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.

Last psych appt

Yesterday afternoon I was seen by the doctors, and my community nurse/case manager also sat in on the meeting. I was asked whether I wanted to be discharged that day or the next, I chose to be discharged that afternoon. Though I still wasn’t great, I at least felt a little better than when I came in and I guess there wasn’t much point in staying any longer. We also discussed my medication, I still remain on 200mg of Pristiq and 50mg of Seroquel XR but have also commenced on 450mg of lithium as a mood stabiliser. It was either lithium or sodium valproate, but according to the doctor the latter has a greater chance of hair loss, weight gain and sedation occurring as side effects.

Spent this morning in tears as I emailed a uni lecturer about something totally unrelated, and in her reply she again brought up an incident last year which resulted in a general miscounduct and me getting into a whole load of trouble. It feels awful that I continue to have that held against me by a lecturer I will again have this semester despite me completing the disciplinary action that was dealt to me and having damn well learnt my lesson. I then attended the last session with my psychologist at the eating disorders program in which I cried some more both talking about this situation with my uni lecturer, and then saying I felt “A bit sad,” when she asked me how I was feeling about it being the last session. It’s the first time I’ve ever admitted to feeling anything other than indifference towards any psychologist I’ve seen as I’ve always been ashamed of feeling attached to or having any emotional connection to others, especially when it’s not reciprocated. Though it wasn’t easy attending knowing it’s my last appointment, I’m glad I did and handled it much better than I did the last time I had to change psychologists. It’s quite embarrassing when I remember how I spent the second last session crying, refused to come back for another session or to see the psychologist I was being transferred to, overdosed and ended up in hospital thus never having a proper concluding session, then wrote him an angry email about how useless therapy is.

I’m starting DBT next week with the group component running on Tuesdays and my first individual therapy session is on Thursday. I’m really nervous about DBT and how full on and strict it seems. At the end of my assessment sessions for DBT I was given a contract and asked to sign it, with rules such as not being allowed to miss a certain number of group or individual sessions, having to complete the homework, rules around interactions with other clients and your therapist not having contact with you for 24 hours if you’ve self harmed. I also have a lot of ambivalence about whether I really do want to change and to stop self harming or not, and so much fear when I think about doing so. Plus I’m hesitant about starting all over again with yet another psychologist knowing that if I do develop a connection it will feel like another loss when we have to cease therapy, especially after weekly appointments for a year. 

In hospital

I’m in hospital at the moment and feeling such a mix of emotions. There’s a part of me that wants help but doesn’t know how to ask for it, there’s a part of me that just wants to go home and is hoping I’ll be okay, there’s a part of me that’s still considering an overdose and there’s a part of me that just doesn’t know any more.

I’d been struggling lately and thinking of taking an overdose but was waiting until at least after Thursday as I was speaking at a conference and didn’t want to back out on that commitment. Thursday night I felt kinda like “What now,” and called up mental health triage to speak to someone about those thoughts. Luckily the nurse who picked up was a nurse I already knew and who knew me, and is one of the best nurses that I’ve met. It helped a bit, and I was able to go to sleep without doing further harm to myself. Friday I saw my psychologist. She could tell I wasn’t feeling great and I talked to her a bit about what was going on and how I was feeling. Because she was concerned that I might take an overdose, she consulted her supervisor who decided that I should go to the ED. My psychologist accompanied me there and I was assessed by two psych registrars and a psych liaison nurse. It was there that I first experienced what it’s like to have “Borderline Personality Disorder” written somewhere on your file, and for clinicians to have preconceived ideas about you. “People with borderline personality often have thoughts of suicide and self harm,” I was told, and it felt like I was being dismissed as someone who “always had those thoughts” so it’s not serious. I was also told “Maybe it’s because you’ve been discussing the eating disorder with your psychologist and this is the first time you’ve talked about self harm and overdosing and that’s why she got so concerned.” Umm no, I don’t say I’m feeling this way unless I’m actually feeling this way, and it don’t tend to call people up unless I’m pretty desperate. But thanks for that. I was presented with the option of going home or staying for a few days as a voluntary patient, and of course, now that I felt as though I was an attention seeker, I said I wanted to go home.

Saturday night I self harmed by cutting my leg, and at midnight I drove myself to the ED to get stitched up. Thankfully the doctors and nurses who treated me there were all really good and the psych registrar who assessed me acknowledged that I’m not always like this and said that she thought coming into hospital for a short while would be a good idea.

I arrived onto the psych ward Monday afternoon and was seen by the consultant psychiatrist whom I’ve seen for the previous three admissions and the new psych registrar on the team. I talked a bit about what has been going on; finding it difficult with having to stop with my current psychologist to do DBT, the fear of starting DBT and starting with another psychologist and the fear of not being able to cope with uni next semester. He told me I’d probably stay just a few days and be discharged Wednesday or Thursday, however, it’s now Thursday afternoon and I still haven’t seen my doctors since I was admitted Monday afternoon. I did however speak to the med student on the team and opened up a little more about how I didn’t understand them keeping me weeks and weeks when I didn’t want help, yet talk about discharging me after just two days when I do want help. I also spoke about the fear of the stigma surrounding BPD and that I’d be classed as “attention seeking.” I’ve been told the doctors and my community nurse are going to come see me, I guess I just have to wait and see what happens next.

Sutures

I’d been experiencing the urge to self harm for a few days, yesterday I ended up giving in. I searched the ward for something I could use, broke a piece of plastic which didn’t really do much. Found a mug, smashed it on the floor and self harmed with that. It’s not what I usually use and did more damage than I’d intended and thought it would. Seeing how much it was gaping panicked me a bit, but once it had stopped bleeding I thought it would be fine. One of the nurses this morning though came up and asked whether I’d cut my leg as someone had seen. I admitted that I had the previous day, and she took the broken fragments of the mug out of my room.

The doctor had a look at the wound and told me they’d stitch it up. “Does it…need stitches?” I asked, not keen on the idea, never having had them before. I was told yes because of how it’s gaping open and reluctantly I agreed. Ended up requiring six stitches, and though the actual suturing didn’t hurt, getting the local anaesthetic injected did.

Despite self harming for about 10 years now I am actually really quite a wuss when it comes to pain and needles and I’m really squeamish. So it’s embarrassing that it was hard for me to tolerate when the doctor was injecting the site with local anaesthetic and halfway through I had to take a break before continuing. The nurses and doctor were really nice about it which makes me feel guilty- I feel like I don’t deserve it and they must be thinking “If you cut yourself on purpose, why are you being a wuss about getting it stitched?!”

It scares me a bit because when people talk about self harm getting worse and/or accidentally going too far, I’ve always thought “I can control how deep it is so that I don’t have to get stitches, I’ve been doing this for years and it hasn’t gotten worse over the years so it’s fine.” And though having to get sutures partly puts me off self harming again because getting the local anaesthetic was a bitch, a part of me doesn’t care and wants to cut even now.

Banned from blogging (but doing it anyway)

Well thank you to whoever reported me/my blog to the staff at this hospital. Not happy.

On Saturday night the registrar came to see me, and it was brought to my attention that they were concerned about what I post on the internet. I asked them to clarify for me what exactly it is I’m not supposed to be posting, as I have many accounts on social media and couldn’t be sure what they were referring to. I was told I’m not allowed to post about myself because “You’re under the Mental Health Act” and “We have a duty if care to protect your reputation.” I call bullshit. Protect my reputation? More like protect their reputation. It’s not like I even use my full name in association with this blog.

Sunday night nurses and security guards came into my room to search it again and that’s when I got angry and tried to take off. Unfortunately they caught up to me in the car park, I was again restrained, put in the seclusion room and sedated. Fun times. My hands are now all bruised from when I punched and hit the wall, and I was knocked out the whole of yesterday from the two shots of midazolam and 100mg of chlorpromazine I was given that night.

The consultant on my team is back from leave. Apparently I’m not meant to be blogging as my reports of being restrained and secluded can “give people the wrong impression of what happens here” and can perpetuate the stigma of mental health. “I don’t write anything that’s not true,” I shrugged.

A tentative discharge date has been planned for this Thursday, as well as a discharge meeting with my mum. The sooner I’m out of here, the better, I say.

Forced ED treatment

In many ways, hospital admissions for depression are easier than hospital admissions for anorexia. With this admission it feels like there’s so many more rules and restrictions, and so much more to lose.

I’ve been getting my feeds through the nasogastric tube, as well as eating the majority of each of my meals so that I can get the NG tube out and ultimately leave hospital as soon as possible. With that, it feels as though I’m rapidly losing control. I’ve only very occasionally self harmed these past few months but over the past couple of days I’ve found those urges to cut returning. Of course, being in a psych ward I don’t have the means to do so and get increasingly desperate and distressed. I’ve tried to make do with punching the wall instead.

Over just the past two days I’ve gained 1.1kg. My stomach is so very bloated, and I look like I could be pregnant. On one hand that gets me out of here sooner. On the other hand, I’m disgusted at myself for eating. For gaining weight. For getting fatter and fatter, after months of hard work in losing that weight. I don’t want to see my body expanding before my eyes, feel the flab returning to my arms and legs, for my stomach to protrude, for my thigh gap to disappear.

The doctor said today that I could be here another three or four weeks. Tomorrow marks two weeks already that I’ve spent in hospital, the thought of another three or four weeks in here just feels horrible. I miss my freedom, and I miss having control over my life. Not to mention this screws up uni for me, yet again. Right now I want nothing more than to discharge myself from all mental health services so that I’m never ever forced into treatment and imprisoned against my will again. Unless they put me under a Community Treatment Order I don’t see what’s stopping me from just going home and losing this weight all over again.

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.

That feeling from self harm *PT*

One or two bad days I could probably handle. I could use distractions, for example, painting.

Image

And it did, to an extent, work. I’m obviously no artist but it was somewhat calming and therapeutic to express myself on canvas. In this case, it represented the tears I had cried over two days.

When it’s four bad days in a row though, forget it. Conflict with my father on top of a long uni day and stress over the workload and study resulted in an end to my two month streak of being self harm free. Two months would be a lot more impressive if I managed to resist the temptation despite having a rough ride. As it is, those two months went pretty well for me, and it was rare I felt the need to self harm. Unfortunately it only took four days of things not going so well for me to return to using old ways to cope.

After self harming, I feel so much better now. The sharp sting of the blade and the blood dripping down my leg both calmed me and helped release the tension I was feeling, distracting me from my emotions and tears. And now that I’m reminded of how damn good this feels, gosh I just want to do it again.

Have you self harmed?

One of the things I dislike in therapy is when a psychologist asks how many times I’ve self harmed that week. Okay, I can kinda see how it’s relevant to gauge whether I’m still self harming or not. From their point of view, it means I’m still engaging in risky, self-destructive behaviours and therefore is an issue that still needs to be worked on. But at the same time, is it really that helpful to put so much focus into it? In my mind, it reinforces the belief that the only way to communicate how I’m feeling on the inside is to physically harm myself on the outside.

A topic that has come up in my appointments with D is rejection; how much  fear it, how much it upsets me, how much I try to avoid it. There is a fear within me that if I report I haven’t self harmed, the professionals will automatically assume everything’s okay. I am afraid of rejection and I am afraid that I will be told at one point or another that I don’t need to continue seeing them any more because I’m ‘cured’.

There’s been a few times D has asked me to record down when I’ve self harmed during the week for homework. I’ve never done what he’s asked. I don’t believe it will do me much good and may even trigger me more by making me think I have to self harm to prove I deserve help.

Shorts

It’s great when I don’t even have to think of an excuse for the scars I have from self harming. Instead, people come up with them for me! “Did you burn yourself with an iron?” my auntie asked me of the couple of scars on my arm, before she found out about my mentalness. Taken by surprise, I gave a vague “mmmmm” in response. More recently in Indonesia, I was again questioned on my scars. This time by my uncle, asking if I got burnt by a frying pan. “Nope, by an iron,” I told him, using my auntie’s ready made explanation.

When I was in the private mental health unit in May, I met another patient who was about the same age as me. She had scars all up and down both arms yet she still wears t-shirts and singlet tops same as everybody else. We got talking about self harm and scars one day. “People aren’t actually that bad,” she told me. “There was one person who stared,” she said, “But other than that most people are fine.”

The two coupled together, and I think I may be a little bit braver. This summer season I bought shorts.  Prior to this season, last time I did was way back in 2008. And as long as I don’t have recent wounds on the show, I wear them too. The shorter ones I only wear with stockings. The slightly longer one I wear by itself. It covers most scars when I’m stood upright, but rides up to reveal scars when I’m sat down. I think I’m okay with that. Others don’t have to be. I’ll never be able to wear the denim underwear that is so popular with 15 year old girls these days. But then again, why would I want to? I’m just happy to be back out in non knee-length shorts, the first time in about three years.