Where’s the ‘Off-Switch’?

While I was driving home from visiting my mother this morning, I realised I was holding my breath. I think I had been doing so most of the morning, as I was terrified (yes, really terrified) that if I didn’t that ‘she’ was going to come out of my mouth.

‘She’ would come bursting forth from what is usually my nice, kind mouth with ‘her’ negativity and judgement. This fear has been building all week and was being triggered by the actions of a staff member at the Dementia Home where my mother lives. I am never impressed by this woman, in total contrast to my usual reaction and appreciative support of the rest of the staff. I don’t like many of the things she does and I don’t think she does her job well. That’s fine, but for some reason she triggers the ‘On-switch’, and I want to tear her to shreds. I think I even want her to lose her job (I am shocked by the strength of my feeling).

That’s right. I’m not always a nice person. Actually, I can be vile. I can be a total bitch. That part of me has been in existence for what seems like as long as I can remember, but actually, my memory of her just goes back to my teenage years when ‘she’ would come burst forth to spew her vileness particularly at my mother.

The explanation of ‘her’ is that I have Borderline Personality Disorder (BPD). I hasten to say that perhaps not every sufferer of BPD has this fragmentation. I don’t know. What I do know is that I do, and every so often the nice, kind, even friendly Cate will transform into this nasty, cruel, bitchy ‘she’ who I recognise well, but cringe when I realise ‘she’ has revealed herself. I don’t like ‘her’. That is an understatement. I just wish I could ‘turn her off’ when I realise ‘she’ has taken over, but most times, I don’t realise ‘she’ is in charge until the damage is done.

Read about BPD and you will quickly realise that some writers refer to us as “drama queens” (and kings, presumably). “attention seekers”, “bitches”, “monsters” even. I try to stay clear of such writers because while I don’t want to label other BPD sufferers, I know that for my own part, sometimes I am a “bitch” and sometimes I am even a “monster”. Yes, really. You might think you know me. You might think I am a nice person, but that is only one side of me. Thankfully it is the dominant side, but in the dark, lies the monster, and ‘she’s’ not at all nice.

Lately, I haven’t seen too much of ‘her’. While I admit my mother was on the receiving end of her for too many years (we didn’t ever have a good relationship anyway), ‘she’ isn’t there anymore. ‘She’ somehow disappeared from our relationship, and even though I don’t really understand the change, I am glad and relieved. My mother has enough to cope with in life, without a monster daughter. This was also the main relationship in which ‘she’ appeared so it was good to have ‘her’ gone.

There have been times lately when I have felt ‘her’ rising to the surface and about to take hold, but somehow I have been able to dissipate the rising pressure and somehow escape ‘her’ clutches. It is always a palpable relief when I can do this, but I never know exactly how it happens. I know that for me, being able to do this is a sign of mental wellbeing.

But then in the last couple of weeks ‘she’ has been back. I usually don’t realise ‘she’s’ back until it’s too late. Until ‘she’ has taken hold of me, and I am a monster. One side of me cringes as the other monster side delights in the ride. Yes, ‘she’ loves it when ‘she’ gets to be in the driver’s seat, while I just wish I wasn’t there. I quietly hope I’m not doing too much damage as my words spew forth, but ‘she’ doesn’t care.

Don’t get me wrong, I’m not talking about having multiple personalities, having Dissociative Identity Disorder (DID). This is different, and while I’m no psychologist to understand and explain the brain, I do understand that we all have different parts to ourselves. Maybe for most people, those parts are not the “monster” I see in myself. Maybe they’re not quite so marked.

Scary and a little weird, I actually find myself liking ‘her’ to some degree. I don’t like the hurt ‘she’ can cause, but I do like that ‘she’ just says whatever ‘she’ thinks. There is no holding back with ‘her’ and I like that ‘she’ isn’t constrained by… well, anything. I don’t like the damage, but just sometimes I admire ‘her’ for being free to say anything without fear of consequence. I am torn. I like this ‘me’ but I’m also terrified of ‘her’ because I know all too well the damage that ‘she’ can cause, and has caused.

Aside from hurting people that I actually care about, I have lost along the way. I have lost people. I have lost jobs. Yes, I have lost two jobs where I wasn’t able to reign ‘her’ in. I was, in those jobs, two people. One Cate was very good at ‘her’ job. Staff and clients thought I was excellent at what I did. I got high praise and was rewarded well. But in both situations ‘she’ rose to the surface in my working relationship with a boss. At the time, I had no understanding of BPD and was totally lost. I didn’t understand why this was happening. All I knew was this “monster” would rise to the surface and I didn’t know how to stop ‘her’.

Recently, ‘she’ took over and destroyed what had been a nice dinner out with someone I care about. ‘She’ ambushed the evening while I wasn’t watching and I admit now that I am ashamed of the things I said and did. Once ‘she’ took over, I couldn’t stop ‘her’. I couldn’t take back the control, and part of that was because I kind of liked what she was doing and saying. That is what I am ashamed of most. What sort of monster am I, that I would cause pain and like it?

‘She’ keeps bubbling toward the surface and I find myself holding my breath, terrified that ‘she’ will take over again and that I will lose more relationships. I am inclined to shut myself away and hope ‘she’ is prevented from rising. If I don’t talk with people, then maybe ‘she won’t be able to rise.

This is a pretty negative post. I know that. I don’t expect many ‘likes’. I am ashamed to admit that I am a monster but I know that maybe by writing about that part of me then maybe I can take ‘her’ control away. Maybe by being open to the point of feeling quite uncomfortable with such disclosure, I might take her power away. Perhaps by bringing that monster in from the dark, to bring light onto how she is, I will find a way to take control again. I hope that it enables me to find that elusive ‘off switch’. That has to be a good thing.

One final note. I have called myself a monster and I have related that to my having BPD. But please know that I am not saying that all people with BPD are monsters. Not at all. I am using this word to describe something in myself that I strongly dislike. Something I find monstrous. I do not know enough about BPD and other sufferers to label them as such. I only know about my BPD. Actually, none of those I know who have BPD are people I would describe this way.

Because humans are complicated beasts, the monster said. How can a queen be both a good witch and a bad witch? How can a prince be a murderer and a saviour? How can an apothecary be evil-tempered but right-thinking? How can a parson be wrong-thinking but good-hearted? How can invisible men make themselves more lonely by being seen?

“I don’t know,” Connor shrugged, exhausted. “Your stories never made any sense to me.”

The answer is that it does not matter what you think, the monster said, because your mind will contradict itself a hundred times each day. You wanted her to go at the same time you were desperate for me to save her. Your mind will believe comforting lies while also knowing the painful truths that make those lies necessary. And your mind will punish you for believing both.

— Patrick Ness (A Monster Calls)

Thanks for reading

 

Cate

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“Everything Seemed So Good”

When “everything seemed so good”, the short story (in case you don’t have time to read the whole post) is that “everything wasn’t so good”. Believe it. Everything was not as good as it seemed. It is not as good as it seems.

There’s been a lot in the media about suicide lately, in New Zealand particularly. There have been the on-going discussions about the Netflix series ‘Thirteen Reasons Why‘ generated by the book of the same name by Jay Asher. I am only just starting to watch the series, so have no other comment to make.

In New Zealand too, there has been an on-going call for a review of the mental health system in our country, some of which has been generated as a response to statistics of suicide, and what seems an ineffective system that all too often ends in the death by suicide of people who don’t get adequate care. More people die by suicide in my country than die on our roads. This is not acceptable, although I would add that neither toll is acceptable to me.

Then this past week, perhaps New Zealand’s best-known advocate for suicide prevention, comedian Mike King, resigned from the government’s Suicide Prevention Guidelines Panel after a draft paper was released contain no specifics or targets to lower statistics. This post is not about Mike King’s resignation, and so I won’t get into it here. But it does seem significant to me, that there has been so a large outpouring of disappointment and anger directed towards those of the Ministry of Health who wrote and released the draft paper. Note however that the paper has been released for public discussion and comment so I would encourage readers who are concerned to make their views known to the Ministry of Health.

And then at the end of last week came news of the death by suicide of musician, Chris Cornell. I admit that I had not heard of him until last week, but now I find myself commenting on reaction to his death. That in itself is a little crazy but as we know, when celebrities die there is a great outpouring of reactions of all types. And when that death appears to be the result of suicide, the outpouring seems to be even greater. Suddenly everyone has an opinion (including me sometimes) and every opinion tends to hold too much in the way of assumptions.

As I said, I wasn’t familiar with Chris Cornell, and I admit I have quickly given up reading much of what has been published both by mainstream media and individuals on social media. That is because, most of it made me so angry. Most of it, missed the point for me.

Let’s take this statement:

“But, why, many are asking, would a man who was worshiped (sic) by his fans, had a beautiful family and successful career, take his own life?”
Matt Agorist, The Free Thought Project.com

Are people that shallow? Do people actually believe that because someone’s life looks so good, that it must be that good? This is what makes me angry. Whether the subject is a celebrity or simply your next door neighbour, reality is never quite as good as it seems to outsiders. Never.

What I know of Chris Cornell is that he was a successful musician, a family man, a middle-aged man, but also a recovering addict and someone taking prescription medication for anxiety.

As an addict myself, let me assure you that addicts are not addicts for the sheer pleasure of it. In very simplistic terms, we are addicts because we wanted reality to be better than it was, you see to addicts it wasn’t as good as it seemed. And being an addict is not as good as it might seem to those outside their world.

The need to take prescription medication for any mental health issue also spells out to me that everything is not as good as it might seem. We don’t take those pills for the buzz! But then, maybe if you’re looking in from the outside, that might be how it seems.

I also know that middle-aged men are taking their own lives too often. The statistics are pretty well published and that suggests to me that their lives are not as good as they might seem to those of us on the outside.

I find it really sad that society generally sees only what it wants to see. When someone dies by suicide, society sees nothing of what was that person’s reality. This must make it incredibly hard on family and friends to grieve when society refuses to see what was real.

It must also make it very difficult for those who have suicidal thoughts, to get help from those around them.  Because those around them refuse to accept that everything might not have been as good as it seemed.

This is not rocket-science, but I think that it can make all the difference in how we are there for those left behind, and those who still struggle. If we are to be of any help, we have to acknowledge that the view from the outside, is not the reality on the inside.

Thanks for reading

Cate

When The Mind Breaks

Rock-a-by baby On the tree top,
When the wind blows The cradle will rock.
When the bough breaks, The cradle will fall,
And down will fall baby Cradle and all.
                                                    – Mother Goose, c.1765

A nursery rhyme that has always struck me as (just a little) scary. Who puts a baby in a cradle, and then in a tree? What do you expect? The baby IS going to fall.

Right now (and actually for a long while previously), my life is dominated by minds that have perhaps been put in a metaphorical tree, the bough has broken and so has the mind.

Firstly, the onset and continuing existence of mental illness in my own life. Mental illness has been very obvious for around twenty years now, although thankfully (for now) it’s not quite the crisis that it has been previously. There’s always the possibility, though that the branch may break again. With the diagnoses and history I carry, I would be a fool to deny that possibility.

But now, I’m living the day-to-day reality of caring for my mother who has Alzheimer’s Disease. It is different from my own broken mind experience yet there are some very real similarities. Sadly, at this stage of medical knowledge, there is no light at the end of the tunnel with Alzheimer’s. Rather it is getting steadily worse and will continue to do so. People don’t survive Alzheimer’s. Not yet, anyway.

That breaking of minds is something I could write about endlessly. Both my own mind, and more recently my Mother’s. But it’s not where my thinking is today. Rather, I’m thinking about what is left when the mind has broken. That thinking comes from the image below, one I came across yesterday on a great Facebook page, Alzheimer’s Sucks – Memories for Joe Hennington. As an aside, I can tell you that Alzheimer’s does indeed suck, so that immediately tells me this page is a good one. It is worth a visit.

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Image credit: Permission to reproduce obtained from FB: Alzheimer’s Sucks – Memories for Joe Hennington

Let me say from the outset, that it is not my intention to conclude whether or not the message contained in this image is correct. I don’t know the answer to that, and I wonder whether anyone really knows. I share it because it made me think, and so I want to discuss it. To hopefully at least start to sort out my own thinking, and maybe find a little of what others think.

This image stopped me in my tracks. “The heart holds what the mind can not“.

I had seen a similar statement before but perhaps because of where I am at with my mother’s Alzheimer’s journey, it really made me ask yesterday:

“When the mind breaks, does the heart step in and protect what really matters (what the mind held)?

Is what was loved, sustained?”

Yes, that is what I want to know. I know the easy way to look at this. I can tell myself, “yes, my mother still loves me now and will continue to do so when she no longer knows me“. That is, of course, what we all want to believe.

And what about with severe mental illness? When my mind was so terribly broken (in an admittedly different way) and I didn’t want to know my family, I suspect they might have wondered “did she still love us?” Clearly, there were times when my actions and words indicated otherwise.

I can remember my then-husband wondering “do you still love me?” Such a question came at a time when he was having to watch me continuously, primarily because the mental health services were simply not available and someone had to make sure that I stayed alive and ate something. I hated it (and I’m sure he did too). I reacted in such a way that he must really have wondered. It probably appeared that I hated him. Perhaps I did.

I don’t think I had the capability to love him (or anyone) at that time. My mind was very much broken and was fighting for survival in such a way that I wonder if love was even possible. If you could magically take away the mental illness then, of course, I would say then that I loved him. But magic isn’t real life, is it?

My mother’s Alzheimer’s Disease is different. She’s not having to fight me for her survival, in the way that I had fought my husband. There is also not some hope that we will get her back, as she was. The mother I knew, has largely faded. I don’t buy the train of thought that the person with dementia has already died and that we are simply left with her body. But that’s a whole other post so I won’t go there right now.

A few days ago Mum and I were in her room looking at something that she has always loved. I said something about it, and I saw her looking at it as if she had never seen it before. Then she looked to me and clearly wanted some explanation. It was an object rather than a person but I found it startling because it was an object she had loved. Only in the last few weeks, she had referred to it with affection, but now she had no connection to it.

And so I wonder, what about when it is a person. When it is me? When the time comes that she doesn’t recognise me, will her heart still hold what the mind has lost? Will she still love me?

I want to believe that she will, even though she won’t even be able to communicate it. Who wouldn’t want to believe this? But I suspect that it’s not quite that easy. Maybe that’s the glass half-full person I am. I don’t know.

Perhaps too, it comes from my own broken mind. I have struggled to believe my mother loved me for most of my life. We haven’t had an easy relationship. It’s difficult for me to believe that her love will be sustained when I’ve spent nearly fifty years doubting the existence of that love.

What matters is that I will keep being there for my mother, even if that love has gone. More so, perhaps I need to turn all of this around. What I need to know is that she will still know that I love her.

And in terms of my own broken mind journey, perhaps what really matters is whether I could still somehow comprehend love from my husband and my family. Actually, I’m pretty sure that I couldn’t and perhaps that was part of the problem. I’m really not convinced that my heart could hold what the mind had lost.

I suspect these are questions for which there will perhaps never be adequate answers (for me anyway). Something I perhaps have to accept as it is, without understanding.

What do you think? When the mind breaks, what happens to what the heart held? But please don’t tell me that of course, my mother loves me. If you do, I will know that you have missed my point.

“You’re so beautiful,” said Alice. “I’m afraid of looking at you and not knowing who you are.”
“I think that even if you don’t know who I am someday, you’ll still know that I love you.”
“What if I see you, and I don’t know that you’re my daughter, and I don’t know that you love me?”
“Then, I’ll tell you that I do, and you’ll believe me.”

— Lisa Genova (Still Alice)

Thanks for reading

 

Cate

What I Missed Out in 2016

Even though we are into 2017, at least in my part of the world, I do have a nagging thought on my mind. The posts I should have written in 2016. Of course, it’s too late for regrets and rather a time for looking forward, but I know that I take, drag these unwritten posts with me. They are posts I still need to write.

Let me be clear that this post is not those unwritten posts, if that makes any sense at all. Rather it is a commitment, at some time in the near future, to write those posts and share those parts of me. They may end up with different titles than I use here, but the content will be there. My commitment to you as readers is also a commitment to myself to get those issues out in the open, and in doing so hopefully shed the weight that they currently are on my shoulders.

Reckless Compulsion (Another Addiction?)

I’ve Been in Denial About for Years (Anxiety)

Eventually, there will be links above to the written posts.

Both posts-to-be-written are deeply personal and perhaps that goes some way to explain why they have been on my mind, yet not written, for a few months now. It’s hard to put them on ‘paper’, yet I know I must do so in an attempt to take some of the weight off my shoulders. In an attempt to begin to heal. And that is all that my posts are ever about.

Keep reading…

 

Cate

This Is My Fight (Song)

This is my fight (song) right at the moment. It feels like I am fighting all the time, which is a little ironic because I can’t stand fighting.

Put a television scene of any form of violence in front of me and I visibly flinch. I can’t bear to watch so will look away, to the extent of moving my head AND covering my eyes. I just can’t face (excuse the pun) it. Whether it’s violence against human, animal or if it is being self-directed, I can’t go there.

Even violence conveyed as sport is too much, and perhaps that’s why I am a rare kiwi who doesn’t like rugby. There is just too much violence in the game for me.

But then there is one type of violence that I don’t flinch at, and that is when I direct violence at myself. I’m not talking about self-harm, although as I’ve written often enough, it is a battle I lost for many years. It’s not even violence per se that I am referring to, but rather a fight.

I’m fighting my body right at the moment. Imagine this:

An about one inch (two and a half centimetres) below your eye is a one inch round lump. But you can’t see it when you look in the mirror. No one can see it, but if you feel around your cheek with your fingers, you can feel it. It’s solid and it feels enormous. Only you and your doctor know it is there. To everyone else, it can’t be anything because they simply can’t see it.

Yes, I am talking about myself. The lump is on the left side of my face, and it’s really doing my head in. I first went to my doctor about this about nine months ago. She told me that it didn’t matter and that no one (she meant specialists) would remove it because there were more important matters to deal with. I’m not exaggerating.

Well, that doctor and I parted company not long after. It wasn’t the off-hand way she dealt with this and another issue, but rather her inability to understand sufficient English language (my native language). We were constantly struggling to understand each other. I was seeing her because my previous doctor had retired, and I was given little choice. But it got to a point when I realised it was REALLY important that I have a doctor fluent with my language. It sounds silly, until you end up in the situation.

Anyway back to my fight. My new doctor has recently referred me to a specialist to get the lump removed and analysed. Great. (It took me a while to raise the issue again, after being fobbed off the last night.)Although the New Zealand Health System can operate at a very slow pace (usually when you want immediate results) and I have yet to learn how long I might wait.

Meantime I am fighting with myself, because while no one else knows, or wants to know, how important the immediate removal of this lump is to me, it is tearing me apart. In addition to being able to feel the lump in my fingers, I can now simply feel that there is ‘something‘ on my face and the need to get it out is at times unbearable.

I admit I have always been a ‘picker’ (not quite to the extent of dermatillomania ever being diagnosed) and I have a great deal of trouble letting lie any perceived imperfection on my skin. I struggle to let any wound heal itself without needing to pick at it. As early as I can remember I would frustrate my mother by picking at my childhood scabs and so it would take longer to heal and leave a larger scar.

This picking was perhaps the innocent start of my self-harming days. When mental illness started to take over, I simply became more violent and picked up a blade.

Do you see the problem? There are times when I just want to rip this lump out, but a rational me doesn’t because… well, this is my face and I could make a terrible mess. Sadly, other times I don’t feel anywhere near as rational as to  be able to caution myself.

I did tell my doctor of this. I didn’t want to confess to her lest she choose to send me direct to the nearest psychiatrist rather than a plastic surgeon. But she needed to know how urgently I need the issue addressed. Knowing her as I am getting to, I doubt it would make much difference. I just doubt she understands how volatile my mental well-being can be. She has never seen that side of me, and I’m sure she hasn’t had time to read back 20+ years of medical records.

And so I fight, even humming the tune. I fight to be rational about this. I fight to protect my face from unnecessary injury. I fight to preserve what mental health (health not illness! There is a difference.) I currently have.

Every time I do something (or don’t do something) to preserve that mental health, I win. No one else sees the lump. Or no one else sees the fight. But it’s in me, and I will win. I have to.

And all those things I didn’t say
Wrecking balls inside my brain
I will scream them loud tonight
Can you hear my voice this time?
This is my fight song
Take back my life song
Prove I’m alright song
My power’s turned on
Starting right now I’ll be strong
I’ll play my fight song
And I don’t really care if nobody else believes
‘Cause I’ve still got a lot of fight left in me

[from ‘This Is My Fight Song’ by Rachel Platten]

Has this been a completely weird post? Perhaps. Certainly, my mind has gone everywhere while I’ve written. But then, for me, that’s exactly how it is. I hope you’ve been able to follow me. One final note that sadly, this is not the only lump which my body is fighting right now. More about the other one in time.

Thanks for reading

 

Cate

One Small Stand Against Stigma

TRIGGER WARNING: this post contains general information of a self-harm event but has no graphic details. There are no images.

I said it was small, and it is. But it’s gigantic for me.

This week I swapped which wrist I wear my watch on.

Earth shattering, isn’t it? And surely not much to do with the stigma against mental illness. But there’s more to it than what meets the eye.

Fifteen years ago I was self-harming pretty regularly. It was probably a daily occurrence at the time of this event. Sometimes I knew what I was doing, but others I was  dissociated and really not aware of the harm I was doing to my body. I would realise afterwards when I was mopping up the damage.

On one occasion I cut my (right) wrist. I wasn’t aware of what I was doing, but I know for certain that it was not some kind of suicide attempt. But don’t ever believe that this makes it better. I don’t believe this [although I acknowledge that some readers might find my thought concerning].

I realised pretty quickly that this large wound was going to need sutures and I didn’t seem able to control the bleeding, so took myself to the local hospital. At the Emergency Department, I encountered a doctor who had perhaps had his fill of self-harmers. I’m not going to make excuses for him, even this much time later but I do acknowledge that the job of an emergency doctor is a difficult one.

He told me what he thought of me in no uncertain terms and that I was completely wasting his time. There were, apparently, more important people than the likes of me. He said that as I had cut myself without anaesthetic, he was going to suture my wrist (15 sutures) without anaesthetic too. He proceeded to do so, although he left me waiting for what I’m guessing was as long as he possibly could.

That night I was vulnerable and scared. It was the first time I had gone to an Emergency Department after self-harming and had no idea what to expect. What I did know was that my self-harming was getting out of control, and I desperately needed help.

What I got was stigma. Against self-harmers and against mental illness. I concluded what I guess I already knew but was hoping that help might tell me otherwise. That I was a bad person, and I had wasted his time.

As soon as the wound healed I switched to wearing my watch on my right wrist for the sole purpose of hiding my scar. I knew some people would think I had attempted suicide. Others would think it was self-harm. There was little chance that anyone would think it was accidental. I was best to hide the evidence. From the world, and also from me. Hiding it from myself as much as possible would save me from the graphic reminder of the person that doctor had said I was.

Fifteen years later and most people in my life wouldn’t know that the scar even exists. I’ve hidden it that well, from everyone. But this past week I came to the conclusion that it’s time to stop hiding the scar from myself, and from anyone else who might see it. I’ve switched the watch back to my left wrist. It just seems right.

I don’t self-harm anymore. I’ve been about five years free. I know that if I got myself into a bad space then maybe I might again. I hope not, but I’m just honest with myself.

Because I have shifted cities and changed friends, most people aren’t aware of either this scar or the many others that litter my body. I’d have to virtually tattoo my whole body to be able to hide all of them and I don’t have that much money or that many ideas of what designs I’d choose.

But I’ve come to a conclusion. Those people who really matter will cope with the sight of my right wrist if and when it comes in front of them. For anyone who doesn’t cope with it, won’t matter anymore. And for those who don’t know me, they don’t matter anyway.

This is one small part of my voice against stigma. People who self-harm are important and do matter. Every time I see the scar on my wrist I am saying that doctor’s attitude doesn’t count because it was so wrong. I don’t have to let him keep telling me that I’m a bad person. And that’s what was happening every time I put my watch on.

Okay so that’s easy to say, but in reality this week I have felt exposed and vulnerable. Everytime I see the scar, I want to hide it again. It’s going to take a while to be comfortable with it. One day… it will come.

And that doctor? Well, he could have helped me that day, and probably avoided a few more scars. But he chose not to and I believe that was because he had stigmatized his patient. He didn’t see me as a person in need of help. God, I hope there aren’t too many doctors like that in Emergency Departments around the world. Sadly, I know better.

“Other times, I look at my scars and see something else: a girl who was trying to cope with something horrible that she should never have had to live through at all. My scars show pain and suffering, but they also show my will to survive. They’re part of my history that’ll always be there.”

— Cheryl Rainfield (Scars)

Thanks for reading

 

Cate

 

World Mental Health Day 2016 – Real People

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World Mental Health Day. That’s today. It’s the day on which we come together, united in a call for better mental health around the world. It’s a day on which I usually know exactly what I want to say. This year has been different.

In the days leading up to today I have thought about writing about the WHO topic chosen of Psychological First Aid. Something that I have thankfully been on the receiving end of in the past. Those in the crisis and caring professions (for me it was the Police) providing psychological care. It helped, enormously.

Then I thought about writing about stigma, this time about sufferers of one mental illness stigmatizing sufferers of other mental illnesses. Yes, it happens and I had been on the receiving end of this just recently. I am, apparently, “a fruit loop”.

Then I was thinking about the people of Haiti. I wondered how their mental health was holding up. The situation in their country leaves me thankful for what I have, but I suspect that their need for psychological first aid doesn’t get a look in, the need for clean water and housing coming up as seemingly more important.

My friend, Motivating Giraffe wrote a wonderful post about the over-abundance of Awareness Days, and how they just don’t matter if we (including people at the top) don’t focus on what ‘really‘ matters. If you read nothing else on this Awareness Day, make sure you read this one (oh, and mine too).

But then heavy on my heart over this past week has been a story in the New Zealand news. It has unfolded as the week went on. It’s one of those stories that in other countries there might not have even been a raised eyebrow, let alone a news headline. But here, these things thankfully don’t happen every day. They can still stop the nation in its’ tracks.

A man with a mental illness went on ‘a rampage’ here. Only three weeks ago he was an inpatient in his local (Waikato) psychiatric hospital, but this week attacked his parents, leaving his mother dead and his father critically ill in hospital. No one knows what motivated this attack, except it must have been somehow driven by his mental illness.

For the next few days, his location was unknown. Police mounted a manhunt with no success. And then at the weekend came the discovery of more dead bodies in an unexpected location. The mentally ill man had killed another elderly couple and then taken his own life. The ‘why’s‘ will perhaps never be known but four people are dead and one still seriously ill in hospital.

What really strikes me is the emergence of this man’s mental illness. He had schizophrenia, and it might be easy to simply conclude “oh, that it explains it“. But that’s not fair. Not all people who suffer from schizophrenia go on to murder. Not all people who suffer from schizophrenia go on to commit crime. And not all people who suffer from schizophrenia go from there to taking their own life. But stigma will have us believing all these things.

This man had no history of mental illness (described in one article I read as a “nice young man”) and then apparently he used illicit drugs once. And ‘once’ was enough to trigger schizophrenia. You see ‘once’ is enough for some people and some mental illnesses. It seems it is a game of Russian Roulette. And that was enough to end four lives and leave hundreds in mourning. Lives changed irreversibly.

My point? That mental illness, and the tragedy that can follow, can happen to anyone. The stigma that too often is applied, is unfounded. It could happen to you too.

This story really hits home to me because I was a ‘nice young wo(man).

I wasn’t mentally ill. I had a good career, a nice home and I had prospects. I was ‘going places“. No one expected my life to change dramatically with the sudden emergence of mental illness. I don’t have schizophrenia, triggered by a casual single use of a drug, but I have another mental illness now. One for which sufferers aren’t often described as ‘nice’.

My friends and family had no reason to expect such a dramatic change to my life. And perhaps more importantly, I had no reason to expect that change.

I could accept a friend’s Bipolar diagnosis. I could even visit her in hospital. I had no difficulty in supporting her, because I believed it could never happen to me.

I could accept that a man known to my family had schizophrenia. But when he began to stalk me, I very clearly saw myself as a victim and him as the perpetrator. I didn’t once stop to think that he was a victim too. And I never once thought it could happen to me.

It did happen to me. I got my own (BPD) diagnosis and spent far too many times in hospital. My days in psychiatric wards and hospitals may not even be over. I don’t know what lies ahead.

If you gain nothing else from World Mental Health Day this year, please  know that it could happen to you. I don’t say that to scare you, rather that you don’t judge those who struggle with mental illness.

Even for the cases, we hear about in the news, those are real people who struggle/d with real illness. Maybe they were on the receiving end of stigma. And maybe they didn’t get the support or treatment they needed. I don’t know why Ross Bremner killed those people or himself this past week. Maybe we will never know. But what we do know is that they were real people, just like you and me.

Thanks for reading

 

Cate

“The Untreatables”

I need to clarify something. For my own sake as much as for anyone else. One of the terms I hate most in the psych world is ‘Treatment-Resistant’. I’ll explain why in a moment, but first what was a new term for me. Maybe it’s not new to you, but I wish it didn’t exist at all. I was quietly checking my Twitter feed recently when these two words came flying off the screen at me. “The Untreatables”. Ughhh!

“The Untreatables”? Really? Does anyone else take an immediate dislike to this term? (As an aside if you’re interested, the tweet I read contained a link to this article). ‘The Untreatables’: the people for whom there is no treatment.

If I had skills in the cartoon drawing you would see now a group of ‘Untreatables’ gathering together in what might be some type of 12-step group aimed at recovery from untreatable mental illnesses. But I can’t draw to save myself so I’ve hopefully left the image in your mind.

I think I have gained entry into this group three times. Firstly, I was pretty quickly labelled with the ‘treatment-resistant depression’ label. It only takes two different types of anti-depressants tried unsuccessfully, and you’re there. I don’t remember how it was put to me, that this was how I was now seen but I always thought it was an odd term. I thought it applied to me personally whereas it actually applied to the illness. A small but necessary difference.

There was I thinking”but I’m not resisting my treatment!?!” I had been taking my pills, careful not to miss a dose, and I had been going to my therapy (with a man who seemed decidedly odd. But that’s another post.). How could I be defined as ‘treatment resistant’?

The second time this applied to me was many years later when I was discharged dumped by the Adult Mental Health Service in my city because I wasn’t responding to their treatment. This time, ‘treatment-resistant’ was being applied to me, the person. A social worker had been working with me using Cognitive Behavioural Therapy (CBT) and I didn’t respond as I should (apparently). Actually, I suspect the term ‘Untreatable’ was used because that’s really what they were saying. There was no treatment for me.

The same thing happened a short while later with the Eating Disorders Service I had been seeing. There I had been in group therapy (using CBT again) and I hadn’t responded as they thought I should. I was discharged dumped again with my untreatable eating disorder. Fortunately, I had got myself past the Anorexic phase before I even got seen by their Service (sitting on a waiting list for years) otherwise, I suspect I would be dead by now.

My point in sharing what was a very frustrating but also depressing stage in my life is that in each case, mental health professionals were leaving me with a sense that all this was my fault. I was either resisting treatment or I was untreatable because I didn’t respond to CBT.

I accept that in the first case, the psychiatrist involved may well have been clear in saying that my depression (the illness rather than me personally) was treatment-resistant, but in my frame of mind, I took it to be about me. It wasn’t. I wasn’t doing anything wrong. I simply hadn’t responded to the anti-depressants he had chosen. It was actually more about him than about me. It was about choices he had made.

When I saw the tweet that hit me between the eyes, I took exception to that term ‘The Untreatables’. It’s an awful description as well as being an easy way out. Class us as ‘untreatable’ and you can send us on our way.

I take exception too, to the term ‘treatment-resistant’ if it is used to describe a person.

To any mental health professionals who happen to read my blog, please think before you use either term whether it is to the patient or not. How you think about it will determine how you see your patient, regardless of whether you use the terms in front of them.

And to mental health patients, please hear me when I say

You are not treatment-resistant.

Your illness may be treatment-resistant, but not you. And I hope that you are never made to feel ‘Untreatable’. Don’t believe it, and know that it is not your fault.

There are theories that some mental illnesses are untreatable, particularly Personality Disorders. I don’t accept that, but then I’m no professional. I think it comes down to how you understand the term ‘treatment’. The Mental Health Services who chose to discharge dump me from their services could have chosen a different treatment path. They could have simply listened to me. Instead, they put a distressed and unwell person out of their systems without support. It wasn’t until a few years later when another mental health professional worked out that I had Borderline Personality Disorder (BPD) and not just depression and an eating disorder, and that is perhaps why I hadn’t responded to the earlier interventions.

I am convinced that sometimes it is just about having the time to work beyond the ‘treatment resistant’ or ‘untreatable’ labels.

Thanks for reading

 

Cate

 

Human 2 Human

Relationships with other humans have to be one of the most difficult and complex aspects of life. They are for me anyway, and there have been a few issues which have reared their ugly head for me in the past few days.

I know that friendships, family connections and intimate relationships are really hard for me and now days I am inclined to pull back from all of them.

With one failed marriage behind me, along with a string of failed relationships, I am alone and pretty certain that I will remain alone. I believe now that I not supposed to have  someone by my side. I have never believed that there is a soul mate for everyone, nor will everyone find their soul mate. Actually,I suspect my soul-mate might just have been and gone.  And sometimes circumstances just get in the way and block the way for what might have been true love.

On the other hand, it was some years ago now that I also came to the conclusion that close friendships were perhaps something I would be best to avoid. You may call it sad but I call it safe. After being let down by a number of friendships, I made a specific decision that friendships I might have been able to rely on were no longer worth it. Yes, I do have friends but not many and I try hard not to rely too much on them. I am inclined probably too much to withdraw rather than depend.

And then there is family. I have been fortunate to date with my family connections. Maybe they didn’t always understand me or my needs, but they did seem to love me. I think they still love me, but their availability  for me to rely on them is perhaps changing.

I know that my Borderline Personality Disorder (BPD) plays a part in how I relate to other humans. I’d like to say it isn’t part of the story. I’d like to say that I have it ‘under control’. But it is part of me, part of my personality if you like, and no matter how many ways I learn to control or even recover, I know that it will always be there.

An article I read highlighted for me some of the issues that float in and out of importance as issues for me with BPD:

“Most patients named gaining control over emotions, mood swings and negative thoughts, followed by reduction of municipality, self-harm and other destructive behavior and improving self-acceptance and self-confidence. However, improving relationships and improvement of social participation, social competence and job situation has been mentioned as important.”

It speaks of the issues important to patients with BPD in the treatment they need. But I use it as it easily highlights in a paragraph issues I deal with when connecting Human 2 Human.

It’s hard. It’s constantly hard, and with those issues at play perhaps it is easier to understand why I choose so often to withdraw.

This week someone important to me said:

“I don’t care…” [about you]

Ouch! Actually, it was more than “ouch”. It was fuck! Under my breath, of course.

The rest of their words no longer mattered. I had heard that they “don’t care” I didn’t matter anymore. They possibly weren’t even aware of having said it, but it was loud and clear. Maybe this person was someone I could no longer rely on (for any number of reasons). Maybe this was connected to my having BPD. Maybe I was too much. Maybe I had misinterpreted what another person might have taken differently. But then maybe it was simply about their issues not connected to me. It hurt anyway.

Do you see why Human 2 Human is hard?

Another relationship came up on my Human 2 Human radar. I know my mother’s Alzheimer’s Disease is not about me, but how I respond to something that is ever-changing is totally about me. I can’t escape this one.

In a conversation with my mother, I discovered that her memory has gone so much that she appears to know nothing of my life beyond my name and that I am her daughter (I am thankful that she still knows this). She also appears to know nothing of her life when I have been a part of it. Of course, I knew that this was coming some day but that day had arrived and it cut deep. My own mother doesn’t know me. Maybe even I don’t exist for my mother anymore.

My father passed on nearly six years ago, and it seems that while my mother sits in front of me, she is in some way gone too. I have heard the expression of grieving for someone who still lives, and that is even harder than it sounds. I feel like the wind has been blown out of me.

My parents have always been very important to me, although I admit that my mother and I have never been close, never even been friends. The tension between us has gone now. Something I can’t totally explain. But maybe she has gone too.

Perhaps my feeling of loss this week connects to my BPD. I know there will be a connection because there always is. It’s just that I have yet to work it out, to be able to put it into words. Meantime it hurts. Both instances I have described here. I need to hide away and lick my wounds.

I want the luxury of time with my therapist again, but I have no therapist anymore.

All I can do is write. I don’t claim to have any answers. Just questions. I hope that what I choose to write and share with you makes even the tiniest ounce of sense. I suspect it will make more sense with others who travel with a Borderline mind.

Thanks for reading

 

Cate

 

Uncharted Territory

“Life is uncharted territory. It reveals its story one moment at a time.”

Leo Buscaglia

 

When I was first dealing with mental illness, I found myself in a world where people wanted to know about my feelings. Feelings? I thought myself an intelligent person, but feelings were something I knew nothing about. Actually, I knew so little that I thought I was being asked what I thought.

I don’t remember  ever talking about feelings in my family while I was growing up. Actually, I’m pretty sure that we simply didn’t talk about how we felt. Even into my adult years, my parents would never talk about how they felt, so I think it’s pretty safe to say that feelings were simply not an issue for discussion.

When I found myself in the offices of doctors, therapists, and psychiatrists, they all wanted to know how I felt. And I had no idea. How I felt simply did not register with me.

In time I found myself able to explain what was happening for me using imagery. I could paint a word picture, and if the health professional had the time to listen, I was able to arrive, through the imagery, at what I was feeling.

I was depressed (apparently). I simply knew there was something very wrong. Even now, after many years of therapy to unearth my feelings, perhaps my first sense, when my mental health is on a downward spiral, is that there is something very wrong. I’m just not that sure what it is.

Using imagery I would eventually arrive at fear. Yes, I was terribly afraid.  I felt like I had fallen off a very high cliff face. I had no idea where I was. And as I fell, I wondered where I would land. It was uncharted territory.

In my mind, this cliff face was in the Waitakere ranges, west of Auckland. I lived in Auckland for a time during my childhood and later as my mental illness was revealing itself. I had childhood memories of walking in the Waitakere’s with my father and brothers. I always felt very safe with them, even on days when we might end up a little bit lost. I don’t remember there being any great rock faces from which I might fall, but my mind’s image was clearly here.

The problem when you fall, you often can’t see where you are or what is above or below. You don’t know whether you have landed at the bottom and so can’t fall any further, or whether you have landed on a ledge. And you don’t know whether the ledge you might be on, might give way and you fall further.

With depression, I found myself falling often. I would think it was rock bottom, and it couldn’t get any worse. But then, worse would come and I would be falling again. I thought I couldn’t possibly feel any worse. I couldn’t feel any more despair. But I did. Over and over.

That’s why Penny Redshaw’s (of Motivating Giraffe fame) drawing hit a note with me. It was my experience of living with depression.

rock-bottom
Image credit: Penny Redshaw,  Facebook/Pics by Penny

Thankfully, I’m not at the bottom of a very big cliff called Depression right now. But I do feel like I’m being dangled over the top of a cliff, and I am very scared terrified of what might happen next. At the moment my doctor (who doesn’t know me very well) and a psychiatrist (who doesn’t know me at all but has somehow ‘assessed’me without me being present!) have decided between them that I should come off lithium, a medication I had previously been told I would need to be on for my lifetime. The doctor has asked what I think but basically ignored my both my thoughts and my fears. It’s happening anyway.

So back to word imagery, I feel like I am being dangled over this very big cliff by these two doctors. There has been a fence (its’ name was lithium) which protected me from a fall but that’s gone and my toes are over the edge. I am currently clinging onto the few bits of greenery, the odd tree also clinging to the edge. I hope they will have strong enough roots to hold me safe (think skills I learnt in the years of therapy which might, if I am lucky, hold me fast to my well-being). Will it all be enough?

I don’t know. And if I fall, I don’t know whether it will be a ledge on which I land or the bottom. I don’t know how hard I will land.

I.Am.Afraid.

As I said, I just don’t know. We never know. With a physical illness, there is often some sort of chart, maybe just a pamphlet or maybe a book, to tell us what to expect.Sometimes it’s called a prognosis. That’s not the case with mental illness. We never know what will come next. That’s just one of the reasons why we need our friends who are on a similar journey. They ‘get’ that uncharted territory can be a scary place to go.

Stay tuned. Hopefully, I’ll be able to grab a passing tree root to stop the fall.

Thanks for reading

 

Cate