Why Boundaries Are Important When Living With Mental Health Problems

A few weeks ago when I was talking about the fact that I am getting discharged from an inpatient setting on the 20th of February/tomorrow if you are reading this on the day of upload, (handy link to that blog post here: The Pressure To “Get Better” When You Are Struggling With Mental Health Problems), I mentioned that there were going to be a lot of rules and boundaries in place regarding my mental illness that I would have to follow back home.
Seeing as these boundaries were set by my parents you might think I live in a particularly strict household with rules and regulations more often seen in a school rather than a home setting, but actually, I am starting to think that when you are living with mental health problems, it is vital for everyone to set some boundaries.

Thing is, when you have a mental illness bobbing along with you through life, you can guarantee that it is going to do all it can to interfere with any plans you had prepared. Thought you were going out for a night with friends? Surprise! Depression has crossed that out of the calendar and scheduled you in for a good old evening of crying into a pillow and thinking about what a terrible person you are. Decided to spend several hours working on that novel and actually being productive with your life? Nope! Instead OCD would like you to waste those hours antibacterialising various objects in the house that were already clean to begin with. No matter what illness you have, it is obviously going to impact your daily routine, and if left with total freedom, it is likely that it will impact your daily routine more and more as time goes on until you find yourself looking back and wondering how on earth things managed to get so out of control. Now when you are in an inpatient setting this aspect of mental health problems is managed somewhat by the rigid structure of your day to day life on the ward, but on the outside it is a hell of a lot easier to get carried away with your own rigid routines.

The reason for this is that I have started to realise that mental illnesses are much like dinosaurs, and living with them is analogous to being that professor that Richard Attenborough plays in Jurassic Park and it is that analogy (to be fair it has been a while since we settled in for a good old traditional Born without Marbles analogy) that I want to talk about today.

Maybe some of you out there haven’t actually seen Jurassic Park (and if you haven’t you really should, it is fabulous), but basically in Jurassic Park there is this guy called Professor Hammond (that’s the person with mental health problems in this analogy), and he owns this safari park of dinosaurs he created out of some blood that has been hiding inside of a mosquito for several thousand years (in the analogy the park is your brain and the dinosaurs are your mental illnesses, except obviously in the mental health version you did not create your dinosaurs/illnesses, rather they appeared one day and as a result you found yourself as keeper of this prehistoric zoo of insanity).

Having the dinosaurs there is obviously dangerous, so Professor Hammond does all he can to keep that danger to a minimum. In order to keep the visitors safe, he has a whole team of keepers helping him to keep an eye on his dinosaurs (aka psychologists and other mental health professionals), and there are physical boundaries/electrified fences set up all over the island around the dinosaurs to keep them in check. They are still dangerous dinosaurs, but when confined by their boundaries, their level of threat is somewhat controlled.

However in the film, before long, this idiotic man with absolutely no common sense turns off all the electric fences and cages that were housing the dinosaurs, and utter chaos ensues.
Without the fences, the dinosaurs do not remain in their neat little pens, they run amok and cause a hell of a lot of destruction and noise when doing so. That image (aka that of dinosaurs running madly all over the place eating people and crashing into everything), pretty much illustrates the importance of boundaries when living with mental health problems and why I have so many regulations in coming home.

For example, whilst I have been in hospital at my local eating disorder unit, there have been very definite rules set out to govern my behaviour. These rules are numerous and I cannot list them all for fear of boring you all to floods of uncontrollable tears, but as an example they have been things like the fact that if I do not eat my meal, there will be a replacement issued which if not completed will lead to consequences in ward round, or the rule that meal times take place at set points throughout the day with no option to delay that peanut butter sandwich for another five minutes. Meal times are meal times, you eat your meals in meal times, end of discussion.

Similarly there are rules to govern my OCD such as time limits for showers because without this kind of rule, my OCD tends to grab hold of all control over how long I take to shower and run with it a lot faster than I can chase after it (I was never one for athletics in school.)
When I have a time limit however, I have something to aim for, and though my OCD will still be present in my behaviours for the duration of the shower, it is my attempt at controlling it as best I can. If in hospital I weren’t to shower within the allocated time, I would be removed from the shower, so I sort of had to reason with my little OCD dinosaur to get through it. My dinosaur wanted to spend the next three years washing yet the rules meant this was impossible, so we had to work together and compromise. I would shower and do all the rituals I was told to, but only for a certain length of time. Having a time limit obviously didn’t always work and there are times where I still couldn’t stick to it, but like I said, it gave something to aim for and consequently I will still have that shower time limit now that I am heading back home again. Again it is unlikely that I will always be able to keep myself in check, but I know that without any rules in the shower things would be a lot worse than they often are and if I didn’t have a boundary set in place, then I doubt I would ever be able to get out of the shower at all.
I can of course tell my OCD that I have finished washing but OCD will always come back with “just another five minutes”, a request that, when given into, will be repeated every five minutes leaving me stuck in a ritual with no way out. With my rule, I at least have an argument against that. In the shower the OCD still dictates behaviours, but when it is time to leave the shower, I at least have the statement of “time is up and we must leave now to avoid consequences” to come back at any “five more minute” suggestions that should arise.

If you are living with mental health problems then, it is important to have your own rules in place to try and keep track of the interference it causes. You can’t control whether or not you have a disorder, but there are some things you do have control of that can help lessen the impact. Say you have an eating disorder and, as I will be attempting when I get home, you are trying to give yourself enough nutrition.
If you say to your eating disorder “I am going to eat better today”, then it is unlikely that you will achieve much, as “better” is a negotiable, subjective term that you will find yourself debating. Instead, hard and fast rules like “I am going to eat three meals and three snacks today” are more likely to merit results. They won’t necessarily mean you achieve what you want, yet again, like the shower time limit, it gives you something to aim for rather than a wishy washy “I will eat something” or “I will shower quicker” which without specifics don’t really mean anything and give too much control to your illness. I know that especially with eating disorders, giving into little things are a sure fire way of letting them spiral completely.
Whenever I have a bowl of cereal for example, I weigh out exactly the same number of grams each day without question. This is disordered of course, and one day I would like to pour cereal with all the gay abandon of a cereal pouring professional, but I know that if I don’t have a weight from my dietician to stick to, aka a boundary, then my portions will just get smaller and smaller. My eating disorder won’t ask for anything dramatic at first, just little requests like “just one flake less today” or “one gram less”, which doesn’t sound much but if you keep listening to that you will end up a few weeks down the line staring at a solitary rice crispy in the bottom of a bowl wondering where all the others went (and possibly hearing a very quiet pitiful sobbing from the rice crispy as they are very social creatures who, when portioned out individually, often get rather lonely. Rice has feelings too kids.)

You don’t have to make loads of rules and they can be small rules to start off, but no matter what the size it is vital that the rules are there. If you have depression, that sucks and you cannot control the effect depression will have on your mood. What you can control however, is things like taking any medication you have been prescribed or attending any appointments to try and keep it in check. If you have an eating disorder and a meal plan you have been told to stick to, make that meal plan your rule, your boundary that cannot be negotiated. Ok the eating disorder will still be there screaming and it may interfere with your behaviours, but having that meal plan there is a non negotiable that is not up for debate. With OCD rituals put time limits on how long they can take so that a quick five minute tidy doesn’t descend into a five hour mass organisation mission or at least put a limit in place as to how many times you are allowed to do something simply to give you something to aim for.
Like I said, this is not going to cure you of any mental health problems nor is it going to stop them interfering/being dangerous beasts much like the dinosaurs in Jurassic Park. In or out of a cage, a T-rex is a T-rex (unless it is a bunny in disguise), and you cannot control the existence of that T-rex or its nature/behaviour as a stomping, roaring, chomping scaly thing. What you can do however, is put boundaries in place to try and limit the destruction that dinosaur can cause, to do the best you can to take control of something that otherwise will take lack of rules as a chance to run amok to see what it can get away with, and that is why, as I go home tomorrow, I go with a set of rules and boundaries in place.

Coincidentally, that is also why mental health problems are like dinosaurs and why it is vital to have boundaries when living with them in your head/prehistoric safari park. Rules may be broken, but having certain rules in place at home does often help me to manage typically unmanageable situations a little better. If you have been in hospital, take hospital rules back home when you are discharged so that the illness doesn’t have the total freedom to reinvade, and if you haven’t been in hospital then maybe come up with some rules with friends and family who are willing to support you in your battle for sanity. Remember, a dinosaur is always going to be a wild destructive interference, but with boundaries, that destruction can at least be controlled as much as possible…I hope…

Take care everyone x

BoundariesDinosaur

The Latest Mental Health News – When Mental Health Treatment Gets Rather Complicated

*Blog opens on a black screen, dramatic music plays, lights flash up to show the bespectacled author of Born Without Marbles sitting in front of a giant spinning globe, wearing a suit and looking very dapper* (Please note that it is the author wearing the suit and not the globe who has instead chosen an inflatable rubber ring as a wardrobe choice, for he is a globe with serious Saturn envy). Author holds up large piles of paper, shuffles unnecessarily, lays them on desk and then begins to speak*

Happy Monday everyone and welcome to the news. Not just any news though, for this is strictly the Born Without Marbles News.

*Globe with inflatable rubber ring spins for dramatic effect…more shuffling of paper*

Whenever you turn on the news these days to see what is going on in the world, the stories you see are usually incredibly depressing tales of natural disasters and various wars between countries who decide it is a better idea to settle their differences by blowing each other up rather than sitting down for a nice cup of tea and talking through their issues. If I were head of a country I know that would be how I would want to resolve any conflicts between nations (I would even have a special teapot for such occasions and there would always be biscuits rather than nuclear bombs or machine guns involved, which is nice because biscuits are far less toxic, noisy, and overall they are much tastier.) Today though I am coming to you with an update in news that is far more jolly, far more positive and exciting than anything you might have heard from some suited person on the television sitting behind a desk shuffling papers about, for I have GOOD news. What news? I AM OUT OF THE MENTAL HOSPITAL.

*Globe spins very excitedly and a party popper is released from an unknown location*

That is right folks, after 9 weeks I am off that psychiatric corridor and into the wonderful world of freedom and…hang on…wait…news just in through the ear piece…ah…yeah…Ok so good news we are out of the mental hospital…bad news is scrap the freedom bit as it is only because I have been transferred to a medical bed for more intensive treatment until I am stable enough to return to the psychiatric unit…hmm…that kind of puts a downer on things…this is awkward…but still yay to no guns or nuclear bombs in this broadcast!…And I do have biscuits!… *Holds up a pitiful broken packet of National Health Service own brand digestives, smiling desperately as a waterfall of dusty crumbs cascade into a pile on the floor*. Clearly it is a lot more difficult to be a cheerful news reader than I thought…

*Globe stops spinning…awkward silence…very awkward…like really awkward*

But back to the news update! As you know, last week I was talking about how unpredictable life is when you have a mental health problem and how currently things to do with my personal care and situation have been rather up in the air. On the positive side this last week has brought about decisions and actions that mean I am no longer up in the air, but have been brought back to earth out of the floaty confusion with a bit of a bump.
I think I mentioned the chance of me being transferred to another eating disorder unit last time because I really haven’t been managing where I am, but over the past week, no beds became available in time (SIDE SHOUT OUT TO THE GOVERNMENT STOP USING MONEY TO BOMB THINGS AND PAY THE POLITICIANS’ COFFEE BILLS AND MAKE MORE HOSPITAL BEDS FOR MENTAL AND PHYSICAL HEALTH FOR GOODNESS SAKE), and it reached the point where we had run out of time and I couldn’t really wait any longer. Thus another transfer had to be made, hence the update that I have now been moved to a medical bed to treat the immediate physical health issues that now need a bit of prioritising over the mental health side to having an eating disorder…

…And unfortunately, as brief as that update is…that is, frustratingly, all I can tell you this week. You see, a lot more has happened that I want to talk about because I am always one to be honest about mental health and do all that awesome awareness raising…

*Waves “I like to raise mental health awareness” flag*

…but recent discussions have taken place over the last week that mean that for now…that really is all I can say about what is happening, where I am and what medical treatment I am currently undergoing. To be honest it is all very “red tape” and “confidentiality” based stuff that I don’t quite understand but would rather clarify with official people first rather than getting myself into any trouble, which is really not needed in the Born Without Marbles world right now, as figures show that levels of troubles are already high above acceptable levels.

*Shows graph with a big red line going up. Arrow points to line labelled “Things that have gone wrong in 2017”…Cue a bit more paper shuffling and a random act of origami in which the aforementioned graph is folded into a lotus flower perfect for adorning a dinner table…It is passed to a member of the sound crew who lays it on a table at which 10 very important people then dine whilst commenting on the beauty of the lotus flower. They eat Salmon en croute*

Hopefully next week or at least sometime in the future I will be able to explain a bit more about what is going on but for now I just wanted to write a brief blog this week to update everyone on the fact that in terms of my mental health and mental health in general, I am personally in one of those “when mental health problems cause physical health problems” situations. Just wanted to at least say that because I also wanted to reassure people out there who may have been lovely enough as to send me concerned messages recently, that I am somewhat ok/being very well looked after and, though I may be hating it with every penguin loving grain in my body, I am in what other people would argue is “the best and safest place/situation right now”.

So yeah, I am afraid that is the blog post for this week. I really am sorry it was not the best/most exciting/most awareness raising but I guess it has raised an interesting discussion about confidentiality when it comes to talking openly about mental health, which I will be writing about a bit more when I am up to it, even if I am still not allowed to go into my current form of medical treatment sometimes used on people with eating disorders.

*Random party popper is released because this is the the Born Without Marbles news update and thus random party poppers and things that do not make sense are required at all times*

Anyway, I hope you are all well and know that I appreciate you all very much, especially if you read/watched this news broadcast to basically let everyone know that normal blogging activities will resume but I am currently somewhat out of order right now…kind of…although now I look at all I have said that is actually quite a lot of words for someone who thought that due to “circumstances” a BRIEF apology update blog was all that was possible this week…Note to self…learn to shut up…like seriously…for example right now…TAKE CARE EVERYONE X”

*Blog cuts to a giant map covered in rain clouds and lightening bolts where Gerry was supposed to be presenting the weather but isn’t because he got bored with the main part of the blog news for not being specific or interesting enough and went to the local bakery to get a sausage roll. Ironically he got rained on having forgotten his umbrella because he had not predicted a high chance of showers…Switch to spinning globe that aspires to be Saturn…fade to black*

NewsUpdate