So. It rears its head again. Borderline Personality Disorder. I was at an appointment with my GP on Tuesday, and we were looking for the latest letter from the PsychDoc. My GPs computer is set up so that the patient can actually see information as it is pulled up. I don't know why, and I'm kind of wishing now that it didn't. Anyway, she pulled a letter that turned out to be from last year when I was with BabyPsychDoc Douchebag, rather than the lovely Dr F that I see at the clinic now. And the top line stated (I'm not sure of it verbatim) basically that patient has diagnosis of PTSD and Borderline Personality Disorder (although patient has expressed discontent over the latter diagnosis). Sigh. Patient did not express 'discontent', patient was never actually formerly given the diagnosis, tested for the diagnosis or had it explained in any way. Patient only found out about the diagnosis attached to her name when she saw it in the hospital records whilst in a neurologist appointment. Patient tried to (rather calmly and rationally, I may add) ask for confirmation and justification of this new added diagnosis, only to be met with noone who would actually admit to being the one to put said diagnosis in her file!
That was last September. Although it pissed me off, I let it go, because a) it didn't seem to be impacting in anyway on my course of treatment (as stated before BabyPsychDoc at the time was a complete and utter douchbag for many reasons, a classic line of his was "you seem to be doing better, but its always hard to tell with 'you people' WTF? But I was changed to seeing the Consultant Psych, until the new registrar replaced him, and she is really quite good) and b)to confront it to aggressively would be to affrim the stereotypes that surround the diagnosis...we wouldn't want a female patient who is actually proactive about her mental health treatment and advocates for herself now would we?
This time, I was pissed and I wanted to do something about it. First, this is now outside of hospital records and in my general medical records which follow me forever, having a chronic medical condition, I need to keep my medical records intact, and although current GP is lovely and it doesn't affect the way she treats me at all, there are others in the medical field who will stigmatise based on this diagnosis...thats just the sad truth of it. If I'm ever in a court case (God knows for what?) it can be supnoead (sp?) If I wanted to adopt etc etc...none of these are issues at the moment, but when you are thinking of something that follows you FOREVER. Second, it creates a distrust in the mental health system I'm supposed to derive support from. It is blatent dishonesty. What other diagnosis would it be acceptable to just sneak into somebody's records and NEVER discuss it with them. How am I supposed to trust what they say with such a fundamental omission in play. This is how it should be. Clinician sees signs and symptoms of a particular disorder, they test their hypothesis against the DSM and through testing. (I've never undergone any of the accepted tests for Borderline diagnosis ie Perry Borderline Personality Disorder Scale) and once they are supported in their diagnosis, they then (here's the important part) sit down with the patient, share their findings and opinions, explain the diagnosis and share the current treatment plan.
I'm not saying that I flat out refuse to accept such a diagnosis. I have issues with the diagnosis itself on conceptual grounds. 5 out of 9 criterion to meet the Disorder. Two people can share 1 symptom and be diagnosed with the same disorder. Statistically there are over 2000 variations of criterion combination that could justify a diagnosis. It just seems to be a very broad brushstroke to me. And any diagnosis that has a 75% female, 25% male split certainly has to be examined in the light of sociological context. That is, behaviour accepted as normal for men, being pathologised in females. Takes us right back to Ancient Greek times when women were thought to suffer from "wandering wombs". It is not at all a far reach to say the broadness of this diagnosis has led to it being used as a wastebin for "difficult" female patient who have the audacity not to respond to the righteous treatment of hubristic practioners, because of course it could not be that their treatment is actually inadequate. And the stigma that comes from such a diagnosis just serves to marginalise and suppress a population that quite often has already had a lengthy history of marginalisation and mistreatment, and should be treated with empathy and understanding. Does Borderline Personality Disorder exist? Most certainly. And it can debilitating for those who do classically fit the criteria. I read some fantastic blogs from people who have accepted this diagnosis, and find it to be helpful in explaining why they see and engage in the world the way they do. Does it automatically apply to anyone with an XX chromosome that self harms? According to the DSM it shouldn't..... but in reality it does.
So, jumping off my soapbox now. Because this is about me. Does it apply to me? My gut says no. After extensive reading, my mind says no. But I am reasonable and open to hearing the professionals opinions. If I can get them to talk to me. I spoke to my Case Manager (another lovely lady) this morning during our appointment and told her what I had seen, and let her know that I was going to bring it up at my appointment with Dr F on Tuesday, that I just wanted to get all of it out in the open, rather than it being dealt with in an underhanded way. I have no idea if it is the enduring opinion of the professionals or just the work of Dr Douchebag. I was just letting her know in case she wanted to be at the appointment, as she has been my Case Manager since the time of Dr Douchebag when this letter was written. She was quite supportive about it, without ever actually saying whether or not she agreed with the diagnosis. She is a psychologist and they can't actually diagnose here in Australia, and really I guess its probably not her place to speak for the team. I think she understood my frustration about the manner in which it was handled, although she did express how incredibly difficult it is to get something like that removed from one's record. I think she still felt it was important for me to find out once and for all, and to feel like there was a transparency in my treatment and not a me versus them thing going on. She also said that if it were her, given the implicit stigmas that can be attached to this particualr diagnosis she would want to ensure that it was thoroughly assessed and valid before it was attached to her file. So all in all, a positive response, and I am sure it will be the same with Dr F. Not necessarily that they will agree with me, but that they will at least be open and honest with me about it... and that's all I ask.
But then.
I went to therapy. (D) is a private psychologist, with no link to the public system. She asked what had been going on over the last few days, and I let her know, about my talk with (M) and the upcoming appointment with Dr F. Now, keep in mind, I didn't actually ask her whether she thought I had this disorder. Why? Well, first because she has stated before that she feels that there is overly too much emphasis on labels and that it takes away from the ability to truly 'see' the person. And second, because I didn't want to know. Seems a bit hypocritical, no? I want full disclosure from the Public Health professionals, but I don't want to know what my therapist thinks? And maybe it is. But her opinion is NOT written down in my records, she cannot officially diagnose me, so her opinion can't hurt me in that sense. But it can sure as hell hurt me in a more practical sense. Unfortunately, I guess by bringing up the conversation she assumed I wanted to know her opinion, and I did nothing to dissuade her from that assumption. Totally my fault. Well, 99% my fault. So she proceeded to give me her take. First, labels tend to be more of a distraction from seeing and understanding the person (see I do know her!), second that she has issues with Borderline Personality as a disorder, for similar reasons to what I mentioned above. But that she does believe that people can suffer from (and I'm paraphrasing) a disorder of their sense of self... I do love how she believes that semiotics make much of a difference at all. And apparantly, a good part of her studies, she focussed on Borderline Personality (a disorder she has issues with, so I'm a little confused) And she does think that some of the criterion I don't think I fulfill, I actually kind of do. For instance, abandoment issues. I certainly don't display the traditionally thought of "Borderline" behaviours around it... ie lack of Object Constancy etc... but that you can't have the experiences I did in infancy and childhood, and not have abandonment issues. She admitted she couldn't quote the DSM verbatim, and would have to have a look at it, and would be happy to bring it in and go through it with me. At this point, I had gotten pretty quiet.... and yes, a little hurt and upset. I told her that I didn't want her to bring it in, and in fact, I hadn't asked her opinion. At which point she stated "I'm a little confused", to which I replied "Me too".
So that's the sum of it. I think I would have been better not knowing her opinion. And now I'm kind of stuck between not wanting to know anymore and needing her to actually explain her position because I don't know if she thinks I have it or not, and now its the elephant in the room. And yeah, my feelings got hurt. But I also have to buck up and be prepared to face the truth, whatever that is, and part of that is being prepared to listen to others opinions. So i think I need to hear her out in full, and of course (M) and Dr F as well, and then test those opinions against my own. Afterall, logically, living with a mental illness, whatever it may be, can distort ones own perceptions and insight. It doesn't mean I have to just unreservedly accept others opionions, but, if they've shown themselves to be trustworthy, and they have taken the time to know me, and try to understand me, which all three of these women have, then I should at least listen.
So, for now, I'm left hurt and confused
Showing posts with label Rant. Show all posts
Showing posts with label Rant. Show all posts
Friday, July 23, 2010
Tuesday, July 13, 2010
Arghhhhh!
Argggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggggh! Therapy sucks balls. That is all.
Saturday, July 10, 2010
I've been thinking....
I have quite a few blogs that I read through Google reader. Some are other "mentals", some are more information based sites, humor sites etc etc. I love flipping open my laptop to see what awaits me in my Google reader each day, and there are a few blogs I get quite excited about when I see a new post in my tool bar. The blogs I read give me a number of different things... laughs, a feeling of "i'm not alone" and "oh, you too?", some inspire, some fill me with awe.... and recently, one in particular has been invoking a sense of "what the?"
Of course, its kind of a given in the Blogosphere that people write their own reality and sometimes that doesn't match up with ... let's say, reality reality. And people may tweak parts of their persona they are not happy with or are ashamed of. But what I really don't get are the people who out and out lie.
Especially about mental illness. Like its a badge of honor. A contest to see who can appear to be the most screwed up. Who has the absolute worst life. Newsflash. Mentalism is nothing to be ashamed of... but its certainly not a bowl of cherries, either. And why put so much effort into fabricating such an elaborate lie. Especially since, like most lies, it becomes more and more transparant as time grows on.
Certainly I tend to suspend my disbelief for the most part. Its a messed up world, and people certainly have unique histories and experiences, that I can barely fathom... but that doesn't make them any less real. This is the first time that my BS-meter has just sounded such loud alarms that I can no longer ignore the discomfort I feel reading this blog. I approach each knew post with a sense of trepidation and "what now?". I leave feeling insulted and patronised that this individual expects me to swallow the bollocks they are posting.
I guess its not restricted to the internetz. I have found myself simarly discombobulated when meeting people on the psych ward. ON THE PSYCH WARD! Why the hell would you take the charade of mental illness to the extent that you get yourself admitted, indeed actively seek admission, to a psych ward? It boggles my mind. But there have certainly been situations when I know, the other patients know, hell, the staff even knows these 'patients' are full of crap. Other patients certainly seem to be better than the staff at assessing who the 'fakers' are. But a person says the magic words "I'm suicidal" or "I hear voices", and they have to admit them. The first time at least. And for sure, often we can put on the most fabulous of fronts despite how crappy we feel. Certainly often the safety of the ward and the acceptance of the patient milleau is therapeutic and leads to positive lifts in the mood and symptoms of an individual. But don't tell me that you are barely sleeping at all because of your mania, when I walk past your room every night to hear your snores reverbrating down the corridor. When you miss every single breakfast because you are sleeping in. When you spend two hours talking perfectly normally and fluently to me, only to put on rapid speech and attempt to model disordered thoughts when a nurse sits and talks to you. You aren't that good an actress.
Why does it bother me? I mean really it doesn't affect me in the slightest. Well, it is somebody who is draining already limited resources and directing them away from people that need them, I guess. But I also guess that even if these people don't have the mental illnesses they claim to have, there is certainly something going on there to require such (and God, I hate this phrase, but I can't think of another) attention-seeking behaviour! And, for sure, I would rather a bunch of people who don't need the help recieve it, than one person who really does need it get pigeon holed with the attention seeking label and not get the help they need. But that's part of the problem. These people with their foolishness, create such an atmosphere of skeptacism and mistrust between mentals and the MH professionals, that people in need do fall through the crack. So many of you in the blogosphere are examples of this. The cynacism and unhelpfulness of those whose jobs it is to help. But I can imagine being taken for a ride over and over again, it must eventually wear down even the most caring of professionals!
Sigh. I don't know. Really, I just need to learn to let it slide off and not bug me so much. As much as it feels incredibly insulting.. its not directed at me. And in the end, I don't have to read it, I don't have to listen. So I won't. I've deleted this particular blog and their caricaturised, overdramatic, histrionic postings from my reader. Maybe I'm wrong about them... but me not reading won't hurt them any, and it will make me feel better.
How do you guys deal with people (on the internet or real life) who set your BS alarm into overdrive with their "mentalism?" Not the people who just misuse the terms 'depression' and 'anxiety' but those who seem to actively construct lies and grossly exaggerate and fabricate?
Of course, its kind of a given in the Blogosphere that people write their own reality and sometimes that doesn't match up with ... let's say, reality reality. And people may tweak parts of their persona they are not happy with or are ashamed of. But what I really don't get are the people who out and out lie.
Especially about mental illness. Like its a badge of honor. A contest to see who can appear to be the most screwed up. Who has the absolute worst life. Newsflash. Mentalism is nothing to be ashamed of... but its certainly not a bowl of cherries, either. And why put so much effort into fabricating such an elaborate lie. Especially since, like most lies, it becomes more and more transparant as time grows on.
Certainly I tend to suspend my disbelief for the most part. Its a messed up world, and people certainly have unique histories and experiences, that I can barely fathom... but that doesn't make them any less real. This is the first time that my BS-meter has just sounded such loud alarms that I can no longer ignore the discomfort I feel reading this blog. I approach each knew post with a sense of trepidation and "what now?". I leave feeling insulted and patronised that this individual expects me to swallow the bollocks they are posting.
I guess its not restricted to the internetz. I have found myself simarly discombobulated when meeting people on the psych ward. ON THE PSYCH WARD! Why the hell would you take the charade of mental illness to the extent that you get yourself admitted, indeed actively seek admission, to a psych ward? It boggles my mind. But there have certainly been situations when I know, the other patients know, hell, the staff even knows these 'patients' are full of crap. Other patients certainly seem to be better than the staff at assessing who the 'fakers' are. But a person says the magic words "I'm suicidal" or "I hear voices", and they have to admit them. The first time at least. And for sure, often we can put on the most fabulous of fronts despite how crappy we feel. Certainly often the safety of the ward and the acceptance of the patient milleau is therapeutic and leads to positive lifts in the mood and symptoms of an individual. But don't tell me that you are barely sleeping at all because of your mania, when I walk past your room every night to hear your snores reverbrating down the corridor. When you miss every single breakfast because you are sleeping in. When you spend two hours talking perfectly normally and fluently to me, only to put on rapid speech and attempt to model disordered thoughts when a nurse sits and talks to you. You aren't that good an actress.
Why does it bother me? I mean really it doesn't affect me in the slightest. Well, it is somebody who is draining already limited resources and directing them away from people that need them, I guess. But I also guess that even if these people don't have the mental illnesses they claim to have, there is certainly something going on there to require such (and God, I hate this phrase, but I can't think of another) attention-seeking behaviour! And, for sure, I would rather a bunch of people who don't need the help recieve it, than one person who really does need it get pigeon holed with the attention seeking label and not get the help they need. But that's part of the problem. These people with their foolishness, create such an atmosphere of skeptacism and mistrust between mentals and the MH professionals, that people in need do fall through the crack. So many of you in the blogosphere are examples of this. The cynacism and unhelpfulness of those whose jobs it is to help. But I can imagine being taken for a ride over and over again, it must eventually wear down even the most caring of professionals!
Sigh. I don't know. Really, I just need to learn to let it slide off and not bug me so much. As much as it feels incredibly insulting.. its not directed at me. And in the end, I don't have to read it, I don't have to listen. So I won't. I've deleted this particular blog and their caricaturised, overdramatic, histrionic postings from my reader. Maybe I'm wrong about them... but me not reading won't hurt them any, and it will make me feel better.
How do you guys deal with people (on the internet or real life) who set your BS alarm into overdrive with their "mentalism?" Not the people who just misuse the terms 'depression' and 'anxiety' but those who seem to actively construct lies and grossly exaggerate and fabricate?
Friday, June 18, 2010
Home Sweet Home
Finished up my prac yesterday, and got back to hometown a few hours ago.
First, can I say, how absolutely proud I am of myself for finishing out this prac and managing to stay somewhat 'together' for the month's duration of absence from home. Made infinitely harder by being surrounded by my family (I went back to childhood hometown for my prac) and barely having a minute of space and time to myself. Very challenging. There was a time I would have crumbled completely. Sure, I stumbled a bit... but in the end, I sucked it up and got the job done. So I feel ok about giving myself a wee pat on the back. My evaluation was quite good....they offered me a job when I graduate. A good compliment indeed, but living permanently around my family?..... Hell to the Naw! They also gave me a little morning tea send off and a box of choccies which was lovely. And my little poppets from the Special Ed unit made me feel very loved, letting me know that they would miss me. :) This was my first prac since taking up my third specialty in Special Education... but my experience has really cemented the fact that this is the area of Education where my passion lies.
Now, back on the homefront. My mum and her husband drove me back this evening (legally cannot drive anymore because of epilepsy). They are staying the weekend. As is older sis (again!) The thing is she doesn't even ask if she can stay. She just assumes its her god given right. OK. I can put up with that. Grit my teeth and deal. But after a month away, needing to come back to my own house and decompress. Especially given the fact I have a HUGE assignment due on Monday. I do NOT need to come back to her stomping around sulky and throwing narky, passive aggressive comments out. So, I did something I rarely ever do...I snapped and had a go at her. Usually I will avoid conflict by any means... it truly takes a lot to make me yell. My therapist (an many many others before her) have opined that I took on the role of mediator and sacraficial lamb in my family. I have been taught that my needs are less important than keeping the harmony, and basically it was my job to give in and not rock the boat, especially when it came to my older sister. The thing is, for so long we have let her get her way to avoid conflict, that we have created a monster. A narcassistic, drama queen, who constantly places herself in the victim role and has no trouble manipulating the truth in order to put herself there. Nothing is ever her fault, woe is me, oh how hard done by she is....blah blah blah.
Well, today, I am not playing. I have held myself together over the last month, now is the time for me to rejuvenate and have some time to just be authentic and true to my needs, rather than having to supress them for the greater goal. Which is basically what I told her (OK, yelled at her). Basically the gist was, she is full of shit, and never lets the truth get in the way of a good story, and she needs to stop playing the victim, or find somewhere else to play violin. Because I'm done. My house, my needs first. Somewhat, diluted by the fact that I then went and spent the evening in my room, because I was too uncomortable to be out in the living room. Sigh. I think its somewhat therapist (D's) fault. Yesterday, I had my phone appointment with her. My sister, was scheduled to take me over to my grandparents to take the call, but she did not end up taking me until 10 minutes before the appointment. I got there just as the phone was ringing, with a stomach full of anxiety knots about being late. (D) theorised that given Big Sis's history of being unable to handle any situation where I may deflect the attention off of her or be getting a little love and support, causing her to have to pull off some bullshit crisis, to return the attention where it 'rightfully' belongs.... that maybe she was intentionally trying to sabotage a connection to someone who would give me support and care (AKA D). I don't know really, but it was certainly a case of the whole world revolves around her, and I, and (D) should just wait and go by her schedule. Anyway, (D) did her validating thang, and spoke about how I shouldn't have to push my needs aside for Big Sis's all the time, blah blah blah....and somewhere in my head it actually stuck. Hence my attempt to stand up for myself and place boundaries. The thing is, as good as it feels....its like a night on the booze...feels good at the times, but the repercussions are going to suck in the long run.
Later in the night, I overheard Big Sis, whinging to mother about how she hadn't said anything back depsite my irrational and unfair 'attack' one her (could that be, because I called you out, and you realise you don't have a f*cking led to stand on, huh?)....wah...wah...back to trying to place herself back in victim role. A converstion she wanted me to hear, as she had it right outside my bedroom door. I went to my mum and basically gave her the heads up, that I'm not putting up with it this weekend, and Big Sis better keep her mouth shut and drop the attitude tomorrow or she can find somewhere else to go.
Sigh. I have a feeling things are going to go to hell tomorrow...you're damned if you do, damned if you don't
Leaving on a positive note......I am thrilled to be home. And will be up and bloggin more now. And I am gradually catching up on all your blogs (still about 500 posts on google reader to trawl through...lol)
Peace and love
Ophelia
First, can I say, how absolutely proud I am of myself for finishing out this prac and managing to stay somewhat 'together' for the month's duration of absence from home. Made infinitely harder by being surrounded by my family (I went back to childhood hometown for my prac) and barely having a minute of space and time to myself. Very challenging. There was a time I would have crumbled completely. Sure, I stumbled a bit... but in the end, I sucked it up and got the job done. So I feel ok about giving myself a wee pat on the back. My evaluation was quite good....they offered me a job when I graduate. A good compliment indeed, but living permanently around my family?..... Hell to the Naw! They also gave me a little morning tea send off and a box of choccies which was lovely. And my little poppets from the Special Ed unit made me feel very loved, letting me know that they would miss me. :) This was my first prac since taking up my third specialty in Special Education... but my experience has really cemented the fact that this is the area of Education where my passion lies.
Now, back on the homefront. My mum and her husband drove me back this evening (legally cannot drive anymore because of epilepsy). They are staying the weekend. As is older sis (again!) The thing is she doesn't even ask if she can stay. She just assumes its her god given right. OK. I can put up with that. Grit my teeth and deal. But after a month away, needing to come back to my own house and decompress. Especially given the fact I have a HUGE assignment due on Monday. I do NOT need to come back to her stomping around sulky and throwing narky, passive aggressive comments out. So, I did something I rarely ever do...I snapped and had a go at her. Usually I will avoid conflict by any means... it truly takes a lot to make me yell. My therapist (an many many others before her) have opined that I took on the role of mediator and sacraficial lamb in my family. I have been taught that my needs are less important than keeping the harmony, and basically it was my job to give in and not rock the boat, especially when it came to my older sister. The thing is, for so long we have let her get her way to avoid conflict, that we have created a monster. A narcassistic, drama queen, who constantly places herself in the victim role and has no trouble manipulating the truth in order to put herself there. Nothing is ever her fault, woe is me, oh how hard done by she is....blah blah blah.
Well, today, I am not playing. I have held myself together over the last month, now is the time for me to rejuvenate and have some time to just be authentic and true to my needs, rather than having to supress them for the greater goal. Which is basically what I told her (OK, yelled at her). Basically the gist was, she is full of shit, and never lets the truth get in the way of a good story, and she needs to stop playing the victim, or find somewhere else to play violin. Because I'm done. My house, my needs first. Somewhat, diluted by the fact that I then went and spent the evening in my room, because I was too uncomortable to be out in the living room. Sigh. I think its somewhat therapist (D's) fault. Yesterday, I had my phone appointment with her. My sister, was scheduled to take me over to my grandparents to take the call, but she did not end up taking me until 10 minutes before the appointment. I got there just as the phone was ringing, with a stomach full of anxiety knots about being late. (D) theorised that given Big Sis's history of being unable to handle any situation where I may deflect the attention off of her or be getting a little love and support, causing her to have to pull off some bullshit crisis, to return the attention where it 'rightfully' belongs.... that maybe she was intentionally trying to sabotage a connection to someone who would give me support and care (AKA D). I don't know really, but it was certainly a case of the whole world revolves around her, and I, and (D) should just wait and go by her schedule. Anyway, (D) did her validating thang, and spoke about how I shouldn't have to push my needs aside for Big Sis's all the time, blah blah blah....and somewhere in my head it actually stuck. Hence my attempt to stand up for myself and place boundaries. The thing is, as good as it feels....its like a night on the booze...feels good at the times, but the repercussions are going to suck in the long run.
Later in the night, I overheard Big Sis, whinging to mother about how she hadn't said anything back depsite my irrational and unfair 'attack' one her (could that be, because I called you out, and you realise you don't have a f*cking led to stand on, huh?)....wah...wah...back to trying to place herself back in victim role. A converstion she wanted me to hear, as she had it right outside my bedroom door. I went to my mum and basically gave her the heads up, that I'm not putting up with it this weekend, and Big Sis better keep her mouth shut and drop the attitude tomorrow or she can find somewhere else to go.
Sigh. I have a feeling things are going to go to hell tomorrow...you're damned if you do, damned if you don't
Leaving on a positive note......I am thrilled to be home. And will be up and bloggin more now. And I am gradually catching up on all your blogs (still about 500 posts on google reader to trawl through...lol)
Peace and love
Ophelia
Tuesday, March 16, 2010
Subsidies and rebates. Oh My! Oh My!
For too long accessible mental health care has been the under resourced, little brother of the medical world. Depressing clincs hidden in spaces, deemed no longer suitable for other purposes. That 'look' you get from the taxi driver when you give them the address, that you are "one of those people". Walking through a building that is on the verge of giving up, just as many of the souls who enter as patients (I hate the term clients) are.
The care afforded through the Public System, is by necessity, crisis driven. Case workers are overworked, wards are understaffed, bed shortages run amuck. Early intervention into the beginning signs of mental illness is left to poorly equipped GPs. Crisis Care is like a conveyor belt of tick the boxes and process the "crazy" through and out ot the system as quickly as humanly possible. The post crisis interventions as a whole can smack of the "bandaid" approach.
Of course this is not just mental health. Public Healthcare all over Australia is suffering economic and staffing shortages. But Mental Health is an area where it is really easy to cut corners, because the ones who access it are less likely to be able to advocate for themselves.
A few years ago, the Government finally caught onto the idea that the average citizen is as entitled to subsidised mental health care visits, as they have been to visits to GPs, Optometrists ect. Well, kinda... I will use myself as an example: If I was to develop a chest infection and need antibiotics, I would book into my GP. Pay their fee (AUD$65 for short consult) and then claim my Medicare rebate (about AUD$38). So, I pay the $17 gap for the visit. Now I can do this as often as I need. With me, it is at least once a month to get my scripts filled and blood levels on my epilepsy meds checked. Under the new mental health scheme, I could go to my GP with a mental health issue (in my case PTSD) and she would write up a mental health plan and refer me to a Psychologist for Medicare subsidised treatments. (Pay AUD$130, Rebate AUD$115) The catch is, it can only be for 12 sessions (18 in extremis), which averages at about one a month. now in a soild block, that might be helpful for say a CBT approach, or even short term psychodynamic therapy. but for people like me? Not so much. Annoyingly, If I was seeing a psychiatrist, who would just want to shove pills down my throat, that would be covered for infinite amounts of sessions under Medicare.
So, the system is kind of better for me then it was, but still not ultra helpful. My private health insurance would assure you that they take mental health very seriously in their plan. They cover a whole.....6 sessions. Grrrrrrrrrrreat! So, thats 24 sessions covered in all, not even one a fortnight. And when you take someone like me, who has to go 2-3 times per week, well that's a heall of a shortfall I have to cover. Luckily, I have a therapist who works on a sliding scale. But let me tell you, it's still bleeding me dry.
I don't expect that EVERYTHING should be covered, and people should have no responsability for their own healthcare costs. But there has to be a balance. And something as important as mental health, should be judged just as importantly as cardiac care. IT KILLS TOO.
Which is why it makes me really mad to read about them considering whether the Medicare Subsidy for Psychology should stay. The fact that it is costing more than projected should be telling the powers that be, that there is a serious shortfall in 'other' mental health services. It should be, in my opinion, expanded, not scrapped. Of course, there has to be limits. That's why the GP's have to do a thorough psych evaluation and you have to meet certain criteria to qualify.
http://www.theaustralian.com.au/news/nation/psychologists-quit-in-row-over-standards/story-e6frg6nf-1225839771023?referrer=email&source=AusBus_Morn_email_nl&emcmp=AusBusMorn&emchn=Newsletter&emlist=Member
*Ahem* Stepping off my soap box for the day
The care afforded through the Public System, is by necessity, crisis driven. Case workers are overworked, wards are understaffed, bed shortages run amuck. Early intervention into the beginning signs of mental illness is left to poorly equipped GPs. Crisis Care is like a conveyor belt of tick the boxes and process the "crazy" through and out ot the system as quickly as humanly possible. The post crisis interventions as a whole can smack of the "bandaid" approach.
Overloaded caseworkers are unable to give due attention to the long-term needs of their clients. Shortages mean that mental health practitioners refuse to carry out early intervention until the person is ‘acutely’ unwell, leading to forceful intervention. Thus, patients are not kept well, risks are not minimised and disorders are not averted when they ostensibly could be...
Even in times of crisis, anecdotal evidence suggests that patients are not admitted or are discharged early due to an inability to access an available inpatient bed. Reduced access to care has been linked to higher rates of post-discharge suicide
A few years ago, the Government finally caught onto the idea that the average citizen is as entitled to subsidised mental health care visits, as they have been to visits to GPs, Optometrists ect. Well, kinda... I will use myself as an example: If I was to develop a chest infection and need antibiotics, I would book into my GP. Pay their fee (AUD$65 for short consult) and then claim my Medicare rebate (about AUD$38). So, I pay the $17 gap for the visit. Now I can do this as often as I need. With me, it is at least once a month to get my scripts filled and blood levels on my epilepsy meds checked. Under the new mental health scheme, I could go to my GP with a mental health issue (in my case PTSD) and she would write up a mental health plan and refer me to a Psychologist for Medicare subsidised treatments. (Pay AUD$130, Rebate AUD$115) The catch is, it can only be for 12 sessions (18 in extremis), which averages at about one a month. now in a soild block, that might be helpful for say a CBT approach, or even short term psychodynamic therapy. but for people like me? Not so much. Annoyingly, If I was seeing a psychiatrist, who would just want to shove pills down my throat, that would be covered for infinite amounts of sessions under Medicare.
So, the system is kind of better for me then it was, but still not ultra helpful. My private health insurance would assure you that they take mental health very seriously in their plan. They cover a whole.....6 sessions. Grrrrrrrrrrreat! So, thats 24 sessions covered in all, not even one a fortnight. And when you take someone like me, who has to go 2-3 times per week, well that's a heall of a shortfall I have to cover. Luckily, I have a therapist who works on a sliding scale. But let me tell you, it's still bleeding me dry.
I don't expect that EVERYTHING should be covered, and people should have no responsability for their own healthcare costs. But there has to be a balance. And something as important as mental health, should be judged just as importantly as cardiac care. IT KILLS TOO.
Which is why it makes me really mad to read about them considering whether the Medicare Subsidy for Psychology should stay. The fact that it is costing more than projected should be telling the powers that be, that there is a serious shortfall in 'other' mental health services. It should be, in my opinion, expanded, not scrapped. Of course, there has to be limits. That's why the GP's have to do a thorough psych evaluation and you have to meet certain criteria to qualify.
http://www.theaustralian.com.au/news/nation/psychologists-quit-in-row-over-standards/story-e6frg6nf-1225839771023?referrer=email&source=AusBus_Morn_email_nl&emcmp=AusBusMorn&emchn=Newsletter&emlist=Member
*Ahem* Stepping off my soap box for the day
Saturday, March 13, 2010
On the ward and out of my mind- My Keepers
For previous "On the ward posts" refer to here, here, here, here, here and here.
Well, it would appear Ophelia, that you are anaughty, naughty girl danger to yourself, and we, in our infinite wisdom have decided to provide one-on one nursing for you to spy on you, and take notes about every meaningless comment and insignificant action keep you company and ensure your safety.
Really, I am being quite unfair. I have only been put on constants once before in my 'mental career' and that was because I had to be on a medical ward, and they were worried about me being around all the shiney, sharp tools. This time, they quite fairly were concerned that while their back was turned I would do myself in, or at least leg it, and then do myself in. So I was put on Special Obs. To be kept within a couple of feet of my nurse for that hour at all times. Or as the nurses put it, in their ever so tactful way, to be babysat.
I'm in two minds over whether this was a great trial for the nurses to endure. It did mean one less nurse on the floor every hour. But each nurse was allocated an hour per shift with me, perhaps two at a stretch. I am told for the first few days I was pretty uncommunicative, so not a heck of a lot of fun. But with the invention of I-Phones the nurses found ways to pass the time. After a while my witty reparte returned, and I am sure I was a wonderful "constant patient". Well, I didn't abuse them, try to attack them, hurl obscenities or anything like that, so they should just be grateful! :P
There were four main reasons being on constants probably sucked for them:
1. They couldn't hide in the staff room "charting"
2. They had to accompany me to the bathrrom
3. They had to sit in an uncomfortable hospital issue chair, while I snoozed away in luxury.
4. I was up and down like a yo yo for ciggies, and as my shadows, so were they! he he.
The four reasons being on constants probably rocked for them:
1. Alarm bell: Sorry can't help I'm on constant
2. Needy patient wanting something. Sorry can't help i'm on constant
3. Code Brown: Sorry can't help I'm on constant
4. Paperwork not complete? Sorry was on a constant.
The four reasons constants sucked for me
1. No privacy. With phone calls, with visitors.
2. Nothing more annoying than someone sticking to you like a barnacle when you just want to be left the f*ck alone
3. The bathroom thing. OMG.
4.Constantly being asked, so "Do you know why you've been sectioned? Placed on constants? How do you feel right now? Blah blah blah.
The four things that rocked about constants for me.
1. Never having to wait for half an hour outside the nurses station for your nurse to actually get off her butt.
2. Always having someone to check the answers to the crossword with
3. Prevents family from having D and M conversations when you are totally not up to it.
4. Honestly, had some shit nurses, ok ones and a few really good ones. The good ones helped me to really process what was going on in my mind as it was happening. provide reassurance in a frightening time. Provide hope in a time of chaos and feeling out of control.
In a perfect world. Nurse caseloads would be a lot less. Paper work would be limited. And then maybe some patients could get the quality of care I recieved in that time. (Minus the "special time" in the bathroom together)
Well, it would appear Ophelia, that you are a
Really, I am being quite unfair. I have only been put on constants once before in my 'mental career' and that was because I had to be on a medical ward, and they were worried about me being around all the shiney, sharp tools. This time, they quite fairly were concerned that while their back was turned I would do myself in, or at least leg it, and then do myself in. So I was put on Special Obs. To be kept within a couple of feet of my nurse for that hour at all times. Or as the nurses put it, in their ever so tactful way, to be babysat.
I'm in two minds over whether this was a great trial for the nurses to endure. It did mean one less nurse on the floor every hour. But each nurse was allocated an hour per shift with me, perhaps two at a stretch. I am told for the first few days I was pretty uncommunicative, so not a heck of a lot of fun. But with the invention of I-Phones the nurses found ways to pass the time. After a while my witty reparte returned, and I am sure I was a wonderful "constant patient". Well, I didn't abuse them, try to attack them, hurl obscenities or anything like that, so they should just be grateful! :P
There were four main reasons being on constants probably sucked for them:
1. They couldn't hide in the staff room "charting"
2. They had to accompany me to the bathrrom
3. They had to sit in an uncomfortable hospital issue chair, while I snoozed away in luxury.
4. I was up and down like a yo yo for ciggies, and as my shadows, so were they! he he.
The four reasons being on constants probably rocked for them:
1. Alarm bell: Sorry can't help I'm on constant
2. Needy patient wanting something. Sorry can't help i'm on constant
3. Code Brown: Sorry can't help I'm on constant
4. Paperwork not complete? Sorry was on a constant.
The four reasons constants sucked for me
1. No privacy. With phone calls, with visitors.
2. Nothing more annoying than someone sticking to you like a barnacle when you just want to be left the f*ck alone
3. The bathroom thing. OMG.
4.Constantly being asked, so "Do you know why you've been sectioned? Placed on constants? How do you feel right now? Blah blah blah.
The four things that rocked about constants for me.
1. Never having to wait for half an hour outside the nurses station for your nurse to actually get off her butt.
2. Always having someone to check the answers to the crossword with
3. Prevents family from having D and M conversations when you are totally not up to it.
4. Honestly, had some shit nurses, ok ones and a few really good ones. The good ones helped me to really process what was going on in my mind as it was happening. provide reassurance in a frightening time. Provide hope in a time of chaos and feeling out of control.
In a perfect world. Nurse caseloads would be a lot less. Paper work would be limited. And then maybe some patients could get the quality of care I recieved in that time. (Minus the "special time" in the bathroom together)
Sunday, February 21, 2010
On the ward and out of my mind: You are nurses, right?
Back to On the Ward and out of my mind, you may also want to read this, this, this and this.
I was diagnosed with epilepsy quite a few years ago. Juvenile Myoclonic Epilepsy to be specific. As I have,moaned about incessantly alluded to on this blog, this has been a bit hard to manage at times because of my PTSD encouraged insomnia. I tend to have a lot of myoclonic episodes (aka petite mals or weird little jerks that make me look freaky) and less of the tonic-clonic seizures (aka grand mals or randomly dropping to the floor unconciously in a break-dance type fashion) At the moment with sleep being completely f*cked less than ideal, I am averaging about 1 or 2 tonic-clonics a month.
Anyhow... when I was admitted to Ward B, I had a plethora of medical health issues as well as the quite obvious fuck-uppery, what with me trying to kill myself and all. I was still recovering from aspiric (sp?) pneumonia, from being extubated, I had a little damage to my cerbellum (a fairly important bit of grey matter when it comes to motor skills and some cognitive processes) and some pretty major damage to my vestibular system (fairly important for staying upright and balanced) and finally I had the pre-exisiting condition of epilepsy.
Upon admission to the ward, the nurses freaked the frack out. I wasn't supposed to overhear these conversations, but meh, if you are going to talk right outside more door what do you expect? Basically, they didn't feel equipped to handle my medical needs, didn't have time to do the extra time with me for the rehab exercises I needed to do twice a day, blah blah blah. Ultimately in the end, they didn't do to badly that first admission. They managed to find time for my exercises, the pneumonia resolved with antibiotics, and although I had a number of seizures they would generally just help me to bed, or if in bed change the sheets if necessary, only calling the doctor in on one occasion where the seizure was longer than average.
However on my second admission about three months later, things were not quite so straightforward. It took four days just to get the necessary equipment (shower chair and toilet chair) brought down, which resulted in some very unsafe practices. (I was using a zimmer frame at this point). And there was oneold bitch nurse who decided unilaterally, and without consultation with doctors or any other nurse, that my seizures were in my head. Had she read my medical notes she would have quickly been dissuaded from this notion... or maybe not, she was pretty old school, and seemed to hold the opinion that all people with mental health issues were merely naughty children needing attention. On particular day, I went back to bed, feeling quite dizzy and unwell. This nurse (not even my designated nurse) took umbrance to me being in bed in the middle of the day. I tried to explain I was feeling poorly and possibly might have a seizure coming on. I hadn't had the aura yet, but generally in the hours leading up to a seizure I can feel a bit poorly, and either way a nap would either resolve it, or else I would be in a reasonably safe place if I had a seizure. She basically told me it was nonsense and frogmarched me back to the tv room. After 10 or 15 minutes I felt decidedly worse, and got up to tell her I needed to be in my room (I also didn't want to have a seizure with a whole room of strangers gawping) but one look at her face told me she wasn't going to listen, so as my aura kicked in I made my way to the bathroom, where I promptly fell face first onto the tiles, smashing in my front teeth and bloodying my nose, having...suprise suprise... a seizure. By the time I properly came out of the post-ictal state, she had gone home and was not back on shift for the rest of my stay. I had smashed in teeth and a swollen nose, to remember our time together though. They took me to the dental hospital and got caps for the broken teeth, which subsequently crumbled, as there was not enough tooth to adhere too. Lucky me also got to endure four root canals about 6 months later, due to the nerve damage done. My teeth are still a mess, and it will likely cost me a great deal of money out of my own pocket to fix them (there is a possibility I can get them fixed through a referral program with new mental health service district... appointment is in March) My mother hit the roof when she found out, but unfortunately we were a bit to busy trying to keep me sane-ish over the next little while, to follow through and make sure my complaint was dealt with adequately.
Other than that, my immune was rather inept at this point, due to lack of sleep and a significant weight drop, and particularly during my first stay I seemed to catch every flu and cold that patients and nurses alike carried in on the germ infested little bodies.
Nothing quite so problematic at Big City Hospital. I did have a few seizures during my stays there. One rather humiliating one in the shower, however in general they did a pretty good job responding. The only gripe I have, is that during one such seizure, I not only voided (not all that unusual), but also threw up (quite unusual). They did help me to change (embarassed much?...yup!) but they left me to sleep it off with some rather unpleasant regurgitated matter in my hair. Fair enough, they were probably allowing me to rest, but running a damp wash cloth over my face and hair... basic nursing 101. I also vaguely recall my designated nurse delegating her student nurse to clean the vomit from the floor, because she could not handle vomit. Possibly why she became a MH nurse?
In my opinion, a nurse is a nurse here in Australia. Yes, Mental Health Nurses are a skilled subset, but that doesn't mean that they should let the basics of patient care go.
End result for the most part, if you are going to be in a mental health ward, you are better off to have no pre-existing medical ailments.
NB: That being said, from a Community Mental Health perspective, both my Case Managers have been super-duper in supporting my other medical issues. CM from my time in Ward B, would drop me off to Outpatient Rehab and Physio, organised to have a safety belt custom made for me so that I could do additional rehab safely at my Gym, and also came to a number of individual assessments with me to to keep abreast of my progress, and see what ways she could help facilitate it. CM from BCH, has made sure I was getting my appointments with NeuroDoc, and has also been the one to get me the referral for aforementioned Dental Appointment in March.
I was diagnosed with epilepsy quite a few years ago. Juvenile Myoclonic Epilepsy to be specific. As I have,
Anyhow... when I was admitted to Ward B, I had a plethora of medical health issues as well as the quite obvious fuck-uppery, what with me trying to kill myself and all. I was still recovering from aspiric (sp?) pneumonia, from being extubated, I had a little damage to my cerbellum (a fairly important bit of grey matter when it comes to motor skills and some cognitive processes) and some pretty major damage to my vestibular system (fairly important for staying upright and balanced) and finally I had the pre-exisiting condition of epilepsy.
Upon admission to the ward, the nurses freaked the frack out. I wasn't supposed to overhear these conversations, but meh, if you are going to talk right outside more door what do you expect? Basically, they didn't feel equipped to handle my medical needs, didn't have time to do the extra time with me for the rehab exercises I needed to do twice a day, blah blah blah. Ultimately in the end, they didn't do to badly that first admission. They managed to find time for my exercises, the pneumonia resolved with antibiotics, and although I had a number of seizures they would generally just help me to bed, or if in bed change the sheets if necessary, only calling the doctor in on one occasion where the seizure was longer than average.
However on my second admission about three months later, things were not quite so straightforward. It took four days just to get the necessary equipment (shower chair and toilet chair) brought down, which resulted in some very unsafe practices. (I was using a zimmer frame at this point). And there was one
Other than that, my immune was rather inept at this point, due to lack of sleep and a significant weight drop, and particularly during my first stay I seemed to catch every flu and cold that patients and nurses alike carried in on the germ infested little bodies.
Nothing quite so problematic at Big City Hospital. I did have a few seizures during my stays there. One rather humiliating one in the shower, however in general they did a pretty good job responding. The only gripe I have, is that during one such seizure, I not only voided (not all that unusual), but also threw up (quite unusual). They did help me to change (embarassed much?...yup!) but they left me to sleep it off with some rather unpleasant regurgitated matter in my hair. Fair enough, they were probably allowing me to rest, but running a damp wash cloth over my face and hair... basic nursing 101. I also vaguely recall my designated nurse delegating her student nurse to clean the vomit from the floor, because she could not handle vomit. Possibly why she became a MH nurse?
In my opinion, a nurse is a nurse here in Australia. Yes, Mental Health Nurses are a skilled subset, but that doesn't mean that they should let the basics of patient care go.
End result for the most part, if you are going to be in a mental health ward, you are better off to have no pre-existing medical ailments.
NB: That being said, from a Community Mental Health perspective, both my Case Managers have been super-duper in supporting my other medical issues. CM from my time in Ward B, would drop me off to Outpatient Rehab and Physio, organised to have a safety belt custom made for me so that I could do additional rehab safely at my Gym, and also came to a number of individual assessments with me to to keep abreast of my progress, and see what ways she could help facilitate it. CM from BCH, has made sure I was getting my appointments with NeuroDoc, and has also been the one to get me the referral for aforementioned Dental Appointment in March.
Friday, February 19, 2010
Showering
Lil Sis turned to me this afternoon and said "You know, Crazyboy is going to be here soon...." Crazyboy, is her new...erm...Bf? Fling? Bit on the side?... its all still a bit unclear. He lives on the coast, about an hour and a half away. She has been heading down there every weekend recently to spend time with him. I guess, after four months of living with her ex AFTER THEY HAD BROKEN UP, she now feels free to pursue something different. I can just hope that she doesn't rush into things. Anyway, I've only met CrazyBoy once when he came down the other weekend to go to the waterpark with us. I'm sure he is a nice guy, but he is soooo full of energy, its drives me insane. He never stops talking. He acts and speaks on impulse. Its like he is the re-incarnation of a Golden Retriever. But.... he makes her happy, and its been a while since she has been happy. And anyways, she usually goes to stay with him.
But this afternoon he was on his way to spend the weekend at our house. Sigh. She tried again "He's going to be here in 15 minutes..." And left that hanging in the air, as she looked me up and down meaningfully. I paused, and did inventory. Last shower, two days ago. Hair stringy and pulled back with a headband. Attire, pajamas with a chocolate stain on the top. "Right, so you want me to have a shower then?". "Well, maybe even just put on a bra?" she replied hopefully. Grudgingly, I made my way to the bathroom to human-ify myself again.
I get it, I do. I mean, that's one of the good things about living with family. When I'm not at my best, and schlepping around unwashed, in pajamas, she accepts it. When I am incommunicative and lying in bed for hours staring at the well, she knows its because I'm having one of my bad days. On the days that I HAVE to go out and face the world, I have to make some effort, but at home, I can just schlep if I don't have the energy. But Crazyboy doesn't know me. And in the bloom of a new relationship, slovenly, depressed sisters aren't high on the romance scales.
I get it. And really, showering and wearing day clothes is not that much of an ask. It's what normal people do. But there is a tiny part of me, that is ever so resentful that for the near future, I am going to have to put on "Game Face" in my own home.
But this afternoon he was on his way to spend the weekend at our house. Sigh. She tried again "He's going to be here in 15 minutes..." And left that hanging in the air, as she looked me up and down meaningfully. I paused, and did inventory. Last shower, two days ago. Hair stringy and pulled back with a headband. Attire, pajamas with a chocolate stain on the top. "Right, so you want me to have a shower then?". "Well, maybe even just put on a bra?" she replied hopefully. Grudgingly, I made my way to the bathroom to human-ify myself again.
I get it, I do. I mean, that's one of the good things about living with family. When I'm not at my best, and schlepping around unwashed, in pajamas, she accepts it. When I am incommunicative and lying in bed for hours staring at the well, she knows its because I'm having one of my bad days. On the days that I HAVE to go out and face the world, I have to make some effort, but at home, I can just schlep if I don't have the energy. But Crazyboy doesn't know me. And in the bloom of a new relationship, slovenly, depressed sisters aren't high on the romance scales.
I get it. And really, showering and wearing day clothes is not that much of an ask. It's what normal people do. But there is a tiny part of me, that is ever so resentful that for the near future, I am going to have to put on "Game Face" in my own home.
Tuesday, February 16, 2010
On the ward and out of my mind- Therapeutic or Babysitting?
Continuing on from here, here and here
One cannot expect to go into a mental health ward (at least in the public system) and experience any real therapy. There are several reasons. The focus on providing treatment in the least restrictive environment (and lets face it, also the lack of financial resources to have enough bed space) mean that all but the most severe cases of psychosis or the forensic cases are discharged in quite a short amount of time. In my experience, most people are there between 2-14 days at most. The emphasis is quite heavily on containment whilst the worst of psychotic symptoms/ suicidal ideations pass and medication adjustments.
I was first admitted to Ward B in 2006. My first admission was quite a lengthy one, in part due to the additional medical issues I experienced as a result of my overdose. I was in hospital for about 2 and a half months. Over the next two years, I was admitted on four other occasions, for periods ranging from 5 days to two weeks. Whilst in hospital there were a number of people I could theoretically talk to, in order to process what I was going through and experiencing.
Consultant Psychiatrist
Generally, I saw this guy maybe once a week at most. Usually it would be him, a Student, my assigned nurse for the shift and I. Occasionally members from my medical team were invited to participate. Not quite like the horrible ward rounds that you guys in the UK have described. But still somewhat intimidating. The focus of these meetings was primarily to establish where I was at, mental health wise and to adjust medications. They usually only lasted five minutes or so, and there was generally no suggestion on how I might deal with some of the symptoms I was experiencing, other than to suggest I ask my nurse for a prn when needed. The consultant changed over the two years that I was in and out, but the one thing that did remain the same was that he was male, usually quite authoritarian and foriegn. I found myself getting quite upset when having to go through my history with these guys, as a) I wasn't really comfortable with men b) several things on Doctor said to me about my family made me feel quite judged (I think it was due to significant cultural differences in the ideas surrounding parents and respect) and finally, as English was not their first language, it was near impossible to talk in the idioms and metaphors, we would generally engage to soften the impact of telling a trauma. They simply did not understand. Language had to be clear cut and brutally to the point. Raw and stark. Being the passive personality I am, I usually just accepted it, but one occasion it got too much for me and I got up and stormed out of the treatment room. Unfortunately, anyone who has ever needed a walking stick before can tell you it is near on impossible to "storm off" and I ended up going arse up in front of the nurses station and all the patients. I then promptly burst into tears, which the nurses responded to quite quickly, as I am known to be a non-crier. Bundled off to my room, the nurse could do little more than pat my shoulder as I howled for the next 15 minutes. That's why I don't cry. Once I do, I can't stop. Anyways....
Nurses
As I mentioned, you got an assigned Nurse at the beginning of each shift, who was supposed to check in with you for that shift, and if you had any additional problems you were to find them. The one thing all the nurses had in common was that they were OVERWORKED. The bulk of their time by necessity had to be spent caring for the geriatric patients. They weren't normally sitting in the office ignoring us (it was a cramped, uncomfortable space anyway), they were working hard. That's where the similarities ended. Some nurses were so burnt out from the demands of "general nursing" on the ward that they had no energy left for mental health nursing. A brief "How are you today?" was sufficient to their requirements and if you did approach them with an issue, they would try to listen but you could see that harried look in their eye of someone who knows they have 1001 things to do before their shift ends. Some were burnt out by the demands, but made the effort anyway. Spent the time developing rapport with the patients. Back in the days before somking restrictions came into full force, they may sit in the courtyard and have a smoke with a group of patients, always observing, in a non-confrontational way that is so much better than "How are you today?". They may be too busy to deal with you straight away but they will tell you when they can see you, and they will keep their promise. They had the skills to turn subjects that we had in common into ways of exploring the patients issues. For instance one nurse, who was also a professional photographer, would always want to see what was new in my portfolio, and we would discuss how it was representative of the way I saw the world..... and finally there was the last kind of nurse....relatively rare, thankfully. The ones who hated mental health patients, thought we were all just lazy sods who were bunging it on for attention. Mind you, the community had its share of acopic personalities that made their way to Ward B, but no excuse for the nastiness these women exuded. If its not a field you want to work in, that interests you...then why the hell work there! I met some wonderful nurses in Ward B. As a gimpy, little long term patient, who wasn't violent or particularly demanding, I was out of the ordinary for them. Most patients were gone too quickly for them to develop rapport and the ones that remained (in Ward B at least) were pretty far gone to dementia. So, I guess in a way I became their little mascot. But for those majority of nurses who did the best they could in an under-resourced area, there were 3 or 4 nurses, whose callous actions or words remain with me today
Case Manager
I didn't get introduced to my first Case Manager until I was about a week away from discharge. Their focus is generally Ccmmunity Care. My first Case Manager (Y) was fantastic. She found away to relate to her clients, she made sure to make the meeting spaces somewhere comfortable, whether it be a park or a coffeespot, and she firmly believed in talking and doing.. in other words, by all means talk about what was going on, but at the same time go for a walk as part of my PT or go and check out a second hand book store. Anyways she was my Case Manager for most of the time I was in that area... and whilst I was in hospital she did check-in on me, she would drive me to and from my private psychiatrist appointments, when I had permission to leave the hospital. She was less of presence than out in the 'real world', I guess because she knew while I was in there I was relatively safe and contained.
Patients
Anyone who has spent time in a mental health facility will know that it is the patients that you spend the most time talking to. And often the ones you turn to, for advice or comfort. There are some inherent difficulties in this. You have to be concious of the fact that a) some of them will not be entirely truthful with you, and b) some of them will have issues that may end up impacting on your own mental health. This is particularly important to keep in mind if you decide to keep in contact outside of the ward. But the benefits are they are usually extremely judgmental, and even though no person has exactly the same experiences as you they do have a greater understanding than the average person. The other thing they bring to the table is some comraderie and humor in a dark time in your life. There is a suprising amount of laughter in a Mental Health Ward. The downside to this, is many of the 'acopic' patients, went from this comraderie and support back to their isolated and lonely existences, felt the void, and so would make a suicidal gesture just to be re-admitted for a few days to a world where they felt accepted.
Other hospital staff
Being a longer term patient, the housekeeping staff got to know me quite well, and would often stop for a quick chat. It was all very light, but it was always nice for them to compliment me on how well my walking was coming along, or as one old duck said to me "Some meat on your skin and those dark circles away from your eyes, you're starting to look quite bonny" :) In addition, (S) my physiotherapist was a fantastic support. She worked really hard to keep me goal focussed on the future, to give me hope, but on the few occasions I did fall apart, she was lovely too. I guess she didn't have to adhere to boundaries as strongly as the MH professionals do, and in those times when I was wondering if I was ever going to walk, read and talk properly again, she would take my hand and let me cry. She also provided me ample opportunites to get out the pent up anger inside me and direct it into my rehab sessions, knowing when to push my buttons to get me to push myself just that little bit further out of anger. She was a big reason why I recovered physically as well as I did, but I also believe she was a big reason why I made the steps forward with my mental health too.
Private Psychiatrist
By this stage I had been seeing Dr B for a little over a year. As soon as I was allowed out on leave, I began to go to my appointments with her twice a week, first on escorted leave with either my mum or Case Manager, and then by myself. I found it quite surreal that I was signing out of a psychiatric hospital to get psychiatric help, but the reality was, in order to get the containment I needed to go outside of the Public System.
There were some differences and some similarities at Big City Hospital.
Consultant Psychiatrist
Usually there was just you, him and the junior doc. Not quite as confronting as at Ward B, but also it meant that there was no nurse to explain things to you when you left. I often found it hard to absorb what was being said. The consultations were the same length, about 5 minutes, but seemed to be more regular than on Ward B. Every 2-3 days. He is also the guy who heads the team the Junior Doctor and Case Manager assigned to me in community care are apart of. This means he is kept more regulalry apprised of what is going on with me, and is generally consulted in CM thinks I might need an admission. So there is a lot less repeating myself. And quite often they will do a direct admit rather than make you endure a horrible A&E admit.
Nurses
Now this is one that I do get quite cranky about. I understand that we live in a world of paperwork, back-up paper work and back up, backup paperwork, but the amount of time the nurses spent even out of the office, let alone actually engaged with patients was abysmal. They did not have the same geriatric workload as Ward B nurses. WHAT ARE THEY DOING?? I believe a small part of it can be attributed to the system of medication hand outs. In Ward B, three times a day you lined up outside a window for your medication, this took two nurses about an hour to do. Of course, they had to track down the odd non-compliant patient, but it worked pretty well. Assigned nurses gave out any prns or the odd medication that fell outside these times. In BCH, each assigned nurse, prepares the meds for each of their patients and then runs around the ward like a headless chook with a dixie cup of pills and another of water, trying to find their patient. As there is a bunch of nurse all trying to do this at the same time, the tiny meds room gets quite jammed up, which slows the process further. I've watched an individual nurse take two hours to get through all her meds. It seems to be a waste of time that could be better spent with patients. In BCH, I quite often went an entire shift without talking to my assigned nurse, or even knowing who is was until they came to give me meds. A common phrase was "Ive been measning to come and see you. Just let me finish these meds". And then you never see them again... I am not a squeaky wheel in hospital, so I am easy to overlook. Additionally, I have had a nurse tell my private psychologist who rang, that I was doing very well, and that she has spoken with me that morning....and she had not even seen me! Most of them are good nurses I think, but there is a culture of inefficiency and a tendency to migrate to the nurses station where its comfy. The nurses station in addition, is nowhere near the middle of the ward, so they had no idea what was actually going on (i.e patients smoking dope in the corner (I witnessed this!), there was gossip about patients getting it on in the laundry (not sure if that's true) If you did need to see your nurse, it would take a lot of banging on the door just to get anybody to respond. Massive Fails in my opinion.
Case Manager
Unlike in Ward B, my Case Manager in BCH was housed in a separate location from the hospital. I think she only came to the hospital once, when I was first admitted to introduce herself. However she does always make sure to let them know if I am coming etc and checks on me when I am discharged.
Other staff
Consumer Advocate (K) came and saw me twice during my lastincarceration admit. She also arranged for her counterpart to check in on me on my birthday, which was sweet.
Patients
Similar to Ward B, but have had a few bad experiences this time round. One of the girls I befriended in there ended up taking me on a bit of a roller coaster ride outside of the hospital. But I will always be grateful for the few months of friendship we did have. And I truly hope she manages to work through her issues. Unfortunately, I had to distance myself to preserve my own mental health.
Private Psychologist
I began seeing (D) about two months before I landed in BCH the first time, over the next 6 months I had two subsequent admissions. I cannot emphasize how much of a support she has been when i have been hospitalised, and I really need to remember that at times like now, when I am pissed off at her. I was really reluctant to go in my first admission. I had stayed out of hospital for nearly two years, I didn't want to go back to that. I didn't want to admit to how far things had gotten out of control. She did not push hospital, in fact she is in many ways anti-hospital, but eventually we both had to admit we were out of options. The first admit, she sat in the ER with me for hours, waiting for admittance. She also did a lot of the talking (background history stuff) that I was unable to do. I don't think I would have stayed and waited if she hadn't have been there. She also rang me pretty much everyday to check how I was going. At the end of the admission, the Consultant Psych told me, that if I was admitted again, (which I think he suspected I would be, with D-day anniversary coming up) that I was to go to my bi-weekly session with her, for continuity. So on the subsequent stays, I was faced with the surreal prospect of leaving a mental health ward on leave, to go and get mental health help. Seems ludicrous! But it helped.
Ultimately, I can see that Public Mental Health Facilities are not meant to be therapeutic communities, I can see the arguements for least restrictive environments etc BUT if the patients are going to be in the hospital anyway, you would think that there should be some attempts to provide an environment more conducive to processing whatever emotions etc they are feeling. I don't know exactly what the answer is, but I suspect a big part of it, particularly in BCH is getting the nurses off their arses, out of the nursing station and into the messy melee that is a psych ward. That's what they signed up for after all.
The second thing I have become aware of in retrospect, is how lucky I have been to have other people, (private practitioners, physiotherapist, auxilary staff ect) step into to fill the void left by the lack of involvement of behalf of the nurses.
One cannot expect to go into a mental health ward (at least in the public system) and experience any real therapy. There are several reasons. The focus on providing treatment in the least restrictive environment (and lets face it, also the lack of financial resources to have enough bed space) mean that all but the most severe cases of psychosis or the forensic cases are discharged in quite a short amount of time. In my experience, most people are there between 2-14 days at most. The emphasis is quite heavily on containment whilst the worst of psychotic symptoms/ suicidal ideations pass and medication adjustments.
I was first admitted to Ward B in 2006. My first admission was quite a lengthy one, in part due to the additional medical issues I experienced as a result of my overdose. I was in hospital for about 2 and a half months. Over the next two years, I was admitted on four other occasions, for periods ranging from 5 days to two weeks. Whilst in hospital there were a number of people I could theoretically talk to, in order to process what I was going through and experiencing.
Consultant Psychiatrist
Generally, I saw this guy maybe once a week at most. Usually it would be him, a Student, my assigned nurse for the shift and I. Occasionally members from my medical team were invited to participate. Not quite like the horrible ward rounds that you guys in the UK have described. But still somewhat intimidating. The focus of these meetings was primarily to establish where I was at, mental health wise and to adjust medications. They usually only lasted five minutes or so, and there was generally no suggestion on how I might deal with some of the symptoms I was experiencing, other than to suggest I ask my nurse for a prn when needed. The consultant changed over the two years that I was in and out, but the one thing that did remain the same was that he was male, usually quite authoritarian and foriegn. I found myself getting quite upset when having to go through my history with these guys, as a) I wasn't really comfortable with men b) several things on Doctor said to me about my family made me feel quite judged (I think it was due to significant cultural differences in the ideas surrounding parents and respect) and finally, as English was not their first language, it was near impossible to talk in the idioms and metaphors, we would generally engage to soften the impact of telling a trauma. They simply did not understand. Language had to be clear cut and brutally to the point. Raw and stark. Being the passive personality I am, I usually just accepted it, but one occasion it got too much for me and I got up and stormed out of the treatment room. Unfortunately, anyone who has ever needed a walking stick before can tell you it is near on impossible to "storm off" and I ended up going arse up in front of the nurses station and all the patients. I then promptly burst into tears, which the nurses responded to quite quickly, as I am known to be a non-crier. Bundled off to my room, the nurse could do little more than pat my shoulder as I howled for the next 15 minutes. That's why I don't cry. Once I do, I can't stop. Anyways....
Nurses
As I mentioned, you got an assigned Nurse at the beginning of each shift, who was supposed to check in with you for that shift, and if you had any additional problems you were to find them. The one thing all the nurses had in common was that they were OVERWORKED. The bulk of their time by necessity had to be spent caring for the geriatric patients. They weren't normally sitting in the office ignoring us (it was a cramped, uncomfortable space anyway), they were working hard. That's where the similarities ended. Some nurses were so burnt out from the demands of "general nursing" on the ward that they had no energy left for mental health nursing. A brief "How are you today?" was sufficient to their requirements and if you did approach them with an issue, they would try to listen but you could see that harried look in their eye of someone who knows they have 1001 things to do before their shift ends. Some were burnt out by the demands, but made the effort anyway. Spent the time developing rapport with the patients. Back in the days before somking restrictions came into full force, they may sit in the courtyard and have a smoke with a group of patients, always observing, in a non-confrontational way that is so much better than "How are you today?". They may be too busy to deal with you straight away but they will tell you when they can see you, and they will keep their promise. They had the skills to turn subjects that we had in common into ways of exploring the patients issues. For instance one nurse, who was also a professional photographer, would always want to see what was new in my portfolio, and we would discuss how it was representative of the way I saw the world..... and finally there was the last kind of nurse....relatively rare, thankfully. The ones who hated mental health patients, thought we were all just lazy sods who were bunging it on for attention. Mind you, the community had its share of acopic personalities that made their way to Ward B, but no excuse for the nastiness these women exuded. If its not a field you want to work in, that interests you...then why the hell work there! I met some wonderful nurses in Ward B. As a gimpy, little long term patient, who wasn't violent or particularly demanding, I was out of the ordinary for them. Most patients were gone too quickly for them to develop rapport and the ones that remained (in Ward B at least) were pretty far gone to dementia. So, I guess in a way I became their little mascot. But for those majority of nurses who did the best they could in an under-resourced area, there were 3 or 4 nurses, whose callous actions or words remain with me today
Case Manager
I didn't get introduced to my first Case Manager until I was about a week away from discharge. Their focus is generally Ccmmunity Care. My first Case Manager (Y) was fantastic. She found away to relate to her clients, she made sure to make the meeting spaces somewhere comfortable, whether it be a park or a coffeespot, and she firmly believed in talking and doing.. in other words, by all means talk about what was going on, but at the same time go for a walk as part of my PT or go and check out a second hand book store. Anyways she was my Case Manager for most of the time I was in that area... and whilst I was in hospital she did check-in on me, she would drive me to and from my private psychiatrist appointments, when I had permission to leave the hospital. She was less of presence than out in the 'real world', I guess because she knew while I was in there I was relatively safe and contained.
Patients
Anyone who has spent time in a mental health facility will know that it is the patients that you spend the most time talking to. And often the ones you turn to, for advice or comfort. There are some inherent difficulties in this. You have to be concious of the fact that a) some of them will not be entirely truthful with you, and b) some of them will have issues that may end up impacting on your own mental health. This is particularly important to keep in mind if you decide to keep in contact outside of the ward. But the benefits are they are usually extremely judgmental, and even though no person has exactly the same experiences as you they do have a greater understanding than the average person. The other thing they bring to the table is some comraderie and humor in a dark time in your life. There is a suprising amount of laughter in a Mental Health Ward. The downside to this, is many of the 'acopic' patients, went from this comraderie and support back to their isolated and lonely existences, felt the void, and so would make a suicidal gesture just to be re-admitted for a few days to a world where they felt accepted.
Other hospital staff
Being a longer term patient, the housekeeping staff got to know me quite well, and would often stop for a quick chat. It was all very light, but it was always nice for them to compliment me on how well my walking was coming along, or as one old duck said to me "Some meat on your skin and those dark circles away from your eyes, you're starting to look quite bonny" :) In addition, (S) my physiotherapist was a fantastic support. She worked really hard to keep me goal focussed on the future, to give me hope, but on the few occasions I did fall apart, she was lovely too. I guess she didn't have to adhere to boundaries as strongly as the MH professionals do, and in those times when I was wondering if I was ever going to walk, read and talk properly again, she would take my hand and let me cry. She also provided me ample opportunites to get out the pent up anger inside me and direct it into my rehab sessions, knowing when to push my buttons to get me to push myself just that little bit further out of anger. She was a big reason why I recovered physically as well as I did, but I also believe she was a big reason why I made the steps forward with my mental health too.
Private Psychiatrist
By this stage I had been seeing Dr B for a little over a year. As soon as I was allowed out on leave, I began to go to my appointments with her twice a week, first on escorted leave with either my mum or Case Manager, and then by myself. I found it quite surreal that I was signing out of a psychiatric hospital to get psychiatric help, but the reality was, in order to get the containment I needed to go outside of the Public System.
There were some differences and some similarities at Big City Hospital.
Consultant Psychiatrist
Usually there was just you, him and the junior doc. Not quite as confronting as at Ward B, but also it meant that there was no nurse to explain things to you when you left. I often found it hard to absorb what was being said. The consultations were the same length, about 5 minutes, but seemed to be more regular than on Ward B. Every 2-3 days. He is also the guy who heads the team the Junior Doctor and Case Manager assigned to me in community care are apart of. This means he is kept more regulalry apprised of what is going on with me, and is generally consulted in CM thinks I might need an admission. So there is a lot less repeating myself. And quite often they will do a direct admit rather than make you endure a horrible A&E admit.
Nurses
Now this is one that I do get quite cranky about. I understand that we live in a world of paperwork, back-up paper work and back up, backup paperwork, but the amount of time the nurses spent even out of the office, let alone actually engaged with patients was abysmal. They did not have the same geriatric workload as Ward B nurses. WHAT ARE THEY DOING?? I believe a small part of it can be attributed to the system of medication hand outs. In Ward B, three times a day you lined up outside a window for your medication, this took two nurses about an hour to do. Of course, they had to track down the odd non-compliant patient, but it worked pretty well. Assigned nurses gave out any prns or the odd medication that fell outside these times. In BCH, each assigned nurse, prepares the meds for each of their patients and then runs around the ward like a headless chook with a dixie cup of pills and another of water, trying to find their patient. As there is a bunch of nurse all trying to do this at the same time, the tiny meds room gets quite jammed up, which slows the process further. I've watched an individual nurse take two hours to get through all her meds. It seems to be a waste of time that could be better spent with patients. In BCH, I quite often went an entire shift without talking to my assigned nurse, or even knowing who is was until they came to give me meds. A common phrase was "Ive been measning to come and see you. Just let me finish these meds". And then you never see them again... I am not a squeaky wheel in hospital, so I am easy to overlook. Additionally, I have had a nurse tell my private psychologist who rang, that I was doing very well, and that she has spoken with me that morning....and she had not even seen me! Most of them are good nurses I think, but there is a culture of inefficiency and a tendency to migrate to the nurses station where its comfy. The nurses station in addition, is nowhere near the middle of the ward, so they had no idea what was actually going on (i.e patients smoking dope in the corner (I witnessed this!), there was gossip about patients getting it on in the laundry (not sure if that's true) If you did need to see your nurse, it would take a lot of banging on the door just to get anybody to respond. Massive Fails in my opinion.
Case Manager
Unlike in Ward B, my Case Manager in BCH was housed in a separate location from the hospital. I think she only came to the hospital once, when I was first admitted to introduce herself. However she does always make sure to let them know if I am coming etc and checks on me when I am discharged.
Other staff
Consumer Advocate (K) came and saw me twice during my last
Patients
Similar to Ward B, but have had a few bad experiences this time round. One of the girls I befriended in there ended up taking me on a bit of a roller coaster ride outside of the hospital. But I will always be grateful for the few months of friendship we did have. And I truly hope she manages to work through her issues. Unfortunately, I had to distance myself to preserve my own mental health.
Private Psychologist
I began seeing (D) about two months before I landed in BCH the first time, over the next 6 months I had two subsequent admissions. I cannot emphasize how much of a support she has been when i have been hospitalised, and I really need to remember that at times like now, when I am pissed off at her. I was really reluctant to go in my first admission. I had stayed out of hospital for nearly two years, I didn't want to go back to that. I didn't want to admit to how far things had gotten out of control. She did not push hospital, in fact she is in many ways anti-hospital, but eventually we both had to admit we were out of options. The first admit, she sat in the ER with me for hours, waiting for admittance. She also did a lot of the talking (background history stuff) that I was unable to do. I don't think I would have stayed and waited if she hadn't have been there. She also rang me pretty much everyday to check how I was going. At the end of the admission, the Consultant Psych told me, that if I was admitted again, (which I think he suspected I would be, with D-day anniversary coming up) that I was to go to my bi-weekly session with her, for continuity. So on the subsequent stays, I was faced with the surreal prospect of leaving a mental health ward on leave, to go and get mental health help. Seems ludicrous! But it helped.
Ultimately, I can see that Public Mental Health Facilities are not meant to be therapeutic communities, I can see the arguements for least restrictive environments etc BUT if the patients are going to be in the hospital anyway, you would think that there should be some attempts to provide an environment more conducive to processing whatever emotions etc they are feeling. I don't know exactly what the answer is, but I suspect a big part of it, particularly in BCH is getting the nurses off their arses, out of the nursing station and into the messy melee that is a psych ward. That's what they signed up for after all.
The second thing I have become aware of in retrospect, is how lucky I have been to have other people, (private practitioners, physiotherapist, auxilary staff ect) step into to fill the void left by the lack of involvement of behalf of the nurses.
Saturday, February 6, 2010
Found my anger..didn't know what to do with it, so lost it again..
Lost my temper and very nearly lost the plot this afternoon. Lil sis just pushed me to far with her inconsideration and unhelpfulness in getting the house ready for prospective tenants. Plus I was on edge from lack of meds...Finally got the call that my script was ready and so removed myself from the house. By the time I reached the Mental Health Building, I was shaking with agitation. Was so bad that when (M) handed me a cup of water I could barely hold the cup. Chatted with her for a few minutes, which centred me a bit. Although she was of the opinion like therapist (D) that it is good for me to get in touch with my anger. Which I understand in theory, but practically, me losing my temper is not going to help the situation. Walked back down the hill to the mall to get script filled, still shaking so bad that the pharmacy attendant was giving me strange looks as I tried to sign my name. Thought I would want to get in and out of mall as quickly as possible, but strangely did not find it as claustrophobic as I would normally. Plus it was airconditioned and 10 000 degrees outside. So stuck around for an hour or so and did some frivilous shopping. Didn't spend much and I had some birthday cash left, so it was a nice splurge. Bought some cushions and a shoe rack and a new mat for the doorway. Also bought a big bag of pick and mix lollies as a treat. Ignored phone calls from sisters. When I finally got home I think lil sis was trying to apologise, as big sis had basically told her, if you don't cut it out then Ophelia is going to crack completely. But didnt realise that's what she was trying to do, and was too pissed off to bother listening. She still didnt really help me clean the rest of the house. So I finished tidying and vacuuming. Aunt arrived with two little cousins and my big sis went to pick up her son, so we have a full house ready for our trip to the water park tomorrow. At first found the infringement on my space a bit tricky, but had a 'good' chat with aunt and sister re: past history, and why therapy is good for me. They see me going month after month and don't think its helping, which I understand, but they don't understand the complexities of it. Besides they don't have a better plan, so.....Is now 2 am and I have to be up in a few hours to leave, so I should try and get some sleep. Sigh. Ex is pretty much all moved out, and has tomorrow while we are out of the house to get the rest. Anyways....longer post tomorrow.
Saturday, January 9, 2010
10 signs I am heading for a fall.
Life is shit. For a variety of reasons I'm just not going to go into right now. But there are a few quite obvious clues that my mental health is circling the drain. 10 Signs, that are historically, harbingers of doom for a complete and utter, to hell in a handbasket, dropping my bundle, breakdown approaching.
1. Sleep. As you would have picked up from my blog. Insomnia is something that I have battled with for many, many years. As a direct result of PTSD induced anxiety and hypervigilance, I have trouble getting to sleep, I am frequently awakened from sleep due to horrible, covered in sweat, screaming, hyperventilating type nightmares, and then if and when I manage to get to sleep, I wake up early, and can't go back to sleep. It cycles, sometimes its worse, sometimes its better. Occasionally, I have found a medication that will allow me to get a semi-decent amount of sleep for a time, but inevitabley, it will stop working. And sometimes its just spirals so ridiculously out of control and there is nothing I can do to bring it back into line. That's where I am at the moment.
2. Mess. When reasonably well (by my standards anyway) I am quite particular about the way things should be in the house. Dishes are done nightly, the house is tidied away nightly, laundry is done every day or so, bathroom cleaned at least once a week ect ect. At the moment, I have been making the occasional brief foray out into the house to clean when I know somebody is coming over ie Case Manager or mother, but in general I just really don't care. Looking around my room now, there are several obvious signs that a crash is coming..
*Beside my bed there are, count em, 11 empty diet coke cans (caffiene free, of course!). This has been pretty much my staple diet for about a week now. And leaving my bed, to go and dispose of them in the trash... just not going to happen. There is also an array of crumpled tissues, and several empty pill blister packs. (Not from an OD, normal usage, just slovenly disposal of the packaging when finished)
*On my bed there are, two teddy bears, one childhood doll, three plastic bags, one handbag, one bag with the materials to start my friends wedding invites (untouched), two weeks worth of unopened mail (bills?...meh!) Three photo albums (necessary for depression inducing trips down memory lane) One air perfume insert, still in its package (I bought it the other day to try and stave off the stale smell that permeates a room when one settles down into a depressive hibernation, but thats as far as my motivation went, actually moving the bed to plug it in...way too much effort).... lets see what else? Five separate articles of dirty clothing that hasnt made it to the floor yet, 9 hairbands, 4 booby pins, an empty chocolate buttons packet, one sleeping cat, and me.... in desperate need of a shower, stringy hair, pjs with a stain on the front, nails bitten to the quick, and an ongoing hand tremor which is telling me that I am due to have another seizure, probably sometime in the next 12 hours.
*On the floor at the foot of my bed... The rest of my dirty clothes, one bag still unpacked from my christmas trip home.
3. Time spent in bedroom. I would estimate I have been out to go to the bathroom four times in the last 24 hours, to the fridge to get a diet coke, probably about 4 times as well. Timing each of these trips at a generous 3 minutes each.. ergo (4+4x3=24min) I have been laying my bed for about 23 hours and 36 minutes. I have only been a sleep for 2 hours and 45 minutes of this time. The other 20 hours and 51 minutes has been spent crying, blogging and reading blogs, staring at the ceiling, thinking, over thinking and then for a change thinking some more, debating calling the crisis line, debating taking all the drugs in my possession and then taking a nice warm bath into oblivian ect ect. That's the last 24 hours, the previous week or so has been pretty much the same, other than the fact that occasionally I *have* to leave the house for a few hours, with appointments, one shift of babysitting (4 hours) and one dismal failure of attempt to be a good girlfriend (2 hours), but other than that, yeah mostly bed. The mattress has hollowed out to quite a nice little hollow where I lie and the sheets are...well, they could be cleaner.
4. Food intake- has pretty much slowed to nothing bar what is put directly under my nose by somebody else (and even then....meh) and the occasional crackers, cheese and vegemite combo to keep me from fainting... which luckily is not much of an issue seeing as I am expending next to no energy
5. Self harm... nuff said.
6. Mobile phone, email, facebook ect are filled to the brim with people trying to contact me. People I will not be contacting back anytime soon. In fact pretty much the only *real life* people I am communicating with are those who will instigate full on intervention methods if I drop off the radar too long- my mum, my grandma, and the mental health people. I give them enough of a response to satisfy them..no more, no less.
7. Alcohol consumption. I am epileptic. I am depressed. I am on a lot of medication. For my own safety I am not allowed to drink. I am usually pretty good about this. At the moment, I am hiding a couple of empty wine bottles under my bed, until I can find a way to sneak them into the trash without my sister noticing... pathetic, huh?
8. Damage Control... involves pulling out the paperwork on my funeral insurance to make sure its all kosher, trying to figure out how to withdraw from people so they won't feel guilty, bad when you are gone...how to do this? Cut contact entirely? Make them hate you? Haven't figure this out, so it runs through my head constantly.
9. Uni work. Yeah, I'm enrolled, that's about as far as it goes. I don't know what is due, past due, due to be due, and I just don't really care, I haven't logged on in over a fortnight, I haven't really touched a book since before Christmas. Setting up a nice little mess for myself with my apathy.
10. Most obvious sign of all..... when I think about the days,weeks, months and years ahead of me, my mind can see nothing good. Nothing good at all.
And I am sick of trying to manage this, to put Daily living and Crisis plans into action. What is the point? Even if I pull myself out of this hole, I'll just cycle back to here in a few days, weeks, months or years time. Better to just let myself crash, and see what's left at the end... whether there is anything worth resurrecting. Let nature take its course.
Bah... fuck it all.
Yes. I know. Its my choice and my responsibility. And this kind of thinking and this kind of apathy is not going to help me. I should try and pull myself together. I should be reaching out to people rather than isolating, I should be sticking to a routine, I should be doing a lot of things.
Sigh.
1. Sleep. As you would have picked up from my blog. Insomnia is something that I have battled with for many, many years. As a direct result of PTSD induced anxiety and hypervigilance, I have trouble getting to sleep, I am frequently awakened from sleep due to horrible, covered in sweat, screaming, hyperventilating type nightmares, and then if and when I manage to get to sleep, I wake up early, and can't go back to sleep. It cycles, sometimes its worse, sometimes its better. Occasionally, I have found a medication that will allow me to get a semi-decent amount of sleep for a time, but inevitabley, it will stop working. And sometimes its just spirals so ridiculously out of control and there is nothing I can do to bring it back into line. That's where I am at the moment.
2. Mess. When reasonably well (by my standards anyway) I am quite particular about the way things should be in the house. Dishes are done nightly, the house is tidied away nightly, laundry is done every day or so, bathroom cleaned at least once a week ect ect. At the moment, I have been making the occasional brief foray out into the house to clean when I know somebody is coming over ie Case Manager or mother, but in general I just really don't care. Looking around my room now, there are several obvious signs that a crash is coming..
*Beside my bed there are, count em, 11 empty diet coke cans (caffiene free, of course!). This has been pretty much my staple diet for about a week now. And leaving my bed, to go and dispose of them in the trash... just not going to happen. There is also an array of crumpled tissues, and several empty pill blister packs. (Not from an OD, normal usage, just slovenly disposal of the packaging when finished)
*On my bed there are, two teddy bears, one childhood doll, three plastic bags, one handbag, one bag with the materials to start my friends wedding invites (untouched), two weeks worth of unopened mail (bills?...meh!) Three photo albums (necessary for depression inducing trips down memory lane) One air perfume insert, still in its package (I bought it the other day to try and stave off the stale smell that permeates a room when one settles down into a depressive hibernation, but thats as far as my motivation went, actually moving the bed to plug it in...way too much effort).... lets see what else? Five separate articles of dirty clothing that hasnt made it to the floor yet, 9 hairbands, 4 booby pins, an empty chocolate buttons packet, one sleeping cat, and me.... in desperate need of a shower, stringy hair, pjs with a stain on the front, nails bitten to the quick, and an ongoing hand tremor which is telling me that I am due to have another seizure, probably sometime in the next 12 hours.
*On the floor at the foot of my bed... The rest of my dirty clothes, one bag still unpacked from my christmas trip home.
3. Time spent in bedroom. I would estimate I have been out to go to the bathroom four times in the last 24 hours, to the fridge to get a diet coke, probably about 4 times as well. Timing each of these trips at a generous 3 minutes each.. ergo (4+4x3=24min) I have been laying my bed for about 23 hours and 36 minutes. I have only been a sleep for 2 hours and 45 minutes of this time. The other 20 hours and 51 minutes has been spent crying, blogging and reading blogs, staring at the ceiling, thinking, over thinking and then for a change thinking some more, debating calling the crisis line, debating taking all the drugs in my possession and then taking a nice warm bath into oblivian ect ect. That's the last 24 hours, the previous week or so has been pretty much the same, other than the fact that occasionally I *have* to leave the house for a few hours, with appointments, one shift of babysitting (4 hours) and one dismal failure of attempt to be a good girlfriend (2 hours), but other than that, yeah mostly bed. The mattress has hollowed out to quite a nice little hollow where I lie and the sheets are...well, they could be cleaner.
4. Food intake- has pretty much slowed to nothing bar what is put directly under my nose by somebody else (and even then....meh) and the occasional crackers, cheese and vegemite combo to keep me from fainting... which luckily is not much of an issue seeing as I am expending next to no energy
5. Self harm... nuff said.
6. Mobile phone, email, facebook ect are filled to the brim with people trying to contact me. People I will not be contacting back anytime soon. In fact pretty much the only *real life* people I am communicating with are those who will instigate full on intervention methods if I drop off the radar too long- my mum, my grandma, and the mental health people. I give them enough of a response to satisfy them..no more, no less.
7. Alcohol consumption. I am epileptic. I am depressed. I am on a lot of medication. For my own safety I am not allowed to drink. I am usually pretty good about this. At the moment, I am hiding a couple of empty wine bottles under my bed, until I can find a way to sneak them into the trash without my sister noticing... pathetic, huh?
8. Damage Control... involves pulling out the paperwork on my funeral insurance to make sure its all kosher, trying to figure out how to withdraw from people so they won't feel guilty, bad when you are gone...how to do this? Cut contact entirely? Make them hate you? Haven't figure this out, so it runs through my head constantly.
9. Uni work. Yeah, I'm enrolled, that's about as far as it goes. I don't know what is due, past due, due to be due, and I just don't really care, I haven't logged on in over a fortnight, I haven't really touched a book since before Christmas. Setting up a nice little mess for myself with my apathy.
10. Most obvious sign of all..... when I think about the days,weeks, months and years ahead of me, my mind can see nothing good. Nothing good at all.
And I am sick of trying to manage this, to put Daily living and Crisis plans into action. What is the point? Even if I pull myself out of this hole, I'll just cycle back to here in a few days, weeks, months or years time. Better to just let myself crash, and see what's left at the end... whether there is anything worth resurrecting. Let nature take its course.
Bah... fuck it all.
Yes. I know. Its my choice and my responsibility. And this kind of thinking and this kind of apathy is not going to help me. I should try and pull myself together. I should be reaching out to people rather than isolating, I should be sticking to a routine, I should be doing a lot of things.
Sigh.
Wednesday, November 18, 2009
Confused
I am completely confused.
I had appointment with BabyDoc today, up at the Public Mental Health offices for my region (which lucky for me happens to be on the same road I live). To start off, he was running over half an hour behind, which meant 40 minutes of staring at the bleak surroundings of the waiting room. I'm sure the staff try their best with posters ect and it is very new, neat and clean. And I'm sure that some very important designer came up with the crisp, minimalist interior.... but seriously! Grey floors, grey paints, dark chairs, all encompassed in a purpley-grey building, that looks alike an amoebic representation of a depressive cloud settling on the hill. But anyway, I waited, because I understand that emergencies ect happen.
Then I walk into the tiny windowless airless office with BabyDoc. These offices alone are enough to get my heart racing. We spoke. I told him that I had good days and bad days, and that I was trying to concentrate on sticking to a good routine and reaching out for help within my crisis network when I needed it. I talked to him about the weight gain, and my attempts to lose the weight through diet and exercise. He pretty much told me that I had nothing to worry about, and that BMIs don't really mean that much in the end, and also made the 'incisive' observation that when patients begin to worry about the side effects of their medication, it meant they were starting to get better... which from my personal experience is just bollocks.
I mentioned that anxiety and panic attacks were still an issue, but I didnt really see the point in raising the serepax, because I think you need to find a balance between throwing meds at a problem and coming up with coping strategies. I told him my sleep was pretty damned bad at the moment. He asked if I thought the Largactil was helping. I said I didn't know. He suggested it would be possible to up the dose a little. He went off to get his prescription pad, leaving me stuck in this tiny room, all by myself. As I have mentioned in previous post, there is something about those rooms that just triggers me off. Its windowless, rectangular...much like being in the back of a closed in truck container. He was gone a few minutes, and I was focussing on trying to calm my breathing, and stop my body shaking, so I didn't go into a full panic attack.
This is where it gets confusing, he comes back in, makes a joke about the airconditioning being to high (I'm not cold, douchebag, I'm trying to convince my body not to totally flip out on me) And then all of a sudden, he says, that he is going to write a letter to my GP letting him know I'm on the Serepax, but to start the process of weaning me off, oh, and just as an experiment, lets cease the largactil all together and see whether it has any affect on my sleeping. I was still concentrating so hard on not flipping out from the panic, that I just kind of half nodded at everything he said.
I walked out of the Centre, and realised what essentially had just happened. I tell him I am still having issues with panic attacks, and that sleeping is pretty bad (about 3 hrs average a night) and he a)starts weaning me off my anti-anxiety meds and b)ceases my sleeping medications.
WTF? I hate that place, I hate the system, I hate being just a number and I am really not a big fan of Baby Doc at the moment. Plus I am Scared as hell, of what these meds changes might mean, especially heading into a time as hard as xmas.
I had appointment with BabyDoc today, up at the Public Mental Health offices for my region (which lucky for me happens to be on the same road I live). To start off, he was running over half an hour behind, which meant 40 minutes of staring at the bleak surroundings of the waiting room. I'm sure the staff try their best with posters ect and it is very new, neat and clean. And I'm sure that some very important designer came up with the crisp, minimalist interior.... but seriously! Grey floors, grey paints, dark chairs, all encompassed in a purpley-grey building, that looks alike an amoebic representation of a depressive cloud settling on the hill. But anyway, I waited, because I understand that emergencies ect happen.I mentioned that anxiety and panic attacks were still an issue, but I didnt really see the point in raising the serepax, because I think you need to find a balance between throwing meds at a problem and coming up with coping strategies. I told him my sleep was pretty damned bad at the moment. He asked if I thought the Largactil was helping. I said I didn't know. He suggested it would be possible to up the dose a little. He went off to get his prescription pad, leaving me stuck in this tiny room, all by myself. As I have mentioned in previous post, there is something about those rooms that just triggers me off. Its windowless, rectangular...much like being in the back of a closed in truck container. He was gone a few minutes, and I was focussing on trying to calm my breathing, and stop my body shaking, so I didn't go into a full panic attack.
This is where it gets confusing, he comes back in, makes a joke about the airconditioning being to high (I'm not cold, douchebag, I'm trying to convince my body not to totally flip out on me) And then all of a sudden, he says, that he is going to write a letter to my GP letting him know I'm on the Serepax, but to start the process of weaning me off, oh, and just as an experiment, lets cease the largactil all together and see whether it has any affect on my sleeping. I was still concentrating so hard on not flipping out from the panic, that I just kind of half nodded at everything he said.
I walked out of the Centre, and realised what essentially had just happened. I tell him I am still having issues with panic attacks, and that sleeping is pretty bad (about 3 hrs average a night) and he a)starts weaning me off my anti-anxiety meds and b)ceases my sleeping medications.
WTF? I hate that place, I hate the system, I hate being just a number and I am really not a big fan of Baby Doc at the moment. Plus I am Scared as hell, of what these meds changes might mean, especially heading into a time as hard as xmas.
Thursday, September 24, 2009
Tag... Your it!
Raise your hand, if you have been slapped with "Borderline Personality Disorder", by a Doctor who has seen you approximately 4 times for about five minutes a pop?
Now, keep it raised, if they didn't bother to tell you that you apparently have "Borderline Personality Disorder", rather just wrote it in indelible black ink to remain a part of your medical file for the rest of your life.
I am pissed off!
It's not so much the label that bothers me, I acknowledge that I do display a few of the "cluster b' traits... I guess that's why there is the push to get BPD re-classified as CPTSD. I do not, however reach the required amount, indicated in the DSM-IV for a diagnosis... I do, however, fit the criteria for PTSD, which rates nary a mention on my chart.
What pisses me off is the stigma that I know is attached to BPD... trouble maker, attention seeker, manipulator.... (all these not necessarily true of most BPD patients). Basically it has become a waste bin diagnosis. And it is in my medical file FOREVER.... how do I know this? Well, I went to my neurologists appointment at the hospital for my epilepsy and there it was in bold print on my chart. She was actually lovely, and agreed with me that until my insomnia was better controlled there was not point messing with my anti-epileptics. BUT, she could easily have been one of those doctor's who sees the BPD diagnosis, and immediately everything you see is circumspect... which is difficult in medical settings where so much is subjective.
Anyway, long story short, when asked about the appearance of this label on my file, the team all shook their heads (we dont know who actually wrote that, BPD doesnt have the stigma it used to, we dont rely on labels...b lah blah, patronising bullshit)
I don't know where this all leaves me, but I'm feeling angry, patronised and pretty let-down, on top of already feeling pretty cruddy... (three nights in hospital to help with insomnia is pretty pointless when they put you in a double room with someone who snores like a banshee, and then goes and complains to staff when your mobile phone wakes her in THE MIDDLE OF THE DAY!
Grumble, grumble... will return and post when I can do something other that rant!
Now, keep it raised, if they didn't bother to tell you that you apparently have "Borderline Personality Disorder", rather just wrote it in indelible black ink to remain a part of your medical file for the rest of your life.
I am pissed off!
It's not so much the label that bothers me, I acknowledge that I do display a few of the "cluster b' traits... I guess that's why there is the push to get BPD re-classified as CPTSD. I do not, however reach the required amount, indicated in the DSM-IV for a diagnosis... I do, however, fit the criteria for PTSD, which rates nary a mention on my chart.
What pisses me off is the stigma that I know is attached to BPD... trouble maker, attention seeker, manipulator.... (all these not necessarily true of most BPD patients). Basically it has become a waste bin diagnosis. And it is in my medical file FOREVER.... how do I know this? Well, I went to my neurologists appointment at the hospital for my epilepsy and there it was in bold print on my chart. She was actually lovely, and agreed with me that until my insomnia was better controlled there was not point messing with my anti-epileptics. BUT, she could easily have been one of those doctor's who sees the BPD diagnosis, and immediately everything you see is circumspect... which is difficult in medical settings where so much is subjective.
Anyway, long story short, when asked about the appearance of this label on my file, the team all shook their heads (we dont know who actually wrote that, BPD doesnt have the stigma it used to, we dont rely on labels...b lah blah, patronising bullshit)
I don't know where this all leaves me, but I'm feeling angry, patronised and pretty let-down, on top of already feeling pretty cruddy... (three nights in hospital to help with insomnia is pretty pointless when they put you in a double room with someone who snores like a banshee, and then goes and complains to staff when your mobile phone wakes her in THE MIDDLE OF THE DAY!
Grumble, grumble... will return and post when I can do something other that rant!
Tuesday, September 15, 2009
Getting sane is making me poor
I have whinged previously about the faults of the public health system here in Oz. And yet here I am, now an official public health 'mental service user'. The state picked up the bill for my two week hospitalisation, my weekly meets with Case Manager and my Psychiatrist. The state gives me a concesssion on my visits to the GP and even on my meds... And pays me a small, but livable stipend pension, whilst I am unable to work.... so I'm doing better than I would be in a lot of other countries.. and for that I'm grateful!
And yet... I recieved an electricity bill today, that was massive! What is the link between that and my mental health, you ask? Well, in my worse periods of depression, just being able to wash and dry clothes so I don't lie around in a stinking mess of bleurghiness (yes, that is a word...i'm making it one!) takes a huuuuuuge amount of effort. The very idea of walking to the clothesline, hanging them up, waiting for them to dry and then taking them down seems an insurmountable task. So environment be damned, I use the clothes dryer. Just one more way, that my mental illness is making me poor!
And even though, I get a concession on my GP and meds, I do still have a co-pay. And then of course there is the cost of the private therapist (though she has been great about reducing her fee) so I can have a therapy better designed for me, rather than the cookie cutter CBT that the public health would ram down my throat. And then the cost of the private health extras insurance to help with said therapy costs and all the other parts of my body that are falling apart...teeth, eyes ect.
Yes, I know, its hard to feel sorry for me....living in a country where the taxpayers fund such things to help me stay afloat during these periods of blackness.... I kinda want to give myself a quick kick up the backside, and pull myself up by my bootstraps like my grandparents would have. But try as I might, I can't.
So instead, I'm just messed up and broke, and hoping for the day I can figure this all out, get it fixed and go back to being a productive member of society...
In the meantime.... I am going to try to stop using the damned clothes dryer!
And yet... I recieved an electricity bill today, that was massive! What is the link between that and my mental health, you ask? Well, in my worse periods of depression, just being able to wash and dry clothes so I don't lie around in a stinking mess of bleurghiness (yes, that is a word...i'm making it one!) takes a huuuuuuge amount of effort. The very idea of walking to the clothesline, hanging them up, waiting for them to dry and then taking them down seems an insurmountable task. So environment be damned, I use the clothes dryer. Just one more way, that my mental illness is making me poor!
And even though, I get a concession on my GP and meds, I do still have a co-pay. And then of course there is the cost of the private therapist (though she has been great about reducing her fee) so I can have a therapy better designed for me, rather than the cookie cutter CBT that the public health would ram down my throat. And then the cost of the private health extras insurance to help with said therapy costs and all the other parts of my body that are falling apart...teeth, eyes ect.
Yes, I know, its hard to feel sorry for me....living in a country where the taxpayers fund such things to help me stay afloat during these periods of blackness.... I kinda want to give myself a quick kick up the backside, and pull myself up by my bootstraps like my grandparents would have. But try as I might, I can't.
So instead, I'm just messed up and broke, and hoping for the day I can figure this all out, get it fixed and go back to being a productive member of society...
In the meantime.... I am going to try to stop using the damned clothes dryer!
Friday, August 14, 2009
Stuck between a rock and a mental ward...
GP appointment today re: antidepressants. Thought it would be good to check whether they might need a bit of a tweak. GP let me know that I am already on above the recommended dose on the Lexapro, so if we were going to do anything we would change it completely to a new med. The hitch is of course, that you have to let the Lexapro leave your system before they can introduce a new AD. Which leaves a very vunerable period. And because I'm already pretty much a snivelling mess on the floor, the GP doesn't want to do it unless I'm in hospital.... I told him I'd think about it...
Spoke to therapist (D) briefly on the phone about it, and she too seems to have some reservations about hospitalisation. It really is to be avoided unless absolutely necessary. Can be a demoralising and infantilising experience.... but can also save your life.. Ho Hum.... She's going to consult with a Psych colleague of hers to give us a little more information to make the decision with.. And when I say us... I mean me. Nobody is forcing me into hospital, they are telling me I know what is the right thing for me. Honestly? I don't. I don't want to have to make the decision. I don't want to risk making the wrong choice. Spoke to my mum, and then to an old friend.... trying to get one of them to tell me what I should do... but nope.. apparently, only I know what's right for me.
So, I made a list of pros and cons. Pros- new meds may help stabilise me somewhat, the AD he wants me to change with has more of a sedating effect then current drug, so may help with insomnia, hospital stays also tend to help sleeping patterns (I feel safer sleeping behind a locked door I guess?) , for at least a few days I wouldn't be responsible for keeping myself safe.. which would be a nice refuge. Cons- new meds might mean new and exciting side effect of the days, I am likely to feel really cruddy for a period (even more so than now), hospital stay (nuff said...bleaurgh) and finally hospitalisation would more than likely result in case management, ehich in my mind would 'officially' make me mentally unwell again................. sigh.
The damndest thing is it is a friday night.... so wont be able to anything until Monday at the earliest, probably more likely Tuesday when my next appointment with therapist is, which means three whole days of ruminating and stressing over this. And you know what, I already feel like shite... shite night last night with off the wall anxiety and suicidal ideation, exhausting day today, socialising with friends at lunch and trying to appear like am not about to completely lose the plot (Don't get me wrong, love my friends, but given the way I was feeling today, probably would have cancelled on them, if not for the fact that it was a make-up lunch for the one I cancelled on Wednesday because I felt too shite to come)
Sigh.
I hate making decisions and I hate being told that only I know whats best for me.. :(
Spoke to therapist (D) briefly on the phone about it, and she too seems to have some reservations about hospitalisation. It really is to be avoided unless absolutely necessary. Can be a demoralising and infantilising experience.... but can also save your life.. Ho Hum.... She's going to consult with a Psych colleague of hers to give us a little more information to make the decision with.. And when I say us... I mean me. Nobody is forcing me into hospital, they are telling me I know what is the right thing for me. Honestly? I don't. I don't want to have to make the decision. I don't want to risk making the wrong choice. Spoke to my mum, and then to an old friend.... trying to get one of them to tell me what I should do... but nope.. apparently, only I know what's right for me.
So, I made a list of pros and cons. Pros- new meds may help stabilise me somewhat, the AD he wants me to change with has more of a sedating effect then current drug, so may help with insomnia, hospital stays also tend to help sleeping patterns (I feel safer sleeping behind a locked door I guess?) , for at least a few days I wouldn't be responsible for keeping myself safe.. which would be a nice refuge. Cons- new meds might mean new and exciting side effect of the days, I am likely to feel really cruddy for a period (even more so than now), hospital stay (nuff said...bleaurgh) and finally hospitalisation would more than likely result in case management, ehich in my mind would 'officially' make me mentally unwell again................. sigh.
The damndest thing is it is a friday night.... so wont be able to anything until Monday at the earliest, probably more likely Tuesday when my next appointment with therapist is, which means three whole days of ruminating and stressing over this. And you know what, I already feel like shite... shite night last night with off the wall anxiety and suicidal ideation, exhausting day today, socialising with friends at lunch and trying to appear like am not about to completely lose the plot (Don't get me wrong, love my friends, but given the way I was feeling today, probably would have cancelled on them, if not for the fact that it was a make-up lunch for the one I cancelled on Wednesday because I felt too shite to come)
Sigh.
I hate making decisions and I hate being told that only I know whats best for me.. :(
Monday, August 10, 2009
I just noticed a mountain goat in the tip I call my loungeroom
Perhaps a sign of the tide starting to turn? I have just looked around and realised what a complete and utter doss house I am currently living in. Usually, I am slightly OCD about keeping the house in order... I guess it makes me feel like I have some sembelance of control in my life. But in the midst of my current 'spin-out', the house and all that it entails has fallen to the wayside. And in my complete and utter apathy regarding everything at the moment, I haven't even really noticed the mess, the dishes piling up (heck, I'm not eating...what do I care?), the washing piling up (I'm wearing my pajamas for the forseeable future...what do I care?) or the fact that I have simply been shifting the detrius to the other side of the bed so I can get into it (I'm only sleeping an hour or two a night...once again...what do I care?) And of course, woe and betide that my housemates would notice and do something about any of the above. I guess they just feel we're embracing a new lifestyle..lol. As, I say, up until today it just hasn't even registered through the fog I've been walking in. But today I took a good, hard, look around and I noticed it... and it even bothered me a bit. I haven't yet got the energy to do anything about it... but the fact that I noticed it has to be a good sign......right?
Sunday, August 9, 2009
When it rains it pours... a rant..
This is primarily just a frustrated rant. Centrelink has suspended my Disability Allowance, until I have completed a Job Capacity Assessment. Apparently they had been trying to contact me for a week before they suspended my payment, but I don't answer calls from blocked numbers, and they don't leave voice messages, for privacy reasons, so I ended up getting a letter suspending my payment. This in itself, whilst frustrating is fine. I understand why it needs to be done. What really gets me is I was approved for the payment 3 months ago, after I had to resign from my job because of instability with my seizure control. By this point I was quite often on unpaid sick leave, because I had used up my sick leave, or I was going into work, and having seizures (that's embarrassing, try walking back into a work place where your colleagues have seen you convulse and lose bladder control!) because I couldn't afford to miss work. The paperwork was filled out, Treating Doctors Reports submitted, I enrolled in University part-time externally, so the time not working was still productive, and have spent the time trying to get my health back to a point where I can return to full-time work.
But then, the depression hit me again. After quite a lengthy 'remission' if you will, its back in full force, and all of my energy is focused on trying to keep that under control (hence the re-introduction of therapy) and trying to get the seizures under control (now increasing dramatically because of the insomnia...what a vicious circle!) and trying to maintain the work needed for my Uni stuff. And just when I'm at a point where I'm barely keeping myself together... now, they want me to come in for a JCA. Not three months ago, when I would have been able to handle it....but now, when even the concept of leaving the house other than for therapy seems insurmountable, they want me to walk into an office and talk to somebody I don't know, about my problems, and try and keep my muddled brain together long enough, to make sense and get what needs to be done, done. It's such a little thing in reality, but my brain is catastrophising it, to the point where it just seems impossible. Added to the stress of the payment being 'suspended' until I have jumped through the hoops, so having to rely on my meagre savings to do what needs to be done.
I understand why it needs to be done, that there are checks and balances in place for a reason. And I am grateful to live in a country where I can get this financial support until I can pull my physical and emotional health back together... but there is another part of me whingeing......"Why now??????????????". Well, all I can do is wait and see what happens on Tuesday, I guess.
The end of rant. :P
But then, the depression hit me again. After quite a lengthy 'remission' if you will, its back in full force, and all of my energy is focused on trying to keep that under control (hence the re-introduction of therapy) and trying to get the seizures under control (now increasing dramatically because of the insomnia...what a vicious circle!) and trying to maintain the work needed for my Uni stuff. And just when I'm at a point where I'm barely keeping myself together... now, they want me to come in for a JCA. Not three months ago, when I would have been able to handle it....but now, when even the concept of leaving the house other than for therapy seems insurmountable, they want me to walk into an office and talk to somebody I don't know, about my problems, and try and keep my muddled brain together long enough, to make sense and get what needs to be done, done. It's such a little thing in reality, but my brain is catastrophising it, to the point where it just seems impossible. Added to the stress of the payment being 'suspended' until I have jumped through the hoops, so having to rely on my meagre savings to do what needs to be done.
I understand why it needs to be done, that there are checks and balances in place for a reason. And I am grateful to live in a country where I can get this financial support until I can pull my physical and emotional health back together... but there is another part of me whingeing......"Why now??????????????". Well, all I can do is wait and see what happens on Tuesday, I guess.
The end of rant. :P
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