names for what roughly equates to a freeze, flight or fight response respectively.

I guess at times I can be a bit resistant in therapy. I will sit there in silence or fail to do what the psychologist has asked me to do during the week. D has accused suggested I am in fact counterattacking the subjugation schema by not doing what he’s asked, whether it be practice relaxation or grounding exercises, record when I’ve self harmed or read certain handouts he’s provided me. How I’ve seen it though, my silence is indifference, not wanting to be there in therapy in the first place. I don’t do relaxation and breathing exercises because I find them lame. Not doing them is my passive aggressive way of saying so. Could D be right though? Is this my way of fighting the subjugation schema? I’m not quite sure. I’ve never looked at it like that before.

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.

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?

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.

GP Appointment

I visited my GP today asking for scripts for the Pristiq and Seroquel. She didn’t provide them to me. Instead, she rang up Dr T’s office requesting an ‘urgent appointment’ for me as I haven’t seen her since August and don’t have an appointment until January. ‘Urgent appointment’? But I’m fineeeeee. I’ve been doing okay since discharge; I’m still seeing the hospital psychologist until the youth counselling agency picks me up, I’ve gotten through my exams and even managed to pass all my first year units.

GP had a conversation with the secretary in which she was told I had ‘missed a few appointments’. Missed a few appointments? I called up and cancelled two for legitimate reasons! Once when I had uni stuff on, and once because I was in the psych ward. I was told by GP that I must give these appointments priority over uni, going out with friends, and basically everything else. GP told the secretary, “She’s asking for these antipsychotics and I don’t feel comfortable giving them to her.” It doesn’t help either that it seems the hospital didn’t send the discharge letter through to my GP and so she has no documentation of what medication I’m on. The only correspondence she has received is from the Emergency Department, detailing my overdose/s.

And so, I’ve been told she is waiting for Dr T to call her back to see if I can get in to see her. I will then be notified of whether she can or not, and if not, GP will provide me enough meds to tide me over until I see Dr T. I’m feeling rather apprehensive about seeing Dr T again, terrified of how she’ll react and what she will say of my most recent overdoses and subsequent hospitalisation and worried about whether she’s willing to continue prescribing me the Seroquel or not.

Home

Yesterday on the 21st of November, four weeks from when I was first admitted, I was discharged from hospital. It was only when I left that I realised my day of discharge came exactly a month from when I was taken by ambulance to my local ED on the 21st of October. Funny how certain dates can become significant without us meaning them to.

So where to from here?

First things first; get through my exams. Three exams, three days consecutively. Wednesday, Thursday, Friday. I am fully expecting to fail my first one tomorrow. Hell-o summer school.

I have an appointment with the hospital psychologist on the coming Monday. Given last appointment he had me rubbing ice up and down my arm as an alternative to cutting, I’m rather skeptical as to how beneficial going will actually be. I had almost forgotten why I was so firm in my resolve not to see a psychologist again after ending with R. I definitely remember now. Apparently I am being referred to YL, a youth counselling agency. Yet again I’ll have to start all over, become comfortable with someone new and retell my story. Can’t wait.

I’ve also been told I should see my GP. I am yet to make an appointment. It’s been explained to me before what GPs can do in terms of mental health care, but I still don’t quite understand. What much can be done in ten minutes, besides obtaining a script? I still have enough of my Pristiq to tide me over for now, and I was given a free box of Seroquel from the hospital as discharge medication.