Tag Archives: GP

Kindness At A Higher Level

We live in a society that is often far from kind. I’m not talking about individuals, I’m talking about policy and societal norms. Being individually kind is important but we need kindness as a society to make a larger change.

Unfortunately we live in a world led my money rather than kindness and what is best for people. I can understand this. Money is finite and so we have to spend with care and this can mean cuts that are the opposite of kindness. We see this in mental health services all the time. People are turned away as not sick enough or not enough resources. People are sent miles from home when unwell and needing the kindness of family close by. There are some changes that really need to be made and cutting more and more is doing the opposite of kindness and therefore worsening mental health issues at times.

Also as a society we are far from kind to those who attempt to end their life. Many are labelled attention seeking and selfish. Many a person has been heard on a train that has hit a person berating them for ending their life and delaying people. The kindness that this person needed appears to of been absent in their life and their death. Instead of asking what could of been done to help them before this event they are condemned for seeing no other way out.

Society is also cruel in its use of social media. While social media can be great there are the trolls and the nasties who are far from kind. They band together to bring cruelty to one person. They push people over the edge as they can’t show kindness. They condemn people as guilty before hearing the full story. They forgot that a little kindness could improve the world and keep people alive.

By changing our outlook from the top down we could prevent so many deaths. By acting as a society we could improve life for many. It’s time to unite to be kind as well as individual acts of kindness.

I’d love to hear your views so feel free to share in the comments or on Twitter, Facebook or Instagram.

Cancer Scare: Waiting For Diagnosis

This is a personal piece. Please be aware that some of the content may be triggering.

The date today as I write this is 15th February 2020. Three weeks ago I found a lump in my breast. I regularly check mine but this one was actually brought to my attention by my cat kneading my chest as she loves to do and it not feeling right. So I checked it out and it felt sizeable. It had been 2 weeks at most since I’d last checked.

I kept checking it over the weekend just to make sure it wasn’t just some lumpiness that would go away. Then the following week I tried repeatedly to get a GP appointment, finally managing to get one on the Thursday. Luckily it was a GP I know well and trust as with my history of sexual abuse it was raising anxiety. When he checked he said he thought it was about 5cm. He referred me on the two week wait cancer initiative.

My appointment came through for 12th February 2020. I went along with more apprehension of facing the tests than the results. It started with an ultrasound of the breast. This seemed to confuse them and another person was brought in to look. Then it was decided I needed both a mammogram and biopsies. Normally someone my age would not be given a mammogram as it may not show anything. But mine showed the lump clearly.

The biopsy process was painless due to local anaesthetic. I was still just thinking it was a normal part of the process and they would be like it’s all fine but we just have to know what it is. That was not the case.

After the biopsy I was asked to wait in a room. My mum was with me. We got called back in and I was faced with a number of people which put me on edge. They explained that they were concerned about the lump. That I was going to have to return for another appointment to get the results of the biopsies and find out the next steps. That they were pretty sure surgery would be needed whatever.

One of the people in the room was a breast care nurse. She had been assigned to my case and would be my point of contact. She was lovely. She took me and mum off into another room. We discussed a few things and she sorted out the appointment. Her comment that there was a lot that they can do to treat cancer made me feel they know already but I can’t be sure. I’m in a state of not knowing.

So I’m sat here having a mixture of thoughts. I’ve been through so many emotions in the last few days. From the incredibly calm to the extremely anxious to suicidal. I’ve been showing others the calm side. I’ve been pushing my emotions down. A few people have heard some of the worry but not the full extent. Not the thoughts that have been going through my head that make me ashamed of myself.

There is a part of me that feels IF it is cancer then I don’t want to go through the treatment. The thought of dealing with being unwell and making it worse to get better scares me. The thought of trying to live when mentally I want to die all the time seems hypocritical. In fact it feels like it could be my way out which is a terrible thought isn’t it? But I know others will want me to go through it all. I know I will have to do it for them.

Obviously at this stage I have no definite answers. But this doesn’t stop the thoughts. Google is not my friend at the moment and the late night Google searches are not a good idea (other search engines still available?). I feel so much guilt over my thoughts. I’m just trying to push all the feelings down. I don’t want the pity. I don’t want to be treated as delicate. I don’t want people thinking I’m brave and strong. I’m not. I’m a mess. Not because I care about me but because of those around me. I don’t want to cause them anymore suffering.

So yeah that is where I’m at as I write this. I don’t know anything definite. If I publish this I may know more by then. I will keep people updated. Feel free to connect in the comments or on Twitter, Facebook or Instagram. For more information and support about cancer click here.

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Dear GP

There is an amazing account on Twitter called Dear GP where people write letters to their GP about their encounters with mental health professionals in the same way mental health professionals write letters about their patients to their GP. You cam visit the website here. I thought I would have my own go at this below after an encounter with a member of staff who is no longer involved with my care.

Dear GP

Today I met with care coordinator P. She was casually dressed in jeans and trainers. She seemed disorientated and unsure about what was happening. She did not know where she had to be and was indecisive of her next steps. She appeared very disorganised and had not booked a room or remembered that she was meant to be attending my psychiatrist appointment.

Before the psychiatrist appointment, P appeared to disappear and it soon became apparent she was making secretive actions with the psychiatrist. She made no eye contact when I entered the room and was distracted and on her phone throughout the appointment.

P made some abstract comments that only just related to the conversation between me and the psychiatrist. She was keen to please the psychiatrist and back up his treatment plan despite knowing the issues with this way forward, which had been discussed previously. P then showed that she had been trying to rid herself of responsibility and discharge herself from my care with no input from myself. This was overruled by the psychiatrist. She seemed disappointed in this course of action and did not make anymore conversation and avoided eye contact for the rest of the appointment.

At the end of the appointment, P decided to arrange another appointment but was inflexible in this leading to no date being set and no forward treatment plan being set.

I thank you for sending P to see me but I think that going forward there may be no working relationship unless her behaviour becomes more open.

Regards

Jo

To share your own experiences feel free to share in the comments or on Twitter, Facebook or Instagram.

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They’re Not All Bad

I realise I’m quite often pretty scathing about mental health professionals but some of them are OK. Some do an amazing job and are let down by their colleagues. Quite often our bad experiences overshadow the good and we get into a negative view of all professionals, which is understandable.

I’ve had a few good experiences with different professionals. The negatives with these professionals only come when they are let down by the system they work within, otherwise they are amazing and make all the difference. When someone is caring and takes time with you it makes you feel valued and has a positive effect.

The first professional I found that was great was my art therapist. This was the first major mental health professional I worked with. At the time she was part of the young person’s service which was part of CAMHS (Child and Adolescent Mental Health Services) and worked with those aged 16-25. I was 20 when I started working with her. She treated me on a level with her. I was training to be a teacher and she treated me like a professional as well as a patient. She didn’t patronise me and went at my pace. Her main work was to get me to communicate and she did well with this but at my pace. She made herself available between sessions if I needed to leave a message or write a letter to help with the next session. She’d talk me through situations. She tried to teach me it wasn’t all my fault and at times I almost believed her. The main thing that sticks with me though is that the young person’s service was disbanded so all over 18 were to be taken on by adult services meaning I’d lose my therapy. However she fought for me and told them it ws totally the wrong time to take it away from me and that she needed to continue her work with me. This led to me having a further 18 months with her. Leaving her was hard and I miss her a lot. I still have the card she gave me at the end of therapy.

Another mental health professional that gave a good impression was a psychiatrist I had in adult services. She is the one that diagnosed me with BPD (Borderline Personality Disorder). She always valued my opinion and explained things when asked. She wasn’t perfect in that she didn’t discuss my diagnosis with me before it appeared on my notes but she was happy to go through it after. She was also a consistent presence for nearly a year before she moved on. This makes a difference.

The next professional who I had a good relationship was a care coordinator of mine, L. L was very proactive in my care and worked hard to get things sorted for me, not only with my mental health but my physical health too, even spending ages on the phone to a hospital trying to sort an appointment for me. She didn’t make me feel like our time was limited, it was always as long as I needed to talk. She took an active role. It was sad when she moved on.

My current care coordinator is also great. She’s not been involved in my care for long but has already shown me how great she is in that she gave me direct contact details for her and allows me to text rather than talk on the phone. She doesn’t mind me messaging between sessions and is quick to reply even if it is to tell me she’ll get back to me properly later. She’s also always on time or early for appointments which makes all the difference. I’ve kind of thrown her in at the deep end with my crisis but she hasn’t made me feel bad about it. I hope we can work together for a while.

Unfortunately these professionals are the exception rather than the rule. It shows as these are four out of many professionals that I have encountered. Hopefully things will improve and we will get more professionals that want to help rather than make us feel like an inconvenience or stigmatise us more. If we can be part of the education of professionals I think it would help them to be more empathetic and understand us more.

Have you had any good experiences? Feel free to share in the comments or on Twitter, Facebook or Instagram.

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Shut Up

This is my response to some comments I’ve had and seen other people have. It is my personal opinion. Please be aware some content may be triggering.

“Shut up!” are the words I wanted to say. Someone tried to tell me what I could do even when I expressed how difficult it would be. They totally invalidated my feelings. They totally disregarded my illness. It was like they thought I had a choice over how I felt.

The thing is this is common for people with mental illnesses (and I’m aware it’s the same for those with chronic physical illnesses, especially if they’re invisible, but I don’t really have much experience of this so would not like to comment further on this). People seem to think you are just being difficult. They seem to think it’s a choice. They can’t see how much of a battle these so called “simple” things are to do.

Mental illness can create barriers to doing certain tasks. Getting through these barriers takes a lot of work. Just because you put it in simple terms does not make it any easier. It does not take away the mental, and sometimes physical, blocks. It does not change my feelings. It does not take away my anxiety (or depression, BPD, bipolar, schizophrenia, etc). All it does is frustrate me as I feel misunderstood.

What can be worse is when it is someone who has experienced their own mental illness. You kind of expect some understanding (and most are) but instead you are met with their own standards of what you “should” be able to do with a mental illness. This is so wrong. Everyone with a mental illness is different. It effects people in different ways. What might be an easy task for me, might be the hardest thing for someone else and vice versa. Please don’t hold us all to the same standards.

In short before you voice that someone can do something (and not in a “you’ve got this” way but in a “you will do this as you are capable” forceful way) think. Why are they saying they can’t do it? What can you do that is a practical way to help? Are they ready to tackle this right now? Maybe ask them these questions. Please don’t invalidate what they are feeling.

If you’ve got any thoughts on this feel free to share in the comments or on Twitter, Facebook or Instagram.

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Self Harm Etiquette For The Medical Profession

This is a blog post for anyone working in the medical profession. This includes Doctors, GPs, Nurses, Healthcare Assistants, Paramedics, Support Workers, Psychiatrists, Care Coordinators, Psychologists, Pharmacists, Admin staff and Receptionists. Basically anyone who comes into contact with a person who may have self harmed (therefore could also be useful for police officers too).

It has come to my attention that some of the people we want to help us deal with self harm can be some of the least useful with their comments and actions regarding dealing with self harm. Therefore I thought I’d put some tips together specifically for them and any professional that needs to help with self harm.

1. Don’t comment on it in front of other patients

This may sound really obvious. Patient confidentiality is key. Bringing it up in front of other patients without permission is wrong and can cause harm to the person who is self harming, the relationship between patient and professional and possibly even the other patient/s who could hear about it. You never know where this information will go. Unfortunately I know it happens. I’ve seen it happen.

2. Don’t guilt trip us

I’ve had this happen with a former GP. I was told I obviously didn’t love my parents over my self harm. It was awful. I didn’t return for treatment until two years later after a suicide attempt. This isn’t the only impact it can have. Self harm is not a selfish act. It’s a way of trying to keep going. It’s a way of coping. Most people who self harm probably already think about the perceived damage they do to others. To be guilt tripped by a professional is more likely to make the situation worse and even cause the patient to withdraw from seeking help, maybe until it is too late.

3. Don’t mimick self harm behaviour

Again this is something I have encountered and not just with one professional but many. It seems some can’t bear to say the words “self harm” and so use actions like using their hand to mimick cutting across an arm. Not only is this not clear communication, it can be triggering. It is a difficult topic but it is one that needs to be dealt with sensitively and professionally. Yes you do need to ask, but please use words rather than miming actions.

4. Be careful with what you say

Most professionals are careful with what they say. They think before they speak and take into account the individuals situation. That’s great if they know the patient. However without continuity of care, which is heavily missing in places, you may not know details or you may just be someone that only encounters someone briefly so has no background information to draw on. This means being careful with what you say. I’ve heard things that concern me. They may be useful for some but I can also see them as potentially inflammatory to the wrong person. I’ve heard “you’re scars look cool”, “just use your faith” and “what would your family think?” as common phrases among others. Let’s work backwards, the last comment can easily be seen as a possible guilt trip but it can also cause some negative emotions to surface, particularly if there is friction within the family. The middle comment is also dangerous as some people don’t have a faith and this may be because of trauma or abuse. It can also suggest unless you have a relationship with a god, you can’t be helped. The first statement may be the most troubling though. You’re reinforcing the behaviour. Yes self harm shouldn’t be something people feel ashamed of, but it shouldn’t be highly celebrated either.

5. Don’t judge or use stereotypes

Some professionals have a preexisting picture of what a person who self harms is. They may see them as frustrating and a drain on resources. They may see it as attention seeking. These stereotypes tend to grow over time within a staff member. I can see how hard it must be to treat someone who seems to be causing their own suffering. But it is a symptom of an illness. It is like an addiction. It is hard once you have started to stop. It can feel like all you have in the world at that time. It is a sign of distress. Being compassionate, non judgemental and just kind to the patient goes a long way. It can help the person to keep accessing help. Doing the opposite could push people away and leave them in dangerous situations.

6. Don’t compare us to other patients who have self harmed

Every person is going through their own unique experience with mental illness and self harm. Self harm is self harm. So it may not be as deep or as “bad” as someone else you have treated, but to that person the pain they feel inside is probably just as intense and unbearable. Hearing that we aren’t as serious as someone else because it doesn’t reach a certain level is heartbreaking and can have a negative impact. It can cause us to try and do more damage. It makes us think we aren’t good enough or that we don’t deserve help. Everyone, whatever level of self harm they present with, deserves support and compassion.

7. Don’t use the terms “superficial” or “attention seeking”

I hate the term superficial when it’s used to describe my self harm. It makes me feel like a rubbish self harmer and that I need to harm worse or more. It can encourage the behaviour and make things worse. The same can be said about the term attention seeking as it can drive the behaviour underground and prevent people getting help.

Those are just a few helpful hints for medical professionals. It might not be a regular thing you encounter but it is always useful to know how to help someone who self harms.

If you have any tips you wish professionals knew then feel free to use the comments or Twitter, Facebook or Instagram.

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Shutting Out The World

This is a personal piece. Please be aware some of the content may be triggering.

Things at the moment aren’t great. I’m not in the best place. My head is a mess and I’m not tolerating the world very well. Therefore I’ve been shutting it out.

I know this is not the best course of action but at the moment it’s what I can cope with. The world feels overwhelming. People feel overwhelming. Life feels overwhelming.

I don’t know what has caused this decline. I have theories. It could just be a depressive episode. It could be the disjointed care. It could be turning 30. It could be a number of individual things or all of them combined. I don’t know. And I guess it doesn’t really matter.

Shutting out the world means avoiding Facebook interaction. It means not messaging friends. It means not asking for help. Instead I have replaced it with self harm and thinking of suicide. I have spent my time dwelling on the fact that everyone would be better if I was no longer here and have been on a mission to prove it to everyone.

I’ve also been experiencing physical symptoms. My body aches. My head is thumping. And I feel sick. I either sleep too little or too much. I either have no appetite or binge on food. It adds to the mental difficulties.

I hate myself for the way I’m coping. I hate myself for doing what I logically know is the wrong thing. I see it as protecting myself but realistically I need people and I need help. What help they can offer I don’t know. I guess I won’t if I don’t ask. The thing is I’m put off asking at the moment by the fact I have no stable care. I feel a burden to everyone, including those paid to care for me. I know I’m just another caseload that they could do without.

So what would my advice be for anyone else feeling this way? I guess it would be to do what feels like the hardest thing, ask for help. You deserve it. You are worth it. Now I just have to try and believe it for myself.

If you are struggling the Samaritans are available 24/7 in the UK. If you are outside the UK then please check out the crisis help page which can be accessed via the menu. To follow my experiences you can do so on Twitter, Facebook or Instagram.

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CMHT Fail

This was not the post I planned on sharing today but I needed to get this out.

Today I had a psychiatrist appointment. It was with a new psychiatrist and my latest care coordinator. Except it wasn’t. While in the waiting area I received a phone call telling me my care coordinator had left on Friday and trying to arrange an appointment with my interim care coordinator. When I told her I was waiting for my appointment that was already running ten minutes late they rushed down. Remember they don’t even know me.

In the appointment the psychiatrist had no access to my notes as he had been blocked from the system. Thanks to the interim care coordinator he was able to access the last letter but couldnt read in detail.

He asked me how I was and when I mentioned my mood was low a lot and unstable, he asked more questions about my concentration, appetite, memory and sleep. He asked me to rate my mood which I put at two at best. I mentioned I was having suicidal thoughts and that the voice I hear is worse. He said I didn’t have plans to end my life, he actually didn’t ask.

The psychiatrist then wanted to refer me to a service that has refused to take me on. When I explained this he said he understood and offered no alternative. He did not want to change my medication despite my obvious deterioration. I managed to persuade him to up my mood stabiliser but he did it by the smallest margin possible.

I tried to bring up some other concerns but by that point he was already wrapping up the consultation and urging me out the door with the words “I’ll see you in two months”.

Everything felt like it was too much effort for them. This is from a trust that is rated as outstanding. A trust that can’t seem to retain staff or offer support. It is currently a postcode lottery within this Trust as to what treatment you can access (I am aware that this is actually down to the CCG).

When did continuity of care in mental health services become unimportant? Especially with people with BPD where fear of abandonment is a major symptom. When did it become acceptable not to fully risk assess people?

Unfortunately this seems to be the way it goes for many service users of mental health services. It isn’t often I cry in an appointment and straight after in the street but today’s fiasco made me feel awful and worthless. (Thanks to the psychiatrist who actually sked if I felt worthless).

To keep up to date with my mental health experience, follow me on Twitter, Facebook or Instagram or use these and the comments to share your experiences.

Losing A Mental Health Professional

This piece contains my personal opinions and some of the content may be triggering.

Sometimes in life we can’t control what is happening around us. People come and go in our lives whether we want them to or not. This can be hard to deal with. One big change can be when we lose a mental health professional who has been involved in our care for a long time. We may have come to rely on their help and support. We may have built up a good relationship with them. And then it ends.

As someone with Borderline Personality Disorder (BPD) endings can be particularly tough. Having a fear of abandonment means that when someone does actually leave our lives it is like a self fulfilling prophecy. Our worst fears are happening. This may lead to us getting involved in risky behaviours or rejecting the person before they are out of our lives in a way we believe will protect us.

Recently I was given the news that my care coordinator was moving on and I was going to have to say goodbye. It was difficult news to take as we had a good relationship and she was a great and supportive care coordinator. Getting the news made me feel like I was being abandoned as at the time there was no replacement on the horizon and no idea when one would be recruited. I was close to tears. Many thoughts went through my head including “was this my fault?”.

As I came to accept that this was going to happen I started to pull away from my care coordinator. This is what often happens with people who have a BPD diagnosis. It’s a way of protecting ourselves from a perceived abandonment even when it is not a true abandonment.

What helped though was the way my care coordinator rounded up our sessions together. She made sure my care plan was updated before everything ended so the next person would know what I needed help with and what I was working on already. Also in the end a new locum care coordinator was appointed so my old care coordinator could introduce me to the new one. This allowed her to inform the new person as to how often we met, what my major issues are and what needs to be brought up at my next psychiatrist appointment. It also helped to make a plan with the new care coordinator as to how our meetings would work.

What should a mental health professional remember to do when leaving a therapeutic relationship?

  1. Let the person know your leaving face to face
  2. Answer any questions about the change that the service user/patient has about the change
  3. If possible introduce your replacement to the service user/patient
  4. If unable to introduce your replacement, leave notes for your successor
  5. Tie up all loose ends

What can I do if I’m losing a mental health professional?

  1. Talk about any issues you feel need to be taken into account with a member of your mental health team
  2. Make sure you have numbers of people you can contact if you need help
  3. Create a support network (if possible) away from the mental health team
  4. Be open to a new mental health professional, remember just because they are new doesn’t mean they’ll be awful

Those are a few pieces of advice that I have but if you have more then feel free to use the comments or Twitter, Facebook or Instagram.

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Why I Keep Self Harming

This is a personal piece. Please be aware the content may be triggering. I do not promote self harm in any way. If you are struggling with self harm please get support from a medical professional. This is just a look into the mind of someone who self harms.

Self harm has been a big part of my life for the last 16 years. That’s over half my life. I’ve been harming longer than I haven’t. People often wonder why I continue to use this as my main coping strategy. So here I thought I would share some reasons why self harm is still in my life. This is not me saying self harm is a good thing. This is me explaining why it is hard to stop. Currently I wish I could stop as I’m in agony but my mind won’t let me.

1. It’s an addiction

Now some may argue with me on this point but to me self harm is an addiction. I find myself craving the time until I can hurt myself. Sometimes it is all I can think about. And the feeling I get when I’ve done it is so satisfying to begin with. Also when you feel pain your body releases endorphins. This makes you feel better and is why you crave it more.

2. It’s a release

To me self harm feels like a release. All the pain and anger can be let out. To me this feels a safer way of getting everything out. I don’t feel like I’m hurting anyone (but myself) so it is safer for everyone. Although this probably isn’t true. My mind however convinces me it is.

3. It helps me feel in control

For me the world is a very scary place and for me to deal with it I have to feel in control. Everything has to be planned. The problem though is that people and events are unpredictable. This leaves me feeling out of control. So to gain back the control I self harm. It calms down everything in my mind. The problem is that the more I think I’m in control I’m actually more out of control. In fact the self harm is in control of me.

4. It’s dependable

Self harm is always there for me. At any time. I think I’m quite a needy person so I need something that won’t let me down or be too busy. I feel I can rely on it to help me deal with the bad thoughts and the voice I hear. I try and use other coping strategies but these fail me at times. I’m not promoting self harm here. I know it is an unhealthy coping strategy. I would never suggest someone use self harm as a coping strategy.

5. I feel I need to be punished

I have felt like a bad person for a long time, since I was a small child. A lot of this stems from things in my past. Therefore I feel I should be punished and self harm meets the criteria. Hurting myself feels the right thing to do. I know realistically that’s not the case but in my mind that’s how it works.

So that is a few reasons I’m finding stopping self harm so difficult. I want to state again that I don’t believe anyone should self harm. You deserve better than to harm. If you want more information on self harm check out the Mind website. Feel free to comment here or on Twitter, Facebook or Instagram.

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