The Pressure To “Get Better” When You Are Struggling With Mental Health Problems

It is official. After five and a half months of being cooped up in hospital with very little interaction with the outside world, I finally have a discharge date and I will be going back home on February the 20th. Considering this hospital admission has been possibly the hardest and most traumatic of my entire life so far (not that I am planning on having another one to top it), I am thrilled, but at the same time I have to admit I am a little scared because the pressure for me to do well when I go back home is overwhelming. Indeed I have had to make a lot of promises in order to get this discharge date agreed, and every day I am starting to doubt a little more whether these are going to be promises that I can keep.

It may be a surprise for some of you reading this to hear that I have a discharge date, considering my posts of late. After all it is only a few weeks since I was writing about the difficulty of being on 1:1 observations and living with a tube up my nose and I will admit this has all moved ahead fairly quickly. To be honest though, I think staff and I have finally come to realise that we have come as far as it is possible for me to go right now and any more time spent in hospital is simply going to be detrimental from now on. As you will know from my post about the body recovering faster than the mind in recovery from an eating disorder (a post you can handily read here…The Difficulty When Mental And Physical Progress Move At Different Speeds In Eating Disorder Recovery), I have been getting rather overwhelmed with the rapid physical progression of my body and weight gain side of things and I really am at a point where I cannot take it anymore. With every ounce of weight I gain my head is screaming louder and louder and the ability to stay alive and simply keep breathing is becoming more and more unbearable to the point where suicidal thoughts and urges to relapse are at an all time high. (God this isn’t a very jolly blog post is it…don’t worry I will try and fit in a knock knock joke or something soon to brighten things up a bit).

On the day that you read this (if you are one of those extremely wonderful keen beans who read my posts on the very day they are uploaded….high five to you and a chocolate chip cookie if you are one of them), my discharge date will still be two weeks and a day away, but in reality I have already checked out of treatment mentally. Then again I suppose you could argue that for the duration of this admission, I never really checked in (it has been five and a half months and I still haven’t fully unpacked and set up my room because I refuse to accept that I am a patient here even now).
I think inpatient admissions for mental health can only ever really be beneficial when both staff and patient are working together to the same end goal, but this time around I have been in such a dark place that I have been finding co-operating impossible and it has very much been an admission of having things done to me, staff feeding me when I was unable to do it for myself and staff keeping me safe because being left alone was too risky even for five minutes. Admittedly, for the past few weeks I have been eating without the tube and keeping myself safe, but that is only with the end goal in sight of going home, and now I am reaching that goal I am not sure if I can carry this good behaviour on. Unfortunately though, like I said there is a lot of pressure for me to carry on because in actual fact, me going home at the end of this admission was never really the plan.

Indeed with the way things have been lately, my parents have been saying that they do not want me back in the family home for the sake of their own mental health. These illnesses may look from my blog that they are only killing me but they are killing them too, so the plan has been for me to move to a more long term hospital. However, though I have been on the waiting list for places you can stay in for over a year, no beds have been coming up (a shortage of mental health beds being available in the NHS?! How shocking and unheard of!) and as I said, since that blog post I linked to earlier, staff and I have realised that I simply cannot wait anymore and that I need to get out of here now.
It may sound harsh to say that my parents have said that they do not want me living at home at the moment but to be fair to them that isn’t exactly what they have said and is only how I have taken it. In actual fact what my parents have said is that they cannot stand having my illness in the house anymore, and after 15 years of dealing with an utter lunatic in their living room (and other rooms of the house of course…I do move around sometimes … I just specifically mentioned the living room for alliteration purposes…) who can blame them? However, as someone who struggles to distinguish between what is “me” and what is “the illness” in my head, them saying that they do not want my illness in the house is very much the same as saying that they do not want me either, seeing as the two in my eyes are so inextricably linked. I know there will be people commenting to say that there is a Katie aside from the mental health stuff and that is very kind of you but really, in the past five months, Katie hasn’t been around much if at all.

Because I was never supposed to be going home then, in order to get my parents to agree to the plan, I have had to agree to live by certain very strict rules to stay in the family home. There are many of these rules but overall they cover general things like agreeing to maintain my new unbearable weight (I don’t even think I will be able to leave the house even when I am “free” because I simply cannot stand the idea of people seeing me with all of these extra kilos I have gained), agreeing to stick to my medication (a medication I hate with a passion due to the side effects) agreeing not to harm myself and agreeing to keep eating. When I made all these promises that I would be able to do these things I honestly meant every word I was saying, but as time has gone on, the doubts have crept in. When I agreed to these conditions initially I was several kilos lighter than I am now, but at this new weight I really don’t know if I can manage and the harder it is getting.

I think there is so much pressure for me to stick to things this time round though because the consequences if I don’t are extremely dramatic. I will be blunt, in my head right now the only thing I want to do is relapse and lose weight, I cannot stand how I feel now in my head or my body and the urges to give up are so strong I might explode, but at the same time I know that if I do, I will quite literally be homeless and back in hospital, neither of which are particularly appealing options. So what do I do? How do I deal with this overwhelming pressure for me to “be well” mentally when it all feels so out of my control. Physically I know what I have to do to be physically well enough to stay out of hospital but how do I manage that when I have pressure to do the opposite piled right alongside the pressure to stay where I am now? Well, if you were looking for answers, I am afraid I don’t have any (and I am afraid I don’t have any knock knock jokes at this point..sorry for that), all I have is pressure, buckets and buckets of it.

I think that for anyone leaving an inpatient admission it is hard because there are so many expectations to be upheld. Will you be able to uphold the changes you have made/carry on with any good behaviour? How? How long for? How long until the million pairs of eyes watching your every move tell you that you haven’t done it well enough and are going to have to be recalled.

What I want to raise the awareness of however is exactly what I have been talking about , the pressure to be well when you leave hospital after a mental health admission which is supposed to have “helped” you, pressure which causes a lot of stress you really don’t need because you are already stressed enough as it is. It is ridiculous really, with physical illnesses you never get this pressure which is why I struggle with this idea in society that mental illnesses are any more in your control. When I left hospital after my appendix there was no pressure to not have another organ explode (although I am rather glad one didn’t and hopefully such organ fireworks never happen again), yet now, leaving a mental hospital, pressure is all I have. I am not sure what will happen when I get home so I guess we will have to see, all I know is that I am going to have to do my best because I cannot afford to not succeed this time. I wish that felt like a manageable task. It just feels very much like a case of knock knock, who’s there? A very scared and messed up in the head person who really wants to stay home but doesn’t know if they can manage (haha see! I told you we would get a knock knock joke in there somewhere…)

Take care everyone x

Pressure

7 thoughts on “The Pressure To “Get Better” When You Are Struggling With Mental Health Problems

  1. Oh, Katie, I’m so sorry! It sounds like a really bad situation. I know exactly how you feel, I felt the same when I was discharged from my admission over a year ago. I know how scary it is but you have to fight the urges to relapse! It’s very hard but you have to try. I know you hate all of this pressure but it’s for your own safety.
    You can do this! You are strong and brave. Never give up!!
    Sending all of my love and strength xx
    Kisses from Portugal ❤

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    • Thank you so much my sweet, I am sorry to be so negative at the moment but I really appreciate you being so kind to me. I promise I will keep trying to fight and use this pressure to get me through. I am not giving up yet. Really hope you are ok and remember that I am here for you always. Loads of love and hugs and kisses from England xxx

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  2. Wow Katie, this sounds tough. I know you might not see it right now, but YOU ARE BEING SO BRAVE. It’s really hard what you’re going through, and I look forward to the day when you and HBC are wifeys together in your old people’s home, sipping on cocoa and smelling of lavender, and you can say “that was tough, the start of 2018, but you know what – I flipping BOSSED it!!” You will get through this Katie. You are wonderful. When I read your jokes or watch your tea parties, it’s not your mental illnesses making me smile and laugh and feel a bit less lonely and like things might be okay. It’s YOU. That’s Katie. YOU ARE WONDERFUL. And anorexia, anxiety, depression, OCD – they are all SH*TBAGS. Hate them. Love you. Bit jealous of HBC not gonna lie 😉

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    • This comment made me cry in the best possible way. Thank you so much, I really am so grateful to you for being so kind to me and for giving me such a boost. I will keep trying and live in hope that you are right and that that image of me and HBC will come true. Thank you for telling me that there is a Katie left somewhere in all this mental health stuff, seriously you are so wonderful to me I don’t know what to say. Really hope you are ok and know that I am always here if you need, loads of love and hugs and general gratefulness to you xxxxxxxx

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  3. I am so sorry that you are going through this and I do understand from both sides of the coin, so to speak. When I was young my OCD was not appreciated and to be accepted I had to learn to hide the compulsions and started doing them in my head (pure O as they call it now); no one got treatment for me. When I have bad flare-ups now, I push through the obsessive thoughts because my kids need me or I set some other goal so that I am not paralyzed by them, but it is very, very hard. I won’t insult you by pretending to know you or your parents personally, so I will give you the example of what I did with our son (try to contain your excitement). When he was discharged from IP (where his goal was just to get out also) I told him that we couldn’t return to the way things were before he was hospitalized; not because I didn’t love him, but because I was limited by human frailty too, and couldn’t keep him safe. I told him that we would have to look at residential if he couldn’t be safe at home. I also understood that he “hated” himself. I told him that if we had someone he hated most in this world living in our home, I would expect him not to starve that person or harm that person in any way. He would be expected to treat that person with respect and basic care. That he was “that person” didn’t change my expectations. I also told him that we couldn’t help how we feel, but we can (unless completely psychotic, which he was not) control how we behave. I reminded him (in a positive way) that his ability to eat and stay safe on the IP unit was a demonstration of his ability to be successful. I do agree totally with your assessment of medical vs mental illness. As “enlightened” as we have become, mental illness is still stigmatized. I will offer one thing though regarding your appendix example. You certainly cannot help your appendix bursting as we cannot help having a mental illness. You can aid recovery though: in the case of your appendix by taking medications, resting, nutrition, etc. If you had a weak heart you could not help that, but would be expected to take medications, observe exercise restrictions, nutrition, etc. and not abuse your heart by doing the opposite. That was the example I gave my son. I know this may sound quite harsh, but it was because I loved him so much that I set the boundaries. There was never a problem with his having a mental illness in my home and never will be, and I do, oh, so well, understand how very difficult it is when your head is so full of “counter” messages (that I understand first hand). It is possible to recover though. I will never be cured (at least as far as I can see) and neither will my son, but it is possible to be safe and to experience recovery and I believe that it is for you too.

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