Something of a Car Crash

A mental health patient explains the frustrations of trying to convince doctors that her illness is biological, rather than caused by a bad night’s sleep, a row with her boyfriend or her menstrual cycle.

The other day I bought a new car. It was a lovely car, but it had a design fault, quite a serious one. Whilst driving along a straight piece of newly-tarmaced road one day, the brakes failed, causing a nasty accident (no onlookers were hurt).

I took the car to a mechanic who confirmed that the brakes were faulty. However, In the weeks following the accident I had to have a series of conversations with the police, safety experts and insurance specialists who were investigating the accident.

The conversations could be summarised like this:

Official: So madam, what do you think caused the accident?

Me: The brakes failed. I have a comprehensive statement from a senior mechanic, confirming that brake failure was the cause.

Official: Yes, but let’s look into this in more detail. Was there perhaps a pothole in the road?

Me: No. The road was newly tarmaced, and in any case, it was the brakes that failed.

Official: I see there are large trees in the area. Leaf build up from overhanging branches can be an attributing factor for car accidents.

Me: It’s the middle of summer, there is no leaf drop. And I think I mentioned, it was the brak-

Official: (interrupting)  It’s currently Ramandan. Fatigue caused by fasting can cause one to lose concentration on the roads…

Me: I’m an atheist. And so is my husband, who was driving the car at the time of the accident.

Official: And how is your relationship with your husband?

Me: IT WAS THE F**KING BRAKES

This is what it’s like trying to explain to health professionals that your mental illness has a biological, rather than a psycho-social, cause.

For the record, I have a dual diagnosis of Bipolar Disorder, which is mainly considered a physical/biological illness, and Borderline Personality Disorder, which is frequently considered to be caused by, and influenced by potholes ooops I mean environmental or social factors. In my experience there is a massive reluctance on the part of the NHS mental healthcare side to accept that sometimes mental illness isn’t attributable to social factors, and is just caused by my brain’s fucked up chemistry.

  1. This website is helpful if you want to know more

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No doubt others will have different experiences.

Catch of the Day

Likely to be a regular feature while I’m in acute mental health services.

Today it went something like this.

Back in the day, when I first developed my spinal problems, I was prescribed large numbers of prescription strength co-codamol. They were handed out in boxes of 100, on repeat prescription, for years, as I detailed in this earlier blog .

Given that the much weaker over-the-counter version of th drug carries a warning that more than three days use may cause addiction, unsurprisingly I became addicted.

Since then I have tried to keep off the strong stuff but still take the over the counter strength daily for the pain.

Because of a history of overdosing, for a long time my GP would only prescribe weekly, so I wouldn’t have a dangerous amount of medication sitting around. It was a hassle but I could see their logic, even thought the combined strength of the seven medications I was on would probably have killed me, even with a week’s supply.

I take eight co-codamol per day, which, maths fans, adds up to 56 tablets.

Eventually my mental health was stable enough that I was returned to monthly scripts, and I received four weeks of everything. Except my co-codamol, which was still given as a box of 56. When I queried this with the GP she said that due to my history they would not prescribe more than one week’s worth for the entire month. I asked for post dated prescriptions and this was refused. This meant that despite paying for my medication on a pre-payment certificate, I had to go to a pharmacy every three days to buy more co-codamol over the counter (and hear the pharmacists warning that ‘more than three days use causes addiction’. You don’t say).

Now I’m in the crisis house, and they will only administer medication that has been prescribed (you’re not allowed to hold your own. In fact I had to smuggle some multivits inside my vagina but that’s another story).

So the GP will not prescribe the correct amount (the fact that I need this drug to treat chronic pain is not in dispute) and the crisis house will not administer over-the-counter co-codamol ‘for more than three days as it says on the packet that they cause addiction’.

So far I have explained this situation to:

The manager who assessed me for the crisis house

The pharmacist at the crisis house who reviewed my medication

The worker who admitted me to the crisis house

and finally, this morning, the member of staff at the crisis house who, when I asked her for my lunchtime meds, disbelieved my concise summary of the situation.

No punchline today. In fact I’m going to go and grovel for one of my Valium and see what difficulties that throws up.

Dry your eyes, mate

I’m ill, which means I need to access mental health services, which in turn makes me more ill. Oh the sweet irony of NHS mental health care.

I write this in my GP’s waiting room having just had an encounter that was almost as unpleasant for the doctor as it was for me.

As ever, whenever I deal with authorities I find myself trapped in some kind of hideous Catch 22 in which the people with the most power have the least intellect.

I turned up for a routine appointment to review my mental health. I explained that things had got worse and please could I have some more diazepam. After a lecture from my somewhat-new-and-inexperienced GP on how addictive it was, I explained that I understood that but my choice was currently to take medication to control how I was feeling, or chuck myself under a bus. I am dealing with the lesser of two evils here.

I also asked for one of my prescriptions to be changed from three times daily to ‘as required’, as I’ve been instructed by the crisis house to which I am hoping to be admitted this afternoon that they can’t administer more medication than prescribed.

There followed the most ludicrous and cyclical conversation, in which the doctor repeatedly told me that she couldn’t give me any more tablets. I explained I did not want any more tablets, I had plenty. I wanted her to change the     prescription from TDS (three times daily) to PRN (as required). She couldn’t give me any more tablets, she repeated. I DON’T NEED ANY MORE TABLETS I repeated.

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No word of a lie, this conversation went round in circles at least four times before she informed me that my psychiatrist would have to agree to this, but she was too busy to contact him today. The crisis house would have to phone the surgery, speak to the duty officer, ask them to phone my psychiatrist (who, as a consultant, is not easy to get hold of at the best of times).

I expressed the view that this was not good patient care, and would likely leave me in a situation of extreme distress with no access to medication for a period of days until contact could be made with the appropriate people.

She refused to budge from this point, so, knowing that I would have to explain this situation to the assessment team at the crisis house, I asked to record her reiterating her position, and turned on my phone.

At this point she left the surgery and did not return. Instead, her senior colleague returned and informed me that she was very upset.

He asked me to stop recording and said he would end the consultation unless I did so, so I agreed I would do so provided he would give me a written account of our consultation to take away with me. On this basis, I quit the record.

He then agreed to contact my psychiatrist today and to phone me and let me know the outcome.

I thanked him. I explained that I was sorry that his colleague was upset but pointed out that I thought it showed skewed priorities that he was asking me to empathise with her.

I was a patient who had presented in the midst of a mental health crisis and has asked for a course of help that would prevent causing me further distress. When that was denied to me I asked for evidence because I knew that I would have to progress this battle with other authorities in the health trust. At no point did I raise my voice or be impolite; what I did do was give a frank account of being unlawfully detained by the trust last year and explained why I felt the need to cover myself from all angles in interaction with mental health services. The other crime I seemingly committed was of having an understanding of my rights and of prescribing guidelines on controlled substances.

 

I can forgive, but forgetting’s the bastard.

Like everyone, bad things have happened in my life. Some have been done to me, and some, I’m ashamed to say, I’ve done to others. Yes, at times in my life I have been a complete cunt.

Years of therapy (man) have helped me move on from childhood shit, from blaming parents for omissions, for the lovers who cheated. There’s a couple of things, however, that I just can’t move on from.

These two betrayals are insidious by the cloak of mystery that surrounds them, because although completely different in nature, these offences have in common that they were carried out by an anonymous aggressor. And no matter how much you try to move on, it still rankles in the wee small hours that someone hates you so very much that they would intentionally hurt you.

The most recent of these occurrences was the absolute charmer who took advantage of the Tories’ ‘shop a scrounger’ anonymous benefit fraud telephone line. Up to then, I had been fortunate to have avoided the perils of ATOS and their heartless and senseless assessments, and had been automatically awarded fairly decent levels of disability benefit. This award was no doubt largely down to a letter from my long-serving psychiatrist who explained that due to my complex, severe and enduring mental health problems I would not only be unable to hold down a job, but (and I have to admit this bit brings me to tears a little) I would ‘never be able to live a normal life’. So, lucky old me with my fucked up brain, at least I got the princely sum of ninety quid a week from the social with which to live like a Queen (in my abnormal life).

However, my nameless adversary knew better than any medical professional. Sitting on the phone, very possibly masturbating with joy, they gave the DWP a full rundown of my appearance, previous married names, height, weight and hair colour. The crux of their analysis, though, was that I am able to leave the house and ‘obviously lead a full life’.

How that phrase rankled my agoraphobic brain. My best mate is my carer and drags me our once every few days, without which I remain inside, often in my pyjamas, sometimes rarely able to shower. God forbid we should put a photo on Facebook of a rare moment of fun, because that obviously means THAT I AM FINE AND DESERVE NOTHING.

Well, dear reader, it’s 1-0 to my nameless Daily Mail reading wanker because my benefits were stopped and now, well I get by in the only way I can. And I can’t pretend that it’s good for my mental health.

My second beef that burns brightly dates way back to university. I studied at Cambridge as a mature student, after a less than illustrious schooling and adolescence. I was aged 29 and I remember the date because it was Burns night, 2005. I attended an all-female college and was invited to the neighbouring mixed-sex college for the Burns night dinner. The booze was flowing and I remember having a silly tiff with one of the male students, who was well known for fancying himself somewhat. Later that night he handed me a drink, and that’s the last thing I remember.

I came to about 14 hours later, having been attended to by paramedics; my friends had seen me become suddenly floppy and completely out of it, and had called an ambulance. The paramedics didn’t do anything except observe me, and lord knows why they didn’t test my blood, but I was subsequently ill for two whole weeks; I couldn’t look at light, I had a blinding headache and was constantly throwing up. I felt like I’d been physically assaulted.

Again, the sense of not knowing is what makes it hard to move on. I have no doubt that someone spiked my drink, but I have no way of knowing who it was, regardless of my suspicions. In the days that followed (because naturally the event had shocked the college; they immediately ran a campaign to raise awareness of drink spiking), several students came up to me independently with suggestions of who the perpetrator could be. For the record, their suspicions matched mine.

This would all be ancient history, an unpleasant anecdote but something that I’d write off as ‘one of those things’ were it not for an unpleasant twist in the tale. The person I suspect assaulted me in this cowardly and pathetic way is still part of my life, and keeps popping up due to mutual friends and interests. I’ve tried blocking on Facebook, and even unfriending people to avoid seeing his image, but he is physically present at places I go to.

There’s nothing I can do. I one thing I refuse to do, is absent myself. No matter how someone chooses to be a bully, their aim is to remove you from their domain. Sometimes just existing in a time and place is a radical act.

 

So these are my confessions. I’m not proud that I can’t forgive, forget and move on from these horrible events. I’d be a better woman if I could. I’d love to hear from anyone who has found that peace.

 

What’s the difference between Ant McPartlin and a civilian? Rehab is not an option for most of us

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I was sorry to read today that TV presenter Ant MacPartlin was “going into rehab” after admitting a struggle with depression, alcohol misuse and addiction to prescription drugs. 

Although McPartlin is in no way my cup of TV tea, I understand that it must have been incredibly hard to have stayed at the top of his game for so many years in a business that delights binning those who have outlived their light entertainment shelf life. I’ve known enough people in the entertainment industry to know how hard they have to work to keep their heads above water.

I understand that McPartlin’s problems have partly arisen as a result of being left in chronic pain following knee surgery, and as a fellow pain sufferer I can see only too easily how this came about.

Dan Baldwin: Fragile - Private View

I suffered a herniated disc back in 2012, as a result of going running to try and control my bipolar disorder. The running was incredibly effective, but my spine was not in agreement andI ended up having to have surgery for a slipped disc. During this time I was placed on high-strength opiate painkillers, on top of my ordinary psychiatric medication, with the advice to “take them, whether you feel the need to or not” (this advice is based upon the reasonable assumption that if you wait until you are in pain, the muscles around the area will be in spasm and the pain will be worse, whereas if you take the painkillers regularly you are less likely to restrict your movement and cause further problems).

Great, I thought. No problem, I thought. 60mg of codeine per dose was easily enough to convince me of the doctor’s wisdom. After the first dose, in fact, I believed I’d never have any problems again. It wasn’t enough to completely kill my agonising pain, but it was certainly enough to help me not care that I was now bedridden.

I had my op. Post-operatively I was prescribed Tramadol on top of the co-codamol and three other painkillers I was taking. I used one of those old lady pill organisers to ensure I was taking my medication correctly and found I couldn’t shut the lid, so great was the number of tablets inside. I didn’t care. I found I didn’t care about much, until I realised it was a year later, I was two stone heavier and I hadn’t left the house for eighteen months.

By this point, I was a long, long way away from being able to enjoy any of the therapeutic effects of exercise on my mental health. I was terribly depressed. The codeine no longer had the same joyous effect, and so I’d drink to try and replicate the blissful state of blotto. When that didn’t work, I’d take extra co-codamol. I remember phoning NHS Direct (now 111) because I couldn’t breathe, and them advising me to sleep propped up on pillows. They didn’t ask the right questions to discover what I know now, which is that my breathing was suppressed as a result of overdosing on co-codamol and alcohol.

This unhappy state of affairs culminated with me being awoken from a drugged sleep one night by the police banging down the door. I’d told my friend online that I’d taken (as had become my custom every evening) about 20 co-codamol, as well as alcohol. Oh and I’d sliced up my arms for good measure.

I don’t know what Ant’s rock bottom was, but I’d hit mine.

But if there are parallels between our stories up to now, this is where they diverge.

Because the thing is, there is no “rehab” for those of us reliant upon the NHS. I spent a few days on a general NHS ward whilst the drip treated my damaged liver. I went on to spend the next six months being buffeted between home (where I could not cope), psychiatric hospital, where they kept on trying to discharge me because, although i was actively suicidal, I wasn’t mentally ill enough, and various short stay ‘crisis’ houses, which had very strict time limits of a week or so. There was no rehabilitation facility for someone who had become addicted to prescription drugs because they were prescribed those drugs by their GP. It was a matter of going home and sitting it out; or more realistically, going home and taking regular overdoses and being buffeted in and out of crisis care, which amounts to one visit every couple of days to check that the knives are hidden. Not “rehab” by a long chalk.

The Telegraph reported McPartlin to have said about his difficulties:

“I’ve spoken out because I think it’s important that people ask for help if they’re going through a rough time and get the proper treatment to help their recovery.”

I’m really pleased McPartlin has spoken out, but let’s be realistic about what this “proper treatment” amounts to for those of us not wealthy enough to afford The Priory. The NHS does not have these mythical rehab facilities. If we feel sorry for McPartlin, we should extend this pity to the average service user who is struggling through these problems alone.

 

This is how it feels.

Are you one of those folk who ‘don’t really understand’ mental health problems? Pull up a chair, my friend.

IMG_5762I am terribly, terribly sad and nothing is making it go away. I know people say that they can’t really understand what mental health problems are like if they haven’t had them – well please allow me to illustrate my example.

A few years ago, I lost my mum to lung cancer. We were close and I very much looked up to her. I thought her death would be the very worst thing that could ever happen to me, and it was pretty horrific.

The way I feel now is worse. With no reason. No bereavement counselling, no reassurance that I will work through ‘stages’ to recovery, no concerned relatives and certainly no fucking flowers. Just a terrifying feeling of darkness, worthlessness of myself and everything around me.

My mental health nurse has moved on to another job and I won’t get another, because the NHS has no money and they have to focus on the people actively taking overdoses rather than the ones fighting the urge. My Personality Disorder psychiatrist  sees so many chaotically ill people – emaciated, angry, covered in scars and cigarette burns – that he understandably says I’m ‘doing well’. I get where he’s coming from, but it’s cold comfort.

I’m so grateful to my friends for sticking around the bundle of definite un-fun that I am. My best mate tells me this will pass, and I have to listen to him. It’s all I have to hold on to.

Sticking it to The Man(ic)

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I know I am currently suffering from hypomania. It’s not pleasant but one of the funnier effects is lack of inhibitions. 

This manifested itself in the pub yesterday afternoon. I’d been trying to enjoy a quiet pint but it was marred by a group of about eight young men in suits, slick haircuts, reeking of Lynx Africa.

They were gathered around a slightly older fellow, all slicked back hair and pin striped shirt, who was ostentatiously holding court. In a loud voice, he was delivering a motivational speech to his acolytes, apparently about what it takes to become a ‘coach’ (of what, I do not know). It will take sacrifices, he said. Your girlfriend won’t understand why you spend so much time at work. Hell, if she doesn’t understand that this is the sacrifice you need to make to bring in the big bucks then maybe you should question if you even need a girlfriend holding you back? 

You need to be hungry, he exhorted them (although I hope they weren’t that hungry because the portion of sweet potato fries I received was measly). You need to be prepared to eat, sleep and shit work, if you want the sweet sweet reward of dollar. On an on he went, while they gawped open mouthed at his increasingly ludicrous proclamations.

In the end I could take no more. I had to leave anyway, so as I passed them on my way out (clutching a bulging Primark bag, which I’m sure added to my air of gravitas) I interrupted the Alpha and addressed myself to the group.

“Excuse me, I’ve been listening to everything you’ve been saying from over there, as this gentleman’s voice is quite loud. I just need to let you know that he is talking absolute bollocks. I’m a coach myself (I’m not; I don’t know why I said that) and he – gesturing at the shirt –  is an utter bellend. Have a nice evening”. And I sashayed from the pub.

Not really sure what it was all about, really. But if I’m going to go publicly and embarrassingly mental then walking up to knob heads and informing them they are talking shite seems quite a productive channel for my energies.