Living life on the borderline

…but thinking of starting a new blog. Fresh starts and all that.

I was almost-recovered & hence completely forgot to update. But since beginning treatment for PTSD, I am now not-very-recovered-at-all and so thinking it might help to start writing again. They say it has to get worse to get better but I’m not sure how much worse it can get.

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Hopefully this won’t be offensive to anyone, in general, with its topic matter. Warning for discussions of self harm, eating distress and general madness.

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I think when one is first diagnosed with a mental health problem, or first realise it, or whatever… it can become strongly entrenched in your identity. Even others, actually especially others will make it your identity for you. I was Outwardly, the 16-year-old depressive, the 16-year-old self harmer, the 16-year-old bulimic. I was the “overdose in cubicle 3”, the “DSH, known to CAMHS” in the paediatric waiting room. I started out identifying with self harmers on forums, curious about the lifestyle of my brothers and sisters in this futile war against our physical selves. I identified with my brothers and sisters in the futile war against the next meal, the next concerned facial expression from a loved one, the next pound dropped.

Then I identified with the other young people held in a psychiatric unit. We, young people, the next generation, who were meant to be living “the best years of your life”. Drugged into oblivion, occasionally sparking into life when something interesting was on the hospital menu. Encouragement to get out of bed, to get dressed, to go to classes were met with the quite reasonable question: Why should I? Why should we, indeed, when this was how it was. Messed up crazy kids on a messed up crazy kids ward. No outside friends, brief phone calls to family on occasion, feeling the sun on our faces only if there were enough staff to control us outside. Yep. That was us, the Messed Up Crazy Kid Brigade.

Then you start wanting out. You don’t want to be the 18, 19, 20… heck, 40-year-old “DSH in cubicle 3”. You know that you have a condition or illness or distress to come to terms with, but you don’t want that to define you. You want people to look at you and think of how funny you are, or how bad you are at maths, or that time you wore that shirt that really shouldn’t have suited you but it did. You don’t want people to look at you and remember you being dragged into the back of an ambulance in the middle of the night. You don’t want people to talk to you and remember the time you screamed the vile details of being abused at them while dissociated.

Where is the equilibrium? How much can I forget, forge a new identity and yet still wonder what other people will remember of me? Is there actually anybody in there, in me, apart from the madness? Who would I have been, had none of this ever happened to me?

What, precisely, is recovery? Because this concept is starting to get my goat.

The Mental Health Foundation describes it thus:

What is recovery?

For many people, the concept of recovery is about staying in control of their life despite experiencing a mental health problem. Professionals in the mental health sector often refer to the ‘recovery model’ to describe this way of thinking.

Putting recovery into action means focusing care on supporting recovery and building the resilience of people with mental health problems, not just on treating or managing their symptoms.

 

Rethink Mental Illness has this to say on the topic of recovery:

Recovery as a concept is about the process of building a meaningful life as defined by the person with a mental health problem themselves.

There are four key component processes suggested:

  • Finding and maintaining hope
  • The re-establishment of a positive identity
  • Finding meaning in life
  • Taking responsibility for one’s life

 

Trying to work out how these relate to my individual story is difficult. Compared to how my mental health was 6 months ago or more, I could be considered “recovered”. My self harm is no longer severe, if it occurs at all. I’m attempting living without medication and I haven’t needed a “break” (of a psychiatric-facility nature) in this time.

There are still things that can trigger a full-scale emotional tits-up, things which I don’t thing are that obvious or understandable. Hearing a story about abuse or bullying in the news won’t set anything off, but I can spend a week or more in a state of constant anxiety over particular nicknames, or songs, or smells, or people behaving in a certain way. I still wake up screaming from nightmares and I still dissociate, quite noticeably “going offline” at times.

This is where I get confused. If I view myself from the point of the “model” of PTSD, these could be thought of as “symptoms” that will be “recovered” from. I’m starting to doubt how valid this is though. Not doubting the validity of the experience, but who would react quite normally and sane-ly when confronted with traumatic experiences? Wouldn’t adapting to such experiences as a normal part of life signal madness on someone’s part? Society as a whole would be in even more of a mess if we had no sense of justice, or self-preservation, or self-protection or… feelings.

So I don’t really know where this leaves me. Maybe the time will come when I’m not as severely affected by things. At what point can I say “that’s enough recovery, the rest of it is just being human”? Or vice versa maybe, how much of my reactions are being human and how much is mental illness?

There’s something quite unique that I have noticed with eating distress, or at least with my experience of it. If I’m way off the mark, let me know. It’d be quite interesting to see what people’s thoughts are on the idea of eating disorders and lack of self care.

To me in my rational mind – food is one of the fundamental aspects of self-care. Hunger can override rational thought in desperate situations. Feeding yourself, getting nutrients, etc. is usually the default setting because we are unconsciously always aware that we need to eat to live.

However I’ve found with my bulimia-type anorexia-type EDNOS-type thing, being irrational takes over that default setting. I’m consciously aware that I am feeling faint or experiencing irregular heart rhythms and yet I continue to abuse myself and deny myself that fundamental self-care of eating. I don’t really know why. Oftentimes when people have ‘flu or something, they want to be curled up on the sofa under a blanket feeling sorry for themselves, even if that is not possible or socially acceptable to say! That cognition has all but gone in my brain. I remember what an ED psychiatrist told me when I was being seen by the EDU and the list of things that can go wrong simply by not feeding yourself properly…. but it doesn’t really bother me.

I don’t understand this part of myself at all, because I thought that with eating disorders, you’re not aware of what you’re doing to yourself. I am aware and I’ve all but given up on trying to get help for it. The physical effects of restricting my intake are increasing again but I have an overwhelming feeling of “cba” when it comes to going back to the GP again, for a blood test again, to be told that it would be a great idea if I ate again and blah… blah… blah.

I got to the point of going into the GP surgery and asking if there were any available appointments with my “regular” doctor. My psychiatrist and RegGP are in cahoots as psychiatrist knows when I haven’t been for my check-up and my bloodwork hasn’t been updated. There are no slots with RegGP for some weeks yet, but I could try again & see if there are any cancellations. I could, but in all honesty, I probably won’t.

Am I punishing myself? Am I attention-seeking, time-wasting, what? Have I taken the hint that I’m wasting my time trying to get better & resigned myself to this way of “living”? I hate not knowing about myself, I used to pride myself on being very psychologically-minded and understanding how my thoughts work.

But.

Cba.

I guess I’m not been updating because I thought things were going well, but I have returned because they are not. Which means you get to put up with me, if you are reading. Sorry.

The crisis team have been fantastic with me this time and not even putting the phone down when I start off the conversation with “I am so *bleep*ing angry, I don’t know what to say” and end with sobbing uncontrollably and repeating “Why can’t I just die?” all the time.

The thing I hate about becoming unwell is that I turn into a total bitch and I don’t even mean to. I curse my family, I curse my friends, I curse God, I curse everything and everyone around me. Nobody will let me die, how dare they try to stop me dying? They are selfish, all of them are selfish *bleeps* and they can *bleep* off and not bother pretending to cry at my funeral (I know, I’m terribly dramatic..) Then when I’ve “snapped out of it”, for want of a better phrase, I want to die because I’m such a horrible person and how could I act like this and I don’t deserve to be alive and…and…and…and…rinse and repeat.

My illness is no excuse for my behaviour. I just wish I could stop. Stop being like this. I’ve self harmed a couple of times but I’m not going to consider it a full relapse because it wasn’t really a conscious decision. It’s not really dissociation, but I don’t know what I’m doing at the time.

An unrelated physical health problem is leaving me in constant pain, which isn’t making me the most fun person to be around either. Feeling very sorry for myself.

Other than that… nothing exciting is happening….

I thought I’d put together some ramblings about things that I learnt over the course of several years of injuring myself, mainly from cutting. This doesn’t sound like any experience you could learn from, especially when I’m only 18 and therefore not necessarily old enough to have “learnt” anything! However, on reflection, and after going through what feels like thousands of distraction lists on the internet to kick this thing in the ass for good… I think I’ve actually got some good understanding from it. I hope it doesn’t sound too preachy and it’s just my experience but hey. Why not.

Lesson one: Self harm is…. invalidating.

Sounds obvious but it definitely wasn’t to me. I felt/feel/etc. as though being able to injure myself as a way of processing my feelings was very validating. I could “see” my pain. I could “take care of” my pain. I was being nice to myself. I was helping myself feel better.

Not really.

Being told that you have made yourself look a mess by A+E staff when you are getting stitched up is not validating. Having stitches put in without anaesthetic because “self harmers would like it too much” is not validating.  Causing yourself painful scarring is not taking care of yourself. Trying not to get infections, buying first aid supplies, rehearsing your “story” for the triage nurse…. it doesn’t deal with the actual problem. Having to hide wounds, bandages, scars, feeling ashamed to wear shorts or swimwear does not improve bad feelings about yourself. It doesn’t take care of the pain, it just gives you something else to think about for a while but it comes back. And like many addictions, you start off small, maybe “recreationally”. Before you know it, you’re down a road that can be really hard to come back out of.

That’s not to say that self harm hasn’t played a strange role in keeping me safe sometimes. The alternative to releasing those pent-up feelings would have likely resulted in a suicide attempt, and it was very helpful to have professionals that encouraged me to limit my self-injury, rather than ban it completely. But after 5 or so years of hurting myself, I’m not really any further forward. I have a lot of scars that hurt and a lot of horrible memories of being in hospital. It makes me sad to think about. I’m nowhere near recovery as yet and there are times I’ve hurt myself when dissociated and not really in control of what I’m doing. On a conscious level, though, I feel like I’m starting to figure out things I can do that make me feel a bit better without resorting to harming. Self harming didn’t really give me an immediate fix and neither do distractions. Maybe the “trauma” or whatever is just something I will have to deal with at some level for a long time yet. It’s very painful and upsetting but there is a certain freedom in trying to accept how you feel and realising there is no magic quick fix, whether it comes from a blade or from a DVD.

It’s crappy and it’s fine for it to be crappy, cos crappy things happened. And maybe I will go through all those freakin’ distractions and end up slipping up anyway but that’s okay because I’m human. And I tried. I’m not a failure if I slip up, sometimes the distractions just don’t work. But learning about them is a process, like learning to cope with uncomfortable feelings.

It’s a process, rather than a cure. Maybe I needed to get to the states of self harm I’ve been in to go through that process? Who knows.

I think this is the nicer mental-health-services term for “immense psychological collapse”. Whichever it is, I feel like I’m going through one of them.

The dissociative-type thing has come back in full force. I’m losing large chunks of the day with no recognizable trigger for it. I’ve been trying to employ the usual defences that are suggested by the crisis team and the MH team, like regular sleep, fresh air, exercise, healthy eating (?!) and so on; so when it doesn’t seem to be working, I get even more frustrated. I’ve lost my ability to read well which has really upset me. Reading has always been something that’s calmed me down and given me pleasure, but words simply don’t make sense. I can barely hold a conversation, the almost physical sensation of the chaos inside me is too distracting.

I’m still able to do artwork and play music, occasionally, because it doesn’t involve any human interaction and it keeps me active. I sound horribly selfish and blah but I literally cannot cope with people at the moment. Trying to read someone’s emotions from their face, deciphering an onslaught of speech and then forming a reply… it’s just too much. I haven’t self harmed which I’m pleased about, but the suicidal thoughts are becoming overwhelming. I’ve been tempted to take a relatively small overdose of benzos and/or painkillers – unconsciousness sounds infinitely more appealing than awareness right now.

I don’t see the point in harassing any of the mental health team or the crisis team – trauma is not their “area”. I was meant to be starting therapy but there was a mix-up and I am still months away from the top of the list. The professionals that I see have been clear on the boundaries of what they deal with and the effects of trauma are definitely not one of them. So I don’t really see the point in trying to talk to them. Meanwhile, the less-than-well-oiled machine of NHS talking therapy waiting lists continues to grind and my education/social life/hope goes down the crapper. Excuse my language.

I could complain a lot more but my attention span has reached it’s limit and I think I’m ready to go back to bed. Two hours after getting out of it.

Apologies for the poor quality and spelling and content.

About the blogger.

I'm an 18 year old girl/woman/person of the female gender who blogs about growing up, living with mental health problems and her experience with the NHS mental health services, both CAMHS and CMHTs. Expect plenty of teenage angst and general craziness. Nothing out of the ordinary here.

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