Being cancelled on

Last week my A, my community nurse, cancelled on me. “She does that a lot, doesn’t she?” a friend remarked when I told her. Well, now that you mention it… :/ A phoned and rescheduled to see me at my next psychiatrist appointment which is next week. I’ve been really tempted to just cancel both altogether and be done with it. When I get cancelled on it just makes me feel like I’m not important and less of a priority compared to other clients, and I think “Fine, don’t bother then.” As for the psychiatrist appointment, last appointment when I met him for the first time, the appointment lasted literally 5 minutes, so I don’t even see the point in going. The round trip to get to the mental health centre takes about 5x that alone.

Part of me knows that it’s the BPD part of me that’s wanting to react in this way. That mentality of wanting to be the rejector as opposed to the one being rejected. “If you cancel on me, I’ll cancel on you!” and wanting to “test” her to see if she’ll follow up with me if I cancel altogether. Unfortunately or fortunately, my anxiety around making phone calls probably means that I won’t end up cancelling, and I’ve never been able to bring myself to simply not turn up to an appointment- that just seems rude. So more than likely I’ll just go and nod and say that everything’s fine. Guess I’ll see what happens.

Besides that, my mood’s been a bit up and down. One moment I’ll feel okay, and the next moment it’ll plummet. I had been feeling empty, and being stuck behind a computer doing an online unit and assignments has not been great for my mental health. I took a small OD a few days ago and downed 500mg of Seroquel. Which, considering some people are prescribed 500mg daily, shouldn’t be that much. Except that I don’t take Seroquel any more, and even when I did I was only on a very small dose, so 20 tablets was quite a bit for my body. I slept about 20 hours before awaking, and when I did I ended up vomiting and blacking out a couple of times and could feel I had tachycardia. It took another 8 hours before the drowsiness fully wore off. It was just self-harm, I knew I wouldn’t do any permanent damage from it. The last time I had taken an OD was about July/August last year and I guess a part of me is also afraid of getting better. I’m also hoping that now that I’ve got that out of my system, I’ll be able to get through my three fieldwork placements this year without getting unwell or any self-harm episodes. Considering my placements start next week and they’re three blocks of seven week full time pracs all in a row, I better get my shit together. This is my seventh year in an undergrad course in uni, which is long enough.

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?”

Admitted to M St

I used to think it’s difficult to get yourself admitted to a mental health ward. But it seems as though once you’ve had one admission, they don’t hesitate so much to chuck you in the nuthouse again. And again.

I took almost a month’s worth of Seroquel and a few days worth of Pristiq. Considering I’m only on a low dose of Seroquel, it’s not that much. Yet, according to my father, the nurse told him I was close to having a seizure.

My memory of what happened is rather hazy. I was asleep for about 20hrs, punctuated by moments of consciousness here and there. I remember dropping to the floor as soon as the paramedics tried to get me to walk. Them carrying me even though they weren’t supposed to because they can hurt themselves, but apparently I’m light enough to do so anyway. Having two cannulas put in me, one on each arm, and an oxygen mask. A doctor giving me sternal rubs whilst asking me questions. No I can’t answer you because I’m too distracted by the pain of you grinding your knuckles up and down my chest. The psych liaison nurse asking me if I remembered him from last time I was in the ED. I confirmed I did. “Don’t come into hospital then if you don’t want help,” he told me. “I didn’t choose to come to hospital,” I retorted. “So your mum did when she called the ambulance.” “Yes.” “Very passive,” he remarked. I remember talking briefly to a psych doctor with him suggesting I be admitted for a few days and me stating I’d rather just go home. Next thing I know, I wake up and they’re already organising a bed for me. I again told the psych liaison nurse I’d rather go home. He explained the doctor wanted me admitted and it’d be better to go in for a few days now rather than end up in ED again and have a longer psych ward stay as a result. I reluctantly agreed.

I was transferred by ambulance to M St where I am currently. Met with the duty doctor. And yes, I again told him I think I’d be better off at home. “But you only just got here and you want to leave already?!” he said, laughing slightly. Um, yes. My treating team will see me on Monday though it seems, and it will be decided then where to from here.

The Story of Ending Up in Emergency

Whilst I was very drowsy and not very with it, I do have a hazy memory of what happened. I remember laying in bed in the afternoon with my mother asking if I was okay. I told her I was. About an hour after she first asked, she cottoned on that I had taken an OD. I hit the floor upon trying to get up out of bed, which foiled her plan to take me to hospital. An ambulance was called…after she asked my fourteen year old brother what the number was. The second time in an ambulance and I’d still have no idea what the inside of it was like if you asked. I remember falling heavily into the wheelchair on arrival at the ED before being put on a bed. Vaguely remember being given an ECG, having a cannula put in by the doctor and given fluids, having a student nurse look after me and being interviewed by the psych liaison nurse. Think I met her back in May actually. The only part of the conversation I remember now is when she asked me what I wanted from ODing again, as I knew what would happen from doing it before.

The next day she came to speak to me again with a doctor. This time I was a bit more with it. The plan was to send me to the private hospital where my psychiatrist is, however, they didn’t have a bed available. And so the options then were; go home and await contact from the private hospital, wait in the ED for a bed in private hospital, or go to a public psych ward. I chose home. But I couldn’t convince them I could stay safe over the weekend and my ‘ambivalence’ worried her. The decision was made for me to spend another day in the ED. Oh the joys.

It was somewhat embarrassing to be recognised from my trip to the ED a week earlier. One nurse saw me and exclaimed, “Weren’t you here just two or three days ago?” “Umm…it was a week ago…” I replied. Another psych liaison nurse too added when he introduced himself to me, “I think I met you three or four weeks ago.” I didn’t bother correcting him, informing him it was only a week. He was the one who finally got me a bed. Not at the private psych clinic, but at the psych ward of another public hospital, where there was a bed. Which is where I am now, and have been since Sunday afternoon. I’ve been told they’re moving me to the private psych clinic when a bed becomes available…but at this rate it’ll be next friggin’ year ’til that happens…

ED again a week later

If you’ve been on Twitter lately and find me interesting enough to follow, you may already have some clue. But for those who don’t, basically I OD’d again. It was the forth one in the past couple of weeks but only the second in terms of landing my arse in the ED because of it.

You can rest assured you’ll be hearing the whole sordid story once I get on a computer…but for now, here’s some photos of where I am to keep you entertained:

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NAC infusion in the ED. Again.

The months following my three week hospital admission in May, I had actually been going okay. Only one small overdose of paracetamol in over four months. Until this week that is. Wednesday night I took several antihistamines and a few different sedatives that I shouldn’t have had in my possession. Slept for about 16 hours. And what do you do the night after you OD? Why you take another one of course…

So what happened? I may as well link to this post made in August 2010. I’m predictable and stupid enough that I do pretty much the exact same thing over a year later. But of course there are always a few differences. Like the nurse who commanded “Show me your scars,” and then proceeded to try and draw them on my notes. The same  nurse who asked me, “Do you think you can be an occupational therapist with your condition?’ She also remarked to the student doctor that it’s “sad” I’ve been on the waitlist for the DBT program for so long as they poured over my file. Yes, ten months is a bit “sad” isn’t it…

A few people ‘had a chat’ to me, as they like to call it. The ED doctor treating me, the aforementioned nurse, a couple of psych liaison nurses and the psych registrar. Got the standard lecture about liver damage from the ED doctor and was told to pick up the phone and call someone instead, next time I want to OD. That simple, huh? When interviewing me, the psych liaison nurse commented that I’m not much of a talker and that I must dislike him asking so many questions of me. I replied that I “guess I’m kinda used to it.” “That’s quite sad really, isn’t it?” he answered. Guess it is quite sad I’ve been through four ED admissions, two psych admissions, three psychologists, two psychiatrists, a school counsellor and two GPs who all ask very similar questions. He’s also another one who seems to think DBT will be the miracle cure all. Given my views on what I’ve seen on DBT so far, really I just wanted to bash my head against a wall at his suggestion. I pointedly informed him I am on the waitlist for DBT and have been since January. “Would you like me to help bump you up the waitlist?” he asked me. I shrugged.

I had entered the ED at about 9am on Friday morning, the NAC infusion finished at about 9am the next day and my bloods came back fine at about 10am too. Which could’ve meant I could go home then, but no. I had to wait for the psych registrar. And it wasn’t a quick wait either. About three hours I waited around just for her to have about a 15 minute chat to me. I was presented with three options; home, the private psych hospital I was at in May or the public psych ward of the hospital I was currently in. I shrugged. And cried. A lot. Neither of those options were particularly appealing to me. Hospital for the reason that it’s well…hospital. Home for the reason that I don’t know how I’m going to cope when I don’t have ANY help at all. Last week I had to cancel my appointment with Dr T scheduled for October 7 due to reasons relating to uni, the next available appointment slot was November 16 so I took it. Which is now a month away. I’ve stopped with R, the psychologist I was seeing, and no, I’m not going back.

In the end Dr Chicken, the psych registrar (and no that’s not a pseudonym, no joke), decided to send me home with the proviso that my parents are around to look out for me and I agree to call someone and seek help if I’m going to overdose. Which I did, amidst much crying, express my reluctance and extreme difficulty in doing so. I know it may not seem that hard to some, but I can’t and find it really, really hard to call or ask for any help when I’m struggling. And if it wasn’t such a show of their inefficiency, it’d be somewhat amusing that despite Dr Chicken’s plan for me to call them, or the private psych hospital I was at, or go to the public psych ward triage, or whatever it was, I’ve been given no numbers to call nor any clear instructions regarding what to do if I’m feeling unsafe. Which is just excellent. Next appointment with your psychiatrist is in a month, and in the meantime goodbye and good luck.

And since being home I’ve been crying and contemplating taking another overdose, trying to convince myself otherwise. My exams being in just over a week isn’t helping matters either… :/ I feel so stuck and as if there are no options for help.

The last of my pills

My mother claims that she came into my room to ‘tidy up my desk’ while I was out. Right. Because the first thing one does in tidying a desk is to pull open and rifle through the drawers. That’s how she came to find the box of escitalopram and sertraline I still had in my possession. And my desk is still as messy neat as it was before I left for the day. 

I was confronted by my mother as soon as I arrived home, when she came into my room, pulled open my drawer and enquired about the two boxes of medication I had. I tried to claim they were ‘left over’ from when I still took the aforementioned medications. Except she pointed out the date written on the dispensing label of my box of sertraline. 24 June 2011. Caught out. She confiscated the two boxes and asked for the script. I gave her the one for escitalopram, leaving the one for sertraline. She came back two minutes later realising, and asked for the sertraline script too. Caught out again.  

I feel as though nobody understands how much more desperate and determined to OD that makes me. I’m left with no more antidepressants and no more scripts in my possession. Similar to some people needing their blade there as a safety blanket in case they have the urge to cut, I need those pills in case I have an urge to self harm by ODing. Yeah, I could OD on something like paracetamol, but then I’d have to go to hospital afterwards for treatment to prevent liver damage. With the SSRIs, I know I can OD without needing hospital treatment. I’ve done it a fair amount of times and recovered at home. I don’t want to self harm and end up in the Emergency Department, I want to self harm without; ending up on a hospital bed, my parents finding out, having a cannula stuck up my arm, adding another OD to my hospital records, being labelled as a ‘psych patient’ and undergoing an assessment by ED psychiatrists.

I’m lucky that my mother didn’t find the good stuff. The stuff that has a much more likely chance of killing me. The stuff I had the sense to hide a little better. The stuff that required some effort to obtain. The stuff I wouldn’t take unless I was really sure I wanted to go. But that’s my ‘suicide stuff.’ I’m still angry, embarrassed and upset that I had my ‘self harm stuff’ taken away from me.

Discharged

My last meeting with Dr T before discharge occurred on Friday evening. We didn’t get into anything too heavy thankfully, as that’s not something I’d want to get into the night before leaving. I was asked whether my mother had discussed with me the intended plan of her keeping my medications and confiscating any I had stocked in my room. “Yes,” I said begrudgingly. She seemed satisfied with that.

“I’m sorry you didn’t find this admission very helpful,” Dr T said. I said nothing in response. She then went on to say that there are other options, and other places to go. I gazed at her questioningly. “There are two other private hospitals in [city where I live], P Clinic and The M Centre. I don’t admit to either of those places so you’d have to find another psychiatrist who would admit you. They both have websites which you can look at,” she informed me. I nodded. “I’ve visited my friend in P Clinic before,” I told her. She nodded. “Yes, so you don’t have to feel you’re stuck to this place and it’s the only place you can go. There are two other places.” I looked at her a little incredulously. “Hopefully you won’t need another inpatient admission,” she said. Dr T further continued, and one of the things she told me was, “Basically I don’t believe in forcing someone to do what doesn’t work for them. It’s not a battle. Otherwise what’s the point? It’s not about who’s right and who’s wrong.”

Dr T is away from this week and I (or rather, my mother) was given the number of a colleague of her’s, Dr S, in case a crisis arises. I’ve seen this guy around the clinic, and gosh is he one stern looking and intimidating guy. Note to self: do not get into a crisis. I was asked about my follow-up appointment with R, whether it is this week that she returns from holidays. “Yes,” I confirmed.

Saturday morning I was discharged after twenty-three nights on a hospital bed, two of them in the ED.

Upon arrival at home, my mother asked for medications I have stored, as per Dr T’s instructions. I handed over a box of antihistamines. “What about paracetamol, do you have that?” my mother enquired. I did, and that was given to her too. Because I totally can’t just nip off to the shops to get a box of paracetamol or more for a few dollars myself. I really don’t see the point in this. My desvenlafaxine and temazepam is now being kept in the kitchen cupboard along with all the other medications in the house. It’s not as though I can’t walk a few metres into the kitchen while my parents are asleep and chuck down all the pills I can find down my throat. So how is this supposed to prevent me from overdosing? The only purposes I can find in this is to a) make it obvious to my parents I’ve OD’d if there’s a whole heap of pills missing, in which if I took a substantial amount of, would be plenty obvious anyway, or b) humiliate me enough with this new arrangement so that I don’t OD again. Which may just work considering how mortifying it is to have my medication doled out to me each morning and how unpleasant it is having that daily reminder I am an overdose risk. I’d hate to imagine what other new scheme Dr T could come up with when if I overdose once more. Then again, it could also serve as the motivator to ensure that the next and last time I overdose it really IS the last time I overdose.

Not allowed pills

Tough meeting with Dr T today at The H Clinic. I was asked whether I would do the right thing by handing over my medications for my mother to dole out each morning when I am discharged. I sat silently as a response. Something must have shown in my facial expression, as she said, “You don’t seem very happy with that.” I shrugged. “BtF, you have to tell me, I can’t guess, I’m not a mind reader,” she said. “Well…I guess I feel like I should be able to look after my own medications,” I mutterred. Some point soon after I started crying, and she speculated I was upset because she doesn’t trust me. “No, because I feel like I need to know I have a way out if things get too much,” I told her. “Maybe that’s why you’re not getting anything out of groups then,” she said. “Instead of using those skills, you think, Oh that’s okay, I’ll just take a heap of pills.” Umm no, maybe because this CBT Thought Diary crap I have done before, brainstorming ‘What lifts my mood?’ does not aid in lifting my mood and being told to use techniques to ‘distract myself’ does not make my sorrow and pain disappear.

Dr T also asked me whether I have pills stored in my room. I hesitated for a few seconds before going with the truth. “Yes,” I admitted. So as well as my mother keeping and doling out my medication daily, she also wants my mother and I to go through my room together to find any medication I have stocked and have it disposed of. No way around it either, as she’s already rang my mother to inform her of these intentions.

I was told I have to ‘cooperate to keep me alive’ otherwise ‘she’s doing all the work’ if I’m not cooperating and asked ‘why are we doing all this [treatment] otherwise?’ Why indeed. Beats me. Did I say I even want treatment? Don’t know why people are so intent on me staying alive…

It was agreed during the meeting that I’d be discharged this coming Saturday. Because of what was said though, she suggested, “Maybe it is too soon to go home then.” I shook my head no. And so after three weeks spent here in H Clinic, I will be discharged in a couple of days.

The pills I have stocked acts as a safety net for me to fall back on. Even though I haven’t and probably won’t take an overdose of what I know would have the best chance of killing me, it’s reassuring to know I have that there. Without it, I feel all the more anxious and desperate. Like I have to seize any chance I have to kill myself before all options are taken away from me.

Day 17 at The H Clinic

I don’t actually know why some people keep persisting on trying to help me, believing I will improve. In my perspective it’s an exercise in futility. My relatives make it sound so easy. “Don’t do this type of thing [overdosing] again. Instead call us and there will be someone who will help.” Dr T tells me today her concern is that overdosing will become habitual for me as a way to cope, and the aim is that I don’t end up turning to overdosing again. According to her, every time an overdose occurs people forget all they have learnt and it becomes a big setback in recovery. It sounds an unrealistic goal, to not keep overdosing, and I tell her so. She then says that maybe I shouldn’t be going to Uni then, as that’s another pressure on top of trying to recover. I point out that my overdosing occurs irrespective of whether I’m attending Uni or not. She acknowledges this, then asks whether it’s fair on the Uni and on the other students. She uses an employer as an analogy. If I were an employer, would I be wanting an employee to overdose, come back to work, overdose, come back to work, repeatedly? Or would I tell them to take time off to sort things out before coming back when they’re ready?

I can kind of see where she’s coming from. The way I see it though, my overdosing is just going to keep happening. And so the way to go about this is to continue attending Uni, if it happens that I overdose, well, it happens, I take a couple of days to recover from it physically, whatever, and then continue chugging along with working towards my degree. An ideal way to progress through Uni? Admittedly no, but recovery seems so, so unattainable. Might as well be overdosing and attempting Uni rather than overdosing as well as doing bugger-all with my life.

My dose of Pristiq was increased again to 150mg. Dr T tells me she will see me again on Wednesday before setting a discharge date. Third week in hospital? Shoot me now. It’s not a good sign either when I barely recognise faces around the ward anymore, many of the people who were here when I arrived have been discharged it seems. Maybe I should have just gone to the public psych ward. As unpleasant as they are I’m almost certain they wouldn’t keep me this long; pressure on beds, others are sicker who need an admission and all that.

I remember scoffing at my aunt upon my discharge from the Emergency Department, prior to arriving at H Clinic, when she warned me of being stuck in a psych ward for a month, as her husband was ten years ago when he attempted suicide. At the time I thought the idea ludicrous given my last admission was only for three days. I’m not that sick, so as if they would keep me that long. I originally thought about a week, tops. Fml for being so wrong.