Here’s the next instalment of ‘writing from the breakdown 2009’ you can read the earlier post here . This jumps all over the place, but reflects how hard everything was back then. Reading this back I feel so desperately sad for myself. I was in such an almighty mess and yet desperately clinging on to the belief that if I appeared ‘normal’ enough I would be ok and not end up being sectioned. My fear of mental health services prevented me getting the help that I so desperately needed. I wish I could go back in time and advocate for myself properly rather than being dictated by the fear of losing all control:
Here I am again, another appointment, sitting across from my doctor inwardly crying out for help but outwardly showing that I am totally pissed off at another intrusion into my life. I am reacting badly to having been referred unexpectedly and without consultation to the Crisis Team or as I fondly renamed them ‘The Nut Squad’.
The Nut Squad is quite a step up the crazy tree in mental health terms where I live. This time I had bypassed the ‘Access and Wellbeing Team’ which is where you go when you are maybe only partly crackers: I’d been there before, but this time, whatever I had said to my doctor, or maybe not said, had been a real cause for concern and I had ended up with a psychiatrist and mental health nurse sitting in my living room asking me a series questions. Things have been really bad, but knowing how stretched mental health services are to have the NHS send people to see me in my own home feels unnecessary.
Questions I can cope with, though. In recent months I’ve answered the same set of questions on multiple occasions and my answers never deviate:
“On a scale of one to ten, one being the least and ten being the most, tell me where you feel in terms of happiness at the moment” (or something along those lines).
“Three” I respond mechanically.
“Still three?” they exchange concerned looks. I had just reported feeling ‘better’ whilst talking in a measured fashion so as not to look manic. How could it possibly be three? My definition of ‘better’ was that I had started to notice the spring buds and had read a book, which were markers in my mind that things were improving for me. It had been months since I had been able to direct my attention towards anything or look outside myself. I thought this would be ample deflection for the fact that I’d been out and blown almost £45,000 in two weeks and pretty much decimated my entire inheritance in less than a year since my dad died.
I think it was probably this insane spending that had led my GP to refer me to the Crisis Team. It had all followed an appointment where I had splurged at the GP that what I was doing wasn’t normal. I left feeling like I had been honest for the first time, and then shat myself with ‘what ifs?’ and devised my plan of action. How I thought I was helping myself, I have no idea. I think in hindsight it was something about being absolutely terrified of being carted off in a straight jacket and being sectioned so I told them what I think they needed to hear and it seemed to work.
To an outsider that would seem like an incredible leap of the imagination that feeling wobbly could result in incarceration. A person exhibits slightly unusual behaviour and so steps are taken to help them, right? Doesn’t mean they’ll end up locked up on a psych ward. I’m sure this is the case, but I have a fear of mental health services. They terrify me. Why? Let’s just put it this way, growing up with a close family member being perpetually in and out of mental health institutions doesn’t do wonders for your confidence in the system.
I would sooner die than end up in a mental hospital. Although looking back on this, perhaps it’s where I belong? I’m sure if I had have been completely honest with all the professionals from the start I would be in much better place now – but it’s hard going from being someone who on the outside appears successful, confident, and independent, to admitting to someone that all of a sudden you feel a failure, have no self belief and feel unable to participate in life. That is the truth of my situation. When I got ill at Christmas the wheels fell off in a big way. I could not cope and yet, instinctively I felt like I had to, to pretend that I was at least managing on some level.
I know, now, that I came across as resistant and inconsistent bouncing from uncommunicative, to dismissive, to out of control, to needy and back again – often all in one appointment. Hats off to my doctor, if the roles had have been reversed I would have given up long ago.
So, back to the psychiatrist and nurse house visit. They looked around the room and commented on how immaculately tidy it was, asked me about all the books on my shelves and noted that they were all placed in alphabetical order (surely this is normal for most English graduates?!) Of course the out of control spending came up in the conversation and I tried to justify the totally abnormal behaviour as if it was normal – cue ‘telling a lie like it’s the truth’ again. Bingo. It seemed to be working:
“If you had the money wouldn’t you go and buy things you’ve always wanted?” I asked, looking at them both imploringly. It’s sort of like the question which you mull over time and again. ‘What would you do if you won the lottery?’ The thing is, I haven’t won the lottery and this money I have doesn’t make me happy. Money can’t make you happy and it can’t fill the void left by a human being. No amount of spending eased the depression or the feelings of helplessness and hopelessness but god, I was willing to try anything to take me out of that dark dark place.
The camper van I had just purchased I did want, but the £8000 diamond ring, first class airline tickets to New York, mountain bikes and snowboards for me and my partner, new windows and guttering, laptop, multiple pairs of shoes, a surfboard, and enough clothes to open my own shop were more what you might call ‘impulse buys’ – funnily enough I didn’t think now was a good time to mention any of that.
I thought I had managed the Crisis Team fairly well. As my consultation came to a close there was a shock. I was told that I couldn’t drive. Not that I can’t drive, I am a competent driver; no, I had been advised not to drive. In that moment I stared at the psychiatrist in disbelief now stripped of my independence and my wheels. The Nut Squad had clearly taken one look at the Jaguar supercar (another part of my inheritance) outside and thought ‘no way– this one is a liability’.
As the psychiatrist left my house she told me to keep my life “boring”. “Not a problem” I replied with a wry smile. In recent months my life had become mundane and really fucking boring. At least this was one promise I could keep.
It was eventually agreed with my GP that neither of the antidepressants that I had tried had worked for me, if anything they had been to my detriment, the first killed my appetite and my will to live, the second sent me on a hyperdrive where I was like a bee in a jar buzzing around out of control and spending like I had a shopping addiction. It was decided that I should not take these pills and I was given a prescription for a different type of drug, from a different family of medications.
I was to be given a mood stabiliser or anti-psychotic. Yes, when I heard the phrase ‘anti-psychotic’ I did panic a little, which I am sure anyone would. It sounded way more intense than ‘anti-depressant’. I dutifully took the pills and slept soundly for the first time in months. As well as this, there was a further but less desirable side effect: the munchies.
It is a well documented side effect of this particular drug that you feel like you are starving all of the time. It’s like stoned munchies without the relaxation of a joint. For two weeks I swear I did nothing but eat. It was totally uncontrollable which did not make my anorexic self feel at all happy and so, I took to cutting myself to regain some of my control and exorcise my self-loathing. In that two week period I gained a stone and hated myself for it.
My body image is completely screwed anyway and this rapid weight gain really sent me into free-fall emotionally. That is the only sensible way of describing it. I have never in my life been overweight, but the moment I hit the region of 7 stone I start to feel bloated and fat. I am having a battle with my 15 year old self right now. I am determined to hold onto my body mass. I am determined to prove my GP wrong and keep myself away from the anorexic label.
Part of my new ritual is each day looking in the mirror at my naked self and telling my reflection that I am not fat. I then go to the fridge and eat my way through something highly calorific to spite my teenage self and then continue with my day. It may seem like a totally insane approach to healthy living, but right now I have exhausted ‘sane’ and this, although not healthy in the long run it works for me and it has stopped the doctors asking me about my eating! Thank god!
Awareness of physical self is something I have always tried to avoid because the moment I become aware of my body I fixate on all that is wrong with it. I know that anyone reading this will still see that I am in denial. Just because the weight is back on does not change the ideas that swirl inside my mind. I have an eating disorder, only right now it is in the stage where I have it hidden again and that is a relief. I am not a skeleton anymore but I hate myself now more than ever.
Some time elapsed after the Crisis Team’s intervention and I eventually received an appointment with another psychiatrist in the mental health hospital. The building which houses mental health services is a gothic style grey stone Victorian affair with a central staircase leading up to the entrance. It has a certain grandeur which is imposing and more than a little intimidating. It is a beautiful piece of architecture, the sort of place that a developer would have a field day with and could turn into some great apartments. But today, for me, it is still a mental health hospital and walking up the steps and into the jaws of the building saw another panic set in.
The interior of the building was dark and depressing and was exactly as I had imagined – ‘Girl Interrupted’ has a lot to answer for! It was as if something had sucked the life and light out of the place. It was eerily quiet and seemingly unoccupied except for the few staff that walked with purpose along the echoing corridors. There was a clinical, hospital smell, cold metal on metal, disinfectant, and I hated it. I have always hated hospitals. The moment I walk inside one I always feel sick to my stomach and as though I could pass out at any second, this is not because I am actually ill, I just cannot stand them and what they signify to me: illness and death.
I was directed by the receptionist on the desk to take a seat in the waiting room a little further down the corridor. It was a tiny, claustrophobic room with four chairs on each side of the door. I took in the sunny, yellow wood-chipped walls and fading green carpet and felt the tendrils of anxiety creeping over me; like a smog it saturated my being and I felt suffocated.
Someone had clearly thought that a bright colour would make depressed people feel optimistic and ‘light’ inside. The colour made me feel chaotic and overstimulated and I wanted to get out of the room as soon as was humanly possible.
As I sat there, watching the clock ticking down to my appointment I wondered what I should do?: Tell the truth about how I felt: flat, sad, depressed, anxious, sometimes suicidal or to rationalise my feelings and make light of the situation. Perhaps I should tell them that I’m sad but I am managing it and I don’t need pills to grieve.
I was eventually called into the psychiatrist’s office and the nice male doctor sitting opposite me began asking me questions. It was those same questions that I had become so used to over the last few months. A few days before this meeting I had had a particularly dark day which saw me sitting in my doctor’s surgery bereft with depression and as close to suicide I have ever felt. For the first time I felt as though we had made progress, I showed her the depth of my pain and she seemed to get it. She insisted I kept my appointment with at the hospital and made a further time to see her to discuss the outcome. She commented on what she perceived as my lack of self esteem and I thought ‘finally, she sees me for me, minus my front’ .
I alluded to this dark day and my lack of confidence with my consultant when he asked me if I felt gifted. ‘Gifted?! Me?! Are you serious?’ I shouted inside my brain. I told him of my feeling like a fraud, like someone who by fluke had got where I had got to, and someone who was on the verge of being found out all the time. My truth.
He then proceeded to read through the notes of the psychiatrist who had visited my home and who suggested I was, in her opinion, very confident and had good self-esteem. In that moment I felt abject disappointment. I guess I should have felt pleased that my acting skills are so good that I can even fool a mental health professional into believing I am in control and happy with myself; but that wasn’t the case at all. I felt like at a time when I needed someone to see through my defences, all that they had seen was the persona.
I have become so skilled at presenting a confident, together version of myself that no one can see through it. I know it’s my own fault.
The next shocker came a little while after this bombshell I was still reeling from the notion that I was a confident person when the doctor suggested that because I was ‘a lesbian and wouldn’t be having children’ that he recommended putting me on lithium. Suddenly alarm bells started ringing in my head. I recognised this drug – my aunt having been on it for years and years. I also was shocked that a doctor would make a judgement that I would not have children because of my sexuality. Most of all though, I was staggered that I had clearly had a breakdown and rather than refer me to psychotherapy it seemed more appropriate to offer me a cocktail of pills. How can that ever be right?
I left the appointment feeling stunned and proceeded to write a letter to my GP. I outlined exactly what had happened when my dad died because no one had ever asked. I explained all the complications: dying abroad, the body being in heat of 40 degrees for a week on a remote island because there was no hospital or morgue, battling with insurance company to move him to the mainland and start a process of repatriation, the unexpected post-mortem, finding out that it could take up to six months to get cremation rights in the UK even if we flew the body home, opting for a cremation abroad and the time being moved, the ashes being flown home and then left outside on a driveway for me to collect along with my dad’s backpack, my family refusing to attend the celebration of life….and so the story poured out of me including the stuff about not eating and self-harm…in the end there 14 pages of it!
I received a letter in the post shortly after this from the GP inviting my in for an extended appointment before the surgery opened. As I sat down, she thanked me for my letter, and said how sorry she was to hear what I had had to go through and that actually she now believed that I was experiencing PTSD. She said, “Let’s remove the psychiatric label shall we?” and then “You are just really unhappy – aren’t you – and I am not surprised. I think we should refer you into psychotherapy because it sounds like you need to talk and there’s a lot to process. You can stop taking the medication because it hasn’t helped and I agree, lithium is not the way forward especially as you want babies.”
So, that’s what’s happened. I’ve had 7 months of bouncing around and now they think I need time to heal and someone to talk to. And this is all I ever wanted, really. I just wish I could have expressed this sooner rather than behaving like a deer in the headlights. I know waiting lists are long for psychotherapy and I plan to find a therapist in the meantime and see what I can do.