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

The Difficulty Of Talking About Anything Other Than Mental Health When You Are An Inpatient In A Psychiatric Ward

I have an amazing family and, since being in hospital, my mum has visited me nearly every day. During visits there are a variety of activities we try to do to distract me from my current situation, sometimes we watch TV programs mum has downloaded to her tablet, we have been known to dabble in a little scrabble and once a week my mum will help me edit these blog posts that you love so much, to let me know if there are any glaring grammatical errors (that’s right. If you ever see a grammatical error on this blog feel free to blame my mother…only kidding…thanks for the help mum). When it comes to conversation however, there is little to no variety in topic and usually, if not every visit, we will end up talking about something mental health related which understandably can get rather tiresome.
It is therefore no wonder that the other afternoon my mum asked if we could possibly “talk about anything else” and lord knows I can see where she is coming from. Anyone would get fed up talking about depressing brain nonsense all the time and I do not blame her at all for asking for a different topic once in a while but at the same time I don’t think people realise how difficult it is to talk about things other than mental health problems when you have mental health problems, even if you are trying really really hard.

I hate admitting that because it makes me sound incredibly boring and self obsessed to say that I am frequently caught up in conversations regarding my head demons but the thing is, when your head demons are in your head 24/7, it is practically impossible to think about the “anything else” that other people wish to be discussing. Which part of your brain is supposed to be free to think about this supposed “anything else”?
When you are lost in your mental health problems, asking such a question is pretty much the same as asking someone who is being repeatedly smacked on the head with a wooden pumpkin to say anything other than “Oww”, “please stop hitting me with that”, “that hurts” or, if the person is a particularly articulate fellow “My frontal lobes are in a state of great pain so please desist with your actions and then tell me where on earth you were able to find a root vegetable carved out of the finest mahogany”.

I think this is especially the case when someone is in hospital because not only are your mental health problems all you can think about but they are all around you and you are in a location in which forgetting them is impossible, like trying to forget the smell of fresh bread in a bakery. I know people are always telling me that I am “more than” my mental illness and that it isn’t my entire identity which should mean I do have other things to talk about, but I think when in hospital you are often treated as an illness rather than an individual, and psychiatric units, though helpful, can make you start to feel like you are not a person at all.

It is like the problem I am currently facing being on 1:1 Observations.
Now, considering I write a blog on the internet all about how I am a flipping lunatic (or “Marbleless Marvel of mysterious Marblelessness when being addressed formally), you could say that I am perhaps not the world’s most private person. I talk about my mental health problems publicly every week and whenever I go into hospital for treatment I no longer ask friends to make up excuses to explain my disappearance in day to day life (my favourite of which was when I was 16 and to cover up my detainment in a psychiatric unit a rumour was spread at school that I was working on voicing a rat in the Disney Pixar sequel to “Ratatouille”, a rumour that was regrettably untrue in that I have never voiced a rat for Disney, nor has a sequel to Ratatouille ever materialised). However, as open and honest as I am, like any regular person, I still do like a reasonable amount of privacy in my life and unfortunately, for the past few months, privacy is something that I have been severely lacking due to the nightmare that is 1:1 and 2:1 observations.

The terms 1:1/2:1 observations in hospital are probably self explanatory and in explaining it I apologise for offending your intelligence, but basically it means that wherever you go, there will be at least one member of staff staring at you (aka 1 or two staff to your 1 patient ratio). It doesn’t matter whether you are going to the toilet, having a shower or having a snooze, the staff member will be with you (possibly within arm’s reach if that is stated in your care plan), and they will be watching every move, almost like a real life version of that song “Every breath you take” by The Police with those creepy lyrics (seriously if you haven’t heard that song look it up. It is weird and is a perfect summary of the 1:1 inpatient experience.) That song and indeed that experience has been my life for the past two months and to be blunt, it is incredibly humiliating. More than humiliating though, it is dehumanising and that is one of the things that takes me back to the question as to how you can talk about anything else other than mental health problems when you are being treated as a new species of disorder that is able to walk and talk. You are not a person, you are a thing that needs to be watched and observed. I am constantly hearing staff in the corridor ask each other “who is watching Katie?” or “who is with Katie for the next hour?” as if I am a ticking time bomb that people are just waiting to go off.

I suppose in fairness everyone loses a certain level of privacy when they are admitted anywhere. Even if you aren’t on 1:1 obs in hospital, you will be on some kind of observations, just as I was initially on 10 minute observations meaning that every ten minutes a staff member would appear at my door to see what I was up to. Therefore staff knew what I was doing all of the time but still in that ten minutes of unobserved time there was an element of privacy that I am sorely missing today, and I think that having just that ten minutes again would make me feel more human and less like a living issue in need of being managed. In those ten minutes I could hum a jolly ditty if I wanted and nobody would know, but now I can’t even convert oxygen to carbon dioxide without a beady eye watching to make sure I do it appropriately.

It is just so humiliating to be watched all of the time, even in the “private moments” that people take for themselves just to respect their own decency. Take urinating for example. Sure I have learnt over time to manage it and can now pee with staff even if I don’t have music playing on my phone (although in the early days such an activity was practically impossible and it is safe to say that I have publicly urinated to every song in the current top 40 charts…have fun getting that image out of your head when you next listen to Ed Sheeran on the radio), but it is still something that I want to do on my own. Worst of all though is showers and I think that is where my main issue lies with this whole 1:1 thing.

Imagine absolutely hating your body, despising every ounce and seeing it as nothing but a source of shame and then having to parade it around naked in front of a different stranger every day whilst you wash yourself. Surely that would be a challenge for even the most body confident person out there but for the person whose body is a constant source of torment and torture? How can anyone feel human or respected then? How can you feel anything other than dehumanised, humiliated and not respected as a proper person with their right to their own privacy whilst they have a good lather? How can you see yourself as, let alone discuss, “anything else” other than mental health problems?

I suppose I know on paper that if I were to print this blog post out and give it to any of the members of staff looking after me right now they would say that they do 1:1 Observations to look after people and keep them safe rather than humiliate but it is a lot harder to believe that when you are the one standing naked in front of a complete stranger whilst you frantically look for a pair of pants (hypothetically of course…this has never actually happened to me… Trust me, when you are on 1:1 you always have your clean pants prepared for after a shower!)

So, when you have mental health problems how easy is it to talk about “anything else”? Well, not very, when you don’t have the brain space or power to think about these “anything else’s”. Sometimes though, the biggest challenge isn’t thinking about anything else, but, when you are on 1:1 observations and have no say in your treatment, it is about trying to see yourself as anything other than a dehumanised circus freak in a constant humiliating parade.
Take care everyone x

TalkAnythingElse

 

The Difficulty When Mental And Physical Progress Move At Different Speeds In Eating Disorder Recovery

In a few days time, I will have been in hospital for 16 weeks aka a grand total of 4 months, and because of this, I am often being asked questions like “How are you getting on?” or “are you feeling better?” which are both very complicated and difficult questions to answer when you are in treatment for an eating disorder. You see, on one set of paper work, things are going rather swimmingly and I am indeed doing much better, yet on the other set of paper work in my opinion, I am actually feeling and am “doing” worse than I ever have done in my life.

Oddly enough, this discrepancy between paper works is not because I have two very different doctors with opposing ideas writing sets of notes about my progress, but because when it comes to recovery from an eating disorder, there are two very distinct and different sides to it, the mental and the physical, and unfortunately these two sides do not work as sleeping otters do (aka hand in hand – yes, fun otter fact for you, otters hold hands when they sleep to make sure that they don’t drift away from each other. Apparently they also make waterslides and play with pebbles. Conclusion: Otters are cool).

Indeed the two sides to eating disorder recovery are so separate that I think that asking someone in treatment for an eating disorder how they are, is a question that needs to be asked twice, once for each side of recovery, because otherwise getting one coherent answer is impossible.

To be fair, towards the beginning of my admission, the physical and mental sides of how I was doing were fairly in sync. Mentally things were a bit all over the place and physically things were too. This then continued as I struggled to work with the program at the eating disorder hospital, until the introduction of my NG tube and since that most unwelcome introduction, everything has changed, in my eyes, for the worse.

Before, when I was mentally struggling and didn’t feel able to manage food, I was able to avoid it which obviously didn’t help my body very much but it prevented my anxiety levels from getting worse. Now though, since the NG tube, I have a constant and unavoidable source of nutrition and it doesn’t matter how I feel, food cannot be avoided. If I don’t eat, the food still goes in, and consequently my mind is in utter turmoil. My body on the other hand is as they say “loving life” and ironically, it is killing me.

Seeing as food is unavoidable now, I have been following my meal plan in one way or another for weeks and the affect this has had on my body is dramatic. I am gaining weight faster than I have ever gained weight before (perhaps because I have never had such an unavoidable source of nutrition stuck up my nostril before), so health wise, I am “improving”. I am no longer at a weight where I require a wheel chair, I am now able to stand in the shower for long periods of time, even on one leg (I am a fantastic flamingo impersonator these days), and when I get out of bed in the morning, the world doesn’t swim before my eyes and go black. Objectively these all sound like good things and for the medical professionals and my friends and family, these are good things but to me, these are terrible things.

I really don’t know how to explain this idea to people who may not have eating disorders as I know that to most people it sounds absolutely ludicrous. Physical health, the ability to stand in the shower and walk down the corridor are abilities to be appreciated not feared, but when you have an eating disorder, these abilities mean entirely different things.
To me, not being able to stand up without things all going fuzzy was a sign that I was “behaving” myself, a sign that I was doing a good job at punishing myself so the guilt I felt at being alive was lessened. Now though, I am unable to “behave myself” by not eating because even if I don’t eat the food will go in without my permission, so with things not going fuzzy, it is like a sign that I am doing something “bad” (even if it isn’t always me who is doing the eating), and I guess I am feeling all the guilt and shame as anyone else would were they to do something they thought was bad, like stealing or punching someone in the face.

Now I take up too much space in the world and with the weight going on as it is I take up more and more space each day, which is something I have always struggled with. When you hate something you want to make it as small as possible (or you want it to disappear altogether), you want it to take up as little of the world’s space as possible so as there is more room for the good things. In gaining weight I feel like a weed taking up too much space in the flower bed and stealing all the sunlight from the marigolds.

It is incredibly hard to watch this body you hate, morph in front of your eyes into this thing that is getting bigger everyday, getting “better” everyday whilst inside you are all the more depressed and tormented.
I don’t have any idea if I am making sense here because to be honest I am on so many medications right now that my brain is not functioning but if I had to resort to the good old Born Without Marbles way of explaining things, aka an analogy, it feels like my body and brain are one of those cars people drive off in after a wedding with tin cans on the back and “just married” scrawled across the rear windscreen.

My body is the car and as it gains weight it is zooming off full speed. Meanwhile my brain is the collection of tin cans tied to the back, being dragged along and through all of this road that it is not ready for, each can bouncing and denting, bruising and breaking a little more with every mile that passes. My body gains weight, my brain cracks a little more, I feel more broken, depressed and bruised and the faster my body goes the further it is from my brain which is actually all the way back at the starting line. I guess this analogy isn’t perfect because you could say “but your brain is moving in the right direction like your body if it is tied to the car” but that is where the analogy fails because that is not happening at all, like I said, as the car moves the brain just gets battered and even staff have admitted that in the past few weeks things have mentally become worse and worse as time has passed and weight has gone on.
Christmas day is a perfect example of this. When I woke up on Christmas day I was weighed (NOT something I asked Santa for and if I ever wake up to a set of scales in my stocking on Christmas morning again I swear to God I am marching to Santa’s grotto to give that beardy man a piece of my mind…and his scales back), and I had gained a lot of weight. On paper then and to the doctors, my body had got “better” but mentally the shock of it all had such a strain on my mind that I totally lost it. Within minutes I was having to take medication to calm down from the anxiety and agony and when my family came to see me for our two hour visit, the visit wasn’t better for the weight gain, it was worse. It should have been better logically, my body was healthier than the last time they had seen it but in becoming that way I became so upset, distressed and anxious that I had what we shall simply call “ a little incident” and I had to ask my family to leave early.

It is that which I think illustrates my point best as to how impossible it is to answer the question as to “how are things going” when you are in recovery for an eating disorder. Am I better? In a way, yes and I am getting “better everyday”, but in the other more important mental side am I better? Am I progressing? Not at all. I hate myself more than ever, I am more unhappy than ever and I feel more trapped than ever in a body that I no longer relate to. The distance between my body and mind is so great now that I have asked staff if there is any chance we can slow down on the weight gain so that my mind has got a chance to catch up but they are refusing and it all feels like I am being dragged and pushed too far out of my comfort zone. I am in hospital being treated for an eating disorder and the physical problem is being taken care of by a tube, but the mental aspect is being torn apart and I really don’t know how much longer I can handle it.

It is so frustrating trying to explain all of this and I guess in the end the main thing I want to do at the end of this blog post is apologise because I feel like I haven’t made any sense and that I have wasted your time with my incoherent waffle. Like I said though, I am on all sorts of crazy meds at the moment (to calm me down because I am in so much distress due to this whole struggling mentally with the physical progress my body is making right now when I am not ready for it), so please blame those meds and not my inabilities as a writer. I don’t understand half the things that are going on at the moment so explaining them coherently is somewhat difficult. I really am sorry. I am just so battered. I hope this makes some sense at least or that I have got the point across in some way that physical recovery and mental recovery for an eating disorder do not go hand in hand and can sometimes be literally travelling in opposite directions. “How are you doing?” is such a simple question but good lord when you have mental health problems is it a difficult one to answer.

Take care everyone x

RecoveryCar

Mental Health New Year’s Resolutions

Quick everyone! Get your noses out…Do you smell that? Just there?
That whiff of hope, new goals, exciting plans and new calendar pages all waiting for you like fresh, crisp bed sheets from the washing machine with just a slight undertone of possible regret for your behaviour last night and the sharp tang of cheap gin? That my friend is the smell of New Year’s Day, aka a day that is only a few hours later in time than the previous one, but a day in which we are supposed to be reborn and regenerated like Doctor Who (yes I am also thrilled that the next Doctor Who is going to be a woman but I have to admit that I’m still disappointed that the BBC didn’t go with casting a penguin in the role…Admittedly it would be hard for a penguin to hold a sonic screwdriver or operate a Tardis with flippy flappy wings but the waddling away from Daleks chase scenes would have been unbeatable).

As lovely as this whole “New year new me” idea is however, like I said in last year’s “new year” post (Oh my goodness, look a handy link to that very post:Why Baby Steps Are More Important Than New Year’s Resolutions In Mental Health Recovery), it does put rather a weight of pressure onto one’s back to make sudden drastic changes, which is why I said last year about the fact that I am very much in favour of setting smalls goals and making small gradual changes over a long period, especially when it comes to goals relating to recovery from mental health problems.
Indeed, last year I made a big point of talking about making small mental health New Year’s Resolutions, but this year I realised that as helpful as that is as a piece of advice, I did not provide any examples or suggestions to help figure out what these goals could be…Shame on you Born Without Marbles of 2017!
Thankfully though, it is, as of today, 2018 and therefore, now being a completely new and different person since midnight (please note the use of extreme sarcasm), I am here to solve that mistake from last year with this post where I am going to try and sprinkle a few ideas out there for you on the internet as to mental health New Year’s resolutions should you so wish to make any this January.

I think that coming up with mental health goals is often a tricky one because mental health is such a broad spectrum that cannot be pinned down or confined (much like a cloud, a wave upon the sand or a certain curtain sewing, puppet operating, singing nun called Maria) so to help make this whole thing a bit easier, I have divided my set of suggestions into four main categories of ways that you can make small and manageable changes over the course of 2018. Let’s go!

1. Goals about treatment – This is probably the easiest category to make mental health goals for because these are basically just goals relating to whatever mental health treatment plan you have going on. Say for example you take medication but struggle to do so, one idea could be to set yourself the goal of taking your medication every time a dose is required, with a calendar or chart to help you keep track and aid as an extra reminder or motivator. Maybe you have an eating disorder and have a meal plan set by a dietician or are working towards building a meal plan up, maybe make a goal to follow what that dietician has said or to gradually keep up with increases in your meal plan until you reach the amount that is right for you and is going to help you best in your recovery. Hate turning up to appointments with your therapist either because you find them awkward or because your local psychologist’s waiting room smells like cauliflower cheese? Make a resolution to attend all appointments or at least increase attendance over a period of time (and maybe invest in an air freshener for your nearby surgery…I recommend something with a hint of lemon if like me you are partial to a citrus tang).
If you already turn up to appointments regularly, then there are still loads of appointment related goals that are possible like doing any therapy homework on time (I think I might need to make that one of my resolutions for 2018…the ”my penguin ate my homework” excuse has not been going down well for some time now), making more use of therapy sessions by being more honest or maybe taking notes of important things that are said to take away so that they don’t get lost in the “post appointment mental blank abyss”.
Even if you have a mental health problem and are not in specific mental health treatment you can still make goals in this category especially if for example pursuing professional support is something you are interested in. Booking yourself an appointment at your local GP surgery to discuss possible treatment options, filling a form in to get your name down on one of those pesky waiting lists, making a phone call about a first appointment or setting up an assessment or perhaps doing some research into nearby therapy groups you could attend, are all awesome mental health treatment related New Year’s resolutions to get 2018 started off with a bang (and by bang I mean therapeutically supportive environment…ahem…Kapow!)

2. Goals about physical self care –  In any toothpaste or shower gel advert they always make acts of self care like brushing your teeth or showering, look like such an easy, pleasant task (to be honest some toothpaste adverts I have seen go way past pleasant to the point where someone will look so eager and thrilled about brushing their teeth in the morning that they have the deranged look of a serial killer in a horror film with minty fresh breath), but in real life those things aren’t as simple as they seem. Sometimes when you have mental health problems just getting out of bed is a task to be proud of, let alone things like brushing your hair, showering, cleaning your teeth, eating or putting something on that isn’t pyjamas…However, as hard as all of those things are to do, they are important and taking care of your physical health and physical needs, though exhausting, often helps take care of the mental side of things too. Trust me I know, I have the days where I stay under a duvet and refuse to move but as hard as it is to drag myself out of my cocoon and into the shower, I have to admit I always feel a bit better when it is done.

Similarly getting fresh air is important for your physical health as is eating which, even if you don’t have an eating disorder, can be difficult when you can barely muster the motivation to blow your nose. That said, it is bad enough being mentally ill without your body becoming physically ill and deprived of care, which will only make you feel more hopeless, so goals around self care physically are also important. Again they don’t have to be big and can start out as small as you like from “get out of bed for at least X amount of time every day” or every other day if that is too big a step. Setting yourself a goal to shower a certain number of times a week, brush your teeth every day, spend five minutes outside for a short walk and fresh air, or maybe make goals regarding eating enough proper food meals to take care of yourself properly. Whatever it is, in this category just make goals that are about taking care of your outer physical needs and hopefully they will have some effect on making your internal mental health nonsense a little better too.

3. Goals about socialising scientific Studies show that humans are social animals and that we feel better when we aren’t lonely. My brain studies however, show that socialising with humans is nevertheless very difficult sometimes, often terrifying and mentally exhausting. Again though, like showering and all that fresh air our lungs crave, it is important so some New Year’s resolutions for your mental health could be to do with your social life and, dare I say it, talking to other people and actually going out to make friends and have “fun” (Oh God I shudder at the thought!). I know that a lot of years my goals in this category include things like “Text a friend at least once a day”, or “meet up with so and so (trusty friend so and so, she really is good to me), X times a month.” When you are getting ready to actually carry out the action part to those goals and are getting ready to see good old so and so, you might be so anxious that the meeting doesn’t feel like it will be of any benefit to your mental health, but at the same time, doing what I usually want to do and isolating myself doesn’t benefit much either. Of course alone time is important but a bit of conversation can be a nice distraction and it can be a great motivator to see and hang around with the people you care about and who care about you. Who knows, despite all the anxieties, maybe you will end up having a bit of a laugh by accident and what a happy accident that would be!

4. Goals about interests I think this category is the hardest category to make goals up for as in this one to help your mental health it is about investing time in things that are nothing to do with mental health. That may sound like trying to improve your swimming without going anywhere near water, but mental health problems tend to be all consuming and it is important to make goals to try and get a bit of space away. I know that for me, days when I have multiple therapy appointments and spend the entire time talking about all the madness in my brain are exhausting and as important as it is to pay attention to the mental health things, it is also important to take space away from them too. Again this is incredibly difficult because i know that for me it can feel like you can’t take space away from your mental health problems because they are not a separate thing to you, they simply are you, glued into your internal brain make up but the key thing to remember is that though you might have mental health problems, you are not entirely your mental health problems (even if they try to convince you that you are). Whether you see it or not, you are a person too and a person who deserves to be treated like one. You would never tell someone with a broken leg that they were their broken leg so don’t let anxiety convince you that you are just one bundle of neuroses either. The best way to make goals here is to think about your interests which once again is difficult because when you are consumed by mental health problems, you don’t really have interests and might not get pleasure or enjoyment from doing anything. In that case I set goals to do things like “try a new hobby” or “try something that I used to enjoy” to at least make an attempt at getting in contact with even the tiniest bit of you that isn’t broken. Like I said you may not feel it, but trust me it is there and making goals that pay that little part attention might make it stronger in the long run.

So there you have it! Four categories in which you can make possible mental health New Year’s resolutions and goals to try and improve your mental health and wellbeing in 2018! Maybe you will love this idea and pick several goals for each category, maybe you will just make one tiny goal in one category or maybe you just want me to shut up so that you can go and put the kettle on to make a coffee (if that third one is the case please make me a tea whilst you are at it). Either way I hope this post has been of some use or benefit to you on this fresh, January New Year’s day or has at least given you something to ponder over whilst you enjoy that coffee you are going to make now (AND A TEA DON’T FORGET THE TEA.)
Maybe if you do make mental health goals, write them down to serve as a daily reminder/keep yourself accountable but unless you know tick boxes are helpful for you to see progress, try to avoid them in the interests of the days when you don’t manage to tick any of the boxes and feel like you have failed. Mental health New Year’s resolutions are NOT something you can fail at, they are just casual things you are trying to do as best you can when you can and any progress is so flipping awesome that if you achieve so much as part of one of your goals once this year I highly encourage you to run to the nearest person and insist they reward you with a well earned pat on the back (unless that nearest person is that serial killer like actor in the toothpaste advert…avoid her at all costs).

Overall, do whatever you can to try and maybe end 2018 in a slightly better place than you were at the end of 2017, even if that slightly better place is only a little to the left or just around the corner from where you were. Any mental health progress is progress and whatever happens, I will be forever proud of you (yes even you person who isn’t making goals and just wants coffee. You just read a whole blog! That is very pride worthy…now go and make that tea!).

Take care everyone x

New Year Marbles

Is It Possible To Be Too Open About Your Mental Health?

TRIGGER WARNING: This blog post contains reference to certain medical treatments that can be used with people with eating disorders, so if that is something you would find unhelpful then please do not read it for your own safety. If you are like the witch in the Wizard of Oz who melts when coming in contact to water, THIS is your warning to STEP AWAY FROM THE FLUME.

In both the mental and physical health worlds, confidentiality is a BIG thing. When it comes to your wellbeing, there are a lot of rules between professionals, your medical notes and what can or can’t be said in front of friends and family.
Want to keep that random extra hand sprouting from your lower back a secret from Aunt Enid so that she doesn’t start knitting you an extra mitten every winter? No problem, medical confidentiality has got you covered (unlike your third hand which is now not going to have a mitten for Christmas).
Don’t want people at work to know that you have a condition that causes you to temporarily morph into a teapot whenever stressed? That’s fine. Tell the doctor and they will keep that tidily hidden away on a computer protected with lots of codes and National Health numbers that would make your deepest medical secrets hard to find, even if people were looking for them.
You see, when you are dealing with hospitals, everything is kind of like some kind of James Bond spy film, it is all very hush hush, very top secret, very “who can we talk about your bunions in front of” (which, coincidentally was the alternative title for the 1964 classic “Goldfinger” but Shirley Bassey didn’t want to sing about Bunions).
Not only is medical confidentiality important though, it is also fragile, and like all fragile things, this unfortunately means that it can very easily, even accidentally, get broken.

My question however, is if it is YOUR personal medical confidentiality, is it ok/are you allowed, to break it yourself? Are you allowed to be “too open” about matters that other people would usually keep private, in the interests of raising awareness of those issues?
Not to talk about any single person or specific situation in particular or anything (THIS ENTIRE BLOG IS ABOUT ME AND MY VERY CURRENT AND SPECIFIC SITUATION), but is it possible I ponder, for one to be too open say, about a mental health condition and the treatment that may be involved as a consequence?

Like I said, we are not talking about anyone in particular (THIS IS ALL ABOUT ME), but as a very rough, vague and unspecific example, lets go back to Monday the 27th of November 2017 at 10:01am when a link to a post on this fabulous mental health blog you might have heard of, was uploaded to try and give a rough update to readers of said blog regarding the situation (or rather, the colossal mess of a situation) of the writer.
Oh screw it, I cant keep the secret anymore. Ok yes! You are right! I am talking about my blog aka this blog and my situation last Monday when I tried to write a post to tell everyone the latest news and was incredibly vague about everything, which is unusual for someone who usually speaks honestly and openly about everything personal and mental health related. Why was I incredibly vague? Well, because I was scared after staff had raised concerns about me sharing certain things on my blog, which really freaked me out and had me very worried and confused.

Thing is, when it comes to medical confidentiality, I kind of see it like you see a piggy bank, it belongs to you, you can look after and protect it, but at the same time, you and you alone are allowed to break it.
Were you to go over to someone else’s house, find and destroy their piggy bank and run off with all the money inside (or say medical details), that would be wrong on many levels. It would be theft, it would be a breach of someone’s privacy, destruction of their property and the murder of a perfectly good ceramic piggy. If however you have your own piggy bank and, after several years of amassing various coins of experience, decide that you don’t mind sharing those experiences and spending those coins out in the world in the hopes of making a difference, and consequently smash your own ceramic oinker to smithereens with a mallet…I think that is ok, because it is your property, your information to share, your little piggy to destroy (and then mourn over appropriately of course).

It is still important to be responsible for your information of course, and I don’t believe people should, as it were, shove their information coins into other peoples faces whether they like it or not.
There should always be warnings to alert people when someone is talking about a sensitive issue that could be triggering or harmful to others, so that they as a reader can use their own personal responsibility to choose to remove themselves from potential harm. Nobody should be forced on a flume and plunged into a bath of emotions without the opportunity to get their rubber duck out but similarly, if you know you melt when you come in contact with water, maybe don’t go on a flume.

Admittedly this is more complicated with things like mental health problems which can sometimes cause you to do things, read things and get involved in things you might know deep down are harmful, but we can’t all be silent about everything, and if Donald Trump is allowed his own twitter account then I like to think I can spout my nonsense freely and use my free speech on my blog in my little corner of the internet.
That is how I see all this, all the drama that I have been caught up in over the past week about what it is and what it is not ok to share, whether there are some things that should be kept confidential and whether you can or can’t be “too honest” about personal matters, and it is that opinion that has led me to just throw caution to the wind and write this post being honest about things anyway.
This is of course merely my opinion, and I am sure there are many people out there who will disagree, but there we go, we can’t all like mashed potatoes made by the same recipe, opinions vary, some people don’t like lumps, some people don’t like pepper and others don’t like to read blogs about people who talk about mental health (weirdos). End of.

So what is going on? What has been happening? What have I been skirting oh so daintily around for the past fortnight? Well I will tell you because like I said, this is my piggy bank and if I want to take a mallet to it then I damn well will.
Basically, as you know, I have been in a psychiatric unit being treated for my eating disorder for the past 10/11 weeks, but things were not going well and I was not managing mentally or physically with any of this recovery business. It was then decided that we had reached a point where it wasn’t safe to keep me where I was anymore (which feels so weird and confusing to write as I still adamantly believe that I am perfectly fine and do not need any of the things going on around me, but that is a topic for another time). Anyway, as a consequence of various decisions regarding my mental and physical health last week, I had a week or so away over to a medical ward, and, if this post is going up in time and all the professionals stick to the current plan, I will hopefully have been transferred back to the mental health place on the Friday before you are reading this.

When you have an eating disorder there are a lot of physical complications that can happen as a result and there are sometimes a lot of things that may need to be medically treated as well as mentally, but the main reason for this transfer was so that I could be fitted with an Nasogastric tube (aka a tube that goes up your nose and then down into your tummy so that you can be given nutrition without having to eat it yourself if needed).
Some eating disorder units can do this procedure on site themselves and many do, but the one I am in has been unable to until now (hence why a few weeks ago I was talking about maybe being sent to Glasgow or somewhere else across the country). With no beds becoming available in time though, I had to just pop off to get it done on the medical ward and have some treatment over there. Like I said though, if all goes to plan, by the time you are reading this, I will be back on the mental health ward, still with my tube for a bit now it is safely up and running, but working to have it out as soon as possible which would be nice, as I am not thrilled about this new accessory (I would have preferred a bowtie but alas you cannot give someone nutrition through a bow tie. Not even a sparkly one). It was this whole tube thing that caused the staff to get a bit over excited with the “shushing” (picture a librarian after several hundred cups of espresso).

If I am trying to see from their point of view, I guess I can kind of sort of understand on some level. For example, I know there are some people who might find talk of NG tubes triggering, and unfortunately there are occasions and certain sufferers/people who see them as something to take pride in, something that proves they are “really ill”. This is of course ridiculous as every eating disorder is equally severe and serious and everyone is “really ill” regardless of whether they have been through certain treatment options or not. Even if you have never received any treatment for an eating disorder you are as ill as someone who may have been in therapy for years, and the last thing I would ever want is to give a message on my blog contradicting that.
However at the same time, whilst a tube is something I do not think one should be proud of, I do not think it is something to be ashamed of either and that was what stressed me out so much last week. I was all there ready to go ahead and write as per usual, and suddenly everyone was telling me that what I wanted to talk about was inappropriate, which had me paranoid that I should be ashamed of what was going on or that this happening meant that I had let everybody down by “failing” to get better, and thus not say anything at all just to be on the safe side. To be honest I don’t think a tube is anything to feel particularly anything about. It just is. Sometimes they just happen to get fitted to people who have eating disorders to help them try and get out of being rather stuck in a highly sticky syrup/velcro/superglue bound/sellotape/plaster situation.

If you are reading this and think that me admitting any of this is to be too open about mental health/confidentiality breaching then I am honestly sorry, but like I said, talking about mental health and my experiences within the realm of mental health treatment is something I am passionate about both in terms of reaching out to others, raising awareness, breaking stigma and misunderstandings about various illnesses and overall making people feel less alone and not as weird and isolated as I did when I kept all of my problems bottled up and never had anyone to relate to. Maybe I am breaking a piggy bank, but it is my piggy bank to break and it has been my decision to be honest about it.

I won’t go on about it any more now because writing this much is scary enough as it is, but I hope in the future I will be able to write about how this experience and tube feeding in general has affected me and how it can be used in treating people with eating disorders. It isn’t a nice topic, nor is it a nice experience, but it happens.
Now if you don’t mind, I am off to hide under my bed as I do when I post all scary blog posts that could potentially make someone angry with me/get me into trouble (I also need to hide from the cleaner…that is one thing nobody warns you about when you get a tube…when you have one in there is a genuine risk of being mistaken for a Henry hoover and dragged across a carpet snorting crumbs for three hours…) I hope this has been ok, I hope having this tube doesn’t mean you feel that I have let you down and if not I really am very sorry. I promise I am still trying.

Take care everyone x

PiggyConfidentiality

The Unpredictability Of Life With Mental Health Problems

Nobody can predict the future (except for Raven Baxter of classic Disney Channel hit “That’s so Raven”…anyone else miss that show? SOMEONE REMINISCE WITH ME).
Predicting the future is, however, a hell of a lot harder when you are living with mental health problems, aka almighty inconveniences that could pop up and smack you right in the nostril at any time. Of course everyone has the risk of things popping up unexpectedly in life and smacking them in the nostril, regardless as to whether they have mental health problems or not (which is why I always keep mine protected and am currently running interviews to employ my own personal nostril body guard…applications are still open for any hopefuls out there), but I think when you are mentally ill, the chances are increased and you are far more aware of them.
It is like leaving the house and wondering whether or not to take an umbrella. Some people may look out of their windows and see a blue sky with no sign of anything to suggest that an umbrella will be needed in the near future. Maybe a storm will randomly come along out of nowhere and surprise them, but they are not thinking about, nor are they aware of that storm before it has arrived. With mental health problems though, you always know that the chance of rain is there, you can always see the black clouds looming and can’t risk planning a picnic too far in advance or leaving the house unprepared without your wellingtons, just incase.

It isn’t that I particularly want to predict the future, but I cannot stand the swirling uncertainty that being a bit bonkers in the head can cause. Take right now for example. Okay I am in hospital so we have my current location all clear, but other than that I have absolutely no idea as to what on earth is going on.
Being under a section, I can’t exactly decide on discharge dates right now, so I do not know how long it will be before I am home. I don’t even know where I might be in the coming weeks as things are currently not going particularly well and there are talks of me being moved to another unit, one of which could be in Glasgow which is a long way from my hometown of Bristol and is terrifying the life out of me (if you do not live in the UK and do not know how far apart these locations are, all you have to do is get out your Atlas and find a map of the UK. All good? Ok, now put one finger on the very top of the country and the other on the very bottom in the little denty bit. That is how far away they are, aka THE ENTIRE LENGTH OF THIS TEA OBSESSED ISLAND. It is so far that there are airports in both locations so that you can fly between them because nobody has time to sit on a train or in a car for three million hours.) Everything is being done both by me and staff to prevent that from happening, but all in all, it is not my decision and more down to professional people in suits. Then if I were to be transferred to some currently unknown location anywhere across the country, I have no idea when it would be or for how long I would be there.
When it comes to medication I am similarly in the dark as to what will happen because a certain medication I have a problem with and do not want to take, has now been approved by a second opinion doctor, so legally if I refuse to take it orally, I can be injected with it. IN THE REAR. People really should not be stabbing that area with needles. I need it kept bruise free for me to sit on!
I don’t know how long I will have to take it, what will happen with the dose, if it will change, or how I will feel if it does (I am really not a fan of the current side effects).

Then there is my appeal against my section at a tribunal in a few days time, again a place where I can share an opinion but not make a choice. Being in hospital means waiting for a decision to be made and permission to be given on EVERYTHING, even whether or not you can go to the toilet, have a shower, or whether you are allowed to have a cup of tea in your room with your friend, aka things you would generally take for granted. You want to pee? You pee! You want tea with a friend? You tea! In hospital though? We are going to have to “discuss that with the team”. Good lord do they love to discuss things. It isn’t even just short term plans either, because things get even more foggy with a chance of showers and a few tornadoes when looking to the long term, especially when people consider their lives outside of a hospital setting, where things can be even more uncertain.

I love to keep things organised, I love to plan and I have always liked the idea of those huge calendars that big families buy brightly coloured magnets for, to stick to the fridge. In my mind every square and every day is scribbled on in black marker with holidays, social occasions, appointments and of course Great Aunt Enid’s 94th birthday. How can you book a holiday to the Canary Islands though when there is a 50/50 chance as to whether or not you will be well enough to go. Maybe when you book the holiday things are fine, but how can you guarantee they will be the same in a few months time? How can you be certain you will be able to make Little David’s football match on the 12th when depression could strike you down into immovable zombie mode ten minutes before the big game? How can you guarantee your presence at Aunt Enid’s all night rave at 2am? (She may be 94 but nobody can control Aunt Enid. When that woman wants a party, you had better be ready. With glow sticks.)

Obviously the only thing you really can do in these situations is to go ahead and agree to these potential plans and hope for the best, but as ok as that is in theory, it doesn’t take the uncertainty of the future out of the equation, sometimes financially worrying uncertainty if there is a risk that your flights to the Canary Islands and all inclusive hotel resort are going to have to be cancelled.
Aside from long term social activities, there are long term considerations like job courses to consider or places at university. In 2014 I was given a place at a university nearby to study to become a teacher, applications, exams, interviews, all done and ready to go…then I went into hospital. No worries we thought! The children can wait an extra year for my excellent teaching skills. Maybe it will be a good thing, give me more “life experience”, “develop me further as a person”. I asked if I could defer my place to the next year, all was agreed and the plan seemed back in place. I left hospital, I started to prepare for a life in the classroom teaching children all the reasons as to why penguins are awesome (might chuck in some lessons on times tables and ABC’s to keep OFSTED happy…Penguin starts with a P…One penguin plus another penguin equals two penguins…potentially three if dinner and a movie goes well).
Then, unexpectedly and unplanned, I ended up in hospital and my 2015 teacher training once again had to be put on hold. I asked if they would let me defer the place one more time but that request was denied and to be fair that is probably a good thing, because since then my mental health has been even more unstable.

Due to this I haven’t really been able to make any future plans because I never know how well my brain will be functioning, so whilst being unsure of the current plan here in hospital, things are even more uncertain when we look to the future. I often see people making “5 year plans” and “10 year plans” involving things like “get married”, “Become manager”, “own first house” or “give birth to child”. 10 year plans? Good lord I don’t know what is happening in the next ten days! Ten hours! Ten minutes (actually that last one is a lie…I am going to finish this blog, make a cup of tea and then mum is coming to visit. YAY).

Like I said, regardless of whether someone has mental health problems or not, we are all going to get unexpected storms that crop up and throw our neatly colour coded calendars from the fridge and into the recycling. It is however made even more complicated when you can already see the clouds forming, have a brain that is known to explode, and you are constantly aware of that ticking time bomb waiting to go off.

Take care everyone x

FortuneTelling

The Importance Of Triangles In Times Of A Mental Health Crisis

When you are going through what is known as a “mental health crisis”, everything feels like such a mess that you cannot even begin to start tidying it all up. Tiny jobs become momentous tasks, trying to survive an hour feels like trying to survive a millennium and it all feels completely unmanageable. Unhelpfully, being in the 21st century, the general busy non stop, non sleep, 24/7 side to modern life does not help matters (on the other hand there is the positive that, helpfully, we are not in the 16th century where, although it was less busy, you had a higher chance of being murdered by your husband if his name was Henry and he happened to wear a crown).
In simpler times your daily activities may have simply comprised of getting some water from your well, milking a few cows, doing a bit of hoeing out in the fields and then perhaps settling down by the fire with a nice bowl of homemade stew, (it is my understanding that in the olden days people ate nothing but stew). Nowadays however, the list of tasks one must perform to get through the days are endless.

Instead of walking out to a field there are specific buses you have to run to catch for work, computer programs that randomly malfunction and delete all the work you have done for the past week (something that never happened when “work” mainly focused on hoeing), specific coffee orders you have to remember for your boss to avoid being fired over a missed shot of espresso in their large cappuccino, bills to pay, TV shows to catch up on, appointments to make, social events to come up with excuses for, washing machines to fix, ironing to do and earphone wires to untangle (SERIOUSLY WHO IS TANGLING ALL OF THE EARPHONE WIRES WHEN I AM NOT LOOKING AND PLEASE CAN YOU STOP IT). It is exhausting and when in crisis, you need to delete it all and focus on one thing.

Triangles.

I am not talking your equilateral triangles, your scalene, or even your isosceles. I sneer at your Bermuda triangles, love triangles, even your 3D Egyptian pyramid triangles, for no triangle is better in a crisis than the great “Maslow’s Triangle” (toast triangles are a close second for being helpful in time of a crisis though, because you can have peanut butter or marmalade on them).

“What is this mysterious Maslow’s Triangle?” I hear you ask? Well I’ll tell you!

Basically there was once this psychologist named Abraham Maslow (I hear he was quite the dude), and he came up with this list of things needed to fulfil humans and reach “self fulfilment” or “self actualisation”, aka “Maslow’s Hierarchy of Needs” (that is the official term in all the text books but I am calling it Maslow’s triangle because it looks like a triangle, that is a catchier name and it meant that I could sound smart in that first paragraph by talking about other kinds of triangle which are now irrelevant to this post…calling it this also gave me the opportunity to mention toast triangles which are tasty, so I went with it and now here we are).
These needs are pretty much all Maslow thinks you need to become a whole and happy person and who knows, he may be right, but right now it doesn’t matter if he was right or not because to be honest, survival is what we want and aiming for his idea for self actualisation is a bit of a stretch at this moment in time/any moment in time during a mental health crisis. As I always say, we need to learn to waddle before we can fly.

“What does this mysterious Maslow’s Triangle look like?” I hear you cry! Well I’ll tell you that too (and may I say you are asking a lot of questions today…)
So here it is:

YayMaslow

As you can see, all of these “needs” are prioritised in order of importance with the most important on the bottom and the least important/ones that will make you happy but are not essential for purely physical survival, on the top. It is like a pointy version of Jenga, you have to have enough of the blocks to make up the bottom or else it doesn’t matter what is going on at the top, that pyramid is going to fall and there will be sand EVERYWHERE.

In times of crisis, I think people (by which I mean I), try to keep going with all the busy things of modern life that make up the entire triangle and in doing so get overwhelmed, miss out some of the more important things, and consequently make myself/my health worse. For example my magnifying glass and entire life focus is pretty much entirely zoomed in on the second from the top level, “esteem needs”, and because I hate myself oh so very much and thus have very low supplies of the “esteems”, I forage for these like a bear who is late in preparing for hibernation, without caring about anything else because in my eyes it is not as important. In my head, I need to feel worthy of and deserving of life before I can do all the things people need to do to actually survive…and yeah…it doesn’t work like that, hence why my pyramid has fallen, leaving me in hospital, in crisis, and trying to pick sand out of all the crevices (like I said, it gets EVERYWHERE).

In every situation I will sacrifice the bottom sections as I claw for that esteem level. When I am worrying about something like my blog/don’t feel productive/like I have accomplished or achieved “enough”, I ignore all other levels of needs until that achievement feeling has been somewhat reached (I say somewhat because, as I am sure many people can relate, no matter what I do in anything, it is never enough). Need to write a blog post but don’t have any time? Better cross “sleep” off the to-do list. Haven’t drawn that pesky diagram of the triangle you need to insert into this blog yet? No food or drink until that triangle is drawn! Not posted on Instagram and need an “outdoorsy” photo but it is freezing outside? Get out there and Valencia the hell out of some greenery even if you freeze to death in the process!
That is exactly what I do, what I think a lot of people do, and that is why mental health crises often get worse and spiral, because we are focusing on the wrong things when trying to survive and get through the day. Self actualisation is great and all that and we can work on getting to that eventually but if you are in a crisis, the most important thing to do is get your Maslow’s triangle out (and toast triangles if you are feeling peckish), and focus all your energy on the bottom levels. No “I should be doing this” or “I need to be doing that”, no, you are in crisis, it is time to prioritise, remove the stress and simply focus on basic survival. Only when you have got that covered can you start building all the other things on top and if you don’t, even if you work really hard at the achievement stuff, eventually it is going to crumble and remember what happens when pyramids crumble…SAND EVERYWHERE.

When you are in a mental health crisis you need to cut yourself a nice bit of slack. If it is necessary, take a mental health day off work to go to an appointment or get some rest, because without the rest you won’t be able to stay at work very long anyway. It is necessary to focus on keeping yourself hydrated (BUT NOT TOO HYDRATED REMEMBER THE SODIUM) and get yourself a cup of tea before sorting out all the ironing (which in the long run is not necessary at all…I don’t see ironing on the triangle…), and it is necessary, nay fundamental, to nourish yourself and give yourself a good supply of food at meal times before worrying about all the other things on your to-do list (I REALLY need to work on this one). In times of mental health crises it is OK to strip things back and take a step back from the things at the top of the triangle so that you can look after yourself and build your way back up to that self actualisation tip. Focus my friends, on the bare necessities, the simple bare necessities, forget about your worries and your strife, I mean the BARE necessities aka the bottom layers of Maslow’s triangle (I think a bear even sang a song about that whilst dancing around in a jungle with a half naked child in orange pants but that might have been one of those weird hallucinations I have been having lately…they are wherever I wander…wherever I roam!)

So, why is it important to focus on triangles in times of mental health crisis? Because my dear friends, in times of crisis, you need to allow yourself to simply focus on looking after yourself, keeping yourself physically well and safe so that you are strong enough to survive that crisis and work your way back up to the top of your Maslow’s triangle with the fun, self actualisation stuff going on. Forget the other shapes, hold onto your triangles, and if those triangles happen to be made of toast, eat them with some jam and a nice mug of warm tea.

As always, take care everyone. x

CoolTriangles

Psychiatric Unit Themed Halloween Parties And Why They Are Always A Bad Idea

So tomorrow is Halloween, and though not exactly my favourite holiday as I may have mentioned in my Halloween themed post last year (…ahem…Why Halloween Can Be Difficult For People With Mental Health Problems…) it is a time that a lot of people celebrate and get rather excited about. Some even have Halloween parties with houses decorated to fit in with some Halloween style theme from haunted mansions to circus tents and unfortunately, insane asylums.
Being actually in an insane asylum for Halloween this year then, you would think I would be in the ideal position. Why decorate a place to look like a mental ward when you are on a real mental ward? My job is done. I don’t have to worry about a costume this year either as simply getting out of bed and putting my normal clothes on will qualify me as an accurate representation of a patient in a psychiatric unit. I don’t even have to bother with face paints or drawing spider webs on my face with black eyeliner which then doesn’t wash off for three months, meaning I have to go to my best friend’s wedding with an arachnid adorning my cheek. Think of the time I will save…I can use it instead to have a nice cup of tea with my feet up. Bargain!

Rather appropriately, Halloween this year falls on the same day as ward round on our unit, aka the scariest event of the week (because you have to sit in a room with a lot of intimidating professional people staring at you making scary decisions, not because there is always a ghoul wailing in the corner…he is there all year round and we are all pretty used to him by now…his name is Derrick.) Other than that spooky coincidence however, there is, rather disappointingly, nothing very Halloween like about Halloween in a real life psychiatric unit which might disappoint some people, but it is important to note if you are planning a party with the “asylum” theme, because trust me when I say this is not the ideal setting for your festive frivolities.

From that opening, you may very well assume that from here I am going to send this post in the direction of a serious “why you shouldn’t set a Halloween party in a psychiatric unit theme” rant, highlighting and raising the awareness of the fact that these parties promote stigmatising ideas of mental health problems that are already far too prominent in society. You may think I am about to get all up in your faces about people needing to be politically correct, plead for you to see us patients as mere troubled folk rather than fodder for a costume idea, but you know what, today I am not even touching any of the politically correct important serious issues with mental hospital themed parties this year. Nope, instead I am going to raise awareness of the far more important fact that, aside from being insensitive and offensive in a million different ways which I should probably talk about but won’t because others have no doubt done it before me, celebrating Halloween with a “mental hospital theme” is simply impractical and will not involve any of the fun games and activities people associate with Halloween.

Think about it, what are the common things people do to celebrate this time of year? Number one on the agenda: pumpkin carving.
Pumpkin carving? I am supposedly in the ideal setting… but how the hell am I supposed to do that? Do you really think I would be allowed a knife in here? I don’t even have the wrap around belt for my dressing gown! Do people have any idea about things that are and are not allowed in a psychiatric unit? You can’t go carving root vegetables with machetes when you are in hospital and if you can’t do that then a Happy Halloween party is pretty much impossible. I mean you can try but a Happy Halloween without a pumpkin? Forget it.
Anyway, where am I and all of these “crazed deranged loons” supposed to be getting these pumpkins? In the supermarket? In my homegrown special organic vegetable patch at the local allotments? I can’t leave the ward!
Unless Cinderella’s fairy Godmother is planning on turning up any time soon, pumpkins are another no go item (although admittedly pumpkins are not specifically mentioned on the list of things staff search your bags for upon admission…they are more focused on things like knives and razor blades…shiny silver things mostly…I have a theory that all of the staff are secretly magpies…).

Aside from pumpkin carving then, what else do people do at Halloween to celebrate the holiday at parties and create merriment? Ah, apple bobbing!
Surely that is possible in a mental health hospital? Surely a party in a real or with a mental hospital theme could celebrate via that classic game? NOPE.
Again party planners, think about the impracticalities! I am on an Eating Disorder ward for goodness sake! Food is scary and hard enough as it is without adding the obstacles of a black eye due to a violently bobbing Granny Smith and the potentially fatal risk of drowning mid meal time. Do people think staff allow patients to go submerging their heads underwater like that? OF COURSE NOT (that is unless the staff have a chance of patients retrieving something shiny for them from the bottom of the pool of water…Magpies the lot of them I tell you.)

How about a Halloween party ghost walk? Sorry. No ghosts.
What ghost would decide to haunt a mental hospital? If you get the opportunity to spend eternity in the location of your choice are you really going to settle on “psych ward” as your idea of a forever home? Of course not! If you ask me it is far more likely there will be ghosts haunting more enjoyable places like a beach in the Bahamas or the local pub. Me? Well, keep it on the down low because I don’t want to give everyone else ideas and end up with my chosen location being overcrowded with the wandering souls of the deceased, but personally if I get a chance to come back to hang around earth for a bit longer, I have my eye on Disneyland. No queuing for Thunder mountain and a chance of bumping into Mickey Mouse every day? Sign me up good Sir! Ok, when it comes to the specific mental ward I am on, we do have Derrick in ward round so I guess I could try celebrating with some kind of ghost walk but like I said…he isn’t really that scary (or clever to be honest. Like I said nobody with any sense would decide to spend eternity in a mental institution. Why is Derrick here you ask? Yeah, turns out he is lost. Broken sat nav. Was aiming for a Broadway Theatre so that he could watch all the musicals he wanted for free every night. It is pitiful really. Sometimes I try to cheer him up by singing Cabaret and doing a bit of a tap dance but alas it just isn’t the same.)

Seriously, throw any Halloween party activity idea or game at me and I will be able to prove my point that realistically, trying to play that game in one of the top rated theme setting type places of a mental hospital is simply not a good idea. Playing with a spooky pet rat or a creepy horror movie style jump scare of a black cat leaping around every doorway? Yeah, good luck getting that around infection control. Pin the bone on the skeleton? WHAT DID I JUST SAY ABOUT SHARP OBJECTS AND STAFF LIKING TO CONFISCATE SHINY THINGS. Huddling up to tell scary stories at midnight? Cancelled. Your anti psychotics will have you asleep by 9pm before you have even had a chance to say “Once upon a time on a dark and stormy night”.

See what I mean? Aside from all that serious nonsense about being politically incorrect and damn well offensive, setting your Halloween party in an insane asylum is simply not a good idea because it is impractical when it comes to celebrating with any of the usual activities. Of course don’t let that stop you, if you feel ultra compelled to promote the stigmatising stereotype that people with mental health problems are terrifying lunatics to be feared, then be my guest. Just thought I should warn you that if you do that you really aren’t going to have a very happy time if you are doing the setting/theme accurately, aka without the obligatory activities pumpkin carving, apple bobbing and other Halloween classics. My advice for your Halloween party theme this year? Go with the haunted mansion plan or vampire lair. Trust me, as well as being less offensive, those ideas will provide a lot more fun…I hear some vampire lairs even come with their own poisonous bats, with no infection control getting in the way and neat vegetable patches supplied with organic, perfectly round pumpkins, ripe for the carving…Hoorah! Happy Halloween!

Take care everyone x

HalloweenInvite

Five Things You Need To know About Re-feeding During Eating Disorder Recovery

Whenever you enter treatment for any kind of eating disorder, you will often be given about a million worksheets, pamphlets and photocopied passages from text books, about the mysterious topic of “re-feeding”.
Indeed, over the years I myself have been handed many of these scientific attempts to explain the various processes the body goes through during re-introduction of food after periods of starvation, and having been through those various processes multiple times, I thought I knew it all. I thought that when it came to re-feeding a patient with anorexia, I was an expert, an oracle of knowledge when combining my scientific genius (aka facts I memorised in text books) and personal experience. So arrogant and confident was I in my “know it all” attitude, that had I been asked to take part in the UK gameshow Mastermind, I would have chosen “the re-feeding process in treatment from an eating disorder” as my specialist subject and would have had a cabinet built for the trophy in my living room before I had even answered the first question. Luckily, nobody has ever asked me to be a contestant on Mastermind because if that had happened, I would have looked like a fool and would have had a very sad and lonely, empty of trophies, trophy cabinet.

Today then, rather than sit and mope with regard to my lack of trophies (and whopping great useless cabinet in my living room), I thought I would use my current situation as “person attempting re-feeding” to share with you the five things everyone needs to know about the re-feeding process when in recovery from an eating disorder.
This is not just the explanations that you get from the science books, this is the Born Without Marbles, real life, honest guide to get you through all the surprises that can happen during the re-feeding experience, even if you have been through it before and think you already know it all…

1. Taking it slow is important: I think there is often this misconception that the more food you can get into a person who has been starving for a long time the better, when really, that can be quite dangerous. When your body isn’t used to being given food, it sort of turns off and goes into a stand-by mode, so booting it up again is a process that needs to happen gradually. It is like if you had an out of work clown, to get them back into juggling you need to start again with 3 soft balls rather than going straight in with 10 flaming knives and a live alligator riding a chainsaw. When coming into hospital for example, people are often started off on half portions to build up from gradually over the space of a few days, to avoid the body going into too much shock and sending your electrolytes and cardiac functions all berserk. Now, this is not an excuse to let your eating disorder sneak in with “well, if it is dangerous to eat much even though you are in recovery, you should probably just eat a little bit of lettuce” because NO. All I am saying is that when you are getting back into the habit of giving your body food, you need to be gentle and start off slowly, preferably under medical supervision/working with a dietician to keep you both physically safe and to make certain you are gradually building up to the amount of food you need rather than sticking to the initial “half portions” of the first stage.

2. Any weight changes on the scales are not going to make any sense: In life, I think we treat scales a lot like calculators, machines that give us logical results and answers to various calculations of input and output made over the week. Unfortunately this is not the case, especially during the re-feeding process of recovery from an eating disorder, and instead of giant body calculators, I would encourage you to treat scales like a very drunk friend following a night out at the pub. This is not to say I advise taking your set of scales to the local takeaway for some cheesy chips and a lamb kebab (scales prefer pizza with a side of garlic bread), rather it is to say you should take everything they say not as fact, more as a vague approximation of reality/what is going on. I am not going into specific numbers here, but when I was admitted to hospital almost three weeks ago (my how time flies when you are in a mental institution!), I ate less than I had been eating at home, due to anxiety and because everything served to me was different and none of it was what I considered one of my safe foods. After a week of eating less than half I had been previously, I stepped on the scales expecting to lose weight. To my horror, I gained. A lot.
“Oh my goodness” I cried out dramatically fainting on the clinic floor. “What is this? My body is broken! Everyone says that when you eat more food you gain and when you eat less you lose weight but I am defying medical science. Someone send me to a laboratory for experimentation!”
When the doctors increased my meal plan, I was even more terrified than I had been before, figuring that if I was already gaining when I wasn’t eating, were I to eat more, my weight would spiral up and out of control. Therefore I continued to restrict in an attempt to lose the weight I had gained…and I gained again.
Soon enough, I had no choice but to start complying a bit and eating a little more, so on the next weigh day, I braced myself for another increase in kilos. You can imagine my surprise then, when I actually lost all the weight I had gained over the previous week despite having eaten double the calories. Logically, that made no sense to me, but, bodies and weights do not make sense during the re-feeding process. As food is reintroduced, chemical reactions explode like fireworks throughout the body, electrolytes get confused, the fluid levels go all over the place so when you get on the scales, any shifts you see are likely to be “false” weights due to all the internal changes going on. Thus, going back to the drunk friend comparison, when they show you a number aka tell you a story summarising the night before, though they will be able to give you a vague idea of what is going on/what your body weighs, they will not provide a logical accurate explanation of your situation/true body weight that you can gain any real knowledge or conclusions from.

3. Your body is going to do some very weird things: When people talk about the re-feeding process they will often whip out phrases like “nourish to flourish”, as if the second you start eating again, sunlight will start shining from your eyes and you will find yourself skipping gaily in a field of daisies. Admittedly, one does need to nourish in order to “flourish” and become physically well, but again this is a gradual process, and at the beginning it is likely your body will do less flourishing and more random weird things that you never expected or understand.
You will probably get tummy aches and indigestion, feel full one minute and ravenous with hunger the next, your bowels may go to sleep or into overdrive, you may fall asleep all the time or even be unable to sleep at all, night sweats and drastic changes in temperature may occur, blood sugar levels will be unpredictably random (recently mine were highest after a day of very little food and then too low after the biggest meal of my admission so far – another reason why medical supervision in re-feeding is vital), and you may experience abdominal bloating as well as this weird thing called Edema. Edema is basically when your body goes through dynamic fluid shifts and parts of your body (mainly your feet and legs) may puff up.
This Edema thing has been especially bad for me this time and my legs and feet swelled up as if someone had thought I was a bouncy castle and plugged me into one of those air machines (during this time I learnt that life is hard when you are a bouncy castle as children are constantly jumping all over you. On the positive side, if you are business savvy you can charge them a few quid a time and make a tidy profit to buy yourself something nice/ice packs to soothe all the bruises made by violently jumping feet all over you).
I think the Edema one had me especially scared because naturally your mind will convince you that rather than water retention your legs are swelling with actual weight and fat, and as someone who is currently managing Edema I can hand on heart promise that is not true. Like I said, I swelled up like a bouncy castle, but after keeping my feet elevated for the past fortnight my legs and feet have started to deflate a little. It feels as if it is a disaster and going to last forever, but it DOESN’T. Me warning you of all these things is not to put you off the re-feeding process, far from it, as it is far more dangerous to remain undernourished with no chance of flourishing in the near future. Instead what I am trying to do here is let you know what might happen so that if it does, you are prepared and know that this kind of thing is totally normal and it is not an excuse for your eating disorder to convince you that it is your body and yours alone being weird and “rejecting food”.

4. Your mind is also going to do some very weird things: You would think that with your body off galavanting and causing mayhem, your mind might perhaps wait to kick up a fuss until after all the physical stuff is over, but no, your mind is going to go a galavanting as well and will also be doing some very weird things. The re-feeding process is very much like the descriptions of puberty I was given in a lesson by my primary school teacher (good Lord was that a terrifying conversation), in that your emotions are going to go all over the place. Like I said, when you are not eating, your mind and body go into standby mode and occasionally emotions shut down. When you start eating again however, the emotions turn back on at weird and unpredictably inappropriate moments. One minute you will be numb and feeling nothing at all, the next you could be laughing hysterically at your shoe, then you will be filled with rage for no particular reason before being overwhelmed with sadness and crying yourself to sleep…It is a lot more fun than it sounds…actually it is not, but again this is not to put you off the process, rather so that you know what to expect!

5. It is different every time: This is probably the most important lesson I am currently learning as I go through the re-feeding process and I imagine it will also be the most important one for people who, like me, have been through it several times before and may be reading this thinking “this is not new information, I know what to expect” much as I may have two weeks ago. I thought that because I knew how my body had reacted to re-feeding before, I would be able to predict how it would be this time round, but that was not the case. Every time you go through re-feeding it will be a different experience and your body will react differently. The longer you have been ill or the more trauma your body has been through, the weirder the experience may be. Like I said, I have really struggled with Edema this time round, and the reason I mentally struggled with it so much is because it has never happened to me before.
I knew all about it and had seen it happen to other people, but when my legs swelled up I was convinced that it was real weight rather than water retention, because my body hadn’t reacted like that on any previous occasion and therefore I thought that kind of problem could never affect me. Had I had Edema before I think I would have coped better with it, as well as the weird things I have noticed this time round on the scales, but it was the fact that “my body doesn’t do this usually” that had me frightened that something was going on and I was actually gaining and swelling with actual weight. Just because your body hasn’t done something before it doesn’t mean it won’t give it a whirl this time and if there is one thing I would want you to take away from this post it is that for all the preparations you make, this is still going to feel very random and very unpredictable…

…What a great final point to end on! Basically I have just told you a list of things to expect during re-feeding and then told you to go into it with no expectations because you cannot predict what will happen…hmm…Great advice…Good one Katie…

To be perfectly honest with you all, I have no idea what is currently going on with my body, what it will do tomorrow and quite frankly I don’t understand a damn word or second of this re-feeding malarky right now.
All I know is that it is scary, it doesn’t feel necessary to me, and I am still doubting the words of every doctor I come into contact with/struggling to accept or trust any of this.
Regardless of any of the mental rationale behind this admission or eating however, this is an honest account of what is and what can happen physically during the re-feeding process as I am trying to get through it, so if you have ever wanted to know what to expect or are going through similar things and are scared, you know that it is not just “your” body being weird and that there is someone else out there with swollen legs covered in the bruises of toddlers who have mistaken you for a bouncy castle.

Take care everyone x

Refeeding

The Difficulty Of Trusting Psychologists When You Have Mental Health Problems

Trigger warning: This post mentions the eating disorder behaviour of distorting your weight from professionals, so if that would trigger you then flee! Flee I say!

When I was younger, I was always taught not to trust someone who promises to give me sweets if I climb into the back of their van (unless of course those sweets involve any kind of combination of chocolate and peanut butter in which case who cares about potential kidnap, get in the damn van and don’t let those beauties drive away).
Unfortunately, somewhere in my brain as I have got older, “don’t trust strangers with sweets in a van” has morphed into “don’t trust psychologists” (regardless of whether or not they drive a van containing a portable candy heaven). Turns out however that when psychologists say they are going to do something and give you ultimatums, you should believe them.

Since coming out of hospital post “appendix explosion gate”, every week in my eating disorder appointments my psychologist has been telling me that I need to increase my intake in order to regain the weight I lost. To be fair, I have been trying, but a problem I have is that unless someone gives me specific deadlines for things I am scared to do, I will procrastinate until my arms fall off and tentacles grow in their place (not eight tentacles like an octopus though…that seems a little excessive…four is enough for me thanks.)

Every time my psychologist would tell me to increase I would hear her, try, but ultimately think “it is fine, she will just say the same next week and I will do it then”. Two Tuesdays ago though, my psychologist gave me a proper ultimatum with proper dates and deadlines by which I had to carry out her instructions. I was given one week to gain a certain amount of weight with the alternative being that I would be recalled back into hospital under the Mental Health Act. Seeing as how my brain works, you would think that this fairly clear statement would be easier to adhere to than the alternative casual “you need to eat more”, but still my head found ways to procrastinate, not because I wasn’t listening, but because I didn’t believe her. This was a mistake.

As much as I know I am mentally not very well at the moment in some aspects, physically I am finding it hard to see that there is a problem at all. Hearing threats and statements about my health that are designed to scare me, therefore make little sense. It is like telling someone over and over again that they are going to die of alcohol poisoning and that their liver is failing because of alcohol when they know that this can’t be the case because they haven’t touched a drop of liquor in their lives.

Back home I tried to increase but I was so scared of gaining weight that it didn’t go well, partly because I didn’t believe the “consequence” I was told about were I to fail to do so. Still, I didn’t want my psychologist to be disappointed or angry with me for failing her, so on the morning of weigh in I drank the weight I had needed to gain in water so that the scales would show the increase required and keep everyone happy. I hate “water-loading” before weigh in (aka the behaviour some people with eating disorders do whereby they drink a lot of water prior to weigh in to manipulate their weight on the scales and prevent therapists from knowing their true weight). It always freaks me out because even though I can know that I have just drunk water, whenever I see the number go up on the scales, my head will convince me that it is real weight and not just excess fluid swishing about in my bladder.

Thus I stepped on the scales prepared to be triggered, but somehow, it didn’t work, and I saw that I had not reached the goal set for me at all. Initially I didn’t really panic because I thought as always that my psychologist had been lying and that I could get out of it. I thought I could easily insist that I would just “meet the target” next week, but she hadn’t been lying and to my utter shock and horror, I couldn’t get out of it. What happened next? Well, considering I am writing this at a hospital desk in an inpatient eating disorder unit, I think you can guess. That’s right, that is the update this week, Born Without Marbles is back in the loony bin, and to be blunt, it sucks.

People keep saying things like “at least you know the place” and “you have done it before” but that doesn’t serve as much comfort because even though I know that, this time it feels different, so unnecessary and therefore scary. If you believe there is a physical problem it is easier to understand the need to take the medicine needed to cure it (in my case that medicine being “Food/general nosh”), but this all feels like one terrible mistake. I don’t need to be here and thus I do not need the medicine.

I am almost waiting for ward round on Tuesday where everyone discusses how things are going and for them all to turn around, apologise for the inconvenience and send me on my way.

The scales may say that I am under my CTO weight (a full explanation of the Mental Health Act and CTO’s can be found here: Demystifying The Mental Health Act…With Penguins, but basically a CTO is a legal document under which you are sectioned but allowed to live in the community as long as you adhere to certain conditions aka in my case, stay above a certain weight), but I don’t think I have actually lost any weight. I can read the scales and everything so I know that the number is lower but I am 100% sure that this is purely because I had my appendix removed and thus the weight of a whole organ has gone. If you chop someone’s arm off their weight is obviously going to go down but it doesn’t mean they have lost “weight” all over, it just means that there is some rude reckless person running around cutting people’s arms off.

I am so scared in here and I don’t know what to do. I am trying my very best to work with people and “listen to the professionals” but it is harder than I thought. Trusting them feels the same as trusting all those terrifying people with vans and sweets when I was a child (especially that particularly frightening lollipop obsessed child catcher in Chitty Chitty Bang Bang…seriously if you ever need to teach kids that “don’t get into vans with sweets lesson” just show them that film and you will be sorted…of course they will also learn that cars can fly and that dressing up as a Jack in the box will get you through security at a royal palace, but I think the worth of the sweets lesson trumps the potential misinformation spread by the latter).

So yeah…Mental health awareness lesson of the week: trusting professionals with medical degrees and things who should technically know more than you is hard when you have mental health problems. Very hard.

Other than that, I don’t really know what to say today. I just want to go home. I feel I should write an extra good, extra long blog today considering I am in hospital and certainly have free time to write but the words won’t come. Maybe I should offer them some sweets as encouragement.
I am also struggling to keep this update upbeat rather than explode all over you, so I think I will sign off for now and hope that I am a little bit more coherent in the next post. Sorry.

Take care everyone x

ChildCatcher