The snappy biting black dog

Last night, I realised something. That in itself isn’t special – I realise a lot of things at night – but I finally understood why I’ve been so reluctant to update this, and it’s a reason which makes me angry. Angry, because I allowed myself to feel scared and worried. Angry because I lost the trust I spent years building – the trust which eventually led me to feeling able to write everything down in a blog. The trust which said, ‘I don’t care what people think’.

It turns out I did care, more than I could have known. It’s not lack of time or energy, it’s not a lack of something to write about. It’s simply… I still feel broken in ways by somebody sharing this blog when they know I write anonymously. When they surely knew that the subject matter was incredibly personal and if I’d wanted it shared I’d have done it myself. Every time I have sat down with the intention to write, I find myself becoming paranoid and shutting my laptop down.

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It all comes back to paranoia. Part of me wants to shake that person; scream in their face. However, I know it’s pointless because the damage has been done and they will never, ever understand how I think and feel, and clearly have no desire to. Personally, I would never share anybody’s mental health tale, but is that just me? Has social media made it so that everyone has a right to poke and pry? I always knew there was a chance somebody would find this blog but I assumed it would be a family member or friend; somebody I knew well, who already knew about my past and would understand at least some of how I communicate and respect that. I never suspected it’d be a virtual stranger who barely knows me, somebody who shouldn’t even have an interest in what I’m doing or saying. It feels horrible; every time I sit down to type there’s a squirmy black worm wrapping itself around my words and reminding me that I’ll never be safe. Since safety is what I’ve always craved and fought for… it’s difficult. I want to ignore it because it’s none of their business what I say, but my brain just doesn’t want to accept that.

I had almost forgotten. I decided to let this blog and the hours of work and difficult words go, and move on. However, maybe I don’t want to move on. Maybe this has always helped me, and I should be doing what’s best for myself regardless of fear.

ImagePart of my need to write regardless is down to an utterly wonderful woman – M – who has been my therapist for a while now. Last week we had our last session and a relapse prevention, and part of the prevention comes down to not letting things build up and explode in panic and irrational behaviour and my way of doing that has always been to put my feelings into words. M has been encouraging me to bring back helpful things into my life and discard the useless; to believe that I’m capable of doing so. When I was first referred, things were… difficult. I had developed full-blown agoraphobia. My flat had become my prison and I only went outside to attend hospital and GP appointments. Stepping out of the front door was the most terrifying thing I could possibly do, and it’s not that I didn’t try; I did, over and over, but just didn’t seem to have the ability. Agoraphobia is a frustrating condition, because there’s absolutely no logic to it. Logically, I knew nothing bad would happen. Logically, I knew that having fellow humans see me wasn’t the end of the world. I like logic and despise anything which is entirely illogical, and so I grew to despise myself and my inability to do normal things like buy a pint of milk. M helped me see that I was reacting to an impossible situation – physically I had been forced indoors by the arthritis, and that gave my brain plenty of time to create fear which didn’t actually exist, so when I became more mobile I found myself stuck between wanting to live a normal-ish life and wanting to hide from everything which seemed so horribly unbearable. It’s a silly thing, really. The world isn’t that scary. My street certainly isn’t. Yet for the longest time I couldn’t even look out of a window without feeling sick at the thought of stepping outside.

I’ve had agoraphobia in the past, but never at this level. I always managed to cope somehow before, putting my mental blinkers on and just barrelling through life as best I can. This time… this time, I found myself leaning against the front door after S had left for work, banging my head against the glass and wanting more than anything to be able to follow him into the world, yet totally unable to. Opening the door was like throwing myself off a high cliff; my body and mind simply said ‘nope’ and shut down.

ImageSlowly, over time, things have improved. I can now go outside alone, although walking to the shop down the road is still difficult and I’ll make excuses not to. I haven’t been near public transport since last Summer. One of the main goals I currently have is to get on a bus; such a simple thing, yet I still don’t feel brave enough. M has helped me understand why I find it so difficult, but it’s still frustrating. I live close to the railway and could go anywhere if I wanted, but all that seems so far away, so impossible. I spent an hour in the garden today, and that was pushing it.

Even now, as I write this, I’m trying to censor myself despite knowing it shouldn’t matter. After all, what’s the worst that can happen – people know I have a personality disorder? It’s not as though I’ve been murdering anyone, I haven’t done anything wrong. That’s what I keep trying to tell myself, but there is always that split part of me laughing at my paranoia and pushing my buttons. I suspect some people will never understand the concept of true paranoia and unrelenting fear and just how horrible it feels; otherwise they’d leave me be.

Heck. I doubt they’re even reading this. I know that in reality I’ll have been long forgotten. If someone were, would it really matter? What are they going to learn about me – that I have a mental illness? That’s nothing special, plenty of people do.

Still. Just typing ‘I still want to self-harm every day’ scares me. I want to be honest. With myself and with the readers who have been incredibly supportive. I know some of you are still looking in, and I appreciate the comments asking if I’m okay after such a long period of silence.

I owe myself that honesty, it’s just difficult untangling it from the snappy biting black dog.

 

My bed feels larger than when I was small

 

I’m tired of struggling through every day. Of pushing and pulling and forcing myself to at least seem okay. I’m tired of speaking and having the words come out jumbled before they can even leave my mouth. Of sleeping only when beyond exhaustion. Of making excuses. Of seeing the sunrise every single morning, having been awake all night. Of not being able to find a single bit of beauty in it.

Today, I broke all my personal promises and posted my feelings on Facebook. Oh, not the big stuff – that’s for here only – but I went into far more detail than I’ve ever felt comfortable with, and I’m still not comfortable with it now. I only did it because I can’t take unrealistic expectations anymore; I have never, ever been able to cope with being expected to act a certain way and, truthfully, I’m sick of pretending.

I was pulling myself out of it, with the help of antidepressants which have been proven to work for me. I was trying really goddamn hard, and I was almost there. I’d started eating normally again, and having showers. Things seemed to be on the up emotionally, even if they weren’t so great physically.

Then… just one little thing. That’s all it takes.

I don’t even know what that little thing was. All I know is I’m sitting on the sofa after leaving S in bed. I cried all day. I realised I just can’t take this. Everything. The pain. The sickness. The tiredness. Any of it.

 

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I’ve been vomiting again, and the conclusion my mother and I came to is that it’s stress. Truthfully, I accepted this explanation because the idea of facing just one more doctor is too much to bear. I’ve thought about it throughout the day though, and I realise it’s probably true; even on days when I don’t feel like a total emotional wreck, I’m still terrified of what will become of me, and it’s like a ball of pure acid in my stomach to even consider the future.

Can I even see a future for myself?

Not really.

I’m relying on those closest to me – my mother, S, and a couple of people I’ve come to call friends – to keep me afloat, because if left to my own devices I begin to sink almost instantly. I can no longer talk to Z about any of this; it became apparent a while ago that we’re probably never going to be on the same page when it comes to life.

Just like last time, the vomiting has kicked off feelings I’d rather not have; feelings of calorie counting and tape measures. Truthfully I hardly need to worry about such things since eating has become incredibly difficult with the constant nausea and risk of sudden projectile sickness, but something inside decided to worry about it anyway. I’ve lost a lot of weight without even trying over the past few months, and you’d think I’d be ecstatic but instead I almost feel cheated because I didn’t do it myself. So, yet again, I grab for control.

I don’t even believe my own lies about having control anymore. I know nothing I do gives me the slightest safety.

 

These wounds are all self-imposed

I fell apart yesterday. In hindsight, it was coming; there’s only so long I can keep things secret before I blow, and I just couldn’t keep it in anymore. I cried all day. I don’t think I’ve ever cried so much.

I’m not coping. There, I said it. Why has it taken me six months to admit this? I know I’ve admitted that things are hard at the moment, but not how hard – I suppose there’s still the fear someone I know will read this. You know what? Fuck them. This is my outlet, not theirs.

Depression

My Medicated Cartoon Life

I’m horribly, hideously depressed. There aren’t words to describe just how lost I feel, and I’m so worried about admitting this because I don’t want to be seen as an attention seeker. Things have… escalated, very quickly. I’ve stopped eating properly – avoiding food all day then binging at night – and the urge to self-harm over the tiniest thing is incredibly strong.

Yesterday, I had an appointment with a doctor. I’d been vomiting for three days, unable to take any medication and struggling to cope with the combination of disability and needing to run to the bathroom every five minutes. The anxiety was beyond extreme, and I could hardly speak without bursting into terrified tears. As soon as I got to the surgery I started panicking and crying, begging my mum not to leave me (she insisted on coming to my appointment because I was so on edge), and once I saw the doctor I became an absolute wreck. I explained how I hate being on so much medication, how my life had become a pathetic cycle of pills, sleep, and insomnia. It went… okay, I suppose. I have another appointment in a week – I assume to check I haven’t topped myself – and I’ve been taken off the anti-inflammatories because my stomach’s utterly destroyed, and been given a much lower dose of the anti-depressant to stop me withdrawing. Duloxetine simply isn’t working for me, so we’re going to try putting me back on Cipralex next week in the hope it’ll stop the panic, or at least control it a little. It used to work wonderfully, and I was useless without it.

Dylan Moran

It took until 1am for me to finally break down in front of S. I haven’t really spoken to him about my mental health – it’s something I’ve always wanted to keep separate from our relationship – but last night was impossible. I simply couldn’t stop crying. I tried to go to bed early, but just lay sobbing in the dark. Eventually, I wrapped a blanket around myself, walked into the living room, and said, “is it okay if I be an emotional wreck in here with you? I’m not keen on doing it on my own”.

He was amazing. We sat on the sofa, his arm around me and my head on his chest, and I told him everything. Not about the tablet abuse, but I think he knows about that anyway. I told him I couldn’t see a future; not just between us, but no future at all. I was too scared to even try looking forwards because everything fucks up eventually. Truthfully, I’ve given up. There have been times recently where, if someone had offered me a quick and painless way out, I’d have taken it.

Somehow, its harder now that I want to make something of myself. In the past, I wasn’t bothered because I didn’t believe I would ever amount to anything, but now… I want a life. I want to go out and see people and speak to other humans. I want to be able to use public transport without having to put mental blinkers on so I don’t panic. I want to be able to eat normally, and sleep properly. I just want to be something close to normal, whatever that is. I want to feel okay.

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The fight never seems to end

Life is good. It is also equally bad. It’s strange to feel this way; things have always tended towards the negative, and so far my life has mostly been 95% bad, 5% good… and it hasn’t been rare to be trapped in a cycle of 0% good, unable to see anything positive either in the present or the future. Heck, there’s been a ridiculous number of times when I couldn’t even see a future.

The fibro flare is lifting, and I’ve been able to function pretty well today. Getting up at two pm wasn’t exactly the plan – I wanted to get up with S when he goes to work at eight am – but otherwise I achieved a few minor things. Washed up. Tidied a little. Swept the kitchen floor and emptied the bathroom bin. Had a shower, washed and dried my hair. I’m trying; as much as I find it difficult to see any real hope for the future at the moment, I am making a small effort to do the normal everyday things and occasionally interact with people other than S and my mother. Socialising has… become an issue. I’ve been wobbling with trust issues for months now, and I’m finding it incredibly difficult to allow myself to even speak to other people face-to-face. Every time I open my mouth, or type something online… I’m questioning whether I’ve said too much, given somebody ammunition. Logically, I know that mistrust is pretty unfounded, but since when did logic feature in my mind?

paranoid

www.techwench.com

It’s strange. I know my fears are unfounded, yet I can’t help feeling persecuted in some way. My awareness of what’s BPD and what’s me is becoming more clear, and I can see the profound differences between my normal personality and the borderline part of who I am. Although I know these feelings are entirely caused by BPD, there’s still part of my mind which refuses to let me look at the situation rationally and comfort myself. I no longer fly into uncontrollable panics over absolutely nothing, but I know those freak-outs are just sitting under the surface, and sometimes they feel so horribly close that I can’t bear it. I’ve let them creep in lately; convincing myself that S will leave, that I’ll do or say something stupid, that I’m not pretty enough or thin enough to have such a wonderful boyfriend. That people are whispering behind my back. Hating me for reasons I can’t quite pinpoint.

I’m taking my medication, but I’m not convinced it’s working that well; although Cipralex had problems towards the end, Duloxetine just doesn’t seem to have that ability to take away all the nasty things I can’t cope with.

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I suppose I just feel frustrated now. I’ve come so far, and there are still hurdles. I was once naive enough to think that life would get easier one day but now I wonder if that’s just a myth; if the whole thing isn’t a lie.

I mean, I’m happy. I am. For the first time in my entire life I can say I’m genuinely happy. I just don’t like knowing the fight never seems to end.

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In which I didn’t die

When you have a fear over something – be it general anxiety, agoraphobia, spiders or – in my case – being sick –   you’re often given the advice “remember, you won’t die”.

On the surface it’s good advice, and very true. CBT (or my experience of it) focused on that a lot, and I can imagine most people who don’t experience such extreme fear see it as perfectly sensible advice which can really help. So I don’t begrudge those who tell me this; apart from those in the psychiatric profession, who should know better, because it’s all well and good saying “it won’t kill you”, but anyone living with fear knows that there’s absolutely nothing rational about the red-hot tangle of despair and terror.

But, I didn’t die. I stopped being sick once the anti-emetics kicked in, and I’ve been able to eat without feeling nauseous. I’m still scared of the idea of it starting again, and there’s a huge bruise on my  hand from the IV, but I didn’t die. I’m okay.

Somehow, it always ends up okay. I don’t know how.

moving on

It will be sunny one day

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Image from Crystal

Maybe I’m just like my father: of psychiatrists and psychotherapy

Psychotherapy is a general term referring to therapeutic interaction or treatment contracted between a trained professional and a client, patient, family, couple, or group. The problems addressed are psychological in nature and of no specific kind or degree, but rather depend on the specialty of the practitioner.

Psychotherapy aims to increase the individual’s sense of his/her own well-being. Psychotherapists employ a range of techniques based on experiential relationship building, dialogue, communication and behavior change that are designed to improve the mental health of a client” – Wikipedia

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In my experience, most mental health centres and hospitals look the same. Red-brick buildings with NHS-standard signs directing patients to different departments, a row or two of (usually blue) chairs in a soulless waiting room, and old copies of Lancashire Life stacked on a low table if you’re lucky. Mazes of corridors and doors which are always kept locked. A buzzer or bell to gain entry or allow exit. Sometimes the paint on the walls differs, but it’s usually a palette of beige, pastel green or pastel yellow. “Calming” colours.

They inevitably make me think of the contents of an unwell baby’s nappy.

Our local mental health centre is, handily, in my town. It was recently refurbished and is now very different from the brief glimpses I got when I was being hauled – twice – to a private room on suicide watch in my teens. Back then the entrance led to a huge staircase which dominated the entire hallway of what used to be a beautiful old building but which has now been added to so much that it’s lost most of its character. Now, the staircase has been remodeled and everything’s been painted an off-white. There’s lots of glass and bright posters. It almost feels like a primary school, except you’re always aware that there are people upstairs, being watched 24 hours a day in case they hurt themselves.

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I sat with my mother, and waited. As my legal appointee, she has a right to accompany me to any appointments and while I usually try to wriggle out of it… sometimes I need her. My fear of going back into the mental health system after over a decade of let-downs and damage inevitably took over, and I know I wouldn’t have coped on my own. As it was, I had a small panic attack when I realised the psychiatrist was stuck in traffic and would be late; if I ever needed control, it’s when I’m about to open up my fucked-up heart to a complete stranger.

I was mildly surprised that the psychiatrist I saw was a young woman. I’ve become used to stuffy old men in shirt and tie, peering at me over their glasses and shrugging off all my concerns as being “down to my age”.

Another blue chair. Another desk, another patient file. I’ve done this so many times that I may as well just record what’s said and play it at the inevitable next appointment a few years later. You see, I have a problem sticking with things, and I’ve already spoken about how I find it almost impossible to be honest when faced with authority. When everything becomes too much I cave in and accept professional help, but I either pretend nothing’s wrong, or never go back. It’s as though I want to help myself, but the process is too frightening. Therapy means a loss of control and a need to be painfully honest; two things I find almost impossible to deal with.

I explained to the psychiatrist that I felt I was too old to still be dealing with all this, and that the mental health system has let me down a lot in the past. Picked at my jeans and stared at the wall as I detailed everything; the panic attacks, obsessions, paranoia, the total lack of self-esteem, the drugs, the painkiller addiction, the times in my teens when I relied on stolen bottles of gin to get me through the night, the self-harm, the bulimia. As I spoke, I realised that honesty was never going to come easy; although I was forcing the words out with all my strength, I still held back. However, my stumbling confessions were enough to confirm the diagnosis of BPD, and to earn me a referral for psychotherapy.

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Specifically, I’m on the 18-week waiting list for CAT Therapy.

Cognitive Analytic Therapy (CAT) is a form of psychological therapy initially developed in the United Kingdom by Anthony Ryle. This time-limited therapy was developed in the context of the UK’s National Health Service with the aim of providing effective and affordable psychological treatment which could be realistically provided in a resource constrained public health system. It is distinctive due to its intensive use of reformulation, its integration of cognitive and analytic practice and its collaborative nature, involving the patient very actively in their treatment.

The CAT practitioner aims to work with the patient to identify procedural sequences; chains of events, thoughts, emotions and motivations that explain how a target problem (for example self-harm) is established and maintained. In addition to the procedural sequence model, a second distinguishing feature of CAT is the use of reciprocal roles (RRs). These identify problems as occurring between people and not within the patient. RRs may be set up in early life and then be replayed in later life; for example someone who as a child felt neglected by parents perceived as abandoning might be vulnerable to feelings of abandonment in later life (or indeed neglect themselves).

It all sounds like much of a muchness, and initially I was reluctant to even consider it. Most experiences I read online leaned very much towards the negative, and the idea of writing a “goodbye” letter to my therapist is an odd one; I usually leave therapy sessions by simply walking out and never coming back.

However, I’ve given it a lot of consideration over the past few days. Knowing CAT is a “cheap” therapy is a concern; does that make me a snob? I’ve decided that a minimum of eighteen weeks is a long time to think it through, and I do have the safety net of being able to leave whenever I want; I’m not being forced into psychotherapy. It’s my choice, and I think at least giving it a go is the right decision.

I think.

I hope.

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