New Year's Eve

Today's appointment with the crisis team wasn't so bad. I've agreed not to see them any more (I don't think the stress / constant let-down was particularly helpful, after all), and they've said they'll get in touch with the complex needs team in x to get them to move my next appointment forward (have just had a letter offering me one on the 20th January).

And it's New Year's Eve so I'm going in to London to see some friends and have a thoroughly civilised meal and drink. I was let down by the person who was meant to be putting me up overnight but after a ring around I've managed to procure a sofa elsewhere at the last minute so now I can try to relax. Girlie can't be with us because she has to work overnight but it will be nice to see everyone before I go back to uni in a couple of weeks.

A bit of a let-down (again)

So, I have had another interesting morning with my local Crisis Team.

I eventually phoned them (under parental duress relating to Dad's general stress about leaving on time) at 10:45. I was rewarded by a lecture from a nurse about the fact that, "we had 22 people to phone this morning so you can't really expect us to phone at exactly 9". I did try to explain that ordinarily I wouldn't mind but I was specifically told to expect a phone call before 10 for a good reason. Anyway, apparently the nurse I saw was all talk. There was no note that the team psychiatrist should see me, nor one suggesting that anyone make an appointment with me or call in the near future at all.

Once she had calmed down, the nurse on the phone was very nice and arranged an appointment for me on Friday at 11 so that I don't have to hang around waiting for any more phone calls. She acknowledged (without me having to say so) that I have obviously been badly let down by the team as a whole and apologised.

So I'm pretty angry about the whole thing and beginning to wonder if continued contact with this team is making my day-to-day low moods worse than they would be if I'd never seen a doctor last week.

We're in the car on the way to the funeral, so I can't do anything more until Friday. Have to look after the family now.

Another appointment

Not sure that appointment went very well. The nurse I saw didn't seem to want to be there and the whole thing only took twenty minutes. He didn't ask if I'm still suicidal (I am) or if I have any plans (I do) but did say that he thinks I should see the team psychiatrist. Apparently she isn't in until Wednesday. I have to go to the other side of the country on Wednesday afternoon for a funeral on Thursday morning but this time I managed to arrange a concrete time. Someone will phone between 9 and 10 and try to see me before midday.

Progress.

Just got a call

The Crisis Team just phoned to tell me that they're worried about me, because I didn't call. I'd never agreed to call, that wasn't the arrangement. I waited for them to call on Christmas Eve., as arranged, and they didn't. Then I waited for them to call on Christmas Day, as arranged, and they didn't. Then I waited for them to call and give me an appointment on Boxing Day, as arranged, and they didn't. So I was a little surprised that I am suddenly told I've worried them by not phoning.

I'm going down later today. Clean start, and all that. I would have said no except that, if anything, I'm feeling a whole lot worse than I was even on the 22nd so I think I need the support.

Just leaving for midnight mass

...and the Crisis Team didn't phone. I don't doubt that it's silly to feel hurt and let down but that's exactly what I feel right now. That and still suicidal, but I'm making my own way around dealing with that by sticking to my original plan to be with people (especially my lovely Girlie) so I can't act anything out.

Up and down like a yo-yo

Today was pretty bad.

So I go to university in town x but I have to spend my holiday at my parents' house in town y. This is not especially unusual for undergraduates (rarer, admittedly for postgraduates) so I would have thought it would be easy enough to understand. I also thought I was pretty lucky because, although they're in different counties and not connected by public transport, x and y are in the same Primary Care Trust (National Health Service local authority). Apparently this doesn't make a difference.

When I phoned them at 11 (under some duress, my mum had to make me do it, I hate feeling like I'm making a fuss) the Crisis Team y had no idea that the psychiatrist from A&E had tried to refer me, and claimed they had no record of a phone call at 8 the night before. Despite that, they agreed to see me at midday so I made my way down there.

After a half hour conversation with two of the nurses, which mostly consisted of telling me off for leaving an area where I had had consistent local health support in order to get on with my life and education rather than remaining in a job I hated for the sake of a thread of support (casting no aspersions on my care co-ordinator, who was brilliant). I just can't do that. I have to go on with my life. One of the nurses also told me that I shouldn't worry about the fact I had a bad time at my first appointment with the complex needs team in x, because "if someone in a shop was rude, you'd still go back". Firstly, that is an appalling analogy. Secondly, no I wouldn't. I have an anxiety disorder and a crippling fear of being disliked. If someone is rude to me, I assume they don't like me and I avoid them at all costs.

I also got a bit annoyed that I was more or less told off for being "emotional", because "that's how you presented to your GP in October". I don't understand why that's not ok? I'm emotional because that's how I am at the moment. I'm a wreck. I don't really leave my room unless it's to go into London because I feel safer there.

Anyway, the rest of the day was spent up-and-down with the Crisis Team. When I left, I had an agreement that we would talk by phone tomorrow and Christmas Day and I'll see them on Boxing Day. The two nurses I saw both agreed that if I feel safer away from home it's not worth changing my plans to be at church on Christmas Eve and Day.

About 20 mins after I'd left, maybe less, when I was with Mum in the supermarket, I had a phone call saying that if they're going to keep me on I need to register as a temporary resident at my parents' surgery so I agreed to that.

I phoned back an hour or so later, just to confirm that I had registered and that seemed to be ok, but almost as soon as I had hung up I got another phone call to say that they won't be able to see me after all, but I can go to my GP if I take another overdose and then maybe they'll see me now I'm on their books.

So that was pretty shit and my parents decided to get involved. I wasn't particularly keen, but couldn't stop them from getting the number and calling so they went ahead and did so. After about 30 minutes of circular argument Dad managed to get them to agree to go back to the original plan, so I'll talk to them by phone over the next two days and see someone on Boxing Day. Don't know when they'll phone but I made it clear when I intend to be travelling, and even offered to go by in the morning if they'd rather see me in person but they said no after all that fuss.

I don't know how much I want to engage with a team of people who don't give a shit but it's only fair to give them a chance, right?

(On the plus side, had to keep an appointment with my parents' surgery in order to maintain the temporary registration, and they were pleasant enough, so if I do have to go back that wouldn't be awful.)

Back in accident and emergency

I was in London today, at the library, and it occurred to me that it would be easier to go to my old GP in Islington than to try and see someone where I'm staying with me parents. So I made a temporary resident appointment and popped in because I'm worried things have been on the decline recently.

I had been worried about seeing anyone at all, and trying to avoid it, but after agonising about it at a friend of mine agreed with her that I would go, and that I would take their advice (after all, if you aren't prepared to take advice you shouldn't ask for it...), but the advice was to go straight to A&E at UCH and ask for the duty psychiatrist.

I've managed to never go to A&E on my own before, so I was pretty nervy but there was no one around. In the end I did go and managed to explain to the receptionist what I needed. Triage was pretty easy. 4pm on the Tuesday before Christmas turns out not to be the busiest time to show up in hospital, thankfully.

The duty psychiatrist saw me at about 5 and she was really nice, worked really hard to understand what was going on, where I'm living when and why, etc. She wanted to admit me at first, but I wasn't keen so she said if she could find my local crisis team (UCH isn't in my local PCT) and get them to agree to see me, then I could go.

So, after a two-hour discussion with her and an hour waiting for her to arrange everything with my local Crisis Team, I'm finally home and under orders to phone the local crisis team if I hadn't heard anything by ten. For some reason I'm nervous. It's not like I've not done this before but I'm nervous. I'm relieved I didn't have to be admitted and surprised that I was taken so seriously. After all, I showed up without having done any major harm to myself. Last time I was at UCH I had taken a fairly large overdose (or two, one in the evening and one in the morning) and all I got from the duty psychiatrist was the following interview:
"Do you feel safe at home?"
"Not really."
"Are you alone a lot?"
"Yes."
"Are you likely to try again if we let you go?"
"Well, I don't feel any better, so I might."
"OK, well I can't see any reason to keep you here...."

So I suppose today was a positive experience, as much as these things ever can be.

Driving home for Christmas

So I'm home. Boxes all upstairs if not unpacked, said goodbye to those brave souls around this morning after a heavy night at the Christmas party, and I'm back.

But I'm not looking forward to a six-week break. Everyone seems to think I'll be safe here, because it's home, but I feel less safe than I have done for ages. For me, it's just a really hard atmosphere to be in. My parents fight a lot and my dad thinks that yelling and swearing is the only way to get anyone to do anything for you. Subsequently, I spend most of my time at home in my room on my own trying to hide away. 

Added to which, I don't have any friends here. My friends are in London or at uni. There are people here I know from school, but although they know I'm here they don't invite me out or anything (just like when we were at school) so I feel very isolated. 

So, along with all my support systems being in place in the town I'm at university in, it's all pretty isolating. 

Not a good appointment

Since I've been at university, my GP and my former care co-ordinator have both been trying to get me some contact with the local CMHT (Community Mental Health Team) to set up an appointment with a care co-ordinator there. This is currently not happening and no amount of suggesting it might be important (as I am currently without care) is making it happen.

Instead, I have been referred to the laughingly euphemistic "Complex Needs" service. I accepted and confirmed the appointment as instructed (left a voicemail that wasn't returned and also sent an email). I was really impressed with the appointment letter they sent me, which contained detailed directions through the health service complex to the right building and an outline of how to gain admission.

Sadly, the reality was somewhat different. It was snowing over most of England today, and the south was badly hit. I arrived for my 2:30 appointment in the middle of a snow storm, and reception was closed. A helpful note on the door suggested I ring the buzzer for my appointment. I did, and no one answered, but I was 10 minutes early so I waited.

At 2:30, I rang the buzzer again. Again, it rang inside the building but wasn't answered. Gave it a few minutes, tried again. And a third time. Then a nice person from the next door building stuck their head out and said they'd tried to phone the complex needs team but no one was answering. Now, I know from experience that appearing not to show up for an appointment (for whatever reason) pushes you right back down the pile and mental health waiting lists are unpredictable things. So I waited some more. At 2:55, just as I was about to give up, a member of staff walked out of the building. I explained the situation, and she let me in and found a colleague of hers to help. He then found the woman I was due to see and she came to find me.

It didn't get much better from there. Firstly, she kept calling me Rachel (which is not even close to being my name), and then she told me that she did call reception but because no one answered the phone she assumed I hadn't shown up. Not especially logical, but she wasn't to know I was stranded outside.

The appointment itself then didn't go too well. I had filled in a detailed questionnaire, which she mis-read and barely gave me a right of reply. She ended up concluding the following:
1) I haven't self harmed since I arrived at university
I self-harm daily, often more than once in a day
2) It is easy to get to my university town, x, from my home town, y
I don't drive and there is no public transport between the two.
3) Despite that, I shouldn't bother coming back for appointments during the six-week vacation...
????
4)...because I am safe at home
I feel least safe at home


So, although I tried to interject and explain where her assumptions were wrong, I failed. So that was perhaps the worst appointment I've been to since the Austrian psychiatrist who told me (aged 17) that I'm gay because I don't feel attractive enough to be straight....

The perils of black tie

It's probably become obvious that I struggle with looking the way that I do. In the past this has come out as serious bulimic episodes (the longest of which lasted seven years, does that still count as an 'episode')?

The state of play at the moment is that I am trying to deal with things as best I can. That means self-harm to stave off the worst, but it also means that with the black tie affair coming up at the end of term I have the usual chaos trying to find a dress - any dress - that will suit the purpose.

So that means, first challenge, it has to be up to a 38E bust. On the high street, that's a tall order (normally I find myself around a size 14 waist, 18-22 top, and most designers don't accommodate me). Then, I need long sleeves. And there are some pretty dresses around with sleeves, but they're almost all 3/4 length (i.e., not long enough) and the same goes for the boleros and shrugs around. Anyone would think it wasn't round about freezing point outside!

For the first time in years, I have managed to find a dress that fits the bill thanks to the wonders of Bravissimo. I first discovered their dresses last year and I love the fact that they make me feel, not slim, but at least somewhere smaller than Dumbo.

So here is a two-fold bid to the clothing industry (which I expect to have zero impact):
1) Could you consider accommodating different bust sizes?
2) Please, please, make long-sleeved tops that aren't plain or frumpy.

This is the idea, for reference:

Bravissimo - lifesavers

Some struggles

I perhaps over-use the word 'struggle' but most of the time that's how it feels. An up-hill-struggle from the moment I get out of bed in the morning. I do manage to do that - I make it to prayer nine out of ten weekdays at 7:30 - and I work my hardest to seem functional. As far as I know, none of the other students have any idea what goes on in my head, and although I haven't managed to control the self-harm in any meaningful way, I have hidden it from them.

The only problem has been the cleaning staff coming into my room. I suppose I didn't expect them to take any notice of my rubbish or whatever, but I must have done something to make it obvious because they took it to my tutor, who came to me.

I'm still reeling, feel like a teenager. It's been years since someone came to me and asked. And I feel terrible about it, but I think it keeps me safe in a funny sort of way and I need that right now.

Change of scene

Student at my university in academic dress (from Wikimedia)

I've moved from London to start a course at one of England's ancient universities. It's quite a change for me from being at one of the largest colleges of the University of London for several years. My college is really small, I think I have met all the students studying here over the last week, which is quite nice. Everyone seems to have a certain pride in the college as well as the university, and that is contagious.

One of the really interesting things for me is that the day is structured around a program of daily prayer and worship. If I want to, I can get up at 6:30 for meditation at 7, followed by Morning Prayer and Mass. I do have a faith, although it is pushed to the limit sometimes by the things that go on in my mind, and I am hoping that this structure will help me keep on top of things. It should help me to focus my mind on what really matters, as well as getting me up in the morning.

Having said that, I made the mistake of going to Mass this morning even though I wasn't feeling very well, and felt like a bit of an idiot because I sobbed my way through most of the service. It's somehow OK to do that at my home church, but I was very self-conscious today. Aside from the new environment and new people - none of whom know about the state of my mental health - the pews are arranged facing across the nave so that you feel like you're on display.

So there are some challenges coming up. As well as the course, I have to try to stay well enough to stay here and complete. The course is entirely assessed by exams, and I am a terrible exam candidate, so I have two terms to get over my nerves in that department, too. Then there is the fact that I am under a new PCT*, who can't offer me the care I had in London. After the struggle I had to go to just to see someone at my local mental health team regularly, it feels like it's going to be quite hard work for a bit. Whether I stay well enough to complete is, therefore, still anyone's guess. Wish me luck!

*Primary Care Trust, the regional NHS

Dreading going to work

I haven't dreaded work ever before; it's a new thing for me. I used to dread going to school so I remember the feelings. I used to get so worked up that mum would assume I was ill and keep me home, which at least kept it at bay for a couple of days. But I can't phone in sick today, I've been in a new job (at the same workplace) for less than a week. I can't afford to lose face.

But the truth is I'm not enjoying it any more. My role is to keep the displays neat, but there's so much time between my shifts (I only work 6 hours a day, not always when we're open, and the shop is open for 10.5 hours) that it's always a mess by the time I get back. I know I'm not the only one feeling the pressure but I get a lot of the heat from the shop manager, who expects me to have instant knowledge of the new department and new role and I'm finding it too hard. Not to mention that I'm working with people I hardly know. One of my new colleagues, in particular, is very difficult. She frequently follows me around (when the shop manager is having a go at someone else for once) and tells me the displays look "shit" or rebuilds something I spent hours on just as soon as my back is turned. Already I've spent more time than I should crying in the back room, I can't go on like this.

Trying to hold off the feelings

It's probably not the case, but it feels like my mood swings are getting worse. And they seem so much less justified than even a few days ago. I'm so confused. I'm losing some of my hours at work; I know that. I don't know how many yet and I don't know how I'll survive the pay cut. But then I got accepted to a good university for a good postgraduate course (which I'm not sure how to fund) and I'm trying to make that mean I have something to live for.

But the truth is that none of that matters when the aching starts. When there's that horrible empty pressure in my throat and my chest. When I end up sat at home writing lists of what I want people to know, to do, to have, if I don't get through it this time. Because it doesn't feel like I'm in control here. I try to be. I try so very hard to be. But I don't know how to beat it except by playing along. Lucid Iris, conscious Iris, smart Iris wants to see her friends again. But then there's this 'other me' that gets overpowering. And it gets to the point where I start to think that, actually, it's not like they don't have other friends. My Girl would find another girlfriend, The Boy has all his university friends and my family don't need this shit anyway. And what's the point of a place at university if I can't fund it?

And that's how the compromises start. How I end up taking risks or making plans. I tell myself I'll stave it off but 'just in case', I'll write a note or itemise my possessions. Or maybe I'll get as far as counting out my tri-cyclics, painkillers and other medications. Maybe I'll 'just' calculate the dosage of this or that I would need for my body weight. Maybe I'll 'just' try to strangle myself, or cut slightly closer to a visible blood vessel this time.

Maybe one day I'll go too far. That scares me, and right now I'm glad it does.

Here's 10p, call someone who cares...

Sometimes that's how it feels when people ask if you're ok and then say, "Oh. Well, you'll be ok. I guess if it gets too much you can call someone." You can just hear the unspoken end of the sentence "...else."

And what is all that, "if you feel suicidal, you can call the crisis team or go to A&E or whatever..." Yes, because showing up at A&E and telling them that you sort of maybe thought about taking an overdose and feel quite constantly like I want to die. Especially when I was ok last week. I'd either be laughed out of the place or committed. I don't know which scares me more.

How to lose friends and alienate people

The person in the world I feel closest to, other than Girlie, is The Boy. He's my best friend, and he's been so constant, such a support, and I'm going to lose him.

I've felt it for a while, but today it's been so clear. He can't keep having to pick me up when I crumble. And I crumble so easily ever since The A&E Incident. Today, he clearly didn't want to talk to me.

Then, I felt better after an appointment with the crisis team, so I worked really hard to get dressed up so I wouldn't disappoint by not showing up to some drinks he'd organised. But after I spent an hour psyching myself up to get out and putting my face and my clothes on but he didn't tell me where they were. I forced myself out to meet other people, after an hour of not getting hold of him, I had a panic attack half way to the bus stop...

So here I am. Friday night on my own. All dressed up, somewhere to go, and no way to get there.

I really hope I don't lose him.

Tonight I wrote my suicide note

Sort of. More of a post-suicide note. Not an explanation, more a 'just in case'. After last time, when I was so impulsive that the thought of a note just didn't occus, I want to leave something.

It's like a codicil, and an auto-eulogy. That is, the things I wish I could say and ask people to remember, as well as my favourite hymns, poems and Bible verses. It's so weird to see your life through your possessions, and although I'm an obsessive hoarder it seems I don't have enough things to give everyone something pertinent. But whatever happens, I hope it would all be used wisely. I just want Li'l Sis, Girlie, The Ex and The Boy to have the things that matter to me, as well as Mum and Dad.

I would miss everyone, of course, but right now it feels like my time here is coming to an end. It feels like time to say goodbye and tie up my loose ends.

Another day, another psychiatrist

One of the reasons that the people at UCH let me go on Saturday morning was that I had a long-standing appointment with a psychiatrist in Islington today. She was good, but seemed to be a little surprised that I only saw a psychiatric nurse and had no contact with a crisis team.

So, within two hours of being at work I had messages from the local crisis team and my GP arranging appointments. I guess it's a good thing but it looks like I'll be spending tomorrow with the crisis team and Thursday with my GP and I don't actually know how I'll square it with work...

A&E, AAU, DSH and other acronyms

So, last night I had a bit of a crisis. At about 9, I started taking paracetamol tablets. My housemate came home at about 9.15, so I couldn't carry on. I began to get scared, so I stuttered out what had happened and ended up going to our local hospital's A&E unit (Accident and Emergency; ER if you're American). I was seen by a triage nurse at 10:15pm, about 15 minutes after arriving. Triage didn't take long, and the nurse was actually lovely. She went through my medications, was pleased that I'd brought the boxes of paracetamol products I'd been taking, recorded doses, looked at my most recent cuts, etc. Exactly what I would have expected, and really quick. It was really reassuring that she wasn't difficult or judgemental, that would have hurt too much.

After about 3 hours of sitting in a very bright corridor, at about 1:30am (i.e. early this morning), a psych nurse came to speak to me. She asked me all the usual questions; what did I take? how much? how did I feel now? was I upset that I was interrupted, or relieved?, &c. I'll admit that I was less than honest about my motivations; I thought that if I said, "I sat down and calculated what out to be a dangerous dosage and had taken 75% of what I intended; I wasn't annoyed at being interrupted, just startled back to reality," that might well get me a one-way ticket to the psychiatric ward. Besides which, she didn't tell me who she was until we'd gone into the consulting room, so my housemate was in the room.

After all the blood tests, at about 2am, I got taken (by The Most Patronising Nurse in the World, and in a wheelchair of all things) to the AAU (Acute Admissions Unit? not sure), where I proceeded to lie awake until 6am, being occasionally prodded by doctors and asked to repeat until I felt 2 inches high.

I was eventually, after breakfast, allowed to leave. It took a few hours to get my discharge papers and I've just got home.

Fail

So I thought the Plan for today would be enhanced by cutting myself, eating lots of chocolate and having several shots of vodka before work. Apparently not.

Epic fail. I felt sick, silly and fat at work. I have a cut that won't close (actually, I have 2, one on each arm) and that keep getting crap stuck in them and need constant cleaning. And I'm still not ok.

Sometimes I wonder...

Is it still worth fighting?

I got a referral for psychoanalytic psychotherapy through today and it pushed me back into a Black Dog day. I didn't exactly have a bad experience with psychoanalytic psychotherapy in the past, but I did invest four years in it and don't feel like the output's been worth it. After three hours a week for three and a half years, huge disruption to my education (possibly contributing to the fact I didn't get the result I wanted), I don't really feel like I've moved on. It's been eighteen months since my sessions ended and I'm back at square one.

Peaks and troughs

Peaks and troughs are normal; a regular feature of life for anyone suffering from a chronic illness. They are not unique to me, don't mark me out as special, as 'more' or 'less' ill than anyone else. But they hurt. Funnily enough, both the peaks and troughs hurt.

When I'm at a peak, I feel unstable. Maybe because I anticipate the trough? I honestly don't know. But I feel as though I don't deserve it. When I am happy, I wonder what I did to deserve to be. I very rarely get through one of these peaks without guilt. And it's the guilt that leads inevitably to a deep trough.

The troughs are different. There is still guilt. Intense, crushing guilt. The guilt this time is centred on knowing that I don't deserve to feel so bad. I'm not that ill, I know that. It's not that bad for me. But that doesn't stop the pain. It doesn't stop the crushing pain, or the dull ache in my chest. The one that makes me feel suicidal. Makes me cut my arms, collect pain killers, wonder how much vodka it would realistically take...

The funny thing is, I never go through with it. I haven't seriously attempted to kill myself since I was 22, but it still hurts. It's like an obsession, the same every time. You just think about it constantly, and one day you feel like you're not scared any more. Like you might as well try, because the worst that can happen is that you die, and it's no more unknown and scary than the reality of continuing alone in a world that doesn't want you.

Who supports the supporter?

I'm really struggling now. I have been for ages but it hurts today. That sickening, crushing pain under your rib cage; the one that gets behind your eyes so that you want to cry. I haven't got out of bed all day, or even got dressed, although I've managed to eat a bowl of Frosties and a pack of Penguin biscuits.

It's this awful despairing feeling that I can never describe. I know it's 'Depression', everyone tells me that, but I hate how all-consuming it is.

I haven't been sick or cut myself for a while but the urge is very much there. I found myself wondering about gong to get a few packets of pills from my local high street earlier 'just in case'.

I don't know what to do. I don't know why I think writing it here will help. It hasn't, really, but I don't have anyone to talk to. My friends are struggling enough without me adding to it.

Looking the way I do

I don't think I'll ever get used to looking how I do. To being a bit flabby, and to my multicoloured stripy arms. I'll never get used to being shouted at in the street for being overweight. I'll never get used to the way people stare when I wear a t-shirt. I don't think I'll ever learn how to answer the questions.

And yet, I can't stop doing the very things that make me overweight and that caused the scars. I'm trying very hard to stop and haven't done it for a while but that doesn't mean I don't want to...