Mental Health Crisis

If you have experience of mental illness then you are probably aware of the charity Mind, they found that “only 14 per cent of people in crisis got all the help and support they needed.” Which is horrific. Try to imagine what would happen if for only 24 hours only 14% of people in a physical health crisis got all the help and support that they needed. It shouldn’t be any different. Mind is involved in an ongoing campaign to better crisis services and the overall treatment of people with mental illness. I will include a link to this campaign website if you are interested.

What is a mental health crisis and when does it become a crisis?

I would describe a mental health crisis as a moment no matter how fleeting when someone feels they have lost control of their mind and their mental illness. It could be triggered by an external stressor event, or medication changes or simply a worsening of a current illness that requires more care. Most of the time, you or your loved ones will be able to make the decision as to whether you are in crisis and whether you need help. For example, if you are afraid that you will self-harm and you don’t want to this would be a crisis, but each case will be personal. The danger or self-harm is not a crisis for everyone, depending on the amount of harm you are likely to cause and the frame of mind you are in at the time. Other experiences that may occur alongside a mental health crisis are psychosis, extreme anxiety or panic attacks, mania, paranoia, and feeling suicidal. When people with an existing mental health condition experience crisis it is likely that their symptoms will become more determined and persistent. If you are afraid that you will hurt yourself or someone else, or lose control of reality then this is a valid crisis and you deserve to have more support and to be helped through this.

I personally keep two lists on my person, they are written very simply as if a child will be reading them to ensure that whatever frame of mind I am in, I have the best chance to help myself through. One list is for when i’m feeling agitated, usually anxious and when I cannot relax. Oddly enough, when I am in this state I know that I am more likely to suddenly decide to attempt suicide, more so than when I’m feeling extremely low. This is when I am most impulsive and least likely to be thinking rationally. From experience I know that if I can use up some energy and distract myself I will calm down within 2 hours. My list is a numbered list, 1-10. I rate how ‘bad’ I’m feeling and start at that number, doing the exercise on the list and if that doesn’t work I move to the next one. It starts with simple activities like 10 mins of intense exercise or intensively cleaning the room, activities that I can channel my energy and obsession into that are satisfying to complete. As the list increases I tell myself to contact certain people who I know can help, and finally number 10 means I have to allow someone else to look after me by going to the emergency department or calling the crisis team. My low mood list is very similar, except it includes calming activities that allow my mind to switch of, such as colouring and taking a shower.

I really recommend that you write your own lists, it really helps to think through and plan for those moments because when you are in the middle of them, its extremely hard to think straight and know what you should do.

Who can help you in a crisis and who can’t?

When you’re experiencing a mental health crisis there are a number of options you have to reach out for support, you can pick the right one for you depending on pervious experience and how serious you feel your crisis is. Its always personal, and it is always as serious as you say it is.

The first options are phone services such as the samaritans (116 123). You might have local services that are available to you, it is a good idea to look these up and make a note of them or save them in your phone so they are easy to access. You could also call the crisis team for your area, if you haven’t been referred or if you don’t know the number of the team in your area you could call the non-emergency hospital line (111) and ask them. The crisis team are usually very good, they will talk to you on the phone and can advise you how to best keep you safe. They could also come and visit you where you are. It all depends on what you feel you need. If you tell the crisis team that you have self harmed seriously or taken something however, they will want you to go to the hospital and have the ability to send an ambulance. If your crisis is during working hours you could call your local GP and tell them that you are in crisis and would like an emergency appointment, they should try to fit you in that day but this wont always be the case, unfortunately. The last option of professionals that I will cover is going to the emergency department. This is not always the best option and in my experience can make things worse. I will cover more about emergency departments and mental health crisis support later in this post.

I find that it is helpful to have written out a ‘script’ for the possibly scenarios where you might be asking for help. This makes it less scary for me to do, especially if its over the phone. It also means that you wont miss out any crucial information.

Another route to support that you could consider is friends and family, however you should pick the people that will be able to help you, rather than be unhelpful or even unkind. Through experience I have learned not to elicit the help of people who are impatient, unkind, dramatic, weak, naive and people who don’t trust me. This final point is important because if you want to talk things through you might be going into the deepest darkest corners of your mind, however we all know when we are done and we are ready to let it go and move on. When a person doesn’t trust you they could end up making the situation worse by not believing you when you say you are ready to move on. Some people will feel comfortable to contact their therapist, some won’t. Some people will want to contact their family as I do, however some people don’t and this is all okay. Everyones inner circle is personal and you shouldn’t feel like you have to go to someone in crisis when you don’t feel comfortable doing so, just because they told you that you should.

The emergency department

The emergency department is an awful place to be, it usually involves a wait of above 3 hours surrounded by people while also being ignored. However, in some cases the care that can be provided by a hospital is the best thing for you, outlined by the number of times you read on the internet ‘go to the ED’ if you are feeling suicidal ect. but it might not be the best equipped place to provide you care.

Pros;

  • There are doctors that can assess you mentally and physically and they can refer you to other services that can help.
  • You are in a controlled environment, which may make you feel safer.
  • You might get a bed in a hospital and psychiatric treatment.
  • You might be listened to and cared for.

Cons;

  • You will be sitting alone for a long period of time.
  • Unless you have a physical injury, a ‘plan’, a suicide note or you have already taken actions to harm yourself. I have no experience of mania or psychosis but I imagine that it is the same, unless you are in acute and what they define as serious danger they will not treat you.
  • It is unlikely that there will be a bed available.
  • It is likely they will simply hand you a phone and tell you to talk to the crisis team (I’d advise you to always call the crisis team before you decide to go to the hospital, so that you don’t have your time wasted).

The emergency department – what will happen if you go?

To begin with this depends on your route there. If you have called an ambulance you will be assessed by the paramedics and then probably taken to wait in the ED for a psychiatric assessment, but not always. If you walk in to the ED, then the first person you will talk to is the receptionist. You will have to tell the receptionist why you are there, including your physical and mental symptoms. They will probably ask you to talk to the nurse at the end of the desk, who will then tell you to give your information including your address to the front desk. The next bit is tedious, your name is added to a list of people, and unless you have serious physical trauma, you will be lowest priority because of how mental health crisis are treated in hospitals. This means a wait of possibly 3-4 hours. It gets tricky here, because if you have told the front desk that you are suicidal or in danger to yourself, and if you get bored or frustrated or simply tired of the long wait, and you walk out, they have the right to send the police to collect you and bring you back to the hospital. Simply put, be sure that you want to be there, and that you have the time and ability to see it through. If you decide to leave the emergency room, make sure you let the receptionist know.

Once your name is called, in my experiences the first thing any doctor will tend to is a physical problem. They will usually take blood tests, and will treat you depending on what you have told them. Most of my experiences involve overdoses, which leads to someone checking your heart, sometimes you are put on a drip and sometimes you are observed. It all depends on the results of your blood tests.

If you don’t also have a physical reason to be in the emergency room, in my experience they don’t treat you seriously. In my times in EDs I have spoken to a handful of nice doctors, but ultimately none of them had any power to help me. The fact that I had asked for help before hurting myself, the fact that I hadn’t written a note, the fact that I couldn’t describe a definitive ‘plan’ meant they dismissed my struggle and sent me home. This is after a phone conversation with the crisis team. My most recent experience in the ED was awful.

I waited 4 hours, only to be dismissed as not in crisis. They handed me a phone with the crisis team on the other end and as the conversation progressed I began to feel less suicidal and more angry, for me this is not a good transition. They were not taking me seriously and had wasted my time. I was discharged. Then the doctor came back and asked if he could take some blood to test, I obliged. However, then he said the results would be ready in about 2 hours and that I should wait back in the main area. I was fuming and refused to wait on the grounds that I knew that I hadn’t taken anything and in my opinion the results were intended to put the doctors at rest, not me. The doctor got impatient and less sympathetic, he told me I could go but he wasn’t happy about it and he would call the police if there was anything abnormal in the results. This was supposed to scare me, and if I was intending on committing suicide, or if I had taken something, he basically just warned me not to go home. I could have gone anywhere.

Personally I feel that the care you receive in emergency departments is the best that they can manage at the time. Sometimes you will receive a psychiatric assessment, sometime you won’t. Sometimes you will leave feeling safer and happier, sometimes you will feel angry and belittled. I would never advise someone in crisis not to go to the hospital, I would just like to make sure that everyone is prepared for what will happen when they arrive.

All of my opinions and advise comes directly from my personal experiences. Everyones experiences will be different. If you feel like I have missed something, or miss-represented something about the crisis experience please let me know. For this post I will add in any notes I am given as I feel that is is an incredibly important topic.

Thank you for reading!

Heres the link to Minds campaign, its an interesting read; http://www.mind.org.uk/news-campaigns/campaigns/crisis-care/about-the-campaign/?ctaId=http://www.mind.org.uk/news-campaigns/campaigns/crisis-care/crisis-care-slices/we-need-excellent-crisis-care/

Borderline Bella xxx

Anxiety’s a B*tch!

Hello everyone!

Sorry for the delay with this post, I’ve been busy learning to ski bumps and haven’t had a moment to type! I’ve also been struggling with what this post should be. I don’t want to only write ‘my story’ as that could become a little self-gratifying, and its not really a joy to write most of the time. I’ll get back to it, but its the kind of story you have to be in the right frame of mind to write.

I was standing on the button lift pondering anxiety this morning. For some reason, no matter how fast I progress on skis, no matter what terrain I learn to ski with minimal fear, I find myself getting really worked up about that button lift. It could be because it’s always the first thing we do on skis in the morning, but I wouldn’t be too happy about the suggestion of using it at the end of the day either. I decided that for some not too rational reason this lift was making me anxious, and decided to write my next post about anxiety.

I have a fair bit of experience with anxiety, that feeling when your thoughts outrun your head and even your inner monologue ceases to make any sense. I’ve had times when I’ve been willing by body to calm down, because I’m certain people around me can see the fear, and will wonder what’s wrong with me. If you don’t believe you’ve experienced anxiety, I assure you that you’re wrong. Its the uncomfortable feeling where your body is certain that you’re in danger and acts appropriately, the nerves you feel before a test, the fear of going to tell someone you’re sorry. My anxiety is no different to this, it’s certainly not stronger or any more persistent. Maybe its a bit easier to set off than the average person but that’s hard to judge. I am lucky that I don’t live with persistent unchanging anxiety, Its caused more by the situation.

Luckily for the moment, the most I have to worry about is that dammed button lift, and I can deal with that. My previous living arrangement was prime for festering anxiety, with people fearful of me and treating me like a stick of charged dynamite, people lying to me and going behind my back to talk about me, about ‘the problem’. It was horrible, and probably, hopefully the closest I’ll ever come to persistent unchanging anxiety.

To help me cope my doctor prescribed me Diazepam. I had asked for Lorazepam as this is what I had used before, but I wasn’t too sure about the difference and I didn’t want to appear like I was looking for drugs. In my experience, Lorazepam is a very instant release, you take it and you sit, and then 10 mins later you magically realise that you feel fabulous! You don’t immediately attribute it to the pill. Diazepam wasn’t such an instant release, but it definitely lasted longer which was useful in my situation. These drugs are helpful for when you are too exhausted to use your meditative and mindful coping strategies, but in my experience they become counterproductive if you begin to rely on them to get through the day.

For the time being, anxiety is not a problem for me. When you surround yourself with people who understand and care, it’s easier to forgive yourself for being you. When your friends understand, they wont moan and roll their eyes when you ask for excessive details about the event you’re going to, who will be there and what the ‘plan’ is, half the anxiety is gone because there’s no fear of judgement or frustration. Everyone needs a little more support sometimes, even for the small things such as going to the shops, it’s always real to the person experiencing it and therefore should never be mocked.

I feel like I could end every one of my posts about my experiences with a statement of how grateful I am to the people around me, I will try not to because It will get a little repetitive, but it is true. I am lucky to have such a supportive network of people around me.

Thank you for reading and wish me luck for the button lift tomorrow morning! I will try to post the next segment of ‘my story’ on the 2nd Feb so keep an eye out.

Borderline Bella xx

BorderlineBella Vs Freshers; Round 1

Hello everyone and welcome to BorderlineBella!

I have decided to start a series of posts that tell my story from the beginning. I hope this will be somewhat enjoyable to read, and that it will provide an understanding of the kinds of treatment you receive when you have a mental illness. If you are worried about triggers around mental illness, self harm activities, and suicide I advise that you don’t read posts in the ‘My BPD Story’ category. This particular post has a trigger warning for suicide and overdoses.

Under Pressure

For as long as I could remember, I wanted to be a doctor. I was pretty obsessive about it, putting extremely high expectations on my grades from GCSEs and felt devastated when I got 2 less A*s than the school had predicted. I wanted to prove to everyone that I was clever and that I was going to be successful, I suppose because I didn’t feel like I would ever be pretty or popular, it was extremely important to me to achieve highly.

After quite a long fight, two interviews and one offer, I did much worse than anyone expected in my A Levels. I might have been over stressed and unhealthy but I don’t know for sure. This meant that I had to put this dream down and apply for clearing places. I was lucky to get into Newcastle University to study Biology and Psychology, however there were not enough places in halls, so I ended up in a shared house with 6 other people who had also come through clearing.

3 Trebbles for a Fiver! (your dignity, reason, self control.. and a fiver)

It became very obvious pretty soon that I was not well, university was not what I expected it to be and I was having problems bonding with my new housemates. I frequently felt anxious about the future and thought that I would always be alone. When we went out together I frequently drank too much or created drama. At this point I didn’t really think that I had a mental illness, I just thought that people didn’t like me. I believed that everyone had the problems I did, but nobody talked about it. Eventually, the first semester culminated in me stealing one of my housemates medication and taking it all, then pretty much immediately calling a housemate to tell them. There was no real danger to my health, but we went to the emergency department for observation. Nobody from the psychiatry department questioned me or my housemate that accompanied me, even though I was clearly trying to tell people that something wasn’t right. I was ignored by the NHS. Unfortunately a few days later I took a more serious overdose, and at this time unlike before, I truly believed that I wanted to die.

“It will be the best time of your life! Make the most of it!”

Moving to university is an extremely hard time for everyone, and this was enough to trigger the start of an illness that would effect me quite extensively, and probably will for the rest of my life. I was showing signs of being unwell from the start of the first semester, but other freshers like I were not and should not have to be equipped with the knowledge and ability to know what to do in this difficult situation. Shame and embarrassment stopped me from telling anyone from home about what I was going through, which was a massive mistake. I did not want to admit that university wasn’t ‘the best time of my life’ as everyone told me it would be.

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Me at Carnage Newcastle dressed as a cat or a leopard or something. See the whiskers? I coped by drinking too much and partying all the time, I wanted everyone to see that I was just another normal ‘fresher’, when in reality excessive drinking was just making me more unwell.

Secrecy, Shame and Suicide

I did not tell anybody from home what had happened. A day or two after I arrived home for christmas I took a much more serious overdose that required an admission to hospital for treatment. I was so confused about what was going on with me, I didn’t know why I felt the way I did and needed to do the things I was doing. My family were completely shocked when they found out. I had climbed out the window in my pyjamas in a panic, realising the seriousness of what I had done. I knew that I would become extremely unwell and eventually would die if I didn’t get treatment (what I thought I wanted) but I would have to look my family in the eye and behave normally until then, and I didn’t know if I was able. I called an ambulance to pick me up from the street away from my house and thought up a plan of how I could get treatment and back to my house without my family realising that I had gone. This included calling a friend from home in the morning and asking them to pick me up, and waiting until 7am to send a text to my mum telling her I had gone out for a run and didn’t know when I would be back. I called pretty much everyone I knew that had a car, I can’t remember exactly what I said to all of them but luckily I told one or two of my close friends the truth. Together, the people who knew what had happened told my mum to find me in the hospital. I felt so ashamed and embarrassed for putting my family through this. They were all so awkward, and obviously had no idea what to say to me, or ask me. Everyone was in shock and confused, including myself.

Attention Seeker

About 30 hours after I had arrived in the emergency department I was physically healthy and discharged from medical treatment. I was seen by the psychiatry department and didn’t know what to tell them. I just wanted them to stop asking questions. My mum and I waited hours to see another psychiatrist but there was nothing helpful that they could offer. Again I felt let down by the NHS and their lack of care for mental illnesses. I was wrongly referred to the CAMHS (child and adolescent mental health services) which shouldn’t have happened because I was 18 at the time.

I’m Fine, I Promise

I was in complete denial about the seriousness of my health at the time, to the horror of my family I went out drinking with my friends almost the night after I was released. I thought that everyone around me was over reacting. I now know that I was dissociated; I had split from my emotions and reality, nothing felt like it was really happening, essentially I was detached from my surroundings. I didn’t feel depressed or anything really, I mainly just felt ambivalent about my life.

I attended a short meeting with CAHMS and was asked questions that were so transparent I could have easily decided what diagnosis I wanted and answered accordingly. It was frustrating and a waste of time. At one point the psychiatrist told me to make a cup of tea next time I felt sad. This is patronising advice that belittled the struggle I was going through. They gave me some contacts including a crisis team number, which I was informed would not be operational 24h a day because it was short staffed over christmas. The next time I was in crisis was boxing day night, I did not make a cup of tea and I did not call the probably unavailable crisis number. All the signs pointed towards me being unsafe and confused about what was happening to me, but nobody acted on these signs. No healthcare professional took me seriously, I was frequently asked if I hurt myself because a boy had broken up with me and silly things like this. They didn’t see a woman who needed help, but a stupid little girl who wanted attention.

Luckily I had and have a strong family around me, that were able to get me the help I needed, but this wouldn’t be until one more crisis. I am grateful for everyone who helped me through this stressful and scary time.

My next post will talk about how I ended up in a hospital for mental illness, and started on a 6 month long journey to a diagnosis and stability.

Thank you for reading

BorderlineBella xxx

My own ways

Hi!

This post will be a little different from my main posts on BPD and coping mechanisms.

I arrived in Switzerland yesterday, visiting my mum. Skiing is a passion of mine, and I am determined to get better as the season moves on. I also feel that being so far away from everything, with such beautiful views and with adrenaline seeking activities occurring daily, it is so much easier to forget about the unimportant things and focus on your mental and physical health. I find that it is easier to put your problems into perspective when you’re in a place of beauty.

Ive been thinking a lot about what i want to do with my life since I’ve dropped out of Newcastle University, and I’m moving towards the idea of applying to join the police force. All I’ve ever wanted to do is be involved with a job that directly effects people and leaves room to build respect and I feel that being a police woman would satisfy these needs. I am yet to explore the rules of police and mental health but i am looking forward to asking my uncle and his girlfriend about this as they are both extremely happy working in the police force.

I have had a fabulous day skiing, and feel duly refreshed. I recommend anyone who is able to ‘escape’ to the alps as a form of therapy.

I originally wrote this random post after a few beers, unsurprisingly there were more than a few mistakes so I have just edited it now. All that has changed is that it now might make some sense and I am no longer calling my uncles girlfriend and my good friend a man (a mixture of wording ‘partner’ and ‘policemen’ insinuated that they were a gay male couple, unfortunately this is not the case, sorry!)

BorderlineBella xxxIMG_1984

My borderline personality

What is BPD?

BPD stands for borderline personality disorder, sometimes referred to as emotionally unstable personality disorder. Everyone with BPD will have their own individual experiences with the symptoms, I’m going to talk about my specific experiences below. It is generally agreed that someone can be diagnosed if they have at least 5 of the following symptoms;

  • Fear of abandonment, presumed or otherwise
  • Unstable, changing relationships (generally easy to make friends but hard to keep them)
  • Impulsive or self-damaging behaviours, which can include drinking, drug use, unsafe sex and binge eating.
  • Unstable self image, struggles with identity and sense of self
  • Suicidal behaviour or self-injury
  • Varied or random mood swings
  • Constant feelings of worthlessness or sadness, sometimes described as emptiness
  • Problems with anger, sometimes culminating in physical acts of aggression
  • Stress related paranoia or loss of contact with reality

My BPD

If I was to go down that list and tick off the relevant symptoms I would tick 8, leaving the anger issues. However, I don’t think this list helps a non-sufferer to understand what the disorder really is.

Describing my own experiences without simply replicating this list is proving harder than I thought it would be. I wrote “define your BPD” in my notebook, but I am now realising that I should have given this some more thought.

I’m going to start with a point on the list; the unstable sense of self. Lots of people with and without mental illnesses will notice that they change aspects of their self according to the context they are in and the people that are around them. For example if you work in an office and your colleagues know you as ‘the tidy one’, you might experience some difficulty if you encountered them alongside your college friends that know you as ‘the wild one’. These two groups of people have interpreted your behaviour and other cues to form an impression of you in two entirely different contexts, shaping their impression of you. As a result, your behaviour will have changed slightly to fit into what they expect based on their impression. Encountering these two groups together might cause you to feel uncomfortable and unsure how to act, and possibly anxious as a result. I probably don’t have two people in my life that experience the exact same person. The uncomfortable feeling I just described is something that shapes every aspect of my life. 

In order to reduce anxiety before I meet someone new, or someone important, I find myself deciding what impression I want the person to form before hand, and then manipulating my behaviour and appearance to ensure that they form the impression I approve of. My wardrobe would confuse anybody, its almost like my character costume box.

Furthermore, because I like to categorise people and find relationships much easier when a person can be cleanly and easily described, I willingly pick up labels. I can promote certain aspects of my personality, in a way exaggerating them, so that people can feel like they know me well. When people feel like they know you, they don’t search deeper or notice the inconsistencies.

I’ve talked a lot about my experience with ‘the self concept’ because I feel it is the most important point on the list. Mood swings and the other emotional issues probably have their roots in an individuals biology and are therefore less interesting to me, however the behavioural issues feel as if they are caused or at least affected by the unstable self image.

Impulsive and reckless behaviour can be a mechanism to find stability. A lot of behaviours that would be considered reckless come with person labels; the party girl, the bad driver, the promiscuous person, the adrenaline junkie ect. Behaving in extremes makes your sense of self feel more stable, because their are fewer contradictions between the idea in your head and the behaviour you’re displaying. 

Finally, I find relationships extremely hard to manage. The friends that I have held for more than a year all have at least one thing in common, they are consistent and clear cut. They are also patient and strong. When people are consistent in the way they treat me, I can be consistent in my responses. When people behave towards me in a way that doesn’t match the way they think about me, I notice. This leads to me being unsure about what category to keep the person in, friend ie good or non-friend ie bad. When someone treats me like a friend but gives signs that they feel differently I experience a fair amount of distress. I am not certain why this is, however I am grateful to the friends that have stuck by me through problems and changes and whatever chaos I’ve thrown up, rather than take on an aspect of my personality and run with it.

I’ve tried to explain my experience with BPD in a way that anyone could understand, however the ideas are complicated and confused in my head, and therefore I imagine that this post might not make too much sense. Trying to understand yourself is a challenge, especially when you are a ‘complicated’ person, and I am still working on it. Based on the difficulty I faced when sitting down to write this post, I still have a lot of work to do. I might set myself this challenge again in a years time, and see what I write differently and what I write the same.

Thank you for reading,

BorderlineBella xxx

 

Hello Everyone!

Hello! My name is Annabel, AKA BorderlineBella. Thank you so much for visiting my new blog. As my name suggests, I have Borderline Personality Disorder which will be the main focus of this blog. I hope to document my everyday experiences and coping mechanisms, and review the different forms of treatment I have embarked on.

The reason I have started a blog now is that I have experienced discrimination at Newcastle University, leading to my withdrawal and my new goal of raising awareness and reducing stigma for this diagnosis.

I enjoy meditation, smoothies, reading (Margaret Atwood is my favourite) and skiing. On an average day you could find me snuggled up on the sofa, drinking strong black coffee from my favourite Star Wars mug. Im incredibly introverted and dyslexic so I apologise in advance for any awkward and misspelt posts!

You might enjoy reading this blog if you or someone you love are new to the diagnosis of Borderline Personality Disorder, or if you are a veteran and also looking to reduce stigma! There will be a little bit for everyone.

IMG_1519I will begin with documenting my experience of discrimination at Newcastle University, keep you up to date with the complaint procedure, and the context around me feeling forced to withdraw from studying there. I feel that my story is one that needs to be heard, as in my experience there is an extreme lack of compassion for people with mental illness at university.

I am embarking on a new journey in my life, leaving university and trying to find my place in the world. I will try to keep it light hearted and fun, I hope you will come on the journey with me!

BorderlineBella xxx