Tag Archives: alcohol

This is a new day.

This time last week, I felt pretty rubbish. The counselling I’d been waiting for for five months had fallen through after I found out that my counsellor and I knew each other professionally. That evening, I told my partner (P) that I was thinking of giving up on counselling. I felt that that even if they found me a new counsellor who I don’t know, I may run into them professionally at some point in the future. I would find uncomfortable and compromising.

Our conversation went badly, to say the least. Given that I’d admitted that I’d also stopped my medication, P was anxious about me abandoning treatment altogether. He tried to engage me in a ‘rational’ discussion about pros and cons, and challenged me on whether it’s really such an issue if I know my counsellor professionally. I clammed up and the conversation ended when I burst into tears. I felt like he thought I was overreacting and that he was making no effort to understand how difficult the experience that afternoon had been. I felt isolated and alone. The discussion may have been helpful in a few days time, but a few hours after the abandoned appointment, I needed someone to listen to how upset I was.

The following day was a friend’s wedding, which was lovely, but socialising with lots of people I barely know is draining and at weddings I always drink far too much free wine, leaving me feeling even lower for the next couple of days.

I started the week with a plan to call Mind and take myself off the waitlist. I figured it would be weeks before another evening slot came up anyway and I didn’t want to risk the blurring of my personal and professional life again. But before I got around to it, the counselling coordinator called me with an offer for a slot with a different female counsellor, starting next week. It caught me by surprised that this felt like good news, and I accepted the appointment. I start my 12 weeks of counselling with Moira* on Thursday, and I’ve been feeling more positive since then.

And I got some more good news: a job interview. It’s a dream job and I’d submitted an application with the attitude of ‘you’ve got to be in it to win it’, but not expecting to ever hear from them. But I’ve got an interview. And if I was successful, I would be much less likely to run into my counsellor in that role. I know it’s still a long shot, but it reminded me that there are other jobs out there and that abandoning counselling because of my job is probably not the most rational solution to my problems.

I walked out of work on Friday evening, the sky was blue and the sun was shining. I was listening to Sally Seltmann, and with this song, I felt like things might just get better.**

 

* Still not her real name

** On the borderline is a pretty problematic song. Seltmann says that she wrote it as an ode to Princess Diana, who apparently had BPD. Whether Diana had BPD or not, the lyrics suggest Seltmann’s complete misunderstanding of what it feels like to have problems with low mood, seeming to prescribe to the notion of ‘drag yourself out of bed by thinking happy thoughts.’ Nevertheless, for some reason, it worked for me on Friday so I’m putting it here anyway.

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Today is the day.

Today is the day: my first counselling session. I would like to write about how I feel, but truthfully, I don’t feel anything. It’s been nearly five months coming, and today, I feel much like I did five months ago. Numb. Empty. And exhausted. Exhausted by the daily grind of depression, the heaviness of trying to get out of bed, the dissonance of putting on an enthusiastic face for the outside world, and the pressure of wanting to be ‘getting better’ for the people in my life who were so relieved to see me getting professional help.

I ran out of citalopram a week ago and can’t find the prescription slip to order a repeat. I could go back to my GP to get a new prescription,  but I’ve explained to myself that since I didn’t want to be on medication anyway, this is a good opportunity to see whether psychological treatment alone is enough. That’s the rational explanation. The truth is, the thought of seeing him again makes my heart beat through my chest, so I’m avoiding it.

Now today, I have to talk. But what to say? My life is good. I have a well paid, interesting job; a partner who I love deeply and have fun with; a nice flat in an area lots of people wish they could live in; good relationships with family; and lots of friends who I love and who care about me. There is no good reason for me to be unhappy. I could dig out supposedly traumatic events from throughout my life, but in my experience, that’s true of pretty much everyone. So that leaves me back where I started: what to talk about? In my last go at psychological treatment, I remember endless silences because I didn’t know what I was meant to talk about.

A couple of months ago, I requested a copy of my patient file from the psychiatrist I saw in 2004-5. It was hard seeing things written down about myself, things that I didn’t recall being spoken in the room. Words like “anorexia nervosa: partial remission”, “drunk today”, “borderline personality traits: see for further assessment”. There were also the letters between my psychiatrist and my GP, which I’d not seen before.

I feel she is suffering from a mild to moderate Borderline Personality Disorder. She describes a long history of labile mood, and has been self lacerating for the 2 years. She also bites her fingers to cause pain, and can also be reckless with spending and sex.

And a year later:

If she remains engaged in therapy she should continue to make slow but steady progress.

I dropped out of treatment a month after that last letter was written.

I feel reassured that this time I am seeing a counsellor without an official referral from my GP, so they won’t share information about me. But I know I suggested in an earlier post that it would be useful for them to share information. The point is, I want information shared in a way that includes me. I want professionals who are collaborating in my treatment with me. If they communicate, I should be copied in. Instead, I get a choice between uncoordinated treatment from two separate professionals who don’t know what the other is doing, or coordinated treatment in which I have no voice.

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Self help.

It’s been just over a month since my first GP appointment and today is the day of my counselling assessment with Mind. The new year was a reflection point and helped me to think of 2013 as the start of a journey towards recovery. I would have liked to access counselling quicker, but in the meantime, 1st January provided an opportunity to set some self-help resolutions aimed at taking responsibility for my own recovery.

I use Mappiness and because I’ve been using it for a while, I have good statistics in there about what activities are associated with me feeling happier. I used this to devise these strategies and I’m recording my progress with them using Evernote. My iPhone is a great tool to keep track of my mood and what works in stabilising it.

1. The Good List: record one good thing that has happened to me every day. It doesn’t need to be big, just a reminder that my life is full of good things. This was inspired by Facebook’s Year in Review, which reminded me that although last year was tough emotionally, it was full of incredible experiences.

2. Listen to music for half an hour a day: music has always been an important part of my life, but when I’m down I often forget to use it as the positive soundtrack that it can be.

3. Read a book every day, even if it’s only for 10 minutes: when I’m feeling low, I can spend hours reading ‘stuff’ on the internet that often makes me feel worse. Putting the screen away and reading a book creates a different space in my life and I feel like it stimulates my creativity. And it doesn’t have to be ‘happy’ reading (I’ve just finished The Bell Jar).

4. Only 1 hour of TV per day: I can get sucked down the hole of endless hours of crap TV, which helps switch my mind off but encourages my feelings of emptiness.

5. Cook 1 new meal from recipe per fortnight: I love cooking for pleasure, I hate cooking when I have to. This is designed to bring back some of the pleasure of cooking into my life and I’m looking forward to exploring Hugh Fearnley-Whittingstall’s Veg.

6. Four days off alcohol per week: I often end up drinking frequently, generally tied to social activities, but I know that alcohol really impacts on my mood. I need to learn to go to the pub and order a soft drink or juice.

7. Get to the pool or gym three times per week: Exercise does help me sometimes, but when I get into it I can get a bit obsessive. A goal of 3 times a week is also about keeping it moderate. I’m training for a 7km run in a few weeks, so the fear of embarrassing failure should help motivate me (still not quite sure if this resolution is a positive coping strategy?).

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Making an appointment.

It’s Friday and I’ve got today off work. When I made the decision to seek professional help, I thought today would be the perfect day to do that. I would have the whole day off to myself, I could relax and prepare ahead of the appointment, and if it didn’t go well, I wouldn’t have anyone to put on a brave face for afterwards.

That was the plan. Since my GP practice advertises that you can get a routine appointment within 48 hours, I called on Tuesday to make the Friday appointment. So they could “deal with my call effectively”, I pressed 1 for the automated service. I prefer not to speak to a person if I can help it: people often inadvertently say the wrong thing, putting me off from following through. So I pressed 1 and it rang me through to the automated service. Except it didn’t. It just kept ringing and ringing and ringing. After about a minute, I accepted it wasn’t going to go through, hung up and rang back, this time pressing 2 to speak to a receptionist.

“Sorry, we haven’t got any appointments available on Friday.”

Oh.

“I guess you don’t have anything sooner, then?”
“No, we’re all booked up. Unless it’s an emergency. I can get you in on Friday if it’s an emergency.”

And there it was. The reason I use the automated service. That question I’ve heard from so many GP receptionists, so many times before: is it an emergency?

I never know how to respond to that question. How can I explain that I need help now, that I’ve worked up the confidence and resolve to get help now, and that if I wait, I might lose that resolve? I know that if I wait, I may end up telling myself that things aren’t so bad, that I can manage this by myself, that there’s nothing professionals can do for me that I can’t do for myself.

How do I explain that I have Friday planned out in my head, that it’s important to me that it’s Friday? If the appointment isn’t on Friday then I know I’m less likely to turn up, and if I do turn up, I’m less likely to actually disclose my mental health problems when I’m sitting there in front of the doctor. But the fact that it’s important to me doesn’t make it an emergency, does it?

And if I say it’s an emergency, what will the doctor think of me when I do disclose? I already worry about being viewed as a time-waster, an attention-seeker, a drama queen. I feel these pejorative labels keenly, associated as they are with with the diagnosis I was lumped with 8 years ago: Borderline Personality Disorder.

“No, it’s not an emergency. When do you have an appointment available?”
“I can do Monday for you?”

No good, I’ve got an all-day meeting on Monday, and I can’t be cancelling meetings for a GP appointment.

“I can’t do Monday. How about Tuesday? And do you have an early appointment?”
“I’ve got 9:40 Tuesday morning.”
“That’s fine, thank you.”

It’s not really fine. It’s a week away, 9:40 means I’ll be late for work, and I’ll probably have to put that brave face on. At least I’m never sick – everyone ‘knows’ that about me – so they’ll all assume the appointment’s something routine, like contraception or a smear.

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Help-seeking starts here.

In my professional life I often discuss help-seeking processes in the health and social care systems, and it’s something widely discussed in the mental health literature. But too often, accounts of help-seeking fail to illuminate the tiny details that actually make or break it. This blog is a personal account of my experience of seeking help for mental health problems in London.

Eighteen months ago, I found myself sitting on a bench in a park near my house, smoking a cigarette and calmly going through in my head the actions I had left on my suicide plan to-do list. Sitting there, the shock of the point I’d let myself get to hit me suddenly with a sharp, physical force. I’d been well – recovered, even – for 7 years. Yet within a couple of months of feeling low, I had a serious suicide plan.

I’d not told anyone that I was feeling low, let alone exactly how bad it was. I hadn’t told myself how bad it was. Suicidal ideation is always in the background for me, my fantasy escape route if I need it, so it was easy not to notice that it had crossed from fantasy to concrete reality.

Sitting on that bench, I realised I needed help. But from who? I didn’t want to burden my partner, who I love, with the responsibility of knowing I was suicidal. Talking to family wasn’t an option for the same reason, and none of them live in this country anyway. Having moved to the UK only a couple of years ago, none of my friends here knew my history of mental health problems and I was keen to keep it that way. The only thing I could think to do was to go to my GP and get a referral for counselling.

So back in August 2011, I made an appointment with my GP. I checked in with the receptionist, who then asked me to weigh myself on the machine in the middle of the waiting room, as well as handing me a slip of paper with a survey about my drinking. This was just routine, but at 21 I had been diagnosed with alcohol dependency and a borderline eating disorder. Already anxious about talking to the GP about my mental health, questions on my alcohol use and weight exacerbated negative feelings associated with past poor treatment from health services. By the time the GP called me in, I’d already decided not to talk. Instead, I asked for, and received, superfluous advice about a minor hand injury.

It’s taken me 18 months of not getting better to feel desperate and exhausted enough to seek help again. Three weeks ago, a friend of ours attempted suicide and I finally felt able to share with my partner exactly how bad things had got for me and how I’m feeling now. It was hard – for me to tell, and for him to hear – but his support since then has been everything I needed it to be that it hasn’t been before now.

And today, I made another appointment to see my GP. But that’s for my next post.

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