Theresa Mays office replied…

Hello everyone! As you may have read a couple of posts ago, I emailed my MP Theresa May about the Mental Health Taskforce. I received a reply from her office and thought I would share the message with you.

“Dear Ms Swatman,

Thank you for contacting Theresa about the independent Mental Health Taskforce. She appreciates your concerns about mental health services.

I hope that you will be pleased to learn that the Prime Minister has recently announced a new approach to mental health based on recommendations from the Taskforce. Thousands of people with mental health conditions will be supported to find or return to work, meaning they have the opportunity to get on in life. The Government plans to deliver true equality between mental and physical health for the first time. An extra £1 billion a year is being provided by this Government for mental health care to make sure that it gets the attention it needs. This will support one million more people with mental health problems to access high quality care that they are not getting today.

Action will be taken to treat potentially debilitating mental health conditions early on through improved access to care. The Prime Minister has also met with business leaders to highlight the need for a shift in attitude to people with mental health conditions in the workplace and to agree new workplace standards. The Government is implementing the first-ever mental health access and waiting time standards. This means 75 per cent of people referred for talking therapies to treat common mental health problems such as depression and anxiety will start their treatment within 6 weeks, and 95 per cent within 18 weeks. Patients experiencing psychosis for the first time must be treated within two weeks. Please be assured that the Government has a vision of a 7-day mental health service where people will get the care they need, when they need it, and will help to prevent mental illness developing in the first place.

Thank you very much again for taking the time to contact Theresa about this important issue.

Best wishes”

I think it is so incredibly promising to hear that the government is making steps to improve the quality of mental health care in the UK in order to bring it up the the physical health standards. Although the aims for waiting times are really great, I believe we can be and we should be more ambitious. With all mental health conditions, a 6 week wait for treatment, although shorter than the waiting times many people are currently experiencing, is a long time. People don’t seek help the moment they suspect something is wrong. Usually, there is a period of pushing everything under the carpet. Many people I know and have talked to didn’t go to the doctor until they were desperate. When your mind is in absolute crisis, waiting 6 weeks before treatment could feel like torture.

Finally I am encouraged by the generally improving attitude in the UK about mental illness, and the greater understanding around what is needed and what can be done. However, through personal experience I know that if you walk into the emergency department and tell them that you are suicidal or in crisis, it feels as if there is nothing that they are able to do, or even that there is nothing that they are willing to do. As a society we should be more ambitious.

Thank you for reading, please ask your own MP about what they are planning to do to help people struggling with mental illness in their constituency.

Borderline Bella xxx

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Invisibility and University Halls

Have a quick google; the types of people you’ll meet in university halls. Every single one of these lists will include a reference to the mysterious housemate that is spotted in person as infrequently as a major astrological event. They could be called The Ghost, The Loner, literally anything under the sun. What’s more, this language is replicated and encouraged within the halls of residence itself. People love to gossip and wander about the girl or boy who never leaves their room, label them weird.

It is only natural to stop trying to include someone you barely know if they keep turning you down, but consider this;

They really want to join you for that drink or a movie, they imagined the same picture perfect university experience as you. It is likely that they are afflicted with social anxiety.

I was ‘The Invisible One’ in my second halls of residence. To begin with, when I met the other flats in the hallway I would receive casual invites to join them whenever I wanted. No matter how much I wanted to meet them and develop relationships that would make my university experience more enjoyable, I didn’t feel able to do so. I would become increasingly anxious even just thinking about knocking on their door. As the semester and year moved on, they understandably stopped asking. Why should they bother if I clearly didn’t want to join them? My anxiety got worse, and eventually I had to build myself up to even step out of my door, just incase I bumped into somebody.

I was in the unusual situation of moving into my studio flat late, so not only did I live entirely on my own, but by the time I moved in everyone else had already met and established friendships. If I wasn’t a person who suffered from varying degrees of social anxiety then it would have been okay. I would have put in the little extra effort required due to my unusual circumstances. However, I couldn’t. There were many times I wished that someone in my block would have an experience of anxiety, personally or through  friends and family. I wished that they would have kept inviting me for just one week longer.

My message to anyone at university and living in halls is if you hear about the notorious flat 12B resident who never leaves, take a moment when nobody else is in the hall to knock on the door and talk to them one-to-one. Worst result for you, turns out they are happy in their own company and want to focus on studying. Best result, you have helped a interesting and valuable person integrate into university and massively increased the chance that when you knock on their door again to invite them out, they will be able to say yes. So please, ask one more time than feels comfortable to you, I guarantee they will appreciate it.

Thank you for reading

Borderline Bella xx

To Theresa May.. regarding the Mental Health Taskforce

I have just read the Mental Health Taskforce published February this year in the UK. If you live in the UK, and care about the quality of mental health services then I urge you to take a look at the Taskforce and email your MP urging them to make mental health a priority.

To Theresa May,

My name is Annabel Swatman and I have a mental health condition called borderline personality disorder. I was displaying symptoms of my condition years before I was eventually diagnosed at age 18. As a 18 year old girl I had high hopes and expectations for my future; I was heading to university to study, with plans to graduate in 3 years and continue on to medical school. Instead, I have spent the past 3 years in and out of hospitals and emergency rooms, dropped out of university and with it dropped my plans for an academic future.

I have learnt through my involvement with the mental health services that there is simply not enough support available for people like me, and the support that is available is not as good as it needs to be. For example; after a crisis I experienced while studying in Newcastle, my GP referred me to the local CMHT (community mental health team). 3 months later, after no contact from CMHT and after struggling to cope on my own, I booked another appointment to see my GP and was informed that as I was no longer in crisis the wait for an appointment would be long, and when I eventually got an appointment there was no guarantee that they would offer any therapy, treatment, or support. I was devastated.

When I first came to the attention of the mental health services I was 18 and had made an attempt on my life. The hospital mistakenly referred me to the CAMHS (child and adolescent mental health services) who were unable to offer me support or treatment as I was 18 years old. This caused a delay to my access of a suitable assessment and to treatment. With the crisis team in my area unavailable for long periods of time over the christmas holidays and no understanding of my then undiagnosed condition or support for how to cope with it, I was left stranded with only a very stressed and concerned family to helplessly watch their daughter disappear. Inevitably, my condition worsened and I made a second attempt on my life. At this time the NHS were unable to offer me the treatment I so clearly needed, and felt content with giving me a list of numbers to call in a crisis. I am extremely lucky that my family were able to get me treatment in the private sector. Without the treatment my family were forced to pay for, I am not sure where I would be today.

The shockingly long amount of time it took for the mental health services to take notice and offer help, meant that I went so deep into my mental illness, it took months to climb out. I had to put my life on hold, which has had a knock on effect with all aspects of my life. If I had been assessed the first time I was taken to the emergency department for suicidal behaviour, and received the preventative treatment then and there, I believe I would be graduating from university this year with good prospects for the future. My parents wouldn’t have had to spend their own money in order to get the treatment their daughter needed. I would not have spent 6 months of my life as a patient in a psychiatric hospital.

I am asking for you to help transform the mental health services, for your constituents who up until now have been putting up with a lesser standard of health care, simply because their illness is mental rather than physical.

I have just read the Mental Health Taskforce, as I am sure you have too.

The Taskforce has so many brilliant recommendations that people in power can use transform the mental health services, that you can use to transform the mental health services in your constituency, for people like me.

I want good mental health support to be a local priority. As my MP, you have a role to play in ensuring the Taskforce recommendations become a reality in our area. I am asking you to:

• Write to the Prime Minister. Ask how he will be implementing the Mental Health Taskforce recommendations for Government, and what governance arrangements will be put in place to support the delivery of this strategy.
• Help raise awareness in Parliament by asking questions about the recommendations, or lead a Westminster Hall debate.
• Speak with our local NHS and CCG leaders. Ask how they will be implementing the recommendations on a local level.
• Read Mind’s Parliamentary briefing on the key recommendations of the Taskforce.

I hope that this is just the starting point, and that mental health in your constituency is a priority, as physical health has always been.

I look forward to hearing your plans for supporting the Taskforce recommendations.

With best wishes,
Annabel Swatman

10 Changes the Taskforce wants to see happen by 2020

If you don’t have time to read the whole document right now, here’s a handy summary taken from Mind;

  1. One million extra people provided with support for their mental health problem.
  2. 10 per cent fewer people take their own lives and everyone in a mental health crisis gets the right care, at the right time, in the right place, seven days a week and 24 hours a day.
  3. People’s mental health and physical health are treated equally – including people with severe mental health problems, pregnant women and new mums, and children and young people.
  4. All children and young people get the right mental health support, when and where they need it.
  5. Clear access and waiting time standards for mental health are in place so you know when you will get treatment.
  6. More people have access to the right talking therapy.
  7. Fewer people are sent miles away from home for mental health care – ultimately no one will have to travel for quality care.
  8. People who fall out of work due to their mental health are provided with personalised, effective and voluntary support to help them back to work.
  9. People who have had the worst experiences of accessing good quality mental health care, particularly people from Black and Minority Ethnic communities, get the help they need.
  10. Public attitudes to mental health have improved by a further 5 per cent.

 

Mind and mental health advocates here in the UK aren’t asking for much, and they have provided the government MPs with guidelines, recommendations and resources to help them achieve these goals. (If you’re interested you can take a look at the Mind parliamentary briefing here).

On the Mind website, there is an option to send your MP an email like I did asking them to prioritise mental health. I used the template offered but wanted to add my own personal story as well.

 

Thank you for reading,

Borderline Bella xxx

BPD; Was I born this way?

The debate of nature versus nurture has been prevalent throughout psychological research since the concept of heritability was first understood. When you first try to understand BPD, one of the questions you’ll likely be asking your doctor, or google, is why? What has caused the personality disorder to manifest?

The answer you’re given is usually a combination of two; your genes have determined that you will have BPD since you were born, or there have been factors in your life and childhood that caused or allowed the disorder to develop as you grew. Even with my minimal scientific background, I don’t entirely understand what this means, and in particular what this means for me. Was I born with BPD?

Psychologists have tried to answer these questions by studying families where a family member has BPD, to see whether members of the same family, with shared genes, are likely to share the disorder. If more than one member of the same family was diagnosed with BPD or showed BPD like traits, this could suggest a degree of heritability. However, members of the same family tend to grow up in a very similar environment, meaning that the BPD traits could have been recreated by a similar familial environment rather than inherited.

Neuroscientists and neuropsychologists have also attempted to find out to what extent genes and biology play a role in the development of BPD. Impulsive aggression is a symptom of many cluster B personality disorders, including BPD. It manifests in people with BPD through self harm, and impulsive and aggressive acts against yourself. Scientists have found that there is a relationship between the serotonergic system in the brain, and impulsive aggression. Essentially, many people with cluster B personality disorders have low serotonin levels in the brain. A chemical difference like this could predispose someone to experience mental illness and BPD later in life. This discovery was also important because it has lead to the use of medications to help manage the symptoms of BPD such as selective serotonin re-uptake inhibitors. you can read more about my experience with this medication here.

Neuroimaging has shown that the brain of someone with BPD is significantly different to the brain of a neurotypical healthy person. These differences could be produced by either the genetic or environmental causes of BPD, because our brain has the ability to change based on how we use it. If we have learned to use our brain ‘the BPD way’ then through plasticity, aspects of our brain change in response to the way we use it. Through researching for this post, I have discovered that there is too much to talk about when comparing the brain images of healthy and borderline subjects here, so I will devote a new post to this topic in the future.

Although I feel much better informed about the known biological and genetic causes of borderline personality disorder, I am finding the information hard to relate to on a personal level. I have no family members who have been diagnosed with BPD or even experience the characteristic symptoms or behaviours on a lesser level. This makes me question whether I inherited the disorder from my parents at all. Additionally, I have found serotonin based medication fairly unhelpful. Although this doesn’t mean I don’t have low levels of serotonin, as there are many different medications available and I have only tried one of them.

It is well known among the psychiatric community that many people who are diagnosed with BPD share the same or similar negative childhood experiences. These experiences are so incredibly prevalent, it is unlikely to be coincidental.

The ‘nurture’ argument states that people will develop BPD because negative experiences have taught the child to develop maladaptive behaviours as coping skills, which are used in place of emotion regulation because the child has not been provided with the opportunity to learn this skill.

I am hesitant to create a list of childhood environments and experiences that contribute to the development of BPD, because I know how varied and individual the experiences leading to BPD are. Mind, a mental illness charity provides a simple list of reasons why a child may not gain enough experience of healthy emotions and relationships. Living with an unreliable parent, for example a parent with an addiction problem, could cause a child to develop the belief that they are unimportant, and that everyone will eventually abandon them. When this belief grows into adulthood, it could manifest in symptoms of BPD such as an extreme fear of abandonment or self harm.

Personally, I find the environmental causes of BPD easier to understand, the path from cause to result is easy to visualise and fairly simple to follow. However, I am not able to pin point an area in my childhood where I may have been made more susceptible to develop BPD. Like many children I was bullied in primary school, and my parents went through a divorce. However, the bullying was dealt with and ended when I moved schools, and the divorce was nothing special and finished while I was still young. I was not neglected or abused as a child. I had a reasonably happy childhood, and wouldn’t change any part of it. However, I do have BPD. I can understand how if I was genetically predisposed to be sensitive to the triggers of BPD, unhealthy lessons about emotions and relationships that I was exposed to in my childhood could have accumulated to affect my emotional development and behaviour in adult life.

If you feel a particular way about whether your BPD was more influenced by genetics or your environment I would be really interested to know, please get in touch!

Thank you for reading,
Borderline Bella xxx

New Year, New Crazy Me; My first inpatient experience

I was really struggling to find a way to describe the experience of my first day at the priory retrospectively. I found it not only hard to remember the facts, but also remembering how I felt at the time was incredibly difficult. I couldn’t convey the experience truly through my normal style, so I decided to write it as if it was an ongoing inner monologue from 2013. You can read this article here. The process of writing it and the feedback I have received made it a therapeutic and cleansing experience, enhancing my connection to and understanding of my younger self.

I stayed at the Priory Hospital for 2 weeks. During this time I explored some of the therapy groups, beginning to recognise the same people day after day. There were many staff members that I encountered daily, the majority were not in my favour. I have to emphasise that I hated the staff and the therapists because of where I was standing mentally and emotionally. I later discovered that they are all caring, kind and supportive people who are brilliant in their fields of work. One staff-patient confrontation sticks in my mind. Months before, my family members had booked a trip to the theatre. For some reason, I believed that I would be and should be allowed to go even if it was only two days after my admission. Numerous emotionally heated conversations culminated in a one-to-one meeting with the ward manager. He told me I would not be allowed to leave the ward, and I replied with nothing less than raw, unfiltered anger and disgust. It was so bad that I wasn’t able to properly look at him for the rest of this or any of my other visits.

I remember having an influx of visitors, almost every day. They bought chocolate and clothes and anything else they imagined would make my experience better. I feel like both parties in these meetings were ignoring and denying the blatant fact of where I was and why. Jokes were made (mostly by me), I would dismiss the importance of everything that was happening there. Although I was grateful for the company and the distraction, this probably wasn’t the best line of attack for two weeks in a psychiatric hospital, and maybe contributed to my lack of immersion in the therapy offered. During my second admission a while later, I put some boundaries on who could visit and how often.

I met my doctor after my first weekend; Dr Woolley. I wasn’t entirely sure what to make of him, a middle aged man with facial expressions and a demeanour like an awkward teen boy, but with marks of his age on his skin. He had a way of talking and looking at me like he was observing a dangerous animal, but with fascination rather than fear. At the time it is likely I was misinterpreting interest and concern. We talked with, and without my mother. I sat up straight with my hands neatly folded in my lap, nodded and smiled where appropriate and answered all questions with a considered and clean cut response. During my time in therapy I frequently confused observations about my detached demeanour and apparent logic based ideology as complements. I distinctly remember a point in one of our early meetings when Dr Woolley said something along the lines of ‘you appear rigidly rational’, my instinctive response was to politely say ‘thank you’ and smile, returning my gaze to my hands. This moment stuck with me because I found his response intriguing; he was quiet, looking invasively at me, amusement visible on his face. He asked why I assumed it was a compliment, I don’t remember my response.

I spent a lot of time watching Breaking Bad and reading the books family members had brought from my bedside, but at least 2 times a day I was expected to attend group therapy. Group therapy at The Priory involved sitting in a cold and slightly damp room, with paint or wallpaper peeling from the wall. Chairs were placed in a circle around the edge of the room, just the normal plastic chairs usually found at schools. Most of the rooms had a flip-chart whiteboard in one of the corners, rarely used, with the same old scribbles never wiped or cleaned away. There were rules for the groups, such as no leaving once the session had started, no talking over people and no hot drinks. Mostly the same people would talk each session, possibly the most confident or veteran patients in the hospital. It sometimes felt like you had to search really hard for something to share on topic, just in case they picked on you and thought you weren’t cooperating, when actually you couldn’t think of an example to share. During this first admission I found group therapy boring and pointless, and usually too early in the morning to fit in with my sleep schedule.

As I was admitted the Friday after boxing day, I spent New Years as an inpatient. New years eve was a strange event to experience in hospital. I did not want to leave my room and ‘celebrate’ with the other patients in the common room, despite the repeated invitations and coaxing from staff members. Not because I thought myself better than they were, I wanted to be on my own, I suppose to allow myself to forget where I was, but also out of some misguided protest. Speaking to friends on New Years, happy and drunk from the parties I should have been at, was the only memorable experience from that night. The few friends who knew the truth about where I was showed a great deal of love and patience by speaking to me that night. I was bored, angry and frustrated, and coming to terms with the fact that I would simply have to drop out of university. I stayed up late into the early hours of the morning, reading books, magazines and listening to music. I didn’t want to sleep, in hindsight the symbol of waking up in a psychiatric hospital on New Years Day was probably too much to handle.

 

Two weeks after my arrival at the Priory, my doctor and I had agreed about my withdrawal from university and my discharge from the hospital. The plan was to continue as a day patient, I was to be under the hospital care during week days in order to undergo therapy. I left that day still detached and in denial, remaining a day patient for 5 weeks before my second admission.

Thank you for reading,

Borderline Bella xxx