Tag Archives: professionals

I Want To Die

This is a personal piece. Please be aware some content may be triggering. I have sought professional help.

I want to die. That is my overbearing thought at the moment. Its there when I wake up until I go to bed. My thoughts go to how I could do it. The voice tells me how much better for everyone it would be and how useless I am that I am still alive.

My body is something I’ve lost respect for again. I feel its failing me again. It’s not doing what it should. It’s a constant trigger at the moment. I hate that I can’t fully get the help I need with it because of what has happened in the past stopping me managing the tests I need. I hate that where I have tried to sort things they are not going to plan. Why should I care about something that has let me down in the past by reacting when I didn’t want it to react? I hate it. I want it gone.

The memories at the moment are overwhelming. I always try to push them down but sometimes they just rise again and again. I hate that they effect me when I know they shouldn’t. I should be over it all. I try and believe people that it’s not my fault but then the logical side kicks in and shows the evidence of why it is my fault. I know people are just trying to be kind to me but I don’t deserve it. I’m a horrible person.

Stress at the moment is also high. Home life is hard. I feel that whatever I do isn’t good enough. Nothing I say is right. If I try to help I’m wrong. If I don’t I’m wrong. I feel guilty constantly and like I’m letting them down. I’m trying to help but it’s getting on top of me and I don’t know how to respond without upsetting people. Noone cares how it effects me. But then I know I’m not worth anything. I’m just a burden.

I feel guilty for asking for support. I feel I take too much. I don’t want to take away from other people but I fail at that. Again a lack of control makes this worse. I don’t want to cry or get emotional in front of others. It’s not me. I don’t want to make them worry. I’m not worth worrying about. Therefore if I’m gone it would be for the best.

My life is pointless. I have no potential. I fail at everything. I try and then things get in the way. I suck. I’m a burden to those around me. Why would they want this useless mess in their lives? They are too kind to say otherwise but I know I shouldn’t be here as it would make their lives easier. They could focus on the important people who deserve help.

I should die. I need to die. I want to die.

If you are feeling suicidal the Samaritans are there to listen or if you are from another country you can find a list of crisis lines around the world in the menu. Feel free to use the comments or Twitter, Facebook or Instagram to share your thoughts.

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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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6 Months From The End Of DBT

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

It’s been roughly six months since I finished my DBT (dialectical behaviour therapy) skills group, therefore I thought I’d reflect on how things are going.

In all honesty I found the DBT skills group difficult. It revealed a lot more areas that I need to work on than I thought I did. I learnt a lot about myself and how BPD (Borderline Personality Disorder) effects my life. It is a lot more than I thought. I think I thought some of the things I thought were normal, when actually it’s far from normal.

DBT gave me some ideas on how to cope with the self harm urges and things to do instead of self harming, as part of the distress tolerance module. While I’ve tried to practice these, I’ve not found them that effective. The urges don’t go away like I hoped. Instead I’ve found myself fixating on the idea of self harm and how much damage I could do. The only thing that seems to relieve this is to self harm. This isn’t a failure on DBT’s part, it’s mine. Although I do feel I would of benefitted from a revisit to the skills, I also feel I needed some individual help to go through the problems that lead me to self harm and someone who could help me find what’s effective for me.

I knew I always had problems identifying emotions. The most I could do was say whether it was a good or bad emotion. I used to use cues from others to put a name to the emotion. It was something I started working on in art therapy as a teenager as before that I could barely express how I was feeling. I think with DBT skills I learnt some more ways to identify my emotions and the 10 page handout on ways to decide which emotion it is you’re feeling was comprehensive. I just wish I had it in the form of an app on my phone as you can’t really carry a thick A4 handout around easily.

I also learnt through the emotional regulation module that emotions aren’t wrong to have. It’s something I’ve always said to others but never applied to myself. Anger has always been a tricky one for me to deal with. But I’m working on accepting it. I punish myself less for feeling angry though I do still struggle to express it outwardly. I think at the moment I’m not in a safe enough space to allow this expression so hopefully with time that will come.

The biggest learning curve for me came with the interpersonal relationships module. I thought this module would be a waste of my time. I thought I was doing OK. How wrong was I? I came to realise that I was allowing people to treat me like dirt and accepting it too easily. I learnt that there were ways to try and change this and that I didn’t have to accept it or just go into a rage over it. I must admit that most of my time doing this unit I was trying to figure out my relationships and which needed working on rather than the skills to tackle this. Over the last six months this has continued but I’ve lost my grasp on what skills to use. I feel I would maybe benefit from repeating this unit at a later date. I’m not ready at the moment still.

In the core mindfulness module of DBT skills I learnt a little about how to make myself be in the present moment. Before DBT skills group I had a tainted view of mindfulness as something I was no good at and would never master due to previous experiences in therapy. What I learnt was that for me I need to approach mindfulness in a different way and that there are many more ways to practice mindfulness than I had been taught before. For me, mindfulness wasn’t about sitting in silence breathing. I needed to do activities mindfully. This was a revelation but it was, and is, useful.

Overall I’m in two minds about whether DBT skills have been useful. I think there is potential for them to be useful in my life but I don’t feel the course was long enough for me personally. I also feel full DBT, which includes individual as well as group therapy, would have been more useful. I feel that one of my psychiatrists agreed with this also (he’s left now but it would of been good to have him on my side). I am also hoping to attend a DBT skills peer support group that is starting as part of my local Mind. Hopefully this may help a little with the gaps in my knowledge.

For more about my therapy you can click here or you can follow me on 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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BPD Awareness Month Round Up

May is BPD Awareness Month so throughout the month of May I shared facts and information about the illness on Twitter, Facebook and Instagram. But I thought I would share them all on the blog as a round up.

1st May

This was my introductory post to announce that I would be sharing information about Borderline Personality Disorder.

2nd May

I thought it was important to share what BPD is and this seemed like a good explanation.

3rd May

Many people mix up BPD and Bipolar disorder. They are have similarities (mood switching, intensity of moods) but are two separate illnesses. For more info check out Mind’s website.

4th May

BPD can be diagnosed when at least 5 of 9 criteria are met (see image for the 9). There are many different combinations and each criteria is on a spectrum.

5th May

This was just to give people an overview of some yes’s and no’s.

6th May

A lot of people say BPD isn’t a real mental illness but it is. There are a lot of theories about what causes BPD, but this doesn’t make it less real.

7th May

A lot of people think that people with BPD are manipulative. We are not and this image explains why. All the people I know with BPD are awesome.

8th May

BPD is exhausting. Unstable moods are a major part of this illness and don’t just change daily but even from 1 minute to the next.

9th May

This further explains the extreme moods that we go through.

10th May

Just a letter many people with BPD would like to write.

11th May

A lot of people think that people with BPD are sensitive. In some ways we are but there are reasons for it. We notice every little thing and if something is wrong we blame ourselves and wait to be abandoned. This makes any kind of relationship hard.

12th May

Many people with BPD have their feelings invalidated because people can’t understand the extreme nature of our emotions. We know to you it may not be a big deal but saying we shouldn’t feel that way makes us feel worse.

13th May

We shouldn’t lie to people in general but lying to someone with BPD can be catastrophic. It can fuel all sorts of thoughts, generally against ourselves. We start doubting everything. Everyone feels unsafe.

14th May

Little things can cause a big reaction for people with BPD but we also know that people will not understand why we have reacted as we have so we tend to hide our feelings. This can result in using negative coping strategies such as self harm or eventually exploding at someone.

15th May

Self harm is one of the criteria for a BPD diagnosis. There are misconceptions about why people with BPD self harm but it is not to be manipulative or for attention generally.

16th May

Some people doubt the seriousness of BPD but it has a suicide rate of 10%. 70% of people with BPD attempt suicide.

17th May

This is my medication that I take in a month. Most of it is for my mental illness. There is no medication that is made for treatment of BPD but it can help us deal with some of the symptoms. Each day I take two antidepressants, one mood stabiliser and an antipsychotic. I also have a medication I can take when my anxiety is overwhelming.

18th May

This statement may sound a little reactive but it has some truth. People with BPD don’t only feel negative emotions strongly, we feel positive ones just as intensely. This means we may come across as quite intense in relationships. But we genuinely love you lots.

19th May

Anger can be a problem for those of us with #BPD. With the intensity of emotions, our anger can be an explosion of rage. It can burn for a long time even after the other person/situation is over it. It will play on our mind. We may do or say things we regret. Sometimes we will turn it inwards.

20th May

I hate this about myself. People with BPD do get jealous of friends hanging out with other friends but we do not do this because we feel you should only hang out with us. We actually feel we are not good enough for you and are scared you will leave us.

21st May

People with BPD are very aware that they are responsible for their actions. Maybe too aware as they are constantly judging their words and actions. But sometimes, and we are not using it as excuse more an explanation, our illness causes us to act in certain ways that are difficult to deal with for others and ourselves.

22nd May

Quite often people with BPD have trouble naming their emotions, which when you feel them so intensely and act out on them can be a problem in getting others to understand you. It is also frustrating as we wish we had the words for what we’re experiencing so we can get support.

23rd May

This is something that is currently hitting me quite hard as I turn 30 in just over a week. This isn’t exclusive to BPD as many people who have a mental illness but I just wanted to share what kind of impact BPD can have. It is a serious illness.

24th May

People with BPD struggle with their sense of self. Part of that is taking on things from other people and our sense of worth often comes from other people too. This means we do our best to be liked so we feel worth. We also put a lot of pressure on ourselves to be perfect and is part of why when we make a mistake we take it so hard.

25th May

People with BPD may struggle with a se se of self. In response to this they take on bits of other people depending on who they’re with. Therefore when they are without someone it can be a struggle to know who they are so they cling to people and may appear needy.

26th May

Living with BPD for me makes me feel like I don’t belong. I feel like I don’t fit in anywhere. The world feels like something I can’t navigate while others seem to just get through. Little things are big. Relationships feel like a huge effort. Even simple socialising is a huge minefield waiting to explode in our faces so everything gets analysed.

27th May

It is a myth that people with BPD are all abusive. In fact we are quite likely to be the victims of abuse and get stuck in abusive situations as even when someone is toxic we are scared of being left by them.

28th May

I’ve talked about the struggles of BPD a lot because they are a huge part of the illness but these same traits can have some positivity. We are passionate and empathetic among other things.

29th May

Apparently BPD gets easier to deal with, with age. And in some ways I’ve seen this myself. My mood swings when I was younger were much stronger and I was more reactive. I think things have got easier in some ways because I’ve learnt about myself and ways to cope. I’m not saying it’s easy, and there are times when it really catches me by surprise but it can be manageable.

30th May

The main treatment for BPD is Dialectical Behavioural Therapy (DBT). The full course involves group and individual therapy. It focuses on dealing with the symptoms of BPD to make life easier. It is hard work.

31st May

I’ve shared a lot about BPD and the difficulties and differences it can make, but people with BPD are more than a mental illness although it can be hard to distinguish the lines. Please remember that the person who tells you about their diagnosis is the same person they were before they told you.

I hope this has been useful. For more information on BPD check out Mind website. You can keep up with me via Twitter, Facebook or Instagram.

BPD Q&A

There is a lot of misinformation out there about BPD and many people don’t have a good understanding of the illness. It can be very confusing, even for those of us who are dealing with the disorder. Therefore I thought I would answer some common(ish) questions. Obviously I only have my experiences to draw on but I hope it is still helpful.

What is BPD?

BPD stands for Borderline Personality Disorder. It may also be known by the name EUPD or Emotionally Unstable Personality Disorder. It is a mental illness classified in the DSM-V (the manual of all mental illnesses). There are a variety of symptoms including relationship difficulties, fear of abandonment, suicidal ideation, self harm, impulsive behaviour, lack of a sense of self and extreme emotions which switch rapidly. To be diagnosed with BPD you need to match five points of a criteria of nine. This means that everyone with BPD is unique as each criteria is also on a spectrum.

What causes BPD?

There are many different theories as to what causes BPD. It is widely agreed that trauma in childhood is a big cause but not everyone who has BPD experiences trauma. There has also been research into changes in brain structure and genetics. However nothing has been conclusive.

What does having BPD feel like?

Everyone with BPD is different so I can only talk about what BPD is like from my point of view. Personally it feels like I’m an alien in this world that seems to be out of my control. And the lack of control reaches even inside me. I also feel constantly scared that people won’t like me or will leave me. I also feel like everything is too much.

What treatment is there for BPD?

The main treatment for BPD is Dialectical Behavioural Therapy (DBT). This is a therapy that is mindfulness based and proper DBT consists of both group and individual therapy to learn skills to deal with distress, relationships and emotions. However it is not always available. People with BPD may also take medication though no medication is suggested for BPD. It can however help with symptoms and other illnesses that people with BPD are likely to have.

What is BPD rage?

BPD rage is the extreme anger that some people with BPD feel. Like all our emotions it is incredibly intense. It can also last a long time after the triggering event is over and when other people have forgotten about it. It also may seem disproportionate to the triggering event. Sometimes we turn the rage inwards and this can lead to self harm and suicidal behaviour.

Can people with BPD get psychosis?

Yes. It is a lesser known symptom of BPD but it can happen. It is more common in times of stress but can be there long term too.

Is BPD serious?

Yes there BPD is serious. It has a suicide rate of 10%. 70% of people with BPD attempt suicide. Self harm is common. Alcohol and substance abuse are also common. It effects everyday life.

Are people with BPD dangerous?

No people with BPD are not dangerous. In fact people with BPD are more likely to be victims of abuse than perpetrators. We are also more likely to hurt ourselves than other people.

So that is a few questions about BPD. I hope it helps with some understanding of the illness. For more information on BPD check out the Mind website. Feel free to share your experiences in the comments or 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.