Call someone who cares

So I called the Crisis Team last night. I didn't know what else to do, I was trying to keep myself safe. Turns out, even though my GP gave me the number, I'm actually not entitled to call them. It's not a self- or GP-referral service and because I'm not under the care of the CMHT (see many other frustrated posts) I'm not entitled to crisis support.

Another frustrating week

I've been incommunicado for a while; my course takes up a lot of time and my poor attention span means that I spend longer on my work than most for less achievement. My exams are coming up in 2 weeks and I'm dreading them.

People have been moving out of my college bit by bit as their courses finished, so now I'm pretty much on my own. The few people I felt close too have gone and it's really quiet; no chance to see people at meal times or 4 o'clock afternoon tea. It is perhaps inevitable that I've been feeling a lot lower than I would consider normal lately (my GP certainly thinks so), but even so things have been pretty bad. I don't want to go into details about how but I've been finding more dangerous ways to self-harm and been feeling suicidal.

So my GP wrote to the CMHT asking for me to see a psychiatrist before Monday (so she told me), but I ended up seeing a social worker and a CPN. Both of them were perfectly nice, but since I'm moving in two weeks there's nothing they can do. I assume that's why my GP wanted me to see a psychiatrist; she was asking for an assessment not a meeting.

sigh


I do sound hideously ungrateful sometimes, I know I do. But I have support from a university psychologist (officially to keep me on track with my studies but actually he more-or-less fills the same role my social worker did in London) so I don't want or need to see a CPN / social worker regularly at the moment. If I'd known that was what the appointment was, I wouldn't have wasted their time. I actually cancelled a standing appointment at uni for it, because I promised my GP I would attend the appointment if they offered one.

All anyone can say to me at the moment is, "Call the crisis team". Whilst that might sound simple enough, it creates huge tension. My last interaction with a crisis team (back in Dec/Jan) was very much a failure and besides I'm not good on the phone. I'm too nervous to call them. I don't have anyone here I can call to just spend time with.

I guess that's my problem, not theirs.

I've been feeling suicidal today. I feel like this every now and again and I want to try and articulate it whilst I'm feeling it because after the event I very rarely can.

It sweeps over me every now and again in the way a physical pain can come on. The smallest thing can spark it, and it's usually something relating to one of my friends or family. Usually, some kind of let down. I don't explain to people how bad these things make me feel, because my reaction is disproportionate. I know that. I'm coming down from the worst of the feelings now so I can see that what happened this morning shouldn't have brought me as low as it did. But that isn't the point.

All that happened was that someone who I have considered to be one of my closest friends decided not to come to my birthday party and I think her excuse was a little lame. So I got pretty angry and (I do regret this) told her that things have gotten pretty bad lately. We had a bit of a row, and as far as I'm concerned I'm not going to get close enough to her for this to happen again. This is probably the end of a good, supportive, fun friendship and that hurts.

As it happens, I think I'm very lucky that this all took place on the way to a lecture. For the next 3 hours there was nothing I could do but think about theology and I was able to focus enough that when I got back to my room (15 minutes ago) I felt better. Not ok, but better.

There's always a cycle to my emotions in this situation. When it happened today it went like this:

• I felt terrible. Sick to my stomach and my chest contracted so it felt like I couldn't breathe. All I could do was cry. I honestly couldn't think of a good enough reason not to kill myself and I started to make a plan. 
• I got distracted by arriving at my lecture, and went in on autopilot.
• By the time I got my own space back after the lecture, I had calmed down but, as I often do in these situations, I don't feel good I just feel nothing.

So that's how I am at the moment.  I don't feel ok, exactly, but I couldn't honestly describe what I'm feeling as bad either. I can dispassionately consider my reaction this morning as an overreaction but I don't regret it. I still feel inclined to follow through on my plan but I can't find the energy necessary.

If things go as they ordinarily do, this will go one of two ways. Either:

1. I will gradually begin to feel better, particularly if I find someone to spend time with or talk to.

2. Something will happen to knock me back down and either the cycle will start again or I'll end it by trying to kill myself.

Here's what spooks me when I'm feeling rational and calm. I can't honestly say that I would go to hospital if I attempted suicide here. I'm in a city that I still don't know well. I don't know where the hospital is, much less how to get there. And I'm far too anxious about calling people or causing a fuss to either call an ambulance or ask someone to go with me. 

Another day, another appointment

I had hoped that I might have something of an ally in my GP. The person I saw last term has moved on, unfortunately, so I was starting with someone new today. All I was intending to do was update them (en bref) on how things were over the holidays. I didn't really need anything, particular, I was just following orders to keep them updated. However, I got a lecture on managing expectations and how difficult it is for doctors to treat people with mental health difficulties.

I had previously had an agreement that I would check in with a GP at least once a fortnight, but the doctor I saw today seemed to think that my being there about an ongoing problem was a waste of his time. He didn't say so, but he also didn't make any effort to check on my progress. He didn't ask why I was seeing the crisis team, or whether I feel any better now.

When you've had mental health difficulties for a long time, going to the doctor is a bit like checking in for a flight if you fly regularly. There are security questions as a formality that are asked to make sure you're safe;

"Do you feel suicidal today?"
(If so, "Do you have a plan?" or "Do you have access to what you would need to harm yourself in that way?")
"Have you been self-harming recently?"
(If so, "Do the wounds need medical attention?")

The absence of these questions, not to mention not telling me to come back if I need  to, just makes me think that they've had enough of me. Maybe it's easier to just withdraw from the system for now. But if I do that, and then something happens and I end up seeking urgent treatment later on, I know I'll be told off for not seeking help sooner.

I just don't know what to do any more. The services that are supposed to help are almost a hindrance, what's a crazy girl to do?!

One Month Before Heartbreak

I became aware of this blog today. In one month the government's consultation on DLA (disability living allowance) is due to end. Many people have contributed stories about how their DLA has made their lives liveable, in some way. This is mine. It's not as dramatic as some people's, I don't receive very much in the great scheme of things, but this small amount keeps me safe.

I have a mental health condition diagnosed as Borderline Personality Disorder. The diagnosis is largely irrelevant; it is characterised by anxiety and depression and I have suffered from those as long as I can remember. Day-to-day, the following things cause me problems:

• I self-harm when I am left alone, in a variety of ways,
• Emotional fatigue causes me to have difficulty concentrating for long periods of time,
• Anxiety sometimes prevents me from leaving the house on time (or at all), and sometimes I need to get the bus for a short distance to compensate for time or get off a busy street,
• I forget to eat, my lack of concentration and low motivation means that I can't cook for myself unsupervised,
• I forget to take my medication, or take it without food so that it makes me ill,
• I don't sleep well; right now I haven't had more than two nights uninterrupted sleep (5 hours or more) in a single week since I started monitoring it in July.

In practice, this means that whilst I am studying (which I am now) I have to live in College and my food is provided usually by the in-house catering. If I can't eat in (if I forget to sign in for meals) I have to buy microwave meals (if I can leave the house to go shopping) or go without. I am lucky that living in College I have a timetable that I can follow and the routine helps me to remember things like eating and taking my medication. If it weren't for my DLA I wouldn't be able to afford this. 

I also need to buy a lot of first-aid kit for self-care. My DLA pays for what I need over-the-counter and allows me to pre-pay for my prescriptions so that I can afford what I need on the NHS. DLA does not entitle anyone to free prescriptions so the rate I receive has to cover my medication. 

When I leave university, I will continue to need this money to pay  for food, and I will need to employ someone to check in on me and make sure I am eating and taking my medication. If - as I anticipate - I start intensive psychological therapies in the months after I leave university, I will also need this small income to supplement my wages as this will compromise my working hours and limit the type of work I can do.

All of that on less than £50 per week.

In a nutshell, my DLA keeps me productive. It kept me in work when I had a crisis in the middle of 2010, saving the government a lot of money in Statutory Sick Pay / Incapacity Benefit / Housing Benefit / etc., and it will enable me to go back to work when my course is over. As someone with a 'hidden' disability, unrelated to mobility, I would probably be one of the 20% who are suddenly ineligible for DLA and if that happens, I honestly don't know what I'll do.

Is this the worst PCT in England?

So, I confirmed my appointment on the 20th January at the complex needs service within the deadline. I spoke to a real person, not voicemail this time, and he said he'd let my contact know. I did ask at the time if it could be brought forward, or if there was any indication that the crisis team from y had made the call they promised to make(!), but apparently it can't and there isn't. Quelle surprise.

Then I got a message on my voicemail at 5pm yesterday saying that I haven't confirmed my appointment, but not to worry because it has to be moved to the 10th February anyway. I tried to call back to say that I had confirmed and although I can make the 10th February I am concerned that's a long way off, but the office closes at 5 so had to leave a voicemail.

Phoned back today to confirm that the message I left yesterday was actually picked up, and apparently it was but I got a bit of an earful for asking if I could see anyone any sooner than the 10th Feb. Never mind.

So I was getting a bit pissed off at everything that's happened with services in both x and y, and started mumbling about the worst PCT in England. It's probably unfair, but I feel that they've been truly dismal. Nothing they've offered has been followed through on, most appointments have been cut short for one reason or another, and when I try to ask for any support at all I'm dismissed and patronised. I left a PCT with the best reputation in London for this. Maybe everyone's right after all, and I shouldn't have bothered trying to move on.

Then, in a truly weird turn of events, I found a voicemail on my phone after an exam today saying that "Doctor [inaudible]'s secretary from [inaudible] got the message from [my local surgery] and will send me an appointment." So I have no idea who they are or what it's for but maybe this represents progress? Or maybe I'm being called in for the obligatory smear test in honour of my twenty-fifth birthday...

Something that makes me really angry

...is when people broadcast deeply personal things on Facebook for sympathy.

Someone, yesterday, put in his Facebook status that he had to go back to the doctor because his depression is "so bad". Another friend of mine broadcasts her anxiety disorder. I don't understand it, I really don't. If I posted "Iris is contemplating suicide ... again", what on earth would I expect people to say? What can you possibly gain by all that? If you need to talk to someone, by all means, do so. Talk to me, if you like. But don't just indiscriminately broadcast your emotions, in the long run that will alienate the people you rely on.