Tsunami (Otherwise known as "Where I'm At")

Some of you may know/remember that November is often a difficult month for me, and despite last year's improvement, this year was something of a set-back. I don't know how obvious it's been (either here or elsewhere), but my mental health has been declining for quite some time. There were several things feeding it, including another visit with my father, but the result is that for particularly the last several months, I've been very unwell.

I've been increasingly paranoid, guilty and ashamed, and withdrawing/guarding my comments, because my thoughts lead me to believe I'm unwanted anyway -- every comment or lack of comment has looked like a closed door; I've been losing large chunks of time and not even realising it; the hallucinations that are part of either my depression or the BPD, and indeed my entire sense of reality, have all gradually spiralled out of control; and all my efforts to right the roller coaster have only confused the issues more.

As a result of all this, after what had been I think around 3 years, I was admitted to the hospital's psychiatric unit for just over a week. I suppose I think that if I had just worked harder at being well, if I had tried harder, this wouldn't have happened. I find myself feeling deeply ashamed to have been admitted back there when I know that I don't think badly of anyone else who is admitted.

The upshot of all this is that my medication and my diagnosis have both been changed, and that there is talk of more intensive support being available, especially since the program I've been seeing my private psychologist (Sonia) under has now ended, leaving me with four sessions until next year (quite a drop since I had been seeing her 2 to 3 times a week). I'm not certain exactly what that support will entail but there was mention of a case manager to help organise some sort of housing, a public psychiatrist once a month or so and someone from the Mobile Intensive Treatment team to see a couple of times a week.

In the meantime, what I do know is that I've been put back onto Avanza (mirtazapine) - though how long that will last (as its sedating effects are already beginning to wear off) remains to be seen - and my diagnosis has been officially changed to also include Dissociative Identities Disorder. I must admit, it feels quite surreal to have that on my record after spending 12 years knowing but undiagnosed. I'm still sorting through how I feel about it, that's for sure.

There's been a lot of upheaval. There's still a lot of upheaval. I'm doing better than I was prior to my admission, but I'm still very unwell and struggling with many of the same issues I was having difficulty with before I went into hospital.

Following Up From Turbulent Waters

Two weeks ago, I wrote a post about what happened when my GP and I tried to get me back into the mental health clinic here. I received some supportive responses (both here and elsewhere) and I received one comment that has been on my mind.

I thought about replying to this on the original post, but most of what I have to say feels appropriate as its own post. I won't lie and say I didn't have an emotional reaction to the comment - in truth, I had an extremely strong one. I felt rejected, dismissed and invalidated; my knee-jerk reaction was to quit and never write here again. Obviously I've chosen not to take that path, but then I had other paths I could take. Should I let the comment stand? Should I treat it as gospel and take it to heart or should I dismiss it entirely?

After a couple of weeks reflecting, I decided to do neither. It's important that I don't simply take on board whatever anyone says about me - but it's equally important to me that I'm open to criticism and don't deny something simply because I don't like hearing it. So I reflected; I thought about what was said, and about the beliefs I have around the statements used, and I read my own post through several times.


So, in response to,

"Anonymous said...

You have to see it from their point of view - if after all that help you're still not much better, why would they invest more time and money in you? They've already invested a lot in you and it didn't do a whole lot, so they are now giving other people a chance. Don't go playing the victim."


I would like to start by saying that I don't believe, in this situation, I am "playing the victim". That term, to me, is about not making use of the power that you have. I am, in actual fact, powerless over what decisions the Mental Health clinic makes about my care once my part is done. Their decision was not in my power - what was/is in my power is my reaction. That, I accept responsibility for entirely -- what I choose to do with and about their decision is in my power (within my own limitations) and nothing to do with Mental Health.

However, that "within my own limitations" is important. It's not an excuse to say "to Hell with it" and give up - but it is important for me to remember that I deserve to give myself leniency for things I legitimately cannot help. Everyone has limitations and nobody is perfect. One of my limitations is that DBT was not enough to stop my self harm.

Whether "anonymous" intended it or not, the implication behind the comment was that because, after investing so much time and effort into me (I assume through my course of DBT), I was not better "enough", I do not deserve further treatment. In my view, this is wrong. Everyone deserves health care. Everyone.

If we apply this logic to physical health concerns, it becomes much more clear. If a skin graft operation is unsuccessful for whatever reason, the surgeon does not simply cross the patient off and move on. He or she sits down and thinks about what to do next - and then puts the options into place. Sometimes this means that the procedure is repeated. Sometimes it means that alternatives are explored. If a surgeon simply threw up his hands and refused further treatment because the patient was not "better enough" there would be an outcry.

Why 'would' (or 'should'!) they invest more time/effort/money in my health? Because they haven't tried everything. Because there are avenues that have not yet been explored. Because DBT is not, and was never intended to be, a one-size-fits-all cure. The fact that DBT has not helped me "enough" doesn't mean I am not trying, it doesn't mean that I am beyond help, and it should not stop me, or anyone else, from receiving further treatment.


And yet... this is what is happening in the mental health industry, especially when dealing with those with Borderline Personality Disorder. I don't mean just locally to me, either, this is happening all over the world. Mental health problems are just as valid as physical health problems, and there should not be barriers to receiving treatment and care based on the fact that you are not "well enough" after completing a particular treatment.


There were two other things I'd like to address from that comment.

First, I'd like to dispute that DBT didn't "do a whole lot" -- I think most people who know me well have seen massive changes in me since DBT. Not curing me is not the same as not doing much.

Second, I'd like to say to everyone that although I have allowed anonymous comments so that those without an account can still comment, I would very much appreciate knowing who leaves comments. As long as things are kept respectful, I don't mind people having opinions that differ from mine, and I'm okay with being called out on things... but I don't think that doing so anonymously is generally respectful. In my opinion, if you don't believe in your opinion enough to stand by it as yourself, then you don't believe in it enough to say it with good intentions.



Take care of yourselves until next time, and may we all find our own small fences along the way.