I’m currently in crisis. For those of you who don’t know mental health speak (what do you do with your lives?!) that means I am really struggling to keep myself safe. I have been getting more and more desperate, painfully desperate actually, to the point where anyone could say anything to me and I’d burst into tears, and I don’t usually cry. I’d been feeling like I was doing the best I possibly could but that I needed more support from others as well, professionals, not just be left to my own devices because it was becoming too much, as I was trying to tell people regularly and unfortunately it did eventually all become too much on Tuesday afternoon when I took quite a reasonable overdose and landed in A&E majors. I’m OK (well alive I suppose) and they did quite a few tests, ECG’s etc to make sure (this was more like a number of staff trying to draw blood by endlessly prodding me with needles as apparently my veins were ‘above their pay grade.’) It was an ordeal for me and my family which in the end didn’t give me that much relief. And as much as I am fully aware of the stress and pain it caused my family I couldn’t cope at that point anymore, I could see no possible way of surviving this pain in my chest any longer.
So I’ve now spent a few days in bed becoming less of an emotional wreck and resenting being alive, to the point where I am capable of writing this blog. And there are two points I want to make:
1) Many of the A&E staff were incredible and so very kind to me: I’m making a special point of this because I hear a lot of terrible stories about A&E staff dealing with people in mental health crises and I myself have had pretty bad experiences before but this time they were as helpful, reassuring and kind as they could have possibly been. A&E is the last place someone in mental distress should be if they can possibly help it- its overcrowded, noisy, stressful and the staff that do deal with mentally ill patients have got a tough job on their hands to communicate with someone compassionately, despite all that. My triage nurse, medical assisstant, doctor, and psychiatric liaison nurse all introduced themselves with ‘Hello my name is…’ got through to the dopey, slurring- half knocked out mess I was at the time and occasionally stroked my shoulder or took hold of my hand. They took me seriously, seemed genuinely sympathetic that I had reached this level of despair, checked on me regularly and did all they could, knowing that their speciality was not in psychiatry and mental health. I really couldn’t have asked for more so thank you to the healthcare professionals at St George’s A&E.
2) Is a bit more complicated. DBT (a therapy I’ve found immensely useful) has a ‘basic assumption’ that the patient is doing the best they can yet can still do more. It’s a principle I’ve always struggled with given its seemingly contradictory nature but yesterday I think I came to understand it a bit. And here it is: I’ve always said to myself you’re not trying hard enough, you’re hurting people, try harder, you can’t give in. And it is true, I shouldn’t give in but I genuinely think I am trying my very hardest because anytime someone says to me try harder I tear up and feel both very despairing and very angry, as I feel they have no idea how hard it all is. So I therefore don’t think its about ‘trying harder,’ I’m doing the best I can- but that said although I’m putting all my effort into fighting this mental illness I could be using it more efficiently, fighting smarter, if that makes sense? In my desperation I was unable to look back on my helpful ways of cling so just fell into the ones I know well and poured all my effort into those- but, for example, you can’t do art or watch TV 24 hours a day and stay engaged enough to be distracted. So although, I was trying my hardest- I could still do more. And when back with it enough that I could think, and want to live just enough try to do something that would help rather than harm me I wrote a list of all the things/skills that help me…and I’m going to include it below in case it would be helpful to anyone else (also please comment if you’ve got any suggestions for me and I’ll add them in!)
- DBT Activities: Tidy room, play games on phone, play Tripeaks, knit/cross-stitch, art/collage, decorate biscuits, colour, call a friend, take a bus journey, bake something, look at Rubyetc & Leonid Afremov art, scrapbooks, read articles,walk in the rain, board games & card games, stress-position when angry and out of control (wall squat.)
- DBT Change thoughts/vacation/opposite emotion: Watch TV, go out to nearby cafe or for short walk, puzzles & crosswords, Blog, look at cute/funny photos & videos, buy present from charity shop for you or a friend, write a card to someone, listen to an audiobook, BBC 4, white noise, go to a pet shop to look at the animals, make sequin bottle, half-smile lying down on floor (See DBT,) Look at Live Through This website to see others who’ve survived desperation.
- DBT Self-soothe: create a self-soothe box & continue to add to it, wear big comfy jumper & trackies, use a heater or fan to change your body temperature, scented oils, play with/stroke dogs (any pets,) listen to music esp Ben Howard or Florence & the machine or O-OH Child by the Five stair steps, by yourself some flowers, eat a treat, imagine a place you’ve been comfortable in in the past, wash hands well with lovely soap, use Twitter support, put some make up on, sort out an outfit for another day.
- Mindfulness: Breathe 10x and notice sounds, use Headspace app, feel feet on floor- which one is hotter? What emotion am I feeling that is triggering this urge? (use emotions wheel,) What Mind am I in- emotion, reasonable or wise mind? Measure breaths by footsteps, walk incredibly slowly (slow motion) and feel every sensation of your foot hitting the floor.
- General wellbeing: Change into day clothes (even if day PJs and going back to bed,) if possible, go out even for 2 mins, When thinking in extremes due to emotion- is there a middle ground? If others have value, do you not as well- why should you be any different? If well enough, think about any meaning that you could make out of this pain- the ability to empathise and possibly help others in the future? Look at (& keep) a list of things/skills to use when feeling desperate, explain to yourself that how you’re feeling is understandable given your internal experience, if possible, go to some mental health/social groups, in crisis, take a few days out to learn ‘how to walk (cope) again’ focusing on your improving your wellbeing, make special effort to be mindful of the positive things (if any) that have happened during the day, try to make sure there are 2 people who’d always be there for you in a crisis who know your situation mental health-wise, see the distress as a wave that you just have to tolerate until it goes down (and know it will.)
- DBT Emotion Regulation (for keeping well rather than just in crisis): If can, go to gym, describe your emotions as I am feeling ‘angry’ rather than I am ‘angry,’ Validate yourself- remembering statements others have made if helpful, pros and cons lists,acceptance-acceptance-acceptance,Build Mastery (DBT)- each day practice a skill, something you are good at/enjoy, make changes in your life so that pleasant things happen more often, don’t think about when a positive experience will end if you can, just be mindful of enjoying it the present, emotions are always valid- even anger, but unhelpful behaviours and violence of any kind are not.
- DBT Interpersonal Effectiveness: Describe how your feeling rather than judging what the situation/the other persons intentions are, validate others, don’t apologise when you don’t need to, weigh up benefits and negatives of compromising in any given situation, if feeling offended or hurt let the other person know & ask if it was their intention, ask for the help you feel you need, don’t over estimate others expectations of you because your judging yourself, tell someone when feeling desperate/unsafe.
- DBT Sensations to deal with SH urges: stress position (wall squat,) pulling rubber bands on your wrist, eating a chilli, holding ice.
WE ARE DOING THE BEST WE CAN BUT WE CAN DO MORE.
Lots of love, bear with me if I take a while to respond- I’m struggling.