Why Am I Sitting Here Typing This?

A friend wondered earlier why I wasn’t in hospital. At the time of speaking to them last night I had 145 sutures in my legs (less now as I took some out), of which 73 were put in on Friday and had spent the afternoon sitting at the top of Beachy Head about 1cm from the edge. The Coastguard told me I might get blown off and offered to drive me back to my car, an offer I accepted.

I told the Crisis Team all of this last night but they seemed less than interested. I spoke with the duty CPN at the CMHT on Friday after being discharged about things as Allison was away, but they just said they’d record it in my notes.

I’m glad I’m still at home, and yet I know that in July I was find by the side of a road and ended up in a psych unit. I don’t know what is different this time. I don’t even know if anything is different. Last weekend I wrote a suicide note and took a small overdose. This weekend I was close to walking off the top of a cliff. Inbetween I have had more the 100 stitches due to self-harming.

When will this end? More to the point, how will this end?

Ruth

Not Waving, But Drowning

Finding it very hard to keep my head above water at the moment.

Ended up in A&E again yesterday having self-harmed.

Required many, many sutures.

Crisis Team refused to come out and see me saying I was already on their caseload and to contact my CPN.

Allison is away on holiday next week.

Been closer to suicide today than I have in a long while.

Just want a magic wand to be waved.

Edit: Rang Crisis Team, as it details in my care plan, to be met with a suggestion to have a hot bath. When I said I couldn’t due to number of sutures then was told to listen to some relaxing music. I detailed what had happened today and the person on the end of the phone just said “can you not wait until Monday to contact the CMHT?”, I said that I felt I needed support now and they said “well I don’t see what you think we can do for you”. Helpful, to say the least.

Just Confirming What We All Already Knew

Disorder	Rating
Paranoid Personality Disorder:	Moderate
Schizoid Personality Disorder:	Low
Schizotypal Personality Disorder:	Moderate
Antisocial Personality Disorder:	High
Borderline Personality Disorder:	Very High
Histrionic Personality Disorder:	Very High
Narcissistic Personality Disorder:	High
Avoidant Personality Disorder:	Low
Dependent Personality Disorder:	Moderate
Obsessive-Compulsive Disorder:	High
– Take the Personality Disorder Test – – Personality Disorder Info –

Being Propped Up: Support Services Can Work For People

I have realised over the past few days that this post is not going to write itself, therefore I have had to scrape myself off my bed and across the room to my laptop. Before I start though, I warn you that this won’t consist of any Booker prize winning literary prose. In fact it is more likely to be an incoherent ramble, but I shall press on.

The appointment with the CMHT on Monday was quite refreshing. It made me realise how much more the CMHT are willing to help me this time around. I was shown a draft copy of my care plan, which seemed accurate and highlighted what I need to do if I hit crisis point. One of the things that was suggested as a long-term approach was a referral to a new form of therapy starting in the new year called STEPPS, which is specifically for people with BPD. I am quite willing to undergo this, especially now Allison has reassured me that it won’t have the ‘competition’ element I have experience within group sessions before (we all know the one; I’m more depressed than you are, I’ve caused myself more damage than you have) and also that by agreeing to the therapy it doesn’t mean that I will lose contact with either Allison or the CMHT.

The session on Monday was one of the joint sessions with 2 CPNs, one of which is Allison; my care co-ordinator, and the other CPN (L) who acts as a facilitator. It is like a cross between psychotherapy and CBT, but in a much more relaxed fashion and without the awkward pauses. We talked about the weekend and I admitted to taking too much zopiclone and Nytol, although I didn’t at that point tell either of them about the suicide note I had written. I explained about feeling as if I couldn’t keep my head above water and they both told me that I can contact either of them when I feel I need to talk, and if they are busy/away then I will always be able to speak to the duty worker.

On Monday afternoon I ended up back in A&E. Somehow after the appointment I felt absolutely awful again, as if I had just lived a lie for an hour by not telling Allison everything that I wanted to say, so I cut myself. I had the same female F2 suture my wounds up as the time before last, and she seemed thoroughly concerned that in 8 days I had attended A&E 3 times and required more than 100 sutures. She wanted to contact the DSH team, but by the time she tried to ring them they had finished for the day and I wasn’t willing to see the Crisis Team. She wrote a letter for me to give to my GP, which I promptly opened as soon as I left the department, suggesting I need more psychiatric input than I am receiving at present.

On Tuesday morning I rang the CMHT in an absolute state and asked to speak with Allison, who was out on a home visit. The secretary asked if I wanted to leave a message or get her to call back, but I stated it wasn’t that important. Anyway, a few hours later she rang back and realised how bad I was feeling. I admitted ending up in A&E again, and that I hadn’t been entirely honest about the overdose over the weekend, and told her how bad my eating is at the moment. The crux of the matter is that she is now going to ring me daily, and I have been referred back to the Crisis Team so that they will contact me each evening.

I feel very supported at the moment. I have a CPN who is prepared to ring me every day, and is perfectly OK with me speaking to her more than once a day, and the Crisis Team ringing me out of hours every day and again are prepared for me to contact them whenever I feel I need to. I know this is what the CMHT and mental health services are meant to do, but it is the first time I have actually experienced them working together and to help me. I was scared at first when the BPD diagnosis was brought up by Allison that it would mean an end to her help and a lack of out of hours support, which is what happened in Newcastle. She reassured me though that although the diagnosis had to be written on my notes and care plan, she acknowledged that there was more going on for me at the moment, and I needed intensive support as I am in a severe depression at present with an eating disorder. It’s refreshing to realise that mental health services can see beyond a personality disorder to the co-morbidity running alongsde it.

I have to take the suicide note to the CMHT today as Allison wants to read it. She feels it will give her more of an insight into my mood and mind at present than talking to me does. When I mentioned it to a friend last night he seemed shocked, stating that it wasn’t my usual MO. It’s true, I don’t write suicide notes. I ring people, leave them voicemails and text messages, but don’t write notes. I think it is one of the things that has scared me recently that things have moved up a notch. The self-harming has reached a critical level, the eating is completely out of control and I am doing things that are detrimental that I have never done before.

I don’t know what the next few days will bring. Constant phone calls with the CMHT and Crisis Team are a definite, but everything else is unplanned and open to suggestion.

Ruth

Dreading The Inevitable

I see my CPN in less than an hour. I don’t know what she is going to say. It’s a CBT session with the other CPN (L) who I spoke to on Friday. I never did contact the Crisis Team this weekend, was too scared.

Did end up writing a nice long suicide note on Saturday morning and taking a few too many zopiclone and Nytol. I woke up late on Sunday afternoon with an incredibly dry mouth and throat and a bit of a fussy head. Made some cuts last night as well but they’re mainly superficial.

Just don’t really want to face people this morning and explain how things have been this weekend.

Ruth

Detachment: I Know It’s Been Happening To Me, But It Just Doesn’t Feel Like It Has Been

I’ve been up to my usual little tricks. On Wednesday night the mother and I had a massive argument which involved her throwing a whole load of insults at me and me storming out of the house. I went to stay with my brother, who lives on the Kent/East Sussex border, but that didn’t really help matters. At 8am on Thursday morning I was sitting in an A&E department that I had never been in before wanting the ground to swallow me up. I ended up having the female consultant suture my wounds up, which worried me because she was a consultant and they don’t usually scrape so low as to suture, but I guess the wounds were bad and they are at the very top of my thigh, so the triage nurse obviously thought having a female medic look after me would be a good idea. The consultant was convinced I had overdosed as well, which I hadn’t, I promised her that I would have told her if I had, which on the whole has been the case.

She then started asking me the where’s, why’s and how’s behind the wounds and I had to admit my feelings. I had been planning on throwing myself under a Tube train on Wednesday afternoon, I’d been planning it for a while and had chosen my station and Tube line. I even got there and stood for a good 20 minutes until I realised that there were too many people around, so I left. I explained that there hadn’t been anything in particular that had stopped me, I just hadn’t done it. And then I had the argument with my Mum and ended up at Kit’s and when I woke up on Thursday morning I felt angry with myself for not completing my plans and stupid for running away again, and so I cut.

The consultant referred me onto the Self-Harm Team and a very nice woman came to see me. She was accompanied by the ward manager of the local psych unit, which freaked me out at first but she explained that it was only because she was due to spend the day with her anyway. She did a psych assessment and for the first time in my life I was purely honest. I explained about my Dad and what he has done to my Mum, and Jenn and me, I told her about the eating, and the cutting, and the overdoses, I confided about hearing music and seeing the spiders and the suicidal thoughts. I explained everything. She went away to ring the CMHT in Kensington to see if they could see me sooner than Monday morning and came back to explain that if I was prepared to get on one of the next trains back up to London then Allison would see me that afternoon.

Seeing Allison didn’t particularly help me. I guess I felt as if I was over-talked by the time I got to see her, plus the self-harm team woman hadn’t had time to fax my notes through, but I explained what I could and tried to make her see how I feel. She told me I needed to formulate a life plan, which I told her was quite difficult when you’re only 23 and even more difficult when you have cancer. She told me she would ring on Friday and that I was to keep the appointment on Monday morning.

Yesterday I went to the nurse to finally get the infected cuts looked at. I’m now on anti-biotics and the sutures are coming out slightly earlier than planned, on Monday, in case plastics need to look at it. The nurse seemed pretty convinced that because they have been infected from 24 hours after closure that they won’t have healed and will need debriding and secondary closure. I also spoke to a CPN, not Allison but the one who sat in on the first appointment. She was really helpful and reiterated the Crisis Team’s number and suggested some things I can do this weekend to try and keep me safe. I admitted that on Thursday night I sat with a pile of tablets in front of me, wanting to take them, so she suggested I moved the tablets, whereupon I admitted that I had thrown them out, alongside most of the razor blades I own (I kept one).

I still feel awful today and last night I was very close to ringing the Crisis Team, but I was scared to call them. Instead I watched Have I Got News For You, took a zopiclone and a couple of Nytol and went to bed. I woke up this morning with the beginnings of yet another cold and I feel depressed as hell. I have been writing this post since 10am, I just haven’t had the energy or concentration to sit continuously and write.

I don’t know what will happen over the next day or so. I feel guilty whining on when other people are in a much worse situation than me. I am worried about Seaneen, who’s actions last night I can wholly understand but I hope she is OK. I don’t know what the CPN appointment on Monday will bring, the other CPN was talking about trying to get me moved out of home, but we’d need to involve my Mum in that plan and currently, apart from the argument, she thinks things aren’t too bad.

Ruth

Singing In The Distance: Psychosis Is Ignored By The Crisis Team

The sutures are infected, typically. I thought at the time that the F2 didn’t clean them very well before closing them, a cursory wipe with some saline soaked gauze, when usually you get iodine and the whole shebang. However, there is now large lumps of gunky stuff oozing out, and it’s even worse if I squeeze it. In short it’s not pleasant. Plus the doctor used braided sutures instead of coated nylon so the infection risk is even higher.

I can’t whinge though as it is purely my fault. I feel guilty enough about wasting people’s time so I’m going to just disinfect them myself and hope it clears up. I feel as if I should just pull away from the help I get and accept that I am just a time wasting attention seeker. Trouble is, I don’t seek attention when I need to.

I’ve been hearing music for about 10 days now. It sounds as if someone has left a CD player on in the distance, but there is no music playing. I’m also seeing spiders run across the floor again, not totally out of the corner of my eye, but always in my peripheral vision. I told a friend about this last night and they asked if I had told the psych from the Crisis Team about it. In fact I did tell him, but he didn’t dwell on it and just moved onto asking me about how I was sleeping (which is badly, I need to double up on zopiclone and take Nytol to get to sleep and even then I wake up – self medication obviously is not the way forwards). The friend couldn’t quite believe a psychiatrist would skim over the fact I have been psychotic for the last 10 days (or week then) but he did. The friend suggested I should mention it to Allison, my CPN, so I rang her today but she was in appointments all day. The receptionist said I could ring back at 4.30pm, but being me I didn’t bother.

I’ve got a killer headache as well and have had it since Sunday, no amount of painkillers seems to be shifting it. Not nice.

Ruth

Oops, I Did It Again: How I Am So Bloody Predictable

After writing yesterday about trying to not self-harm, I slipped up this morning and cut myself. Pretty badly. So I trundled off to A&E where the triage nurse asked me why I didn’t speak with my CPN first. I was in a foul mood, still am, so I just snapped “have you tried to get hold of a CPN at the weekend?”. She dressed the wounds and told me to wait for a doctor. The doctor was a lovely F2 who was very neat at suturing but took forever as she was so neat. She also didn’t talk at all whilst stitching me up which was a bizarre experience having someone in close proximity to your legs for about an hour, saying absolutely nothing.

The triage nurse and F2 agreed it was a good idea for me to see the Crisis Team, so I sat down expecting a long wait. It actually wasn’t that long before a nurse and the duty psychiatrist turned up. Having the psych turn up as well as a nurse freaked me out because the only other times that has happened has been when I’ve been admitted. This is going to sound awful but the psych really pissed me off, he clearly didn’t have English as his first language so I couldn’t understand what he was saying and he asked me to repeat everything about 3 times before writing it down. The nurse was a bit better, but wholly patronising asking me why someone clearly so intelligent as me self-harms and could I not flick an elastc band against my wrist instead of cutting. They assessed me for about half an hour and then said I could go whereupon I picked my bag up as fast as I could and walked away.

I walked to the female toilets nearby and was about to cut myself again when I realised it probably wasn’t the best plan I’ve had all year as if I ended back in A&E, as I invariably would given the mood I’m in at present, less than half an hour after being discharged by the Crisis Team then I might not be allowed home tonight and that would mean a hell of a lot of questions when I did appear home. I am obviously back home now and still battling with the self-harm thoughts and feelings. Part of me wants to rip the sutures out that the F2 so neatly put in and make those wounds a lot worse, but then a larger part of me wants to create even more damage to myself.

I know I’m a fuck up when it comes to cutting myself. One of the consultants happened to walk into the minor operating theatre when I was in there waiting for the F2 to get some more local anaesthetic and he was sympathetic. He saw I was nearly in tears and waited for the F2 to come back until he left. He decided to have a look at the wounds as well and merely commented “you’ve got a bloody high pain threshold and a severe intent to cause yourself serious damage, haven’t you?”. I didn’t know what to reply to that, in fact I am 99% sure it was a rhetorical question so I just sat there, staring at the floor.

I know I self-harm badly, I have done for a while. I do have a high pain threshold, I also have some perverse logic in my head that if I self-harm with the intent to cause damage (rather than the angry ‘let’s slash as much skin as I can’) and I don’t need sutures, then I feel as if I have failed somehow. Each time I do it then I raise the stakes. The first time I needed sutures, I promised myself that the next time I would need more, and so it has continued. Then I had to have internal sutures and the bar got higher again. It scares me when I think rationally as I’m not sure how high the stakes can go before it gets utterly serious and dangerous.

For the moment though, I’m just concentrating on trying not to do it again.

Ruth

Life Is Pretty Bad At My End

I discovered on Thursday that the tumour hasn’t shrunk by anywhere near the amount they would have hope through chemo, so instead of cutting it out, I am to undergo more chemo. I asked if they could operate, but apparently the only way to remove the tumour through surgery at the moment would be to amputate my leg below the knee, so I opted for chemo.

I reacted to this the only way I know how and ran away. I got in my car and drove to Eastbourne with the intention of throwing myself off Beachy Head but couldn’t bring myself to do it so drove onto Hastings where an old friend of mine lives, but instead of contacting them I just sat and got hideously drunk. My sister (who is over at the moment) eventually rang me to find out where I was, so I told her I was in Hastings and couldn’t possibly drive my car back as I was drunk and she got the train down and drove me and my car back to London. She had been with me in the oncology appointment so knew I was feeling pretty screwy and we had a long chat, which involved me telling her what my plan was for being on the south coast.

Now my Mum/sister is controlling all my tablets, although I have my own supply of venlafaxine from a prescription that I collected today. The pharmacist told me that venlafaxine/Efexor is one of the best drugs to be on. I just looked at him and nodded, whereupon he reiterated that there really wasn’t any class of anti-depressant better than the SNRIs. I just mumbled “yeah ok” and confirmed my address; I really wasn’t in the mood to be chatting to a well meaning pharmacist who was probably going to spout some crap at me about pharmokinetics.

I want to cut. I want to cause horrendous damage to myself. I’ve taken the sutures out from last Saturday, although one of the cuts is infected, but hopefully it’ll clear up on it’s own, and I had a huge urge to open all of them up again. I didn’t in the end, but I don’t quite trust myself at the moment.

No one appears to trust me at the moment. I don’t trust me, my Mum doesn’t trust me, my sister doesn’t trust me and my CPN, despite the fact I spoke to her yesterday afternoon after my Mum rang the CMHT, is still not going to move the appointment forwards stating I can always see my GP or ring the Samaritans if I feel I need more support between now and the 20th. I felt like telling her some fucking support would be nice, but I resisted.

Ruth

Pushed Down The Line: When You Need An Appointment One Doesn’t Come

The CMHT rang me back. They can next offer me an appointment with both the CPNs I need to see at 9.30am on Monday 20th October (that’s over 10 days away). I took it, and spoke with the duty worker for a while about A&E/Crisis Team stuff at the weekend, and feeling generally shitty and all the other crap and he told me to “phone a friend” and “keep hold of some normality”. Half the problem in my life at the moment is that I have no normality. My life revolves around medical appointments and going for chemo, I have no job and no money, and I have to face my court case at the end of the month. What is normal? That’s what I want to ask.

Anyway, I saw Allison (my CPN who is off work ill for the rest of this week) looking perfectly happy and healthy filling her car with petrol at the pump next to mine earlier today. She recognised me, smiled and then went to pay. It made me angry, I mean I don’t know what’s wrong with her, but I could have grabbed her there and then and ranted on about everything that’s swirling around my head at the moment. Instead I followed her out of the filling station for about half a mile and then turned off down a street to where I live. I need to talk to her, and somehow even though I’ve ony met her once and spoken to her a couple of times I feel as if it has to be her, the duty worker seemed distant and my conversation stilted. I guess I could ring her next week when she’s back at work and just talk through things with her, that might help.

I’ve got bad intrusive thoughts at the moment and when I escape them it’s into the weird and wonderful world of dissocation. I don’t know what’s happening in my head at present, but I know it isn’t good. I want to self-harm all the time, I want to take 2 weeks worth of zopiclone just so it is a new week and I don’t have to go through the banality of day to day living, I want someone to wave a magic wand and make everything OK. I want never gets though, eh? I’m angry, I’m sad, I’m confused, I’m hyper but lethargic, I’m miserable, I’m unable to move, I’m tired but can’t sleep; I’m a paradoxical situation and it’s not nice.

Ruth