Monday, 31 January 2011


I have spent most of the day online responding to peoples posts on SF. It has been keeping me distracted for wanting to self harm and getting in to an even lower mood. I have had quite a bad weekend. I haven't self harmed massively, just blood letting. To me that is better in terms of medically. I am not taking up resources, I don't need treatment for it and it doesn't leave massive gashes that can go infected like the ones at the moment. Although I am probably to blame with these as I haven't been taking the antibiotics as they make me ill so I hope I will fight the infection myself. I planned on staying in bed all day yesterday and I actually cried when my mum said I was actually expected to be at my brothers for dinner at 12.

Originally I thought it was just my parents invited and was quite happy with that. So yesterday when she woke me at 11.15 to say I needed to get ready I actually cried. I did not want to get out of bed. I felt so low. So low that I couldn't consider doing anything like self harm or suicide I just did not have the energy. Dinner was lovely though and I do enjoy seeing my nephews. I think my mum had called my brother to see about me going though as I had a talk yesterday from my Dad that they were worried as I was spending too much time in my room. And then he asked me why I was so miserable. I could have exploded. I am not being miserable. I am more than that. I hate the way people play down my emotions. From Gom I used to get "have you tried just being happy". From my Dad a few weeks ago "are you feeling happier now"; used as if it was just a bad day I was having the day they found out about the SH. People do it all the time. "Are you feeling sad"? No I am not feeling sad. Sad, miserable, unhappy do not even come close. I don't know what does.  But when people use such loose terms as those it makes me angry as there is so much more going on.

So back from dinner and then in to my room. I was asked if I would sit downstairs with them and read. But there was no way. I want to be on my own at the moment. I don't want to be around other people. Especially when they are drinking and then take the piss out of me by mimicking me if I don't give a bright, upbeat reply. I can't be that person at the moment. Sometimes I can pretend but I don't have the energy to do that at the moment.

So today, I have had an appointment with the Psychiatrist. He said I seemed lower in mood since last week - I do. I am not sure if was last week I was coming out of crisis point with the SH over the weekend and being able to SH and being able to do what I wanted. We talked about the build up to when I SH and I said that sometimes I can feel it, sometimes I am not aware of it, sometimes it just happens. But sometimes I make a decision. "Tonight I will SH". That's what I woke up with this morning. Even before going to see him today.

So we talked about my mood, my medication. He asked me what I wanted and I said I didn't want to feel like this anymore. For me my main problem at the moment is my low mood. I can deal with the SH when I am not feeling as low. I suggested combining medication. I said I wanted to try combining different groups. He said it was not likely they would do that as he doesn't think it is something that can be medicated. He feels that we should be increasing the dose of Mirtazapine first which I said I wouldn't take at all if he did as it made my appetite massive and I put on weight while on maximum dose which meant that I stopped taking it. He then went on to say would be looking at trying different types of medication next which would have worse side effects for me. Another thing I don't want. He said the only times they look at combinations is in inpatients.

We then had another argument about diagnosis and I told him what I thought. I said it's not just that there is a stigma with personality disorders within mental health professionals and that it insinuates it is something innate that can't be fixed, it's that I honestly don't believe I meet criteria for it. I told him that all I was getting was low mood and I self harmed. He was then saying it was feelings of chronic emptiness I was feeling. I hate that. I hate it when people tell me what I am feeling. So I asked him what the difference was. He didn't give a very good answer really but from what he was describing anyone with re-occurring could have the feelings of chronic emptiness. Chronic emptiness is basically low mood that can persist or go away and come back for no reason. Can anyone see the difference here? Me neither. So here is what I got from Wiki. I know it's not exactly the best reference but it is the same info as I was given in a lecture about it

A pervasive pattern of instability of interpersonal relationships, self-image and affects, as well as marked impulsivity, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1.Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-injuring behavior covered in Criterion 5

2.A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.

3.Identity disturbance: markedly and persistently unstable self-image or sense of self.

4.Impulsivity in at least two areas that are potentially self-damaging (e.g., promiscuous sex, eating disorders, binge eating, substance abuse, reckless driving). Note: Do not include suicidal or self-injuring behavior covered in Criterion 5

5.Recurrent suicidal behavior, gestures, threats or self-injuring behavior such as cutting, interfering with the healing of scars (excoriation) or picking at oneself.

6.Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability or anxiety usually lasting a few hours and only rarely more than a few days).

7.Chronic feelings of emptiness

8.Inappropriate anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).

9.Transient, stress-related paranoid ideation, delusions or severe dissociative symptoms

Ok, so out of these. I meet no5 as I self harm and have tried to kill myself numerous times, 7 if this is the same as low mood and possibly 9 as of the occasional voices I hear, the dreams, and how I can get quite paranoid about silly things. So a possible 3. But, if I look at other PD types I would meet some of those. So would most people. OK, there are traits but then everyone has them.

So talking more with Dr he sort of gave in on arguing with me as he knew he wouldn't be able to tell me otherwise. I'm quite stubborn me you see.

Anyhoo, he recommended Psychoanalytic Therapy. I said I would give this ago. He said the only thing was was that no one would take me on while I was self harming still. At this I got quite upset and nearly started crying. I can usually manage my emotions really well but think as I was feeling so low I couldn't really hold it back. I said how the hell was I supposed to stop SH when I didn't know what caused it or when it was going to happen. It was not like I could just flick a switch. He said he understood and said I need to learn to ask for help. He said I had been given the details of crisis team I needed to be aware of when the feelings were coming on and to call them and ask for help. I said I couldn't do that as I find it really hard to speak to people on the phone. I don't even like speaking to family on the phone. I don't like not being able to gauge peoples reactions so I would struggle with speaking on the phone to someone. And, the having to explain everything that was going on. I can't do that. I have tried all these helpline things before also and have just found them patronising and so I won't use them.

He then went on to say people without PD's have used the PD networks services before and found them helpful and that they would take people on who still self harm as will integrate different therapies. I said from what I knew of the PD Network it was mainly group based and there was no way I would  sit in a group and talk about my emotions. I said it's hard enough for me to do it with one person never mind a few. And, it wasn't just that it was that I worked in mental health for the last 2 years, am likely to carry on working on the wards once this mood lifts and possibly even want a career in that area. There was no way I would risk previous patients I had nursed seeing me there. I also may see patients and service users I may come across in the next couple of years.

I know it seems I am full of "I won't do this". I appreciate I have gone and asked for help and people are trying to and I am not accepting it. I apologised to the Dr for this as if I had a patient like that it would drive me mad. But I know myself. I know that group work wont work with me. I know I wouldn't engage. I am also fighting this "diagnosis", I put it in speech marks as they were saying they haven't diagnosed me yet just that there are traits. Well I keep getting told different things. I will carry on fighting it also. So with me fighting it I don't want to engage in something that they do as looks as though I am accepting it as a diagnosis. But, the group thing put me off more than anything.

So in the end, the Dr said he would refer me to a Clinical Psychologist. They would work individually with me and is more flexible in their approach. So it's just a matter of time of waiting for appointments etc to come through. He said I should get an assessment appointment through in a couple of weeks and then should be able to start seeing someone regularly quite quickly.

I know this post has been a bit he said she said but as I said I am also using this as a distraction technique and also like a diary so it's something I will look back on in a few days, weeks, months and then I'll laugh at myself for being so pathetic.

I have an idea what I will write about in the next one and I would appreciate peoples comments on the next blog as I need feedback on it. But I'll probably wait a few days before posting again.

Thanks for reading - if you do?

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