Tag Archives: treatment

Ashamed

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

Today I had a melt down. Not just a little one but a major, uncontrollable show of emotion. I was in the DBT peer support group that I’ve started attending and I got triggered and that was it. My mind started turning over everything. Memories came back with full force. The voice started. It was overwhelming. I started by sitting quietly with tears going down my face. We were doing an exercise and everyone was focused and I just couldn’t ask for help. Then someone noticed me. They asked if I was OK and I got asked if I wanted to take a moment. That’s when things just nose dived.

I practically ran out the room. I wanted to slam the door behind me but couldn’t do it. This infuriated me and I hit the wall and ran to the stairs. At that point I just sobbed and emotion overtook me. There were so much emotion that I have no idea what it was I was feeling. All I know is it was horrible. In that moment I wanted to die. Everything was so intense. It felt unmanageable. I felt nothing was going to be OK again.

Luckily the peer support facilitator followed me. She was amazing. She got down to my level. I think she grabbed my arms. It’s a little hazy. I can’t remember what she said. All I know is she got someone else to go in with the group and took me somewhere quiet.

When we got in the office I just wanted to curl up small and hurt myself. I hated my reaction as well as still feeling the heightened emotions. Also everything was still going through my head. I couldn’t look at her. I was so ashamed of myself for so many reasons. For my reaction. For my feelings. For the thoughts of what had happened in the past. For what the voice was telling me. I started to hit myself as I was asked to stop. I hadn’t even realised I was. Things were hazy. It was like being in two different places.

The facilitator started talking to me. The conversation is a little bit of a blur. But it started to calm me. She got me to focus on my breathing to bring me back to the moment. She then had to leave me to go back to the group but someone else sat with me. They talked to me about nothing in particular but it helped. I started to be able to respond and the tears seemed to stop. The intensity of the emotions slowly eased.

When the facilitator came back we decided to have another talk. I opened up about a lot of things from my past. It all kind of blurted out. There were things I had never really spoken about. It just felt, well not easy but, OK to talk about. I felt listened to. I felt understood. I felt I mattered. But this was also contradicted by other feelings of shame (of what had happened in the past and of needing to ask for help), of being selfish, of guilt. I hated myself. As much as I was told it was OK I couldn’t believe it. I was (and am) an awful person. I couldn’t stop apologising.

Eventually I left, apologising as I went and promising to email her and contact my care coordinator. I decided to text my friend. She was the only one I wanted. I explained to some extent what had happened and she was concerned about me. Immediately guilt started to escalate again. But I kept talking (still apologising). She kept me calm. She was great. I’m so grateful for her. I’m so grateful for the facilitator too.

When I got home I got into trouble for being home late. It started as soon as I walked in. Immediately all the negative emotions started to rise again. I tried to explain I had a melt down and the questions started. They were things I found difficult to discuss but they wouldn’t leave it alone. Even when out walking with mum she brought it up and told me I just need to get over it. Maybe she is right but it added to how bad I’m feeling. Shame came forward again.

Since then things have been hard. My mind has been going over things. The voice has played its role. I’m trying hard to stay afloat. But its tough. I hate myself.

If you have any suggestions on dealing with shame feel free to share in the comments or on Twitter, Facebook or Instagram.

Picture from Pinterest

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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.

Picture from Pinterest

Self Harm Scar Etiquette

As it’s summer the weather is warmer and people are starting to reveal more of their body. This brings an anxiety to people who have self harmed, past or present, as they are faced with the choice of covering up (and boiling) or revealing their scars and self harm to the world. Therefore I thought I’d come up with some things that will make it easier for the person with the scars or self harm if you encounter them. Obviously this is just my opinion and others may feel differently.

1. Don’t point it out

This seems obvious to some but not to others. Pointing out scars adds to the self consciousness. We’re already worried what people are thinking without it being obvious that they’re looking at the scars. Also if we are starting to forget about them and enjoy what we’re doing then pointing them out takes away from our enjoyment.

2. Don’t ask us why we did it

Again, this adds to self consciousness. We become aware that you’re really looking and thinking about our self harm or scars. It can make us feel awkward and like we’re being judged. Quite often we don’t know why we self harm or don’t want to discuss it as its obviously something that has caused us great pain. We can easily be taken back to that dark place.

3. Don’t tell us to cover up

First of all why should we cover up? This makes me a little annoyed. I’ve been made to feel ashamed of my scars a long time and this shouldn’t be the case. It’s part of an illness. I have every right to not boil in summer. I don’t want to make people uncomfortable but I also shouldn’t have to feel uncomfortable. People who self harm feel enough shame and it takes guts to show your scars, we shouldn’t have that shame added to.

4. Please don’t stare

This can feel awful. I already feel self conscious enough without people staring at me. I had this once on the train and it really fed in to my paranoia. I know it can be hard to look away sometimes but please think of the person you’re staring at.

It takes real bravery to overcome the barriers to have your scars on show. It is revealing yourself to many people, including strangers. It can take a long time to accept your scars are part of you. Shame is a really strong emotion that people who self harm feel and can be added to by other people making ill thought out comments. Please think before you speak.

If you have any other things you feel people should do or not do help you feel comfortable showing scars feel free to share in the comments or on Twitter, Facebook or Instagram.

Picture from Pinterest

Come Outside

If you’re an adult of a certain age in the UK you will remember a programme called Come Outside, which had a lady going on adventures in an aeroplane with her dog Pippin (not an animation, a real woman, plane and dog!). It was prime viewing if you were off school sick. You may be wondering why I bring this up but I’ve realised something lately: being outside is good for my mental health and so I should of taken Auntie Mabel’s advice a long time ago and gone outside.

There are a number of reasons I found going outside difficult. Sometimes even my own back garden felt off limits. My anxiety around being in public places was the worst part. I found going out alone difficult and things got gradually worse until I couldn’t use public transport (my only means of transport at the time) or be alone outside the house apart from attending my medical appointments and even then I needed music to cope. The idea of going for a walk was horrifying. At one point agoraphobia was added to my diagnosis.

The thing is, with some changes that have enabled me to get outside more often, I have realised that being outside actually aids my mental health. I’m very lucky to live in a house with a back garden. Although at times it has been hard to get into it, I’m glad I managed to work through it to get out there. I now hate it when it rains as it doesn’t feel pleasant going into the garden and I can’t sit out there. I’m no gardener but I do find mowing the grass therapeutic. I put my music on and enjoy seeing the finished lawn with its lines (is it even a lawn if it doesn’t have lines?).

So what got me into the garden? The answer: Guinea Pigs. I got myself two Guinea Pigs. And due to my mum’s stance that she wasn’t having them in the house they lived in the garden (in the shed or garage in the winter). This meant I had to go outside every day to them. At first it was really tough. I’m not the greatest with dirt and it was an adjustment to dealing with it every day. But I loved my boys so much that the challenges were fighting through.

The problem was though that they didn’t get me away from home on my own. This was something that got harder and harder. Things went even further back when my Guinea Pigs passed away. Going outside got harder again. Then I started slowly in the summer trying to sit and read out in the garden. This slowly got easier, especially without the dirt aspect and having my cats sit with me helped. But again I wasn’t really leaving home alone apart from attending medical appointments and I had started to go to a group at my local Mind which had been recommended by my psychiatrist. Public transport was a definite no and walking alone was also something I didn’t feel I could do.

The biggest change for me came with another new addition to the family: a puppy. Suddenly I had a little thing that needed me to go out. To begin with it was a case of going out with someone else to walk him, but this was still progress, I was out walking. As he got older I felt more confident taking him out on my own. I didn’t feel alone as he was with me and he’d shown he was protective of me. He made my confidence grow. We also took him to puppy school. Again, to begin with, I couldn’t go on my own. It was hard coping with new people but he was my focus in the classes so that helped.

Now I walk him regularly on my own and enjoy it instead of constantly being anxious. Don’t get me wrong I still get anxious at times going out with him. Also in puppy school I now take him inside alone (my dad waits outside). I’ve also started doing some voluntary work which involves going into new situations on my own regularly. Without my puppy I couldn’t of done it. Without going outside I couldn’t of done it. Not everything is perfect. I still can’t use public transport or go to busy places alone but I’m making progress.

So what are the benefits of going outside? There are many benefits to mental health as well as physical health. These include:

  • Stress relief
  • Increased concenteation
  • Better short term memory
  • Restored mental energy
  • Sharper thinking and creativity

Getting outside makes me feel more able to deal with things and to even escape my thoughts for a while.

So even if it’s just sitting outside for 5 minutes or standing in your doorway, getting outside can help. Take slow steps to get there. Don’t over do it. And don’t punish yourself if you can’t do it straight away. For more information on going outside check out these links on the Mind website which detail different aspects on getting outside.

If you have any advice please feel free to use the comments or Twitter, Facebook or Instagram.

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.

Picture is from Pinterest

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.