To alcohol the cause of and solution to all of life’s problems

A young drunk dino.

drunk (2)
A picture of me drunk with my mouth open wearing a black and white striped top

I’m a mouthy drunk, not the messy head down the toilet drunk of my early 20’s or the numbing my body with vodka so I could take action to numb my mind drunk of my late 20’s, I’ve never had a problem with alcohol as such more a problem with the things I do when I’ve had alcohol.

I don’t drink much now, chronic illness and medication have seen to that and I’m really only a social drinker but I’m also anxious socially and alcohol is a great way to reduce the anxiety and my tongue. When I say I’m a mouthy drunk I don’t mean rude or aggressive (passive aggressive maybe) more that my tendency to over share increases as my inhibitions decrease adding this to a habit of using humour as a way of making light of difficult subjects it can be awkward at best and messy at worst.

But this isn’t really about alcohol, to quote thirteen being drunk doesn’t change who you are it just reveals it” I recently did a support plan at work about supporting my mental health including triggers, what I can do to support myself, how work can support me and what signs there might be that I’m struggling. One of the things I included here was changes to my relationships with colleagues, I feel I have some good relationships with some of the people I work with and we tend to have a laugh and joke about things including each other it’s banter but if I’m struggling or not in a great place mentally I can take that too far past it being funny or harmless.

The problem with banter is when mixed with anxiety and alcohol and a loosened tongue the less fun parts come out, I’m not incapable of being unpleasant or bitchy I’m certainly no saint but it’s not always just to be a dick it can and recently was in reaction to hurt, those annoying attachment issues rearing up again at unplanned social interactions with someone who was once a source of support who then let me down and lied to me more than once. I’ve struggled with change and boundaries but I’m not oblivious to them and I’m not naive I don’t need people to lie to me and give me false hope only to completely go against what they said, the worst part is although I’m angry part of me still misses them but I don’t want to not that I particularly want to be angry either but it would be easier to just be angry.

It would be better if I didn’t have to see people who let me down or at least have some control over the interactions but that’s not always possible and while the banter may have gone a bit far and the anger crept in aided by alcohol it didn’t messy and there were no close encounters with the toilet or trips to a&e.

It’s personal

I’m clearly no stranger to sharing my life both online and offline, if I was this blog wouldn’t exist and you wouldn’t be reading this now but offline I’m starting to get tired of sharing my story and talking to people about my history and mental health. I’ve spoken to so many people in different settings from pop up cafes to fundraisers, funding bids for work and over 1000 young people through volunteering on the youth service I now run and although logically I know it’s not true it does feel as though there must be a shortage of people who haven’t heard my story by now.

Today I’m running training with my new volunteers on writing their personal story and although no one is forcing me to I don’t feel like I can avoid telling it again it doesn’t seem fair to ask them to share theirs and me not share mine, I’ve been thinking about it for a couple of weeks and Im still not entirely sure why I’m so against telling it now I think it’s partly that I’m tired of hearing it and then the fear of being judged and the shame of not really having achieved much in my life. I really do enjoy my job and it’s not that I think it doesn’t count but I’m in my 30’s and just getting started in career where most of the people around me are younger than me and more qualified. I don’t feel like an inspiration or someone to look up to, hearing other people’s educational backgrounds and qualifications reminds me of what I don’t have and what I’m not clever enough to ever achieve, maybe this is internalised to an extent but I also know the reality of my experiences in education.

When you’re known for one thing or people see you a certain way it can be hard to break that view no matter how much you change or try to move on you’ll still be seen the same way, I’ve talked about my past so many times as a volunteer and although not in great detail there’s a high chance that I’ll be meeting people in my new role that have heard my story, I don’t hide having mental health problems and it’s not like I even could if I wanted to I’ve made sure of that it’s something I’ll never be able to fully hide but even though it’s my own fault I wish I had a choice.

Working 9 (30) – 5 (30)

A photo of me at work wearing pink glasses and a black top with my chin resting on my hand looking stressed

I took part in a photo project on Facebook for people with chronic illness a few months ago and balance was one of the prompts that stood out for me, people talk about a work life balance and having a life outside of work but another type of work life balance for me is the balance between how I’m seen as a member of staff and a person with mental health problems.

My mental health isn’t a secret it couldn’t be if I wanted it to be not just because of this blog or the very obvious signs all over my body including my hands (big regret) but also because I came into the organisation as a service user which is something I make no secret of but at times it’s hard to know how others see me. This may be my own internalised anxieties or not feeling good enough but I find it hard to know whether at times of stress I’m see as a stressed or frustrated member of staff like any other or if I’m seen as a person with a mental health problem overeating as a result of their mental health.

Again this may be internalised anxiety and probably a generous dose of feeling like I don’t deserve help or that I shouldn’t ask for help and should be capable and prove myself (probably mostly the last part) but because I feel like I should be able to cope and I’m afraid of being seen as incapable I find it really hard to say I’m struggling at work. I know I keep going on about how scary it is that people having expectations for me to live up to but Friday afternoons seem to be the time my brain likes to have a breakdown and I even got left off work early for being mental today, being overtired and alone all day meant I spent more time crying at my desk than actually working.

My mental health and volunteer experiences help me support my volunteers but I worry that I’m seen as less professional especially because of my self harm and the fact that I don’t cover my scars or that people will think I’m not capable; as it is I’ve been judged by professionals when I’ve attended consultations or panels as a person with lived experience or service user rep, metaphorically patted on the head or had things I’ve been dealing with for years explained to me with a patronising smile and yes some of these people may do it to everyone but when you’re trying to prove yourself or been seen as more than just a token or a tick box to satisfy a requirement it’s that bit more frustrating. I keep being told that everyone experiences anxiety at the start of a new job and it’s normal to have doubts but again this is where the difference lies because I always feel I’m waiting for people to see through me and tell me this was all a mistake.

This blog is a bit all over the place but what (I think) I’m trying to say is that the balance between work and life is more complex for me than just work and outside work.

This existential crisis was brought to you by caffeine and chocolate.

Part of the problem?

Dinos back
A green backgroud with pink dinosaur cartoon carrying a black brefcase and pink walking stick. The words dinos back are at the top in black

Guess who’s back? Back again, dinos back, please like and share.

So it’s been a while, I’ve had to do lots of writing for work recently which hasn’t left me with much brain capacity to write for enjoyment, but I’m back and return with a rant.

This week is Mental Health Awareness Week and the theme is stress which is ironic as stress and work are the reasons I haven’t blogged recently. It often feels like a week can’t go by without there being some kind of awareness day/ week/ month so far this year we’ve had time to talk day, self injury awareness day, university mental health day, eating disorders awareness week and no doubt many others. This month is borderline personality disorder awareness month normally I’d write something about these or use them as a springboard to write about a related subject but this time I’m writing about other peoples way of promoting these awareness days.

I know that I often use these awareness days and campaigns to promote my blog and that’s not what I have an issue with but people using it to promote their illness or compete over who is the illest especially on social media. Mental health problems and chronic illness already have so much stigma attached and there are so many misconceptions around them, the biggest areas of stigma I’ve found are within the medical system from Drs and medical staff I’ve had several occasions where I’ve been poorly treated and discriminated against due to my mental health and especially self harm. So why when there is already stigma attached do people within the mental health and chronic illness “communities” claim to be “raising awareness” by glorifying their illness or posting things that just add to the misconceptions?

Posting pictures of your self harm as part of an awareness day isn’t going to reduce stigma, posting pictures of your face scratched up or countless pictures of your starved body is shocking and attention grabbing but ultimately adds to the idea that self harm is purely graphic and bloody, that personality disorders are all about self harm or that eating disorders are about being thin and fragile, mental illness is complex but it’s not pretty and we don’t need more images of fragile, delicate white girls or bloody and bruised bodies in the name of raising awareness. If I had £1 for every time a health professional made a throw away comment about people with personality disorders or treated someone’s self harm in an unprofessional or even cruel way I would be a wealthy Dino.

We need to change how we raise awareness and avoid glorifying mental health problems as a way to show the reality of living with a mental health issue because the reality isn’t just what’s visible and just showing that side of things not only gives a very narrow view but also undermines people who don’t experience mental illness this way, it’s a broad spectrum and everyone is different and we all experience things, everyone has different symptoms and lifestyles, mental illness is invisible not everyone has scars (at least not physical ones) and that should be the message we send that mental health problems aren’t uncommon and they’re increasing and you can’t always tell just by looking at someone.

Body and mind

Shark bag
A picture of a shark rucksack looking anxious wih the caption “my face when people ask what happened to my arms”

*For the purpose of this post i’ll be using the word disabled to mean people with a physical impairment, I do consider mental health problems to be a disability but for clarity i’ll refer to mental health seperatly.

So my brain whirred into action last night thanks to an Instagram post by the amazing feeding of the fox. There’s a type of self harm that’s rarely mentioned; self neglect comes up in the context of depression but even I’ve never seen a discussion around the connection between disability or chronic illness and self harm or disabled people deliberately not taking care physical needs as a way of self harming. There are times when I say yes when I should say no, times when I will push myself because I don’t deserve to rest, times when I don’t take painkillers because it’s an indirect way of inflicting pain on myself, going to places that aren’t accessible or doing things when I’m not well enough.

Any disabled person will also tell you there is a big divide in the treatment of physical and mental health problems the two rarely mix and the mental health services are not always good at recognising the impact that physical disability or chronic illness can have on mental health or that the things that could benefit you mentally aren’t always possible physically (like going for a walk or having a bath), being told I should do more exercise after I’ve explained that I have chronic pain and chronic fatigue can result in me feeling lazy and making myself do things that result in pain or injury and an increase in fatigue and related symptoms. This is where the lack of understanding or knowledge of the connections between mental health and physical impairments is such a problem because for me it can be an increase in symptoms but for others it can be much worse.

Then there’s the other side the health services who treat your body as if your mind isn’t a part of it, although I’ve always been disabled to some extent in the last couple of years my mobility has got worse and I’ve been using mobility aids and dealing with more pain and fatigue.

At the beginning of 2017 I tried to access psychological therapy for long term health problems. I wanted help accepting my chronic illness and dealing with no longer being able to do the things I used to and things people my age can do, I wanted some support in balancing my physical health and mental health. It took several months for them to tell me that they don’t offer support for chronic pain, between that they rejected me because I was under mental health services (I was in the process of being discharged and they were completely different services), they then said my self harm made me too much of a risk and they said they didn’t think I’d be able to manage classroom based psychoeducation (thanks for that).

Last time I checked neither my body or my brain can function without the other yet services treating each are still very separate and mental health services are often not accommodating for people with physical impairments and often aren’t accessible there’s also an assumption that if you’re disabled and have mental health problems then of course you’re depressed because you’re disabled because who wouldn’t be?

Ableism unfortunately is still well rooted within the medical profession and the even within the disability communities there is still too much separation of physical impairment and mental health issues.

Rocket Science

If you can’t here expecting a review of a lush  bathbomb then sorry to disappoint you this is a rant about mental health services, maybe try Lulu or Jen

IMG_5726
A blue rocket shaped bath bomb made by Lush cosmetics

I am not a frequent flyer, I don’t have air miles I haven’t been on a plane in years and the last time I went abroad was to Edinburgh by train. Despite this I and other in a similar are labelled frequent flyers or regular attenders (this is meant to be the better term) because we find ourselves in situations where our mental health has got to a point when we need support and intervention often requiring medical attention as a result of harming ourselves.

Self harm isn’t something people do for fun or because they enjoy being in a&e it’s because emotions become overwhelming (and this is a very simplified explanation of a complex issue) and as I’ve written before the treatment once you’re at a&e is often not pleasant or equal to the treatment of people going in for accidental injuries with long waits in loud and busy waiting areas and psych liaison who at most may give you a leaflet and discharge you at 4am with no way of getting home.

It’ll be no surprise that this latest rant is inspired by a crisis concordat meeting this morning, two hours of frustration at having to bite my tongue in frustration at the language used and throwaway comments about people with personality disorders and the triggering content in the suicide prevention information listing the age groups and sex of people who ended their life and details of methods chosen again separated by sex.

Sometimes I look at the people sitting around the same table as me and wonder how they can be so oblivious to the blatantly obvious, do they really not see the link between the high numbers of people in Richmond who come into contact with the street triage team and the above average number of people detained under section 136 of the mental health act and the complete lack of crisis services in the borough? Are they actually surprised that people who are distressed or in crisis don’t want to travel an hour or more to an area they may not know to get support? And may not have the means to do so? It really isn’t rocket science or a difficult connection to make, I don’t exactly consider myself the sharpest tool in the box yet I can see it so why can’t they?

Aside from Mind since I’ve been a part of the crisis concordat (around 2 years now) and the outcome based commissioning program (coming up for 8 months) only one person has actually asked me about my experiences of a&e and the treatment I receive it still seems like a radical idea to most of the people involved to actually listen to someone who’s been in the very situation they’re talking about. Despite feeling like i’m banging my head against a wall (thanks Steph) and frequently coming away wondering if being there serves any purpose I still keep going if only to play my own version of crisis bingo.

All Roads Lead to A&E

IMG_3951

“If you’re struggling you can go to a&e”

“If you really need support go to a&e”

“There’s always a&e if you’re in crisis”

Have you ever sat in a busy a&e waiting area? I have, 35 times between January 2015 and now. It’s not much fun, long waits, uncomfortable seats and lots of sick people. Now think about sitting in that environment when you’re in extreme emotional distress, maybe feeling suicidal or wanting to harm yourself, it’s not a very nice environment at the best of times let alone when you’re in crisis.

Someone at a mental health crisis planning meeting recently said that everyone under a mental health service should have a detailed crisis plan drawn up in collaboration with them, their mental health team and carers/ family/ partner where appropriate; this seems like a sensible suggest except there are no crisis services. Mental health isn’t 9 – 5 people are more likely to be in crisis outside those hours when there are less things to do or people to see and when they’re more likely to be alone.

As I’ve said before I’m a regular at a&e a “frequent flyer” or “frequent attender” but I’ve never been pre crisis or because I want to hurt myself it’s always been afterwards. I’m used to it now I know the drill busy Drs and nurses on 12 hour shifts earning far too little don’t have the time, energy and often experience to sit down and talk about what’s wrong they often see stitching my arms up as an inconvenience when there are people who aren’t there because of self inflicted injuries. Sometimes I see the psych liaison which is more waiting usually on the “observation ward” a holding pen in a&e where people are dumped to avoid breaching the 4 hour rule, because there’s no a&e in my borough the psych team aren’t from my area or the services that operate in it, I’ve been discharged by the psych team in the early hours of the morning with no way of getting home and told to wait in reception until the buses start running, when I told them I was suicidal I was given a leaflet (it went in the bin as soon as I left).

When I was under a mental health team they’d let them know but now a letter gets sent to my GP and that’s it, no follow up, no further support, no one pretends I won’t be back again, my self harm has been described as chronic and not a concern because it’s been going on so long despite having permanent damage to my arms and recently a cut that took over a year to heal. I don’t see a&e as a place of support it’s not the appropriate place for people with mental health problems yet all over the country it’s the only option for so many people, the police and ambulance service are as frustrated by it as I am, although the police have some powers to take people to the minimal crisis services that exist the ambulance service has no option but to take people in crisis to a&e whether they want to go or not.

It may sound defeatist to say I’d only go to a&e after I self harm because I don’t see the point in going beforehand but the experiences I’ve had in a&e don’t feel supportive and often leave me feeling worse. At the last mental health crisis service meeting I attended a paramedic spoke about her frustration at not being able to take someone in distress to a more appropriate place than a&e, despite there being two crisis cafes and a crisis and recovery house covered by the mental health trust my borough comes under (though not actually located in my borough) only the police can actually take someone there the paramedics only option is to take someone to a&e whether they want to go or not.

A&e should be the last option not the only option it should only be considered after all other options have been exhausted or if someone needs medical attention it shouldn’t be a place people in distress are routinely sent to.

 

A paper collage of an open mouth screaming

I know I’ve talked about cost before and I do understand the pressures placed on the NHS however this isn’t just about the actual finances but the attitudes towards money being spent on mental health care. Last year when the mental health trust that covers my area was considering putting in a crisis café I went to a consultation which was for service users, mental health professionals, third sector workers and generally anyone that might be interested or might consider bidding on to run the service.

Someone else attending the event worked out how much it would cost per person per night to attend a crisis café based on the figures from the model that the trust were basing it on and asked whether this was good value for money. This frustrated me for so many reasons one of them being why are we looking whether someone’s life is a cost effective use of funds and another was that the alternative to me is self harm and a&e.

It costs the NHS money to treat me – stitches and anaesthetic, dressings, bandages, Doctors and nurses time and psych liaison, if I get an ambulance to take me there because of blood loss or not feeling physically able to get there alone it costs the health service money and although I don’t know the exact figures (and I’m not sure I’d want to as it increases the guilt) but I’m sure it’s a lot more than the cost of attending a crisis café. I’ve seen people say that if you do it to yourself you shouldn’t expect the NHS to pay to fix it and while I can think of a few things I’d like to these people I also think once you start going down the route of denying people treatment if they’re responsible for the cause I think it’s a slippery slope towards finding blame for almost anything (didn’t notice your laces were undone sorry your fault, broke your leg skiing should have stayed at home).

Prevention is almost always better then cure and while I’m under no illusion that crisis cafés or any other crisis support would mean that no one went to a&e; I know it wouldn’t mean I never self harm but it would be an alternative. There’s a lot of talk at the moment especially with an election coming up about mental health and in particular the mental health of young people. I volunteer on a Youth wellbeing project and highly encourage mental health education and advice in schools but it doesn’t help the adults or children already experiencing mental health difficulties, it looks good on paper and even a liberal cynic like me can almost believe that’s not the only motive but it’s almost as if they want to write off those already in need of help and start again.
If we want people to thrive rather than just survive there needs to be more support, more money and more collaboration between the NHS and the third sector (actually collaboration not just expecting the third sector to pick up the pieces), the crisis concordat I’m part of has been cancelled twice in a row, it only meets every three months and the last one was in October there now won’t be another one until August. People with mental health problems deserve better and deserve more, too many people are left with nothing or sent home from a&e at 3 am with no way to get home, at this rate we cannot survive let alone thrive.

Dear Dr (a message to Healthcare professionals treating self harmers in hospital)

I’m a regular in my local, that probably doesn’t sound unusual or uncommon except I don’t mean my local pub I mean my local a&e department. Like around 1 in 4 people in the U.K. I have mental health problems and often require medical attention for self harm, I decided to write a post about my experiences in a&e as an open letter to medical professionals.

A collage picture of a wolf howling with song lyrics “Lately it’s hard to let you know that I’ll never learn” above and below

Dear Dr or health care professional

The NHS is underfunded and over stretched, you work long hours in a challenging conditions often with little thanks or support; it’s impossible to be oblivious to the current state of our health care system. When you’re juggling patients and trying to be in 3 places at once it’s not hard to understand why you might not want to spend an hour or more treating someone for self inflicted injuries especially when you’re coming to the end of a long shift; however you chose a career helping people and taking care of their medical needs and I am a person in need of medical attention.

If you’ve never experienced a mental health problem or felt a need to harm yourself then I don’t expect you to understand how I feel or why I do what I do but the way I got my injuries doesn’t change the way they should be treated. I’ve been treated in ways I can’t imagine people who are there after an accident would be. 
I’ve had wounds washed out in a sink in front of all the other cubicles and taken from one part of the department to another with nothing covering my arm while people stare at me often horrified, on one occasion my arm was covered so it wouldn’t scare the children in the paediatric a&e. 

I’ve been stapled with no local anaesthetic and told it’s fine because it doesn’t hurt (it does), I know this is in partly due to guidelines but I’ve also had malicious treatment where one Dr repeatedly pulled the Staples out and re did them all the while telling me if I didn’t stop I’d lose my arm while I sat in bed crying. I’ve had Drs tell me to think about how long it took them to treat me compared to the time it took me to hurt myself and when I’ve felt faint from blood loss and said I need to sit down told I can wait a couple of minutes. 

In my a&e notes it says most of the time that I’m not distressed or that I was making eye contact; apparently that means I’m fine. My mental state is frequently being judged as fine because I’m not shouting or being abusive or absconding however on times when I have been visibly upset I’m ignored.

I know accident and emergency staff are there to treat my physical injuries and leave the psychological side of things to the psych liaison but please remember that attached to the arm you’re treating is a person, I know my cuts can be deep and you may need another opinion but I’m not an exhibition for everyone to come and have a good look and discuss the damaged I’ve done, I see the signs that talk about dignity privacy and respect yet that doesn’t seem to apply if you’re a mental health patient; a little discretion wouldn’t hurt.

This isn’t intended as a criticism of the NHS I know I’d be dead without it but I didn’t choose to be this way, it’s something I’ve not been able to break away from despite treatment and no amount of snapping elastic bands of holding ice cubes has ever replaced it as a coping mechanism.

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